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https://www.readbyqxmd.com/read/29036757/a-case-of-medullary-infarction-presented-initial-symptoms-similar-to-meniere-s-disease
#1
Jang Hee Park, Dong Hyun Kim, Jae Moon Sung, Chang Woo Kim
Fluctuating hearing loss and vertigo are the typical presentations of Meniere's disease. However, it is unusual that fluctuating hearing loss and vertigo are caused by vertebral artery occlusion or cerebral infarction. Here, we described the case of a 54-year-old male patient with hypertension and diabetes mellitus who presented with fluctuating hearing loss in his left ear and severe whirling-type dizziness without associated neurological signs or symptoms. Temporal magnetic resonance imaging (MRI) was normal...
October 17, 2017: Journal of Audiology & Otology
https://www.readbyqxmd.com/read/29033410/total-small-vessel-disease-score-in-neurologically-healthy-japanese-adults-in-the-kashima-scan-study
#2
Yusuke Yakushiji, Andreas Charidimou, Tomoyuki Noguchi, Masashi Nishihara, Makoto Eriguchi, Yusuke Nanri, Atsushi Kawaguchi, Tatsumi Hirotsu, David J Werring, Hideo Hara
Objective We explored the association between the total small vessel disease (SVD) score obtained with magnetic resonance imaging and risk factors and outcomes in the Japanese population. Methods The presence of SVD features, including lacunes, cerebral microbleeds, white matter changes, and basal ganglia perivascular spaces on MRI, was summed to obtain a "total SVD score" (range 0-4). Ordinal and multinomial logistic regression analyses were performed to investigate the association of higher total SVD scores with vascular risk factors, the Mini Mental State Examination (MMSE) score, and cerebral atrophy...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29027859/quantitative-cerebral-blood-flow-using-xenon-enhanced-ct-after-decompressive-craniectomy-in-traumatic-brain-injury
#3
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Few studies have reported on changes in quantitative cerebral blood flow (CBF) after decompressive craniectomy and the impact of these measures on clinical outcome. The aim of the present study was to evaluate global and regional CBF patterns in relation to cerebral hemodynamic parameters in patients after decompressive craniectomy for traumatic brain injury (TBI). METHODS The authors studied clinical and imaging data of patients who underwent xenon-enhanced CT (XeCT) CBF studies after decompressive craniectomy for evacuation of a mass lesion and/or to relieve intractable intracranial hypertension...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29025748/compromised-cerebrovascular-regulation-and-cerebral-oxygenation-in-pulmonary-arterial-hypertension
#4
Simon Malenfant, Patrice Brassard, Myriam Paquette, Olivier Le Blanc, Audrey Chouinard, Valérie Nadeau, Philip D Allan, Yu-Chieh Tzeng, Sébastien Simard, Sébastien Bonnet, Steeve Provencher
BACKGROUND: Functional cerebrovascular regulatory mechanisms are important for maintaining constant cerebral blood flow and oxygen supply in heathy individuals and are altered in heart failure. We aim to examine whether pulmonary arterial hypertension (PAH) is associated with abnormal cerebrovascular regulation and lower cerebral oxygenation and their physiological and clinical consequences. METHODS AND RESULTS: Resting mean flow velocity in the middle cerebral artery mean flow velocity in the middle cerebral artery (MCAvmean); transcranial Doppler), cerebral pressure-flow relationship (assessed at rest and during squat-stand maneuvers; analyzed using transfer function analysis), cerebrovascular reactivity to CO2, and central chemoreflex were assessed in 11 patients with PAH and 11 matched healthy controls...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29019942/nadph-oxidase-related-pathophysiology-in-experimental-models-of-stroke
#5
REVIEW
Hiroshi Yao, Tetsuro Ago, Takanari Kitazono, Toru Nabika
Several experimental studies have indicated that nicotinamide adenine dinucleotide phosphate (NADPH) oxidases (Nox) exert detrimental effects on ischemic brain tissue; Nox-knockout mice generally exhibit resistance to damage due to experimental stroke following middle cerebral artery occlusion (MCAO). Furthermore, our previous MCAO study indicated that infarct size and blood-brain barrier breakdown are enhanced in mice with pericyte-specific overexpression of Nox4, relative to levels observed in controls. However, it remains unclear whether Nox affects the stroke outcome directly by increasing oxidative stress at the site of ischemia, or indirectly by modifying physiological variables such as blood pressure or cerebral blood flow (CBF)...
