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https://www.readbyqxmd.com/read/28647711/down-syndrome-and-moyamoya-disease-unusual-cause-of-stroke
#1
Carlos Tavares Bello, Catarina Barreiros, Inês Gil, Carlos Vasconcelos
Down syndrome is a frequent clinical entity, being considered one of the most frequent chromosomal aberrations. It is characterised by a typical clinical phenotype and is associated with a heterogeneous group of organ and system-specific abnormalities. The cardiovascular system is commonly affected and if so, it may be associated with an increased morbidity and mortality. Cerebrovascular events in patients with Down syndrome are multifactorial, being possibly related to congenital heart disease, vascular malformations and traditional cardiovascular risk factors...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647705/revolution-in-acute-ischaemic-stroke-care-a-practical-guide-to-mechanical-thrombectomy
#2
REVIEW
Matthew Evans, Phil White, Peter Cowley, David Werring
Rapid, safe and effective arterial recanalisation to restore blood flow and improve functional outcome remains the primary goal of hyperacute ischaemic stroke management. The benefit of intravenous thrombolysis with recombinant tissue-type plasminogen activator for patients with severe stroke due to large artery occlusion is limited; early recanalisation is generally less than 30% for carotid, proximal middle cerebral artery or basilar artery occlusion. Since November 2014, nine positive randomised controlled trials of mechanical thrombectomy for large vessel occlusion in the anterior circulation have led to a revolution in the care of patients with acute ischaemic stroke...
June 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28646330/-imaging-of-vessels-supplying-the-brain
#3
REVIEW
S M Schellong, N Abolmaali, B Voigts, C Stelzner
Nowadays, several technically validated modalities are available for imaging both the extracranial and intracranial segments of arteries supplying blood to the brain. In the acute stroke setting, computed tomography (CT) angiography is of utmost importance because it provides the key diagnostic criteria indicative for the use of catheter-based recanalization techniques. Ultrasound imaging of extracranial arteries is most suitable for detecting an underlying stenosis of the internal carotid artery (ICA) in patients with stroke, transient ischemic attacks (TIA), retinal vessel occlusion and amaurosis fugax...
June 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28645938/practice-patterns-for-acute-ischemic-stroke-workup-a-longitudinal-population-based-study
#4
Matthew C Loftspring, Brett M Kissela, Matthew L Flaherty, Jane C Khoury, Kathleen Alwell, Charles J Moomaw, Dawn O Kleindorfer, Daniel Woo, Opeolu Adeoye, Simona Ferioli, Joseph P Broderick, Pooja Khatri
BACKGROUND: We examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence. METHODS AND RESULTS: We identified stroke cases and related diagnostic testing from four 1-year study periods (July 1993 to June 1994, 1999, 2005, and 2010) of the Greater Cincinnati/Northern Kentucky Stroke Study. Patients aged ≥18 years were included. We focused on evaluation of extracranial arteries for carotid stenosis and assessment of atrial fibrillation because randomized controlled trials supported treatment of these conditions for stroke prevention across all 4 study periods...
June 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28644968/serum-lipoprotein-associated-phospholipase-a2-predicts-the-formation-of-carotid-artery-plaque-and-its-vulnerability-in-anterior-circulation-cerebral-infarction
#5
Yuping Yang, Tao Xue, Juehua Zhu, Jiayi Xu, Xiaowei Hu, Penghao Wang, Tao Kong, Yan Yan, Lihui Yang, Shouru Xue
OBJECTIVE: Circulation inflammation markers such as high-sensitive C-reactive protein (hsCRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are considered as predictors of cerebral and cardiac vascular diseases. However, the role of hsCRP and Lp-PLA2 in the anterior circulation cerebral infarction (ACI) is to be elaborated. PATIENTS AND METHODS: We included 100 patients with acute anterior circulation cerebral infarction (AaCI group) and 50 non-infarction subjects (control group)...
June 12, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28643554/combined-effects-of-physical-inactivity-and-acute-hyperglycemia-on-arterial-distensibility
#6
David Montero, Sune Dandanell, Laura Oberholzer, Stefanie Keiser, Andreas Breenfeldt-Andersen, Thomas Haider, Mario Merlini, Anne-Kristine Meinild-Lundby, Carsten Lundby
Arterial distensibility, an independent predictor of cardiovascular events, is transiently increased with acute hyperglycemia (AHG) in healthy individuals. Whether this response interacts with physical inactivity remains unknown. We examined the effects of short-term bed rest (BR) on the response of carotid artery distensibility (CD) to AHG, and the influence of underlying changes in insulin resistance and blood volume. CD was assessed with ultrasonography before as well as 30 and 120 minutes following ingestion of 75 g of glucose prior to and after 3 days of BR in 15 healthy male volunteers...
June 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28643504/direct-common-carotid-artery-puncture-for-acute-thrombectomy-against-ischemic-stroke
#7
Masahito Kawabori, Toshiya Osanai, Shuho Goto, Motoyuki Iwasaki, Yoshimasa Niiya, Shoji Mabuchi, Kiyohiro Houkin
No abstract text is available yet for this article.
