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https://www.readbyqxmd.com/read/28068417/preserved-collateral-blood-flow-in-the-endovascular-m2cao-model-allows-for-clinically-relevant-profiling-of-injury-progression-in-acute-ischemic-stroke
#1
Philip Little, Ola Kvist, Rikard Grankvist, Stefan Jonsson, Peter Damberg, Michael Söderman, Fabian Arnberg, Staffan Holmin
Interventional treatment regimens have increased the demand for accurate understanding of the progression of injury in acute ischemic stroke. However, conventional animal models severely inhibit collateral blood flow and mimic the malignant infarction profile not suitable for treatment. The aim of this study was to provide a clinically relevant profile of the emergence and course of ischemic injury in cases suitable for acute intervention, and was achieved by employing a M2 occlusion model (M2CAO) that more accurately simulates middle cerebral artery (MCA) occlusion in humans...
2017: PloS One
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#2
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28064357/ischemic-stroke-experimental-models-and-reality
#3
REVIEW
Clemens J Sommer
The vast majority of cerebral stroke cases are caused by transient or permanent occlusion of a cerebral blood vessel ("ischemic stroke") eventually leading to brain infarction. The final infarct size and the neurological outcome depend on a multitude of factors such as the duration and severity of ischemia, the existence of collateral systems and an adequate systemic blood pressure, etiology and localization of the infarct, but also on age, sex, comorbidities with the respective multimedication and genetic background...
January 7, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28057635/in-vivo-assessment-of-the-impact-of-regional-intracranial-atherosclerotic-lesions-on-brain-arterial-3d-hemodynamics
#4
C Wu, S Schnell, P Vakil, A R Honarmand, S A Ansari, J Carr, M Markl, S Prabhakaran
BACKGROUND AND PURPOSE: Intracranial atherosclerosis induces hemodynamic disturbance, which is not well-characterized, particularly in cerebral flow redistribution. We aimed to characterize the impact of regional stenotic lesions on intracranial hemodynamics by using 4D flow MR imaging. MATERIALS AND METHODS: 4D flow MR imaging was performed in 22 symptomatic patients (mean age, 68.4 ± 14.2 years) with intracranial stenosis (ICA, n = 7; MCA, n = 9; basilar artery, n = 6) and 10 age-appropriate healthy volunteers (mean age, 60...
January 5, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28050720/indocyanine-green-visualization-of-middle-meningeal-artery-before-craniotomy-during-surgical-revascularization-for-moyamoya-disease
#5
Nozomu Tanabe, Shusuke Yamamoto, Daina Kashiwazaki, Naoki Akioka, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda
BACKGROUND: The middle meningeal artery (MMA) is well known to function as an important collateral channel to the territory of the anterior cerebral artery in moyamoya disease. This study was aimed to evaluate whether indocyanine green (ICG) videoangiography could visualize the anterior branch of the MMA before craniotomy during surgical revascularization for moyamoya disease. METHODS: This study included 19 patients who developed TIA, ischemic stroke or hemorrhagic stroke due to moyamoya disease...
January 3, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28029271/hemodynamic-mechanisms-underlying-elevated-oxygen-extraction-fraction-oef-in-moyamoya-and-sickle-cell-anemia-patients
#6
Jennifer M Watchmaker, Meher R Juttukonda, Larry T Davis, Allison O Scott, Carlos C Faraco, Melissa C Gindville, Lori C Jordan, Petrice M Cogswell, Angela L Jefferson, Howard S Kirshner, Manus J Donahue
Moyamoya is a bilateral, complex cerebrovascular condition characterized by progressive non-atherosclerotic intracranial stenosis and collateral vessel formation. Moyamoya treatment focuses on restoring cerebral blood flow (CBF) through surgical revascularization, however stratifying patients for revascularization requires abilities to quantify how well parenchyma is compensating for arterial steno-occlusion. Globally elevated oxygen extraction fraction (OEF) secondary to CBF reduction may serve as a biomarker for tissue health in moyamoya patients, as suggested in patients with sickle cell anemia (SCA) and reduced oxygen carrying capacity...
