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Stroke and Cerebrovascular Diseases

Jan C Frich
Henrik Ibsen (1828-1906) is a Norwegian playwright and poet who is known as the father of modern drama. Ibsen was in good health when he announced at his 70th birthday celebration that he intended to continue writing. His last play, When We Dead Awaken, was published in 1899. Why did Ibsen's dramatic writing come to an end? This chapter presents a medical account of Ibsen's health condition during the last 6 years of his life. It is based on a review of a document written by one of his doctors, Edvard Bull (1845-1925), letters, biographic information, and Ibsen's death certificate...
2018: Frontiers of Neurology and Neuroscience
Runhua Zhang, Gaifen Liu, Yong Jiang, Gang Li, Yuesong Pan, Yilong Wang, Zaihua Wei, Jing Wang, Yongjun Wang
Background and Purpose: A large body of literature reported the association of particulate matter (PM) with stroke in high-income countries. Few studies have examined the association between PM and stroke in middle- and low-income countries and considered the types of stroke. In this study, we examined the short-term effects of particulate matter <2.5 μm in diameter (PM2.5 ) and particulate matter <10 μm in diameter (PM10 ) on ischemic stroke mortality and hemorrhagic stroke mortality in Beijing, China...
2018: Frontiers in Neurology
Osman Shabir, Jason Berwick, Sheila E Francis
Efficient blood supply to the brain is of paramount importance to its normal functioning and improper blood flow can result in potentially devastating neurological consequences. Cerebral blood flow in response to neural activity is intrinsically regulated by a complex interplay between various cell types within the brain in a relationship termed neurovascular coupling. The breakdown of neurovascular coupling is evident across a wide variety of both neurological and psychiatric disorders including Alzheimer's disease...
October 17, 2018: BMC Neuroscience
David P Fisher, Eric Johnson, Sebastien Haneuse, David Arterburn, Karen J Coleman, Patrick J O'Connor, Rebecca O'Brien, Andy Bogart, Mary Kay Theis, Jane Anau, Emily B Schroeder, Stephen Sidney
Importance: Macrovascular disease is a leading cause of morbidity and mortality for patients with type 2 diabetes, and medical management, including lifestyle changes, may not be successful at lowering risk. Objective: To investigate the relationship between bariatric surgery and incident macrovascular (coronary artery disease and cerebrovascular diseases) events in patients with severe obesity and type 2 diabetes. Design, Setting, and Participants: In this retrospective, matched cohort study, patients with severe obesity (body mass index ≥35) aged 19 to 79 years with diabetes who underwent bariatric surgery from 2005 to 2011 in 4 integrated health systems in the United States (n = 5301) were matched to 14 934 control patients on site, age, sex, body mass index, hemoglobin A1c, insulin use, observed diabetes duration, and prior health care utilization, with follow-up through September 2015...
October 16, 2018: JAMA: the Journal of the American Medical Association
Natalie C Wheeler, Sadhana Murali, Justin A Sattin
There are ethical aspects to each of the three phases of cerebrovascular disease: hyperacute management, acute prognostication and management of early complications, and long-term recovery and reintegration with the community. This article addresses ethical concerns pertinent to each phase. First, we discuss ethical issues regarding consent for thrombolysis and endovascular treatment for acute ischemic stroke, including a review of considerations regarding the provision of acute stroke treatment advice over the telephone...
October 2018: Seminars in Neurology
Sang Jun Park, Hee Kyung Yang, Seong Jun Byun, Kyu Hyung Park, Jeong-Min Hwang
PURPOSE: To determine whether ocular motor cranial nerve (CN) palsy raises the risk of subsequent stroke in the general population. METHODS: We investigated the association between ocular motor CN palsy and occurrence of stroke using the National Health Insurance Service-National Sample Cohort database from 2002 to 2013. We included individuals aged ≥ 20 years on January 1st, 2004, and excluded those having any paralytic strabismus, disorders in binocular movement, diplopia and any cerebrovascular diseases before entering the cohort...
