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

Vascular dementia (VaD) is the second most common form of dementia after Alzheimer's dementia (AD). It is characterized by loss of executive function with milder memory loss as compared with AD and is associated with cerebral brain infarction or hemorrhage. Treatment is predominantly focused on cardiovascular risk factor reduction, but anticholinesterase inhibitors and memantine may play a role. The data is most robust for donepezil.
Top Stroke Rehabil
PMID:Vascular dementia. 1825 70

There are several processes implicated as uncommon causes of temporal lobe epilepsy. Trauma is the leading cause of epilepsy in young adults, intracerebral blood collection being the most consistent risk factor of seizures, especially subdural hematomas and brain contusions. Infarction is the entity most commonly related to epilepsy in the elderly population. Seizures usually present as complex seizures with high recurrence between 6 months and 2 years after stroke. There are some radiological characteristics of the affectation associated with high risk of early and late seizures. Noninfectious limbic encephalitis is a syndrome characterized by seizures, memory loss, and confusion. It includes paraneoplasic and non-paraneoplasic limbic encephalitis, both presenting as hyperintense lesion affecting temporobasal regions more evident with fluid-attenuated inversion recovery sequences. Paraneoplasic limbic encephalitis is associated with several types of tumor-induced autoimmunity against the nervous system. The tumors most frequently implicated are the lungs, testis, and breast, including Hodgkin's lymphoma, teratoma, and thymoma in young patients. Once a tumor is excluded, non-paraneoplasic limbic encephalitis has to be considered by investigating the presence of antibodies against voltage-gated potassium channels. It is associated with hyponatremia and responds to regimens of steroids, plasma exchange, and intravenous immunoglobulins. Finally, herpetic limbic encephalitis is also associated with seizures, accompanied by fever and neurologic symptoms. It presents characteristic findings and distribution on magnetic resonance imaging, which shows abnormalities in more than 90% of patients with proven Herpes simplex virus type 1.
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PMID:Uncommon epiloptogenic lesions affecting the temporal lobe. 1838 7

Stroke patients often experience cognitive dysfunctions. One of the parameters assessing cognitive function is the reaction time as it reflects the speed of information processing. The aim of the study was to assess cognitive and psychomotor dysfunctions and the effectiveness of rehabilitation in stroke patients. The subjects of the study were 30 stroke patients who underwent rehabilitation at the Department of Neurorehabilitation. The mean age of patients was 65.33+/-13.2 years. During the study, the patients' cognitive functions, the handgrip strength, reaction time, and frequency of movements were assessed. There was a substantial improvement in patients' cognitive function after rehabilitation. Assessing the results obtained by Mini Mental State Examination, the change was 6.4+/-2.3 points, and assessing by Neurobehavioral Cognitive Status Examination (Cognistat), the change was 13.3+/-10 points (P<0.05). Before the early stage of rehabilitation, Cognistat results showed that the majority of the patients experienced memory loss, diminished constructive abilities, and disorientation. After occupational therapy, there was a statistically significant improvement in all cognitive function domains. At the end of the inpatient rehabilitation period, there was a significant change in patients' reaction time and movement frequency. At the end of early rehabilitation stage, the estimated reaction time in patients with stroke was compared with reaction time in healthy elderly people of the same age. There was no significant difference between these groups; consequently, we concluded that after rehabilitation, improvement of function was achieved. The results of this study showed that at the beginning of early rehabilitation period and after rehabilitation applied, there was a significant moderate correlation between mental state and reaction time in stroke patients.
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PMID:The evaluation of the rehabilitation effects on cognitive dysfunction and changes in psychomotor reactions in stroke patients. 1912 63

Memory loss is the most common early symptom of Alzheimer's disease (AD). For this study, we chose the hippocampi as regions of interest. The hippocampus, which is closely associated with memory processing, is known to be vulnerable to damage in the early stage of AD. We considered both inter-group (patients vs controls) and intra-group (right vs left hippocampus) comparisons. We examined seven patients meeting the DSM-III-R criteria of senile dementia and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS - ADRDA) criteria of probable AD, and II aged controls. This study focused on the measurement of phosphorus 31 ((31)P) Nuclear Magnetic Resonance (NMR) spectroscopy metabolites in each hippocampus. We found significant differences in phosphorus metabolites for both intra-group comparison (pH shifted towards relative alkalosis in the left hippocampus of patients) and inter-group consideration (reduced phosphodiesters [Pde]and elevated gamma adenosine triphosphate (ATP) in the right hippocampus, higher inorganic phosphate (pHi) in the left hippocampus for patients as compared to controls). We suggest energy failure and membrane functional breakdown in patients compared to aged controls.
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PMID:In vivo hippocampal (31)P NMR metabolites in Alzheimer's disease and ageing. 1969 21

It has been demonstrated that hypertension can lead to coronary heart disease, heart failure, stroke, and memory loss. In this study we investigated the effect of acute and chronic hypertension on the avoidance and spatial learning and memory in rats. The forty male rats were divided into acute hypertensive, chronic hypertensive and control for each group rats. Hypertension was induced by Deoxy Corticosterone Acetate (DOCA)-salt method. DOCA was injected 30mg/kg of body weight subcutaneously, twice a week. These rats received NaCl 1% instead of tap water for drinking throughout the experiment. The control group received normal saline injection with usual drinking water. Spatial learning and memory was investigated by Morris water maze test and passive avoidance learning by Shuttle box test in the rats after hypertension induction. Results showed that acute hypertension impaired short-term memory in passive avoidance learning. However, acute and chronic hypertension did not affect spatial learning and memory. These data suggest that simple uncomplicated hypertension does not remarkably alter cognition.
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PMID:Effect of acute and chronic hypertension on short- and long-term spatial and avoidance memory in male rats. 1976 67

