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NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS
Official Journal of the Bulgarian Society of Neurosonology and Cerebral Hemodynamics
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hypertension
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1.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, Vol. 1, 2005
,
,
,
Dynamic regulation of middle cerebral artery blood flow velocity in aging and
hypertension
.
Lipsitz LA, Mukai S, Hamner J, Gagnon M., Babikian V.
Dynamic regulation of middle cerebral artery blood flow velocity in aging and hypertension.
read the entire text >>
Altered cerebral vasoregulation in
hypertension
and stroke.
Novak V, Chowdhary A, Farrar B, Nagaraja H, Braun J, Kanard R, Novak P, Slivka A.
Altered cerebral vasoregulation in hypertension and stroke.
read the entire text >>
2.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 1, 2005, No. 2
,
,
,
symptomatic. The following risk factors – diabetes, smoking, hyperlipidemia, arterial
hypertension
, ischemic heart diseases, and peripheral artery diseases were recorded.
symptomatic. The following risk factors – diabetes, smoking, hyperlipidemia, arterial hypertension, ischemic heart diseases, and peripheral artery diseases were recorded.
Transcranial Doppler monitoring of microembolic signals (MES) in both middle cerebral arteries was performed. The relationship between MES and the presence of the risk factors for cerebrovascular diseases was studied.
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Smoking was found in 45.8% of the patients, arterial
hypertension
Smoking was found in 45.8% of the patients, arterial hypertension
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The existence of cerebrovascular factors (age, sex, dyslipidemia, smoking, diabetes, arterial
hypertension
, peripheral artery diseases and ischemic heart diseases) – individually or in combination, does not influence the appearance of MES in patients with symptomatic or asymptomatic carotid artery diseases.
MES were more prevalent in patients with high grade stenoses as well as in those with symptomatic stenoses.
The existence of cerebrovascular factors (age, sex, dyslipidemia, smoking, diabetes, arterial hypertension, peripheral artery diseases and ischemic heart diseases) – individually or in combination, does not influence the appearance of MES in patients with symptomatic or asymptomatic carotid artery diseases.
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3.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 1
,
,
,
Angiotensin I converting enzyme (ACE) gene polymorphism and essential
hypertension
Ishigami T, Iwamoto T, Tamura K, Yamaguchi S, Iwasawa K, Uchino K, Umemura S, Ishii M.
Angiotensin I converting enzyme (ACE) gene polymorphism and essential hypertension
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Carotid thickening, cardiac hypertrophy, and angiotensin converting enzyme gene polymorphism in patients with
hypertension
.
Jeng JR.
Carotid thickening, cardiac hypertrophy, and angiotensin converting enzyme gene polymorphism in patients with hypertension.
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Genetic polymorphism of the renin-angiotensin system and organ damage in essential
hypertension
.
Pontremoli R, Ravera M, Viazzi F, Nicolella C, Berruti V, Leoncini G, Giacopelli F, Bezante GP, Sacchi G, Ravazzolo R, Deferrari G.
Genetic polymorphism of the renin-angiotensin system and organ damage in essential hypertension.
read the entire text >>
The case report represents a 43-year-old man with acute ischemic cerebral stroke in the right middle cerebral artery (MCA) territory related to arterial
hypertension
, thrombosis of the origine of the right MCA and long-lasting risk factors-smoking, alcohol abuse and stress.
The case report represents a 43-year-old man with acute ischemic cerebral stroke in the right middle cerebral artery (MCA) territory related to arterial hypertension, thrombosis of the origine of the right MCA and long-lasting risk factors-smoking, alcohol abuse and stress.
The clinical examination reveals a mild left-sided hemiparesis, left facial palsy and left hemihypesthesia, which undergo improvement and complete recovery one year after the incident. In the acute stage of stroke a subcortical lacunar infarction in the right hemisphere (motor region) is proved by a CT scan. The magnetic resonance imaging registers ischemic zones in the right cerebral hemisphere and transcranial Doppler sonography (TCD) reveals thrombosis of the sphenoid part of the right MCA, confirmed by magnetic resonance angiography (MRA). On the 17th day from the stroke onset some initial recanalization of the MCA is detected by TCD and one year later a complete racanalization is observed.
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4.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 2
,
,
,
To evaluate VMR in patients with different vascular risk factors such as arterial
hypertension
and diabetes mellitus.
To evaluate VMR in patients with different vascular risk factors such as arterial hypertension and diabetes mellitus.
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Hanley DF, Feldman E, Borel CO, Rosenbaum AE, Goldberg AL.Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial
hypertension
.
Hanley DF, Feldman E, Borel CO, Rosenbaum AE, Goldberg AL.Treatment of sagittal sinus thrombosis associated with cerebral hemorrhage and intracranial hypertension.
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Hypertension
intracranienne benigne.
Kinnert CL, Dietermann JL, Warter JM, Bronner A.
Hypertension intracranienne benigne.
A propos de cinq cas d,association a une selle turcique vide.
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Arterial
hypertension
and dyslipidemia – cardiovascular
Arterial hypertension and dyslipidemia – cardiovascular
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5.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 1
,
,
,
The most frequent risk factor is arterial
hypertension
.
The most frequent risk factor is arterial hypertension.
The increase of cho
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Asymptomatic carotid lesions and aging: Role of
hypertension
and other traditional and emerging risk factors.
Milio G, Corrado E, Sorrentino D, Muratori I, La Carrubba S,Mazzola G, Tantillo R, Vitale G, Mansueto S, Novo S.
Asymptomatic carotid lesions and aging: Role of hypertension and other traditional and emerging risk factors.
read the entire text >>
Residual lifetime risk for developing
hypertension
in middle-aged women and men: the Framingham Heart Study.
Vasan RS, Beiser A, Seshadri S, Larson MG, Kannel WB, D’Agostino RB, Levy D.
Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study.
read the entire text >>
6.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 2
,
,
,
Some other risk factors as smoking, arterial
hypertension
, diabetes mellitus, and hyperlipidemia may increase additionaly the overall risk for cerebrovascular and cardiovascular diseases.
It has been proved that the increase in homocysteine levels over 12 µmol/l correlates significantly with the increase in the frequency of vascular events and these have been associated with changes of vascular morphology and induction of the endothelium blood clotting cascade. The pathogenetic background for this mechanism is the homocysteinemediated oxidative stress. Various factors from the environment, different diseases and drugs could influence the homocysteine metabolism. Among the nutrition’s factors the folic acid deficiency is considered as the most frequent reason for hyperhomocysteinemia. It has been shown that the reduction of elevated plasma homocysteine concentration may prevent the cerebrovascular and cardiovascular events up to 25%.
Some other risk factors as smoking, arterial hypertension, diabetes mellitus, and hyperlipidemia may increase additionaly the overall risk for cerebrovascular and cardiovascular diseases.
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sex) and some modifiable (
hypertension
, diabetes, atrial fibrillation or other cardiac conditions, dyslipidemia, carotid artery stenoses, obesity) RF for CVD were evaluated.
sex) and some modifiable (hypertension, diabetes, atrial fibrillation or other cardiac conditions, dyslipidemia, carotid artery stenoses, obesity) RF for CVD were evaluated.
In 67 subjects with RF, 57 patients with CVD (31 with TIAs and 26 with CUI) and 16 healthy volunteers correlative clinical, neurosonographic and echocardiographic investigations were performed.
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Arterial
hypertension
was the most common RF in all patients.
Arterial hypertension was the most common RF in all patients.
An asymmetrical hypertrophy of the left ventricle of the heart and a decrease of its contractility was found as a typical cardiac dysfunction in most of them. Mild stenoses of ICA predominated in all groups while moderate and severe carotid stenoses were relatively rare. Symptomatic thromboses of ICA were seen in 4.5% from the patients with CUI. IMT of the ICA on the side of infarction correlated positively with the arterial blood pressure (r=+0.60, p
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Predictors of carotid stenosis in older adults with and without isolated systolic
hypertension
. Stroke
Sutton-Tyrrell K, Alcorn H, Wolfson S, Kesley Sh, Kuller L.
Predictors of carotid stenosis in older adults with and without isolated systolic hypertension. Stroke
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7.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 1
,
,
,
Blood pressure and pulse rate changes induced by strong noise in patients with arterial
hypertension
.
Ivanov I, Ignatova K, Kolev O.
Blood pressure and pulse rate changes induced by strong noise in patients with arterial hypertension.
In Bodo G, Lang J, Spellenberg S, (eds) The vegetative nervous system and the vestibular, visual and cochlear functions. Budapest: ONO Section of the Hungarian Otorhinolaryngological Society, 1985, 392-395.
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8.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 2
,
,
,
The patients were devided in two groups depending of the stage of arterial
hypertension
(AH): stage І [140-159/90-99], stage ІІ [160-179/100-109], stage ІІІ [≥180/≥110].
The study included 93 patients with AIDCC, 30 patients with risk factors (RF) for cerebrovascular disease (CVD) and 78 healthy subjects. A questionnaire for RF for CVD was filled out.
The patients were devided in two groups depending of the stage of arterial hypertension (AH): stage І [140-159/90-99], stage ІІ [160-179/100-109], stage ІІІ [≥180/≥110].
Colour-coded duplex sonography was used to determine the extracranial blood flow velocity and the intima media thickness (IMT) of
read the entire text >>
Remodeling of cerebral arterioles in chronic
hypertension
,
Baumbach GL, Heistad DD.
Remodeling of cerebral arterioles in chronic hypertension,
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Microcirculation in
hypertension
: a new target for treatment;
Levy BI, Ambrosio G, Pries AR.
Microcirculation in hypertension: a new target for treatment;
read the entire text >>
Noninvasive study of arterial
hypertension
and carotid atherosclerosis.
Luisiani L, Visona A.
Noninvasive study of arterial hypertension and carotid atherosclerosis.
read the entire text >>
Hypertension
, other risk factors, and the risk of cardiovascular disease.
Wilson PW, Kannel WB.
Hypertension, other risk factors, and the risk of cardiovascular disease.
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Hypertension
Hypertension
read the entire text >>
9.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1
,
,
,
in Arterial
Hypertension
and
in Arterial Hypertension and
read the entire text >>
Echographic measurement of the optic nerve in patients with intracranial
hypertension
.
Gangemi M, Cennamo G, Maiuri F, D’Andrea F.
Echographic measurement of the optic nerve in patients with intracranial hypertension.
read the entire text >>
Correlative Neurosonographic and Neuroimaging Studies in Arterial
Hypertension
and Asymptomatic Ischaemic Disturbances of the Cerebral Circulation
Correlative Neurosonographic and Neuroimaging Studies in Arterial Hypertension and Asymptomatic Ischaemic Disturbances of the Cerebral Circulation
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То evaluate the correlation between the arterial
hypertension
and changes of carotid arteries and cerebral parenchima in patients with asymptomatic ischaemic disturbances of cerebral circulation (AIDSS) using comparative neurosonographic and neuroimaging studies.
То evaluate the correlation between the arterial hypertension and changes of carotid arteries and cerebral parenchima in patients with asymptomatic ischaemic disturbances of cerebral circulation (AIDSS) using comparative neurosonographic and neuroimaging studies.
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The patients were devided in two groups depending of the stage of arterial
hypertension
(AH): stage І [140-159/ 90-99], stage ІІ АH [160-179/ 100-109], stage ІІІ АH [≥180 /≥110].
The study included 93 patients with AIDCC, 30 patients with risk factors (RF) for cerebrovascular disease (CVD) and 78 healthy subjects.
The patients were devided in two groups depending of the stage of arterial hypertension (AH): stage І [140-159/ 90-99], stage ІІ АH [160-179/ 100-109], stage ІІІ АH [≥180 /≥110].
read the entire text >>
Neurosonographic and Neuroimaging Studies in Arterial
Hypertension
and AIDCC
Neurosonographic and Neuroimaging Studies in Arterial Hypertension and AIDCC
read the entire text >>
Neurosonographic and Neuroimaging Studies in Arterial
Hypertension
and AIDCC
Neurosonographic and Neuroimaging Studies in Arterial Hypertension and AIDCC
read the entire text >>
Remodeling of cerebral arterioles in chronic
hypertension
.
Baumbach GL, Heistad DD.
Remodeling of cerebral arterioles in chronic hypertension.
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Atherosclerosis and
hypertension
: mechanisms and interrelationships.
Dzau VJ.
Atherosclerosis and hypertension: mechanisms and interrelationships.
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Microcirculation in
hypertension
: a new target for treatment.
Levy BI, Ambrosio G, Pries AR.
Microcirculation in hypertension: a new target for treatment.
read the entire text >>
Noninvasive study of arterial
hypertension
and carotid atherosclerosis.
