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Middle Cerebral Artery

Won Jang, Hyo Sung Kwak, Gyung Ho Chung, Seung Bae Hwang
OBJECTIVES: This study evaluated the utility of three-dimensional (3D), black-blood (BB), contrast-enhanced, magnetic resonance imaging (MRI) for the detection of intraluminal thrombi in acute stroke patients. METHODS: Forty-seven patients with acute stroke involving the anterior circulation underwent MRI examination within 6 h of clinical onset. Cerebral angiography was used as the reference standard. In a blinded manner, two neuroradiologists interpreted the following three data sets: (1) diffusion-weighted imaging (DWI) + 3D BB contrast-enhanced MRI; (2) DWI + susceptibility weighted imaging (SWI); (3) DWI + 3D BB contrast-enhanced MRI + SWI...
March 19, 2018: European Radiology
Prince C Esiobu, Mi Jin Yoo, Erin M Kirkham, R Eugene Zierler, Benjamin W Starnes, Matthew P Sweet
Eagle syndrome is caused by an elongated styloid process or calcified stylohyoid ligament. The stylocarotid variant with neurologic symptoms is rare and presents a diagnostic challenge. Patients may present with transient ischemic attacks, syncope, or less well defined symptoms like episodic dizziness. We report use of vascular laboratory testing in the management of Eagle syndrome. In one patient, on Doppler ultrasound examination of the ipsilateral temporal artery, the signal was lost with provocative neck flexion...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Il-Doo Kim, Hahnbie Lee, Seung-Woo Kim, Hye-Kyung Lee, Juli Choi, Pyung-Lim Han, Ja-Kyeong Lee
Post-stroke infection (PSI) is known to worsen functional outcomes of stroke patients and accounts to one-third of stroke-related deaths in hospital. In our previous reports, we demonstrated that massive release of high-mobility group box protein 1 (HMGB1), an endogenous danger signal molecule, is promoted by N-methyl-D-aspartic acid-induced acute damage in the postischemic brain, exacerbating neuronal damage by triggering delayed inflammatory processes. Moreover, augmentation of proinflammatory function of lipopolysaccharides (LPS) by HMGB1 via direct interaction has been reported...
March 19, 2018: Cell Death & Disease
Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Pingping Xia, Yundan Pan, Fan Zhang, Na Wang, E Wang, Qulian Guo, Zhi Ye
BACKGROUND/AIMS: Recent researches highlighted the protective potential of pioglitazone, a PPAR-γ agonist, in the progression of cerebral ischemia-reperfusion injury. However, there has been no study on the application of pioglitazone in treating ischemic stroke through mechanisms involving pyroptosis. METHODS: The cerebral injury was established by middle cerebral artery occlusion (MCAO). in vitro ischemia in primary cultured astrocytes was induced by the oxygen-glucose deprivation (OGD)...
March 13, 2018: Cellular Physiology and Biochemistry
Junhui Chen, Chunlei Zhang, Peipei Li, Lei Chen, Yuhai Wang
Giant intracranial aneurysms have always been remain the most difficult cerebrovascular lesions to treat, especially for giant cavernous carotid aneurysm (CCA). The treatment of giant CCA is a greatest challenge for neurosurgeons. Surgical clipping morbidity and mortality rates are relatively high, and endovascular embolization also have a high complication. The authors reported a special 74-year-old female patient who presented with blurred vision and double vision for 3 years, a giant CCA was found by digital subtraction angiography and computed tomography angiography...
March 16, 2018: Journal of Craniofacial Surgery
Charlotte Spicher, Ruth Schneider, Peter Mönnings, Christiane Schneider-Gold, Dennis Kallenberg, Bilal Cevik, Carsten Lukas, Ralf Gold, Christos Krogias
Background: Duchenne muscular dystrophy (DMD) is an X-linked recessive skeletal muscle myopathy which is caused by mutations in the dystrophin gene. Lack of dystrophin also results to cardiomyopathy, which raises significantly the stroke risk in DMD-patients. However, data about therapeutic opportunities in the acute setting are scarce in literature. So far, only two cases receiving IV thrombolysis are described, one of them with fatal outcome. Method: Case report of a case of successful mechanical thrombectomy (MTE) in an acute ischemic stroke (AIS) patient with DMD and associated dilatative cardiomyopathy...
