Updates on Prevention of Hemorrhagic and Lacunar Strokes / 대한뇌졸중학회지
Journal of Stroke
; : 167-179, 2018.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-714728
Biblioteca responsável:
WPRO
ABSTRACT
Intracerebral hemorrhage (ICH) and lacunar infarction (LI) are the major acute clinical manifestations of cerebral small vessel diseases (cSVDs). Hypertensive small vessel disease, cerebral amyloid angiopathy, and hereditary causes, such as Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), constitute the three common cSVD categories. Diagnosing the underlying vascular pathology in these patients is important because the risk and types of recurrent strokes show significant differences. Recent advances in our understanding of the cSVD-related radiological markers have improved our ability to stratify ICH risk in individual patients, which helps guide antithrombotic decisions. There are general good-practice measures for stroke prevention in patients with cSVD, such as optimal blood pressure and glycemic control, while individualized measures tailored for particular patients are often needed. Antithrombotic combinations and anticoagulants should be avoided in cSVD treatment, as they increase the risk of potentially fatal ICH without necessarily lowering LI risk in these patients. Even when indicated for a concurrent pathology, such as nonvalvular atrial fibrillation, nonpharmacological approaches should be considered in the presence of cSVD. More data are emerging regarding the presentation, clinical course, and diagnostic markers of hereditary cSVD, allowing accurate diagnosis, and therefore, guiding management of symptomatic patients. When suspicion for asymptomatic hereditary cSVD exists, the pros and cons of prescribing genetic testing should be discussed in detail in the absence of any curative treatment. Recent data regarding diagnosis, risk stratification, and specific preventive approaches for both sporadic and hereditary cSVDs are discussed in this review article.
Texto completo:
Disponível
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
/
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Objetivo 9: Redução de doenças não transmissíveis
/
Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis
/
Doença de Alzheimer e outras Demências
/
Doença Cardiovascular
/
Doença Cerebrovascular
/
Doenças do Sistema Endócrino
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Patologia
/
Fibrilação Atrial
/
Pressão Sanguínea
/
Hemorragia Cerebral
/
Testes Genéticos
/
Angiopatia Amiloide Cerebral
/
Acidente Vascular Cerebral
/
CADASIL
/
Diagnóstico
/
Doenças de Pequenos Vasos Cerebrais
Tipo de estudo:
Estudo diagnóstico
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of Stroke
Ano de publicação:
2018
Tipo de documento:
Artigo