Luisiani L, Visona A.
Noninvasive study of arterial hypertension and carotid atherosclerosis.
read the entire text >>
Hypertension
, other risk factors, and the risk of cardiovascular disease.
Wilson PW, Kannel WB.
Hypertension, other risk factors, and the risk of cardiovascular disease.
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Blood pressure and pulse rate changes induced by strong noise in patients with arterial
hypertension
.
Ivanov I, Ignatova K, Kolev O.
Blood pressure and pulse rate changes induced by strong noise in patients with arterial hypertension.
In Bodo G, Lang J, Spellenberg S, eds. The vegetative nervous system and the vestibular, visual and
read the entire text >>
10.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1
,
,
,
The main RF in the patients` groups were
hypertension
and hyperlipidemia.
The main RF in the patients` groups were hypertension and hyperlipidemia.
SBP, WBV and IMT were significantly increased in the patients with UCI and RF for CVD in comparison to controls. Lower systolic WSS and
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Modifiable risk factors for cerebrovascular diseases (arterial
hypertension
, hyperlipidemia and regular smoking) were registered.
Non-specific features and mild neurological and cognitive impairment were found by clinical examination.
Modifiable risk factors for cerebrovascular diseases (arterial hypertension, hyperlipidemia and regular smoking) were registered.
Hypertonic angiopathy with cholesterol emboli in the retinal vessels were seen by ophtalmoscopy. Chronic thrombosis of the common and internal carotid arteries caused by confluent heterogenic plaques and collateral circulation through the external carotid arteries, the vertebral arteries and the posterior part of the circle of Willis were demonstrated by color-coded duplex scan. A good correlation between the neurosonographic and angiographic findings was established. Focal leucoencephalopathy and ventriculomegaly were detected by MRI. Irregular alpha rhythm from the parietooccipital regions and mild intraocular asymmetry with relatively prolonged P 100 latency on the right side were registered electrophysiologically.
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Dironorm – double effect in the treatment of arterial
hypertension
.
Dironorm – double effect in the treatment of arterial hypertension.
read the entire text >>
11.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 1
,
,
,
Further evidence of interrelation between homocysteine and
hypertension
in stroke patients: a cross-sectional study.
Mizrahi EH, Noy S, Sela BA, Fleissig Y, Arad M, Adunsky A.
Further evidence of interrelation between homocysteine and hypertension in stroke patients: a cross-sectional study.
read the entire text >>
Guidelines for management of
hypertension
: report of the fourth working party of the British
Hypertension
Society, 2004:BHS IV.
Williams B, Poulter NR, Brown MJ, Davis M, Mclnnes GT, Potter JF, Sever PS, Thom SMcG.
Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004:BHS IV.
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Scientific Meeting of the International Society of
Hypertension
Scientific Meeting of the International Society of Hypertension
read the entire text >>
12.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 2
,
,
,
Days" organized by the regional representatives of the Society on actual neurological problems such as cerebrovascular diseases, neurological complications of arterial
hypertension
, treatment of acute ischemic stroke with thrombolysis, new methods in Neurosonology, treatment with statins, etc.
Days" organized by the regional representatives of the Society on actual neurological problems such as cerebrovascular diseases, neurological complications of arterial hypertension, treatment of acute ischemic stroke with thrombolysis, new methods in Neurosonology, treatment with statins, etc.
Similar meetings were held in Shoumen (2005, 2006, 2009), Ruse (2005, 2007, 2008), Gab-
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As accompaning diseases the patient has arterial
hypertension
, spinal disc herniations L
Weakness in the lower limbs and gait disturbances were noted at the age of 49. Gradually he experienced weakness of the distal muscles of the upper limbs, accompanied by hypotrophy of the distal muscles of the four limbs. His voice became nasal. The disease had a slowly progressive course of the gait disturbances and the weakness of the distal muscles. He had a subjective feeling of “cold” in the hands and the feet.
As accompaning diseases the patient has arterial hypertension, spinal disc herniations L
read the entire text >>
Scientific Meeting of the International Society of
Hypertension
Scientific Meeting of the International Society of Hypertension
read the entire text >>
Dironorm – a decisive step forward in the treatment of
hypertension
.
Dironorm – a decisive step forward in the treatment of hypertension.
read the entire text >>
13.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 1
,
,
,
He reported arterial
hypertension
with good medication control.
56-year-old male presented at the hospital with right-sided weakness and inability to speak for 1 day. Four years ago he survived an IS in the left MCA territory with a complete recovery.
He reported arterial hypertension with good medication control.
Neurologic examination revealed right central hemiparesis, and motor aphasia. Laboratory tests revealed dyslipidemia. Echocardiography excluded the presence of thrombotic masses in the cardiac chambers. Color-coded duplex sonography showed a bifurcation thrombus with a distal-shaped tail creating highgraded stenosis, lying free in the lumen of the internal carotid artery with a total thrombus length – about 4 cm (fig. 1A). CTA of supraaortal arteries confirmed the presence of a free floating thrombus in the initial part of the left ICA (fig. 1B).
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Epidemiological data say that patients with OSAS more often suffer from overweight, arterial
hypertension
, usually smoke and abuse alcohol [7].
Recent studies have shown that acute sleep apnea syndrome (OSAS) is associated with a high risk of cardiovascular and cerebrovascular diseases, because of the high frequency of risk factors for their appearance [13].
Epidemiological data say that patients with OSAS more often suffer from overweight, arterial hypertension, usually smoke and abuse alcohol [7].
Apnoeic episodes can induce cardiovascular, hemodynamic and
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The following risk factors for CVD are estimated: non changeable (age and sex) and some changeable – arterial
hypertension
(AH), diabetes mellitus (DM), dyslipidemia (DL), rhythmic and conductive heart disorders (RCD), overweight.
The following risk factors for CVD are estimated: non changeable (age and sex) and some changeable – arterial hypertension (AH), diabetes mellitus (DM), dyslipidemia (DL), rhythmic and conductive heart disorders (RCD), overweight.
Patients with central or mixed sleep apnea who have survived heart attack or stroke, are excluded of the study. To all patients from the control group the systolic (SAP) and the diastolic (DAP) arterial pressure are registered using the cuff method, while the usual therapy has not been
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More than 66% of them suffer from arterial
hypertension
.
There is no significant difference between the anthropometric parameters and the accompanying cardiovascular and metabolic diseases of the two groups of patients. The patients are between 50 and 60 years old and except for one all are overweight men.
More than 66% of them suffer from arterial hypertension.
In both groups dyslipidemic smokers prevaluate and there are more diabetics in the group with
read the entire text >>
артериална хипертония / arterial
hypertension
артериална хипертония / arterial hypertension
read the entire text >>
Atherosclerosis and
hypertension
: mechanisms and interrelationships.
Dzau VJ.
Atherosclerosis and hypertension: mechanisms and interrelationships.
read the entire text >>
Hypertension
Hypertension
read the entire text >>
He had arterial
hypertension
and diabetes mellitus from 5 years, dyslipidemy
procedure the patient had no recurrent episodes of angina pectoris.
He had arterial hypertension and diabetes mellitus from 5 years, dyslipidemy
read the entire text >>
14.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 2
,
,
,
The patient had been diagnosed with arterial
hypertension
and unstable angina.
The study was conducted in a 63 years old, right-handed woman admitted to the clinic with complaints of left-sided headache irradiating to the left ear, dizziness, nausea and “dazed” sight.
The patient had been diagnosed with arterial hypertension and unstable angina.
Two weeks before admission a stenting of the right coronary artery was performed because of significant stenosis. Treatment with Plavix and Aspirin was initiated in the periprocedural period. Two days after the intervention headache and nausea appeared
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A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of
Hypertension
.
Brunner H, Cockcroft JR, Deanfield J, Donald A, Ferrannini E, Halcox J, Halcox J, Kiowski W, Luscher TF, Manciah G, Natali A, Oliver JJ, Achille C. Pessinaj AC, Rizzoni D, Rossi GP, Salvetti A, Spieker LE, Taddei S, Webb D Endothelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases.
A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension.
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Important additional factors could be arterial
hypertension
, hyperlypidemia, cigarette smoking, age etc [6].
Diabetes mellitus (DM) is a socially important disease leading to early (hypoglycemia and ketoacidosis) and late complications. The late complications are macrovascular (cerebrovascular and cardiovascular diseases) and microvascular (diabetic retinopathy, nephropathy and neuropathy). The rate of diabetic neuropathy varies from 16% to 50% in patients with different types of DM [3, 11, 24]. The main risk factors (RF) for its appearance are duration of DM and glicemic control.
Important additional factors could be arterial hypertension, hyperlypidemia, cigarette smoking, age etc [6].
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), height (m) and arterial
hypertension
.
), height (m) and arterial hypertension.
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It has been shown that several factors (hypercholesterolemia, hyperlipidemia,
hypertension
, hyperhomocysteinemia etc.).
In recent years there has been a disturbing trend for the occurrence of cerebrovascular accidents in young age.
It has been shown that several factors (hypercholesterolemia, hyperlipidemia, hypertension, hyperhomocysteinemia etc.).
Alone or in combination vessel wall damage and increased risk of cardiovascular disease [1, 3, 29, 34]. Genetically determined risk for their development is the subject of intensive studies [6, 27, 35, 36].
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The presence of triggers from the external environment (
hypertension
, stress, improper diet, smoking) in combination with genetically deterministic increased platelet aggregation leads to early onset of arterial obstruction and cerebrovascular disease [20, 25, 30, 32].
The presence of triggers from the external environment (hypertension, stress, improper diet, smoking) in combination with genetically deterministic increased platelet aggregation leads to early onset of arterial obstruction and cerebrovascular disease [20, 25, 30, 32].
Of significance
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The Pl(A1/A2) polymorphism of glycoprotein IIIa and cerebrovascular events in
hypertension
: increased risk of ischemic stroke in high-risk patients.
Lanni F, Santulli G, Izzo R, Rubattu S, Zanda B, Volpe M, Iaccarino G, Trimarco B.
The Pl(A1/A2) polymorphism of glycoprotein IIIa and cerebrovascular events in hypertension: increased risk of ischemic stroke in high-risk patients.
read the entire text >>
Further evidence of interrelation between homocysteine and
hypertension
in stroke patients: a cross-sectional study.
Mizrahi EH, Noy S, Sela BA, Fleissiq Y, Arad M, Adunsky A.
Further evidence of interrelation between homocysteine and hypertension in stroke patients: a cross-sectional study.
read the entire text >>
15.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 8, 2012, No. 1
,
,
,
There is a combination of several cardiovascular risk factors longstanding
hypertension
, dyslipidemia, degenerative aortic valve stenosis, chronic thrombosis of the right ICA and severe stenosis (75%) of the left ICA (proved by ultrasound methods Fig.
The study was conducted in a 62-year-old man with multifocal atherosclerosis, caused ischemic heart disease, chronic arterial insufficiency of lower extremities as a result of chronic thrombosis of the deep femoral artery and transient motor aphasia 1 month before hospitalization.
There is a combination of several cardiovascular risk factors longstanding hypertension, dyslipidemia, degenerative aortic valve stenosis, chronic thrombosis of the right ICA and severe stenosis (75%) of the left ICA (proved by ultrasound methods Fig.
1), followed by CEA patch plastic without shunt in 2011.
read the entire text >>
Others: pulmonary embolus, acute aortic dissection, pulmonary
hypertension
.
Others: pulmonary embolus, acute aortic dissection, pulmonary hypertension.
read the entire text >>
16.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2012, No. 2
,
,
,
arterial
hypertension
, post-infarction cardiomyopathy, atrial fibrillation with recovered sinus rhythm and gout complicated by nephropathy and initial renal failure.
arterial hypertension, post-infarction cardiomyopathy, atrial fibrillation with recovered sinus rhythm and gout complicated by nephropathy and initial renal failure.
A pointed laboratory examination of complete blood count (CBC), biochemistry, coagulation status, antithrombin III, protein C, antiphospholipid antibodies, p-ANCA, c-ANCA, anticardiolipin Ig G, anticardiolipin Ig M, beta 2 glycoprotein 1 Ig M and Ig G was performed. The cerebrospinal fluid was erythrochromic.
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17.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 1
,
,
,
A significantly increased prevalence of IJVVI was recently also shown for transient monocular blindness [30], leucoaraiosis [15], primary exertional headache [23], primary intracranial
hypertension
[40] and chronic obstructive pulmonary disease [19].
