References

4 (6), 1509-1513.

Abstract: The purpose of this study was to assess the acute effect of an intravenous bolus of the calcium antagonist gallopamil on left ventricular diastolic function using Doppler echocardiography. Fifteen patients with acute myocardial infarction in the first Killip class and sinus rhythm were randomized to an intravenous bolus of gallopamil (50-mu-g/kg over 5 minutes) or placebo in a crossover sequence. Doppler echocardiography was performed at baseline and 15 minutes after each bolus. No patients had received calcium antagonists or beta blockers before the study; all patients received nitroglycerin, which was withdrawn at least 2 hours before the baseline Doppler echocardiogram. The following Doppler parameters were calculated: the early (E) and late (A) peak filling velocities, the velocities ratio (E/A), the diastolic filling time-velocity integral (TVI), the peak filling rate normalized to the mitral stroke volume (nMPFR), the isovolumic relaxation time (IVRT), and the systolic flow velocity integral (SFVI). Expressing the parameters measured after a gallopamil bolus as the percent change of those measured after placebo, E, E/A, and nMPFR increased by 25.5 +/- 11.5%, 30.6 +/- 15.5%, and 19.0 +/- 12.2%, respectively (p < 0.001); IVRT decreased by 13.5 +/- 7.0% (p < 0.001); and TVI increased mildly by 6.9 +/- 9.9% (p = 0.01). SFVI and A did not change significantly. Negligible differences were observed between placebo and baseline values. Heart rate, mean blood pressure, and left ventricular and atrial diameters did not change significantly. It was concluded that gallopamil infusion improves early left ventricular filling and relaxation in patients with acute myocardial infarction. Considering the unchanged loading conditions, this indicates an improvement in left ventricular diastolic performance

Keywords: ACUTE MYOCARDIAL INFARCTION/CALCIUM ANTAGONISTS/CARE/DIASTOLIC FUNCTION/DOPPLER ECHOCARDIOGRAPHY/DRUG/DRUG THERAPY/GALLOPAMIL/LEFT VENTRICULAR FILLING/LEFT VENTRICULAR RELAXATION/NETHERLANDS/THERAPY

Vanderwalt, J.J., Vanrooyen, J.M., Cilliers, G.D., Vanryssen, J.C.J. and Vanaarde, M.N. (1981), Ratio of Cardiopulmonary Blood-Volume to Stroke Volume As An Index of Cardiac-Function in Animals and in Man. Cardiovascular Research, 15 (10), 580-587

Baan, J., Jong, T.T.A., Kerkhof, P.L.M., Moene, R.J., Vandijk, A.D., Vandervelde, E.T. and Koops, J. (1981), Continuous Stroke Volume and Cardiac-Output from Intraventricular Dimensions Obtained with Impedance Catheter. Cardiovascular Research, 15 (6), 328-334

Ebert, T.J., Eckberg, D.L., Vetrovec, G.M. and Cowley, M.J. (1984), Impedance Cardiograms Reliably Estimate Beat-By-Beat Changes of Left-Ventricular Stroke Volume in Humans. Cardiovascular Research, 18 (6), 354-360

Vanrooyen, J.M. and Vanderwalt, J.J. (1989), The Regulation of the Ratio of the Cardiopulmonary Blood-Volume to Stroke Volume in Sheep. Cardiovascular Research, 23 (5), 453-459

Gueret, P., Meerbaum, S., Zwehl, W., Wyatt, H.L., Davidson, R.M., Uchiyama, T. and Corday, E. (1981), Two-Dimensional Echocardiographic Assessment of Left- Ventricular Stroke Volume - Experimental Correlation with Thermodilution and Cineangiography in Normal and Ischemic States. Catheterization and Cardiovascular Diagnosis, 7 (3), 247-258

Lindboe, C.F., Dahl, T. and Rostad, B. (1989), Fatal Stroke in Migraine - A Case-Report with Autopsy Findings. Cephalalgia, 9 (4), 277-280

