Cerebrovascular syndrome

Cerebrovascular syndrome Rapid incapacitation, death within a few days. 

Aberrant thrombus formation and deposition on blood vessel walls imderlies the pathogenesis of acute cardiovascular disease states which remain the principal cause of morbidity and mortality in the industrialized world [1,2,3]. Plasma proteins, proteases and specific cellular receptors that participate in hemostasis have emerged as important risk considerations in thrombosis and thromboembolic disorders. The clinical manifestations of the above disease states include acute coronary artery and cerebrovascular syndromes, peripheral arterial occlusion, deep vein thrombosis and pulmonary/renal embolism [3]. The most dilabilitating acute events precipitated by these disorders are myocardial infarction and stroke. In addition, the interplay between hemostatic factors and hypertension (4) or atherosclerosis (5) dramatically enhances the manifestation of these pathologic states. 

Infection, acute coronary syndrome, cerebrovascular accidents, trauma, noncompliance with insulin pharmacotherapy, new-onset diabetes mellitus, and medications (e.g., corticosteroids and sympathomimetics)... 

Infection, acute coronary syndrome, cerebrovascular accidents, and trauma... 

Suggested Alternatives for Differential Diagnosis Encephalitis, Herpes Simplex, tetanus, Guillain-Barre syndrome, poliomyelitis, transverse myelitis, cerebrovascular accident, psychosis, intracranial mass, epilepsy, atropine poisoning, and Creutzfeldt-Jacob disease. 

Naratriptan and sumatriptan Cerebrovascular or peripheral vascular syndromes, severe hepatic impairment (Child-Pugh grade C) severe renal impairment (Ccr less than 15 mL/min) (naratriptan only). 

C. Ginkgo would be the most likely herbal treatment to benefit this patient, since it would improve cerebrovascular blood flow and cognitive function. Vertigo and tinnitus may also respond, although there is more evidence for the former. GarUc is traditionally used for cardiovascular benefits (Upid, blood pressure reduction), but it would be unlikely to produce immediate results. Peppermint is used as an antispasmodic in irritable bowel syndrome, while ginger tea is a common carminative (gas reducer) and motion sickness treatment. Valerian is useful as a sedative. 

It is indicated in spasticity due to neurological disorders e.g., multiple sclerosis, chronic myelopathy, degenerative diseases of the spinal cord, cerebrovascular accidents and cerebral palsy painful muscle spasm associated with static and functional disorders of the spine (cervical and lumbar syndromes) painful muscle spasm following surgery e.g., for herniated intervertebral disc or for osteoarthritis of the hip. 

It is indicated in organic brain syndrome, intellectual impairment of senility, encephalitis, alcohol withdrawal state and perinatal distress, cerebrovascular accidents, and organic psychosyndrome. 

Cerebrovascular Carotid spasm Compromise of ECA ostium Hyperfusion syndrome Contrast encephalopathy Transient symptomatic cerebral ischemia Global Focal Carotid dissection Carotid perforation Hyperperfusion syndrome Acute stent thrombosis Major ischemic stroke Cerebral hemorrhage... 

Feldmann E, Daneault N, Kwan E et al (1990) Chinese-white differences in the distribution of occlusive cerebrovascular disease. Neurology 40 1541-1545 Ferber S, Karnath HO (2001) Size perception in hemianopia and neglect. Brain 124 527-536 Ferro JM (2001) Hyperacute cognitive stroke syndromes. J Neurol 248 841-849... 

Transient ischemic attack (TIA) is a clinical syndrome characterized by focal neurological symptoms presumed to be of vascular origin that last less than 24 h. Despite the transient nature of symptoms, the cerebrovascular thread is not over yet following a TIA. The mechanism that has given rise to the transient spell may also cause more severe ischemic syndromes if not properly treated. About 10% of patients with TIA suffer from stroke within the ensuing 3 months, 50% of which occur within the first 2 days (Johnston et al. 2003). Accurate and prompt recognition of ischemia as the cause of neurological symptoms is imperative to prevent subsequent strokes. This is, however, a complicated task... 

Given the common mechanisms underlying TIA and stroke, the investigation of patients with these syndromes is similar. However, in TIA and minor stroke, the emphasis is on rapid identification and treatment of the underlying cause in order to prevent a recurrent and possibly more severe event, whereas in severe stroke, the initial emphasis of investigation is on targeting treatment to minimize subsequent deficit Therefore, in this book, we have considered TIA and minor stroke separately from severe stroke to reflect the difference in clinical approach to minor versus more severe cerebrovascular events. 

Rothwell PM (2005). Prevention of stroke in patients with diabetes mellitus and the metabolic syndrome. Cerebrovascular Diseases 1 24-34... 

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