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https://www.readbyqxmd.com/read/29222799/middle-cerebral-artery-occlusion-by-an-intraluminal-suture-method
#1
Rosalia Crupi, Rosanna Di Paola, Emanuela Esposito, Salvatore Cuzzocrea
Stroke represents the most common fatal neurological disease especially in highly developed countries. Even today, treatment options are very limited. The development of new therapeutic approaches replies, to a great extent, on experimental rodent models of focal cerebral ischemia. Since ~80% of ischemic strokes occur in the area of middle cerebral artery (MCA), a number of these stroke models are based on this artery. The intraluminal monofilament model of MCA occlusion involves the insertion of a surgical filament inside the external carotid artery and its extension into the internal carotid artery until the tip occludes the source of the MCA-thus arresting blood flow with resultant infarction in the MCA area...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29202815/normothermia-after-decompressive-surgery-for-space-occupying-middle-cerebral-artery-infarction-a-protocol-based-approach
#2
Jan Rahmig, Matthias Kuhn, Hermann Neugebauer, Eric Jüttler, Heinz Reichmann, Hauke Schneider
BACKGROUND: Moderate hypothermia after decompressive surgery might not be beneficial for stroke patients. However, normothermia may prove to be an effective method of enhancing neurological outcomes. The study aims were to evaluate the application of a pre-specified normothermia protocol in stroke patients after decompressive surgery and its impact on temperature load, and to describe the functional outcome of patients at 12 months after treatment. METHODS: We analysed patients with space-occupying middle cerebral artery (MCA) infarction treated with decompressive surgery and a pre-specified temperature management protocol...
December 4, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29202730/selection-bias-in-clinical-stroke-trials-depending-on-ability-to-consent
#3
Benjamin Hotter, Lena Ulm, Sarah Hoffmann, Mira Katan, Joan Montaner, Alejandro Bustamante, Andreas Meisel
BACKGROUND: Clinical trials are the hallmark of evidence-based medicine, but recruitment is often challenging, especially in stroke trials investigating patients not being able to give informed consent. In some nations, ethics committees will not approve of inclusion in a clinical study via consent of a legal representative. The ethical dilemma of including or excluding those patients has not been properly addressed, as there is little data on the effect of stroke characteristics on the ability to give informed consent...
December 4, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29201539/assessment-of-cerebral-blood-flow-with-magnetic-resonance-imaging-in-children-with-sickle-cell-disease-a-quantitative-comparison-with-transcranial-doppler-ultrasonography
#4
Paula L Croal, Jackie Leung, Przemyslaw Kosinski, Manohar Shroff, Isaac Odame, Andrea Kassner
Introduction: Transcranial Doppler ultrasonography (TCD) is a clinical tool for stratifying ischemic stroke risk by identifying abnormal elevations in blood flow velocity (BFV) in the middle cerebral artery (MCA). However, TCD is not effective at screening for subtle neurologic injury such as silent cerebral infarcts. To better understand this disparity, we compared TCD measures of BFV with tissue-level cerebral blood flow (CBF) using arterial spin-labeling MRI in children with and without sickle cell disease, and correlated these measurements against clinical hematologic measures of disease severity...
November 2017: Brain and Behavior
https://www.readbyqxmd.com/read/29183174/limit-of-intraoperative-near-infrared-spectroscopy-monitoring-during-endovascular-thrombectomy-in-acute-ischemic-stroke
#5
Ryo Hiramatsu, Motomasa Furuse, Ryokichi Yagi, Hiroyuki Ohnishi, Naokado Ikeda, Naosuke Nonoguchi, Shinji Kawabata, Shigeru Miyachi, Toshihiko Kuroiwa
Endovascular thrombectomy is recommended for a persistent ischemic penumbra if recanalization cannot be achieved by the intravenous (IV) administration of recombinant tissue-plasminogen activator (rt-PA) alone. Although endovascular thrombectomy is a powerful treatment for major cerebral artery occlusion, the monitoring of recanalization and reperfusion during acute ischemic stroke presents a therapeutic challenge, and a previous study reported the usefulness of near-infrared spectroscopy (NIRS) for intraoperative monitoring during emergency endovascular thrombectomy for acute large ischemic stroke...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29178027/mri-guiding-of-the-middle-cerebral-artery-occlusion-in-rats-aimed-to-improve-stroke-modeling
#6
Ilya L Gubskiy, Daria D Namestnikova, Elvira A Cherkashova, Vladimir P Chekhonin, Vladimir P Baklaushev, Leonid V Gubsky, Konstantin N Yarygin
The middle cerebral artery occlusion (MCAO) model in rats closely imitates ischemic stroke and is widely used. Existing instrumental methods provide a certain level of MCAO guidance, but monitoring of the MCA-occluding intraluminal filament position and possible complications can be improved. The goal of this study was to develop a MRI-based method of simultaneous control of the filament position, blood flow in the intracranial vessels, and hemorrhagic complications. Rats were subjected to either MRI-guided MCAO (group 1, n = 51) or MCAO without MRI control (group 2, n = 38)...
