The effect of warfarin administration on platelet aggregation.

Background: The aim of this study was to assess the effect of anticoagulation treatment on platelet aggregation.

Methods: The study group consisted of 24 patients on long-term warfarin therapy without any antiaggregation therapy. Platelet aggregation was measured using VerifyNow with arachidonic acid (AA) as an inducer in 23 patients and with light transmission aggregometry (LTA) in 19 patients using four different agonists.

Recommendations for cerebrospinal fluid analysis.

Diseases of the central nervous system (CNS) mean for the human organism a potentially dangerous situation. An investigation of cerebrospinal fluid (CSF) provides important information about a character of CNS impairment in the decision-making diagnostic and therapeutic algorithm. The authors present a brief overview of available cerebrospinal fluid assays, shortened indication criteria, a recommended algorithm of CSF assessment in different suspected diseases, and a view of the external quality system.

The effect of different doses and different routes of acetylsalicylic acid administration on platelet aggregation in healthy volunteers and ischemic stroke patients.

The purpose was to assess the effect of different doses and different routes of acetylsalicylic acid (ASA) administration on platelet aggregation and the comparison between platelet aggregation after the single and the repetitive administration of ASA in healthy individuals and in patients after ischemic stroke. The study group consists of 22 healthy individuals and 30 patients with documented ischemic stroke. Platelet aggregation was measured in healthy individuals: (a) twice before ASA and (b) 2 h after different single doses and different routes of ASA administration-(b1) 500 mg orally, (b2) 500 mg intravenously, and (b3) 100 mg orally.

Non-invasive evaluation of proximal vertebral artery stenosis using color Doppler sonography and CT angiography.

Background And Purpose: A reliable and safe diagnostic procedure for vertebral artery (VA) stenosis is needed, but none is generally accepted yet. In our study, we evaluated symptomatic VA stenoses using color Doppler sonography (CDS). CT angiography (CTA) has been employed as a non-invasive reference method.

Stroke care in Central Eastern Europe: current problems and call for action.

Stroke is a major medical problem and one of the leading causes of mortality and disability all over in Europe. However, there are significant East-West differences in stroke care as well as in stroke mortality and morbidity rates. Central and Eastern European countries that formerly had centralized and socialist health care systems have serious and similar problems in organizing health and stroke care 20 years after the political transition.

Impact of aging on cerebral vasoregulation and parenchymal integrity.

Unlabelled: Sufficient vasodilatory and vasoconstrictive reactivity of cerebral arterioles is an important prerequisite for adequate capillary perfusion. To appreciate its capacity during aging and to elucidate its impact on parenchymal integrity we undertook a correlation using ultrasonography and brain MRI. Sixty healthy persons with no stenoses in the carotid and vertebral arteries were examined by transcranial Doppler to assess middle cerebral artery mean flow velocities (MFV) at rest, after 30 s apnea and after 90 s hyperventilation.

History of dementia research in Bohemia and middle Europe.

Unlabelled: The clinical aspects and histopathology of dementia are best understood when based on knowledge of the historical milestones associated with its development. We studied archive materials and visited some of the psychiatric asylums that were active in Prague during the 19th century.

Results: The gradual recognition of dementia and its histological correlates on the territory of the actual Czech Republic from the 1830s are described, together with its links to Austrian, German, and other foreign psychiatry and neurology.

Cerebral infarction due to vasoconstriction after a hymenoptera stin.

A 22-year-old woman developed an anaphylactic reaction after two hornet stings. Left-sided hemiparesis and gaze paresis were revealed after extubation 24 hours later. The vasoconstriction of the right MCA together with hypotension are the suggested pathogenetic determinants of the stroke.

Mastoiditis complicated with Gradenigo syndrome and a hypertrophic pachymeningitis with consequent communicating hydrocephalus.

We present the clinical, radiological and pathological features of a case of a cranial hypertrophic pachymeningitis that developed in the course of mastoiditis and petrous apex inflammation and responded to immunosuppressive therapy only. Documented by the development of clinical findings, magnetic resonance imaging, cerebrospinal fluid changes, histopathology findings, by otosurgical intervention and finally by the insertion of a ventriculo-peritoneal shunt, the case illustrates a gradual development of pachymeningitis with consequent hydrocephalus and intracranial hypertension. We consider this disease development an example of immune-induced proliferative fibrotic changes in meninges.

Cerebral blood supply with aging: normal, stenotic and recanalized.