2018: Therapeutic Advances in Neurological Disorders
Julian Conrad, Rainer Boegle, Matthias Ertl, Thomas Brandt, Marianne Dieterich
Objective: Vestibular signals are involved in higher cortical functions like spatial orientation and its disorders. Vestibular dysfunction contributes, for example, to spatial neglect which can be transiently improved by caloric stimulation. The exact roles and mechanisms of the vestibular and visual systems for the recovery of neglect are not yet known. Methods: Resting-state functional connectivity (fc) magnetic resonance imaging was recorded in a patient with hemispatial neglect during the acute phase and after recovery 6 months later following a right middle cerebral artery infarction before and after caloric vestibular stimulation...
2018: Frontiers in Neurology
Le Kang, Mingsan Miao
Objective: To observe the intervention effect of total flavonoid of ilex pubesceus on animal models of cerebral ischemic tolerance. Methods: A rat model of global-focal cerebral ischemic tolerance was established by blocking bilateral common carotid artery blood flow and occluding left middle cerebral artery using thread-occlusion method. After the first operation, the Ginaton group and large-dosage, medium-dosage and small-dosage groups of total flavonoid of ilex pubesceus were given intragastric administration of corresponding drugs...
December 2017: Saudi Journal of Biological Sciences
Ying Song, Yun Bei, Yan Xiao, Hai-Da Tong, Xie-Qi Wu, Man-Ting Chen
To investigate the neuroprotective effect of edaravone was dependent on 5-lipoxygenase (5-LOX) signalling pathway or not. Middle cerebral artery occlusion (MCAO) and oxygen glucose deprivation (OGD) were established in SD rats and PC12 cells to mimic ischemic injury. In vivo, edaravone can significantly reduce neurological deficit scores, infarct volume and expression of 5-LOX. For in vitro experiment, reduced viability, cell death which occurred via necrosis and apoptosis were shown after OGD and even severer in OGD-reperfusion (OGD-R)...
March 15, 2018: Brain Research
Marta Aleksandrowicz, Ewa Kozniewska
Vasopressin (arginine vasopressin, AVP) plays a crucial role in maintaining body fluid homeostasis. Excessive release of vasopressin can lead to hyponatremia. Changes in cerebral circulation during vasopressin-induced chronic hyponatremia are not elucidated. The present study has been designed to investigate the effect of chronic vasopressin-induced hyponatremia on the regulation of the tone of the middle cerebral artery (MCA) of the rat. Chronic hyponatremia was induced in vivo with the help of vasopressin, released continuously from subcutaneously implanted ALZET mini-osmotic pumps, and a liquid diet...
March 17, 2018: Pflügers Archiv: European Journal of Physiology
Xiaoqin Zhang, Yiping Zhang, Songqi Tang, Lishuang Yu, Youqin Zhao, Qiangqiang Ren, Xiaoqiang Huang, Wen Xu, Mingqing Huang, Jun Peng
ETHNOPHARMACOLOGICAL RELEVANCE: Pien-Tze-Huang (PZH) is a famous formula of traditional Chinese medicine used to treating stroke. However, the protective effect of PZH and its mechanisms in acute ischemic stroke remain to be explored. AIM OF THE STUDY: To investigate the protective effect of PZH on neuronal apoptosis in acute cerebral ischemic injury rats and explore its underlying mechanisms. MATERIALS AND METHODS: The effects of PZH were studied in acute ischemic stroke rats induced by transient middle cerebral artery occlusion, and the mitochondria-mediated apoptotic proteins including cytochrome C (Cyt C), Bax, Bcl-xl, P53, caspase-3, and caspase-9 as well as AKT and glycogen synthase kinase-3 beta (GSK-3β) were assessed...
March 14, 2018: Journal of Ethnopharmacology
Fuat Arikan, Marta Rubiera, Joaquín Serena, Ana Rodríguez-Hernández, Darío Gándara, Carles Lorenzo-Bosquet, Alejandro Tomasello, Ivette Chocrón, Maximiliano Quintana-Corvalan, Juan Sahuquillo
INTRODUCTION: Cerebral revascularization techniques are an indispensable tool in the current armamentarium of vascular neurosurgeons. We present revascularization surgery experience and results in both moyamoya disease and occlusive cerebral ischaemia. PATIENTS AND METHODS: Patients with ischaemic occlusive disease and moyamoya disease who underwent microsurgical revascularization between October 2014 and September 2017 were analysed. RESULTS: In the study period, 23 patients with occlusive ischaemic disease underwent microsurgical revascularization...
