Ischemic cerebral vascular disease an overview

Fisher, Marc

doi:10.1590/S0004-282X1991000100001

Abstracts

The management of patients with cerebrovascular ischemic disease (ICD) is rapidly changing due to newer diagnostic approaches and therapies being developed. In the present article, the author reviews part of his experience in the clinical and basic fields of ICD which is the most common neurologic problem leading to acute hospitalization. Clinico-anatomic categories of ICD as well as prognosis and differential diagnosis are discussed. Data from basic and research are analysed with a main focus on their implications for clinical management.

A doença cerebrovascular isquêmica (DCVI) representa a maior causa de hospitalização aguda por problemas neurológicos. Recentes avanços diagnósticos e terapêuticos, provenientes de pesquisa em áreas básicas, prometem modificar o atual panorama de desesperança terapêutica em curto prazo. No presente artigo, o autor revê parte de sua experiência no campo das DCVI e, com base em dados de pesquisa básica e clínica, discute aspectos essenciais de classificação, diagnóstico diferencial, prognóstico e tratamento, enfatizando o ponto de vista do clínico praticante à beira do leito.

CONTENTS CONTEÚDO

Ischemic cerebral vascular disease an overview

Doença cerebrovascular isquêmica: uma avaliação

Marc Fisher

Professor of Neurology, University of Massachusetts Medical School; Chief of Neurology, The Medical Center of Central Massachusetts-Memorial

SUMMARY

The management of patients with cerebrovascular ischemic disease (ICD) is rapidly changing due to newer diagnostic approaches and therapies being developed. In the present article, the author reviews part of his experience in the clinical and basic fields of ICD which is the most common neurologic problem leading to acute hospitalization. Clinico-anatomic categories of ICD as well as prognosis and differential diagnosis are discussed. Data from basic and research are analysed with a main focus on their implications for clinical management.

RESUMO

A doença cerebrovascular isquêmica (DCVI) representa a maior causa de hospitalização aguda por problemas neurológicos. Recentes avanços diagnósticos e terapêuticos, provenientes de pesquisa em áreas básicas, prometem modificar o atual panorama de desesperança terapêutica em curto prazo. No presente artigo, o autor revê parte de sua experiência no campo das DCVI e, com base em dados de pesquisa básica e clínica, discute aspectos essenciais de classificação, diagnóstico diferencial, prognóstico e tratamento, enfatizando o ponto de vista do clínico praticante à beira do leito.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Acknowledgement - The author is indebted to Dr. Ricardo de Oliveira-Souza (Hospital Universitario Gaffr6e e Guinle, UNI-RIO, Rio de Janeiro) for commenting on the manuscript and making editorial notes for publication.

Marc Fisher, M.D. - 119 Belmont Street - Worcester, MA 01065 - USA.

