DOCSLIB.ORG

Stroke in the Young

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Stroke in the Young Stroke Research and Treatment Stroke in the Young Guest Editors: Halvor Naess, Turgut Tatlisumak, and Janika Kõrv Stroke in the Young Stroke Research and Treatment Stroke in the Young Guest Editors: Halvor Naess, Turgut Tatlisumak, and Janika Korv˜ Copyright © 2011 SAGE-Hindawi Access to Research. All rights reserved. This is a special issue published in volume 2011 of “Stroke Research and Treatment.” All articles are open access articles distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Editorial Board Alison Baird, USA Cathy Helgason, USA David Russell, Norway Daniel Bereczki, Hungary Carlos S. Kase, USA Stefan Schwab, Germany Natan M. Bornstein, Israel Scott E. Kasner, USA Veronika Skvortsova, Russia Raymond T. Cheung, Hong Kong ChelseaS.Kidwell,USA Michael A. Sloan, USA G. A. Donnan, Australia David S. Liebeskind, USA Helmuth Steinmetz, Germany V. L. Feˇıgin, New Zealand Christopher S. Ogilvy, USA Graham S. Venables, UK Masayuki Fujioka, Japan Bruce Ovbiagele, USA Daniel Woo, USA G. J. Hankey, Australia David Reutens, Australia Osama O. Zaidat, USA Contents Stroke in the Young, Halvor Naess, Turgut Tatlisumak, and Janika Korv˜ Volume 2011, Article ID 271979, 2 pages Ischemic Stroke in Infants and Children: Practical Management in Emergency, Sara Ciccone, Michela Cappella, and Caterina Borgna-Pignatti Volume 2011, Article ID 736965, 8 pages Treatment Challenges in Pediatric Stroke Patients,A.Yılmaz,S.Teber,O.¨ Bektas¸,N.Akar,L.Z.Uysal, E. Aksoy, and G. Deda Volume 2011, Article ID 534362, 9 pages Pediatric Stroke: Clinical Findings and Radiological Approach, Giuseppe Lanni, Alessia Catalucci, Laura Conti, Alessandra Di Sibio, Amalia Paonessa, and Massimo Gallucci Volume 2011, Article ID 172168, 11 pages Diabetic Ketoacidosis-Associated Stroke in Children and Youth, Jennifer Ruth Foster, Gavin Morrison, and Douglas D. Fraser Volume 2011, Article ID 219706, 12 pages Paediatric Stroke: Review of the Literature and Possible Treatment Options, including Endovascular Approach, Elisa F. Ciceri, Valeria Cuccarini, Luisa Chiapparini, Veronica Saletti, and Luca Valvassori Volume 2011, Article ID 781612, 11 pages Current Proceedings of Childhood Stroke, Hueng-Chuen Fan, Chih-Fen Hu, Chun-Jung Juan, and Shyi-Jou Chen Volume 2011, Article ID 432839, 10 pages Does Stroke Impair Learning in Children?, Sonia das Dores Rodrigues, Sylvia Maria Ciasca, Inesˆ Elcione Guimaraes,˜ Karla Maria Ibraim da Freiria Elias, Carolina Camargo Oliveira, and Maria Valeriana Leme de Moura-Ribeiro Volume 2011, Article ID 369836, 6 pages Incidence of Stroke in Young Adults: A Review, Carmine Marini, Tommasina Russo, and Giorgio Felzani Volume 2011, Article ID 535672, 5 pages Epidemiology and Etiology of Young Stroke,DaynaGriffiths and Jonathan Sturm Volume 2011, Article ID 209370, 9 pages Intravenous Thrombolysis of Occlusion in the Middle Cerebral and Retinal Arteries from Presumed Ventricular Myxoma, Cheung-Ter Ong and Rei-Yeuh Chang Volume 2011, Article ID 735057, 3 pages Ischemic Stroke during Pregnancy and Puerperium, Elisabetta Del Zotto, Alessia Giossi, Irene Volonghi, Paolo Costa, Alessandro Padovani, and Alessandro Pezzini Volume 2011, Article ID 606780, 13 pages Preeclampsia and Stroke: Risks during and after Pregnancy, Cheryl Bushnell and Monique Chireau Volume 2011, Article ID 858134, 9 pages Hereditary Connective Tissue Diseases in Young Adult Stroke: A Comprehensive Synthesis, Olivier M. Vanakker, Dimitri Hemelsoet, and Anne De Paepe Volume 2011, Article ID 712903, 18 pages The Migraine-Ischemic Stroke Relation in Young Adults, Alessandro Pezzini, Elisabetta Del Zotto, Alessia Giossi, Irene Volonghi, Paolo Costa, Giorgio Dalla Volta, and Alessandro Padovani Volume 2011, Article ID 304921, 7 pages Role of Investigating Thrombophilic