Sacquegna, T., Andreoli, A., Baldrati, A., Lamieri, C., Guttmann, S., Decarolis, P., Dipasquale, G., Pinelli, G., Testa, C. and Lugaresi, E. (1989), Ischemic Stroke in Young-Adults - the Relevance of Migrainous Infarction. Cephalalgia, 9 (4), 255-258

Uchida, S., Ohta, H., Niwa, M., Mori, A., Nonaka, G., Nishioka, I. and Ozaki, M. (1990), Prolongation of Life-Span of Stroke-Prone Spontaneously Hypertensive Rats (Shrsp) Ingesting Persimmon Tannin. Chemical & Pharmaceutical Bulletin, 38 (4), 1049-1052

Keywords: JAPAN

Nelles, J., Mey, F. and Adler, R. (1988), Experimental and Calculating Methods of Investigations of Reaction-Engineering Heterogeneous-Gas-Catalytic Processes .20. Turbo-Stroke-Reactors T-1 and T-2 in the System of Gradientless Laboratory Reactors According to the Modular Principle - Construction, Mode of Operation and Prospects. Chemische Technik, 40 (5), 193-195

Levin, J.O., Nilsson, C.A. and Norstrom, A. (1984), Sampling and Analysis of Polycyclic Aromatic-Hydrocarbons (Pah) from 2-Stroke Chain-Saw Engines. Chemosphere, 13 (3), 427-435

Rasmussen, S., Corya, B.C., Phillips, J.F. and Black, M.J. (1982), Unreliability of M-Mode Left-Ventricular Dimensions for Calculating Stroke Volume and Cardiac-Output in Patients Without Heart-Disease. Chest, 81 (5), 614-619

Her, C. (1983), Right Ventricular Stroke-Work - An Index of Distribution of Pulmonary Perfusion in Acute Respiratory-Failure. Chest, 84 (6), 719-724

Zahger, D., Moses, A. and Weiss, A.T. (1989), Evidence of Prolonged Myocardial Dysfunction in Heat-Stroke. Chest, 95 (5), 1089-1091

Scarfo, G.B., Piane, R., Mencattini, G. and Tomaccini, D. (1982), Stroke-Like Onset of Pineal Region Tumors in 2 Children. Childs Brain, 9 (3-4), 274-279

Wanifuchi, H., Kagawa, M., Takeshita, M., Izawa, M. and Kitamura, K. (1988), Ischemic Stroke in Infancy, Childhood, and Adolescence. Childs Nervous System, 4 (6), 361-364

Wu, Y.K., Yu, J.S., Lu, C.Q., Wu, Z.S., Chen, Y.F. and Yu, M.H. (1981), A 5-Year Report on Community Control of Hypertension, Stroke and Coronary Heart-Disease in the Shijingshan-People-Commune, Beijing. Chinese Medical Journal, 94 (4), 233-236

Wu, R.Q., Zhu, J.K., Zhang, C. and Zhang, Y.J. (1982), Extra-Intracranial Arterial Bypass in 278 Cases with Severe Ischemic Complete Stroke. Chinese Medical Journal, 95 (8), 583-588

Wu, R.Q., Zhu, J.K., Zhang, C., Zhang, Y.J., Zhang, S.M. and Zhao, M.X. (1986), Follow-Up-Study on 250 Patients with Extra-Intracranial Arterial Bypass Operation for Ischemic Stroke. Chinese Medical Journal, 99 (9), 703-707

Pan, T.B. (1987), Correlation Between Stroke Onset and Atmospheric Humidity, Temperature and Pressure. Chinese Medical Journal, 100 (7), 603-604

Shi, Y.M., Wang, G.Q., Zheng, H.M., Niu, L.Z., Chen, D.R. and Xue, G.B. (1988), Effect of Comprehensive Management on Stroke Prevention. Chinese Medical Journal, 101 (5), 361-364

Liu, L.S., Zhao, Y., Lei, Y.P., Wang, W., Zhang, X.E. and Jin, L. (1989), Calcium-Antagonists in Prevention of Hypertension and Stroke in Stroke Prone Spontaneously Hypertensive Rats. Chinese Medical Journal, 102 (2), 106-113

Chen, D.G., Feng, Q.P., Wang, Z.Q. and Chen, K. (1990), Nifedipine Pharmacodynamics and Pharmacokinetics in Treatment of Congestive-Heart-Failure. Chinese Medical Journal, 103 (12), 1008-1014.

