Stroke - Contraindications

BMJ 1999 May 29;318(7196):1485; discussion 1486

Migraine and stroke in young women. Authors' results suggest that all types of migraine are contraindications to oral contraceptives.

MacGregor EA, Guillebaud J

Publication Types:

• Comment
• Letter

Comments:

• Comment on: BMJ 1999 Jan 2;318(7175):13-8

PMID: 10346783, UI: 99276406

Schweiz Med Wochenschr 1998 Mar 7;128(10):374-83

Medical treatment of migraine: from mechanisms of action to contraindications.

Higelin F, Annoni JM

Department de medecine communautaire, Hopital cantonal universitaire de Geneve.

Management of migraine patients with or without aura must include appropriate medication to treat the attack and long-term preventive therapy, especially if the frequency of the attacks is greater than 2-4 per month. In both cases the choice of treatment depends on its efficacy and side effects. With regard to acute drug therapy, group studies do not suggest that ergot derivatives and sumatriptan are superior to simple analgesics and anti-inflammatory drugs, particularly if a prokinetic agent is added. These new substances are indicated for severe attacks refractory to more conventional therapy. Chronic drug abuse may induce drug-induced or rebound headaches. As regards long-term prophylaxis, group studies suggest that calcium antagonists and 5-HT-influencing drugs are superior concerning attacks frequency to beta-blocking agents, but involve very frequent side effects (weight gain and somnolence). Interesting preliminary results have also been reported with valproate and enalapril, which will confirmation by controlled studies. Finally, the choice of drug must take into account the patient's comorbidities (cardiovascular diseases, asthma, diabetes etc).

Publication Types:

• Review
• Review literature

PMID: 9556832, UI: 98217578

J Radiol 1989 Feb;70(2):123-6

[Cerebral vascular clips in MRI. Absolute or relative contraindications].

Doyon D, David P, Halimi P

Service de radiologie, Hopital de Bicetre, C.I.E.R.M. Faculte Paris-Sud, Bicetre.

MRI is sometimes of no value in investigating a region close to a metallic foreign body. Presentation of a patient with non ferromagnetic cerebral vascular clips where MRI did not allow for the study of the chiasmatic region because of major artefacts.

PMID: 2715973, UI: 89236193

Eur Heart J 1988 Apr;9 Suppl F:71-6

Contraindications to physical training in patients with impaired ventricular function.

Kellermann JJ, Shemesh J, Ben-Ari E

Hermann Mayer Cardiac Rehabilitation Institute, Tel Hashomer, Israel.

Exercise performance in patients with impaired ventricular function does not correlate well with the severity of dysfunction. Patients with ventricular dysfunction can achieve a fairly high work capacity, and the physiological variables respond in a similar way, regardless of whether or not the patients do or do not have impaired function. Furthermore, patients with pump dysfunction can benefit from a supervised physical training programme by improving their functional capacity and thus, their quality of life. The absolute contraindications for exercise therapy in this group of patients with coronary artery disease should therefore be identical to those who have normal ventricular function. In our opinion, special attention should be exercised in patients who have chronotropic incompetence, lack of an elevation or decrease in blood pressure during exercise performance and in those whose stroke volume is not elevated during even low to moderate work-loads. Recommendations as to the implication of exercise therapy as a therapeutic modality in patients with ventricular impairment must be accepted with caution. The reason for this is that our observations are based on historical, anecdotal trials, most of which included only a modest number of patients. Future research and a prolonged follow-up is needed in order to obtain both a more exact analysis and eventually scientifically based evidence on the benefits and hazards involved.

PMID: 3391187, UI: 88271408

Neurol Neurochir Pol 1982 Jul-Aug;16(4):153-7

[Indications and contraindications in the surgical treatment of stenosis and occlusion of the extracranial cerebral arteries].

Nielubowiczowa H, Nielubowicz J

On the basis of a survey of the pertinent literature and own experiences the authors discuss briefly the indications and contraindications to surgical treatment of stenosis or occlusion of the extracranial arteries supplying the brain. They stress that reconstructive operations on the extracranial cerebral arteries are primarily of prophylactic importance preventing stroke development, they should be carried out in transient brain ischaemia and imminent stroke, severe completed strokes are not treated in this way. Stenosis of the internal carotid artery lends itself in the first place to this reconstructive operation which should be done possibly early when the artery is not yet completely occluded. The best time for the operation is 3-4 weeks after development of brain symptoms after abating of the acute stage of the disease.

PMID: 7145001, UI: 83063115

MMW Munch Med Wochenschr 1976 Sep 17;118(38):1195-202

[Surgical treatment of coronary insufficiency. Indications and contraindications].

Angelino PF, Gensini GG, Baduini G, Diamond JR

The indications for surgical treatment by aortocoronary bypass have been considerably extended during the last few years as a result of experience in the clinical, hemodynamic and surgical fields. The mortality of the operation is about 4%. Important criteria are: 1. More than one coronary vessel must be affected. 2. The artery below the lesion must have a diameter of more than 1 mm. 3. The end-diastolic pressure in the left ventricle must be below 20 mm Hg. 4. The stroke volume fraction in the left ventricle must not be less than 0.40. 5. Serious intractable diseases must not be present.

Publication Types:

• Review

PMID: 823411, UI: 77011517

Kardiologiia 1976 Jun;16(6):32-6

[Indications and contraindications for surgical treatment of abdominal-aortic aneurysm].

Ermoliuk RS

An analysis of 176 patients with aneurysms of the abdominal aorta is presented, 125 of these patients having been operated on (the average age was 60 years). The presence of an aneurysm of the abdominal aorta, irrespective of its dimentions and nature of clinical manifestations, serves as an indication for surgery, provided the following contraindications are absent: severe state of the patient, fresh myocardial infarction, cardiac lesions with circulatory insufficiency of stage II B or III, fresh haemorrhage to the brain, hepatic and renal lesions with azotemia, atherosclerotic occlusion of vessels in the lower extremities with a complete block of all major vessels.