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Texto completo SciELO Brasil
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Id: biblio-1131709
Autor: Maia, Isaac Holanda Mendes; Melo, Thaissa Pinto de; Lima, Fabrício Oliveira; Carvalho, João José de Freitas; Montalverne, Francisco José Arruda; Lopes Júnior, Edson; Diógenes, Marcelo Bezerra; Cunha, Thaís Saraiva Leão; Queiroz, Bárbara Matos Almeida; Tamietti, Marina Franciss; Maia, Fernanda Martins.
Título: Decompressive craniectomy versus conservative treatment: limits and possibilities in malignant stroke / Craniectomia descompressiva versus tratamento conservador: limites e possibilidades no AVC maligno
Fonte: Arq. neuropsiquiatr;78(6):349-355, June 2020. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background: Malignant infarction of the middle cerebral artery (MCA) occurs in a subgroup of patients with ischemic stroke and early decompressive craniectomy (DC) is one of its treatments. Objective: To investigate the functional outcome of patients with malignant ischemic stroke treated with decompressive craniectomy at a neurological emergency center in Northeastern Brazil. Methods: Prospective cohort study, in which 25 patients were divided into two groups: those undergoing surgical treatment with DC and those who continued to receive standard conservative treatment (CT). Functionality was assessed using the modified Rankin Scale (mRS), at follow-up after six months. Results: A favorable outcome (mRS≤3) was observed in 37.5% of the DC patients and 29.4% of CT patients (p=0.42). Fewer patients who underwent surgical treatment died (25%), compared to those treated conservatively (52.8%); however, with no statistical significance. Nonetheless, the proportion of patients with moderate to severe disability (mRS 4‒5) was higher in the surgical group (37.5%) than in the non-surgical group (17.7%). Conclusion: In absolute values, superiority in the effectiveness of DC over CT was perceived, showing that the reduction in mortality was at the expense of increased disability.

