Neurovascular disorders articles within Nature Reviews Neurology

Featured

  • Review Article |

    Overall survival rates for traumatic brain injury have improved, but affected individuals often experience persistent and debilitating long-term complications. In this Review, the authors discuss recent evidence for the role of spreading depolarization in the initiation of long-term pathology in traumatic brain injury, including effects on blood–brain barrier dysfunction and neuroinflammation.

    • Gerben van Hameren
    • , Refat Aboghazleh
    •  & Alon Friedman

  • Review Article |

    In this Review, the authors give an overview of the genetics of common small vessel disease, and provide insights into causal genes and the biological pathways involved, the overlap with monogenic small vessel disease, and the therapeutic implications of these factors.

    • Constance Bordes
    • , Muralidharan Sargurupremraj
    •  & Stéphanie Debette

  • Review Article |

    Cerebral small vessel disease (SVD) is associated with highly heterogeneous clinical symptoms. This Review considers how new advances in structural and functional neuroimaging have revealed ways in which focal lesions can affect remote brain regions and lead to global dysfunction, resulting in the variable presentation of SVD.

    • Annemieke ter Telgte
    • , Esther M. C. van Leijsen
    •  & Frank-Erik de Leeuw

  • Review Article |

    The epidemiology, risk factors, causes, treatment and outcomes of intracerebral haemorrhage (ICH) in young adults (aged ∼18–50 years) can differ markedly from those in elderly patients with ICH. Challenges in this setting include high early mortality and long-term mortality as well as long-term disability and ICH recurrence in survivors.

    • Turgut Tatlisumak
    • , Brett Cucchiara
    •  & Jukka Putaala

  • Review Article |

    PET is a versatile imaging technique that is advancing our understanding of cerebrovascular disease and intracerebral pathophysiology. In this Review, Evans and colleagues describe mechanistic insights from PET studies relating to the metabolic pathophysiology of carotid atherosclerosis, salvageable penumbra after stroke, and neuroinflammatory changes associated with small vessel disease and vascular cognitive impairment.

    • Nicholas R. Evans
    • , Jason M. Tarkin
    •  & Elizabeth A. Warburton

  • Review Article |

    Cerebral venous thrombosis (CVT) is a prominent cause of stroke, particularly in young adults. Knowledge of this condition has greatly increased in the past two decades, primarily owing to new data from international patient registries. This Review provides an overview of the epidemiology, pathophysiology, diagnosis and treatment of CVT, with a focus on new advances in the field.

    • Suzanne M. Silvis
    • , Diana Aguiar de Sousa
    •  & Jonathan M Coutinho

  • News & Views |

    In patients with acute ischaemic stroke resulting from anterior circulation occlusion, endovascular therapy provides greater long-term benefits than does intravenous tissue plasminogen activator. However, further improvement of systems of care and research regarding adjunct therapies is still needed.

    • Charlotte Zerna
    •  & Mayank Goyal

  • News & Views |

    Two studies have shown no added benefit of intravenous thrombolysis in patients with acute stroke who are treated with mechanical thrombectomy. We review the importance and interpretation of these findings, compare them to the current guidelines on stroke thrombectomy, and discuss how these studies can change our daily clinical practice.

    • Elad I. Levy
    •  & Maxim Mokin

  • Review Article |

    Unruptured intracranial aneurysms (UIAs) have a prevalence of 3% in the adult population. Currently, there is a large variability in how patients with UIAs are managed. Here, the authors review the latest human data on the formation, progression and rupture of intracranial aneurysms, as well the risks associated with preventive treatment.

    • Nima Etminan
    •  & Gabriel J. Rinkel

  • Opinion |

    Drawing on data from social network studies, Dhand and colleagues suggest that focusing on a patient's personal network can help identify individuals at risk of poor health outcomes. The authors provide an overview of the terminology used in social network studies, discuss social network structures that put patients at risk, and suggest how social network research might be applied in the neurology clinic.

