Thrombolytic Therapy in Acute Ischemic Stroke III

ISBN-13: 9784431701392 / Angielski / Miękka / 1996 / 357 str.

Takenori Yamaguchi; Etsuro Mori; Kazuo Minematsu

Opis

On the threshold of an exciting new era for acute stroke diagnosis and treatment, the Third International Symposium on Thrombolytic Therapy in Acute Ischemic Stroke was held in Nara, Japan, in April 1994. The symposium brought together some 200 basic and clinical scientists for presentations and discussions of issues vital to the understanding of thrombolytic therapy. This volume compiles the major presentations of the symposium, with attention to applications of new diagnostic measures such as diffusion and perfusion MRI, contrast-enhanced transcranial Doppler and angioscopy. Other presentations examine the mechanisms of ischemia/reperfusion injury, hemorrhagic transformation, and reocclusion, with reviews of recent developments in thrombolytic agents. The proceedings of the symposium will be of special interest to researchers, physicians, and students in the fields of neurology, neurosurgery, and nuclear medicine, as well as those in pharmacology, critical care medicine, and related fields.

Spis treści

Papers Presented.- Basic Understandings in Ischemia-Reperfusion and Neuronal Death.- Time Course of Leukocyte Influx Following Middle Cerebral Artery Occlusion in the Wistar Rat.- The Role of P-Selectin and ICAM-1 During Focal Brain Ischemia/Reperfusion.- Delayed Neuronal Death and Ischemic Tolerance.- Positron Emission Tomography in Patients with an Acute Embolic Occlusion of the Carotid Artery.- Discussion Summary.- Early Diagnosis and Patient Selection.- 1. Measures for Thrombolytic Therapy.- Early Findings of Computed Tomography and Angiography in Acute Stroke and Thrombolytic Therapy.- Role of Extracranial Ultrasound and Angioscopy in Thrombolytic Therapy.- Transcranial Contrast-Enhanced Color-Flow Imaging.- Value of Single Photon Emission Computed Tomography in Acute Stroke Therapeutic Trials.- Correlation of SPECT with Angiography in Early Ischemic Stroke.- New MR Technologies for Diagnosis of Acute Ischemic Stroke: MR Angiography, Diffusion, and Perfusion Imaging.- Discussion Summary.- 2. Early Clinical Diagnosis of Acute Ischemic Stroke.- Behavioral Syndromes in Early Right Middle Cerebral Artery Territory Stroke.- Symptoms and Signs in Early Vertebrobasilar Territory Stroke.- Natural History of Acute Stroke.- Subtypes of Infarction and Their Differentiation: Relevance to Thrombolytic Therapy and Early Randomization.- Discussion Summary.- Strategies for Acute Ischemic Stroke Treatment.- Applications of Diffusion-Weighted Magnetic Resonance Imaging for Stroke Diagnosis and Treatment.- Strategies of Early Patient Recruitment: A Community-Based Study.- Neuro-Intensive Care Units and Management of Acute Stroke Patients: Benefits and Limitations.- Brain-Oriented Intensive Care: Standardization of Postresuscitation Therapy.- Statistical Problems in Stroke Trials.- Meta-Analysis of Data from Trials of Thrombolytic Therapy in Acute Ischemic Stroke.- Discussion Summary.- Future in Thrombolytic Therapy: New Thrombolytic Agents and Combination Therapies.- Thrombolytic Therapy in Acute Ischemic Stroke: Combination Therapy with Antiplatelet and Anticoagulant Agents.- Combination Therapy with Cytoprotective Agents.- New Thrombolytic Agents: Basic Development.- Discussion Summary.- Results and Progress in Clinical Trials of Thrombolytic Therapy.- Thrombolytic Therapy in Acute Thrombotic/Thromboembolic Stroke (TTATTS).- The NINDS t-PA Stroke Trial: Progress Report.- Is Thrombolysis Useful for Acute Stroke Patients? The Experience of the MAST-I Study.- The Multicenter Acute Stroke Trial (MAST)—Thrombolysis Study: Study Design and Progress Report.- Australian Streptokinase Trial: Progress Report.- European Cooperative Acute Stroke Study: Trial Protocol.- Clinical Efficacy and Safety of Intravenous Tissue Plasminogen Activator in Acute Embolic Stroke: A Randomized, Double-Blind, Dose-Comparison Study of Duteplase.- Discussion Summary.- Unresolved Problems.- 1. Recanalization and Hemorrhage.- Delayed Recanalization and Reocclusion Following Thrombolysis for Acute Stroke.- Intracranial Hemorrhage in Association with Thrombolysis: Multiple Causes and Risk Factors (No Simple Answer).- Mechanisms of Fibrinolysis-Associated Hemorrhagic Transformation.- Discussion Summary.- 2. Which Route is Best?.- Plasminogen Plus rt-PA Improves Intraarterial Thrombolytic Therapy in Acute Ischemic Stroke.- Intraarterial Therapy in Acute Ischemic Stroke.- Intravenous Thrombolytic Therapy for Acute Ischemic Stroke.- Interventional Neurovascular Techniques in Acute Thrombolytic Therapy for Stroke.- “Central” Intraarterial Thrombolysis Using a Newly Developed Low Friction Guidewire/Catheter System.- Discussion Summary.- Free Communications.- Microvascular Leukocyte Plugging in Evolving Brain Infarction in Humans.- Recombinant Tissue Plasminogen Activator and Mutant rt-PA: Binding Kinetics and Cytotoxicity on Brain Endothelial Cells—Relevance to Brain Hemorrhage.- Reperfusion in Patients with the “Spectacular Shrinking Deficit” Demonstrated by 99mTc-hexamethylpropyleneamine Oxime Single Photon Emission Computed Tomography.- Reliability of the Barthel Index Outcome Measure Selected for the NINDS t-PA Stroke Trial.- Acute Local Fibrinolysis for Embolic Middle Cerebral Artery Occlusion Using Recombinant Tissue Type Plasminogen Activator.- Intracarotid Recombinant Tissue Plasminogen Activator in Acute Carotid Artery Territory Stroke.- Thrombolytic Therapy of Basilar Artery Occlusion: Preconditions for Recanalization and Good Clinical Outcome.- Discussion Summary.