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MCA İnfarction

Jun Zhang, Xiao Zhang, Jinping Zhang, Yun Song, Ju Han
BACKGROUND: Endovascular therapy has been increasingly recommended for the treatment of acute ischemic stroke with large vessel occlusion of the anterior circulation. However, occlusions of the distal cerebral artery are not uncommon and may cause clinical deficits, especially when combined with ipsilateral chronic large vessel occlusion. Therefore, in this patient population, the recognition of chronic occlusion and recanalization of the distal occlusive artery might be of great value for flow compensation...
December 8, 2018: World Neurosurgery
Luis Cartier R, Jorge Parra, Juan P Contreras S
BACKGROUND: Cerebral ptosis is understood as the bilateral paralysis of eyelid elevation linked to a stroke or hemorrhage of the middle cerebral artery (MCA). It is a transient condition, independent of the evolution of the lesion. AIM: To analyze six patients with the condition. PATIENTS AND METHODS: Report of five women and one male aged 42 to 72 years. RESULTS: All suffered an infarction or hemorrhage in the territory of the middle cerebral artery of the non-dominant hemisphere and developed a bilateral palpebral ptosis...
August 2018: Revista Médica de Chile
Junpei Koge, Seiya Kato, Tetsuya Hashimoto, Yukihiko Nakamura, Masakazu Kawajiri, Takeshi Yamada
BACKGROUND: There is increasing experimental evidence that stent retriever thrombectomy (SRT) may cause arterial wall damage, although histopathological findings focused on vessel wall injury after SRT have not fully been reported in humans. CASE DESCRIPTION: We describe an autopsy case of an 82-year-old woman who presented with acute left intracranial internal carotid artery (ICA) occlusion and received SRT. When we attempted to catheterize the M1 segment of the normal middle cerebral artery (MCA), we were not aware of a duplicated MCA, and the microcatheter was advanced into the main MCA trunk with a smaller caliber than that of the normal M1 segment...
December 6, 2018: World Neurosurgery
Reza Jahan, J Pablo Villablanca, Robert J Harris, Sandra Duarte-Vogel, Christopher K Williams, Harry V Vinters, Neal Rao, Dieter R Enzmann, Benjamin M Ellingson
BACKGROUND: A reliable animal model of ischemic stroke is vital for pre-clinical evaluation of stroke therapies. We describe a reproducible middle cerebral artery (MCA) embolic occlusion in the French Lop rabbit characterized with multimodal MRI and histopathologic tissue analysis. NEW METHOD: Fluoroscopic-guided microcatheter placement was performed in five consecutive subjects with angiographic confirmation of MCA occlusion with autologous clot. Multimodal MRI was obtained prior to occlusion and up to six hours post after which repeat angiography confirmed sustained occlusion...
December 7, 2018: Journal of Neuroscience Methods
Taichi Ishiguro, Yoshikazu Okada, Tatsuya Ishikawa, Koji Yamaguchi, Akitsugu Kawashima, Takakazu Kawamata
The effects of superficial temporal artery to middle cerebral artery (STA-MCA) double bypass on recurrent hemorrhage in the operated hemisphere in hemorrhagic moyamoya disease (HMD) have not been clearly demonstrated. This study evaluated the effectiveness of STA-MCA double bypass in the prevention of further hemorrhagic or ischemic events in the operated hemispheric sides in comparison to the conservatively treated non-operated sides. We retrospectively analyzed 52 hemispheres of 36 patients with adult-onset HMD treated with STA-MCA double bypass...
December 3, 2018: Neurosurgical Review
Christian F Freyschlag, Christian Boehme, Marlies Bauer, Johannes Kerschbaumer, Daniel Pinggera, Marina Riedmann, Claudia Unterhofer, Astrid E Grams, Michael Knoflach, Claudius Thomé
BACKGROUND: Malignant middle cerebral artery (MCA) stroke represents a life-threatening condition. The outcomes of surgical treatments have shown strong evidence in favor of decompressive hemicraniectomy. A significant subpopulation of patients, however, still experience very poor outcomes. In particular, the indication for decompressive surgery is based on few objective parameters to facilitate the decision. OBJECTIVE: We hypothesized that larger volumes of ischemic brain would have large impact on the outcome METHODS: A cohort study of 34 patients undergoing hemicraniectomy was carried out using a volumetric analysis of the infarction volume (measured preoperatively, and again on postoperative day [POD] 1 and 3)...
