New Concepts in Stroke Diagnosis and Therapy

Book Series: Current Developments in Stroke

Volume 1

by

Alberto Radaelli, Giuseppe Mancia, Carlo Ferrarese, Simone Beretta

DOI: 10.2174/97816810842131170101
eISBN: 978-1-68108-421-3, 2017
ISBN: 978-1-68108-422-0
ISSN: 2542-5110 (Print)
ISSN: 2542-5129 (Online)



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This volume presents a summary of recent research and debates on old and new aspects in stroke medicine. The volume covers topics such...[view complete introduction]

Table of Contents

Foreword

- Pp. i

Danilo Toni

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Preface 1

- Pp. ii

Alberto Radaelli

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Preface 2

- Pp. iii

Carlo Ferrarese

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List of Contributors

- Pp. iv-vi (3)

Alberto Radaelli, Giuseppe Mancia, Carlo Ferrarese and Simone Beretta

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Stroke and Hypertension

- Pp. 3-25 (23)

Cristina Sierra and Antonio Coca

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Autonomic Nervous System Dysfunction and Risk of Stroke

- Pp. 26-56 (31)

Alberto Radaelli, Paolo Castiglioni and Giuseppe Mancia

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Stroke and the Immune System: Therapeutic Targeting of Toll-Like Receptors

- Pp. 57-84 (28)

Vincenza Sofo, Luca Soraci, Francesca Maria Salmeri, Giulia Soraci, Paolo La Spina and Maria Elsa Gambuzza

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Intracerebral Bleeding and Oral Anticoagulant Therapies: Clinical Relevance and Management

- Pp. 85-111 (27)

Monica Carpenedo

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Cerebral Collateral Circulation in Acute Ischemic Stroke: Translational Evidence for Outcome Prediction and Modulation Strategies

- Pp. 112-130 (19)

Simone Beretta, Fausto De Angeli, Elisa Cuccione, Giada Padovano, Davide Carone, Alessandro Versace and Carlo Ferrarese

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Life in the Penumbra with the BRODERICK PROBE®

- Pp. 131-175 (45)

P.A. Broderick, L. Wenning and Y-S. Li

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On the Influence of Normalization Strategies for Perfusion MRI in Acute Stroke

- Pp. 176-190 (15)

Mathilde Giacalone, Carole Frindel, Robin Zagala, Tae-Hee Cho, Yves Berthezène, Norbert Nighoghossian and David Rousseau

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Genetic Causes of Ischemic Stroke

- Pp. 191-215 (25)

Anna Bersano and M. Ranieri

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Diagnostic Challenges: Cryptogenic Ischemic Stroke

- Pp. 216-232 (17)

Antonio Vincenti

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Emerging Concepts for Neuroprotection

- Pp. 233-249 (17)

Barbara Casolla, Serena Candela, Giuliano Sette and Francesco Orzi

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Pharmacological and Endovascular Recanalization Therapy

- Pp. 250-269 (20)

E.C. Agostoni and M. Longoni

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Neuroregeneration after Stroke

- Pp. -270 (299)

Marco Bacigaluppi, Gianluca Luigi Russo and Gianvito Martino

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Post-Stroke Rehabilitation

- Pp. 300-330 (31)

Michela Coccia and Leandro Provinciali

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Subject Index

- Pp. 331-337 (7)

Alberto Radaelli, Giuseppe Mancia, Carlo Ferrarese and Simone Beretta

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Foreword

Stroke is likely the neurological disease with the most relevant developments in all the research fields, from knowledge of the mechanisms leading to brain tissue death to codification of rehabilitation mainstays, through better definition of risk factors and consequent improvement of primary and secondary prevention, diagnosis with advanced imaging or by identification of genetic mechanisms in rare cases, treatments of the acute phase of ischemic events, with the well-established role of i.v. thrombolysis now backed up by combined endovascular treatments and with the potentialities of neuroprotection and neuroregeneration, or of iatrogenic hemorrhagic stroke, with the advent of antidotes for the new generation of direct oral anticoagulants.

As a consequence, a terribly huge literature on stroke has been produced: by typing the word “stroke” one may find approximately 140000 papers indexed in PubMed in the last 20 years. Hence, a book summarizing all the “new concepts in stroke diagnosis and therapy” is highly appreciated. The Authors report the present knowledge on all the above mentioned issue, with updated and well selected reference literature. The book can be a good “traveling companion” for neurologists working daily on stroke patient management and having little time to look for scientific literature, but also a guide for stroke basic and clinical researchers to pick up the most recent information and to get suggestions for further research.

My compliments to the Authors and “enjoy the reading” to all the readers.

Prof. Danilo Toni, MD
Associate Professor of Neurology
Director Emergency Department Stroke Unit
Hospital Policlinico Umberto I
Dept. of Neurology and Psychiatry, Sapienza Univerisity.


