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https://www.readbyqxmd.com/read/28081270/outcome-and-treatment-effects-in-stroke-associated-with-acute-cervical-ica-occlusion
#1
Michael Gliem, John-Ih Lee, Aurica Barckhan, Bernd Turowski, Hans-Peter Hartung, Sebastian Jander
BACKGROUND: Endovascular therapy (EVT) with stent retrievers in addition to i.v. thrombolysis (IVT) has proven effective in acute stroke patients with middle cerebral artery (MCA, M1 segment) and distal internal carotid artery (ICA) occlusion. Limited data exist concerning acute cervical ICA occlusion, either alone or in combination with intracranial ICA occlusion (tandem occlusion). Therefore we analyzed outcome and treatment effects in stroke associated with cervical ICA occlusion, with specific focus on the impact of intracranial ICA or M1 patency...
2017: PloS One
https://www.readbyqxmd.com/read/28068417/preserved-collateral-blood-flow-in-the-endovascular-m2cao-model-allows-for-clinically-relevant-profiling-of-injury-progression-in-acute-ischemic-stroke
#2
Philip Little, Ola Kvist, Rikard Grankvist, Stefan Jonsson, Peter Damberg, Michael Söderman, Fabian Arnberg, Staffan Holmin
Interventional treatment regimens have increased the demand for accurate understanding of the progression of injury in acute ischemic stroke. However, conventional animal models severely inhibit collateral blood flow and mimic the malignant infarction profile not suitable for treatment. The aim of this study was to provide a clinically relevant profile of the emergence and course of ischemic injury in cases suitable for acute intervention, and was achieved by employing a M2 occlusion model (M2CAO) that more accurately simulates middle cerebral artery (MCA) occlusion in humans...
2017: PloS One
https://www.readbyqxmd.com/read/28064357/ischemic-stroke-experimental-models-and-reality
#3
REVIEW
Clemens J Sommer
The vast majority of cerebral stroke cases are caused by transient or permanent occlusion of a cerebral blood vessel ("ischemic stroke") eventually leading to brain infarction. The final infarct size and the neurological outcome depend on a multitude of factors such as the duration and severity of ischemia, the existence of collateral systems and an adequate systemic blood pressure, etiology and localization of the infarct, but also on age, sex, comorbidities with the respective multimedication and genetic background...
January 7, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28060307/lateral-chronic-cranial-window-preparation-enables-in-vivo-observation-following-distal-middle-cerebral-artery-occlusion-in-mice
#4
Simon H Bayerl, Melina Nieminen-Kelhä, Thomas Broggini, Peter Vajkoczy, Vincent Prinz
Focal cerebral ischemia (i.e., ischemic stroke) may cause major brain injury, leading to a severe loss of neuronal function and consequently to a host of motor and cognitive disabilities. Its high prevalence poses a serious health burden, as stroke is among the principal causes of long-term disability and death worldwide(1). Recovery of neuronal function is, in most cases, only partial. So far, treatment options are very limited, in particular due to the narrow time window for thrombolysis(2,3). Determining methods to accelerate recovery from stroke remains a prime medical goal; however, this has been hampered by insufficient mechanistic insights into the recovery process...
December 29, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28056282/-diagnostic-value-of-clot-burden-score-of-susceptibility-vessel-sign-in-arterial-thrombosis-of-acute-ischemic-stroke-and-its-association-with-prognosis
#5
Y Huang, W L Mei, H Q Liu, Y L Li, Z Z Chen, D D Li, J W Zhang
Objective: To analysis the value of susceptibility vessel sign (SVS) in susceptibility weighted imaging (SWI) in detecting thrombogenesis in middle cerebral artery (MCA) and its association with clinical prognosis. Methods: From December 2014 to December 2015 in People's Hospital of Zhengzhou University, we retrospectively examined clinical, imaging and experimental datafrom 104 consecutive patients with acute ischemic strokeand compared the consistency of detecting thrombus between SWI and magnetic resonance angiography (MRA) using Kappa analysis...