1. Asinger RW, Dyken ML, Fisher M, Hart RG, Sherman D. Cardiogenic brain embolism. Arch Neurol 1989, 46:727-743.
2. Bogousslavsky J, Hachinski VC, Boughner DR, Fox AJ, Vineula F, Barret HJM. Cardiac and arterial lesions in carotid transient ischemic attacks. Arch Neurol 1986, 43:223-228.
3. Bogousslavsky J, Regli F. Unilateral watershed cerebral infarcts. Neurology 1988, 36:372-377.
4. Bogousslavsky J, van Melle G, Regli F. The Lausanne stroke registry. Stroke 1988, 19:1083-1092.
5. Callow AD, Caplan LR, Correl JW. Carotid endarterectomy; what is its current status? Am J Med 1988, 85:835-838.
6. Caplan LR, Stein RW. Stroke: A Clinical Approach. Boston: Butterworths, 1986.
7. Cerebral Embolism Study Group. Cardiogenic stroke, early anticoagulation and brain hemorrhage. Arch Intern Med 1987. 147:636-640.
8. Chambers BR, Norris JW, Shurvell BL, Hachinski VC. Prognosis of acute stroke. Neurology 1987, 27:221-225.
9. Dewitt LD, Wechsler LR. Transcranial doppler. Stroke 1988, 19:915-921.
10. Duke RJ, Block RF, Turpie AG. Intravenous heparin for the prevention of stroke in acute partial stable stroke. Ann Intern Med 1986, 105:821-828.
11. Dyken ML, Wolf PA, Barnett HJM. Risk factors in stroke. Stroke 1984, 15:1105-1111.
12. Gauthier JC. Stroke in progression. Stroke 1985, 16:729-733.
13. Gelmers HJ, Gorter K, de Weerdt CT. A controlled trial of nimodipin in acute ischemic stroke. N Engl J Med 1988, 318:203-207.
14. Hachinski VC, Norris JW. The Acute Stroke. Philadelphia : F.A. Davis, 1985.
15. Hall ED, Pazara KE, Braughler JM. 21-aminosteroid lipid peroxidation inhibitor U74006F protects against cerebral ischemia in gerbils. Stroke 1988, 19:997-1002.
16. Heyman A, Leviton A, Millikan CH. Transient focal cerebral ischemia: epidemiological and clinical aspects. Stroke 1974, 10:271-284.
17. Italian Acute Stroke Study Group. Hemodilution in acute ischemic stroke: results of the Italian hemodilution trial. Lancet 1988, 1:318-321.
18. Jones HR, Millikan CM. Temporal profile (clinical course) of acute carotid system cerebral infarction. Stroke 1976, 7:64-71.
19. Kase CS. Clinicoanatomic correlations. In Woods JH (ed): Cerebral Blood Flow. New York: McGraw-Hill, 1987, p 92-118.
20. Keith DS, Phillips SJ, Whisnant JP, Nishinaru K, O' Fallon WM. Heparin treatment for recent transient focal cerebral ischemia. Mayo Clin Proc 1987, 62:1101-1106.
21. Kertesz A, Black SE, Nicholson L, Carr T. The sensitivity and specificity of MRI in stroke. Neurology 1987, 37:1580-1585.
22. Lechat P, Mar JL, Lascault G. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med 1988, 318:1148-1154.
23. Levine SR. Acute cerebral ischemia in a critical care unit. Arch Intern Med 1989, 149:90-98.
24. Mohr JP. Lacunes. Stroke 1982, 13:3-10.
25. Mohr JP, Caplan LR, Melski JW. The Harvard Cooperative Stroke Registry. Neurology 1978, 28:754-762.
26. Rothrock JF, Walicke P, Swenson MR, Leyden PD, Logan WR. Migranous stroke. Arch Neurol 1988, 45:63-67.
27. The Canadian American Ticlopidine Study in Thromboembolic Stroke. Lancet 1989, 1:1215-1220.
28. The ESPS Group. The European Prevention Study (ESPS) : principal endpoints. Lancet 1987, 2:1351-1354.
29. Woo E, Robinson JD, Yu YL. Hyperglicemia is a stress response in acute stroke. Stroke 1988, 19:1359-1364.
30. Zivin JA, Fisher M, DeGirolami U. Tissue plasminogen activator reduces neurologic damage after cerebral embolism. Stroke 1985, 320:1289-1292.

Publication Dates

Publication in this collection
22 Feb 2011
Date of issue
Mar 1991

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Asinger RW, Dyken ML, Fisher M, Hart RG, Sherman D. Cardiogenic brain embolism. Arch Neurol 1989, 46:727-743.

[2] 2. Bogousslavsky J, Hachinski VC, Boughner DR, Fox AJ, Vineula F, Barret HJM. Cardiac and arterial lesions in carotid transient ischemic attacks. Arch Neurol 1986, 43:223-228.

[3] 3. Bogousslavsky J, Regli F. Unilateral watershed cerebral infarcts. Neurology 1988, 36:372-377.

[4] 4. Bogousslavsky J, van Melle G, Regli F. The Lausanne stroke registry. Stroke 1988, 19:1083-1092.

[5] 5. Callow AD, Caplan LR, Correl JW. Carotid endarterectomy; what is its current status? Am J Med 1988, 85:835-838.

