Small rodents fleas from the bubonic plague focus located in the Serra dos Orgãos Mountain Range, State of Rio de Janeiro, Brazil.

Eleven species of fleas were collected from 601 small rodents, from November 1995 to October 1997, in areas of natural focus of bubonic plague, including the municipalities of Nova Friburgo, Sumidouro and Teresópolis, State of Rio de Janeiro, Brazil. Among 924 fleas collected, Polygenis (Polygenis) rimatus (Rhopalopsyllidae) was the predominant species regarding the frequency, representing 41.3% (N:382), followed by P. (Neopolygenis) pradoi, representing 20% (N:185) and Craneopsylla minerva minerva (Stephanocircidae), representing 18.9% (N:175). The host Akodon cursor harbored 47.9% of these fleas. Other six host species were infested by 52.1% of the remaining fleas. Fleas were found on hosts and in places within the focus not previously reported by the literature.

[Acute cerebrovascular disorder and arterial hypertension. Prospective study with 248 patients]. / O acidente vascular cerebral agudo e a hipertensão arterial. Estudo prospectivo com 248 doentes.

OBJECTIVE: To evaluate the hypertension associated to different types and sub-types of cerebrovascular disease (stroke), with particular reference to the frequency of hypertension, the values of blood pressure, the risk factors and the involvement of other target organs. DEFINITION: Prospective study in 248 patients with acute stroke admitted to a Clinical Medicine Unit in three independent time periods. SETTING: Internal Medicine Clinic of University Hospital in Lisbon. METHODS: Medical, neurological and cardiologic examination were performed and all patients were also submitted to different complementary tests, including a computer tomography scan of the brain, and an echocardiogram. The values of blood pressure were measured in the admission at the urgent service and 24 h after in the the ward. We identified three sub-types of stroke: intracerebral hemorrhage (IH), ischaemic stroke (IS) and lacunes (L). For each sub-type and for those with hypertension or not, we evaluated: age, sex, duration of stay in hospital and mortality. We also compared for each sub-type the values of blood pressure, the risk factor and the repercussion on other target organs. PATIENTS: Two hundred and forty eight patients (52% were men) with mean age 68.0 +/- 10.2 years, and ages among 40 and 92 years. Thirty-seven patients (15%) died. MAIN RESULTS: In the entire population (n = 248) hypertension were more prevalent in IH 83% and L 82% than in IS 59% (p < 0.0005). Hypertension was present in 172 patients (69%) and 81 (47%) were IS, 58 (34%) L and 33 (19%) IH. Sixty six percent of the 172 patients with hypertension had at least another risk factor and the most aged ones (> 65 years old) were more frequent in IS 75% than in HI 45% or L 58% (p < 0.001). For all subtypes blood pressure measurements were higher in admission than in ward and they were also higher in IH than in IS (p < 0.05). Hypertensive cardiopathy was more prevalent in IH 76% and L 61% than in IS 49% (p < 0.05). Renal failure was more frequent in IS 37% than in IH 28% and L 17% (p < 0.05). CONCLUSIONS: Hypertension is very frequent, and like advanced age is a major risk factor of stroke. Hypertension is frequently associated with one or more risk factors. Hypertensive cardiopathy is more related with IH and L and the renal involvement with IS.

[Acute cerebrovascular accident and heart disease. Prospective study of 248 patients]. / O acidente vascular cerebral agudo e a doença cardíaca. Estudo prospectivo com 248 doentes.

