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Overview on Strokes
Stroke is sudden death of brain cells due to lack of oxygen due to blood supply blockage or rupture of arteries of the brain. WHO indicates Stroke as the second leading cause for global mortality. Stroke is categorised into subtypes based on aetiology, assisting treatment evaluation. Risk factors for stroke are age, race, heredity, hypertension, diabetes, smoking, alcohol consumption, obesity, cholesterol. Prevention methods involve lifestyle modifications, low cholesterol diet, physical activity, minimising risk factors like cigarette smoking and alcohol consumption. Pharmacological treatments for hypertension, diabetes and interventional procedures are suggested. The prognosis depends on type extent, severity, duration of stroke and co-morbid risk factors. Timely management of stroke, pre-hospital stroke care minimise mortality rate and enhances survival rates. Life style modifications, decrease the recurrence, thereby decrease the economic burden of stroke.
Keywords
Stroke, Pathophysiology of Stroke, Classification of Stroke, Risk Factors of Stroke, Treatment of Stroke
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- Ballinger A, and Patchett S (2007). Essentials of Kumar and Clark clinical medicine, 4th Edn., Elsevier Saunders, 725–733.
- WHO, Stroke, Cerebrovascular accident, Available from: http://www.who.int/topics/cerebrovascular_accident/en/
- WHO, Global burden of stroke, Available from: http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_stroke.pdf
- Truelsen T, Piechowski-Jóźwiak B et al. (2006). Stroke incidence and prevalence in Europe: a review of available data, European Journal of Neurology, vol 13(6), 581–598.
- WHO Stroke, Available from: http://www.who.int/ncd_surveillance/ncds/strokerationale/en/
- Green A R (2008). Pharmacological approaches to acute ischaemic stroke: reperfusion certainly, neuroprotection possibly, vol 153, Suppl 1, S325–S338.
- Jovićević M, Divjak I et al. (2010). Non-atherosclerotic arteriopathy as the cause of ischemic stroke among young adults. Medicinski pregled, vol 63(5–6), 324–332.
- Elkind M S (2010). Inflammatory mechanisms of stroke, Stroke, vol 41(10 Suppl), S3–S8.
- Fuster V, Stein B et al. (1990). Atherosclerotic plaque rupture and thrombosis, Evolving concepts. Circulation, vol 82(3 Suppl), II47–II59.
- Broussalis E, Killer M et al. (2011). Current therapies in ischemic stroke, Part A, Recent developments in acute stroke treatment and in stroke prevention, Drug Discovery Today.
- Sacco R L (1997). Wolf PA, American Heart Association Prevention Conference, IV. Prevention and Rehabilitation of Stroke, Risk factors, Stroke, (7), 507–517.
- He J, Klag M J et al. ( 1995). Stroke in the People’s Republic of China, I. Geographic variations in incidence and risk factors, Stroke, (12), 2222–2227.
- Howard G, Cushman M et al. (2011 ). for the Reasons for geographic and racial differences in stroke (regards) investigators, Traditional risk factors as the underlying cause of racial disparities in stroke: lessons from the half-full (empty?) glass, (12), 3369–3375.
- Muthaian R, Minhas G et al. (2011). Pathophysiology of stroke and stroke induced retinal ischemia: Emerging role of stem cells. Journal of Cellular Physiology, doi: 10.1002/jcp.23048 [Epub ahead of print].
- O’Donnell M J, Xavier D et al. (2010). Interstroke investigators.
- Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the Interstroke study): a case-control, Lancet, vol 376(9735), 112–123.
- Kolominsky-Rabas P L et al. (2001) Epidemiology of ischemic stroke subtypes according to Toast criteria: incidence, recurrence, and long-term survival in ischemic stroke subtypes: a population-based study, vol 32(12), 2735–2740.
- Sumer M M, and Erturk O (2002). Ischemic stroke subtypes: risk factors, functional outcome and recurrence, Neurological Sciences, vol 22(6), 449–454.
- Shang W Y, and Liu J Y (2011). Stroke subtype classification: a comparative study of ASCO and modified TOAST, Journal of the Neurological Sciences.
- Han S W, Kim S H et al. (2007). A new subtype classification of ischemic stroke based on treatment and etiologic mechanism, vol 57(2), 96–102.
- Bardutzky J, and Schwab S (2007). Antiedema therapy in ischemic stroke, Stroke, vol 38(11), 3084–3094.
- Paciaroni M, and Bogousslavsky J (2010). Primary and secondary prevention of ischemic stroke, European Neurology, vol 63(5), 267–278.
- Bergman D (2011). Preventing recurrent cerebrovascular events in patients with stroke or transient ischemic attack: The current data, Journal of the American Academy of Nurse Practitioners, vol 23(12), 659–666, DOI: 10.1111/j.1745-7599.2011.00650.x
- Kessler C, Khaw AV et al. (2011). Standardized prehospital treatment of stroke, Deutsches Ärzteblatt international, 108(36), 585–591.
- Walter S, Kostpopoulos P et al. (2010). Bringing the hospital to the patient: first treatment of stroke patients at the emergency site, PLoS One, vol 5(10), e13758.
- Bae H J, Kim D H et al. (2010). Prehospital notification from the emergency medical service reduces the transfer and intra-hospital processing times for acute stroke patients, The Journal of Clinical Neurology, vol 6(3), 138–142.
