[Aspirin in primary prevention of cardiovascular and cerebrovascular diseases].

Acetylsalicylic acid (aspirin) is one of the most used medications worldwide. The antithrombotic agent acts mainly through inhibition of cyclooxygenase-1 and consequently thromboxane A synthesis, causing an irreversible suppression of platelet function. Despite of its proven benefit in the treatment and secondary prevention of atherosclerotic diseases, its use for the primary prevention remains controversial due to an unclear balance between the benefits and risks of aspirin.

Risk of Ischemic Stroke and Transient Ischemic Attack Is Increased up to 90 Days after Non-Carotid and Non-Cardiac Surgery.

Background: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery.

Quality monitoring of acute stroke care in Rhineland-Palatinate, Germany, 2001-2006.

Background And Purpose: Quality monitoring projects are useful tools to improve the quality and to assess temporal trends of stroke care in larger populations.

Methods: In Rhineland-Palatinate, Germany, a statewide, hospital-based, acute stroke care quality monitoring project was started in 2001. Initially, participation was mandatory for all hospitals with dedicated stroke units and from 2006 onward was mandatory for all hospitals.

Cerebral embolic ischemia in rats: correlation of stroke severity and functional deficit as important outcome parameter.

The embolic MCA occlusion model in rats is used for recanalisation studies in acute stroke. In addition to the determination of lesion size, the assessment of functional outcome may improve the value of this model. Male Wistar rats were submitted to MCA clot embolism or sham surgery.

Increased incidence of jugular valve insufficiency in patients with transient global amnesia.

Objective: While transient global amnesia (TGA) is a clinically well defined disorder, its etiology is poorly understood. Cerebral venous hypertension and subsequent damage to hippocampal and diencephalic structures are among the discussed hypothetical causes. Using a direct method for the study of retrograde flow during a Valsalva maneuver, we determined whether jugular valve insufficiency contributes to cerebral venous hypertension in patients with TGA.

Ultrasound-induced blood clot dissolution without a thrombolytic drug is more effective with lower frequencies.

Background And Purpose: Therapeutic ultrasound as stand-alone therapy or in combination with rt-PA has proven to be an effective measure for recanalisation of acute vessel occlusion in different in vitro and in vivo studies. Uncertainty still exists concerning the optimal frequency and intensity with regard to the thrombolytic efficacy of ultrasound. The purpose of this study was a direct comparison of different ultrasound frequencies, when otherwise using identical measurement settings and parameters.

Functional and morphological criteria of internal jugular valve insufficiency as assessed by ultrasound.

Background And Purpose: Jugular venous valve insufficiency may play a role in different neurological diseases. This study describes the methodology to detect internal jugular valve insufficiency and establishes functional and morphological criteria to discriminate retrograde flow during valve closure from retro grade insufficiency flow.

Methods: Valve closure was assessed in 100 valves (50 healthy volunteers).

Volume flow rate evaluation in patients with obstructive arteriosclerotic disease.

This study was performed to quantify the volumetric impact of extracranial arteriosclerotic lesions. We investigated patients with different degrees of carotid stenosis as defined by conventional velocity-based duplex criteria and different patterns of collateralization. We studied the volume flow rate (color duplex M-mode device) in 37 patients with symmetrical internal carotid artery (ICA) plaques (<50% stenosis) and compared these data to 43 patients with a unilateral 50-74% stenosis, 75-99% stenosis (n = 73) and occlusion of the ICA (n = 37).

Low-frequency ultrasound induces nonenzymatic thrombolysis in vitro.

Objective: To evaluate whether ultrasound, applied over a distance of several centimeters and in the absence of thrombolytic agents, may have a thrombolytic effect on blood clots.

Methods: Low-frequency (20 kHz) continuous wave ultrasound at different intensity levels (0.15-1.

Extracranial internal carotid artery occlusion: the role of common carotid artery volume flow.

Background And Purpose: Quantitative measurement of blood flow volume in the common carotid artery (CCA) is now possible using the color velocity imaging quantification (CVI-Q) ultrasound technique. The aim of this study was to evaluate the cerebral hemodynamic effects of unilateral internal carotid artery (ICA) occlusion on CCA blood flow volumes (FVs) using CVI-Q.

Methods: Records of ultrasound studies in our neurosonology laboratory were retrospectively reviewed to identify patients with unilateral ICA occlusions who at a minimum received both a routine color duplex carotid ultrasound examination and quantitative measurement of FV in the CCA, bilaterally, using the CVI-Q method.

[The ultrasound contrast medium levovist increases the thrombolytic effect of low frequency ultrasound].

Background: Therapeutic application of ultrasound is a promising tool to develop an alternative or additional treatment modality of acute vessel occlusion. It has previously been shown that ultrasound enhances the effect of pharmacologic thrombolytic agents and has a thrombolytic potential in "stand-alone" therapy. The purpose of this study was to determine, whether the presence of the echo contrast agent Levovist further increases the thrombolytic efficacy of ultrasound.