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https://www.readbyqxmd.com/read/28328002/endovascular-treatment-of-middle-cerebral-artery-m2-occlusion-strokes-clinical-and-procedural-predictors-of-outcomes
#1
Maxim Mokin, Christopher T Primiani, Zeguang Ren, Peter Kan, Edward Duckworth, Raymond D Turner, Aquilla S Turk, Kyle M Fargen, Guilherme Dabus, Italo Linfante, Travis M Dumont, Leonardo B C Brasiliense, Hussain Shallwani, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Patients with strokes from M2 segment middle cerebral artery (MCA) occlusion have been underrepresented in recent randomized trials of endovascular therapy. OBJECTIVE: To better understand the clinical, imaging, and procedural predictors of successful recanalization and clinical outcomes in this population of patients. METHODS: We performed a multicenter retrospective analysis of consecutive patients with acute MCA M2 segment occlusion who underwent thrombectomy with stent retrievers or primary aspiration thrombectomy (including A Direct Aspiration First Pass Technique approach)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28318956/carotid-endarterectomy-to-remove-retained-solitaire-stent-retriever-inside-carotid-stent-after-mechanical-thrombectomy
#2
Mary In-Ping Huang Cobb, Tony P Smith, Patrick A Brown, L Fernando Gonzalez, Ali R Zomorodi
BACKGROUND: Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important. CASE REPORT: A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot...
March 16, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28300680/evaluation-by-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#3
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
OBJECTIVE: To report the prevalence of Silent Brain Infarcts (SBI) at MRI before and after surgery for asymptomatic high grade carotid stenosis. DESIGN: Single-center retrospective observational study METHODS: Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a CT scan dating less than 3 months. A neurological examination was performed during the anesthesia consultation and in the 15 days before surgery...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28298139/emergent-carotid-stenting-and-intra-arterial-abciximab-in-acute-ischemic-stroke-due-to-tandem-occlusion
#4
Fawaz Al-Mufti, Krishna Amuluru, Nathan W Manning, Imad Khan, Lissa Peeling, Chirag D Gandhi, Charles J Prestigiacomo, Galyna Pushchinska, David Fiorella, Henry H Woo
OBJECTIVE: Acute occlusions of the extracranial internal carotid artery (ICA) and a major intracranial artery respond poorly to intravenous tissue plasminogen activator (tPA) and present an endovascular challenge. The aim of our study was to retrospectively delineate the feasibility of the combined use of emergent carotid stenting and intra-arterial (IA) Abciximab with intracranial revascularization in the setting of acute ischemic stroke and carotid occlusions at our institution. METHODS: Eleven patients with complete cervical carotid occlusion with or without concomitant intracranial ICA and/or MCA occlusion were identified from a single center, retrospective review of patients admitted to the Stroke unit...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28288870/tia-model-is-attainable-in-wistar-rats-by-intraluminal-occlusion-of-the-mca-for-10-min-or-shorter
#5
A Durukan Tolvanen, E Tatlisumak, E Pedrono, U Abo-Ramadan, T Tatlisumak
Transient ischemic attack (TIA) has received only little attention in the experimental research field. Recently, we introduced a TIA model for mice, and here we set similar principles for simulating this human condition in Wistar rats. In the model: 1) transient nature of the event is ensured, and 2) 24 h after the event animals are free from any sensorimotor deficit and from any detectable lesion by magnetic resonance imaging (MRI). Animals experienced varying durations of ischemia (5, 10, 12.5, 15, 25, and-30 min, n=6-8 per group) by intraluminal middle cerebral artery occlusion (MCAO)...
March 10, 2017: Brain Research
https://www.readbyqxmd.com/read/28286721/functional-outcome-after-decompressive-craniectomy-in-patients-with-dominant-or-non-dominant-malignant-middle-cerebral-infarcts
#6
Bilal Kamal Alam, Ahmed S Bukhari, Salman Assad, Pir Muhammad Siddique, Haider Ghazanfar, Muhammad Junaid Niaz, Maryam Kundi, Saima Shah, Maimoona Siddiqui
BACKGROUND:  The use of decompressive craniectomy (DC) has been studied in the setting of different conditions, including traumatic brain injury, subarachnoid hemorrhage, and malignant middle cerebral artery (MCA) infarction. The rationale of this study is to determine the functional outcome after DC in patients with malignant MCA infarcts. METHODS:  A longitudinal cohort study was performed based on patients diagnosed with malignant MCA territory infarction admitted to the Neurosurgery Department of a tertiary care hospital in Islamabad, Pakistan between July 2015 and November 2016...
