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Cerebral small vascular disease

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https://www.readbyqxmd.com/read/28906205/preventing-cognitive-decline-and-dementia-from-cerebral-small-vessel-disease-the-laci-1-trial-protocol-and-statistical-analysis-plan-of-a-phase-iia-dose-escalation-trial-testing-tolerability-safety-and-effect-on-intermediary-endpoints-of-isosorbide-mononitrate
#1
Gordon W Blair, Jason P Appleton, Zhe Kang Law, Fergus Doubal, Katie Flaherty, Richard Dooley, Kirsten Shuler, Carla Richardson, Iona Hamilton, Yulu Shi, Michael Stringer, Julia Boyd, Michael J Thrippleton, Nikola Sprigg, Philip M Bath, Joanna M Wardlaw
Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms of action to support their testing to prevent stroke recurrence, cognitive impairment, or radiological progression after lacunar stroke. Aim LACI-1 will assess the tolerability, safety, and efficacy, by dose, of isosorbide mononitrate and cilostazol, alone and in combination, in patients with ischemic lacunar stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28906203/the-relation-between-total-cerebral-small-vessel-disease-burden-and-gait-impairment-in-patients-with-minor-stroke
#2
Caroline Mj Loos, Caroline McHutchison, Vera Cvoro, Stephen Dj Makin, Julie Staals, Francesca Chappell, Martin S Dennis, Robert J van Oostenbrugge, Joanna M Wardlaw
Background and aims Individual MRI markers of cerebral small vessel disease are associated with gait impairment. The impact of total cerebral small vessel disease-related brain damage, expressed by a cerebral small vessel disease MRI burden score, on mobility after stroke, has not been considered, although this score gives a better representation of the overall effect of cerebral small vessel disease on the brain. We determined if the total cerebral small vessel disease burden is associated with gait impairment three years after minor stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28905043/vascular-parkinsonism-and-vascular-dementia-are-associated-with-an-increased-risk-of-vascular-events-or-death
#3
Jacek Staszewski, Renata Piusińska-Macoch, Bogdan Brodacki, Ewa Skrobowska, Katarzyna Macek, Adam Stępień
INTRODUCTION: The natural course of vascular parkinsonism (VaP) and dementia (VaD) due to cerebral small vessel disease (SVD) is not well known. The aim of this single-center study was to evaluate the long-term risk of vascular events, death and dependency in patients with VaP or VaD and to compare it with patients without cerebrovascular disease but with high atherothrombotic risk. MATERIAL AND METHODS: Seventy-eight consecutive, functionally independent patients with MRI features of SVD and with recently diagnosed VaD (n = 50) and VaP (n = 28) and 55 controls (control group - CG) with high 10-year risk of total cardiovascular disease (SCORE ≥ 5%) were prospectively recruited and followed for 24 months...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28899518/relationship-between-obstructive-sleep-apnea-and-neuroimaging-signatures-of-cerebral-small-vessel-disease-in-community-dwelling-older-adults-the-atahualpa-project
#4
Oscar H Del Brutto, Robertino M Mera, Mauricio Zambrano, Pablo R Castillo
BACKGROUND/OBJECTIVES: Evidence of a relationship between obstructive sleep apnea (OSA) and neuroimaging signatures of cerebral small vessel disease (SVD) is limited. The present study aimed to evaluate this association in older adults living in rural Ecuador, where small vessel disease is a major pathogenetic mechanism underlying stroke. METHODS: A representative random sample of Atahualpa residents aged ≥60 years enrolled in the Atahualpa Project neuroimaging substudy underwent a single-night diagnostic polysomnography...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28870545/arterial-stiffness-and-cognitive-impairment
#5
REVIEW
Xiaoxuan Li, Peiyuan Lyu, Yanyan Ren, Jin An, Yanhong Dong
BACKGROUND: Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28861335/diffusion-tensor-image-segmentation-of-the-cerebrum-provides-a-single-measure-of-cerebral-small-vessel-disease-severity-related-to-cognitive-change
#6
Owen A Williams, Eva A Zeestraten, Philip Benjamin, Christian Lambert, Andrew J Lawrence, Andrew D Mackinnon, Robin G Morris, Hugh S Markus, Rebecca A Charlton, Thomas R Barrick