Currently, US is one popular technique for imaging the venous system. In the field of neurology, research begun to focus in the mid-nineties of the past century primarily on impaired venous drainage in primarily venous disorders like cerebral venous and sinus thrombosis [12, 55]. Subsequently, primarily non-venous disease entities were studied. In transient global amnesia (TGA) an increased prevalence of IJV valve insufficiency (IJVVI) was seen which occurs in 20-30% of the normal population, but in up to 70% of TGA patients [1, 52, 54].
A significantly increased prevalence of IJVVI was recently also shown for transient monocular blindness [30], leucoaraiosis [15], primary exertional headache [23], primary intracranial hypertension [40] and chronic obstructive pulmonary disease [19].
More recent research data suggest that the venous system may play a considerable role in arterial stroke. Yu and co-workers found that an impaired ipsilateral venous drainage due to a hypoplastic or aplastic lateral sinus (transversus and sigmoid sinus) was accompanied by pronounced infarction leading to higher morbidity and mortality [65]. A further study analysed whether collapsed veins as a result of intracranial artery occlusion might influence the extent
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52, 54] and non-neurological diseases (primary pulmonary
hypertension
, COPD, primary exertional headache) [19, 23].
52, 54] and non-neurological diseases (primary pulmonary hypertension, COPD, primary exertional headache) [19, 23].
The sole publication on MS patients reported no significant difference to the control group [21]. Despite the fact that neurologists debate the significance of valve insufficiency for several years, the Zamboni group has not yet addressed this in MS patients, not even in the form of a critical discussion of the literature available to date.
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Internal jugular vein valve incompetence in COPD and primary pulmonary
hypertension
.
hr D, John M, Hoernig S, Valdueza JM, Schreiber SJ.
Internal jugular vein valve incompetence in COPD and primary pulmonary hypertension.
read the entire text >>
Site and mechanism for compression of the venous system during experimental intracranial
hypertension
.
Nakagawa Y, Tsuru M, Yada K.
Site and mechanism for compression of the venous system during experimental intracranial hypertension.
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Venous obstruction and jugular valve insufficiency in idiopathic intracranial
hypertension
.
Nedelmann M, Kaps M, Mueller-Forell W.
Venous obstruction and jugular valve insufficiency in idiopathic intracranial hypertension.
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Furthermore, concomitant risk factors, especially atherosclerosis, arterial
hypertension
, cardiovascular diseases and diabetes mellitus worsen cognitive functions in both acute and chronic period of stroke [2, 7, 22, 23].
21, 27].
Furthermore, concomitant risk factors, especially atherosclerosis, arterial hypertension, cardiovascular diseases and diabetes mellitus worsen cognitive functions in both acute and chronic period of stroke [2, 7, 22, 23].
Although inflammatory mechanisms are implicated in the pathogenesis of post-stroke cognitive impairment, the causal relationships have not been completely clarified yet [17]. Data published suggest that increased levels of some inflammatory markers in patients with acute ischemic stroke predict further cognitive deterioration [29]. Certain combinations of factors may enhance the risk of vascular cognitive impairment after stroke, but the determinants and mechanisms of post-stroke cognitive deterioration remain obscure [6, 12, 20, 33].
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After arterial
hypertension
was added to the complex of independent significant variables (model 2), an improvement of data fitting was achieved (χ
After arterial hypertension was added to the complex of independent significant variables (model 2), an improvement of data fitting was achieved (χ
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Cognitive deficit at discharge was mostly found in older female patients with lower level of education, high baseline systolic arterial
hypertension
, hyperglycemia and increased serum level of hs-CRP in the first 24 hours of stroke onset.
The clinical course of stroke is characterized by total or partial physical and cognitive recovery the first weeks or months after onset [5]. However, early cognitive deterioration is seen in some patients from the acute phase of stroke and this is a powerful predictor of further dementia [25]. We diagnosed a mild to moderate cognitive deficit at discharge in more than half of the patients studied (57%) as it is confirmed by other authors [15].
Cognitive deficit at discharge was mostly found in older female patients with lower level of education, high baseline systolic arterial hypertension, hyperglycemia and increased serum level of hs-CRP in the first 24 hours of stroke onset.
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With age arterial
hypertension
in females becomes constantly
The results we obtained indicated a 6-fold higher probability for female patients to develop cognitive impairment in the acute phase of stroke. The published data about the effect of gender on post-stroke cognitive state are still controversial [4, 13, 21, 30]. Usually ischemic stroke in female patients occurs at older age, when the role of genetic factors associated with gender-related specific variations of blood pressure has disappeared [11]. The existence of sexual dimorphism in blood pressure regulation is confirmed by the results of many population-based studies [19].
With age arterial hypertension in females becomes constantly
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According to our results baseline hyperglycemia was a significant determinant of cognitive impairment at discharge due to its positive correlation with systolic arterial
hypertension
(Rs=0.358; p=0.016).
Hyperglycemia is often found in acute stroke, even in cases without a history of diabetes mellitus [3]. It causes lactic acidosis, tissue acidosis and exerts direct neurotoxicity. Hyperglycemia worsens functional outcome of cerebral ischemia and influences negatively the cognitive state of patients in the acute phase of ischemic stroke [3] by impairing mainly the executive functions [18].
According to our results baseline hyperglycemia was a significant determinant of cognitive impairment at discharge due to its positive correlation with systolic arterial hypertension (Rs=0.358; p=0.016).
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Our study results confirm the role of increased hs-CRP as significant predictor of cognitive deficit after acute ischemic stroke in female patients with systolic arterial
hypertension
.
In conclusion, cognitive disorders after acute ischemic stroke are associated with complex interrelations between the acute cerebrovascular event, vascular risk factors and individual genetic characteristics of the patient.
Our study results confirm the role of increased hs-CRP as significant predictor of cognitive deficit after acute ischemic stroke in female patients with systolic arterial hypertension.
Future studies aiming at modification of risk factors and CRP are necessary to prevent or delay post-stroke cognitive decline.
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Hypertension
Hypertension
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According to the Bulgarian National Statistical Institute, cardiovascular diseases, including acute myocardial infarction,
hypertension
and cerebrovascular disease, are the primary reasons for death (67% of all deaths) in Bulgaria for 2011.
According to the Bulgarian National Statistical Institute, cardiovascular diseases, including acute myocardial infarction, hypertension and cerebrovascular disease, are the primary reasons for death (67% of all deaths) in Bulgaria for 2011.
The mortality rate for these illnesses has reached
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18.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 2
,
,
,
Cerebral Hemodynamic Assessment with Transcranial Color Duplex in Intracranial
Hypertension
Experimental Model.
Cerebral Hemodynamic Assessment with Transcranial Color Duplex in Intracranial Hypertension Experimental Model.
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The measurement of PI is also an useful adjunct to guide the use of hyperosmolar therapy in various conditions with intracranial
hypertension
.
TCD PI has emerged as a surrogate marker for ICP.
The measurement of PI is also an useful adjunct to guide the use of hyperosmolar therapy in various conditions with intracranial hypertension.
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The primary goal monitoring is to prevent secondary insults to the brain, primarily cerebral ischemia due to the posttraumatic vasospasm (PTV), and intracranial
hypertension
(ICH).
Critical care management of patients with traumatic brain injury (TBI) has undergone tremendous advances. Neurosurgeons, neurologists and neurointensivists, including military, have a large armamentarium of invasive monitoring modalities available to detect secondary brain injury and guide therapy.
The primary goal monitoring is to prevent secondary insults to the brain, primarily cerebral ischemia due to the posttraumatic vasospasm (PTV), and intracranial hypertension (ICH).
This lecture summarizes the advantages and the specific roles of transcranial Doppler (TCD) ultrasound to establish and monitor the presence of PTV and ICH.
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intracranial
hypertension
, posttraumatic vasospasm, transcranial Doppler ultrasound, traumatic brain injury.
intracranial hypertension, posttraumatic vasospasm, transcranial Doppler ultrasound, traumatic brain injury.
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Risk factors, such as age, gender, genetic factors,
hypertension
, diabetes mellitus, hypercholsterolemia, atrial fibrillation, orlifestyle,are causing changes of vessel walls which lead to CVD.
Cerebrovascular diseases (CVD) represent conditions which occur as a result of changes in blood vessels of the brain, as well as the vessels supplying the brain. The most common types of CVDs are ischemic stroke, transient ischemic attack, hemorrhagic stroke and vascular dementia. CVDs affect millions of people worldwide, regardless of age, and represent a group of very important medical and social problems. Therefore, their prevention is becoming an imperative.
Risk factors, such as age, gender, genetic factors, hypertension, diabetes mellitus, hypercholsterolemia, atrial fibrillation, orlifestyle,are causing changes of vessel walls which lead to CVD.
Early changes of the blood vessel wall can be detected by early ultrasound screening methods which allow us to detect changes before the disease becomes clinically evident. Intracranial hemodynamics can be assessed by Transcranial Doppler Sonography (TCD), functional TCD with various functional tests, and TCD detection of cerebral emboli. Extracranial circulation (carotid and vertebral arteries) can be assessed by means of color Doppler flow imaging (CDFI). Novel ultrasound technology enables us non-invasive, bedside detection ofearly vascular changes such as arterial stiffness,
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The main RF in the patients` groups were
hypertension
and hyperlipidemia.
The main RF in the patients` groups were hypertension and hyperlipidemia.
Heterogenous atherosclerotic plaques, greater IMT and larger diameters of the CCA were measured. The SBP and WBV were significantly higher in the patients with CUCI and RF for CVD in comparison to controls. Lower systolic WSS, τ and higher T were established in the patients with CUCI. Significant correlations of WBV with the carotid diameters predominating in the subgroups with MBP ≥ 100 were revealed. The IMT correlated with WSS and τ.
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The most frequent single VRFs in this population were elevated LDL cholesterol level (61.5%) – (LDL-C), arterial
hypertension
(44.2%) – (AH) and ACS (61%).
The most frequent single VRFs in this population were elevated LDL cholesterol level (61.5%) – (LDL-C), arterial hypertension (44.2%) – (AH) and ACS (61%).
The prevalence of ACS
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Nonmodifiable (age and sex) and some modifiable (
hypertension
, diabetes mellitus, atrial fibrillation or other cardiac conditions, dyslipidemia, carotid artery stenoses and obesity) RF for CVDs were evaluated.
Color duplex sonography of carotid arteries was performed in 924 patients: 368 with RF for CVDs, 126 with transient ischemic attacks (TIAs), 287 with chronic unilateral infarction (CUI) and 143 with multiple infarctions. The intima media thickness (IMT) of the common carotid (CCA) and internal carotid (ICA) arteries was measured by B-mode and M-mode scanning.
Nonmodifiable (age and sex) and some modifiable (hypertension, diabetes mellitus, atrial fibrillation or other cardiac conditions, dyslipidemia, carotid artery stenoses and obesity) RF for CVDs were evaluated.
In 67 subjects with RF, 57 patients with CVDs (31 with TIAs and 26 with CUI) and 16 healthy volunteers correlative clinical, neurosonographic and echocardiographic investigations were performed.
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Arterial
hypertension
was the most common RF in all patients.
Arterial hypertension was the most common RF in all patients.
An asymmetrical hypertrophy of the left ventricle of the heart and a decrease of its contractility were found as a typical cardiac dysfunction in most of them. Mild ICA stenoses predominated in all groups while moderate and severe carotid stenoses were relatively rare. Symptomatic ICA thromboses were seen in 4.5% from the patients with CUI. IMT of the ICA on the side of infarction correlated positively with the arterial blood pressure (r=+0.60, p
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No modifiable (age and sex) and some modifiable (
hypertension
, diabetes, atrial fibrillation, dyslipidemia, carotid stenosis, obesity, hemorheological variables – leucocytes (Leuc) hemoglobin (Hb), hematocrit (Ht), FR for CVD were evaluated.
Exercise stress-test (EST) and echocardiography were performed in 503 patients (mean age 54±17 years) with symptoms for CVD in two cardiological centers. Based on EST the patients were classified in three groups with positive, negative or questionable results. Color duplex sonography of both carotid arteries was performed in transverse and longitudinal planes and intima media thickness (IMT) of the common carotid (CCA) and internal carotid (ICA) arteries was measured.
No modifiable (age and sex) and some modifiable (hypertension, diabetes, atrial fibrillation, dyslipidemia, carotid stenosis, obesity, hemorheological variables – leucocytes (Leuc) hemoglobin (Hb), hematocrit (Ht), FR for CVD were evaluated.
The pts with positive EST were on PTCA undergone and pts with questionable EST the decision for PTCA was taken after severity of carotid pathology and clinical exam.
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Arterial
hypertension
(AH) was the most common risk factor (RF) in 75% of all patients, dyslipidemia in 64% and diabetes mellitus in 28%.
