Skip to main content
SpringerLink
Log in

Cerebrovascular Interactions in Cerebral Disorders (Stroke, Transient Ischaemic Attacks, Microvascular Disease, Migraine)

  • Chapter
  • First Online:
Arterial Disorders

  • 1377 Accesses

Abstract

The complexity of the interaction between the blood and brain is well known since the hemato-encephalic barrier (BEE) was firstly described. Most of the neurological diseases lead to BEE disruption. In this chapter, we will focus the attention on the neurological deficits due to vascular impairment.

In particular we will analyse the clinical manifestation, pathogenic mechanisms and therapy of stroke, transient ischaemic attack (TIA), microvascular disease and migraine.

Stroke and TIA are the most frequent neurological diseases. Stroke is the third leading cause of death and the first cause of disability in western countries. TIA is a risk factor for stroke development and might be considered itself a microscopic stroke.

Small-vessel diseases are the first cause of vascular dementia and may also play a role in neurodegenerative diseases.

Finally migraine, a common benign neurological disease, represents a good example of the interaction between arterial cells (endothelial and blood cells) and neurons.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 149.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    A headache occurring after aura may sometimes be of non-migrainous semiology or even absent (aura without headache). Aura may sometimes occur during the headache.

References

  1. Mohr JP, Wolf PA, Grotta JC et al (2011) Stroke: pathophysiology, diagnosis, and management, 5th edn. Elsevier, Philadelphia

    Google Scholar 

  2. Bamford J, Sandercock P, Dennis M et al (1991) Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 337:1521–1526

    Article  CAS  PubMed  Google Scholar 

  3. Fernandes PM, Whiteley WN, Hart SR et al (2013) Strokes: mimics and chameleons. Pract Neurol 13(1):21–28. doi:10.1136/practneurol-2012-000465

    Article  PubMed  Google Scholar 

  4. Eilaghi A, d'Esterre CD, Lee TY et al (2014) Toward patient-tailored perfusion thresholds for prediction of stroke outcome. AJNR Am J Neuroradiol 35:472–477

    Article  CAS  PubMed  Google Scholar 

  5. Powers WJ, Grubb RL, Darriet D et al (1985) Cerebral blood flow and cerebral metabolic rate of oxygen requirements for cerebral function and viability in humans. J Cereb Blood Flow Metab 5:600–608

    Article  CAS  PubMed  Google Scholar 

  6. Brouns R, De Deyn PP (2009) The complexity of neurobiological processes in acute ischemic stroke. Clin Neurol Neurosurg 111(6):483–495

    Article  CAS  PubMed  Google Scholar 

  7. Goldstein LB (2007) Contemporary reviews in cardiovascular medicine acute ischemic stroke treatment in 2007. Circulation 116:1504–1514

    Article  PubMed  Google Scholar 

  8. Jaunch EC, Saver JL, Adams HPJ et al (2013) Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44:870–947

    Article  Google Scholar 

  9. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group (1995) Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 333:1581–1588

    Article  Google Scholar 

  10. Hill MD, Lye T, Moss H et al (2003) Hemi-orolingual angioedema and ACE inhibition after alteplase treatment of stroke. Neurology 60:1525–1527

    Article  CAS  PubMed  Google Scholar 

  11. Külkens S, Hacke W (2007) Thrombolysis with alteplase for acute ischemic stroke: review of SITS-MOST and other phase IV studies. Expert Rev Neurother 7(7):783–788

    Article  PubMed  Google Scholar 

  12. Hacke W M.D., Kaste M M.D., Bluhmki E et al (2008) Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 359:1317–1329

    Article  CAS  PubMed  Google Scholar 

  13. Chimowitz MI (2013) Endovascular treatment for acute ischemic stroke — still unproven. N Engl J Med 368:952–955

    Article  CAS  PubMed  Google Scholar 

  14. Rønning OM, Guldvog B (1998) Stroke unit versus general medical wards, II: neurological deficits and activities of daily living: a quasi-randomized controlled trial. Stroke 29:586–590

    Article  PubMed  Google Scholar 

  15. Gilligan AK, Thrift AG, Sturm JW et al (2005) Stroke units, tissue plasminogen activator, aspirin and neuroprotection: which stroke intervention could provide the greatest community benefit? Cerebrovasc Dis 20:239–244

    Article  CAS  PubMed  Google Scholar 

  16. Xian Y, Holloway RG, Chan PS et al (2011) Association between stroke center hospitalization for acute ischemic stroke and mortality. JAMA 305:373–380

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Stroke Unit Trialists’ Collaboration (2007) Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev (4):CD000197

    Google Scholar 

  18. CAST (Chinese Acute Stroke Trial) Collaborative Group (1997) CAST: randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. Lancet 349:1641–1649

    Article  Google Scholar 

  19. International Stroke Trial Collaborative Group (1997) The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet 349:1569–1581

    Article  Google Scholar 

  20. Pantoni L (2010) Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol 9(7):689–701

    Article  PubMed  Google Scholar 

  21. Bullmore E, Sporns O (2012) The economy of brain network organization. Nat Rev Neurosci 13(5):336–349

    CAS  PubMed  Google Scholar 

  22. van der Flier WM, van Straaten EC, Barkhof F et al (2005) Small vessel disease and general cognitive function in nondisabled elderly: the LADIS study. Stroke 36:2116–2120