Preface

Stroke prevention, diagnosis and therapy are all evolving fields that give us the idea of how in progress is the clinical job and the scientific work. Stroke in particular deserves a special mention as it is perceived both by patients and by physicians and it is one of the most feared and invalidating condition.

In this regard, every single step able to improve prevention, accelerate diagnosis and therapy is welcome and need to be rapidly shared with all the scientific community.

On the one hand, despite the stabilization of stroke events in civilized countries other emerging countries contribute to new events so keeping a high prevalence of stroke worldwide. In this regard, stroke prevention still represents one of the missing opportunities and the recognition and treatment of old and new risk factors are mandatory. On the other hand, imaging and therefore diagnosis and therapeutic opportunities are now available to treat faster than ever ischemic events in order to reduce overall cerebral damage and therefore disability. These new possibilities nevertheless should not remain restricted to few golden clinical and scientific realities but be rapidly shared and diffused to the emerging countries where the prevalence of stroke is growing.

This book aims to be an aid to the diffusion and discussion of what is new in the field and what are some of the new directions of prevention, diagnosis and therapy. At least, eighty five per cent of strokes are of ischemic origin and are therefore the results of a missed prevention in vascular atherosclerosis and thrombosis. This has always been a “cardiology” field. It is evident that a tighter cooperation between cardiologists and neurologists is needed in order to share expertise and to create more powerful tools to improve prevention, diagnosis and therapy of vascular events that involve in a similar dramatic way both the heart and the brain.

Dr. Alberto Radaelli
Division of Cardiac Rehabilitation,
San Gerardo Hospital,
Monza,
Italy

Preface 2

Only few decades ago stroke was considered a devastating condition with high mortality, high disability, without adequate prevention strategies, any tool to perform accurate diagnosis and consequently without any effective treatment available.

Scientific and technological advances in the last few years have dramatically changed the scenario: epidemiologic, genetic, imaging, biological and therapeutic advances have made it possible to effectively prevent strokes, to perform accurate differential diagnosis of stroke type and of location of vessel occlusion and new treatments for acute phase have recently demonstrated dramatic results.

In the context of this new scenario, new concepts for stroke diagnosis and therapy emerged, and this book specifically addresses this point.

Major experts and opinion leaders in respective fields extensively review and discuss new advances in the knowledge of the role of stroke risk factor for their prevention; new technological tools to perform in vivo imaging of cerebral collateral circulation and ischemic penumbra are widely described and their relevance for more accurate diagnosis and prognosis is discussed.

Diagnostic challenges in rare aethiologies of stroke are described in detail and new studies on recanalization and neuroprotection strategies are reported, with analysis of their impact on stroke health organization.

Finally, the hemorrhagic risk associated to older and new anticoagulants is discussed and new studies on stroke recovery are presented.

The reader of this new book may obtain a state-of-the-art knowledge of stroke diagnosis and treatment options to address the challenges of this severe, but now treatable disease.

Dr. Carlo Ferrarese,
Department of Neurology, San Gerardo Hospital,
University of Milano Bicocca, Monza,
Italy

List of Contributors

Editor(s):
Alberto Radaelli
Division of Cardiac Rehabilitation
Ospedale San Gerardo
Monza
Italy


Giuseppe Mancia
University of Milano-Bicocca and IRCCS Istituto Auxologico Italiano
Institute of Catalysis & Petroleochemistry. Spanish Research Council CSIC
Milan
Italy


Carlo Ferrarese
Department of Neurology, San Gerardo Hospital
University of Milano Bicocca
Milan
Italy


Simone Beretta
Milan Center for Neuroscience (NeuroMi)
Milan
Italy




Contributor(s):
Antonio Coca
Hypertension and Vascular Risk Unit. Department of Internal Medicine,
Institute of Medicine and Dermatology, Hospital Clinic (IDIBAPS), University of Barcelona,
Barcelona,
Spain,


Alberto Radaelli
Division of Cardiac Rehabilitation,
Ospedale San Gerardo, Monza,
Italy


Alessandro Versace
Laboratory of Experimental Stroke Research,
School of Medicine, University of Milano Bicocca, Monza,
Italy


Antonio Vincenti
Electrophysiology Unit,
Multimedica IRCCS Sesto San Giovanni, Milan,
Italy


Barbara Casolla
NESMOS (Neuroscience Mental Healt and Sensory Organs) Department,
School of Medicine and Psichology, Sapienza University,
Rome,
Italy


Carlo Ferrarese
Department of Neurology, San Gerardo Hospital,
University of Milano Bicocca, Monza,
Italy


Carole Frindel
Université de Lyon,
CREATIS; CNRS UMR5220; Inserm U1206; INSA-Lyon; Université Claude Bernard Lyon 1,
France


Cristina Sierra
Hypertension and Vascular Risk Unit. Department of Internal Medicine,
Institute of Medicine and Dermatology, Hospital Clinic (IDIBAPS), University of Barcelona, Barcelona, Spain



