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Selective cerebral perfusion

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https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#1
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27889577/brain-uptake-and-metabolism-of-the-endocannabinoid-anandamide-labeled-in-either-the-arachidonoyl-or-ethanolamine-moiety
#2
Kun Hu, Shilpa Sonti, Sherrye T Glaser, Richard I Duclos, Samuel J Gatley
INTRODUCTION: Anandamide (N-arachidonoylethanolamine) is a retrograde neuromodulator that activates cannabinoid receptors. The concentration of anandamide in the brain is controlled by fatty acid amide hydrolase (FAAH), which has been the focus of recent drug discovery efforts. Previous studies in C57BL/6 mice using [(3)H-arachidonoyl]anandamide demonstrated deposition of tritium in thalamus and cortical areas that was blocked by treatment with an FAAH inhibitor and that was not seen in FAAH-knockout mice...
November 9, 2016: Nuclear Medicine and Biology
https://www.readbyqxmd.com/read/27886010/discriminative-properties-of-hippocampal-hypoperfusion-in-marijuana-users-compared-to-healthy-controls-implications%C3%A2-for-marijuana-administration%C3%A2-in%C3%A2-alzheimer-s-dementia
#3
Daniel G Amen, Borhan Darmal, Cyrus A Raji, Weining Bao, Lantie Jorandby, Somayeh Meysami, Cauligi S Raghavendra
BACKGROUND: Few studies have evaluated the impact of marijuana use on regional cerebral blood flow. OBJECTIVE: To determine whether perfusion in specific brain regions on functional neuroimaging, including those affected by Alzheimer's disease pathology, are abnormal in marijuana users compared to controls. METHOD: Persons with a diagnosis of cannabis use disorder by DSM-IV and DSM-V criteria (n = 982) were compared to controls (n = 92) with perfusion neuroimaging with SPECT at rest and at a concentration task...
November 24, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27879446/quantification-of-serial-cerebral-blood-flow-in-acute-stroke-using-arterial-spin-labeling
#4
George W J Harston, Thomas W Okell, Fintan Sheerin, Ursula Schulz, Phil Mathieson, Ian Reckless, Kunal Shah, Gary A Ford, Michael A Chappell, Peter Jezzard, James Kennedy
BACKGROUND AND PURPOSE: Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset. METHODS: Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month...
November 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27879370/validation-of-mri-determination-on-pet-measurements-in-ischemic-stroke
#5
Wolf-Dieter Heiss, Olivier Zaro Weber
The concept of the ischemic penumbra was formulated based on animal experiments showing functional impairment and electrophysiological disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with blood supply further decreased (the threshold for infarction). The perfusion range between these thresholds was termed "penumbra", and restitution of flow above the functional threshold was able to reverse the deficits without permanent damage...
November 22, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27861231/wavelet-based-angiographic-reconstruction-of-computed-tomography-perfusion-data-diagnostic-value-in-cerebral-venous-sinus-thrombosis
#6
Wolfgang G Kunz, Felix Schuler, Wieland H Sommer, Matthias P Fabritius, Lukas Havla, Felix G Meinel, Maximilian F Reiser, Birgit Ertl-Wagner, Kolja M Thierfelder
OBJECTIVE: The aim of this study was to test the diagnostic value of wavelet-based angiographic reconstruction of CT perfusion data (waveletCTA) to detect cerebral venous sinus thrombosis (CVST) in patients who underwent whole-brain CT perfusion imaging (WB-CTP). MATERIALS AND METHODS: Datasets were retrospectively selected from an initial cohort of 2863 consecutive patients who had undergone multiparametric CT including WB-CTP. WaveletCTA was reconstructed from WB-CTP: the angiographic signal was generated by voxel-based wavelet transform of time attenuation curves (TACs) from WB-CTP raw data...
November 17, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27845320/-perfusion-computed-tomography-in-the-diagnosis-of-mild-brain-injury
#7
I A Balandina, K V Shevchenko, E A Zolotovskaya
AIM: To evaluate and compare the characteristics of the regional cerebral blood flow in patients with mild cerebral concussion or injury using the results of perfusion computed tomography (CT). MATERIAL AND METHODS: Thirty-eight men, aged 18-35 years, including 21 with concussion and 17 with mild cranial/brain injury (CBI), were examined at the early stage of disease. The control group consisted of 7 age-matched men with non-confirmed CBI. RESULTS AND CONCLUSION: The results of CT-perfusion revealed generalized changes in the hemodynamics...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27837185/quantitative-estimation-of-a-ratio-of-intracranial-cerebrospinal-fluid-volume-to-brain-volume-based-on-segmentation-of-ct-images-in-patients-with-extra-axial-hematoma
#8
Ha Son Nguyen, Mohit Patel, Luyuan Li, Shekar Kurpad, Wade Mueller
BACKGROUND: Diminishing volume of intracranial cerebrospinal fluid (CSF) in patients with space-occupying masses have been attributed to unfavorable outcome associated with reduction of cerebral perfusion pressure and subsequent brain ischemia. OBJECTIVE: The objective of this article is to employ a ratio of CSF volume to brain volume for longitudinal assessment of space-volume relationships in patients with extra-axial hematoma and to determine variability of the ratio among patients with different types and stages of hematoma...
