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posterior circulation stroke

Yu Fan, Yuechun Li, Tianyou Zhang, Xia Li, Junfeng Yang, Baojun Wang, Changchun Jiang
OBJECTIVE: To compare the safety and efficacy of endovascular therapy in acute ischemic stroke (AIS) caused by large artery occlusion (LAO) in the posterior circulation with or without intracranial atherosclerosis (ICAS). PATIENT AND METHODS: The study enrolled patients who underwent endovascular therapy for AIS caused by posterior circulation LAO. Inclusion criteria for endovascular therapy of vertebrobasilar occlusion were as follows: (1) CTA or MRA confirmed acute vertebrobasilar occlusion; (2) baseline NIHSS score ≥2; (3) premorbid mRS score ≤2; (4) onset or last known well time to puncture within 24 h; (5) pc-ASPECTS ≥6...
November 29, 2018: Clinical Neurology and Neurosurgery
Jian Sun, Fa Liang, Youxuan Wu, Yan Zhao, Zhongrong Miao, Li Zhang, Adrian W Gelb, Matthew T V Chan, Yuming Peng, Ruquan Han
BACKGROUND: The effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear. METHODS: We conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia...
December 7, 2018: Journal of Neurosurgical Anesthesiology
Mustafa Aldag, Cemal Kocaaslan, Mehmet Senel Bademci, Zeynep Yildiz, Aydin Kahraman, Ahmet Oztekin, Mehmet Yilmaz, Tamer Kehlibar, Bulend Ketenci, Ebuzer Aydin
INTRODUCTION: The aim of this study was to determine the outcomes of patients developing ischemic stroke after coronary artery bypass grafting (CABG). METHODS: From March 2012 to January 2017, 5380 consecutive patients undergoing elective coronary surgery were analyzed. Ninety-five patients who developed ischemic strokes after on-pump coronary surgery were included in the study, retrospectively. The cohort was divided into four subgroups [total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), posterior circulation infarction (POCI), and lacunar infarction (LACI)] according to the Oxfordshire Community Stroke Project (OCSP) classification...
September 2018: Brazilian Journal of Cardiovascular Surgery
Elodie Zürcher, Benjamin Richoz, Mohamed Faouzi, Patrik Michel
BACKGROUND: There are limited data comparing posterior (PC) and anterior (AC) circulation acute ischemic strokes (AIS). We aimed to identify specific features of PC and AC strokes regarding clinical, etiological, radiological, and outcome factors. METHODS: Patients from the Acute STroke Registry and Analysis of Lausanne, a prospective cohort of consecutive AIS, from years 2003 to 2008 were included. The stroke territory was determined by a combination of neuroimaging and clinical symptoms...
November 27, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Junji Uno, Katsuharu Kameda, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND: It is debatable whether mechanical thrombectomy has benefits in a real-world setting outside the more rigid and selective clinical trial environment. OBJECTIVE: To evaluate clinical outcomes, efficacy, and safety of mechanical thrombectomy in single-center retrospective cohort case series. METHODS: We reviewed prospectively collected data from our large-vessel occlusion stroke database to identify patients undergoing mechanical thrombectomy using Penumbra catheters (Penumbra, Almeida, California) as first-line devices...
November 28, 2018: Operative Neurosurgery (Hagerstown, Md.)
(no author information available yet)
OBJECTIVEMorbidity and mortality in patients with posterior circulation stroke remains an issue despite advances in acute stroke therapies. The intravenous infusion of mesenchymal stem cells (MSCs) elicits therapeutic efficacy in experimental supratentorial stroke models. However, since there are few reliable animal models of ischemia in the posterior circulation, the therapeutic approach with intravenous MSC infusion has not been tested. The objective of this study was to test the hypothesis that intravenously infused MSCs provide functional recovery in a newly developed model of brainstem infarction in rats...
October 1, 2018: Journal of Neurosurgery
Jun Liu, Wenpeng Lu, Hao Han, Lijian Zheng, Lei Feng, Weimei Chen
BACKGROUND: Stenosis of the target intracranial vertebral artery is one of the major causes of posterior circulation ischemic stroke. The objective of this paper is to explore methods for reducing the occurrence of medullary artery occlusion after intracranial vertebral artery stenting. CASE DESCRIPTION: The current research presents a retrospective analysis of 48 patients who received Gateway-Wingspan stent angioplasty to treat severe stenosis of the intracranial vertebral artery, evaluates the results of stenosis remission and perfusion improvement after stent angioplasty, and explores the causes of postoperative medullary artery occlusion...