David Rousseau
Université de Lyon,
CREATIS; CNRS UMR5220; Inserm U1044; INSA-Lyon, Lyon, France,



Elio Clemente Agostoni
Department of Neuroscience,
Neurology and Stroke Unit, ASST Ospedale Niguarda, Milan,
Italy,


Elisa Cuccione
Laboratory of Experimental Stroke Research,
School of Medicine, University of Milano Bicocca,
Monza,
Italy


Fausto De Angeli
Laboratory of Experimental Stroke Research,
School of Medicine, University of Milano Bicocca,
Monza,
Italy


Francesco Orzi
NESMOS (Neuroscience Mental Healt and Sensory Organs) Department,
School of Medicine and Psichology, Sapienza University, Rome,
Italy


Francesca Maria Salmeri
Department of Biomedical,
Dental Sciences and Morphological and Functional Images, University of Messina –
Italy


Giuseppe Mancia
University of Milano-Bicocca and IRCCS Istituto Auxologico Italiano,
Milan,
Italy


Gianvito Martino
Institute of Experimental Neurology,
Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan,
Italy


Giada Padovano
Laboratory of Experimental Stroke Research,
School of Medicine, University of Milano Bicocca, Monza,
Italy


Gianluca Luigi Russo
Institute of Experimental Neurology,
Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan,
Italy


Giuliano Sette
NESMOS (Neuroscience Mental Healt and Sensory Organs) Department,
School of Medicine and Psichology, Sapienza University, Rome,
Italy


Giulia Soraci
University of “La Cattolica Sacro Cuore” Rome-Italy,



Leandro Provinciali
Department of Neuroscience,
Polytechnic University of Marche Medical School, Ancona,
Italy


Luca Soraci
Department of Biomedical,
Dental Sciences and Morphological and Functional Images, University of Messina –
Italy


Leslie Wenning
Dept. of Physiology, Pharmacology and Neuroscience,
The City University of New York School of Medicine, The Sophie Davis School of Biomedical Education, The City College of New York, New York, NY USA; Dept. of Anesthesiology, NYU Langone Medical Center, New York, NY
USA


Marco Bacigaluppi
Department of Experimental Neurology,
Università Vita-Salute San Raffaele, Milano,
Italy,


Monica Carpenedo
Hematology and Transplant Unit,San Gerardo Hospital,
Monza,
Italy


Michela Coccia
Neurological Clinic,
Department of Experimental and Clinical Medicine

/
Marche Polytechnic University, 60121 Ancona,
Italy


Maria Elas Gambuzza
Ministry of Health –
Italy


Mathilde Giacalone
Université de Lyon,
CREATIS; CNRS UMR5220; Inserm U1206; INSA-Lyon;Université Claude Bernard Lyon 1,
France


Marco Longoni
Department of Neuroscience,
Neurology and Stroke Unit of the ASST: “Grande Ospedale Metropolitano Niguarda”, Milan,
Italy


Michela Ranieri
Cerebrovascular Unit; IRCCS Foundation Neurological Institute “C. Besta”,
Via Celoria 11, Milan 20133,
Italy


Norbert Nighoghossian
Université de Lyon,
CREATIS; CNRS UMR5220; Inserm U1206; INSA-Lyon;Université Claude Bernard Lyon 1,
France


Patricia Ann Broderick
Dept. of Physiology,
Pharmacology and Neuroscience, The City University of New York School of Medicine, The Sophie Davis School of Biomedical Education, The City College of New York,
New York, NY
USA


Paolo Castiglioni
IRCCS Fondazione Don Carlo Gnocchi,
Milan,
Italy,


Paolo La Spina
Department of Clinical and Experimental Medicine,
University of Messina,
Italy


Robin Zagala
Université de Lyon, CREATIS; CNRS UMR5220;
Inserm U1206; INSA-Lyon; Université Claude Bernard Lyon 1,
France


Simone Beretta
Laboratory of Experimental Stroke Research,
School of Medicine, University of Milano Bicocca,
Italy


Serena Candela
NESMOS (Neuroscience Mental Healt and Sensory Organs) Department,
School of Medicine and Psichology, Sapienza University, Rome,
Italy


Tae-Hee Cho
Université de Lyon, CREATIS; CNRS UMR5220; Inserm U1206; INSA-Lyon; Université Claude Bernard Lyon 1,
France


Vincenza Sofo
Department of Biomedical,
Dental Sciences and Morphological and Functional Images, University of Messina –
Italy


Yves Berthezène
Université de Lyon,
CREATIS; CNRS UMR5220; Inserm U1206; INSA-Lyon;Université Claude Bernard Lyon 1,
France


Yong-Sheng Li
Dept. of Physiology,
Pharmacology and Neuroscience, The City University of New York School of Medicine, The Sophie Davis School of Biomedical Education, The City College of New York,
New York, NY
USA




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