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https://www.readbyqxmd.com/read/28417216/pathogenic-mechanisms-following-ischemic-stroke
#1
REVIEW
Seyed Esmaeil Khoshnam, William Winlow, Maryam Farzaneh, Yaghoob Farbood, Hadi Fathi Moghaddam
Stroke is the second most common cause of death and the leading cause of disability worldwide. Brain injury following stroke results from a complex series of pathophysiological events including excitotoxicity, oxidative and nitrative stress, inflammation, and apoptosis. Moreover, there is a mechanistic link between brain ischemia, innate and adaptive immune cells, intracranial atherosclerosis, and also the gut microbiota in modifying the cerebral responses to ischemic insult. There are very few treatments for stroke injuries, partly owing to an incomplete understanding of the diverse cellular and molecular changes that occur following ischemic stroke and that are responsible for neuronal death...
April 17, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28416412/successful-treatment-of-symptomatic-intracranial-carotid-artery-stenosis-using-a-24-mm-long-bare-metal-coronary-stent
#2
Azeem A Rehman, Ryan C Turner, Brandon P Lucke-Wold, SoHyun Boo
BACKGROUND: Intracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis. CASE DESCRIPTION: We present a case of a 42-year-old male with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management...
April 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#3
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28366059/stent-technology-in-ischemic-stroke
#4
REVIEW
Nam K Yoon, Al-Wala Awad, M Yashar S Kalani, Philipp Taussky, Min S Park
Atherosclerotic disease of the cerebral vasculature is a major cause of stroke worldwide. Atherosclerosis that is refractory to best medical management may require revascularization. In these instances, endovascular treatment provides a popular and safe alternative to open surgical techniques. The authors provide an overview of stent technology in the treatment of ischemic stroke, discussing the major studies evaluating stenting for extracranial carotid artery, vertebral artery, and intracranial atherosclerotic disease...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28334718/sex-differences-do-not-exist-in-outcomes-among-stroke-patients-with-intracranial-atherosclerosis-in-china-subgroup-analysis-from-the-chinese-intracranial-atherosclerosis-study
#5
Yuehua Pu, Na Wei, Dandan Yu, Yilong Wang, Xinying Zou, Yannie O Y Soo, Yuesong Pan, Thomas W H Leung, Lawrence K S Wong, Yongjun Wang, Liping Liu
BACKGROUND: To date, sex difference in outcomes among patients with intracranial atherosclerosis (ICAS) has rarely been discussed in China as well as in the world. This study aimed to estimate the sex difference in outcomes among patients with ICAS in Chinese cerebral ischemia patients. METHODS: We analyzed 1,335 men and women with ICAS who were enrolled in the Chinese Intracranial Atherosclerosis study. They were followed-up for ischemic stroke recurrence, any cause of death, cerebral vascular events (including transient ischemic attack, ischemic and hemorrhagic stroke), combined end points (including cerebral vascular events, angina or myocardial infarction, pulmonary embolism, peripheral vascular events), and unfavorable outcome (modified Rankin scale score of 3-6) at 1 year...
March 24, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28330958/intracranial-atherosclerosis-and-dementia-the-atherosclerosis-risk-in-communities-aric-study
#6
Jennifer L Dearborn, Yiyi Zhang, Ye Qiao, Muhammad Fareed K Suri, Li Liu, Rebecca F Gottesman, Andreea M Rawlings, Thomas H Mosley, Alvaro Alonso, David S Knopman, Eliseo Guallar, Bruce A Wasserman
OBJECTIVE: To explore the association of intracranial atherosclerotic disease (ICAD) with mild cognitive impairment (MCI) and dementia. METHODS: From 2011 to 2013, 1,744 participants completed high-resolution vessel wall MRI from the population-based Atherosclerosis Risk in Communities Study by a sampling strategy that allowed weighting back to the cohort. We defined ICAD by plaque features (presence, territory, stenosis, number). Trained clinicians used an algorithm incorporating information from interviews and neuropsychological and neurologic examinations to adjudicate for MCI and dementia...
April 18, 2017: Neurology
https://www.readbyqxmd.com/read/28319156/differential-impact-of-serum-total-bilirubin-level-on-cerebral-atherosclerosis-and-cerebral-small-vessel-disease
#7
Jonguk Kim, Seung-Jae Yoon, Min-Hee Woo, Sang-Heum Kim, Nam-Keun Kim, Jinkwon Kim, Ok-Joon Kim, Seung-Hun Oh
BACKGROUND: A low serum total bilirubin (T-bil) level is associated with an increased risk of atherosclerosis. However, the differential impact of the serum T-bil level on cerebral atherosclerosis and cerebral small vessel disease (SVD) is still unclear. METHODS: We evaluated serum T-bil levels from 1,128 neurologically healthy subjects. Indices of cerebral atherosclerosis (extracranial arterial stenosis [ECAS] and intracranial arterial stenosis [ICAS]), and indices of SVD (silent lacunar infarct [SLI], and moderate-to-severe white matter hyperintensities [msWMH]) were evaluated by the use of brain magnetic resonance imaging (MRI) and MR angiography...
