E-Book Overview
Accurate diagnosis, appropriate investigation, reliable risk stratification, and urgent treatment are essential after TIA and minor stroke and can reduce the risk of stroke recurrence by up to 80%. This book reviews recent developments in each of these areas. To reflect the fact that TIAs and minor strokes are simply one end of the clinical spectrum of cerebrovascular disease, the book also covers the management of major stroke, and long-term outcomes - such as cognitive impairment - which can complicate all types of cerebrovascular events. The book is therefore a comprehensive primer in stroke medicine. Written by a leading team of researchers in the field, this book will be of interest to neurologists, stroke physicians, and all others with an interest in stroke.
E-Book Content
This page intentionally left blank Transient Ischemic Attack and Stroke Transient Ischemic Attack and Stroke Diagnosis, Investigation and Management Sarah T. Pendlebury Matthew F. Giles Peter M. Rothwell CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521735124 © S. Pendlebury, M. Giles and P. Rothwell 2009 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2009 ISBN-13 978-0-511-53338-9 eBook (EBL) ISBN-13 978-0-521-73512-4 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this publication to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. Contents Foreword vii 12 Vascular imaging in transient ischemic attack and stroke 159 Section 1–Epidemiology, risk factors, pathophysiology and causes of transient ischemic attacks and stroke 1 Epidemiology 2 Risk factors 3 Genetics 1 16 Section 3–Prognosis of transient ischemic attack and stroke 14 Methods of determining prognosis 179 30 4 Anatomy and physiology 13 Non-radiological investigations for transient ischemic attack and stroke 173 38 5 Pathophysiology of acute cerebral ischemia 49 6 Causes of transient ischemic attack and ischemic stroke 55 7 Causes of spontaneous intracranial hemorrhage 91 Section 2–Clinical features, diagnosis and investigation 8 Clinical features and differential diagnosis of a transient ischemic attack 101 9 The clinical features and differential diagnosis of acute stroke 113 15