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intracranial atherosclerosis

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https://www.readbyqxmd.com/read/28168435/is-obstructive-sleep-apnea-associated-with-the-presence-of-intracranial-cerebral-atherosclerosis
#1
Tae-Jin Song, Jung-Hyun Park, Kang Hyun Choi, Ju-Hee Kim, Yunseo Choi, Yoonkyung Chang, Hyeon Jin Kim, Jangsup Moon, Yong-Jae Kim, Hyang Woon Lee
PURPOSE: Intracranial cerebral atherosclerosis (ICAS) is one of critical atherosclerosis which closely related with stroke. Obstructive sleep apnea (OSA) is associated with systemic atherosclerosis, but it is unclear whether OSA is related with the presence of ICAS. We aimed to investigate the association between the presence of ICAS and severity of OSA in patients with suspected OSA. METHODS: This retrospective, cross-sectional study included 283 patients who suspected OSA (presence of one or more OSA-related symptom and high-risk category in Berlin questionnaire) and underwent polysomnography and brain magnetic resonance angiography (MRA)...
February 7, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28157748/large-artery-atherosclerotic-occlusive-disease
#2
John W Cole
PURPOSE OF REVIEW: Extracranial or intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack. Given the high prevalence of large artery atherosclerosis in the general population, determining whether an identified atherosclerotic lesion is truly the cause of a patient's symptomatology can be difficult. In all cases, optimally treating each patient to minimize future stroke risk is paramount. Extracranial or intracranial large artery atherosclerosis can be broadly compartmentalized into four distinct clinical scenarios based upon the individual patient's history, examination, and anatomic imaging findings: asymptomatic and symptomatic extracranial carotid stenosis, intracranial atherosclerosis, and extracranial vertebral artery atherosclerotic disease...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28154100/stroke-caused-by-atherosclerosis-of-the-major-intracranial-arteries
#3
Chirantan Banerjee, Marc I Chimowitz
Our goal in this review is to discuss the pathophysiology, diagnosis, and treatment of stroke caused by atherosclerosis of the major intracranial arteries. References for the review were identified by searching PubMed for related studies published from 1955 to June 2016 using search terms intracranial stenosis and intracranial atherosclerosis. Reference sections of published randomized clinical trials and previously published reviews were searched for additional references. Intracranial atherosclerotic disease is a highly prevalent cause of stroke that is associated with a high risk of recurrent stroke...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28121918/intracranial-dermoid-cyst-rupture-related-brain-ischemia-case-report-and-hemodynamic-study
#4
Hang Jin, Zhen-Ni Guo, Yun Luo, Ren Zhao, Ming-Shuo Sun, Yi Yang
RATIONALE: Spontaneous rupture of intracranial dermoid cyst is a rare but serious clinical event that can result in cerebral ischemia. Cerebral vasospasm and vasculitis are considered as potential mechanisms of dermoid cyst rupture-related cerebral ischemia. However, the hemodynamic mechanisms between cerebral ischemia and dermoid cyst rupture are not well known. PATIENT CONCERNS: A 55-year-old, right-handed man was admitted to our hospital with sudden receptive aphasia and right-sided hypoalgesia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28104642/evaluation-of-encephaloduroarteriosynangiosis-efficacy-using-probabilistic-independent-component-analysis-applied-to-dynamic-susceptibility-contrast-perfusion-mri
#5
A N Laiwalla, F Kurth, K Leu, R Liou, J Pamplona, Y C Ooi, N Salamon, B M Ellingson, N R Gonzalez
BACKGROUND AND PURPOSE: Indirect cerebral revascularization has been successfully used for treatment in Moyamoya disease and symptomatic intracranial atherosclerosis. While angiographic neovascularization has been demonstrated after surgery, measurements of local tissue perfusion are scarce and may not reflect the reported successful clinical outcomes. We investigated probabilistic independent component analysis and conventional perfusion parameters from DSC-MR imaging to measure postsurgical changes in tissue perfusion...
January 19, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28089094/postprandial-clearance-of-oxidized-low-density-lipoprotein-in-patients-with-stroke-due-to-atherosclerosis
#6
Sami Al Kasab, Christy Cassarly, Ngoc-Anh Le, Renee Martin, Julia Brinley, Marc I Chimowitz, Tanya N Turan
BACKGROUND: Oxidized low-density lipoprotein (OxLDL) is a contributor to atherosclerosis development. OxLDL formation increases in the postprandial state due to oxidative stress in subjects with coronary artery disease (CAD) and diabetes, but has not been studied in patients with atherosclerotic stroke. We aimed to determine differences in postprandial OxLDL in patients with atherosclerotic stroke compared to stroke from other causes. METHODS: Patients with ischemic stroke but no history of CAD (n = 42) were enrolled and categorized by stroke subtype as extracranial atherosclerosis (EC), n = 12; intracranial atherosclerosis (IC), n = 16; or other cause, n = 14...
