The care of stroke patients has changed dramatically. As well as improvements in the emergency care of the condition, there have been marked advances in our understanding, management and rehabilitation of residual deficits. This book is about the care of stroke patients, focusing on behavioural and cognitive problems. It provides a comprehensive review of the field covering the diagnostic value of these conditions, in the acute and later phases, their requirements in terms of treatment and management and the likelihood and significance of long-term disability. This book will appeal to all clinicians involved in the care of stroke patients, as well as to neuropsychologists, other rehabilitation therapists and research scientists investigating the underlying neuroscience.
Clinical case studies have long been recognized as a useful adjunct to problem-based learning and continuing professional development. They emphasize the need for clinical reasoning, integrative thinking, problem-solving, communication, teamwork and self-directed learning – all desirable generic skills for health care professionals. This book is a teaching tool that bridges the gap between textbook information and everyday experience of clinicians 'in the trenches'. Leading practitioners bring a practical approach to these complex conditions, highlighting specific areas of diagnostic uncertainty in evaluation and treatment. Each case is taken from real-world clinical practice and reviews the diagnostic and treatment process in a systematic manner, identifying common challenges and potential pitfalls. This concise and useful guide in the Common Pitfalls series provides a step-by-step guide for everyday clinical practice, invaluable to anyone dealing with cerebrovascular disease on a front-line basis. The intended readership is trainees and non-specialist practitioners in neurology, stroke medicine, and neurosurgery.
This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.
This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. The book also includes a synopsis of pediatric imaging. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care.
Now presented in full color, this updated edition of Memory Loss, Alzheimer's Disease, and Dementia is designed as a practical guide for clinicians that delivers the latest treatment approaches and research findings for dementia and related illnesses. Drs. Budson and Solomon — both key leaders in the field — cover the essentials of physical and cognitive examinations and laboratory and imaging studies, giving you the tools you need to consistently make accurate diagnoses in this rapidly growing area. Access in-depth coverage of clinically useful diagnostic tests and the latest treatment approaches. Detailed case studies facilitate the management of both common and uncommon conditions. Comprehensive coverage of hot topics such as chronic traumatic encephalopathy, in addition to new criteria on vascular dementia and vascular cognitive impairment. Includes new National Institute on Aging–Alzheimer's Association and DSM-5 criteria for Alzheimer’s Disease and Mild Cognitive Impairment. Learn how to use new diagnostic tests, such as the amyloid imaging scans florbetapir (Amyvid), flutemetamol (Vizamyl), and florbetaben (Neuraceq), which can display amyloid plaques in the living brains of patients. Updated case studies, many complete with videos illustrating common tests, clinical signs, and diagnostic features, are now incorporated into the main text as clinical vignettes for all major disorders. Brand-new chapters on how to approach the differential diagnosis and on primary progressive aphasia. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, references, and videos from the book on a variety of devices.
This up-to-date, superbly illustrated book is a practical guide to the effective use of neuroimaging in the patient with cognitive decline. It sets out the key clinical and imaging features of the various causes of dementia and directs the reader from clinical presentation to neuroimaging and on to an accurate diagnosis whenever possible. After an introductory chapter on the clinical background, the available "toolbox" of structural and functional neuroimaging techniques is reviewed in detail, including CT, MRI and advanced MR techniques, SPECT and PET, and image analysis methods. The imaging findings in normal ageing are then discussed, followed by a series of chapters that carefully present and analyze the key findings in patients with dementias. Throughout, a practical approach is adopted, geared specifically to the needs of clinicians (neurologists, radiologists, psychiatrists, geriatricians) working in the field of dementia, for whom this book will prove an invaluable resource.
This ambitious and comprehensive handbook represents an essential contribution to our current understanding of interactions between heart and brain, a research topic generating growing interest. Despite the increasing awareness that neural mechanisms are the primary cause of cardiac disease and its progression, therapy continues to focus on end-organ protection and does not approach the neural core of the problem. Growing public health problems such as heart failure are still treated with autonomic drugs that are 30-40 years old and simply act on cardiac receptors. However, it has now been shown that the progression of ischemic heart disease to heart failure is mainly due to abnormal central responses to incipient cardiac disease, with neural activation the primary cause rather than the consequence of cardiac remodeling. Written by leading international experts in their respective research areas, the book presents a variety of perspectives on the core topic: from social and philosophical to gender-related aspects. It is designed for a broad readership and includes dedicated sections for cardiologists, psychiatrists, neurologists and psychotherapists looking for a more insightful and targeted approach to neuro-cardiovascular disease.