title: Effects of enzymatic blood defibrination in subcortical arteriosclerotic encephalopathy.
abstract: 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.
authors.affiliation: Department of Neurology, University Hospital of the RWTH Aachen, Federal Republic of Germany.
authors.forename: E B
authors.initials: EB
authors.lastname: Ringelstein
authors.forename: A
authors.initials: A
authors.lastname: Mauckner
authors.forename: R
authors.initials: R
authors.lastname: Schneider
authors.forename: W
authors.initials: W
authors.lastname: Sturm
authors.forename: W
authors.initials: W
authors.lastname: Doering
authors.forename: S
authors.initials: S
authors.lastname: Wolf
authors.forename: N
authors.initials: N
authors.lastname: Maurin
authors.forename: K
authors.initials: K
authors.lastname: Willmes
authors.forename: M
authors.initials: M
authors.lastname: Schlenker
authors.forename: H
authors.initials: H
authors.lastname: Brückmann
mesh_terms: 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
chemical_list: D005340:Fibrinogen; D000721:Ancrod