[Optimism or pessimism in the treatment of cerebral infarct]. / Optimizmus ci pesimizmus v liecbe mozgového infarktu.

The aim of the study was to analyse the effects of drug and rehabilitation treatment of cerebral stroke. Material consists of 2,500 patients with focal brain ischemia. About three-fourths (68.7%) of patients with cerebral stroke improved receiving complex drug treatment, rehabilitation and psychological care. 54.9% of the whole group of patients had a neurological deficit score below 150, i.e. more than one half of the whole group (n = 2,500) left the hospital practically in good health capable of carrying on in their original occupation. Only 11.9% of patients died, but 48.9%, i.e. practically one half of them showed an extracerebral cause of death. The results of treatment are dependent on age. In the higher age group, the number of deteriorated cases as well as the number of death increases. The results of treatment are dependent on an early initiation of treatment after the onset of brain ischemia. In the 2nd time-period, the results of treatment are better in comparison to the 1st period due to new strategies of treatment, i.e. due to drugs that improve heart failure, rheological properties of the blood and brain metabolism and due to intensive rehabilitation care. The results have shown the improvement not only in movement possibilities of the patients, but also the improvement in majority of the psychological parameters (IQ, emotionality, sociability scale etc.).

[Changes in carbohydrate metabolism before and after the development of focal cerebral ischemia. III. Function of the diencephalon]. / Zmeny glycidového metabolizmu pred a po vzniku loziskovej ischémie mozgu. III. cast. Funkcia diencefala.

The purpose of the investigation was to assess whether the mechanism of reduced glucose tolerance in focal ischaemia of the brain can be considered a functional disorder of the regulatory brain centres or a manifestation of inadequate glucose utilization due to impaired insulin secretion. The function of centres regulating metabolic processes was tested by the i.v. administration of Pyrifer. It was revealed that after Pyrifer administration a parallel rise of the investigated values does not occur (i.e. number of leucocytes, body temperature, pulse, systolic and diastolic pressure, blood sugar level), the maximum values do not reach the levels of the control group, their rise is retarded, persists twice as long as in the control group and does not return to baseline values in the appropriate time. A pathological constellation of responses was recorded in 85.71% of the cases. A similar trend of changes was found also in a group of arteriosclerotic and hypertonic patients although in a lower percentage. The results confirmed the assumption that in the mechanism of reduced glucose tolerance in the periphery an important part is played by the impaired function of regulating centres in the diencephalon.

[Changes in glucose metabolism before and after the onset of focal cerebral ischemia. II. Production of insulin]. / Zmeny glycidového metabolizmu pred a po vzniku loziskovej ischémie mozgu. II. cast: produkcia inzulínu.

The purpose of the work was to assess the insulin secretion after a glucose load in a group of patients with cerebral infarction and in a group of arteriosclerotic and hypertonic patients, i.e. potential candidates of cerebral infarction. The material comprised 46 patients, incl. 29 with focal cerebral ischaemia and 17 with arteriosclerosis and hypertension. After oral glucose administration plasma insulin was assessed by radiooimmuncassay (IRI). It was revealed that insulinsecretion in the group of hypertonic and arteriosclerotic patients follows the rise of the blood sugar level, the rise is somewhat lower than in the control group but persists longer and returns later to baseline values. Similar but quantitatively more marked changes were refealed also in the group with focal cerebral ischaemia. From the results ensues that a reduced glucose tolerance in patients with cerebral infarction recorded in previous work is not due to an inadequate insulin secretion, i.e. the peripheral glucose metabolism, but indicates rather the ineffectiveness of insulin to restore glucose homeostasis.

[Vascular headache: circulatory, hemorrheologic, electrophysiologic and psychological aspects]. / Vaskulárna cefalea: cirkulacné, hemorheologické, elektrofyziologické a psychologické aspekty.

The aim of the work was to analyze circulatory, rheological, electrophysiological and psychological characteristics of patients with vascular headache, mostly migraine and vasomotor cephalea. The group was formed by 69 patients, mean age 40.4 +/- 9.0 years. It was revealed that: 1. there were no significant changes in rheological properties of blood in the following six parameters: coagulation, viscosity of plasma and blood, platelzo aggregation, of circulating aggregates, 2. there were no significant changes in rCBF (FF,SF,AF and ISI) parameters in the group of patients with bilateral headache but a rising rCBF in unilateral headache, 3. there was a significant reduction of the "peak frequency" in supratrochlear arteries and a significant increase of the flow rate in the intracerebral arteries (a.cerebralis media, a.cerebralis anterior), 42.4% of the patients displayed abnormal but non-specific EEg changes, 5. there was a significant increase of the amplitude of P1 and N2 waves of visual evoked potentials and a non-significant shortening of the latency of wave N1, 6. significant changes were recorded in some psychological parameters, in particular an increase of the score of depressivity, anxiety and neuroticism.

[Changes in glucose metabolism before and after the onset of focal cerebral ischemia. I. The intravenous glucose tolerance test]. / Zmeny glycidového metabolizmu pred a po vzniku loziskovej ischémie mozgu. I. cast: Intravenózny glukózotoleracný test.

In a group of 22 patients with focal ischemia of the brain and in 11 patients with cerebral arteriosclerosis and vascular hypertension the tolerance to glucose administered by the i.v. route was investigated. The rate of glucose utilization was expressed by a utilization coefficient. The tolerance to i.v. glucose administration is reduced in the group of arteriosclerotic and hypertensive subjects. As a result of acute focal ischemia of the brain it declines even more, as compared with subjects in the control group. In the mean values of the coefficient of glucose utilization a significant difference was recorded between the group of patients with focal ischemia of the brain, as compared with the control group (p less than 0.001) and the group of arteriosclerotic and hypertonic patients, as compared with controls (p less than 0.005). The authors conclude from the results that the reduced glucose tolerance to orally administered glucose in patients with focal ischemia of the brain and their potential candidates in no causal relationship with the variability of intestinal absorption, as similar changes in glucose tolerance were recorded also after intravenous administration.