Cerebral small vessel disease (SVD) is the primary cause of vascular cognitive impairment and is associated with decline in executive function (EF) and information processing speed (IPS). Imaging biomarkers are needed that can monitor and identify individuals at risk of severe cognitive decline. Recently there has been interest in combining several magnetic resonance imaging (MRI) markers of SVD into a unitary score to describe disease severity. Here we apply a diffusion tensor image (DTI) segmentation technique (DSEG) to describe SVD related changes in a single unitary score across the whole cerebrum, to investigate its relationship with cognitive change over a three-year period...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28842512/cerebral-microbleeds-and-the-risk-of-incident-ischemic-stroke-in-cadasil-cerebral-autosomal-dominant-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy
#7
Laurent Puy, François De Guio, Ophélia Godin, Marco Duering, Martin Dichgans, Hugues Chabriat, Eric Jouvent
BACKGROUND AND PURPOSE: Cerebral microbleeds are associated with an increased risk of intracerebral hemorrhage. Recent data suggest that microbleeds may also predict the risk of incident ischemic stroke. However, these results were observed in elderly individuals undertaking various medications and for whom causes of microbleeds and ischemic stroke may differ. We aimed to test the relationship between the presence of microbleeds and incident stroke in CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy)-a severe monogenic small vessel disease known to be responsible for both highly prevalent microbleeds and a high incidence of ischemic stroke in young patients...
August 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28828972/endothelium-and-oxidative-stress-the-pandora-s-box-of-cerebral-and-non-only-small-vessel-disease
#8
M Maccarrone, L Ulivi, N Giannini, V Montano, L Ghiadoni, R M Bruno, U Bonuccelli, M Mancuso
Common cerebral small vessel disease (cSVD) abnormalities are a common neuroradiological finding, especially in the elderly. They are associated with a wide clinical spectrum that leads to an increasing disability, impaired global function outcome and a reduced quality of life. A strong association is demonstrated with age and hypertension and other common vascular risk factors, including diabetes mellitus, dyslipoproteinemia, smoking, low vitamin B12 level, and hyperomocysteinemia. Although these epidemiological associations suggest a systemic involvement, etiopathogenetic mechanisms remain unclear...
August 21, 2017: Current Molecular Medicine
https://www.readbyqxmd.com/read/28819361/unilateral-headache-status-after-intra-aortic-balloon-pump-placement
#9
Garret M Weber, Alan L Gass, Shalvi B Parikh
INTRODUCTION: Intra-aortic balloon pump (IABP) counterpulsation is a catheter-based treatment for coronary artery disease and decompensated heart failure to increase coronary blood flow and improve cardiac output. IABP is generally well tolerated, and complications are usually related to peripheral vasculature or red blood cell and platelet consumption. The usual insertion site via femoral artery renders the patient bedbound. Recently, axillary artery has been used in patients with atherosclerotic peripheral vascular disease and documented small arteries or in those awaiting transplant to ensure ambulation and prevent deconditioning...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28810566/correlation-analysis-between-the-ldl-c-in-serum-and-the-onset-of-transient-ischemic-attack-caused-by-csvd
#10
Yaqi Chen, Mei Hu, Hongying Gong
The aim of this study was to investigate the correlation between the low-density lipoprotein cholesterol (LDL-C) in serum and the onset of transient ischemic attack caused by cerebral small vascular disease (CSVD). Between September 2012 and September 2015, 249 patients who were diagnosed as CSVD were randomly enrolled in this study. According to MRI results, patients were divided into the patient and control groups. In the patient group, the patients were further subdivided into the white matter lesion (WML) group (n=86) and lacunar infarction (LI) group (n=53)...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810250/cerebral-small-vessel-disease-is-associated-with-dysregulation-in-the-ubiquitin-proteasome-system-and-other-major-cellular-pathways-in-specific-brain-regions
#11
Marie-Françoise Ritz, Caspar Grond-Ginsbach, Felix Fluri, Manja Kloss, Markus Tolnay, Nils Peters, Stefan Engelter, Philippe Lyrer
BACKGROUND/AIMS: Cerebral small vessel disease (SVD) is characterized by periventricular white matter (WM) changes and can lead to vascular dementia, the second most common form of age-dependent dementia. The pathogenesis of the disease remains poorly understood, and studies of its molecular basis are limited. By profiling gene expression of dissected postmortem brain tissue in SVD patients and comparisons with tissue of nonneurological controls, we aimed to identify genes and processes that are involved in the pathogenesis of SVD to gain new pathogenetic insights...
