Neuroinflammation in Stroke

Neuroinflammation in Stroke
Author: Ulrich Dirnagl
Publisher: Springer Science & Business Media
Total Pages: 248
Release: 2013-04-17
Genre: Medical
ISBN: 3662054264

The successful treatment of acute stroke remains one of the major challenges in clinical medicine. Over the last decades, the understanding of stroke pathophysiology has greatly improved, while the therapeutic options in stroke therapy remain very limited. Today, hyperacute mechanisms of damage, such as excitotoxicity, can be discriminated from delayed ones, such as inflammation and apoptosis. Targeting of inflammation has already been successfully applied in various stroke models, but translation into a clinically efficacious strategy has not been achieved so far. In this book, leading experts in basic cerebrovascular research as well as stroke treatment review the current evidence for and against an important role for inflammation in stroke, and explore the potential of treating or modulating inflammation in stroke therapy.

Mechanisms of Neuroinflammation

Mechanisms of Neuroinflammation
Author: Gonzalo Emiliano Aranda Abreu
Publisher: BoD – Books on Demand
Total Pages: 320
Release: 2017-08-23
Genre: Medical
ISBN: 9535134515

"Mechanisms of Neuroinflammation" book explains how the neuronal cells become swollen at the moment of the blood-brain barrier disruption and how they lose their immunological isolation. A cascade of cytokines and immune cells from the bloodstream enters the nervous system, inflaming neurons and activating the glia. This produces a neuroinflammatory process that can generate different neurodegenerative diseases. Better understanding of mechanisms that are activated at the time when the damage to the brain occurs could lead to the development of suitable therapies that revert the neuronal inflammation and thus prevent further damage to the nervous system.

Neuroinflammation

Neuroinflammation
Author: Alireza Minagar
Publisher: Elsevier
Total Pages: 541
Release: 2010-12-17
Genre: Medical
ISBN: 0123849144

Inflammation is a central mechanism in many neurological diseases, including stroke, multiple sclerosis, and brain trauma as well as meningitis and contributes to the generation of pain. We are now beginning to understand the impact of the immune system on different nervous system functions and diseases, ranging from damage through tolerance to modulation and repair.This book discusses some of the more common neuro-inflammatory diseases. Topics covered include multiple sclerosis, optic neuritis and Susac syndrome. - Comprehensive review of the latest developments in neuroinflammation - Includes contributions from leading authorities

Textbook of Stroke Medicine

Textbook of Stroke Medicine
Author: Michael Brainin
Publisher: Cambridge University Press
Total Pages: 425
Release: 2014-09-11
Genre: Medical
ISBN: 1107047498

Fully revised throughout, the new edition of this concise textbook is aimed at doctors preparing to specialize in stroke care.

Prevention and Treatment of Ischemic Stroke

Prevention and Treatment of Ischemic Stroke
Author: Scott Eric Kasner
Publisher: Butterworth-Heinemann
Total Pages: 446
Release: 2004
Genre: Medical
ISBN: 9780750674645

This volume covers prevention and treatment options for both primary and secondary ischemic stroke; offers practical, scientific guidance on all aspects of patient care, including critical care management and rehabilitation; provides author recommendations where clinical answers are not yet clear; and discusses topics such as diagnostic evaluation of TIA and ischemic stroke, large vessel atherosclerosis, small vessel occlusive disease, ususual and cryptogenic etiologies of stroke, and emerging therapies.

Clinical Pathways in Stroke Rehabilitation

Clinical Pathways in Stroke Rehabilitation
Author: Thomas Platz
Publisher: Springer Nature
Total Pages: 284
Release: 2021-01-14
Genre: Medical
ISBN: 3030585050

