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https://www.readbyqxmd.com/read/29345593/antithrombotic-therapy-after-tavr
#1
Tobias Geisler, Michal Droppa, Karin Mueller, Oliver Borst
Transvascular aortic valve replacement (TAVR) has emerged as a treatment option in patients with severe aortic stenosis who are inoperable and has recently been evaluated in patients with intermediate surgical risk. The number of procedures is increasing worldwide in parallel with the demographic changes in industrial countries. The risk for cerebral embolism is of main concern and represents a major determinant for prognosis and quality of live after TAVR. The empiric antithrombotic therapy consists of dual antiplatelet therapy (DAPT); however the risk-benefit of this approach is lacking evidence from randomized, placebo-controlled trials regarding choice and duration of antithrombotic treatment...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345035/pressure-and-pipes-from-neuroimaging-to-virtual-measurement
#2
Marialuisa Zedde, Rosario Pascarella
Leng et al. [1] described the practical application of a computational fluid dynamics (CFD) model based on Computed Tomography Angiography (CTA) in 85 patients with symptomatic atherosclerotic M1 middle cerebral artery (MCA) stenosis, to virtually measure arterial pressure (AP) across the stenotic segment, according to the theory that translesional pressure gradient (PG) drives arteriologenesis and leptomeningeal collaterals (LMC) development. This is a fundamental pathophysiological issue about the risk of recurrent stroke downstream an intracranial artery stenosis and both the degree of stenosis and the collateral circulation affect it; in WASID trial [2] patients with severe (> 70%) intracranial stenosis and efficient collaterals had a lower risk of recurrent stroke than patients with poor collaterals...
January 18, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29344983/anti-inflammatory-effect-of-4-methylcyclopentadecanonein-rats-submitted-to-ischemic-stroke
#3
Yan Jin, Fang Wei, Xiaoli Dai, Min Qi, Yukui Ma
The present study aimed to investigate the anti-inflammatory effect of 4-methylcyclopentadecanone (4-MCPC) in rats suffering from a cerebral ischemia/ reperfusion (I/R) injury. In this study, the focal cerebral ischemia in rats was induced by middle cerebral artery occlusion (MCAO) for 2 h, and the rats were treated with 4-MCPC (8 mg/kg) just 0.5 h before reperfusion. The ischemic infarct volume was recorded 24 h after the MCAO. In addition, myeloperoxidase (MPO) activity and TNF-α and IL-1β levels in the ischemic cerebral cortex were determined by ELISA, while nuclear translocation of NF-κB p65 subunit and expression of p-IκBα were investigated by western blotting...
January 18, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29344828/neuroprotective-effect-of-p-coumaric-acid-in-mice-with-cerebral-ischemia-reperfusion-injuries
#4
Romgase Sakamula, Wachiryah Thong-Asa
Cerebral ischemia reperfusion (IR) is associated with neuronal death, which leads to disability and cognitive decline. The pathomechanism occurs because ischemia is exacerbated during the reperfusion period. Neuronal damage susceptibility depends on the affected brain areas and the duration of ischemia. Prevention and supplementation to neurons may help them endure during IR and further benefit them in rehabilitation. We investigated the protective effect of p-coumaric acid (PC) on cerebral IR injuries in mice...
January 17, 2018: Metabolic Brain Disease
https://www.readbyqxmd.com/read/29344065/optociliary-shunt-vessels-role-in-diagnosis-and-treatment-of-atypical-pseudotumor-cerebri
#5
Frederico Castelo Moura, Ida Fortini
A 46-year-old man presented with severe visual loss and optic atrophy associated with optociliary shunt vessels. The diagnostic work-up revealed intracranial hypertension and cerebral venous sinus stenosis, with no evidence of previous thrombosis. In view of the severe visual dysfunction, both eyes were submitted to optic nerve sheath fenestration. After surgery, a regression of collateral vessels was observed in both eyes.