OBJECTIVE: To evaluate the heart disease associated to different type and sub-types of cerebrovascular disease with particular reference to potential cardiac sources of embolus (CPE). DESIGN: Prospective study in 248 consecutive patients with acute stroke, admitted to a Clinical Medicine Unit in three independent time periods. SETTING: Internal Medicine Clinic of University Hospital in Lisbon. METHODS: Neurologic and cardiologic examination were performed and all patients were also submitted to different complementary tests, including a Computer Tomography Scan of the brain (TAC) and a Echocardiogram (ECO). We identified two types and two sub-types: intracerebral haemorrhage (HI) or ischemic stroke (AI) and among AI, cortical (C) or subcortical (SC) ischemic stroke. For each type and sub-type we evaluated past history, heart disease, hypertension (HTA), electrocardiogram, echocardiogram (ECO) and CPE. PATIENTS: Two hundred and forty eight patients (52% were men) with mean age 68.0 +/- 10.2 years and ages between 40 and 92 years. Thirty seven (15%) died. MAIN RESULTS: Eighty four percent were AI and among them 45% were C. Previous strokes were more prevalent in AI 29% (p < 0.01). There was heart disease in 81% and hypertensive cardiopathy was more frequent in HI 63% (p < 0.002). HTA and atrial fibrillation (FA) were more frequent in HI 83% (p < 0.05) and in AI 25% (p < 0.004) respectively. ECO showed a dilatation of left atrium more frequent in AI 28% (p < 0.05) and left ventricular concentric hypertrophy index (IHCE) in HI 50% (p < 0.05). CPE, including FA, was identified in 34% of patients, was more prevalent in AI 38% (p < 0.001) and among it FA was significantly more frequent in C 32% (p < 0.02). CONCLUSIONS: Heart disease is very frequent in stroke. The diagnosis of this condition is very important for stroke prophylaxis and prognosis. HTA and hypertensive cardiopathy have a great prevalence and were more related to HI. CPE and FA were very frequent and their diagnosis are important for prevention of AI and specially for embolic stroke. ECO is useful to identify CPE in elderly patient in particular to characterize heart disease.

[Blood glucose and insulin in arterial hypertension. The elderly hypertensive patient]. / Glicemia e insulinemia na hipertensão arterial. Em destaque o hipertenso idoso.

The clinical importance of relationship between insulin resistance, hyperinsulinemia and high blood pressure is not yet fully understood. The aim of this study was to evaluate the influence of age in the relation between hyperglycemia, hyperinsulinemia and hypertension (HT). Two groups of patients with moderate to severe essential hypertension, aged < 65 (n = 40) and > or = 65 (n = 55) were compared with two other groups of normotensive subjects (NT) matched for sex (n = 14) and age (n = 18). The radioimmunoassay method and glucose oxidase methods were used to evaluate plasma insulin and plasma glucose concentrations. The global analysis shows: The plasma glucose level was significantly lower (p < 0.02) in NT group (n = 32; glycemia: 67.52 +/- 44 mg/dl) than in the HT group (n = 95; glycemia: 86.25 +/- 34.7 mg/dl. Further more the plasma insulin level in NT (3.37 +/- 3.18 microU/ml) was also lower than in HT (4.29 +/- 3.08 microU/ml) although without statistical significance. The patients (HT) aged < 65 years old had higher glycemia (85.76 +/- 26.8 mg/dl) and insulinemia (4.92 +/- 3.56) than NT of same age (glycemia: 59.0 +/- 11.8 mg/dl, insulinemia: 2.86 +/- 1.86), respectively p < 0.001 and p < 0.05. In HT aged > or = 65 the glycemia (82.38 +/- (9.67 mg/dl) was higher than in the NT matched group (65.5 +/- 20.36 mg/dl), p < 0.01, but plasma insulin was not different in the two groups (3.88 +/- 2.63 and 3.80 +/- 2.27 microU/ml).(ABSTRACT TRUNCATED AT 250 WORDS)

[Automatic measurement of arterial pressure]. / Medição automática da pressão arterial.

Whenever we have a new technique for the measurement of Blood Pressure (BP), variations to standard devices should be expected. Recent guidelines for measurement and validation of automatic devices by Scientific Societies should be followed if doctors want to improve the accuracy of readings, avoiding mistakes in the diagnosis and monitoring of hypertension. To characterize the variability and reproducibility of the DINAMAP (Dynamic Automatic Mean Arterial Pressure), a random comparison with two observers (A; B) between this device and the sphygmomanometer was performed in a group of 80 patients with different pathologies. To evaluate the variability and reproducibility in the same person we analysed as well the mean variation in a setting of successive readings in 3 persons. The global correlation was good for both systolic (r = 0.9) and diastolic pressures. The behaviour of the DINAMAP for different pressure levels was obtained by the regression analyses of the pressures differences between both devices. The best correlation is found around the 140 mmHg measurements, pressures above or under this level are respectively underestimated and undervalued. We discuss the needs of a standard statistical methodology with physiological meaning for the analysis which enables to understand the multiple variations that doctors can find when performing the comparison tests.

[Delayed-action calcium antagonists and therapy of arterial hypertension]. / Antagonistas do cálcio de acção prolongada e terapêutica da hipertensão arterial.

