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Strokes are divided into two groups: ischemic strokes (85%) and hemorrhagic strokes (15%). Brain tissue is very sensitive to ischemia. When the blood flow is interrupted in the vessels feeding the brain, permanent damage occurs within minutes in the areas fed by that vessel. Especially in large vessel occlusions, an irreversible area called ischemic nucleus occurs in areas where the minute blood flow falls below the critical level. There are different blood flow belts that increase from the regions surrounding the ischemic nucleus towards the periphery and are fed by collateral vascular systems. Infarcts have not yet occurred in these areas under ischemic stress. This region is called the penumbra. This area can be saved by opening the vessel in suitable patients presented in the acute period. This is valid for vascular occlusion, but not for brain hemorrhages. Rarely, if an aneurysm is detected in subarachnoid hemorrhages, angiographic intervention may be required to prevent re-bleeding. Early and appropriate treatment of a stroke, which is important in terms of mortality and morbidity, is of vital importance. In our book, the identification and prevention of risk factors, as well as stroke treatment, will be covered. In this context, our book is intended to be a resource for medical doctors and students.

A transdisciplinary approach to the medical, radiologic, interventional, and surgical treatment of strokeIn the last decade, advances in interventional, microsurgcial, radiosurgical techniques, medical approaches and imaging technology have dramatically changed the management of ischemic stroke. Perhaps the most important advance has been the increasing collaboration between multispecialty clinicians to deliver team-based stroke care. Hemorrhagic and Ischemic Stroke: Medical, Imaging, Surgical, and Interventional Approaches, Second Edition by renowned neurosurgeons Bernard R. Bendok and H. Hunt Batjer and acclaimed contributors provides a user-friendly, single resource for managing ischemic and hemorrhagic stroke. The second edition has been updated to reflect progress, most notably acute evaluation and triage, advanced imaging, critical care and medical support, and endovascular and surgical interventions. In addition to scientifically supported content, readers will benefit from pragmatic, real-world applications and concise, practical reviews.Organized into four sections and 41 chapters, the text starts with the section Acute Triage, which includes early diagnosis and medical decision-making, advances in medical imaging, innovations in prehospital management of stroke, and the promise of telestroke networks. The second section, Critical Care, covers the importance of astute clinical examination, stabilization, and advanced neuromonitoring techniques. The third section, Open Surgical, Minimally Invasive, and Microsurgical Approaches, reviews recent surgical innovations that have the potential to be lifesaving and enhance quality of life in select patients. The fourth and final section, Neurointerventional Approaches, explores recent innovations in image-guided catheter techniques to deliver new therapies for stroke treatment and prevention.Key HighlightsThe often difficult yet important adjudication of antithrombotic medication useInsightful discussion of the importance of prehospital systems of care and stroke center certificationInsightful discussions of interventional and microsurgical approaches for hemorrhagic and ischemic stroke managementMedical illustrations and author-narrated videos provide a visual learning experienceClinical pearls and case presentations enhance learning and retention of knowledgeThe goal of this book is to increase collaborative stroke management among neuroradiologists, neurologists, neurosurgeons, neuroanesthesiolgists, neurologic critical care physicians, and allied health care professionals to achieve better patient outcomes.

Stroke is one of the leading causes of disability and death worldwide. It has become the first disease leading to neurologic referrals to hospital and, while recognized in medicine since antiquity, stroke did not acquire a proper place within neurology until the second part of the 20th century. The main reason for this is that, because it deals with blood vessels and circulation, neurologists themselves did not want to include stroke as a primary disorder of the nervous system. However, this is one of the many reasons the historical development of stroke and cerebrovascular disease is of unique interest; it touches not only on neurology but also on internal medicine, angiology, cardiology, rehabilitation, and psychiatry within the frame of secondary behavioral and personality changes after stroke. For the same reasons, the study of the developments in the field of stroke over time is an excellent mirror of historical developments in medicine in general, encompassing many different domains. It is, thus, rather paradoxical that the last book on the history of stroke was published over thirty years ago (Fields and Lemak's History of Stroke in 1989). Along with the many new developments in stroke diagnosis, acute management and prevention, a new look at the evolution of stroke concepts over time has become necessary, and this is what the present volume is attempting to accomplish. Since stroke has developed into several different smaller fields, we have organized the book with four editors from different fields who have chosen authors with specific expertise in the corresponding overviewed issues. Our principle goal is to underline how and to follow the paths of these developments over the years. History is not a minor part of medical knowledge. Indeed, history defines what we are and think today and how we will envision and plan the future. This fresh look at history of stroke may also have a significant impact on future advances and research in cerebrovascular disease and stroke.

