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https://www.readbyqxmd.com/read/28808606/middle-cerebral-artery-dissection-causing-subarachnoid-hemorrhage-and-cerebral-infarction-trapping-with-high-flow-bypass-preserving-the-lenticulostriate-artery
#1
Hideaki Ono, Tomohiro Inoue, Shinya Suematsu, Takeo Tanishima, Akira Tamura, Isamu Saito, Nobuhito Saito
BACKGROUND: Spontaneous intracranial arterial dissection (IAD) is an increasingly important cause of stroke, such as subarachnoid hemorrhage (SAH) and hemodynamic or thromboembolic cerebral ischemia. IAD usually occurs in the posterior circulation, and is relatively rare in the anterior circulation including the middle cerebral artery (MCA). Various surgical and endovascular methods to reduce blood flow in the dissected lesion have been proposed, but no optimum treatment has been established...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28799861/absence-of-cortical-vein-opacification-is-associated-with-lack-of-intra-arterial-therapy-benefit-in-stroke
#2
Ivo G H Jansen, Annemieke B van Vuuren, Wim H van Zwam, Ido R van den Wijngaard, Olvert A Berkhemer, Hester F Lingsma, Cornelis H Slump, Robert J van Oostenbrugge, Kilian M Treurniet, Diederik W J Dippel, Marianne A A van Walderveen, Aad van der Lugt, Yvo B W E M Roos, Henk A Marquering, Charles B L M Majoie, René van den Berg
Purpose To assess the degree of cortical vein opacification in patients with internal carotid artery or middle cerebral artery (MCA) stroke and to evaluate the relationship with treatment benefit from intra-arterial therapy (IAT). Materials and Methods Written informed consent was obtained from all patients in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands. From the trial's database, all patients (recruited from December 2010 until March 2014) with baseline computed tomographic (CT) angiograms were retrospectively included...
August 11, 2017: Radiology
https://www.readbyqxmd.com/read/28790049/cor-triatriatum-and-stroke
#3
Jose Danilo Bengzon Diestro, Joseph Justin Hipolito Regaldo, Eddieson Masangcay Gonzales, Maria Kristina Casanova Dorotan, Adrian Isidro Espiritu, Jose Leonard Rivera Pascual
Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28775139/permeability-surface-of-deep-middle-cerebral-artery-territory-on-computed-tomographic-perfusion-predicts-hemorrhagic-transformation-after-stroke
#4
Qiao Li, Xinyi Gao, Zhenwei Yao, Xiaoyuan Feng, Huijin He, Jing Xue, Peiyi Gao, Lumeng Yang, Xin Cheng, Weijian Chen, Yunjun Yang
BACKGROUND AND PURPOSE: Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. METHODS: We retrospectively reviewed 70 consecutive acute ischemic stroke patients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA...
August 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28761525/the-minipterional-approach-for-ruptured-and-unruptured-anterior-circulation-aneurysms-our-initial-experience
#5
Kenan A Alkhalili, Jack R Hannallah, Gasser H Alshyal, Mohab M Nageeb, Khaled M Abdel Aziz
OBJECTIVE: To report our experience with the minipterional (MPT) craniotomy approach for anterior circulation aneurysms and to discuss the clinical outcomes as well as to evaluate the advantages of this unique approach. MATERIALS AND METHODS: Single-center retrospective review of 57 cases involving anterior circulation aneurysms both ruptured and unruptured aneurysms treated with the MPT. We analyzed the clinical and patient demographic data, aneurysm characteristics, surgical outcomes, and complications in these individuals...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28760542/how-to-avoid-false-positive-hyperdense-middle-cerebral-artery-sign-detection-in-ischemic-stroke
#6
Robert Chrzan, Agnieszka Gleń, Andrzej Urbanik
OBJECTIVES: The aim of the study was to find how to differentiate hyperdense middle cerebral artery sign (HMCAS) in stroke patients from asymmetric hyperdensity not related to stroke, by comparison of the CT density values typical for HMCAS to the values in normal or atherosclerotic middle cerebral artery (MCA). METHODS: The group analyzed consisted of 100 patients with ischemic stroke, presenting HMCAS on the admission CT. Density measurements in HU were performed in the hyperdense segment of the involved MCA, contralateral MCA, brain cortex adjacent to the hyperdense MCA...
July 25, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28758968/middle-cerebral-artery-stroke-as-amusement-park-injury-case-report-and-review-of-the-literature
#7
Abby Baumgartle, Laura Wolfe, Vinay Puri, Karen Moeller, Salvatore Bertolone, Ashok Raj
Strokes as amusement park injuries are rare, but have been reported in the literature. Only about 20 cases of cerebrovascular accidents after amusement park visits have been described. We report a healthy 12-year-old boy who presented with facial droop, slurred speech, and inability to use his right arm after riding roller coasters at a local amusement park. He was evaluated and found to have a left middle cerebral artery (MCA) infarction. The patient was treated with anticoagulants and has recovered with no major residual symptoms...
