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Stroke, cerebral aneurysm, avm

Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
June 15, 2017: Neurologia Medico-chirurgica
Kazumichi Yoshida, Jun C Takahashi, Yohei Takenobu, Norihiro Suzuki, Akira Ogawa, Susumu Miyamoto
BACKGROUND AND PURPOSE: The incidence and cause of strokes associated with pregnancy and the puerperium are still not fully understood. The aim of this study was to characterize pregnancy-related strokes in Japan using a large-scale survey with current imaging techniques. METHODS: A retrospective analysis was conducted based on clinical chart reviews in 736 stroke teaching hospitals certified by the Japan Stroke Society between 2012 and 2013, using a web-based questionnaire requesting the detailed clinical course without any personally identifying information...
February 2017: Stroke; a Journal of Cerebral Circulation
Jonathan M Coutinho, Sheldon Derkatch, Alphonse R J Potvin, George Tomlinson, Leanne K Casaubon, Frank L Silver, Daniel M Mandell
OBJECTIVE: To determine whether there is an association between carotid artery web and ischemic stroke. METHODS: This was a single-center, age- and sex-matched, case-control study. Cases were consecutive patients with anterior circulation ischemic stroke of undetermined etiology (Trial of Org 10172 in Acute Stroke Treatment [TOAST] classification). Controls were consecutive patients with cerebral aneurysms, arteriovenous malformations, or primary intracerebral hemorrhages...
January 3, 2017: Neurology
Keiko Fukuda, Monica Majumdar, Hesham Masoud, Thanh Nguyen, Amir Honarmand, Ali Shaibani, Sameer Ansari, Lee A Tan, Michael Chen
BACKGROUND: The optimal management strategy for unruptured cerebral arteriovenous malformations (AVMs) is controversial since the ARUBA trial (A Randomized trial of Unruptured Brain AVMs). An accurate understanding of the morbidity associated with AVM hemorrhages may help clinicians to formulate the best treatment strategy for unruptured AVMs. OBJECTIVE: To determine the morbidity associated with initial cerebral AVM rupture in patients presenting to tertiary medical centers...
June 22, 2016: Journal of Neurointerventional Surgery
Daniel J Korchinski, May Taha, Runze Yang, Nabeela Nathoo, Jeff F Dunn
Iron oxide contrast agents have been combined with magnetic resonance imaging for cell tracking. In this review, we discuss coating properties and provide an overview of ex vivo and in vivo labeling of different cell types, including stem cells, red blood cells, and monocytes/macrophages. Furthermore, we provide examples of applications of cell tracking with iron contrast agents in stroke, multiple sclerosis, cancer, arteriovenous malformations, and aortic and cerebral aneurysms. Attempts at quantifying iron oxide concentrations and other vascular properties are examined...
2015: Magnetic Resonance Insights
A H Chowdhury, S K Ghose, Q D Mohammad, M Habib, S U Khan, K M Rahman
This study was carried out to compare MRA and DSA in diagnosis of cerebral AVM. It was a retrospective observational study conducted in the Department of Neurology Dhaka Medical College Hospital (DMCH), Dhaka during the period of January 2010 to December 2010. Thirty patients with haemorrhagic stroke age ranging from 13 to 65 years were selected on the basis of inclusion and exclusion criteria as the study sample. MRA and DSA were done in all the selected patients. The mean age of the patients of haemorrhagic stroke was 30...
April 2015: Mymensingh Medical Journal: MMJ
Georgios Tsivgoulis, Apostolos Safouris, Andrei V Alexandrov
INTRODUCTION: Intravenous administration of tissue-type plasminogen activator (IV-tPA) remains the only approved therapy that may reverse neurological deficit in patients with acute ischemic stroke (AIS). During the past 20 years, accumulating real-word experience have provided additional information regarding its safety and efficacy in various clinical settings that were originally considered as contraindications for systemic thrombolysis. AREAS COVERED: In this narrative review, we address the safety of intravenous thrombolysis (IVT) in specific conditions: dissection of the aortic arch of extracranial and intracranial arteries, concomitant presence of unruptured intracranial aneurysms, arteriovenous malformations and dural fistulas, co-existing brain tumors as well as in conditions mimicking AIS...
