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Cerebrovascular Diseases

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https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#1
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319954/comparison-of-initial-vasopressors-used-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#2
Bhaskar Roy, Louise D McCullough, Rajat Dhar, James Grady, Yu-Bo Wang, Robert J Brown
BACKGROUND: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. METHODS: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319953/dual-versus-single-energy-ct-angiography-imaging-for-patients-undergoing-intracranial-aneurysm-repair
#3
Amr Abdulazim, Christian Rubbert, Dorothea Reichelt, Christian Mathys, Bernd Turowski, Hans-Jakob Steiger, Daniel Hänggi, Nima Etminan
BACKGROUND: The invasiveness and risk of thromboembolic complications of catheter angiography underline the need for alternative imaging modalities in patients following intracranial aneurysm (IA) repair. However, the overall image quality of existing noninvasive imaging modalities, such as single-energy CT angiography (SE-CTA), compromises its value in this respect. OBJECTIVE: We prospectively investigated the value of a novel dual-energy CTA (DE-CTA) scanner and algorithm for assessing the degree of occlusion and parent vessel patency in patients following IA repair...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319946/rebleeding-and-outcome-in-patients-with-symptomatic-brain-stem-cavernomas
#4
Antonio Arauz, Hernán M Patiño-Rodriguez, Mónica Chavarria-Medina, Mayra Becerril, Gabriel Mauricio Longo, Edgar Nathal
PURPOSE: We sought to evaluate the long-term functional outcomes and identify the potential risk factors for rebleeding in patients with brain stem cavernous malformations (BCMs) who presented with hemorrhages and were surgically or conservatively treated and prospectively monitored. METHODS: From January 1990 to July 2015, we included patients with first hemorrhagic episodes secondary to single BCMs. Modified Rankin score (mRS) was used for neurological status assessment...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28319944/time-of-day-could-affect-cognitive-screening-performance-in-older-patients-with-tia-and-stroke
#5
Sara Mazzucco, Linxin Li, Maria A Tuna, Sarah T Pendlebury, Rhoda Frost, Rose Wharton, Peter M Rothwell
BACKGROUND AND PURPOSE: The impact of time-of-day on the cognitive performance of older patients with limited cognitive reserve after a transient ischemic attack (TIA) or stroke, and on short cognitive tests, such as the Montreal Cognitive Assessment (MoCA), is unknown. We retrospectively studied whether morning versus afternoon assessment might affect the classification of patients aged 70 or older as severe (SCI), mild (MCI), and no (NCI) cognitive impairment by the MoCA. METHODS: Morning (12 p...
March 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28315867/update-on-intracerebral-hemorrhages
#6
Michael G Hennerici
No abstract text is available yet for this article.
March 18, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28259890/carotid-intraplaque-hemorrhage-a-biomarker-for-subsequent-ischemic-cerebrovascular-event
#7
Zhongzhao Teng, Adam J Brown, Jonathan H Gillard
No abstract text is available yet for this article.
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28259886/post-stroke-seizures-is-associated-with-low-alberta-stroke-program-early-ct-score
#8
Ziyuan Chen, Leonid Churilov, Miriam Koome, Ziyi Chen, Jillian Naylor, Patrick Kwan, Bernard Yan
BACKGROUND: Ischemic stroke is a leading cause of new-onset seizures. Cortical ischemia and large ischemic lesion size are among the most consistently reported risk factors for post-stroke seizures. Alberta Stroke Program Early CT Score (ASPECTS) is a simple and reliable tool for quantifying the extent of cerebral ischemia and may function as a screening tool for patients with high risk of seizure development. We investigated the association of post-stroke seizures with the extent of ischemia assessed by ASPECTS and with cortical involvement identified on non-contrast CT (NCCT)...
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28259876/asymptomatic-carotid-t1-high-intense-plaque-as-a-risk-factor-for-a-subsequent-cerebrovascular-ischemic-event
#9
Yoshitaka Kurosaki, Kazumichi Yoshida, Hitoshi Fukuda, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: Intraplaque hemorrhage, detected as a high-signal intensity on carotid MRI, is also strongly associated with ischemic events in symptomatic patients. However, in asymptomatic patients, the relationship of the T1-high intense plaque and the subsequent stroke is not clear. The aim of this study is to test the hypothesis that asymptomatic carotid T1-high intense plaque is a risk factor for a subsequent cerebrovascular ischemic event. METHODS: Of the 1,353 consecutive patients, who underwent head and carotid MRI as part of their annual medical check-up, the imaging quality of 13 was poor and 150 did not present for follow-up examination, thus leaving 1,190 subjects for evaluation...
