Zusammenfassung
Die zeitlichen Aspekte einer zerebralen Ischämie und die dynamische Entwicklung neurologischer Ausfallserscheinungen sind wichtige Anhaltspunkte für die Analyse der zugrunde liegenden pathophysiologischen Mechanismen und bei der Suche nach einer hämodynamischen oder embolischen Ursache von großer Bedeutung. Die Krankheitssymptome selbst werden für die Lokalisation der ischämischen Hirnregion und zur Identifikation der betroffenen Gefäßterritorien herangezogen. Selbst bei typischen Krankheitsbildern ermöglichen die klinischen Daten allein oft keine eindeutige anatomische und pathogenetische Zuordnung, so wichtig sie für die Wahl der diagnostischen und therapeutischen Maßnahmen sein mögen: in den ersten Stunden nach einer zerebralen Ischämie ist auch die prognostische Beurteilung außerordentlich schwierig, und meist ist es unmöglich zu entscheiden, ob mit einer vollständigen Remission zu rechnen ist, oder ob sich unter einer progredienten Entwicklung ein schweres Defizit einstellt. Angesichts der aktuellen Überlegungen, ob thromboembolisch bedingte zerebrale Ischämien in der Akutphase ähnlich wie beim frischen Myokardinfarkt lysiert werden sollen (Zeumer 1985; del Zoppo et al. 1986; del Zoppo und Hacke 1987; Hacke et al. 1988), sind diese prognostischen Aspekte besonders wichtig, da nur solche Patienten dem mit der Behandlung verbundenen Blutungsrisiko ausgesetzt werden sollten, bei denen keine rasche Spontanremission erwartet wird.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Adams R (1943) Occlusion of the anterior inferior cerebella artery. Arch Neurol Psychiatry 49: 765
Adams RD, Eecken HM vander (1953) Vascular disease of the brain. Ann Rev Med 4: 213
Babikian V, Ropper AH (1987) Binswanger’s disease: A review. Stroke 18: 2
Barnett HJM, Boughner DR, Taylor DW, Couper PE, Kostuk WJ, Nichol PM (1980) Further evidence relating mitral-valve prolapse to cerebral ischemic event. N Engl J Med 302: 139
Berlit P, Kessler C, Storch B, Krause K-H (1983) Immunvaskulitis and Nervensystem. Nervenarzt 54: 497
Biller J, Hingtgen WL, Adams HP, Smoker WRK, Godersky JC, Toffol GJ (1986) Cervico-cephalic arterial dissections. Arch Neurol 43: 1234
Blackwood W, Hallpike JF, Kocen RS, Mair WGP (1969) Atheromatous disease of the carotid arterial system and embolism from the heart in cerebral infarction: A morbid anatomical study. Brain 92: 897
Bogdahn U, Dommasch D, Wodarz R (1980) Thrombolytische Therapie der Sinusthrombose. In: Mertens HG, Przuntek H (Hrsg) Pathologische Erregbarkeit des Nervensystemes and ihre Behandlung. Springer, Berlin Heidelberg New York, S 675
Bogousslaysky J, Hachinski VC, Barnett HJM (1985) Causes cardiaques et arterielles de cecite monoculaire transitoire. Rev Neurol 141: 774
Bogousslaysky J, Regli F, Uske A (1988) Thalamic infarcts Clinical syndromes, etiology, and prognosis. Neurology 38: 837
Bousser MG, Chiras J, Bories JB, Castaigne P (1985) Cerebral venous thrombosis — a review of 38 cases. Stroke 16: 199
Brown MS, Kovanen PT, Goldstein JL (1981) Regulation of plasma cholesterole by lipoprotein receptors. Science 212: 628
Burton JL (1988) Livedo reticularis, porcelaine-white scars, and cerebral thrombosis. Lancet I: 1263
Caplan LR (1988) Clinical course and lesion distribution in carotid and middle cerebral artery occlusive disease. In: Hennerici M, Sitzer G, Weger H-D (eds) Carotid artery plaques. Karger, Basel, p 186
Caplan LR, Gorelick PB, Hier DB (1986) Race, sex and occlusive cerebrovascular disease: A review. Stroke 17: 648
Chambers BR, Norris JW (1986) Outcome in patients with asymptomatic neck bruits. N Engl J Med 315: 860
Connett MC, Lanche JM (1965) Fibromuscular hyperplasia of the internal carotid artery: Report of a case. Ann Surg 162: 59