    Article  PubMed  Google Scholar 

  23. Sudlow CLM, Warlow CP (1997) Comparable studies of the incidence of stroke and its pathological types. Results from an international collaboration. Stroke 28:491–499

    Article  CAS  PubMed  Google Scholar 

  24. Greenberg SM, Nandigam RN, Delgado P et al (2009) Microbleeds versus macrobleeds: evidence for distinct entities. Stroke 40:2382–2386

    Article  PubMed Central  PubMed  Google Scholar 

  25. Pantoni L, Garcia JH, Gutierrez JA (1996) Cerebral white matter is highly vulnerable to ischemia. Stroke 27:1641–1647

    Article  CAS  PubMed  Google Scholar 

  26. Fisher CM (1965) Lacunes: small, deep cerebral infarcts. Neurology 15:774–784

    Article  CAS  PubMed  Google Scholar 

  27. Boiten J, Lodder J (1991) Lacunar infarcts. Pathogenesis and validity of the clinical syndromes. Stroke 22:1374–1378

    Article  CAS  PubMed  Google Scholar 

  28. Hawkins BT, Davis TP (2005) The blood-brain barrier/neurovascular unit in health and disease. Pharmacol Rev 57(2):173–185

    Article  CAS  PubMed  Google Scholar 

  29. Cocho D, Belvís R, Martí-Fàbregas J et al (2006) Does thrombolysis benefit patients with lacunar syndrome? Eur Neurol 55:70–73

    Article  PubMed  Google Scholar 

  30. Amarenco P, Benavente O, Goldstein LB, SPARCL Investigators et al (2009) Results of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial by stroke subtypes. Stroke 40:1405–1409

    Article  CAS  PubMed  Google Scholar 

  31. The SPS3 Investigators (2012) Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N Engl J Med 367:817–825

    Article  PubMed Central  Google Scholar 

  32. Headache Classification Committee of the International Headache Society (2013) The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 33:629–808

    Article  Google Scholar 

  33. Bhaskar S, Saeidi K, Borhani P et al (2013) Recent progress in migraine pathophysiology: role of cortical spreading depression and magnetic resonance imaging. Eur J Neurosci 38:3540–3551

    Article  PubMed  Google Scholar 

  34. Noseda R, Burstein R (2013) Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, CSD, sensitization and modulation of pain. Pain 154(Suppl 1):S44–S53

    Article  CAS  PubMed  Google Scholar 

  35. Goadsby PJ, Charbit AR, Andreou AP et al (2009) Neurobiology of migraine. Neuroscience 161:327–341

    Article  CAS  PubMed  Google Scholar 

  36. Olesen J, Burstein R, Ashina M et al (2009) Origin of pain in migraine: evidence for peripheral sensitisation. Lancet Neurol 8:679–690

    Article  PubMed  Google Scholar 

  37. Bell IM (2014) Calcitonin gene-related peptide receptor antagonists: new therapeutic agents for migraine. J Med Chem 57:7838–7858

    Article  CAS  PubMed  Google Scholar 

  38. Tfelt-Hansen P, Olesen J (2011) Possible site of action of CGRP antagonists in migraine. Cephalalgia 31:748–750

    Article  PubMed  Google Scholar 

  39. Edvinsson L, Tfelt-Hansen P (2008) The blood–brain barrier in migraine treatment. Cephalalgia 28:1245–1258

    Article  CAS  PubMed  Google Scholar 

  40. Ferrari M, Roon K, Lipton R, Goadsby P (2001) Oral triptans (serotonin 5-HT1B/1D agonists) in acute migraine treatment: a meta-analysis of 53 trials. Lancet 358:1668–1675

    Article  CAS  PubMed  Google Scholar 

  41. Loder E, Burch R, Rizzoli P (2012) The 2012 AHS/AAN Guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. Headache 52:930–945

    Article  PubMed  Google Scholar 

  42. Lampl C, Katsarava Z, Diener HC, Limmroth V (2005) Lamotrigine reduces migraine aura and migraine attacks in patients with migraine with aura. J Neurol Neurosurg Psychiatry 76:1730–1732

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurology and Stroke Unit, A.O Niguarda Ca’ Granda Milano, Piazza dell’Ospedale Maggiore 3, Milan, 20162, Italy

    Elio Clemente Agostoni & Marco Longoni

Authors
  1. Elio Clemente Agostoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marco Longoni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Longoni .

Editor information

Editors and Affiliations

  1. American University of Beirut Medical Center, Beirut, Lebanon

    Adel Berbari

  2. University of Milano Bicocca IRCCS Istituto Auxologico Italiano, Milan, Italy

    Giuseppe Mancia

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Agostoni, E.C., Longoni, M. (2015). Cerebrovascular Interactions in Cerebral Disorders (Stroke, Transient Ischaemic Attacks, Microvascular Disease, Migraine). In: Berbari, A., Mancia, G. (eds) Arterial Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-14556-3_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-14556-3_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14555-6

  • Online ISBN: 978-3-319-14556-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation