Lege Artis Medicinae

[CEREBRAL AMYLOID ANGIOPATHY - A FATAL CASE OF RECURRENT MULTIFOCAL CEREBRAL HEMORRHAGE]

POGÁNY Péter, HERMANN Zsuzsa

DECEMBER 20, 2003

Lege Artis Medicinae - 2003;13(08)

[Atherosclerosis and hypertension are the leading etiological factors in the pathogenesis of cerebral hemorrhage. With old age though, several other factors may appear of which cerebral amyloid angiopathy (CAA) is of major importance. This condition is characterized by the deposition of β-amyloid in the leptomeningeal vessels as well as in the small and medium sized arteries of the cerebral cortex and it is not associated with systemic amyloidosis. This pathological protein is also seen in the brains of otherwise healthy older individuals and may also appear in other diseases such as Alzheimer disease, Down-syndrome, vascular malformations, spongiform encephalopathy and dementia pugilistica. The condition may be asymptomatic but it may also cause cerebral hemorrhage, dementia or various transient neurological symptoms. Most cases are sporadic, but familial subtypes have also been described.]

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[Cardiac rehabilitation programs are performed to decrease the physiologic and psychological effects of cardiac illness, reduce the risk of reinfarction and cardiac symptoms, stabilize the arteriosclerotic process and enhance the psychosocial status of selected cardiac patients. The cardiac rehabilitation intervention should be integrated into multifactorial secondary prevention program involving hospital phase, medical evaluation and adequate oral and interventional treatment, risk factor modification, prescription of exercise training, education and psychosocial counseling. These rehabilitation programs should be followed by long term risk reduction and secondary prevention program directed by the family physicians. On the basis of the review of scientific literature, the authors present the important components of cardiac rehabilitation and address actual objectives like new indications, selection of a professional rehabilitation team, appropriate training programs, counseling and education.]

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