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Cerebral collateral

Estelle Seyman, Hilla Shaim, Shani Shenhar-Tsarfaty, Tali Jonash-Kimchi, Natan M Bornstein, Hen Hallevi
BACKGROUND: Acute ischemic stroke (AIS) is a common neurological event that causes varying degrees of disability. AIS outcome varies considerably, from complete recovery to complete loss of tissue and function. This diversity is partly explained by the compensatory ability of the collateral circulation and the ensuing cerebral flow grade. The collateral flow to the anterior circulation largely supplies the cortical areas. The deep brain tissue is supplied by penetrating arteries and has little or no collateral supply...
October 21, 2016: BMC Neurology
S Sundaram, S Kannoth, B Thomas, P S Sarma, P N Sylaja
BACKGROUND AND PURPOSE: Cervical internal carotid artery occlusion can present with varied clinical manifestations such as transient ischemic attack, stroke, and chronic ocular ischemia, or can be asymptomatic. The outcome in these patients is considerably influenced by cerebral hemodynamic compensatory adaptation of the intracranial collateral pathways. Our aim was to study whether collateral circulation as assessed by CT angiography can predict 3-month outcome and initial stroke severity in patients with symptomatic cervical ICA occlusion...
October 20, 2016: AJNR. American Journal of Neuroradiology
Rhett A Reichard, Suriya Subramanian, Mikiyas T Desta, Tej Sura, Mary L Becker, Comeron W Ghobadi, Kenneth P Parsley, Daniel S Zahm
Behavioral flexibility is subserved in part by outputs from the cerebral cortex to telencephalic subcortical structures. In our earlier evaluation of the organization of the cortical-subcortical output system (Reynolds and Zahm, J Neurosci 25:11757-11767, 2005), retrograde double-labeling was evaluated in the prefrontal cortex following tracer injections into pairs of the following subcortical telencephalic structures: caudate-putamen, core and shell of the accumbens (Acb), bed nucleus of stria terminalis (BST) and central nucleus of the amygdala (CeA)...
October 4, 2016: Brain Structure & Function
William T C Yuh, Matthew David Alexander, Toshihiro Ueda, Masayuki Maeda, Toshiaki Taoka, Kei Yamada, Norman J Beauchamp
OBJECTIVE: Advanced stroke imaging has generated much excitement for the early diagnosis of acute ischemic stroke (AIS) and facilitation of intervention. However, its therapeutic impact has not matched its diagnostic utility; most notably, lacking significant contributions to recent major AIS clinical trials. It is time to reexamine the fundamental hypotheses from the enormous body of imaging research on which clinical practices are based and reassess the current standard clinical and imaging strategies, or golden rules, established over decades for AIS...
September 28, 2016: AJR. American Journal of Roentgenology
Kota Kurisu, Takeo Abumiya, Masaki Ito, Masayuki Gekka, Toshiya Osanai, Hideo Shichinohe, Naoki Nakayama, Ken Kazumata, Kiyohiro Houkin
The robust neuroprotective effects of transarterial regional hypothermia have been demonstrated in the typical transient middle cerebral artery occlusion (tMCAO) model, but have not yet been tested in other ischemic stroke models, even though clinical ischemic conditions are diverse. In order to clarify these effects in a different ischemic stroke model, we employed a rat model of permanent MCAO (pMCAO) with transient collateral hypoperfusion (tCHP), which was achieved by direct MCA ligation through craniotomy and 1-hour bilateral common carotid artery occlusion at the beginning of pMCAO...
September 20, 2016: Brain Research
Dezhi Liu, Fabien Scalzo, Neal M Rao, Jason D Hinman, Doojin Kim, Latisha K Ali, Jeffrey L Saver, Wen Sun, Qiliang Dai, Xinfeng Liu, David S Liebeskind
BACKGROUND AND PURPOSE: In acute arterial occlusion, fluid-attenuated inversion recovery vascular hyperintensity (FVH) has been linked to slow flow in leptomeningeal collaterals and cerebral hypoperfusion, but the impact on clinical outcome is still controversial. In this study, we aimed to investigate the association between FVH topography or FVH-Alberta Stroke Program Early CT Score (ASPECTS) pattern and outcome in acute M1-middle cerebral artery occlusion patients with endovascular treatment...