November 29, 2018: World Neurosurgery
Suparna Das, Patrick Mitchell, Nicholas Ross, Peter Whitfield
BACKGROUND: Malignant middle cerebral artery infarctions are large space-occupying infarctions involving massive oedema, herniation, and, frequently death. Survivors are disabled. Management involves medical treatment, with or without decompressive hemicraniectomy and later duraplasty. OBJECTIVES: This meta-analysis aims to determine whether surgery is worthwhile with particular regard to views on quality of life of professionals and patients. METHODS: Study eligibility criteria A Medline search was performed with the search terms "decompressive surgery", "craniectomy", "hemicraniectomy", "decompressive hemicraniectomy", and "middle cerebral artery", "MCA" "infarct*", "stroke*", "embolus", "emboli", "thrombosis", "occlusion", "infarction", and "middle cerebral artery stroke"...
November 27, 2018: World Neurosurgery
Magalie Fréchou, Isabelle Margaill, Catherine Marchand-Leroux, Virginie Beray-Berthat
Efforts are still needed regarding the research of therapeutics for ischemic stroke. While in experimental studies the protective effect of pharmacological agents is often highlighted by a reduction of the lesion size evaluated in the short term (days), in clinical studies a functional recovery of patients suffering from stroke is expected on the long-term (months and years). Long-term functional preclinical studies are highly recommended to evaluate potential neuroprotective agents for stroke, rather than an assessment of the infarction size at a short time point...
November 27, 2018: Behavioural Brain Research
Yuka Terasawa, Ayumi Arai, Kenichiro Sakai, Hidetaka Mitsumura, Yasuyuki Iguchi
Reversible cerebral vasoconstriction syndromes (RCVS) have been well recognized recently as one cause of cerebrovascular disease, but the time course of vessel vasoconstriction remains uncertain. We report herein 2 cases with RCVS in which we clarified temporal changes in vessel vasoconstriction in detail using transcranial color-coded sonography (TCCS). The first case involved a 27-year-old woman who developed intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) after severe headache. TCCS showed peak systolic velocity (PSV) in the left middle cerebral artery (MCA) peaked at 212 cm/s on day 6 and gradually decreased, whereas PSV of the left posterior cerebral artery (PCA) and left anterior cerebral artery (ACA) re-elevated to 190 cm/s on day 15...
November 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hyuksool Kwon, Kyuseok Kim, You Hwan Jo, Min Ji Park, Sang-Bae Ko, Tae Jung Kim, Jihoon Kang, Hyeon-Min Bae, Ji Eun Lee
Background: NIRSIT, a functional near-infrared spectroscopy (fNIRS) device with 204 channels, can measure oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) in non-pulsatile blood flow non-invasively using the absorption difference between HbO2 and HbR at a wavelength of 700-1,000 nm and can display the perfusion status in real time. Objective: We applied NIRSIT to patients with stroke to evaluate the usefulness of NIRSIT as an fNIRS device for the early detection of stroke. Methods: We performed a prospective pilot study in an emergency department (ED)...
2018: Frontiers in Neurology
Volker Puetz, Johannes C Gerber, Philipp Krüger, Matthias Kuhn, Heinz Reichmann, Hauke Schneider
Background: Cerebral venous drainage might influence brain edema characteristics and functional outcome of patients with severe ischemic stroke. The purpose of the study was to evaluate whether hypoplasia of transverse sinuses or the internal jugular veins is associated with poor functional outcome in patients with space-occupying middle cerebral artery (MCA) infarction who underwent decompressive surgery. Methods: We performed a retrospective analysis of patients with space-occupying MCA infarction treated with decompressive surgery at our university hospital...
2018: Frontiers in Neurology
Li-Min Zhang, Rui Li, Xiao-Chun Zhao, Ming-Li Wang, Yue Fu
BACKGROUND: The colloid transfusion during surgical decompressive hemicraniectomy (DHC) after space-occupying cerebral infarction induced by middle cerebral artery (MCA), is controversial. A multicenter retrospective study was conducted to determine whether or not an increased colloid transfusion during surgery is associated with lower incidence of post-operative pneumonia and better long-term outcomes after space-occupying cerebral infarction. METHOD: Data from surgical DHC within 48 h to treat space-occupying cerebral infarction that took place between Nov...
November 15, 2018: World Neurosurgery
Ji-Yue Wen, Mei Wang, Ya-Nan Li, Hui-Hui Jiang, Xuan-Jun Sun, Zhi-Wu Chen
This study was undertaken to demonstrate the vascular protection of exogenous and endogenous hydrogen sulfide (H2 S) on cerebral ischemia/reperfusion (I/R) injury. The effect of H2 S on cerebrovascular dysfunction in middle cerebral artery (MCA) and neuronal damage were measured after cerebral I/R induced by transient middle cerebral artery occlusion (MCAO) in cystathionine c-lyase (CSE) knockdown and wild-type rats. The effect of sodium hydrosulfide (NaHS, donor of exogenous H2 S), L-cysteine (L-Cys, substrate of endogenous H2 S), and endothelium cells on the responses of isolated MCA derived from non-ischemic rats was also evaluated to assess the underlying mechanism of H2 S-mediate cerebral vasodilation...
