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Vascular neurology

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https://www.readbyqxmd.com/read/28106525/open-and-endovascular-treatment-of-spinal-dural-arteriovenous-fistulas-a-10-year-experience
#1
Matthew J Koch, Christopher J Stapleton, Pankaj K Agarwalla, Collin Torok, John H Shin, Jean-Valery Coumans, Lawrence F Borges, Christopher S Ogilvy, James D Rabinov, Aman B Patel
OBJECTIVE Vascular malformations of the spine represent rare clinical entities with profound neurological implications. Previously reported studies on management strategies for spinal dural arteriovenous fistulas (sDAVFs) appeared before the advent of modern liquid embolic agents. Authors of the present study review their institutional experience with endovascularly and surgically treated sDAVFs. METHODS The authors performed a retrospective, observational, single-center case series on sDAVFs treated with endovascular embolization, microsurgical occlusion, or both between 2004 and 2013...
January 20, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#2
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28105635/dental-and-extra-oral-clinical-features-in-41-patients-with-wnt10a-gene-mutations-a-multicentric-genotype-phenotype-study
#3
C Tardieu, S Jung, K Niederreither, M Prasad, S Hadj-Rabia, N Philip, A Mallet, E Consolino, E Sfeir, B Noueiri, N Chassaing, H Dollfus, M-C Manière, A Bloch-Zupan, F Clauss
WNT10A gene encodes a canonical wingless pathway signaling molecule involved in cell fate specification as well as morphogenetic patterning of the developing ectoderm, nervous system, skeleton, and tooth. In patients, WNT10A mutations are responsible for ectodermal-derived pathologies including isolated hypo-oligodontia, tricho-odonto-onycho-dermal dysplasia (TOODD) and Schöpf-Schulz-Passarge Syndrome (SSPS). Here we describe the dental, ectodermal, and extra-ectodermal phenotypic features of a cohort of 41 patients from 32 unrelated families...
January 20, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28104525/regional-spinal-cord-atrophy-is-associated-with-poor-outcome-after-surgery-on-intramedullary-spinal-cord-ependymoma-a-new-aspect-of-delayed-neurological-deterioration
#4
Bedjan Behmanesh, Florian Gessler, Johanna Quick-Weller, Andrea Spyrantis, Lioba Imöhl, Volker Seifert, Gerhard Marquardt
BACKGROUND: A considerable number of patients suffer delayed neurological deficits even after a successful removal of intramedullary spinal cord ependymoma. The underlying pathology remains unknown. Radiological findings could be an explanation for poor outcome after surgery. METHODS: We conducted a retrospective study of all cases treated from 1980 to 2016 in our department. Included were all patients with intramedullary spinal cord ependymoma treated with microsurgical excision...
January 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28102862/mutation-spectrum-in-the-abcc6-gene-and-genotype-phenotype-correlations-in-a-french-cohort-with-pseudoxanthoma-elasticum
#5
Anne Legrand, Laurence Cornez, Wafa Samkari, Jean-Michael Mazzella, Annabelle Venisse, Valérie Boccio, Karine Auribault, Boris Keren, Karelle Benistan, Dominique P Germain, Michael Frank, Xavier Jeunemaitre, Juliette Albuisson
PURPOSE: Pseudoxanthoma elasticum (PXE) is an autosomal recessive disorder caused by variants in the ABCC6 gene. Ectopic mineralization of connective tissues leads to skin, eye, and cardiovascular manifestations with considerable phenotypic variability of unknown cause. We aimed to identify genotype-phenotype correlations in PXE. METHODS: A molecular analysis was performed on 458 French PXE probands clinically evaluated using the Phenodex score (PS). Variant topographic analysis and genotype-phenotype correlation analysis were performed according to the number and type of identified variants...
January 19, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28101763/mir-126-affects-brain-heart-interaction-after-cerebral-ischemic-stroke
#6
Jieli Chen, Chengcheng Cui, Xiaoping Yang, Jiang Xu, Poornima Venkat, Alex Zacharek, Peng Yu, Michael Chopp
Cardiovascular diseases are approximately three times higher in patients with neurological deficits than in patients without neurological deficits. MicroRNA-126 (MiR-126) facilitates vascular remodeling and decreases fibrosis and is emerging as an important factor in the pathogenesis of cardiovascular diseases and cerebral stroke. In this study, we tested the hypothesis that decreased miR-126 after ischemic stroke may play an important role in regulating cardiac function. Wild-type (WT), specific conditional-knockout endothelial cell miR-126 (miR-126(EC-/-)), and miR-126 knockout control (miR-126(fl/fl)) mice were subjected to distal middle cerebral artery occlusion (dMCAo) (n = 10/group)...
