Motor Recovery: How Rehabilitation Techniques and Technologies Can Enhance Recovery and Neuroplasticity
Semin Neurol DOI: 10.1055/s-0041-1725138There are now a large number of technological and methodological approaches to the rehabilitation of motor function after stroke. It is important to employ these approaches in a manner that is tailored to specific patient impairments and desired functional outcomes, while avoiding the hype of overly broad or unsubstantiated claims for efficacy. Here we review the evidence for poststroke plasticity, including therapy-related plasticity and functional imaging data. Early demonstrations of remapping in somatomotor and somatosensory representations have been succeeded by findings of whit...
Source: Seminars in Neurology - March 4, 2021 Category: Neurology Authors: Braun, Robynne G. Wittenberg, George F. Tags: Review Article Source Type: research
Assessment and Treatment of Concussion in the Pediatric Population
Semin Neurol DOI: 10.1055/s-0041-1725135Traumatic brain injury (TBI) is common in children. The evaluation and management of children with TBI is based on the research performed in adults. There is a relative paucity of research in the literature involving children and many of the practice recommendations for this age are based on expert opinion in the absence of good research studies in both sports and non–sports-related injuries. The pediatric population is heterogeneous and the approach might be specific for infants, preschoolers, school age children, and adolescents. Children may also suffer from neurodevelopmental d...
Source: Seminars in Neurology - March 3, 2021 Category: Neurology Authors: Lugo, Giancarlo J. Beletanga, Maria Goldstein, Laura Rana, Mandeep Jonas, Rinat Torres, Alcy R. Tags: Review Article Source Type: research
Acute Stroke
Semin Neurol 2021; 41: 003-003 DOI: 10.1055/s-0041-1722922 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - February 22, 2021 Category: Neurology Authors: Sangha, Navdeep Ishida, Koto Tags: Preface Source Type: research
Navdeep Sangha, MD, and Koto Ishida, MD
Semin Neurol 2021; 41: 001-002 DOI: 10.1055/s-0041-1722921 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - February 22, 2021 Category: Neurology Authors: Greer, David M. Tags: Introduction to the Guest Editors Source Type: research
Surgical Interventions for Supratentorial Intracranial Hemorrhage: The Past, Present, and Future
Semin Neurol DOI: 10.1055/s-0040-1722639Spontaneous supratentorial intracranial hemorrhage is extremely disabling and is associated with high mortality. Primary treatment for patients with this disease process is maximal medical management with blood pressure control and correction of clotting disorders due to comorbid conditions or medications. Over the past decade, significant strides have been made in understanding the benefits of surgical intervention in the treatment of intracranial hemorrhage through multiple clinical trials. In this article, we review the evolution of surgical treatments beginning with the STICH tri...
Source: Seminars in Neurology - January 28, 2021 Category: Neurology Authors: Patel, Smruti K. Saleh, Mohamed S. Body, Alaina Zuccarello, Mario Tags: Review Article Source Type: research
Neuropsychiatric Complications after Stroke
Semin Neurol DOI: 10.1055/s-0040-1722723Neuropsychiatric disturbances represent a common and uniquely challenging consequence of stroke. These disorders arise at the intersection of lesion-related brain dysfunction and psychological distress related to the event and its aftermath, making it difficult to identify what symptom is a direct physiological consequence of the stroke. Depression, anxiety, fatigue, apathy, emotionalism, and anger are the most common of these syndromes, and posttraumatic stress disorder related to the stroke event has become increasingly recognized as a relevant entity. Mania, obsessive–compulsive...
Source: Seminars in Neurology - January 28, 2021 Category: Neurology Authors: Nemani, Katlyn Gurin, Lindsey Tags: Review Article Source Type: research
Mobile Stroke Units: Current and Future Impact on Stroke Care
Semin Neurol DOI: 10.1055/s-0040-1722724Ischemic stroke is a leading cause of death and major disability that impacts societies across the world. Earlier thrombolysis of blocked arteries with intravenous tissue plasminogen activator (tPA) and/or endovascular clot extraction is associated with better clinical outcomes. Mobile stroke units (MSU) can deliver faster tPA treatment and rapidly transport stroke patients to centers with endovascular capabilities. Initial MSU trials in Germany indicated more rapid tPA treatment times using MSUs compared with standard emergency room treatment, a higher proportion of patients treated...
Source: Seminars in Neurology - January 28, 2021 Category: Neurology Authors: Bowry, Ritvij Grotta, James C. Tags: Review Article Source Type: research
Prehospital EMS Triage for Acute Stroke Care
Semin Neurol DOI: 10.1055/s-0040-1722725Acute stroke has had major advances over the last two decades due to the introduction of pharmacologic and endovascular revascularization, which can improve functional outcome. Stroke systems of care have been developed to provide faster, more efficient care for stroke patients. A major part of these care pathways is prehospital care, when patients are triaged to appropriate levels of care. It is essential that prehospital scales are used accurately and effectively by emergency medical services to assist them with the triage process. New technologies including mobile stroke units, te...