Unlabelled: The prosperity of brain parenchyma during aging depends on the preservation of cerebral blood flow (CBF) parameters. We have analysed ultrasonographic measurements of peak systolic (PSV) and end diastolic velocities (EDV) along with pulsatility (PI) and resistance indexes (RI) in common (CCA), internal (ICA) and external carotid artery (ECA) (N=199) and in vertebral arteries (VA) (N=200) in patients without any signs of stenosis. In two other cohorts patients with internal carotid artery stenosis (N=231) and patients prior to and after therapeutic recanalization (N=81) were evaluated in the same parameters.

Cerebral microangiopathy in the mosaic of new discoveries.

After a short historical note on the diversion of the vascular concept of dementia from that of primary degeneration, this review describes cerebral deterioration on vascular grounds in three levels. Occlusions of big vessels with a single major infarct, middle calibre vasculopathy with multiple lacunes and finally microangiopathy causing leukoaraiosis--all these three entities produce cognitive disorders. Changes in the vessel wall, in cerebral blood flow velocity, the territorial and interterritorial rules for the location of malacia or lacunes are reviewed using neuroradiologic aspects revealed by ultrasound, by CT and MRI.

Neuroprotective treatment with cerebrolysin in patients with acute stroke: a randomised controlled trial.

Background And Purpose: Cerebrolysin is a compound with neurotrophic and neuroprotective activity. It is produced by enzymatic breakdown of purified brain proteins and consists of low molecular weight peptides and amino acids. Cellular and animal models of cerebral ischaemia have shown that it is a potent neuroprotective agent.

[Loss of intelligence in aphasic disorders].

Background: Certain level of aphasia is considered to be an integral component of dementia. More controversial is the question whether every--e.g.

The current availability of neurological in-patient services in post-communist central and eastern European countries.

Background And Purpose: Limited information can be obtained as to the availability of neurological in-patient services in the former communist countries of Eastern and Central Europe. The objective was to analyse data received directly from representatives of the particular countries.

Methods: The data were collected under the auspices of the 'First European Cooperation Neurology Workshop' held in April 2000, in Trest, Czech Republic.

Postgraduate education in neurology in Central and Eastern Europe.

The policy of the European co-operation in the new atmosphere of an international solidarity became one of the priorities of the European Federation of Neurological Societies (EFNS). It could be hardly pursued more efficiently in any other field of neurological performance as in education. To review several aspects of neurological practice and education the 'First European Co-operation Neurology Workshop' was held in the castle of Trest', Czech Republic, 13-20 April 2000.

Arnold Pick and German neuropsychiatry in Prague.

Circumscribed focal atrophy with frontal lobe dementia and progressive aphasia, as described originally by Arnold Pick, has been recognized recently as being much more common than previously believed. Although Pick disease became linked with argyrophilic inclusions (Pick bodies) and swollen neurons (Pick cells), the majority of focal atrophies have findings that are a variation of the classic histologic features. We discuss Pick's background and the circumstances that led to his major contributions to the study of behavioral neurology.

Clinical correlates of proton magnetic resonance spectroscopy findings after acute cerebral infarction.

Background And Purpose: We sought to determine whether lactate and N-acetyl signals measured by proton magnetic resonance spectroscopy (MRS) in the first days after stroke correlate with clinical measures of disability and functional outcome.

Methods: One-dimensional spectroscopic imaging was performed after stroke on 32 patients using a 2.1-T magnet.

[The most frequent localization of cerebral ischemia attacks. III. Status lacunaris cerebri].

The initial two parts of a 3-volume study on cerebral ictus concerned with analysis of macroangiopathic ischaemic defects are concluded with a final study analyzing microangiopathic defects. In a group of 93 patients with status lacunaris cerebri, the authors evaluated the presence and morphology of three main manifestations of status lacunaris: cerebral atrophy (periventricular and cortical), subcortical arteriosclerotic encephalopathy and the position of cerebral lacunae. The cerebral lacunae were mostly localized at the interphase of the individual cerebrovascular systems, which shows that their pathogenesis was due to interterritorial infarct.

CT findings in cerebral metastases.

In a series of 120 patients presenting a CT image of a cerebral tumor metastasis an analysis of 88 verified cases has been performed aiming at a determination of the morphological criteria which might enable us to speculate on the site of the primary lesion. The following properties have been studied: the location, size and shape of the lesions, their number, the extent of the surrounding edema and their postcontrast enhancement. Lung cancer participated as a source in 30.