Telestroke helps readers develop a deeper understanding on how to utilize telestroke in clinical practice, a key step in providing optimal treatment and management to those with geographical and social/economic disparities. The book discusses how to provide accurate and fast revascularization for patients with acute ischemic stroke and how to continue remote care of patients. It also reviews underlying stroke etiology, interpretation and assessment of stroke diagnostic tools/teleradiology, complications of care, discusses targeted, secondary preventative therapies and covers telerehabilitation, outpatient follow-up and clinical trial engagement. - Includes tactics on how to enact rapid implementation by stroke neurologists - Explains recent changes to telehealth coding/reimbursement - Reviews the underlying stroke etiology, interpretation and assessment of stroke diagnostic tools/teleradiology, and complications of care - Covers targeted, preventative therapies, telerehabilitation, outpatient follow-up, and clinical trial engagement

Our Divide: Two Sides of Locked in Syndrome is the story of the other side—the side of the young, pregnant wife of a man who, at age twenty-seven, is struck down by an obstruction in the brain stem, leaving him with a rare neurological disorder called locked-in syndrome. Like Jean-Dominique Bauby of The Diving Bell and the Butterfly, Cleve is rendered mute and paralyzed by the syndrome—but unlike Bauby, he is unable to move at all, unable to sit up in a wheelchair or communicate by blinking an eye.Our Divide is a beautifully written, honest account of the experience of watching a loved one suffer. Harrison delivers both a peek into the world of a unique other and an intimate view of one young woman's grieving process. A heartbreaking story that's at once a grief, a coming-of-age, and a survival narrative, this genuine, honest portrayal of one woman's mistakes and courage while learning how to take responsibility and create a life for herself will sweep readers away.

This book presents state of the art knowledge on dyslipidemia in stroke, covering both basic and clinical aspects in detail. The focus is in particular on two major themes: the clinical significance of dyslipidemia in stroke and the treatment of dyslipidemia in stroke patients. Readers will find up-to-date information on lipid metabolism, biomarkers, and advances in treatment options, including novel biologic drugs. Specific management considerations and pitfalls are also discussed. The individual components of pathophysiology, treatment, and key issues are addressed with the aid of complementary illustrations that facilitate understanding of practical aspects and enable the reader to retrieve fundamental information quickly. This book is timely in bringing together within one volume the most important current knowledge on dyslipidemia in stroke. It will be invaluable for stroke physicians, pharmacists, and students seeking to acquire up-to-date knowledge.

This book, written by renowned experts from across the world, provides readers with a detailed and up-to-date understanding of posterior circulation stroke and its management. Anatomy, pathophysiology, clinical syndromes, and imaging findings are clearly and thoroughly described with the aid of illustrative cases and schematic drawings. The management-oriented chapters explain all forms of treatment, including the use of antiplatelet agents and anticoagulants, thrombolysis, mechanical thrombectomy, stenting, and surgical therapy, i.e., bypass and decompression. Throughout, full account is taken of recent significant advances in knowledge and clinical practice. Stroke affecting the posterior circulation continues to pose particular challenges for clinicians. This book will help readers to avoid misdiagnosis, which still occurs far too frequently, and to manage individual patients optimally. It will be an excellent learning resource for residents in neurology, neurosurgery, radiology, interventional radiology, and vascular surgery, as well as an ideal reference for more experienced practitioners in these specialties.

