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https://www.readbyqxmd.com/read/29329733/association-between-leukoaraiosis-and-cerebral-blood-flow-territory-alteration-in-asymptomatic-internal-carotid-artery-stenosis
#1
Y-F Chen, Y-S Kuo, W-C Wu, S-C Tang, S-F Jiang
AIM: To test the hypothesis that leukoaraiosis (also known as white matter lesion) is associated with cerebral blood flow territory change as revealed by territorial arterial spin-labeling (TASL) magnetic resonance imaging (MRI) in patients with asymptomatic internal carotid artery stenosis (aICAS). MATERIALS AND METHODS: The institutional review board approved this study. Thirty-three patients with aICAS were included prospectively and divided into high-grade (ultrasonographic stenosis ≥70%, n=17) and low-grade (n=16) groups; 16 healthy subjects were also included...
January 9, 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29328023/features-of-formation-of-collateral-circulation-in-patients-with-subclavian-steal-syndrome
#2
I Kopolovets, P Štefanič, V Rusyn, Š Tóth, V Mashura, P Berek
To date in patients with subclavian steal syndrome diagnosis is only grade of stenosis or localization of occlusion described. Authors recommend to take into account also type of a collateral compensation of cerebral circulation for selection of an optimal treatment The objective of the research was to study the features of formation of collateral circulation in patients with subclavian steal syndrome. The authors described changes in the direction of blood flow in the extracranial vessels of 42 patients with subclavian steal syndrome...
December 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29323038/electroacupuncture-improves-neurovascular-unit-reconstruction-by-promoting-collateral-circulation-and-angiogenesis
#3
Lei Shi, Hong-Mei Cao, Ying Li, Shi-Xin Xu, Yan Zhang, Yang Zhang, Zhe-Feng Jin
Acupuncture at Shuigou (GV26) shows good clinical efficacy for treating stroke, but its mechanism remains poorly understood. In this study, a cerebral infarction model of ischemia/reperfusion injury received electroacupuncture at GV26 (15 Hz and 1 mA, continuous wave [biphasic pulses], for 5 minutes). Electroacupuncture effectively promoted regional cerebral blood flow on the infarct and non-infarct sides, increased infarct lesions, lectin, and number of blood vessels, upregulated von Willebrand factor and cell proliferation marker Ki67 expression, and diminished neurological severity score...
December 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29310957/revascularization-for-aplastic-or-twiglike-middle-cerebral-artery-a-case-report
#4
Yuki Matsunaga, Tsuyoshi Izumo, Yoichi Morofuji, Nobutaka Horie, Kentaro Hayashi, Takayuki Matsuo
An aplastic or twiglike middle cerebral artery (Ap/T-MCA) is a congenital anomaly related to interference of normal embryonic development of the middle cerebral artery (MCA). This condition may cause ischemic and hemorrhagic strokes as a result of hypoperfusion, vulnerable collateral circulation, and associated aneurysms. We reported a case of Ap/T-MCA with transient ischemic attack, which was successfully treated with revascularization. A 19-year-old woman with a history of transient left upper limb hemiparesis, dysesthesia, and headache visited our hospital...
January 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29299616/increased-variability-of-watershed-areas-in-patients-with-high-grade-carotid-stenosis
#5
Stephan Kaczmarz, Vanessa Griese, Christine Preibisch, Michael Kallmayer, Michael Helle, Isabel Wustrow, Esben Thade Petersen, Hans-Henning Eckstein, Claus Zimmer, Christian Sorg, Jens Göttler
PURPOSE: Watershed areas (WSAs) of the brain are most susceptible to acute hypoperfusion due to their peripheral location between vascular territories. Additionally, chronic WSA-related vascular processes underlie cognitive decline especially in patients with cerebral hemodynamic compromise. Despite of high relevance for both clinical diagnostics and research, individual in vivo WSA definition is fairly limited to date. Thus, this study proposes a standardized segmentation approach to delineate individual WSAs by use of time-to-peak (TTP) maps and investigates spatial variability of individual WSAs...
