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International Review of Psychiatry... Oct 2017Cardio-vascular diseases (CVDs) and CVD-related disorders (including cerebrovascular diseases; CBVDs) are a major public health concern as they represent the leading... (Review)
Review
Cardio-vascular diseases (CVDs) and CVD-related disorders (including cerebrovascular diseases; CBVDs) are a major public health concern as they represent the leading cause of mortality and morbidity in developed countries. Patients with CVDs and CBVDs co-morbid with mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD), suffer reduced quality-of-life and significant disability adjusted for years of life and mortality. The relationship between CVDs/CBVDs and mood disorders is likely to be bidirectional. Evidence for shared genetic risk of pathways involved in stress reaction, serotonin or dopamine signalling, circadian rhythms, and energy balance was reported in genome-wide association studies. There is some evidence of a neuroprotective effect of various antidepressants, which may be boosted by physical exercise, especially by aerobic ones. Patients with CVDs/CBVDs should be routinely attentively evaluated for the presence of mood disorders, with tools aimed at detecting both symptoms of depression and of hypomania/mania. Behavioural lifestyle interventions targeting nutrition and exercise, coping strategies, and attitudes towards health should be routinely provided to patients with mood disorders, to prevent the risk of CVDs/CBVDs. A narrative review of the evidence is herein provided, focusing on pharmacological and physical therapy interventions.
Topics: Cerebrovascular Disorders; Comorbidity; Exercise; Humans; Mood Disorders; Neurobiology; Psychopharmacology
PubMed: 28681620
DOI: 10.1080/09540261.2017.1299695 -
British Journal of Neurosurgery Oct 2021Cerebrovascular disorders represent a group of uncommon, heterogeneous, and complex conditions in children. We reviewed the screening practice for the detection of...
Cerebrovascular disorders represent a group of uncommon, heterogeneous, and complex conditions in children. We reviewed the screening practice for the detection of cerebrovascular disorder in asymptomatic children referred to our neurovascular service on the basis of a positive family history and parental and/or treating physician concern. Retrospective case-note review of referrals to our neurovascular service (July 2008-April 2018). Patients were included if the referral was made for screening, on the basis of a positive family history of cerebrovascular disorder. Symptomatic children, those with previous cranial imaging, or children under the care of a clinical geneticist (i.e. due to the child or their relative having HHT or mutations in KRIT1) were not eligible for inclusion. Forty-one children were reviewed, 22 males (Median age 10.7 years, range 0.6-15.6 years). This represented 22% of the total number of referrals over a 10-year period. Twenty-nine children had an MRI/MRA brain. Twenty-eight children were referred due to a family history of intracranial aneurysm and/or subarachnoid haemorrhage, but only two had two first-degree relatives affected. Ten children were referred due to a family history of arteriovenous malformation. Three children were referred due to a family history of stroke. No cerebrovascular disease was detected during the study period ( = 29). Parental and/or physician concern generated a substantial number of referrals but no pathology was detected after screening. Whilst general screening guidance exists for the detection of intracranial aneurysms, consensus guidelines for the screening of children with a positive family history do not, but are required both to guide clinical practice and to assuage parental and/or physician concerns.
Topics: Adolescent; Child; Child, Preschool; Humans; Infant; Intracranial Aneurysm; Male; Mass Screening; Retrospective Studies; Stroke; Subarachnoid Hemorrhage
PubMed: 34169790
DOI: 10.1080/02688697.2021.1922607 -
Mayo Clinic Proceedings Feb 2006Cerebrovascular disease is an important cause of cognitive Impairment and dementia in elderly patients. This review highlights the challenges involved in examining the... (Review)
Review
Cerebrovascular disease is an important cause of cognitive Impairment and dementia in elderly patients. This review highlights the challenges involved in examining the role of cerebrovascular disease In dementia, areas in which consensus is emerging, and an operational framework for clinicians. Two important challenges exist. First, there is no accepted neuropathologic scheme for quantitating cerebrovascular disease In cognitive disturbances. Second, agreement on clinical definitions of vascular dementia is incomplete. Despite the barriers posed by these 2 deficiencies, many consistencies in the clinical, imaging, epidemiological, and neuropathologic aspects of cerebrovascular disease and cognitive impairment have been Identified. Different levels of cerebrovascular disease related to cognitive impairment can be suggested on clinical and Imaging grounds. The overlap between cerebrovascular disease and Alzheimer disease produces a disorder that might be amenable to therapeutic approaches based on either mechanism.
