6 research outputs found
Oedema-related tissue damage after temporary and permanent occlusion of the middle cerebral artery
Eleven adults spontaneously-hypertensive male rats (SHR) were studied 22 h or 7 days after a 2 h unilateral occlusion of the right middle cerebral artery (MCA). Another 11 SHR were studied after 24 h or 7 days of permanent MCA ligation. The brain infarcts were significantly larger (P < 0.05) after permanent occlusion than after a 2 h occlusion. More extensive and widespread vasogenic oedema, emanating from the infarcts, was visualized immunohistochemically in the temporarily-ligated animals and the relative number of astrocytes in their contralateral hemispheres was greater, thereby indicating that the vasogenic oedema influences the degree of gliosis. An immunopositivity for albumin but not for fibrinogen extended via the white matter into the ipsilateral thalamic nuclei, where cytolytic nerve cell damage, severely shrunken and karyorrhectic nerve cells as well as gliosis were found one week after permanent and temporary MCA ligation. The histological changes in the thalamus indicated a difference in timing between lateral and medial parts of the lesion as well as between temporarily- and permanently-ligated SHR. These findings together with the close spatial correlation with albumin immunoreactivity indicate that the spread of extravasated plasma constituents or degradation products with the oedema bulk flow from the infarct influences the timing, character and extent of thalamic lesions after cerebral infarction
Oedema-related tissue damage after temporary and permanent occlusion of the middle cerebral artery
Severidade clínica e funcionalidade de pacientes hemiplégicos pós-AVC agudo atendidos nos serviços públicos de fisioterapia de Natal (RN) Clinical severity and functionality of acute stroke patients attended at the physiotherapy public services of Natal, Rio Grande do Norte State, Brazil
O acidente vascular cerebral (AVC) representa a terceira causa de morte em vários países do mundo e principal causa de incapacidade física. O objetivo deste estudo foi investigar por meio de uma equipe multidisciplinar a severidade clínica e a independência funcional de pacientes hemiplégicos pós-AVC. Trata-se de estudo descritivo composto por quarenta hemiplégicos atendidos nos quatro maiores serviços públicos de fisioterapia da cidade de Natal (RN). Foram utilizados uma ficha de avaliação, a medida de independência funcional e o NIHSS. A amostra é predominantemente feminina(55%), AVC isquêmico(90%), hemisfério cerebral direito(52,5%) e fator de risco hipertensão(90%). A média da severidade clínica é 13,32±4,7 e da independência funcional, 54,6±17,15. Não houve diferença significativa entre as médias funcionais dos pacientes quanto ao lado do AVC (pvalor=0,66). Existiu relação significativa entre severidade clínica e independência funcional (r=-0,45 pvalor=0,003). A severidade clínica e a dependência funcional de pacientes com AVC, ao darem entrada na fisioterapia, são significativas e evidenciam a necessidade de, além do tratamento clássico, serem incentivadas condutas educacionais que visem à conscientização da população.<br>This article investigates the severity and functional independence of hemiplegics patients' post-acute stroke by means of a multidisciplinary clinical staff. It is a descriptive study composed by 40 hemiplegics attended at the four largest physiotherapy public services in Natal, Rio Grande do Norte State. The methods used were an evaluation form, Functional Independence Measure and NIHSS. The results showed a sample predominantly female (55%), stroke ischemic (90%), right brain hemisphere (52.5%) and Hypertension Risk Factor (90%). The mean of clinical severity and functional independence was 13.32±4.7 and 54.6±17.15 respectively. There was no significant difference between the mean of functionality about stroke side (pvalue = 0.66). There is a significant relation between clinical severity and functional independence (r = -0.45 pvalue=0.003). It can be concluded that the level of clinical severity and functional dependence of stroke patients that make use of public physiotherapy services is significant and show the necessity, beyond the classic treatment, to be encouraged preventive educational actions to improve knowledge of this population