Arterial hypertension (AH) was the most common risk factor (RF) in 75% of all patients, dyslipidemia in 64% and diabetes mellitus in 28%.
A symmetrical hypertrophy of the left ventricle and a decrease of its contractility was found as typical diastolic dysfunction. Mild ICA stenoses predominated in all groups while the moderate or severe carotid stenoses were relatively rare, especially with positive EST. ICA symptomatic thromboses were seen in 4,5% with positive EST. The IMT of the ICA correlated positively with the AH (r=+0.60,p0,05). Asymptomatic thrombosis are 67 (87%), and symptomatic-10 (13 %), p
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CEREBRAL HEMODYNAMIC ASSESSMENT WITH TRANSCRANIAL COLOR DUPLEX IN INTRACRANIAL
HYPERTENSION
EXPERIMENTAL MODEL
CEREBRAL HEMODYNAMIC ASSESSMENT WITH TRANSCRANIAL COLOR DUPLEX IN INTRACRANIAL HYPERTENSION EXPERIMENTAL MODEL
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The image of the real-time ultrasound combined with pulsed Doppler system is a noninvasive and bedside method that allows the cerebral blood flow velocity and evaluation and flow resistance measurement in intracranial
hypertension
patients.
The image of the real-time ultrasound combined with pulsed Doppler system is a noninvasive and bedside method that allows the cerebral blood flow velocity and evaluation and flow resistance measurement in intracranial hypertension patients.
The intracranial hypertension is an important clinical condition and represents high risk to patients with acute brain injury. In this study, we describe in an experimental model, application of cerebral duplex to evaluate changes in pre and post-intracranial hypertension.
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The intracranial
hypertension
is an important clinical condition and represents high risk to patients with acute brain injury.
The image of the real-time ultrasound combined with pulsed Doppler system is a noninvasive and bedside method that allows the cerebral blood flow velocity and evaluation and flow resistance measurement in intracranial hypertension patients.
The intracranial hypertension is an important clinical condition and represents high risk to patients with acute brain injury.
In this study, we describe in an experimental model, application of cerebral duplex to evaluate changes in pre and post-intracranial hypertension.
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In this study, we describe in an experimental model, application of cerebral duplex to evaluate changes in pre and post-intracranial
hypertension
.
The image of the real-time ultrasound combined with pulsed Doppler system is a noninvasive and bedside method that allows the cerebral blood flow velocity and evaluation and flow resistance measurement in intracranial hypertension patients. The intracranial hypertension is an important clinical condition and represents high risk to patients with acute brain injury.
In this study, we describe in an experimental model, application of cerebral duplex to evaluate changes in pre and post-intracranial hypertension.
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The experimental
hypertension
was performed with an intracranial balloon.
An experimental study, using 30 crossbred Landrace and Duroc pigs weighing approximately 18–20 kg and aged 2months. Prior to surgery, pigs were starved for 12 h but had free access to water. We coadministered intramuscular ketamine at dose of 15mg/ kgand xylazine at a dose of 2 mg/kg.
The experimental hypertension was performed with an intracranial balloon.
At each intervention we performed a neurological assessment of the pupils and Doppler exam (Ultrasound color duplex SonoSite-Micromax). Continuous intracranial pressure measurement by intraparenchymal and extradural catheters was also performed. The animals underwent to a baseline measurement, a pre-balloon insufflation, a post-balloon insufflation before and after saline solution infusion. The association of the results of duplex was compared with ICP and systemic monitoring. In complementary we measured
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animal model, intracranial
hypertension
, transcranial color duplex.
animal model, intracranial hypertension, transcranial color duplex.
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Her previous medical history displayed
hypertension
.
The subject is a 86-year old female presenting with sudden loss of consciousness lasting few seconds after flexing neck. After the episode the patient remained with dizziness and vertigo.
Her previous medical history displayed hypertension.
At admission, she presented with right apendicular ataxia and left homonymous hemyanopsia. She performed skull computadorized tomography (CT), which revealed a large ischemic zone in right cerebellar hemisphere and ipsilateral occipital lobe. TCD was then performed before and during mechanical maneuvers. The vessel chosen was the posterior cerebral artery. There was an important amplitude in mean flow velocity: 38 cm/s before maneuver, 20 cm/s during cervical flexion and rotation maneuver (reduction of 48%); 50 cm/s after assuming neutral position (increase in 24% – reactive hyperemia).
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After adjustment for sex, age,
hypertension
, diabetes mellitus and hypercholesterolemia, the significant correlation remained
There was significant correlation between PI and infarct size (r=0.251, p=0.037, by Spearman`s correlation).
After adjustment for sex, age, hypertension, diabetes mellitus and hypercholesterolemia, the significant correlation remained
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The clinical course of patients with fulminant hepatic failure (FHF) is often worsened by loss autoregulation of cerebral blood flow (CBF), which leads to cerebral edema and intracranial
hypertension
.
The clinical course of patients with fulminant hepatic failure (FHF) is often worsened by loss autoregulation of cerebral blood flow (CBF), which leads to cerebral edema and intracranial hypertension.
The development these complications is an important event in patients with FHF that needs intensive care and urgent liver transplantation. To evaluate the hemodynamic and cerebrovascular autoregulation capacity of patients with fulminant hepatic failure before and after liver transplantation and those not undergoing transplantation.
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Transcranial Doppler can evaluate intracranial
hypertension
relief after this surgical procedure measuring brain blood flow velocities, pulsatility and resistivity index.
shunt (RVSS) is proposed in order to solve the question of ventricular catheterization complications related to siphoning.
Transcranial Doppler can evaluate intracranial hypertension relief after this surgical procedure measuring brain blood flow velocities, pulsatility and resistivity index.
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19.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 1
,
,
,
Xипертония/
Hypertension
155 93.4
Xипертония/Hypertension 155 93.4
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The leading risk factors are arterial
hypertension
, smoking, atrial fibrillation and ischemic heart disease.
The leading risk factors are arterial hypertension, smoking, atrial fibrillation and ischemic heart disease.
The patients with combined two and three risk factors constitute 71% of all patients.
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There were many risk factors for cerebrovascular disease: arterial
hypertension
, dyslipidemia, obesity.
А 35-year-old male admitted for the first time in Second Neurology Сlinic in the University Hospital "St. Мarina" Varna with sudden weakness of the left extremities based on high blood pressure was examined.
There were many risk factors for cerebrovascular disease: arterial hypertension, dyslipidemia, obesity.
А pointed laboratory examination of complete blood count, biochemistry and coagulation status was performed. Мain head arteries were examined with Sonix SP (Сanada) by color coded duplex scanning using 7.5 Hz transducer. The thickness of the carotid artery intima-media complex was measured by B-mode imaging in real-time using a standard program for automatic averaging of values. With pulse Doppler sonography speed parameters of blood flow were measured. Neuroimaging examination of the brain was conducted by 1.5 Tesla МRl (GE HTХ Sigma
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Evaluation of the clinical benefit of decompression hemicraniectomy in intracranial
hypertension
not controlled by medical treatment.
Jourdan C, Convert J, Mottolese C.
Evaluation of the clinical benefit of decompression hemicraniectomy in intracranial hypertension not controlled by medical treatment.
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20.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 2
,
,
,
This lead to the CHADS2 and later to the CHA2DS2VASc risk score, considering as risk factors congestive heart failure,
hypertension
, age (2 points if >75 years, 1 point if 65-74 years), diabetes, prior stroke/TIA (2 points), vascular disease and female gender [24].
Cardioembolic risk is not uniform in all patients with AF. The Stroke Risk in Atrial Fibrillation Working Group performed a systematic review of studies using multivariate regression techniques to identify independent risk factors for stroke in patients with AF, and reported absolute stroke rates in subgroups of patients with these risk factors collected [29].
This lead to the CHADS2 and later to the CHA2DS2VASc risk score, considering as risk factors congestive heart failure, hypertension, age (2 points if >75 years, 1 point if 65-74 years), diabetes, prior stroke/TIA (2 points), vascular disease and female gender [24].
For treatment purposes, anticoagulation is recommended with a score of at least 2 [6].
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The HAS-BLED scores for
hypertension
, abnormal renal/liver function, stroke, bleeding condition, labile INR, being elderly and drugs/alcohol.
On the other hand, a score for haemorrhagic risk was also proposed.
The HAS-BLED scores for hypertension, abnormal renal/liver function, stroke, bleeding condition, labile INR, being elderly and drugs/alcohol.
Some of these risk factors for bleeding are also risk factors for stroke related to AF which complicates evaluation of benefit/risk.
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Regarding aetiology, it should be noted that the hypertensive small vessels condition might be easier to control, through an effective treatment of the arterial
hypertension
, while cortical haemorrhages associated with amyloid angiopathy tend to recur more easily [23] and are not susceptible of prevention, thus contraindicating the restart of anticoagulation therapy [28].
therapy after a haemorrhagic stroke. It can be restarted 10 to 14 days after the haemorrhagic stroke when the cardioembolic risk is high and the risk of suffering another haemorrhagic stroke is low [16]. Nonetheless, a retrospective study that estimated the risk in a specific cohort suggested that the anticoagulation restart could be delayed to 10 to 30 weeks after the haemorrhagic stroke [20]. It should be reminded that the occurrence of spontaneous intracerebral haemorrhage under VKA or NOAC therapy makes these oral anticoagulation drugs contraindicated, unless when the cause of the haemorrhage is controllable [25].
Regarding aetiology, it should be noted that the hypertensive small vessels condition might be easier to control, through an effective treatment of the arterial hypertension, while cortical haemorrhages associated with amyloid angiopathy tend to recur more easily [23] and are not susceptible of prevention, thus contraindicating the restart of anticoagulation therapy [28].
Non-pharmaceutical prevention strategies (e.g.: ablation or occlusion of the auricular appendix) might be considered as an alternative to the oral anticoagulation drugs, when its restart is contraindicated [31].
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Most cardiovascular risk factors, such as
hypertension
, diabetes mellitus, hypercholesterolemia, atrial fibrillation, and smoking are not exclusively risk factors for VD, but also for AD.
Aging is often associated with some cognitive impairment. Greater population life expectancy is one explanation for increased incidence of cognitive impairment cases. A large number of people with cognitive impairment and dementia is becoming one of the most important medical and social problems worldwide. Therefore, prevention of cognitive impairment is an imperative. Dementia includes a heterogeneous group of disorders, the most common being Alzheimer's dementia (AD) and Vascular dementia (VD).
Most cardiovascular risk factors, such as hypertension, diabetes mellitus, hypercholesterolemia, atrial fibrillation, and smoking are not exclusively risk factors for VD, but also for AD.
Early changes in the blood vessel wall can be detected by early ultrasound screening methods which allow us to detect changes before the disease becomes clinically evident. Early disease detection enables in-time management, and studies have shown that careful control of vascular risk factors can postpone or even reverse disease progression.
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While cardiovascular risk factors, such as diabetes mellitus,
hypertension
, hypercholesterolemia, atrial fibrillation, and smoking, are particularly relevant in the development of VaD, they may also play a role in AD [9, 10, 11, 12, 13, 14].
Dementia is a clinical syndrome characterized by the impairment of cognitive functions, such as memory, language, praxis, recognition and executive function, with the loss of functional capacity [8]. Dementia may be caused by a heterogeneous group of disorders, the most common being Alzheimer's disease (AD) and vascular dementia (VaD).
While cardiovascular risk factors, such as diabetes mellitus, hypertension, hypercholesterolemia, atrial fibrillation, and smoking, are particularly relevant in the development of VaD, they may also play a role in AD [9, 10, 11, 12, 13, 14].
Thus both conditions may represent different spectrums of cerebral vascular disease depending on the extent of microvascular changes [15]. An association between impaired function of cerebral microvessels and cognitive impairment in patients with mild to moderate AD was shown in a study by Silvestrini [16].
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Diagnostic tools for the study of vascular cognitive dysfunction in
hypertension
and antihypertensive drug research.
Semplicini A, Amodio P, Leonetti G, Cuspidi C, Umilta C, Schiff S, Scheltens P, Barkhof F, Emanueli C, Cagnin A, Pizzolato G, Macchini L, Realdi A, Royter V, Bornstein N, Madeddu P.
Diagnostic tools for the study of vascular cognitive dysfunction in hypertension and antihypertensive drug research.
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Aortic diameter, aortic stiffness, and wave reflection increase with age and isolated systolic
hypertension
.
O'Rourke MF, Nichols WW.
Aortic diameter, aortic stiffness, and wave reflection increase with age and isolated systolic hypertension.
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Hypertension
Hypertension
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Secondary prevention is in accordance with the recommendation of secondary stroke prevention: treatment of
hypertension
, hypotension, diabetic control, lipids, cardiac control of rhythmic activity or antithrombotic therapy, vascular risk factor management.
