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Stroke imaging

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https://www.readbyqxmd.com/read/28346330/differentiation-of-impaired-from-preserved-hemodynamics-in-patients-with-fontan-circulation-using-real-time-phase-velocity-cardiovascular-magnetic-resonance
#1
Hermann Körperich, Katja Müller, Peter Barth, Jürgen Gieseke, Nikolaus Haas, Ingram Schulze-Neick, Wolfgang Burchert, Deniz Kececioglu, Kai T Laser
PURPOSE: Progressive impairment of hemodynamics in patients with Fontan circulation is common, multifactorial, and associated with decreased quality of life and increased morbidity. We sought to assess hemodynamic differences between patients with preserved (preserved Fontans) and those with impaired circulation (impaired Fontans) after pulmonary vasodilation using oxygen and under forced breathing conditions. MATERIALS AND METHODS: Real-time phase-contrast cardiovascular magnetic resonance was performed using non-ECG triggered echo-planar imaging (temporal resolution=24 to 28 ms) in the ascending aorta (AAo) and superior vena cava (SVC)/inferior vena cava (IVC) on room air, after 100% oxygen inhalation (4 L/min; 10 min) and on forced breathing in 29 Fontan patients (17...
March 24, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28345479/imaging-the-physiological-evolution-of-the-ischemic-penumbra-in-acute-ischemic-stroke
#2
Richard Leigh, Linda Knutsson, Jinyuan Zhou, Peter Cm van Zijl
We review the hemodynamic, metabolic and cellular parameters affected during early ischemia and their changes as a function of approximate cerebral blood flow ( CBF) thresholds. These parameters underlie the current practical definition of an ischemic penumbra, namely metabolically affected but still viable brain tissue. Such tissue is at risk of infarction under continuing conditions of reduced CBF, but can be rescued through timely intervention. This definition will be useful in clinical diagnosis only if imaging techniques exist that can rapidly, and with sufficient accuracy, visualize the existence of a mismatch between such a metabolically affected area and regions that have suffered cell depolarization...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#3
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28342654/the-role-of-the-signal-intensity-ratio-on-fluid-attenuated-inversion-recovery-in-stroke-patients-achieving-successful-recanalization-with-endovascular-treatment
#4
Taehoon Kim, Jong-Won Chung, Myung Suk Jang, Mi Hwa Yang, Sang-Hwa Lee, Beom Joon Kim, Moon-Ku Han, Jae Hyoung Kim, Cheolkyu Jung, Jae-Sung Lim, Hee-Joon Bae
BACKGROUND: This study aimed to investigate whether fluid-attenuated inversion recovery (FLAIR) imaging hyperintensity can be used as a surrogate marker for the severity of ischemic insult and predict lesion growth. METHODS: Based on a prospective stroke registry database, we identified patients with ischemic stroke who were treated with endovascular treatment (EVT) within 8 hours of onset and achieved successful recanalization (modified thrombolysis in cerebral infarction ≥2B)...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28342523/early-experience-with-a-modified-preloaded-system-for-fenestrated-endovascular-aortic-repair
#5
Blandine Maurel, Tim Resch, Rafaelle Spear, Blayne Roeder, Umberto M Bracale, Stephan Haulon, Tara M Mastracci
OBJECTIVE: Preloaded endovascular delivery systems expand the anatomic eligibility for complex aortic repair by requiring only one iliac access vessel and providing a stable platform for guiding sheaths into challenging target vessels. This article reports the lessons learned and early clinical outcomes using a modified preloaded delivery system for fenestrated endovascular aneurysm repair (FEVAR) in three aortic centers in Europe. METHODS: From October 2015 to March 2016, consecutive patients presenting with extensive aortic aneurysm treated with a modified preloaded FEVAR were prospectively enrolled from three high volume European aortic centers...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28341754/proportional-recovery-from-lower-limb-motor-impairment-after-stroke
#6
Marie-Claire Smith, Winston D Byblow, P Alan Barber, Cathy M Stinear
BACKGROUND AND PURPOSE: In people with preserved corticospinal tract (CST) function after stroke, upper limb impairment resolves by ≈70% within 3 months. This is known as the proportional recovery rule. Patients without CST function do not fit this rule and have worse upper limb outcomes. This study investigated resolution of motor impairment in the lower limb (LL). METHODS: Patients with stroke and LL weakness were assessed 3 days and 3 months after stroke with the LL Fugl-Meyer...
March 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28341719/brain-perivascular-spaces-as-biomarkers-of-vascular-risk-results-from-the-northern-manhattan-study
#7
J Gutierrez, M S V Elkind, C Dong, M Di Tullio, T Rundek, R L Sacco, C B Wright
BACKGROUND AND PURPOSE: Dilated perivascular spaces in the brain are associated with greater arterial pulsatility. We hypothesized that perivascular spaces identify individuals at higher risk for systemic and cerebral vascular events. MATERIALS AND METHODS: Stroke-free participants in the population-based Northern Manhattan Study had brain MR imaging performed and were followed for myocardial infarction, any stroke, and death. Imaging analyses distinguished perivascular spaces from lesions presumably ischemic...
March 24, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28341559/-moyamoya-disease-associated-with-kidney-angiodysplasia-in-a-child
#8
A Dibi, Z Maana, F Jabourik, A Bentahila
INTRODUCTION: Moyamoya disease is a progressive, chronic occlusive vascular disease of the circle of Willis arteries leading to the development of collateral circulation to compensate the occlusion. CASE REPORT: An 11-year-old girl presented an abrupt loss of consciousness and a right-sided motor deficit. Clinical examination found hypertension with 220/120mmHg arterial blood pressure. Brain magnetic resonance imaging showed a large left hemispheric ischemic lesion...
March 21, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28338911/new-horizons-in-hospital-acquired-pneumonia-in-older-people
#9
Victoria Ewan, Thomas Hellyer, Julia Newton, John Simpson
Approximately 1.5% of hospital patients develop hospital acquired pneumonia. Aspiration is the major risk factor for pneumonia and is associated with reduced ability to mechanically clear respiratory pathogens into the stomach. Currently non-invasive methods of diagnosing hospital acquired pneumonia are less robust than invasive methods, and lead to over-diagnosis. Accurate diagnosis is key to surveillance, prevention and treatment of HAP, and also to improving outcomes; newer imaging modalities such as phase contrast X-ray imaging and nanoparticle enhanced magnetic resonance imaging may help...
February 27, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338570/a-case-of-all-developing-posterior-reversible-encephalopathy-secondary-to-hyponatremia
#10
Nilgun Eroglu, Aysenur Bahadir, Erol Erduran
Posterior reversible encephalopathy syndrome (PRES), may be due to different causes. It may develop secondary to hypertension, renal decompensation, electrolyte imbalance, and chemotherapeutic drugs. We describe a case of acute lymphoblastic leukemia in which PRES developed secondary to hyponatremia despite being normotensive during receipt of chemotherapy. Magnetic resonance imaging findings were suggestive of PRES. Partial diffusion restriction was observed in lesions in the bilateral occipitoparietal regions and the cerebellum...
March 23, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28337932/stroke-lesions-in-a-large-upper-limb-rehabilitation-trial-cohort-rarely-match-lesions-in-common-preclinical-models
#11
Matthew A Edwardson, Ximing Wang, Brent Liu, Li Ding, Christianne J Lane, Caron Park, Monica A Nelsen, Theresa A Jones, Steven L Wolf, Carolee J Winstein, Alexander W Dromerick
BACKGROUND: Stroke patients with mild-moderate upper extremity motor impairments and minimal sensory and cognitive deficits provide a useful model to study recovery and improve rehabilitation. Laboratory-based investigators use lesioning techniques for similar goals. OBJECTIVE: To determine whether stroke lesions in an upper extremity rehabilitation trial cohort match lesions from the preclinical stroke recovery models used to drive translational research. METHODS: Clinical neuroimages from 297 participants enrolled in the Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) study were reviewed...
