Intracranial arterial narrowing and spasm in acute head injury

1972 ◽  
Vol 36 (3) ◽  
pp. 314-323 ◽  
Author(s):  
Charas Suwanwela ◽  
Nitaya Suwanwela
Keyword(s):  
Head Injury ◽  
Clinical Symptoms ◽  
Cerebral Arteries ◽  
Gunshot Wounds ◽  
Cerebral Contusion ◽  
Content Type ◽  
Acute Head Injury ◽  
Middle Cerebral Arteries ◽  
Intracranial Arteries ◽  
Vascular Spasm

✓ Arteriography in 350 patients with a moderate to severe head injury, including repeated studies in 40 patients, revealed narrowing of one or more of the intracranial arteries in 65 patients (18.6%). Narrowing of the intracranial portion of the internal carotid artery and the first part of the anterior and middle cerebral arteries was found in 18 patients and was believed to be responsible for the clinical symptoms in some. Narrowing of the branches of the cerebral arteries at the site of the cerebral contusion was seen in 33 patients and diffuse narrowing of the intracranial arteries in 12. In two additional patients with gunshot wounds of the brain, there was narrowing of the cerebral artery adjoining a torn vessel. The evidence suggests that vascular spasm is responsible for the narrowing in some patients, while contusion and hemorrhage in the arterial wall is the cause in others. Whatever the mechanism, the occurrence and significance of cerebral arterial narrowing in association with acute head injury needs to be emphasized.

Embolism from intracranial aneurysms

1980 ◽  
Vol 53 (3) ◽  
pp. 300-304 ◽  
Author(s):  
Toshisuke Sakaki ◽  
Kazuhiko Kinugawa ◽  
Tatsuo Tanigake ◽  
Seiji Miyamoto ◽  
Kikuo Kyoi ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Great Care ◽  
Content Type ◽  
Middle Cerebral Arteries ◽  
Internal Carotid Arteries ◽  
Distal Artery ◽  
Fine Print

✓ Embolism from an aneurysm is one of the mechanisms involved in the pathogenesis of ischemic symptoms associated with intracranial aneurysms. Four cases are reported in which aneurysms of the internal carotid arteries and middle cerebral arteries were the source of emboli resulting in cerebral infarction. In the treatment of these aneurysms, it is best to clip the neck of the aneurysm with great care to avoid embolism due to extrusion of clot into the distal artery.

Adrenergic innervation of the cerebral blood vessels in the rabbit

1971 ◽  
Vol 35 (2) ◽  
pp. 148-154 ◽  
Author(s):  
S. John Peerless ◽  
M. Gazi Yasargil
Keyword(s):  
Basilar Artery ◽  
Cerebral Arteries ◽  
Adrenergic Innervation ◽  
Cerebral Blood Vessels ◽  
Content Type ◽  
Middle Cerebral Arteries ◽  
Transmitter Substance ◽  
Subarachnoid Blood ◽  
Adrenergic Fibers ◽  
Adrenergic Terminals

✓ The Hillarp technique of fluorescent staining of monoamines was used to examine the adrenergic fibers in the cerebral vessels of rabbit brains. These fibers were found to lie wholly within the deeper layers of the adventitia and not within muscle layers. Varicosities were interpreted as representing neural transmitter substance. The basilar artery had a sparse innervation; the anterior cerebral, carotid, and middle cerebral arteries were more richly supplied by adrenergic terminals, with the most dense innervation in the superficial vessels between 100 and 300 µ in diameter. Mild trauma to the basilar artery, as well as subarachnoid blood without trauma, caused the catecholamine reaction to disappear. A marked depletion of adrenergic fibers was also noted after administration of alpha methyl tyrosine and subjection of the animals to extremes of blood pressure.