RESUMO Introdução: O infarto maligno da artéria cerebral média (ACM) ocorre em um subgrupo de pacientes com acidente vascular cerebral (AVC) isquêmico e a craniectomia descompressiva (CD) precoce é um de seus tratamentos. Objetivo: Investigar o desfecho funcional de pacientes com acidente vascular cerebral isquêmico maligno submetidos à craniectomia descompressiva em um centro de emergência neurológica do nordeste do Brasil. Métodos: Nesta coorte prospectiva, os pacientes foram divididos em dois grupos: aqueles submetidos a tratamento cirúrgico com craniectomia descompressiva (CD) e aqueles que mantiveram tratamento conservador (TC) padrão. A funcionalidade foi avaliada por meio da Escala de Rankin modificada (ERm) ao final de seis meses de seguimento. Resultados: Evidenciou-se desfecho favorável (ERm≤3) em 37,5% dos pacientes craniectomizados e em 29,4% dos pacientes não craniectomizados (p=0,42). A mortalidade foi menor no grupo de pacientes que se submeteram a tratamento cirúrgico (25%) do que entre aqueles tratados conservadoramente (52,8%), porém sem significância estatística. Por outro lado, a proporção de pacientes com incapacidade moderada a grave (ERm 4‒5) foi maior no grupo cirúrgico (37,5%) do que no grupo não cirúrgico (17,7%). Conclusão: Em valores absolutos, percebeu-se superioridade na eficácia do tratamento cirúrgico sobre o conservador, mostrando que a redução de mortalidade se dá à custa de aumento da incapacidade funcional.
Descritores: Acidente Vascular Cerebral/cirurgia
Craniectomia Descompressiva
-Brasil
Estudos Prospectivos
Resultado do Tratamento
Infarto da Artéria Cerebral Média/cirurgia
Infarto da Artéria Cerebral Média/diagnóstico por imagem
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1131729
Autor: De Brito, Marcelo Houat; Pimentel, Gabriela Almeida; Docema, Marcos Fernando de Lima; Trindade, Mateus Correa da.
Título: Three territory sign in cancer-related acute ischemic stroke / Sinal de três territórios arteriais em acidente vascular cerebral isquêmico agudo relacionado a câncer
Fonte: Arq. neuropsiquiatr;78(7):453-453, July 2020. graf.
Idioma: en.
Descritores: Adenocarcinoma/patologia
Isquemia Encefálica/diagnóstico por imagem
Neoplasias do Colo/patologia
Acidente Vascular Cerebral
-Infarto da Artéria Cerebral Média
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
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Id: biblio-1004338
Autor: González L, Roberto; Reyes M, Rodrigo; Riquelme U, Alejandra; Seguel S, Enrique; Stockins L, Aleck; Jadue T, Andrés; Alarcón C, Emilio.
Título: Accidente cerebrovascular embólico secundario a fibroelastoma papilar de válvula mitral / Embolic stroke secondary to a mitral valve fibroelastoma: case report
Fonte: Rev. méd. Chile;147(2):243-246, Feb. 2019. graf.
Idioma: es.
Resumo: Embolic stroke secondary to cardiac tumors is uncommon. However, 25-30% of cardiac tumors may cause systemic emboli. We report a 29-year-old male consulting for a sudden episode of aphasia and right hemiparesis, compatible with infarct of the left middle cerebral artery territory. Transthoracic echocardiography reported an ovoid tumor of 8 × 7 × 7 mm in relation to the sub valvular apparatus of the mitral valve. After neurologic stabilization, surgical treatment was performed. Approached by median sternotomy and in cardiopulmonary bypass, the mitral valve was explored. A macroscopic tumor consistent with a papillary fibroelastoma curled in sub valvular chordae was found. It was deployed and resected from its base, while the anterior mitral leaflet was preserved intact. Histopathological examination confirmed the intraoperative macroscopic diagnosis. The patient recovered uneventfully postoperatively and was discharged on the fifth day after surgery. He currently is in functional capacity I without cardiovascular symptoms at five years follow-up.
Descritores: Infarto da Artéria Cerebral Média/etiologia
Fibroma/complicações
Neoplasias Cardíacas/complicações
Doenças das Valvas Cardíacas/complicações
-Músculos Papilares
Ecocardiografia
Esternotomia
Fibroma/cirurgia
Fibroma/patologia
Fibroma/diagnóstico por imagem
Neoplasias Cardíacas/cirurgia
Neoplasias Cardíacas/patologia
Neoplasias Cardíacas/diagnóstico por imagem
Doenças das Valvas Cardíacas/cirurgia
Doenças das Valvas Cardíacas/diagnóstico por imagem
Valva Mitral
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Cuba
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Id: biblio-1094142
Autor: Sierra Benítez, Enrique Marcos; León Pérez, Mairianny Quianella; Morales Fuentes, Manuel Alejandro.
Título: Controversias de la craniectomía descompresiva en el tratamiento de la hipertensión endocraneana / Controversies of decompressive craniotomy in the treatment of intracranial hypertension
Fonte: Rev. medica electron;41(6):1457-1470, oct.-dic. 2019.
Idioma: es.
Resumo: RESUMEN La hipertensión intracraneal influye negativamente en el pronóstico del traumatismo craneoencefálico grave y del infarto maligno de la arteria cerebral media. La craniectomía descompresiva constituye una opción de tratamiento. Con esta revisión se persigue valorar las controversias de la craniectomía descompresiva en el tratamiento de la hipertensión endocraneana. Para lo cual se realizó una exhaustiva revisión de la literatura donde se tuvieron en cuenta diversos estudios multicéntricos y multinacionales que plasmaron aspectos polémicos acerca de la utilización de este proceder neuroquirúrgico como terapia en el manejo de la hipertensión endocraneana refractaria a tratamiento conservador. Se concluye que la craniectomía descompresiva se considera beneficiosa en el infarto maligno de la arteria cerebral media, mientras que en el trauma craneoencefálico grave su utilidad es controvertida (AU).

SUMMARY Intracranial hypertension negatively influences the prognosis of severe craniaencephalic trauma and malignant infarction of the middle cerebral artery. Decompressive craniotomy is a treatment option. The aim of this review is to assess the controversies of decompressive craniotomy in the treatment of intracranial hypertension. For this purpose, an exhaustive review of the literature was carried out, taking into account several multicentric and multinational studies revealing controversial aspects on the use of this neurosurgical procedure as therapy in the management of intracranial hypertension refractory to conservative treatment. It is concluded that decompressive craniotomy is considered beneficial in the malignant infarction of the middle cerebral artery, while in the case of severe craniaencephalic trauma its utility is controversial (AU).
Descritores: Hipertensão Intracraniana/cirurgia
Craniectomia Descompressiva/métodos
-Ensaios Clínicos Controlados Aleatórios como Assunto
Infarto da Artéria Cerebral Média/diagnóstico
Infarto da Artéria Cerebral Média/terapia
Lesões Encefálicas Traumáticas/cirurgia
Lesões Encefálicas Traumáticas/terapia
Sobrevivência
Limites: Humanos
Tipo de Publ: Revisão
Responsável: CU424.1 - Centro Provincial de Información de Ciencias Médicas