March 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28245439/demographic-risk-factors-for-vascular-lesions-as-etiology-of-intraventricular-hemorrhage-in-prospectively-screened-cases
#10
Maged D Fam, Alice Pang, Hussein A Zeineddine, Steven Mayo, Agnieszka Stadnik, Michael Jesselson, Lingjiao Zhang, Rachel Dlugash, Wendy Ziai, Daniel Hanley, Issam A Awad
BACKGROUND: Spontaneous intraventricular hemorrhage (IVH) is associated with high rates of morbidity and mortality despite critical care and other advances. An important step in clinical management is to confirm/rule out an underlying vascular lesion, which influences further treatment, potential for further bleeding, and prognosis. Our aim is to compare demographic and clinical characteristics between IVH patients with and without an underlying vascular lesion, and among cohorts with different vascular lesions...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241134/risk-of-ischemic-stroke-and-transient-ischemic-attack-is-increased-up-to-90-days-after-non-carotid-and-non-cardiac-surgery
#11
Armin J Grau, Martin Eicke, Christoph Burmeister, Roland Hardt, Eberhard Schmitt, Sieghard Dienlin
BACKGROUND: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery. METHODS: Data on type and date of surgery and similar interventions within the last year or planned for the next 2 weeks were anonymously collected together with demographic data, vascular risk factors, stroke severity, handicap before stroke and stroke etiology within a state-wide, mandatory, hospital-based acute stroke care quality monitoring project (Rhineland-Palatinate, Germany) for 1 year (2010)...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241129/how-should-we-lower-blood-pressure-after-cerebral-hemorrhage-a-systematic-review-and-meta-analysis
#12
Simona Lattanzi, Claudia Cagnetti, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The optimal treatment of high blood pressure (BP) after acute intra-cerebral hemorrhage (ICH) is controversial. SUMMARY: The aim of the study was to evaluate the safety and efficacy of early intensive vs. conservative BP lowering treatment in patients with ICH. Randomized controlled trials with active and control groups receiving intensive and conservative BP lowering treatments were identified. The following outcomes were assessed: 3-month mortality and combined death or major disability, 24-h hematoma growth, early neurological deterioration, occurrence of hypotension, severe hypotension, and serious treatment-emergent adverse events...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241126/morbidity-after-hemorrhage-in-children-with-untreated-brain-arteriovenous-malformation
#13
Li Ma, Helen Kim, Xiao-Lin Chen, Chun-Xue Wu, Jun Ma, Hua Su, Yuanli Zhao
BACKGROUND: Children with untreated brain arteriovenous malformations (bAVM) are at risk of encountering life-threatening hemorrhage very early in their lives. The primary aim of invasive treatment is to reduce unfavorable outcome associated with a bAVM rupture. A better understanding of the morbidity of bAVM hemorrhage might be helpful for weighing the risks of untreated bAVM and invasive treatment. Our aim was to assess the clinical outcome after bAVM rupture and identify features to predict severe hemorrhage in children...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28241122/numerical-investigation-of-vasospasm-detection-by-extracranial-blood-velocity-ratios
#14
Jaiyoung Ryu, Nerissa Ko, Xiao Hu, Shawn C Shadden
BACKGROUND: Early diagnosis of vasospasm following subarachnoid hemorrhage can prevent cerebral ischemia and improve neurological outcomes. This study numerically evaluates the relevance of extracranial blood velocity indices to detect vasospasm. METHODS: A numerical model of cerebral blood flow was used to evaluate the hemodynamics associated with anterior and posterior vasospasm under normal and impaired cerebral autoregulation conditions. Extracranial blood velocities at the carotid and vertebral arteries and their ratios between ipsilateral and contralateral, anterior and posterior, and downstream and upstream arteries were monitored during vasospasm progression...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28208149/distal-middle-cerebral-artery-branch-recanalization-does-not-affect-final-lesion-volume-in-ischemic-stroke
#15
Verena van Ginneken, Daniel Gierhake, Heinrich J Audebert, Jochen B Fiebach