January 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#7
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28061015/impact-of-vessel-wall-lesions-and-vascular-stenoses-on-cerebrovascular-reactivity-in-patients-with-intracranial-stenotic-disease
#8
Petrice M Cogswell, Taylor L Davis, Megan K Strother, Carlos C Faraco, Allison O Scott, Lori C Jordan, Matthew R Fusco, Blaise deB Frederick, Jeroen Hendrikse, Manus J Donahue
PURPOSE: To compare cerebrovascular reactivity (CVR) and CVR lagtimes in flow territories perfused by vessels with vs. without proximal arterial wall disease and/or stenosis, separately in patients with atherosclerotic and nonatherosclerotic (moyamoya) intracranial stenosis. MATERIALS AND METHODS: Atherosclerotic and moyamoya patients with >50% intracranial stenosis and <70% cervical stenosis underwent angiography, vessel wall imaging (VWI), and CVR-weighted imaging (n = 36; vessel segments evaluated = 396)...
January 6, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28060941/computed-tomographic-distinction-of-intimal-and-medial-calcification-in-the-intracranial-internal-carotid-artery
#9
Remko Kockelkoren, Annelotte Vos, Wim Van Hecke, Aryan Vink, Ronald L A W Bleys, Daphne Verdoorn, Willem P Th M Mali, Jeroen Hendrikse, Huiberdina L Koek, Pim A de Jong, Jill B De Vis
BACKGROUND: Intracranial internal carotid artery (iICA) calcification is associated with stroke and is often seen as a proxy of atherosclerosis of the intima. However, it was recently shown that these calcifications are predominantly located in the tunica media and internal elastic lamina (medial calcification). Intimal and medial calcifications are thought to have a different pathogenesis and clinical consequences and can only be distinguished through ex vivo histological analysis. Therefore, our aim was to develop CT scoring method to distinguish intimal and medial iICA calcification in vivo...
2017: PloS One
https://www.readbyqxmd.com/read/28059659/antiplatelet-therapy-for-the-prevention-of-peri-coiling-thromboembolism-in-high-risk-patients-with-ruptured-intracranial-aneurysms
#10
Nancy J Edwards, Wesley H Jones, Aditya Sanzgiri, Juan Corona, Mark Dannenbaum, Peng Roc Chen
OBJECTIVE The most frequent procedural complication of the endovascular treatment of intracranial aneurysms is a thromboembolic event (TEE); in a subset of patients, such events will cause permanent neurological disability. In patients with unruptured aneurysms, increasing evidence supports the use of periprocedural antiplatelet therapy to prevent TEEs. The object of this study was to evaluate whether patients with ruptured aneurysms and subarachnoid hemorrhage would also benefit from periprocedural antiplatelet therapy...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28057635/in-vivo-assessment-of-the-impact-of-regional-intracranial-atherosclerotic-lesions-on-brain-arterial-3d-hemodynamics
#11
C Wu, S Schnell, P Vakil, A R Honarmand, S A Ansari, J Carr, M Markl, S Prabhakaran
BACKGROUND AND PURPOSE: Intracranial atherosclerosis induces hemodynamic disturbance, which is not well-characterized, particularly in cerebral flow redistribution. We aimed to characterize the impact of regional stenotic lesions on intracranial hemodynamics by using 4D flow MR imaging. MATERIALS AND METHODS: 4D flow MR imaging was performed in 22 symptomatic patients (mean age, 68.4 ± 14.2 years) with intracranial stenosis (ICA, n = 7; MCA, n = 9; basilar artery, n = 6) and 10 age-appropriate healthy volunteers (mean age, 60...
January 5, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28041720/atrial-fibrillation-is-a-major-cause-of-stroke-in-apneic-patients-a-prospective-study
#12
M Poli, P Philip, J Taillard, S Debruxelles, P Renou, J M Orgogozo, F Rouanet, I Sibon
OBJECTIVES: Large prospective studies have established that sleep-disordered breathing (SDB) is associated with an increased incidence of cardiovascular and cerebrovascular diseases. Heterogeneous results have been published about SDB and ischaemic stroke mechanism. The aim of this study was to evaluate the relationship between poststroke apneic syndrome and stroke aetiologies according to the ASCO classification. METHODS: A total of 134 patients with acute ischaemic cerebrovascular events were prospectively included...