Corston RN, Kendall BE, Marshall J (1984) Prognosis in middle cerebral artery stenosis. Stroke 15: 237
Craig DR, Meguro K, Watridge C, Robertson JT, Barnett HJM, Fox AJ (1982) Intracranial internal carotid artery stenosis. Stroke 13: 825
Critchley M (1930) The anterior cerebral artery and its syndromes. Brain 53: 120
Currier R, Giles C, DeJong R (1961) Some comments on Wallenberg’s lateral medullary syndrome. Neurology 11: 778
Del Zoppo GJ, Hacke W (1987) Fibrinolytische Therapie bei ischämischen Hirninfarkten. Dtsch Med Wochenschr 112: 603
Del Zoppo GJ, Harker LA (1984) Blood-vessel interaction in coronary disease. Hosp Pract 19: 163
Del Zoppo GJ, Zeumer H, Harker LA (1986) Thrombolytic therapy in acute stroke: Possibilities and hazards. Stroke 17: 595
DePalma RG, Hubay CA, Insull W, Robinson AV, Hartman PH (1970) Progression and regression of experimental atherosclerosis. Surg Gynecol Obstet 131: 633
Di Rocco C, Iannelli A, Leone G, Moschini M, Valori VM (1981) Heparin-urokinase treatment in aseptic durai sinus thrombosis. Arch Neurol 38: 431
Dörstelmann D, Dobiasch H, Mattes W, Reuther R (1981) Hirnvenen and Sinusthrombose. Ein Beitrag zur Antikoagulantienbehandlung. Nervenarzt 52: 243
Ehringer H, Bockelmann L, Konecny U, Koppensteiner R, Marosi L, Minar E, Schöfl R (1987) Verschlußkrankheit der extrakraniellen A. carotis: Spontanverlauf and frühe Phase nach Thrombendarteriektomie im bildgebenden Ultraschall. VASA (Suppl) 20: 71
Einhäupl K (1988) Sinus-and Hirnvenenthrombosen. In: Brandt T, Dichgans J, Diener HC (Hrsg) Therapie and Verlauf neurologischer Krankheiten. Kohlhammer, Stuttgart, S 275
Feuer D, Weinberger J (1987) Extracranial carotid artery in patients with transient global amnesia. Stroke 18: 951
Fisher CM, Goore I, Okabe N, White PD (1965 a) Atherosclerosis of the carotid and vertebral arteries — extracranial and intracranial. J Neuropathol Exp Neurol 24: 455
Fisher CM, Goore I, Okabe N, White PD (1965b) Calcification of the carotid siphon. Circulation 32: 538
Freund H-J (1987) Abnormalities of motor behavior after cortical lesions in humans In• Handbook of physiology, Vol 5: The nervous system, p 763
Freund H-J, Hummelsheim H (1985) Lesions of premotor cortex in man. Brain 108: 697
Gaul JJ, Marks SJ, Weinberger J (1986) Visual disturbance and carotid artery disease. 500 symptomatic patients studied by non-invasive carotid artery testing including B-mode ultrasonography. Stroke 17: 393
Goodwin JA, Gorelick PB, Helgason CM (1987) Symptoms of amaurosis fugax in atherosclerotic carotid artery disease. Neurology 37: 829
Gotoh F (ed) (1983) Annual Report (1982) of the Research Committee on Spontaneous Occlusion of the Circle of Willis (Moyamoya Disease). Ministry of Health and Welfare, Japan
Gorelick PB, Caplan LR, Hier DB, Parker SL, Patel D (1984) Racial differences in the distribution of anterior circulation occlusive disease. Neurology 34: 54
Hacke W (1986) Clinical relevance of multimodal assessment of brainstem functions in severe vascular brainstem lesions. In: Kunze K, Zangemeister WH, Arlt A (eds) Clinical problems of brainstem disorders. Thieme, Stuttgart, p 101
Hacke W, del Zoppo GJ, Harker LA (1987) Thrombosis and cerebrovascular disease. In: Poeck K, Ringelstein EB, Hacke W (eds) New trends in the diagnosis and management of stroke. Springer, Berlin Heidelberg New York Tokyo, p 59
Hacke W, Zeumer H, Ferbert A, Brückmann H, del Zoppo GJ (1988) Intraarterial fibrinolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19: 1216
Hart RG (1988) Vertebral artery dissection. Neurology 38: 987
Hart R, Easton DF (1986) Dissections and trauma of cervico-cerebral arteries. In: Barnett HJM, Mohr JP, Yatsu FM, Stein BM (eds) Stroke, Churchill Livingstone, Edinburgh, p 293
