Neurologische Klinik und Poliklinik
Josef-Schneider-Str. 11, 97080 Würzburg
Research foci (and basic equipment-based research projects):
The research of this group focuses on cerebral stroke and development of TC5 for the analysis and diagnosis of CNS diseases. Factors likely modifying biocompatibility of extracorporeal circulation in coronary artery bypass grafting are investigated. Clinical endpoints are stroke and neuropsychologic testing. A standard test procedure for measurement of early postoperative encephalopathy was developed, and long-term observations are performed. Intraoperative Doppler ultrasound embolus detection and near-infrared spectroscopy, perioperative MR imaging and serial measurements of cytokine liberation, S 100 B as well as of prothrombotic and fibrinolytic markers were performed. Other projects evaluate brain tumors by B-mode-sonography and the correlation of ventricular size with clinical findings in patients with multiple sclerosis. An ultrasound method for investigation of the cerebral microcirculation was developed. By contrast-enhanced colour-coded transcranial Duplex sonography, the timely difference between an increase of intensity in the PCA and the vene of Galen reflects the cerebral transit time (cTT). Furthermore, modern tools in stroke diagnosis and therapy were evaluated.
Mechanisms of plaque destabilization in the internal carotid artery: High-grade (>70%) stenosis of the internal carotid artery in general is associated with a higher risk for developing cerebral ischemia. The risk, however, does not solely depend on the degree of the stenosis, but also on so far unknown intrinsic factors of the plaque. We could show that the extent of T-cell and macrophage infiltration in thrombendarterectomy specimens of patients strongly correlates with preceding transient ischemic attacks (TIA´s) and positive microembolism as revealed by transcranial doppler sonography. In extension we could recently provide a possible molecular link between thrombembolism and plaque infiltration. Macrophages in plaques strongly expressed tissue factor (TF), a thrombophilic molecule that activates clotting factor VII with ensuing thrombus formation. The extent of TF expression strongly correlated to a history of recent TIA´s and positive microemboli counts. These findings point to the development of novel antinflammatory treatment strategies bridging the transient risk in symptomatic carotid artery disease.
Rewards and prizes: