http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Recent Advances in Primary and Secondary Prevention of Atherosclerotic Stroke
Georgios Tsivgoulis,Apostolos Safouris,김동억,Andrei V. Alexandrov 대한뇌졸중학회 2018 Journal of stroke Vol.20 No.2
Atherosclerosis is a major cause of ischemic stroke that can be effectively prevented with appropriate lifestyle modifications and control of cardiovascular risk factors. Medical advances in recent years along with aggressive cardiovascular risk factor modifications have resulted in decreased recurrence rates of atherosclerotic stroke. Non-statin lipid-lowering molecules have recently shown clinical benefit and are recommended for very high-risk patients to reduce their risk of stroke. Aggressive hypertension treatment is crucial to reduce atherosclerotic stroke risk. Advances in antithrombotic treatments include combinations of antiplatelets and new antiplatelet agents in the acute phase post-stroke, which carries a high risk of recurrence. Intensive medical treatment has also limited the indications for carotid interventions, especially for asymptomatic disease. Intracranial atherosclerotic disease may provoke stroke through various mechanisms; it is increasingly recognized as a cause of ischemic stroke with advanced imaging and is best managed with lifestyle modifications and medical therapy. The diagnostic search for the vulnerable culprit atherosclerotic plaque is an area of intense research, from the level of the intracranial arteries to that of the aortic arch. Ultrasonography and novel magnetic resonance imaging techniques (high-resolution vessel-wall imaging) may assist in the identification of vulnerable atherosclerotic plaques as the underlying cause in cryptogenic or misdiagnosed non-atherosclerotic ischemic stroke. Vertebrobasilar atherosclerotic disease is less common than carotid artery disease; thus, high-quality data on effective prevention strategies are scarcer. However, aggressive medical treatment is also the gold standard to reduce cerebrovascular disease located in posterior circulation.
Advanced Imaging in the Current Era of Acute Reperfusion Therapies
Klearchos Psychogios,Odysseas Kargiotis,Apostolos Safouris,Georgios Magoufis,Lina Palaiodimou,Mariana Papadopoulou,Stavros Spiliopoulos,Georgios Velonakis,Michail Mantatzis,Theodore Karapanayiotides,P 대한신경초음파학회 2023 대한신경초음파학회지 (JNN) Vol.15 No.1
Reperfusion of the ischemic brain parenchyma with intravenous thrombolysis and/or mechanical thrombectomy is the cornerstone of acute ischemic stroke treatment. A paradigm shift from “time is brain” to a more precision medicine approach now called “imaging is brain”, has taken place during the last decade. This transformation has been fueled by the progress in neuroimaging. Advanced Neuroimaging incorporates perfusion imaging in order to depict real-time cerebral perfusion disturbances and provide maps of the penumbra and ischemic core that will inform individualized clinical decisions. Advance neuroimaging has now a fundamental role in triaging patients that will receive reperfusion treatments beyond the conventional time windows of 4.5 hours for intravenous thrombolysis and 6 hours for mechanical thrombectomy. We provide a narrative review of all the pivotal observational studies and randomized-controlled clinical trials that supported the use of advance neuroimaging, as well as technical issues and pitfalls that may be useful for its implementation in routine clinical practice.
The Emerging Clinical Utility of Neurosonology During COVID-19 Pandemic
Eleni Bakola,Odysseas Kargiotis,Klearchos Psychogios,Apostolos Safouris,Lina Palaiodimou,Maria-Ioanna Stefanou,Maria Chondrogianni,Theodoros Karapanayiotides,Konstantinos Vadikolias,Christos Krogias,S 대한신경초음파학회 2021 대한신경초음파학회지 (JNN) Vol.13 No.2
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 infection. Over the last 2 years the virus has spread worldwide with enormous implications on the healthcare systems. COVID-19 patients suffer from mild upper-airway manifestations to pneumonia and severe acute respiratory distress syndrome and their hospitalizations are often prolonged. Neurological manifestations of the disease are common. Neurosonology (transcranial Doppler & cervical duplex ultrasound) is an easily repeatable diagnostic imaging modality that can be simply applied at the bedside of COVID-19 patients with cerebrovascular diseases or in critically ill patients in the intensive care unit. Neurosonology may provide hemodynamic assessment of cerebral circulation, quantitative evaluation of increased intracranial pressure and detection of micro-embolic signals in real-time. Consequently, it may assist substantially in the diagnosis, risk stratification and therapeutic approach of COVID-19 patients with or without cerebrovascular complications. In the present narrative review, we discuss the emerging clinical utility of neurosonology during COVID-19 pandemic and highlight the upgraded role of neurosonology resulting from the combination of the established applications coupled with the reduced risk of virus spreading during ultrasound evaluation compared to other imaging modalities including computed tomography and magnetic resonance imaging.