January 1, 2017: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/28335706/transcarotid-artery-revascularization-with-flow-reversal
#12
Alper Alpaslan, Max Wintermark, László Pintér, Sumaira Macdonald, Richard Ruedy, Ralf Kolvenbach
PURPOSE: To report a study evaluating the safety and efficacy of stenting via direct carotid access with flow reversal using the ENROUTE Transcarotid Neuroprotection System. METHODS: Between March 2009 and June 2012, 75 patients (mean age 72.6 years; 45 men) underwent carotid artery stenting with the ENROUTE System; the majority of patients (63, 84%) were asymptomatic. The primary safety endpoint was the composite of major stroke, myocardial infarction, or death at 30 days...
April 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28335644/heart-rate-and-dyssynchrony-in-patients-with-cardiac-resynchronization-therapy-a-pilot-study
#13
Jan Naar, Lars Mortensen, Reidar Winter, Jonas Johnson, Kambiz Shahgaldi, Aristomenis Manouras, Frieder Braunschweig, Marcus Ståhlberg
OBJECTIVES: The objective of this pilot study was to describe the impact of paced heart rate on left ventricular (LV) mechanical dyssynchrony in synchronous compared to dyssynchronous pacing modes in patients with heart failure. METHODS: Echocardiography was performed in 14 cardiac resynchronization therapy (CRT) patients at paced heart rates of 70 and 90 bpm in synchronous- (CRT), and dyssynchronous (atrial pacing + wide QRS activation) pacing modes. LV dyssynchrony was quantified using the 12-segment standard deviation model (Ts-SD) derived from Tissue Doppler Imaging...
March 23, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28335021/mri-visible-perivascular-space-location-is-associated-with-alzheimer-s-disease-independently-of-amyloid-burden
#14
Gargi Banerjee, Hee Jin Kim, Zoe Fox, H Rolf Jäger, Duncan Wilson, Andreas Charidimou, Han Kyu Na, Duk L Na, Sang Won Seo, David J Werring
Perivascular spaces that are visible on magnetic resonance imaging (MRI) are a neuroimaging marker of cerebral small vessel disease. Their location may relate to the type of underlying small vessel pathology: those in the white matter centrum semi-ovale have been associated with cerebral amyloid angiopathy, while those in the basal ganglia have been associated with deep perforating artery arteriolosclerosis. As cerebral amyloid angiopathy is an almost invariable pathological finding in Alzheimer's disease, we hypothesized that MRI-visible perivascular spaces in the centrum semi-ovale would be associated with a clinical diagnosis of Alzheimer's disease, whereas those in the basal ganglia would be associated with subcortical vascular cognitive impairment...
February 17, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28334882/decreased-integration-and-information-capacity-in-stroke-measured-by-whole-brain-models-of-resting-state-activity
#15
Mohit H Adhikari, Carl D Hacker, Josh S Siegel, Alessandra Griffa, Patric Hagmann, Gustavo Deco, Maurizio Corbetta
While several studies have shown that focal lesions affect the communication between structurally normal regions of the brain, and that these changes may correlate with behavioural deficits, their impact on brain's information processing capacity is currently unknown. Here we test the hypothesis that focal lesions decrease the brain's information processing capacity, of which changes in functional connectivity may be a measurable correlate. To measure processing capacity, we turned to whole brain computational modelling to estimate the integration and segregation of information in brain networks...