September 22, 2016: Stroke; a Journal of Cerebral Circulation
Shin-Joe Yeh, Sung-Chun Tang, Li-Kai Tsai, Ya-Fang Chen, Hon-Man Liu, Ying-An Chen, Yu-Lin Hsieh, Shih-Hung Yang, Yu-Hsuan Tien, Chi-Cheng Yang, Meng-Fai Kuo, Jiann-Shing Jeng
The marked cerebral hypoperfusion of moyamoya disease (MMD) can be treated with encephaloduroarteriosynangiosis (EDAS), an indirect revascularization surgery. Collateral establishment after the surgery is a gradual process; thus, easy access to serial assessment is of great importance. We prospectively recruited 15 pediatric moyamoya patients who underwent EDAS surgeries on a total of 19 hemispheres. Ultrasonography of extracranial and intracranial arteries was performed pre-operatively and post-operatively at 1, 3 and 6 mo...
September 14, 2016: Ultrasound in Medicine & Biology
Paolo Zamboni, Erica Menegatti, Corrado Cittanti, Francesco Sisini, Sergio Gianesini, Fabrizio Salvi, Francesco Mascoli
OBJECTIVE: Increased ventricle volume and brain hypoperfusion are linked to neurodegeneration. We hypothesized that in patients with restricted jugular flow, surgical restoration may reduce brain ventricle volume, because it should improve the pressure gradient, hence promoting cerebrospinal fluid reabsorption into the venous system. METHODS: The effects of restoring the jugular flow were assessed by means of a validated echocardiography with color Doppler (ECD) protocol of flow quantification, magnetic resonance venography, and single-photon emission computed tomography combined with computed tomography (SPECT-CT)...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Myron D Ginsberg
This review surveys the efforts taken to achieve clinically efficacious protection of the ischemic brain and underscores the necessity of expanding our purview to include the essential role of cerebral perfusion and the collateral circulation. We consider the development of quantitative strategies to measure cerebral perfusion at the regional and local levels and the application of these methods to elucidate flow-related thresholds of ischemic viability and to characterize the ischemic penumbra. We stress that the modern concept of neuroprotection must consider perfusion, the necessary substrate upon which ischemic brain survival depends...
September 13, 2016: Progress in Neurobiology
Peter Kan, Visish M Srinivasan, Nnenna Mbabuike, Rabih G Tawk, Vin Shen Ban, Babu G Welch, Maxim Mokin, Bartley D Mitchell, Ajit Puri, Mandy J Binning, Edward Duckworth
The Pipeline Embolization Device (PED) was approved for the treatment of intracranial aneurysms from the petrous to the superior hypophyseal segment of the internal carotid artery. However, since its approval, its use for treatment of intracranial aneurysms in other locations and non-sidewall aneurysms has grown tremendously. The authors report on a cohort of 15 patients with 16 cerebral aneurysms that incorporated an end vessel with no significant distal collaterals, which were treated with the PED. The cohort includes 7 posterior communicating artery aneurysms, 5 ophthalmic artery aneurysms, 1 superior cerebellar artery aneurysm, 1 anterior inferior cerebellar artery aneurysm, and 2 middle cerebral artery aneurysms...
September 16, 2016: Journal of Neurosurgery
Diederik W Dippel, Charles B Majoie, Yvo B Roos, Aad van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Hester F Lingsma, Peter J Koudstaal, Kilian M Treurniet, Lucie A van den Berg, Debbie Beumer, Puck S Fransen, Olvert A Berkhemer
BACKGROUND AND PURPOSE: Intra-arterial treatment by means of retrievable stents has been proven safe and effective. In MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands), the choice of the type of thrombectomy device was left to the discretion of the interventionist. The aim of this study was to explore the differences in functional outcome, neurological recovery, reperfusion, extent of infarction, and adverse events according to stent type and make...
October 2016: Stroke; a Journal of Cerebral Circulation
Haruka Miyabe, Atsuhiko Uno, Takahiro Nakajima, Natsue Morizane, Keisuke Enomoto, Masayuki Hirose, Toshinori Hazama, Yukinori Takenaka
Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction...
2016: Case Reports in Otolaryngology
Ji Man Hong, Yoon Hee Hong, Seong-Joon Lee, Sung Eun Lee, Jin Soo Lee, Dong Hoon Shin
To evaluate the hemodynamic contributions of collateral flow in adult patients with moyamoya disease, neurological deterioration or fluctuation during admission, Suzuki grade, various collateral routes, lesion volume, cerebral blood flow (CBF), and their associations were analyzed. Thirty patients (60 cerebral hemispheres, mean age 45 ± 25 years, and 73.3 % female) who were diagnosed with moyamoya disease or syndrome were enrolled over 3 years. Moyamoya stages from each hemisphere were stratified according to the Suzuki's criteria through six-vessel angiography into internal carotid arteries (ICAs), external carotid arteries (ECAs), and vertebral arteries (VAs)...
