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Lacune infarct or silent infarction

Eric Jouvent, Edouard Duchesnay, Foued Hadj-Selem, François De Guio, Jean-François Mangin, Dominique Hervé, Marco Duering, Stefan Ropele, Reinhold Schmidt, Martin Dichgans, Hugues Chabriat
OBJECTIVE: To obtain simple models predicting disease evolution at 3 years for a given patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). METHODS: Based on data obtained in a prospective study of 236 patients, we built and validated models predicting, at the individual level, 3-year changes in Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale (MDRS), Trail Making Test version B (TMTB), and modified Rankin Scale (mRS)...
September 30, 2016: Neurology
Yuek Ling Chai, Saima Hilal, Jenny P C Chong, Yan Xia Ng, Oi Wah Liew, Xin Xu, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian, A Mark Richards, Mitchell K P Lai, Christopher P Chen
Vascular pathology plays an important role in the development of cognitive decline and dementia. In this context, growth differentiation factor-15 (GDF-15) has been suggested to be a biomarker due to its regulatory roles in inflammatory and trophic responses during tissue injury. However, limited data exist on the associations of GDF-15 with either cerebrovascular disease (CeVD) burden or the spectrum of cognitive impairment. Therefore, we aimed to study peripheral levels of GDF-15 incognitive impairment no dementia (CIND) or Alzheimer disease (AD) subjects assessed for CeVD using a case-control cohort design, with cases recruited from memory clinics and controls from memory clinics and the community...
August 2016: Medicine (Baltimore)
Xiangliang Chen, Lihui Duan, Yunfei Han, Ling Tian, Qiliang Dai, Shang Wang, Ying Lin, Yunyun Xiong, Xinfeng Liu
BACKGROUND: Around two thirds stroke patients may suffer from vascular cognitive impairment (VCI). Our previous study has validated the NINDS-CSN harmonization standard for VCI diagnosis in Chinese. In this study, we aimed to investigate the predictors for VCI in Chinese post-stroke patients. METHODS: We compared epidemiological, clinical, and neuroimaging data (number, size and location of acute infarcts and lacunes, severities of white matter hyperintensities and brain atrophy) between stroke patients with and without VCI...
2016: BMC Neurology
Shanshan Duan, Shan Zhang, Liang Li, Chuancheng Ren, Juan Xieb
BACKGROUND AND PURPOSE: Small deep brain infarcts are often caused by two different vascular pathologies: branch atheromatous disease (BAD) and lipohyalinotic degeneration (LD). In the present study༌ we compare the clinical characteristics of BAD and LD and investigate the role of C-reactive protein (CRP), homocysteine (Hcy), and carotid artery intima-media thickness (IMT) in the prognosis of patients with BAD and LD. METHODS: Of 262 adult patients with small deep infarcts, 104 were considered BAD and 158 were considered LD...
April 6, 2016: International Journal of Neuroscience
Benno Gesierich, Edouard Duchesnay, Eric Jouvent, Hugues Chabriat, Reinhold Schmidt, Jean-Francois Mangin, Marco Duering, Martin Dichgans
BACKGROUND AND PURPOSE: Lacunes are a major manifestation of cerebral small vessel disease. Although still debated, the morphological features of lacunes may offer mechanistic insights. We systematically analyzed the shape of incident lacunes in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, a genetically defined small vessel disease. METHODS: A total of 88 incident lacunes from 57 patients were segmented from 3-dimensional T1 magnetic resonance images and 3 dimensionally reconstructed...
May 2016: Stroke; a Journal of Cerebral Circulation
Laura K Wilson, Lesly A Pearce, Antonio Arauz, David C Anderson, Jorge Tapia, Carlos Bazan, Oscar R Benavente, Thalia S Field
BACKGROUND: Pontine infarcts are common and often attributed to small vessel disease ("small deep infarcts") or basilar branch atherosclerosis ("wedge shaped"). A well-described morphological differentiation using magnetic resonance images has not been reported. Furthermore, whether risk factors and outcomes differ by morphology, or whether infarct morphology should guide secondary prevention strategy, is not well characterized. METHODS: All participants in the Secondary Prevention of Small Subcortical Strokes Study with magnetic resonance imaging -proven pontine infarcts were included...
June 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Eric Jouvent, Zhong Yi Sun, François De Guio, Edouard Duchesnay, Marco Duering, Stefan Ropele, Martin Dichgans, Jean-François Mangin, Hugues Chabriat
BACKGROUND AND PURPOSE: Both brain and cognitive reserves modulate the clinical impact of chronic brain diseases. Whether a motor reserve also modulates the relationships between stroke and disability is unknown. We aimed to determine whether the shape of the central sulcus, a marker of the development of underlying motor connections, is independently associated with disability in patients with a positive history of small subcortical ischemic stroke. METHODS: Shapes of central sulci were reconstructed from high-resolution magnetic resonance imaging and ordered without supervision according to a validated algorithm in 166 patients with a positive history of small subcortical ischemic stroke caused by CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy), a severe monogenic cerebral small vessel disease affecting young patients...