2018: PloS One
Carlos Branco, Gonçalo F Coutinho, Filipe Soares, Pedro E Antunes, Manuel J Antunes
BACKGROUND: Complete revascularization is the gold standard of coronary artery bypass grafting (CABG). However, the rationale for revascularization of all diseased vessels is questionable. We aimed at evaluating the impact of multiple versus single grafts in each diseased coronary territory in the long-term survival and incidence of major adverse cardiac and cerebrovascular events (MACCE). METHODS: From January/00 to November/15, 5.694 consecutive patients were submitted to isolated CABG, of whom 4...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
D M Akpanova, S F Berkinbayev, A T Mussagaliyeva, D A Ospanova, B S Zhussupov
BACKGROUND: Stroke takes the second place among all causes for cardiovascular death and the first place in mortality and disability among other nervous system diseases. Atrial fibrillation (AF) is presently is a commonly recognized, independent risk factor for ischemic stroke, which fivefold increases the risk of an unfavorable outcome. Prevention of stroke is a complicated medical and social challenge. AIM: To study AF prevalence among patients with stroke/transient ischemic attack (TIA) who had received an anticoagulant therapy before hospitalization...
2018: Kardiologiia
Jun Mo, Lei Huang, Jianhua Peng, Umut Ocak, Jianmin Zhang, John H Zhang
Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia...
October 11, 2018: Neuroscience Bulletin
Mihaela Găman, Ana-Maria Vlădăreanu, Camelia Dobrea, Minodora Onisâi, Cristina Marinescu, Diana Cîşleanu, Cristina Ciufu, Daniela Vasile, Horia Bumbea, Irina Voican
POEMS syndrome (acronym consisting of: polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) is an uncommon disorder associated with an underlying plasma cell dyscrasia. There is no single specific test for POEMS, and due to its rarity and heterogeneity, patients are often mis- or underdiagnosed. Castleman disease (CD) is a rare lymphoproliferative disorder, closely related to POEMS syndrome; ~11%-30% of POEMS patients are associated with concomitant CD. In contrast to frequently published reports on vascular events in POEMS syndrome affecting coronary arteries or lower limbs, cases of cerebrovascular events are rarely mentioned in literature...
2018: OncoTargets and Therapy
Luís Almeida Morais, Lídia de Sousa, Antonio Fiarresga, José Diogo Martins, Ana Teresa Timóteo, André Viveiros Monteiro, Cristina Soares, Ana Agapito, Fátima Pinto, Rui Cruz Ferreira
The benefits of patent foramen ovale (PFO) closure for cryptogenic stroke secondary prevention are still debated. The Risk of Paradoxical Embolism (RoPE) study developed a score to improve patient selection for this procedure. We proposed to assess the validity of this score to assess the prognostic impact of PFO closure.From 2000 to 2014, all consecutive patients submitted to PFO closure were included in a prospective registry in a university center. The primary endpoint was recurrent ischemic cerebrovascular events and the secondary endpoints were all-cause, neurological, and cardiac mortality rates and new-onset atrial fibrillation (NOAF) rates...
October 10, 2018: International Heart Journal
Sampath Gunda, Santosh K Padala, Aditya Saini, Le Kang, Kenneth A Ellenbogen, Jayanthi N Koneru
Aims: Outcome data on ventricular tachycardia (VT) ablation has been limited to few experienced centres. We sought to identify complication rates, predictors, and create a risk score model for predicting complications in patients from real-world data. Methods and results: A total of 25 451 patients undergoing VT ablation from year 2006 to 2013 were identified from the National Inpatient Sample (NIS) database. The whole cohort was randomly divided into derivation cohort to derive the model and validation cohort to validate the model...
October 9, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Frederik Geisler, Syed F Ali, Martin Ebinger, Alexander Kunz, Michal Rozanski, Carolin Waldschmidt, Joachim E Weber, Matthias Wendt, Benjamin Winter, Lee H Schwamm, Heinrich J Audebert
Background Patients with a sudden onset of focal neurological deficits consistent with stroke, who turn out to have alternative conditions, have been labeled stroke mimics. Aims We assessed a recently validated telemedicine-based stroke mimic score (TeleStroke mimic score; TM-score) and individual patient characteristics with regard to its discriminative value between cerebrovascular disease and stroke mimic patients in the in-person, pre-hospital setting. Methods We evaluated patients cared for in a mobile stroke unit in Berlin, Germany...
October 10, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Joshua A Cuoco, Christopher M Busch, Brendan J Klein, Michael J Benko, Rachel Stein, Andrew D Nicholson, Eric A Marvin
BACKGROUND: Missense mutations in the gene that codes for smooth muscle actin, ACTA2, cause diffuse smooth muscle dysfunction and a distinct cerebral arteriopathy collectively known as multisystemic smooth muscle dysfunction syndrome (MSMDS). Until recently, ACTA2 cerebral arteriopathy was considered to be a variant of moyamoya disease. However, recent basic science and clinical data have demonstrated that the cerebral arteriopathy caused by mutant ACTA2 exhibits genetic loci, histopathology, neurological sequelae, and radiographic findings unique from moyamoya disease...
