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MCA İnfarction

James Vogler, Veer Gariwala, Anthony Trace, Victor Fong, John Plemmons
Hyperdense middle cerebral artery (MCA) is a classic sign of acute thromboembolic disease. Simultaneous bilateral occurrence is uncommon and traditionally attributed to physiological hemoconcentration or attributable to imaging artifact. We present the case of a 71-year-old man whose admission noncontrast computed tomography (CT) demonstrated bilateral hyperdense middle cerebral arteries without other radiographic evidence of acute stroke. CT angiography confirmed bilateral MCA, M1 segment vascular occlusion and follow-up noncontrast CT demonstrated MCA territory infarctions...
October 2018: Radiology Case Reports
Kyung-Yul Lee, Sang Hyun Suh, Sung Jun Ahn
OBJECTIVES: To elucidate the pathogenesis of hyperintense arteries on Gd-enhanced 3D T1W BB FSE and their clinical significance in acute middle cerebral artery (MCA) stroke. METHODS: We retrospectively reviewed 20 patients with MCA infarction. We measured the contrast-to-noise ratio between hyperintense artery and adjacent grey matter on T2-FLAIR and Gd-enhanced 3D T1W BB FSE and compared them by using Student's t test. The agreement of positive hyperintense artery between T2 FLAIR and Gd-enhanced 3D T1WI BB FSE was estimated with intraclass correlation coefficient...
August 7, 2018: European Radiology
Lisa Rancan, Sergio D Paredes, Cruz García, Pablo González, Cruz Rodríguez-Bobada, Mario Calvo-Soto, Bryan Hyacinthe, Elena Vara, Jesús A F Tresguerres
Aging is associated with an increase in stroke risk. Melatonin, a potent free radical scavenger and broad spectrum antioxidant, has been shown to counteract inflammation and apoptosis in brain injury. However, little is known on the possible protective effects of melatonin in aged individuals affected by brain ischemia. Also, using melatonin before or after an ischemic stroke may result in significantly different molecular outcomes. The objective of the present study was to compare the effects of pre-ischemia vs...
July 19, 2018: International Journal of Molecular Sciences
Weirong Fang, Xuan Zhai, Dong Han, Xiaoxing Xiong, Tao Wang, Xun Zeng, Shucheng He, Rui Liu, Masaaki Miyata, Baohui Xu, Heng Zhao
Rationale: Peripheral blood monocytes are recruited into the ischemic brain and transform into macrophages after stroke. Nevertheless, the exact role of CCR2-dependent monocytes/macrophages in brain injury after stroke remains elusive. Methods: We used CCR2 knockout (KO) mice and the CCR2 pharmacological inhibitor, propagermanium (PG), to address the role of CCR2-dependent monocytes/macrophages in the acute stage and neurological functional recovery after middle cerebral artery (MCA) occlusion and reperfusion...
2018: Theranostics
Jonghoon Kim, Chulhoon Chang, Young Jin Jung
BACKGROUND: Endovascular coiling has emerged as an option for the management of unruptured intracranial aneurysms, which was traditionally treated via surgical clipping. Unlike aneurysms elsewhere, aneurysms of the middle cerebral artery (MCA) have several features that are favorable for surgery. However, endovascular treatment can be difficult for MCA aneurysms, especially if they have incorporated branches. We report the results of coil embolization of incorporated MCA aneurysms. METHODS: From 2012 to 2017, 129 unruptured aneurysms including 10 incorporated MCA aneurysms were treated...
July 12, 2018: World Neurosurgery
Benjamin Friedrich, Felix Kempf, Tobias Boeckh-Behrens, Johanna Fischer, Manuel Lehm, Maria Bernd, Silke Wunderlich, Sebastian Mönch, Claus Zimmer, Christian Maegerlein
PURPOSE: In patients with acute occlusions of the middle cerebral artery, the collaterals play an important role in infarct growth and potentially on clinical outcome. As the primary collateral pathway, the posterior cerebral artery with the posterior communicating artery (PComA) is important. We analyzed the influence of the presence of an ipsilateral PComA on infarct growth and clinical outcome. METHODS: We included 101 patients with M1 occlusions and subsequent endovascular treatment and differentiated patients without an ipsilateral PComA from those with an ipsilateral PComA...
July 10, 2018: Cardiovascular and Interventional Radiology
Jaechun Hwang, Mi Ji Lee, Jong-Won Chung, Oh Young Bang, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee
Background and purpose The status of collateral vessels has important clinical implications in acute ischemic stroke. To evaluate which components of ischemic symptoms were predictive of pretreatment collateral status, we tested the hypothesis that sub-item scores from the National Institutes of Health Stroke Scale (NIHSS) are associated with leptomeningeal collateral status in acute ischemic stroke with middle cerebral artery (MCA) occlusion. Methods This study included consecutive patients with acute M1 occlusion who underwent revascularization treatment for acute MCA infarction...