Abstract: In 22 of 27 cases of congestive heart failure (CHF) treated with nifedipine (NIF), significant improvements in resting hemodynamics were noticed. The higher the basal systemic vascular resistance (SVR) and pulmonary artery end diastolic pressure (PAEDP), the greater the magnitude of reduction was achieved (r = 0.84 and 0.77, P < 0.01, respectively). Exercise hemodynamic investigation showed that NIF lowered SVR, PAEDP and pulmonary vascular resistance (PVR), with an increase in stroke volume (SV) at the serum concentration of 5-10 ng/ml. Maximum effect was observed at the concentration of 20 ng/ml. No further vasodilation was attainable with serum concentrations above 20 ng/ml. No remarkable deviation of NIF pharmacokinetic parameters from the normal ranges was found in CHF patients. The plasma norepinephrine level decreased markedly 2 and 7 hours after the use of NIF. It is concluded that oral NIF is beneficial to severe CHF patients with low cardiac output and high SVR

Keywords: AGENTS/ASSOCIATION/CHINESE

Hagberg, J.M., Ehsani, A.A. and Holloszy, J.O. (1983), Effect of 12 Months of Intense Exercise Training on Stroke Volume in Patients with Coronary-Artery Disease. Circulation, 67 (6), 1194-1199

Rodeheffer, R.J., Gerstenblith, G., Becker, L.C., Fleg, J.L., Weisfeldt, M.L. and Lakatta, E.G. (1984), Exercise Cardiac-Output Is Maintained with Advancing Age in Healthy-Human Subjects - Cardiac Dilatation and Increased Stroke Volume Compensate for A Diminished Heart-Rate. Circulation, 69 (2), 203-213

Mckay, R.G., Spears, J.R., Aroesty, J.M., Baim, D.S., Royal, H.D., Heller, G.V., Lincoln, W., Salo, R.W., Braunwald, E. and Grossman, W. (1984), Instantaneous Measurement of Left and Right Ventricular Stroke Volume and Pressure-Volume Relationships with An Impedance Catheter. Circulation, 69 (4), 703-710

Karam, M., Wise, R.A., Natarajan, T.K., Permutt, S. and Wagner, H.N. (1984), Mechanism of Decreased Left-Ventricular Stroke Volume During Inspiration in Man. Circulation, 69 (5), 866-873

Lewis, J.F., Kuo, L.C., Nelson, J.G., Limacher, M.C. and Quinones, M.A. (1984), Pulsed Doppler Echocardiographic Determination of Stroke Volume and Cardiac-Output - Clinical Validation of 2 New Methods Using the Apical Window. Circulation, 70 (3), 425-431

Ausubel, K., Steingart, R.M., Shimshi, M., Klementowicz, P. and Furman, S. (1985), Maintenance of Exercise Stroke Volume During Ventricular Versus Atrial Synchronous Pacing - Role of Contractility. Circulation, 72 (5), 1037-1043

Glower, D.D., Spratt, J.A., Snow, N.D., Kabas, J.S., Davis, J.W., Olsen, C.O., Tyson, G.S., Sabiston, D.C. and Rankin, J.S. (1985), Linearity of the Frank-Starling Relationship in the Intact Heart - the Concept of Preload Recruitable Stroke Work. Circulation, 71 (5), 994-1009

Olsen, C.O., Tyson, G.S., Maier, G.W., Davis, J.W. and Rankin, J.S. (1985), Diminished Stroke Volume During Inspiration - A Reverse Thoracic Pump. Circulation, 72 (3), 668-679

