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Vascular neurology

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https://www.readbyqxmd.com/read/28230629/point-of-injury-tourniquet-application-during-operation-protective-edge-what-de-we-learn
#1
Amir Shlaifer, Avraham Yitzhak, Erez N Baruch, Avi Shina, Alexandra Satanovsky, Amiram Shovali, Ofer Almog, Elon Glassberg
BACKGROUND: Hemorrhage is a leading cause of preventable death on the battlefield. Timely tourniquet application to massively bleeding extremity wounds is critical for casualty survival albeit with reported adverse effects to extremity integrity. The aim of this study was to describe the immediate and short term outcomes of point of injury (POI) tourniquet applications during 'Operation Protective Edge' (OPE). METHODS: A case series study regarding tourniquet application at the POI during OPE was collected...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28229442/-rapidly-progressive-dementia-and-parkinsonism-associated-to-multiple-dural-arteriovenous-fistulas
#2
P Mejia, L M Piedra, X Merchan-Del Hierro
INTRODUCTION: Rapidly progressive dementias are an infrequent group of diseases characterised by cognitive deterioration and other neurological disorders that develop over a period ranging from weeks to months. Their causation is varied and includes a large number of neurodegenerative, toxic, metabolic, autoimmune, infectious and vascular conditions. CASE REPORT: We report the case of a 69-year-old male who was admitted to hospital due to a rapidly progressive dementia and parkinsonism caused by multiple dural arteriovenous fistulas, which were successfully treated by means of endovascular therapy...
March 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28217455/neoplastic-diseases-of-the-spermatic-cord-an-overview-of-pathological-features-evaluation-and-management
#3
REVIEW
Gautam Dagur, Jason Gandhi, Kailash Kapadia, Rafid Inam, Noel L Smith, Gargi Joshi, Sardar Ali Khan
Extracellular tumors found with the spermatic cord, known as neoplasms, are usually identified to be benign. However, the accurate and timely diagnosis of spermatic cord masses is highly crucial, especially when most results are often overlooked or unclear. In this review, we discuss the anatomy and embryology of the spermatic cord. Upon rooting these fundamental concepts, we discuss an array of benign and malignant neoplastic tumors, including their origin, pathological features, clinical evaluation and management, as well as other case-specific characteristics of unique presentation...
February 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28216356/fixed-and-variable-cost-of-carotid-endarterectomy-and-stenting-in-the-united-states-a-comparative-study
#4
Tammam Obeid, Husain Alshaikh, Besma Nejim, Isibor Arhuidese, Satinderjit Locham, Mahmoud Malas
OBJECTIVE: Despite multiple landmark clinical trials, little data exists on real-world cost of carotid artery stenting (CAS) and carotid endarterectomy (CEA) to the United States healthcare system. We aim to study differences in actual hospitalization cost between patients who underwent CAS vs CEA in a nationally representative database. METHODS: We studied hospital discharge and billing records of all patients, in the Premier Perspective Database, who underwent CEA or CAS between the third quarter of 2009 and the first quarter of 2015...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28215907/spinal-arteriovenous-fistulas-in-adults-management-of-a-series-of-patients-treated-at-a-neurology-department
#5
G Ortega-Suero, J Porta Etessam, M Moreu Gamazo, G Rodríguez-Boto
OBJECTIVE: Spinal arteriovenous fístulas (SAVF), a rare type of vascular malformation, account for 3% of all spinal cord lesions. Without early treatment, the associated morbidity is high; furthermore, SAVF pose a major diagnostic challenge. Our purpose was to evaluate the clinical characteristics of SAVF and review their progress after treatment to determine whether it may be too late for treatment in some cases. METHODS: We present a retrospective series of 10 patients diagnosed with SAVF and treated at a tertiary hospital during a 3-year period...