January 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28017753/amplitude-of-tissue-oxygenation-index-change-predicts-cerebral-hyperperfusion-syndrome-during-carotid-artery-stenting
#7
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Yasushi Motoyama, Young Su Park, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
OBJECTIVE: Hyperperfusion syndrome (HPS) following carotid artery stenting (CAS) is a rare but serious complication. HPS is associated with preoperative hemodynamic impairment due to poor collateral flow and intraoperative cerebral ischemia. Filter-type embolic protection devices (EPDs) maintain anterograde carotid flow during CAS and somewhat prevent HPS. Early treatment of patients undergoing CAS and at risk for HPS is essential. Near-infrared spectroscopy (NIRS) allows non-invasive, real-time measurement of frontal lobe regional cerebral O2 saturation (TOI; tissue oxygenation index)...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27974985/anomalous-origin-of-the-left-common-carotid-artery-from-the-main-pulmonary-artery-a-rare-association-in-an-infant-with-charge-syndrome
#8
Onyekachukwu Osakwe, Blaise Jones, Russel Hirsch
Case Report. Isolated carotid artery originating from the pulmonary trunk is an exceedingly rare anomalous origin of head and neck vessels. We present this finding, along with a persistent embryonic trigeminal artery, in a male infant with multiple cardiac defects and other congenital anomalies associated with CHARGE syndrome. After extensive investigations, cardiac catheterization revealed the anomalous left common carotid artery arising from the cranial aspect of the main pulmonary artery. There was retrograde flow in this vessel, resulting from the lower pulmonary pressure, essentially stealing arterial supply from the left anterior cerebral circulation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27974692/multi-delay-asl-can-identify-leptomeningeal-collateral-perfusion-in-endovascular-therapy-of-ischemic-stroke
#9
Xin Lou, Songlin Yu, Fabien Scalzo, Sidney Starkman, Latisha K Ali, Doojin Kim, Neal M Rao, Jason D Hinman, Paul M Vespa, Reza Jahan, Satoshi Tateshima, Nestor R Gonzalez, Gary R Duckwiler, Jeffrey L Saver, Bryan Yoo, Noriko Salamon, Jinhao Lyu, Lin Ma, Danny Jj Wang, David S Liebeskind
BACKGROUND AND PURPOSE: Multi-delay arterial spin-labeling (ASL) perfusion imaging has been used as a promising modality to evaluate cerebral perfusion. Our aim was to assess the association of leptomeningeal collateral perfusion scores based on ASL parameters with outcome of endovascular treatment in patients with acute ischemic stroke (AIS) in the middle cerebral artery (MCA) territory. MATERIALS AND METHODS: ASL data at 4 post-labeling delay (PLD) times (PLD = 1...
December 10, 2016: Oncotarget
https://www.readbyqxmd.com/read/27960175/moyamoya-disease
#10
Miki Fujimura, Oh Young Bang, Jong S Kim
Moyamoya disease (MMD) is a chronic occlusive cerebrovascular disease characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. Although its etiology is unknown, recent genetic studies have identified RNF213 in the 17q25-ter region as an important susceptibility gene of MMD among East Asian populations. A c.14576G>A polymorphism in RNF213 was identified in 95% of MMD patients with a family history and in 79% of sporadic cases, and patients carrying this polymorphism exhibited significantly earlier disease onset and a more-severe form of MMD...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960167/intracranial-arteries-anatomy-and-collaterals
#11
David S Liebeskind, Louis R Caplan
Anatomy, physiology, and pathophysiology are inextricably linked in patients with intracranial atherosclerosis. Knowledge of abnormal or pathological conditions such as intracranial atherosclerosis stems from detailed recognition of the normal pattern of vascular anatomy. The vascular anatomy of the intracranial arteries, both at the level of the vessel wall and as a larger structure or conduit, is a reflection of physiology over time, from in utero stages through adult life. The unique characteristics of arteries at the base of the brain may help our understanding of atherosclerotic lesions that tend to afflict specific arterial segments...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960164/clinical-stroke-syndromes
#12
Jong S Kim, Louis R Caplan
The main mechanism of stroke in patients who have extracranial atherosclerosis is artery to artery embolism, occasionally associated with hemodynamic disturbances. Although these mechanisms are also important in patients with intracranial atherosclerosis, branch occlusion and in-situ thrombotic occlusion play a relatively more important role in these patients. Accordingly, clinical stroke syndromes differ between extracranial atherosclerosis and intracranial atherosclerosis. In anterior circulation, middle cerebral artery atherosclerosis frequently produces subcortical infarction by way of branch occlusion...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27942925/low-cerebral-blood-volume-identifies-poor-outcome-in-stent-retriever-thrombectomy
#13
Sara Protto, Juha-Pekka Pienimäki, Janne Seppänen, Heikki Numminen, Niko Sillanpää
BACKGROUND: Mechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers. METHODS: We prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included...
December 9, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27928391/a-moyamoya-patient-with-bilateral-consecutive-branch-retinal-vein-occlusion
#14
Hande Güçlü, Vuslat Pelitli Gurlu, Sadık Altan Ozal, Haluk Esgin
We describe a moyamoya (MMD) patient with bilateral consecutive branch retinal vein occlusion (BRVO). The patient had a medical history of severe headache, cranial haemorrhage, bilateral supraclinoid carotid artery occlusion, and "puff of smoke" collaterals on cerebral angiography and an encephalomyosynangiosis operation. On ophthalmic examination, he had superior temporal branch vein occlusion with intraretinal haemorrhage and visual acuity of 20/25 in the right eye. Twelve years later, he presented with superior temporal branch vein occlusion in the left eye and visual acuity of 20/60...
April 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27924799/collateral-flow-and-white-matter-disease-in-patients-with-internal-carotid-artery-occlusion
#15
Mami Ishikawa, Hitoshi Sugawara, Mutsumi Nagai, Gen Kusaka, Yuichi Tanaka, Heiji Naritaka
BACKGROUND: When an internal carotid artery (ICA) occludes, a patient may develop cerebral infarction (CI). We investigated whether CI caused by ICA occlusion (ICAO) is associated with collateral flow through the anterior and posterior communicating arteries (ACoA and PCoA). METHODS: In 100 patients with ICAO, we investigated CI and white matter disease by performing an MRI and the anatomy of the ACoA and PCoA were investigated by performing magnetic resonance angiography...