This open access book focuses on practical clinical problems that are frequently encountered in stroke rehabilitation. Consequences of diseases, e.g. impairments and activity limitations, are addressed in rehabilitation with the overall goal to reduce disability and promote participation. Based on the available best external evidence, clinical pathways are described for stroke rehabilitation bridging the gap between clinical evidence and clinical decision-making. The clinical pathways answer the questions which rehabilitation treatment options are beneficial to overcome specific impairment constellations and activity limitations and are well acceptable to stroke survivors, as well as when and in which settings to provide rehabilitation over the course of recovery post stroke. Each chapter starts with a description of the clinical problem encountered. This is followed by a systematic, but concise review of the evidence (RCTs, systematic reviews and meta-analyses) that is relevant for clinical decision-making, and comments on assessment, therapy (training, technology, medication), and the use of technical aids as appropriate. Based on these summaries, clinical algorithms / pathways are provided and the main clinical-decision situations are portrayed. The book is invaluable for all neurorehabilitation team members, clinicians, nurses, and therapists in neurology, physical medicine and rehabilitation, and related fields. It is a World Federation for NeuroRehabilitation (WFNR) educational initiative, bridging the gap between the rapidly expanding clinical research in stroke rehabilitation and clinical practice across societies and continents. It can be used for both clinical decision-making for individuals and as well as clinical background knowledge for stroke rehabilitation service development initiatives.

Rodent Models of Stroke

Rodent Models of Stroke
Author: Ulrich Dirnagl
Publisher: Humana Press
Total Pages: 0
Release: 2010-07-08
Genre: Medical
ISBN: 9781607617495

In view of the numerous failures of clinical trials aimed at improving stroke therapy, the role and potential benefit of experimentally modeling focal cerebral ischemia in rodents has been debated. When methods of systematic review and metaanalyis are applied, however, it turns out that experimental models actually faithfully predicted the negative outcomes of clinical trials. In addition, thrombolysis and neuroprotection by hypothermia, first described in animal models, are key examples of treatment modalities that have made it successfully into clinical practice. In Rodent Models of Stroke, an international consortium of authors aims at critically addressing the issues on a very practical level, from choosing the model and outcome measures, designing the experiment, conducting and analyzing it, to reporting it in a scientific publication. The structure and content of the book reflect both the authors’ longstanding expertise in experimental and clinical stroke research and their roles in training the scientific community in the tools of the trade. As a volume in the successful Neuromethods series, the chapters provide authoritative reviews of the most commonly used, well-honed approaches in the field today. Stimulating and easy-to-use, Rodent Models of Stroke will help its readers understand the limitations and the opportunities of modeling stroke in rodents and enable them to conduct experiments which will not only improve our understanding of the pathophysiology of this devastating disorder but also serve as the basis for developing new highly effective treatments.

Precision Medicine in Stroke

Precision Medicine in Stroke
Author: Ana Catarina Fonseca
Publisher: Springer
Total Pages: 0
Release: 2022-05-06
Genre: Medical
ISBN: 9783030707637

This book provides a comprehensive coverage of the state of the art in precision medicine in stroke. It starts by explaining and giving general information about precision medicine. Current applications in different strokes types (ischemic, haemorrhagic) are presented from diagnosis to treatment. In addition, ongoing research in the field (early stroke diagnosis and estimation of prognosis) is extensively discussed. The final part provides an in-depth discussion of how different interdisciplinary areas like artificial intelligence, molecular biology and genetics are contributing to this area. Precision Medicine in Stroke provides a practical approach to each chapter, reinforcing clinical applications and presenting clinical cases. This book is intended for all clinicians that interact with stroke patients (neurologists, internal medicine doctors, general practitioners, neurosurgeons), students and basic researchers.

Neuroinflammation as a Target for Intervention in Subarachnoid Hemorrhage

Neuroinflammation as a Target for Intervention in Subarachnoid Hemorrhage
Author: Fernando Testai
Publisher: Frontiers Media SA
Total Pages: 88
Release: 2020-01-10
Genre:
ISBN: 2889633039

