Current opinion in neurology
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Curr. Opin. Neurol. · Jun 2010
ReviewMechanisms of cerebral edema in traumatic brain injury: therapeutic developments.
Although a number of factors contribute to the high mortality and morbidity associated with traumatic brain injury (TBI), the development of cerebral edema with brain swelling remains the most significant predictor of outcome. The present review summarizes the most recent advances in the understanding of mechanisms associated with development of posttraumatic cerebral edema, and highlights areas of therapeutic promise. ⋯ Attenuating blood-brain barrier permeability has become a promising approach to managing brain edema and associated swelling given that increases in cranial water content can only be derived from the vasculature. Inflammation, both classical and neurogenic, offers a number of attractive targets.
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Chronic migraine is a common cause of chronic daily headache, which is often refractory to standard treatment. New research has increased our understanding of this disorder and its treatment. This review focuses on recent clinical trials and advances in our understanding of migraine pathophysiology. ⋯ This review explains advances in the treatment of chronic migraine, a common disorder seen in neurological practice. These new advances in preventive treatment and a better understanding of its risk factors will allow clinicians to better identify individuals at greatest risk and prevent the development of chronic migraine.
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The purpose of this study is to focus on recent advances in understanding of the genetic and epidemiologic risk factors, development, modeling, and prevention of epilepsy after traumatic brain injury (TBI). ⋯ These observations provide small but encouraging steps towards a better understanding of the mechanisms of posttraumatic epileptogenesis, which is a key to developing a cure for this condition.
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Experimental and clinical studies have suggested that epileptic seizures can be modulated or interrupted by electrical stimulations of subcortical structures that may exert a remote control on seizure generators. The aim of this review is to present these recent reports and to address the perspectives of this approach. ⋯ New directions for studies are proposed for a better understanding of the mechanisms of action of this treatment.
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Curr. Opin. Neurol. · Feb 2010
ReviewReperfusion for acute ischemic stroke: arterial revascularization and collateral therapeutics.
Reperfusion of the ischemic territory forms the basis of most acute stroke treatments. This overview of the literature relating to reperfusion in acute ischemic stroke published within the last year provides a snapshot of a rapidly evolving aspect of cerebrovascular disease. ⋯ These timely findings illustrate the essential role of reperfusion in acute stroke, delineating aspects of arterial revascularization and collateral therapeutics to be refined in coming years.