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Selective cerebral perfusion

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https://www.readbyqxmd.com/read/29339713/neuroprotective-effect-of-selective-antegrade-cerebral-perfusion-during-prolonged-deep-hypothermic-circulatory-arrest-cerebral-metabolism-evidence-in-a-pig-model
#1
Zhixian Tang, Mengya Liang, Guangxian Chen, Jian Rong, Jianping Yao, Zhen Chen, Xiao Yang, Zhongkai Wu
OBJECTIVE: The aim of this study was to elucidate the mechanism of cerebral injury and to evaluate selective antegrade cerebral perfusion (SACP) as a superior neuroprotective strategy for prolonged deep hypothermic circulatory arrest (DHCA). METHODS: Twelve pigs (6-8-week old) were randomly assigned to DHCA alone (n=6) and DHCA with SACP (n=6) at 18°C for 80 min groups. Serum S100 was determined using an immunoassay analyzer. The concentrations of cerebral dialysate glucose, lactate, pyruvate, glycerol, and glutamate were measured using a microdialysis analyzer...
January 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29337197/brain-perfusion-alterations-in-tick-borne-encephalitis-preliminary-report
#2
Zuzanna Tyrakowska-Dadełło, Eugeniusz Tarasów, Dariusz Janusek, Anna Moniuszko-Malinowska, Joanna Zajkowska, Sławomir Pancewicz
BACKGROUND: Magnetic resonance imaging (MRI) changes in Tick-borne encephalitis (TBE) are nonspecific and pathophysiologic mechanisms leading to their formation remain unclear. This study aimed to investigate brain perfusion in TBE patients using dynamic susceptibility contrast (DSC) MR perfusion imaging. METHODS: MRI scans were performed in 12 patients in the acute phase, 3-5days after TBE diagnosis, with conventional MR images and DSC-MRI perfusion studies. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to peak (TTP) parametric maps were created...
January 11, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29334980/reoperation-for-a-giant-arch-anastomotic-pseudoaneurysm-eleven-years-after-total-arch-replacement-with-island-reconstruction
#3
Ryohei Matsuura, Yasushi Tsutsumi, Osamu Monta, Hisazumi Uenaka, Kenji Tanaka, Takaaki Samura, Hirokazu Ohashi
BACKGROUND: The long-term effects of some surgical treatment procedures of arch replacement for aortic dissection or aortic aneurysm are unknown. CASE PRESENTATION: The present study reports the case of a 68-year-old man admitted to our hospital for aortic arch anastomotic pseudoaneurysm with concomitant aortic root enlargement and coronary artery stenosis. Eleven years ago, at the age of 56 years, he underwent total arch replacement with island reconstruction for chronic aortic dissection...
January 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29299616/increased-variability-of-watershed-areas-in-patients-with-high-grade-carotid-stenosis
#4
Stephan Kaczmarz, Vanessa Griese, Christine Preibisch, Michael Kallmayer, Michael Helle, Isabel Wustrow, Esben Thade Petersen, Hans-Henning Eckstein, Claus Zimmer, Christian Sorg, Jens Göttler
PURPOSE: Watershed areas (WSAs) of the brain are most susceptible to acute hypoperfusion due to their peripheral location between vascular territories. Additionally, chronic WSA-related vascular processes underlie cognitive decline especially in patients with cerebral hemodynamic compromise. Despite of high relevance for both clinical diagnostics and research, individual in vivo WSA definition is fairly limited to date. Thus, this study proposes a standardized segmentation approach to delineate individual WSAs by use of time-to-peak (TTP) maps and investigates spatial variability of individual WSAs...
January 3, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29286398/evaluation-of-vascular-control-mechanisms-utilizing-video-microscopy-of-isolated-resistance-arteries-of-rats
#5
Kathleen M Lukaszewicz, Matthew J Durand, Jessica R C Priestley, James R Schmidt, L Adrienne Allen, Aron M Geurts, Julian H Lombard
This protocol describes the use of in vitro television microscopy to evaluate vascular function in isolated cerebral resistance arteries (and other vessels), and describes techniques for evaluating tissue perfusion using Laser Doppler Flowmetry (LDF) and microvessel density utilizing fluorescently labeled Griffonia simplicifolia (GS1) lectin. Current methods for studying isolated resistance arteries at transmural pressures encountered in vivo and in the absence of parenchymal cell influences provide a critical link between in vivo studies and information gained from molecular reductionist approaches that provide limited insight into integrative responses at the whole animal level...