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Texto completo SciELO Chile
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Id: biblio-1058624
Autor: Navia, Víctor; Riveros, René; Brunser, Alejandro.
Título: Trombolisis endovenosa post reversión de acenocumarol con complejo de protrombina: caso clínico / Intravenous thrombolysis after reversion of acenocoumarol anticoagulation: report of one case
Fonte: Rev. méd. Chile;147(7):932-934, jul. 2019. graf.
Idioma: es.
Resumo: We report an 89-year-old male under oral anticoagulant therapy with a therapeutic international normalized ratio, presenting at the emergency room with right side hemiparesis and aphasia. Neuroimaging was compatible with an acute middle cerebral artery ischemic stroke. Anticoagulation was reverted with the use of four factor prothrombin complex, followed by thrombolysis with alteplase, with a favorable evolution, returning to his basal functional status.
Descritores: Protrombina/administração & dosagem
Terapia Trombolítica/métodos
Anlodipino/efeitos adversos
Acidente Vascular Cerebral/tratamento farmacológico
Infarto da Artéria Cerebral Média/tratamento farmacológico
Acenocumarol/efeitos adversos
Metformina/efeitos adversos
-Tomografia Computadorizada por Raios X
Anlodipino/administração & dosagem
Acidente Vascular Cerebral/etiologia
Infarto da Artéria Cerebral Média/etiologia
Administração Intravenosa
Acenocumarol/administração & dosagem
Metformina/administração & dosagem
Limites: Humanos
Masculino
Idoso de 80 Anos ou mais
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-889118
Autor: Wanchao, Shi; Chen, Ma; Zhiguo, Su; Futang, Xie; Mengmeng, Shi.
Título: Protective effect and mechanism of Lactobacillus on cerebral ischemia reperfusion injury in rats
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;51(7):e7172, 2018. graf.
Idioma: en.
Resumo: The present study was designed to investigate the protective effects and mechanism of inactivated lactobacillus (ILA) on cerebral ischemia reperfusion injury (CIRI) in rats. In this experiment, 30 male Sprague Dawley rats were randomly divided into control group, IRI groups, and ILA group. A middle cerebral artery occlusion and reperfusion model was prepared. The rats were killed after 24 hours of recovery of blood flow of cerebral ischemia resulting from 60-min occlusion. The cerebral infarction volume and neurological scores were assayed by staining and behavioral observation. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were assayed by biochemical kits. Cell apoptosis was assayed by Tunnel and the Toll-like receptor (TLR)-4, IkB, and A20 were assayed by western blot. The neurobehavioral scores in IRI rats were significantly lower compared to the control group while ILA improved the neurobehavioral scores of the ILA groups. The cerebral infarction volume and neural cell apoptosis of rats in the ILA groups decreased significantly compared with those in the IRI group. In addition, MDA level in the ILA groups decreased whereas SOD activity increased compared to the IRI group. Moreover, ILA also inhibited the expression of TLR-4 and promoted the expression of IkB and A20. ILA inhibited the apoptosis of neural cells, decreased cerebral infarction volume, and reduced oxidative stress through inhibition of TLR-4/NF-kappa B signaling, improving neurobehavioral scores. Thus from the present study it was concluded that ILA has protective effect on CIRI.
Descritores: Apoptose
Isquemia Encefálica/prevenção & controle
Infarto da Artéria Cerebral Média/complicações
Lactobacillus paracasei
Fármacos Neuroprotetores/administração & dosagem
Traumatismo por Reperfusão/prevenção & controle
-Isquemia Encefálica/etiologia
Modelos Animais de Doenças
Regulação para Baixo
NF-kappa B/sangue
Distribuição Aleatória
Ratos Sprague-Dawley
Traumatismo por Reperfusão/etiologia
Receptor 4 Toll-Like/sangue
Limites: Animais
Masculino
Responsável: BR1.1 - BIREME


