Preface

Among all neurological diseases, cerebrovascular diseases (CVDs) stand out for their considerable frequency. They are a leading cause of death for both men and women. A stroke is the sudden onset of a focal neurologic deficit. Strokes are categorized as ischemic or hemorrhagic, with the former being due to occlusion of a blood vessel and the latter being due to bursting of a blood vessel. The resulting neurological syndrome corresponds to a portion of the brain that is supplied by one or more cerebral vessels, resulting in stroke syndromes.

This book discusses the fundamental principles of cerebrovascular diseases. Chapter 1 presents aspects of inflammatory and oxidative stress associated with CVDs, focusing on biomarkers. It also examines the role of omega oils and the intracellular molecular network associated with tissue load in these conditions. Chapter 2 deals with CVD and hypertension, particularly systemic hypertension, which is a major public health problem affecting nearly one-third of the global adult population. It is the main modifiable risk factor for vascular diseases leading to considerable degrees of morbidity and mortality. A large body of clinical evidence has shown that adequate control of high blood pressure can be a very effective tool in reducing the incidence and prevalence of CVDs. Chapter 3 discusses atrial fibrillation, which is one of the main causes of morbidity and mortality in adults, especially due to its strong association with stroke. The chapter presents the typical clinical and radiological features of cardioembolic strokes, addressing acute reperfusion therapies. Chapter 4 discusses cryptogenic stroke (CS), which is a challenging pathology responsible for approximately 30%–40% of all ischemic strokes. Despite being defined as the presence of cerebral infarctions, a cause that was not identified despite an adequate diagnostic evaluation, there is a certain subgroup of CS with embolic features in neuroimaging studies and without evidence of alternative atrial fibrillation or any alternative cause. Therefore, the chapter reviews information on the rationale and data behind the pathophysiology, proposed biomarkers, and therapeutic implications of CS. Despite being defined as the presence of cerebral infarctions, a cause that was not identified despite an adequate diagnostic evaluation, there is a certain subgroup of CS with embolic features in neuroimaging studies and without evidence of alternative atrial fibrillation or any alternative cause, therefore we reviewed information on the rationale and data behind its pathophysiology, proposed biomarkers of atrial heart disease, and therapeutic implications in cerebrovascular disease. Chapter 5 discusses cerebrovascular diseases as an important cause of dementia. Their presence, isolated or associated with degenerative conditions, increases the risk of conversion to progressive cognitive decline, with neuropsychiatric manifestations varying according to the affected brain territory and the disrupted neuronal circuits. The chapter also explores diagnostic and therapeutic approaches, including preventive and health promotion strategies for timely management of vascular risk factors and symptomatic approaches. Chapter 6 discusses cerebral vasospasm, which is a major cause of mortality and disability in patients with acute cerebral circulatory disorders. Chapter 7 reviews and addresses reperfusion therapies with a focus on intravenous thrombolytic therapy, one of the reperfusion therapies applied in the acute phase of stroke. Chapter 8 deals with infarction stroke and

blood glucose associated with food consumption in Indonesia. Chapter 9 shows that there is an age-associated specificity in the temporal dynamics of changes in visualspatial short-term memory. It also highlights the considerable success of systematic long-term visual-spatial memory training in old age. Finally, Chapter 10 concludes by presenting an overview of stroke and rehabilitation with a specific emphasis on occupational therapy. It discusses the activities and areas of participation considered important by stroke patients, their needs, and the perceived satisfaction of these needs to provide targeted interventions. It also presents the results of studies conducted in Zimbabwe.

> **Dr. Patricia Bozzetto Ambrosi** Professor, Independent Neuroradiologist Consultant, Clinical Professor and Academic Researcher, Fellow of European Academy of Neurology, London, United Kingdom

Section 1 Pathophysiology

## **Chapter 1**