January 3, 2018: Neuroradiology
https://www.readbyqxmd.com/read/29288845/surgical-revascularization-for-the-treatment-of-complex-anterior-cerebral-artery-aneurysms-experience-and-illustrative-review
#6
Sung Ho Lee, Yeongu Jung, Ji Wook Ryu, Seok Keun Choi, Byung Duk Kwun
BACKGROUND: A variety of methods for tackling complex anterior cerebral artery (ACA) aneurysms are available; however, there is substantial variation among methods because of various aneurysm locations, the relationship of the aneurysm to arterial branches, aneurysm size and other morphological characteristics, and/or the diameters of the parent or branching arteries. METHODS: We review complex ACA aneurysm cases based on both our own experience as well as the available literature...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29274451/treatment-of-progressive-herpes-zoster-induced-vasculopathy-with-surgical-revascularization-effects-on-cerebral-hemodynamics
#7
Sarah K Lants, Jennifer M Watchmaker, Meher R Juttukonda, Larry T Davis, Manus J Donahue, Matthew R Fusco
BACKGROUND: Herpes zoster ophthalmicus (HZO) is caused by the reactivation of the herpes simplex virus in the trigeminal nerve. HZO-initiated cerebral vasculopathy is well-characterized, however there are no documented cases that report the efficacy of surgical revascularization for improving cerebral hemodynamics following progressive HZO-induced vasculopathy. We present a case where quantitative anatomical and hemodynamic imaging were performed longitudinally before and after surgical revascularization in a patient with HZO and vasculopathic changes...
December 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29260256/mechanical-thrombectomy-in-basilar-artery-occlusion-presence-of-bilateral-posterior-communicating-arteries-is-a%C3%A2-predictor-of-favorable-clinical-outcome
#8
Volker Maus, Alev Kalkan, Christoph Kabbasch, Nuran Abdullayev, Henning Stetefeld, Utako Birgit Barnikol, Thomas Liebig, Christian Dohmen, Gereon Rudolf Fink, Jan Borggrefe, Anastasios Mpotsaris
BACKGROUND: Mechanical thrombectomy (MT) of basilar artery occlusions (BAO) is a subject of debate. We investigated the clinical outcome of MT in BAO and predictors of a favorable outcome. MATERIAL AND METHODS: A total of 104 MTs of BAO (carried out between 2010 and 2016) were analyzed. Favorable outcome as a modified Rankin scale (mRS) ≤ 2 at 90 days was the primary endpoint. The influence of the following variables on outcome was investigated: number of detectable posterior communicating arteries (PcoAs), patency of basilar tip, completeness of BAO and posterior circulation Alberta Stroke Program early computed tomography score (PC-ASPECTS)...
December 19, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29260078/reversal-of-carotid-dissection-induced-ocular-and-cerebral-ischemia-by-stenting
#9
Daniel L Albertus, Baldassare Pipitone, Ashok Srinivasan, Jonathan D Trobe
Purpose: To present an example of how close clinical monitoring of a patient with acute Horner syndrome from carotid artery dissection may be critical in reversing neurologic dysfunction. Observations: A patient whose initial neuro-ophthalmic manifestation was Horner syndrome, but who evolved over 14 days to display transient monocular vision loss, ipsilateral ocular ischemic syndrome, and episodic contralateral hemiparesis. Digital subtraction angiography demonstrated progressive ipsilateral carotid occlusion with lack of collateral flow...
September 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29245300/treatment-of-the-superior-sagittal-sinus-and-transverse-sinus-thrombosis-associated-with-intracranial-hemorrhage-with-the-mechanical-thrombectomy-and-thrombolytics-case-report
#10
Yuchun Liu, Keqin Li, Yi Huang, Jie Sun, Xiang Gao
RATIONALE: The superior sagittal sinus (SSS) and transverse sinus are the major dural sinuses that receive a considerable amount of venous drainage. The occlusion of them has been suggested to cause intracranial hypertension, hemorrhage, and lead to potentially fatal consequences. PATIENT CONCERNS: We reported a 35-year-old woman with headache presented to our emergency department with a decreased level of consciousness and epileptic seizures. The examination of speech, higher mental function, and cranial nerve were normal...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29231236/relevance-of-the-cerebral-collateral-circulation-in-ischaemic-stroke-time-is-brain-but-collaterals-set-the-pace
#11
Simon Jung, Roland Wiest, Jan Gralla, Richard McKinley, Heinrich Mattle, David Liebeskind
Blood supply to the brain is secured by an extensive collateral circulation system, which can be divided into primary routes, i.e., the Circle of Willis, and secondary routes, e.g., collaterals from the external to the internal carotid artery and leptomeningeal collaterals. Collateral flow is the basis for acute stroke treatment, since neurones will only survive long enough to be rescued with reperfusion therapies if there is sufficient collateral flow. Poor collateral flow is associated with worse outcome and faster growth of larger infarcts in acute stroke treatment...
