Cerebrovascular strokes

On the pathophysiological side, hyperactive nNOS has been implicated in A/-methyl-D-aspartate (NMDA)-receptor-mediated neuronal death in cerebrovascular-stroke. Some disturbances of smooth muscle tone within the gastrointestinal tract (e.g., gastroesophageal reflux disease) may also be related to an overproduction of NO by nNOS in peripheral nitrergic nerves. 

Neurodegeneration Localised or widespread death of neurons, a feature of a number of brain disorders, such as Alzheimer s disease, Parkinson s disease and cerebrovascular stroke. It can also be caused by neurotoxic drugs like MDMA/Ecstasy, although there is debate over whether this occurs in humans as well as laboratory animals. 

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. 

One of the earliest symptoms of hypertensive crisis is headache (usually occipital), followed by a stiff or sore neck, nausea, vomiting, sweating, fever, chest pain, dilated pupils, and bradycardia or tachycardia. If a hypertensive crisis occurs, immediate medical intervention is necessary to reduce the blood pressure Strokes (cerebrovascular accidents) and death have been reported. 

Diabetes mellitus is a complicated, chronic disorder characterized by either insufficient insulin production by the beta cells of die pancreas or by cellular resistance to insulin. Insulin insufficiency results in elevated blood glucose levels, or hyperglycemia As a result of the disease, individuals with diabetes are at greater risk for a number of disorders, including myocardial infarction, cerebrovascular accident (stroke), blindness, kidney disease, and lower limb amputations. 

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

Leira R, Davalos A, Silva Y, Gil-Peralta A, Tejada J, GarciaM, Castillo J Stroke Project, Cerebrovascular Diseases Group of the Spanish Neurological Society. Early neurological deterioration in intracerebral hemorrhage Predictors and associated factors. Neurology 2004 63(3) 461 67. 

Mohr JP, Sacco RL. Morbidity and mortality of stroke. In Moore, WS editor. Surgery for cerebrovascular disease. W.B. Saunders Company, 1996 p 9-15. 

Risk factors for embolic cerebrovascular accidents include previous ischemic stroke, transient ischemic attacks (TIA), systemic embolism, age >75 yr, moderately or severely impaired left ventricular systolic function, hypertension, diabetes mellitus... 

Stroke A transient ischaemic attack or cerebrovascular accident due to occlusion (blockage) of blood vessels supplying an area of the brain. The subsequent nerve cell death may result in major disability. 

J7. Gurgens, G., and Kdltringer, P., Lipoprotein(a) in ischemic cerebrovascular disease A new approach to the assessment of risk of stroke. Neurology 37, 513-515 (1987). 

Cardiovascular disease Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH]... 

Uyama O, Nagatsuka K, Nakabayashi S, Isaka Y, Yoneda S, et al. 1985. The effect of a thromboxane synthetase inhibitor, OKY-046, on urinary excretion of immunoreactive thromboxane B2 and 6-keto-prostaglandin El alpha in patients with ischemic cerebrovascular disease. Stroke 16 241-244. 

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). 

Heart Protection Study Collaborative Group. Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions. Lancet 2004 363 757-67. 

Recent cerebrovascular accident, stroke, intracerebral surgery, or other neuraxial procedures... 

Smoking- Smoking in combination with OC use has been shown to contribute substantially to the incidence of Mis in women in their mid-30s or older, with smoking accounting for the majority of excess cases. Mortality rates associated with circulatory disease have been shown to increase substantially in smokers, especially in those 35 years of age and older who use OCs. Cerebrovascular diseases - OCs increase the risks of cerebrovascular events (thrombotic and hemorrhagic strokes). In general, the risk is greatest in hypertensive women older than 35 years of age who also smoke. 

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. 

In a number of cases, it appears possible that the cerebrovascular events were primary, the agonist having been administered in the incorrect belief that the symptoms experienced were a consequence of migraine, when they were not. It should be noted that patients with migraine may be at increased risk of certain cerebrovascular events (eg, stroke, hemorrhage, TIA). 

Drug-associated cerebrovascular events and fatalities Cerebral hemorrhage, subarachnoid hemorrhage, stroke, and other cerebrovascular events have been reported in patients treated with dihydroergotamine some have resulted in fatalities. Other vasospasm-related events Dihydroergotamine, like other ergot alkaloids, may cause vasospastic reactions other than coronary artery vasospasm. Myocardial and peripheral vascular ischemia have been reported with dihydroergotamine. 

Crack Cocaine Street Names Freebase. Mexican speedballs (crack w/ methamphetamine), roosten tornado (ovct 40 street slang terms) Use Crack is cocaine that comes in a rock crystal that can be heated and its vapors smoked. The tOTn crack ref s to the crackling sound heard when it is heated Actions CNS stimulant induces euphoria. Highly addictive Effects Acute CV or cerebrovascular emergencies (heart attack or stroke), could result in sudden death. Cocaine-related deaths are often a result of cardiac arrest or seizure followed by resp arrest (see also Cocaine)... 

A 38-year-old man with a family history of cardiovascular and cerebrovascular disease makes an appointment for a routine physical examination with a physician he has not seen before. He explains that his father died young of a heart attack and that two paternal uncles have suffered strokes in their late 40s. Physical examination reveals yellowish lumps on his eyelids (xanthelasmas, which are often associated with a lipid disorder) and a resting blood pressure of 186/95 mm Hg. There is some excess visceral fat, and his body mass index calculates to 26.5. Total serum cholesterol (476 mg/dL) and triglycerides (288 mg/dL) are elevated and subsequent angiography reveals atherosclerotic restrictions of at least two coronary arteries. 

The main indications for aspirin as a platelet aggregation inhibitor are prevention of stroke in patients with cerebrovascular disease, prevention of myocardial infarct in patients with unstable angina or after myocardial infarction. For the prevention of myocardial infarction in someone with documented or suspected coronary artery disease, doses as low as 75 mg daily (or possibly even lower) are sufflcient. 

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