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001-es BibID:	BIBFORM046048
Első szerző:	Schulte-Altedorneburg, Gernot
Cím:	On the origin of microembolic signals / Schulte-Altedorneburg Gernot, Nam Eun Mi, Ritter Martin, Magyar Tünde, Dittrich Ralf, Csiba László, Ringelstein E. Bernd, Droste Dirk W.
Dátum:	2003
ISSN:	0340-5354
Megjegyzések:	Clinically silent circulating microembolic signals (MES) can be identified by transcranial Doppler ultrasound (TCD). It is not yet clear whether their occurrence is always linked to the presence of embolic sources. METHODS: 24 terminally ill patients (7 women, 17 men; mean age 68 years) were investigated by TCD of the middle cerebral arteries. These findings were correlated with a complete post-mortem examination of potential embolic pathways. RESULTS: Four patients out of the 24 under investigation showed MES, 2 of them bilaterally. All these 4 MES-positive patients had a definite embolic source, i. e. bilateral carotid artery occlusive disease, endocarditis with thrombotic valvular adhesions and severe plaques in the aortic arch, dilated left atrium and a patent foramen ovale, or severe plaques in the aortic arch and a dilated left atrium, respectively. CONCLUSION: In the investigated patient group, we could demonstrate that MES can only be found when an embolic source is present. The finding of MES justifies an extensive clinical and laboratory search for potential embolic sources including extracranial and intracranial colour-coded duplex ultrasound, ECG, Holter-ECG, and TEE.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Journal Of Neurology. - 250 : 9 (2003), p. 1044-1049. -
További szerzők:	Nam, E. M. Ritter, Martin A. Magyar Mária Tünde (1970-) (neurológus) Dittrich, R. Csiba László (1952-) (neurológus, pszichiáter) Ringelstein, E. Bernd Droste, Dirk W.
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001-es BibID:	BIBFORM020788
Első szerző:	Völker, W.
Cím:	The outer arterial wall layers are primarily affected in spontaneous cervical artery dissection / Völker W., Dittrich R., Grewe S., Nassenstein I., Csiba L., Herczeg L., Borsay B. A., Robenek H., Kuhlenbäumer G., Ringelstein E. B.
Dátum:	2011
ISSN:	0028-3878
Megjegyzések:	To evaluate the macroscopic and microscopic phenotype of the distal superficial temporal artery (STA) in patients with spontaneous cervical artery dissection (sCAD, n = 14). Arteries of accident victims, free of clinically apparent vascular disease, served as reference samples (n = 9). METHODS: Specimens of distal STA branches were obtained by biopsy or at autopsy. Their fine and ultrafine structure was documented by close-up photography of native STA branches, light microscopy, and electron microscopy in a case-control study. RESULTS: STA specimens from patients with sCAD revealed pathologic changes mainly in the adventitial and medial layers. In these areas, vacuolar degeneration and fissuring were associated with neoangiogenesis of capillaries and microscopic erythrocyte extravasation into the connective tissue. In addition, some specimens showed overt microhematomas close to the medial/adventitial border visible at low magnification. The reference arteries showed virtually no pathologic changes in the outer arterial layers. CONCLUSION: Bearing in mind that the STA is only a surrogate for the cervical arteries affected by sCAD, we propose the following pathogenetic model. We hypothesize that sCAD affects primarily the outer arterial layers. The process starts with degenerative changes at the medial-adventitial border associated with neoangiogenesis of capillary vessels branching from vasa vasorum in the adventitia. Leakage of neoangiogenetic capillaries releases blood cells into the connective tissue and leads to formation of microhematomas along the medial/adventitial border, as well as disintegration of the medial and adventitial texture. Microhematomas might then cause successive rupture of multiple neoangiogenetic capillaries and vasa vasorum, ultimately resulting in dissection.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Neurology. - 76 : 17 (2011), p. 1463-1471. -
További szerzők:	Dittrich, R. Grewe, S. Nassenstein, I. Csiba László (1952-) (neurológus, pszichiáter) Herczeg László (1954-) (igazságügyi orvosszakértő) Borsay Beáta Á. (1982-) (igazságügyi orvosszakértő) Robenek, H. Kuhlenbäumer, Gregor Ringelstein, E. Bernd
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