Disorders in Young Stroke,KayW.P.Ng,PeiK.Loh, and Vijay K. Sharma Volume 2011, Article ID 670138, 9 pages Fabry Disease and Early Stroke, U. Feldt-Rasmussen Volume 2011, Article ID 615218, 7 pages Stroke in Young in India, Manjari Tripathi and Deepti Vibha Volume 2011, Article ID 368629, 6 pages Comparison between Ischemic Stroke Patients <50 Years and ≥50 Years Admitted to a Single Centre: TheBergenStrokeStudy, Annette Fromm, Ulrike Waje-Andreassen, Lars Thomassen, and Halvor Naess Volume 2011, Article ID 183256, 8 pages Electroencephalography as a Tool for Assessment of Brain Ischemic Alterations after Open Heart Operations, Elena Z. Golukhova, Anna G. Polunina, Natalia P. Lefterova, and Alexey V. Begachev Volume 2011, Article ID 980873, 14 pages Neckties and Cerebrovascular Reactivity in Young Healthy Males: A Pilot Randomised Crossover Trial, Mark Rafferty, Terence J. Quinn, Jesse Dawson, and Matthew Walters Volume 2011, Article ID 692595, 4 pages The Psychology of Stroke in Young Adults: The Roles of Service Provision and Return to Work, Reg Morris Volume 2011, Article ID 534812, 10 pages Long-Term Prognosis of Ischemic Stroke in Young Adults,JoseF.Varona Volume 2011, Article ID 879817, 5 pages SAGE-Hindawi Access to Research Stroke Research and Treatment Volume 2011, Article ID 271979, 2 pages doi:10.4061/2011/271979 Editorial Stroke in the Young Halvor Naess,1 Turgut Tatlisumak,2 and Janika Korv˜ 3 1 Department of Neurology, Haukeland University Hospital, N-5021 Bergen, Norway 2 University of Helsinki, Finland 3 University of Tartu, Estonia Correspondence should be addressed to Halvor Naess, [email protected] Received 20 November 2011; Accepted 20 November 2011 Copyright © 2011 Halvor Naess et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Study of stroke among young adults and children has been small studies and shifted to several multicenter collabora- a relatively neglected area until recently. Stroke in young tions, scientists establish firmly many facades of stroke in adults is often considered to be rare, but this misconception children and in the young, including epidemiologic, etio- is colored by the high incidence of stroke in old people. Ap- logic, genetic, and prognostic features. Describing risk factor proximately 5% of all strokes occur in people younger than profiles has led to improved treatments. Evidence-based 45 years of age, another 5% occur in those 45 to 50 years of treatments have started to emerge, for example, in Sickle cell age, and 1/4 occur in working aged individuals. Although disease. New etiologic classifications and one international stroke mortality is lower among the young, their risk to die guideline for childhood stroke have appeared. Few textbooks from their stroke is almost 100 times compared to their non- have been published or are under preparation, and an inter- stroke age counterparts, whereas the same ratio is only 4-fold national meeting dedicated to young stroke is planned. in the elderly. Similarly, stroke morbidities are lower in the This special issue is one of the numerous efforts in dis- young, but these patients live with their neurological deficits seminating state-of-the-art information on the field covering much longer and many have to give up their work and social a broad range of important topics as to stroke in children life. Stroke care in young people is especially demanding be- and young adults. It includes two case reports, two research cause it often affects work, education, and close family to a articles, three clinical articles and 15 reviews. Seven articles largeextentandbecauseofexpectedlongsurvival. deal with stroke in children, and 15 articles with stroke in The study of stroke among young people is important for young adults. Several review articles in this special issue stress several reasons. The etiology of stroke is much more diverse the importance