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Small vessel cerebrovascular disease

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https://www.readbyqxmd.com/read/29116947/cerebrovascular-steal-phenomenon-and-electroconvulsive-therapy-a-case-report-and-review-of-the-literature
#1
Ana Hategan, Calvin H Hirsch
Electroconvulsive therapy (ECT) is a safe and effective treatment for major depressive disorder, but cerebrovascular and cardiovascular complications, although rare, remain the most concerning. This is particularly notable in those with preexisting cerebrovascular disease, which impacts dynamic cerebral autoregulation. In these patients, the increased blood flow to the seizing portions of the brain induced by ECT potentially can reduce cerebral blood flow to ischemic areas, possibly causing adverse neurological events...
November 8, 2017: Journal of ECT
https://www.readbyqxmd.com/read/29084064/new-insights-into-cerebral-small-vessel-disease-and-vascular-cognitive-impairment-from-mri
#2
Eric E Smith, Andrew E Beaudin
PURPOSE OF REVIEW: We review recent MRI research that addresses two important challenges in cerebral small vessel disease (SVD) research: early diagnosis, and linking SVD with cognitive impairment. First, we review studies of MRI measurements of blood flow and blood-brain barrier integrity. Second, we review MRI studies identifying neuroimaging correlates of SVD-related cognitive dysfunction, focusing on brain connectivity and white matter microarchitecture. This research is placed in context through discussion of recent recommendations for management of incidentally discovered SVD, and neuroimaging biomarker use in clinical trials...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29066902/effects-of-sevoflurane-versus-propofol-on-cerebrovascular-reactivity-to-carbon-dioxide-during-laparoscopic-surgery
#3
Chunyi Wang, Cheng Ni, Gang Li, Yan Li, Liyuan Tao, Nan Li, Jun Wang, Xiangyang Guo
PURPOSE: Cerebrovascular reactivity to carbon dioxide (CVR-CO2) reflects cerebrovascular reserve capacity, which is important in many brain disorders, including cerebrovascular and Alzheimer's diseases. Meanwhile, there is a relationship between CVR-CO2 and cognitive function. Therefore, the study is aimed at investigating the effects of sevoflurane versus propofol on CVR-CO2 during laparoscopic surgery, as well as the role of CVR-CO2 on cognitive function during perioperative period...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29061396/increased-level-of-procalcitonin-is-associated-with-total-mri-burden-of-cerebral-small-vessel-disease-in-patients-with-ischemic-stroke
#4
Guangzong Li, Chen Zhu, Jing Li, Xiangming Wang, Qingbin Zhang, Hongjia Zheng, Cheng Zhan
BACKGROUND: Procalcitonin (PCT) has been found to be associated with subclinical cerebrovascular damage. The relationship between PCT levels and cerebral small vessel disease (cSVD), especially cSVD burden, has not been fully understood. This study aimed to investigate the association between PCT levels and cSVD in patients with first-ever acute ischemic stroke or transient ischemic attack (TIA). METHODS: Two hundred and seventy-eight consecutive patients were prospectively recruited during Jan 2016 to Jun 2017...
October 20, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29040166/measurement-of-retinal-vessels-as-a-biomarker-of-cerebrovascular-ageing-in-older-hiv-positive-men-compared-to-controls
#5
Lewis Haddow, Rosanna Laverick, Irene Leung, Frank Post, Jaime Vera, Richard Gilson, Ian Williams, Marta Boffito, Caroline Sabin, Alan Winston, Tunde Peto
BACKGROUND: To compare retinal vascular measurements, biomarkers of cerebral small vessel disease (SVD), in HIV positive men aged 50 years and above with similarly-aged HIV negative men and younger HIV positive men. METHODS: We recruited white, non-diabetic men to a cross-sectional substudy of a larger cohort including three demographically-matched groups. Optic disc centred 45° colour fundus photographs were used to calculate central retinal arterial and venous calibre and the arterial-venous ratio (AVR)...
