Cerebrovascular disorders

In summary, the steadily increasing size of geriatric populations in developed countries and the resultant increases in age-related diseases of the brain have provided the impetus for intensive study of the processes underlying neurodegeneration. A better understanding of these processes will likely lead to better methods of treatment not only for progressive memory disorders such as Alzheimer disease, but also for motor disorders such as amyotrophic lateral sclerosis, and cerebrovascular disorders such as stroke. 

Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke 1989 20 1407-1431. 

J6. Joviiic, A., Ivanisevic, V., and Ivanovic, I., Lipoprotein(a) in patients with carotid atherosclerosis and ischemic cerebrovascular disorders. Atherosclerosis (Shannon, Irel.) 98, 59-65 (1993). 

Kaye and Fainstat 1987 Wooten et al. 1983). The risk of cerebral hemorrhage is even greater when combining ephedrine with other catecholamine stimulants such as the over-the-counter stimulant phenyl-propanolamine (StoessI et al. 1985). Pseudoephedrine may be safer than ephedrine in some respects (Porta et al. 1986). In a large sample (n > 100,000) of pseudoephedrine users, there were no reports of cerebrovascular disorders within 15 days after administration. The incidence of myocardial infarction, seizures, and neuropsychiatric disorders were no greater than base rates in the general population. 

Cardiovascular and cerebrovascular disorders associated with lipid metabolism disturbance and atherosclerosis represent major risk factors for dementia (3,25,59). Atherosclerosis is the primary cause of heart disease and stroke in which genetic and environmental factors converge (553). More than 90% of patients older than 70-80 yr with dementia show signs of atherosclerosis in their arteries and a clear cerebrovascular component in their dementia process. It is very likely that pure AD is practically absent in octogenarians, in whom the prevalent diagnosis is vascular or mixed dementia (3,25,59), in which the APOE-4 allele also accumulates (18-20,554). 

Thrombotic disorders Thrombotic disorders (thrombophlebitis, cerebrovascular disorders, retinal thrombosis, pulmonary embolism) occasionally occur in patients taking progestins. 

Cerebrovascular disorders - Combination oral contraceptives have been shown to increase the relative and attributable risks of cerebrovascular events (thrombotic and hemorrhagic strokes), although, in general, the risk is greatest among older (older than 35 years of age) hypertensive women who also smoke. 

G. biloba L. is a member of the Ginkgoaceae family, a gymnosperm that has survived unchanged from the Triassic period. In traditional Chinese medicine, the seeds (nuts) of G. biloba were used as an antitussive, expectorant, and antiasthmatic, and in bladder infection (20). In China, the leaves of G. biloba were also used for the treatment of asthma and cardiovascular disorders (21). Today, standardized concentrated extracts prepared from the leaves of G. biloba are used for the treatment of peripheral circulatory insufficiency, cerebrovascular disorders, geriatric complaints, and for Alzheimer dementia. For a more extensive treatment, readers are referred to the many authoritative reviews available, e.g.. Refs. (22-27). 

These drugs are contraindicated in patients with thrombophlebitis, thromboembolic phenomena, and cardiovascular and cerebrovascular disorders or a past history of these conditions. They should not be used to treat vaginal bleeding when the cause is unknown. They should be avoided in patients with known or suspected tumors of the breast or other estrogen-dependent neoplasms. Since these preparations have caused aggravation of preexisting disorders, they should be avoided or used with caution in patients with liver disease, asthma, eczema, migraine, diabetes, hypertension, optic neuritis, retrobulbar neuritis, or convulsive disorders. 

Effects Euphoria and hallucinations. Vincamine improves mental ability in cerebrovascular disorders. 

There is some evidence that the availability of choline may be limiting for the synthesis of acetylcholine in the central nervous system under some conditions, and supplements of phosphatidylcholine increase the rate of acetylcholine turnover. One systematic review concludes that phosphatidylcholine supplements result in some improvement in cognitive function in patients with dementia, especially when this is secondary to cerebrovascular disorder (Fioravanti and Yanagi, 2000), but another concludes that there is no evidence to support its use in the treatment of dementia (Higgins and Flicker, 2000). Although phosphatidylcholine has been used to treat tardive dyskinesia... 

Down syndrome Retrolental fibroplasia Cerebrovascular disorders Ischemia reperfusion injury... 

Bono G, Martucci N, Merlo P, et al. Safety profile of flunar-izine. A retrospective study in migraine and cerebrovascular disorders. Ann NY Acad Sci 1988 522 712. 

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