This book provides a comprehensive coverage of the state of the art in precision medicine in stroke. It starts by explaining and giving general information about precision medicine. Current applications in different strokes types (ischemic, haemorrhagic) are presented from diagnosis to treatment. In addition, ongoing research in the field (early stroke diagnosis and estimation of prognosis) is extensively discussed. The final part provides an in-depth discussion of how different interdisciplinary areas like artificial intelligence, molecular biology and genetics are contributing to this area.Precision Medicine in Stroke provides a practical approach to each chapter, reinforcing clinical applications and presenting clinical cases. This book is intended for all clinicians that interact with stroke patients (neurologists, internal medicine doctors, general practitioners, neurosurgeons), students and basic researchers.

Cerebral small vessel disease (CSVD) silently affects a large part of the population, increasing in prevalence with age and with the presence of vascular risk factors. Its harmful effects on brain parenchyma increase the risk of stroke, cognitive decline and dementia, and it is responsible for a spectrum of symptoms that are much less obvious, such as unrecognized mild signs or symptoms of neurocognitive dysfunction, mild mood or behavioral disturbances, gait dysfunction, and a general decline in function generally attributed to normal aging. These consequences pose a heavy burden on patients, families and countries that need to be addressed. Understanding and Treating Cerebral Small Vessel Disease provides an insight into a broad area of research in this field, focusing on topics that deal with the underlying pathophysiological mechanisms of CSVD, recent clinical and neuroimaging findings, biomarker developments, comorbidities, prevention strategies and emerging therapeutic options. The contents are distributed in five sections that span these topics. Section I, “Pathophysiology and Subtypes of Cerebral Small Vessels Disease”, includes three chapters that deal with the prevalence of different forms of small-vessels disease in vascular cognitive impairment, and the pathophysiological mechanisms of CSVD. Section II, “New Approaches for Diagnosis and Treatment of CSVD”, includes six chapters which deal with the microvascular assessment of CSVD through the study of retinal blood (chapter four), a global vision of brain MRI findings in CSVD (chapter five), and digital electroencephalographic changes and computerized analysis methods in CSVD (chapter six). Chapters seven, eight and nine approach the treatment of CSVD, from the assessment of advanced immunoactive therapy for CSVD to the use of non-pharmacological therapies such as transcranial magnetic stimulation and extracorporeal shock wave therapy. The targeting of key pathogenic mechanisms is also discussed in light of experimental data and clinical trials, as well as the introduction of neuroprotection in the treatment of symptomatic and asymptomatic CSVD. Section III, “Potential Biomarkers for CSVD”, includes chapters 10—13 dedicated to the early detection of CSVD through brain MRI imaging and the development of alternative circulating biomarkers (brain specific proteins, inflammatory and oxidative stress biomarkers, autoantibodies). The application of these biomarkers in other conditions closely associated with small vessel neurovascular networks, such as migraine, is also discussed. Section IV, “Cerebral Small Vessels Disease and Comorbid Conditions” is comprised of five chapters (14—18) which approach the relationship of CSVD with infectious diseases (viral, bacterial and parasitic infections), highlighting findings in COVID-19. Conditions related with the nervous system, such as cognitive impairment, schizophrenia and chronic alcohol consumption in association with the development of small vessel pathology in the brain are also discussed. Section V includes chapter 19, which briefly summarizes the main topics presented in this book and offers a quick vision from the editors of future trends in microangiopathy diagnosis and treatment.

This new book on vascular malformations brings together international experts to present advances and discuss controversies in the multidisciplinary management of patients with congenital vascular malformations.Major advances in recent years in medical genetics, and tremendous progress in the fields of imaging and minimally invasive percutaneous interventions have revolutionized both evaluation and management of vascular malformations. The six major parts of this state of the art book ensure that the reader has the most up to date valuable clinical information to ensure the delivery of world class clinical practice. Beautifully illustrated with color line drawings, numerous photographs and informative tables, the advances and controversies of the full spectrum of vascular malformations are presented in 90 definitive chapters. Vascular Malformations brings new information and unparalleled insights to vascular specialists and physicians, trainees and allied health professionals who participate in the care of patients with vascular malformations, either in a private practice setting or at a major institution in an interdisciplinary vascular center.

