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https://www.readbyqxmd.com/read/29025779/scorpion-bite-induced-ischaemic-stroke
#1
Rakesh Reddy C, Nandakishore Bompelli, Vikram Khardenavis, Anirudda Deshpande
We report a 54-year-old woman with scorpion bite. After 3 hours of admission, the patient developed sudden onset tachycardia with hypotension. Cardiac evaluation showed raised creatine kinase MB isoenzyme was elevated; ECG and two-dimensional echocardiography findings were suggestive of myocarditis. Subsequently, she developed transient ventricular tachycardia before developing abrupt onset, right hemiplegia, global aphasia and progressive worsening of sensorium 12 hours after the bite. MRI of brain revealed massive left middle cerebral artery (MCA) territory infarct...
October 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28993752/histological-characteristics-of-intracranial-atherosclerosis-in-a-chinese-population-a-postmortem-study
#2
Wen Jie Yang, Mark Fisher, Lu Zheng, Chun Bo Niu, Annlia Paganini-Hill, Hai Lu Zhao, Yun Xu, Ka Sing Wong, Ho Keung Ng, Xiang Yan Chen
BACKGROUND: Anterior and posterior circulation atherosclerosis differ in vascular risk factors and stroke mechanisms. However, few studies have compared the pathological features between these lesions. Using a series of intracranial artery specimens, we characterized the intracranial atherosclerotic lesions and compared pathological features among different arteries of the intracranial vasculature. METHODS: Intracranial large arteries of 32 consecutively recruited autopsy cases of Chinese adults aged 45 years or older were examined pathologically using routine histology and immunostaining, to characterize the pathological features of the atherosclerotic lesions...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28983488/neurovascular-function-recovery-after-focal-ischemic-stroke-by-enhancing-cerebral-collateral-circulation-via-peripheral-stimulation-mediated-interarterial-anastomosis
#3
Han-Chi Pan, Lun-De Liao, Yu-Chun Lo, Jia-Wei Chen, Han-Lin Wang, Li Yang, Yao-Wen Liang, Po-Yu Huang, Ming-Hsun Yang, You-Yin Chen
Current treatments for ischemic stroke have focused on the administration of a tissue plasminogen activator, although the associated side effects and subsequent reperfusion injury remain challenging. Peripheral electrical stimulation has shed light on therapeutic interventions for ischemia by increasing cerebral blood flow (CBF) to the target region through collateral circulation, although the mechanism remains elusive. Here, a focal photothrombotic ischemic (PTI) stroke was induced in the right hemispheric primary somatosensory forelimb cortex (S1FL) of rat brains, and the therapeutic effects of forelimb and hindlimb stimulation were characterized at the contralesional S1FL...
July 2017: Neurophotonics
https://www.readbyqxmd.com/read/28982332/asymmetric-cerebrovascular-collateral-supply-affects-cognition-in-patients-with-unilateral-carotid-artery-stenosis
#4
Kuo-Lun Huang, Ting-Yu Chang, Chien-Hung Chang, Ho-Ling Liu, Yeu-Jhy Chang, Chi-Hung Liu, Ho-Fai Wong, Yi-Ming Wu, Tsong-Hai Lee, Meng-Yang Ho
BACKGROUND: The time to maximum of the residue function (TMax) has been employed to identify the penumbra in acute ischemic stroke. Cognitive impairment in patients with carotid artery stenosis (CAS) has been attributed to chronic cerebral hypoperfusion. The study aimed to examine whether cognitive impairment can be detected based on a preliminary TMax cutoff in patients with unilateral CAS. METHODS: Fifty unilateral CAS patients underwent dynamic susceptibility contrast MR perfusion...
October 5, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28972945/pharyngolaryngeal-sensory-deficits-in-patients-with-middle-cerebral-artery-infarction-lateralization-and-relation-to-overall-dysphagia-severity
#5
Thomas Marian, Jens Burchard Schröder, Paul Muhle, Inga Claus, Axel Riecker, Tobias Warnecke, Sonja Suntrup-Krueger, Rainer Dziewas
BACKGROUND: Dysphagia is a frequent and dangerous complication of acute stroke. Apart from a well-timed oropharyngeal muscular contraction pattern, sensory feedback is of utmost importance for safe and efficient swallowing. In the present study, we therefore analyzed the relation between pharyngolaryngeal sensory deficits and post-stroke dysphagia (PSD) severity in a cohort of acute stroke patients with middle cerebral artery (MCA) infarction. METHODS: Eighty-four first-ever MCA stroke patients (41 left, 43 right) were included in this trial...