Aneurysmal subarachnoid hemorrhage (SAH) is a stroke subtype that affects, preponderantly, young adults. This condition carries a mortality of approximately 30-50% and a rate of permanent neurological disability of 30%. In addition, a substantial number of patients with an apparent good outcome suffer from residual neurocognitive impairment which, though subtle, prevents them from returning to work and having a normal life. Based on these data, it has been estimated that SAH is responsible for almost a quarter of all the years lost because of stroke. The calcium channel blocker nimodipine remains the only pharmacological treatment for SAH. This drug, however, has limited effectiveness and its use in clinical practice may be limited due to hypotension. Therefore, novel and effective treatments for this condition are desperately needed. The outcome in SAH has been associated with early brain injury, vasospasm, and delayed cerebral ischemia. Mechanistically, these processes are characterized by micro- and macro-vascular dysfunction, microthrombi formation, blood-brain barrier (BBB) dysregulation, brain edema, and neural-cell survival. Soon after SAH, there is a robust inflammatory response characterized by pyrexia, leukocytosis, and upregulation of adhesion molecules and cytokines in the periphery and in the CNS. Observational studies have shown that patients with more severe inflammatory responses experience worse outcomes after SAH. At the molecular level, different proinflammatory intracellular signaling pathways, including mitogen-activated protein-kinase and nuclear factor kappa-β, are activated in cerebral vessels after experimental SAH and their inhibition has been shown to decrease the occurrence of vasospasm. In addition, clinical and preclinical data have linked cytokine upregulation (interleukins [IL]-1B, IL-6 and IL-8, tumor necrosis factor-α, and monocyte chemoattractant protein-1), enhanced expression of adhesion molecules (selectins, integrins, and ICAM), and neutrophil activation to vasospasm of large cerebral arteries, microvascular dysregulation, and cell death. Moreover, immune cells regulate hemostasis and secrete active proteases, including matrix metalloproteinase 9, which promote microthrombosis and induce blood brain barrier dysfunction, respectively. In this context, it has been suggested that an enhanced inflammatory burden might contribute to brain injury in SAH through numerous downstream mechanisms. On the other hand, growing evidence demonstrates that neuroinflammation may influence the proliferation and migration of progenitor cells that participate of synaptic plasticity, neurogenesis, and neurorepair.

Mechanisms of Neuroinflammation and Inflammatory Neurodegeneration in Acute Brain Injury

Mechanisms of Neuroinflammation and Inflammatory Neurodegeneration in Acute Brain Injury
Author: Arthur Liesz
Publisher: Frontiers Media SA
Total Pages: 286
Release: 2015-11-13
Genre: Neurosciences. Biological psychiatry. Neuropsychiatry
ISBN: 2889196917

Mechanisms of brain-immune interactions became a cutting-edge topic in systemic neurosciences over the past years. Acute lesions of the brain parenchyma, particularly, induce a profound and highly complex neuroinflammatory reaction with similar mechanistic properties between differing disease paradigms like ischemic stroke, intracerebral hemorrhage (ICH) and traumatic brain injury (TBI). Resident microglial cells sense tissue damage and initiate inflammation, activation of the endothelial brain-immune interface promotes recruitment of systemic immune cells to the brain and systemic humoral immune mediators (e.g. complements and cytokines) enter the brain through the damaged blood-brain barrier. These cellular and humoral constituents of the neuroinflammatory reaction to brain injury contribute substantially to secondary brain damage and neurodegeneration. Diverse inflammatory cascades such as pro-inflammatory cytokine secretion of invading leukocytes and direct cell-cell-contact cytotoxicity between lymphocytes and neurons have been demonstrated to mediate the inflammatory ‘collateral damage’ in models of acute brain injury. Besides mediating neuronal cell loss and degeneration, secondary inflammatory mechanisms also contribute to functional modulation of neurons and the impact of post-lesional neuroinflammation can even be detected on the behavioral level. The contribution of several specific immune cell subpopulations to the complex orchestration of secondary neuroinflammation has been revealed just recently. However, the differential vulnerability of specific neuronal cell types and the molecular mechanisms of inflammatory neurodegeneration are still elusive. Furthermore, we are only on the verge of characterizing the control of long-term recovery and neuronal plasticity after brain damage by inflammatory pathways. Yet, a more detailed but also comprehensive understanding of the multifaceted interaction of these two supersystems is of direct translational relevance. Immunotherapeutic strategies currently shift to the center of translational research in acute CNS lesion since all clinical trials investigating direct neuroprotective therapies failed. To advance our knowledge on brain-immune communications after brain damage an interdisciplinary approach covered by cellular neuroscience as well as neuroimmunology, brain imaging and behavioral sciences is crucial to thoroughly depict the intricate mechanisms.