DIAGNOSIS AND TREATMENT OF THREATENED ISCHEMIC STROKE (Part 1)

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SECTION D Vascular Diseases of the Nervous System

Sixty-five Ischemic Cerebrovascular Disease

CHAPTER OUTLINE

EPIDEMIOLOGY AND RISK FACTORS

Risk Factors for Stroke Heredity and Risk of Stroke Common Modifiable Risk Factors Other Risk Factors for Stroke

PATHOLOGY OF ISCHEMIC STROKE

DIAGNOSIS AND TREATMENT OF THREATENED ISCHEMIC STROKE

CARDIOGENIC EMBOLISM

Dissections

INHERITED AND MISCELLANEOUS DISORDERS HYPERCOAGULABLE DISORDERS

INFARCTS OF UNDETERMINED CAUSE

Neuroimaging Cardiac Evaluation of the Stroke Patient Cerebral Angiography

Platelet Antiaggregants Oral Anticoagulants

Stenting of the Carotid Artery and Other Cervicocerebral Vessels

EPIDEMIOLOGY AND RISK FACTORS

Risk Factors for Stroke

Heredity and Risk of Stroke

Common Modifiable Risk Factors

Other Risk Factors for Stroke

PATHOPHYSIOLOGY OF CEREBRAL ISCHEMIA

PATHOLOGY OF ISCHEMIC STROKE

CLINICAL SYNDROMES OF CEREBRAL ISCHEMIA

Transient Ischemic Attacks

Box sixty-five point one. Recognition of Carotid and Vertebrobasilar Transient Ischemic Attacks

Symptoms suggestive of vertebrobasilar transient ischemic attacks

Symptoms not acceptable as evidence of transient ischemic attack

Carotid Artery System Syndromes Carotid Artery Syndromes

Middle Cerebral Artery Syndromes

Syndromes of the Anterior Cerebral Artery and Related Blood Vessels

Lacunar Syndromes

Vertebrobasilar System Syndromes

Posterior Cerebral Artery Syndromes

Syndromes of Thalamic Infarction

Watershed Ischemic Syndromes

DIAGNOSIS AND TREATMENT OF THREATENED ISCHEMIC STROKE

LARGE-ARTERY ATHEROTHROMBOTIC INFARCTIONS

SMALL-VESSEL OR PENETRATING ARTERY DISEASE

CARDIOGENIC EMBOLISM

NONATHEROSCLEROTIC VASCULOPATHIES

Dissections

Box sixty-five point four. Classification of Cerebral Vasculitides

Trauma

Radiation Vasculopathy

Moyamoya

Fibromuscular Dysplasia

Inflammatory Vasculitides

Infections and Stroke

Drug Abuse and Stroke

Stroke and Systemic Vasculitides

Migraine and Stroke

INHERITED AND MISCELLANEOUS DISORDERS

HYPERCOAGULABLE DISORDERS

Primary Hypercoagulable States

Secondary Hypercoagulable States

Sickle Cell Disease

Thrombotic Thrombocytopenia Purpura

INFARCTS OF UNDETERMINED CAUSE

ESSENTIAL INVESTIGATIONS FOR PATIENTS WITH THREATENED STROKES

Neuroimaging

Cardiac Evaluation of the Stroke Patient

Cerebral Angiography

PREVENTING STROKE RECURRENCE: MEDICAL THERAPY

Platelet Antiaggregants

Oral Anticoagulants

TREATMENT OF ACUTE ISCHEMIC STROKE

Heparins and Heparinoids

Thrombolytic Therapy

Defibrinogenating and Hemorheological Agents

Neuroprotective Agents

Surgical Therapy

Hypothermia

Asymptomatic Carotid Artery Stenosis

Stenting of the Carotid Artery and Other Cervicocerebral Vessels

GENERAL MANAGEMENT OF ACUTE ISCHEMIC STROKE

BOX sixty-five point eight Medical Management Guidelines for Elevated Intracranial Pressure in Patients with Acute Ischemic Stroke

FLUID MANAGEMENT

CEREBRAL VENOUS THROMBOSIS

Intracerebral Hemorrhage

MECHANISMS OF INTRACEREBRAL HEMORRHAGE Hypertension

Vascular Malformations

Intracranial Tumors

Bleeding Disorders, Anticoagulants, and Fibrinolytic Treatment

Overview

The document outlines the diagnosis and treatment strategies for threatened ischemia in stroke patients, emphasizing the importance of identifying risk factors and employing effective medical therapies. It covers various syndromes associated with stroke and provides guidelines for acute management and secondary prevention.

Key Points

1Approximately eight hundred sixty thousand new strokes occur annually in the U.S., with a high prevalence of ischemic strokes
2Nonmodifiable risk factors, such as age and family history, significantly increase stroke risk
3Modifiable lifestyle factors like hypertension, diabetes, and dyslipidemia play a crucial role in stroke prevention
4Effective management strategies include the use of antiplatelet agents and blood pressure control to reduce recurrent stroke risk
5Despite advances in treatment, stroke mortality rates are rising in developing countries due to a lack of resources and management strategies.

Details

Authors: José Biller, Sean Ruland, Michael J. Schneck
Category: Health and Medicine

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