June 2015: Expert Opinion on Drug Safety
Monica Majumdar, Lee A Tan, Michael Chen
BACKGROUND: An accurate understanding of the morbidity and mortality associated with brain arteriovenous malformation (AVM) hemorrhage is important in determining the management of unruptured AVMs. Recent studies suggest this morbidity to be lower than assumed. We sought to perform a detailed critical assessment of the morbidity associated with ruptured brain AVMs. METHODS: A retrospective chart review from a single-center tertiary care medical center was performed...
February 2016: Journal of Neurointerventional Surgery
A Garg
INTRODUCTION: The field of Neurointervention has attracted some of the very best physicians across the world. Given the interdisciplinary nature of this specialty, radiologists, neurosurgeons, and neurologists have been trained in this specialty. This relatively new field has brought in ground breaking changes in the ways we now treat a number of cerebrovascular disorders. However, there continues to be controversy regarding the advantages/benefits of this treatment modality for certain conditions as well as lack of evidence for other conditions...
July 2014: Journal of Neurointerventional Surgery
Francesco Signorelli, Benjamin Gory, Isabelle Pelissou-Guyotat, Jacques Guyotat, Roberto Riva, Frédéric Dailler, Francis Turjman
INTRODUCTION: The impact of targeted embolization of ruptured cerebral arteriovenous malformation (AVM)-associated arterial aneurysms in the acute phase of bleeding is not well known. The objective of our study was to analyze the safety and efficacy of this treatment strategy with special emphasis on its protective effect against rebleeding. METHODS: From a prospective database, all patients presenting between December 2005 and March 2012 with a ruptured cerebral AVM associated with arterial aneurysms contiguous to the hemorrhage were selected...
September 2014: Neuroradiology
Sun Ho Ahn, Ethan A Prince, Gregory J Dubel
Neuroangiography (NA) is an important part of diagnosis and treatment of patients with neurological disease. Although NA may be performed for diagnostic purposes, in many instances NA is performed with the intent to treat. Indications for NA range from extracranial diseases (vertebrobasilar insufficiency from subclavian steal, extracranial carotid stenosis, cavernous-carotid fistula, neck trauma, epistaxis, tumor invasion of the carotid artery, and tumor embolization) to intracranial diseases (nontraumatic subarachnoid hemorrhage, cerebral aneurysms, cerebral arteriovenous malformations, cerebral vasospasm, acute stroke, tumor embolization, and WADA test)...
September 2013: Seminars in Interventional Radiology
Jun C Takahashi, Koji Iihara, Akira Ishii, Eiju Watanabe, Tomoaki Ikeda, Susumu Miyamoto
BACKGROUND: Pregnancy-associated hemorrhagic stroke is considered a serious complication. Although coagulopathy, pregnancy-induced hypertension, eclampsia, and other systemic complications have been emphasized, pre-existing cerebrovascular diseases (CVDs) have not been fully analyzed. To clarify the role of these vascular lesions more in detail, the Japan Neurosurgical Society conducted a nationwide survey on all the neurosurgical institutes across Japan. METHODS: This 2-year survey focused on hemorrhagic stroke occurring in pregnancy, delivery, and puerperium...
February 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Nader Sawiris, Alexander Venizelos, Bichun Ouyang, Demetrius Lopes, Michael Chen
BACKGROUND: The role of diagnostic catheter cerebral angiography has been recently thought to have diminished with the increasing use of noninvasive modalities such as computed tomography angiography and magnetic resonance angiography. Because it is invasive and costly, we sought to elucidate the clinical utility of catheter angiography by evaluating the indications, incidence of new and clinically meaningful findings, and its utility compared with noninvasive studies. METHODS: We performed an observational cross-sectional study of consecutive patients undergoing diagnostic cerebral angiography at an urban tertiary care center...
March 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Akira Ishii, Susumu Miyamoto
There is an increased risk of stroke during pregnancy and the puerperium. Decisions should be made immediately upon transfer to each institution, particularly with respect to when and how to treat the patient. This review highlights the feasibility of endovascular treatment in pregnancy. Most of the pharmaceutical agents and therapeutic devices used in clinical practice can be utilized in pregnant patients. Comprehensive information on the benefits and risks of treatment should be explained to the patient and her family, with particular attention to the safety of the mother and fetus...