Hass WK, Fields WS, North RR, Kricheff JI, Chase NE, Bauer RB (1968) Joint study of extracranial arterial occlusions: II. Arteriography, techniques, sites, and complications. JAMA 203: 961
Healton EB (1986) Fibromuscular dysplasia. In: Barnett HJM, Mohr JP, Stein DM, Yatsu FM (eds) Stroke. Churchill Livingstone, Edinburgh, p 831
Helgason C, Caplan LR, Goodwin J, Hedges T (1986) Anterior choroidal artery-territory infarction. Arch Neurol 43: 681
Hennerici M (1987) Hochauflösende Ultraschall-Duplexsystemanalyse der extrakraniellen Karotisstrombahn. In: Hartmann A, Wassmann H (Hrsg) Hirninfarkt. Urban & Schwarzenberg, München, S 228
Hennerici M, Aulich A, Sandmann W, Freund H-J (1981) Incidence of asymptomatic extracranial arterial disease. Stroke 12: 750
Hennerici M, Hülsbömer H-B, Hefter H, Lammerts D, Rautenberg W (1987) Natural history of asymptomatic extracranial arterial disease — results of a long-term prospective study. Brain 110: 777
Hennerici M, Hülsbömer H-B, Hefter H, Rautenberg W (1986) Spontaneous history of asymptomatic internal carotid occlusion. Stroke 17: 718
Hennerici M, Rautenberg W, Mohr S (1982) Stroke risk from symptomless extracranial disease. Lancet II: 1180
Hennerici M, Rautenberg W, Trockel U, Kladetzky RG (1985) Spontaneous progression and regression of small carotid atheroma. Lancet I: 1415
Hennerici M, Klemm C, Rautenberg W ( 1988 a) The subclavian steal phenomenon: A common vascular disorder with rare neurologic deficits. Neurology 38: 669
Hennerici M, Sitzer G, Weger H-D (1988b) Carotid artery plaques. Karger, Basel
Hennerici M, Steinke W, Aulich A (1988c) High resistance Doppler flow pattern in extracranial carotid dissection. (In press)
Hutchinson EC, Yates PO (1957) Carotico-vertebral stenosis. Lancet I: 2
Imparato AM, Riles TS, Gorstein F (1979) The carotid bifurcation plaque: Pathologic findings associated with cerebral ischemia. Stroke 10: 238
Jentzer A (1954) Dissecting aneurysm of the left internal carotid artery. Angiology 5: 232
Kunitz SC, Gross CR, Heyman A, Kase CS, Mohr JP, Price TR, Wolf PA (1984) The pilot stroke data bank: Definition, design and data. Stroke 15: 740
Leadbetter WF, Burkland CE (1938) Hypertension in unilateral renal disease. J Urol 39: 611
Little JR, Sawany B, Weinstein M (1980) Pseudotandemstenosis of the internal carotid artery. Neurosurgery 7: 574
Luhan J, Pollock 5 (1953) Occlusion of the superior cerebellar artery. Neurology 3: 77
Malinow MR (1984) Atherosclerosis: Progression, regression and resolution. Am Heart J 108: 1523
Marzewski DJ, Furlan AJ, Louis PS, Little JR, Modic MT, Williams G (1982) Intracranial internal carotid artery stenosis: Long-term prognosis. Stroke 13: 821
McGill H, Arias-Stella J, Carbonell L (1968) General findings of the internal atherosclerosis project. Lab Invest 18: 498
Mitsuyama Y, Thompson LR, Hayashi T, Lee KK, Keehn RJ, Resch JA, Steer A (1979) Autopsy study of cerebrovascular disease in Japanese men who lived in Hiroshima, Japan and Honolulu, Hawai, Stroke 10: 389
Mohr JP, Caplan LR, Melski JW et al. (1978) The Harvard Cooperative Stroke Registry: A prospective registry. Neurology 28: 754
Mokri B, Sundt TM, Houser OW, Piepgras DG (1986) Spontaneous dissection of the cervical internal carotid artery. Ann Neurol 19: 126
Morris GC, Lechter A, DeBakey ME (1968) Surgical treatment of fibromuscular disease of the carotid arteries. Arch Surg 96: 636
Norris JW, Bornstein NM (1986) Progression and regression of carotid stenosis. Stroke 17: 755
Palubinskas AJ, Ripley HR (1964) Fibromuscular hyperplasia in extrarenal arteries. Radiology 82: 451
Paullus WS, Pate TG, Rhoton AL (1977) Microsurgical exposure of the petrous portion of the carotid artery. J Neurosurg 47: 713
Pessin MS, Kwan E, DeWitt LD, Hedges TR, Gale D, Caplan LR (1987) Posterior cerebellar artery stenosis. Ann Neurol 21: 85
