Main description:

New, exciting, and innovative advances in the field of cerebrovascular medicine continue to occur at a rapid pace. The fourth edition of Current Review of Cerebrovascular Disease provides an update on these rapidly evolving topics and a gives the reader insight into the thought-provoking issues in stroke neurology that have undergone tremendous changes during the past two years. The volume covers four main sections: basic science, diagnostics, clinical aspects, and treatment.

Contents:

1 New Approaches to Atherosclerosis Based on Endothelial function.- Biology of Atherosclerosis.- The Endothelium: Not Just Plastic Wrap.- Postmenopausal Hormone Replacement Therapy.- Antioxidants.- Homocyst(e)ine.- Postprandial Lipids.- Compensatory Enlargement.- Measurement of Atherosclerosis.- A Paradigm Shift to Management of Arteries, Not Risk Factors.- Genetics.- Conclusions.- 2 Mechanisms of Neuronal Cell Death After Ischemic Injury to the Brain.- Historical Background.- Definition.- Morphologic Identification of Dead Cells.- Differences Between Necrosis and Apoptosis.- Delayed Neuronal Death.- Conclusions.- 3 Growth Factors and Cerebral Ischemia.- Prevention.- Acute Treatment.- Recovery.- Conclusions.- 4 The Ischemic Penumbra and the Therapeutic Time Window.- Concepts and Evolution of the Ischemic Penumbra.- Evolution of the Ischemie Penumbra to Irreversible Injury.- The Therapeutic Time Window.- 5 Temperature Changes and Ischemic Stroke.- Global and Focal Cerebral Ischemia.- Limitations of Postischemic Hypothermia.- The Importance of Chronic Outcome Measures in Assessing Neuroprotective Strategies.- Fever and Ischemie Hyperthermia.- Temperature Measurements in the Clinical Setting.- Temperature Mechanisms.- Future Applications to Stroke Treatment.- 6 Diffusion-Weighted and Perfusion-Weighted Magnetic Resonance Imaging in Clinical Stroke.- Diagnostic Value of the Magnetic Resonance Imaging Examination.- Perfusion-Weighted Magnetic Resonance Imaging in Stroke.- Prognostic Value.- Emerging Magnetic Resonance Imaging Techniques for Clinical Stroke.- Conclusions.- 7 New Trends in Neurosonology.- The Most Predictive Parameters of an Internal Carotid Artery Stenosis.- Reproducibility of Ultrasound Assessment of Carotid Plaques and Their Relationship with the Risk of Stroke.- Power Doppler Imaging.- Transcranial Color-Coded Duplex Sonography Versus Magnetic Resonance Angiography.- Contrast- or Echo-Enhanced Transcranial Duplex Imaging.- Harmonic Contrast Imaging.- Three-Dimensional Transcranial Power Doppler Ultrasound Imaging.- Microembolic Signals.- Patent Foramen Ovale.- Cardiac Ultrasound.- Conclusions.- 8 Magnetic Resonance Angiography.- Basic Principles.- Clinical Applications in Cerebrovascular Diseases.- Conclusions.- 9 Computed Tomography Angiography and Perfusion Imaging of Acute Stroke.- Helical CT Imaging.- The Role of Noncontrast CT in Acute Stroke.- The Role of Contrast CT in Acute Stroke.- Combined CT Angiogram and Steady State CT Perfusion Imaging.- First-Pass CT Perfusion Imaging.- Rapid Triage to Appropriate Treatment.- Conclusions.- 10 Clinical Evaluation of Stroke.- Emergency Evaluation.- Differential Diagnosis.- Clinical Features of Stroke.- Classification of Stroke.- Quantification of the Neurologic Deficit.- Conclusions.- 11 Lacunar Stroke.- Clinical Interest of the Lacunar Hypothesis.