    • Amar Dhand
    • , Douglas A. Luke
    •  & Jin-Moo Lee

  • Review Article |

    Drawing on data from the Global Burden of Disease 2013 Study, Feigin and colleagues highlight the increasing global stroke burden, which indicates deficiencies in current primary prevention strategies. The authors present a four-point plan to improve primary stroke prevention, which includes a shift in emphasis from a high-risk approach to a more comprehensive approach that targets people at all levels of cardiovascular disease risk.

    • Valery L. Feigin
    • , Bo Norrving
    •  & George A. Mensah

  • Review Article |

    In addition to the functional impairments that can arise after stroke, about one-third of stroke survivors experience neuropsychiatric disorders such as depression, anxiety or apathy. In this Review, Ferro and colleagues provide an update on the diagnosis and pathophysiology of the acute and long-term psychiatric consequences of stroke, and discuss available treatments and management strategies for these stroke-associated disorders.

    • José M. Ferro
    • , Lara Caeiro
    •  & Maria Luísa Figueira

  • News & Views |

    Prognostic scoring systems are widely used as objective outcome predictors in neurocritical care, for example, after haemorrhagic stroke. A new study, however, has unexpectedly shown that clinicians can predict outcome after intracerebral haemorrhage more accurately than do formal scoring scales.

    • Daniel F. Hanley Jr

  • News & Views |

    The detection of an unruptured intracranial aneurysm poses a dilemma for the patient and the physician: an aneurysm rupture is a catastrophic event, but preventive repair is not without risks. The recently updated AHA/ASA guidelines provide some foundation for decision-making by summarizing the available evidence, but several clinically relevant questions remain uncertain.

    • Nima Etminan
    •  & Gabriel J. E. Rinkel

  • Review Article |

    Vascular parkinsonism can result from a variety of vascular disorders, and most frequently manifests as an impairment of gait known as lower body parkinsonism. In this Review, Amos Korczyn summarizes the current understanding of clinical and pathogenetic aspects of vascular parkinsonism, including knowledge gained from neuroimaging, and considers current and future therapy for this condition. He also considers whether similarities between vascular parkinsonism and Binswanger disease mean that they should be considered as manifestations of the same pathology.

    • Amos D. Korczyn

  • News & Views |

    A long-term outcome analysis in patients with lacunar stroke enrolled in the Secondary Prevention of Small Subcortical Strokes trial highlights the relevance of functional disability after small-vessel strokes. These data support the emerging 'burden of disease' concept in individuals with cerebral microangiopathy, and the role of MRI in outcome prediction.

    • Natalia S. Rost

  • Review Article |

    Neuroinflammation during critical phases of brain development can increase the risk of neurological and neuropsychiatric disorders, even in adulthood. In this Review, Hagberg et al. review the mechanisms through which inflammation can exacerbate perinatal brain injury, and outline how understanding the interplay between inflammation and brain injury can aid the identification of new strategies to alleviate neurological and neuropsychiatric morbidity.

    • Henrik Hagberg
    • , Carina Mallard
    •  & Pierre Gressens

  • Opinion |

    The neurovascular unit is a key concept in stroke medicine that for many years has been defined as the endothelial cells, neurons and glia surrounding cerebral capillaries. In this Perspectives article, the authors expand this concept to encompass more-distant circulation, smooth muscle cells and perivascular innervation. This 'neural vascular network' in turn points to new strategies for stroke therapy.

    • John H. Zhang
    • , Jerome Badaut
    •  & William J. Pearce

  • Review Article |

    The immune response is increasingly recognised as a complex modulator of outcome after acute stroke. Chamorro and colleagues review key players of the innate and adaptive immune systems that are activated following brain ischaemia, and discuss stroke-induced immunodepression and the associated increased risk of infection in patients with stroke.

    • Ángel Chamorro
    • , Andreas Meisel
    •  & Roland Veltkamp

  • News & Views |

    A new study suggests that lesion volume assessed within 72 h of stroke onset is an important independent predictor of 90-day functional outcome and neurological recovery. If used in stroke trials, outcome models including stroke volume, age and NIH Stroke Scale scores could increase power for detecting treatment effect.

