Stroke in Children
Stroke in Children Important differences from adults characterize childhood stroke: 1) predisposing factors (e.g., cyanotic heart disease) common; 2) clinical evolution (outcome often better in children); 3) anatomic site of…
Differential Diagnosis of Stroke
Differential Diagnosis of Stroke Clinical Features of Stroke Subtypes Distinction essential in choice of acute treatment of stroke: in first 3 hours, thrombolysis may be indicated in acute infarct; contraindicated…
Other Cerebrovascular Syndromes
Other Cerebrovascular Syndromes Lacunar Strokes Small ischemic infarcts due to occlusion of small penetrating arterioles, usually with sustained hypertension. Location: distribution of deep penetrating arteries (basal ganglia, deep hemispheric white…
Genetics of Stroke
Genetics of Stroke Ischemic Stroke Role of genetics incompletely understood in pathogenesis of ischemic stroke; confounded by possible environmental factors. Documented risk factors of ischemic stroke with strong genetic influence:…
Cerebral and Cerebellar Hemorrhage
Cerebral and Cerebellar Hemorrhage Intracerebral Hemorrhage Blood in brain parenchyma. Etiology Arteriopathy of deep penetrating arteries (arteriolosclerosis): basal ganglia, thalamus, brainstem, cerebellum. Most common type of intracerebral hemorrhage. Greatest risk…
Cerebral Infarction
Cerebral Infarction Specific Vessel Occlusions See Table 39.1. Following are notes on selected features. Middle Cerebral Artery (MCA) Unusual Signs of Dominant Hemisphere Damage Apraxia: see Chapter 2. Gerstmann syndrome:…
Transient Ischemic Attack
Transient Ischemic Attack Definition TIA: neurologic symptoms of ischemic origin that last less than 24 hours; most 1 to 60 minutes. Postulated Mechanisms Transient occlusion: intermittent occlusion by fragment of…
Examination of the Patient with Cerebrovascular Disease
Examination of the Patient with Cerebrovascular Disease Goals Immediate information about size, location, etiology of stroke, to guide acute treatment. Establish site and number of suspected lesions, which may not…
Pathogenesis, Classification, and Epidemiology of Cerebrovascular Disease
Pathogenesis, Classification, and Epidemiology of Cerebrovascular Disease Definition and Nosology Stroke: sudden loss of neurologic function (global or focal) due to vascular disruption (infarction or hemorrhage) in CNS. Transient Ischemic…
Whipple Disease
Whipple Disease Caused by bacilliform bacterium, Tropheryma whippelii (Actinomycetaceae family). Involves intestinal tract, heart, lungs, liver, kidneys, brain. Rare. Systemic manifestations: weight loss, abdominal pain, diarrhea, arthritis. Anemia, hypoalbuminemia, steatorrhea….
