Stroke - 5th Edition - ISBN: 9781416054788, 9781437737806


5th Edition

Pathophysiology, Diagnosis, and Management (Expert Consult - Online and Print)

Authors: J. Mohr James Grotta Philip Wolf Michael Moskowitz Marc Mayberg Rudiger Von Kummer
eBook ISBN: 9781437737806
Hardcover ISBN: 9781416054788
Imprint: Saunders
Published Date: 31st March 2011
Page Count: 1520

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First published in 1986 under the editorial direction of Dr. Henry J.M. Barnett, Stroke: Pathophysiology, Diagnosis, and Management continues to provide the dependable, current answers you need to effectively combat the increasing incidence of this disease. Dr. J.P. Mohr, together with new associate editors Philip A. Wolf, James C. Grotta, Michael A. Moskowitz, Marc Mayberg, and Rüdiger von Kummer as well as a multitude of expert contributors from around the world, offer you updated and expanded coverage of mechanisms of action of commonly used drugs, neuronal angiogenesis and stem cells, basic mechanisms of spasm and hemorrhage, prevention of stroke, genetics/predisposing risk factors, and much more, equipping you to understand the latest scientific discoveries and make effective use of the newest approaches to diagnosis and treatment. Plus, a new organization and new full-color images make diagnosis easier and more efficient, and full-text online access at allows you to rapidly search this indispensable reference from any computer.

Key Features

  • Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke.
  • Access the comprehensive, expert clinical guidance you need to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan.

Table of Contents

section one


Michael A. Moskowitz

Vascular Biology and Atherosclerosis of Cerebral Arteries 03

Alyson A. Miller, Christopher G. Sobey

The Cerebral Microvasculature and Responses to Ischemia 16

Gregory J. del Zoppo, Gerhard F. Hamann

Mechanisms of Thrombosis and Thrombolysis 29

Gregory J. del Zoppo, Mary A. Kalafut

Cerebral Blood Flow and Metabolism in Human Cerebrovascular Disease 44

Allyson R. Zazulia, Joanne Markham, William J. Powers

Histopathology of Cerebral Ischemia 68


Molecular and Cellular Mechanisms of Ischemia-Induced Neuronal Death 75

Dimitry Ofengeim, Takahiro Miyawaki, R. Suzanne Zukin

Apoptosis and Related Mechanisms in Cerebral Ischemia 107

Turgay Dalkara, Michael A. Moskowitz

Molecular Pathophysiology of White Matter Anoxic-Ischemic Injury 122

Bruce R. Ransom, Mark P. Goldberg, Selva Baltan

Cerebral Ischemia and Inflammation 138

Costantino Iadecola, Takato Abe, Alexander Kunz, John Hallenbeck

Intracellular Signaling: Mediators and Protective Responses 154

Valina L. Dawson, Ted M. Dawson

Enhancing Brain Reorganization and Recovery of Function after Stroke 162

Michael Chopp, Zheng Gang Zhang

Genetics and Vascular Biology of Brain Vascular Malformations 169

Helen Kim, Ludmila Pawlikowska, William L. Young

section two

Epidemiology and Prevention

Philip A. Wolf

Distribution of Stroke: Heterogeneity by Age, Race, and Sex 189

Virginia J. Howard, George Howard

Epidemiology of Stroke 198

Philip A. Wolf, William B. Kannel

Prognosis after Stroke 219

TATJANA Rundek, Ralph L. Sacco

16 Primary Prevention of Stroke 242

Larry B. Goldstein, Ralph L. Sacco

Vascular Dementia and Vascular Cognitive
Decline 252

Sudha Seshadri

18 Stroke Genetics 268

James F. Meschia, Daniel Woo

19 The Global Burden of Stroke 279

Kathleen Strong, Colin Mathers

section three

Clinical Manifestations

J.P. Mohr

Classification of Ischemic Stroke 293

Danilo Toni, Ralph L. Sacco, Michael Brainin, J.P. Mohr


Clinical Scales to Assess Patients with Stroke 307

Harold P. Adams, Jr.

