Abstract
Stroke is the third leading cause of death in the USA, Canada, Europe, and Japan. According to the American Heart Association and the American Stroke Association, there are now 750,000 new strokes that occur each year, resulting in 200,000 deaths, or 1 of every 16 deaths, per year in the USA alone. Endovascular therapy for patients with acute ischemic stroke is an area of intense investigation. The American Stroke Association has given a qualified endorsement of intra-arterial thrombolysis in selected patients. Intra-arterial thrombolysis has been studied in two randomized trials and numerous case series. Although two devices have been granted FDA approval with an indication for mechanical stroke thrombectomy, none of these thrombectomy devices has demonstrated efficacy for the improvement of patient outcomes. The purpose of the present document is to define what constitutes adequate training to perform neuroendovascular procedures in patients with acute ischemic stroke and what performance standards should be adopted to assess outcomes. These guidelines have been written and approved by multiple neuroscience societies which historically have been directly involved in the medical, surgical and endovascular care of patients with acute stroke. The participating member organizations of the Neurovascular Coalition involved in the writing and endorsement of this document are the Society of NeuroInterventional Surgery, the American Academy of Neurology, the American Association of Neurological Surgeons/Congress of Neurological Surgeons Cerebrovascular Section, and the Society of Vascular & Interventional Neurology.
Highlights
Langham’s Ischemia and Loss of Vascular Autoregulation in Ocular and Cerebral Diseases: A New Perspective summarizes a life’s work dedicated to understanding how a complex interaction of factors, such as intraocular pressures, ocular perfusion, and autoregulation affect ocular health. This sole-authored text explores the subtle nuances of highly sophisticated instrumentation used to determine these factors that will exceed the needs or interests of most practicing ophthalmologists and neuroradiologists
The book is divided into 3 main sections: “Invasive Studies of the Parameters Regulating Ocular Physiology and Vision”; “Noninvasive Studies on the IOP, PA, and Blood Flow Autoregulation in Healthy and Diseased Eyes”; and “Ophthalmodynamometry, the Ophthalmic Arterial Pressure and the Effect of Increased Vascular Resistance Proximal and Distal to the Ophthalmic Artery on Ocular Blood Flow, the IOP/PA Relation and Vision.”
The title suggests an equal treatment of autoregulation in ocular and cerebral disease, only Chapter 29, “Modulation of the Intraocular Pressure/Pulse Amplitude Relation in Subjects with Stenosis of the Internal Carotid Artery,” and Chapter 30, “Alzheimer Disease and the Eye,” focus on disease mechanisms that would likely be of greater interest to the neuroradiologist
Summary
Ischemia and Loss of Vascular Autoregulation in Ocular and Cerebral Disease: A New Perspective Springer; 2009, 192 pages, 94 illustrations, $99.00. Langham’s Ischemia and Loss of Vascular Autoregulation in Ocular and Cerebral Diseases: A New Perspective summarizes a life’s work dedicated to understanding how a complex interaction of factors, such as intraocular pressures, ocular perfusion, and autoregulation affect ocular health.
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