Introduction Diabetes mellitus is a global health problem. About 350 million people worldwide are affected and this number is expected to increase by a staggering 50% in the next decade because of increases in the prevalence of obesity and inactivity…
Introduction Chronic hypertension is a known risk factor for acute ischemic as well as hemorrhagic strokes. There is an independent, graded relationship between the two, and hypertension is therefore aggressively treated in the outpatient environment in order to reduce future…
Introduction A significant overlap exists between cerebrovascular disease and cardiac disease. Cardiac disease is frequent in stroke patients, and cardiac abnormalities are also common following stroke. The most serious events include acute myocardial infarction (MI), heart failure, arrhythmias such as…
Introduction Cerebral ischemia, resulting in neuronal death, is seen in a wide range of conditions. Most often, it results from arterial occlusion secondary to thromboembolic or atherosclerotic diseases. Trauma is also a common cause of ischemic disease. In other instances,…
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Introduction Stroke is the fifth leading cause of death in the United States, resulting in greater than 125,000 deaths annually . Large brain infarctions are associated with edema and, in severe cases, shift of intracranial contents and elevation of intracranial…
Introduction Hypertensive encephalopathy is an acute syndrome characterized by acute hypertension (HTN) associated with various neurological symptoms and characteristic neuroimaging findings. The common clinical signs and symptoms of the condition include encephalopathy, seizures, headache, visual disturbances, and focal neurological deficits…
Physiological monitoring is the cornerstone of critical care; it allows for identifying hemodynamic instability and assessing response to therapy. Utility of most hemodynamic monitoring remains unproven and rather serves as a trigger for detection of cardiorespiratory instability. Some have argued…
Introduction Meticulous critical care is key to achieve the best possible outcome after stroke. There has been considerable evolution in our approach to critically ill patients over the recent years, including the establishment of standardized protocols that cover both general…
In 1996, the FDA approved the use of intravenous alteplase for the treatment of acute ischemic stroke after publication of the National Institute of Neurological Disorders and Stroke (NINDS) trial. There were five randomized controlled trials that laid the groundwork…