of extensive investigations in children with in the young compared to old patients. This has therapeutical stroke including MRI to disclose the underlying etiology and consequences and may affect outcome both in the short and risk factors. Rare causes including diabetic ketoacidosis-as- the long term. Risk factors for stroke differ between young sociated stroke, cardiac diseases, vascular abnormalities such and old patients and may indicate separate approaches as to as Moyamoya disease, but also more general causes such as secondary preventive treatment. Stroke in young adults pro- dissection must be considered. A clinical study concludes vides an opportunity to study stroke in general because of that correct prophylaxis reduces the rate of recurrence in less comorbidity than in old patients. This may disclose children with stroke. Other review articles disclose that more mechanisms also relevant to older patients. than half of the surviving children have long-term neurolog- Stroke in children is rare and is associated with unique ical sequels. A research article reports impaired cognitive de- challenges. Diagnosis is often delayed because symptoms velopment and impaired performance as to writing, reading, may be subtle and unspecific. Furthermore, etiology and risk and arithmetic in children with stroke. A review article re- factors in children with stroke differ from young adults with ports that the annual incidence of stroke in adults under 45 stroke. years ranges between 8.7 and 21 per 100,000. Several review Once almost neglected, now stroke in children and young articles show that etiology of cerebral
Load more

Recommended publications
  • The Epidemiology of Silent Brain Infarction: a Systematic Review of Population-Based Cohorts Jonathon P Fanning1,2*, Andrew a Wong1,3 and John F Fraser1,2
    Fanning et al. BMC Medicine 2014, 12:119 http://www.biomedcentral.com/1741-7015/12/119 RESEARCH ARTICLE Open Access The epidemiology of silent brain infarction: a systematic review of population-based cohorts Jonathon P Fanning1,2*, Andrew A Wong1,3 and John F Fraser1,2 Abstract Background: Cerebral infarction is a commonly observed radiological finding in the absence of corresponding, clinical symptomatology, the so-called silent brain infarction (SBI). SBIs are a relatively new consideration as improved imaging has facilitated recognition of their occurrence. However, the true incidence, prevalence and risk factors associated with SBI remain controversial. Methods: Systematic searches of the Medline and EMBASE databases from 1946 to December 2013 were performed to identify original studies of population-based adult cohorts derived from community surveys and routine health screening that reported the incidence and prevalence of magnetic resonance imaging (MRI)-determined SBI. Results: The prevalence of SBI ranges from 5% to 62% with most studies reported in the 10% to 20% range. Longitudinal studies suggest an annual incidence of between 2% and 4%. A strong association was seen to exist between epidemiological estimates of SBI and age of the population assessed. Hypertension, carotid stenosis, chronic kidney disease and metabolic syndrome all showed a strong association with SBI. Heart failure, coronary artery disease, hyperhomocysteinemia and obstructive sleep apnea are also likely of significance. However, any association between SBI and gender, ethnicity, tobacco or alcohol consumption, obesity, dyslipidemia, atrial fibrillation and diabetes mellitus remains unclear. Conclusions: SBI is a remarkably common phenomenon and endemic among older people. This systematic review supports the association of a number of traditional vascular risk factors, but also highlights disparities between clinically apparent and silent strokes, potentially suggesting important differences in pathophysiology and warranting further investigation.