January 3, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28028726/predictors-of-in-hospital-mortality-and-dependence-at-discharge-in-patients-with-mca-stroke-with-intravenous-thrombolysis
#6
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola
Early risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge...
December 27, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28028565/severe-cerebral-hypovolemia-on-perfusion-ct-and-lower-body-weight-are-associated-with-parenchymal-haemorrhage-after-thrombolysis
#7
S Tsetsou, M Amiguet, A Eskandari, R Meuli, P Maeder, B Jiang, M Wintermark, P Michel
INTRODUCTION: Haemorrhagic transformation of acute ischemic stroke (AIS) and particularly parenchymal haemorrhage (PH) remains a feared complication of intravenous thrombolysis (IVT). We aimed to identify clinical and perfusion CT (PCT) variables which are independently associated with PHs. METHODS: In this observational cohort study, based on the Acute Stroke Registry Analysis of Lausanne (ASTRAL) from 2003 to December 2013, we selected patients with AIS involving the middle cerebral artery (MCA) territory who were thrombolysed within 4...
December 27, 2016: Neuroradiology
https://www.readbyqxmd.com/read/28018286/intra-arterial-infusion-of-autologous-bone-marrow-mononuclear-stem-cells-in-subacute-ischemic-stroke-patients
#8
Azza Abass Ghali, Mohamed Khalil Yousef, Osama AbdAllah Ragab, Enas Arafa ElZamarany
INTRODUCTION: Based on many preclinical and small clinical trials, stem cells can help stroke patient with the possibility of replacing the cells and supporting the remaining cells. The aim of this study was to evaluate the safety and feasibility of bone marrow mononuclear (BMMN) stem cell transplantation in subacute ischemic stroke patients. MATERIALS AND METHODS: Thirty-nine (n = 39) patients with subacute ischemic cerebral infarct due to large artery occlusion in the middle cerebral artery (MCA) territory were recruited...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/28012949/cannabidiol-reduces-brain-damage-and-improves-functional-recovery-in-a-neonatal-rat-model-of-arterial-ischemic-stroke
#9
Maria Ceprián, Laura Jiménez-Sánchez, Carlos Vargas, Lorena Barata, Will Hind, Jose Martínez-Orgado
BACKGROUND: and purpose: Currently there is no effective treatment for neonatal arterial ischemic stroke (AIS). Cannabidiol (CBD) is neuroprotective in models of newborn hypoxic-ischemic brain damage and adult stroke. The purpose of this work was to study the protective effect of CBD in a neonatal rat model of AIS. METHODS: Middle Cerebral Artery Occlusion (MCAO) was achieved in neonatal Wistar rats by introducing a nylon filament to the left MCA for 3 h; 15 min after removing the occluder vehicle (MCAO-V) or CBD single dose 5 mg/kg (MCAO-C) were administered i...
December 21, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/28009766/urgent-bypass-surgery-following-failed-endovascular-treatment-in-acute-symptomatic-stroke-patient-with-mca-occlusion
#10
Chang Yeob Lee, Chang Hyun Kim, Chang-Young Lee, Sung-Il Sohn, Jeong-Ho Hong
INTRODUCTION: Although the benefits of extracranial-intracranial bypass surgery remain controversial, there is some surgical rationale for the augmentation of cerebral blood flow in cases of acute ischemic stroke with hemodynamic instability. CASE REPORT: We report a case of a 62-year-old woman who suddenly developed right hemiplegia and global aphasia. Initial magnetic resonance imaging and magnetic resonance angiography revealed a small acute ischemic lesion in left parietal lobe with occlusion at the left middle cerebral artery...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28003156/direct-comparison-of-microglial-dynamics-and-inflammatory-profile-in-photothrombotic-and-arterial-occlusion-evoked-stroke
#11
Maria L Cotrina, Nanghong Lou, Jessica Tome-Garcia, James Goldman, Maiken Nedergaard
Many focal cerebral ischemia models utilize the middle cerebral artery occlusion (MCAO) evoked by coagulation to induce ischemic damage in the cortex and mimic the pathology observed in human patients. A second, increasingly popular model, the photothrombotic stroke, uses a laser beam to irradiate the MCA after administration of a photosensitizing dye. This widely used procedure is slowly replacing the MCAO model because of the easiness of the surgical protocol and the reproducibility of the damage. However, the photochemical reaction also results in wider microvascular injury...
