Stroke in Blacks: A Guide to Management and Prevention

Contents......Page 5
Foreword......Page 8
Preface......Page 11
Introduction and Overview Commentary......Page 13
Conclusions......Page 16
References......Page 17
StrokeMechanisms and Subtypes......Page 19
Racial Differences in the Distribution and Severity of Atherosclerosis Derived from Autopsy Studies......Page 21
Racial Differences Derived from Arterial Investigations Performed during Life......Page 23
Clinical Differences among Stroke Patients......Page 26
Possible Pathogenesis of the Racial Differences in the Distribution of Vascular Lesions......Page 27
References......Page 28
Brief History......Page 31
Risk Factors......Page 32
Presentation and Diagnosis......Page 34
Prognosis......Page 37
References......Page 38
Clinical Presentation and Diagnosis......Page 41
Incidence and Risk Factors......Page 42
Treatment......Page 44
Conclusion......Page 46
References......Page 47
Cerebral Embolic Stroke......Page 48
Procoagulant States......Page 55
References......Page 59
Clinical Assessment of Cerebrovascular Disease in African-Americans......Page 61
CT Imaging in Stroke......Page 62
MR Imaging in Stroke......Page 63
Radiological Evaluation in African-American Stroke Patients......Page 65
Social and Economic Issues......Page 67
Stroke Clinical Imaging Evaluation......Page 69
References......Page 72
Epidemiology......Page 74
Risk Factors......Page 75
Clinical Manifestations......Page 76
Prevention......Page 77
DiagnosticWork-Up......Page 78
Management......Page 79
References......Page 80
Epidemiology of Stroke in African Populations Outside of the United States......Page 82
Stroke Rates......Page 83
Gradient of Risk Factors......Page 85
Hypertension......Page 87
Obesity......Page 88
Diabetes......Page 89
Conclusions......Page 90
References......Page 91
Incidence......Page 95
Survivorship......Page 99
References......Page 101
Ethnic Differences in Cerebral Atherosclerosis......Page 106
Cerebrovascular Atherosclerosis in Stroke/TIA Populations......Page 107
Cerebrovascular Atherosclerosis in Asymptomatic Populations......Page 109
Discussion......Page 113
References......Page 115
Stroke Incidence, Comorbid Conditions, Health Care Utilization, and Poststroke Mortality in Black and White Medicare Beneficiaries......Page 118
Stroke Incidence......Page 119
Comorbid Conditions and Utilization of Health Care......Page 122
National Trends in PoststrokeMortality......Page 124
References......Page 127
Hypertension......Page 130
Noninsulin-Dependent Diabetes......Page 132
Cigarette Smoking......Page 133
Diet and the Prevention of Stroke and Hypertension......Page 134
Alcohol......Page 136
Community Prevention......Page 137
References......Page 138
Atrial Fibrillation, Heart Disease, and Ischemic Stroke in Blacks......Page 141
Atrial Fibrillation......Page 142
Coronary Heart Disease......Page 145
Valvular Heart Disease......Page 147
Implications for Clinical Practice......Page 148
Conclusion......Page 149
References......Page 150
Acute and Subacute Treatment following Ischemic Stroke: Neurological Perspective......Page 154
Prevention of Recurrent Stroke and Stroke after Transient Ischemic Attack (TIA)......Page 161
Conclusion......Page 163
References......Page 164
Rapid Identification and Treatment of Stroke in African-Americans......Page 168
Perspectives of Tissue Plasminogen Activator......Page 169
Early Treatment of Stroke: What Needs to Be in Place......Page 173
References......Page 178
Aspirin......Page 179
Ticlopidine......Page 182
Dipyridamole......Page 184
Warfarin......Page 185
References......Page 188
Overview......Page 192
Hypertension......Page 194
Cardiac Dysfunction......Page 195
Infections......Page 196
Seizures and Depression......Page 197
References......Page 198
Epidemiology......Page 200
Classification and Mechanism......Page 203
Clinical Features......Page 205
Treatment......Page 206
Closing Remarks......Page 207
References......Page 208
Stroke Rehabilitation in African-American Patients......Page 210
Functional Impact of Stroke and Measurement Instruments......Page 211
Rehabilitation and Poststroke Functional Recovery......Page 212
Rehabilitation and Poststroke Complications......Page 215
Delivery of Rehabilitative Services......Page 216
Use of Rehabilitation Services by Blacks......Page 217
References......Page 218
Overview......Page 222
DiagnosticWorkup......Page 223
Treatment......Page 225
Other Practical Considerations......Page 226
Conclusion......Page 227
References......Page 228
Future Research Directions......Page 229
Depression and Stroke......Page 230
Recruitment......Page 231
Retention and Culture......Page 233
Future Studies of Risk Factors and Prevention Strategies......Page 234
References......Page 235
Author Index......Page 237
Subject Index......Page 238