November 19, 2018: World Neurosurgery
Joji Inamasu, Shunsuke Nakae, Yoko Kato, Yuichi Hirose
Objectives and Background: Arterial dissection (AD) of the vertebral artery (VA) or its branches may cause ischemic stroke of the posterior circulation. However, clinical and radiological characteristics of patients with AD-related cerebellar infarction (CI) have rarely been reported. Methods: Forty-nine patients with CI admitted to our department from April 2008 to March 2015 were identified from our database. After dichotomization into the AD and non-AD group, their demographics and presenting symptoms were compared...
October 2018: Asian Journal of Neurosurgery
Yuhan Wang, Wenchao Cheng, Yajun Lian
BACKGROUND AND PURPOSE: The symptom of headache and neck pain is common in patients with cervicocerebral artery dissection (CAD). We attempt to screen ischemic stroke patients with CAD based on the characteristics of the pain. METHODS: Eighty-one consecutive ischemic stroke patients with CAD from 2010 to 2017 and 84 consecutive ischemic stroke patients with large artery atherosclerosis (LAA) were registered prospectively and observed in Zhengzhou, China. Those ischemic stroke patients complained of headache and neck pain were categorized into 2 groups...
November 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sumeet R Dhawan, Renu Suthar, Hansashree Padmanabha, Paramjeet Singh, Devi Dayal, Naveen Sankhyan
No abstract text is available yet for this article.
November 19, 2018: Neuropediatrics
Imama Naqvi, Alexis N Simpkins, Kaylie Cullison, Emily Elliott, Dennys Reyes, Richard Leigh, John K Lynch
Lacunar strokes account for about a fourth of all ischemic strokes. Pontine infarcts often present with stuttering symptoms, referred to as pontine warning syndrome (PWS). Patients presenting with fluctuating symptoms can appear to have rapidly improving symptoms and thus often go untreated despite the risk of recurrent deficits. MRI carries a higher sensitivity in detecting posterior circulation strokes compared to computed topagraphy, but does not always indicate irreversible injury. Here we present the first description of a stuttering lacune, captured radiographically on serial magnetic resonance imaging (MRI), that was initially averted with the administration of intravenous (IV) tissue plasminogen activator (tPA), only to return a month later and progress on imaging despite re-administration of tPA...
December 2018: ENeurologicalSci
Tuğçe Aksu Uzunhan, Nur Aydinli, Mine Çalişkan, Burak Tatli, Meral Özmen
BACKGROUND: Our aim is to retrospectively assess short-term neurological outcomes in pediatric stroke with patient features. METHODS: Children aged 28 days-18 years with arterial ischemic stroke (AIS), cerebral sinovenous thrombosis (CSVT), and hemorrhagic stroke (HS) between 2007 and 2013 were evaluated. Neurological findings within the first three months were accepted as short-term prognosis and modified Rankin scale was used. RESULTS: In the study, 33 patients (62%) with AIS, 12 (23%) with HS, and 8 (15%) with CSVT were included...
November 18, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Katharina Millesi, Johannes Sebastian Mutzenbach, Monika Killer-Oberpfalzer, Constantin Hecker, Lukas Machegger, Nele Bubel, Christian Ramesmayer, Slaven Pikija
BACKGROUND: Clinical outcome after large vessel occlusion (LVO) stroke depends on collateral integrity. We aimed to evaluate whether the completeness of the circle of Willis (CoW) and anterior temporal artery (ATA) determines the status of leptomeningeal collaterals (LC) in patients with acute LVO (internal carotid artery (ICA) and middle cerebral artery M1 (MCA) occlusion) treated with endovascular thrombectomy. PATIENTS AND METHODS: LC, cross-flow through the anterior communicating artery (ACoA), presence of the ipsilateral posterior communicating artery (IpsiPCoA) and presence of the ATA were evaluated using CT angiography...