October 14, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28987197/neuropathology-of-cerebrovascular-diseases
#6
Isidro Ferrer, Noemi Vidal
The chapter describes the epidemiology of cerebrovascular diseases, anatomy of the cerebral blood vessels, pathophysiology of ischemia, hypoxia, hypoxemia, anemic hypoxia, histotoxic hypoxia, carbon monoxide damage, hyperoxid brain damage and decompression sickness, and selective cell and regional vulnerability; diseases of the blood vessels including atherosclerosis, hypertensive angiopathy, small vessel disease, inflammatory vascular diseases, cerebral amyloid angiopathies, CADASIL, CARASIL and other diseases that can lead to cerebrovascular occlusion; intracranial and intraspinal aneurysms and vascular malformations; hematologic disorders that can cause cerebral infarct or hemorrhage; brain ischemic damage; and spontaneous intracranial bleeding...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28984315/pet-imaging-of-the-neurovascular-interface-in-cerebrovascular-disease
#7
REVIEW
Nicholas R Evans, Jason M Tarkin, John R Buscombe, Hugh S Markus, James H F Rudd, Elizabeth A Warburton
Cerebrovascular disease encompasses a range of pathologies that affect different components of the cerebral vasculature and brain parenchyma. Large artery atherosclerosis, acute cerebral ischaemia, and intracerebral small vessel disease all demonstrate altered metabolic processes that are key to their pathogenesis. Although structural imaging techniques such as MRI are the mainstay of clinical care and research in cerebrovascular disease, they have limited ability to detect these pathophysiological processes in vivo...
November 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28974571/endothelial-mineralocorticoid-receptor-mediates-parenchymal-arteriole-and-posterior-cerebral-artery-remodeling-during-angiotensin-ii-induced-hypertension
#8
Janice M Diaz-Otero, Courtney Fisher, Kelsey Downs, M Elizabeth Moss, Iris Z Jaffe, William F Jackson, Anne M Dorrance
The brain is highly susceptible to injury caused by hypertension because the increased blood pressure causes artery remodeling that can limit cerebral perfusion. Mineralocorticoid receptor (MR) antagonism prevents hypertensive cerebral artery remodeling, but the vascular cell types involved have not been defined. In the periphery, the endothelial MR mediates hypertension-induced vascular injury, but cerebral and peripheral arteries are anatomically distinct; thus, these findings cannot be extrapolated to the brain...
December 2017: Hypertension
https://www.readbyqxmd.com/read/28969386/genetic-variants-influencing-elevated-myeloperoxidase-levels-increase-risk-of-stroke
#9
Chia-Ling Phuah, Tushar Dave, Rainer Malik, Miriam R Raffeld, Alison M Ayres, Joshua N Goldstein, Anand Viswanathan, Steven M Greenberg, Jeremiasz M Jagiella, Björn M Hansen, Bo Norrving, Jordi Jimenez-Conde, Jaume Roquer, Alexander Pichler, Christian Enzinger, Joan Montaner, Israel Fernandez-Cadenas, Arne Lindgren, Agnieszka Slowik, Reinhold Schmidt, Alessandro Biffi, Natalia Rost, Carl D Langefeld, Hugh S Markus, Braxton D Mitchell, Brad B Worrall, Steven J Kittner, Daniel Woo, Martin Dichgans, Jonathan Rosand, Christopher D Anderson
Primary intracerebral haemorrhage and lacunar ischaemic stroke are acute manifestations of progressive cerebral microvascular disease. Current paradigms suggest atherosclerosis is a chronic, dynamic, inflammatory condition precipitated in response to endothelial injury from various environmental challenges. Myeloperoxidase plays a central role in initiation and progression of vascular inflammation, but prior studies linking myeloperoxidase with stroke risk have been inconclusive. We hypothesized that genetic determinants of myeloperoxidase levels influence the development of vascular instability, leading to increased primary intracerebral haemorrhage and lacunar stroke risk...
October 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28939865/a-replication-study-of-genetic-risk-loci-for-ischemic-stroke-in-a-dutch-population-a-case-control-study
#10
Allard J Hauer, Sara L Pulit, Leonard H van den Berg, Paul I W de Bakker, Jan H Veldink, Ynte M Ruigrok
We aimed to replicate reported associations of 10 SNPs at eight distinct loci with overall ischemic stroke (IS) and its subtypes in an independent cohort of Dutch IS patients. We included 1,375 IS patients enrolled in a prospective multicenter hospital-based cohort in the Netherlands, and 1,533 population-level controls of Dutch descent. We tested these SNPs for association with overall IS and its subtypes (large artery atherosclerosis, small vessel disease and cardioembolic stroke (CE), as classified by TOAST) using an additive multivariable logistic regression model, adjusting for age and sex...