June 22, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28640969/control-of-breathing-and-ventilatory-acclimatization-to-hypoxia-in-deer-mice-native-to-high-altitudes
#8
Catherine M Ivy, Graham R Scott
AIM: We compared the control of breathing and heart rate by hypoxia between high- and low-altitude populations of Peromyscus mice, to help elucidate the physiological specializations that help high-altitude natives cope with O2 limitation. METHODS: Deer mice (P. maniculatus) native to high altitude and congeneric mice native to low altitude (P. leucopus) were bred in captivity at sea level. The F1 progeny of each population were raised to adulthood and then acclimated to normoxia or hypobaric hypoxia (12 kPa, simulating hypoxia at ~4300 m) for 5 months...
June 22, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28637375/anticoagulant-therapy-for-recurrent-in-stent-thrombosis-following-carotid-artery-stenting-a-case-report
#9
Akinori Miyakoshi, Hiroki Toda, Makoto Hayase, Takeshi Kawauchi, Yuki Oichi, Etsuko Hattori
We report a case in which strict anticoagulant therapy management was useful for a recurrent in-stent thrombosis after carotid artery stenting (CAS). An 84-year-old man presented with cognitive decline that progressed rapidly over two months. Head magnetic resonance imaging showed an acute-stage infarct occurring frequently in the right cerebral hemisphere, and he underwent hospitalization and treatment. On neck magnetic resonance angiography (MRA), severe stenosis was found at the origin of the right internal carotid artery...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28630245/internal-carotid-artery-occlusion-and-stroke-as-a-complication-of-cisplatin-based-chemotherapy-for-metastatic-testicular-germ-cell-tumour
#10
Roberto Christian Cerrud-Rodriguez, Maria Gabriela Quinteros, Mohammed Azam
Testicular tumours are the most common tumours in young men. Germ cell tumours (GCTs) account for 95% of all testicular cancers, and the non-seminomatous type (NSGCT) accounts for 50% of all GCTs. Cisplatin-based chemotherapy is curative in up to 90% of patients, but it is not without its inherent risks. Ischaemic stroke is a very uncommon, but severe complication of cisplatin-based chemotherapy. Strokes in young patients cause a disproportionately large economic impact by leaving victims disabled during their most productive years and strains the healthcare system with expensive hospital stays...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28626055/ischemic-stroke-what-does-the-histological-composition-tell-us-about-the-origin-of-the-thrombus
#11
Peter B Sporns, Uta Hanning, Wolfram Schwindt, Aglaé Velasco, Jens Minnerup, Tarek Zoubi, Walter Heindel, Astrid Jeibmann, Thomas Ulrich Niederstadt
BACKGROUND AND PURPOSE: The introduction of stent retrievers allows for a complete extraction and histological analysis of human thrombi. Ischemic stroke is a major health issue, and differentiation of underlying causes is highly relevant to prevent recurrent stroke. Therefore, histopathologic analysis of the embolic clots after removal may provide valuable information about underlying pathologies. This study analyzes histological clot composition and aims to identify specific patterns that might help to distinguish causes of ischemic stroke...
June 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28624098/utility-of-neurovascular-imaging-in-acute-neonatal-arterial-ischemic-stroke
#12
Ishita Siddiq, Derek Armstrong, Ann-Marie Surmava, Nomazulu Dlamini, Daune MacGregor, Mahendranath Moharir, Rand Askalan
OBJECTIVE: To evaluate the prevalence of magnetic resonance angiography (MRA) findings and clinically characterize neonates with arterial ischemic stroke (AIS) who have abnormal or variable vasculature. STUDY DESIGN: This was a single-center, retrospective study of patients with neonatal stroke from 1991 to 2012. We reviewed charts and neuroimaging, including MRA, in neonates with AIS. Clinical data of patients with MRA findings were compared with the control group of neonates with AIS and a normal MRA...
June 14, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28623378/carotid-stenting-in-neuroradiology-a%C3%A2-short-journey-from-the-past-to-current-debates
#13
REVIEW
Joachim Berkefeld, Marlies Wagner, Richard du Mesnil
After a period of stagnation due to negative results of randomized trials for patients with symptomatic stenosis, the relevance of carotid artery stenting (CAS) is increasing again. CAS has become an important and evidence-based part of interventional stroke treatment. Our ability to manage acute recanalization of carotid occlusions and other niche indications properly led some skeptical neurologists to trust in carotid intervention for elective cases as well. The evolution of CAS from initial euphoria to more realistic views under consideration of trial results and guidelines is reviewed...