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Id: biblio-839280
Autor: Li, Y; Gao, X; Wang, Q; Yang, Y; Liu, H; Zhang, B; Li, L.
Título: Retinoic acid protects from experimental cerebral infarction by upregulating GAP-43 expression
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;50(4):e5561, 2017. graf.
Idioma: en.
Projeto: National Natural Science Foundation; . Science and Technology Planning Project.
Resumo: The aim of this study was to investigate whether exogenous retinoic acid (RA) can upregulate the mRNA and protein expression of growth-associated protein 43 (GAP-43), thereby promoting brain functional recovery in a rat distal middle cerebral artery occlusion (MCAO) model of ischemia. A total of 216 male Sprague Dawley rats weighing 300–320 g were divided into 3 groups: sham-operated group, MCAO+vehicle group and MCAO+RA group. Focal cortical infarction was induced with a distal MCAO model. The expression of GAP-43 mRNA and protein in the ipsilateral perifocal region was assessed using qPCR and immunocytochemistry at 1, 3, 7, 14, 21, and 28 days after distal MCAO. In addition, an intraperitoneal injection of RA was given 12 h before MCAO and continued every day until the animal was sacrificed. Following ischemia, the expression of GAP-43 first increased considerably and then decreased. Administration of RA reduced infarction volume, promoted neurological functional recovery and upregulated expression of GAP-43. Administration of RA can ameliorate neuronal damage and promote nerve regeneration by upregulating the expression of GAP-43 in the perifocal region after distal MCAO.
Descritores: Proteína GAP-43/metabolismo
Expressão Gênica/efeitos dos fármacos
Infarto da Artéria Cerebral Média/prevenção & controle
Fármacos Neuroprotetores/farmacologia
Tretinoína/farmacologia
Regulação para Cima/efeitos dos fármacos
-Isquemia Encefálica/prevenção & controle
Proteína GAP-43/genética
Imuno-Histoquímica
Infarto da Artéria Cerebral Média/metabolismo
Infarto da Artéria Cerebral Média/patologia
Distribuição Aleatória
Ratos Sprague-Dawley
Reação em Cadeia da Polimerase em Tempo Real
Reprodutibilidade dos Testes
Fatores de Tempo
Limites: Animais
Masculino
Tipo de Publ: Estudo de Avaliação
Responsável: BR1.1 - BIREME


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Texto completo SciELO Cuba
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Texto completo
Id: lil-791521
Autor: González Díaz, María Elena; Morales Aguiar, Diana Rosa.
Título: La enfermedad periodontal, ¿un factor de riesgo más para el infarto cerebral isquémico aterotrombótico? / Periodontal disease, is it one more risk factor for atherothrombotic ischemic stroke?
Fonte: Rev. cuba. med. gen. integr;32(1):0-0, mar. 2016.
Idioma: es.
Resumo: De forma compactada se explica la relación biológicamente plausible que existe entre la aparición de accidentes cerebrovasculares, particularmente de infarto cerebral isquémico aterotrombótico y la precedencia de enfermedad periodontal inmuno-inflamatoria crónica. Se sugiere la necesidad de estudios que vinculen ambas entidades para conciliar los resultados de las investigaciones internacionales con las realizadas en nuestro medio. Se propone el análisis del estado periodontal en los pacientes pertenecientes a grupos de riesgo o víctimas de enfermedades cerebrovasculares. La consideración de la enfermedad periodontal inmuno-inflamatoria crónica como un factor de riesgo más para el infarto cerebral isquémico aterotrombótico, debe pasar de una interrogante a una estrategia(AU)

The biologically plausible relation existing between the occurrence of cerebrovascular accidents, particularly of atherothrombotic ischemic stroke, and the presence of chronic immunoinflammatory periodontal disease is explained in a compacted way. The need for studies linking both entities is suggested for conciliating the results of the international researches with those carried out in our environment. The analysis of the periodontal state in patients from risk groups of victims on cerebrovascular disease is proposed. Considering the chronic immunoinflammatory periodontal disease as a risk factor for atherothrombotic ischemic stroke should pass from a question to a strategy(AU)
Descritores: Infarto da Artéria Cerebral Média/etiologia
Infarto da Artéria Cerebral Média/prevenção & controle
Doenças Periodontais/complicações
-Fatores de Risco
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: lil-790601
Autor: Carvallo, P; Carvallo, E; Rivas, R; Carvallo, L; Sol, M. del.
Título: Oclusión de la arteria cerebral media en ataque cerebrovascular isquémico agudo / Middle cerebral artery occlusion in acute ischaemic cerebrovascular attack
Fonte: Int. j. med. surg. sci. (Print);3(1):747-751, 2016. ilus, tab.
Idioma: es.
Resumo: El ataque cerebrovascular isquémico (ACV) es una de las principales causas de morbimortalidad a nivel mundial y nacional. Se estudiaron 35 pacientes identificándose que las arterias que presentaron mayor frecuencia de oclusión en el ACV isquémico agudo fueron la arteria cerebral media y la arteria cerebral posterior. Consideramos necesario que los especialistas puedan localizar anatómicamente los ACV para la aplicación de terapias neuroprotectoras mejorando las opciones de tratamiento y previniendo obstrucciones secundarias...

