Cerebrovascular Diseases S217 of heparin-therapy and consequently to the need for an early noninvasive diagnosis, especially if initial symptoms are unspecific. 4-07-l 2 Comparative study of scales and evaluation index for hemipiegic or hemiparetic stroke patients S.V. Fontes, M.M. Fukujima, R.M.C. Oliveira, J.O. Cardeal, L.A.F. Andrade. Department of Neurology and Neurosurgery of ,550 Paul0 Federal University; Paulista School of Medicine, Sao Paula, Brazil Objective: it is to compare the valid scales, observing the concordance degree among them, applying them after group physiotherapy for stroke patients. Methods: 70 hemiparetic or hemiplegic patients who suffered stroke in midle cerebral artery, 50 could walk by themselves [w], and 20 could not [nw]. They were evaluated by: Barthel Index (Bl), Rivermead Mobility Index (RMI), Canadian Neurological Scale (CNS), Orgogozo Unifed Form for Neurological Stroke Scales (OUFNSS), Motrlcity Index (MI) and were treated using Bobath and Carr & Shepherd methods adapted to group therapy. Statistical tests: MC Nemar and Kappa (p < 0.05). Results: At the end of the physioterapical treatment, we had the following results: BI X RMI: [nw] non analyseble (NA), [w] non significant (NS); 81 X MI: [nw] NA, [w] significant; BI x CNS: [nw] NS, [w] significant: BI x OUFNSS: [nw] NA, [w] significant; RMI X MI: [nw] NA, [w] significant; RMI X CNS: [nw] NS, [w] significant; RMI X OUFNSS: [nw] NA, [w] significant; MI X CNS: [nw] e [w] NS; CNS X OUFNSS: [nw] e [w] NS; Ml X OUFNSS: [nw] e [w] NS. (NA = 100% improved in both scales). Conclusion: for the group of patients who could not walk by themselves [nw] there were no statistical significant concordance among the scales. For the walking group, there were significance for: BI x Ml; BI x CNS; BI x OUFNSS; RMI X Ml; RMI X CNS; RMI X OUFNSS. We conclude that the scales are equivalent, therefore, they all may be appliable, so that they focus different aspects. 4-07-l 3 The five year outcome of stroke; dementia and activities in daily living in a long term follow up study T. Kulkas, T. Erila, H. Frey. Tampere University Hospital, Department of Neurology and Rehabilitation, Tampere, Finland The aim of the study was to examine survival, independence and dementia of stroke patients in a long term follow up study. There were 1000 stroke patients in Pirkanmaa during a 13 months period (1.6.199&30.6.1991). The patients made control visits to Tampere University Hospital one year, two years and five years after the stroke. Activities in daily living were evaluated by Barthel index (BI), and dementia was searched by the Folstein Mini Mental State Examination (MMSE). DSM-III-R- and HIS-R-criteria were used for the diagnosis of vascular dementia. The five year survival was 40%. 66% came to the five year control visit and 20.6% were interviewed by telephone. BI was good (65-100) in 90.5%. 15.9% (42 patients) had MMSE below 24 points, 14 of them had no dementia but other reasons for lower points (afasia, depression, poor visus). 26 patients had dementia, 16 of them had vascular dementia or mixed vascular demen- tia/Alzheimers disease. Other reasons for dementia were intracerebral and subarachnoidal haemorrhagias, Parkinsons disease, brain tumor, hypothyreo- sis, head trauma, alcoholism and tuberculosis. This study shows that most survivors five years after stroke are nearly independent in every day life and dementia is not very common among them. 4-07-l 4 Therapeutic attitude in the use of aspirin for stroke preventlon among argentine doctors 0. Fustinoni, A.C. Mut, V. Rocchi, L. Garau. Department of Neurology, J.A. Ferndndez Hospital Buenos Aires, Argentina Beckground/Objectlve: The optimal dose of aspirin is still controversial. We investigated whether the basis for its indication, choice of dose and attitude toward recurrence among argentine doctors warrant a trial of low/high dose aspirin for stroke prevention. DeslgnlMethods: We surveyed 161 doctors from various specialties and institutions in the Buenos Aires area with a multiple choice questionnaire, and compared them statistically to identify therapeutic trends (chi square). Results: Doctors generally favoured aspirin for secondary rather than pri- mary prevention (75%, p < 0.001) and 64% chose a daily dose of 325 mg or less, preferring it to 4100 mg (p c 0.01). Only 6% chose 2650 mg. Most believed the dose they chose was proven effective. Only 27.5% would raise the dose after recurrence (p < 0.001). Conclusions: Thedoctors surveyed significantly avoid high doses of aspirin even after stroke recurrence, though