September 2, 2016: Neurological Sciences
Shusaku Omoto, Yuki Hasegawa, Kenichiro Sakai, Hiromasa Matsuno, Ayumi Arai, Yuka Terasawa, Hidetaka Mitsumura, Yasuyuki Iguchi
Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Fei Wu, Lei Huang, Gang Lu, Liang Ge, Xiaolong Zhang, Wenjie Cao, Qiang Dong
BACKGROUND/OBJECTIVE: We sought to assess the different patterns of cerebral hemodynamic changes in staged carotid angioplasty and stenting (CAS). METHODS: We prospectively recruited a cohort of patients with regular angioplasty or staged angioplasty from October 2013 to August 2015. The hemodynamic changes, including peak systolic, end-diastolic, and mean flow velocities in the ipsilateral middle cerebral artery (MCA) and the contralateral anterior cerebral artery (ACA), were recorded by transcranial Doppler ultrasound...
August 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hui Fang, Xiang Yan Chen, Bo Song, Bo Cheng, Yu Ming Xu, Ka Sing Wong, Stella Sin Yee Ho
BACKGROUND: Stroke patients with carotid disease have a high risk of recurrent. By measuring cerebral blood flow volume (BFV) using extracranial duplex technique for clinical estimation of intracranial collaterals, we aimed to investigate the relationship between the presence of intracranial collaterals and stroke recurrence in stroke patients with carotid disease. METHODS: Consecutive stroke patients indicated for carotid duplex ultrasound investigations in our hospital were recruited during three years' period...
August 16, 2016: Current Neurovascular Research
Yorito Hattori, Jun-Ichiro Enmi, Satoshi Iguchi, Satoshi Saito, Yumi Yamamoto, Kazuyuki Nagatsuka, Hidehiro Iida, Masafumi Ihara
The bilateral common carotid artery stenosis (BCAS) mouse model, which replicates chronic cerebral hypoperfusion and white matter ischemic lesions, is considered to model some aspects of vascular cognitive impairment. Cerebral blood flow (CBF) changes in the brain surface post-BCAS have been demonstrated by laser speckle flowmetry, but CBF levels in the brain parenchyma remain unknown. Adult C57BL/6J male mice were subjected to BCAS using external microcoils. Brain magnetic resonance angiography (MRA) was conducted to visualize the intracranial main arteries while arterial spin labeling (ASL) was used to measure cortical and subcortical parenchymal CBF levels before and after BCAS...
2016: Scientific Reports
Andrea M Alexandre, Emiliano Visconti, Chiara Schiarelli, Paolo Frassanito, Alessandro Pedicelli
BACKGROUND: Bilateral segmental agenesis of the internal carotid artery is a very rare congenital anomaly. We present a case of bilateral internal carotid artery segmental agenesis in an asymptomatic 18-old man. Embryology, common collateral pathways, clinical presentation and clinical importance of this condition are discussed. According to our review of the literature, this report is the first to describe bilateral internal carotid artery segmental agenesis in a patient studied with MRI, CT, Doppler-US and DSA...
August 12, 2016: World Neurosurgery
Reinier C van Houwelingen, Gert-Jan Luijckx, Aryan Mazuri, Reinoud P H Bokkers, Omid S Eshghi, Maarten Uyttenboogaart
Importance: After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO). Objective: To report up-to-date outcome data of intra-arterial (IA) treatment in patients with BAO and to evaluate the influence of collateral circulation on outcome. Design, Setting, and Participants: Single-center retrospective case series of 38 consecutive patients with BAO who underwent IA treatment between 2006 and 2015 at a comprehensive stroke center...
October 1, 2016: JAMA Neurology
Ulas Cikla, Guner Menekse, Arman Quraishi, Gabriel Neves, Abdullah Keles, Collin Liu, Shahriar M Salamat, Mustafa K Baskaya
Understanding the anatomy of temporal lobe sulci and their variations can allow for safer neurosurgical approaches. Although the inferior temporal sulci and their relations to each other has been described by several authors, the nomenclature used has not been universal. The aim of this study was to investigate the anatomic features of the three main sulci of the inferior temporal lobe and provide a simple description of complex patterns among these sulci. Sulcal variations and their relations were examined in seventy formalin-fixed, adult cadaveric cerebral hemispheres...
October 2016: Clinical Anatomy
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