    [Show full text]
  • Risk Factors for Recurrent Arterial Ischemic Stroke in Children and Young Adults
    brain sciences Review Risk Factors for Recurrent Arterial Ischemic Stroke in Children and Young Adults Beata Sarecka-Hujar 1,* and Ilona Kopyta 2 1 Department of Pharmaceutical Technology, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland 2 Department of Paediatric Neurology, School of Medicine in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland; [email protected] * Correspondence: [email protected] or [email protected]; Tel.: +48-32-269-9820 Received: 14 November 2019; Accepted: 30 December 2019; Published: 2 January 2020 Abstract: Arterial ischemic stroke (AIS) experienced at a young age is undoubtedly a serious medical problem. AIS very rarely occurs at a developmental age, whereas in young adults, it occurs with a higher frequency. The etiologic mechanisms of AIS occurring in childhood and adulthood differ. However, for both age populations, neurological consequences of AIS, including post-stroke seizures, motor disability, and recurrence of the disease, are connected to many years of care, rehabilitation, and treatment. Recurrent stroke was observed to increase the risk of patients’ mortality. One of the confirmed risk factors for recurrent stroke in children is the presence of vasculopathies, especially Moyamoya disease and syndrome, and focal cerebral arteriopathy of childhood (FCA). FCA causes a 5-fold increase in the risk of recurrent stroke in comparison with idiopathic AIS. In turn, young adults with recurrent stroke were found to more often suffer from hypertension, diabetes mellitus, or peripheral artery disease than young patients with first-ever stroke. Some reports also indicate relationships between specific genetic polymorphisms and AIS recurrence in both age groups.
    [Show full text]
  • Inadequate Knowledge About Sickle Cell Disease Among African
    Michael R. DeBaun MD, MPH Director of Vanderbilt, Meharry Center of Excellence for Sickle Disease Professor of Pediatrics and Medicine Vanderbilt University School of Medicine Questions • What is the impact of primary stroke prevention in children with SCD? • What is the impact of blood transfusion therapy on secondary stroke prevention? – Should we increase the threshold from 30% to 50% • Should we perform exchange transfusion therapy at initial presentation for focal neurological examination? • How common is silent stroke and how should we transfuse for silent strokes? Changing Epidemiology of Overt Strokes prior to 1998 Changing Epidemiology of Overt Strokes After 1998 Estimated Hazard Function based on recent literature and after routine use of TCD ; J Pediatr. 2010 Apr 29. 18 year old with hemoglobin SS is seen in the ED for an acute neurological deficit. What should be the initial management? A. Simple transfusion only B. Exchange transfusion only with the goal to decrease hemoglobin S level less than 30% C. Simple transfusion and exchange transfusion with a goal to decrease hemoglobin S levels to less than 30% Treatment of Acute Stroke • Goals of treatment of acute stroke – Restore cerebral blood flow – Maximize tissue oxygen delivery – Reverse neurological injury – Prevent further neurological injury • Methods of treatment – Simple blood transfusion – Exchange blood transfusion (manual exchange vs. erythrocytapheresis) Consequence of Stroke in SCD • High Recurrence Rate (Progressive) • Motor, Speech, Sensory Impairment • Cognitive
    [Show full text]
  • Atrial Fibrillation and Silent Stroke: Links, Risks, and Challenges
    Vascular Health and Risk Management Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW Atrial fibrillation and silent stroke: links, risks, and challenges Kathrin Hahne¹ Abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia, with a projected Gerold Mönnig2 number of 1 million affected subjects in Germany. Changes in age structure of the Western Alexander Samol¹ population allow for the assumption that the number of concerned people is going to be doubled, maybe tripled, by the year 2050. Large epidemiological investigations showed that AF leads to a ¹Division of Cardiology, 2Division of Electrophysiology, Department of significant increase in mortality and morbidity. Approximately one-third of all strokes are caused Cardiovascular Medicine, University by AF and, due to thromboembolic cause, these strokes are often more severe than those caused Hospital Münster, Münster, Germany by other etiologies. Silent brain infarction is defined as the presence of cerebral infarction in the absence of corresponding clinical symptomatology. Progress in imaging technology simplifies diagnostic procedures of these lesions and leads to a large amount of diagnosed lesions, but For personal use only. there is still no final conclusion about frequency, risk factors, and clinical relevance of these infarctions. The prevalence of silent strokes in patients with AF is higher compared to patients without AF, and several studies reported high incidence rates of silent strokes after AF ablation procedures. While treatment strategies to prevent clinically apparent strokes in patients with AF are well investigated, the role of anticoagulatory treatment for prevention of silent infarctions is unclear. This paper summarizes developments in diagnosis of silent brain infarction and its context to AF.