December 18, 2016: Neuroscience
https://www.readbyqxmd.com/read/27994695/ct-angiographic-evaluation-of-pattern-and-distribution-of-stenosis-and-its-association-with-risk-factors-among-indian-ischemic-stroke-patients
#12
Amit Shrivastava, Trilochan Srivastava, Richa Saxena
BACKGROUND: Stroke is the major cause of disability and third major cause of death. Ischemia causes about 80% of stroke cases; stenosis and occlusion are the predominant cause of stroke. Our purpose for this study was to evaluate the pattern and distribution of stenosis and its association with risk factors in Indian ischemic stroke patients and in other countries, for comparison. MATERIAL/METHODS: We evaluated 60 patients after ischemic stroke with CT angiography...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27974692/multi-delay-asl-can-identify-leptomeningeal-collateral-perfusion-in-endovascular-therapy-of-ischemic-stroke
#13
Xin Lou, Songlin Yu, Fabien Scalzo, Sidney Starkman, Latisha K Ali, Doojin Kim, Neal M Rao, Jason D Hinman, Paul M Vespa, Reza Jahan, Satoshi Tateshima, Nestor R Gonzalez, Gary R Duckwiler, Jeffrey L Saver, Bryan Yoo, Noriko Salamon, Jinhao Lyu, Lin Ma, Danny Jj Wang, David S Liebeskind
BACKGROUND AND PURPOSE: Multi-delay arterial spin-labeling (ASL) perfusion imaging has been used as a promising modality to evaluate cerebral perfusion. Our aim was to assess the association of leptomeningeal collateral perfusion scores based on ASL parameters with outcome of endovascular treatment in patients with acute ischemic stroke (AIS) in the middle cerebral artery (MCA) territory. MATERIALS AND METHODS: ASL data at 4 post-labeling delay (PLD) times (PLD = 1...
December 10, 2016: Oncotarget
https://www.readbyqxmd.com/read/27966092/attitudes-of-patients-and-relatives-toward-disability-and-treatment-in-malignant-mca-infarction
#14
Hermann Neugebauer, Matthias Schnabl, Dorothée Lulé, Peter U Heuschmann, Eric Jüttler
BACKGROUND: Attitudes among patients and relatives toward the degree of acceptable disability and the importance of aphasia are critical in deciding on decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMI). However, most MMI patients are not able to communicate their will. Furthermore, attitudes of healthy individuals and relatives may not correspond to those of stroke patients. METHODS: This is a multicenter survey among 355 patients and 199 relatives during treatment for acute minor or moderate severe ischemic stroke in Germany...
December 13, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27960189/surgical-therapy
#15
Chang Wan Oh, Gary K Steinberg
Many prior investigations have indicated the important role of medical treatment to prevent stroke in patients with intracranial atherosclerosis, with angioplasty and stenting occasionally being performed. In a subgroup of patients with severe hemodynamic impairment, extracranial-intracranial (EC-IC) bypass surgery may be considered. Additionally, in patients with massive infarctions due to middle cerebral artery (MCA) occlusion, the use of decompressive craniectomy may lower mortality rates and improve long-term quality of life...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27957790/transcranial-doppler-in-hemoglobin-sc-disease
#16
Camilo Vieira, Carolina Nogueira Costa de Oliveira, Ludmila Araújo Borges de Figueiredo, Rayra Pereira Santiago, Corynne Stephanie Ahouefa Adanho, Sanzio Silva Santana, Caroline Lang Burak, Isa Menezes Lyra, Marilda Souza Goncalves
BACKGROUND: Stroke is a severe clinical disorder in sickle cell disease (SCD), and few studies have evaluated transcranial Doppler (TCD) flow velocities in hemoglobin SC disease (HbSC). The guidelines for stroke risk are based on evaluations in sickle cell anemia (SCA) or HbS/β thalassemia. PROCEDURE: In this study, we compare cerebral blood flow in patients with SCD stratified by genotypes. A total of 1,664 pediatric patients with SCD underwent TCD velocity screening, and the time-averaged maximum mean velocity (TAMM) was determined in the middle cerebral artery (MCA), anterior cerebral artery (ACA), and distal intracranial internal carotid artery (ICA) ...