2017: PloS One
https://www.readbyqxmd.com/read/28302605/quantifying-intracranial-internal-carotid-artery-stenosis-on-mr-angiography
#8
H Baradaran, P Patel, G Gialdini, K Al-Dasuqi, A Giambrone, H Kamel, A Gupta
BACKGROUND AND PURPOSE: Intracranial atherosclerosis is a common cause of ischemic stroke. Intracranial stenosis is most commonly quantified by the Warfarin-Aspirin Symptomatic Intracranial Disease method, which involves calculating a ratio of luminal diameter measurements on conventional angiography. Our purpose was to determine whether a single linear measurement of the narrowest caliber of the intracranial ICA on MRA can accurately predict Warfarin-Aspirin Symptomatic Intracranial Disease stenosis measurements...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28273724/imaging-angiogenesis-using-68-ga-nota-prgd2-positron-emission-tomography-computed-tomography-in-patients-with-severe-intracranial-atherosclerotic-disease
#9
Shi Shu, Li Zhang, Yi Cheng Zhu, Fang Li, Li Ying Cui, Hao Wang, Yi Sun, Pei Lin Wu, Zhao Hui Zhu, Bin Peng
Angiogenesis is a critical compensation route, which has been demonstrated in the brain following ischemic stroke; however, few studies have investigated angiogenesis in chronic intracranial atherosclerosis disease (ICAD). We used (68)Ga-NOTA-PRGD2 positron emission tomography/computed tomography based imaging to detect angiogenesis in chronic ICAD and to explore the factors that may have affected it. A total of 21 participants with unilateral severe chronic ICAD were included in the study. Of the 21 participants, 19 were men; the mean (SD) age was 52 (15) years...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28261756/association-between-hyperhomocysteinemia-and-stroke-with-atherosclerosis-and-small-artery-occlusion-depends-on-homocysteine-metabolism-related-vitamin-levels-in-chinese-patients-with-normal-renal-function
#10
Guan-Hui Wu, Fan-Zhen Kong, Xiao-Feng Dong, De-Feng Wu, Qian-Zhu Guo, Ai-Rong Shen, Qing-Zhang Cheng, Wei-Feng Luo
This study was conducted to investigate the role of different homocysteine metabolism-related vitamin (HMRV) levels in the correlation between hyperhomocysteinemia (HHCY) and ischemic stroke (IS) subtypes. Three hundred and forty-eight IS patients manifesting different vascular subtypes were subclassified on the basis of HMRV deficiencies. Correlation between HHCY and IS subtypes was investigated in all the subgroups. In this study, HHCY was significantly correlated with the IS subtypes in large artery atherosclerosis (OR 1...
March 6, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28248916/light-induced-hemiplegia-an-atypical-case-of-retinal-steal-syndrome
#11
David Kerek, Sami Al Kasab, Michael U Antonucci, Raymond D Turner, Tanya N Turan
Atherosclerosis affecting the carotid arteries accounts for up to 20% of ischemic strokes 1. The clinical effects of atherosclerotic occlusive disease vary according to multiple factors, one of which is collateral circulation. In response to a chronic decrease in cerebral perfusion from atherosclerotic occlusion, alternative flow pathways, or collaterals, develop in a variety of patterns. In the setting of carotid occlusion, flow from the Circle of Willis, if complete, often comprises the main cerebral collateral network...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28238629/apolipoprotein-a1-rs5070-a-g-polymorphism-with-stroke-subtypes-in-taiwan
#12
Li-Chi Hsu, Tsong-Hai Lee
BACKGROUND: Apolipoprotein A1 (ApoA1) is a structural protein of high-density lipoprotein cholesterol; ApoA1 is involved in lipid and cholesterol metabolism. This study evaluated the association of ApoA1 polymorphism (rs5070) with different stroke subtypes in Taiwanese individuals. METHODS: A total of 2139 cases, including 614 controls and 708 large artery atherosclerosis (LAA), 377 small-vessel occlusion, and 440 hypertensive intracranial hemorrhage cases, were enrolled in this study...
February 23, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28168435/is-obstructive-sleep-apnea-associated-with-the-presence-of-intracranial-cerebral-atherosclerosis
#13
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
#14
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
#15
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
#16
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
#17
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...
March 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
#18
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
#19
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...
April 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
#20
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
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