February 16, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28215423/chads2-score-predicts-postoperative-atrial-fibrillation-in-patients-undergoing-elective-pulmonary-lobectomy
#6
Svetlana Kotova, Mansen Wang, Katie Lothrop, Gary Grunkemeier, Heather E Merry, John R Handy
BACKGROUND: Postoperative atrial fibrillation (PAF) affects 12% to 17% of patients undergoing lobectomy and is associated with increased morbidity. CHADS2 (congestive heart failure history, hypertension history, age ≥75 years, diabetes mellitus history, and stroke or transient ischemic attack symptoms previously) is used to predict stroke risk in patients with existing AF. It also has been shown also to predict new-onset PAF. Our objective was to determine whether CHADS2 can predict PAF in patients undergoing lobectomy...
February 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28214828/role-for-target-of-rapamycin-mtor-signal-pathway-in-regulating-neuronal-injury-after-intracerebral-hemorrhage
#7
Jie-Ping Wang, Meng-Yu Zhang
BACKGROUND/AIMS: Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase and activation of its signal pathway plays an important role in regulating protein growth and synthesis as well as cell proliferation and survival. In the present study, we examined the contribution of mTOR signal and its downstream products to brain injuries induced by intracerebral hemorrhage (ICH) in rats. METHODS: Western Blot analysis was employed to examine the protein expression of mTOR and its downstream pathway and Caspase-3...
January 18, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28214641/posterior-reversible-encephalopathy-syndrome-causing-vision-loss-following-endoscopic-endonasal-resection-of-pituitary-adenoma-a-case-report
#8
Nicolas W Villelli, Daniel M Prevedello, Daniel S Ikeda, Alaa S Montaser, Bradley A Otto, Ricardo L Carrau
BACKGROUND: Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by headache, altered mental status, visual changes, and seizure combined with brain imaging consistent with cerebral edema without infarction. To the best of our knowledge, we report the first case of PRES following an endoscopic endonasal resection of a pituitary macroadenoma. CASE DESCRIPTION: A 59-year-old female was diagnosed with a pituitary macroadenoma, for which she underwent endoscopic endonasal extracapsular resection...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28212524/role-of-nrf2-and-protective-effects-of-metformin-against-tobacco-smoke-induced-cerebrovascular-toxicity
#9
Shikha Prasad, Ravi K Sajja, Mohammad Abul Kaisar, Jee Hyun Park, Heidi Villalba, Taylor Liles, Thomas Abbruscato, Luca Cucullo
Cigarette smoking (CS) is associated with vascular endothelial dysfunction in a causative way primarily related to the TS content of reactive oxygen species (ROS), nicotine, and inflammation. TS promotes glucose intolerance and increases the risk of developing type-2 diabetes mellitus (2DM) with which it shares other pathogenic traits including the high risk of cerebrovascular and neurological disorders like stroke via ROS generation, inflammation, and blood-brain barrier (BBB) impairment. Herein we provide evidence of the role played by nuclear factor erythroid 2-related factor (Nrf2) in CS-induced cerebrobvascular/BBB impairments and how these cerebrovascular harmful effects can be circumvented by the use of metformin (MF; a widely prescribed, firstline anti-diabetic drug) treatment...
February 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28212190/endothelial-cell-disease-emerging-knowledge-from-cerebral-cavernous-malformations
#10
Maria Grazia Lampugnani, Matteo Malinverno, Elisabetta Dejana
PURPOSE OF REVIEW: Endothelial cells dysfunctions are crucial determinants of several human diseases. We review here the most recent reports on endothelial cell defects in cerebral cavernous malformations (CCMs), particularly focusing on adherens junctions. CCM is a vascular disease that affects specifically the venous microvessels of the central nervous system and which is caused by loss-of-function mutation in any one of the three CCM genes (CCM1, 2 or 3) in endothelial cells. The phenotypic result of these mutations are focal vascular malformations that are permeable and fragile causing neurological symptoms and occasionally haemorrhagic stroke...
