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Source: Seminars in Neurology
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Total 93 results found since Jan 2013.
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
Stroke: New Developments and Their Application in Clinical Practice
Semin Neurol 2016; 36: 317-323 DOI: 10.1055/s-0036-1586261Significant advances have been made in recent years in primary stroke prevention, improved stroke outcomes in high-income populations, emergency stroke therapy, and stroke prevention. In this article, we review recent trends in stroke epidemiology, improvements in delivery of intravenous thrombolysis (via stroke system-wide approaches, application of ‘Lean Principles’ to improve workflow processes, and re-evaluation of exclusion criteria), recent stroke thrombectomy trials, and new developments in stroke prevention, with emphasis on risk prediction in transient ...
Source: Seminars in Neurology - September 18, 2016 Category: Neurology Authors: Kelly, Peter J. Kavanagh, Eoin Murphy, Sean Tags: Review Article Source Type: research
Atrial Fibrillation and Ischemic Stroke: A Clinical Review
Semin Neurol DOI: 10.1055/s-0041-1726332Atrial fibrillation (AF) is an important risk factor for ischemic stroke resulting in a fivefold increased stroke risk and a twofold increased mortality. Our understanding of stroke mechanisms in AF has evolved since the concept of atrial cardiopathy was introduced as an underlying pathological change, with both AF and thromboembolism being common manifestations and outcomes. Despite the strong association with stroke, there is no evidence that screening for AF in asymptomatic patients improves clinical outcomes; however, there is strong evidence that patients with embolic stroke of ...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Migdady, Ibrahim Russman, Andrew Buletko, Andrew B. Tags: Review Article Source Type: research
Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Semin Neurol DOI: 10.1055/s-0041-1726329Heart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Rece...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Seol, Hyeyoung Kim, Jong S. Tags: Review Article Source Type: research
Modifiable Risk Factors for Stroke and Strategies for Stroke Prevention
Semin Neurol 2017; 37: 237-258 DOI: 10.1055/s-0037-1603685The pathophysiology of stroke is well characterized, and 9 out of 10 strokes are due to modifiable factors. However, preventive strategies thus far have been relatively ineffective in curbing the global stroke burden, which is projected to increase given the aging of the world's population and epidemiological transition in many low- to middle-income countries. In this review we will summarize our current understanding of behavioral, environmental, and metabolic stroke risk factors not covered elsewhere in this issue. Specifically, we will review the evidence for env...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Hill, Valerie A. Towfighi, Amytis Tags: Review Article Source Type: research
Blood Pressure and Prevention of Stroke
Semin Neurol 2017; 37: 274-285 DOI: 10.1055/s-0037-1603501Stroke is a common cause of morbidity and mortality worldwide, and hypertension is the most common modifiable risk factor for stroke. The treatment of hypertension reduces the primary occurrence of stroke as well as the risk of stroke recurrence. Although there are conflicting data regarding the optimal blood pressure for stroke prevention, an individualized approach taking into account the patient's age, comorbidities, and side effects of medication is a helpful strategy. Current guidelines support the pursuit of a systolic blood pressure under 140 mm Hg for both...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Dakay, Katarina Silver, Brian Tags: Review Article Source Type: research
Gastrointestinal Dysfunction in Stroke
Semin Neurol DOI: 10.1055/s-0043-1771470Gastrointestinal (GI) complications are seen in over 50% of ischemic stroke survivors; the most common complications are dysphagia, constipation, and GI bleeding. The bidirectional relationship of the gut–brain axis and stroke has recently gained traction, wherein stroke contributes to gut dysbiosis (alterations in the normal host intestinal microbiome) and gut dysbiosis perpetuates poor functional neurologic outcomes in stroke. It is postulated that the propagation of proinflammatory cells and gut metabolites (including trimethylamine N-oxide and short-chain fatty acids) from the ...