    • Christian Weimar

  • Review Article |

    Anticoagulant therapy aims to prevent recurrent ischaemic stroke and venous thromboembolism; however, anticoagulant drugs currently in use or in trials have limitations. In this article, Graeme Hankey provides an update of the clinical data on the safety and efficacy of anticoagulant therapies, and discusses the clinical implications and future directions.

    • Graeme J. Hankey

  • News & Views |

    Spinal angiography has historically been associated with a high risk of complications, but up-to-date safety reports are lacking. A recent retrospective review found a low complication rate of catheter angiography of the spine, and suggests that MRI performs poorly as an alternative approach to the diagnosis of spinal vascular disorders.

    • Michael C. Hurley
    •  & Timothy J. Carroll

  • Review Article |

    Cases of postural tachycardia syndrome (PoTS) have been described dating back to the 19thcentury; however, the condition remains poorly understood, and the diagnosis is not readily made. Mathias and colleagues provide a comprehensive Review detailing the characteristics and possible pathophysiological mechanisms of PoTS, as well as investigation and treatment.

    • Christopher J. Mathias
    • , David A. Low
    •  & Rodney Grahame

  • News & Views |

    Clazosentan—a drug previously demonstrated to reduce angiographic vasospasm in patients with aneurysmal subarachnoid hemorrhage—had no significant effect on vasospasm-related morbidity and mortality in the CONSCIOUS-2 trial. A multifactorial cause for delayed ischemic neurological deficits might partly account for these negative findings.

    • Philip M. Meyers
    •  & E. Sander Connolly Jr

  • News & Views |

    Accumulating evidence suggests that prestroke statin therapy could improve functional recovery following acute ischemic stroke. A recent meta-analysis of previous findings and a new study support this suggestion. These findings should, however, be interpreted with caution owing to possible publication bias favoring small studies with positive results.

    • Joshua Z. Willey
    •  & Mitchell S. V. Elkind

  • News & Views |

    Increased blood pressure is associated with poor outcomes in acute stroke, but studies assessing the use of antihypertensive agents have been inconclusive. The recent SCAST trial has found that the angiotensin receptor blocker candesartan does not benefit patients with acute stroke and elevated blood pressure, and might even be harmful.

    • Robert J. Wityk

  • Review Article |

    Thrombolysis was first shown to be effective for treating acute ischemic stroke around 15 years ago, but therapeutic uptake worldwide has been modest to date. Here, Donnan et al. outline the various strategies that are being explored to optimize the use of thrombolysis, including enhancement of thrombolytic efficacy, extension of the therapeutic time window, reduction in the risk of intracerebral hemorrhage, and improvements in prehospital and in-hospital patient management.

    • Geoffrey A. Donnan
    • , Stephen M. Davis
    •  & David W. Howells

  • Review Article |

    Ischemic stroke is a major public health concern, and research to determine the underlying genetics of this disease is ongoing. Meschia and colleagues describe the single-gene disorders associated with stroke and progress in understanding the complex genetics of this condition, as well as discussing the relevance of pharmacogenomics and endophenotypes to stroke risk and treatment.

    • James F. Meschia
    • , Bradford B. Worrall
    •  & Stephen S. Rich

  • News & Views |

    Decisions regarding resumption of anticoagulation are difficult in patients who present with a warfarin-associated intracranial hemorrhage and also have atrial fibrillation or a prosthetic heart valve. Current guidelines suggest waiting 1–2 weeks on average, but new research suggests that the optimal time to restart anticoagulation could be much later.

    • Elisabeth B. Marsh
    •  & Rebecca F. Gottesman

  • Review Article |

    Dolichoectasia is a condition that causes dilatation and/or tortuosity of both intracranial and extracranial arteries. Intracranial dolichoectasia can be asymptomatic or manifest with compressive and/or vascular symptoms, such as cranial neuropathies or hemorrhagic stroke. In this article, Gutierrez et al. provide a review of the existing dolichoectasia literature and identify gaps in our knowledge to aid future research.

    • Jose Gutierrez
    • , Ralph L. Sacco
    •  & Clinton B. Wright

Browse broader subjects

Browse narrower subjects

Browse Neurovascular disorders across other nature.com journals