Kenny, J.F., Plappert, T., Doubilet, P., Saltzman, D.H., Cartier, M., Zollars, L., Leatherman, G.F. and Sutton, M.G.S. (1986), Changes in Intracardiac Blood-Flow Velocities and Right and Left-Ventricular Stroke Volumes with Gestational-Age in the Normal Human-Fetus - A Prospective Doppler Echocardiographic Study. Circulation, 74 (6), 1208-1216

Kenny, J., Plappert, T., Doubilet, P., Salzman, D. and Sutton, M.G.S. (1987), Effects of Heart-Rate on Ventricular Size, Stroke Volume, and Output in the Normal Human-Fetus - A Prospective Doppler Echocardiographic Study. Circulation, 76 (1), 52-58

Natarajan, T.K., Wise, R.A., Karam, M., Permutt, S. and Wagner, H.N. (1987), Immediate Effect of Expiratory Loading on Left-Ventricular Stroke Volume. Circulation, 75 (1), 139-145

Christie, J., Sheldahl, L.M., Tristani, F.E., Sagar, K.B., Ptacin, M.J. and Wann, S. (1987), Determination of Stroke Volume and Cardiac-Output During Exercise - Comparison of Two-Dimensional and Doppler Echocardiography, Fick Oximetry, and Thermodilution. Circulation, 76 (3), 539-547

Zisbrod, Z., Rose, D.M., Jacobowitz, I.J., Kramer, M., Acinapura, A.J. and Cunningham, J.N. (1987), Results of Open-Heart-Surgery in Patients with Recent Cardiogenic Embolic Stroke and Central-Nervous-System Dysfunction. Circulation, 76 (5), 109-112

Shimamoto, T., Komachi, Y., Inada, H., Doi, M., Iso, H., Sato, S., Kitamura, A., Iida, M., Konishi, M., Nakanishi, N., Terao, A., Naito, Y. and Kojima, S. (1989), Trends for Coronary Heart-Disease and Stroke and Their Risk- Factors in Japan. Circulation, 79 (3), 503-515

Fann, J.I., Sarris, G.E., Miller, D.C., Mitchell, R.S., Oyer, P.E., Stinson, E.B. and Shumway, N.E. (1989), Surgical-Management of Acute Aortic Dissection Complicated by Stroke. Circulation, 80 (3), 257-263

Beebe, H.G., Clagett, G.P., Deweese, J.A., Moore, W.S., Robertson, J.T., Sandok, B. and Wolf, P.A. (1989), Assessing Risk Associated with Carotid Endarterectomy - A Statement for Health-Professionals by An Ad Hoc Committee on Carotid Surgery Standards of the Stroke Council, American- Heart-Association. Circulation, 79 (2), 472-473

Werber, A.H. and Heistad, D.D. (1984), Effects of Chronic Hypertension and Sympathetic-Nerves on the Cerebral Microvasculature of Stroke-Prone Spontaneously Hypertensive Rats. Circulation Research, 55 (3), 286-294

Sunagawa, K., Maughan, W.L. and Sagawa, K. (1985), Optimal Arterial Resistance for the Maximal Stroke Work Studied in Isolated Canine Left-Ventricle. Circulation Research, 56 (4), 586-595

Higginbotham, M.B., Morris, K.G., Williams, R.S., Mchale, P.A., Coleman, R.E. and Cobb, F.R. (1986), Regulation of Stroke Volume During Submaximal and Maximal Upright Exercise in Normal Man. Circulation Research, 58 (2), 281-291

Arai, H., Nakao, K., Saito, Y., Morii, N., Sugawara, A., Yamada, T., Itoh, H., Shiono, S., Mukoyama, M., Ohkubo, H., Nakanishi, S. and Imura, H. (1988), Augmented Expression of Atrial Natriuretic Polypeptide Gene in Ventricles of Spontaneously Hypertensive Rats (Shr) and Shr- Stroke Prone. Circulation Research, 62 (5), 926-930

Joseph, R., Welch, K.M.A., Oster, S.B., Grunfeld, S. and Dandrea, G. (1989), A Plasmatic Factor May Cause Platelet Activation in Acute Ischemic Stroke. Circulation Research, 65 (6), 1679-1687