The prevention of expected common complication is one of the important targets after stroke onset. Primary prevention should avoid typical complications in the early phase after stroke such as aspiration, joint luxation, decubitus, malnutrition, bladder infection, pulmonary embolism and trauma by falling.
Secondary prevention is in accordance with the recommendation of secondary stroke prevention: treatment of hypertension, hypotension, diabetic control, lipids, cardiac control of rhythmic activity or antithrombotic therapy, vascular risk factor management.
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Noninvasive echosonography of the optic nerves could easily reveal changes of the intracranial pressure (intracranial hypoor
hypertension
) while duplex sonography could easily detect central retinal artery or vein occulsion.
Noninvasive echosonography of the optic nerves could easily reveal changes of the intracranial pressure (intracranial hypoor hypertension) while duplex sonography could easily detect central retinal artery or vein occulsion.
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Sonographic assessment of the optic nerve sheath in idiopathic intracranial
hypertension
.
Bauerle J, Nedelmann M.
Sonographic assessment of the optic nerve sheath in idiopathic intracranial hypertension.
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21.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 1
,
,
,
According to Eurostat 41.8% of the Bulgarian population aged 24–65 (44.3% men and 39.5% women) suffer from arterial
hypertension
The high morbidity and mortality from stroke are associated with the high incidence of risk factors.
According to Eurostat 41.8% of the Bulgarian population aged 24–65 (44.3% men and 39.5% women) suffer from arterial hypertension
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[15] and 72% of stroke patients have arterial
hypertension
.
[15] and 72% of stroke patients have arterial hypertension.
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The study was carried out in 28 clinically healthy subjects (15 men and 13 women in the age range from 22 to 79, mean age 51.3±20.5 years without a history of ophthalmic diseases and syndromes) and 20 patients (12 women and 8 men in the age range from 21 to 85 years, mean age 45±17 years) with ocular pathology: 10 of the patients were with papilledema caused by various pathological processes (bilateral papillitis or intracranial
hypertension
, brain tumors, arteriovenous malformation, dural transverse sinus venous thrombosis), 6 of the patients were with retinal detachment, 1 – with macular degeneration, 1 – with intraocular metastasis of the right eye, 1 – with amaurosis and visual hallucinations and 1 – with hemophthalmos.
The study was carried out in 28 clinically healthy subjects (15 men and 13 women in the age range from 22 to 79, mean age 51.3±20.5 years without a history of ophthalmic diseases and syndromes) and 20 patients (12 women and 8 men in the age range from 21 to 85 years, mean age 45±17 years) with ocular pathology: 10 of the patients were with papilledema caused by various pathological processes (bilateral papillitis or intracranial hypertension, brain tumors, arteriovenous malformation, dural transverse sinus venous thrombosis), 6 of the patients were with retinal detachment, 1 – with macular degeneration, 1 – with intraocular metastasis of the right eye, 1 – with amaurosis and visual hallucinations and 1 – with hemophthalmos.
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Intraocular hemorrhages (hemophthalm) are polietiologic (diabetes, atherosclerosis,
hypertension
, antikoyagulantno treatment and others.).
Intraocular hemorrhages (hemophthalm) are polietiologic (diabetes, atherosclerosis, hypertension, antikoyagulantno treatment and others.).
They are defined as partial or full hemophthalm and often associated with the wrong dosage of anticoagulant therapy. The changes are heterogeneous and predominantly located in the posterior segment of the vitreous and are age-depended of the bleeding in the subacute stage they are variable hyperechogenic artifacts and could be absorbed partially or in full (fig. 7).
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Echographic measurement of the optic nerve in patients with intracranial
hypertension
.
Gangemi M, Cennamo G, Maiuri F, D'Andrea F.
Echographic measurement of the optic nerve in patients with intracranial hypertension.
Neurochirurgia (Stuttg) 30, 1987:53-55.
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22.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 2
,
,
,
Data were collected on vascular risk factors (
hypertension
, diabetes, dyslipidemia, smoking), as well as on the possible association between right-to-left cardiac shunt with changes in the carotid arteries (carotid intima-media thickness (CIMT), the presence of carotid plaque) and the presence of deep venous thrombosis (DVT).
We conducted a retrospective review of de-identified reports from 58 patients with positive TCD that were subsequently subjected to c-TEE examination.
Data were collected on vascular risk factors (hypertension, diabetes, dyslipidemia, smoking), as well as on the possible association between right-to-left cardiac shunt with changes in the carotid arteries (carotid intima-media thickness (CIMT), the presence of carotid plaque) and the presence of deep venous thrombosis (DVT).
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Hypertension
(an indicator of
hypertension
was a systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg, or if the patient was on medicines for treating high blood pressure).
Hypertension (an indicator of hypertension was a systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg, or if the patient was on medicines for treating high blood pressure).
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Hypertension
Hypertension
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The highest was the incidence of smoking (31%), and somewhat lower the incidence of dyslipidemia (24.1%) and
hypertension
(20.7%).
Vascular risk factors, as well as their effect on “bubble test” parameters, were also analyzed in all patients (Table 3).
The highest was the incidence of smoking (31%), and somewhat lower the incidence of dyslipidemia (24.1%) and hypertension (20.7%).
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His previous medical history included
hypertension
, hyperlipidemia, aortic regurgitation (2 grade) and mitral regurgitation (1 grade).
A 41 year old right-handed man presented with acute onset of inability to speak and right-sided weakness.
His previous medical history included hypertension, hyperlipidemia, aortic regurgitation (2 grade) and mitral regurgitation (1 grade).
Two years ago he suffered anterior ST elevation myocardial infarction, with primary PCI: PTCA/stent on proximal LAD. The patient was on two antihypertensive medications, a statin, a beta-blocker and antiplatelet therapy (Clopidogrel) 75mg/day. The patient was not a candidate for tPa because of the inability to determine the time of onset of symptoms. At admission, his blood pressure was 140/90 mmHg, regular heart rate of 95/min, central right facial palsy, aphasia with right-sided hemiplegia. Initial brain CT showed a small post-ischemic zone in the left parietal lobe.
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23.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 1
,
,
,
92 beats per minute, which suggests essential
hypertension
.
92 beats per minute, which suggests essential hypertension.
The echocardiographic study shows preserved left ventricular geometry, with preserved global systolic function and contractility. The aortic valve is with three flaps, degenerative fibrotic changes on the right coronary flap – peak gradient 9,4 mmHg and with low-grade aortic regurgitation. The velocity in the descending aorta is preserved. The right ventricle is with upper borderline size and is apically trabeculated.
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Carotid stenosis, coronary artery disease and peripheral arterial occlusive disease have similar risk factors such as
hypertension
, diabetes mellitus, smoking and elevated blood cholesterol levels, but may include patient age and sex.
Initial steps in evaluating a patient with potential ACAS are medical history and physical examination.
Carotid stenosis, coronary artery disease and peripheral arterial occlusive disease have similar risk factors such as hypertension, diabetes mellitus, smoking and elevated blood cholesterol levels, but may include patient age and sex.
A carotid bruit is an often overlooked sign and is not necessarily indicative of carotid stenosis.
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24.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 2
,
,
,
Well defined risk factors for ICH are age, alcohol consumption,
hypertension
, cerebral amyloid angiopathy, anticoagulant therapy, hemorrhagic transformation of ischemic stroke, vascular abnormalities, venous thrombosis, vasculitis, coagulopathy, and neoplasia.
Nontraumatic intracerebral hemorrhage (ICH) leads to a high rate of morbidity and mortality and constitutes a major public health problem worldwide, accounting for 10%– 15% of all strokes each year.
Well defined risk factors for ICH are age, alcohol consumption, hypertension, cerebral amyloid angiopathy, anticoagulant therapy, hemorrhagic transformation of ischemic stroke, vascular abnormalities, venous thrombosis, vasculitis, coagulopathy, and neoplasia.
Although CT is the first-line diagnostic approach, MR imaging with gradient echo sequences can detect hyperacute ICH with equal sensitivity and overall accuracy. Furthermore, MR imaging is more accurate for the detection of micro-hemorrhages.
read the entire text >>
The measurement of PI is also an useful adjunct to guide the use of hyperosmolar therapy in various conditions with intracranial
hypertension
.
Growing body of literature demonstrates the usefulness of transbulbar B-mode sonography of the optic nerve for detecting increased ICP in patients requiring neurocritical care. TCD findings compatible with the diagnosis of brain death include systolic spikes without diastolic flow or with diastolic reversed flow, and no demonstrable flow in a patient in who flow had been clearly documented on a previous examination. Assessment of cerebral autoregulation using TCD blood flow velocity has been previously validated to be predictive of outcome following traumatic brain injury. The commonly used bedside methods of determining the status of autoregulation include the transient hyperemic response test, the leg-cuff deflation test and reaction to spontaneous blood pressure fluctuations. TCD PI has emerged as a surrogate marker for ICP.
The measurement of PI is also an useful adjunct to guide the use of hyperosmolar therapy in various conditions with intracranial hypertension.
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Laboratory tests show two untreated risk factors for cerebrovascular disease:
hypertension
and dyslipidemia.
We present a 39 years old patient with history of abrupt neck pain and headache ten days before the hospitalization. On this occasion a massage of his neck and back was performed on the hospitalization day. A few hours after the procedure, he felt dizziness and nausea, had double vision and weakness of the left limbs.
Laboratory tests show two untreated risk factors for cerebrovascular disease: hypertension and dyslipidemia.
MRA was obtained.
read the entire text >>
25.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 1
,
,
,
Hypertension
, Hyperglycemia, Hyperthermia
Hypertension, Hyperglycemia, Hyperthermia
read the entire text >>
The CABG 3+ group had higher incidence of arterial
hypertension
(p=0.0298) and hyperlipidemia (p=0.0388).
The study included 66 patients. There were 35 patients in the CABG3+ group and 31 patients in the CABG2group. We found no statistically significant difference in the mean intima-media thickness of the common carotid artery between these two groups (p= 0.5637), neither between C-IMT and the extent of the coronary artery disease (p=0.82612).
The CABG 3+ group had higher incidence of arterial hypertension (p=0.0298) and hyperlipidemia (p=0.0388).
No statistically significant difference was found between age, gender, previous ischemic stroke, and smoking between groups.
read the entire text >>
Arterial
hypertension
and hyperlipidemia are more important risk factors, more commonly present in patients with greater extent of CABG surgery.
Our study did not show statistically significant relationship between common carotid artery (CCA) IMT and the extent of CABG surgery and coronary artery disease.
Arterial hypertension and hyperlipidemia are more important risk factors, more commonly present in patients with greater extent of CABG surgery.
read the entire text >>
vessels (CABG 3+) have higher incidence of arterial
hypertension
and hyperlipidemia (n=31).
vessels (CABG 3+) have higher incidence of arterial hypertension and hyperlipidemia (n=31).
We found no statistically significance between age, gender, previous ischemic stroke, smoking and performing coronary artery bypass surgery with two, three or more grafts. Table 2 shows patients’ angiographic findings. Figure 1 shows relationship between mean carotid intima media thickness with the extent of coronary disease. Mean CCA IMT in patients with 1–vessel disease was 0.898±0.16, in patients with 2-vessel disease was 0.932±0.15, while in patients with 3-vessel disease was 0.96±0.14 (p=0.82612). Mean C-IMT in the CABG
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The study also revealed statistically higher incidence of
hypertension
(p=0.0298) and hyperlipidemia (p=0.0388) in the CABG 3+ group which also indicates that comorbidities (in this particular case
hypertension
and hyperlipidemia) could be additional factors influencing the number of grafts placed during CABG, and that the severity of coronary artery disease is not the only factor for deciding on the number of grafts placed during coronary artery bypass surgery.
The study also revealed statistically higher incidence of hypertension (p=0.0298) and hyperlipidemia (p=0.0388) in the CABG 3+ group which also indicates that comorbidities (in this particular case hypertension and hyperlipidemia) could be additional factors influencing the number of grafts placed during CABG, and that the severity of coronary artery disease is not the only factor for deciding on the number of grafts placed during coronary artery bypass surgery.
read the entire text >>
Arterial
hypertension
and hyperlipidemia are more important risk factors more commonly present in patients with greater extent of CABG surgery.
Our study did not show statistically significant relationship between common carotid artery (CCA) IMT and the extent of CABG surgery and coronary artery disease.