BACKGROUND: Early recanalization in ischemic stroke is associated with favorable outcome. However, limited data are available on the effect of recanalization on infarct growth and functional outcome in stroke with distal middle cerebral artery (MCA) pathology. This study was aimed at determining the effect of recanalization in acute stroke patients with perfusion-diffusion mismatch and occlusion or high-grade stenosis of a distal MCA branch. METHODS: We prospectively examined 34 consecutive stroke patients with perfusion-diffusion mismatch and M3 or M4 pathology within 24 h of symptom onset...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28208146/serum-lipid-fractions-and-cerebral-microbleeds-in-a-healthy-japanese-population
#16
Shingo Mitaki, Atsushi Nagai, Hiroaki Oguro, Shuhei Yamaguchi
BACKGROUND: Cerebral microbleeds (CMBs) are associated with focal hemosiderin deposits and represent a form of cerebral small vessel disease. To date, indefinite and inconsistent reports are available regarding the association between serum lipid fractions and CMBs. In addition, these previous studies did not include Asian populations, who may have a higher risk of cerebral hemorrhage. The purpose of this study was to examine the associations between serum lipid fractions and CMBs in healthy Japanese subjects...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#17
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28208130/factors-related-to-cardioembolism-as-major-predictors-of-poor-survival-after-first-ever-middle-cerebral-artery-stroke-treated-with-thrombolysis
#18
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola, Tatjana Rundek
BACKGROUND AND PURPOSE: Prognostic factors related to mortality rates after stroke have been reported; however, most studies included different treatments and did not focus solely on ischemic stroke. The study aimed to report the short- and long-term survival and predictors of death in patients with first-ever ischemic stroke in the middle cerebral artery (MCA) territory, submitted to intravenous thrombolysis (IVT). METHODS: A prospective observational cohort study of patients with first-ever ischemic stroke in the MCA territory treated with IVT from March 2010 to February 2015 was conducted, and patients were followed up until May 2015...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28199997/specificities-of-ischemic-stroke-risk-factors-in-arab-speaking-countries
#19
Halim Abboud, Leila Sissani, Julien Labreuche, Antonio Arauz, Marie-Germaine Bousser, Alain Bryer, Angel Chamorro, Marc Fisher, Ian Ford, Kim M Fox, Michael G Hennerici, Pablo M Lavados, Ayrton Massaro, Heinrich P Mattle, Mario Munoz Collazos, Peter M Rothwell, Philippe Gabriel Steg, Eric Vicaut, Bassem Yamouth, Pierre Amarenco
BACKGROUND: Stroke is largely preventable, and therefore, a better understanding of risk factors is an essential step in reducing the population stroke rate and resulting disease burden in Arab countries. SUMMARY: We performed 2 separate analyses in 2 similar populations of patients with noncardioembolic ischemic stroke. This first involved 3,635 patients in the Outcomes in Patients with TIA and Cerebrovascular disease (OPTIC) registry (followed for 2 years), with baseline collection of the usual risk factors and 5 socioeconomic variables (unemployment status, residence in rural area, living in fully serviced accommodation, no health-insurance coverage, and low educational level)...
February 15, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28142144/do-lacunar-infarcts-have-different-aetiologies-risk-factor-profiles-of-lacunar-infarcts-in-deep-white-matter-and-basal-ganglia-the-second-manifestations-of-arterial-disease-magnetic-resonance-study
#20
Raoul P Kloppenborg, Paul J Nederkoorn, Anne M Grool, Laurens J L De Cocker, Willem P T M Mali, Yolanda van der Graaf, Mirjam I Geerlings
BACKGROUND: Evidence suggests that lacunar infarcts have different etiologies, possibly related to their anatomical location and vascular territory. We investigated the risk factor profiles of patients with new lacunar infarcts in the basal ganglia and deep white matter. METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance study, a prospective cohort on brain changes on MRI in patients with symptomatic atherosclerotic disease, 679 patients (57 ± 9 years) had vascular screening and MRI at baseline and after a mean follow-up of 3...
January 31, 2017: Cerebrovascular Diseases
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