The most recent book in the very successful “black book” Contemporary neurology series from Oxford University Press is a monograph on brain ischaemia. The book is written by three experienced and well respected North American authors—Adams from the United States and Hachinski and Norris from Canada. The present monograph is a successor to a previous book entitled The acute stroke by Hachinski and Norris published 16 years ago.

There are now many books on stroke and on brain ischaemia. While reading this present endeavour, I continued to ponder the role of this monograph among the already burgeoning library of books. Whom is it aimed at? Who will profit most by its content? When, why, and how will readers use this book?

The text can be conveniently divided into four parts. The initial portion consists …

https://jnnp.bmj.com/content/jnnp/73/1/99.1.full.pdf

Ischemic cerebrovascular disease

The transient ischemic attack (TIA) is a kind of sudden disease, which has the characteristics of short duration and high frequency. Since most patients can return to normal after the onset of the disease, it is often neglected. Medical research has proved that patients are prone to stroke in a relatively short time after the transient ischemic attacks. Therefore, it is extremely important to effectively monitor transient ischemic attack, especially for elderly people living alone. At present, video monitoring and wearing sensors are generally used to monitor transient ischemic attacks, but these methods have certain disadvantages. In order to more conveniently and accurately monitor transient ischemic attack in the indoor environment and improve risk management of stroke, this paper uses a microwave sensing platform working in C-Band (4.0 GHz–8.0 GHz) to monitor in a non-contact way. The platform first collects data, then preprocesses the data, and finally uses principal component analysis to reduce the dimension of the data. Two machine learning algorithms support vector machine (SVM) and random forest (RF) are used to establish prediction models respectively. The experimental results show that the accuracy of SVM and RF approaches are 97.3% and 98.7%, respectively; indicating that the scheme described in this paper is feasible and reliable.

/pdf/transient-ischemic-attack-analysis-through-non-contact-32h1u1btvt.pdf

Transient ischemic attack analysis through non-contact approaches

Stroke essentials for primary care : , Stroke essentials for primary care : , کتابخانه دیجیتال جندی شاپور اهواز

http://centlib.ajums.ac.ir//multiMediaFile/69306206-4-1.pdf

Stroke Essentials for Primary Care

Background: Studies of homocysteine in vascular disorders have yielded conflicting data. There are also differences based on various ethnicities and cultures. In this study, we have examined the homocysteine patterns in local stroke patients, so as to ascertain the homocysteine status in a sample of local population. Homocysteine-white matter hypodensities relationship in stroke is emerging, as an important aspect in stroke pathophysiology and is thought to have prognostic and therapeutic values. Methods: We included 150 stroke patients who were diagnosed as having clinical stroke on the basis of history; physical examination and CT (Computerized Tomography) scan of brain. These patients were recruited from neurology and emergency wards of two public sector hospitals of Lahore. The presence or absence of white matter hypodensities were diagnosed after consultation with a radiologist. Blood samples were collected from the same stroke patients. Results: We found a strong association between white matter hypodensities and total homocysteine in plasma of stroke patients p <0.001. Conclusion: Homocysteine is a risk factor for white matter hypodensities in stroke patients in our study.

Association of plasma homocysteine and white matter hypodensities in a sample of stroke patients.

Abstract Background: Modern treatment of acute ischemic stroke includes thrombolysis and thrombectomy performed for eligible patients in specialized stroke centers. However, a number of patients are admitted in Neurosurgical or Intensive Care Departments of emergency hospitals, units where routine treatment strategies are applied. Objective: To evaluate the management of patients admitted in these departments that do not benefit from thrombolytic or endovascular treatment. Methods: A retrospective analysis was performed, including all patients admitted to the Neurosurgery Department and Intensive Care Unit (ICU) of the “St. Pantelimon” Clinical Emergency Hospital with the primary diagnosis of acute ischemic stroke in the year 2016. The following data was retrospectively collected: patient age and sex, comorbidities, risk factors for ischemic stroke, level of consciousness at admission, neurological deficits, stroke location, blood glucose levels, interval from stroke onset to admission, treatment and discharge status. Results: In 2016, 63 patients with primary diagnosis of acute ischemic stroke confirmed by head CT scan were admitted in our hospital. None presented indication for decompressive craniectomy. Over a half of them (57,14%) were comatose. The majority of patients admitted to the ICU (76,47%) received glucose 10% infusions in the first 24 hours from admission, despite increased blood glucose levels at admission. A number of 38 (60,32%) of these patients died. Conclusions: Patients with acute ischemic stroke should be treated in stroke units with proper equipment and specialists. National public health institutions should take the necessary measures in order to ensure that patients get to the best facility in order to receive the right therapy in the right amount of time.

Do acute ischemic stroke patients receive the right treatment in non-stroke units?

Ischemic stroke is most often due to a lack of blood flow to all or part of the brain, resulting in the deprivation of neurons of vital glucose and oxygen. This deprivation, if severe and prolonged, results in the interruption of normal cellular processes and eventual cell death with breakdown of the neuronal cell membrane. Ischemia can also result from oxygen deprivation alone (hypoxic– ischemic damage, as may occur in patients who experience a cardiac arrest, respiratory collapse, or both) or glucose deprivation alone (as may occur with insulin overdoses in diabetic patients). A very low (or no) blood pressure can produce a distinct pattern of ‘watershed’ infarcts, which are typically regions of infarcted tissue between themajor cerebral arterial territories.More commonly, ischemic stroke involves only a portion of the brain due to an occlusion of a large or small artery. It also may develop rapidly in multiple arterial territories in the event of multiple emboli or a single embolus which breaks up as it travels. When an artery is occluded and the brain is deprived of blood flow, there is an almost immediate inhibition of the natural function of the neurons feed by that artery. The neurons cease to perform their normal function, and patients will experience symptoms relevant to the area of the brain involved (weakness, numbness, vision loss, etc.). There is a gradient of blood flow around the location of a large arterial occlusion. So, for example, at the center of the region of ischemia, blood flow may be less than 10 mL/100 g/min. This represents the

https://www.springer.com/cda/content/document/cda_downloaddocument/9781934115015-c2.pdf?SGWID=0-0-45-733853-p173746232

Ischemic Stroke and Transient Ischemic Attack – Acute Evaluation and Management

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Ischemic Stroke and Transient Ischemic Attack – Acute Evaluation and Management