March 4, 2016: Sleep Medicine
https://www.readbyqxmd.com/read/28027739/intracranial-arterial-wall-enhancement-using-gadolinium-enhanced-3d-black-blood-t1-weighted-imaging
#13
Koichi Takano, Kosuke Hida, Yasuo Kuwabara, Kengo Yoshimitsu
PURPOSE: We investigated the enhancement of the intracranial arterial walls with gadolinium-enhanced, black-blood three-dimensional T1-weighted imaging (Gd-3DBB) by using an improved motion-sensitized driven-equilibrium (iMSDE)-prepared volumetric isotropic turbo spin-echo acquisition (VISTA). METHODS: A total of 115 patients underwent FLAIR, 3D-TOF-MRA and Gd-3DBB with a 1.5-T scanner. The degree and distribution of the arterial wall enhancement on Gd-3DBB was assessed...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28003500/relationship-between-risk-factor-control-and-vascular-events-in-the-sammpris-trial
#14
Tanya N Turan, Azhar Nizam, Michael J Lynn, Brent M Egan, Ngoc-Anh Le, Maria F Lopes-Virella, Kathie L Hermayer, Jamie Harrell, Colin P Derdeyn, David Fiorella, L Scott Janis, Bethany Lane, Jean Montgomery, Marc I Chimowitz
OBJECTIVE: The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study is the first stroke prevention trial to include protocol-driven intensive management of multiple risk factors. In this prespecified analysis, we aimed to investigate the relationship between risk factor control during follow-up and outcome of patients in the medical arm of SAMMPRIS. METHODS: Data from SAMMPRIS participants in the medical arm (n = 227) were analyzed...
January 24, 2017: Neurology
https://www.readbyqxmd.com/read/27960191/pathological-characteristics
#15
Xiang-Yan Chen, Mark Fisher
Within the intracranial vasculature, atherosclerosis occurs in two distinctive patterns: (1) in Western populations who have severe extracranial and systemic atherosclerosis, the severity of intracranial involvement is consistently less than that within extracranial arteries; and (2) in Asians, Africans, and Hispanics, who often have isolated intracranial arterial disease that is found to be more often accompanied by brain infarction than comparable extracranial atherosclerotic disease. Compared to coronary and extracranial carotid atherosclerosis, intracranial atherosclerosis has distinct pathological characteristics compared to that of extracranial arteries...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960189/surgical-therapy
#16
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/27960184/vessel-and-vessel-wall-imaging
#17
Seung Chai Jung, Dong-Wha Kang, Tanya N Turan
Angiography is a useful, important, common imaging method, with digital subtraction angiography (DSA) remaining the gold standard for luminal imaging. Computed tomography angiography (CTA) is minimally invasive and quite accurate in the evaluation of stenosis. Magnetic resonance angiography (MRA) is a good screening tool with the least invasiveness. Angiography mostly represents intracranial artery disease as luminal stenosis, which is often not sufficient to evaluate intracranial vascular pathology. The modalities provide indirect information about vascular pathology because luminal change, such as stenosis, results from the changes of vessel walls...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960183/antithrombotic-therapy
#18
Sun U Kwon, Jong S Kim
Symptomatic cerebral atherosclerosis including intracranial atherosclerosis (ICAS) is associated with a high risk of recurrent stroke. Antithrombotic agents are the mainstay of therapy in these patients. Several studies have found anticoagulation (warfarin) to increase the risk of bleeding events and have an efficacy no better than that of aspirin. Therefore, anticoagulants are not widely used unless patients develop recurrent ischemic symptoms despite receiving antiplatelet therapy. Because ICAS progression is not uncommon and the risk of stroke recurrence is high when aspirin monotherapy is used, dual antiplatelet agents may be needed at least in the early disease stage...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960181/stroke-mechanisms
#19
Ka Sing Wong, Louis R Caplan, Jong S Kim
Recent advances in neuroimaging technologies, such as diffusion weighted magnetic resonance imaging (MRI), perfusion weighted computed tomography (CT)/MRI, MR/CT angiography and Doppler ultrasonography allow us to determine the mechanisms of stroke and transient ischemic attack. In addition, high-resolution vessel wall MRI is nowadays increasingly used to understand the stroke mechanism in patients with intracranial atherosclerosis. Artery to artery embolism, hypoperfusion and the combination of the two are the important stroke mechanisms in patients with extracranial atherosclerosis...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960174/non-atherosclerotic-intracranial-arterial-diseases
#20
Jong S Kim, Louis R Caplan
Atherosclerosis is not the only cause of intracranial arterial disease. Arterial dissection, moyamoya disease, vascular inflammatory disease, vasospasm and immunologic disorders are important non-atherosclerotic intracranial arterial diseases. Identification of the correct etiology is important in establishing treatment strategies and assessing prognosis. Careful history taking and appropriate laboratory testing are essential. Although catheter angiography is the most important diagnostic tool to examine various intracranial arterial diseases, other diagnostic modalities such as CT angiography and MR angiography are nowadays widely used...
2016: Frontiers of Neurology and Neuroscience
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