Ischaemic stroke (CVA) is one of the leading causes of morbidity and mortality at a global and national level. We studied 35 patients, determined the arteries that presented a higher frequency of occlusion in acute ischemic stroke and identified the middle cerebral artery and the posterior cerebral artery. We consider it necessary that specialists can locate anatomically strokes in order to apply neuroprotective therapies to improve treatment options and preventing secondary obstructions...
Descritores: Infarto da Artéria Cerebral Média/epidemiologia
Infarto da Artéria Cerebral Posterior/epidemiologia
Isquemia Encefálica/complicações
-Doença Aguda
Acidente Vascular Cerebral/complicações
Infarto da Artéria Cerebral Média/patologia
Infarto da Artéria Cerebral Posterior/patologia
Imagem por Ressonância Magnética
Índice de Gravidade de Doença
Limites: Humanos
Masculino
Adulto
Feminino
Pessoa de Meia-Idade
Idoso de 80 Anos ou mais
Responsável: CL1.1 - Biblioteca Central


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Id: lil-788941
Autor: Fang, T; Zhou, D; Lu, L; Tong, X; Wu, J; Yi, L.
Título: LXW7 ameliorates focal cerebral ischemia injury and attenuates inflammatory responses in activated microglia in rats
Fonte: Braz. j. med. biol. res = Rev. bras. pesqui. méd. biol;49(9):e5287, 2016. graf.
Idioma: en.
Projeto: Scientific and Technological Innovation Committee.
Resumo: Inflammation plays a pivotal role in ischemic stroke, when activated microglia release excessive pro-inflammatory mediators. The inhibition of integrin αvβ3 improves outcomes in rat focal cerebral ischemia models. However, the mechanisms by which microglia are neuroprotective remain unclear. This study evaluated whether post-ischemic treatment with another integrin αvβ3 inhibitor, the cyclic arginine-glycine-aspartic acid (RGD) peptide-cGRGDdvc (LXW7), alleviates cerebral ischemic injury. The anti-inflammatory effect of LXW7 in activated microglia within rat focal cerebral ischemia models was examined. A total of 108 Sprague-Dawley rats (250–280 g) were subjected to middle cerebral artery occlusion (MCAO). After 2 h, the rats were given an intravenous injection of LXW7 (100 μg/kg) or phosphate-buffered saline (PBS). Neurological scores, infarct volumes, brain water content (BWC) and histology alterations were determined. The expressions of pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β)], and Iba1-positive activated microglia, within peri-ischemic brain tissue, were assessed with ELISA, western blot and immunofluorescence staining. Infarct volumes and BWC were significantly lower in LXW7-treated rats compared to those in the MCAO + PBS (control) group. The LXW7 treatment lowered the expression of pro-inflammatory cytokines. There was a reduction of Iba1-positive activated microglia, and the TNF-α and IL-1β expressions were attenuated. However, there was no difference in the Zea Longa scores between the ischemia and LXW7 groups. The results suggest that LXW7 protected against focal cerebral ischemia and attenuated inflammation in activated microglia. LXW7 may be neuroprotective during acute MCAO-induced brain damage and microglia-related neurodegenerative diseases.
Descritores: Anti-Inflamatórios/uso terapêutico
Isquemia Encefálica/tratamento farmacológico
Infarto da Artéria Cerebral Média/complicações
Inflamação/tratamento farmacológico
Fármacos Neuroprotetores/uso terapêutico
Peptídeos Cíclicos/uso terapêutico
-Isquemia Encefálica/etiologia
Modelos Animais de Doenças
Interleucina-1beta/metabolismo
Microglia/efeitos dos fármacos
Ratos Sprague-Dawley
Fator de Necrose Tumoral alfa/metabolismo
Limites: Animais
Masculino
Ratos
Responsável: BR1.1 - BIREME



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