Topics: Age Factors; Alzheimer Disease; Cerebrovascular Disorders; Dementia, Vascular; Diagnosis, Differential; Humans; Prognosis; Risk Factors
PubMed: 16471078
DOI: 10.4065/81.2.223 -
Current Hypertension Reports Aug 2015Preeclampsia is a hypertensive, multisystem disorder of pregnancy that affects several organ systems, including the maternal brain. Cerebrovascular dysfunction during... (Review)
Review
Preeclampsia is a hypertensive, multisystem disorder of pregnancy that affects several organ systems, including the maternal brain. Cerebrovascular dysfunction during preeclampsia can lead to cerebral edema, seizures, stroke, and potentially maternal mortality. This review will discuss the effects of preeclampsia on the cerebrovasculature that may adversely affect the maternal brain, including cerebral blood flow (CBF) autoregulation and blood-brain barrier disruption and the resultant clinical outcomes including posterior reversible encephalopathy syndrome (PRES) and maternal stroke. Potential long-term cognitive outcomes of preeclampsia and the role of the cerebrovasculature are also reviewed.
Topics: Animals; Blood-Brain Barrier; Cerebrovascular Disorders; Cognition; Female; Humans; Pre-Eclampsia; Pregnancy; Stroke; White Matter
PubMed: 26126779
DOI: 10.1007/s11906-015-0575-8 -
The British Journal of Psychiatry : the... Feb 1989Depression appears to be common after stroke, and therefore may have a bearing upon rehabilitation. To examine whether the depression is due to a specific brain lesion,...
Depression appears to be common after stroke, and therefore may have a bearing upon rehabilitation. To examine whether the depression is due to a specific brain lesion, or is reactive to the consequent disability, this study looked at the frequency and associations of depressed mood in a stroke rehabilitation unit in-patient population, unselected for site of lesion. Depression affected 50% of the patients; history of previous psychiatric disorder and cerebrovascular accident appeared to be important risk factors. There were hemispheric differences in the relationships between measures, with both the site-of-lesion and reactive viewpoints being upheld.
Topics: Brain; Cerebrovascular Disorders; Disabled Persons; Female; Humans; Male; Middle Aged; Mood Disorders; Time Factors
PubMed: 2528388
DOI: 10.1192/bjp.154.2.195 -
Circulation Research Feb 2017Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder... (Review)
Review
Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration. Vascular brain injury results in loss of structural and functional connectivity and, hence, compromise of functional networks within the brain. Vascular cognitive impairment is common both after stroke and in stroke-free individuals presenting to dementia clinics, and vascular pathology frequently coexists with neurodegenerative pathology, resulting in mixed forms of mild cognitive impairment or dementia. Vascular dementia is now recognized as the second most common form of dementia after Alzheimer's disease, and there is increasing awareness that targeting vascular risk may help to prevent dementia, even of the Alzheimer type. Recent advances in neuroimaging, neuropathology, epidemiology, and genetics have led to a deeper understanding of how vascular disease affects cognition. These new findings provide an opportunity for the present reappraisal of vascular cognitive impairment. We further briefly address current therapeutic concepts.
Topics: Brain; Cerebrovascular Disorders; Cognition Disorders; Dementia, Vascular; Humans; Risk Factors
PubMed: 28154105
DOI: 10.1161/CIRCRESAHA.116.308426 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2021In the International Classification of Diseases 11th revision in the section «Diseases of the nervous system», it is proposed to distinguish «Cerebrovascular disorder...