June 16, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28623120/association-between-ischemic-stroke-and-erdheim-chester-disease-a-case-report-and-review-of-literature
#14
Guillaume Fargeot, Sabrina Stefanizzi, Sebastien Depuydt, Frederic Klapczynski, Alain Ameri
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis characterized by a xanthogranulomatous infiltration of tissues by spumous histiocytes. Neurological involvement is frequent, but ischemic strokes have been exceptionally described. We report the case of a 68-year-old woman who presented with an acute ischemic stroke associated with a multisystemic disorder including insipidus diabetes, infiltration of the aorta and the carotid arteries, perirenal infiltration, aortitis, and lytic bone lesions...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28621574/endovascular-plug-for-internal-carotid-artery-occlusion-in-the-management-of-a-cavernous-pseudoaneurysm-with-bifrontal-subdural-empyema-technical-note
#15
Sunil Manjila, Gagandeep Singh, Obinna Ndubuizu, Zoe Jones, Daniel P Hsu, Alan R Cohen
The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema. They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors' institution...
June 16, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28619499/results-of-early-high-flow-bypass-and-trapping-for-ruptured-blood-blister-like-aneurysms-of-the-internal-carotid-artery
#16
Yuichiro Kikkawa, Toshiki Ikeda, Ririko Takeda, Hiroyuki Nakajima, Takeshi Ogura, Hidetoshi Ooigawa, Hiroki Kurita
OBJECTIVE: The aim of this study is to clarify the efficacy and safety of early surgery using trapping of the affected internal carotid artery (ICA) and high-flow bypass between second portion of the middle cerebral artery and cervical external carotid artery with radial artery graft for ruptured blood blister-like aneurysms (BBAs) arising from anterior wall of the ICA. METHODS: Medical chart of consecutive 16 patients (M:F=7:9, mean 59 years) with subarachnoid hemorrhage (WFNS grade I:2, II:5, III:2, IV:4, V:3) due to ruptured BBA surgically treated between July 2010 and October 2015 were retrospectively reviewed...
June 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28612122/effect-of-passive-heat-stress-and-exercise-in-the-heat-on-arterial-stiffness
#17
Aaron R Caldwell, Forrest B Robinson, Matthew A Tucker, Cash H Arcement, Cory L Butts, Brendon P McDermott, Matthew S Ganio
PURPOSE: Prior evidence indicates that acute heat stress and aerobic exercise independently reduce arterial stiffness. The combined effects of exercise and heat stress on PWV are unknown. The purpose of this study was to determine the effects of heat stress with passive heating and exercise in the heat on arterial stiffness. METHODS: Nine participants (n = 3 females, 47 ± 11 years old; 24.1 ± 2.8 kg/m(2)) completed four trials. In a control trial, participants rested supine (CON)...
June 13, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28611829/stent-retriever-mediated-manual-aspiration-thrombectomy-for-acute-ischemic-stroke
#18
Ashutosh P Jadhav, Amin Aghaebrahim, Anat Horev, Dan-Victor Giurgiutiu, Andrew F Ducruet, Brian Jankowitz, Tudor G Jovin
BACKGROUND AND PURPOSE: Stent retriever thrombectomy and manual aspiration thrombectomy (MAT) have each been shown to lead to high rates of recanalization as single-modality endovascular stroke therapy. We sought to describe the safety and efficacy of a multimodal approach combining these two techniques termed 'stent retriever-mediated manual aspiration thrombectomy' (SMAT) and compared them to MAT alone. METHODS: Retrospective review of a prospectively acquired acute endovascular stroke database...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611828/heads-up-a-novel-provocative-maneuver-to-guide-acute-ischemic-stroke-management
#19
Latisha K Ali, Julius K Weng, Sidney Starkman, Jeffrey L Saver, Doojin Kim, Bruce Ovbiagele, Brian H Buck, Nerses Sanossian, Paul Vespa, Oh Young Bang, Reza Jahan, Gary R Duckwiler, Fernando Viñuela, David S Liebeskind
BACKGROUND: A common dilemma in acute ischemic stroke management is whether to pursue recanalization therapy in patients with large vessel occlusions but minimal neurologic deficits. We describe and report preliminary experience with a provocative maneuver, i.e. 90-degree elevation of the head of bed for 30 min, which stresses collaterals and facilitates decision-making. METHODS: A prospective cohort study of <7.5 h of acute anterior circulation territory ischemia patients with minimal deficits despite middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease...
March 2017: Interventional Neurology
https://www.readbyqxmd.com/read/28611087/acute-ischemic-stroke-after-moderate-to-severe-traumatic-brain-injury-incidence-and-impact-on-outcome
#20
Robert G Kowalski, Juliet K Haarbauer-Krupa, Jeneita M Bell, John D Corrigan, Flora M Hammond, Michel T Torbey, Melissa C Hofmann, Kristen Dams-O'Connor, A Cate Miller, Gale G Whiteneck
BACKGROUND AND PURPOSE: Traumatic brain injury (TBI) leads to nearly 300 000 annual US hospitalizations and increased lifetime risk of acute ischemic stroke (AIS). Occurrence of AIS immediately after TBI has not been well characterized. We evaluated AIS acutely after TBI and its impact on outcome. METHODS: A prospective database of moderate to severe TBI survivors, admitted to inpatient rehabilitation at 22 Traumatic Brain Injury Model Systems centers and their referring acute-care hospitals, was analyzed...
June 13, 2017: Stroke; a Journal of Cerebral Circulation
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