November 25, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29171118/translesional-pressure-gradient-and-leptomeningeal-collateral-status-in-symptomatic-middle-cerebral-artery-stenosis
#7
Xinyi Leng, Linfang Lan, Hing Lung Ip, Florence Fan, Sze Ho Ma, Karen Ma, Haipeng Liu, Zhengzheng Yan, Jia Liu, Jill Abrigo, Yannie Oy Soo, David S Liebeskind, Ka Sing Wong, Thomas W Leung
BACKGROUND AND PURPOSE: Leptomeningeal collateral (LMC) status governs prognosis of large artery occlusive stroke, while factors determining the LMC status were not fully elucidated. We aimed to investigate metrics affecting LMC status in such patients by using computational fluid dynamics (CFD) models based on CT angiography (CTA). METHODS: In this cross-sectional study, we recruited patients with recent ischemic stroke or transient ischemic attack attributed to atherosclerotic M1 middle cerebral artery (MCA) stenosis (50-99%)...
November 24, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29170186/a-case-of-large-right-mca-stroke-with-hyperdense-mca-sign-in-ct-imaging
#8
Dileep Unnikrishnan, Srujana Yada, Noah Gilson
No abstract text is available yet for this article.
November 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29166955/brain-arterial-diameters-and-cognitive-performance-the-northern-manhattan-study
#9
Jose Gutierrez, Erin Kulick, Yeseon Park Moon, Chuanhui Dong, Ken Cheung, Bagci Ahmet, Yaakov Stern, Noam Alperin, Tatjana Rundek, Ralph L Sacco, Clinton B Wright, Mitchell S V Elkind
OBJECTIVES: To test the hypothesis that brain arterial diameters are associated with cognitive performance, particularly in arteries supplying domain-specific territories. METHODS: Stroke-free participants in the Northern Manhattan Study were invited to have a brain MRI from 2003-2008. The luminal diameters of 13 intracranial arterial segments were obtained using time-of-flight magnetic resonance angiogram (MRA), and then averaged and normalized into a global score and region-specific arterial diameters...
November 23, 2017: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#10
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29146830/mechanical-thrombectomy-performs-similarly-in-real-world-practice-a-2016-nationwide-study-from-the-czech-republic
#11
Ondrej Volny, Antonin Krajina, Silvie Belaskova, Michal Bar, Petra Cimflova, Roman Herzig, Daniel Sanak, Ales Tomek, Martin Köcher, Miloslav Rocek, Radek Padr, Filip Cihlar, Miroslava Nevsimalova, Lubomir Jurak, Roman Havlicek, Martin Kovar, Petr Sevcik, Vladimir Rohan, Jan Fiksa, Bijoy K Menon, Robert Mikulik
BACKGROUND: Randomized clinical trials have proven mechanical thrombectomy (MT) to be a highly effective and safe treatment in acute stroke. The purpose of this study was to compare neurothrombectomy data from the Czech Republic (CR) with data from the HERMES meta-analysis. METHODS: Available nationwide data for the CR from 2016 from the Safe Implementation of Treatments in Stroke-Thrombectomy (SITS-TBY) registry for patients with terminal internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusions were compared with data from HERMES...
November 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29146434/cerebral-hyperperfusion-syndrome-after-endovascular-reperfusion-therapy-in-a-patient-with-acute-internal-carotid-artery-and-middle-cerebral-artery-occlusions
#12
Tetsuya Hashimoto, Shoji Matsumoto, Mitsushige Ando, Hideo Chihara, Atsushi Tsujimoto, Taketo Hatano
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) is known to be a rare but devastating complication of carotid artery revascularization. Because patients with acute ischemic stroke due to acute major cerebral and/or cervical artery occlusion treated with endovascular reperfusion therapy may have impaired autoregulation in the cerebral vasculature, these patients may also develop CHS. Despite the growing number of endovascular reperfusion procedures for acute ischemic stroke, this complication has only rarely been reported...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29134723/the-ct-defined-hyperdense-arterial-sign-as-a-marker-for-acute-intracerebral-large-vessel-occlusion
#13
Jaims Lim, Jordan A Magarik, Michael T Froehler
BACKGROUND AND PURPOSE: To determine the sensitivity and specificity of the hyperdense artery sign (HAS) on thin-slice non-contrast computed tomography (NCCT), combined with brief clinical history, as an indicator for large vessel occlusion (LVO) in the setting of acute ischemic stroke. METHODS: Ninety-nine LVO and 102 non-LVO acute ischemic stroke patients were retrospectively identified from a prospective database at a single institution. After reviewing each patient's neurologic presentation based on his or her initial National Institute of Health Stroke Scale (NIHSS) and neurologic evaluation, all thin (1 mm) and thick (5 mm) NCCT scans were reviewed for the HAS...