Source: Seminars in Neurology - January 27, 2021 Category: Neurology Authors: Noorian, Ali Reza Tags: Review Article Source Type: research
Stem Cell Treatment for Ischemic Stroke Recovery
This report reviews the different biological repair approaches using cell implants, discusses clinical trial design and surgical methods, and the current state of research. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - January 27, 2021 Category: Neurology Authors: Kondziolka, Douglas Tags: Review Article Source Type: research
Alteplase and Adjuvant Therapies for Acute Ischemic Stroke
Semin Neurol DOI: 10.1055/s-0040-1722720Acute ischemic stroke (AIS) is a time sensitive medical emergency and a leading cause of morbidity and mortality worldwide. Intravenous (IV) recombinant tissue plasminogen activator (IV alteplase) is currently the only proven effective medication for the treatment of AIS with promising adjuvant medications currently under investigation. Recent advances in endovascular thrombectomy have broadened therapeutic options in specific patient populations, with modern treatment strategies utilizing advanced imaging modalities to extend the window for treatment. In all cases, rapid treatment r...
Source: Seminars in Neurology - January 20, 2021 Category: Neurology Authors: Gottula, Adam L. Barreto, Andrew D. Adeoye, Opeolu Tags: Review Article Source Type: research
Blood Pressure Management Before, During, and After Endovascular Thrombectomy for Acute Ischemic Stroke
Semin Neurol DOI: 10.1055/s-0040-1722721There is an absence of specific evidence or guideline recommendations on blood pressure management for large vessel occlusion stroke patients. Until randomized data are available, the periprocedural blood pressure management of patients undergoing endovascular thrombectomy can be viewed in two phases relative to the achievement of recanalization. In the hyperacute phase, prior to recanalization, hypotension should be avoided to maintain adequate penumbral perfusion. The American Heart Association guidelines should be followed for the upper end of prethrombectomy blood pressure: ≤18...
Source: Seminars in Neurology - January 20, 2021 Category: Neurology Authors: de Havenon, Adam Petersen, Nils Sultan-Qurraie, Ali Alexander, Matthew Yaghi, Shadi Park, Min Grandhi, Ramesh Mistry, Eva Tags: Review Article Source Type: research
Tenecteplase for Acute Ischemic Stroke Treatment
Semin Neurol DOI: 10.1055/s-0040-1722722The introduction of thrombolytic therapy in the 1990s has transformed acute ischemic stroke treatment. Thus far, intravenous recombinant tissue plasminogen activator (rt-PA) also known as alteplase is the only thrombolytic proven to be efficacious and approved by the United States Food and Drug Administration. But the thrombolytic agent tenecteplase (TNK) is emerging as a potential replacement for rt-PA. TNK has greater fibrin specificity, slower clearance, and higher resistance to plasminogen activator inhibitor-1 than rt-PA. Hence, TNK has the potential to provide superior lysis wi...
Source: Seminars in Neurology - January 20, 2021 Category: Neurology Authors: Baird, Alison E. Jackson, Richard Jin, Weijun Tags: Review Article Source Type: research
Poststroke Pain
Semin Neurol DOI: 10.1055/s-0040-1722641Pain is common but often underrecognized after stroke. Poststroke pain (PSP) hinders recovery, impairs quality of life, and is associated with the psychological state of patients with stroke. The most common subtypes of PSP include central PSP, complex regional pain syndrome, shoulder pain, spasticity-related pain, and headache. The pathophysiologies of these PSP subtypes are not yet clearly understood, and PSP is refractory to conventional treatment in many patients. However, recent studies have proposed potential pathophysiologies of PSP subtypes, which may help prioritize therapie...
Source: Seminars in Neurology - January 14, 2021 Category: Neurology Authors: Yang, Seoyon Chang, Min Cheol Tags: Review Article Source Type: research
Basilar Artery Occlusion and Emerging Treatments
Semin Neurol DOI: 10.1055/s-0040-1722638Basilar artery occlusion is a relatively uncommon but neurologically devastating condition. If revascularization is not achieved, the potential for death and disability is substantial. During the last several years, there have been positive endovascular stroke trials for the treatment of large vessel occlusion; however, all of them excluded patients with basilar artery occlusion. The current treatment of basilar artery occlusion is still founded on small observational studies or meta-analyses. As case selection for revascularization and treatment protocols often vary widely across in...
Source: Seminars in Neurology - January 14, 2021 Category: Neurology Authors: Liu, Zuolu Liebeskind, David S. Tags: Review Article Source Type: research
Cognitive Impairment in Patients with Stroke
Semin Neurol DOI: 10.1055/s-0040-1722217Despite substantial advances in stroke care, vascular cognitive impairment remains a prominent source of disability. Unlike sensorimotor impairments, cognition often continues to decline after stroke. An aging population will increase the prevalence of vascular cognitive impairment, with stroke playing an important role. Ten percent of patients presenting with stroke have pre-stroke dementia; an additional 10% will develop incident dementia with a first stroke, and 30% with a recurrent stroke. While stroke increases the risk of cognitive impairment, the presence of cognitive impairme...
Source: Seminars in Neurology - January 8, 2021 Category: Neurology Authors: D'Souza, Caitlin E. Greenway, Melanie R. F. Graff-Radford, Jonathan Meschia, James F. Tags: Review Article Source Type: research