January 26, 2017: Curēus
https://www.readbyqxmd.com/read/28280639/delayed-stroke-following-blunt-neck-trauma-a-case-illustration-with-recommendations-for-diagnosis-and-treatment
#7
Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28277460/aspects-ct-in-acute-ischemia-review-of-current-data
#8
Supada Prakkamakul, Albert J Yoo
The Alberta Stroke Program Early CT score (ASPECTS) is a 10-point semiquantitative topographic scoring system developed for the assessment of early ischemic changes (EICs) on noncontrast-enhanced computed tomography (NCCT) in patients with acute ischemic stroke involving the middle cerebral artery (MCA) territory. One point is subtracted from a total score of 10, if an EIC is present in any part of each of the ASPECTS regions. Higher ASPECTS has been associated with better outcomes and a lower risk of symptomatic intracerebral hemorrhage...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28262403/clinical-predictors-for-favorable-outcomes-from-endovascular-recanalization-in-wake-up-stroke
#9
Sang Min Sung, Tae Hong Lee, Han Jin Cho, Gi Yong Cho, Dae Soo Jung, Jae Il Lee, Jun Kyeung Ko, Samuel Yip
BACKGROUND AND PURPOSE: Patients who have acute stroke symptoms present on awakening are ineligible for standard intravenous thrombolysis due to the unclear onset time of symptoms. Some of these wake-up stroke (WUS) patients may benefit from endovascular recanalization. This study aimed to evaluate clinical predictors of outcomes from endovascular recanalization in WUS patients. METHODS: Forty-one WUS patients with internal carotid (ICA) or middle cerebral artery (MCA) occlusion treated with endovascular recanalization were reviewed...
March 2, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28255031/progressive-cortical-neuronal-damage-and-extracranial-intracranial-bypass-surgery-in-patients-with-misery-perfusion
#10
H Yamauchi, S Kagawa, Y Kishibe, M Takahashi, T Higashi
BACKGROUND AND PURPOSE: Misery perfusion may cause selective neuronal damage in atherosclerotic ICA or MCA disease. Bypass surgery can improve misery perfusion and may prevent neuronal damage. On the other hand, surgery conveys a risk for neuronal damage. The purpose of this retrospective study was to determine whether progression of cortical neuronal damage in surgically treated patients with misery perfusion is larger than that in surgically treated patients without misery perfusion or medically treated patients with misery perfusion...
March 2, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28253509/the-clinical-characteristics-of-acute-cerebrovascular-accidents-resulting-from-ovarian-hyperstimulation-syndrome
#11
Shuna Yang, Junliang Yuan, Wei Qin, Yue Li, Lei Yang, Wenli Hu
BACKGROUND AND PURPOSE: Ovarian hyperstimulation syndrome (OHSS) is a serious complication that occurs after the ovarian-induction treatment. Acute cerebrovascular accident is one of the most dangerous manifestations of the syndrome. However, the characteristics of stroke resulting from OHSS have so far not been well summarised in any study. METHODS: We reported 2 cases of acute cerebrovascular accidents secondary to OHSS. And then we performed a literature search for reports on this type of stroke, and summarised their characteristics...
March 3, 2017: European Neurology
https://www.readbyqxmd.com/read/28247188/diabetes-worsens-functional-outcomes-in-young-female-rats-comparison-of-stroke-models-tissue-plasminogen-activator-effects-and-sexes
#12
Weiguo Li, Rebecca Ward, John Paul Valenzuela, Guangkuo Dong, Susan C Fagan, Adviye Ergul
Diabetes worsens stroke outcome and increases the risk of hemorrhagic transformation (HT) after ischemic stroke, especially with tissue plasminogen activator (tPA) treatment. The widespread use of tPA is still limited by the fear of hemorrhagic transformation (HT), and underlying mechanisms are actively being pursued in preclinical studies. However, experimental models use a 10 times higher dose of tPA than the clinical dose (10 mg/kg) and mostly employ only male animals. In this translational study, we hypothesized that low-dose tPA will improve the functional recovery after the embolic stroke in both control and diabetic male and female animals...
March 1, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28246519/assessment-of-arterial-wall-enhancement-for-differentiation-of-parent-artery-disease-from-small-artery-disease-comparison-between-histogram-analysis-and-visual-analysis-on-3-dimensional-contrast-enhanced-t1-weighted-turbo-spin-echo-mr-images-at-3t
#13
Jinhee Jang, Tae-Won Kim, Eo-Jin Hwang, Hyun Seok Choi, Jaseong Koo, Yong Sam Shin, So-Lyung Jung, Kook-Jin Ahn, Bum-Soo Kim
OBJECTIVE: The purpose of this study was to compare the histogram analysis and visual scores in 3T MRI assessment of middle cerebral arterial wall enhancement in patients with acute stroke, for the differentiation of parent artery disease (PAD) from small artery disease (SAD). MATERIALS AND METHODS: Among the 82 consecutive patients in a tertiary hospital for one year, 25 patients with acute infarcts in middle cerebral artery (MCA) territory were included in this study including 15 patients with PAD and 10 patients with SAD...
