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TIA clinic: a major advance in management of transient ischemic attacks.
Authors: Lavallée P, Amarenco P Abstract Patients with transient ischemic attack (TIA) are at very high risk of imminent stroke. This risk could be decreased by 80% if patients are immediately investigated and treated by stroke specialists. However, because TIA workup includes not only specialist advices but also a wide range of investigations such as brain, arterial and cardiac imaging, management of these patients in emergency required well-organized dedicated health care system, such as TIA clinics. Management of TIA patients in outpatient clinics has been shown to be safe and cost-effective avoiding full hospi...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Transient ischemic attack as a medical emergency.
Authors: Okada Y Abstract Since transient ischemic attack (TIA) is regarded as a medical emergency with high risk for early stroke recurrence, the underlying mechanisms should be immediately clarified to conclude a definitive diagnosis and provide early treatment. Early risk stratification using ABCD(2) scores can predict the risk of ischemic stroke occurring after TIA. Carotid ultrasonography (US) can evaluate the degree of stenosis, plaque properties and flow velocity of ICA lesions. High-risk mobile plaques can be classified by carotid US, and aortogenic sources of emboli can be detected by transesophageal echoc...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

The concept of acute cerebrovascular syndrome.
Authors: Uchiyama S Abstract Early after the onset of transient ischemic attack (TIA), patients are at very high risk of stroke. There is no meaning to differentiate TIA in acute settings from acute ischemic stroke (AIS) only by the duration of symptoms. Acute TIA and AIS are on the same spectrum of acute ischemic syndrome in the central nervous system. We proposed a new concept termed acute cerebrovascular syndrome (ACVS), which includes TIA in acute settings and AIS. The concept of ACVS is comparable to acute coronary syndrome (ACS), which includes unstable angina and acute myocardial infarction. When a focal sym...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

History of transient ischemic attack definition.
Authors: Mohr JP Abstract Transient ischemic attacks have been recognized as a clinical entity for well over a century. Efforts before the availability of modern imaging to establish a diagnosis of inferred ischemic stroke led to acceptance of too long a time period (>24 h) compared with the actual typical events lasting <24 min (usually 5-15 min). Revision of the time period has improved diagnostic yield and discovered many whose image-documented acute infarct is associated with a short clinical course. PMID: 24157552 [PubMed - indexed for MEDLINE]
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Prevention of post-stroke disuse muscle atrophy with a free radical scavenger.
Authors: Naritomi H, Moriwaki H Abstract In spite of appropriate treatment in the acute phase of stroke, quite a few patients with hemiparetic stroke become disabled and stay in a wheelchair or bedridden state in the chronic phase. In stroke patients, gait dysfunction results mainly from severe hemiparesis due to ischemic damage to the motor neuron tract and partly from disuse muscle atrophy in paretic and nonparetic legs. Disuse muscle atrophy occurs even in healthy subjects as early as 4 days after bed rest immobilization and progresses further correlating with the duration of immobilization. Although detailed me...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

High voltage electric potentials to enhance brain-derived neurotrophic factor levels in the brain.
Authors: Yanamoto H, Nakajo Y, Kataoka H, Iihara K Abstract Development of a safe method to increase brain-derived neurotrophic factor (BDNF) levels in the brain is expected to enhance learning and memory, induce tolerance to cerebral infarction or tolerance to depressive state, improve glucose metabolism, and suppress appetite and body weight. We have shown that repetitive applications of high-voltage electric potential (HELP) to the body increase BDNF levels in the brain, improving learning and memory in mice. Here, we investigated the effects of HELP treatment for a chronic period on the BDNF levels in the mouse...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Influence of therapeutic hypothermia on regeneration after cerebral ischemia.
Authors: Yenari MA, Han HS Abstract The protective effect of therapeutic hypothermia in cerebral ischemia is well accepted in experimental models, and some clinical studies show that there is benefit in humans as well. Long-term observations in animal and clinical studies have documented recovery of neurological function following hypothermia treatment. Diminished damage by hypothermic protection should contribute to the recovery in many ways, but hypothermia appears to enhance regeneration of brain tissue as well. Since regeneration of the brain after damage initiates within hours and is active days and weeks afte...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Role of repetitive transcranial magnetic stimulation in stroke rehabilitation.
Authors: Pinter MM, Brainin M Abstract In recent years, efforts have focused on investigating the neurophysiological changes that occur in the brain after stroke, and on developing novel strategies such as additional brain stimulation to enhance sensorimotor and cognitive recovery. In the 1990s, repetitive transcranial magnetic stimulation (rTMS) was introduced as a therapeutic tool for improving the efficacy of rehabilitation for recovery after stroke. It is evident that disturbances of interhemispheric processes after stroke result in a pathological hyperactivity of the intact hemisphere. The rationale of using r...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Novel methods to study aphasia recovery after stroke.
Authors: Hartwigsen G, Siebner HR Abstract The neural mechanisms that support aphasia recovery are not yet fully understood. It has been argued that the functional reorganization of language networks after left-hemisphere stroke may engage perilesional left brain areas as well as homologous right-hemisphere regions. In this chapter, we summarize how noninvasive brain stimulation can be used to elucidate mechanisms of plasticity in language networks and enhance language recovery after stroke. We first outline some basic principles of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