September 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28937045/carotid-atherosclerosis-and-cognitive-impairment-in-nonstroke-patients
#11
REVIEW
Wei-Hong Chen, Wei Jin, Pei-Yuan Lyu, Yang Liu, Rui Li, Ming Hu, Xiang-Jian Xiao
OBJECTIVE: As a vascular risk factor, carotid atherosclerosis is crucial to cognitive impairment. While carotid intima-media thickness, carotid artery plaque, and carotid stenosis can reflect carotid atherosclerosis in different stages, this review aimed to explore researches on the role of carotid intima-media thickness, carotid artery plaque, and carotid stenosis in the progress of cognitive impairment in nonstroke patients and tried to illustrate the possible mechanisms. DATA SOURCES: We searched the PubMed database for recently published research articles up to July 2017, with the key words of "carotid atherosclerosis," "carotid intima-media thickness," "carotid plaque," "carotid stenosis," "nonstroke," and "cognitive impairment...
October 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28933655/cerebrovascular-reactivity-measurement-in-cerebral-small-vessel-disease-rationale-and-reproducibility-of-a-protocol-for-mri-acquisition-and-image-processing
#12
Michael J Thrippleton, Yulu Shi, Gordon Blair, Iona Hamilton, Gordon Waiter, Christian Schwarzbauer, Cyril Pernet, Peter Jd Andrews, Ian Marshall, Fergus Doubal, Joanna M Wardlaw
Background Impaired autoregulation may contribute to the pathogenesis of cerebral small vessel disease. Reliable protocols for measuring microvascular reactivity are required to test this hypothesis and for providing secondary endpoints in clinical trials. Aims To develop and assess a protocol for acquisition and processing of cerebrovascular reactivity by MRI, in subcortical tissue of patients with small vessel disease and minor stroke. Methods We recruited 15 healthy volunteers, testing paradigms using 1- and 3-min 6% CO2 challenges with repeat scanning, and 15 patients with history of minor stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28906205/preventing-cognitive-decline-and-dementia-from-cerebral-small-vessel-disease-the-laci-1-trial-protocol-and-statistical-analysis-plan-of-a-phase-iia-dose-escalation-trial-testing-tolerability-safety-and-effect-on-intermediary-endpoints-of-isosorbide-mononitrate
#13
Gordon W Blair, Jason P Appleton, Zhe Kang Law, Fergus Doubal, Katie Flaherty, Richard Dooley, Kirsten Shuler, Carla Richardson, Iona Hamilton, Yulu Shi, Michael Stringer, Julia Boyd, Michael J Thrippleton, Nikola Sprigg, Philip M Bath, Joanna M Wardlaw
Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms of action to support their testing to prevent stroke recurrence, cognitive impairment, or radiological progression after lacunar stroke. Aim LACI-1 will assess the tolerability, safety, and efficacy, by dose, of isosorbide mononitrate and cilostazol, alone and in combination, in patients with ischemic lacunar stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28906204/context-is-everything-from-cardiovascular-disease-to-cerebral-microbleeds
#14
Andreas Charidimou, Deborah Blacker, Anand Viswanathan
Increasingly, our approach to cerebrovascular disease has become blurred by evidence published in literature often without careful consideration of what this evidence implies for specific patients at hand. In this essay, we analyze key contextual issues in cerebrovascular small vessel disease, in an attempt to highlight the symbolic gap that exists between research and clinical practice, a recurring theme in medicine. We highlight the importance of considering context when using data from epidemiologic, neuroimaging, and biomarker studies in determining relevance to the patient at hand...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28905043/vascular-parkinsonism-and-vascular-dementia-are-associated-with-an-increased-risk-of-vascular-events-or-death
#15
Jacek Staszewski, Renata Piusińska-Macoch, Bogdan Brodacki, Ewa Skrobowska, Katarzyna Macek, Adam Stępień