2013: Neurologia Medico-chirurgica
Sunil A Sheth, Matthew B Potts, Penny K Sneed, William L Young, Daniel L Cooke, Nalin Gupta, Steven W Hetts
PURPOSE: Arteriovenous malformations (AVMs) are a frequent cause of hemorrhagic stroke in children. Stereotactic radiosurgery (SRS) is an established treatment for these lesions, particularly those that are surgically inaccessible. Because only complete AVM obliteration is believed to protect against the future risk of hemorrhage, identifying lesion characteristics that predict response to therapy is an important objective. The goal of this study is to evaluate the influence of angiographic features of AVMs on the rate of obliteration following treatment with SRS...
February 2014: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
M W Hayman, M S Paleologos, P C A Kam
Interventional neuroradiology is a rapidly expanding field, and the complexity and duration of these procedures makes anaesthetic support essential to their success. Such has been the development in this area, that the American Heart Association has published a scientific statement on the indications for these procedures. A detailed understanding of patient pathology, the technical aspects of the interventions and their associated risks, and the remote location in which they are performed are important for providing expert anaesthetic care...
March 2013: Anaesthesia and Intensive Care
A M Mortimer, M D Bradley, N G Stoodley, S A Renowden
Thunderclap headache (TCH) is an acute and severe headache that has maximum intensity at onset; TCH can be primary or secondary. Primary TCH is diagnosed when no underlying cause is discovered; however, imaging is crucial in distinguishing secondary causes, which are wide-ranging. The radiologist should be aware of the list of potential diagnoses. Subarachnoid haemorrhage (SAH) is the most common cause of secondary TCH. Aneurysmal SAH accounts for the majority of cases, although other causes should also be considered and these include perimesencephalic haemorrhage, arteriovenous malformations, and dural arteriovenous fistula as well as reversible cerebral vasoconstriction syndrome...
March 2013: Clinical Radiology
Andrew P Carlson, Ali Alaraj, Reza Dashti, Victor A Aletich
PURPOSE: Although the anatomic course of the posterior interior cerebellar artery (PICA) is variable, it is thought to be very rare for the artery to cross midline, with an estimated incidence of 0.1%. Bihemispheric PICA crosses midline and typically serves both PICA territories. METHODS: We present 11 cases of bihemispheric PICA discovered from retrospective angiogram review, the largest to date reported in the literature. RESULTS: Five cases were the typical bihemispheric PICA pattern, three were bihemispheric with distal vertebral hypoplasia, two cases were the vermian type, and one was atypical, with the PICA feeding a contralateral cerebellar arteriovenous malformation (AVM)...
November 2013: Journal of Neurointerventional Surgery
Bradley A Gross, Rose Du
Several landmark studies in cerebrovascular neurosurgery were published in 2011. In this brief review, we highlight advances in our understanding of cerebral aneurysms, arteriovenous malformations (AVM), cavernous malformations (CM) and cerebral ischemia. Specifically, results from the Barrow Ruptured Aneurysm Trial (BRAT), the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis trial (SAMMPRIS) and the Carotid Occlusion Surgery Study (COSS) are highlighted. In addition, studies detailing the effect of aspirin on aneurysm rupture, the question of shrinking of ruptured aneurysms, and important endovascular reports including the Pipeline embolization device for the Intracranial Treatment of Aneurysms trial (PITA) are reviewed...
October 2012: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
A Büttner
Cocaine abuse represents a significant health issue worldwide. Besides cardiovascular complications, psychiatric and neurologic symptoms are the most common manifestations of cocaine toxicity. In cocaine abusers brain abnormalities have been shown with computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or single photon emission computed tomography (SPECT). The spectrum of neuropathologic alterations seen in cocaine abusers is broad. The major findings consist of vascular complications such as stroke, subarachnoid and intracerebral hemorrhages and cerebral ischemia...
2012: Current Medicinal Chemistry
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