NEUROVASCULAR PROGRESS IN THE DAWN OF THE 21ST CENTURY

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Vol. 87 No. 1 (2009): Issue Jan 2009

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Ibtissem Ben Hamouda
Service de Neurologie EPS Charles Nicolle Tunis
Amel Mrabet
Service de Neurologie EPS Charles Nicolle Tunis

Abstract

Aim : Background: Development on progress in cerebral vascular pathology.
Method : Research on PubMed concerning advances on Neurovascular diseases during the last twenty years.
Results : Stroke incidence and prevalence have shown an increase for a few years. High blood pressure (HBP) is well the main risk factor; the implication of tabagism, even passive, and of hormone substitutive therapy were also proven. Vascular and cellular mechanisms are implied in cerebral ischemia. The definition of transient ischemic attack (TIA) is currently based on a lesion criterion, conveying the emergency concept. The physiological rise in blood pressure on stroke early phase must be respected for the majority of patients. Progress of radiological explorations revolutionized stroke’s care. Biological markers at the early stage of stroke are under development. New causes of stroke are reported. Stroke Units reduced the morbi-mortality by 50%. The treatment profited from solid clinical trials data and is now more effective. Physical rehabilitation benefitted from new movement and balance evaluation technologies and neuroplasticity concept, for better adapting the patient’s rehabilitation.
Conclusion : Neuro-vascular research knew a formidable renewed interest during two last decades. Stroke constitutes today a major public health’s stake. It is important to organize the stroke channel’s care in order to shorten hospitalization’delay, not to harm and carry out urgent clinical and paraclinic expertise for optimal therapeutic choice.

Keywords:

Stroke, transient ischemic attack, cerebral haemorrhage, cerebral infarct, physiopathology, imagery, biological marker, Stroke Unit, prevention, rehabilitation

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