    [Show full text]
  • Managing Cerebrovascular Disease
    Managing Cerebrovascular Disease An Educational Slide Set American Society of Hematology 2020 Guidelines for Sickle Cell Disease Slide Set Authors: Ahmar U. Zaidi, MD, Children’s Hospital of Michigan and Michael R. DeBaun, MD, Vanderbilt University School of Medicine Clinical Guidelines American Society of Hematology 2020 guidelines for sickle cell disease: cerebrovascular disease in children and adults M. R. DeBaun, L. C. Jordan, A. A. King, J. Schatz, E. Vichinsky, C. K. Fox, R. C. McKinstry, P. Telfer, M. A. Kraut, L. Daraz, F. J. Kirkham, M. H. Murad https://ashpublications.org/bloodadvances/article/4/8/1554/454384/ American-Society-of-Hematology-2020-guidelines-for ASH Clinical Practice Guidelines on SCD 1. Cardiopulmonary and Kidney Disease 2. Transfusion Support 3. Cerebrovascular Disease 4. Acute and Chronic Pain 5. Stem Cell Transplantation How were these ASH guidelines developed? PANEL FORMATION CLINICAL QUESTIONS EVIDENCE SYNTHESIS MAKING Each guideline panel 10 clinically-relevant Evidence summary RECOMMENDATIONS was formed following questions generated in generated for each PICO Recommendations these key criteria: PICO format (population, question via systematic intervention, comparison, made by guideline • Balance of expertise outcome) review of health effects panel members based (including disciplines plus: on evidence for all beyond hematology, • Resource use factors. and patients) • Feasibility • Close attention to Example: PICO question • Acceptability minimization and “Should automated red cell • Equity management of exchange vs simple transfusion • Patient values and conflicts of interest or manual red cell exchange be preferences used for patients with SCD receiving chronic transfusions?” How to use these recommendations Key terms in SCD stroke • Stroke – acute neurologic injury of the brain, retina, or spinal cord that occurs as a result of ischemia or hemorrhage that last longer than 24 hours (World Health Organization Bull World Health Organ.
    [Show full text]
  • C-Reactive Protein and Glycemic Control in Adults with Type 2 Diabetes Mellitus
    C-REACTIVE PROTEIN AND GLYCEMIC CONTROL IN ADULTS WITH TYPE 2 DIABETES MELLITUS Dissertation submitted to THE TAMIL NADU DR. M.G.R MEDICAL UNIVERSITY, CHENNAI In fulfilment of the regulations for the award of the degree of Doctor of Medicine in General Medicine DEPARTMENT OF GENERAL MEDICINE P.S.G INSTITUTE OF MEDICAL SCIENCES & RESEARCH THE TAMIL NADU DR. M.G.R MEDICAL UNIVERSITY, CHENNAI, TAMIL NADU APRIL 2016 C-REACTIVE PROTEIN AND GLYCEMIC CONTROL IN ADULTS WITH TYPE 2 DIABETES MELLITUS Dissertation submitted to The Tamil Nadu Dr. M.G.R Medical University, Chennai In fulfilment of the requirements for the award of the degree of Doctor of Medicine in General Medicine Under the guidance of PROFESSOR. SUJAYA MENON, M.D., DEPARTMENT OF GENERAL MEDICINE P.S.G INSTITUTE OF MEDICAL SCIENCES & RESEARCH, COIMBATORE THE TAMIL NADU DR. M.G.R MEDICAL UNIVERSITY, CHENNAI, TAMIL NADU APRIL 2016 CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled, “C-REACTIVE PROTEIN AND GLYCEMIC CONTROL IN ADULTS WITH TYPE 2 DIABETES MELLITUS” is the bonafide original work of Dr. NANUBALA SIVA KRISHNA in fulfilment of the requirements for the degree of Doctor of Medicine in General Medicine. Signature of the guide Dr. SUJAYA MENON, M.D., Professor of Medicine Department of General Medicine PSG IMS&R, Coimbatore-04. ENDORSEMENT BY THE HOD, DEAN / HEAD OF THE INSTITUTION This is to certify that the dissertation entitled, “C-REACTIVE PROTEIN AND GLYCEMIC CONTROL IN ADULTS WITH TYPE 2 DIABETES MELLITUS” is the bonafide original research work of Dr. NANUBALA SIVA KRISHNA under the guidance of Dr.