Doll, N.J. and Salvaggio, J.E. (1981), Stroke and Gangrene - Complications of Therapeutic Plasma- Exchange Therapy. Clinical and Experimental Dialysis and Apheresis, 5 (4), 415-421

Rascher, W., Dietz, R., Schomig, A., Voss, U. and Gross, F. (1983), Effects of Neonatal Sympathectomy by 6-Hydroxydopamine on Blood-Pressure and Intravascular Volume in Young Stroke-Prone Spontaneously Hypertensive Rats. Clinical and Experimental Pharmacology and Physiology, 10 (1), 27-33

Howe, P.R.C., Rogers, P.F. and Smith, R.M. (1985), Retarded Development of Hypertension in Stroke-Prone Spontaneously Hypertensive Rats Following Chronic Alcohol- Consumption. Clinical and Experimental Pharmacology and Physiology, 12 (3), 273-277

Minematsu, K., Yamaguchi, T., Tsuchiya, M., Ito, K., Ikeda, M. and Omae, T. (1987), Effect of Angiotensin Converting-Enzyme-Inhibitor (Captopril) on Cerebral Blood-Flow in Hypertensive Patients Without A History of Stroke. Clinical and Experimental Hypertension Part A-Theory and Practice, 9 (2-3), 551-557

Hales, J.R.S., Khogali, M., Fawcett, A.A. and Mustafa, M.K.Y. (1987), Circulatory Changes Associated with Heat-Stroke - Observations in An Experimental Animal-Model. Clinical and Experimental Pharmacology and Physiology, 14 (10), 761-777

Kawashima, K., Watanabe, T.X., Sokabe, H. and Saito, K. (1987), Prevention of Renal Damage and Decrease of Urinary Kinins Excretion by Chronic Treatments with Enalapril and Captopril in Stroke-Prone Spontaneously Hypertensive Rats. Clinical and Experimental Hypertension Part A-Theory and Practice, 9 (2-3), 409-413

Ashihara, T., Takeshita, A., Imaizumi, T., Yamamoto, K., Hoka, S. and Nakamura, M. (1988), Decreased Hindquarters Venous Distensibility During High Salt Intake in Stroke-Prone Spontaneously Hypertensive Rats. Clinical and Experimental Hypertension Part A-Theory and Practice, 10 (1), 59-78

Mcneil, J.J. (1989), Analysis of Antihypertensive Treatment Outcome and Stroke. Clinical and Experimental Hypertension Part A-Theory and Practice, 11 (5-6), 761-777

Macmahon, S. (1989), The Effects of Antihypertensive Drug-Treatment on the Incidence of Stroke and of Coronary Heart-Disease. Clinical and Experimental Hypertension Part A-Theory and Practice, 11 (5-6), 807-823

Sunano, S., Shimada, T., Moriyama, K. and Shimamura, K. (1990), Relaxation of Mesenteric-Artery of Stroke-Prone Spontaneously Hypertensive Rats by Calcium Removal. Clinical and Experimental Pharmacology and Physiology, 17 (6), 413-425

Keywords: AUSTRALIA

Barrettconnor, E. (1990), Obesity, Hypertension and Stroke. Clinical and Experimental Hypertension Part A-Theory and Practice, 12 (5), 769-782

Corea, M., Kloss, R., Stober, T., Schimrigk, K. and Keller, H.E. (1989), Elevated Serum Ck-Bb Levels in Patients with Cerebral Transtentorial Herniation After Ischemic Stroke. Clinical Biochemistry, 22 (2), 131-134

Miller, V.T. (1990), Transient Ischemic Attacks and Ischemic Stroke - Indications for Anticoagulation. Clinical Cardiology, 13 (4), 29-30

Watanabe, Y., Shikano, M., Ohba, M., Ohkubo, M. and Niwa, T. (1989), Correlation Between Somatosensory Evoked-Potentials and Sensory Disturbance in Stroke Patients. Clinical Electroencephalography, 20 (3), 156-161

