Neurovascular Complications of Acute Aortic Syndrome.

IF 6 1区 医学 Q1 CLINICAL NEUROLOGY
Journal of Stroke Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI:10.5853/jos.2024.02915
Dean Zeldich, Matthew Bierowski, Leah Shabo, Sridhara Yaddanapudi, Gregary Marhefka
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引用次数: 0

Abstract

Acute aortic syndromes (AAS) such as aortic dissection, intramural hematoma, and penetrating aortic ulcer pose significant neurovascular risks, affecting patient outcomes. This review examines the incidence, clinical presentation, and outcomes of neurovascular complications in AAS patients. Common complications include stroke, spinal cord ischemia, and transient ischemic attacks, with stroke being the most prevalent. Managing aortic dissection necessitates careful blood pressure control to prevent dissection progression while avoiding compromised cerebral and spinal perfusion. Carotid involvement, particularly dissection, increases stroke and transient ischemic attack risks. Emergency surgical interventions, though essential to prevent rupture or repair dissection, carry risks of perioperative neurovascular complications. The use of electroencephalography and transcranial Doppler can aid in the early detection and monitoring of neurovascular events. We discuss the pros and cons of certain blood pressure medications in the acute treatment of aortic dissection. A multidisciplinary approach involving cardiovascular surgeons, neurologists, and critical care specialists is vital for optimizing outcomes and mitigating risks. Early recognition and management of neurovascular complications are crucial, and further research is needed to develop targeted prevention and treatment strategies.

急性主动脉综合征的神经血管并发症。
急性主动脉综合征(AAS),如主动脉夹层、壁内血肿、穿透性主动脉溃疡等,对神经血管构成重大风险,影响患者预后。本文综述了AAS患者神经血管并发症的发生率、临床表现和预后。常见的并发症包括中风、脊髓缺血和短暂性脑缺血发作,其中中风最为常见。处理主动脉夹层需要小心控制血压,以防止夹层进展,同时避免受损的脑和脊髓灌注。颈动脉受累,特别是剥离,增加中风和短暂性脑缺血发作的风险。紧急手术干预虽然对防止破裂或修复夹层至关重要,但也存在围手术期神经血管并发症的风险。使用脑电图和经颅多普勒可以帮助早期发现和监测神经血管事件。我们讨论了某些血压药物在主动脉夹层急性治疗中的利弊。涉及心血管外科医生、神经科医生和重症监护专家的多学科方法对于优化结果和减轻风险至关重要。神经血管并发症的早期识别和处理至关重要,需要进一步研究制定有针对性的预防和治疗策略。
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来源期刊
Journal of Stroke
Journal of Stroke CLINICAL NEUROLOGYPERIPHERAL VASCULAR DISE-PERIPHERAL VASCULAR DISEASE
CiteScore
11.00
自引率
3.70%
发文量
52
审稿时长
12 weeks
期刊介绍: The Journal of Stroke (JoS) is a peer-reviewed publication that focuses on clinical and basic investigation of cerebral circulation and associated diseases in stroke-related fields. Its aim is to enhance patient management, education, clinical or experimental research, and professionalism. The journal covers various areas of stroke research, including pathophysiology, risk factors, symptomatology, imaging, treatment, and rehabilitation. Basic science research is included when it provides clinically relevant information. The JoS is particularly interested in studies that highlight characteristics of stroke in the Asian population, as they are underrepresented in the literature. The JoS had an impact factor of 8.2 in 2022 and aims to provide high-quality research papers to readers while maintaining a strong reputation. It is published three times a year, on the last day of January, May, and September. The online version of the journal is considered the main version as it includes all available content. Supplementary issues are occasionally published. The journal is indexed in various databases, including SCI(E), Pubmed, PubMed Central, Scopus, KoreaMed, Komci, Synapse, Science Central, Google Scholar, and DOI/Crossref. It is also the official journal of the Korean Stroke Society since 1999, with the abbreviated title J Stroke.
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