January 1, 2018: Interventional Neuroradiology
Eiji Higashi, Takeshi Uwatoko, Taichiro Mizokami, Yusuke Sakaki, Shuji Sakata, Hiroshi Sugimori
Reversible cerebral vasoconstriction is a very rare complication after carotid artery stenting (CAS). It has been reported to occur more than several hours after CAS and to have a good clinical course. A 73-year-old man underwent CAS for a high-grade symptomatic stenosis of his left carotid artery. Immediately after CAS, he had consciousness disturbance and right hemiparesis. We first suspected hyperperfusion syndrome, but antihypertensive therapy exacerbated his symptoms. On repeated postoperative angiography, the middle cerebral artery (MCA) appeared to become progressively narrower...
January 1, 2018: Interventional Neuroradiology
Hidetoshi Matsukawa, Hiroyasu Kamiyama, Takanori Miyazaki, Yu Kinoshita, Nakao Ota, Kosumo Noda, Takaharu Shonai, Osamu Takahashi, Sadahisa Tokuda, Rokuya Tanikawa
BACKGROUND: Regardless of acceptable surgical results of middle cerebral artery aneurysms (MCAs), MCA territory infarction (MCATI) remains a major obstacle to achieving a good outcome. We investigated the MCATI in patients with surgically treated MCA aneurysms. METHODS: The data of 286 consecutive patients with 322 MCA aneurysms were evaluated retrospectively. The aneurysm location was classified as early frontal cortical branch (EFCB), early temporal cortical branch (ETCB), bifurcation or trifurcation (M1-2), and distal aneurysms on the insular, opercular, or cortical segments of the MCA (distal MCA)...
June 19, 2018: World Neurosurgery
Zhang-Ning Zhao, Xiao-Lin Li, Jin-Zhi Liu, Zhi-Ming Jiang, Ai-Hua Wang
BACKGROUND: Young ischemic stroke patients are common while classification and analysis based upon imaging characteristics are rarely reported. We intend to compare the clinical and MRI characteristics of cerebral stroke induced by intracranial atherosclerosis between young patients with branch occlusive disease (BOD) and those with non-branch occlusive disease (non-BOD) or small artery disease (SAD). METHODS: A total of 151 subjects with acute infarction within the middle cerebral artery (MCA) territory were included and patients with ipsilateral internal carotid artery stenosis or cardioembolism were excluded...
June 20, 2018: BMC Neurology
Erkan Acar, Zeynep Ozdemir, Hatem Hakan Selcuk, Eda Coban, Aysun Soysal
Atrial myxoma is a rare cause of stroke. In this report we present the case of a 52-year-old female patient who went to hospital suffering from a headache. Her neurological examination was normal except for a positive Babinski sign on the left. In the superolateral of the right, a Sylvian fissure consistent with a thrombosed aneurysm was detected using computerised tomography (CT). Diffusion MRI showed an acute infarction on the right MCA area. Transthorasic Echocardiography and ECG were normal. A -16×4 mm-sized fusiform perpendicular aneurysm on the M2 segment Sylvian curve of right MCA and a -6×4 mm-sized dissecting aneurysm on P3 segment of the left posterior cerebral artery (PCA) were observed in cerebral angiography...
March 30, 2018: Ideggyógyászati Szemle
Seiichiro Hirono, Kou Ozaki, Daisuke Ito, Tomoo Matsutani, Yasuo Iwadate
BACKGROUND: Delayed infarction in the lenticulostriate artery (LSA) area after insular glioma resection are not common and its pathophysiology remains unknown. CASE DESCRIPTION: A 32-year-old right-handed man with a giant insular low-grade glioma with frontal and temporal extension underwent awake craniotomy with an intentional staged surgery strategy. Preoperative radiological images demonstrated a diagonally elevated middle cerebral artery (MCA) by the temporal tumor and the a significantly compressed striatum...
June 7, 2018: World Neurosurgery
João Sargento-Freitas, Anabela Pereira, André Gomes, Paula Amorim, Teresa Matos, Carla M P Cardoso, Fernando Silva, Gustavo Cordeiro Santo, César Nunes, Orlando Galego, José Carda, João Branco, Víctor Lourenço, Luís Cunha, Lino Ferreira
Rationale/aim: Despite the increasing efficacy of recanalization therapies for acute ischemic stroke, a large number of patients are left with long-term functional impairment, devoid of efficacious treatments. CD34+ cells comprise a subset of bone marrow-derived mononuclear cells with the capacity to promote angiogenesis in ischemic lesions and have shown promising results in observational and in vitro studies. In this study, we aim to assess the efficacy of an autotransplant of CD34+ cells in acute ischemic stroke...