October 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29018129/neuroimaging-correlates-of-cerebral-microbleeds-the-aric-study-atherosclerosis-risk-in-communities
#6
Jonathan Graff-Radford, Jeannette Simino, Kejal Kantarci, Thomas H Mosley, Michael E Griswold, B Gwen Windham, A Richey Sharrett, Marilyn S Albert, Rebecca F Gottesman, Clifford R Jack, Prashanthi Vemuri, David S Knopman
BACKGROUND AND PURPOSE: Cerebral microbleed (CMB) location (deep versus strictly lobar) may elucidate underlying pathology with deep CMBs being more associated with hypertensive vascular disease and lobar CMBs being more associated with cerebral amyloid angiopathy. The objective of this study was to determine whether neuroimaging signs of vascular disease and Alzheimer pathology are associated with different types of CMBs. METHODS: Among 1677 nondemented ARIC (Atherosclerosis Risk in Communities) participants (mean age=76±5 years; 40% men; 26% black) with 3-Tesla MRI scans at the fifth examination (2011-2013), we fit multinomial logistic regression models to quantify relationships of brain volumes (Alzheimer disease signature regions, total gray matter, frontal gray matter, and white matter hyperintensity volumes), infarct frequencies (lacunar, nonlacunar, and total), and apolipoprotein E(number of ε4 alleles) with CMB location (none, deep/mixed, or strictly lobar CMBs)...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29016776/atrial-fibrillation-is-associated-with-decreased-total-cerebral-blood-flow-and-brain-perfusion
#7
Marianna Gardarsdottir, Sigurdur Sigurdsson, Thor Aspelund, Hrafnhildur Rokita, Lenore J Launer, Vilmundur Gudnason, David O Arnar
Aims: Atrial fibrillation (AF) has been associated with cognitive impairment. Additionally, brain volume may be reduced in individuals with AF. Potential causes may include cerebral micro-embolism or reduced stroke volume due to the beat-to-beat variation in AF. The aims of this study were to measure cerebral blood flow and estimate whole brain perfusion in elderly individuals with and without AF. Methods and results: Blood flow in the cervical arteries was measured with phase contrast MRI and brain perfusion estimated in a large cohort from the AGES-Reykjavik Study...
August 9, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28993755/extracranial-internal-carotid-artery-tortuosity-and-body-mass-index
#8
Hai-Feng Wang, Da-Ming Wang, Jun-Jie Wang, Li-Jun Wang, Jun Lu, Peng Qi, Shen Hu, Xi-Meng Yang, Kun-Peng Chen
BACKGROUND: Extracranial internal carotid artery (eICA) tortuosity may trigger cerebral ischemia, and body mass index (BMI) is a measure of body mass based on height and weight. The main purpose of this study is to determine the influence of BMI on the tortuosity of eICA. METHODS: A total of 926 carotid artery angiograms were performed in 513 patients, of which 116 cases and matched controls were selected. Arterial tortuosity was defined as simple tortuosity, kinking, or coiling...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28992723/severe-cerebellar-hemorrhage-following-transverse-sinus-stenting-for-idiopathic-intracranial-hypertension
#9
Pascale Lavoie, Marie-Ève Audet, Jean-Luc Gariepy, Martin Savard, Steve Verreault, Alain Gourdeau, Geneviève Milot, Sylvine Carrondo Cottin
We report a severe adverse event occurring in the course of a cohort study (ISRCTN13784335) aimed at measuring the efficacy and safety of venous stenting in the treatment of patients with medically refractory idiopathic intracranial hypertension (IIH). The patient was a 41-year-old woman who was not overweight, who presented with severe headache, grade 1 bilateral papilledema and transient tinnitus, refractory to medical treatment. Right transverse sinus stenting was successfully performed. Following surgery, the patient's state of consciousness decreased acutely with rapid and progressive loss of brainstem reflex...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28991060/hemodynamic-instability-and-cardiovascular-events-after-traumatic-brain-injury-predict-outcome-after-artifact-removal-with-deep-belief-network-analysis
