RESUMO
BACKGROUND: Works of art may serve as a source of evidence of diseases and help to better understand their natural history. SUMMARY: Bernardino da Fossa was a 15th-century Italian Franciscan friar who wrote sermons and historical works. He described the events of the Observance Reformation movement since its dawn, but the last chapter is unexplainably interrupted. This has been considered suggestive for an acute and disabling illness. A painting dating back 12 years after his death depicts Bernardino holding a crutch with his left arm. This may represent an important clue to establish a gait disturbance, whereas the permanent interruption in drafting his writing may be ascribed to a serious writing impairment. KEY MESSAGES: The historical detail of the writing suspension and the crutch in this painting represent important hints of the stroke suffered by Bernardino da Fossa.
Assuntos
Monges , Pinturas , Acidente Vascular Cerebral , Masculino , Humanos , Acidente Vascular Cerebral/história , Pinturas/história , Braço , MarchaAssuntos
Envelhecimento , Pesquisa Biomédica/história , Cardiologia/história , Doenças Cardiovasculares/história , Neurologia/história , Acidente Vascular Cerebral/história , Fatores Etários , Envelhecimento/genética , Envelhecimento/metabolismo , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , História do Século XX , História do Século XXI , Fatores de Risco , Acidente Vascular Cerebral/genética , Acidente Vascular Cerebral/metabolismo , Acidente Vascular Cerebral/fisiopatologiaRESUMO
Stroke is a principal cause of mortality in China and Japan. High systolic blood pressure (SBP) was considered a chief risk factor for stroke mortality. Herein, we evaluated temporal trends of high SBP-attributable stroke mortality in China and Japan between 1990 and 2017. Data on stroke mortality were retrieved from the Global Burden of Disease Study 2017 (GBD 2017). Using the age-period-cohort method, we computed overall net drifts, local drifts, longitudinal age curves, and cohort/period rate ratios (RRs) for high SBP-attributable stroke mortality. The age-standardized mortality rates (ASMRs) displayed decreasing trends for high SBP-attributable stroke mortality. The annual net drift values were - 1.4% and - 3.5% in Chinese men and women versus - 3.1% and - 4.9% in Japanese men and women. The local drift values in both countries were < 0 among all age groups but were lower in women than in men. The longitudinal age curves showed a greater high SBP-attributable stroke mortality in men than in women across all age groups. Similar decreasing patterns were shown in the period and cohort RRs in both sexes with women having a quicker decline than men. In China and Japan, the ASMRs, as well as the period and cohort RRs of high SBP-attributable stroke mortality, decreased between 1990 and 2017 in both sexes and across all age groups. Yet, the prevalence of high SBP remained worrisome in both countries. Thus, SBP control should be encouraged to prevent stroke mortality.
Assuntos
Hipertensão/epidemiologia , Acidente Vascular Cerebral/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , China/epidemiologia , Feminino , História do Século XX , História do Século XXI , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipertensão/história , Japão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Mortalidade/história , Mortalidade/tendências , Prevalência , Religião e Sexo , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/história , Acidente Vascular Cerebral/prevenção & controle , Adulto JovemRESUMO
This article describes the project that led Virchow to his discovery of cerebral embolism as a cause of stroke, made during the 1840s, at the beginning of his remarkable career. It includes comment on Virchow's statements on cerebral thrombosis and stroke.