Source: Seminars in Neurology - August 10, 2023 Category: Neurology Authors: Yong, Heather Y.F. Ganesh, Aravind Camara-Lemarroy, Carlos Tags: Review Article Source Type: research
Treating Dyslipidemia for the Primary and Secondary Prevention of Stroke
Semin Neurol 2017; 37: 286-293 DOI: 10.1055/s-0037-1603511Stroke is associated with a heavy burden of mortality and disability, underscoring the importance of effective primary and secondary prevention measures. Dyslipidemia as a risk factor for ischemic stroke has long been disputed. Nevertheless, accumulating epidemiological evidence supports a role of lipid abnormalities in increasing ischemic stroke risk and representing a potential target for therapeutic interventions. 3-hydroxy-3-methyl-glutaryl- (HMG-) CoA reductase inhibitors (i.e., statins) are currently the mainstay of therapy for the management of hypercholester...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Barkas, Fotios Milionis, Haralampos Tags: Review Article Source Type: research
Global Burden of Stroke
This article reviews the epidemiological and clinical data concerning stroke incidence and burden around the globe. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text
Source: Seminars in Neurology - May 23, 2018 Category: Neurology Authors: Katan, Mira Luft, Andreas 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
Nutrition in Stroke Prevention
Semin Neurol 2017; 37: 259-266 DOI: 10.1055/s-0037-1603470Nutrition is far more important to the prevention of stroke than most physicians realize. Key issues include a Mediterranean diet, the interaction of the intestinal microbiome, impaired renal function and diet, missed metabolic B12 deficiency, and the lowering of homocysteine with B vitamins to prevent stroke. The Cretan Mediterranean diet is high in olive oil, whole grains, fruits, vegetables, and legumes, and is close to a vegetarian diet. Compared with a low-fat diet, it reduced stroke by over 40%, and is clearly the best diet for diabetes. Metabolic B12 deficien...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Spence, J. David Tags: Review Article Source Type: research
Systematic Review and Meta-Analysis of Psychosocial Risk Factors for Stroke
Semin Neurol 2017; 37: 294-306 DOI: 10.1055/s-0037-1603758Several studies have assessed the link between psychosocial risk factors and stroke; however, the results were inconsistent. We have conducted a systemic review and meta-analysis of cohort or case-control studies to ascertain the association between psychosocial risk factors (psychological, vocational, behavioral, interpersonal, and neuropsychological) and the risk of stroke. Systematic searches were undertaken in MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews between 2000 and January 2017. Two reviewers independently screened tit...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Lightbody, C. Elizabeth Clegg, Andrew Patel, Kulsum Lucas, Julie Cook Storey, Hannah Hackett, Maree L. Watkins, Dame Caroline L. Tags: Review Article Source Type: research
Single Gene Causes of Stroke
Semin Neurol 2017; 37: 351-365 DOI: 10.1055/s-0037-1603952Though rare, monogenic causes of stroke are recognizable by key clinical and radiographic features. A lack of epidemiological data leaves their true incidence unknown, but the most common monogenetic causes of stroke are sickle cell disease, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), Fabry's disease, and cerebral cavernous malformations. In this article, the author covers the epidemiology, clinical features, and treatment of those diseases as well as other well-described monogenic causes of ischemic and hemo...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Majersik, Jennifer Juhl Tags: Review Article Source Type: research
Learning and Stroke Recovery: Parallelism of Biological Substrates
Semin Neurol DOI: 10.1055/s-0041-1725136Stroke is a debilitating disease. Current effective therapies for stroke recovery are limited to neurorehabilitation. Most stroke recovery occurs in a limited and early time window. Many of the mechanisms of spontaneous recovery after stroke parallel mechanisms of normal learning and memory. While various efforts are in place to identify potential drug targets, an emerging approach is to understand biological correlates between learning and stroke recovery. This review assesses parallels between biological changes at the molecular, structural, and functional levels during learning an...
Source: Seminars in Neurology - March 9, 2021 Category: Neurology Authors: Joy, Mary Teena Carmichael, S Thomas Tags: Review Article Source Type: research
Primary Prevention of Ischemic Stroke
This article provides an overview on conventional modifiable risk factors for ischemic stroke and highlights the emerging risk factors and approaches for high-risk group identification and treatment. [...] 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 - November 17, 2022 Category: Neurology Authors: Sabayan, Behnam Tags: Review Article Source Type: research
