@article{MTMT:1743119,
	title = {Impaired cerebrovascular reactivity in sepsis-associated encephalopathy studied by acetazolamide test},
	url = {https://m2.mtmt.hu/api/publication/1743119},
	author = {Szatmári, Szilárd Attila and Végh, Tamás and Csomós, Ákos and Hallay, Judit and Takács, István and Molnár, Csilla and Fülesdi, Béla},
	doi = {10.1186/cc8939},
	journal-iso = {CRIT CARE},
	journal = {CRITICAL CARE},
	volume = {14},
	unique-id = {1743119},
	issn = {1364-8535},
	abstract = {Introduction: The pathophysiology of sepsis-associated encephalopathy (SAE) is not entirely clear. One of the possible underlying mechanisms is the alteration of the cerebral microvascular function induced by the systemic inflammation. The aim of the present work was to test whether cerebral vasomotor-reactivity is impaired in patients with SAE. Methods: Patients fulfilling the criteria of clinical sepsis and showing disturbance of consciousness of any severity were included (n = 14). Non-septic persons whithout previous diseases affecting cerebral vasoreactivity served as controls (n = 20). Transcranial Doppler blood flow velocities were measured at rest and at 5, 10, 15 and 20 minutes after intravenous administration of 15 mg/kgBW acetazolamide. The time course of the acetazolamide effect on cerebral blood flow velocity (cerebrovascular reactivity, CVR) and the maximal vasodilatory effect of acetazolemide (cerebrovascular reserve capacity, CRC) were compared among the groups. Results: Absolute blood flow velocities after adminsitration of the vasodilator drug were higher among control subjects than in SAE. Assessment of the time-course of the vasomotor reaction showed that patients with SAE reacted slower to the vasodilatory stimulus than control persons. When assessing the maximal vasodilatory ability of the cerebral arterioles to acetazolamide during vasomotor testing, we found that patients with SAE reacted to a lesser extent to the drug than did control subjects (CRC controls: 46.2 +/- 15.9%, CRC SAE: 31,5 +/- 15.8%, P < 0.01). Conclusions: We conclude that cerebrovascular reactivity is impaired in patients with SAE. The clinical significance of this pathophysiological finding has to be assessed in further studies.},
	keywords = {Humans; DYSFUNCTION; Ultrasonography, Doppler, Transcranial; Cerebrovascular Circulation/*drug effects; Blood Flow Velocity/drug effects; Sepsis; CIRCULATION; Acetazolamide/administration & dosage/*pharmacology; Sepsis/*complications; RESERVE CAPACITY; CEREBRAL VASCULATURE; Open Access; Brain Diseases/blood/*etiology/*physiopathology/ultrasonography; Anticonvulsants/administration & dosage/*pharmacology; egyetemen (Magyarországon) készült közlemény; SEPSIS-ASSOCIATED ENCEPHALOPATHY},
	year = {2010},
	eissn = {1466-609X}
}

@article{MTMT:1033940,
	title = {Transcranial Doppler-determined pulsatility index in the evaluation of endoscopic third ventriculostomy (preliminary data)},
	url = {https://m2.mtmt.hu/api/publication/1033940},
	author = {Vajda, Zsolt and Büki, András and Vető, Ferenc and Horváth, Zsolt and Sándor, János and Dóczi, Tamás Péter},
	doi = {10.1007/s007010050294},
	journal-iso = {ACTA NEUROCHIR},
	journal = {ACTA NEUROCHIRURGICA},
	volume = {141},
	unique-id = {1033940},
	issn = {0001-6268},
	abstract = {OBJECTIVE: Endoscopic 3rd ventriculostomy has become the method of choice in the 
		management of occlusive hydrocephalus. The treatment is accompanied by
		significantly less peri-operative complications than the cerebrospinal fluid
		shunting procedures previously employed. Close surveillance of patients, however,
		is necessary to avoid the consequences of raised intracranial pressure that may
		develop in case of obstruction of the artificial outlet of the 3rd ventricle. The
		aim of this study was to confirm the value of transcranial Doppler-determined
		pulsatility index (PI) in the assessment of the patency of endoscopic 3rd
		ventriculostomy and to elucidate its usefulness in early postoperative
		recognition of increased intracranial pressure. METHODS: In twenty-two patients
		suffering from occlusive hydrocephalus, transcranial Doppler sonography (TCD) was
		performed before, immediately after, and five days after endoscopic fenestration 
		of the floor of the 3rd ventricle. PI was defined with fast Fourier
		transformation. Mean PI values were determined in both middle cerebral arteries
		(MCA), over five cardiac cycles. RESULTS: In nineteen cases, PI values showed a
		significant decrease immediately as well as five days after the intervention as
		compared to the pre-operative values, and flow-sensitive MRI confirmed the
		patency of the fenestration in all cases. In one patient the operation failed to 
		produce an effective diversion of cerebrospinal fluid as shown by flow-sensitive 
		MRI, and the pulsatility index was unchanged. In two patients, a significant
		immediate postfenestration drop in PI was followed by a recurrence of PI to
		pre-operative levels without any clinical deterioration. CONCLUSIONS: Preliminary
		results suggest that the transcranial Doppler-determined pulsatility index is a
		useful non-invasive tool for the evaluation of the patency of the fenestration in
		the early follow-up of patients who underwent endoscopic third ventriculostomy.},
	year = {1999},
	eissn = {0942-0940},
	pages = {247-250}
}