#10
Hakseung Kim, Seung-Bo Lee, Yunsik Son, Marek Czosnyka, Dong-Joo Kim
BACKGROUND: Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the signals. A machine-learning model for the elimination of artifactual events shows promising results for improving signal quality. However, the actual impact of the improvements on the performance of the clinical parameters after the elimination of the artifacts is not well studied...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28991058/red-cell-distribution-width-after-subarachnoid-hemorrhage
#11
Vito Fontana, Ottavia Bond, Savino Spadaro, Filippo Annoni, Leda Nobile, Rafael Badenes, Carlo A Volta, Jean-L Vincent, Jacques Creteur, Fabio S Taccone
BACKGROUND: High red cell distribution width (RDW) values have been associated with increased hospital mortality in critically ill patients, but few data are available for subarachnoid hemorrhage (SAH). METHODS: We analyzed an institutional database of adult (>18 y) patients admitted to the Department of Intensive Care after nontraumatic SAH between January 2011 and May 2016. RDW (normal value, 10.9% to 13.4%) was obtained daily from admission for a maximum of 7 days, from routine blood analysis...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28989805/migraine-and-stroke
#12
REVIEW
Yonghua Zhang, Aasheeta Parikh, Shuo Qian
Migraines are generally considered a relatively benign neurological condition. However, research has shown an association between migraines and stroke, and especially between migraine with aura and ischaemic stroke. Patients can also suffer from migrainous infarction, a subset of ischaemic stroke that often occurs in the posterior circulation of younger women. The exact pathogenesis of migrainous infarct is not known, but it is theorised that the duration and local neuronal energy level from cortical spreading depression may be a key factor...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28989801/blood-pressure-gradients-in-cerebral-arteries-a-clue-to-pathogenesis-of-cerebral-small-vessel-disease
#13
Pablo J Blanco, Lucas O Müller, J David Spence
RATIONALE: The role of hypertension in cerebral small vessel disease is poorly understood. At the base of the brain (the 'vascular centrencephalon'), short straight arteries transmit blood pressure directly to small resistance vessels; the cerebral convexity is supplied by long arteries with many branches, resulting in a drop in blood pressure. Hypertensive small vessel disease (lipohyalinosis) causes the classically described lacunar infarctions at the base of the brain; however, periventricular white matter intensities (WMIs) seen on MRI and WMI in subcortical areas over the convexity, which are often also called 'lacunes', probably have different aetiologies...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28988884/cerebral-hyperperfusion-syndrome-an-unusual-but-disastrous-complication-of-carotid-recanalization-a-case-report
#14
Bahaadin Siroos, Mohammad Hossein Harirchian, Ali Kazemi Khaledi, Majid Ghaffarpour, Samad Golshani
Cerebral hyperperfusion syndrome (CHS), known as the dark side of carotid recanalization, happens in about 0%-3% of patients. Unfortunately, physicians involving in carotid recanalization generally are not aware of diagnostic and therapeutic aspects of this unusual but potentially life-threatening disorder. Severe bilateral carotid stenosis is suggested to predispose patients to CHS by decrement of cerebrovascular reactivity in a setting of chronic hypoperfusion state. We here introduced such a case; a 69-year-old man, a known case of hypertension and ischemic heart disease, who developed progressive intracranial hypertension underlying CHS after carotid stenting because of symptomatic severe bilateral carotid stenosis...
