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22 results

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Cerebral Small Vessel Disease
  • Edited by Leonardo Pantoni, Philip B. Gorelick
  • Published online:
    05 June 2014
    Print publication:
    01 May 2014
  • Small vessel disease is an important frontier in neurology; about 25% of strokes are classified as small vessel, and SVD is the most common cause of vascular cognitive impairment. The risk of developing SVD increases with age, making this a growing concern for countries with aging populations. Despite this, there has been a paucity of information about its causes, diagnosis, prevention and treatment. This volume brings together contributions from leading international experts in the field and discusses pathogenesis, pathophysiology, clinical and radiologic manifestations, prevention and treatment modalities, and future directions for research and practice. Genetic forms of SVD are discussed, as well as the rapid development of neuroimaging techniques as tools for screening and treatment. This authoritative book is essential reading for neurologists, stroke physicians, geriatricians, and interventional neuroradiologists, as well as researchers in the fields of aging and dementia.

  • 48 - CALCIUM, HYPERCALCEMIA, MAGNESIUM, AND BRAIN ISCHEMIA

  • from PART V: - SYSTEMIC DISORDERS THAT ALSO INVOLVE THE CEREBROVASCULAR SYSTEM
  • Edited by Louis R. Caplan, Julien Bogousslavsky
  • Book:
    Uncommon Causes of Stroke
    Published online:
    06 January 2010
    Print publication:
    09 October 2008, pp 357-364

  • Summary

    This chapter reviews the role of calcium and magnesium in causing and ameliorating brain ischemia, respectively. Three different effects of hypercalcemia are posited to contribute to the development and severity of brain ischemia: (i) hypercalcemia stimulates vascular smooth muscle causing vasoconstriction; (ii) increased calcium concentrations enhance platelet aggregation and activate the body's intrinsic coagulation system; and (iii) calcium entry into cells, a process enhanced by an elevated extracellular-to-intracellular calcium ion gradient, causes cytotoxic effects that promote cell death and brain infarction. The rationale for the use of calcium antagonists in the prevention or treatment of secondary brain ischemia was based on the assumption that these drugs reduce the frequency of vasospasm by counteracting the influx of calcium into vascular smooth muscle cells. There is some benefit from the use of the dihydropyridine CCA nimodipine for improving outcome after aneurysmal subarachnoid hemorrhage.

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