April 2016: Stroke; a Journal of Cerebral Circulation
Breda Cullen, Fiona C Moreton, Michael S Stringer, Rajeev Krishnadas, Dheeraj Kalladka, Maria R López-González, Celestine Santosh, Christian Schwarzbauer, Keith W Muir
Cognitive impairment is an inevitable feature of cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), affecting executive function, attention and processing speed from an early stage. Impairment is associated with structural markers such as lacunes, but associations with functional connectivity have not yet been reported. Twenty-two adults with genetically-confirmed CADASIL (11 male; aged 49.8 ± 11.2 years) underwent functional magnetic resonance imaging at rest...
May 2016: Journal of Cerebral Blood Flow and Metabolism
Eda Kiliç Çoban, Sedat Gez, Batuhan Kara, Aysun Soysal
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological entity characterized by epileptic seizures, headaches, altered mental status and focal neurological signs. Hypertension is the second most common condition associated with PRES. The 50-year-old-male patient with, right-sided hemiparesis and speech disturbances admitted to our clinic. His blood pressure at the emergency service was 220/140 mmHg. A left putaminal hematoma was seen in his CT and MRI. In his brain MRI, FLAIR and T2 -weighted sequences showed bilateral symmetric diffuse hyperintensities in the brain stem, basal ganglia, and occipital, parietal, frontal, and temporal lobes...
November 30, 2015: Ideggyógyászati Szemle
Erin L Abner, Peter T Nelson, Richard J Kryscio, Frederick A Schmitt, David W Fardo, Randall L Woltjer, Nigel J Cairns, Lei Yu, Hiroko H Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L Tyas, David A Bennett, Julie A Schneider, Zoe Arvanitakis
INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood. METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression. RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1...
August 2016: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
Maria Del C Valdés Hernández, Paul A Armitage, Michael J Thrippleton, Francesca Chappell, Elaine Sandeman, Susana Muñoz Maniega, Kirsten Shuler, Joanna M Wardlaw
RATIONALE: Cerebral small vessel disease (SVD) is common in ageing and patients with dementia and stroke. Its manifestations on magnetic resonance imaging (MRI) include white matter hyperintensities, lacunes, microbleeds, perivascular spaces, small subcortical infarcts, and brain atrophy. Many studies focus only on one of these manifestations. A protocol for the differential assessment of all these features is, therefore, needed. AIMS: To identify ways of quantifying imaging markers in research of patients with SVD and operationalize the recommendations from the STandards for ReportIng Vascular changes on nEuroimaging guidelines...
December 2015: Brain and Behavior
Yong Bum Kim, Kwang-Yeol Park, Pil-Wook Chung, Jeong-Min Kim, Heui-Soo Moon, Young Chul Youn
OBJECTIVE: The aim of this study was to determine the association of brachial-ankle pulse wave velocity (baPWV) with both acute and chronic cerebral small vessel disease (SVD). METHODS: We identified 1282 consecutive patients with acute ischemic stroke or transient ischemic attack. Neuroimaging correlates of chronic lacunes, white matter hyperintensity (WMH), and cerebral microbleed (CMB) were assessed using MR images. Combined SVD score was defined as the number of presence of SVD markers including chronic lacunes, WMH, deep CMB, and acute lacunar infarction...
February 2016: Atherosclerosis
Xiaoyu Zhang, Lingling Ding, Junliang Yuan, Wei Qin, Wenli Hu
BACKGROUND: White matter hyperintensities (WMH) predict incident strokes and new lacunes; moreover, WMH may also affect infarct locations. Our aim in this study was to examine the spatial relationship between WMH and acute lacunar infarction. METHODS: Five hundred and ninety patients with acute lacunar infarction in supratentorial region were included. Four situations between infarction and WMH were assessed by axial and coronal MRI: no contact (Grade 0), contact without overlap (Grade Ia), partial overlap (Grade Ib), and complete overlap (Grade II) with preexisting WMH...
2015: European Neurology
Nagaendran Kandiah, Russell Jude Chander, Xuling Lin, Aloysius Ng, Yen Yeong Poh, Chin Yee Cheong, Alvin Rae Cenina, Pryseley Nkouibert Assam
BACKGROUND: Post stroke cognitive impairment (PSCI), an important complication of strokes, has numerous risk factors. A scale adequately classifying risk of cognitive impairment 3-6 months after mild stroke will be useful for clinicians. OBJECTIVE: To develop a risk score based on clinical and neuroimaging variables that will be useful in identifying mild ischemic stroke patients at high risk for PSCI. METHODS: The risk score development cohort comprised of a retrospective dataset of 209 mild stroke patients with MRI confirmed infarcts, without pre-stroke cognitive impairment, and evaluated within 6 months post-stroke for PSCI...