August 2017: Neuro-ophthalmology
https://www.readbyqxmd.com/read/29343482/par1-biased-signaling-is-required-for-activated-protein-c-in-vivo-benefits-in-sepsis-and-stroke
#6
Ranjeet K Sinha, Yaoming Wang, Zhen Zhao, Xiao Xu, Laurent Burnier, Naveen Gupta, José A Fernandez, Greg Martin, Sergey Kupriyanov, Laurent O Mosnier, Berislav V Zlokovic, John H Griffin
Activated Protein C (APC) cleaves protease activated receptor (PAR)1 in vitro at R46 to initiate beneficial cell signaling; however, thrombin and APC can cleave at R41. To elucidate PAR1-dependent aspects of pharmacologic APC's in vivo mechanisms, we generated C57BL/6 mouse strains carrying QQ41 or QQ46 point mutations in PAR1 (F2r gene). Using these strains, we determined whether or not recombinant murine signaling-selective APC mutants would reduce septic death or provide neuroprotection against ischemic stroke when mice carried PAR1 homozygous mutations that prevent cleavage at either R41 or R46...
January 17, 2018: Blood
https://www.readbyqxmd.com/read/29343148/predictors-of-intracranial-hemorrhage-volume-and-distribution-in-brain-arteriovenous-malformation
#7
Jay F Yu, Andrew D Nicholson, Jeffrey Nelson, Matthew D Alexander, Stephanie H Tse, Steven W Hetts, J Claude Hemphill, Helen Kim, Daniel L Cooke
Background and purpose Despite evidence regarding risk factors for brain arteriovenous malformation (bAVM)-associated spontaneous intracranial hemorrhage (ICH), few data exist describing the spectrum of clinical outcomes that bAVM-associated ICH may manifest. This study aimed to identify the demographical, clinical, and bAVM anatomical variables associated with ICH volume and the presence of intraventricular hemorrhage (IVH) of ruptured bAVMs, two indicators of worse clinical outcome, to help better predict outcome for unruptured bAVMs...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29342151/cd8-signaling-in-microglia-macrophage-m1-polarization-in-a-rat-model-of-cerebral-ischemia
#8
Jan Boddaert, Kenny Bielen, Bart 's Jongers, Ekta Manocha, Laetitia Yperzeele, Patrick Cras, Daniel Pirici, Samir Kumar-Singh
Classical or M1 activity of microglia/macrophages has been described in several neurodegenerative and brain inflammatory conditions and has also been linked to expansion of ischemic injury in post-stroke brain. While different pathways of M1 polarization have been suggested to occur in the post-stroke brain, the precise underlying mechanisms remain undefined. Using a transient middle cerebral artery occlusion (MCAO) rat model, we showed a progressive M2 to M1 polarization in the perilesional brain region with M1 cells becoming one of the dominant subsets by day 4 post-stroke...
2018: PloS One
https://www.readbyqxmd.com/read/29341803/licorice-pretreatment-protects-against-brain-damage-induced-by-middle-cerebral-artery-occlusion-in-mice
#9
Chiyeon Lim, Sehyun Lim, Byoungho Lee, Buyeo Kim, Suin Cho
Licorice is extracted from the roots of plants in the Glycyrrhiza genus, especially Glycyrrhiza uralensis in China and Korea. It has several pharmacological activities, including neuro-protective, anti-fungal, and anti-cariogenic effects. Ischemia/reperfusion-induced brain injury is a leading cause of adult disability and death; thus, the identification of anti-apoptotic, neuro-protective therapeutic agents is viewed as an attractive drug development strategy. Infarct volumes and the expression of several apoptosis-related proteins, including Bcl-xL, Bcl-2, caspase-8, and caspase-9, were evaluated by western blotting in the brains of mice subjected to middle cerebral artery occlusion (MCAO)...