Altered reactivity of human cerebral arteries after subarachnoid hemorrhage

1995 ◽  
Vol 83 (3) ◽  
pp. 510-515 ◽  
Author(s):  
Hisashi Onoue ◽  
Nobuyoshi Kaito ◽  
Masahiko Akiyama ◽  
Masato Tomii ◽  
Shogo Tokudome ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Arteries ◽  
Isometric Tension ◽  
Vasoactive Agents ◽  
Content Type ◽  
Vasoactive Substances ◽  
Middle Cerebral Arteries ◽  
Prostaglandin F ◽  
Human Cadavers ◽  
Endothelium Dependent Relaxation

✓ To investigate the effects of subarachnoid hemorrhage (SAH) on the responsiveness of human cerebral arteries to vasoactive substances, the authors measured the isometric tension generated in helical strips of basilar and middle cerebral arteries isolated from human cadavers Contractions caused by KCl, prostaglandin F2α, noradrenaline, and serotonin were reduced in arteries obtained from cadavers with aneurysmal SAH damage and compared to those obtained from cadavers with no indication of intracranial diseases. Endothelium-dependent relaxation elicited by substance P and bradykinin, and endothelium-independent relaxation induced by prostaglandin I2 and nitroglycerin were also markedly decreased in arteries affected by SAH. However, the reduction in relaxation response to prostaglandin I2 was significantly less than that to the other vasodilator agents. These results indicate that human cerebral artery functions are severely impaired after SAH and that poor responses to vasoactive agents may result primarily from dysfunction of smooth-muscle cells.

Evaluation of a subdural pressure transducer

1972 ◽  
Vol 37 (1) ◽  
pp. 117-121 ◽  
Author(s):  
George T. Tindall ◽  
Charles P. McGraw ◽  
Hans O. Wendenburg ◽  
Herbert H. Peel
Keyword(s):  
Head Injury ◽  
Intracranial Pressure ◽  
Pressure Transducer ◽  
Pressure Gauge ◽  
Practical Method ◽  
Absolute Pressure ◽  
Subdural Space ◽  
Content Type ◽  
Acute Head Injury ◽  
Fine Print

✓ A simple practical method for monitoring intracranial pressure has been developed; it is based on a diaphragm-type, full-bridge, absolute-pressure gauge that is stable. The transducer is calibrated to absolute pressure at body temperature. It is placed in a trephine opening where it is in contact with the subdural space. The transducer is contained in a self-threading case that will fit in a 14 mm trephine opening. Its use in 30 patients with acute head injury is reported.

Intraoperative perfusion computerized tomography scanning for management of intracranial stent placement in a patient with tandem intracranial stenoses

2005 ◽  
Vol 102 (5) ◽  
pp. 918-921 ◽  
Author(s):  
Matthew F. Sanford ◽  
Aquilla S. Turk ◽  
David B. Niemann ◽  
Kari A. Pulfer ◽  
Beverly A. Aagaard-Kienitz
Keyword(s):  
Computerized Tomography ◽  
Stent Placement ◽  
Cerebral Perfusion ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
The Novel ◽  
Content Type ◽  
Carotid Artery Stent ◽  
Middle Cerebral Arteries ◽  
Tomography Scanning

✓ The authors describe the novel use of cerebral perfusion computerized tomography studies to evaluate the effectiveness of internal carotid artery stent placement in a man with symptomatic transient ischemic attacks caused by tandem stenoses of the internal carotid and middle cerebral arteries.

Fatal paradoxical muscle embolization in traumatic carotid-cavernous fistula repair

1976 ◽  
Vol 44 (4) ◽  
pp. 513-516 ◽  
Author(s):  
William F. McCormick ◽  
Patrick J. Kelly ◽  
Mohammed Sarwar
Keyword(s):  
Internal Carotid ◽  
Brain Infarction ◽  
Cerebral Arteries ◽  
Fistula Repair ◽  
Carotid Cavernous Fistula ◽  
Unique Case ◽  
Content Type ◽  
Cavernous Fistula ◽  
Middle Cerebral Arteries ◽  
The Right

✓ A unique case of fatal paradoxical muscle embolism in a patient with a traumatic carotid-cavernous fistula is described. The muscle plug intended to occlude a left-sided fistula passed through the large fistula, bypassed the lungs by way of a patent foramen ovale, and embolized through the right carotid artery to lodge in the internal carotid and middle cerebral arteries producing fatal brain infarction.

Treatment of head injuries in the American Civil War

1993 ◽  
Vol 78 (5) ◽  
pp. 838-845 ◽  
Author(s):  
Howard H. Kaufman
Keyword(s):  
Civil War ◽  
Head Injury ◽  
Head Injuries ◽  
Closed Head Injury ◽  
Gunshot Wounds ◽  
American Civil War ◽  
Content Type ◽  
Severity Of Injury ◽  
Surgical History ◽  
Fine Print

✓ At the time of the American Civil War (1861–1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery.