- Evenson K R, Foraker R E et al. (2009). A comprehensive review of prehospital and in-hospital delay times in acute stroke care, International Journal of Stroke, vol 4(3),187–199.
- Muthaian R, Minhas G et al. (2011). Pathophysiology of stroke and stroke induced retinal ischemia: Emerging role of stem cells, Journal of Cellular Physiology, DOI: 10.1002/ jcp.23048
- Mayberg M R, Wilson S E et al. (1991). Carotid endarterectomy and prevention of cerebral ischemia in symptomatic carotid stenosis, Veterans Affairs Cooperative Studies Program 309 Trialist Group, JAMA, vol 266(23), 3289–3294.
- European Carotid Surgery Trialists’ Collaborative Group (1991). MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis, European Carotid Surgery Trialists’ Collaborative Group, Lancet, vol 337(8752), 1235–1243.
- North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis, North American Symptomatic Carotid Endarterectomy Trial Collaborators, The New England Journal of Medicine, vol 325(7), 445–453.
- Barnett H J, Taylor D W et al. ( 1998). Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators, The New England Journal of Medicine, vol 339(20), 1415–1425.
- Storey G S, Marks M P et al. (1996). Vertebral artery stenting following percutaneous transluminal angioplasty, Technical note, Journal of Neurosurgery, vol 84(5), 883–887.
- Sacco R L, Adams R et al. (2006). American Heart Association/American Stroke Association Council on Stroke, Council on Cardiovascular Radiology and Intervention, American Academy of Neurology, Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline, Circulation, vol 113(10), e409–449.
- ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2002). The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), JAMA, vol 288(23), 2981–2997.
- Tuomilehto J, Rastenyte D et al. (1999). Effects of calcium-channel blockade in older patients with diabetes and systolic hypertension. Systolic Hypertension in Europe Trial Investigators, The New England Journal of Medicine, vol 340(9), 677–684.
- Amarenco P, and Tonkin A M (2004). Statins for stroke prevention: disappointment and hope, Circulation, vol 109(23 Suppl 1), III44–III49.
- Rubins H B, Davenport J et al. (2001). VA-HIT Study Group. Reduction in stroke with gem fibrozil in men with coronary heart disease and low HDL cholesterol: The Veterans Affairs HDL Intervention Trial (VA-HIT), Circulation, vol 103(23), 2828–2833.
- Rexrode K M, Hennekens C H et al. (1997). A prospective study of body mass index, weight change, and risk of stroke in women, JAMA, vol 277(19), 1539–1545.
- DiPietro L, Ostfeld A M et al. (1994). Adiposity and stroke among older adults of low socioeconomic status: the Chicago Stroke Study, American Journal of Public Health, vol 84(1), 14–19.
- Lee I M, Hennekens C H et al. (1999). Exercise and risk of stroke in male physicians, Stroke, vol 30(1), 1–6.
- Hu F B, Stampfer M J et al. (2000). Physical activity and risk of stroke in women, JAMA, vol 283(22), 2961–2967.
- Lee C D, Folsom A R et al. (2003). Physical activity and stroke risk: a meta-analysis, vol 34(10), 2475–2481.
- Kokkinos P F, Narayan P et al. (1995). Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-Americanmen with severe hypertension, The New England Journal of Medicine, vol 333(22), 1462–1467.
- Endres M, Gertz K et al. ( 2003). Mechanisms of stroke protection by physical activity, Annals of Neurology, vol 54(5), 582–590.
- Ezekowitz M (1998). Antithrombotics for left-ventricular impairment? Lancet, vol 351(9120), 1904.
- Cleland J G, Findlay I et al. (2004). The Warfarin/Aspirin Study in Heart failure (WASH): a randomized trial comparing antithromboticstrategies for patients with heart failure, American Heart Journal, vol 148(1), 157–164.
- Massie B M, Krol W F et al. (2004). The Warfarin and Antiplatelet Therapy in Heart Failure trial (WATCH): rationale, design, and baseline patient characteristics, Journal of Cardiac Failure, vol 10(2), 101–112.
- Barnett H J, Jones M W et al. (1976). Cerebral ischemic events associated with prolapsing mitral valve, Archives of Neurology, vol 33(11), 777–782.
- Fiorelli M, Bastianello S et al. ( 1999). Hemorrhagic transformation within 36 hours of a cerebral infarct: relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort, vol 30(11), 2280–2284.
- Ananthasubramaniam K, Beattie J N et al. (2001). How safely and for how long can warfarin therapy be withheld in prosthetic heart valve patientshospitalized with a major hemorrhage? Chest Journal, vol 119(2), 478–484.
- Eckman M H, Rosand J et al. (2003). Greenberg SM. Can patients be anticoagulated after intracerebral hemorrhage? A decision analysis, vol 34(7), 1710–1716.
- Campbell N R, Hull R D et al. (1996). Aging and heparin-related bleeding, Archives of Internal Medicine, vol 156(8), 857–860.
- Glazier R L, and Crowell E B (1976). Randomized prospective trial of continuous vs intermittent heparin therapy, JAMA, vol 236(12), 1365–1367.
- Stroke Prognosis: What You Should Know, Available from: http://www.caring.com/articles/stroke-prognosis
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