February 20, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28334314/a-template-and-probabilistic-atlas-of-the-human-sensorimotor-tracts-using-diffusion-mri
#16
Derek B Archer, David E Vaillancourt, Stephen A Coombes
The purpose of this study was to develop a high-resolution sensorimotor area tract template (SMATT) which segments corticofugal tracts based on 6 cortical regions in primary motor cortex, dorsal premotor cortex, ventral premotor cortex, supplementary motor area (SMA), pre-supplementary motor area (preSMA), and primary somatosensory cortex using diffusion tensor imaging. Individual probabilistic tractography analyses were conducted in 100 subjects using the highest resolution data currently available. Tractography results were refined using a novel algorithm to objectively determine slice level thresholds that best minimized overlap between tracts while preserving tract volume...
March 14, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/28333777/arteriovenous-lesions-of-the-internal-auditory-canal
#17
Charles L Anzalone, John I Lane, Michael J Link, Matthew L Carlson
OBJECTIVE: To describe a unique case of an asymptomatic arteriovenous lesion of the internal auditory canal (IAC) and present the associated imaging findings. METHODS: Retrospective case report and review of the literature. RESULTS: A 55-year-old man presented for further evaluation of a left-sided sudden sensorineural hearing loss that occurred 8 years earlier. Careful review of outside serial magnetic resonance (MR) imaging revealed a contralateral, ill-defined right-sided IAC mass with low T2 signal and subtle peripheral enhancement on postcontrast T1-weighted sequencing...
March 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28332250/visual-hallucinations-in-patients-with-acute-stroke-a-prospective-exploratory-study
#18
E Morenas-Rodríguez, P Camps-Renom, A Pérez-Cordón, A Horta-Barba, M Simón-Talero, E Cortés-Vicente, D Guisado-Alonso, E Vilaplana, C García-Sánchez, A Gironell, C Roig, R Delgado-Mederos, J Martí-Fàbregas
BACKGROUND AND PURPOSE: The incidence, underlying physiopathology, features and association with lesion topography of visual hallucinations in acute stroke have scarcely been investigated. METHODS: Patients with a diagnosis of acute stroke (ischaemic or haemorrhagic) in any vascular territory, admitted within 24 h after the onset of symptoms, were consecutively included in the study. Patients with a previous history of psychosis or cognitive impairment were excluded...
March 22, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28330942/primary-angiitis-of-the-central-nervous-system-magnetic-resonance-imaging-spectrum-of-parenchymal-meningeal-and-vascular-lesions-at-baseline
#19
Grégoire Boulouis, Hubert de Boysson, Mathieu Zuber, Loïc Guillevin, Eric Meary, Vincent Costalat, Christian Pagnoux, Olivier Naggara
BACKGROUND AND PURPOSE: Primary angiitis of the central nervous system remains challenging. To report an overview and pictorial review of brain magnetic resonance imaging findings in adult primary angiitis of the central nervous system and to determine the distribution of parenchymal, meningeal, and vascular lesions in a large multicentric cohort. METHODS: Adult patients from the French COVAC cohort (Cohort of Patients With Primary Vasculitis of the Central Nervous System), with biopsy or angiographically proven primary angiitis of the central nervous system and brain magnetic resonance imaging available at the time of diagnosis were included...
March 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28330690/subclinical-leaflet-thrombosis-in-surgical-and-transcatheter-bioprosthetic-aortic-valves-an-observational-study
#20
Tarun Chakravarty, Lars Søndergaard, John Friedman, Ole De Backer, Daniel Berman, Klaus F Kofoed, Hasan Jilaihawi, Takahiro Shiota, Yigal Abramowitz, Troels H Jørgensen, Tanya Rami, Sharjeel Israr, Gregory Fontana, Martina de Knegt, Andreas Fuchs, Patrick Lyden, Alfredo Trento, Deepak L Bhatt, Martin B Leon, Raj R Makkar
BACKGROUND: Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter valve replacement (TAVR) and surgical aortic valve replacement (SAVR) has been found with CT imaging. The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR...
March 19, 2017: Lancet
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