INTRODUCTION: The natural course of vascular parkinsonism (VaP) and dementia (VaD) due to cerebral small vessel disease (SVD) is not well known. The aim of this single-center study was to evaluate the long-term risk of vascular events, death and dependency in patients with VaP or VaD and to compare it with patients without cerebrovascular disease but with high atherothrombotic risk. MATERIAL AND METHODS: Seventy-eight consecutive, functionally independent patients with MRI features of SVD and with recently diagnosed VaD (n = 50) and VaP (n = 28) and 55 controls (control group - CG) with high 10-year risk of total cardiovascular disease (SCORE ≥ 5%) were prospectively recruited and followed for 24 months...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28870545/arterial-stiffness-and-cognitive-impairment
#16
REVIEW
Xiaoxuan Li, Peiyuan Lyu, Yanyan Ren, Jin An, Yanhong Dong
BACKGROUND: Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28859027/subarachnoid-hemorrhage-revealing-moyamoya-syndrome-in-a-patient-with-may-hegglin-anomaly
#17
Yannick Béjot, José-Luis Barnay, Adrien Chavent, Benoit Daubail, Agnès Jacquin, Apolline Kazemi, Frédéric Ricolfi, Maurice Giroud
INTRODUCTION: Moyamoya syndrome is a rare progressive cerebrovascular occlusive disease for which several associated conditions have been described. CASE REPORT: We report the case of a 76-year-old woman with a history of May-Hegglin anomaly who presented with an isolated unusual diffuse headache. Initial laboratory investigations showed only thrombocytopenia (platelet count 95000/μL). Unenhanced brain computed tomography scan revealed a small subarachnoid hemorrhage in the left frontal lobe...
September 2017: Neurologist
https://www.readbyqxmd.com/read/28798076/perivascular-spaces-glymphatic-dysfunction-and-small-vessel-disease
#18
REVIEW
Humberto Mestre, Serhii Kostrikov, Rupal I Mehta, Maiken Nedergaard
Cerebral small vessel diseases (SVDs) range broadly in etiology but share remarkably overlapping pathology. Features of SVD including enlarged perivascular spaces (EPVS) and formation of abluminal protein deposits cannot be completely explained by the putative pathophysiology. The recently discovered glymphatic system provides a new perspective to potentially address these gaps. This work provides a comprehensive review of the known factors that regulate glymphatic function and the disease mechanisms underlying glymphatic impairment emphasizing the role that aquaporin-4 (AQP4)-lined perivascular spaces (PVSs), cerebrovascular pulsatility, and metabolite clearance play in normal CNS physiology...
September 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28783808/recrudescence-of-deficits-after-stroke-clinical-and-imaging-phenotype-triggers-and-risk-factors
#19
Mehmet A Topcuoglu, Esen Saka, Scott B Silverman, Lee H Schwamm, Aneesh B Singhal
Importance: Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon. Objective: To investigate the clinical features, triggers, and risk factors for PSR. Design, Setting, and Participants: This retrospective study incorporated a crossover cohort study to identify triggers and a case-control study to identify risk factors. The study used the Massachusetts General Hospital Research Patient Data Repository to identify patients for the period January 1, 2000, to November 30, 2015, who had a primary or secondary diagnosis of cerebrovascular disease, who underwent magnetic resonance imaging of the brain at least once, and whose inpatient or outpatient clinician note or discharge summary stated the term recrudescence...
September 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28716371/detection-risk-factors-and-functional-consequences-of-cerebral-microinfarcts
#20
REVIEW
Susanne J van Veluw, Andy Y Shih, Eric E Smith, Christopher Chen, Julie A Schneider, Joanna M Wardlaw, Steven M Greenberg, Geert Jan Biessels
Cerebral microinfarcts are small lesions that are presumed to be ischaemic. Despite the small size of these lesions, affected individuals can have hundreds to thousands of cerebral microinfarcts, which cause measurable disruption to structural brain connections, and are associated with dementia that is independent of Alzheimer's disease pathology or larger infarcts (ie, lacunar infarcts, and large cortical and non-lacunar subcortical infarcts). Substantial progress has been made with regard to understanding risk factors and functional consequences of cerebral microinfarcts, partly driven by new in-vivo detection methods and the development of animal models that closely mimic multiple aspects of cerebral microinfarcts in human beings...
September 2017: Lancet Neurology
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