October 9, 2018: Cerebrovascular Diseases
Michael I Nahhas, David C Hess
PURPOSE OF REVIEW: The purpose of this article is to provide a review of state-of-the-art cellular therapy in cerebrovascular diseases by discussing published and ongoing clinical trials. RECENT FINDINGS: In spite of the challenge in translating the success of cellular therapy in acute strokes from preclinical models to clinical trials, early phase clinical trial have recently shown promise in overcoming these challenges. Various stem cell types and doses are being studied, different routes of administration are under investigation, as well as defining the optimal time window to intervene...
October 9, 2018: Current Treatment Options in Neurology
Yulu Shi, Michael J Thrippleton, Gordon W Blair, David A Dickie, Ian Marshall, Iona Hamilton, Fergus N Doubal, Francesca Chappell, Joanna M Wardlaw
Cerebral small vessel disease (SVD) contributes to 25% of ischemic strokes and 45% of dementias. We aimed to investigate the role of cerebral blood flow (CBF) and intracranial pulsatility in SVD. We scanned 60 patients with minor ischemic stroke, representing a range of white matter hyperintensities (WMH). We rated WMH and perivascular spaces (PVS) using semi-quantitative scales and measured WMH volume. We measured flow and pulsatility in the main cerebral vessels and cerebrospinal fluid (CSF) using phase-contrast MRI...
October 8, 2018: Journal of Cerebral Blood Flow and Metabolism
Temmy Lee Ting Lo, Janet Lok Chun Lee, Rainbow Tin Hung Ho
Background: Stroke is a life-threating cerebrovascular disease. Without proper and immediate treatment, it can cause long-term disabilities and even death. While current rehabilitation focuses on functional needs, it does not fully address the psychosocial issues. Creative arts-based therapies, however, may have the potential to be of assistance. Methods: A systematic review was conducted to synthesize the qualitative findings of the stroke survivors' positive and negative experiences in participating in creative arts-based therapies...
2018: Frontiers in Psychology
Virginia A Pujol Lereis, Mario O Melcon, Maximiliano A Hawkes, Maia M Gomez Schneider, Daiana E Dossi, Matías J Alet, Guillermo P Povedano, Claudio D Gonzalez, Sebastián F Ameriso
BACKGROUND: Epidemiological data on stroke is scarce in Latin America. Estudio Epidemiológico Poblacional sobre Accidente Cerebrovascular (EstEPA) is a population-based program planned to assess prevalence, incidence, mortality, and burden of disease for stroke in the Department of General Villegas, province of Buenos Aires, Argentina. METHODS AND DESIGN: Prevalence study will consist of a two-phase survey approach in the urban area of General Villegas. First, trained social workers with a structured questionnaire will collect data in 2000 randomly selected housing units...
October 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Xiaodong Chen, Jihui Wang, Yilong Shan, Wei Cai, Sanxin Liu, Mengyan Hu, Siyuan Liao, Xuehong Huang, Bingjun Zhang, Yuge Wang, Zhengqi Lu
Cerebral small vessel disease (CSVD) is a broad category of cerebrovascular diseases which primarily affect the perforating arterioles, capillaries and venules with multiple distinct etiologies. In spite of distinctive pathogenesis, CSVD shares similar neuroimaging markers, including recent small subcortical infarct, lacune of presumed vascular origin, white matter hyperintensity of presumed vascular origin, perivascular space and cerebral microbleeds. The radiological features of neuroimaging markers are indicative for etiological analysis...
October 5, 2018: Journal of Neurology
Jaewon Shin, Jong-Won Chung, Moo Seok Park, Hanul Lee, Jihoon Cha, Woo-Keun Seo, Gyeong-Moon Kim, Oh Young Bang
OBJECTIVE: To compare the outcomes between patients with nontraumatic intracranial arterial dissection (ICAD) and intracranial atherosclerotic stenosis (ICAS) using high-resolution MRI (HR-MRI). METHODS: We conducted a prospective study using HR-MRI in patients with acute symptomatic cerebrovascular disease due to intracranial occlusive disease and no dissection on luminal images. Patients were followed-up for 27.9 ± 19.3 months. We compared the functional outcome, recurrence, and changes in vascular status between patients with ICAD (dissection and no plaque on HR-MRI) and ICAS (atherosclerosis plaque on HR-MRI)...
October 5, 2018: Neurology
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