December 5, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29283434/elevation-of-the-head-during-intensive-care-management-in-people-with-severe-traumatic-brain-injury
#6
REVIEW
Jose D Alarcon, Andres M Rubiano, David O Okonkwo, Jairo Alarcón, Maria José Martinez-Zapata, Gerard Urrútia, Xavier Bonfill Cosp
BACKGROUND: Traumatic brain injury (TBI) is a major public health problem and a fundamental cause of morbidity and mortality worldwide. The burden of TBI disproportionately affects low- and middle-income countries. Intracranial hypertension is the most frequent cause of death and disability in brain-injured people. Special interventions in the intensive care unit are required to minimise factors contributing to secondary brain injury after trauma. Therapeutic positioning of the head (different degrees of head-of-bed elevation (HBE)) has been proposed as a low cost and simple way of preventing secondary brain injury in these people...
December 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29274600/evidence-of-intimal-tear-in-type-a-intramural-hematoma-of-the-aorta-a-case-series
#7
Gianfranco Filippone, Giovanni Caruana, Claudia Calia, Violetta Moscaritolo, Vincenzo Argano
INTRODUCTION: Aortic intramural hematoma (IMH) is described as "dissection without intimal tear" due to rupture of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in patients with IMH and to suggest that this entity may represent a part of a disease and not a separate disease. PRESENTATION OF CASES: We report two patients admitted to our institution with sudden onset thoracic pain...
December 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29244086/cerebral-blood-flow-changes-after-radiation-therapy-identifies-pseudo-progression-in-diffuse-intrinsic-pontine-gliomas
#8
Raphael Calmon, Stephanie Puget, Pascale Varlet, Volodia Dangouloff-Ros, Thomas Blauwblomme, Kevin Beccaria, David Grevent, Christian Sainte-Rose, David Castel, Marie-Anne Debily, Christelle Dufour, Stéphanie Bolle, Frederic Dhermain, Ana Saitovitch, Monica Zilbovicius, Francis Brunelle, Jacques Grill, Nathalie Boddaert
Background: The interval between progression and death in diffuse intrinsic pontine glioma (DIPG) is usually < 6 months. However, reports of longer patient survival following radiotherapy, in the presence of radiological signs of progression, suggest that these cases may be comparable to pseudo-progression observed in adult glioblastoma. Our aim was to identify such cases and compare their multimodal MRI features with those of patients that did not present the same evolution. Methods: Multimodal MRI of 43 children treated for DIPG were retrospectively selected at four time points: baseline, after-radiotherapy, during true-progression, and at the last-visit...
December 13, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/29234612/near-infrared-spectroscopy-versus-transcranial-doppler-based-monitoring-in-carotid-endarterectomy
#9
Jun Woo Cho, Jae Seok Jang
Background: Proper monitoring of cerebral perfusion during carotid artery surgery is crucial for determining if a shunt is needed. We compared the safety and reliability of near-infrared spectroscopy (NIRS) with transcranial Doppler (TCD) for cerebral monitoring. Methods: This single-center, retrospective review was conducted on patients who underwent carotid endarterectomy (CEA) using selective shunt-based TCD or NIRS at Daegu Catholic University Medical Center from November 2009 to June 2016...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29212156/effects-of-cerebral-perfusion-pressure-on-regional-cerebral-blood-flow-in-dogs-with-acute-epidural-hematoma-quantitative-evaluation-with-contrast-enhanced-ultrasound
#10
Hongwei Cheng, Xiang Mao, Zonggang Hou, Jian Xu, Shuyu Hao, Huan Li, Baiyun Liu
To discuss the relationship between the regional cerebral blood flow (rCBF) and cerebral perfusion pressure (CPP) and the effect of CPP on rCBF in different spaces in an experimental animal model. As the ICP increased, the CPP and rCBF (A × β value measured by CEU) decreased to varying degrees. The rCBF1 and rCBF2 were well correlated with the CPP. At the same CPP, rCBF1 decreased significantly than the level of rCBF2 (p < 0.01). Six healthy cross-breed dogs, both males and females, weighing 18.3 ± 1...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29201841/the-combined-use-of-cardiac-output-and-intracranial-pressure-monitoring-to-maintain-optimal-cerebral-perfusion-pressure-and-minimize-complications-for-severe-traumatic-brain-injury