October 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28987433/cerebral-venous-thrombosis-a-challenging-neurologic-diagnosis
#15
REVIEW
Brit Long, Alex Koyfman, Michael S Runyon
Headache is a common emergency department chief complaint. Although most are benign, emergency physicians must rapidly identify and manage the uncommon, sometimes subtle, presentation of headache from a life-threatening cause. Cerebral venous thrombosis imparts significant morbidity and mortality, and can be a challenging diagnosis. It most commonly occurs in those under 50 years of age with thrombosis of the cerebral veins/sinuses. Diagnosis is frequently delayed. The disease can present with 1 or more clinical syndromes, including intracranial hypertension with headaches, focal neurologic deficits, seizures, and encephalopathy...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28987262/acute-liver-failure
#16
REVIEW
Chalermrat Bunchorntavakul, K Rajender Reddy
Acute liver failure (ALF) is a life-threatening condition of heterogeneous etiology. Outcomes are better with early recognition and prompt initiation of etiology-specific therapy, intensive care protocols, and liver transplantation (LT). Prognostic scoring systems include the King's College Criteria and Model for End-stage Liver Disease score. Cerebral edema and intracranial hypertension are reasons for high morbidity and mortality; hypertonic saline is suggested for patients with a high risk for developing intracranial hypertension, and when it does, mannitol is recommended as first-line therapy...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987197/neuropathology-of-cerebrovascular-diseases
#17
Isidro Ferrer, Noemi Vidal
The chapter describes the epidemiology of cerebrovascular diseases, anatomy of the cerebral blood vessels, pathophysiology of ischemia, hypoxia, hypoxemia, anemic hypoxia, histotoxic hypoxia, carbon monoxide damage, hyperoxid brain damage and decompression sickness, and selective cell and regional vulnerability; diseases of the blood vessels including atherosclerosis, hypertensive angiopathy, small vessel disease, inflammatory vascular diseases, cerebral amyloid angiopathies, CADASIL, CARASIL and other diseases that can lead to cerebrovascular occlusion; intracranial and intraspinal aneurysms and vascular malformations; hematologic disorders that can cause cerebral infarct or hemorrhage; brain ischemic damage; and spontaneous intracranial bleeding...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28985324/protective-effects-of-japanese-soybean-paste-miso-on-stroke-in-stroke-prone-spontaneously-hypertensive-rats-shrsp
#18
Hiromitsu Watanabe, Megumi Sasatani, Toshiki Doi, Takao Masaki, Kenichi Satoh, Masao Yoshizumi
BACKGROUND AND HYPOSESIS: Soybean isoflavones have been shown to reduce the risk of cerebral infarction in humans according to epidemiological studies. However, whether intake of miso can reduce the incidence of stroke in animal models remains unknown. In this study, we investigated the effects of soybean paste (miso) in an animal model of stroke. METHODS: Stroke-prone spontaneously hypertensive rats (SHRSP) were fed a miso diet (normal diet 90%, miso 10%; final NaCl content 2...
July 31, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28983856/effect-of-hhh-therapy-on-regional-cbf-after-severe-subarachnoid-hemorrhage-studied-by-bedside-xenon-enhanced-ct
#19
Henrik Engquist, Elham Rostami, Elisabeth Ronne-Engström, Pelle Nilsson, Anders Lewén, Per Enblad
BACKGROUND: Management of delayed cerebral ischemia (DCI) following subarachnoid hemorrhage (SAH) is difficult and still carries controversies. In this study, the effect of therapeutic hypervolemia, hemodilution, and hypertension (HHH-therapy) on cerebral blood flow (CBF) was assessed by xenon-enhanced computerized tomography (XeCT) hypothesizing an increase in CBF in poorly perfused regions. METHODS: Bedside XeCT measurements of regional CBF in mechanically ventilated SAH patients were routinely scheduled for day 0-3, 4-7, and 8-12...
October 5, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28983815/the-association-between-fabp7-serum-levels-with-survival-and-neurological-complications-in-acetaminophen-induced-acute-liver-failure-a-nested-case-control-study
#20
Constantine J Karvellas, Jaime L Speiser, Mélanie Tremblay, William M Lee, Christopher F Rose
BACKGROUND: Acetaminophen (APAP)-induced acute liver failure (ALF) is associated with significant mortality due to intracranial hypertension (ICH), a result of cerebral edema (CE) and astrocyte swelling. Brain-type fatty acid-binding protein (FABP7) is a small (15 kDa) cytoplasmic protein abundantly expressed in astrocytes. The aim of this study was to determine whether serum FABP7 levels early (day 1) or late (days 3-5) level were associated with 21-day mortality and/or the presence of ICH/CE in APAP-ALF patients...
October 5, 2017: Annals of Intensive Care
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