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  • 1
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; plasma renin activity ; sympathetic nervous system ; brainstem dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The possible relationship between plasma renin activity and neurological deficits was examined in ten patients with spontaneous subarachnoid haemorrhage in a prospective clinical study. The patients were examined daily, particular attention being given to signs of brain stem dysfunction. The degree of impaired consciousness was assessed using the Glasgow Coma Score. Plasma renin activity was determined on days 1–5, 7, 9, 11, 13, 15 and 21 after the initial bleeding episode using an Angiotensin-I-radioimmunoassay. Six of seven patients with signs of brain stem dysfunction displayed a marked increase in plasma renin activity. Thus a significant negative correlation between the degree of consciousness and the plasma renin activity resulted. An explanation for this correlation may be found in the localization of the autonomous centres and the high concentrations of renin in the hypothalamus and brain stem. The individual changes in plasma renin activity have prognostic significance, whereas single estimated plasma renin activities show great interindividual differences and have only limited prognostic value.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 121 (1993), S. 119-122 
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; autonomic deregulation ; beta-blockade ; metoprolol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of beta-blockade to prevent autonomic disorders after acute aneurysmal subarachnoid haemorrhage were prospectively investigated. 11 patients were treated with the beta-1-selective beta-blocker metoprolol (up to 200 mg/die intravenously). 14 patients received standard therapy as controls. Pulse rate, blood pressure and dosage of the additional antihypertensive medication as signs of sympathetic disturbance were registered. The main result was the normalizing of the pulse rate especially during the first two weeks in contrast to the control group. The patients in the beta-blocker group did not need further antihypertensive medication. This was mainly a result of the reduction in sympathetic activation. No severe side-effects were documented and the survival was better in the treated group. Thus, beta-blockade is able to prevent and reduce autonomic disorders, especially activation of the sympathetic tone, in subarachnoid haemorrhage. Metoprolol as a so called cardioselective beta-blocker seems to be one of the suitable agents and is considered superior to the non-selective agents.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1459
    Keywords: Key words Emotions ; Evoked ; cerebral blood flow ; Transcranial ; Doppler sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The cerebral representation of emotions has previously been investigated by the study of patients with local brain damage, experiments with selective stimulation of only one hemisphere, and more recently by imaging techniques such as positron-emission tomography or magnetic resonance imaging measuring local cerebral blood flow. We investigated the mean flow velocity (FVmean) in the middle cerebral artery (MCA) by transcranial Doppler sonography during emotional stimulation with video scenes in 24 healthy test persons. The videos consisted of an erotic scene and a violent scene shown in contrast to a calming scene. Blood pressure, heart rate, and breathing frequency were monitored continuously by noninvasive measurement. FVmean increased during the erotic scene to 108.5 ± 11.9% (P 〈 0.05) of the baseline value in the right MCA and to 109.0 ± 10.6% (n.s.) in the left MCA. During the violent scene FVmean reached 109.0 ± 8.7% (P 〈 0.05) on the right side and 108.1 ± 13.0% (n.s.) on the left side. The FVmean time course showed a close relationship to the video sequence. During scenes involving great tension FVmean showed a plateaulike state and peaked during sudden actions. Blood pressure, heart rate, and respiratory rate showed no significant changes. However, we observed a tendency towards lower heart rates (lowest value 94.5 ± 13.6%) during the erotic scene and two peaks (103.2 ± 13.3%, 104.8 ± 16.8%) coinciding with sudden violent actions. The significant increase in FVmean in the right MCA supports the theory of a right hemisphere dominance for the processing of emotions.
    Type of Medium: Electronic Resource
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