Assuntos
Embolia Intracraniana/história , Médicos/história , Acidente Vascular Cerebral/história , História do Século XIX , Humanos , MasculinoRESUMO
Stroke of the cerebellum represents about 10% of strokes of the brain. Both infarction and hemorrhage manifest with symptoms related to the location and extent of the lesion(s). Bilateral cerebellar infarcts constitute up to one third of all cerebellar infarctions. The leading cause of cerebellar infarcts is emboli of cardiac origin or from intra-arterial sources. Potential complications include brainstem compression and hydrocephalus. Malignant cerebellar edema is a life-threatening complication of ischemic posterior circulation stroke requiring urgent management. The advent of MRI has revolutionized the early diagnosis in vivo, showing small and large territorial infarcts, hemorrhages, and venous infarcts. Endovascular procedures are growingly applied and are impacting on the prognosis of stroke, although cerebellar stroke from occlusion of small cerebellar arteries is currently not accessible to thrombectomy. Surgical procedures of space-occupying stroke include external ventricular drainage, suboccipital craniotomy, or combined procedures. In 1849, Robert Dunn (1799-1877), an English surgeon, reported the details of a case of apoplexy of the cerebellum in a 52-year-old man, pointing to the importance of post-mortem studies of patients followed meticulously during lifetime. Dunn discussed inflammation surrounding hemorrhage as a source of cerebral degeneration, linking for the first time cerebellar stroke, neuroinflammation, and atherosclerosis.
Assuntos
Doenças Cerebelares/história , Neurociências/história , Acidente Vascular Cerebral/história , Doenças Cerebelares/fisiopatologia , Inglaterra , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Acidente Vascular Cerebral/fisiopatologiaAssuntos
Atenção à Saúde/história , Neoplasias/história , Radioterapia (Especialidade)/história , Conflitos Armados/história , Institutos de Câncer , Educação Médica/história , Emigração e Imigração/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde , História do Século XX , História do Século XXI , História Antiga , História Medieval , Humanos , Iraque/epidemiologia , Masculino , Neoplasias/epidemiologia , Neoplasias/radioterapia , Radioterapia (Especialidade)/educação , Radioterapia (Especialidade)/instrumentação , Sociedades Médicas/história , Acidente Vascular Cerebral/históriaAssuntos
Arritmias Cardíacas/história , Pessoas Famosas , Ataque Isquêmico Transitório/história , Literatura Moderna/história , Acidente Vascular Cerebral/história , Arritmias Cardíacas/complicações , História do Século XIX , Humanos , Ataque Isquêmico Transitório/etiologia , Recidiva , Acidente Vascular Cerebral/etiologiaRESUMO
Even if Babinski (1914) is usually considered as the discoverer of anosognosia, other authors before him contributed to the development of this construct. Von Monakow (1885) and Dejerine and Vialet (1893) gave the first descriptions of patients with cortical blindness who were unaware of their disability, but did not distinguish this unawareness from the rest of the clinical description. Anton (1999) described patients with cortical deafness and cortical blindness, considering these defects of awareness as a symptom independent from the neurological dysfunction. He conceptualized them as a phenomenon in its own right and tried to link this unawareness of a disability with specific neuro-anatomical changes. Finally, Babinski (1914) coined the term "anosognosia" to designate the clinical entity conceptualized by Anton (1899) and extended this concept from the unawareness of cortical deafness and blindness to the unawareness of hemiplegia. The choice of the term "anosognosia" to denote the observed phenomenon was important, because referring to "lack of knowledge of the disease" (anosognosia), he not only emphasized the separation between "lack of knowledge" and "disease, " but also suggested a general use of this term, because disease can refer to many other disabilities besides hemiplegia. Further investigations have shown that: (a) brain-damaged patients may be unaware of different kinds of disabilities; (b) anosognosia can be selective, in that an affected person with multiple impairments may be unaware of only one handicap, while appearing fully aware of any others; and (c) lack of acknowledgment of a disease may not necessarily be due to a defective awareness, but must sometimes be considered as an extreme but understable pattern of adaptation to stress. For this condition, the term "Denial of Illness" seems preferable to that of anosognosia. Anosognosia must perhaps be viewed as a multifaceted phenomenon, resulting from both cognitive and motivational factors.