March 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28243346/correlation-of-acute-m1-middle-cerebral-artery-thrombus-location-with-endovascular-treatment-success-and-clinical-outcome
#14
Seyedmehdi Pavabvash, Shayandokht Taleb, Shahram Majidi, Adnan I Qureshi
PURPOSE: The location of the arterial occlusion can help with prognostication and treatment triage of acute stroke patients. We aimed to determine the effects of M1 distance-to-thrombus on angiographic recanalization success rate and clinical outcome following endovascular treatment of acute M1 occlusion. METHODS: All acute ischemic stroke patients with M1 segment middle cerebral artery (MCA) occlusion on admission CT angiography (CTA) who underwent endovascular treatment were analyzed...
January 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28242586/feasibility-and-safety-of-direct-catheter-based-thrombectomy-in-the-treatment-of-acute-ischemic-stroke-cooperation-of-cardiologists-neurologists-and-radiologists-prospective-registry-prague-16
#15
Petr Widimsky, Boris Koznar, Tomas Peisker, Peter Vasko, Filip Rohac, Jana Vavrova, Josef Kroupa, Ivana Stetkarova
AIMS: The aim of this study was to evaluate the role of direct catheter-based thrombectomy (d-CBT, without thrombolysis) and the feasibility and safety of d-CBT performed in an interventional cardiology center. METHODS AND PATIENTS: Single center, prospective observational registry based on the prespecified protocol included 3 months follow-up. The decision to perform acute stroke intervention was done by a neurologist based on the clinical and imaging findings...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28210239/flow-diversion-for-the-treatment-of-mca-bifurcation-aneurysms-a-single-centre-experience
#16
Pervinder Bhogal, Muhammad AlMatter, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes, Marta Aguilar Pérez
BACKGROUND: Intracranial aneurysms located at the bifurcation of the middle cerebral artery (MCA) can often be challenging for the neurointerventionalist. We aimed to evaluate the efficacy and safety of flow diverting stents (FDS) in the treatment of these aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our prospectively maintained database to collect information for all patients with unruptured saccular bifurcation MCA aneurysms treated with FDS between January 2010 and January 2016...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28208149/distal-middle-cerebral-artery-branch-recanalization-does-not-affect-final-lesion-volume-in-ischemic-stroke
#17
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/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/28192099/role-of-interleukin-10-in-the-neuroprotective-effect-of-the-angiotensin-type-2-receptor-agonist-compound-21-after-ischemia-reperfusion-injury
#19
Abdelrahman Y Fouda, Bindu Pillai, Krishnan M Dhandapani, Adviye Ergul, Susan C Fagan
INTRODUCTION: We and others have shown that the angiotensin type 2 (AT2) receptor agonist, compound 21 (C21), provides neuroprotection and enhances recovery in rodent stroke models yet the mechanism involved is not known. Moreover, C21 treatment is associated with an anti-inflammatory response. Here we tested the hypothesis that C21 mediates neuroprotection by upregulating the neuroprotective and anti-inflammatory cytokine, interleukin (IL)-10. METHODS: Wistar rats were subjected to 3h-middle cerebral artery suture occlusion and treated at reperfusion with C21 (0...
February 10, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28178170/use-of-susceptibility-weighted-imaging-in-assessing-ischemic-penumbra-a-case-report
#20
Xiujuan Wu, Song Luo, Ying Wang, Yang Chen, Jun Liu, Jing Bai, Jiachun Feng, Hongliang Zhang
RATIONALE: The ischemic penumbra assessment is essential for the subsequent therapy and prediction of evolution in patients with acute ischemic infraction. Although controversial as a perfect equivalence to penumbra, perfusion-weighted imaging (PWI)-diffusion-weighted imaging (DWI) mismatch may predict the response to thrombolysis. Due to the reliance of PWI on contrast agents, noninvasive alternatives remain an unmet need. PATIENT CONCERNS: We reported a 65-year-old man complained of paroxysmal hemiplegia of his right limbs and anepia for 2 days, whereas the symptoms lasted for about 12 hours when he admitted to the hospital...
February 2017: Medicine (Baltimore)
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