Authors: Larry B Goldstein

Topics: Cerebrovascular Disorders; Female; Humans; Incidence; Male; Prevalence; Risk Factors; Stroke

PubMed: 32078448
DOI: 10.1161/STROKEAHA.119.024159

Review

Authors: Rehan Aziz, David C Steffens

Although depression in old age is less common than depression in younger populations, it still affects more than 1 million community-living older adults. Depression in late life has been associated with reduced quality of life and increased mortality from both suicide and illness. Its causes are multifactorial but are prominently related to both biologic and social factors. Psychological factors, although less studied in elders, are also important in understanding its cause. In this article, multiple facets of late-life depression are reviewed, including its clinical presentation, epidemiology, and biopsychosocial causes.

Topics: Aged; Aging; Anxiety Disorders; Bereavement; Brain; Cerebrovascular Disorders; Chronic Disease; Comorbidity; Dementia; Depressive Disorder; Female; Humans; Life Change Events; Loneliness; Neuroticism; Population Dynamics; Recurrence; Risk Factors; Social Support; Stress, Psychological; Suicide

PubMed: 24229653
DOI: 10.1016/j.psc.2013.08.001

Authors: Craig S Anderson

Topics: Cerebrovascular Disorders; Endovascular Procedures; Humans; Immunosuppressive Agents; Mobile Health Units; Neurology; Thrombolytic Therapy

PubMed: 34350880
DOI: 10.1159/000518427

Review

Authors: Hidehiro Ishikawa, Akihiro Shindo, Akane Mizutani...

Vascular cognitive impairment (VCI) refers to all forms of cognitive disorder related to cerebrovascular diseases, including vascular mild cognitive impairment, post-stroke dementia, multi-infarct dementia, subcortical ischemic vascular dementia (SIVD), and mixed dementia. Among the causes of VCI, more attention has been paid to SIVD because the causative cerebral small vessel pathologies are frequently observed in elderly people and because the gradual progression of cognitive decline often mimics Alzheimer's disease. In most cases, small vessel diseases are accompanied by cerebral hypoperfusion. In mice, prolonged cerebral hypoperfusion is induced by bilateral carotid artery stenosis (BCAS) with surgically implanted metal micro-coils. This cerebral hypoperfusion BCAS model was proposed as a SIVD mouse model in 2004, and the spreading use of this mouse SIVD model has provided novel data regarding cognitive dysfunction and histological/genetic changes by cerebral hypoperfusion. Oxidative stress, microvascular injury, excitotoxicity, blood-brain barrier dysfunction, and secondary inflammation may be the main mechanisms of brain damage due to prolonged cerebral hypoperfusion, and some potential therapeutic targets for SIVD have been proposed by using transgenic mice or clinically used drugs in BCAS studies. This review article overviews findings from the studies that used this hypoperfused-SIVD mouse model, which were published between 2004 and 2021.

Topics: Humans; Mice; Animals; Aged; Carotid Stenosis; Dementia, Vascular; Cognitive Dysfunction; Cerebrovascular Disorders; Disease Models, Animal; Brain Ischemia; Mice, Inbred C57BL

PubMed: 36883344
DOI: 10.1177/0271678X231154597

Review

Authors: Jing Jin, Jian Duan, Leiya Du...

Intracranial aneurysm subarachnoid hemorrhage (SAH) is a cerebrovascular disorder associated with high overall mortality. Currently, the underlying mechanisms of pathological reaction after aneurysm rupture are still unclear, especially in the immune microenvironment, inflammation, and relevant signaling pathways. SAH-induced immune cell population alteration, immune inflammatory signaling pathway activation, and active substance generation are associated with pro-inflammatory cytokines, immunosuppression, and brain injury. Crosstalk between immune disorders and hyperactivation of inflammatory signals aggravated the devastating consequences of brain injury and cerebral vasospasm and increased the risk of infection. In this review, we discussed the role of inflammation and immune cell responses in the occurrence and development of aneurysm SAH, as well as the most relevant immune inflammatory signaling pathways [PI3K/Akt, extracellular signal-regulated kinase (ERK), hypoxia-inducible factor-1α (HIF-1α), STAT, SIRT, mammalian target of rapamycin (mTOR), NLRP3, TLR4/nuclear factor-κB (NF-κB), and Keap1/nuclear factor (erythroid-derived 2)-like 2 (Nrf2)/ARE cascades] and biomarkers in aneurysm SAH. In addition, we also summarized potential therapeutic drugs targeting the aneurysm SAH immune inflammatory responses, such as nimodipine, dexmedetomidine (DEX), fingolimod, and genomic variation-related aneurysm prophylactic agent sunitinib. The intervention of immune inflammatory responses and immune microenvironment significantly reduces the secondary brain injury, thereby improving the prognosis of patients admitted to SAH. Future studies should focus on exploring potential immune inflammatory mechanisms and developing additional therapeutic strategies for precise aneurysm SAH immune inflammatory regulation and genomic variants associated with aneurysm formation.

