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Intracranial atherosclerosis is the dominant cause of stroke inover 70% of the world’s population. Globalization is leadingto an increasingly heterogeneous society everywhere. Advances inimaging techinology allow this previously inaccessible pathology tobe clinically studied. Edited by internationally renowned clinicians, IntracranialAtherosclerosis is the first book to examine intracranialcauses of stroke. Clinical practice is allied with basic science toguide all those with an interest in stroke on the diagnosis andmanagement of intracranial atherosclerosis.
Intracranial atherosclerosis is a leading cause of stroke in Asians and Africans. As these ethnic groups account for more than 70% of the world’s population, it is in fact the major cause of ischemic stroke worldwide. This timely book provides readers with up-to-date knowledge of intracranial atherosclerosis, covering vascular anatomy, pathology, epidemiology, stroke mechanisms and syndromes, diagnostic methods as well as treatment strategies such as antithrombotics, angioplasty/stenting and surgery. Furthermore, nonatherosclerotic intracranial arterial diseases like Moyamoya disease, dissection, vasculitis and other miscellaneous disorders are extensively discussed. Experts from both East and West present the latest findings from cutting-edge research and discuss controversial topics from different yet balanced points of view, allowing readers to form their own unbiased opinion on these issues. With this approach, the book serves as a useful and stimulating guide on the diagnosis and management of intracranial atherosclerosis for neurologists, neurosurgeons, neuroradiologists and vascular interventionists.
This important title brings together a distinguished panel of thought-leaders, known for their insights into the development and application of minimally-invasive surgical and endovascular techniques, to provide a comprehensive and discerning compendium of our most current knowledge and state-of-the-art procedures in the management of cerebral vascular diseases. Written in a style that is accessible to students and experienced practitioners alike, the book covers all the important recent advances that have reshaped the field in dramatic ways. Emphasizing how surgical and endovascular techniques are complementary, the volume includes illuminating chapters on the nexus of endovascular and conventional “open” cerebrovascular surgery, including patient assessment and practice in a hybrid operating environment, utilizing the best methods to achieve optimal outcomes. A major addition to the clinical literature, Management of Cerebrovascular Disorders: A Comprehensive, Multidisciplinary Approach will be of significant interest to neurosurgeons, neurologists, neuroradiologists, neurointensivists, students, residents, fellows, and specialized attending physicians.
An essential companion for busy professionals seeking to navigate stroke-related clinical situations successfully and make quick informed treatment decisions.
Up-to-date discussion of the etiology, diagnosis, treatment, and prevention of this common cause of stroke and cognitive impairment.
Neurosonology is non-invasive, portable, and has excellent temporal resolution, making it a valuable and increasingly popular tool for the diagnosis and monitoring of neurological conditions when compared to other imaging techniques. This guide looks beyond the use of neurovascular ultrasound in stroke to encompass a wide range of other neurological diseases and emergencies. It offers a practical approach to the examination of patients, interpretation of ultrasound studies, and the application of neurosonology to the development of management and treatment strategies. Each chapter incorporates a thorough and clear procedural methodology alongside scanning tips for trainees; this step-by-step approach is further enhanced by example images and focused diagnostic questions. Authored and edited by international experts, this practical manual of neurosonology is an invaluable resource for neurologists, neurosurgeons, intensivists, radiologists, and ultrasonographers.
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.
Stroke is a major cause of death and the major cause of adult neurological disability in most of the world. Despite its importance on a population basis, research into the genetics of stroke has lagged behind that of many other disorders. However, the situation is now changing. An increasing number of single gene disorders causing stroke are being described, and there is growing evidence that polygenic factors are important in the risk of apparently "sporadic" stroke. Stroke Genetics provides an up-to-date review of the area, suitable for clinicians treating stroke patients, and both clinical and non-clinical researchers in the field of cerebrovascular disease. The full range of monogenic stroke disorders causing cerebrovascular disease, including ischaemic stroke, intracerebral haemorrhage, aneurysms and arteriovenous malformations, are covered. For each, clinical features, diagnosis, and genetics are described. Increasing evidence suggest that genetic factors are also important for the much more common multifactorial stroke; this evidence is reviewed along with the results of genetic studies in this area. Optimal and novel strategies for investigating multifactorial stroke, including the use of intermediate phenotypes such as intima-media thickness and MRI detected small vessel disease are reviewed. The book concludes by describing a practical approach to investigating patients with stroke for underlying genetic disorders. Also included is a list of useful websites.