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Source: Seminars in Neurology
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Total 93 results found since Jan 2013.
Ocular Fundus Photography as a Tool to Study Stroke and Dementia
Semin Neurol 2015; 35: 481-490DOI: 10.1055/s-0035-1563570Although cerebral small vessel disease has been linked to stroke and dementia, due to limitations of current neuroimaging technology, direct in vivo visualization of changes in the cerebral small vessels (e.g., cerebral arteriolar narrowing, tortuous microvessels, blood–brain barrier damage, capillary microaneurysms) is difficult to achieve. As the retina and the brain share similar embryological origin, anatomical features, and physiologic properties with the cerebral small vessels, the retinal vessels offer a unique and easily accessible “window” to study the...
Source: Seminars in Neurology - October 6, 2015 Category: Neurology Authors: Cheung, Carol Y.Chen, ChristopherWong, Tien Y. Source Type: research
Acute Care of Ischemic Stroke Patients in the Hospital
Semin Neurol 2015; 35: 629-637DOI: 10.1055/s-0035-1564301Ischemic stroke is a leading cause of death and disability worldwide. Recent advances in acute treatment provide hope that the impact of this disease will be reduced. Rapid assessment for large vessel occlusion is now a key element in acute stroke care given advances in endovascular therapy. Because access to acute therapies is limited, development of systems of care to triage appropriate patients to specialized centers is essential. Acute hospitalization management requires multiple strategies including initiation of secondary prevention measures. In addition to pre...
Source: Seminars in Neurology - November 23, 2015 Category: Neurology Authors: Meisel, Karl M.Thabet, Ahmad M.Josephson, S. Andrew Source Type: research
Intensive Care Management of the Endovascular Stroke Patient
Semin Neurol 2016; 36: 520-530 DOI: 10.1055/s-0036-1592360Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long durat...
Source: Seminars in Neurology - November 30, 2016 Category: Neurology Authors: B ösel, Julian Tags: Review Article Source Type: research
Cardioembolic Stroke: Mechanisms and Therapeutics
Semin Neurol 2017; 37: 326-338 DOI: 10.1055/s-0037-1603465Cardioembolic stroke accounts for nearly 30% of all known stroke mechanisms. This percentage may be underestimated, however, when considering the large proportion of cryptogenic strokes that likely have a covert cardiac source. Although it is well known that cardioembolic stroke can occur in the setting of atrial fibrillation, other mechanisms such as a systolic heart failure, patent foramen ovale, valvular dysfunction, and aortic arch atheroma are commonly encountered in daily practice. The authors provide an overview on the epidemiology, pathogenesis, diagnostic e...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Sacchetti, Daniel C. Furie, Karen L. Yaghi, Shadi Tags: Review Article Source Type: research
Antiplatelet Therapy in Noncardioembolic Stroke: A Review of Current Evidence
Semin Neurol 2017; 37: 366-375 DOI: 10.1055/s-0037-1603469Acute stroke is a leading cause of death and disability in the developed world. Among survivors, the risk of stroke recurrence is highest within the first few days, and up to 15% will be affected within the first year. In the case of noncardioembolism, antiplatelets, such as aspirin, clopidogrel, and the combination of aspirin and dipyridamole, remain the mainstay of treatment. Aspirin given immediately is beneficial, but when combined with clopidogrel is associated with a higher risk of bleeding. Dual antiplatelet therapy of aspirin and dipyridamole was no more eff...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Krishnan, Kailash Jusufovic, Mirza Sandset, Per Morten Sandset, Else Charlotte Tags: Review Article Source Type: research
Special Considerations for Primary and Secondary Stroke Prevention in Women
Semin Neurol 2017; 37: 376-382 DOI: 10.1055/s-0037-1603684There are gender differences in stroke in several areas. Overall, the incidence of stroke is greater in women because of the increased risk of stroke with increasing age and the longer life expectancy of women. However, gender-specific risk factors for stroke include hormonal changes during pregnancy and exogenous hormonal therapies. Also, cerebral venous thrombosis, thrombophilia, and migraine are more prevalent in women. These gender differences are the subject of this review. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in T...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Alrasheed, Deema Jaigobin, Cheryl Tags: Review Article Source Type: research
Organized Outpatient Care of Patients with Transient Ischemic Attack and Minor Stroke
Semin Neurol 2017; 37: 383-390 DOI: 10.1055/s-0037-1603510The risk of recurrent stroke after transient ischemic attack (TIA) is high. In the past 10 years, TIA has increasingly been recognized as a medical emergency. Health systems have adapted toward rapid evaluation, investigation, and secondary prevention in patients with presumed TIA and minor stroke, and the significant benefits in reducing recurrent stroke and mortality have been borne out in several landmark studies. Various scores have been developed and debated to better risk stratify patients with TIA for hospitalization or urgent referral. However, scoring syste...
