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https://www.readbyqxmd.com/read/28431954/isolated-intracranial-fibromuscular-dysplasia-of-the-posterior-cerebral-artery
#1
Min-Ju Yeo, Ho-Yeong Jeon, Min-Ju Cha, Hye-Yeon Jang, Sang-Gil Lee, Ji Seon Kim, Sung-Hyun Lee, Sang-Soo Lee, Dong-Ick Shin
Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory arterial disease that most commonly affects the renal and internal carotid arteries, but intracranial FMD is very rare. We report a patient with FMD involving the posterior cerebral arteries (PCAs). A 24year old female was presented with a 4day history of right homonymous hemianopsia with throbbing headache in the left temporo-occipital area. The brain magnetic resonance imaging (MRI) revealed an acute ischemic stroke in the left PCA territory, while the Time of Flight (TOF) magnetic resonance angiogram (MRA) showed segmental luminal irregularities in the left proximal PCA...
April 18, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28431614/permeability-surface-area-product-analysis-in-malignant-brain-edema-prediction-a-pilot-study
#2
O Volny, P Cimflova, T-Y Lee, B K Menon, C D d'Esterre
BACKGROUND AND PURPOSE: Using an extended CT perfusion acquisition (150s), we sought to determine the association between perfusion parameters and malignant edema after ischemic stroke. METHODS: Patients (from prospective study PROVE-IT, NCT02184936) with terminal internal carotid artery±proximal middle cerebral occlusion were involved. CTA was assessed for clot location and status of leptomeningeal collaterals. The following CTP parameters were calculated within the ischemic territory and contralaterally: permeability surface area product (PS), cerebral blood flow (CBF) and cerebral blood volume (CBV)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28424016/acute-brain-injury-following-illicit-drug-abuse-in-adolescent-and-young-adult-patients-spectrum-of-neuroimaging-findings
#3
Shai Shrot, Andrea Poretti, Elizabeth W Tucker, Bruno P Soares, Thierry Agm Huisman
The use of illicit drugs is currently a major medical problem among adolescents. Several illicit drugs have a high abuse potential and can be neurotoxic causing high morbidity and mortality. The clinical manifestation of adolescents with acute drug-induced neurotoxicity is often characterized by non-specific symptoms and findings. Early diagnosis is important to prevent death and permanent long-term neurological impairments. We report on clinical and neuroimaging findings in five adolescents with acute brain imaging following illicit drug intoxication to highlight the role of neuroimaging findings in the diagnostic work-up of pediatric acute drug-induced neurotoxicity...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28419949/characteristics-of-seizure-induced-signal-changes-on-mri-in-patients-with-first-seizures
#4
Si Eun Kim, Byung In Lee, Kyong Jin Shin, Sam Yeol Ha, JinSe Park, Kang Min Park, Hyung Chan Kim, Joonwon Lee, Soo-Young Bae, Dongah Lee, Sung Eun Kim
PURPOSE: The aim of this study was to investigate the predictive factors and identify the characteristics of the seizure-induced signal changes on MRI (SCM) in patients with first seizures. METHODS: We conducted a retrospective study of patients with first seizures from March 2010 to August 2014. The inclusion criteria for this study were patients with 1) first seizures, and 2) MRI and EEG performed within 24h of the first seizures. The definition of SCM was hyper-intensities in the brain not applying to cerebral arterial territories...
April 11, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28412316/differentiating-stroke-and-seizure-in-acute-setting-perfusion-computed-tomography
#5
Katarzyna Kubiak-Balcerewicz, Urszula Fiszer, Ewa Nagańska, Cezary Siemianowski, Aleksander Sobieszek, Agnieszka Witak-Grzybowska, Aldona Kosińska-Szot
BACKGROUND: Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting. METHODS: Patients with acute focal neurologic deficits and without acute ischemic lesions on routine CT underwent PCT and electroencephalography (EEG) within 12 hours after symptom onset...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28411967/utility-of-relative-adc-ratio-in-patient-selection-for-endovascular-revascularization-of-large-vessel-occlusion
#6
Narihide Shinoda, Shinya Hori, Kazuyuki Mikami, Toshiaki Bando, Daisuke Shimo, Takahiro Kuroyama, Yoji Kuramoto, Masato Matsumoto, Osamu Hirai, Yasushi Ueno
PURPOSE: The relative apparent diffusion coefficient (ADC) ratio on magnetic resonance imaging (MRI) can be used to evaluate the degree of ischemia. Here, we assessed the predictability of ischemic reversibility and the risk of hemorrhagic transformation using the relative ADC ratio. METHODS: This single-center retrospective study analyzed 56 patients with acute occlusion of the internal carotid artery (ICA) or the middle cerebral artery (M1) with endovascular revascularization...