Drug treatment of high blood pressure had important improvements is the last few decades, that allowed an efficiente control of hypertension, avoiding or stabilysing cardiovascular consequences. Non pharmacological management is always important; however most hypertensive patients need also drug treatment that is unavoiable in severe and in most cases of moderate hypertension. Borderline hypertension involves difficult decisions. Quantitative diagnosis of high blood pressure has been based on casual measurement. Non invasive ambulatory blood pressure measurement gives access to much more valures over the whole day and night periods, and has been an important tool for clinical research. However it implicates a correct assessment of the device's accuracy and calibration, and also a correct statistical treatment of the huge range of values obtained. Blood pressure control over the 24 hours is probably obtained with some long acting drugs. So, calcium antagonista are reviewed, exemplofying with slow release diltiazem. It has been prescribed twicely a day, and more recently once a day, what is considered by some authors quite adequate on the point of view of pharmacocinetics and pharmacodynamics. So the benefits depending on patient's compliance and the possible obliteration of hypertensive spikes may be important. There is perhaps, in the overall, reduction of health care costs, in what concerns hypertension.

[Hypertensive cardiopathy. Functional evaluation during isometric effort after regression of left ventricular hypertrophy]. / Cardiopatia hipertensiva. Avaliação funcional durante esforço isométrico após regressão da hipertrofia ventricular esquerda.

OBJECTIVE: Echocardiographic evaluation of the response to isometric exercise of hypertensive patients with and without left ventricular hypertrophy. PARTICIPANTS: 28 patients with severe arterial hypertension on long-term follow-up with or without regression of left ventricular hypertrophy on medical therapy; a control group of 10 healthy volunteers. METHODS: Two groups were considered: Group A persistent left ventricular hypertrophy and group B normalization of the left ventricular wall thickness and mass index. The arterial blood pressure and heart rate were evaluated and an echocardiographic record was obtained both at rest and after isometric exercise (maximal effort for 1 to 1.5 minutes). The following echocardiographic data were obtained: left ventricular diameters and thickness of septum and posterior wall during systole and diastole. Volumes, shortening and ejection fractions, cardiac output and index, mass index, end-systolic stress, contractility index and periferal resistance were calculated as usual. RESULTS: During isometric exercise there was a rise in systolic, diastolic and mean arterial pressures and heart rate. Systolic function was normal in all groups at rest. The shortening fraction was not altered in normotensive individuals with isometric exercise. Hypertensive patients showed a significant reduction within normal limits, however. End-systolic stress increased significantly in all groups although the rise was greater in hypertensive patients. The cardiac index rose significantly only in normotensives and hypertensive patients without left ventricular hypertrophy (group B). On the contrary the periferal resistance rose significantly only in hypertensive patients with left ventricular hypertrophy (group A). The contractility index (end-systolic stress/end-systolic volume index) increased significantly only in normotensive and hypertensive patients without left ventricular hypertrophy. CONCLUSIONS: There are functional alterations in hypertensive heart disease which although not evident at rest, can be revealed by isometric exercise. The regression of left ventricular hypertrophy back to normal, sets a trend for normalization of function and cardiac inotropic reserve, suggesting the importance of a complete regression of ventricular hypertrophy.

[Arterial hypertension and the right heart. A hemodynamic and echocardiographic study]. / Hipertensão arterial e coração direito. Estudo hemodinâmico e ecocardiográfico.

OBJECTIVE: To evaluate the effects of arterial hypertension on the pulmonary circulation and the right heart. SETTING: Coronary Care Unit (UTIC Arsénio Cordeiro) Hemodynamics Laboratory and Medicine I Echocardiography Laboratory-Santa Maria Hospital. PARTICIPANTS: 38 hypertensive patients separated in two groups: 24 with thickened septum and left ventricular posterior wall (10 with hemodynamic evaluation)--Group A--and 14 without thickening--Group B; a control group of 12 healthy volunteers--Group C. RESULTS: The hypertensive patients with hemodynamic evaluation had normal pulmonary capillary wedge pressure the average pulmonary resistance (135.29 +/- 63.47 dyn.cm.5), pulmonary systolic (31.30 +/- 10.01 mmHg) and mean pressures (18.23 +/- 8.21 mmHg) were raised, but the diastolic pulmonary pressure was normal. The right ventricle systolic pressure was raised (32.10 +/- 9.12 mmHg) and there was no modification of the right atrial or ventricular telediastolic pressures. On echocardiography there was a diastolic thickening of the right ventricular free wall in both group A (7.08 +/- 1.41 mm) and B (4.07 +/- 1.00 mm) as compared to group C (3.08 +/- 0.51 mm); there were similar findings regarding systolic thickness with statistical significance in group A (p less than 0.001). The right ventricular ejection fraction was normal in both groups. There was a positive correlation between the diastolic thickness of left ventricular posterior wall and right ventricular free wall in hypertensive patients and normotensive volunteers (r = 0.7754; p less than 0.001). CONCLUSIONS: The findings suggest an anatomic an functional relationship between both ventricles regarding the cardiac repercussions of arterial hypertension.