Serial S-100 protein serum measurements related to early magnetic resonance imaging after minor head injury

1996 ◽  
Vol 85 (5) ◽  
pp. 945-948 ◽  
Author(s):  
Tor Ingebrigtsen ◽  
Bertil Romner
Keyword(s):  
Magnetic Resonance Imaging ◽  
Head Injury ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Minor Head Injury ◽  
Cerebellar Hemisphere ◽  
Resonance Imaging ◽  
Cerebral Contusion ◽  
Content Type ◽  
S 100

✓ The authors studied 24 patients with a Glasgow Coma Scale score of 14 or 15 and normal computerized tomography scans after minor head injury. The study protocol included obtaining serial measurements of S-100 protein in serum during the first 12 hours after injury and early magnetic resonance (MR) imaging. Four patients (17%) had detectable levels of S-100 protein in serum. The S-100 protein levels were highest immediately after trauma, declining hour by hour. In two patients, MR imaging revealed intracranial contusion. Levels of S-100 protein were not detectable in serum in one patient with MR-verified cerebral contusion, but the first measurements were made late, 6 hours after trauma. The highest serum level of S-100 protein (0.9 µg/L) was seen in a 73-year-old man 2 hours after injury. Magnetic resonance imaging revealed a contusion of the left cerebellar hemisphere, and the patient suffered permanent sequelae of impaired posture and dizziness.

Cerebral arterial spasm

1974 ◽  
Vol 40 (4) ◽  
pp. 433-441 ◽  
Author(s):  
George S. Allen ◽  
Lavell M. Henderson ◽  
Shelly N. Chou ◽  
Lyle A. French
Keyword(s):  
Small Volume ◽  
Contractile Activity ◽  
Cerebral Arteries ◽  
Arterial Spasm ◽  
Vasoactive Agents ◽  
Response Curves ◽  
Content Type ◽  
Middle Cerebral Arteries ◽  
Fine Print

✓ In vitro experiments were performed using a small volume chamber to determine the contractile activity of various vasoactive agents on the canine basilar and middle cerebral arteries. Cumulative dose-response curves were obtained for most of the agents tested including serotonin and three different prostaglandins; many of these curves were found to be similar for segments from both arteries. It was concluded from these curves, and the known concentrations in blood, that serotonin is probably the agent in blood responsible for the cerebral arterial spasm that often follows a subarachnoid hemorrhage. This in vitro method is capable of detecting serotonin concentrations as low as 10−12 gm/ml and may prove useful as a quantitative and well-controlled method for studying the etiology of spasm and the receptor mechanisms present in the cerebral arteries.

Cerebral vasospasm evaluated by transcranial ultrasound correlated with clinical grade and CT-visualized subarachnoid hemorrhage

1986 ◽  
Vol 64 (4) ◽  
pp. 594-600 ◽  
Author(s):  
Rolf W. Seiler ◽  
Peter Grolimund ◽  
Rune Aaslid ◽  
Peter Huber ◽  
Helge Nornes
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Brain Infarction ◽  
Cerebral Arteries ◽  
Clinical Status ◽  
Transcranial Doppler Sonography ◽  
Transcranial Ultrasound ◽  
Unaffected Side ◽  
Content Type ◽  
Middle Cerebral Arteries ◽  
Subarachnoid Blood

✓ In 39 patients with a proven subarachnoid hemorrhage (SAH), the clinical status, the amount of subarachnoid blood on a computerized tomography scan obtained within 5 days after SAH, and the flow velocities (FV's) in both middle cerebral arteries (MCA's) measured by transcranial Doppler sonography were recorded daily and correlated. All patients had pathological FV's over 80 cm/sec between Day 4 and Day 10 after SAH. The side of the ruptured aneurysm showed higher FV's than did the unaffected side in cases of laterally localized aneurysms. Increase in FV preceded clinical manifestation of ischemia. A steep early increase of FV's portended severe ischemia and impending infarction. Maximum FV's in the range of 120 to 140 cm/sec were not critical and in no case led to brain infarction. Maximum FV's over 200 cm/sec were associated with a tendency for ischemia, but the patients may remain clinically asymptomatic. In cases of no or only a little blood in the basal cisterns, mean FV's in both MCA's increased only moderately whereas, with thick clots of subarachnoid blood, there was a steeper and higher increase of mean FV's.

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