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Effects of enzymatic blood defibrination in subcortical arteriosclerotic encephalopathy.
  1. E B Ringelstein,
  2. A Mauckner,
  3. R Schneider,
  4. W Sturm,
  5. W Doering,
  6. S Wolf,
  7. N Maurin,
  8. K Willmes,
  9. M Schlenker,
  10. H Brückmann
  1. Department of Neurology, University Hospital of the RWTH Aachen, Federal Republic of Germany.


    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.

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