Clinical Neuroscience

[First Hungarian Stroke Conference]

MAY 20, 1993

Clinical Neuroscience - 1993;46(05-06)

[Neurodiagnosis in stroke disease. Comparative isotope diagnostic studies with SPECT in cerebrovascular diseases. Monitoring of cerebral artery media flow by transcranial Doppler sonography during carotid artery reconstruction surgery. Correlation of vascular parameters and laboratory findings in cerebral circulatory disorders. Measurement of autoregulatory reserve capacity by TCD and SPECT. Results of SPECT-rCBF studies in cerebral infarcts of different localization and duration. SPECT-rCBF (Tc 99mHMPAO) in the collateral study of chronic cerebrovascular disease. SPECT findings suggestive of cerebral vascular disease in Parkinson's disease. Pathophysiological basis for a correct therapeutic approach in acute cerebral ischaemia. Neuropsychological studies in stroke patients. Autopsy of deceased stroke patients. Lacunar stroke: clinicopathological evaluation. Cerebrovascular disease, ultrasound and angiographic diagnostic possibilities. Correlation of supraaortic ultrasound studies, angiography and clinical symptoms. Cervical duplex ultrasound studies in the light of dsa angiography and surgical findings. Investigation of the flow in the middle cerebral artery and anterior cerebral artery as a function of haematocrit. Sleep as a risk factor for stroke? Vascular changes in familial systemic amyloidosis. Role of coagulation inhibitors in the etiopathogenesis of stroke. Tracking regional cerebral flow changes in acute stroke cases, a new possibility to separate therapeutic subgroups. Aetiology of stroke in children. Cerebral embolisation of cardiac origin. The role of mitral prolapse in cerebrovascular disease in young women. Ischaemic vascular lesions of cardiac cause in a one-year paper of our department (1991). Some suggestions for the practical solution of the stroke program. Mechanisms of endothelium-dependent cerebral vascular damage after haemorrhagic hypotension and reperfusion. A study of the dynamics of the cerebral autoregulatory response in normotensive and spontaneously hypertensive rats. "Whole-cell patch-clamp" analysis: hypoxic changes in ca1 pyramidal cells. The relationship between blood flow and metabolism in cerebral ischemia in the cat. Cerebroprotective compounds in a 3-lead brain ischemia model. Effect of levemopamil on EEG changes and cerebral infarct size due to focal ischemia in the cat. Investigation of an approximate mathematical model of cerebral microcirculation for the treatment of patients with cerebral ischemia. Current approaches in the specific treatment of acute ischemic stroke. The role of atenolol in the prevention of stroke. Early results and experience with everusion endarterectomy of the internal carotid artery. Surgery for carotid artery restenosis in the vascular and cardiac surgery clinic. Beneficial effect of nimodipine in focal cerebral ischemia. Changes in autoregulatory reserve capacity after endarterectomy. Care of patients with polyglobular chronic cerebrovascular disease. A retrospective study of intra- and postoperative problems of carotid reconstructive surgery performed in our clinic from January 1, 1989 to December 31, 1991. Indications and late results of ptfe interposition of the internal carotid artery (ica). Applicability of the national stroke programme in hospital practice. Opportunities for collaboration between angiology and neurology departments in the care of cerebrovascular patients Cooperation between the family physician and the cerebrovascular outpatient clinic in screening for risk factors. Role of duplex scan in stroke care. Follow-up of cerebrovascular patients with spectral EEG analysis. Experience with duplex ultrasound scanning of carotid arteries. The significance of duplex scan and quantitative EEG studies in cases of cerebral occlusion and stenosis. EEG mapping in cerebrovascular pathologies. CT image changes of extensive cerebral infarcts over time. The Hungarian language specificity of aphasia. Neuropsychological rehabilitation of mental disorders caused by organic brain lesions. Small brainstem haemorrhages. Cerebral arteriosclerosis in the csengersima '92 study: rheoencephalography data. Mazes in stroke diagnosis (with the case histories of three of our patients). Post-stroke depression. Lacunar stroke. Cerebrovascular pathologies in young age. Carotid morphological lesions and rheological risk factors in cerebrovascular disease. Prognostic factors in spontaneous intracerebral hemorrhage. Transcranial Doppler study of the middle cerebral artery and anterior cerebral artery in unilateral internal carotid artery occlusion. Life events and stroke (preliminary studies). Dementia data from the csengersima '92 study. Stroke risk factors, neurosis, depression and anxiety in the csengersima '92 study. Everziós endarterectomy (EEA) as a new surgical technique for the resolution of internal carotid artery stenosis Left subclavian occlusion caused by right carotid territory intracerebral steal. Goretex graft interposition in internal carotid artery surgery: indication and late results. Lipid peroxidation background of slow hypoxia. In-hospital morbidity of cerebrovascular diseases. Prevalence of risk factors in cerebrovascular disease. Risk factors in the development of cerebral vascular damage analysis based on "Budapest stroke database". Stroke and its risk factors - with special reference to cardiac diseases - in the 2-yearly material of our department. Incidence of cerebrovascular diseases in 10 years of practice of our department. Cerebrovascular patient flow in the Kecskemét County Hospital. Stroke and its care in the neurology department in Salgótarján and its surroundings (10-year review). Continuous computerized blood pressure tracking system - a new method in stroke patient care. Cerebral arteriosclerosis in the csengersima '92 study: Doppler data.]



