Effects of enzymatic blood defibrination in subcortical arteriosclerotic encephalopathy.
Plasma hyperviscosity is a striking abnormality in patients suffering from subcortical arteriosclerotic encephalopathy (SAE) and is thought to perpetuate the chronic ischaemic demyelinating process of the periventricular white matter. Ancrod, a defibrinating enzyme, was given to 10 patients with SAE in an attempt to reduce plasma fibrinogen, which would thus normalise hyperviscosity. This was paralleled by a significant improvement of the initially abnormal retinal arteriovenous passage time, as well as a significant augmentation of the CO2-induced cerebral vasomotor response. This did not lead, however, to any clinical improvement with respect to performance of neuropsychological tests, recurrences of strokes during a 6 month observation period or improvement of various audiological parameters. The findings indicate that hyperviscosity in patients with SAE is merely an epiphenomenon. A potentially reversible, chronic penumbral state of the brain tissue apparently does not exist in SAE.
Ringelstein
E B
EB
Department of Neurology, University Hospital of the RWTH Aachen, Federal Republic of Germany.
Mauckner
A
A
Schneider
R
R
Sturm
W
W
Doering
W
W
Wolf
S
S
Maurin
N
N
Willmes
K
K
Schlenker
M
M
Brückmann
H
H
D000368:Aged; D000721:Ancrod / Q000627:therapeutic use*; D001809:Blood Viscosity / Q000187:drug effects*; D002545:Brain Ischemia / Q000097:blood / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D015161:Dementia, Multi-Infarct / Q000188:drug therapy; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000188:drug therapy*; D011446:Prospective Studies; D012212:Rheology
D005340:Fibrinogen; D000721:Ancrod