    [Show full text]
  • Pseudotumor Cerebri in Children with Sickle Cell Disease: a Case Series
    Pseudotumor Cerebri in Children With Sickle Cell Disease: A Case Series Michael Henry, MD*; M. Catherine Driscoll, MD*; Marijean Miller, MD‡; Taeun Chang, MD§; and Caterina P. Minniti, MD* ABSTRACT. Headache is a frequent symptom in sickle Approximately 10% of SCD patients will have a clin- cell disease (SCD) that usually is attributable to anemia ical stroke by the age of 20 years,6 and an additional or cerebrovascular disease. We report 3 pediatric patients 22% can have a clinically silent stroke detected by with SCD (1 patient with SCD-SC and 2 patients with magnetic resonance imaging (MRI).7,8 Regardless of SCD-SS) who presented with headache and were diag- whether it is clinically evident, stroke in SCD can nosed with pseudotumor cerebri (PC). All 3 patients had cause neurocognitive deficits and associated learning elevated opening pressures during a lumbar puncture 9 with normal cerebrospinal fluid studies. Magnetic reso- impairment. nance imaging revealed no evidence of hydrocephalus or The most common ophthalmologic complications arteriopathy in all 3 cases. Magnetic resonance veno- of SCD include retinopathy,10,11 vitreous hemor- grams performed in 2 of the patients at diagnosis re- rhage,11 and retinal artery occlusion.10,12,13 When con- vealed no evidence of cerebral sinus thrombosis. Each sidered together, ophthalmologic and neurologic patient received a thorough ophthalmologic examina- complications comprise a large portion of the com- tion. A diagnostic funduscopic examination revealed bi- plications of SCD. lateral papilledema without signs of retinopathy in all 3 Pseudotumor cerebri (PC), or benign intracranial patients. There were no clinically significant changes in hypertension, is a rare syndrome defined by in- visual acuity or abnormalities of color vision in any creased intracranial pressure in the absence of a patient.
    [Show full text]
  • Cerebral Blood Flow and Metabolism in Patients with Silent Brain Infarction
    J Neurol Neurosurg Psychiatry 1998;65:317–321 317 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.65.3.317 on 1 September 1998. Downloaded from Cerebral blood flow and metabolism in patients with silent brain infarction: occult misery perfusion in the cerebral cortex Hiroshi Nakane, Setsuro Ibayashi, Kenichiro Fujii, Seizo Sadoshima, Katsumi Irie, Takanari Kitazono, Masatoshi Fujishima Abstract Recent advances in neuroimaging techniques Objectives—Silent brain infarction (SBI) have disclosed frequent silent brain infarctions is of growing interest as a possible risk (SBIs). Many reports have focused on the factor for symptomatic stroke. Although morphological characteristics of SBIs. Silent morphological characteristics of SBI have brain infarctions are usually located in the basal been well defined, their characteristic ganglia,1–4 and the size and number of SBIs are patterns of cerebral blood flow (CBF) and less than those of symptomatic brain 25 metabolism are in dispute. The purpose of infarctions. Aging, hypertension, and atrial 2–467 this study was to elucidate CBF and fibrillation are closely related to SBIs. metabolism in patients with SBI in rela- Moreover, nocturnal hypotension may play an 89 tion to symptomatic stroke. important part in the development of SBIs. Whether SBIs a ect cognitive function,510 Methods—The patients underwent PET V recurrence of vascular disease,11 12 residual and were separated into three groups; 51314 511 control group (C group), with no lesions handicap, and mortality is still contro- on CT (n=9, mean age 57), SBI group, with versial. Thus it is important to evaluate changes in cerebral blood flow (CBF) and no neurological signs or history of stroke, metabolism among patients with SBIs in com- but with ischaemic lesions on CT (n=9, parison with those with symptomatic brain inf- mean age 63), and brain infarction group arction or control patients.