October 3, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28970969/slower-eeg-alpha-generation-synchronization-and-flow-possible-biomarkers-of-cognitive-impairment-and-neuropathology-of-minor-stroke
#6
Jelena Petrovic, Vuk Milosevic, Miroslava Zivkovic, Dragan Stojanov, Olga Milojkovic, Aleksandar Kalauzi, Jasna Saponjic
BACKGROUND: We investigated EEG rhythms, particularly alpha activity, and their relationship to post-stroke neuropathology and cognitive functions in the subacute and chronic stages of minor strokes. METHODS: We included 10 patients with right middle cerebral artery (MCA) ischemic strokes and 11 healthy controls. All the assessments of stroke patients were done both in the subacute and chronic stages. Neurological impairment was measured using the National Institute of Health Stroke Scale (NIHSS), whereas cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) and MoCA memory index (MoCA-MIS)...
2017: PeerJ
https://www.readbyqxmd.com/read/28970816/direct-visualization-of-arterial-emboli-in-moyamoya-syndrome
#7
Julie G Shulman, Samuel Snider, Henri Vaitkevicius, Viken L Babikian, Nirav J Patel
BACKGROUND: Hemodynamic insufficiency is often considered the cause of ischemic stroke in patients with moyamoya syndrome. While high-intensity transient signals (HITS) on transcranial Doppler (TCD) have been reported in this population, the relationship between these signals and ischemic symptoms is not clearly established. Accordingly, current treatment is directed at improving perfusion. CLINICAL PRESENTATION: We present two patients with symptoms of cerebral ischemia and angiographic findings of moyamoya syndrome...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28965156/decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-including-patients-with-additional-involvement-of-the-anterior-and-or-posterior-cerebral-artery-territory-outcome-analysis-and-definition-of-prognostic-factors
#8
Sven Kürten, Christopher Munoz, Kerim Beseoglu, Igor Fischer, Jason Perrin, Hans-Jakob Steiger
BACKGROUND: According to current evidence, adding decompressive craniectomy (DC) to best medical therapy reduces case fatality rate of malignant middle cerebral artery infarction by 50-75%. There is currently little information available regarding the outcome of subgroups, in particular of patients with extensive infarctions exceeding the territory of the middle cerebral artery. METHODS: The records of 101 patients with large hemispheric infarctions undergoing DC were retrospectively reviewed...
September 30, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28958688/what-influenced-the-lesion-patterns-and-hemodynamic-characteristics-in-patients-with-internal-carotid-artery-stenosis-a-retrospective-study
#9
Jinjie Liu, Hong Wang, Meiyan Zhang, Xiaowen Sui, Furong Li, Zanhua Liu, Sibo Liu, Hongling Zhao
OBJECTIVES: This study aimed to explore the dynamic changes of lesion patterns and hemodynamic characteristics in patients with internal carotid artery stenosis (ICAS). PATIENTS AND METHODS: Patients who had suffered an acute ischemic stroke in the distribution of ipsilateral ICAS were included. Computed tomography (CT) and transcranial doppler ultrasound (TCD) were conducted to evaluate the degree of ICAS and the hemodynamic characteristics of the intracranial and extracranial arteries...
