Asunto(s)
Arritmias Cardíacas/historia , Personajes , Ataque Isquémico Transitorio/historia , Literatura Moderna/historia , Accidente Cerebrovascular/historia , Arritmias Cardíacas/complicaciones , Historia del Siglo XIX , Humanos , Ataque Isquémico Transitorio/etiología , Recurrencia , Accidente Cerebrovascular/etiologíaAsunto(s)
Personajes , Empleados de Gobierno/historia , Urología/historia , Historia del Siglo XX , Ataque Isquémico Transitorio/complicaciones , Ataque Isquémico Transitorio/historia , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/historia , Estados Unidos , Retención Urinaria/etiología , Retención Urinaria/historia , Retención Urinaria/terapiaAsunto(s)
Infarto Cerebral/historia , Infarto Cerebral/enfermería , Investigación en Enfermería Clínica/historia , Enfermería Holística/historia , Hospitales Generales/historia , Ataque Isquémico Transitorio/historia , Ataque Isquémico Transitorio/enfermería , Proceso de Enfermería/historia , Calidad de Vida , Enfermería en Rehabilitación/historia , Historia del Siglo XX , Humanos , SuizaAsunto(s)
Infarto Cerebral/historia , Infarto Cerebral/enfermería , Investigación en Enfermería Clínica/historia , Enfermería Holística/historia , Hospitales Generales/historia , Ataque Isquémico Transitorio/historia , Ataque Isquémico Transitorio/enfermería , Proceso de Enfermería/historia , Calidad de Vida , Enfermería en Rehabilitación/historia , HumanosRESUMEN
Here I have reviewed how good luck, bad luck and barriers determined my research directions in stroke over the last 30 or so years. Good luck should be exploited, and very often barriers can be not just overcome but put to good use as well. It is crucial for the young researcher to find mentors as good as I have had, and to move around to gain a broad experience, and for the experienced researchers to bring on the younger generation as I have tried to do.
Asunto(s)
Investigación Biomédica/historia , Ataque Isquémico Transitorio/historia , Accidente Cerebrovascular/historia , Aspirina/uso terapéutico , Endarterectomía Carotidea , Europa (Continente) , Fibrinolíticos/uso terapéutico , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Ataque Isquémico Transitorio/tratamiento farmacológico , Ataque Isquémico Transitorio/epidemiología , Ataque Isquémico Transitorio/cirugía , Sistema de Registros , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/cirugía , Resultado del TratamientoAsunto(s)
Trastornos Cerebrovasculares/terapia , Actitud Frente a la Salud , Trastornos Cerebrovasculares/epidemiología , Trastornos Cerebrovasculares/historia , Trastornos Cerebrovasculares/patología , Bases de Datos Factuales , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Ataque Isquémico Transitorio/historia , Ataque Isquémico Transitorio/patología , Ataque Isquémico Transitorio/terapia , Sistema de RegistrosRESUMEN
In summary, over a period of approximately four decades, an important new pathologic process was identified. There is no longer any doubt that the deposition of the subarachnoid clot in the basal cisterns can, over the course of a few days, lead to a progressive, severe vasoconstriction. This, in turn, can reduce cerebral blood flow to the distal brain, which, depending on a multitude of factors, can result in cerebral infarction. It is highly likely that the erythrocyte is the most important blood element in the pathophysiology of this process. The exact mechanism by which the blood vessel is forced into this destructive spasm remains to be elucidated. Significant steps have been taken to avoid the consequences of vasospasm by using hypertension and hypervolemia (or at the very least avoiding iatrogenic hypotension and hypovolemia). These measures have resulted in a reduced incidence of delayed ischemia. Because clot has been shown to cause vasospasm, it has seemed only logical that the early removal of clot would be efficacious in its prophylaxis. Experimental and clinical evidence to support this view has been gathered. Therapeutic measures based on it have been shown to be effective in the experimental situation but await controlled clinical evaluation. In the past decade, thanks to such trials, one of the calcium antagonist drugs has been shown to be effective in improving the outcome following subarachnoid hemorrhage, probably on the basis of reducing the frequency and extent of infarction by small vessel dilatation or neuronal protection. Although patients still die from this lethal complication of subarachnoid hemorrhage, it is difficult not to have some measure of optimism, based on the history just reviewed, that cerebral vasospasm will be a treatable disease within a few decades.