[6] 6. Caplan LR, Stein RW. Stroke: A Clinical Approach. Boston: Butterworths, 1986.

[7] 7. Cerebral Embolism Study Group. Cardiogenic stroke, early anticoagulation and brain hemorrhage. Arch Intern Med 1987. 147:636-640.

[8] 8. Chambers BR, Norris JW, Shurvell BL, Hachinski VC. Prognosis of acute stroke. Neurology 1987, 27:221-225.

[9] 9. Dewitt LD, Wechsler LR. Transcranial doppler. Stroke 1988, 19:915-921.

[10] 10. Duke RJ, Block RF, Turpie AG. Intravenous heparin for the prevention of stroke in acute partial stable stroke. Ann Intern Med 1986, 105:821-828.

[11] 11. Dyken ML, Wolf PA, Barnett HJM. Risk factors in stroke. Stroke 1984, 15:1105-1111.

[12] 12. Gauthier JC. Stroke in progression. Stroke 1985, 16:729-733.

[13] 13. Gelmers HJ, Gorter K, de Weerdt CT. A controlled trial of nimodipin in acute ischemic stroke. N Engl J Med 1988, 318:203-207.

[14] 14. Hachinski VC, Norris JW. The Acute Stroke. Philadelphia : F.A. Davis, 1985.

[15] 15. Hall ED, Pazara KE, Braughler JM. 21-aminosteroid lipid peroxidation inhibitor U74006F protects against cerebral ischemia in gerbils. Stroke 1988, 19:997-1002.

[16] 16. Heyman A, Leviton A, Millikan CH. Transient focal cerebral ischemia: epidemiological and clinical aspects. Stroke 1974, 10:271-284.

[17] 17. Italian Acute Stroke Study Group. Hemodilution in acute ischemic stroke: results of the Italian hemodilution trial. Lancet 1988, 1:318-321.

[18] 18. Jones HR, Millikan CM. Temporal profile (clinical course) of acute carotid system cerebral infarction. Stroke 1976, 7:64-71.

[19] 19. Kase CS. Clinicoanatomic correlations. In Woods JH (ed): Cerebral Blood Flow. New York: McGraw-Hill, 1987, p 92-118.

[20] 20. Keith DS, Phillips SJ, Whisnant JP, Nishinaru K, O' Fallon WM. Heparin treatment for recent transient focal cerebral ischemia. Mayo Clin Proc 1987, 62:1101-1106.

[21] 21. Kertesz A, Black SE, Nicholson L, Carr T. The sensitivity and specificity of MRI in stroke. Neurology 1987, 37:1580-1585.

[22] 22. Lechat P, Mar JL, Lascault G. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med 1988, 318:1148-1154.

[23] 23. Levine SR. Acute cerebral ischemia in a critical care unit. Arch Intern Med 1989, 149:90-98.

[24] 24. Mohr JP. Lacunes. Stroke 1982, 13:3-10.

[25] 25. Mohr JP, Caplan LR, Melski JW. The Harvard Cooperative Stroke Registry. Neurology 1978, 28:754-762.

[26] 26. Rothrock JF, Walicke P, Swenson MR, Leyden PD, Logan WR. Migranous stroke. Arch Neurol 1988, 45:63-67.

[27] 27. The Canadian American Ticlopidine Study in Thromboembolic Stroke. Lancet 1989, 1:1215-1220.

[28] 28. The ESPS Group. The European Prevention Study (ESPS) : principal endpoints. Lancet 1987, 2:1351-1354.

[29] 29. Woo E, Robinson JD, Yu YL. Hyperglicemia is a stress response in acute stroke. Stroke 1988, 19:1359-1364.

[30] 30. Zivin JA, Fisher M, DeGirolami U. Tissue plasminogen activator reduces neurologic damage after cerebral embolism. Stroke 1985, 320:1289-1292.

Brasil

Brasil

Ischemic cerebral vascular disease an overview

Doença cerebrovascular isquêmica: uma avaliação

Abstracts

Publication Dates