there is no definite evidence that low doses prevent stroke more effectively. Patients might thus be undertreated and a low/high dose aspirin trial seems therefore warranted. I__I 4 07 15 Corporal mass index as one indicator to determine the best dose of aspirin for anti-platelet effects R.J. Gagliard, LT. Damiani, A.T. Lebre, R. Menoncello, E. Gisoldi, M.L.S. Guedes, M.A. Moura. Dep. de Neurologia, Santa Casa de Scio Paula, hzil Usually the Cerebral Vascular Disease (CVD) can be treated and prevented by platelet aggregation and the aspirin (AAS) have been useful drug for that; but, the scientists could not determinate the best dose until this moment. Thus, to get the ideal dose we use the relation effects of the AAS with the corporal mass index and insert the platelet aggregation curve results. We have accompanied 63 patients with CVD that used doses of AAS of 100, 200, 466 and 500 mg. During 30 days and using the AAS the platelet aggregation curve was made quantify the percentage of own platelet and stimulated by adrenaline and ADP. We could fix the corporal mass index (CMI) adjusting weight (kg)/heightz (m). Thus the relation AAS was established comparing the state of aggregation getting from CAP. The patients are considered hipoaggregated when the level of platelet aggregation curve are between zero to forty percent; from forty-one to sixty are considered moderated hipoaggregated, and above this level (261%) are considered normal aggregated to CPP. This casuistic show us that the patients with the platelet aggregation curve between 0% and 40% received doses aspirin above 6 mg/kg/m*. This index can be one way to help us to determinate the right dose of aspirin. Nevertheless, we need others studies to associate our results with patients that have other factors of the vascular disease risk. 4-07-l 6 intracerebral hemorrhage model in the swine Ken Gaines, Robert Ferguson, Scott Williams, Carolyn Chesney, John Schweitzer. 6aptist Memorial Hospital, Memphis, Tennessee, USA, University of Tennessee, Department of Neurology, Memphis, Tennessee, USA lntracerebral hemorrhage (ICH) represents about 10% of all strokes but carries a high case fatality rate. Little information is available to guide treatment of edema and blood pressure in ICH, and no clear guidelines are available on the usefulness of surgical evacuation. Animal models of ICH have often been models of cerebral masses and have not duplicated the natural disease state. We report preliminary results of work on development of a model of ICH in 20 adult swine. A microguidewire technique is used to puncture the rete vessels at the base of the brain inducing a basal ganglia hemorrhage. The methodology, effects of induced Mood pressure elevations, and the pathologic anatomy of the induced hemorrhages will be discussed. Our data demonstrate the usefulness of this technique in simulating the natural disease state and the positive effect of induced blood pressure elevations of ICH size. 4-07-l 7 Sexual hormone levels in postmenopausal women with early ischemic stroke A.J. Moreno-Rojas, A. Gil-Peralta, J.R. Gonzalez, J. Lapetra, A. Cayuela, J.M. Santos. S. de Neurologfa. Hosp. U. Virgen de/ Rocfo de Sevilla, Spain Studies designed to assess the endogenous oestrogen and testosterone levels in cardiovascular diseases (CVD) have shown contradictory results. Increased levels of endogenous oestrogens with an ischemic stroke have been reported. The role of lower levels of testosterone or dehydroepiandrosterone-sulfate (DHEA-S) as possible risk factors for CVD remains unclear. The aim of this case and control study is to define the sexual hormone profile in non diabetic postmenopausal women aged less than 65 years-old with a nonembolic ischemic stroke. Possible relationship between sexual hor- mones levels and glucose, fat metabolism and coagulation parameters is also evaluated. Thirty cases and 60 aged matched controls will be studied using a clinical and laboratory protocol that includes serum levels of sexual hormones, glucose, insulin, lipoproteins and coagulation test. Preliminary analysis in 21 cases and 31 controls have shown significative (p < 0.01) lower levels of total testosterone (0.49 vs. 0.69 nmol/l) and DHEA-S (0.77 vs. 1.53 mcgfml) in the stroke group and no difference in oestraiol levels. Lower levels of serum DHEA-S and testosterone may play a role as risk factors for nonembolic ischemic stroke in postmenopausal women. Their rela- tionship with modifications of glucose and fat metabolism or with coagulation disorders will be assessed in posterior analysis.