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Stroke
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
A stroke occurs when a brain artery becomes blocked, or it ruptures. An area of brain tissue becomes necrotic as its blood supply is lost. This is known as a cerebral infarction. Approximately 14 million new strokes occur globally every year. Symptoms develop quickly. Most strokes are ischemic, usually caused by arterial blockage, and fewer are hemorrhagic, caused by arterial rupture. Transient ischemic attacks are like ischemic strokes, except that symptom usually resolve in less than 1 hour, and there is no permanent brain damage. Since diabetes mellitus increases risk factors for hypertension and high cholesterol, there are increased chances for having a stroke or heart attack. Adults with diabetes are about two times as likely to have a stroke or heart disease compared to adults without diabetes.
Headache
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Permanent focal neurologic symptoms persisting beyond 24 hours after the cessation of migraine headache. Cranial CT or MRI scan shows features consistent with cerebral infarction. The cause is probably arterial thrombosis, provoked by arterial spasm and a procoagulant state (e.g. cigarette smoking and the oral contraceptive pill).
Prophylactic and Preventive Use of Antiepileptic Drugs
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Prevention of seizures could be considered for patients with cerebral infarction. Epilepsy complicates stroke in 6 to 9% of patients (19). Patients with cerebral infarctions involving the cerebral cortex and with persistent paresis have 20% liability to develop seizures (20). Although the risk of epilepsy following stroke has been recognized, administration of AEDs as a prophylaxis has not been reported. If medications are to be administered to this group, specific knowledge of the risks and benefits would be important.
Impact of cerebral microbleeds on cognitive functions and its risk factors in acute cerebral infarction patients
Published in Neurological Research, 2023
Linyun Chen, Feng Liu, Xuan Tian, Tian Zhang, Jian Zhang, Fang Ran
Cerebral infarction is a clinical condition in which the blood supply of intracranial vascular tissue is insufficient due to various reasons, which eventually leads to necrosis of brain tissue [16]. Patients with cerebral infarction will have symptoms such as dizziness, vomiting, nausea, tinnitus, hemiplegia, and even coma shock, which seriously affects the health and quality of life of the patients [17]. Acute cerebral infarction has the characteristics of rapid onset, rapid disease progression, and serious disease [18]. With the aging of the population, the incidence of acute cerebral infarction is increasing year by year, and it has become an important disease that threatens human life and health [19]. Cerebral microbleeds are caused by small blood vessel lesions in the brain, characterized by the deposition of hemosiderin around the small blood vessels or the phagocytosis of hemosiderin mononuclear cells, with a tendency to hemorrhage [20]. Studies have shown that the incidence of cerebral microbleeds in ACI patients is 53.54% [6,21]. The incidence and severity of cerebral microbleeds in patients with different types of cerebral infarction are different [22]. Hemorrhagic transformation is a common complication in patients with ACI [23].
Persistent Trigeminal Artery Causing an Abducens Nerve Palsy: A Case Report
Published in Neuro-Ophthalmology, 2023
Aimee Lloyd, Sunila Jain, Diana Duke, Somenath Chatterjee, Bahauddin Ibrahim
Although not identified in this case, a PTA can lead to cerebral ischaemia. This was documented in a case report by Palmer and Gulcer in 1981, whereby a PTA was deemed the likely cause for emboli to pass from an ulcerated carotid bifurcation to the vertebro-basilar circulation.19 Since then, there has been a growing body of evidence linking a PTA with cerebral ischaemia.4,20–22 It is thought that the PTA allows a channel of communication allowing a plaque from atherosclerotic internal carotid emboli to flow into the vertebrobasilar network. Kwon et al. presented a case of right-sided weakness secondary to cerebral infarction. The patient received thrombolysis with intravenous tissue plasminogen activator. On MRI, it was shown that the patient had a PTA occlusion leading to the cerebral ischaemia. Post-thrombolysis the PTA occlusion resolved and circulation was restored to the basilar artery.21 This research highlights the importance of the consideration of ischaemic events due to a PTA.
The role of blood pressure management in stroke prevention: current status and future prospects
Published in Expert Review of Cardiovascular Therapy, 2022
Keisuke Narita, Satoshi Hoshide, Kazuomi Kario
The one of greatest risk factor common to both cerebral infarction and cerebral bleeding is hypertension. Blood pressure (BP) level and stroke risk have a direct linear relationship[2]. Appropriate management of hypertension is very important in the primary prevention of stroke. In Japan, however, according to a patient survey by the Ministry of Health, Labor and Welfare, an estimated 43 million people (approximately 1 out of every 3 people) have hypertension, and only half of these patients are receiving treatment; among patients undergoing treatment, more than half have not achieved their treatment goals[3]. Therefore, although hypertension can be diagnosed easily and there are many therapeutic agents, the prevalence of patients who are treated with well-controlled BP levels is often very low. This phenomenon is known as the ‘hypertension paradox’ in the Japanese guideline (Figure 1). Appropriate management of hypertension remains a very important issue in the prevention of stroke in developing countries and industrialized countries alike.