January 17, 2018: Journal of Medicinal Food
https://www.readbyqxmd.com/read/29341424/fetal-ultrasonographic-findings-including-cerebral-hyperechogenicity-in-a-patient-with-non-lethal-form-of-raine-syndrome
#10
Kei Tamai, Katsuhiko Tada, Akihito Takeuchi, Makoto Nakamura, Hidenori Marunaka, Yosuke Washio, Hiroyuki Tanaka, Fuyuki Miya, Nobuhiko Okamoto, Misao Kageyama
Raine syndrome is a rare osteosclerotic bone dysplasia characterized by craniofacial anomalies and intracranial calcification. Most patients with Raine syndrome are of Arab ancestry and die during the neonatal period. We herein report a Japanese patient with non-lethal Raine syndrome who presented with characteristic cerebral hyperechogenicity and a hypoplastic nose by fetal ultrasonography. She was admitted to the NICU due to pyriform aperture stenosis. Craniofacial abnormalities, intracranial calcification, osteosclerosis, chondrodysplasia punctata, and a mutation of FAM20C was identified...
January 17, 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29340741/-platelet-inhibition-in-patients-with-coronary-cerebral-and-peripheral-macroangiopathy-what-when-and-how-long
#11
REVIEW
M Halbach, S Baldus
BACKGROUND: Inhibition of platelet aggregation can reduce the rate of vascular events in patients with coronary artery disease, carotid artery stenosis and symptomatic peripheral arterial disease. The choice of platelet inhibitors in monotherapy and combination therapy as well as the duration of dual platelet inhibition depend on the clinical situation and individual patient characteristics. GOAL: The present review summarizes the latest data from clinical trials and recommendations regarding platelet inhibition in coronary, cerebral and peripheral arterial disease...
January 16, 2018: Der Internist
https://www.readbyqxmd.com/read/29340071/hypoxia-inducible-factor-1%C3%AE-regulates-microglial-functions-affecting-neuronal-survival-in-the-acute-phase-of-ischemic-stroke-in-mice
#12
Seoyeon Bok, Young-Eun Kim, Youngsik Woo, Soeun Kim, Suk-Jo Kang, Yoontae Lee, Sang Ki Park, Irving L Weissman, G-One Ahn
Cells universally adapt to ischemic conditions by turning on a transcription factor hypoxia-inducible factor (HIF), in which its role is known to differ widely across many different types of cells. Given that microglia have been reported as an essential mediator of neuroinflammation in many brain diseases, we examined the role of HIF in microglia in the progression of an acute phase of ischemic stroke by challenging our novel strains of myeloid-specific Hif-1α or Hif-2α knockout (KO) mice created by Cre-loxP system via middle cerebral artery occlusion (MCAO)...
December 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/29339964/cerebral-venous-thrombosis-with-papilloedema-secondary-to-skull-base-plasmacytoma
#13
Peter W MacIntosh, Amy Y Lin, Jin Suh Kim, Fernando D Testai, Heather E Moss
A 60-year-old woman with history of multiple myeloma was in remission after stem cell transplant 6 years prior. She was undergoing work-up for headaches that were thought to be secondary to a right mastoiditis seen on magnetic resonance imaging (MRI). On routine eye exam, papilloedema was noted. A lumbar puncture was performed, with elevated opening pressure with normal constituents. She was an atypical age for idiopathic intracranial hypertension, and her mastoiditis raised concern for secondary cerebral venous sinus thrombosis...
October 2017: Neuro-ophthalmology
https://www.readbyqxmd.com/read/29339370/nature-s-wastebasket-the-role-of-the-external-carotid-artery-in-acute-stroke
#14
Jesse Jones, Conrad William Liang, Nima Ramezan-Arab, Gary Duckwiler, Satoshi Tateshima
We describe a novel technical approach to acute stroke illustrated by the case of a 41 year old male who presented with tandem right common carotid artery (CCA) and M1 occlusions. His NIHSS was 17 and Alberta stroke programe early CT score (ASPECTs) was 8. Thrombectomy initially proved challenging due to large volume CCA thrombus that repeatedly occluded the aspiration catheters. However, by inflating a balloon distally and pulling clot into the adjacent ECA, we were able to quickly restore distal contrast flow to the intracranial circulation and achieve Thrombolysis In Cerebral Infarction/Arterial Occlusive Lesion (TICI2C/AOL3) revascularization...