Assuntos
Agnosia/diagnóstico , Agnosia/história , Hemiplegia/história , Neurologia/história , Conscientização/fisiologia , Hemiplegia/diagnóstico , Hemiplegia/psicologia , História do Século XIX , História do Século XX , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/históriaAssuntos
Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/terapia , Tromboembolia/prevenção & controle , Tromboembolia/terapia , Cardiologia/história , História do Século XX , Humanos , Publicações Periódicas como Assunto , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/história , Tromboembolia/complicações , Tromboembolia/históriaAssuntos
Acidentes por Quedas/história , Pessoas Famosas , Fraturas da Coluna Vertebral/história , Acidente Vascular Cerebral/história , Vértebras Torácicas/lesões , História do Século XX , Humanos , Masculino , Fraturas da Coluna Vertebral/complicações , Acidente Vascular Cerebral/etiologia , Reino UnidoRESUMO
Adolphe Gubler (1821-1879) is a typical example of a 19th century hospital physician in Paris. Head of a medical unit at Beaujon hospital in 1855, he was nominated to the treatment and pharmacognosia Chair in 1868. He trained many students who became his disciples and remained very close to him. Gubler published prolifically in all areas of medicine. His most well-known work is clearly his contribution to the study of vascular accidents affecting the brain stem, which Auguste Millard worked on simultaneously; hence the eponymous Millard-Gubler syndrome, an example of crossed hemiplegia. Following a brief biography, we will present Gubler's main publications in the area of neurology: on migraine, neurological damage during acute rheumatic fever, aphasia, and the autonomic nervous system. Much of this work was carried out through student theses that Gubler directed. The fame of his contemporary Jean-Martin Charcot (1825-1893) eclipsed that of Gubler, even though the latter was well known and respected among Parisian professors. By tying together the diverse threads of his work, we hope to renew interest in this 19th century neurologist.
Assuntos
Neurologia/história , Infartos do Tronco Encefálico/patologia , História do Século XIX , Neurologistas , Paris , Acidente Vascular Cerebral/história , Acidente Vascular Cerebral/patologiaRESUMO
Joseph Stalin was one of the most important world leaders during the first half of the 20th century. He died suddenly in early March 1953 after a short illness, which was described in a series of medical bulletins in the Soviet newspaper Pravda. Based on both the clinical history and autopsy findings, it was concluded that Stalin had died of a massive hemorrhagic stroke involving his left cerebral hemisphere. However, almost 50â¯years later, a counter-narrative developed suggesting a more nefarious explanation for his sudden death, namely, that a "poison," warfarin, a potent anticoagulant, had been administered surreptitiously by one or more of his close associates during the early morning hours prior to the onset of his stroke. In the present report, we will examine this counter-narrative and suggest that his death was not due to the administration of warfarin but rather to a hypertension-related cerebrovascular accident resulting in a massive hemorrhagic stroke involving his left cerebral hemisphere. The counter-narrative was based on the misunderstanding of certain specific autopsy findings, namely, the presence of focal myocardial and petechial hemorrhages in the gastric and intestinal mucosa, which could be attributed to the extracranial pathophysiologic changes that can occur as a consequence of a stroke rather than the highly speculative counter-narrative that Stalin was "poisoned" by the administration of warfarin.
Assuntos
Morte Súbita , Hipertensão/história , Hemorragia Intracraniana Hipertensiva/história , Acidente Vascular Cerebral/história , Autopsia , Causas de Morte , Morte Súbita/etiologia , Pessoas Famosas , História do Século XX , Humanos , Hipertensão/complicações , Hipertensão/patologia , Hipertensão/terapia , Hemorragia Intracraniana Hipertensiva/etiologia , Hemorragia Intracraniana Hipertensiva/patologia , Hemorragia Intracraniana Hipertensiva/terapia , Federação Russa , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/patologia , Acidente Vascular Cerebral/terapiaRESUMO
This narrative overview of stroke epidemiology shows dramatic changes in stroke incidence, prevalence, mortality, disability, and the understanding of risk factors and primary stroke prevention strategies over the last few decades. Likely future directions of stroke epidemiology and prevention are outlined.