:: Jun-Jul 2008

Welcome to our Monthly Online Newsletter!

View all Treatment articles in our Treatment Report . The most recent articles are listed on top (not in alphabetical order). Click on the Topic on our home page and then the subtopic - Treatment Report. Stay updated on drugs and their side effects, and various other treatments, including exercise, nutrition, and supplements.

View all Stroke Rehabilitation articles in our Rehabilitation subtopic.

Highlighted Article

Factors associated with the steep increase in late midlife stroke occurrence among US men. (J Stroke Cerebrovasc Dis. 2008) “CONCLUSION: Elevated serum HCY level is the sole independent predictor of stroke among men aged 55 to 64 years in the United States. Further study to assess the efficacy of HCY-lowering treatment in mitigating a steep increase in late midlife stroke occurrence among men may be warranted.”

Clinical Guidelines

AMERICAN HEART ASSOCIATION ISSUES NEW STROKE-PREVENTION GUIDELINES

Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack (Stroke. 2006)

Guidelines for the Early Management of Adults With Ischemic Stroke (Stroke. 2007)

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage in Adults. (Stroke 2007)

ICSI - Stroke, Ischemic; Diagnosis and Initial Treatment of

New AHA/ASA Guidelines for Primary Prevention of Stroke

NGC - EFNS guideline on neuroimaging in acute stroke. Report of an EFNS task force. (2006)

NGC - Diagnosis and initial treatment of ischemic stroke. (2006)

NGC - Guidelines and recommendations for perfusion imaging in cerebral ischemia.

NGC - Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack. (2006)

NGC - Management of patients with stroke: identification and management of dysphagia. A national clinical guideline. (2004)

NGC - Physical activity and exercise recommendations for stroke survivors. (2004)

NGC - Stroke management and prevention in the long-term care setting. (2005)

NGC - Stroke: 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. (2005)

NGC - VA/DoD clinical practice guideline for the management of stroke rehabilitation in the primary care setting. (2003)

NPBG - Stroke Assessment Across the Continuum of Care (2005)

Primary Prevention of Ischemic Stroke. A Guideline From the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group (Stroke 2006)

Stroke Prevention Guidelines

Updated Guidelines for Primary Prevention of Stroke Issued

Internet Sites

Featured site

NIH - Stroke

NIH - Medical Encyclopedia Hemorrhagic stroke

NIH - Medical Encyclopedia Stroke

NIH - NINDS Brain Basics: Preventing Stroke

NIH - NINDS Know Stroke. Know the Signs. Act in Time.

NIH - NINDS Stroke Information Page

NIH - NINDS Stroke Risk Factors and Symptoms

NIH - NINDS What You Need to Know About Stroke

NIH - Questions and Answers About Stroke

NIH - Post-Stroke Rehabilitation Fact Sheet

NIH - Stroke Rehabilitation Tutorial

NIH - Stroke Resources

Related Topics - Highlighted Articles

Cardiovascular: Atherosclerosis

Carotid plaque pathology: thrombosis, ulceration, and stroke pathogenesis. (Stroke. 2005) "BACKGROUND AND PURPOSE: To determine the relationship between ulceration, thrombus, and calcification of carotid artery atherosclerotic plaques and symptoms of ipsilateral or contralateral stroke. ? CONCLUSIONS: Carotid plaque ulceration and thrombosis are more prevalent in symptomatic patients. Ulceration is more common in symptomatic patients regardless of side of carotid symptoms, whereas thrombus is associated with ipsilateral symptoms and plaque ulceration. Preoperative identification of carotid ulceration and thrombus should lead to greater efficacy of stroke prevention by carotid endarterectomy."

Diabetes

Stroke prevention in diabetic and other high cardiovascular risk patients. (Curr Diab Rep. 2005) "Diabetes is a major risk factor for stroke that is usually associated with risk factors such as hypertension, obesity, albuminuria, and dyslipidemia. Furthermore, atrial fibrillation and heart failure, two of the most important risk factors of stroke, are common in the diabetic population. With the rising epidemic of diabetes, the incidence of stroke is also on the rise. ? In this review, we examine the epidemiologic and the pathophysiologic association between stroke and diabetes, highlighting the population-based stroke preventive measures."

In this newsletter:

Diagnosis, Imaging, and Screening
General Information
Risk Factors
Risk Reduction

	Diagnosis, Imaging, and Screening

	General Information
Low Vitamin D Levels Independent Predictor of Fatal Stroke “Low levels of vitamin D appear to be an independent predictor of fatal stroke — a finding that suggests supplementation may be a promising approach for stroke prevention. Investigators at the University of Heidelberg, in Germany, found that among individuals referred for coronary angiography, low levels of 25-hydroxyvitamin D were more likely to suffer fatal stroke even after adjusting for cardiovascular risk factors, physical activity level, and calcium and parathyroid hormone levels. "Vitamin D supplementation in stroke patients has already been shown to reduce osteopenia, fractures, and falls while improving muscle strength. Apart from these beneficial effects, our results suggest that vitamin D might also directly protect against stroke," the authors write. “ Nonaspirin NSAIDs, Cyclooxygenase 2 Inhibitors, and the Risk for Stroke (Stroke 2008) Prevalence and Correlates of Silent Cerebral Infarcts in the Framingham Offspring Study. (Stroke. 2008)

	Risk Factors
Too Much, Too Little Sleep Linked to Stroke Risk: Postmenopausal women who slept more than nine hours a night had up to 70% higher risk “The risk of stroke was 14 percent higher for women who regularly slept six hours or less, compared to those sleeping seven hours a night. … Simply setting the clock to sleep an allotted amount of hours is not a solution to the problem, Wassertheil-Smoller said. "If a woman is not sleeping long enough, she can try stress reduction and other methods to get more sleep," she said. "If a woman is habitually sleeping more than nine hours, she can discuss it with her doctor. She should also act to lower the known risk factors for stroke, especially high blood pressure."

	Risk Reduction
Heavy Drinking Increases Stroke Risks