January 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29339323/mechanical-thrombectomy-of-acute-middle-cerebral-artery-occlusion-using-trans-anterior-communicating-artery-approach
#15
Krishna Amuluru, Charles E Romero, Logan Pyle, Mohammad El-Ghanem, Fawaz Al-Mufti
BACKGROUND: A cross-circulation technique involves gaining access to a cerebral vessel through a patent anterior or posterior communicating artery. This technique may be utilized in patients with emergent large vessel occlusions and an unfavorable direct route to the occlusion. While few previous reports have demonstrated successful cross-circulation technique for treatment of emergent large vessel occlusions, we present the first two cases of trans-anterior communicating artery stent-retriever thrombectomy...
January 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29339317/arterial-stenosis-in-antiphospholipid-syndrome-update-on-the-unrevealed-mechanisms-of-an-endothelial-disease
#16
REVIEW
Ghita Harifi, Wared Nour-Eldine, Mohammad Hassan A Noureldine, Mohammad Baker Berjaoui, Romy Kallas, Rita Khoury, Imad Uthman, Jamal Al-Saleh, Munther A Khamashta
First described in 1983, antiphospholipid syndrome (APS) is an autoimmune condition characterized by the occurrence of recurrent arterial and/or venous thrombosis, and/or pregnancy morbidity, in the setting of persistent presence of antiphospholipid antibodies (aPL). While thrombosis is the most well-known pathogenic mechanism in this disorder, the relevance of some other mechanisms such as arterial stenosis is being increasingly recognized. Arterial stenosis has been first described in the renal arteries in patients with APS, however intracranial and coeliac arteries can also be involved with various and treatable clinical manifestations...
January 12, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29338983/dipyridamole-plus-triflusal-versus-triflusal-alone-in-infarct-reduction-after-middle-cerebral-artery-occlusion
#17
Zareen Amtul, Wasimul Haque, David F Cechetto
BACKGROUND AND PURPOSE: The objective of this work is to study the dose-dependent effect of combination therapy with dipyridamole and triflusal over that of triflusal alone on infarct size after middle cerebral artery occlusion (MCAO) ischemia. MATERIALS AND METHODS: Male Wistar rats were subjected to a permanent MCAO in the right hemisphere. Rats received triflusal alone and with dipyridamole via oral route. Three days after surgery, infarct volumes were measured...
January 12, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29338384/human-umbilical-cord-mesenchymal-stem-cells-preserve-adult-newborn-neurons-and-reduce-neurological-injury-after-cerebral-ischemia-by-reducing-the-number-of-hypertrophic-microglia-macrophages
#18
Willie Lin, Yogi Chang-Yo Hsuan, Mao-Tsun Lin, Ting-Wei Kuo, Cheng-Hsien Lin, Yu-Chin Su, Ko-Chi Niu, Ching-Ping Chang, Hung-Jung Lin
Microglia are the first source of a neuroinflammatory cascade, which seems to be involved in every phase of stroke-related neuronal damage. Two weeks after transient middle cerebral artery occlusion (MCAO), vehicle-treated rats displayed higher numbers of total ionized calcium-binding adaptor molecule 1 (Iba-1)-positive cells, greater cell body areas of Iba-1-positive cells, and higher numbers of hypertrophic Iba-1-positive cells (with a cell body area over 80 μm2) in the ipsilateral ischemic brain regions including the frontal cortex, striatum, and parietal cortex...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29337840/targeted-temperature-management-at-33%C3%A2-c-or-36%C3%A2-c-produces-equivalent-neuroprotective-effects-in-the-middle-cerebral-artery-occlusion-rat-model-of-ischemic-stroke
#19
Jung Ho Lee, Jisoo Lim, Yong Eun Chung, Sung Phil Chung, Incheol Park, Chul Hoon Kim, Je Sung You
Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke...
January 15, 2018: Shock
https://www.readbyqxmd.com/read/29337170/virtual-cerebral-aneurysm-clipping-with-real-time-haptic-force-feedback-in-neurosurgical-education
#20
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education and should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force-feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012-2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software and the prototype was evaluated by 18 neurosurgeons...
January 11, 2018: World Neurosurgery
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