Source: Seminars in Neurology - July 31, 2017 Category: Neurology Authors: Joundi, R. A. Saposnik, G. Tags: Review Article Source Type: research
Stroke in Pregnancy
Semin Neurol 2017; 37: 669-678 DOI: 10.1055/s-0037-1608940Pregnancy and the postpartum period confer an increased risk of stroke. The risk appears to be increased for all strokes during the puerperium and for hemorrhagic strokes during pregnancy. During pregnancy, physiologic systems are under increased stress to accommodate the growing fetus, which results in substantial hemodynamic, cardiovascular, hematologic, immunologic, and structural connective tissue changes that account for much of this increased risk. In addition, preeclampsia–eclampsia has major effects on the vascular system, and this disorder, unique to preg...
Source: Seminars in Neurology - December 21, 2017 Category: Neurology Authors: Sells, Christina Mijalski Feske, Steven K. Tags: Review Article Source Type: research
Acute Stroke
Semin Neurol 2019; 39: 061-072 DOI: 10.1055/s-0038-1676992Stroke remains one of the leading determinants of death and severe disability worldwide. It is a medical emergency with a narrow window for recognition and administration of outcome-modifying treatment in the emergency department. Ischemic stroke accounts for the majority of cerebrovascular events and revascularization therapies such as intravenous thrombolysis and endovascular thrombectomy are the mainstays of treatment in carefully selected patients. Intracerebral hemorrhage is less common but remains the deadliest type of stroke. Blood pressure reduction and hemo...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Morotti, Andrea Poli, Loris Costa, Paolo 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
Principles of Neural Repair and Their Application to Stroke Recovery Trials
Semin Neurol DOI: 10.1055/s-0041-1725140Neural repair is the underlying therapeutic strategy for many treatments currently under investigation to improve recovery after stroke. Repair-based therapies are distinct from acute stroke strategies: instead of salvaging threatened brain tissue, the goal is to improve behavioral outcomes on the basis of experience-dependent brain plasticity. Furthermore, timing, concomitant behavioral experiences, modality specific outcome measures, and careful patient selection are fundamental concepts for stroke recovery trials that can be deduced from principles of neural repair. Here we discus...
Source: Seminars in Neurology - March 4, 2021 Category: Neurology Authors: Lin, David J. Cramer, Steven C. Tags: Review Article Source Type: research
Antithrombotic Therapy for Stroke Patients with Cardiovascular Disease
Semin Neurol DOI: 10.1055/s-0041-1726331Prevention of ischemic stroke relies on the use of antithrombotic medications comprising antiplatelet agents and anticoagulation. Stroke risk is particularly high in patients with cardiovascular disease. This review will focus on the role of antithrombotic therapies in the context of different types of cardiovascular disease. We will discuss oral antiplatelet medications and both IV and parental anticoagulants. Different kinds of cardiovascular disease contribute to stroke via distinct pathophysiological mechanisms, and the optimal treatment for each varies accordingly. We will explo...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Gusdon, Aaron M. Farrokh, Salia Grotta, James C. Tags: Review Article Source Type: research
The Role of Diabetes, Obesity, and Metabolic Syndrome in Stroke
Semin Neurol 2017; 37: 267-273 DOI: 10.1055/s-0037-1603753The prevalence of obesity, diabetes, and metabolic syndrome has increased globally. These epidemiologic changes are likely responsible for a rise in stroke incidence among young adults, despite declining stroke incidence rates in the elderly. In this review, the authors summarize the current understanding of the epidemiology and pathophysiology of stroke associated with obesity, diabetes, and metabolic syndrome. [...] 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 - July 31, 2017 Category: Neurology Authors: Tang, Xian Nan Liebeskind, David S. Towfighi, Amytis Tags: Review Article Source Type: research
Acute Stroke Multimodal Imaging: Present and Potential Applications toward Advancing Care
Semin Neurol 2017; 37: 558-565 DOI: 10.1055/s-0037-1607355In the past few decades, the field of acute ischemic stroke (AIS) has experienced significant advances in clinical practice. A core driver of this success has been the utilization of acute stroke imaging with an increasing focus on advanced methods including multimodal imaging. Such imaging techniques not only provide a richer understanding of AIS in vivo, but also, in doing so, provide better informed clinical assessments in management and treatment toward achieving best outcomes. As a result, advanced stroke imaging methods are now a mainstay of routine AIS practi...
Source: Seminars in Neurology - December 5, 2017 Category: Neurology Authors: Matos Diaz, I. Liang, J. W. Ostojic, L. Velickovic Tansy, Aaron P. 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