November 11, 2016: Neuroradiology Journal
https://www.readbyqxmd.com/read/27825691/long-term-outcomes-of-open-arch-repair-after-a-prior-aortic-operation-our-experience-in-154-patients
#9
Roberto Di Bartolomeo, Paolo Berretta, Antonio Pantaleo, Giacomo Murana, Mariano Cefarelli, Jacopo Alfonsi, Giuseppe Barberio, Alessandro Leone, Luca Di Marco, Davide Pacini
BACKGROUND: This study assessed the early and long-term results of arch operations performed after a prior aortic operation. METHODS: From 1994 to 2014, 154 consecutive patients (mean age, 59.7 years) underwent an aortic arch repair, after a previous aortic operation, at our institution. Antegrade selective cerebral perfusion was used in all cases. Chronic postdissection aortic aneurysm (87 [56.5%]) and degenerative aneurysm (43 [27.9%]) represented the most common indications for surgical intervention...
November 5, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27822669/asl-and-susceptibility-weighted-imaging-contribution-to-the-management-of-acute-ischaemic-stroke
#10
REVIEW
Sébastien Verclytte, Olivier Fisch, Lucie Colas, Olivier Vanaerde, Manuel Toledano, Jean-François Budzik
: Magnetic resonance imaging (MRI) plays a central role in the early diagnosis of cerebral vascular events. Today, MRI is used not only for the detection of acute ischaemic lesions, but also to fine tune the diagnosis and improve patient selection for early therapeutic decision-making. In this perspective, new tools such as arterial spin labelling (ASL) and susceptibility-weighted imaging (SWI) sequences have been developed. These MRI sequences enable noninvasive assessment of brain damage, providing important diagnostic and prognostic information: evaluation of cerebral parenchymal perfusion; detection and aetiological assessment of thrombi; ruling out differential diagnoses...
November 7, 2016: Insights Into Imaging
https://www.readbyqxmd.com/read/27821787/arterial-cannulation-and-cerebral-perfusion-strategies-for-aortic-arch-operations
#11
REVIEW
Lisa S Foley, Katsuhiro Yamanaka, T Brett Reece
Neurologic injuries following aortic arch operations can be devastating, with stroke occurring in up to 12% of elective operations and significant cerebral dysfunction occurring in up to 25% of cases. The primary challenge unique to aortic arch operations involves interruption of direct perfusion of the brachiocephalic vessels during arch reconstruction. For this reason, neuroprotection is paramount. The 2 main modes of protection are (1) reducing metabolic demand through hypothermia and (2) limiting, or even eliminating, the ischemic period...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27820620/endovascular-treatment-for-patients-with-acute-stroke-who-have-a-large-ischemic-core-and-large-mismatch-imaging-profile
#12
Leticia C Rebello, Mehdi Bouslama, Diogo C Haussen, Seena Dehkharghani, Jonathan A Grossberg, Samir Belagaje, Michael R Frankel, Raul G Nogueira
Importance: Endovascular therapy (ET) is typically not considered for patients with large baseline ischemic cores (irreversibly injured tissue). Computed tomographic perfusion (CTP) imaging may identify a subset of patients with large ischemic cores who remain at risk for significant infarct expansion and thus could still benefit from reperfusion to reduce their degree of disability. Objective: To compare the outcomes of patients with large baseline ischemic cores on CTP undergoing ET with the outcomes of matched controls who had medical care alone...
November 7, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27815557/whole-body-perfusion-for-hybrid-aortic-arch-repair-evolution-of-selective-regional-perfusion-with-a-modified-extracorporeal-circuit
#13
Philip Fernandes, Graham Walsh, Stephanie Walsh, Michael O'Neil, Jill Gelinas, Michael W A Chu
BACKGROUND: Patients undergoing hybrid aortic arch reconstruction require careful protection of vital organs. We believe that whole body perfusion with tailored dual circuitry may help to achieve optimal patient outcomes. METHODS: Our circuit has evolved from a secondary circuit utilizing a cardioplegia delivery device for lower body perfusion to a dual-oxygenator circuit. This allows individually controlled regional perfusion with ease of switching from secondary to primary circuit for total body flow...