December 12, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29220356/color-doppler-ultrasonography-as-an-alternative-tool-for-postoperative-evaluation-of-collaterals-after-indirect-revascularization-surgery-in-moyamoya-disease
#12
Shin-Joe Yeh, Sung-Chun Tang, Li-Kai Tsai, Chung-Wei Lee, Ya-Fang Chen, Hon-Man Liu, Shih-Hung Yang, Meng-Fai Kuo, Jiann-Shing Jeng
The cerebral hypoperfusion caused by chronic progressive stenosis or occlusion of intracranial arteries in moyamoya disease can be treated by direct bypass or indirect revascularization procedures. The extent of collaterals from the external carotid artery (ECA) after indirect revascularization surgery is the key point of angiographic follow-up, and the invasiveness of angiography impelled us to investigate the role of ultrasonography in the evaluation of collaterals. We hypothesized that the collaterals shown on angiography might produce corresponding hemodynamic changes in color Doppler ultrasonography...
2017: PloS One
https://www.readbyqxmd.com/read/29208850/carotid-artery-stenosis-contralateral-to-acute-tandem-occlusion-an-independent-predictor-of-poor-clinical-outcome-after-mechanical-thrombectomy-with-concomitant-carotid-artery-stenting
#13
Volker Maus, Daniel Behme, Jan Borggrefe, Christoph Kabbasch, Fatih Seker, Cicek Hüseyin, Utako Birgit Barnikol, Leonard Leong Litt Yeo, Patrick Brouwer, Michael Söderman, Markus Möhlenbruch, Marios Nikos Psychogios, Thomas Liebig, Christian Dohmen, Gereon Rudolf Fink, Anastasios Mpotsaris
BACKGROUND AND PURPOSE: Cerebral ischemic strokes due to extra-/intracranial tandem occlusions (TO) of the anterior circulation are responsible for causing mechanical thrombectomy (MT). The impact of concomitant contralateral carotid stenosis (CCS) upon outcome remains unclear in this stroke subtype. METHODS: Retrospective analysis of prospectively collected data of 4 international stroke centers between 2011 and 2017. One hundred ninety-seven consecutive patients with anterior TO were treated with MT and acute carotid artery stenting (CAS)...
November 24, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29199136/cerebral-venous-collaterals-a-new-fort-for-fighting-ischemic-stroke
#14
REVIEW
Lu-Sha Tong, Zhen-Ni Guo, Yi-Bo Ou, Yan-Nan Yu, Xiao-Cheng Zhang, Jiping Tang, John H Zhang, Min Lou
Stroke therapy has entered a new era highlighted by the use of endovascular therapy in addition to intravenous thrombolysis. However, the efficacy of current therapeutic regimens might be reduced by their associated adverse events. For example, over-reperfusion and futile recanalization may lead to large infarct, brain swelling, hemorrhagic complication and neurological deterioration. The traditional pathophysiological understanding on ischemic stroke can hardly address these occurrences. Accumulating evidence suggests that a functional cerebral venous drainage, the major blood reservoir and drainage system in brain, may be as critical as arterial infusion for stroke evolution and clinical sequelae...
