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Acute Stroke Treatment, Second Edition Acute Stroke Treatment Acute Stroke Treatment Second Edition Edited by Julien Bogousslavsky Professor of Neurology and Cerebrovascular Diseases Chairman, University Hospital of Neurology Centre Hospitalier Universitaire Vaudois Lausanne Switzerland LONDON AND NEW YORK © 1997, 2003 Martin Dunitz, an imprint of the Taylor & Francis Group plc First published in the United Kingdom in 1997 by Martin Dunitz, an imprint of the Taylor & Francis Group plc, 11 New Fetter Lane, London EC4P 4EE Tel: +44 (0)20 7583 9855 Fax: +44 (0)20 7842 2298 E-mail: [email protected] Website: http://www.dunitz.co.uk This edition published in the Taylor & Francis e-Library, 2005. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” Second edition 2003 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P OLP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. A CIP record for this book is available from the British Library. ISBN 0-203-42721-1 Master e-book ISBN ISBN 0-203-44190-7 (Adobe eReader Format) ISBN 1-84184-078-5 (Print Edition) Distributed in the USA by Fulfilment Center Taylor & Francis 10650 Toebben Drive Independence, KY 41051 USA Toll Free Tel: 1–800–634–7064 E-mail: [email protected] Distributed in Canada by Taylor & Francis 74 Rolark Drive Scarborough, Ontario M1R 4G2, Canada Toll Free Tel: +1–877 226 2237 E-mail: [email protected] Distributed in the rest of the world by Thomson Publishing Services Cheriton House, North Way Andover, Hampshire SP10 5BE, UK iv Tel: +44 (0)1264 332424 E-mail: [email protected] Composition by EXPO Holdings, Petaling Jaya, Malaysia Contents List of contributors vi I Present stage 1. Acute stroke management around the world 1 Stephen M Davis, David M Rosen and Geoffrey A Donnan 2. The behaviors of the acute stroke patient 16 Antonio Carota, Fabienne Staub and julien Bogousslavsky 3. What is the place of clinical assessment in acute stroke management? 50 Gabriel R de Freitas and julien Bogousslavsky 4. Acute stroke units and teams 66 Philippe Lyrer 5. Computed tomography in acute stroke 78 Rüdiger von Kummer 6. Ultrasound in acute stroke: recent advances and future perspectives 95 Michael Hennerici and Stephen Meairs 7. General care in the acute phase 116 Peter Limpar and Daniel F Hanley 8. Management of blood pressure in acute stroke 135 Philip Bath 9. Reopening occluded cerebral arteries 150 James F Meschia and Thomas G Brott 10. Anticoagulant therapy 179 Jacob S Elkins and Raymond A Swanson 11. Antiplatelet therapy in acute brain ischemia 190 Jacques R Leclerc and julien Bogousslavsky 12. Intensive care of ischemic stroke 207 Eckhard Bonmann, Thorsten Steiner and Werner Hacke 13. What should become the treatment of cerebral hemorrhage? 222 Ahmed S Aly and Carlos S Kase vi 14. Surgery for acute stroke 238 Yasuhiro Yonekawa, Dilek Könü, Peter Roth and Emanuela Keller 15. New management trends in aneurysmal subarachnoid hemorrhage 265 Edward M Manno and Eelco F M Wijdicks 16. Prevention of early recurrences in acute stroke 283 Ritu Saxena and Peter J Koudstaal II A look at the future 17. Published guidelines: update and synthesis 294 Risto O Roine and Markku Kaste 18. Experimental findings with important clinical implications for stroke treatment 303 Turgay Dalkara, Lorenz Hirt and Michael A Moskowitz 19. What is the future of imaging in acute stroke? 320 Max Wintermark, Pierre Schnyder, Reto Meuli and julien Bogousslavsky 20. Trends in protecting ischemic brain 328 Kennedy R Lees 21. Gene and cell therapy in stroke 338 Antoine M Hakim, Mukul Sharma and Charlie Thompson 22. Combination therapies, restorative therapies and future directions 352 Majaz Moonis and Marc Fisher Index 361 Contributors Ahmed S Aly MDStroke Fellow Department of Neurology Boston University School of Medicine 715 Albany Street B-603 Boston MA 02118 USA Philip Bath MD FRCPStroke Association Professor of Stroke Medicine Division of Stroke Medicine University of Nottingham City Hospital Campus Nottingham NG5 1PB UK Julien Bogousslavsky MDProfessor and Chairman Department of Neurology University Hospital (CHUV) CH-1011 Lausanne Switzerland Eckhard Bonmann MDDepartment of Neurology University of Heidelberg 400 Im Neuenheimer Feld D-69120 Heidelberg Germany Thomas G BrottProfessor of Neurology Mayo Medical School Department of Neurology 4500 San Pablo Road Jacksonville FL 32224 USA Antonio Carota MDDepartment of Neurology University Hospital (CHUV) CH-1011 Lausanne Switzerland Turgay Dalkara MD PhDVisiting Professor of Neurology Stroke and Neurovascular Regulation Laboratory Department of Neurology and Neurosurgical Service Massachusetts General Hospital Harvard Medical School 149 13th Street, Room 6403 Charlestown MA 02129 USA viii Stephen M Davis MD FRACPDirector of Neurology and Head of Stroke Service The Melbourne Neuroscience Centre Royal Melbourne Hospital and University of Melbourne Parkville, Victoria 3050 Australia Geoffrey A Donnan MD FRACPDirector of Neurology Austin and Repatriation Medical Centre Heidelberg Australia Jacob S Elkins MDNeurovascular Service Department of Neurology University of California 505 Parnassus Avenue San Francisco CA 94143 USA Marc Fisher MDProfessor of Neurology University of Massachusetts Medical School Worcester MA 01605 USA Gabriel R de Freitas MDDepartment of Neurology Hospital Universitàrio Clementino Fraga Filho Universidade Federal do Rio de Janeiro Avenue Brigadeiro Trompowsky, s/n Rio de Janeiro CEP 21941–590 Brazil Werner Hacke MDProfessor and Chairman Department of Neurology University of Heidelberg 400 Im Neuenheimer Feld D-69120 Heidelberg Germany Antoine M Hakim MD PhDDirector, Neuroscience Research Institute The Ottowa Health Research Institute University of Ottawa 451 Smyth Ottawa, Ontario K1H 8M5 Canada Daniel F Hanley MDDirector, Division of Brain Injury Outcomes John Hopkins University 600 N. Wolfe Street, Jefferson 1–109 Baltimore MD 21287 USA ix Michael Hennerici MDProfessor of Neurology Ruprecht-Karls-Universitat Heidelberg-Klinikum Theodor-Kutzer-Ufer 1 D-68135 Mannheim Germany Lorenz Hirt MDService de Neurologie University Hospital (CHUV) CH-1011 Lausanne Switzerland Carlos S Kase MDDepartment of Neurology Boston University School of Medicine 715 Albany Street, B-605 Boston MA 02118 USA Markku Kaste MD PhDProfessor and Chairman Department of Neurology Helsinki University Central Hospital PB 340 FIN-00029 HUCH Finland Emanuela KellerNeurosurgical University Clinic University Hospital of Zurich Ramistrasse 100 CH-8091 Zurich Switzerland Dilek KönüNeurosurgical University Clinic University Hospital of Zurich Ramistrasse 100 CH-8091 Zurich Switzerland Peter J Koudstaal MDDepartment of Neurology Erasmus Medical Center Rotterdam The Netherlands Jacques Leclerc MDLilly Research Lab Lilly Corporate Center Indianapolis IN 46285–6072 USA Kennedy R Lees MDUniversity Dept Medicine & Therapeutics Western Infirmary Glasgow G11 6NT x UK Peter Limpar MDPost Doctoral Fellow John Hopkins University Neurology Division of Brain Injury Outcomes 600 N.Wolfe Street, Jefferson 1–109 Baltimore MD 21287 USA Philippe Lyrer MDNeurologische Universitaetsklinik Kantonsspital Basel Petersgraben 4 CH-4031 Basel Switzerland Edward M Manno MDMayo Medical School 200 First Street SW Rochester MN 55905 USA Stephen Meairs MDDepartment of Neurology Mannheim Medical School of the University of Heidelberg D-68135 Mannheim Germany James F Meschia MDMayo Clinic 4500 San Pablo Road Jacksonville FL 32224 USA Reto Meuli MD PhDDepartment of Diagnostic and Interventional Radiology University Hospital (CHUV) CH-1011 Lausanne Switzerland Majaz Moonis MDAssociate Professor of Neurology Director, Stroke Prevention Clinic UMass Memorial Medical Center 55 Lake Avenue North Worcester MA 01655 USA Michael A Moskowitz MDProfessor of Neurology and Director, Stroke and Neurovascular Regulation Laboratory Department of Neurology and Neurosurgical Service Massachusetts General Hospital Harvard Medical School149 13th Street, Room 6403 Charlestown MA 02129 USA xi Risto O Roine MD PhDAssociate Professor, Head of Acute Stroke Unit Department of Neurology Helsinki University Central Hospital PB 340 FIN-00029 HUCH Finland David M Rosen MB BS FRACPHead of Neurology Far West Area Health Service Broken Hill New South Wales Australia Peter RothNeurosurgical University Clinic University Hospital of Zurich Ramistrasse 100 CH-8091 Zurich Switzerland Ritu Saxena MDDepartment of Neurology Erasmus Medical Center And Medical Center Rijnmond Zuid Rotterdam The Netherlands Pierre SchnyderDepartment of Diagnostic and Interventional Radiology University Hospital (CHUV) CH-1011 Lausanne Switzerland Mukul Sharma MDDivision of Neurology The Ottowa Hospital University of Ottawa 451 Smyth Ottawa, Ontario K1H 8L6 Canada Fabienne StaubDepartment of Neurology University Hospital (CHUV) CH–1011 Lausanne Switzerland Thorsten Steiner
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