Arterial hypertension and hyperlipidemia are more important risk factors more commonly present in patients with greater extent of CABG surgery.
read the entire text >>
Management of the “HYPER” triad in Acute Ischemic Stroke:
Hypertension
, Hyperglycemia, Hyperthermia
Management of the “HYPER” triad in Acute Ischemic Stroke: Hypertension, Hyperglycemia, Hyperthermia
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acute ischemic stroke,
hypertension
, hyperglycemia, hyperthermia, treatment
acute ischemic stroke, hypertension, hyperglycemia, hyperthermia, treatment
read the entire text >>
Significant number of patients with acute ischemic stroke suffers from
hypertension
, hyperglycemia or hyperthermia, particularly in hyper acute stage of ischemic stroke.
Significant number of patients with acute ischemic stroke suffers from hypertension, hyperglycemia or hyperthermia, particularly in hyper acute stage of ischemic stroke.
read the entire text >>
That is why early recognition and adequate treatment of
hypertension
, hyperglycemia and hyperthermia are very important.
These conditions dramatically influence early and late outcome of acute ischemic stroke.
That is why early recognition and adequate treatment of hypertension, hyperglycemia and hyperthermia are very important.
read the entire text >>
This review paper summarizes recent knowledge on association between acute ischemic stroke and
hypertension
, hyperglycemia and hyperthermia as well as emphasizes current treatment recommendations.
This review paper summarizes recent knowledge on association between acute ischemic stroke and hypertension, hyperglycemia and hyperthermia as well as emphasizes current treatment recommendations.
read the entire text >>
Hypertension
Hypertension
read the entire text >>
Explanations for high blood pressure are numerous: pre-existing
hypertension
, stress of hospitalization, neuroendocrine activation, Cushing reflex, and pain due to for example urinary retention [3].
Within the first 24−48 h after stroke onset, up to 84% of patients have spontaneous elevation of blood pressure. Blood pressure elevation typically resolves within a few days or weeks [1]. A significant decline in blood pressure occurs in a third of patients in the first few days after stroke onset [2].
Explanations for high blood pressure are numerous: pre-existing hypertension, stress of hospitalization, neuroendocrine activation, Cushing reflex, and pain due to for example urinary retention [3].
There are two opposing opinions regarding the treatment of high blood pressure in acute ischemic stroke (AIS) [4]. Despite the prevalence of arterial hypertension following stroke, its optimal management has not been established [5]. However, it should be mentioned that there are a lot of deleterious effects of high blood pressure. There is an increased risk of hemorrhage into the infarcted area, malignant cerebral edema, recurrent stroke and hypertensive encephalopathy. On the other hand, low blood pressure can lead to shift of the cerebral auto regulation curve in chronically hypertensive patients, loss of normal cerebral auto regulation in ischemic brain, and extension of ischemic damage by hypoperfusion [5].
read the entire text >>
Despite the prevalence of arterial
hypertension
following stroke, its optimal management has not been established [5].
Within the first 24−48 h after stroke onset, up to 84% of patients have spontaneous elevation of blood pressure. Blood pressure elevation typically resolves within a few days or weeks [1]. A significant decline in blood pressure occurs in a third of patients in the first few days after stroke onset [2]. Explanations for high blood pressure are numerous: pre-existing hypertension, stress of hospitalization, neuroendocrine activation, Cushing reflex, and pain due to for example urinary retention [3]. There are two opposing opinions regarding the treatment of high blood pressure in acute ischemic stroke (AIS) [4].
Despite the prevalence of arterial hypertension following stroke, its optimal management has not been established [5].
However, it should be mentioned that there are a lot of deleterious effects of high blood pressure. There is an increased risk of hemorrhage into the infarcted area, malignant cerebral edema, recurrent stroke and hypertensive encephalopathy. On the other hand, low blood pressure can lead to shift of the cerebral auto regulation curve in chronically hypertensive patients, loss of normal cerebral auto regulation in ischemic brain, and extension of ischemic damage by hypoperfusion [5]. Leonardi-Bee et al. showed that both high blood pressure and low blood pressure were independent prognostic factors for poor outcome of AIS, relationships that appear to be mediated in part by increased rates of early recurrence and death resulting from presumed cerebral edema in patients with high blood pressure and increased coronary heart disease events in those with low blood pressure.
read the entire text >>
showed that blood pressure reduction in the first 24 h after stroke onset is independently associated with poor outcome after 3 months [7], and some studies suggest that induced
hypertension
is a treatment option in acute stroke.
Leonardi-Bee et al. showed that both high blood pressure and low blood pressure were independent prognostic factors for poor outcome of AIS, relationships that appear to be mediated in part by increased rates of early recurrence and death resulting from presumed cerebral edema in patients with high blood pressure and increased coronary heart disease events in those with low blood pressure. This study was performed on 17 398 patients from the International Stroke Trial with confirmed ischemic stroke [6]. So, the question still remains, what is good for the patient? On the one side, the study of Oliveira-Filho et al.
showed that blood pressure reduction in the first 24 h after stroke onset is independently associated with poor outcome after 3 months [7], and some studies suggest that induced hypertension is a treatment option in acute stroke.
Denny-Brown was probably the first to note that improvement of neurological function following a brain ischemic episode is often associated with a rise in blood pressure [8]. In one study, Wise et al. administered vasopressor drugs (antihypotensive agents) to 13 patients soon after the development of focal brain ischemia even though there was no significant decrease in their blood pressure. The neurological function of five patients improved following an increase in their blood pressure. After this treatment was discontinued, significant recovery was maintained in three patients.
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Nowadays, induced
hypertension
has been abandoned as a treatment for ischemic stroke due to the perceived risk of hemorrhage and edema, but interestingly similar therapy has become the gold standard for management of cerebral vasospasm after subarachnoid hemorrhage (triple H therapy) [10].
mind that vasopressor agents may cause edema or hemorrhage if they are administered after the stroke has already occurred. That is why Wise et al. suggest that it is probably better to discontinue vasopressor therapy in patients who do not have any clinical improvement after several hours of treatment [9].
Nowadays, induced hypertension has been abandoned as a treatment for ischemic stroke due to the perceived risk of hemorrhage and edema, but interestingly similar therapy has become the gold standard for management of cerebral vasospasm after subarachnoid hemorrhage (triple H therapy) [10].
Rordorf and colleagues have conducted a retrospective study on 63 patients admitted to the neurological intensive care unit with a diagnosis of ischemic stroke. Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion. The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11]. A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke. They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12].
read the entire text >>
The results of this study suggest that careful use of phenylephrineinduced
hypertension
is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11].
That is why Wise et al. suggest that it is probably better to discontinue vasopressor therapy in patients who do not have any clinical improvement after several hours of treatment [9]. Nowadays, induced hypertension has been abandoned as a treatment for ischemic stroke due to the perceived risk of hemorrhage and edema, but interestingly similar therapy has become the gold standard for management of cerebral vasospasm after subarachnoid hemorrhage (triple H therapy) [10]. Rordorf and colleagues have conducted a retrospective study on 63 patients admitted to the neurological intensive care unit with a diagnosis of ischemic stroke. Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion.
The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11].
A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke. They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12]. Data about the safety of induced arterial hypertension therapy also came from the retrospective study by Marzan et al. These authors concluded that induced arterial hypertension is feasible and safe in patients with acute stroke [13]. In a randomized double-blind, placebo-controlled trial with 16 hypertensive patients, Lisk et al.
read the entire text >>
A few years later the same author and his colleagues conducted a pilot study of druginduced
hypertension
for the treatment of acute stroke.
suggest that it is probably better to discontinue vasopressor therapy in patients who do not have any clinical improvement after several hours of treatment [9]. Nowadays, induced hypertension has been abandoned as a treatment for ischemic stroke due to the perceived risk of hemorrhage and edema, but interestingly similar therapy has become the gold standard for management of cerebral vasospasm after subarachnoid hemorrhage (triple H therapy) [10]. Rordorf and colleagues have conducted a retrospective study on 63 patients admitted to the neurological intensive care unit with a diagnosis of ischemic stroke. Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion. The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11].
A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke.
They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12]. Data about the safety of induced arterial hypertension therapy also came from the retrospective study by Marzan et al. These authors concluded that induced arterial hypertension is feasible and safe in patients with acute stroke [13]. In a randomized double-blind, placebo-controlled trial with 16 hypertensive patients, Lisk et al. found that hypertensive ischemic stroke patients with a moderate elevation of blood pressure in the first few days may not require antihypertensive therapy and that nicardipine and possibly other calcium channel blockers may cause an excessive fall in blood pressure and impair cerebral blood flow in these patients and should therefore be used with caution [14].
read the entire text >>
They concluded that induced
hypertension
in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12].
Nowadays, induced hypertension has been abandoned as a treatment for ischemic stroke due to the perceived risk of hemorrhage and edema, but interestingly similar therapy has become the gold standard for management of cerebral vasospasm after subarachnoid hemorrhage (triple H therapy) [10]. Rordorf and colleagues have conducted a retrospective study on 63 patients admitted to the neurological intensive care unit with a diagnosis of ischemic stroke. Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion. The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11]. A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke.
They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12].
Data about the safety of induced arterial hypertension therapy also came from the retrospective study by Marzan et al. These authors concluded that induced arterial hypertension is feasible and safe in patients with acute stroke [13]. In a randomized double-blind, placebo-controlled trial with 16 hypertensive patients, Lisk et al. found that hypertensive ischemic stroke patients with a moderate elevation of blood pressure in the first few days may not require antihypertensive therapy and that nicardipine and possibly other calcium channel blockers may cause an excessive fall in blood pressure and impair cerebral blood flow in these patients and should therefore be used with caution [14].
read the entire text >>
Data about the safety of induced arterial
hypertension
therapy also came from the retrospective study by Marzan et al.
Rordorf and colleagues have conducted a retrospective study on 63 patients admitted to the neurological intensive care unit with a diagnosis of ischemic stroke. Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion. The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11]. A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke. They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12].
Data about the safety of induced arterial hypertension therapy also came from the retrospective study by Marzan et al.
These authors concluded that induced arterial hypertension is feasible and safe in patients with acute stroke [13]. In a randomized double-blind, placebo-controlled trial with 16 hypertensive patients, Lisk et al. found that hypertensive ischemic stroke patients with a moderate elevation of blood pressure in the first few days may not require antihypertensive therapy and that nicardipine and possibly other calcium channel blockers may cause an excessive fall in blood pressure and impair cerebral blood flow in these patients and should therefore be used with caution [14].
read the entire text >>
These authors concluded that induced arterial
hypertension
is feasible and safe in patients with acute stroke [13].
Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion. The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11]. A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke. They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12]. Data about the safety of induced arterial hypertension therapy also came from the retrospective study by Marzan et al.
These authors concluded that induced arterial hypertension is feasible and safe in patients with acute stroke [13].
In a randomized double-blind, placebo-controlled trial with 16 hypertensive patients, Lisk et al. found that hypertensive ischemic stroke patients with a moderate elevation of blood pressure in the first few days may not require antihypertensive therapy and that nicardipine and possibly other calcium channel blockers may cause an excessive fall in blood pressure and impair cerebral blood flow in these patients and should therefore be used with caution [14].
read the entire text >>
Restarting antihypertensive medications is reasonable after the first 24 hours for patients who have pre-existing
hypertension
and are neurologically stable unless a specific contraindication to restarting treatment is known
Initiation of antihypertensive therapy within 24 hours of stroke is relatively safe.
Restarting antihypertensive medications is reasonable after the first 24 hours for patients who have pre-existing hypertension and are neurologically stable unless a specific contraindication to restarting treatment is known
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The management of arterial
hypertension
in patients not undergoing reperfusion strategies remains challenging.
The management of arterial hypertension in patients not undergoing reperfusion strategies remains challenging.
Data to guide recommendations for treatment are inconclusive or conflicting. Many patients have spontaneous declines in blood pressure during the first 24 hours after stroke onset. Until more definitive data are available, the benefit of treating arterial hypertension in the setting of acute ischaemic stroke is not well established. Patients who have malignant hypertension or other medical indications for aggressive treatment of blood pressure should be treated accordingly
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Until more definitive data are available, the benefit of treating arterial
hypertension
in the setting of acute ischaemic stroke is not well established.
The management of arterial hypertension in patients not undergoing reperfusion strategies remains challenging. Data to guide recommendations for treatment are inconclusive or conflicting. Many patients have spontaneous declines in blood pressure during the first 24 hours after stroke onset.
Until more definitive data are available, the benefit of treating arterial hypertension in the setting of acute ischaemic stroke is not well established.