August 23, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28956514/verapamil-induced-breakdown-of-the-blood-brain-barrier-presenting-as-a-transient-right-middle-cerebral-artery-syndrome
#10
Jonathan Pace, Jeffrey Nelson, Abhishek Ray, Yin Hu
A middle-aged patient presented for elective embolization of an incidentally found right internal carotid aneurysm. An angiogram was performed, during which the left internal carotid artery was visualized to evaluate a second, small aneurysm. During the embolization of the right internal carotid artery aneurysm, a catheter-induced vasospasm was identified that prompted treatment with intra-arterial verapamil. The procedure was uncomplicated; a postoperative rotational flat-panel computed tomography scan was performed on the angiography table that demonstrated right hemisphere contrast staining...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28950911/assessment-of-intracranial-vessels-in-association-with-carotid-atherosclerosis-and-brain-vascular-lesions-in-rheumatoid-arthritis
#11
Csaba Oláh, Zsófia Kardos, Mariann Sepsi, Attila Sas, László Kostyál, Harjit Pal Bhattoa, Katalin Hodosi, György Kerekes, László Tamási, Attila Valikovics, Dániel Bereczki, Zoltán Szekanecz
BACKGROUND: Stroke has been associated with rheumatoid arthritis (RA). We assessed patients with RA and healthy control subjects by transcranial Doppler (TCD), carotid ultrasonography and brain magnetic resonance imaging (MRI). METHODS: Altogether, 41 female patients with RA undergoing methotrexate (MTX) or biologic treatment and 60 age-matched control subjects underwent TCD assessment of the middle cerebral artery (MCA) and basilar artery. Pulsatility index (PI), resistivity (resistance) index (RI) and circulatory reserve capacity (CRC) were determined at rest (r) and after apnoea (a) and hyperventilation (h)...
September 26, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28948072/correlation-of-tmax-volumes-with-clinical-outcome-in-anterior-circulation-stroke
#12
Fatih Seker, Johannes Pfaff, Arne Potreck, Sibu Mundiyanapurath, Peter A Ringleb, Martin Bendszus, Markus A Möhlenbruch
BACKGROUND AND PURPOSE: The recent thrombectomy trials have shown that perfusion imaging is helpful in proper patient selection in thromboembolic stroke. In this study, we analyzed the correlation of pretreatment Tmax volumes in MR and CT perfusion with clinical outcome after thrombectomy. METHODS: Forty-one consecutive patients with middle cerebral artery occlusion (MCA) or carotid T occlusion treated with thrombectomy were included. Tmax volumes at delays of >4, 6, 8, and 10 s as well as infarct core and mismatch ratio were automatically estimated in preinterventional MRI or CT perfusion using RAPID software...
September 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28939676/the-protective-effect-of-middle-cerebral-artery-calcification-on-symptomatic-middle-cerebral-artery-infarction
#13
Jang-Hyun Baek, Joonsang Yoo, Dongbeom Song, Young Dae Kim, Hyo Suk Nam, Ji Hoe Heo
BACKGROUND AND PURPOSE: The presence of intracranial artery calcification is associated with an increased risk for stroke. However, calcified atherosclerotic plaques are also known to be less vulnerable to rupture. Given this discrepancy, we investigated whether the vulnerability of intracranial arterial atherosclerosis differed based on the presence or absence of calcification. METHODS: We considered consecutive patients with acute stroke in the unilateral middle cerebral artery (MCA) territory...
September 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28939540/long-term-patency-of-posterior-auricular-artery-middle-cerebral-artery-bypass-for-adult-onset-moyamoya-disease-case-report-and-review-of-literature
#14
Seiei Torazawa, Hirotaka Hasegawa, Taichi Kin, Hiroaki Sato, Shigeo Sora
BACKGOUND: Direct extracranial-intracranial (EC-IC) bypass is one of the fundamental techniques to prevent recurrent stroke in patients with adult-onset ischemic moyamoya disease. When the standard superficial temporal artery (STA) cannot be used for a graft, the posterior auricular artery (PAA) can be a potential surrogate graft. CASE DESCRIPTION: In this article, the authors reported a 34-year-old female patient suffering from ischemic moyamoya disease. To widely revascularize the anterior half of the hemisphere, direct double EC-IC bypass was considered beneficial; however, she had only a single-branched STA but had a prominent branch of the PAA...
September 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28935424/temporal-remodeling-of-pial-collaterals-and-functional-deficits-in-a-murine-model-of-ischemic-stroke
#15
Benjamin Okyere, Miranda Creasey, Yeonwoo Lebovitz, Michelle H Theus
BACKGROUND: Leptomeningeal anastomoses play a critical role in regulating reperfusion following cerebrovascular obstruction; however, methods to evaluate their temporospatial remodeling remains under investigation. NEW METHOD: We combined arteriole-specific vessel painting with histological evaluation to assess the density and diameter of inter-collateral vessels between the middle cerebral artery and anterior cerebral artery (MCA-ACA) or posterior cerebral artery (MCA-PCA) in a murine model of permanent middle cerebral artery occlusion (pMCAO)...
