Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2003
Practice Guideline GuidelineEuropean Stroke Initiative Recommendations for Stroke Management-update 2003.
This article represents the update of 'European Stroke Initiative Recommendations for Stroke Management', first published in this Journal in 2000. The recommendations are endorsed by the 3 European societies which are represented in the European Stroke Initiative: the European Stroke Council, the European Neurological Society and the European Federation of Neurological Societies.
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Cerebrovascular diseases · Jan 2003
Clinical TrialNoninvasive monitoring of cerebral oxygenation during vasomotor reactivity tests by a new near-infrared spectroscopy device.
Spatially resolved spectroscopy is a recently developed technique for noninvasive monitoring of cerebral tissue oxygenation using the photon diffusion theory. ⋯ Spatially resolved spectroscopy provides an encouraging, noninvasive new tool to study cerebral tissue oxygenation during vasomotor reactivity tests consistent with physiological changes.
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Cerebrovascular diseases · Jan 2003
ReviewLong-term outcome after ischaemic stroke/transient ischaemic attack.
During the first 30 days after a stroke, the case fatality is about 25% and the major cause of death is the index stroke and its sequelae. The most consistent predictor of 30-day mortality after stroke is stroke severity. Other predictors include increasing age, a history of previous stroke, cardiac failure, and a high blood glucose concentration and white blood cell count. ⋯ The most powerful predictor of early recurrent stroke (within 30 days after stroke) is an atherosclerotic ischaemic stroke caused by large-artery atherosclerosis with >50% stenosis, whereas the strongest predictor of stroke recurrence over 5 years is diabetes. Other predictors of recurrent stroke include increasing age, previous TIA, atrial fibrillation, high alcohol consumption, haemorrhagic index stroke, and hypertension at discharge. The clinical implication of these findings is that strategies for optimizing long-term outcome after TIA and stroke should be directed toward reducing the high risk of recurrent stroke and coronary events by removing/recanalizing the symptomatic atherosclerotic plaque, controlling the underlying causal vascular risk factors, and administering long-term, effective antiplatelet therapy.
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Cerebrovascular diseases · Jan 2003
Cerebral magnetic resonance imaging within 6 hours of stroke onset: inter- and intra-observer reproducibility.
Magnetic resonance imaging (MRI) provides valuable pathophysiological information during the very first hours of cerebral ischemia. However, the reliability of prime-time MRI in the setting of emergency care remains unknown. ⋯ The visual assessment of T2* gradient echo, TOF, diffusion and perfusion sequences at the acute stage of stroke is reproducible between and within observers. The visual assessment is as good as the volumetric assessment to detect a mismatch of >20%.
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Cerebrovascular diseases · Jan 2003
Noninvasive assessment of spontaneous baroreflex sensitivity and heart rate variability in patients with carotid stenosis.
Previous limited observations have suggested that atherosclerosis may affect the distensibility of the carotid sinus and then impair the baroreflex sensitivity (BRS). No studies have been done to compare the BRS and heart rate variability (HRV) in patients with carotid stenosis and normal controls. ⋯ Our study linked significant carotid stenosis to two important autonomic markers (BRS and HRV) that may have prognostic value for patients with cardiovascular events. Further prospective studies are needed to explore whether or not the decreased BRS and HRV can be predictors for poor cardiovascular prognosis, or even for shortened life span in general, in patients with significant carotid stenosis.