April 12, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28400822/pacemaker-placement-in-patients-with-stroke-mediated-autonomic-dysregulation
#7
Ali A Alsaad, Christopher O Austin, Maisha T Robinson, Michael B Phillips
Lateral medullary syndrome (LMS) is an ischemic disease of the medulla oblongata, which involves the territory of the posterior inferior cerebellar artery. Lateral medullary syndrome is often missed as the cause of autonomic dysregulation in patients with recent brain stem stroke. Due to the location of the baroreceptor regulatory center in the lateral medulla oblongata, patients with LMS occasionally have autonomic dysregulation-associated clinical manifestations. We report a case of LMS-associated autonomic dysregulation...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28393638/vascular-territorial-segmentation-and-volumetric-blood-flow-measurement-using-dynamic-contrast-enhanced-magnetic-resonance-angiography-of-the-brain
#8
Oren Geri, Shelly I Shiran, Jonathan Roth, Moran Artzi, Liat Ben-Sira, Dafna Ben Bashat
This study proposes a method for territorial segmentation and volumetric flow rate (VFR) distribution measurement of cerebral territories based on time-resolved contrast enhanced magnetic-resonance-angiography (MRA). The method uses an iterative region-growing algorithm based on bolus-arrival-time with increased temporal resolution. Eight territories were segmented: (1) right and (2) left internal carotid arteries, including the middle cerebral artery (ICA+MCA), excluding the anterior cerebral arteries (ACA); (3) right and left ACA (R+L-ACA); (4) right and (5) left external carotid arteries (ECA); (6) right and (7) left posterior cerebral arteries (PCA); and (8) vertebrobasilar territory...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28393628/cerebral-watershed-infarcts-may-be-induced-by-hemodynamic-changes-in-blood-flow
#9
Jingfei Shi, Ran Meng, Sanjay Konakondla, Yuchuan Ding, Yunxia Duan, Di Wu, Bincheng Wang, Yinghao Luo, Xunming Ji
OBJECTIVES: A watershed infarct is defined as an ischemic lesion at the border zones between territories of two major arteries. The pathogenesis of watershed infarcts, specifically whether they are caused by hemodynamic or embolic mechanisms, has long been debated. In this study, we aimed to examine whether watershed infarcts can be induced by altering the hemodynamic conditions in rats. MATERIALS AND METHODS: In phase one, to determine the proper clamping duration for a reproducible infarct, 30 rats were equally divided into 5 subgroups and underwent bilateral common carotid artery (CCA) clamping for different durations (0...
April 9, 2017: Neurological Research
https://www.readbyqxmd.com/read/28367905/4d-flow-mr-imaging-of-ophthalmic-artery-flow-in-patients-with-internal-carotid-artery-stenosis
#10
Tetsuro Sekine, Ryo Takagi, Yasuo Amano, Yasuo Murai, Erika Orita, Yoshimitsu Fukushima, Yoshio Matsumura, Shin-Ichiro Kumita
BACKGROUND AND PURPOSE: To assess the clinical feasibility of time-resolved three-dimensional phase contrast (4D Flow) magnetic resonance imaging (MRI) assessment of the ophthalmic artery (OphA) flow in patients with internal carotid artery stenosis (ICS). MATERIALS AND METHODS: Twenty-one consecutive patients with unilateral ICS were recruited. 4D Flow MRI and acetazolamide-stress brain perfusion single photon emission computed tomography (SPECT) were performed...
March 27, 2017: Magnetic Resonance in Medical Sciences: MRMS
https://www.readbyqxmd.com/read/28366663/recurrent-stroke-due-to-metastatic-pulmonary-tumor-emboli-as-an-important-clinical-entity
#11
Junji Takasugi, Manabu Sakaguchi, Naoki Oyama, Yasufumi Gon, Yasukazu Terasaki, Tsutomu Sasaki, Susumu Nakahara, Kenji Ohshima, Yumiko Hori, Eiichi Morii, Hideki Mochizuki
We present an autopsy case of repetitive stroke due to tumor emboli, indistinguishable from thromboembolism with a hypercoagulable state in its clinical course. A 72-year-old man diagnosed with stage IVA oropharyngeal squamous cell carcinoma received chemoradiotherapy. Follow-up imaging revealed mediastinal lymph nodes and pulmonary metastasis. One year later, the patient experienced right arm weakness, and brain magnetic resonance imaging showed acute ischemic lesions in multiple vascular territories. He was diagnosed with paradoxical cerebral embolism due to cancer-associated venous thrombosis and treated with rivaroxaban...
March 30, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28363514/voxel-based-lesion-mapping-of-cryptogenic-stroke-in-patients-with-advanced-cancer-a-detailed-magnetic-resonance-imaging-analysis-of-distribution-pattern
#12
Takamune Achiha, Masatoshi Takagaki, Hiroshi Oe, Mio Sakai, Hitoshi Matsui, Katsuhiko Nakanishi, Tomohiko Ozaki, Yasunori Fujimoto, Toshiki Yoshimine, Katsuyuki Nakanishi, Manabu Kinoshita
BACKGROUND: Ischemic stroke is one form of cancer-associated thrombosis that can greatly worsen a patient's performance status. The present investigation aimed to elucidate the characteristic distribution pattern(s) of cryptogenic stroke lesions using a voxel-based lesion-mapping technique and examine the differences in clinical manifestations between cryptogenic and conventional strokes in patients with advanced cancer. METHODS: Data from 43 patients with advanced cancer who developed acute ischemic stroke were retrospectively collected...