[Arterial pressure and race. A study in pauper children attending schools in an urban strip in Lisbon]. / Pressão arterial e raça. Um estudo em crianças pobres de escolas duma franja urbana de Lisboa.

OBJECTIVE: To determine whether race is a factor of blood pressure levels in school-age children of similar social status, and to investigate other potential determinants of the levels of blood pressure. DESIGN: Inquiry in schools of the suburbs of Lisbon. SETTING: Three schools, four medical observers (general practitioners with school-health functions). SUBJECTS: Three hundred ninety seven children, aged 6-14 years, both sexes, 296 being white and 101 non-white. INTERVENTIONS: Inquiry to the following individual characteristics--sex, age, race, birthplace, type of housing, house availability of water, electricity and waste water, type of transportation to school, number of cohabitans, family income, school marks. Individual determination of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), weight and height. MEASUREMENTS AND MAIN RESULTS: Blood pressure values were cross-analyzed with all the determined variables, and the virtual correlations were checked. Main results as follows: Race does not influence either SBP or DBP. In this age group, sex does not influence blood pressure values. The used markers of socioeconomical status have equally no influence on blood pressure. Age has only a significant repercussion on SBP. No significant correlation was found between height and blood pressure. Body weight, however, influence either SBP or DBP. SBP was found to be lower in the second of two successive measurements, and the difference increases with age. CONCLUSIONS: In this school-aged biracial population, body weight seems to be the major factor of blood pressure levels, in the sense-bigger weight, higher SBP and DBP.

[Ambulatory monitoring of blood pressure. Validation of a method]. / Medicação ambulatória da pressão arterial. validação do método.

Before the routine use of our ambulatory blood pressure (ABP) device, we did the correlation analysis of 153 pairs of blood pressure measurements within the ABP and gold-standard sphygmomanometer. We got a good correlation but a systematic statistical error about less 7 mmHg on systolic measurement and 11 mmHg on diastolic measurement by the ABP device. The different qualities found among the devices that we have in the market, lead to the proposal of protocols of validation in the premarketing and periodic quality assessment by the clinics.

[The patient with acute cerebrovascular disorders: assessment of associated diseases]. / O doente com acidente vascular cerebral agudo: avaliação da patologia associada.

We performed a prospective study in 106 patients with acute stroke. The main purpose was to evaluate the associated diseases and to determine their prevalence and incidence in two different types of cerebrovascular disease: the intracerebral hemorrhage (HI) and ischaemic events (AI). The studied population included 54 men and 52 women with a mean age of 66.8 +/- 10.3 years. A clinical examination was performed in all patients by different specialists and all were submitted to diverse complementary tests, including a computed tomography scan of the brain (TAC) and an echocardiogram (ECO). We found 24 (23%) HI and 82 (77%) AI. In the past history, previous stroke were more prevalent in AI (p less than 0.01). Heart disease was present in 87 (82%) patients but, among them, only atrial fibrillation which was found in 19 (18%) patients, was significantly more frequent in AI (p less than 0.02). Hypertension (HTA) existed in 79 (75%) patients, respiratory complications and periferic vascular disease in 9 (8%), diabetes in 44 (42%) and dyslipidemia in 31 (29%) patients. No significant difference was found between the two groups of stroke regarding these diseases; however, there was a tendency for HTA and diabetes to be more prevalent in HI and for periferic vascular disease in AI. In the blood tests, high haematocrit was found in 35 (33%) patients, anemia in 21 (20%), hypercholesterolemia in 17 (16%), hypertrigliceridemia in 18 (17%) and uremia or creatinemia or ionic alteration in 32 (30%) patients, without any difference in their prevalence and incidence in the two groups of stroke. In conclusion, in this prospective study of patients with an acute stroke, there was 23% of HI and 77% of AI, a high prevalence of previous stroke, heart disease and HTA, but only the previous stroke and, within heart disease, the atrial fibrillation were significantly more frequent in the AI group. Also, periferic vascular disease had a tendency to be more frequent in AI, as well as diabetes and HTA had in HI.

