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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acupuncture is a valuable method of complementary medicine with broad application in neurology. It is based on the experiences of traditional Chinese medicine as well as on experimentally proven biological (biochemical and neurophysiological) effects. Acupuncture-induced analgesia is mediated by inhibition of pain transmission at a spinal level and activation of central pain-modulating centers by release of opioids and other peptides that can be prevented by opioid antagonists (naloxone). Modern neuroimaging methods (functional MRI) confirmed the activation of subcortical and cortical centers, while transcranial Doppler sonography and SPECT showed an increase of cerebral blood flow and cerebral oxygen supply in normal subjects. Clinical experience and controlled studies confirmed the efficacy of acupuncture in various pain syndromes (tension headache, migraine, trigeminal neuralgia, posttraumatic pain, lumbar syndrome, ischialgia, etc.) and suggest favorable effects in the rehabilitation of peripheral facial nerve palsy and after stroke. Appropriate techniques, hygiene safeguards and knowledge of contraindications will minimize the risks of rare side effects of acupuncture which represents a valuable adjunction to the treatment repertoire in modern neurology. There is sufficient evidence of acupuncture to expand its use into conventional medicine and to encourage further studies of its pathophysiology and clinical value.
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PMID:[Principles and application of acupuncture in neurology]. 1107 28

A growing body of evidence suggests the involvement of inflammatory mediators, including cytokines, in the development of ischaemic brain lesions. The aim of the present study was to investigate whether tumour necrosis factor-alpha (TNF-alpha), the proinflammatory cytokine, contributes to early pathophysiological mechanisms leading to brain damage as a consequence of acute stroke. We have studied TNF-alpha levels in cerebrospinal fluid (CSF) and serum in 23 stroke patients within the first 24 hours after ischaemic stroke, confirmed by computerized tomography of the brain (CT). The control group consisted of 15 patients with the diagnosis of tension headache and neurasthenia. In stroke patients the levels of TNF-alpha both in CSF and serum were significantly higher in comparison with the control group. The positive correlation between the levels of TNF-alpha in CSF and serum of the studied patients has been observed. Furthermore, a positive correlation between both TNF-alpha levels in CSF and serum and the volume of evolving brain infarct have been shown.
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PMID:Tumour necrosis factor-alpha is increased in the cerebrospinal fluid and serum of ischaemic stroke patients and correlates with the volume of evolving brain infarct. 1142 51

Tumour necrosis factor alpha (TNF-alpha) is a proinflammatory cytokine. Stroke induces a rapid increase in TNF-alpha levels within and around the focus of damaged brain. The aim of our study was to evaluate, whether patients with stroke differ from control patients in the concentrations of TNF-alpha in cerebrospinal fluid and serum. We studied TNF-alpha levels in cerebrospinal fluid and serum in 30 patients with stroke within 24 h after onset of neurological signs and in 15 patients of control group with the diagnosis of tension headache and neurasthenia. In patients with stroke the levels of TNF-alpha in the cerebrospinal fluid and serum were significantly higher in comparison with control group. The results of our study may suggest the overproduction of TNF-alpha during first twenty-four hours of stroke.
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PMID:[Tumor necrosis factor alpha (TNF-alpha) in patients with ischemic stroke]. 1146 15