March 14, 2018: Neurocirugía
Rumiko Takayama, Katsumi Imai, Hiroko Ikeda, Koichi Baba, Naotaka Usui, Yukitoshi Takahashi, Yushi Inoue
We describe two cases of refractory epilepsy with cerebral hemiatrophy and contralateral electroencephalographic (EEG) abnormalities, in which hemispherotomy of the atrophic hemisphere effectively controlled seizures. Case 1 was a 5-year-1-month-old girl with refractory bilateral asymmetrical tonic posturing seizures predominantly in the right arm. Magnetic resonance imaging showed left porencephaly corresponding to a left middle cerebral artery infarction. Case 2 was a 3-year-8-month-old boy with refractory bilateral asymmetrical tonic posturing seizures predominantly in the right arm due to atrophy of the left cerebral hemisphere after septic meningitis...
March 14, 2018: Brain & Development
Lizhen Liang, Jun Wang, Yanrong Yuan, Yan Zhang, Huili Liu, Chunli Wu, Yongxing Yan
PURPOSE: To investigate the protective effects of miR-320 on cerebral ischemia/reperfusion (I/R) injury in mice and PC12 cells. METHODS: miR-320 normal control (NC), inhibitor fragment and overexpression fragments were injected into mice lateral ventricles. Thereafter, the middle cerebral artery occlusion (MCAO) for left cerebrum method was employed in order to establish a cerebral I/R injury mice model. Apoptosis in the peripheral region of cerebral infarction and the volume of cerebral infarction and brain edema were tested as well...
March 14, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Jinbing Zhao, Hongyi Liu, Yuanjie Zou, Wenbin Zhang, Shengxue He
The present retrospective study was performed to evaluate the clinical outcome, as well as post-operative collateral formation and revascularization patterns in combined bypass. Surgical revascularization has been the mainstay of treatment for moyamoya patients. A total of 76 hemispheres from 64 moyamoya patients undergoing combined superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and encephalo-duro-myo-synangiosis (EDMS) were retrospectively reviewed. Computed tomography perfusion and DSA were routinely performed...
April 2018: Experimental and Therapeutic Medicine
Yamaan S Saadeh, Luis E Savastano, Julian L Gendreau, Aditya S Pandey
Optimal management of patients with stroke due to symptomatic carotid artery disease coexistent with bacterial endocarditis is still not well established. We report the case of a patient who presented with multifocal left middle cerebral artery stroke in the setting of Enterococcus faecalis endocarditis and was found to have near-occlusive ipsilateral carotid artery stenosis in stroke workup. Carotid artery endarterectomy was performed, and atheroma material demonstrated complicated plaque with cultures positive for E...
March 15, 2018: BMJ Case Reports
Jun Zhang, Xiao Zhang, Jin-Ping Zhang, Ju Han
The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions...
March 15, 2018: BMJ Case Reports
V Bhatia, V Gupta, D Khurana, R R Sharma, N Khandelwal
BACKGROUND AND PURPOSE: Stroke is a debilitating illness for which treatment window is limited. Most patients present to the healthcare facility beyond that window. Autologous stem cells have shown some promise for this group of patients. This study was performed to evaluate the safety and the efficacy of intra-arterial infusion of bone marrow-derived mononuclear cells in patients with middle cerebral artery ischemic stroke. MATERIALS AND METHODS: A prospective, randomized, open-label, blinded-end point study was performed from July 2015 to June 2016...
March 15, 2018: AJNR. American Journal of Neuroradiology
Giulia Cisbani, Audrey Le Behot, Marie-Michèle Plante, Paul Préfontaine, Manon Lecordier, Serge Rivest
Stroke is the second cause of mortality worldwide and occurs following the interruption of cerebral blood circulation by cerebral vessel burst or subsequent to a local thrombus formation. Ischemic lesion triggers an important inflammatory response, characterized by massive infiltration of leukocytes, activation of glial cells and neurovascular reorganization. Chemokines and their receptors, such as CCR2 and CX3CR1, play an important role in leukocyte recruitment in the damaged area. Mice genetically depleted for the two receptors CCR2 and CX3CR1 underwent focal cerebral ischemia, based on the topical application of ferric chloride to truncate the distal middle cerebral artery...
March 12, 2018: Brain, Behavior, and Immunity
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