Powers WJ, Press GA, Grubb RL, Gado M, Raichle ME (1987) The effect of hemodynamically significant carotid artery disease in the hemodynamic states of the cerebral circulation. Ann Intern Med 106: 27
Powers WJ, Press GA, Grubb RL, Gado M, Raichle ME (1987) The effect of hemodynamically significant carotid artery disease in the hemodynamic states of the cerebral circulation. Ann Intern Med 106: 27
Rautenberg W, Hennerici M (1988) Pulsed Doppler assessment of innominate artery obstructive disease. Stroke (in press)
Reivich M, Holling HE, Robberts B, Toole JF (1961) Reversal of blood flow through the vertebral artery and its effect on cerebral circulation. N Engl J Med 265: 878
Ringelstein EB, Zeumer H, Angelou D (1983) The pathogenesis of strokes from internal carotid artery occlusion. Diagnostic and therapeutical implications. Stroke 14: 867
Roederer GO, Langlois YE, Jager KA, Primozich JF, Beach KW, Phillips DJ, Strandness DWE (1984) The natural history of carotid arterial disease in asymptomatic patients with cervival bruits. Stroke 15: 605
Ross R, Glomset J (1976) The pathogenesis of atherosclerosis. N Engl J Med 295: 369, 1332
Scharff RE, Hennerici M, Bluschke V, Lück J, Kladetzky RG (1982) Cerebral ischemia in young patients: Is it associated with mitral valve prolapse and abnormal platelet activity in vivo? Stroke 13: 454
Schlesinger B (1976) The upper brainstem in the human. Springer, Berlin Heidelberg New York
Shinar D, Gross CR, Mohr JP et al. (1985) Interobserver variability in the assessment of neurologic history and examination in the Stroke Data Bank. Arch Neurol 42: 557
Soria ED, Fine EJ, Paroski NW (1987) Lacunes: The pervasive Strokes. NY State J Med 6: 650
Spitzer K, Thie A, Becker V, Kunze K (1988) Klinische Verläufe bei ausgedehnten supratentoriellen Hirninfarkten mit Hirnödem. Intensivmedizin 25: 192
Takeuchi K, Shimitzu K (1955) Hypoplasia of the bilateral internal carotid arteries. Brain Verve (Tokyo) 9: 37
Toole JF, Janeway R, Choi K, Cordell R, Davis C, Johnston F, Miller HS (1975) Transient ischemic attacks due to atherosclerosis. Arch Neurol 32: 5
Toole JL (1984) Cerebrovascular disorders, 3rd edn. Raven Press, New York
Torvik H, Jörgenson L (1964) Thrombotic and embolic occlusions of the carotid arteries in an autopsy material, Part I: Prevalence, location and associated diseases. J Neurol Sci 1: 24
Tour RL, Hoyt WF (1959) The syndrome of the aortic arch. Am J Ophthalmol 47: 35
Wechsler LR, Kistler JP, Davies KR, Kampinski MJ (1986) The prognosis of carotid siphon stenosis. Stroke 17: 714
Whisnant JP, Martin MJ, Sayre GP (1961) Atherosclerotic stenosis of cervical arteries. Arch Neurol 5: 429
Yatsu FM (1986) Atherogenesis and stroke. In: Barnett HJM, Mohr JP, Stein BM, Yatsu FM (eds) Stroke. Churchill Livingstone, Edinburgh, p 45
Yatsu FM, Loeb J (1981) Atherosclerosis: The role of lipids. Clin Neurosurg 29: 437
Zenker G, Erbel R, Krämer G, Mohr-Kahaly S, Drexler M, Harnoncourt K, Meyer J (1988) Transesophageal two-dimensional echocardiography in young patients with cerebral ischemic events. Stroke 19: 345
Zeumer H, Hacke W (1988) Ischämische Insulte. In: Hacke W (Hrsg) Neurologische Intensivmedizin. 2. Aufl Perimed, Erlangen, S. 86
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 1989 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Gelmers, HJ., Krämer, G., Hacke, W., Hennerici, M. (1989). Klinische Syndrome, Pathogenese und Differentialdiagnose. In: Zerebrale Ischämien. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10993-9_4
Download citation
DOI: https://doi.org/10.1007/978-3-662-10993-9_4
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-10994-6
Online ISBN: 978-3-662-10993-9
eBook Packages: Springer Book Archive