July 31, 2017: Children
https://www.readbyqxmd.com/read/28756015/mechanical-thrombectomy-in-acute-stroke-five-years-of-experience-in-poland
#8
Agnieszka Słowik, Marcin Wnuk, Paweł Brzegowy, Joanna Chrzanowska-Waśko, Aleksandra Golenia, Bartłomiej Łasocha, Dorota Włoch-Kopeć, Antoni Ferens, Wojciech Serednicki, Piotr Jarocki, Halina Bartosik-Psujek, Rafał Kaczorowski, Edward Filip, Monika Grzegorzak, Jarosław Homa, Janusz Darocha, Daniel Dudek, Wiesław Guz, Konrad Rejdak, Piotr Luchowski, Joanna Wojczal, Michał Sojka, Michał Górnik, Sylwia Stachowicz, Jacek Jaworski, Kinga Buraczyńska, Remigiusz Ficek, Anna Szczepańska-Szerej, Tomasz Jargiełło, Małgorzata Szczerbo-Trojanowska, Anetta Lasek-Bal, Przemysław Puz, Aldona Warsz-Wianecka, Arkadiusz Stęposz, Krzysztof Ziaja, Wacław Kuczmik, Tomasz Urbanek, Damian Ziaja, Witold Tomalski, Adam Kobayashi, Przemysław Richter, Andrzej Płoński, Marcin Kotkowski, Wojciech Czepiel, Iwona Kurkowska-Jastrzębska, Halina Sienkiewicz-Jarosz, Anna Członkowska, Beata BłażejewskaHyżorek, Danuta Ryglewicz, Magdalena Konopko, Edyta Brelak, Jacek Antecki, Igor Szydłowski, Maciej Włosek, Adam Stępień, Krzysztof Brzozowski, Jacek Staszewski, Piotr Piasecki, Piotr Zięcina, Izabela Wołoszyńska, Norbert Kolmaga, Jerzy Narloch, Tomasz Hasiec, Jacek Gawłowicz, Monika Pędracka, Jacek Porębiak, Bogumił Grzechnik, Vadym Matsibora, Michał Frąszczak, Marcin Leus, Maciej Mazgaj, Violetta Palacz-Duda, Grzegorz Meder, Wojciech Skura, Piotr Płeszka, Milena Świtońska, Krzysztof Słomiński, Józef Kościelniak, Paulina Sobieszak-Skura, Magdalena Konieczna-Brazis, Olgierd Rowiński, Andrzej Opuchlik, Anatol Mickielewicz, Beata Szyluk, Piotr Szczudlik, Anna Kostera-Pruszczyk, Maciej Jaworski, Rafał Maciąg, Jarosław Żyłkowski, Bożena Adamkiewicz, Wojciech Szubert, Jarosław Chrząstek, Marek Raźniewski, Agnieszka Pawelec, Paweł Wilimborek, Ryszard Wagner, Paweł Pilarski, Paweł Gierach, Jan Baron, Wojciech Gruszka, Stanisław Ochudło, Agnieszka Krzak-Kubica, Monika Rudzińska-Bar, Miłosz Zbroszczyk, Kamila Smulska, Michał Arkuszewski, Dorota Różański, Dariusz Koziorowski, Izabela Meisner-Kramarz, Stanisław Szlufik, Artur Zaczyński, Krzysztof Kądziołka, Kazimierz Kordecki, Michał Zawadzki, Mirosław Ząbek, Bartosz Karaszewski, Dariusz Gąsecki, Paweł Łowiec, Waldemar Dorniak, Tomasz Gorycki, Edyta Szurowska, Ewa Wierzchowska-Cioch, Tomasz Smyk, Beata Szajnoga, Marcin Bachta, Kajetan Mazurek, Magdalena Piwowarska, Wojciech Kociemba, Artur Drużdż, Adrian Dąbrowski, Michał Glonek, Małgorzata Wawrzyniak, Radosław Kaźmierski, Robert Juszkat, Witold Tomalski, Adam Heliosz, Adam Ryszczyk, Jacek Zwiernik, Grzegorz Wasilewski, Andrzej Tutaj, Grzegorz Dałek, Krzysztof Nosek, Sławomir Bereza, Katarzyna Lubkowska, Jerzy Kamienowski, Piotr Sobolewski, Adam Bielecki, Maciej Miś, Marcin Miś, Maria Krużewska-Orłowska, Jan Kochanowicz, Zenon Mariak, Marta Jakoniuk, Grzegorz Turek, Urszula Łebkowska, Andrzej Lewszuk, Kazimierz Kordecki, Tomasz Dziedzic, Tadeusz Popiela
OBJECTIVES: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. METHODS AND RESULTS: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. RESULTS: Most of the CSCs (74%) were founded at University Hospitals and most (65...