#11
Jin Shup So, Jung-Ho Yun
Objective: To show the effect of dual monitoring including cardiac output (CO) and intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI) patiens. We hypothesized that meticulous treatment using dual monitoring is effective to sustain maintain minimal intensive care unit (ICU) complications and maintain optimal ICP and cerebral perfusion pressure (CPP) for severe TBI patiens. Methods: We included severe TBI, below Glasgow Coma Scale (GCS) 8 and head abbreviation injury scale (AIS) >4 and performed decompressive craniectomy at trauma ICU of our hospital...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29190675/in-patients-with-suspected-acute-stroke-ct-perfusion-based-cerebral-blood-flow-maps-cannot-substitute-for-dwi-in-measuring-the-ischemic-core
#12
William A Copen, Albert J Yoo, Natalia S Rost, Lívia T Morais, Pamela W Schaefer, R Gilberto González, Ona Wu
BACKGROUND: Neuroimaging may guide acute stroke treatment by measuring the volume of brain tissue in the irreversibly injured "ischemic core." The most widely accepted core volume measurement technique is diffusion-weighted MRI (DWI). However, some claim that measuring regional cerebral blood flow (CBF) with CT perfusion imaging (CTP), and labeling tissue below some threshold as the core, provides equivalent estimates. We tested whether any threshold allows reliable substitution of CBF for DWI...
2017: PloS One
https://www.readbyqxmd.com/read/29188429/spike-in-glucose-levels-after-reperfusion-during-aortic-surgery-assessment-by-continuous-blood-glucose-monitoring-using-artificial-endocrine-pancreas
#13
Koji Kawahito, Hirotaka Sato, Mamoru Kadosaki, Atsushi Egawa, Yoshio Misawa
OBJECTIVES: Although strict blood glucose control during cardiovascular surgery is essential to avoid postoperative complications, the various changes in glucose levels that occur during surgery have not been investigated in detail. In this study, we continuously monitored blood glucose changes during aortic surgery using the STG-55Ⓡ artificial endocrine pancreas (Nikkiso Inc., Tokyo). METHODS: Between December 2015 and 2016, we performed continuous blood glucose monitoring in 22 patients (14 men and 8 women, 72 ± 11 years old), who required hypothermic circulatory arrest during an ascending/aortic arch surgery, at the Jichi Medical University Hospital...
November 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29182658/high-permeability-region-size-on-perfusion-ct-predicts-hemorrhagic-transformation-after-intravenous-thrombolysis-in-stroke
#14
Josep Puig, Gerard Blasco, Pepus Daunis-I-Estadella, Cecile van Eendendburg, María Carrillo-García, Carlos Aboud, María Hernández-Pérez, Joaquín Serena, Carles Biarnés, Kambiz Nael, David S Liebeskind, Götz Thomalla, Bijoy K Menon, Andrew Demchuk, Max Wintermark, Salvador Pedraza, Mar Castellanos
OBJECTIVE: Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. METHODS: We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4...
2017: PloS One
https://www.readbyqxmd.com/read/29173394/outcome-after-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#15
Simon Messer, Aravinda Page, Richard Axell, Marius Berman, Jules Hernández-Sánchez, Simon Colah, Barbora Parizkova, Kamen Valchanov, John Dunning, Evgeny Pavlushkov, Sendhil K Balasubramanian, Jayan Parameshwar, Yasir Abu Omar, Martin Goddard, Stephen Pettit, Clive Lewis, Anna Kydd, David Jenkins, Christopher J Watson, Catherine Sudarshan, Pedro Catarino, Marie Findlay, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: The requirement for heart transplantation is increasing, vastly outgrowing the supply of hearts available from donation after brain death (DBD) donors. Transplanting hearts after donation after circulatory-determined death (DCD) may be a viable additive alternative to DBD donors. This study compared outcomes from the largest single-center experience of DCD heart transplantation against matched DBD heart transplants. METHODS: DCD hearts were retrieved using normothermic regional perfusion (NRP) or direct procurement and perfusion (DPP)...
