D. Jianu, S. Jianu, G. Munteanu, Flavius Dan, Claudia Bârsan
{"title":"Cerebral Vein and Dural Sinus Thrombosis","authors":"D. Jianu, S. Jianu, G. Munteanu, Flavius Dan, Claudia Bârsan","doi":"10.5772/INTECHOPEN.76918","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.76918","url":null,"abstract":"Cerebral venous thrombosis (CVT) is an uncommon disorder in the general population. At least 1 risk factor can be identified in 85% of patients with CVT. Because of the high frequency of thrombophilia among patients with CVT, screening for hypercoagulable conditions should be performed. Two pathophysiological mechanisms contribute to their highly variable clinical presentation. Four major syndromes have been described: isolated intracranial hypertension, focal neurological abnormalities, seizures, and encephalopathy. Cavernous sinus thrombosis represents the single CVT which produces a characteristic clinical syndrome. Head Computed Tomography is the most frequently performed imaging study, but Magnetic Resonance Imaging of the head combined with Magnetic Resonance venography are the most sensitive studies. Acute phase therapy for CVT focuses on anticoagulation, management of seizures, increased intracranial pressure, and prevention of cerebral herniation. The majority of patients have a complete or partial recovery, however they have an increased incidence of venous thromboembolism. Clinical and imaging follow-ups 3–6 months after diagnosis are recommended to assess for recanalization.","PeriodicalId":367513,"journal":{"name":"Ischemic Stroke of Brain","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123288805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cerebral Venous Thrombosis: A Clinical Overview","authors":"C. Stack, J. Cole","doi":"10.5772/INTECHOPEN.79049","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.79049","url":null,"abstract":"Cerebral venous thrombosis (CVT) is a less common cause of stroke that is an often under recognized entity in clinical practice. The goal of this chapter will be to provide clinicians with the knowledge to succinctly recognize the various presentations of CVT, emphasizing rapid diagnosis and the potential treatments necessary to produce optimal clinical outcomes. Detailed descriptions of the relevant anatomy and associated clinical syndromes will be discussed. Detailed sections regarding CVT epidemiology, pathophysiology, etiology, diagnosis and treatment will be provided. Prognosis and long-term follow-up will also be discussed. Relevant literature will be cited and clinical trials across the spectrum of CVT will be highlighted.","PeriodicalId":367513,"journal":{"name":"Ischemic Stroke of Brain","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116173077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Complementary Therapy with Traditional Chinese Medicine for Neonatal Hypoxic Ischemic Encephalopathy","authors":"Chun-Ting Lee, Yu-Chiang Hung, Wen-Long Hu","doi":"10.5772/INTECHOPEN.76373","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.76373","url":null,"abstract":"Hypoxic ischemic encephalopathy (HIE) is one of the most significant causes of mor - bidity, mortality, and lifelong disability in newborns. The diagnosis of neonatal HIE is based on the dysfunction of neurogenic signs and classification according to the Sarnat staging system, which evaluates conscious level, neuromuscular control, complex reflexes, autonomic function, seizures, electroencephalogram readings, and duration of neurologic sign. There is no standard treatment for neonatal HIE, but it is widely accepted that hypothermia therapy is a safe and effective method for treating neonates with HIE. Traditional Chinese medicine (TCM) has recently been used to treat cases of neonatal HIE, especially herbal medicine prescriptions. Acupuncture is a common method used in TCM and is another promising therapy for neonatal HIE due to its dem onstrated effective treatment of the disease in animal models. While there is a lack of direct evidence in clinical practice, we have observed acupuncture to be useful in adult HIE and in animal studies; therefore, we believe a clinical trial designed to evaluate the effectiveness of acupuncture in neonatal HIE treatment is worthwhile. Taken together, TCM is a promising technique that can be integrated into the conventional therapies for neonatal accumulation in cells, nNOS and ROS increase, which causes lipid peroxidation and induce cell apoptosis. Furthermore, excess Ca 2+ will reduce Bcl- 2 expression and increase Bax expression, also leading cells to undergo apoptosis. In addition, CO might play an important role in preventing immune cell recruitment, decrease the inflammatory response, inhibit cell apoptosis, and promote vasodilation. (3) In the days to months following the initial HIE onset: BDNF and GDNF might be involved in many signaling cascades responsible for brain tissue repair and remodeling.","PeriodicalId":367513,"journal":{"name":"Ischemic Stroke of Brain","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134444805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intravenous Thrombolysis for Acute Ischemic Stroke in a High Complex Regional Hospital","authors":"Álvaro Soto Venegas","doi":"10.5772/INTECHOPEN.79544","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.79544","url":null,"abstract":"Background : Intravenous thrombolysis (IVT) with alteplase (tissue plasminogen activa- tor) is the standard pharmacological treatment in acute ischemic stroke (AIS), reducing disability in patients. Aim : To report the results of a thrombolysis protocol taken during 6 years in a regional public hospital at Temuco, Chile. Material and methods : Data from 231 consecutive patients aged 67.1 ± 13.1 years (58.9% men) who were treated with IVT, from May 2012 until April 2018, were analyzed. Results: The median door-to-needle time was 71 min (interquartile range = 53–102). The median National Institute of Health Stroke Scale (NIHSS) scores on admission and at discharge were 13 and 4 points, respectively. At discharge, 27% of hospitalized patients had a favorable outcome, defined as having 0 to 1 points in the modified Rankin scale. Symptomatic intracerebral hemorrhage and mortality rates were 5.7 and 13.1%, respec- tively. The thrombolysis rate rose from 0.7% in 2012 to 5.5% in 2018. Conclusions: The implementation of 24/7 neurology shifts in the Emergency Department allowed us to increase the amount and quality of IVT in our hospital, as measured by the rate of thrombolysis and by process indicators such as door-to-needle","PeriodicalId":367513,"journal":{"name":"Ischemic Stroke of Brain","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115257724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kowalska, Katarzyna Wize, I. Wieczorek, W. Kozubski, J. Dorszewska
{"title":"Migraine and Risk Factors of Vascular Diseases","authors":"M. Kowalska, Katarzyna Wize, I. Wieczorek, W. Kozubski, J. Dorszewska","doi":"10.5772/INTECHOPEN.72570","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.72570","url":null,"abstract":"Migraine is a common neurological disease that affects both women and men in a dif - ferent age. It is believed that migraine is a multifactorial disease with strong genetic and environmental factors. Current molecular studies in migraine are focused on biochemical (homocysteine, asymmetric dimethylarginine) and genetic ( ACE , MTHFR , MTR , MTRR , CBS , eNOS , NOTCH3 ) risk factors associated with vascular diseases. Polymorphisms and mutations in mentioned genes predispose to migraine as well as cardiovascular diseases and stroke. According to the literature data, 13–15% of migraine with aura patients suffer from vascular diseases, too. The strict relation between migraine with aura and stroke is observed in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Lifestyle plays an important role both in the pathomechanism of migraine and vascular diseases. Hypertension, obesity, dyslipidemia, and diabetes mel - litus are the important risk factors for those pathological conditions. Therefore, early diagnosis of migraine and the implementing effective pharmacotherapy can lead to the prevention of cardiovascular and cerebrovascular diseases.","PeriodicalId":367513,"journal":{"name":"Ischemic Stroke of Brain","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115328065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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