Stoltz, J.F., Penin, F., Voisin, P., Gaillard, S., Donner, M. and Streiff, F. (1985), Blood-Viscosity and Platelet Parameters During Recent Cerebral Vascular Stroke in Elderly Patients. Clinical Hemorheology, 5 (6), 965-973

Anadere, I., Chmiel, H. and Witte, S. (1985), Hemorheological Findings in Patients with Completed Stroke and the Influence of A Ginkgo Biloba Extract. Clinical Hemorheology, 5 (5), 411-420

Coull, B.M., Beamer, N.B. and Seaman, G.V.F. (1986), Physicochemical Risk-Factors in Stroke. Clinical Hemorheology, 6 (1), 17-33

Lechner, H., Ott, E., Ossama, N. and Fazekas, F. (1986), Follow-Up-Studies of the Hemorheologic Profile in Acute Ischemic Stroke. Clinical Hemorheology, 6 (1), 3-9

Candelise, L. (1986), Italian Acute Stroke Study Hemodilution (Iass-H)-Organization and Methodology. Clinical Hemorheology, 6 (1), 11-16

Wang, B.P. and Sun, F.C. (1988), Treatment of Ischemic Cerebral Stroke by Isovolumic Hemodilution. Clinical Hemorheology, 8 (2), 269-272

Claudio, T., Antonio, C., Enzo, M., Andrea, M., Oreste, P., Manfredo, S. and Sergio, T. (1990), Effects of Iv Glycerol on Some Hemorheological Parameters in Patients with Acute Stroke. Clinical Hemorheology, 10 (2), 185-189

Gorsselink, E.L. and Lodder, J. (1985), Pure Sensory Stroke with Lacunar Infarction in the Posterior Ventral Thalamus on Ct. Clinical Neurology and Neurosurgery, 87 (1), 45-46

Dereus, R., Dereuck, J., Vermander, F., Dekeyser, H., Kint, A. and Vandevelde, E. (1985), Livedo Racemosa Generalisata and Stroke. Clinical Neurology and Neurosurgery, 87 (2), 143-148

Krijnekubat, B., Lodder, J. and Vanderlugt, P.J.M. (1987), Hemorrhagic Infarction on Ct in Cardioembolic Stroke. Clinical Neurology and Neurosurgery, 89 (2), 103-105

Viriyavejakul, A. (1990), Stroke in Asia - An Epidemiologic Consideration. Clinical Neuropharmacology, 13 S26-S33.

Abstract: Although the study of the epidemiology of stroke in developed Western countries (as judged from the number of relevant articles published in international medical journals) is extensive, in Asian countries it has been comparatively limited (with the exception of Japan). Many of the studies from Asian countries also appear to be deficient, thus making comparison between the countries difficult. In addition, many of these studies are believed to be published in local journals not usually cited and difficult to retrieve from, and relevant and retrievable data from many developing countries often show considerable time lapse, making a meaningful comparison between countries even more difficult. In Thailand, Public Health Statistics show that stroke has been on the increase. Taken as an example, the death rate from cerebrovascular disease (CVD) was 3.7/100,000 in 1950, rising to 6.7/100,000 in 1970, and to 11.8/100,000 in 1983. In 1984, there were 9,414 cases of CVD admitted to hospitals in Thailand. The incidence (in patients) increased from 12.7/100,000 in 1981 to 18.7/100,000 in 1984. Since 1957, the mortality rate has been steadily increasing, from approximately 1/100,000 to approximately 6/10,000. In a survey taken in 1983 of a medium-size community in Bangkok, it was found that the prevalence of CVD was 6.9/1,000. The same Public Health Statistics also showed that the rate of immediate death after stroke (which is defined as death within 4 weeks after the onset) from nonembolic cerebral infarction, cerebral embolism, and cerebral hemorrhage was reported to be 19.5, 37, and 85% respectively. Considerable difference was noted in the death rates from CVD in various Asian countries. In 1970, the number of deaths per 100,000 in Japan was reported to be 174.9, whereas in other countries these figures (per 100,000) were: Malaysia, 15.9 (in 1981); Hong Kong, 45.8 (in 1970); and Singapore, 50.2 (in 1971). The reported data from some countries are considered too low, possibly the result of the method of collection of public health data

Keywords: ASIAN COUNTRIES/CEREBROVASCULAR DISEASE/CEREBROVASCULAR-DISEASE/EAST/MORTALITY RATE

Lassen, N.A. (1990), Pathophysiology of Brain Ischemia As It Relates to the Therapy of Acute Ischemic Stroke. Clinical Neuropharmacology, 13 S1-S8.