    [Show full text]
  • Silent Cerebral Infarction in Patients with Nonrheumatic Atrial Fibrillation Mark Louis Meyer Yale University
    Yale University EliScholar – A Digital Platform for Scholarly Publishing at Yale Yale Medicine Thesis Digital Library School of Medicine 1994 Silent cerebral infarction in patients with nonrheumatic atrial fibrillation Mark Louis Meyer Yale University Follow this and additional works at: http://elischolar.library.yale.edu/ymtdl Recommended Citation Meyer, Mark Louis, "Silent cerebral infarction in patients with nonrheumatic atrial fibrillation" (1994). Yale Medicine Thesis Digital Library. 2929. http://elischolar.library.yale.edu/ymtdl/2929 This Open Access Thesis is brought to you for free and open access by the School of Medicine at EliScholar – A Digital Platform for Scholarly Publishing at Yale. It has been accepted for inclusion in Yale Medicine Thesis Digital Library by an authorized administrator of EliScholar – A Digital Platform for Scholarly Publishing at Yale. For more information, please contact [email protected]. HU VALE MEDICAL LIBRARY UMI 3 9002 08676 1112 HARVEY CUSHING / JOHN HAY WHITNEY MEDICAL LIBRARY MANUSCRIPT THESES Unpublished theses submitted for the Master's and Doctor's degrees and deposited in the Medical Library are to be used only with due regard to the rights of the authors. Bibliographical references may be noted, but passages must not be copied without permission of the authors, and without proper credit being given in subsequent written or published work. This thesis by has been used by the following persons, whose signatures attest their acceptance of the above restrictions. NAME AND ADDRESS DATE Digitized by the Internet Archive in 2017 with funding from The National Endowment for the Humanities and the Arcadia Fund https://archive.org/details/silentcerebralinOOmeye SILENT CEREBRAL INFARCTION IN PATIENTS WITH NONRHEUMATIC ATRIAL FIBRILLATION A Thesis submitted to the Yale University School of Medicine in Partial Fulfillment of the Requirements for the Degree of Doctor of Medicine by Mark Louis Meyer 1994 ACKNOWLEDGEMENTS I would like to express my gratitude to Dr.
    [Show full text]
  • Prevalence of Silent Stroke in Kurdistan, Iraq
    Prevalence of silent stroke in Kurdistan, Iraq Ehsan K. Al-Shimmery, FICMS, DCN/UCL/UK, Saddam H. Amein, MBChB, MD, Namir G. Al-Tawil, MBChB, FICMS/CM. ABSTRACT of affected individuals was significantly higher than the age of the non-affected individuals. اﻷهداف: قياس حدوث اجللطات الدماغية الصامتة في سكان Conclusions: The percentage of silent infarcts among apparently normal individuals in the Kurdish كردستان، العراق وبحث عوامل اخلطر للجلطات الدماغية population is around 19%, and physicians must الصامتة. always keep this diagnosis in mind, especially among .hypertensive and older aged patients الطريقة: أجريت دراسة مقطعية في املستشفى التعليمي رزكاري – أربيل – العراق خﻻل الفترة من يناير حتى يونيو Neurosciences 2010; Vol. 15 (3): 167-171 2009م. حضرت العينة املختارة من 200 مريض العيادة اخلارجية. CT From the Neurology Division (Al-Shimmery), and the Community Medicine Division (Al-Tawil), Department of Medicine, College of مت حتليل نتائج تصوير الكمبيوتر ، وتصوير الرنني املغناطيس MRI( Medicine, Hawler Medical University, and the Department of Neurology ،وقياس (نسبة اجللطة الدماغية. متت مقابلة املرضى (Amein), Emergency Hospital, Erbil, Iraq. لفحص ظهور ارتفاع ضغط الدم، والسكر، ومرض إقفار القلب، .Received 5th December 2009. Accepted 9th March 2010 وتناول الكحول، والتدخني. كما مت قياس مؤشر كتلة اجلسم، ,Address correspondence and reprint request to: Dr. Ehsan K. Al-Shimmery ومستويات الدهن. Neurology Division, Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq. E-mail: [email protected] النتائج: من بني 200 فرد ظهرت اجللطة الصامت بنسبة 19%، وأظهر التحليل اﻹحصائي اللوجستي عﻻقة مهمة بني ارتفاع -troke is defined as the sudden occurrence of a non ضغط الدم، وزيادة العمر مع ظهور اجللطة الصامتة.