July 5, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28751636/increased-functional-connectivity-after-stroke-correlates-with-behavioral-scores-in-non-human-primate-model
#9
Carlos R Hernandez-Castillo, Joseph Y Nashed, Juan Fernandez-Ruiz, Justin Wang, Jason Gallivan, Douglas J Cook
Here we characterized the functional connectivity (FC) changes occurring after a controlled MCA stroke in a primate model. We hypothesize that if FC can inform about the neural changes after a stroke in the non-human primate (NHP) stroke model, then significant FC changes after the stroke would have to correlate with the remaining behavioral capacities. Eleven cynomolgus monkeys underwent an experimental middle cerebral artery occlusion while five monkeys remained as the control group. One month later the neurological function was assessed with a set of fine motor tasks and the Nonhuman Primate Stroke Scale (NHPSS)...
July 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28746427/decompressive-craniotomy-for-the-treatment-of-malignant-infarction-of-the-middle-cerebral-artery-mortality-and-outcome
#10
Gianise Toboliski Bongiorni, Marjeane Cristina Jaques Hockmuller, Cristini Klein, Ápio Cláudio Martins Antunes
Objective: To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA) ischemic stroke, who underwent decompressive craniotomy (DC) within the first 30 days. Methods: A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period...
July 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28744672/unresolved-issues-in-thrombectomy
#11
REVIEW
Mahesh V Jayaraman, Ryan A McTaggart, Mayank Goyal
PURPOSE OF REVIEW: Trials demonstrating marked benefit of mechanical thrombectomy (MT) for acute stroke caused by large vessel occlusion (LVO) in the anterior circulation have been the most significant advance in acute ischemic stroke in the past 20 years. However, despite this marked advance, there are still many hurdles to improving access to thrombectomy worldwide. Additionally, despite these advances, a substantial portion of patients with LVO still are left disabled. RECENT FINDINGS: The major randomized trials focused on patients within 6 h from symptom onset, with occlusion of the ICA or proximal MCA, small amount of permanently damaged brain, and a moderate to large clinical deficit...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28737109/clinical-outcome-prediction-after-thrombectomy-of-proximal-middle-cerebral-artery-occlusions-by-the-appearance-of-lenticulostriate-arteries-on-magnetic-resonance-angiography-a-retrospective-analysis
#12
Johannes Kaesmacher, Kornelia Kreiser, Nathan W Manning, Alexandra S Gersing, Silke Wunderlich, Claus Zimmer, Justus F Kleine, Benedikt Wiestler, Tobias Boeckh-Behrens
Post-ischemic vasodynamic changes in infarcted brain parenchyma are common and range from hypo- to hyperperfusion. In the present study, appearance of the lenticulostriate arteries (LSAs) on postinterventional 3T time-of-flight (TOF)-MRA suggestive for altered post-stroke vasodynamics following thrombectomy was investigated. Patients who underwent thrombectomy for a proximal MCA occlusion and for whom postinterventional 3T TOF-MRA (median at day 3) was available, were included in this retrospective analysis (n=98)...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28736129/clinical-and-radiological-predictors-of-malignant-middle-cerebral-artery-infarction-development-and-outcomes
#13
Angelique F Albert, Matthew A Kirkman
BACKGROUND: Optic nerve sheath diameter (ONSD) can predict intracranial hypertension and outcomes in severe traumatic brain injury. Its utility in middle cerebral artery (MCA) stroke is unknown. AIMS: We reviewed serial radiological measurements, including ONSD, in patients with MCA stroke undergoing decompressive craniectomy (DC) for malignant MCA syndrome and compared demographic, clinical, and radiological data with an age- and gender-matched group of nonmalignant MCA stroke patients...
July 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28736114/flow-diversion-within-seven-days-after-stroke-onset-is-associated-with-favorable-outcome-in-anterior-circulation-stroke
#14
Fei Wu, Wenjie Cao, Yifeng Ling, Lumeng Yang, Xin Cheng, Qiang Dong
Anterior cerebral artery (ACA) flow diversion (FD), defined as ipsilateral mean velocity (MV) of at least 30% greater than the contralateral artery, could be seen an indirect sign of leptomeningeal collateralization in the setting of middle cerebral artery occlusion. The purpose of the study was to evaluate the association between dynamic FD and functional outcome in acute anterior stroke patients with large artery occlusion. Acute middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive stroke patients within 12h were recruited...