Further articles in this publication

Clinical Neuroscience

[New data in the classification, diagnostic and in the therapy of cerebrovascular diseases]

NAGY Zoltán

[High stroke morbidity and mortality in Hungary have focused to attention on stroke prevention and the organization of adequate therapy. Up till 1990 both cardiovascular and the cerebrovascular mortality had increased. The Precise analysis risk factors' determines the primary and secondary stroke prevention. The most important issues in of prevention are: proper care of hypertension, gradual change of dietary habits of the Hungarian population, and reduction of smoking. The revised stroke classification, published in 1990 suggested the further breakdown of ischemic strokes into embolic, atherothrombotic and lacunar forms. The new categories reflect the pathomechanism, and thus help in planning more successful treatment. The early treatment of embolic stroke with thrombolysis looks promising, thrombolysis in lacunar stroke implies a certain amount of risk. Hemodilution and dehydration therapy in the treatment of different forms of ischemic strokes need to be evaluated differently. Both invasive and non-invasive diagnostic examinations follow a well thought out algorithmic pattern. Since thrombolysis is a possible therapeutic choice, laboratory tests, especially the analysis of hemostatic factors have gained more significance.]

Clinical Neuroscience

[NMDA antagonists: possible kinetic and neuroprotective effect with special regard to parkinson's disease]

TAKÁTS Annamária

[The role of excitatory amino acids in the pathomechanism of several neuropsychiatric disorders became known in the last few years. Special attention is paid to glutamate, since this has proved to be an excitotoxin under certain pathological conditions. It acts through the ion-channel of the NMDA receptors via enormous Ca++ ion flow into the cell. NMDA antagonists may be of importance in the treatment of Parkinson's disease, which is characterized by increased glutamate hyperactivity. The clinical use of adamantane derivatives might be suggested because of their possible symptomatic and neuroprotective effect.]

Clinical Neuroscience

[Arteriovenous malformation and occlusive cerebrovascular disease]

BODOSI Mihály, KUNCZ Ádám, DÓCZI Tamás, BARZÓ Pál, VÖRÖS Erika

[Five rare case histories of intracranial occlusive cerebrovascular disease with arteriovenous malformation are presented. In 2 cases the middle cerebral artery and in a further 2 cases the internal carotid artery were occluded (3 ipsilateral frontal and 1 parietal angiomas). In the fifth case a temporal angioma and ipsilateral posterior cerebral artery occlusion was detected. In the first 4 cases extra-intracranial arterial bypass was performed before the excision of the malformation. ]

Clinical Neuroscience

[The role of PCR in the diagnosis of duchenne/becker muscular dystrophy]


[The majority of Duchenne/Becker muscular dystrophy (DMD/BMD) cases are caused by deletions affecting exons of the dystrophin gene, which results in defective protein synthesis. In order to detect deletions the multiplex PCR method was utilized on the DNA of 15 DMD/BMD patients by amplifying 9 deletion-prone exons as a first step followed by a further 5 exons when necessary. Delection were found in more than 50% of patients by this method which correlates well with that expected from the literature data. This rapid and reliable method is an important diagnostic tool in the precise characterization of muscular dystrophies.]

Clinical Neuroscience

[Fibrinogen as a general risk factor in stroke ]


[Fibrinogen and other laboratory variables of 348 patients with various types of stroke were statistically analysed in the acute, subacute and chronic stage of the disease. Seventy two patients with non-vascular disease served as control. The actual level of plasma fibrinogen in cerebrovascular patients was attributed to the following factors: 1. presence of atherosclerotic plaques in extra and intracranial arteries, 2. the time lag between the onset of stroke and laboratory testing, 3. degre of post stroke mobility of the patients. Initial level of fibrinogen is a predictive value of death both in hemorrhagic and ischemic patients. The highest plasma concentration of fibrinogen was found in the atherothrombotic stroke group, in which was a significant negative correlation between the plasma fibrinogen and high density lipoprotein level. It was concluded that fibrinogen is a risk factor in cerebrovascular diseases.]

All articles in the issue

Related contents

Lege Artis Medicinae

[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]


Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]


[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]


[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Lege Artis Medicinae

[A short chronicle of three decades ]


[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Lege Artis Medicinae

[History of vaccine production in Hungary ]


[This study presents the complete history of the Hungarian vaccine production, partly in association with the process of fighting vaccine-preventable infectious diseases, and underlines the fact that every government actively contributed to the age-adjusted mandatory vaccination schedule of the past 140 years. It demonstrates the various achievements from the smallpox lymph production through the launch of diphtheria serum production at Phylaxia and the establishment of the National Public Health Institute (OKI) with its vaccine production and the later institutional transformation of OKI into Humán as economic corporation to its closure. Among all OKI’s vaccine production activities, this study focuses on the production of influenza vaccines, due to its international importance in the 1960s and 1970s. The vaccine production against diphtheria tetanus and pertussis stands out from Humán’s activities, and the tetanus component of this vaccine is still used in the products of a multinational vaccine manufacturer. ]