Stroke
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Winter 1991
Volume 2, Number 2
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Abstracts
of this issue appear
below. Send e-mail or call 303-788-4010 to order a printed copy.
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 Abstracts
Also see the latest issue on Stroke, Fall
2000
Treatment of
Acute Ischemic Cerebral Infarction
James C. Grotta, MD
Neuronal death
in ischemic stroke is the result of a cascade of events,
set in motion by vascular occlusion. Experimental
evidence demonstrates that early intervention can alter
this process and can rescue brain tissue that would
otherwise have perished. Herein, we review pharmacologic
strategies for treating acute stroke. Although most of
these are still being investigated, it is anticipated
that, within the decade, safe and effective treatment for
acute stroke will become available.
Surgery for
the Prevention of Stroke
Glenn L. Kelly, MD
Stroke kills
125,000 and cripples an additional 375,000 people each
year, at an annual cost of about $15 billion dollars.
Individuals with transient cerebral or ophthalmic
ischemia, hemodynamically significant carotid stenoses
and large carotid artery ulcers are at considerable risk
for sustaining a stroke. Carotid endarterectomy, by
surgical teams with verified low stroke and death rates,
can substantially reduce the risk of cerebral and retinal
infarction.
Imaging the
Stroke Patient
Richard E. Latchaw, MD
Today, the
stroke patient is evaluated acutely with non-enhanced
computed tomography scanning. The ineffectiveness of
acute therapy has discouraged more intensive evaluation.
In the future, more effective treatment will stimulate
the early use of magnetic resonance imaging to evaluate
perfusion, diffusion and the extracranial vasculature.
Improved therapy for chronic ischemia will likewise lead
to an increase in the use and precision of techniques for
evaluating cerebral physiology.
Dysphagia
Elena Draznin, MD
Dysphagia and
the risk of aspiration pneumonia are associated with a
variety of neurologic disorders. Yet, patients only
rarely complain of difficulty swallowing. Several
nonspecific signs of abnormal swallowing can arouse
suspicion, but the bedside evaluation underestimates the
frequency of aspiration. Videofluoroscopy is superior to
clinical assessment. It can provide information about the
pathophysiology of aspiration and can help assess the
safety and efficacy of compensatory techniques that may
be utilized for safe oral feedings.
Stroke Prevention
Don B. Smith, MD
Improved
understanding of stroke risk factors, and evidence of the
efficacy of risk factor modification in stroke prevention
make it important for clinicians to aggressively seek out
and modify risks before stroke occurs.
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