August 16, 2017: Neuro-degenerative Diseases
https://www.readbyqxmd.com/read/28782182/heterozygous-mutations-of-htra1-gene-in-patients-with-familial-cerebral-small-vessel-disease
#12
Ilaria Di Donato, Silvia Bianchi, Gian Nicola Gallus, Alfonso Cerase, Ilaria Taglia, Francesca Pescini, Serena Nannucci, Carla Battisti, Domenico Inzitari, Leonardo Pantoni, Andrea Zini, Antonio Federico, Maria Teresa Dotti
AIMS: Cerebral small vessel disease (SVD) is the leading cause of vascular dementia. Although the most of cases are sporadic, familial monogenic causes have been identified in a growing minority of patients. CADASIL, due to mutations of NOTCH3 gene, is the most common genetic SVD, and CARASIL, linked to HTRA1 gene mutations, is a rare but well known autosomal recessive SVD. Recently, also heterozygous HTRA1 mutations have been described in patients with familial SVD. To detect a genetic cause of familial SVD, we performed mutational analysis of HTRA1 gene in a large cohort of Italian NOTCH3-negative patients...
September 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28775055/in-vivo-imaging-of-venous-side-cerebral-small-vessel-disease-in-older-adults-an-mri-method-at-7t
#13
C E Shaaban, H J Aizenstein, D R Jorgensen, R L MacCloud, N A Meckes, K I Erickson, N W Glynn, J Mettenburg, J Guralnik, A B Newman, T S Ibrahim, P J Laurienti, A N Vallejo, C Rosano
BACKGROUND AND PURPOSE: Traditional neuroimaging markers of small-vessel disease focus on late-stage changes. We aimed to adapt a method of venular assessment at 7T for use in older adults. We hypothesized that poorer venular morphologic characteristics would be related to other small-vessel disease neuroimaging markers and a higher prevalence of small-vessel disease-Alzheimer disease risk factors. MATERIALS AND METHODS: Venules were identified in periventricular ROIs on SWI and defined as tortuous or straight...
August 3, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28769872/intracranial-arterial-dolichoectasia
#14
REVIEW
Victor J Del Brutto, Jorge G Ortiz, José Biller
An increased diameter (ectasis) and/or long and tortuous course (dolichosis) of at least one cerebral artery define intracranial arterial dolichoectasia (IADE). IADE could be detected incidentally or may give rise to an array of neurological complications including ischemic stroke, intracranial hemorrhage, or compression of surrounding neural structures. The basilar artery is preferentially affected and has been studied in more detail, mainly due to the presence of accepted diagnostic criteria proposed by Smoker and colleagues in 1986 (1)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28756941/peripheral-lipid-oxidative-stress-markers-are-related-to-vascular-risk-factors-and-subcortical-small-vessel-disease
#15
Walter Swardfager, Di Yu, Gustavo Scola, Hugo Cogo-Moreira, Parco Chan, Yi Zou, Nathan Herrmann, Krista L Lanctôt, Joel Ramirez, Fuqiang Gao, Mario Masellis, Richard H Swartz, Demetrios J Sahlas, Pak Cheung Chan, Carmen Ojeda-Lopez, Angela Milan-Tomas, Jacqueline A Pettersen, Ana C Andreazza, Sandra E Black
Subcortical white matter hyperintensities (WMH), presumed to indicate small vessel ischemic vascular disease, are found commonly in elderly individuals with and without Alzheimer's disease (AD). Oxidative stress may instigate or accelerate the development of vascular disease, and oxidative stress markers are elevated in AD. Here, we assess independent relationships between three serum lipid peroxidation markers (lipid hydroperoxides [LPH], 8-isoprostane, and 4-hydroxynonenal) and the presence of extensive subcortical WMH and/or AD...
