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https://www.readbyqxmd.com/read/28203181/bilateral-superior-cerebellar-artery-embolic-occlusion-with-a-fetal-type-posterior-cerebral-artery-providing-collateral-circulation
#1
Taylor J Bergman, Rachael C Saporito, Thomas Hope
Bilateral infarction of the superior cerebellar arteries with sparing of the rest of the posterior circulation, particularly the posterior cerebral arteries, is an uncommon finding in neurological practice. Most commonly, the deficits of the superior cerebellar arteries and posterior cerebral arteries occur together due to the close proximity of their origins at the top of the basilar artery. A patient was transferred to the neurological intensive care unit with a history of recent-onset falls from standing, profound hypertension, dizziness, and headaches...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/28191623/the-ivy-sign-on-fluid-attenuated-inversion-recovery-images-related-to-single-photon-emission-computed-tomography-cerebral-blood-flow-in-moyamoya-disease-a-case-report
#2
Fumihiro Matano, Yasuo Murai, Asami Kubota, Takayuki Mizunari, Shiro Kobayashi, Akio Morita
BACKGROUND: Moyamoya disease is an idiopathic progressive cerebrovascular steno-occlusive disorder characterized by the formation of numerous collaterals called moyamoya vessels. Accurate evaluation of vascular status and CBF is needed for prompt treatment to prevent ischemic and/or hemorrhagic events. The pathogenesis of the ivy sign on fluid attenuated inversion recovery (FLAIR) images of moyamoya disease patients is unclear. We report a moyamoya disease case wherein the ivy sign changed in relation to SPECT-measured CBF during progression and following treatment...
January 17, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28188261/role-of-genetic-variation-in-collateral-circulation-in-the-evolution-of-acute-stroke-a-multimodal-magnetic-resonance-imaging-study
#3
Yu-Chieh Jill Kao, Esteban A Oyarzabal, Hua Zhang, James E Faber, Yen-Yu Ian Shih
BACKGROUND AND PURPOSE: No studies have determined the effect of differences in pial collateral extent (number and diameter), independent of differences in environmental factors and unknown genetic factors, on severity of stroke. We examined ischemic tissue evolution during acute stroke, as measured by magnetic resonance imaging and histology, by comparing 2 congenic mouse strains with otherwise identical genetic backgrounds but with different alleles of the Determinant of collateral extent-1 (Dce1) genetic locus...
February 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28183839/mr-imaging-of-individual-perfusion-reorganization-using-superselective-pseudocontinuous-arterial-spin-labeling-in-patients-with-complex-extracranial-steno-occlusive-disease
#4
V Richter, M Helle, M J P van Osch, T Lindner, A S Gersing, P Tsantilas, H-H Eckstein, C Preibisch, C Zimmer
BACKGROUND AND PURPOSE: Patients with multiple stenoses or occlusions of the extracranial arteries require an individualized diagnostic approach. We evaluated the feasibility and clinical utility of a novel MR imaging technique for regional perfusion imaging in this patient group. MATERIALS AND METHODS: Superselective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients (10 women, 70...
February 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28179559/acute-cerebral-venous-thrombosis-three-dimensional-visualization-and-quantification-of-hemodynamic-alterations-using-4-dimensional-flow-magnetic-resonance-imaging
#5
Florian Schuchardt, Anja Hennemuth, Laure Schroeder, Stephan Meckel, Michael Markl, Thomas Wehrum, Andreas Harloff
BACKGROUND AND PURPOSE: Cerebral venous thrombosis (CVT) affects venous hemodynamics and can provoke severe stroke and chronic intracranial hypertension. We sought to comprehensively analyze 3-dimensional blood flow and hemodynamic alterations during acute CVT including collateral recruitment and at follow-up. METHODS: Twenty-two consecutive patients with acute CVT were prospectively included and underwent routine brain magnetic resonance imaging (MRI) and 4-dimensional flow MRI at 3 T for the in vivo assessment of cerebral blood flow...
February 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28176499/ct-angiography-of-collateral-vessels-and-outcomes-in-endovascular-treated-acute-ischemic-stroke-patients
#6
Beom Joon Kim, Jong Won Chung, Hong Kyun Park, Jun Yup Kim, Mi Hwa Yang, Moon Ku Han, Cheolkyu Jeong, Gyojun Hwang, O Ki Kwon, Hee Joon Bae
BACKGROUND AND PURPOSE: Measuring the extent of the collateral blood vessels using computed tomography (CT) angiography source images may promote tissue survival and functional gain in acute ischemic stroke patients who are candidates for endovascular recanalization treatment. METHODS: Of 5,558 acute stroke patients registered in a prospective clinical stroke registry, 104 met the selection criteria of endovascular recanalization treatment for internal cerebral artery or middle cerebral artery main-stem (M1) occlusions and presented for treatment ≤4 hours after the event...
January 12, 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28151850/distinctive-patterns-on-ct-angiography-characterize-acute-internal-carotid-artery-occlusion-subtypes
#7
Ji Man Hong, Sung Eun Lee, Seong-Joon Lee, Jin Soo Lee, Andrew M Demchuk
Noninvasive computed tomography angiography (CTA) is widely used in acute ischemic stroke, even for diagnosing various internal carotid artery (ICA) occlusion sites, which often need cerebral digital subtraction angiography (DSA) confirmation. We evaluated whether clinical outcomes vary depending on the DSA-based occlusion sites and explored correlating features on baseline CTA that predict DSA-based occlusion site.We analyzed consecutive patients with acute ICA occlusion who underwent DSA and CTA. Occlusion site was classified into cervical, cavernous, petrous, and carotid terminus segments by DSA confirmation...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28112023/cerebral-collateral-therapeutics-in-acute-ischemic-stroke-a-randomized-preclinical-trial-of-four-modulation-strategies
#8
Simone Beretta, Alessandro Versace, Davide Carone, Matteo Riva, Valentina Dell'Era, Elisa Cuccione, Ruiyao Cai, Laura Monza, Silvia Pirovano, Giada Padovano, Fabio Stiro, Luca Presotto, Giovanni Paternò, Emanuela Rossi, Carlo Giussani, Erik P Sganzerla, Carlo Ferrarese
Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat stroke model of transient middle cerebral artery (MCA) occlusion. A composed randomization design was used to assign rats (n = 118) to receive phenylephrine (induced hypertension), polygeline (intravascular volume load), acetazolamide (cerebral arteriolar vasodilation), head down tilt (HDT) 15° (cerebral blood flow diversion), or no treatment, starting 30 min after MCA occlusion...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
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
#9
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
#10
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
#11
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...
February 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
#12
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
#13
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...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28029271/hemodynamic-mechanisms-underlying-elevated-oxygen-extraction-fraction-oef-in-moyamoya-and-sickle-cell-anemia-patients
#14
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
#15
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
#16
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
#17
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...
January 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/27960175/moyamoya-disease
#18
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
#19
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
#20
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
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