[Automatic measurement of arterial pressure. A new method for analysis, quantification and evaluation of hypertensive disease]. / A medição automática da pressão arterial. Novo método de análise, quantificação e valorização da doença hipertensiva.

The authors try to analyse the role of ambulatory 24 h blood pressure monitoring (ABP) in the diagnosis of hypertension, and review medical literature on this subject. They emphasized the quantification and definition value of normal results and circadian profiles in ABP. The accuracy of the device and the choice of a correct statistical parameter of prognosis is essential in all prospectives studies. In the future a better correlation is expected between blood pressure and organ damage when blood pressure is measured by ambulatory recordings then office method.

[Hypertensive hypertrophy of the left ventricle: its regression in hypertensive patients with different profiles of plasma renin activity, treated with enalapril]. / Hipertrofia ventricular esquerda hipertensiva: sua regressão em hipertensos com diferentes perfis de actividade da renina plasmática, sob terapêutica com enalapril.

STUDY OBJECTIVE: To determine the action of enalapril maleate in cardiac mass and ventricular performance; to investigate virtual differences of anti-hypertensive action, and regression of left ventricular hypertrophy, between subgroups of patients with different profiles of plasma renin activity (PRA). DESIGN: Randomized, single-blind, placebo-controlled study, along 14 weeks, the last 12 under active treatment with enalapril maleate. SETTING: Outpatient clinics of an university department of Internal Medicine and Cardiology. PATIENTS: Sequential series of twenty patients with mild to moderate essential hypertension. Two patients were lost to follow-up. Eighteen patients completed the study. Seventeen out of them were studied for plasma renin activities, and echocardiographic measurements were performed in ten, during the 2 weeks placebo period, and by the end of active treatment. No patients were excluded because of side-effects. INTERVENTION: After a 2-weeks washout period, enalapril maleate has been given in a single daily dose of 20 mg, at bedtime. In 14 patients the dosage was elevated to 40 mg once daily and, in 5 out of these, 12.5 mg hydrochlorothiazide once a day has been added. MEASUREMENTS AND MAIN RESULTS: The mean of systolic/diastolic sitting blood pressures was reduced from 171.6/112 to 151.6/98.1 mmHg (p less than 0.001). The mean of systolic/diastolic standing blood pressures lowered from 167.8/113.7 to 148.6/99.6 mmHg (p less than 0.001). No significant differences were found between blood pressure reductions in 5 patients with elevated PRA, 5 patients with slightly elevated PRA, and 7 patients with normal or low PRA. The analysis of echocardiographic measurements revealed regression of left ventricular hypertrophy (LVH) and, in one patient who had no criteria of LVH, actually occurred reduction of the thickness of ventricular walls. No unfavourable influence over ventricular function indices, neither systolic nor diastolic, was found. End-systolic stress and inotropic activity remained unchanged. The tolerability of the study drug was very good. CONCLUSIONS: Enalapril maleate appears, in this study, an effective anti-hypertensive compound. Its therapeutic action seems independent of the plasma renin activity profile. The drug induced regression of left ventricular hypertrophy after a period of 12 weeks of treatment, and did not promote any unfavourable influence over ventricular functions indices. Inotropic activity and end-systolic stress were not modified. The tolerability was very good.

[The importance of heart disease in the various types of cerebral vascular disease. A prospective study]. / A importância da doença cardíaca nos vários tipos de Acidente Vascular Cerebral. Estudo prospectivo.