December 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29172122/brain-substrates-of-early-4h-cigarette-abstinence-identification-of-treatment-targets
#16
Teresa R Franklin, Kanchana Jagannathan, Nathan Hager, Zhuo Fang, Sihua Xu, Joyce Wong, Anna Rose Childress, John A Detre, Hengyi Rao, Reagan Wetherill
INTRODUCTION: Research indicates that overnight nicotine abstinence disrupts neural activity in the mesocorticolimbic reward network; however, less is known about the time course of abstinence-induced brain changes. To examine the potential neural effects of early abstinence, we used arterial spin labeling perfusion fMRI, to measure regional cerebral blood flow (rCBF) changes in the resting brain induced by 4h of nicotine abstinence. METHODS: In a repeated measures design, 5min of resting perfusion fMRI data were acquired in awake nicotine-dependent individuals (eyes open) during 'smoking as usual' (SMK) and following 4h of monitored nicotine abstinence (ABS) conditions (N=20)...
November 20, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29157444/a-tool-to-visualize-and-analyze-perfusion-data-development-and-application-of-the-r-package-ctp
#17
Seth T Lirette, Andrew D Smith, Inmaculada B Aban
BACKGROUND AND OBJECTIVE: Computed tomography perfusion (CTP) is a widely used imaging modality especially in neuroimaging. Despite this, CTP is often prohibitive due to the dearth of free/open-source software. This could have wide-ranging implications for instruction and research. We have implemented an online-available CTP tool built and run completely within the R computing environment. METHODS: Called from within R, the user can select one of four different methods to construct a cerebral blood flow (CBF) map: (1) max-slope (2) singular value decomposition (3) block circulant singular value decomposition or (4) oscillation minimization singular value decomposition...
January 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#18
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29136088/abcd1-dysfunction-alters-white-matter-microvascular-perfusion
#19
Arne Lauer, Xiao Da, Mikkel Bo Hansen, Gregoire Boulouis, Yangming Ou, Xuezhu Cai, Afonso Liberato Celso Pedrotti, Jayashree Kalpathy-Cramer, Paul Caruso, Douglas L Hayden, Natalia Rost, Kim Mouridsen, Florian S Eichler, Bruce Rosen, Patricia L Musolino
Cerebral X-linked adrenoleukodystrophy is a devastating neurodegenerative disorder caused by mutations in the ABCD1 gene, which lead to a rapidly progressive cerebral inflammatory demyelination in up to 60% of affected males. Selective brain endothelial dysfunction and increased permeability of the blood-brain barrier suggest that white matter microvascular dysfunction contributes to the conversion to cerebral disease. Applying a vascular model to conventional dynamic susceptibility contrast magnetic resonance perfusion imaging, we demonstrate that lack of ABCD1 function causes increased capillary flow heterogeneity in asymptomatic hemizygotes predominantly in the white matter regions and developmental stages with the highest probability for conversion to cerebral disease...
November 9, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29111297/mid-term-outcomes-of-repair-of-coarctation-of-aorta-with-hypoplastic-arch-extended-end-to-side-anastomosis-technique
#20
Eung Re Kim, Woong-Han Kim, Jinhae Nam, Kwangho Choi, Woo Sung Jang, Jae Gun Kwak
OBJECTIVE: The optimal surgical repair technique for coarctation associated with aortic arch hypoplasia (CoA/AAH) in neonates and infants is controversial. This study evaluates our current strategy utilizing extended end-to-side anastomosis (EESA) under selective cerebral and myocardial perfusion (SCMP) in treating this group of patients. METHODS: Through a retrospective review, we analyzed the outcome of 87 infants who underwent surgical repair of CoA/AAH from January 2004 to December 2015...
October 27, 2017: Seminars in Thoracic and Cardiovascular Surgery
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