November 3, 2018: Journal of the Neurological Sciences
William J Ares, Benjamin M Zussman, Cynthia L Kenmuir, Gregory M Weiner, Habibullah Ziayee, Devin Burke, Ashutosh P Jadhav, Tudor G Jovin, Brian T Jankowitz, Bradley A Gross
Introduction: Microcatheter selection is an infrequent focus of stroke thrombectomy technique evaluation. The Headway27 microcatheter strikes an excellent balance of microcatheter dimensions (156 cm length, 2.6 Fr distal OD, ID 0.027 inches) and visibility, making it ideal for stroke thrombectomy. Methods: We evaluated a prospectively maintained acute stroke thrombectomy database containing 50 consecutive cases using the Headway27 microcatheter. From the database, patient demographics, clinical and angiographic information as well as procedural technical details and complications were extracted...
October 2018: Interventional Neurology
Timothy H Shore, Timothy J Harrington, Kenneth Faulder, Brendan Steinfort
INTRODUCTION: Stroke caused by basilar artery occlusion (BAO) is a rare but potentially devastating neurological condition, with poor outcomes and high mortality rates, approaching 70-90%. Success of intravenous and intra-arterial thrombolysis in BAO is variable, leading to Endovascular Therapy (EVT) being utilized to a greater degree in this clinical setting. We investigate the use of EVT in BAO with regard to success of revascularization and patient mortality/outcome. METHODS: Retrospective patient data was collected from medical records and radiology information systems...
November 8, 2018: Journal of Medical Imaging and Radiation Oncology
Song J Kim, Raul G Nogueira, Diogo C Haussen
Importance: A succession of research has explored the linkage between carotid webs (CaWs) and ischemic strokes. Imaging and pathologic analysis have defined CaW as an intimal variant of fibromuscular dysplasia, which appears as a shelflike lesion on the posterior aspect of the carotid bulb, more specifically at the origin of internal carotid artery. Reported findings of carotid webs in young patients with recurrent ischemic strokes without an otherwise determined cause have raised questions about the mechanism, natural history, and need for intervention...
November 5, 2018: JAMA Neurology
Hyun-Nyung Lee, Bum-Tea Kim, Soo-Bin Im, Sun-Chul Hwang, Je-Hoon Jeong, Moon-Young Chung, Jong-Hyun Park, Dong-Seong Shin
Objective: Protocols for posterior circulation ischemic stroke have not been established by randomized clinical trials. Mechanical endovascular thrombectomy (MET) devices are evolving, and many of these devices already developed or in development are suitable for posterior circulation MET. Materials and Methods: We investigated the medical records of patients who underwent MET for posterior circulation ischemic stroke from January 2012 to August 2016. Fifteen patients were included...
September 2018: Journal of Cerebrovascular and Endovascular Neurosurgery
Adam Langton Burnell, Anna Ranta, Teddy Wu, John Fink, Ben McGuinness, James Caldwell, Wayne Collecutt, Stefan Brew, P Alan Barber
AIMS: Stroke endovascular clot retrieval (ECR) in patients with large proximal vessel occlusion improves clinical outcomes. We present the New Zealand ECR experience. METHODS: All New Zealand patients treated with ECR since 2011 were included. Patients were considered eligible if they were independent prior to stroke and had proximal intracranial arterial occlusion. RESULTS: Three hundred and twelve patients [136 women, mean (SD) age of 64 (17) years] from 11 district health boards have been treated between March 2011 and April 2018...
October 26, 2018: New Zealand Medical Journal
Michael J Schneck
No abstract text is available yet for this article.
November 2018: Stroke; a Journal of Cerebral Circulation
Peter Sommer, Alexandra Posekany, Wolfgang Serles, Martha Marko, Sebastian Scharer, Elisabeth Fertl, Julia Ferrari, Wilfried Lang, Milan Vosko, Simon Szabo, Stefan Kiechl, Michael Knoflach, Stefan Greisenegger
Background and Purpose- Posterior circulation stroke (PCS) account for 20% of all ischemic strokes. There is limited evidence whether functional outcome of PCS is comparable to that of anterior circulation stroke (ACS). We aimed to analyze whether 3-month functional outcome is different in PCS and ACS. Methods- Patients with acute ischemic stroke prospectively enrolled within the Austrian Stroke Unit Registry were stratified by infarct localization according to the Oxfordshire Community Stroke Project Classification...
November 2018: Stroke; a Journal of Cerebral Circulation
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