December 13, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27956837/a-stress-related-explanation-to-the-increased-blood-pressure-and-its-course-following-ischemic-stroke
#17
Christopher Elnan Kvistad, Halvor Oygarden, Nicola Logallo, Lars Thomassen, Ulrike Waje-Andreassen, Gunnar Moen, Halvor Naess
BACKGROUND: A hypertensive response after ischemic stroke is frequent, yet its pathophysiology is unknown. Mechanisms related to local ischemic damage, major vascular occlusion, and psychological stress due to acute illness have been proposed. We assessed the natural course of blood pressure (BP) within the first 24 h in groups of ischemic stroke patients with different characteristics. We hypothesized that a consistent BP reduction, regardless of stroke location, time window from debut to admission and presence of persistent vascular occlusion, would favor a stress-related mechanism as an important cause of the hypertensive response after ischemic stroke...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27942770/management-of-unruptured-saccular-aneurysms-of-the-m1%C3%A2-segment-with-flow-diversion-a%C3%A2-single-centre-experience
#18
Pervinder Bhogal, Rosa Martinez, Oliver Gansladt, Hansjörg Bäzner, Hans Henkes, Marta Aguilar
PURPOSE: The optimal strategy for the treatment of M1 segment aneurysms has not yet been determined as both standard microneurosurgical and endovascular techniques can pose challenges. We sought to determine the efficacy of flow diverting stents to treat small, unruptured aneurysms of the M1 segment. METHODS: We retrospectively reviewed our database of prospectively collected information for all patients treated with flow diversion for an unruptured saccular aneurysm of the middle cerebral artery (MCA) between February 2009 and February 2016...
December 11, 2016: Clinical Neuroradiology
https://www.readbyqxmd.com/read/27939902/cilostazol-protects-against-microvascular-brain-injury-in-a-rat-model-of-type-2-diabetes
#19
Yuko Tsukamoto, Eiichiro Nagata, Naoto Fukuyama, Yoshiko Itoh, Hiroko Yuzawa, Saori Kohara, Mie Shimizu, Yoko Takahari, Shunya Takizawa
Cilostazol, a pluripotent phosphodiesterase III-specific inhibitor with anti-platelet and vasculogenic effects, is useful for preventing recurrent brain vascular events, particularly in stroke patients with diabetes mellitus (DM). However, it is unclear whether cilostazol affects autoregulatory responses in small cerebral arteries. Thus, we investigated the effect of cilostazol on diabetic brain vasculopathy in a model of type II DM using male OLETF rats. OLETF rats were treated with either cilostazol (CG) or vehicle (VG) and subjected to microangiography with monochromatic synchrotron radiation to investigate middle cerebral artery (MCA) vasoreactivity following an injection of acetylcholine (Ach)...
December 8, 2016: Neuroscience Research
https://www.readbyqxmd.com/read/27929569/disappearance-of-the-hyperdense-mca-sign-after-stroke-thrombolysis-implications-for-prognosis-and-early-patient-selection-for-clot-retrieval
#20
P Elofuke, J M Reid, A Rana, M-J Macleod
Disappearance of the hyperdense middle cerebral artery sign (HMCAS) following intravenous thrombolysis for ischaemic stroke is associated with improved outcome. Debate exists over which radiological thrombus characteristics can predict disappearance of the HMCAS after thrombolysis such as vessel attenuation or extent of thrombus length. Methods Ischaemic stroke patients treated with intravenous thrombolysis from our hospital were entered into a European registry. Patient demographics, stroke severity pre- and 24 hours post-thrombolysis were recorded...
June 2016: Journal of the Royal College of Physicians of Edinburgh
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