November 3, 2016: Perfusion
https://www.readbyqxmd.com/read/27807197/venous-imaging-based-biomarkers-in-acute-ischaemic-stroke
#14
REVIEW
Josep Munuera, Gerard Blasco, María Hernández-Pérez, Pepus Daunis-I-Estadella, Antoni Dávalos, David S Liebeskind, Max Wintermark, Andrew Demchuk, Bijoy K Menon, Götz Thomalla, Kambiz Nael, Salvador Pedraza, Josep Puig
Vascular neuroimaging plays a decisive role in selecting the best therapy in patients with acute ischaemic stroke. However, compared with the arterial system, the role of veins has not been thoroughly studied. In this review, we present the major venous imaging-based biomarkers in ischaemic stroke. First, the presence of hypodense veins in the monophasic CT angiography ipsilateral to the arterial occlusion. Second, the asymmetry of venous drainage in the pathological cerebral hemisphere on CT and MRI dynamic angiography...
November 2, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27798267/fully-automated-stroke-tissue-estimation-using-random-forest-classifiers-faster
#15
Richard McKinley, Levin Häni, Jan Gralla, M El-Koussy, S Bauer, M Arnold, U Fischer, S Jung, Kaspar Mattmann, Mauricio Reyes, Roland Wiest
Several clinical trials have recently proven the efficacy of mechanical thrombectomy for treating ischemic stroke, within a six-hour window for therapy. To move beyond treatment windows and toward personalized risk assessment, it is essential to accurately identify the extent of tissue-at-risk ("penumbra"). We introduce a fully automated method to estimate the penumbra volume using multimodal MRI (diffusion-weighted imaging, a T2w- and T1w contrast-enhanced sequence, and dynamic susceptibility contrast perfusion MRI)...
October 19, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27790786/tonotopic-maps-in-human-auditory-cortex-using-arterial-spin-labeling
#16
Anna Gardumi, Dimo Ivanov, Martin Havlicek, Elia Formisano, Kâmil Uludağ
A tonotopic organization of the human auditory cortex (AC) has been reliably found by neuroimaging studies. However, a full characterization and parcellation of the AC is still lacking. In this study, we employed pseudo-continuous arterial spin labeling (pCASL) to map tonotopy and voice selective regions using, for the first time, cerebral blood flow (CBF). We demonstrated the feasibility of CBF-based tonotopy and found a good agreement with BOLD signal-based tonotopy, despite the lower contrast-to-noise ratio of CBF...
October 28, 2016: Human Brain Mapping
https://www.readbyqxmd.com/read/27765887/total-aortic-arch-replacement-advantages-of-varied-techniques
#17
REVIEW
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27757739/cerebral-hemodynamics-in-sepsis-assessed-by-transcranial-doppler-a-systematic-review-and-meta-analysis
#18
Daniel Silva de Azevedo, Angela Salomao Macedo Salinet, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu, Ricardo de Carvalho Nogueira
Cerebral microcirculation is gradually compromised during sepsis, with significant reductions in the function of capillaries and blood perfusion in small vessels. Transcranial Doppler ultrasound (TCD) has been used to assess cerebral circulation in a typical clinical setting. This study was to systematically review TCD studies, assess their methodological quality, and identify trends that can be associated with the temporal evolution of sepsis and its clinical outcome. A meta-analysis of systematic reviews was conducted according to the PRISMA statement...
October 18, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27742818/a-clinical-protocol-for-goal-directed-cerebral-perfusion-during-aortic-arch-surgery
#19
Matthew S Mosca, George Justison, T Brett Reece
OBJECTIVE: The optimal strategy to deliver antegrade cerebral perfusion for cerebral protection during hypothermic circulatory arrest has not been established. The purpose of this review was to present our current clinical protocol utilizing selective antegrade cerebral perfusion during aortic arch surgery and to compare it to other published experience. CLINICAL PROTOCOL: Since 2013, our clinical protocol for aortic arch surgery has evolved to using selective antegrade cerebral perfusion via the innominate artery, moderate hypothermia, and ancillary strategies such as goal-directed perfusion (GDP)...
October 14, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27734011/neurologic-injury-associated-with-rewarming-from-hypothermia-is-mild-hypothermia-on-bypass-better-than-deep-hypothermic-circulatory-arrest
#20
Utpal S Bhalala, Elumalai Appachi, Muhammad Ali Mumtaz
Many known risk factors for adverse cardiovascular and neurological outcomes in children with congenital heart defects (CHD) are not modifiable; however, the temperature and blood flow during cardiopulmonary bypass (CPB), are two risk factors, which may be altered in an attempt to improve long-term neurological outcomes. Deep hypothermic circulatory arrest, traditionally used for aortic arch repair, has been associated with short-term and long-term neurologic sequelae. Therefore, there is a rising interest in using moderate hypothermia with selective antegrade cerebral blood flow on CPB during aortic arch repair...
2016: Frontiers in Pediatrics
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