September 18, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28922885/patient-selection-and-clinical-efficacy-of-urgent-superficial-temporal-artery-middle-cerebral-artery-bypass-in-acute-ischemic-stroke-using-advanced-magnetic-resonance-imaging-techniques
#16
Hyun-Seok Park, Sang-Hyeon Kim, Hyun-Wook Nah, Jae-Hyung Choi, Dae-Hyun Kim, Myong-Jin Kang, Jae-Kwan Cha, Jae-Taeck Huh
BACKGROUND: Selected patients with acute ischemic stroke might benefit from superficial temporal artery-middle cerebral artery (STA-MCA) bypass, but the indications for urgent STA-MCA bypass are unknown. OBJECTIVE: To report our experiences of urgent STA-MCA bypass in patients requiring urgent reperfusion who were ineligible for other reperfusion therapies, using advanced magnetic resonance imaging (MRI) techniques. METHODS: The inclusion criteria for urgent STA-MCA bypass were as follows: acute infarct volume <70 mL with a ratio of perfusion/diffusion lesion volume ≥1...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28887332/the-cerebro-cardiovascular-response-to-periodic-squat-stand-maneuvers-in-healthy-subjects-a-time-domain-analysis
#17
Sam C Barnes, Naomi Ball, Victoria Joanna Haunton, Thompson G Robinson, Ronney B Panerai
BACKGROUND: Squat-stand maneuvers (SSMs) have been used to improve the coherence of transfer function analysis (TFA) estimates during the assessment of dynamic cerebral autoregulation (dCA). There is a need to understand the influence of peripheral changes resulting from SSMs on cerebral blood flow, which might confound estimates of dCA. METHODS: 29 healthy subjects underwent recordings at rest (5 min standing) and 15 SSMs (0.05Hz). Heart rate (3-lead ECG), end-tidal CO2 (capnography), blood pressure (Finometer), cerebral blood velocity (CBV, transcranial Doppler, MCA) and the angle of the thigh (tilt sensor) were measured continuously...
September 8, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28887285/the-occipital-artery-as-an-alternative-donor-for-low-flow-bypass-to-anterior-circulation-after-ica-occlusion-failure-prior-to-exenteration-for-an-atypical-cavernous-sinus-meningioma-a-technical-case-report
#18
Shunya Hanakita, Stéphanie Lenck, Moujahed Labidi, Kentaro Watanabe, Damien Bresson, Sébastien Froelich
BACKGROUND: and Importance: In skull-base tumors involving the cavernous sinus (CS), indications for aggressive resection are sparse and must be carefully examined because of their invasiveness. With careful evaluation, techniques including internal carotid artery (ICA) sacrifice with or without extracranial-intracranial (EC-IC) bypass may still be an option in some cases. In addition, previous surgery with the sacrifice of potential donor vessels requires adjusting the revascularization strategy...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882130/the-hemorrhagic-transformation-index-score-a-prediction-tool-in-middle-cerebral-artery-ischemic-stroke
#19
Mikhail N Kalinin, Dina R Khasanova, Murat M Ibatullin
BACKGROUND: We aimed to develop a tool, the hemorrhagic transformation (HT) index (HTI), to predict any HT within 14 days after middle cerebral artery (MCA) stroke onset regardless of the intravenous recombinant tissue plasminogen activator (IV rtPA) use. That is especially important in the light of missing evidence-based data concerning the timing of anticoagulant resumption after stroke in patients with atrial fibrillation (AF). METHODS: We retrospectively analyzed 783 consecutive MCA stroke patients...
September 7, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28882090/stenosis-length-of-middle-cerebral-artery-and-branch-atheromatous-disease-associated-infarct
#20
Jian Wang, Yujie Wang, Zijia Chai, Yue Xin, Jialiang Wang, Jianting Qiu
ABSRACT Background: We analyzed the relationship between the characteristics of branch atheromatous disease associated infarct (BAI) and stenosis length (SL) of relevant middle cerebral artery (MCA) M1 segment. METHODS: 95 patients with BAI were recruited from 1024 consecutive acute ischemic stroke patients. Among them, 59 patients (62.11%) had concurrent relative stenosis of MCA M1 segment. The neurologic deficit severity at admission was assessed by NIHSS and the infarct size by infarct lesion thickness and maximum diameter...
September 8, 2017: International Journal of Neuroscience
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