1,721,322 research outputs found
Should memory clinic physicians be independent in assessing neuroimaging of patients with cognitive impairment?
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Thrombolysis in dementia patients with acute stroke : is it justified?
No full textThe administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke may be controversial, because the reported risk of rt-PA associated intracerebral hemorrhage in these patients is higher compared with that of patients without dementia and because these patients are already disabled. Moreover, there are known risk factors for hemorrhagic transformation in patients with dementia: amyloid angiopathy, leukoaraiosis and the presence of microbleeds. In this review, we describe the impact of dementia on functional outcome following thrombolytic therapy for acute ischemic stroke and discuss some of the issues related to the use of this therapy in this specific patient's population
The Relevance of Assessing Cognitive Performances in Patients With Cerebrovascular Diseases
No full textHave Stroke Neurologists Entered the Arena of Stroke-Related Cognitive Dysfunctions?: Not Yet, but They Should!
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2001-2011: a decade of the LADIS (leukoaraiosis and DISability) study : What have We learned about white matter changes and small-vessel disease?
No full textOver the last 20 years, evidence about the clinical correlates of cerebral white matter changes (WMC; also called leukoaraiosis) has been accumulating. WMC are now listed among the neuroimaging expressions of cerebral small-vessel disease and are no longer considered an innocuous finding because they are associated, in cross-sectional surveys, with various disturbances and, in follow-up studies, with poor prognosis. The Leukoaraiosis And DISability (LADIS) study has contributed substantially to this body of knowledge. LADIS is a European multicenter collaboration that was started in 2001 with the aim of assessing the independent role of WMC in predicting disability in subjects aged 65-84. The main results of the LADIS study have been released in 2009 with the demonstration that severe WMC more than double the risk of transition from an autonomous to a dependent status after 3 years of follow-up. The LADIS study has also contributed more focused substudies assessing the possible role of WMC in the decline of cognitive and motor performances, depressive symptoms associated with aging and cerebrovascular diseases, urinary disturbances, and also the role of other brain lesions (lacunar infarcts, cerebral atrophy, and corpus callosum morphology). The LADIS study provides a good example of harmonization of instruments (MRI protocol, clinical, neuropsychological, and functional scales) within an international collaboration. Currently, the LADIS study is providing data about the natural history of WMC. In this paper, we review the background and the main results of the LADIS study. This review puts forward some considerations for future studies in the field
Progressive stroke in pontine infarction
No full textObjective - The pathogenesis of isolated pontine infarctions is still unclear, being attributed both to small or large vessel disease. The extension of infarcted tissue to the pons surface has been indicated as a possible marker of basilar branch atheromatous disease and some neuroimaging evidence confirms this finding. Methods - On the basis of Kim's et al., study, we performed a revision of the literature addressing this topic. Results - Several authors confirm an association between basilar artery branch disease and isolated pontine infarction; moreover, the enlargement of pontine lesion seems to be associated with neurological worsening. We therefore performed a brief analysis of possible mechanisms of progression. Conclusions - Prospective studies could be useful to evaluate predictors of neurological worsening in pontine stroke. Improvement of neuroimaging techniques is needed for a deeper comprehension of the etiopathogenesis of isolated pontine infarction
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