Oral contraceptive (OC) users' leading complaint is headaches, but no study definitely links OC use to headache development or exacerbation. Unexplained headaches tend to begin in young adults, the same group that extensively uses OCs. Women suffering from tension headaches, caused by muscular contraception and not vascular effects, can use OCs. The decision to use or not use OCs is not so easy for women suffering from migraines, however, because migraines are hard to diagnose. They may have a vascular origin. Scientists do not really know the etiology of migraines. Some believe changes in estrogen levels contribute to migraines. For example, about 60% of women have a migrate during menstruation. A physician suggests treating such women with estrogen supplements during menstruation or with continual administration of monophasic OCs for 2-3 months with no withdrawal bleeds. Another physician asks OC users with headaches to keep a record of when the headaches occur and the conditions (e.g., time during menstrual cycle). Other alternatives are to switch OC users with headaches to progestin-only contraceptives. Family planning providers should not be concerned about women who have had a history of headaches before starting OCs. They should be concerned about those who did not have any headaches before taking OCs and then suddenly started having them after OC use. The former group of women are less likely to have a stroke, since a long history of headaches suggests that a vessel is not involved. Due to the legal environment, a family planning physician recommends that the provider talk to an OC user who has increasing headaches about other methods and possible risks. If an OC user begins having stroke like symptoms (e.g., visual symptoms when eyes are open and true vertigo), it is highly recommended to switch her to another contraceptive and have her undergo a neurological examination.
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PMID:Headaches: OCs are "guilty by association". 1228 98

Many physicians will not provide oral contraceptives (OCs) to women with a history of migraine due to concerns about increasing the risk of a cerebrovascular accident. The World Health Organization's revised medical eligibility criteria indicate that only women with serious migraine that includes focal neurologic symptoms should be cautioned against OC use. This article reviews the research evidence on headache, migraine, and OCs. The recent literature suggests that healthy, nonsmoking women using low-dose OCs (35 mcg of estrogen or less) have no increased risk of stroke. Although the presence of diabetes, hypertension, and/or migraine appears to be associated with an increased risk of cerebral thromboembolism, the use of OCs does not synergistically add to the risk. It is important, however, for physicians to differentiate between tension headaches, migraines with aura (classic migraine), and migraines without aura (common migraine). Women with classic migraine should avoid OCs if an alternative method of contraception can be used. Common migraine is not a contraindication to OC use, although the frequency and severity of headaches during OC use should be monitored. OC discontinuation should be discontinued, at least temporarily, if previously existing migraine suddenly worsens, headaches that are qualitatively different than the type usually experienced by the patient occur, headaches wake a patient from sleep, or double vision or loss of vision occur.
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PMID:Headache, migraine and oral contraceptives. 1229 64

Women with tension headaches or migraine headaches without aura can use oral contraceptives (OCs) and other hormonal methods without concern. The use of combined OCs by women with severe, recurrent headaches with focal neurologic symptoms (including migraine headaches with aura) is contraindicated, however. It has been suggested that women with migraine headaches are at increased risk of stroke while taking OCs, but no data have been collected to support this contention.
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PMID:Hormonal methods may affect headaches. 1229 54

Inflammation is an important feature of the pathophysiological response to ischaemic stroke. The ischaemic brain-invading leukocytes, neutrophils in particular, contribute to the exacerbation of tissue injury in stroke. Chemokines are a growing family of proteins performing chemotactic activity on selective leukocyte subpopulations. Chemokines are broadly divided into two major subfamilies on the basis of the arrangement of the two N-terminal cysteine residues, CXC and CC, depending on whether the first two cysteine residues have an amino acid between them (CXC) or are adjacent (CC). CXC chemokines possessing, close to the N terminus, the amino acid sequence glutamic acid-leucine-arginine (ELR motif) specifically act on neutrophils. CXCL5 is one of the ELR-expressing CXC chemokines and is a potent neutrophil attractant and activator. The objective of the study was to detect CXCL5 levels in the cerebrospinal fluid (CSF) and sera of stroke patients and to investigate the relation between these levels and the volume of brain computed tomography (CT) hypodense areas representing early ischaemic lesions. A total of 23 ischaemic stroke patients were studied. CSF and blood sampling and brain CT were performed within the first 24 hours of stroke. The control group consisted of 15 patients with tension headache. CXCL5 levels were determined by the ELISA method. CSF CXCL5 levels in stroke patients were significantly higher in comparison with the control group (38.2 +/- 18.4 pg/ml vs. 18.7 +/- 8.2 pg/ml; p < 0.001). No significant differences in serum CXCL5 levels were found between the stroke patients and the control group. CSF CXCL5 levels correlated positively with the volume of early brain CT hypodense areas (p < 0.0001). The results suggest that CXCL5 may play a role in the inflammatory reaction during the early phase of ischaemic stroke.
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PMID:The level of chemokine CXCL5 in the cerebrospinal fluid is increased during the first 24 hours of ischaemic stroke and correlates with the size of early brain damage. 1678 27

