It might appear bold to publish the proceedings of yet another sym posium on the diagnosis and management of stroke. However, I hope in selecting topics to reflect 'new trends' and in inviting speakers to discuss these trends and the related concepts and results, that we have been suc cessful in attaining a high level of scholarship as well as in appealing to a wide readership. The central issues here derive from a new typology of strokes that should replace the obsolete distinction based on purely temporal param eters so aptly criticized by Caplan. A classification of strokes on the basis of pathogenesis requires a synopsis of information gained from history, neurological and cardiovascular findings, ultrasound studies (ex tracranial as well as transcranial), correctly timed CT scan investigation and, if necessary, from selective angiography. Only the recognition of the role of pathogenetic events for a patient permits the application of a ra tional therapy regimen.
Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.
This updated second edition of Acute Ischemic Stroke: Imaging and Intervention provides a comprehensive account of the state of the art in the diagnosis and treatment of acute ischemic stroke. The basic format of the first edition has been retained, with sections on fundamentals such as pathophysiology and causes, imaging techniques and interventions. However, each chapter has been revised to reflect the important recent progress in advanced neuroimaging and the use of interventional tools. In addition, a new chapter is included on the classification instruments for ischemic stroke and their use in predicting outcomes and therapeutic triage. All of the authors are internationally recognized experts and members of the interdisciplinary stroke team at the Massachusetts General Hospital and Harvard Medical School. The text is supported by numerous informative illustrations, and ease of reference is ensured through the inclusion of suitable tables. This book will serve as a unique source of up-to-date information for neurologists, emergency physicians, radiologists and other health care providers who care for the patient with acute ischemic stroke.
Offered in print, online, and downloadable formats, this updated edition of Stroke: Pathophysiology, Diagnosis, and Management delivers convenient access to the latest research findings and management approaches for cerebrovascular disease. Picking up from where J. P. Mohr and colleagues left off, a new team of editors - Drs. Grotta, Albers, Broderick, Kasner, Lo, Mendelow, Sacco, and Wong - head the sixth edition of this classic text, which is authored by the world's foremost stroke experts. Comprehensive, expert clinical guidance enables you to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan. Abundant full-color CT images and pathology slides help you make efficient and accurate diagnoses. Data from late-breaking endovascular trials equips you with recent findings. Includes comprehensive coverage of advances in molecular biology of cell death; risk factors and prevention; advances in diagnostics and stroke imaging; and therapeutic options, including a thorough review of thrombolytic agents and emerging data for endovascular therapy. Features brand-new chapters on Intracellular Signaling: Mediators and Protective Responses; The Neurovascular Unit and Responses to Ischemia; Mechanisms of Cerebral Hemorrhage; Stroke Related to Surgery and Other Procedures; Cryptogenic Stroke; and Interventions to Improve Recovery after Stroke. Highlights new information on genetic risk factors; primary prevention of stroke; infectious diseases and stroke; recovery interventions such as robotics, brain stimulation, and telerehabilitation; and trial design. Details advances in diagnostic tests, such as ultrasound, computed tomography (including CT angiography and CT perfusion), MRI (including MR perfusion techniques), and angiography. Includes extracted and highlighted evidence levels. Expert Consult eBook version included with print purchase. This enhanced eBook experience allows you to search all of the text, figures, and references on a variety of devices. The content can also be downloaded to tablets and smart phones for offline use. Combat stroke with the most comprehensive and updated multimedia resource on the pathophysiology, diagnosis, and management of stroke from leaders in the field
This issue is a dedicated supplement published in addition to the regular issues of 'Cerebrovascular Diseases' focussing on one specific topic. 'Cerebrovascular Diseases' is a well-respected, international peer-reviewed journal in Neurology. Supplement issues are included in the subscription.
Stroke is a major cause of death and the major cause of adult neurological disability in most of the world. Despite its importance on a population basis, research into the genetics of stroke has lagged behind that of many other disorders. However, the situation is now changing. An increasing number of single gene disorders causing stroke are being described, and there is growing evidence that polygenic factors are important in the risk of apparently "sporadic" stroke. Stroke Genetics provides an up-to-date review of the area, suitable for clinicians treating stroke patients, and both clinical and non-clinical researchers in the field of cerebrovascular disease. The full range of monogenic stroke disorders causing cerebrovascular disease, including ischaemic stroke, intracerebral haemorrhage, aneurysms and arteriovenous malformations, are covered. For each, clinical features, diagnosis, and genetics are described. Increasing evidence suggest that genetic factors are also important for the much more common multifactorial stroke; this evidence is reviewed along with the results of genetic studies in this area. Optimal and novel strategies for investigating multifactorial stroke, including the use of intermediate phenotypes such as intima-media thickness and MRI detected small vessel disease are reviewed. The book concludes by describing a practical approach to investigating patients with stroke for underlying genetic disorders. Also included is a list of useful websites.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.
An essential companion for busy professionals seeking to navigate stroke-related clinical situations successfully and make quick informed treatment decisions.