Carotid Artery Disease 334

J.P. Mohr, Henning Mast

Anterior Cerebral Artery Disease 362

John C.M. Brust, Angel Chamorro


Middle Cerebral Artery Disease 384

J.P. Mohr, Ronald M. Lazar, Randolph S. Marshall

Posterior Cerebral Artery Disease 425

J.P. Mohr, Jeffrey R. Binder

Vertebrobasilar Disease 446

J.P. Mohr, Louis R. Caplan

Microangiopathies (Lacunes) 485

J.L. Martí-Vilalta, Adrià Arboix, J.P. Mohr

Cerebral Venous Thrombosis 516

José M. Ferro, Patrícia Canhão

Intracerebral Hemorrhage 531

Carlos S. Kase, Steven M. Greenberg, J.P. Mohr, Louis R. Caplan

Aneurysmal Subarachnoid Hemorrhage 589

Eric M. Bershad, José I. Suarez

Arteriovenous Malformations and Other Vascular Anomalies 616

Christian Stapf, J.P. Mohr, Andreas Hartmann,
Henning Mast, Alexander Khaw, Jae H. Choi,
John Pile-Spellman

32 Spinal Cord Ischemia 643

Joshua Z. Willey, Henry J.M. Barnett, J.P. Mohr

section four

Specific Medical Diseases and Stroke

J.P. Mohr

Arterial Dissections and Fibromuscular
Dysplasia 661

Richard M. Zweifler, Gerald Silverboard

Collagen Vascular and Infectious Diseases 687

Sachin Agarwal, J.P. Mohr, Mitchell S.V. Elkind

Moyamoya Disease 703

Masahiro Yasaka, Junichi Masuda, Jun Ogata, Takenori Yamaguchi

Migraine and Stroke 720

Hans C. Diener, Tobias Kurth

Hypertensive Encephalopathy 734

Catherine Lamy, Jean-Louis Mas

Atherosclerotic Disease of the Proximal Aorta 741

Marco R. Di Tullio, Shunichi Homma

CADASIL: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy 758

Hugues Chabriat, Anne Joutel, Elisabeth Tournier-Lasserve, Marie-Germaine Bousser

Reversible Cerebral Vasoconstriction
Syndromes 765

Aneesh B. Singhal, Anne Ducros

Coagulation Abnormalities in Stroke 772

Bruce M. Coull, Kendra Drake

Stroke and Substance Abuse 790

John C.M. Brust

Cardiac Diseases 814

David M. Greer, Shunichi Homma, Karen L. Furie

section five

Diagnostic Studies

Rüdiger von Kummer

Ultrasonography 831

Stephen Meairs, Michael Hennerici, J.P. Mohr

Computed Tomography–Based Evaluation of Cerebrovascular Disease 870

Imanuel Dzialowski, Volker Puetz, Rüdiger von Kummer

Magnetic Resonance Imaging of Cerebrovascular Diseases 882

Steven Warach, Alison E. Baird, Krishna A. Dani, Max Wintermark, Chelsea S. Kidwell

47 Cerebral Angiography 910

Ronald J. Sattenberg, Jeffrey L. Saver, Y. Pierre Gobin, David S. Liebeskind

section six


Part A: Medical Therapy

James C. Grotta

Prehospital and Emergency Department Care of the Patient with Acute Stroke 929

Opeolu Adeoye, Arthur Pancioli

Intravenous Thrombolysis 945

Wendy Brown, Lama Al-Khoury, Gilda Tafreshi, Patrick D. Lyden

Antithrombotic Therapy for Treatment of Acute Ischemic Stroke 971

Harold P. Adams, Jr., Patricia H. Davis

General Stroke Management and Stroke Units 992

Markku Kaste, Risto O. Roine

Critical Care of the Patient with Acute Stroke 1008

Jennifer Diedler, Marek Sykora, Werner Hacke

Pharmacologic Modification of Acute Cerebral Ischemia 1049

Nicole R. Gonzales, James C. Grotta

Treatment of "Other" Stroke Etiologies 1084

Scott E. Kasner, Brett L. Cucchiara

Medical Therapy of Intracerebral and
Intraventricular Hemorrhage 1106

Lewis B. Morgenstern, Darin B. Zahuranec

Rehabilitation and Recovery of the Patient with Stroke 1116

Bruce H. Dobkin

Enhancing Stroke Recovery with Cellular
Therapies 1134

Sean I. Savitz

Antiplatelet Therapy for Secondary Prevention of Stroke 1147

Mar Castellanos, Babette B. Weksler, Oscar R. Benavente

Secondary Prevention of Cardioembolic
Stroke 1173

Maria I. Aguilar, Oscar R. Benavente

Conduct of Stroke-Related Clinical Trials 1192

Barbara C. Tilley, Yuko Y. Palesch

Part B: Interventional Therapy

Rüdiger von Kummer

Interventional Neuroradiologic Therapy
of Atherosclerotic Disease and Vascular Malformations 1204