2017: European Neurology
https://www.readbyqxmd.com/read/27909265/prevention-of-the-collapse-of-pial-collaterals-by-remote-ischemic-perconditioning-during-acute-ischemic-stroke
#16
Junqiang Ma, Yonglie Ma, Bin Dong, Mischa V Bandet, Ashfaq Shuaib, Ian R Winship
Collateral circulation is a key variable determining prognosis and response to recanalization therapy during acute ischemic stroke. Remote ischemic perconditioning (RIPerC) involves inducing peripheral ischemia (typically in the limbs) during stroke and may reduce perfusion deficits and brain damage due to cerebral ischemia. In this study, we directly investigated pial collateral flow augmentation due to RIPerC during distal middle cerebral artery occlusion (MCAo) in rats. Blood flow through pial collaterals between the anterior cerebral artery (ACA) and the MCA was assessed in male Sprague Dawley rats using in vivo laser speckle contrast imaging (LSCI) and two photon laser scanning microscopy (TPLSM) during distal MCAo...
December 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27888269/internal-carotid-artery-pseudoaneurysm-and-ischemic-stroke-secondary-to-retropharyngeal-and-parapharyngeal-abscess-a-case-report-and-review-of-the-literature
#17
Michael W Ruff, Deena M Nasr, James P Klaas, Deborah L Renaud
Internal carotid artery pseudoaneurysm is an uncommon complication of retropharyngeal and parapharyngeal abscess in children. Treatment of the pseudoaneurysm has evolved in recent years from surgical ligation to endovascular techniques. Neurologic sequelae most commonly consist of Horner's syndrome with cerebral ischemia being uncommon. The clinical course of a 2-year-old boy with retropharyngeal abscess complicated by internal carotid artery pseudoaneurysm, is described and the literature is reviewed. A conventional angiogram confirmed the presence of a large pseudoaneurysm with no anterograde flow distal to the pseudoaneurysm and substantial collateral flow across the circle of Willis, with filling of the left anterior and middle cerebral arteries via the anterior and posterior communicating arteries...
November 25, 2016: Journal of Child Neurology
https://www.readbyqxmd.com/read/27859886/collateral-blood-flow-in-different-cerebrovascular-hierarchy-provides-endogenous-protection-in-cerebral-ischemia
#18
Chuanming Luo, Fengyin Liang, Huixia Ren, Xiaoli Yao, Qiang Liu, Mingyue Li, Dajiang Qin, Ti-Fei Yuan, Zhong Pei, Huanxing Su
Collateral blood flow as vascular adaptions to focal cerebral ischemia is well recognized. However, few studies directly investigate the dynamics of collateral vessel recruitment in vivo and little is known about the effect of collateral blood flow in different cerebrovascular hierarchy on the neuropathology after focal ischemic stroke. Here, we report that collateral blood flow is critically involved in blood vessel compensations following regional ischemia. We occluded a pial arteriole using femtosecond laser ablating under the intact thinned skull and documented the changes of collateral flow around the surface communication network and between the surface communication network and subsurface microcirculation network using in vivo two photon microscopy imaging...
November 15, 2016: Brain Pathology
https://www.readbyqxmd.com/read/27856435/impact-of-pial-collaterals-on-infarct-growth-rate-in-experimental-acute-ischemic-stroke
#19
G A Christoforidis, P Vakil, S A Ansari, F H Dehkordi, T J Carroll
BACKGROUND AND PURPOSE: Cerebral infarction evolves at different rates depending on available blood flow suggesting that treatment time windows vary depending on the degree of pial collateral recruitment. This work sought to mathematically model infarct growth and determine whether infarct volume growth can be predicted by angiographic assessment of pial collateral recruitment in an experimental MCA occlusion animal model. MATERIALS AND METHODS: Pial collateral recruitment was quantified by using DSA, acquired 15 minutes following permanent MCA occlusion in 6 canines based on a scoring system (average pial collateral score) and arterial arrival time...
November 17, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27856113/clinical-outcome-predicted-by-collaterals-depends-on-technical-success-of-mechanical-thrombectomy-in-middle-cerebral-artery-occlusion
#20
Alexandra S Gersing, Benedikt J Schwaiger, Justus F Kleine, Johannes Kaesmacher, Silke Wunderlich, Benjamin Friedrich, Sascha Prothmann, Claus Zimmer, Tobias Boeckh-Behrens
BACKGROUND: This study aimed to analyze the effects of technical outcome of mechanical thrombectomy (MTE) on the associations between collateral status, assessed with pretreatment computed tomography angiography (CTA), and neurological and functional outcome, as well as associations between collaterals and metabolic risk factors (arterial hypertension, diabetes, hyperlipidemia, overweight). METHODS: Prospectively collected data of 115 patients with CTA-proven isolated middle cerebral artery occlusion treated successfully with MTE (Thrombosis in Cerebral Infarction [TICI] scale 2b or 3) were assessed retrospectively...
November 14, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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