    [Show full text]
  • EBRSR: Secondary Prevention of Stroke
    EBRSR [Evidence-Based Review of Stroke Rehabilitation] 8 Secondary Prevention of Stroke Katherine Salter PhD (cand.), Robert Teasell MD, Norine Foley MSc, Adam Hopfgartner MSc (cand.), Jennifer Mandzia MD, Shannon Janzen MSc, Danielle Rice BA, Mark Speechley PhD Last Updated: September 2016 Abstract The Heart and Stroke Foundation of Canada has estimated that there are approximately 400,000 individuals living with the effects of stroke (Statistics Canada, 2011). While there is disagreement among studies assessing the relative cost associated with secondary compared to first-ever stroke, recurrent strokes appear to contribute a disproportionate share to the overall national burden of stroke, principally due to costs associated with long-term disability (e.g. nursing home care and re-hospitalization). The secondary prevention of stroke includes strategies used to reduce the risk of stroke recurrence among patients who had previously presented with a stroke or TIA. Management strategies, which should be specific to the underlying etiology, include risk factor modification, the use of antithrombotic or anticoagulant drugs, carotid surgery, endovascular treatments. The present review provides information on risk factor management programs, management of hypertension, diabetes, hyperlipidemia, the role of infection, lifestyle modification (diet, smoking, use of alcohol, physical activity) as well as treatment for atherosclerosis and cardiac abnormalities (e.g. atrial fibrillation) and reperfusion techniques. The review may be downloaded in
    [Show full text]
  • AHA/ASA Scientific Statement Management of Stroke in Neonates and Children Slide
    AHA/ASA SCIENTIFIC STATEMENT MANAGEMENT OF STROKE IN NEONATES AND CHILDREN A SCIENTIFIC STATEMENT FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION American Heart Association The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. 1 SLIDE SET PREPARED BY MEMBERS OF THE STROKE PROFESSIONAL EDUCATION COMMITTEE CHARLES KIRCHER MD MICHAEL ABRAHAM MD 2 ©2019 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. OVERVIEW OF CHILDHOOD AND PERINATAL STROKE 3 INTRODUCTION AND DEFINITION • Standard adult definition of stroke—an acute onset neurological sign or symptom attributable to focal brain infarction or hemorrhage—applies to children as reflected by the NIH Common Data Elements (CDE) definition • Important for pediatric health professionals to be able to recognize stroke at different ages and to treat stroke to preserve brain function and promote repair and recovery. 4 CLASSIFICATION • By age • stroke occurring from 28 weeks gestation to 28 post-natal days of life is broadly classified as perinatal stroke • stroke occurring after 28 days to 18 years of age is classified as childhood stroke • Perinatal stroke • Acute perinatal stroke - newborn infants at or near birth and typically presents shortly after onset with focal seizures or encephalopathy • Presumed perinatal stroke - chronic infarcts, diagnosed in a delayed fashion, that are presumed to have occurred in the perinatal period • typically present with pathologic early handedness or seizures, leading to brain imaging and the diagnosis of a remote infarction 5 ISCHEMIC OR HEMORRHAGIC Ischemic stroke • arterial ischemic stroke (AIS) • venous infarction • cerebral sinovenous thrombosis (CSVT) • may or may not be accompanied by hemorrhage • cortical vein thrombosis • older infants and children, some literature uses the term ‘silent stroke’ when asymptomatic infarcts are found on neuroimaging • misnomer, as the definition of stroke includes a clinical event; we use the term “silent infarct” in this review.
    [Show full text]