July 11, 2017: Neurobiology of Aging
https://www.readbyqxmd.com/read/28749838/bevacizumab-for-the-treatment-of-gammaknife-radiosurgery-induced-brain-radiation-necrosis
#16
Yifang Ma, Chutian Zheng, Yiping Feng, Qingsheng Xu
BACKGROUND: Radiation necrosis is one of the complications of Gammaknife radiosurgery. The traditional treatment of radiation necrosis carries a high risk of failure, Bevacizumab is an antiangiogenic monoclonal antibody against vascular endothelial growth factor, a known mediator of cerebral edema. It can be used to successfully treat brain radiation necrosis. PATIENT DESCRIPTION: Two patients with a history of small cell lung cancer presented with metastatic disease to the brain...
September 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28740770/versatility-of-the-latissimus-dorsi-free-flap-during-the-treatment-of-complex-postcraniotomy-surgical-site-infections
#17
Nobutaka Yoshioka
BACKGROUND: Some intractable cases of postcraniotomy infection, which can involve compromised skin, an open frontal air sinus, and residual epidural dead space, have been reported. In such cases, reconstructing the scalp and skull is challenging. METHODS: Between 2009 and 2016, the author treated 12 patients with recalcitrant postcraniotomy surgical site infections with latissimus dorsi (LD) free flaps. The patients' ages ranged from 37 to 79 years (mean, 63.5 years), and their underlying diseases included subarachnoid hemorrhaging (n = 5), brain tumors (n = 4), and cerebral arteriovenous malformations (n = 3)...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28731570/susceptibility-weighted-imaging-and-quantitative-susceptibility-mapping-of-the-cerebral-vasculature-using-ferumoxytol
#18
Saifeng Liu, Jean-Christophe Brisset, Jiani Hu, E Mark Haacke, Yulin Ge
PURPOSE: To demonstrate the potential of imaging cerebral arteries and veins with ferumoxytol using susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM). MATERIALS AND METHODS: The relationships between ferumoxytol concentration and the apparent susceptibility at 1.5T, 3T, and 7T were determined using phantom data; the ability of visualizing subvoxel vessels was evaluated using simulations; and the feasibility of using ferumoxytol to enhance the visibility of small vessels was confirmed in three healthy volunteers at 7T(with doses 1 mg/kg to 4 mg/kg)...
July 21, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28715552/large-perivascular-spaces-visible-on-magnetic-resonance-imaging-cerebral-small-vessel-disease-progression-and-risk-of-dementia-the-age-gene-environment-susceptibility-reykjavik-study
#19
Jie Ding, Sigurður Sigurðsson, Pálmi V Jónsson, Gudny Eiriksdottir, Andreas Charidimou, Oscar L Lopez, Mark A van Buchem, Vilmundur Guðnason, Lenore J Launer
Importance: With advancing age, an increased visibility of perivascular spaces (PVSs) on magnetic resonance imaging (MRI) is hypothesized to represent impaired drainage of interstitial fluid from the brain and may reflect underlying cerebral small vessel disease (SVD). However, whether large perivascular spaces (L-PVSs) (>3 mm in diameter) visible on MRI are associated with SVD and cognitive deterioration in older individuals is unknown. Objective: To examine whether L-PVSs are associated with the progression of the established MRI markers of SVD, cognitive decline, and increased risk of dementia...
September 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28708772/successful-laparoscopic-harvesting-of-omental-pedicle-flap-for-salvage-cerebral-revascularization-in-2-adults-with-moyamoya-disease-technique-and-lessons-learned
#20
Max Schumm, Kathleen Simon, Rapheal Sacho, Jon C Gould
Moyamoya is an idiopathic and progressive disease that leads to occlusion of intracranial arteries. When other methods of revascularization fail, omentum can be used as an indirect bypass to improve cerebral perfusion. Laparoscopic mobilization of a pedicled omental flap with subcutaneous tunneling to the brain has been described in small case series in children. We report our techniques and outcomes in 2 adults with Moyamoya to undergo such a procedure. An omental flap based on the right gastroepiploic artery was created and intraoperative fluorescence imaging using indocyanine green was used to assess the viability of the flap and to guide lengthening of the pedicle...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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