February 16, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28211486/motor-phenotype-is-not-associated-with-vascular-dysfunction-in-symptomatic-huntington-s-disease-transgenic-r6-2-160-cag-mice
#11
A Di Pardo, A Carrizzo, A Damato, S Castaldo, E Amico, L Capocci, M Ambrosio, F Pompeo, C De Sanctis, C C Spinelli, A A Puca, P Remondelli, V Maglione, C Vecchione
Whereas Huntington's disease (HD) is unequivocally a neurological disorder, a critical mass of emerging studies highlights the occurrence of peripheral pathology like cardiovascular defects in both animal models and humans. The overt impairment in cardiac function is normally expected to be associated with peripheral vascular dysfunction, however whether this assumption is reasonable or not in HD is still unknown. In this study we functionally characterized the vascular system in R6/2 mouse model (line 160 CAG), which recapitulates several features of human pathology including cardiac disease...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28210071/update-on-the-medical-management-of-gastrointestinal-beh%C3%A3-et-s-disease
#12
REVIEW
Giuseppe Lopalco, Donato Rigante, Vincenzo Venerito, Claudia Fabiani, Rossella Franceschini, Michele Barone, Giovanni Lapadula, Mauro Galeazzi, Bruno Frediani, Florenzo Iannone, Luca Cantarini
Behçet's disease (BD) is a multisystemic disorder of unknown etiology mainly defined by recurrent oral aphthosis, genital ulcers, and chronic relapsing bilateral uveitis, all of which represent the "stigmata" of disease. However, many other organs including the vascular, neurological, musculoskeletal, and gastrointestinal systems can be affected. The gastrointestinal involvement in Behçet's disease (GIBD), along with the neurological and vascular ones, represents the most feared clinical manifestation of BD and shares many symptoms with inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28209646/rete-mirabile-associated-with-pial-arteriovenous-fistula-imaging-features-with-literature-review
#13
Prabath Kumar Mondel, Rashmi Saraf, Uday S Limaye
A rete mirabile is a vascular network of intercommunicating small arteries or arterioles that replace the definitive adult artery supplying the brain. It supplies the brain in lower mammals but is not seen in normal human embryological development. A 26-year-old man presented with worsening tinnitus that was interfering with his sleep. On CT and digital subtraction angiography he was found to have a temporal lobe pial arteriovenous fistula with bilateral carotid and vertebral rete mirabile. The patient was offered open surgical and endovascular treatment options for pial arteriovenous fistula but he refused both and opted for conservative medical management...
February 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28205591/protective-effect-of-17%C3%AE-estradiol-upon-hippocampal-spine-density-and-cognitive-function-in-an-animal-model-of-vascular-dementia
#14
Ying Zhu, Quanguang Zhang, Wenli Zhang, Ning Li, Yongxin Dai, Jingyi Tu, Fang Yang, Darrell W Brann, Ruimin Wang
The current study examined whether the steroid hormone, 17β-estradiol (E2) can exert long-lasting beneficial effects upon axonal health, synaptic plasticity, dementia-related amyloid-beta (Aβ) protein expression, and hippocampal-dependent cognitive function in an animal model of chronic cerebral hypoperfusion and vascular dementia (VaD). Chronic cerebral hypoperfusion and VaD was induced by bilateral common carotid artery occlusion (BCCAO) in adult male Sprague Dawley rats. Low dose E2 administered for the first 3-months after BCCAO exerted long-lasting beneficial effects, including significant neuroprotection of hippocampal CA1 neurons and preservation of hippocampal-dependent cognitive function when examined at 6-months after BCCAO...