November 30, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/29191051/preoperative-evaluation-of-moyamoya-spontaneous-anastomosis-of-combined-revascularization-donor-vessels-in-adults-by-duplex-ultrasonography
#15
Li Chen, Bin Xu, Yong Wang, Yujun Liao, Huiwen Pan, Yi Wang
OBJECTIVE: To evaluate the preoperative diagnostic value of duplex ultrasonography in moyamoya spontaneous anastomosis of combined revascularization donor vessels in adults. METHODS: A total of 99 preoperative adult patients who underwent superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis were retrospectively analyzed. Each side of the cerebral hemisphere was examined as a separate procedure. A total of 198 cerebral hemispheres were divided into three groups: a collateral, non-collateral, and control group based on digital subtraction angiography (DSA)...
November 30, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29182658/high-permeability-region-size-on-perfusion-ct-predicts-hemorrhagic-transformation-after-intravenous-thrombolysis-in-stroke
#16
Josep Puig, Gerard Blasco, Pepus Daunis-I-Estadella, Cecile van Eendendburg, María Carrillo-García, Carlos Aboud, María Hernández-Pérez, Joaquín Serena, Carles Biarnés, Kambiz Nael, David S Liebeskind, Götz Thomalla, Bijoy K Menon, Andrew Demchuk, Max Wintermark, Salvador Pedraza, Mar Castellanos
OBJECTIVE: Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. METHODS: We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4...
2017: PloS One
https://www.readbyqxmd.com/read/29171118/translesional-pressure-gradient-and-leptomeningeal-collateral-status-in-symptomatic-middle-cerebral-artery-stenosis
#17
Xinyi Leng, Linfang Lan, Hing Lung Ip, Florence Fan, Sze Ho Ma, Karen Ma, Haipeng Liu, Zhengzheng Yan, Jia Liu, Jill Abrigo, Yannie Oy Soo, David S Liebeskind, Ka Sing Wong, Thomas W Leung
BACKGROUND AND PURPOSE: Leptomeningeal collateral (LMC) status governs prognosis of large artery occlusive stroke, while factors determining the LMC status were not fully elucidated. We aimed to investigate metrics affecting LMC status in such patients by using computational fluid dynamics (CFD) models based on CT angiography (CTA). METHODS: In this cross-sectional study, we recruited patients with recent ischemic stroke or transient ischemic attack attributed to atherosclerotic M1 middle cerebral artery (MCA) stenosis (50-99%)...
November 24, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29169168/anterior-borderzone-angle-for-hemodynamic-collateral-metric-in-patients-with-symptomatic-middle-cerebral-artery-stenosis
#18
Yongkun Li, Yunyun Xiong, Qiankun Cai, Dezhi Liu, Qiliang Dai, Wenhua Liu, Zhixin Huang, Wen Sun, David S Liebeskind, Yinzhou Wang, Xinfeng Liu
BACKGROUND AND AIMS: We aimed to introduce a parameter of anterior borderzone angle (ABZA) to quantitatively evaluate the ACA-MCA leptomeningeal collaterals for middle cerebral artery stenosis (MCAS). METHODS: Two hundred seventy-five patients with 50-100% MCAS and 100 controls were included. The 95% reference range of ABZA was obtained from the controls. ABZAtrans was defined as "ABZA/the 95% upper limit." Relationships between ABZA and MCAS, -ABZAtrans and the TICI grade, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grade were analyzed...
November 23, 2017: European Neurology
https://www.readbyqxmd.com/read/29150867/near-infrared-diffuse-reflectance-signals-for-monitoring-spreading-depolarizations-and-progression-of-the-lesion-in-a-male-rat-focal-cerebral-ischemia-model
#19
Satoko Kawauchi, Izumi Nishidate, Hiroshi Nawashiro, Shunichi Sato
In ischemic stroke research, a better understanding of the pathophysiology and development of neuroprotection methods are crucial, for which in vivo imaging to monitor spreading depolarizations (SDs) and evolution of tissue damage is desired. Since these events are accompanied by cellular morphological changes, light-scattering signals, which are sensitive to cellular and subcellular morphology, can be used for monitoring them. In this study, we performed transcranial imaging of near-infrared (NIR) diffuse reflectance at ∼800 nm, which sensitively reflects light-scattering change, and examined how NIR reflectance is correlated with simultaneously measured cerebral blood flow (CBF) for a rat middle cerebral artery occlusion (MCAO) model...
November 18, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#20
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
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