2015: Journal of Alzheimer's Disease: JAD
Hugues Chabriat, Dominique Hervé, Marco Duering, Ophelia Godin, Eric Jouvent, Christian Opherk, Nassira Alili, Sonia Reyes, Aude Jabouley, Nikola Zieren, Jean-Pierre Guichard, Chahin Pachai, Eric Vicaut, Martin Dichgans
BACKGROUND AND PURPOSE: Predictors of clinical worsening in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy remain unknown. This study aims to identify demographic, clinical, and magnetic resonance imaging predictors of incident strokes, incident dementia, clinical deterioration, and death in patients with this genetically proven disease. METHODS: Two hundred ninety subjects (mean age, 50.6±11.4 years) were assessed at baseline and followed up for 36 months...
January 2016: Stroke; a Journal of Cerebral Circulation
Maria del C Valdés Hernández, Lucy C Maconick, Susana Muñoz Maniega, Xin Wang, Stewart Wiseman, Paul A Armitage, Fergus N Doubal, Stephen Makin, Cathie L M Sudlow, Martin S Dennis, Ian J Deary, Mark Bastin, Joanna M Wardlaw
BACKGROUND: Acute lacunar ischaemic stroke, white matter hyperintensities, and lacunes are all features of cerebral small vessel disease. It is unclear why some small vessel disease lesions present with acute stroke symptoms, whereas others typically do not. AIM: To test if lesion location could be one reason why some small vessel disease lesions present with acute stroke, whereas others accumulate covertly. METHODS: We identified prospectively patients who presented with acute lacunar stroke symptoms with a recent small subcortical infarct confirmed on magnetic resonance diffusion imaging...
October 2015: International Journal of Stroke: Official Journal of the International Stroke Society
Veronica van der Land, Jaco J M Zwanenburg, Karin Fijnvandraat, Bart J Biemond, Jeroen Hendrikse, Henri J M M Mutsaerts, Fredy Visser, Joanna M Wardlaw, Aart J Nederveen, Charles B L M Majoie, Paul J Nederkoorn
BACKGROUND: Patients with sickle cell anemia (SCA) are at a high risk to develop cerebral damage. Most common are silent cerebral infarctions (SCIs), visible as white matter hyperintensities (WMHs) on MRI in a patient without neurological deficits. The etiology of SCIs remains largely unclear. In addition, patients are at an increased risk for overt stroke, which is associated with large vessel disease. This classification based on the presence or absence of neurological deficits may not be the most fitting for research purposes, as it does not match the different underlying pathology...
2015: Cerebrovascular Diseases
Lorena Blanco-Rojas, Adrià Arboix, David Canovas, Marta Grau-Olivares, Joan Carles Oliva Morera, Olga Parra
BACKGROUND: The detection of early neuropsychological abnormalities as precursors of cognitive decline of vascular origin in patients with lacunar stroke is a subject of increasing interest. The objective of this study was to assess whether there were differences in the performance of a battery of neuropsychological tests in first-ever lacunar stroke patients with and without associated silent multiple lacunar infarctions found incidentally on the brain magnetic resonance imaging (MRI) scan...
2013: BMC Neurology
Xin Wang, Maria C Valdés Hernández, Fergus Doubal, Francesca M Chappell, Joanna M Wardlaw
BACKGROUND: White matter lesions (WML) and brain atrophy are important biomarkers in stroke and dementia. Stroke lesions, either acute or old, symptomatic or silent, are common in older people. Such stroke lesions can have similar signals to WML and cerebrospinal fluid (CSF) on magnetic resonance (MR) images, and may be classified accidentally as WML or CSF by MR image processing algorithms, distorting WML and brain atrophy volume from the true volume. We evaluated the effect that acute or old stroke lesions at baseline, and new stroke lesions occurring during follow-up, could have on measurement of WML volume, cerebral atrophy and their longitudinal progression...
2012: Cerebrovascular Diseases
Adrià Arboix
Lacunar infarcts or lacunes result from occlusion of a single penetrating artery and account for approximately a quarter of cerebral infarctions. The short-term prognosis of symptomatic lacunar infarct is favorable - that is, low early mortality and a high proportion of symptom-free patients at hospital discharge - but the prognosis in the mid- and long-term is less favorable as there is an increased risk of death, recurrence of stroke and vascular-type dementia. This unfavorable prognosis is mostly related to asymptomatic progression of small-vessel disease...
September 2011: Expert Review of Neurotherapeutics
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