2018: Frontiers in Neurology
Joo-Seok Lee, Dong-Jun Song, Jong-Hwan Hong, Tae-Sun Kim, Sung-Pil Joo
Objective: Ischemic postconditioning (IPostC), consisted of transient brain ischemia/reperfusion cycles, is considered to have neuroprotective effect. However, there is no best single protocol of IPostC, because varied factors like species tested and characteristics of the tissue may affect the efficacy of IPostC. Thus, we investgated whether different protocols of IPostC affect neuroprotective effects in experimental animal models. Materials and Methods: Through occlusion of middle cerebral artery (MCA) with intraluminal suture, stroke was induced in a transient focal ischemia model in mice...
September 2018: Journal of Cerebrovascular and Endovascular Neurosurgery
Eric R Miller, Elena A Kharlamov, Zeyu Hu, Edwin C Klein, Deng-Shan Shiau, Kevin M Kelly
The pathophysiological mechanisms of epileptogenesis following ischemic stroke in the aged brain are not well understood, largely due to limited developments in animal modeling of poststroke epilepsy (PSE). A recent study in our laboratory (Kelly et al., 2018) using transient (3 h) unilateral middle cerebral artery (MCA) and common carotid artery (CCA) occlusion (MCA/CCAo) in 4- and 20-month-old Fischer (F344) rats resulted in epileptic seizures in both age groups; age and infarction factors independently had effects on seizure frequency...
December 2018: Epilepsy Research
Yun-Hee Choi, Hyun-Seok Park, Myong-Jin Kang, Jae-Kwan Cha
Intravenous thrombolysis (IVT) and endovascular treatment (EVT) are currently the main treatments for reperfusion in acute ischemic stroke. Although the EVT recanalization rate has increased, unsuccessful recanalization is still observed in 10-30% cases. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass is considered a rescue therapy in such cases, but in most centers it is not usually performed for acute ischemic stroke. Graft occlusion is rare following STA-MCA bypass, but it might lead to recurrent ischemic stroke...
June 2018: Journal of Cerebrovascular and Endovascular Neurosurgery
Estelle Pruvost-Robieux, David Calvet, Wagih Ben Hassen, Guillaume Turc, Angela Marchi, Nicolas Mélé, Pierre Seners, Catherine Oppenheim, Jean-Claude Baron, Jean-Louis Mas, Martine Gavaret
Background: Stroke is a major cause of death and disability worldwide. The related burden is expected to further increase due to aging populations, calling for more efficient treatment. Ischemic stroke results from a focal reduction in cerebral blood flow due to the sudden occlusion of a brain artery. Ischemic brain injury results from a sequence of pathophysiological events that evolve over time and space. This cascade includes excitotoxicity and peri-infarct depolarizations (PIDs). Focal impairment of cerebral blood flow restricts the delivery of energetics substrates and impairs ionic gradients...
2018: Frontiers in Neurology
Aneeka M Hancock, Ron D Frostig
Assessing potential stroke treatments in the presence of risk factors can improve screening of treatments prior to clinical trials and is important in testing the efficacy of treatments in different patient populations. Here, we test our noninvasive, nonpharmacological sensory stimulation treatment in the presence of the main risk factor for ischemic stroke, hypertension. Utilizing functional imaging, blood flow imaging, and histology, we assessed spontaneously hypertensive rats (SHRs) pre- and post-permanent middle cerebral artery occlusion (pMCAO)...
2018: PloS One
Xiaoyang Tao, Yin Liu, Jun Chen, Li Xu, Zhijie Zhou, Haiyan Lei, Yiming Yin
BACKGROUND Moyamoya disease (MMD) is an idiopathic disease caused by progressive steno-occlusion of the distal internal carotid artery. Ideal surgical treatment for adult patients with ischemic-type MMD has not been achieved. The aim of this study was to evaluate the efficacy of single-barrel superficial temporal artery-middle cerebral artery (STA-MCA) bypass in treatment for adult patients with ischemic-type MMD by analyzing clinical and radiological data retrospectively. MATERIAL AND METHODS The present study included 37 patients with non-hemorrhagic MMD, including 21 women and 16 men (21~55 years old, mean age 38...
October 19, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jianye Liang, Jun Guo, Dexiang Liu, Changzheng Shi, Liangping Luo
BACKGROUND: This study aimed to analyze the vascular wall and atherosclerotic plaques of the middle cerebral artery (MCA) and compare their differences between patients with cerebral infarction and transient ischemic attack (TIA) using 3-dimensional fast-spin-echo T1-weighted sequence (namely CUBE). METHODS: Forty-seven patients with atherosclerotic stenosis of the MCA were included in this study. They received magnetic resonance examinations with routine T1WI, T2WI, 3-dimensional time-of-flight magnetic resonance angiography and diffusion-weighted imaging, as well as high-resolution CUBE T1WI sequence...
October 13, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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