- Ataxic Hemiparesis and Pure Motor Stroke.- Remarkable Clinical Features of Lacunar Infarcts.- Functional Outcome of Lacunar Strokes.- Stroke Recurrence in Lacunar Infarction.- New Insights in Risk Factors Involved in Lacunar Infarction.- Pathophysiology of Lacunar Infarction.- Imaging Lacunes.- Conclusions.- 12 Cardioembolic Stroke.- Echocardiography in Stroke.- Atrial Fibrillation.- Other Rhythm Disturbances.- Prosthetic Valves.- Valvular Heart Disease.- Myocardial Infarction.- Heart Failure and Cardiomyopathy.- Patent Foramen Ovale.- Spontaneous Echo Contrast and Left Atrial-Atrial Appendage Thrombus.- Endocarditis.- Cardiac Tumors.- 13 Aortic Arch Atherosclerotic Disease.- Case-Control Studies.- Aortic Arch Plaques as a Risk Factor for IschemiC Stroke.- Prospective Studies.- Treatment.- Conclusions.- 14 Subarachnoid Hemorrhage.- Epidemiology.- Causes Other Than Aneurysms.- Management of Aneurysmal Subarachnoid Hemorrhage.- Prevention of Subarachnoid Hemorrhage.- 15 Vascular Dementia.- Diagnostic Criteria.- Descriptive Epidemiology.- Clinical Features.- Risk Factors.- Mechanisms of Vascular Dementia.- Role of White Matter Changes.- Does Dementia Predict a Worse Outcome in Stroke Patients?.- Therapy.- Management of Patients with Vascular Dementia.- Conclusions.- 16 Progressing Stroke.- Definitions and New Concepts on Progressing Stroke.- Epidemiology, Clinical Characteristics, and Outcome.- Risk Factors of Progressing Stroke.- Novel Biochemical and Imaging Techniques in the Diagnosis of Progressing Stroke.- Mechanisms Leading to Cell Death After an Acute Stroke.- Management of Acute Stroke to Limit the Damaging Effects of Progressing Stroke.- Conclusions.- 17 Antithrombotic Therapy in Stroke.- Preventive Treatment in Stroke.- Indications of Acute Anticoagulation.- 18 Neuroprotective Therapy.- Maintaining Perfusion Pressure.- Time Windows for Therapeutic Intervention.- What Can We Expect from Neuroprotective Therapy?.- Is Stroke Subtype Important for Outcome of Neuroprotective Therapy?.- Neuroprotective Treatment Strategies 1: Inhibition of the Ischemic Cascade.- Neuroprotective Treatment Strategies 2: Inhibition of Reperfusion Injury.- Neuroprotective Treatment Strategies 3: Relearning Therapeutic Strategy.- The Future Prospective: Combined Therapies.- 19 Thrombolytic Therapy.- Intravenous Thrombolysis Trials.- Intra-Arterial Thrombolysis.- Vertebrobasilar Thrombolysis.- Risks of Hemorrhagic Transformation.- Other Factors Affecting Outcomes with Thrombolysis.- Thrombolysis in the Community Setting.- Ancrod.- Conclusions.- 20 Surgical Therapy.- Cerebral Ischemia.- Cerebral Aneurysm.- Aneurysm Surgery.- Arteriovenous Malformations.- Cavernous Angioma.- Conclusions.- 21 Stroke in Developing Countries.- Stroke Mortality.- Stroke Incidence.- Stroke Prevelance.- Stroke Subtypes.- Health Care Facilities.- Traditional Medicine.- Solutions.- Conclusions.- 22 Mega Trials Versus Small Trials in Stroke.- Editor's Commentary.- The Need for Large- Scale Randomized Evidence in Acute Stroke Perspective: Peter Sandercock.- The Importance of Small Acute Stroke Trials Perspective: Michael G. Hennerici.- Perspective: Jean-Marc Orgogozo.- The Importance of Both Mega Trials and Small Trials Perspective: Stephen M. Davis.- Are More Subjects Better in a Randomized Controlled Trial? Perspective: Philip B. Gorelick.- Color Plates.