A brain-computer interface to support functional recovery.
Authors: Kjaer TW, Sørensen HB Abstract Brain-computer interfaces (BCI) register changes in brain activity and utilize this to control computers. The most widely used method is based on registration of electrical signals from the cerebral cortex using extracranially placed electrodes also called electroencephalography (EEG). The features extracted from the EEG may, besides controlling the computer, also be fed back to the patient for instance as visual input. This facilitates a learning process. BCI allow us to utilize brain activity in the rehabilitation of patients after stroke. The activity of the cerebral cort...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Experimental evidence and early translational steps using bone marrow derived stem cells after human stroke.
Authors: Kasahara Y, Ihara M, Taguchi A Abstract Neurogenesis is principally restricted to the subventricular zone of the lateral ventricle wall and the subgranular zone of the hippocampal dentate gyrus in physiological situations. However, neuronal stem cells are known to be mobilized into the post- and peristroke area and we have demonstrated that appropriate support of these stem cells, achieved by therapeutic angiogenesis, enhances neuroregeneration followed by neuronal functional recovery in an experimental stroke model. We also found that neural stem cells are mobilized in patients after stroke, as well as in...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Translational challenge for bone marrow stroma cell therapy after stroke.
Authors: Kuroda S, Houkin K Abstract There is increasing evidence that the transplanted bone marrow stromal cells (BMSC) significantly promote functional recovery after central nervous system (CNS) damage in the animal models of various kinds of CNS disorders, including cerebral infarct. However, there remain several challenges before considering BMSC transplantation for patients with ischemic stroke. In this review, therefore, the authors discuss what should be clarified to establish cell transplantation therapy in the clinical setting and describe their scientific contributions in this matter. The BMSC have the a...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Regeneration of neuronal cells following cerebral injury.
Authors: Dailey T, Tajiri N, Kaneko Y, Borlongan CV Abstract Stem cells possess a definitive role in neuronal rejuvenation following a cerebral injury. Whether endogenous, from the neurogenic niches of the subventricular zone and subgranular zone, or recruited from the bone marrow through peripheral circulation, accumulating evidence demonstrates that stem cells ameliorate the consequences of cerebrovascular events, particularly cerebral ischemia. In this chapter, we review milestone studies implicating the role of stem cells in response to disease. Furthermore, we outline specific mechanisms of action along with t...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Compensatory contribution of the contralateral pyramidal tract after stroke.
Authors: Otsuka N, Miyashita K, Krieger DW, Naritomi H Abstract Stroke is a leading cause of long-term disability with early accelerated followed by gradual recovery during the first 6 months after the ictus. The most important mechanism concerning early recovery is thought to be brain plasticity provided by anatomical and functional reorganization of the central nervous system after injury. Recent advances in noninvasive, functional brain imaging techniques provided some insight indicating the contribution of ipsilateral uncrossed corticospinal tracts in motor recovery after stroke. Since motor tracts vary conside...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Compensatory contribution of the contralateral pyramidal tract after experimental cerebral ischemia.
Authors: Takatsuru Y, Nakamura K, Nabekura J Abstract Many people escape sudden death from ischemic brain stroke, but suffer from severe disabilities such as aphasia and/or paralysis. These survivors of focal brain injury need chronic care to recover from and/or compensate for the impaired sensory and motor functions previously controlled by the focal ischemic core. Functional compensation not only involves the remaining brain areas around the infarction but also the areas contralateral to the stroke lesion, with the need for remodeling of neuronal circuits in some cases. In this review, recent human and animal stu...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

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