UNLABELLED: A prospective study was performed in 106 patients with acute stroke. The main purpose was the cardiac evaluation in the different types of cerebrovascular disease: Intracerebral hemorrhage (H), Cortical ischaemic events (C) and Subcortical ischaemic events (SC) and also to evaluate the interest of echocardiography in detecting occult cardiac sources of emboli. The study population included 54 men and 52 women with a mean age of 66.8 +/- 10.3 years. A thorough neurologic and cardiologic study with a computed tomography of the brain (TAC) and an echocardiogram (ECO) were performed in all patients. It was found 24 (23%) of H, 40 (38%) of C and 32 (30%) of SC. In the past history, heart diseases were more prevalent in C (p less than 0.04); previous stroke and systemic hypertension (HTA) were less prevalent in H (p less than 0.008) and in C (p less than 0.004), respectively. Atrial fibrillation (FA) was more frequent in ischaemic stroke (p less than 0.02) and within these in C (p less than 0.005). No more clinical and functional cardiac features or echocardiographic aspects had any difference in their prevalence in different types of stroke. Without clinical heart disease there were 19 (18%) cases but only in 10 were found in their echocardiograms a potentially embolic heart disease (PEHD) but 8 of them had questionable pathologic significance. IN CONCLUSION: C had more heart disease in their past history; FA is more frequent in C; it is difficult to diagnose a cerebral embolism with only a coexistent C and CPE, but if there is FA or a past history of heart disease in a C, the diagnosis of cerebral embolism is more probable; finally, echocardiography is of limited value to diagnose a PEHD in the elderly, however it makes possible to better evaluate most cardiac situations.

[Oncologic pathology at an internal medicine service]. / Patologia oncológica num serviço de medicina interna.

A retrospective survey of the patients with oncological disease admitted to our Department of Internal Medicine in 1987 was conducted to determine its prevalence and to draw a descriptive profile of these patients' admissions. The results show that oncological diseases were the second cause of hospital admissions that year (12%) only exceeded by cardiovascular diseases. About 60% of the patients had neoplasms already diagnosed elsewhere and were admitted for complications or with therapeutic purposes; in 40% of cases the disease was diagnosed in our Department. A wide variety of hematological and non-hematological tumors was found. There were some difficulties in interdisciplinary coordination in the diagnostic and therapeutic approach. More than 50% of the patients had advanced disease, limiting medical intervention to supportive measures. In about 60% of them were oriented to primary care physicians after physicians after discharged from Hospital. These results suggest the dispersion of the available resources for the diagnosis, treatment and follow-up of oncological diseases in our population. A better cancer patients' assistance in Portugal will depend on the promotion of national cancer registers as well as the improvement of cancer prevention and early detection programs, according to the directives of EEC and WHO. We also emphasize the need of investment on undergraduate and postgraduate education programs, specially for primary care physicians.

[Cerebral vascular disorders and arterial hypertension: cardiologic and neurologic aspects]. / Acidente vascular cerebral e hipertensão arterial: aspectos cardiológicos e neurológicos.

OBJECTIVE: To report and discuss some cardiologic, neurologic and radiologic aspects in different types of stroke (AVC) present in hypertensive patients. DESIGN: Retrospective study in patients with acute cerebrovascular accident (AVC) and high blood pressure (HTA). Separate this population in three groups according to the results of computerized tomography scanning of the brain (TAC): hemorrhage (H) cerebral infarction (IC) and lacune (L). In each group describe the findings. SETTING: Department of Internal Medicine in a University Hospital of Lisbon. PATIENTS: Thirty-four patients, after having discarded 8 because their TAC were normal. Twenty were men (M), 14 women (F) with a total age average of 58 years. MEASUREMENTS AND MAIN RESULTS: All patients had AVC, HTA and underwent initial TAC. For each group were considered: Past history, cardiac repercussions of HTA, neurologic features and the localisations of cerebral lesions. For statistical study were used the Student T Test. There was 45% of IC, 24% of H and 26% of L. In past history was found 35% of cardiac diseases and 24% of diabetes. There wasn't any difference in blood pressure (systolic and diastolic) between the groups. Fifty-six percent had an important cardiac repercussion, with 72% of alterations of ventricular repolarization and 35% of coronary heart diseases. Both were more prevalent in IC than in the others. Twenty percent of H were in physical activity, 20% had a progressive start and in 10% there were meningeal signals. The site of cerebral lesions were characteristical, specially the H and L and 60% of H were thalamic. There wasn't any lacune neither in the cerebral stem nor in the cerebellum. It was reviewed some theoric aspects of neurologic feature. CONCLUSIONS: IC is the more frequent AVC in hypertensive patients. The cardiac involvement, is the most frequent disease in past history. The cardiac repercussion of HTA is more important in IC. The findings were insufficient to well characterize the neurologic feature. Sometime TAC and seldom magnetic resonance are necessary. The localisations, specially of H and L are the same that have been described in medical literature.