Topics: Humans; Subarachnoid Hemorrhage; Kelch-Like ECH-Associated Protein 1; Intracranial Aneurysm; Phosphatidylinositol 3-Kinases; NF-E2-Related Factor 2; Signal Transduction; Inflammation; Brain Injuries

PubMed: 36505409
DOI: 10.3389/fimmu.2022.1027756

Review

Authors: A L Ren, R J Digby, E J Needham...

Coronavirus Disease 2019 is predominantly a disorder of the respiratory system, but neurological complications have been recognised since early in the pandemic. The major pathophysiological processes leading to neurological damage in COVID-19 are cerebrovascular disease, immunologically mediated neurological disorders and the detrimental effects of critical illness on the nervous system. It is still unclear whether direct invasion of the nervous system by the Severe Acute Respiratory Syndrome Coronavirus 2 occurs; given the vast numbers of people infected at this point, this uncertainty suggests that nervous system infection is unlikely to represent a significant issue if it occurs at all. In this review, we explore what has been learnt about the neurological complications of COVID-19 over the course of the pandemic, and by which mechanisms these complications most commonly occur.

Topics: COVID-19; Cerebrovascular Disorders; Humans; Nervous System Diseases; Pandemics; SARS-CoV-2

PubMed: 33929617
DOI: 10.1007/s00415-021-10581-y

Review

Authors: Constantine E Kosmas, Maria D Bousvarou, Evangelia J Papakonstantinou...

The role of lipoprotein (a) [Lp(a)] in cerebrovascular disease is a topic of importance. In this narrative review, pertinent studies have been leveraged to comprehensively examine this relationship from diverse perspectives.Lp(a) shares structural traits with low-density lipoprotein cholesterol. Lp(a) is synthesized by hepatocytes, and its plasma levels are genetically determined by the LPA gene, which produces apolipoprotein (a).Numerous epidemiological studies have confirmed the positive correlation between elevated serum Lp(a) levels and the occurrence or recurrence of cerebrovascular events, especially ischemic strokes, in adults. It should be noted that the correlation strength varies among studies and is marginal in Mendelian randomization studies.Regarding pediatric patients, screening is currently limited to those with a relevant medical history. Lp(a) seems to play a significant role in the pathogenesis of arterial ischemic stroke in children because environmental thrombotic and atherogenic factors are generally not present.Phase 3 trials of novel Lp(a) targeting agents, such as pelacarsen and olpasiran, are anticipated to demonstrate their efficacy in reducing the incidence of stroke. Given the richness of the literature, new guidelines regarding Lp(a) screening and management in targeted populations are warranted to provide more effective primary and secondary prevention.

Topics: Humans; Lipoprotein(a); Cerebrovascular Disorders; Risk Factors

PubMed: 39082245
DOI: 10.1177/03000605241264182

Authors: Craig Anderson

Topics: Biomedical Research; COVID-19; Cerebrovascular Disorders; Coronavirus Infections; Editorial Policies; Humans; Pandemics; Periodicals as Topic; Pneumonia, Viral

PubMed: 32866957
DOI: 10.1159/000510781

Review

Authors: Jiajie Lu, Wei Liu, Hongru Zhao...

Headache is a common accompanying symptom of cerebrovascular diseases. The most common patterns of headache for different cerebrovascular disorders, aetiology and pathogenesis and diagnostic workup are reviewed with emphasis on distinguishing characteristics. It will be a clinical guide for physicians who treat patients with headache or cerebral vascular disease.

Topics: CADASIL; Cerebrovascular Circulation; Cerebrovascular Disorders; Headache; Hemodynamics; Humans; Intracranial Thrombosis; MELAS Syndrome; Prognosis; Risk Factors; Subarachnoid Hemorrhage; Vasculitis, Central Nervous System; Vasospasm, Intracranial; Vertebral Artery Dissection

PubMed: 32606088
DOI: 10.1136/svn-2020-000333

Review

Authors: S L Barnwell

A wide variety of diseases affecting the central nervous system and head and neck can be treated using interventional neuroradiologic techniques. These new treatments have depended on advances in radiologic imaging, catheter technology, and the development of new embolic agents. These procedures may be an adjunct to other therapy, palliative or curative. Diseases for which interventional neuroradiologic techniques have been major advances in treatment include cerebral aneurysms, vasospasm after subarachnoid hemorrhage, cerebral arteriovenous malformations, dural arteriovenous fistulas, dural sinus thrombosis, atherosclerosis, scalp arteriovenous fistulas, carotid-cavernous fistulas, and stroke. This field is rapidly evolving as advances are made in catheter technology and new embolic agents are developed.

Topics: Cerebral Angiography; Cerebrovascular Disorders; Humans; Radiography, Interventional

PubMed: 8434468
DOI: No ID Found