February 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28203097/cerebral-malaria-insight-into-pathogenesis-complications-and-molecular-biomarkers
#15
Farah Hafiz Yusuf, Muhammad Yusuf Hafiz, Maria Shoaib, Syed Ahsanuddin Ahmed
Cerebral malaria is a medical emergency. All patients with Plasmodium falciparum malaria with neurologic manifestations of any degree should be urgently treated as cases of cerebral malaria. Pathogenesis of cerebral malaria is due to damaged vascular endothelium by parasite sequestration, inflammatory cytokine production and vascular leakage, which result in brain hypoxia, as indicated by increased lactate and alanine concentrations. The levels of the biomarkers' histidine-rich protein II, angiopoietin-Tie-2 system and plasma osteoprotegrin serve as diagnostic and prognostic markers...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28202828/-diagnosis-of-cochleovestibular-neurovascular-compression-syndrome-a-scoring-system-based-on-five-clinical-characteristics
#16
Tomomi Okamura, Takafumi Nishizaki, Norio Ikeda, Shigeki Nakano, Takanori Sakakura, Natsumi Fujii, Takeshi Okuda
: The optimal method for diagnosing cochleovestibular neurovascular compression syndrome(CNVC)remains controversial, and the aim of this study is to develop a standard diagnostic instrument for the condition. The clinical features of 53 sides of 50 patients with a combination of vertigo, tinnitus, and/or hearing loss were retrospectively evaluated. The following five clinical features were evaluated and given a score of 1 or 0:1)a long history of recurrent vertigo, tinnitus, or hearing loss;2)neurological findings related to positional vertigo, nystagmus, tinnitus, or hearing loss;3)neuro-otological findings involving tinnitus, audiometry, or vestibular testing;4)auditory brainstem response(ABR)evaluation with the detection of a low 25-75% II wave amplitude on the contralateral side and delayed interpeak latency in the I-III or I-V waves(usually low II wave amplitude combined with double peaks and a wide-based form)during ABR evaluation using 80 and 90dB clicks;and 5)the detection of vascular contact with the eighth cranial nerve on magnetic resonance imaging-constructive interference in steady state or air computed tomography imaging...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28202819/-melas-mitochondrial-encephalomyopathy-lactic-acidosis-and-stroke-like-episodes
#17
Hidetomo Murakami, Kenjiro Ono
Mitochondrial disease is caused by a deficiency in the energy supply to cells due to mitochondrial dysfunction. Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) is a mitochondrial disease that presents with stroke-like episodes such as acute onset of neurological deficits and characteristic imaging findings. Stroke-like episodes in MELAS have the following features: 1) neurological deficits due to localization of lesions in the brain, 2) episodes often accompany epilepsy, 3) lesions do not follow the vascular supply area, 4) lesions are more often seen in the posterior brain than in the anterior brain, 5) lesions spread to an adjacent area in the brain, and 6) neurological symptoms often disappear together with imaging findings, but later relapse...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28202749/endothelial-cell-oligodendrocyte-interactions-in-small-vessel-disease-and-aging
#18
REVIEW
Rikesh M Rajani, Anna Williams
Cerebral small vessel disease (SVD) is a prevalent, neurological disease that significantly increases the risk of stroke and dementia. The main pathological changes are vascular, in the form of lipohyalinosis and arteriosclerosis, and in the white matter (WM), in the form of WM lesions. Despite this, it is unclear to what extent the key cell types involved-the endothelial cells (ECs) of the vasculature and the oligodendrocytes of the WM-interact. Here, we describe the work that has so far been carried out suggesting an interaction between ECs and oligodendrocytes in SVD...
March 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28199998/delayed-intraparenchymal-and-intraventricular-hemorrhage-requiring-surgical-evacuation-after-mri-guided-laser-interstitial-thermal-therapy-for-lesional-epilepsy
#19
Sean M Barber, Luke Tomycz, Timothy George, Dave F Clarke, Mark Lee
BACKGROUND: Symptomatic intracranial hemorrhage is a rare complication of laser interstitial thermal therapy (LITT). OBJECTIVES: To present a unique case of delayed symptomatic intracranial hemorrhage occurring after a LITT procedure for epilepsy in a high-volume center (68 LITT procedures for pediatric epilepsy have been performed). METHODS: An 18-year-old male with epilepsy underwent LITT to an area of heterotopia near the right lateral ventricle...
February 16, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28199045/nasal-juvenile-angiofibroma-current-perspectives-with-emphasis-on-management
#20
Fernando López, Asterios Triantafyllou, Carl H Snyderman, Jennifer L Hunt, Carlos Suárez, Valerie J Lund, Primož Strojan, Nabil F Saba, Iain J Nixon, Kenneth O Devaney, Isam Alobid, Manuel Bernal-Sprekelsen, Ehab Y Hanna, Alessandra Rinaldo, Alfio Ferlito
Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands...
February 15, 2017: Head & Neck
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