Meet the editor

Dr. Pratap Sanchetee is a first batch alumnus of Dr. SN Medical College, Jodhpur, and achieved his MBBS in 1970. Subsequently, he received his MD diploma (Medicine) from the University of Rajasthan in 1974, and DM (Neurology) from the Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh in 1985. He served in the Armed Forces India as a Physician and Neurologist for 24 years and retired as Lt Col in 1998.

From 1994 to 1998, he also served as an Associate Professor, Armed Forces Medical College, Pune. He was awarded Chief of Army Staff's Commendation in 1980. Since 1998, he has been pursuing clinical practice in neurology at various hospitals at Jodhpur and at Guwahati Assam. He has been a Visiting Professor, Ph.D. guide, and advisor to Jain Visva Bharti University (JVBI) and Bhagwan Mahaveer International Research Centre (BMIRC), Ladnun, Rajasthan since 2009. He is a Director of Research at the Spiritual Training Research Foundation (STRF), Mumbai, India. His areas of active interest are the mind as an interface between soul and body, meditation and the brain, and delivery of neurology care in society. Dr. Sanchetee has a life membership of 9 national associations. He is the editor of four books and has published 110 original papers, chapters, and review articles in national and international journals. He is currently the Chairperson of the "Tropical Neurology Subsection" of the Indian Academy of Neurology. He regularly participates in national and international conferences and presents academic papers. He was an executive editor of the Medical Journal Armed Forces India and Journal of Indian Academy of Geriatrics.

Contents

**Section 1**

*by Pratap Sanchetee*

Vascular Aphasias

**Section 2**

Telestroke: A New Paradigm

*Sanjeeva Onteddu and Aliza Brown*

The Treatment of Acute Stroke

Vinpocetine and Ischemic Stroke

*by Hayder M. Al-kuraishy and Ali I. Al-Gareeb*

Current Trends in Stroke Rehabilitation

Ischemic Stroke in Young Adults: Practical Diagnosis Guide *by Diana Mihai, Florentina Cristina Plesa, Any Docu Axelerad, Alice Munteanu, Minerva Claudia Ghinescu and Carmen Adella Sirbu*

*by Dragoș Cătălin Jianu, Silviana Nina Jianu, Ligia Petrica,* 

*by Irina Alexandrovna Savvina and Anna Olegovna Petrova*

*by Rohan Sharma, Krishna Nalleballe, Nidhi Kapoor, Vasuki Dandu, Karthika Veerapaneni, Sisira Yadala, Madhu Jasti, Suman Siddamreddy,* 

*Traian Flavius Dan and Georgiana Munteanu*

**Preface XI**

Ischemic Stroke - Diagnosis **1**

**Chapter 1 3**

**Chapter 2 17**

**Chapter 3 37**

**Chapter 4 61**

Treatment of Ischemic Stroke **83**

**Chapter 5 85**

**Chapter 6 103**

## Contents


Preface

Stroke continues to be a major public health issue. It is the third leading cause of death and disability across the globe. Its early identification, early treatment, and prevention are major issues that confront a treating physician. Early recognition of the disease involves public awareness, an emergency transport system, a good and well-rehearsed stroke care program, and an organized rehabilitation setup both at the hospital and in the community. We have understood the importance of early intervention and the quote 'time is brain' has been understood by neurologists across the globe and by most physicians. Our endeavor now should be directed to the public at large and paramedics in particular. Until recently, a stroke was considered to be an illness of old people but we are diagnosing an increasing number of such cases in young people. Carmen et al. in their article on ischemic strokes in young people have dealt with this issue in detail. Aphasia and difficulty in swallowing, though an important component of stroke-related disabilities have not been stressed in detail in current textbooks. Cătălin et al. in their article on vascular aphasia have elaborated on this problem.

Although a stroke is a common condition, the availability of a neurologist or stroke specialist is quite scarce. Today, management of a suspected case of stroke is done by a specialist team of medical and paramedical personnel who are trained and tuned to act swiftly without wasting any time. However, the availability of such facilities is limited by cost and geographical distance. To deal with and manage it in the periphery, telestroke is a novel concept. Through this, many patients now have the access to a qualified stroke specialist in remote areas. Aliza et al. in their article

Advances in imaging, newer therapeutic agents, and endovascular management have revolutionized the management of ischemic stroke. Intravenous thrombolysis in a window period of four and half hours is a revolutionary development and now it is possible to salvage the ischemic brain and save many patients from death and gross disabilities. Irina et al. have reviewed many burning issues related to managing ischemic strokes and have given us some practical tips. Protection of brain tissue from ischemic damage during various phases i.e. pre-hospital phase, during hospitalization, and poststroke phase, is a long-felt need. Unfortunately, none of the available agents or procedures have been proved clinically and this has been highlighted in the last article.

Currently, we are witnessing a new era in the management of strokes and I am hopeful that continued research will get us to a satisfactory solution. This book along with another book from IntechOpen titled 'Ischemic Stroke of Brain' is a great source for postgraduate medical students in medicine and neurology who have an

**Dr. Pratap Sanchetee, MD, DM (Neurology)**

Sanchetee Neurology Research Institute,

Consultant Neurologist,

Rajasthan, India

'Telestroke: A New Paradigm ' have highlighted its application.

interest in stroke care.