J Mocco, Stanley H. Kim, Bernard R. Bendok,
Alan S. Boulos, L. Nelson Hopkins, Elad I. Levy

Intraarterial Thrombolysis in Acute Ischemic
Stroke 1227

Anthony J. Furlan, Jitendra Sharma, Randall Higashida

Endovascular Treatment of Cerebral
Aneurysms 1241

Ajay K. Wakhloo, Matthew J. Gounis, Michael J. De Leo III

Interventional Therapy of Brain and Spinal Arteriovenous Malformations 1255

Timo Krings, Sasikhan Geibprasert, Karel ter Brugge

65 Dural Arteriovenous Malformations 1280

J. Paul Elliott, Daniel Huddle, Issam A. Awad

Part C: Surgical Therapy

Marc R. Mayberg

Genetics of Aneurysms and Arteriovenous Malformations 1292

Ynte M. Ruigrok, CATHARINA  J.M. Klijn

67 Anterior Circulation Aneurysms 1301

Brian V. Nahed, Christopher S. Ogilvy

Surgical Management of Posterior Circulation Aneurysms 1322

Mark J. Dannenbaum, Rose Du, Arthur L. Day

69 Surgery for Intracerebral Hemorrhage 1336

Alexander David Mendelow, BARBARA A. GREGSON

70 Intraventricular Hemorrhage 1349

J. Max Findlay

Surgical Decision Making, Techniques, and Periprocedural Care of Cerebral Arteriovenous Malformations 1358

Robert M. Starke, Ricardo J. Komotar, E. Sander Connolly

72 Spinal Arteriovenous Malformations 1366

Shervin R. Dashti, Louis J. Kim, Udaya K. Kakarla, Min S. Park, Michael F. Stiefel, Robert F. Spetzler

Radiosurgery for Arteriovenous
Malformations 1374

William A. Friedman, Frank J. Bova

Cerebral Cavernous Malformations and Venous Anomalies: Diagnosis, Natural History, and Clinical Management 1388

Christopher S. Eddleman, H. Hunt Batjer, Issam A. Awad

Indications for Carotid Endarterectomy in Patients with Symptomatic Stenosis 1398

Jonathan L. Brisman, Marc R. Mayberg

Surgical Management of Asymptomatic Carotid Stenosis 1403

Mohamed Samy Elhammady, Roberto C. Heros, Jacques J. Morcos

Extracranial to Intracranial Bypass for Cerebral Ischemia 1417

David W. Newell, Marcelo D. Vilela

78 Cerebral Infarction: Surgical Treatment 1426

Eric Jüttler, Werner Hacke

79 Cerebellar Infarction and Hemorrhage 1440

Tetsuyoshi Horiuchi, Kazuhiro Hongo, Shigeaki Kobayashi

Index 1447


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About the Author

J. Mohr

Affiliations and Expertise

Daniel Sciarra Professor of Neurology, Department of Neurology, Columbia University, New York, NY, USA.

James Grotta

Professor of Neurology, Chairman, Department of Neurology, University of Texas Medical School at Houston; Director, Stroke Program, Memorial Hermann - Texas Medical Center, Houston, TX

Affiliations and Expertise

Director, Stroke Program, Memorial Hermann - Texas Medical Center; Professor of Neurology; Chairman, Department of Neurology, University of Texas Medical School at Houston, Houston, TX, USA.

Philip Wolf

Affiliations and Expertise

Professor of Neurology, Medicine, and Public Health, Boston University School of Medicine; Principal Investigator, Framingham Heart Study, Boston, MA, USA.

Michael Moskowitz

Affiliations and Expertise

Professor of Neurology, Harvard-MIT Division of Health Science and Technology, Boston, MA, USA.

Marc Mayberg

Affiliations and Expertise

Executive Director, Seattle Neuroscience Institute at Swedish Medical Center, Seattle, WA, USA.

Rudiger Von Kummer

Affiliations and Expertise

Professor of Diagnostic Radiology/ Neuroradiology; Head, Department of Neuroradiology, Technische Universitat Dresden; Director, Dresden University Stroke Center, Dresden, Germany