Patients who have malignant hypertension or other medical indications for aggressive treatment of blood pressure should be treated accordingly
read the entire text >>
Patients who have malignant
hypertension
or other medical indications for aggressive treatment of blood pressure should be treated accordingly
The management of arterial hypertension in patients not undergoing reperfusion strategies remains challenging. Data to guide recommendations for treatment are inconclusive or conflicting. Many patients have spontaneous declines in blood pressure during the first 24 hours after stroke onset. Until more definitive data are available, the benefit of treating arterial hypertension in the setting of acute ischaemic stroke is not well established.
Patients who have malignant hypertension or other medical indications for aggressive treatment of blood pressure should be treated accordingly
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Hypertension
:
Hypertension:
read the entire text >>
Bath P, Chalmers J, Powers W et al.; International Society of
Hypertension
Writing Group.
Bath P, Chalmers J, Powers W et al.; International Society of Hypertension Writing Group.
International Society of Hypertension (ISH): statement on the management of blood pressure in acute stroke.
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International Society of
Hypertension
(ISH): statement on the management of blood pressure in acute stroke.
Bath P, Chalmers J, Powers W et al.; International Society of Hypertension Writing Group.
International Society of Hypertension (ISH): statement on the management of blood pressure in acute stroke.
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Hypertension
in acute ischemic strokes.
Yatsu FM, Zivin J.
Hypertension in acute ischemic strokes.
Not to treat.
read the entire text >>
A pilot study of drug-induced
hypertension
for treatment of acute stroke.
Rordorf G, Koroshetz WJ, Ezzeddine MA, Segal AZ, Buonanno FS.
A pilot study of drug-induced hypertension for treatment of acute stroke.
read the entire text >>
Feasibility and safety of norepinephrineinduced arterial
hypertension
in acute ischemic stroke.
hler HJ, Studer A, Baumgartner RW, Georgiadis D.
Feasibility and safety of norepinephrineinduced arterial hypertension in acute ischemic stroke.
read the entire text >>
Should
hypertension
be treated after acute stroke?
Lisk DR, Grotta JC, Lamki LM et al.
Should hypertension be treated after acute stroke?
A randomized controlled trial using single photon emission computed tomography.
read the entire text >>
Controlling
hypertension
and hypotension immediately post-stroke (CHHIPS): a randomised, placebo-controlled, double-blind pilot trial.
Potter JF, Robinson TG, Ford GA et al.
Controlling hypertension and hypotension immediately post-stroke (CHHIPS): a randomised, placebo-controlled, double-blind pilot trial.
read the entire text >>
26.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 2
,
,
,
Stroke risk factors can be subdivided into non-modifiable (age, sex, race-ethnicity, genetic factors) and modifiable (
hypertension
, diabetes, dyslipidemia, atrial fibrillation, carotid artery stenosis, smoking, poor diet, physical inactivity, and obesity).
It is defined by WHO (World Health Organization) as the clinical syndrome of rapid onset of focal or global cerebral deficit, lasting more than 24 hours or leading to death, with no apparent cause other than a vascular one. It is one of the most common causes of death and disability in the adult population of the modern society. Stroke is a life changing disease, affecting the quality of life of patients and their families. It is also a huge social and financial burden for the family as well as the society. In spite of huge development in the management of stroke, with stroke units, thrombolytic therapy, endovascular treatment, neurosurgical and vascular surgical treatment, primary prevention of stroke is still one of the most important contributors for stroke management.
Stroke risk factors can be subdivided into non-modifiable (age, sex, race-ethnicity, genetic factors) and modifiable (hypertension, diabetes, dyslipidemia, atrial fibrillation, carotid artery stenosis, smoking, poor diet, physical inactivity, and obesity).
The four most important keys for healthy brain are in our hands: healthy nutrition (Mediterranean Diet), regular physical activity, stress management and “brain fitness”.
read the entire text >>
The management of
hypertension
is not properly addressed.
Obviously, over the years, we missed to fill out several gaps in stroke prevention. Despite efforts to modify health behavior, the knowledge about stroke, it's risk factors and symptoms is low, which means there is still lack of awareness. Then, “low risk” individuals are falsly reassured and therefore are not motivated.
The management of hypertension is not properly addressed.
Important risk factors for stroke are not considered in sreening (i.e. sedentary lifstyle, alcohol intake). The specificity of cerebovascular disease (CVD) prediction algorithms is low due to the fact they may not be applicable to all races. There is also a cost barrier for some high risk strategies, lack of effectiveness in screening of high-risk inividuals
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Overall favorable effect is observed on: lipid profiles, threshold for arrhythmias, platelet activity, inflammation and endothelial function, atherosclerosis and
hypertension
.
-3 polyunsaturated fatty acids (LCn3PUFAs): eicosapentaenoic acids (EPA), docosapentaenoic acid (DPA), docosahexaenoic acid (DHA) in fish are the key nutrients responsible for the cardioprotective benefits and CVD prevention. Beneficial effects of fish consumption on the risk of CVD are derived from synergistic effects among nutrients in fish. Fish is considered to be an excellent source of proteins with low saturated fat (taurine, arginine, glutamine-known to regulate cardiovascular function)' and some nutritious trace elements (selenium and calcium) which may directly or indirectly provide cardiovascular benefits, alone or in combination with LCn3PUFAs and vitamins (vitamin D and B). Interactions between LCn3PUFAs and other nutrients, including nutritious trace elements and vitamins and amino acids are important in reducing the risk of CVD.
Overall favorable effect is observed on: lipid profiles, threshold for arrhythmias, platelet activity, inflammation and endothelial function, atherosclerosis and hypertension.
The American Heart Association recommends eating fish (particularly fatty fish) at least 2 times a week. Fish consumption may be inversely associated with ischemic stroke but not with hemorrhagic stroke, because of the potential antiplatelet aggregation property of LCn3PUFAs. A meta-analysis of 8 independent prospective cohort studies which included 200575 subjects and 3491 stroke events showed that individuals with higher fish intake had lower risk of total stroke, compared with those who never consumed fish or ate fish less than once per month. The reduction in risk of total stroke was statistically significant for fish intake once per week; for individuals who ate fish 5 times or more per week, the risk of stroke was lowered by 31%. The risk of ischemic stroke was also significantly reduced by eating fish twice per month.
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Up to 70-90% of ICH are caused by rupture of small vessels chronically damaged by
hypertension
.
Up to 70-90% of ICH are caused by rupture of small vessels chronically damaged by hypertension.
Typically, such primary hypertensive ICH are located in the basal ganglia (28-42%) and the thalamus (10-26%) [6, 57]. Lobar ICH, as well as cerebellar and brainstem ICH are less frequent [57]. Secondary ICH are associated with vascular malformations, aneurysms, tumors, secondary hemorrhagic transformation of ischemic areas, amyloid angiopathy (especially in older patients), drug abuse, or disturbances of coagulation, including patients treated with oral anticoagulants (up to 20% of all ICH) [13, 57]. According to their variable etiology, such bleedings are often atypically located.
read the entire text >>
Hypertension
as a risk factor for spontaneous intracerebral hemorrhage.
Brott T, Thalinger K, Hertzberg V.
Hypertension as a risk factor for spontaneous intracerebral hemorrhage.
read the entire text >>
A patient, after four ischemic strokes (the first, 15 years ago), with comorbidity of
hypertension
and diabetes type II, participated in a four-week individually tailored PT program.
A patient, after four ischemic strokes (the first, 15 years ago), with comorbidity of hypertension and diabetes type II, participated in a four-week individually tailored PT program.
Preand post-training assessment included neurological examination, Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). The program consisted of 90 min, 3-4 times/week gradually progressive PT sessions with strength training, static and dynamic task practice for trunk and postural control (in sitting and standing) with gradual narrowing the base of support and stress on optimal alignment, sensory training, walking in different environment.
read the entire text >>
The patient has concomitant diseases: arterial
hypertension
, congestive heart failure III degree, COPD, type II diabetes mellitus, and diabetic polyneuropathy.
day, with COPD exacerbation.
The patient has concomitant diseases: arterial hypertension, congestive heart failure III degree, COPD, type II diabetes mellitus, and diabetic polyneuropathy.
Medical condition and vital signs (blood pressure, saturation, heart and respiratory rate), Barthel Index of activities of daily living, Borg Scale for perceived exertion has been monitored. After daily medical condition’s assessment the following physical therapy has been applied for two weeks: patient’s education about safe bed mobility and activities of daily life, respiratory care, mobilization, specific methods to neurologic deficits and callisthenic exercises.
read the entire text >>
27.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 1
,
,
,
Arterial
hypertension
was the most common risk factor for all patients.
Multiple artery involvement accounted for 8/25 patients.
Arterial hypertension was the most common risk factor for all patients.
Migraine and thyroid abnormalities (hyperthyreosis, remote thyroidectomy) were the most common abnormalities in the group of patients with multiple artery involvement. Hypertension and hyperlipidemia were the most common risk factor for carotid dissection. All patients had favorable outcome (mRS
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Hypertension
and hyperlipidemia were the most common risk factor for carotid dissection.
Multiple artery involvement accounted for 8/25 patients. Arterial hypertension was the most common risk factor for all patients. Migraine and thyroid abnormalities (hyperthyreosis, remote thyroidectomy) were the most common abnormalities in the group of patients with multiple artery involvement.
Hypertension and hyperlipidemia were the most common risk factor for carotid dissection.
All patients had favorable outcome (mRS
read the entire text >>
The cohort of 25 patients (Table 1) showed that
hypertension
was the most common risk factor for craniocervical artery dissection in all patients.
5 out of 8 patients with bilateral dissection.
The cohort of 25 patients (Table 1) showed that hypertension was the most common risk factor for craniocervical artery dissection in all patients.
Migraine and thyroid abnormalities (hyperthyreosis, remote thyroidectomy) were the most common abnormalities in the group of patients with bilateral carotid or bilateral vertebral dissection (Table 1). Hypertension and hyperlipidemia were the most common risk factors for carotid dissection (Table 1).
read the entire text >>
Hypertension
and hyperlipidemia were the most common risk factors for carotid dissection (Table 1).
5 out of 8 patients with bilateral dissection. The cohort of 25 patients (Table 1) showed that hypertension was the most common risk factor for craniocervical artery dissection in all patients. Migraine and thyroid abnormalities (hyperthyreosis, remote thyroidectomy) were the most common abnormalities in the group of patients with bilateral carotid or bilateral vertebral dissection (Table 1).
Hypertension and hyperlipidemia were the most common risk factors for carotid dissection (Table 1).
read the entire text >>
Age (range)/Възраст 52 (34-84) years 39 (23-58) years 45 (34-72) years
Hypertension
/
Age (range)/Възраст 52 (34-84) years 39 (23-58) years 45 (34-72) years Hypertension/
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Our results showed that
hypertension
was the most common risk factor for cervical artery dissection, involving more than half of patients.
Although the number of patients with cervical artery dissection was small, it showed that one third of them had multiple artery dissection. This finding is in line with previous published results for multiple artery dissection accounting from 13% to 28% of overall CCAD cases [2, 11, 1, 16].
Our results showed that hypertension was the most common risk factor for cervical artery dissection, involving more than half of patients.
However, in CADISP study, hypertension was not so frequently found as in ours [8], but it significantly varied between countries (supplemental material). We found hypercholesterolemia to be the most common risk factor for dissection in all groups, contrary to CADISP study showing inverse association of CCAD with hypercholesterolemia [8]. Other vascular risk factors like diabetes mellitus, smoking and obesity were not frequently found, similar to other studies [8]. Other risk factors recorded in population studies [8] like migraine, previous infection, remote neck surgery, low BMI, MTHFRC6775 genotype, were recorded
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However, in CADISP study,
hypertension
was not so frequently found as in ours [8], but it significantly varied between countries (supplemental material).
Although the number of patients with cervical artery dissection was small, it showed that one third of them had multiple artery dissection. This finding is in line with previous published results for multiple artery dissection accounting from 13% to 28% of overall CCAD cases [2, 11, 1, 16]. Our results showed that hypertension was the most common risk factor for cervical artery dissection, involving more than half of patients.
However, in CADISP study, hypertension was not so frequently found as in ours [8], but it significantly varied between countries (supplemental material).
We found hypercholesterolemia to be the most common risk factor for dissection in all groups, contrary to CADISP study showing inverse association of CCAD with hypercholesterolemia [8]. Other vascular risk factors like diabetes mellitus, smoking and obesity were not frequently found, similar to other studies [8]. Other risk factors recorded in population studies [8] like migraine, previous infection, remote neck surgery, low BMI, MTHFRC6775 genotype, were recorded
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= 49.4 (6.45), classified into three risk categories (diabetes,
hypertension
, smoking cigarettes) and a control group of subjects without CVRF were examined.
= 49.4 (6.45), classified into three risk categories (diabetes, hypertension, smoking cigarettes) and a control group of subjects without CVRF were examined.