Abstract: Current knowledge of the pathophysiology of cerebral ischemia, summarized in the present study, predicts that neurological deficits caused by moderate ischemia (flows in the penumbral range between 23 and 10 ml/100 g/min) are reversible provided flow is restored within 3-4 h of onset. It also predicts that areas of dense ischemia cannot be salvaged and that reperfusion of such areas is risky, because massive edema or even hemorrhage may develop following reperfusion. On this basis, it is argued that selection of stroke cases for thrombolysis or surgical revascularization must be based not only on computed tomographic (CT) scanning to exclude hemorrhagic stroke, but also on cerebral blood flow (CBF) tomography to exclude lacunar infarcts, early reperfusion, and dense ischemia. The methods available for routing CBF tomography in acute stroke cases are discussed, and it is concluded that single photon emission computed tomography (SPECT) using [99mTc]hexamethyl propyleneamine oxide (HM-PAO) or [99mTc]ethyl cysteinate dimer (ECD) should be explored for this use. In concluding, the glutamate receptor antagonist is mentioned. This compound is therapeutically active in some animal stroke models. In humans, it is probably used only in the acute phase, and in those in whom some degree of collateral flow is preserved. Therefore, even with this therapeutic approach, CBF tomography may be of value for patient selection

Keywords: BLOOD-FLOW/CEREBRAL BLOOD FLOW TOMOGRAPHY/CEREBRAL ISCHEMIA/CT/FOCAL CEREBRAL-ISCHEMIA/HM-PAO/HMPAO/PERFUSION/RECOVERY/SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY/SPECT/STROKE/STROKE THERAPY/THRESHOLDS

Depresseux, J.C., Franck, G., Vancauwenberge, H. and Cattelin, F. (1990), Metabolic and Circulatory Evaluation of Cerebral Ischemic- Accident in Humans by Positron Emission Tomography - A Pilot- Study with Almitrine Raubasine. Clinical Neuropharmacology, 13 S40-S49.

Abstract: Positron emission tomography and oxygen-15 were used to evaluate the effect of almitrine-raubasine combination on cerebral blood flow and oxidative metabolism in patients with cerebral ischemia. In five patients aged between 58 and 74 years, with a cerebral ischemic accident in the territory of the middle cerebral artery, blood flow rate, oxygen metabolic rate, and cerebral oxygen extraction were measured before and after a 90-min intravenous perfusion of almitrine bismesilate 15 mg and raubasine 5 mg. Investigations were performed from day 2 to day 7 after stroke occurred. One patient showed evidence of initial relative luxury perfusion, the degree of which was reduced by such combined treatment. The other four patients had a focal reduction in cerebral blood flow and oxygen consumption prior to treatment. The statistical analysis of three cerebral areas (epicenter of lesion, anterior and posterior juxtalesional areas, and homologous heterolateral areas) showed a 3.6% increase in oxygen metabolic rate at the epicenter, when both hemispheres were taken together, and a significant increase in cerebral blood flow in all three areas (3% on the healthy hemisphere, 13% on the injured hemisphere). These changes were greater in some patients than in others. This suggests that heterogeneity of drugs responses may correspond to the heterogeneity of the intial status

Keywords: 5023-SE/ALMITRINE-RAUBASINE/BLOOD-FLOW/DISORDERS/INHALATION/ISCHEMIC STROKE/O-15/OXYGEN-METABOLISM/POSITRON/STROKE

Procter, A.W. (1990), Can We Reverse Ischemic Penumbra - Some Mechanisms in the Pathophysiology of Energy-Compromised Brain-Tissue. Clinical Neuropharmacology,