In the International Classification of Diseases 11th revision in the section «Diseases of the nervous system», it is proposed to distinguish «Cerebrovascular disorder with neurocognitive impairment», which corresponds to both discirculatory encephalopathy (DEP) or chronic cerebral ischemia (CCI) accepted in our country, and also vascular cognitive impairments. The terminology, prevalence, risk factors and pathological basis of the disease are discussed, in particular multiple infarctions, strategic infarctions, cerebral small vessel disease, specific microangiopathies, intracerebral hemorrhage and global hypoperfusion. Post-stroke cognitive impairments are discussed in detail. The article presents relevant data on the pathogenesis of the disease, highlights the issues of clinical and neuroimaging diagnostics. Based on the data presented in the article, we can conclude that the diagnosis of DEP, CCI should be based on the presence of cerebrovascular disease with neurocognitive impairment, which implies the verification of vascular cognitive impairments and reliable neuroimaging signs of cerebrovascular pathology while excluding other causes. Early diagnosis and effective treatment of cerebrovascular disease with neurocognitive impairment (DEP, CCI) is becoming increasingly important, since treatment can slow the progression of the disease and lead to a decrease in the incidence of stroke and dementia.
Topics: Brain; Cerebrovascular Disorders; Dementia, Vascular; Humans; Neuroimaging; Stroke
PubMed: 34693700
DOI: 10.17116/jnevro2021121091121 -
Mayo Clinic Proceedings Jan 2005Physicians must be able to recognize stroke caused by a mendelian or mitochondrial disorder. Some genetic disorders such as sickle cell anemia and Fabry disease have... (Review)
Review
Physicians must be able to recognize stroke caused by a mendelian or mitochondrial disorder. Some genetic disorders such as sickle cell anemia and Fabry disease have proven disease-specific treatments, whereas others have no effective treatment, including cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Proper diagnosis of a genetic disorder has prognostic value and prevents patient exposure to unnecessary and potentially harmful therapeutic agents and diagnostic tests. This article reviews the clinical and genetic features of some mendellan and mitochondrial disorders associated with ischemic stroke, hemorrhagic stroke, and cerebrovascular malformations.
Topics: Acidosis, Lactic; Anemia, Sickle Cell; CADASIL; Cerebrovascular Disorders; Fabry Disease; Humans; Intracranial Arteriovenous Malformations; Mitochondrial Encephalomyopathies; Stroke
PubMed: 15667040
DOI: 10.1016/S0025-6196(11)62969-8 -
The Lancet. Neurology Jun 2013Movement disorders can occur as primary (idiopathic) or genetic disease, as a manifestation of an underlying neurodegenerative disorder, or secondary to a wide range of... (Review)
Review
Movement disorders can occur as primary (idiopathic) or genetic disease, as a manifestation of an underlying neurodegenerative disorder, or secondary to a wide range of neurological or systemic diseases. Cerebrovascular diseases represent up to 22% of secondary movement disorders, and involuntary movements develop after 1-4% of strokes. Post-stroke movement disorders can manifest in parkinsonism or a wide range of hyperkinetic movement disorders including chorea, ballism, athetosis, dystonia, tremor, myoclonus, stereotypies, and akathisia. Some of these disorders occur immediately after acute stroke, whereas others can develop later, and yet others represent delayed-onset progressive movement disorders. These movement disorders have been encountered in patients with ischaemic and haemorrhagic strokes, subarachnoid haemorrhage, cerebrovascular malformations, and dural arteriovenous fistula affecting the basal ganglia, their connections, or both.
Topics: Animals; Basal Ganglia; Cerebrovascular Disorders; Humans; Movement Disorders
PubMed: 23602779
DOI: 10.1016/S1474-4422(13)70057-7 -
TheScientificWorldJournal 2014Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD) is the most... (Review)
Review
Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD) is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.
Topics: Auditory Diseases, Central; Cerebrovascular Disorders; Hallucinations; Health Services Needs and Demand; Humans; Quality of Life
PubMed: 25401133
DOI: 10.1155/2014/261824