The natural history of intracranial arterial stenoses remains relatively unknown. To monitor the progression of these lesions over time, the authors reviewed transcranial Doppler (TCD) laboratory reports at five hospitals for patients with angiographically documented intracranial arterial stenoses along the internal carotid artery distribution, and at least two TCD studies conducted more than 2 months apart. Twenty-two patients (19 men and 3 women; mean age, 64 years) with 29 stenoses were identified. The findings were compared to reproducibility data obtained from 11 age-matched control subjects with repeat TCD studies. During a mean follow-up period of 21 months, peak systolic flow velocities corresponding to the areas of stenosis increased in 9 arteries with lesions, and new collateral flow patterns, indicating further hemodynamic compromise distal to the lesions, developed in 2; one of the latter also had increased corresponding velocities. Thus, 10 (35%) arteries with lesions had TCD evidence of progression. Flow velocities remained the same in 13 (45%) stenotic vessels and dropped in 2 (7%). Findings were considered inconclusive for 4 lesions (14%). These findings suggest that intracranial arterial stenoses are dynamic lesions, and that they can evolve and cause further reductions of the arterial diameters after relatively short periods of time. TCD can noninvasively detect their hemodynamic effects.
The National Heart, Lung, and Blood Institute (NHLBI) convened a conference call working group, consisting of experts in stroke and cerebrovascular biology on January 28, 2005. The purpose of this working group was to develop a prioritized set of recommendations for NHLBI to establish a focused and comprehensive set of research activities in cerebrovascular biology and disease. Three thematic areas of research emerged: (1) molecular and cellular neurobiology of cerebral blood vessels, focusing on genomics and proteomics, neurovascular signaling and cerebrovascular embryogenesis, development and plasticity; (2) resource development, involving the development of new methodological approaches for normal and altered function of the neurovascular unit, collaborative research, and training in cerebrovascular pathobiology; and (3) cerebrovascular diseases and translational approaches, addressing vascular mechanisms of disease, the role of risk factors, importance of biomarkers with the ultimate goal of developing new treatments.
Letters1 April 1991Recreational Drug Use and StrokeMichael A. Sloan, MD, Steven J. Kittner, MD, MPH, Steven R. Levine, MDMichael A. Sloan, MDSearch for more papers by this author, Steven J. Kittner, MD, MPHSearch for more papers by this author, Steven R. Levine, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-7-605_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors: Kaku and Lowenstein (1) recently reported that the estimated relative risk for stroke among young recreational drug users compared with nondrug users was 6.5 overall and was 11.2 in patients less than 35 years of age. These figures are striking, particularly when they are compared with the relative risk for stroke associated with nonvalvular atrial fibrillation and hypertension in older adults. This case-control study is an important contribution to the literature. We would like to mention several points that future research in this area should consider.Because the prevalence of drug use may vary widely among different...References1. KakuLowenstein DD. Emergence of recreational drug use as a major risk factor for stroke in young adults. Ann Intern Med. 1990;113:821-7. LinkGoogle Scholar2. SchlesselmanStolley JP. Sources of bias. In: Schlesselman JJ, ed. Case Control Studies: Design, Conduct, Analysis. New York: Oxford University Press; 1982;124-43. Google Scholar3. EurmanPotashEylerPaganussiBeute DHWPG. Chest pain and dyspnea related to "crack" cocaine smoking: value of chest radiography. Radiology. 1989;172:459-62. CrossrefMedlineGoogle Scholar4. LevineBrustFutrell SJN. Cerebrovascular complications of the use of the "crack" form of alkaloidal cocaine. N Engl J Med. 1990;323:699-704. CrossrefMedlineGoogle Scholar5. SloanKittnerRigamontiPrice MSDT. Incidence of stroke associated with use/abuse of drugs. Neurology. 1990;40(Suppl):325. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Michael A. Sloan, MD; Steven J. Kittner, MD, MPH; Steven R. Levine, MD PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byStrokeCardiovascular Complications of Cocaine Abuse 1 April 1991Volume 114, Issue 7Page: 605-605KeywordsAddictsAtrial fibrillationDrugsElderlyForecastingHypertensionRecreational drug useRelative riskRisk managementStroke ePublished: 1 December 2008 Issue Published: 1 April 1991 PDF downloadLoading ...
2007;49;126-170 J. Am. Coll. Cardiol. H. Stein, Cynthia M. Tracy, Robert A. Vogel, and Deborah J. Wesley Lindner, Gerald M. Pohost, Richard S. Schofield, Samuel J. Shubrooks, JR, James Eisenberg, Cindy L. Grines, Mark A. Hlatky, Robert C. Lichtenberg, Jonathan R. Harrington, Jonathan Abrams, Jeffrey L. Anderson, Eric R. Bates, Mark J. Rundback, Robert D. Safian, Michael A. Sloan, Christopher J. White, Robert A. William A. Gray, Kenneth Ouriel, Eric D. Peterson, Kenneth Rosenfield, John H. Donald E. Casey, Jr, Christopher U. Cates, Gary R. Duckwiler, Ted E. Feldman, Biology, Society of Interventional Radiology, Eric R. Bates, Joseph D. Babb, Cardiovascular Angiography and Interventions, Society for Vascular Medicine and American Society of Interventional & Therapeutic Neuroradiology, Society for Committee on Carotid Stenting) (ACCF/SCAI/SVMB/SIR/ASITN Clinical Expert Consensus Document Task Force on Clinical Expert Consensus Documents Carotid Stenting: A Report of the American College of Cardiology Foundation ACCF/SCAI/SVMB/SIR/ASITN 2007 Clinical Expert Consensus Document on This information is current as of January 4, 2011 http://content.onlinejacc.org/cgi/content/full/49/1/126 located on the World Wide Web at: The online version of this article, along with updated information and services, is