Postmortem studies have revealed a state of chronic inflammation in affected regions of the brain in Alzheimer's disease (AD). Chronic inflammation can be damaging to host cells and the brain may be particularly vulnerable as neurons are not replaced. Evidence suggests that the inflammation is killing neurons in AD brain, so anti-inflammatory agents might slow the process of the disease. More than 20 epidemiological studies have shown that persons taking nonsteroidal anti-inflammatory drugs (NSAIDs) have a greatly reduced incidence of AD. In one clinical trial, indomethacin appeared to halt the progression of memory loss in AD patients. NSAIDs inhibit synthesis of prostaglandins, which are fringe players in the inflammatory process. Agents that would block the more important actors, such as the complement system, activated microglia and inflammatory cytokines, might have important therapeutic benefits in AD as well as in other conditions, such as heart disease and stroke, where inflammation also plays a deleterious role.
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PMID:Chronic inflammation in Alzheimer's disease offers therapeutic opportunities. 1981 Oct 46

Many trials focused on cardiovascular outcomes demonstrate that reduction in blood pressure to levels below 140/90 mm Hg reduce cardiovascular events including stroke and myocardial infarction. There are very few such trials, however, in the elderly cohort, especially among those aged 70 and older. In the few outcome trials that have been completed in this older age group, systolic blood pressures in the range between 140 and 149 mm Hg demonstrate a clear reduction in cardiovascular events. Moreover, among the subgroup that has a vasculature that allows a systolic pressure to go below 140 mm Hg without cognitive side effects, ie, somnolence, memory loss, etc, does even better than those whose blood pressures are in the 140 to 149 mm Hg range. Thus, titration of systolic blood pressure goals in the elderly should strive for a goal of less than 140 mm Hg, and if not achievable without side effects, compromise to below 150 mm Hg.
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PMID:Hypertension and its management in the elderly. 2000 92

Evidence is accumulating indicating that some protein kinase C (PKC) isozymes play an essential role in various phases as well as types of learning and memory. Abnormal functions of PKC signal cascades in the brains have been found to represent one of the earliest changes in patients with Alzheimer's disease (AD) and other types of memory deficits, including those related to cerebral ischemic/stroke events. In preclinical studies, an inhibition or impairment of PKC activity leads to compromised learning and memory, whereas an appropriate activation of some PKC isozymes results in an enhancement of learning and memory and/or antidementic effects against memory disorders. PKC activators not only increase activity of PKC isozymes and thereby restore PKC signaling activity, including neurotrophic activity, synaptic/structural remodeling, and synaptogenesis in the hippocampus and related cortical areas, but also reduce the accumulation of neurotoxic amyloid and tau protein hyperphosphorylation in the brain. These observations strongly suggest that PKC isoform pharmacology may represent an attractive area for the development of cognition-enhancing agents and therapeutics against memory loss in the future.
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PMID:Pharmacology of protein kinase C activators: cognition-enhancing and antidementic therapeutics. 2038 81

Chronic heart failure (CHF) is one of the leading causes of hospitalization, morbidity and mortality. Moreover, there is a high rate of neurological as well as neuropsychological comorbidities, namely ischemic stroke, structural brain alterations, cognitive impairment, sleep apnea and possible side-effects of HF medication such as delirium or (intracerebral) hemorrhage. The higher stroke risk in patients with HF increases further with age, concomitant arterial hypertension or atrial fibrillation (AF). In women the stroke risk increases with reduced ejection fraction (EF). In general stroke in HF patients is associated with a poor outcome and higher mortality, which is increased more than 2-fold. Furthermore, approximately 25-80% of all patients with CHF experience cognitive impairments such as decreased attention and concentration, memory loss, diminished psychomotor reaction time and decreased executive functions. Cognitive impairment in patients with HF has been linked to losses in gray matter, (silent) ischemic strokes, decreased cerebral perfusion and higher mortality. Moreover, sleep apnea occurs in more than half of all patients with CHF and reduced EF. However, prospective studies are needed to test whether early detection and optimal treatment of HF reduces the burden of neurological and neuropsychological sequelae.
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PMID:[Neurological aspects of chronic heart failure]. 2069 90

Retrograde memory is frequently tested in the mental status examination of patients with stroke or degenerative dementia. The goal of this experiment was to compare gradients of retrograde memory in patients without neurologic disease (n = 26), patients with cerebrovascular disease (n = 43), and patients with probable Alzheimer's disease (n = 27). Patients were asked to recall and then name photographs of the 6 most recent US presidents. The free recall of patients with both cerebrovascular disease and probable Alzheimer's disease formed an exaggeration of the normal forgetting curve seen in control patients, in that the most recent presidents were most likely to be remembered. For photo naming, control patients showed essentially no forgetting, whereas patients with cerebrovascular disease or Alzheimer's disease had substantial memory loss with no temporal gradient. Alzheimer's disease caused significantly worse retrograde memory loss than did cerebrovascular disease, despite the two groups' equivalence in global intellectual functioning. Consistent with the focal or multifocal nature of cerebrovascular disease, stepwise multiple regression of retrograde memory on neuropsychological testing indicated that producing names by free recall was predicted by aphasic deficits, and that photo naming was predicted by visuoperceptual deficits. In Alzheimer's disease, free recall was predicted primarily by deficits in verbal new learning, consistent with amnesia, whereas photo naming was predicted by loss of general knowledge, consistent with dementia. The results are consistent with the idea that free recall of names from the past is a form of episodic memory, whereas naming of famous faces from the past is a form of semantic memory.
J Stroke Cerebrovasc Dis 2012 May
PMID:Retrograde memory in cerebrovascular disease and Alzheimer's disease. 2128 67


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