Stroke

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REVIEW our Selected Stroke Articles in 2006. Stay informed and updated!

Stroke

NIH - Medical Encyclopedia: Stroke

"The goal is to get the person to the emergency room immediately, determine if he or she is having a bleeding stroke or a stroke from a blood clot, and start therapy -- all within 3 hours of when the stroke began."

Highlighted Article

Transient Ischemic Attack: A Dangerous Harbinger and an Opportunity to Intervene. (Semin Neurol. 2005)

"Transient ischemic attack (TIA) and ischemic stroke are both characterized by sudden onset of neurological symptoms due to focal cerebral ischemia, but they are distinguished by the duration of neurological symptoms, with TIA traditionally defined by resolution of symptoms within 24 hours and stroke reserved for symptoms of longer duration. ... The short-term risk of ischemic stroke after TIA is very high ..."

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Stroke

Risk Factors

NEWS:

Air Pollution During Warm Weather Linked With Stroke Mortality

Depression Quadruples Stroke Risk in Patients < 65 Years Old "Individuals with symptoms of depression appear to have an increased risk of ischemic stroke or transient ischemic attacks (TIA), but only subjects younger than 65 years old, according to an analysis of data from the Framingham Heart Study, published in the January issue of Stroke. However, the risk was not seen among individuals older than 65."

Heavy drinking raises risk of stroke: study

Low Vitamin B12 Level Linked to Increased Risk of Cerebral Ischemia "Low vitamin B12 plasma levels, especially in combination with low folate levels, are associated with an increased risk of ischemic stroke or transient ischemic attack ..."

Low-Grade Inflammation Is a Risk Factor for Clinical Stroke Events in Addition to Silent Cerebral Infarcts in Japanese Older Hypertensives: The Jichi Medical School ABPM Study, Wave 1 (Stroke. 2007) "Conclusion— High-sensitivity C-reactive protein is a risk factor for clinical stroke events in addition to silent cerebral infarcts in Japanese older hypertensives, indicating that the risk for clinical stroke events increases with preexisting hypertensive target organ damage in the brain and additionally with ongoing low-grade inflammation."

Stroke risk higher in less well-educated women "A study involving Swedish women indicates that the risk of stroke has a marked inverse correlation with years of education, European researchers report in the journal Stroke."

ARTICLES:

JOURNAL ARTICLES:

A review of genetic causes of ischemic and hemorrhagic stroke. (J Neurol Sci. 2007)

Acute ischemic lesions of varying ages predict risk of ischemic events in stroke/TIA patients (NEUROLOGY 2007) "Conclusion: The presence of multiple diffusion-weighted imaging lesions of varying ages suggests very active early recurrence over time and portends a higher early risk of future ischemic events."

B Vitamin Plasma Levels and the Risk of Ischemic Stroke and Transient Ischemic Attack in a German Cohort (Stroke 2007) "Conclusions—Our data suggest that low vitamin B12 plasma levels, particularly in combination with low folate levels, increase the risk of cerebral ischemia. This effect may be mediated at least partly through elevations of homocysteine levels."

Blood Pressure and Estimated Risk of Stroke in the Elderly Population of Spain (Stroke. 2007) "Conclusion— The 10-year estimated stroke risk was 19.6%, and it was greater in hypertensive patients as compared with the remainder people at any blood pressure range. The concomitant stroke risk factors are more prevalent in patients with hypertension already diagnosed, which implies an important additional estimated risk of stroke."

Body Mass Index, Waist Circumference, and Waist-Hip Ratio on the Risk of Total and Type-Specific Stroke (Arch Intern Med. 2007) "Conclusions Body mass index was a risk factor for total and ischemic stroke in men and women. Abdominal adiposity was a risk factor for total and ischemic stroke only in men."

Causes of Ischemic Stroke in Young Adults, and Evolution of the Etiological Diagnosis over the Long Term (European Neurology 2007) "Conclusions: The etiological diagnosis of stroke in young adults has changed over time as a result of improvements in diagnostic workup. While cryptogenic stroke was the most frequent diagnosis in the past, today specific causes (non-atherosclerotic vasculopathy, large-artery atherosclerosis, cardioembolism and hematological disorder) are identified in the majority of patients."

Cocaine use and stroke. (Postgrad Med J. 2007)

Depressive Symptoms and Risk of Stroke (Stroke. 2007) "Conclusions— In this community-based study, depressive symptoms were an independent risk factor for incident stroke/TIA in individuals <65 years. These data suggest that identification of depressive symptoms at younger ages may have an impact on the primary prevention of stroke."

Diversity of risk factors for stroke: The putative roles and mechanisms of depression and air pollution. (J Neurol Sci. 2007)

Genome-Wide Linkage Scan of Common Stroke in Families From Northern Sweden (Stroke. 2007) "Conclusions— Genetic analysis of stroke in families from northern Sweden did not identify any new major stroke loci. This indicates that multiple minor susceptibility loci in addition to the previously known locus on chromosome 5 could contribute to the disease."

Inflammation and ischaemic stroke. (Curr Opin Neurol. 2007) "SUMMARY: Inflammation is implicated in several aspects of acute ischaemic stroke. It remains to be established whether the inflammatory response is a truly independent risk factor in general, or whether specific anti-inflammatory interventions are beneficial either in prevention or acute treatment."

Is Diabetic Retinopathy an Independent Risk Factor For Ischemic Stroke? (Stroke. 2007) " Conclusions— Diabetic retinopathy predicts incident ischemic stroke in people with diabetes, independent of other risk factors."

Is the ‘Stroke Belt’ Worn From Childhood? (Stroke. 2007)

Joint effects of risk factors for stroke and transient ischemic attack in a German population : The EPIC Potsdam Study. (J Neurol. 2007) "58.5% of ischemic strokes and 26.2% of TIA cases were attributable to the 5 risk factors hypertension, diabetes mellitus, high alcohol consumption, hyperlipidemia, and smoking. CONCLUSION: Our data indicate that classical risk factors may explain almost 60% of ischemic stroke but only one in four TIA cases."

Kidney dysfunction as a risk factor for first symptomatic stroke events in a general Japanese population--the Ohasama study. (Nephrol Dial Transplant. 2007) "CONCLUSION: Decreased kidney function increased the risk of first symptomatic stroke events in a general Japanese population. The high prevalence of stroke in this population prompts the need for greater public awareness about risks for CKD."

Lipid levels and the risk of ischemic stroke in women (NEUROLOGY 2007) "Conclusions: In this large cohort of apparently healthy women, total cholesterol, low-density lipoprotein cholesterol, the total cholesterol to high-density lipoprotein cholesterol ratio, and non-high-density lipoprotein cholesterol were significantly associated with increased risk of ischemic stroke."

Lipoprotein (a) and Stroke. A Meta-Analysis of Observational Studies. (Stroke. 2007) "CONCLUSIONS: This meta-analysis suggests that elevated Lp(a) is a risk factor for incident stroke."

Lowest Systolic Blood Pressure Is Associated with Stroke in Stages 3 to 4 Chronic Kidney Disease. (J Am Soc Nephrol. 2007)

Metabolic syndrome increases the risk of ischemic stroke in women. (Intern Med. 2007) "Conclusions Metabolic syndrome is more likely to influence a risk for ischemic stroke in women than in men."

Migraine With Aura Linked to Hemorrhagic Stroke in Women "New analysis of data from the Women's Health Study (WHS) shows an association between migraine with aura and hemorrhagic stroke risk in women. Migraine, particularly with aura, is well established as a risk factor for ischemic stroke as well as coronary heart disease, but the relationship with hemorrhagic stroke has been less investigated."

Patent Foramen Ovale and Cryptogenic Stroke in Older Patients (NEJM 2007) "Conclusions There is an association between the presence of patent foramen ovale and cryptogenic stroke in both older patients and younger patients. These data suggest that paradoxical embolism is a cause of stroke in both age groups."

Patent foramen ovale and cryptogenic stroke. A critical review. (J Cardiovasc Med (Hagerstown). 2007)

Patent foramen ovale and the risk of first ischemic stroke. (Expert Rev Cardiovasc Ther. 2007)

Phenylpropanolamine contained in cold remedies and risk of hemorrhagic stroke (NEUROLOGY 2007) "PPA contained in cold remedies increases the risk of HS, particularly in women."

Plasma levels of apolipoprotein e and risk of stroke in old age. (Ann N Y Acad Sci. 2007) "In conclusion, in old age, except for epsilon2-allele carriers, high plasma apoE levels are associated with a higher risk of stroke, independent of APOE genotype, plasma levels of lipids, and other cardiovascular risk factors."

Reversible brain ischemia: lessons from transient ischemic attack. (Curr Opin Neurol. 2007) " Transient ischemic attack is now understood to indicate a higher risk of recurrence than completed ischemic stroke. Efforts to unravel the mechanisms of this instability following transient ischemic attack using imaging studies have led to new concepts and definitions, and sparked further debate. While imaging has increased diagnostic certainty, it has yet to provide reliable prognostic markers. The evidence suggests that risk of clinical recurrence is most closely linked to the degree to which the initial deficit reverses."

Risk factors for acute ischaemic stroke in young adults in South India. (J Neurol Neurosurg Psychiatry. 2007) " CONCLUSIONS: Key components of the metabolic syndrome and smoking are associated with ischaemic stroke in young south Indian adults. Our observations underscore the importance of targeting adolescents and young adults for screening and prevention to reduce the burden of ischaemic stroke in young adults."

[Risk factors for cerebral stroke.] (Tidsskr Nor Laegeforen. 2007) "High blood pressure and cigarette smoking are the most important modifiable risk factors for stroke. Serum cholesterol is positively associated with cerebral infarction, but not with intracerebral hemorrhage. Diabetes, atrial fibrillation and carotid stenosis are important predictors of cerebral infarcts, especially in the elderly. Cohort studies and randomized trials have shown that hormone replacement therapy in women increases the risk of stroke, while modern oral contraceptives do not represent a risk factor for stroke in young women. There is a clear social gradient in stroke occurrence, with a higher incidence in lower social classes."

Risk of ischemic stroke and lifetime estrogen exposure. (Neurology. 2007)

Serum estradiol and risk of stroke in elderly men (NEUROLOGY 2007) " Conclusions: High levels of serum estradiol may be associated with an elevated risk of stroke in elderly men."

Stroke in Young Adults Who Abuse Amphetamines or Cocaine (Arch Gen Psychiatry. 2007) "Conclusion Increases in stimulant drug abuse may increase the rate of hospital admissions for strokes and stroke-related mortality."

[Strokes caused by infection in the tropics.] (Rev Neurol. 2007) "CONCLUSIONS. Several diseases that are endemic in the tropics can be responsible for up to 10% of the cases of strokes in adults."

The role of genetics in stroke. (Postgrad Med J. 2007)

Why now? Moving from stroke risk factors to stroke triggers. (Curr Opin Neurol. 2007) " Acute infections, particularly upper respiratory infections, and other inflammatory stimuli have emerged as important triggers of acute ischemic stroke. The mechanisms involved include immunologically mediated activation of platelets and endothelial dysfunction. There also appears to be a period of time, or 'stroke-prone state', characterized by diffuse activation of the vasculature during which patients may be at increased risk of initial and recurrent ischemic events."

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