The thirteen volume in the Evidence-based Clinical Chinese Medicine series is a must read for Chinese medicine practitioners interested in neurology or rehabilitation. Using a'whole evidence'approach, this book aims to provide an analysis of the management of post-stroke spasticity with Chinese and integrative medicine.This book describes the understanding and management of post-stroke spasticity with conventional medicine and Chinese medicine. Chinese medicine treatments used in past eras are analysed through data mining of classical Chinese medicine books. Several treatments are identified that are still used in contemporary clinical practice.Attention is then turned to evaluating the current state of evidence from clinical studies using an evidence-based medicine approach. Scientific techniques are employed to evaluate the results from studies of Chinese herbal medicine, acupuncture and other Chinese medicine therapies. The findings from these reviews are discussed in terms of the implications for clinical practice and research.Chinese medicine practitioners and students can use this book as a desktop reference to support clinical decision making. Having ready access to the current state of evidence for herbal formulas and acupuncture treatments allows practitioners to be confident in providing evidence-based health care.This book provides:With this information provided in an easy to use reference, practitioners can focus on giving high quality care supported by the best available evidence.

Stroke is a leading cause of mortality and morbidity worldwide. Just a decade ago, stroke management was simple. Apart from secondary prevention, and education, there was not much a clinician could do that would significantly change outcomes. There were no acute interventions, no tPA, and no endovascular therapies. Stroke was thus not an emergency. Today, we live in a different world. With the advent of tPA and endovascular intervention, acute stroke is an emergency of epic proportions. Time literally is brain and the clinician has to be acutely aware of the advances in stroke in order to maximize the therapeutic impact. Many books have been written about stroke. The authors and editors envisioned a succinct, yet comprehensive guide for the clinician in the management of stroke. From the medical management of stroke, to neuroimaging, thrombolysis, endovascular therapies, and rehabilitation, this book guides the novice clinician as well as the seasoned vascular neurologist to be able to recognize, manage, and treat acute stroke to the best of medical science's guidelines.

The book provides detailed information on all major neuroemergencies, and includes a detailed checklist for practical care during the first hour of an emergency. Reinforcing the concept of quality care for better outcomes in patients with neurological diseases, the book discusses approaches to comatose patients, neurological evaluation, neuropharmacology, neuroradiology, traumatic brain and spine injury, and various other neurological disorders. The field of neuroanesthesiology and neurocritical care has expanded with the advent of newer, complex surgeries, and neurocritical care is becoming an established subspecialty of neuroscience. Neurological emergencies require special care since prevention of secondary damage to the brain is of paramount importance. A valuable resource for intensivists, neurointensivists, emergency medicine physicians, neurology and neurosurgeons and nursing professionals involved in neurocare, this book also serves as study material forparticipants of the two-day course on “Acute Neuro Care” designed by the Indian Society of Neuroanesthesiology and Critical Care (ISNACC).

Stroke is a condition that predominantly affects older people, often leading to death, disability and dependency as well as occupancy of hospital and nursing-home beds. Older stroke patients are similar in many ways to their younger counterparts, but at the same time exhibit several key differences. Their outcome and care are complicated by delayed diagnosis, polypharmacy, difficult rehabilitation, ageism, false assumptions of poor outcome, multiple co-morbidity, social issues including implications for independent living, ethical dilemmas, and many others. The proportion of older people is increasing every day and with it the burden of disease and disability. The implications this has for health services are immense, especially for long-term conditions. Despite this there is limited literature available to clinicians on stroke with a particular focus on this age group. Traversing the whole stroke pathway, Stroke in the Older Person brings together key discussions on every aspect of the disease as it affects the older person, including its general aspects and those very specific to the older populations. All chapters are written by highly experienced clinicians that offer up-to-date evidence-based information as well as practical tips to promote excellent, empathetic care to older patients. Over 30 chapters, this resource addresses the epidemiology, aetio-pathogenesis, clinical presentation, diagnostic work-up (including imaging), primary and secondary prevention, and rehabilitation of older people. There is a special focus on intracerebral haemorrhage, carotid re-vascularisation, transient ischaemic attack, cognitive impairment, research, ethical and moral dilemmas including DNAR, advanced directives and end-of-life care.