Skip to main content
  • Home
  • Articles
    • Archive from 2022 July
    • Archive 1960 to 2022 June
    • Accepted Articles
    • Published Ahead-of-Print
    • Supplement
  • About
  • For Authors
  • Podcasts

Brain attack: needing resuscitation

< Back to Listing

Share this Article

Singapore Med J 2011; 52(8): 620-630
Brain attack: needing resuscitation

  • Abstract
  • PDF

Venketasubramanian N, Chan BPL, Chang HM, Chua HC, Gan RN, Hui F, Lee W, Ng I, Sharma VK, Singh R, Teoh HL, Wang E, Chen CLH
Correspondence: Dr N Venketasubramanian, ramani_nv@nuhs.edu.sg

ABSTRACT
The brain is extremely susceptible to focal ischaemia. Following vascular occlusion, a core of severely damaged brain tissue develops, surrounded by an ischaemic penumbra. This potentially-salvageable penumbra may be estimated by advanced neuroimaging techniques, particularly by diffusion-perfusion mismatch. Clinical trials have demonstrated the efficacy of intravenous thrombolysis within three hours of onset of ischaemic stroke in reducing short-term disability. Recanalisation is enhanced by intraarterial thrombolysis, sonothrombolysis and clot-retrieval devices. Occasionally, reperfusion injury may lead to clinical deterioration. The search continues for effective neuroprotectants. Brain perfusion needs to be maintained through blood and intracranial pressure management. Hemicraniectomy for ‘malignant’ cerebral oedema reduces death and disability. Elevated glucose should be controlled and hypoxia alleviated. Public education of symptoms and the need for immediate presentation to a medical facility is needed. Stroke unit care reduces death and disability with little increase in cost. Current evidence supports urgent efforts to resuscitate the brain after stroke.

Keywords: brain attack, cerebrovascular disease, penumbra, resuscitation, stroke
Singapore Med J 2011; 52(8): 620-630

http://smj.org.sg/sites/default/files/5208/5208ra17.pdf
×

Around the Site

Home

About SMJ

For Reviewers

Sign Up for Alerts

Issues

Current Issue

All Issues

Online First

Supplement

CME

For Authors

Instructions for Authors

Submit Manuscript


Follow us on:
        

More Links

Contact Us

Copyright

Advertise

SMJ Forms

Privacy Policy

SMA Home

Copyright 2021. Singapore Medical Association. All Rights Reserved.