November 14, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29131102/a-case-of-a-4-year-old-female-with-a-primary-spinal-malignancy-presenting-with-froin-s-syndrome
#14
Andrew T Hale, Gregory P Fricker, Travis W Crook
We report the case of a 4-year-old female with a primary extradural intramedullary atypical teratoid/rhabdoid tumor (AT/RT) leading to a middle cerebral artery (MCA) infarct and Froin's syndrome. She presented with a 6-pound weight loss over the previous week, as well as a decreased urinary output and an altered mental status. She underwent a brain MRI that revealed a left MCA infarct, mild ventriculomegaly, and bilateral internal carotid artery, M1, and A1 stenosis. An external ventricular drain (EVD) was placed due to increased intracranial pressure...
November 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29127196/mechanical-thrombectomy-for-acute-ischemic-stroke-with-occlusion-of-the-m2-segment-of-the-middle-cerebral-artery-a-meta-analysis
#15
Hamidreza Saber, Sandra Narayanan, Mohan Palla, Jeffrey L Saver, Raul G Nogueira, Albert J Yoo, Sunil A Sheth
BACKGROUND: Endovascular thrombectomy has demonstrated benefit for patients with acute ischemic stroke from proximal large vessel occlusion. However, limited evidence is available from recent randomized trials on the role of thrombectomy for M2 segment occlusions of the middle cerebral artery (MCA). METHODS: We conducted a systematic review and meta-analysis to investigate clinical and radiographic outcomes, rates of hemorrhagic complications, and mortality after M2 occlusion thrombectomy using modern devices, and compared these outcomes against patients with M1 occlusions...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29125072/predictors-of-dependence-after-mca-ischemic-stroke-submitted-to-thrombolysis
#16
Renata Dal-Prá Ducci, Marcos Christiano Lange, Francisco Manoel Branco Germiniani, Viviane de Hiroki Flumignan Zétola
OBJECTIVES: Stroke is one of the most common causes of disability-adjusted life years worldwide. The aim of this study is to identify variables associated with dependence at 3 months and also after the first 3 months after the first-ever ischemic stroke (IS) in middle cerebral artery (MCA) territory submitted to intravenous thrombolysis (IVT). METHODS: A single-center cohort study of patients with first-ever MCA IS treated with IVT at the Hospital de Clínicas, Universidade Federal do Paraná, was followed over 5 years...
November 10, 2017: Neurological Research
https://www.readbyqxmd.com/read/29125024/wingspan-stent-delivery-catheter-fracture-and-the-trap-technique-for-endovascular-salvage
#17
Manoj Jagani, Huy M Do, Jeremy J Heit
Background Intracranial atherosclerotic disease may result in ischemic infarction and has a high rate of recurrent ischemic strokes despite medical therapy. Patients who fail medical therapy may undergo endovascular treatment with cerebral artery angioplasty and possible Wingspan stent placement. We present a unique case of Wingspan delivery microcatheter fracture that resulted in a retained foreign body and an endovascular salvage maneuver. Case description An elderly patient presented with an acute ischemic stroke due to a severe stenosis in the proximal left middle cerebral artery (MCA)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29124813/a-simplified-quantitative-method-to-measure-brain-shifts-in-patients-with-middle-cerebral-artery-stroke
#18
Nina Paletta, Laith Maali, Abdurrehman Zahran, Sankara Sethuraman, Ramon Figueroa, Fenwick T Nichols, Askiel Bruno
BACKGROUND AND PURPOSE: A standardized and validated method to measure brain shifts in malignant middle cerebral artery (MCA) stroke with decompressive hemicraniectomy (DHC) could facilitate clinical decision making, prognostication, and comparison of results between studies. METHODS: We tested for reliability simplified methods to measure transcalvarial herniation, midline brain shift, and the contralateral cerebral ventricular atrium in malignant MCA stroke after DHC...
November 10, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29118796/a-comparison-of-mechanical-thrombectomy-in-the-m1-and-m2-segments-of-the-middle-cerebral-artery-a-review-of-585-consecutive-patients
#19
Pervinder Bhogal, Philipp Bücke, Muhammad AlMatter, Oliver Ganslandt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar Pérez
Background: Mechanical thrombectomy for anterior-circulation large-vessel occlusion has shown benefit; however, the question of whether this technique is safe and effective in the distal vasculature remains unanswered. We sought to compare the outcome data from mechanical thrombectomy of the M2 branches of the middle cerebral artery (MCA) with those of the M1 segment. Methods: We performed a retrospective analysis of prospectively collected data of patients with acute ischaemic stroke undergoing mechanical thrombectomy of isolated M1 or M2 branches of the MCA between August 2008 and August 2016...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29116545/intravenous-thrombolysis-in-sle-related-stroke-a-case-report-and-literature-review
#20
Xiaodong Chen, Gelin Xu
Patients with systemic lupus erythematosus (SLE) bear an increased risk of ischemic stroke. However, evidences for treating acute stroke due to artery thrombosis in SLE patients are extremely limited. A 45-year-old woman experienced sudden left hemiplegia. She was transported to the emergency department of our hospital 2 hours after the initial symptom. According to the medical records, the patient was diagnosed with SLE at the age of 28. CT scanned 150 min after the initial symptom showed no evidence of acute changes or hemorrhage...
November 7, 2017: Neurological Sciences
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