July 20, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28730452/transcranial-color-doppler-in-stroke-free-adult-patients-with-sickle-cell-disease
#15
COMPARATIVE STUDY
G Graziadei, F M Casoni, F Annoni, I Cortinovis, P Ridolfi, I Gandolfi, A Marcon, E Di Pierro, M D Cappellini
The threshold velocity ≥200 cm/s at transcranial Doppler (TCD) evaluation is a useful cut-off for preventing the stroke (STOP trial) in pediatric patients with sickle cell disease (SCD), term including different types of sickle genotypes. Scanty data are available for adult SCD patients. We compared intracranial blood flow velocities between adult SCD patients and controls using transcranial color Doppler (TCCD), measuring the peak of systolic velocity (PSV) with the insonation angle correction and the pulsatility index (PI), an indicator of endothelial elasticity...
September 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28724339/influence-of-cerebrovascular-reactivity-on-outcome-of-the-patients-with-%C3%A2-50-symptomatic-unilateral-middle-cerebral-artery-stenosis
#16
Weiqing Zhang, Yanwei Yin, Yingqian Zhang, Fen Yang, Wenqian Shi, Dawei Chen, Chen Song, Huiping Shi, Xuanzhu Zhao, Jin Shi
Cerebrovascular reactivity (CVR) reflects the vasodilatory reserve of cerebral resistance vessels, which is an important marker for assessing cerebrovascular disease. The present study is to investigate whether CVR impairment increases adverse long-term outcome risk of patients with ≥ 50% symptomatic unilateral middle cerebral artery (MCA) stenosis (ischemic stroke (IS) or transient ischemic attack (TIA)). Digital subtraction angiography (DSA) was used to assess the degree of stenosis, and perfusion CT and 5% CO2 inhalation were adopted to evaluate CVR...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28721332/to-stent-or-not-to-stent-a-tale-of-two-occlusions
#17
Ali S Haider, Lyndon K Lee, Tijani Osumah, Saira Alli, Umair Khan, Steven Vayalumkal, Aida Kafai Golahmadi, Richa Thakur, Phu Nguyen, Kennith F Layton
Stenting and balloon angioplasty, along with mechanical thrombectomy, have gained notability as adjunctive treatment options to intravenous tissue plasminogen activator (IV-tPA) for tandem internal carotid artery (ICA) and middle cerebral artery (MCA) occlusions (TIM occlusions). Acute ischemic strokes (AISs) secondary to TIM occlusions are associated with poor patient outcomes primarily due to low recanalization rates following intravenous thrombolysis, consequently prompting the need for more invasive recanalization efforts...
June 17, 2017: Curēus
https://www.readbyqxmd.com/read/28700481/a-multiparameter-model-predicting-in-hospital-mortality-in-malignant-cerebral-infarction
#18
Chien-Fu Chen, Ruey-Tay Lin, Hsiu-Fen Lin, A-Ching Chao
The early identification of patients with large hemisphere infarctions (LHIs) at risk of fatal brain edema may result in better outcomes. A quantitative model using parameters obtained at admission may be a predictor of in-hospital mortality from LHI.This prospective study enrolled all patients with LHI involving >50% of the middle cerebral artery (MCA) admitted to our neurological intensive care unit within 48 hours of symptom onset. Early clinical and radiographic parameters and the baseline CHADS2 score (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke [double weight]) were analyzed regarding their ability to predict patient outcomes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#19
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta, middle cerebral artery, and ductus venosus and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS + sIUGR; and 8 uncomplicated)...
July 11, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28694110/predictors-of-in-hospital-mortality-after-decompressive-hemicraniectomy-for-malignant-ischemic-stroke
#20
Saadat Kamran, Abdul Salam, Naveed Akhtar, Aymen Alboudi, Arsalan Ahmad, Rabia Khan, Rashed Nazir, Muhammad Nadeem, Jihad Inshasi, Ahmed ElSotouhy, Ghanim Al Sulaiti, Ashfaq Shuaib
OBJECTIVE: The purpose of this retrospective multicenter, pooled-data analysis was to determine the factors associated with in-hospital mortality in decompressive hemicraniectomy (DHC) for malignant middle cerebral artery (MMCA) stroke. PATIENTS AND METHODS: The authors reviewed pooled DHC database from 3 countries for patients with MMCA with hospital mortality in spite of DHC to identify factors that predicted in-hospital mortality after DHC. The identified factors were applied to the group of patients who were selected for DHC but either refused surgery and died or stabilized and did not undergo DHC...
September 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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