Headache in an elderly patient can be a sign of serious, potentially life-threatening disorders. All patients require a full assessment, including a complete neurologic examination. Particular emphasis should be placed on excluding subarachnoid hemorrhage, subdural hematoma, giant cell arteritis, intracranial neoplasm, cerebrovascular accident, acute-angle-closure glaucoma, and infectious etiologies such as meningitis and encephalitis. Once life-threatening disorders are excluded, the geriatrician can focus on more benign etiologies such as migraine, tension headache, and medication withdrawal. Treatment depends on the underlying etiology. This article discusses headaches that require emergent treatment and then describes more benign etiologies of headaches.
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PMID:Headache in the elderly. 1746 18

Recent studies indicated that migraine is associated with specific vascular risk profile. However, the functional and structural vascular abnormalities in migraine are rarely addressed. We evaluated the vascular risk factors, endothelial function, and carotid artery (CA)-intima-media thickness (IMT), segregators of preclinical atherosclerosis, in migraineurs. This preliminary study included 63 adults with headache (migraine with aura [n=14], migraine without aura [n=24], transformed migraine [n=6], and tension headache [n=19]) and 35 matched healthy subjects. The following vascular risks were assessed: body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressures (DBP), serum levels of C-reactive protein, fasting glucose, fasting insulin, total cholesterol, and triglycerides. Plasma endothelin (ET)-1, a vasoactive peptide produced by vascular smooth muscle cells and marker for endothelial injury and atherosclerosis, was measured. Endothelial-dependent vasoreactivity was assessed using brachial artery flow-mediated dilatation (FMD) in response to hyperemia. CA-IMT, structural marker of early atherosclerosis, was measured. Compared with control subjects, SBP, DBP, glucose, insulin, ET-1, and CA-IMT were elevated with migraine. FMD% was inversely correlated with SBP (P < .001), DBP (P < .01), glucose (P < .001), and insulin levels (P < .01). CA-IMT was correlated with BMI (P < .05), SBP (P < .01), total cholesterol (P < .01), triglycerides (P < .001), glucose (P < .001), insulin (P < .01), and FMD% (P < .05). In multivariate analysis, ET-1 was correlated with duration of illness, SBP, DBP, glucose, insulin, IMT, and FMD%. We conclude that endothelial injury, impaired endothelial vasoreactivity, and increased CA-IMT occur with migraine and are associated with vascular risk factors that strongly suggest that migraine could be a risk for atherosclerosis.
J Stroke Cerebrovasc Dis 2010 Mar
PMID:Vascular risk factors, endothelial function, and carotid thickness in patients with migraine: relationship to atherosclerosis. 2018 84

Botulinum toxin is one of the most toxic natural substances; it acts by blocking the neuromuscular transmission by inhibiting Acetylcholine (Ach) releasing from the motor nerve into the neuromuscular junction. Although the toxin inhibits ACh release, other transmitters can also be inhibited. Botulinum toxin, specifically toxin type A (BONT-A) has been used since the 1970s to treat many different disorders, such as general spasticity resulting from stroke, multiple sclerosis or cerebral palsy, strabismus, hyperhidrosis or excessive sweating, pain, and it is effective in combating migraine and tension headaches. Since prostate gland is under the influence of autonomic innervation and associated neurotransmitters, the effects of BONT-A on the prostate have gained attention in the urological community and it has been studied in different species, including rats, dogs and humans. The aim of this paper is to review the mechanism of action of botulinum toxin and to discuss in particular the results of BONT-A treatment for benign prostatic hyperplasia (BPH), providing perspectives on potential therapy according to actual knowledge.
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PMID:Botulinum toxin A in prostate disease: a venom from bench to bed-side. 2240 79


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