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Persistent primitive hypoglossal artery (PPHA) is a recognised, albeit infrequent, intracranial vascular anomaly usually detected during angiography. Its presence is associated with an increased incidence of aneurysm, arteriovenous malformation and ischaemic stroke. A unique case of PHHA discovered during autopsy is described. Additionally, the significance of PPHA in neuroscience is discussed in detail.
When measured by ultrasound, the morphological markers of carotid atherosclerosis such as intima-media thickness (IMT) and cross-sectional plaque area have been associated with the risk of ischaemic stroke. We set out to determine whether the morphological parameters of the carotid arteries made it possible to better differentiate between groups of older atherothrombotic stroke patients and persons without cerebrovascular disease than conventional and novel risk factors of stroke. Of the total number of 623 persons examined, 54 stroke patients (mean age 63.3 years) and 74 controls without cerebrovascular disease (mean age 66.3 years) fulfilled the inclusion criteria for this investigation and were enrolled in the case-control study. After adjustment for age, gender and education level, the strongest associations were found between stroke and carotid IMT [odds ratio (OR) = 10.6; 95% confidence interval (CI): 4.3–26.9] and plaque area (OR = 5.4; 95%CI: 2.3–13.1). Other risk factors showed weaker associations with stroke occurrence. Of the clinical risk factors, a significant association was found between stroke and coronary heart disease (OR = 3.5; 95%CI: 1.2–10.2), hypertension (OR = 3.2; 95%CI: 1.5–7.2) and smoking (OR = 2.7; 95%CI: 1.1– –6.4). From the laboratory-derived risk factors a significant association was found between stroke and triglyceride levels (OR = 4.4; 95%CI: 1.9–10.0), and an inverse correlation was observed between stroke occurrence and HDL-cholesterol level (OR = 0.4; 95%CI: 0.2–0.8). The carotid IMT and plaque area, measured with the use of ultrasonography, showed a better correlation with stroke occurrence than currently recognised clinical and biochemical risk factors. The intima-media thickness and plaque area of the carotid arteries could be useful parameters in the development of strategies to identify patients at high risk of atherothrombotic ischaemic stroke.
This study analyzes the effects of cold air on catecholamine (CA) levels. The CA levels of patients with cardio-cerebrovascular diseases, healthy people, Wistar rats, and spontaneously hypertensive (SHR) rats were determined before, during, and after cold air activity. The levels of dopamine (DA), norepinephrine (NE), and adrenaline (AD in humans and experimental animals changed in all three periods of cold air activity. The change in DA levels was statistically significant (P<0.05). The DA, NE, and AD levels in the controls and the Wistar rats increased during cold air activity and decreased after cold air activity. The variation in CA levels was not exactly the same between the SHR rats and the cardio-cerebrovascular disease patients. The special meteorological conditions caused by cold air affects CA secretion, which induces the occurrence, development, and outcome of cardio-cerebrovascular diseases. Moreover, the results of the animal experiments could not be directly extrapolated to humans.
In prenatal and pediatric cardiovascular surgery knowledge of the various arrangements of the aortic arch and its branches as well as the normative data are essential. The variability and morphometric features of the brachiocephalic trunk in 131 human foetuses (65 male, 66 female) ranging from 15 to 34 weeks of gestation were studied by means of anatomical, digital and statistical methods. In all the foetuses examined the left aortic arches were found to have three different arrangements. In 74.05% of cases the usual pattern of the aortic arch with its three main branches were observed. A common origin of the brachiocephalic trunk and left common carotid artery occurred in 20.61% of individuals. In 5.34% of cases the left vertebral artery was an additional vessel and arose from the aortic arch between the left common carotid and subclavian arteries. No significant gender differences were found with respect to the brachiocephalic trunk (p ≥ 0.05). The developmental increase in length (r₁ = 0.78) and diameter (r₂ = 0.83) correlated with a linear function but the increase in volume in relation to age corresponded to a quadratic function (r₃ = 0.73). Our results show the largest increases in the brachiocephalic trunk according to the following parameters: the length — between the 4th and 5th, and 7th and 8th months, diameter — between the 8th and 9th months and volume — between the 4th and 5th, and 7th and 9th months of gestation (p £ 0.01). The present study constructs a normal range for the morphometric features of the foetal brachiocephalic trunk.
Background. Many scientific reports have shown a decrease in total cerebrovascular disease (CeVD) mortality over the past few decades, but too little attention has been paid to premature mortality. CeVD accounted for 22.5% and 17.8% of premature cardiovascular disease deaths in Poland, in 2000 and 2016, respectively. Objective. The aim of the study was to analyse premature CeVD mortality in the Polish population in the recent years, the dynamics of its changes and the potential factors that may have contributed to the decline in mortality. The main goal of the study was to overview the levels and trends in premature CeVD mortality with an emphasis on haemorrhagic, ischaemic and unspecified (not specified as haemorrhagic or ischaemic) stroke. Material and methods. The analysis was based on a database of the Central Statistical Office of Poland and included data from 2000-2016 on premature cerebrovascular deaths occurring between 25 and 64 years of age (N=104,786). CeVD and haemorrhagic, ischaemic or unspecified stroke were coded with ICD-10 codes I60-I69, I61-I62, I63 and I64, respectively. The analysis included assessment of CeVD deaths distribution and evaluation of age-specific mortality rates in 10-year age groups and age-standardised mortality rates (SMR) in the age group 25-64 years, separately for men and women. Trends in SMRs have been studied in the period 2000-2016. Results. The number of CeVD deaths decreased by 32.8% in men and 48.8% in women. There was a two-fold decline in CeVD mortality: from 59 to 29 male and from 30 to 12 female per 100,000. In addition, a 2-year increase in the median age of CeVD death was observed (Men: 56.4 to 58.4 years, Women: 56.4 to 58.7 years, p<0.001). A statistically significant decline in mortality (per 100,000) was also noticed for haemorrhagic stroke (Men: 18.7 to 10.4; Women: 9.6 to 3.8), ischaemic stroke (Men: 11.8 to 8.4; Women: 4.7 to 3.0) and unspecified stroke (Men: 19.7 to 3.5; Women: 9.1 to 1.3). Conclusions. A substantial decline in premature CeVD mortality was observed in the period 2000-2016. Additionally, the number of deaths that could not be classified as haemorrhagic or ischaemic stroke death decreased significantly. The increasingly widespread use of new post-stroke therapies and their availability make it possible to expect a further decrease in CeVD mortality. However, the necessary actions should be taken to compensate for the disparities in CeVD mortality between men and women.
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