Seminars in neurology
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Seminars in neurology · Dec 2005
ReviewPediatric stroke: what do we know and what do we need to know?
Stroke is a heterogeneous disorder and an important cause of mortality and chronic morbidity in children. Estimates of international incidence rates for childhood stroke have varied widely. Arterial ischemic stroke is reported to be more common than hemorrhagic stroke in children. ⋯ Over half of children with stroke will develop lifelong cognitive or motor disability, and up to a third will have a recurrent stroke. International studies have provided important information on stroke in children, but major gaps in our knowledge of the disorder still exist. Currently, there is a need for prospective cohort studies in diverse populations, which utilize a consensus pediatric stroke classification system and a standard evaluation of risk factors and outcome, so that treatment and prevention strategies can be developed.
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Seminars in neurology · Dec 2005
ReviewSubarachnoid hemorrhage and inflammation: bench to bedside and back.
Subarachnoid hemorrhage (SAH) is a devastating and complicated disease. The development of therapeutic interventions has been hampered by a poor understanding of the three components of the disease pathology in SAH: aneurysm rupture, cerebral edema, and vasospasm. The role of inflammation in the pathology of subarachnoid hemorrhage will be reviewed. ⋯ Evidence supports the role of inflammation in free radical formation and in perturbations in nitric oxide and endothelin-1 levels that are important mediators of the vasoconstriction in vasospasm. Targeting the inflammatory mediators associated with the three prominent events in SAH is a promising strategy for reducing the mortality and morbidity in these patients. More study is needed to determine which specific effectors in the inflammatory cascade may serve as targets for intervention.