2018: Frontiers in Neurology
Daša Viszlayová, Miroslav Brozman, Kateřina Langová, Roman Herzig, David Školoudík
BACKGROUND: Silent brain infarcts can be detected on magnetic resonance imaging (MRI) in ~22% of patients after coronary angioplasty and stenting (CS). The effect of periprocedural sonolysis on the risk of new brain infarcts during CS was examined. METHODS: Patients undergoing elective CS were allocated randomly to a bilateral sonolysis group (70 patients, 58 men; mean age, 59.9 years) or a control group (74 patients, 45 men; mean age, 65.5 years). Neurologic examination, cognitive function tests, and brain MRI were performed prior to intervention and at 24 h after CS...
September 15, 2018: International Journal of Cardiology
Makoto Kobayashi
Horizontal gaze deviation (HGD) on computed tomography (CT) is considered a useful finding for detecting ischemic stroke. To enhance its availability, we studied the criterion suitable for visual determination and lesion characteristics. The clinical records of 327 ischemic stroke patients and 193 non-stroke controls were reviewed with measurements of eye deviation angles on CT. Initially, the HGD criterion defined by the minimum angle in unidirectionally deviated eyes was determined from control data. Subsequently, patients were classified by infarcted arterial territory and stroke subtype, and compared with controls in HGD frequency using Fisher's exact test...
May 28, 2018: Acta Neurologica Belgica
Mitsuya Watanabe, Eiji Abe, Reo Ishimoto, Naohide Fujita, Hiroshi Hasegawa, Hideaki Ueno, Yasuaki Nakao, Takuji Yamamoto, Ryo Wada
A 40-year-old man with a rare case of dissecting aneurysm of the distal middle cerebral artery(MCA, M2 segment)presented with ischemic stroke, manifesting as headache, nausea, and visual disorder. Computed tomography(CT)scan revealed cerebral infarction, and three-dimensional CT angiogram revealed stenotic change at the M2 segment. The patient was conservatively treated and remained neurologically stable. Ten months later, CT scan and magnetic resonance imaging(MRI)revealed outpouching of the M2 segment at the location of the initial stenosis...
May 2018: No Shinkei Geka. Neurological Surgery
Seung Jae Lee, Jin Sung Cheong, Han Uk Ryu, Hyun Goo Kang
OBJECTIVES: Patients with chronic proximal middle cerebral artery (MCA) occlusion do not present with severe symptoms, but early recanalization of acute occlusion is associated with high morbidity and mortality. Tissue plasminogen activator (tPA) is a recombinant thrombolytic agent approved for treating ischemic stroke, although only a few cases of tPA administration in chronic MCA occlusion have yielded positive results. METHODS: A 71-year-old patient had a history of right MCA territorial infarction with the occlusion occurring 12 years ago (November 2005)...
July 2018: Clinical Neuropharmacology
Xiaodong Zhang, Yumei Yan, Frank Tong, Chun-Xia Li, Benjamin Jones, Silun Wang, Yuguang Meng, E Chris Muly, Doty Kempf, Leonard Howell
Background: Previous Diffusion Tensor Imaging (DTI) studies have demonstrated the temporal evolution of stroke injury in grey matter and white matter can be characterized by DTI indices. However, it still remains not fully understood how the DTI indices of white matter are altered progressively during the hyperacute (first 6 hours) and acute stage of stroke (≤ 1 week). In the present study, DTI was employed to characterize the temporal evolution of infarction and white matter injury after stroke insult using a macaque model with permanent ischemic occlusion...
2018: Open Neuroimaging Journal
Tarek Mohammed El-Gammal, Wafik Said Bahnasy, Osama Abd Allah Ragab, Ayman Mohammed Al-Malt
Background: Border zone infarcts (BZI) are ischemic lesions at the junction between two main arterial territories which may be either cortical or internal BZI. Methods: This study was conducted on 76 cerebral BZI patients and 20 healthy control subjects. Patients were divided to group I included 26 internal BZI, group II included 19 cortical BZI and group III included 21 mixed internal/cortical BZI patients. Included subjects were submitted to neurological examination, laboratory investigations, ECG, echocardiogram, brain CT and/or MRI and extra and intracranial blood vessels imaging by duplex and CT angiography...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
Doron Bushi, Joab Chapman, Anton Wohl, Efrat Shavit Stein, Ekaterina Feingold, David Tanne
Factor Xa (FXa) plays a critical role in the coagulation cascade by generation of thrombin. During focal ischemia thrombin levels increase in the brain tissue and cause neural damage. This study examined the hypothesis that administration of the FXa inhibitor, apixaban, following focal ischemic stroke may have therapeutic potential by decreasing brain thrombin activity and infarct volume. Male mice were divided into a treated groups that received different doses of apixaban (2, 20, 100 mg/kg administered I...
August 2018: Journal of Neuroscience Research
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