March 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28352965/dual-energy-ct-to-diagnose-pseudoedema-in-contrast-induced-encephalopathy-following-cerebral-angiography
#13
Gabriel L Pagani-Estévez, Deena M Nasr, Waleed Brinjikji, Avital Perry, Jennifer E Fugate
BACKGROUND: Contrast-induced encephalopathy (CIE) is a syndrome that may be clinically unrecognized and misdiagnosed as cerebral edema. METHODS: Case report and review. RESULTS: A 72-year-old woman was admitted for elective endovascular embolization of a 10-mm left anterior communicating artery aneurysm. One hour post-procedure, she acutely developed global aphasia. Emergent head computed tomography (CT) and computed tomography-angiography (CTA) showed high attenuation of the left hemispheric subarachnoid spaces interpreted as hemispheric edema; emergent magnetic resonance imaging revealed left hemispheric punctate infarcts...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28341559/-moyamoya-disease-associated-with-kidney-angiodysplasia-in-a-child
#14
A Dibi, Z Maana, F Jabourik, A Bentahila
INTRODUCTION: Moyamoya disease is a progressive, chronic occlusive vascular disease of the circle of Willis arteries leading to the development of collateral circulation to compensate the occlusion. CASE REPORT: An 11-year-old girl presented an abrupt loss of consciousness and a right-sided motor deficit. Clinical examination found hypertension with 220/120mmHg arterial blood pressure. Brain magnetic resonance imaging showed a large left hemispheric ischemic lesion...
May 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28323180/early-and-severe-symptomatic-cerebral-vasospasm-after-mild-traumatic-brain-injury-case-report
#15
Kyle Ogami, Melissa Dofredo, Asma M Moheet, Shouri Lahiri
BACKGROUND: Symptomatic cerebral vasospasm has been reported in a low percentage of patients with moderate or severe traumatic brain injury as defined by Glasgow Coma Score (GCS). Here, we present case of mild traumatic brain injury (GCS 14) complicated by early and severe symptomatic cerebral vasospasm. CASE DESCRIPTION: A 63-year-old female was admitted following mild traumatic brain injury with a Glasgow Coma Score of 14. Concurrent with the onset of sonographic vasospasm, the patient developed severe neurological symptoms consistent with ischemia of the left middle cerebral artery territory...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28319185/real-time-monitoring-of-human-blood-brain-barrier-disruption
#16
Vesa Kiviniemi, Vesa Korhonen, Jukka Kortelainen, Seppo Rytky, Tuija Keinänen, Timo Tuovinen, Matti Isokangas, Eila Sonkajärvi, Topi Siniluoto, Juha Nikkinen, Seppo Alahuhta, Osmo Tervonen, Taina Turpeenniemi-Hujanen, Teemu Myllylä, Outi Kuittinen, Juha Voipio
Chemotherapy aided by opening of the blood-brain barrier with intra-arterial infusion of hyperosmolar mannitol improves the outcome in primary central nervous system lymphoma. Proper opening of the blood-brain barrier is crucial for the treatment, yet there are no means available for its real-time monitoring. The intact blood-brain barrier maintains a mV-level electrical potential difference between blood and brain tissue, giving rise to a measurable electrical signal at the scalp. Therefore, we used direct-current electroencephalography (DC-EEG) to characterize the spatiotemporal behavior of scalp-recorded slow electrical signals during blood-brain barrier opening...
2017: PloS One
https://www.readbyqxmd.com/read/28316866/alberta-stroke-program-early-ct-score-in-the-prognostication-after-endovascular-treatment-for-ischemic-stroke-a-meta-analysis
#17
Chang-Woo Ryu, Hee Shup Shin, Soonchan Park, Sang Hyun Suh, Jun Seok Koh, Hye-Yeon Choi
PURPOSE: The Alberta Stroke Program Early CT Score (ASPECTS) was devised to quantify the extent of early ischemic changes in the middle cerebral artery territory on brain CT. We performed a systematic review and meta-analysis of studies that presented clinical outcomes and baseline ASPECTS in ischemic stroke patients managed with endovascular methods to validate the use of ASPECTS for risk prognostication. MATERIALS AND METHODS: We searched the MEDLINE, EMBASE, and Cochran databases for observational or interventional studies that reported clinical outcomes and baseline ASPECTS in ischemic stroke patients treated with endovascular methods...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28300680/evaluation-by-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#18
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/28286721/functional-outcome-after-decompressive-craniectomy-in-patients-with-dominant-or-non-dominant-malignant-middle-cerebral-infarcts
#19
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
#20
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
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