Standardized ultrasound intima-media thickness (IMT), maximum and minimum carotid artery diameter and blood pressure were used to calculate elasticity (distensibility coefficient (DC), compliance coefficient (CC)) and stiffness (Young’s elastic modulus (YEM), beta stiffness index (
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were formed based on risk factors (
hypertension
, diabetes mellitus type II and smoking) present over the last five years.
were formed based on risk factors (hypertension, diabetes mellitus type II and smoking) present over the last five years.
The fourth group was the control one, without CVRF. To eliminate the possibility for arterial hypertension (according to the American Heart Association), each respondent’s blood pressure was set at
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To eliminate the possibility for arterial
hypertension
(according to the American Heart Association), each respondent’s blood pressure was set at
were formed based on risk factors (hypertension, diabetes mellitus type II and smoking) present over the last five years. The fourth group was the control one, without CVRF.
To eliminate the possibility for arterial hypertension (according to the American Heart Association), each respondent’s blood pressure was set at
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The measurement was carried out by automatic electronic sphygmomanometer (Omron M6 Comfort, Kyoto, Japan), which was validated according to the international protocol of the European Society of
Hypertension
[2, 4].
media area of close and far arterial wall was performed in maximum systolic expansion of the artery and minimal lumen width during the relaxation of the artery at the end of diastole [1]. It was performed 4 or 5 times on each artery, with the maximum magnification, along with the examination of previously recorded and stored images over 3 to 5 cardiac cycles [17]. The results of the measuring of the maximum and minimum diameter were an average of two maximal systolic and two minimal diastolic lumen diameters. Shortly before and during the measurement of the carotid arteries diameter, the blood pressure was also measured on the upper arm side that corresponded to the test of the current carotid artery.
The measurement was carried out by automatic electronic sphygmomanometer (Omron M6 Comfort, Kyoto, Japan), which was validated according to the international protocol of the European Society of Hypertension [2, 4].
The conversion factor of the measured blood pressure from mmHg to kPa is 0.13.
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The
hypertension
group indicated the highest values of systolic and diastolic blood pressure.
Table 1 presents the basic hemodynamic and metabolic variables of respondents with respect to CVRF.
The hypertension group indicated the highest values of systolic and diastolic blood pressure.
Statistically significant difference in the levels of total cholesterol, LDL cholesterol and HDL cholesterol was not found with respect to different groups (p>0.05). Fasting blood glucose and HbA1c was significantly higher in the group of respondents with diabetes when compared to other groups (p
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Hypertension
(N=30)
Hypertension (N=30)
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– in detecting statistically significant differences in subclinical atherosclerotic alteration in women with diabetes and
hypertension
with respect to women without CVRF.
– in detecting statistically significant differences in subclinical atherosclerotic alteration in women with diabetes and hypertension with respect to women without CVRF.
Similar results for some of the ultrasound markers have been published before [5, 15, 18, 23]. Van Sloten’s research led to conclusion that YEM is valid indicator of difference in carotid stiffness of people with and without cardiovascular incident [29]. In our research YEM did not indicate significant differences in carotid stiffness of observed groups of women. Contrary to the effect of other CVRF, Sharett et al. reported on conclusive correlation of smoking and lower stiffness of carotid artery (based on YEM) and higher elasticity of carotid artery (based on DC) [26].
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It could be argued that women need a longer period of exposure to cigarette smoke for the formation of functional vascular changes that can be detected by ultrasound than in the case of diabetes or
hypertension
.
results indicate lower arterial stiffness in women smokers in comparison with the control group, but these data are not statistically significant (p>0.05).
It could be argued that women need a longer period of exposure to cigarette smoke for the formation of functional vascular changes that can be detected by ultrasound than in the case of diabetes or hypertension.
The high dispersion between the minimum and maximum DC results in women-smokers (Fig. 1) could indicate a possible influence of other CVRF associated with smoking, but that was not the focus of this research. In the scientific literature, we have not found comparison of different ultrasound tests of functional properties of the arterial wall in the prediction of subclinical atherosclerosis. Our results (ROC analysis) indicate that DC and
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are acceptable ultrasound markers of early arteriosclerotic changes of functional characteristics of carotid arterial wall, especially those arising in the presence of diabetes and
hypertension
.
are acceptable ultrasound markers of early arteriosclerotic changes of functional characteristics of carotid arterial wall, especially those arising in the presence of diabetes and hypertension.
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Validation of four automatic devices for self-measurement of blood pressure according to the International Protocol of the European Society of
Hypertension
.
Belghazi J, El Feghali RN, Moussalem T, Rejdych M, Asmar RG.
Validation of four automatic devices for self-measurement of blood pressure according to the International Protocol of the European Society of Hypertension.
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remodeling of vascular wall in persons with family history of
hypertension
.
remodeling of vascular wall in persons with family history of hypertension.
Kardiologiia 55(2), 2015:27-31.
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Age,
hypertension
and arterial function.
McEniery CM, Wilkinson IB, Avolio AP.
Age, hypertension and arterial function.
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28.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 2
,
,
,
hypertension
, hypercholesterolemia, hyperglycemia, etc.) were corrected according to current guidelines [8].
>4 – immediate CT or MRI was obtained to check for ICH or recurrence. Having completed the diagnostic work-up, we excluded from the study those patients with large vessel disease, small vessel disease, cardioembolism, other specific causes (e.g. dissection, vasculitis, confirmed source for paradoxical embolism), and multiple causes (undetermined etiology). Furthermore, based on MRI/CT scan pattern, cryptogenic strokes were divided into two categories: ESUS and non-ESUS [10]. All patients were placed on anti-thrombotic treatment and modifiable risk factors (eg.
hypertension, hypercholesterolemia, hyperglycemia, etc.) were corrected according to current guidelines [8].
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Hypertension
Hypertension
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Hypertension
Hypertension
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According to modern scientific literature, vascular risk factors and especially diabetes mellitus (1/3 of our patients) and arterial
hypertension
(80% of our patients) are the basis of the so-called incidental
It is found in 10-12% of population [34]. Mild cognitive impairment is detected in 3-19 % of subjects above 65 years, in 10% of 70-79 year olds and in 25% of 80-89 year olds [2]. According to these data, the frequency of “pure” post-stroke cognitive impairment is 5759% at the first 3 days and 62-64% at the 3rd month after IS. If the dementia frequency is 3-6% for individuals between 65 and 79 years and 2030% for those over 80 years [7], then the “pure” post-stroke dementia frequency will be 2-5%. This high frequency may be due to additional nonstroke vascular cognitive deficit [23].
According to modern scientific literature, vascular risk factors and especially diabetes mellitus (1/3 of our patients) and arterial hypertension (80% of our patients) are the basis of the so-called incidental
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Focus on
Hypertension
.
Focus on Hypertension.
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NEUROSONOLOGY AND PHARMATRIALS: FOCUS ON
HYPERTENSION
NEUROSONOLOGY AND PHARMATRIALS: FOCUS ON HYPERTENSION
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Age,
hypertension
, hyperlipidemia, smoking, alcohol influence the intima-media thickness (IMT), which should be less than 1 mm in healthy persons.
Age, hypertension, hyperlipidemia, smoking, alcohol influence the intima-media thickness (IMT), which should be less than 1 mm in healthy persons.
It was proven with prospective trials, that the IMT could be decreased by appropriate treatment. The positive effect of statins, antihypertensive drugs have been proven. Some statins and antihypertensive drugs resulted in significant decrease of IMT thickness after one or 2 years therapy while others did not have beneficial effect. Besides, the majority of trials detected significant positive correlation between the reversal of IMT and the risk of vascular events. The advantages of carotid IMT trials are: a/ measure the effect of a new drug onto the IMT; b/ the results (needs much shorter time than a morbidity-mortality trial) may be decisive to start or refute a long-lasting and expensive morbidity trial on drugs aimed on atherosclerosis.
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ultrasound, pharmatrials,
hypertension
ultrasound, pharmatrials, hypertension
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The patient has been with arterial
hypertension
since 32 years of age with suboptimal control of the blood pressure values.
We present a 35-year-old patient with three TIAs in the territory of the left middle cerebral artery (MCA).
The patient has been with arterial hypertension since 32 years of age with suboptimal control of the blood pressure values.
A clinical examination, color coded duplex scanning (CCDS) of extraand intracranial cerebral arteries, computer tomographic angiography (CTA) and magnetic resonance angiography (MRA) were performed.
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29.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 15, 2019, No. 1
,
,
,
It has been shown that over 75% of patients have generalized atherosclerosis combined with arterial
hypertension
and diabetes mellitus [4], with risk factors similar to those in cerebrovascular disease.
Central retinal artery thrombosis is apolyethiological disease. The pathogenesis of CRA thrombosis is associated with atherosclerosis, emboli from various sources (platelet aggregates, cholesterol, fat, air embolism), vasculitis, vasospasm or hypotension.
It has been shown that over 75% of patients have generalized atherosclerosis combined with arterial hypertension and diabetes mellitus [4], with risk factors similar to those in cerebrovascular disease.
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– presence of thrombi and emboli due to atherosclerosis in 2/3 of patients, arterial
hypertension
, diabetes mellitus, carotid and coronary atherosclerosis, TIA or AIS, smoking, in patients
– presence of thrombi and emboli due to atherosclerosis in 2/3 of patients, arterial hypertension, diabetes mellitus, carotid and coronary atherosclerosis, TIA or AIS, smoking, in patients
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Hypertension
Hypertension
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Hypertension
Hypertension
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Population-based study on the prevalence and correlates of orthostatic hypotension/
hypertension
and orthostatic dizziness.
Wu JS, Yang YC, Lu FH, Wu CH, Chang CJ.
Population-based study on the prevalence and correlates of orthostatic hypotension/hypertension and orthostatic dizziness.
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cranial nerves, and arterial
hypertension
200/110 mmHg.
cranial nerves, and arterial hypertension 200/110 mmHg.
The CT scan of the brain shows extensive infarct in the territory of the right middle cerebral artery. Laboratory tests on admission show a mild normocytic normochromic anemia without any other significant abnormalities in blood count. The ultrasound diagnostics (USD) of main cervical vessels depicts bilateral aneurysms of the common carotid arteries with peripheral thromboses. The internal carotid arteries are poorly traceable, and the patient is referred for CTA.
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Ischemic stroke may be the first manifestation of the tumor, alone or in combination with mitral regurgitation and subsequent secondary pulmonary
hypertension
and heart failure due to the local tumor growth [7].
Myxoma is the most common primary benign tumor of the heart originating from the endocardium and is а rare cause of stroke, which has to be considered in younger patients or unclear etiology [5]. Most often these tumors are accidentally found, when imaging studies, such as magnetic resonance imaging (MRI), computed tomography (CT), and transthoracic/transesophageal echocardiography are conducted. Neurological complications are observed in 20-35% of patients with myxoma due to embolism in systemic circulation [6].
Ischemic stroke may be the first manifestation of the tumor, alone or in combination with mitral regurgitation and subsequent secondary pulmonary hypertension and heart failure due to the local tumor growth [7].
The only definitive treatment is the surgical excision of the tumor, leading to removal of the embolus source [8].
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Recent data show that coronary disease, cerebrovascular disease, arterial
hypertension
and diabetes mellitus are associated with cerebral atherosclerosis [14].
Recent data show that coronary disease, cerebrovascular disease, arterial hypertension and diabetes mellitus are associated with cerebral atherosclerosis [14].
Some races (Latin Americans, African Americans), female gender, age, hypertension, smoking, diabetes and lipid disorders are pointed as risk factors. There is a correlation between extracranial atherosclerosis, peripheral and coronary atherosclerosis, male gender and hypercholesterolemia. Such correlation is not proved for intracranial atherosclerosis [23]. Carbohydrate metabolism impairment is one of the most common diseases, affecting 8-10% of the population in different parts of the world [16, 27]. This high rate is a result of increased population and elderly people, long
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Some races (Latin Americans, African Americans), female gender, age,
hypertension
, smoking, diabetes and lipid disorders are pointed as risk factors.
Recent data show that coronary disease, cerebrovascular disease, arterial hypertension and diabetes mellitus are associated with cerebral atherosclerosis [14].
Some races (Latin Americans, African Americans), female gender, age, hypertension, smoking, diabetes and lipid disorders are pointed as risk factors.
There is a correlation between extracranial atherosclerosis, peripheral and coronary atherosclerosis, male gender and hypercholesterolemia. Such correlation is not proved for intracranial atherosclerosis [23]. Carbohydrate metabolism impairment is one of the most common diseases, affecting 8-10% of the population in different parts of the world [16, 27]. This high rate is a result of increased population and elderly people, long
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