January 19, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28101529/cortico-cortical-connections-of-primary-sensory-areas-and-associated-symptoms-in-migraine
#7
Duncan J Hodkinson, Rosanna Veggeberg, Aaron Kucyi, Koene R A van Dijk, Sophie L Wilcox, Steven J Scrivani, Rami Burstein, Lino Becerra, David Borsook
Migraine is a recurring, episodic neurological disorder characterized by headache, nausea, vomiting, and sensory disturbances. These events are thought to arise from the activation and sensitization of neurons along the trigemino-vascular pathway. From animal studies, it is known that thalamocortical projections play an important role in the transmission of nociceptive signals from the meninges to the cortex. However, little is currently known about the potential involvement of cortico-cortical feedback projections from higher-order multisensory areas and/or feedforward projections from principle primary sensory areas or subcortical structures...
November 2016: ENeuro
https://www.readbyqxmd.com/read/28100097/spina-bifida-and-lower-limb-amputation-in-northern-ireland-a-retrospective-study-of-demographics-and-outcome
#8
Lorraine Graham
BACKGROUND: Spina bifida is an uncommon cause for lower limb amputation. The causes and level of amputation and mobility outcome for these patients have not been reported previously. CASE DESCRIPTION: To identify the causes and level of amputation and the mobility outcome for amputee patients with spina bifida. STUDY DESIGN: Retrospective case series. METHODS: Chart review of patients identified by computer as having an amputation secondary to neurological or congenital cause...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28099983/-the-relevance-of-abducent-nerve-palsy-in-ent
#9
Veit Maria Hofmann, Stephan M Niehues, Annett Pudszuhn
Patients suffering from abducent nerve palsy are usually primary seen by a conservative medical Specialist. In most cases the ENT specialist is secondary involved for treatment. In the majority of cases abducent nerve palsy is a temporary symptom associated with neurologic or vascular diseases. Rarely inflammation, neoplasm or fracture of the skull base cause this symptom and lead to an intervention done by the ENT surgeon. This case series describes retrospectively the abducent palsy seen through the eyes of an ENT surgeon...
January 18, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28097183/local-anesthesia-for-percutaneous-thoracic-endovascular-aortic-repair
#10
Martijn van Dorp, Martijn Gilbers, Patrick Lauwers, Paul E Van Schil, Jeroen M H Hendriks
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) requires large-bore vascular access due to the considerable diameters of the endoprosthesis and delivery device. The preclose technique preceding endograft delivery has opened the door for an evolved access strategy. In addition, treatment under local anesthesia offers the advantage of optimal neuromonitoring. The goal of this study was to analyze the efficacy and safety of percutaneous TEVAR under local anesthesia. METHODS: All patients undergoing TEVAR in an elective setting at the Antwerp University Hospital between June 2012 and June 2015 were prospectively entered into an endovascular database...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28094088/usefulness-of-multiparametric-computerized-tomography-findings-in-the-differential-diagnosis-of-stroke-mimics-of-epileptic-origin-a-preliminary-study
#11
R López Ruiz, S Quintas, P Largo, M de Toledo, M T Carreras, A Gago-Veiga, R Manzanares, J Vivancos
OBJECTIVE: Thirty percent of the patients for whom code stroke is activated have stroke mimics, the most common being epilepsy. Our purpose was to evaluate the usefulness of multiparametric CT for differentiating between seizure-related symptoms and vascular events. MATERIAL AND METHODS: We conducted a retrospective observational study; data were gathered prospectively during one year. We studied multiparametric CT images of patients admitted following code stroke activation and finally diagnosed with epilepsy...
January 13, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#12
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28093478/long-non-coding-rna-malat1-regulates-cerebrovascular-pathologies-in-ischemic-stroke
#13
Xuejing Zhang, Xuelian Tang, Kai Liu, Milton H Hamblin, Ke-Jie Yin
: The study is designed to determine the role of long non-coding RNA (lncRNA), metastasis associated lung adenocarcinoma transcript 1 (Malat1), in ischemic stroke outcome. Primary mouse brain microvascular endothelial cells (BMECs) were cultured and treated with Malat1 GapmeR prior to 16h oxygen and glucose depravation (OGD). Cell death was assayed by LDH and MTT methods. Malat1 knockout and wildtype mice were subjected to 1h of middle cerebral artery occlusion (MCAO) and 24-72h of reperfusion...
January 16, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#14
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28089809/sensitivity-and-specificity-of-intraoperative-neuromonitoring-for-identifying-safety-and-duration-of-temporary-aneurysm-clipping-based-on-vascular-territory-a-multimodal-strategy
#15
Brittany Staarmann, Kelly O'Neal, Mark Magner, Mario Zuccarello
BACKGROUND: Patients who undergo clipping of cerebral aneurysms face inherent risk for new postoperative neurological deficits. Intraoperative neuromonitoring (IONM) is used often for early detection of ischemic changes, while still potentially reversible. However, the value, safety, and efficacy of temporary clipping and multimodal intraoperative neuromonitoring (IONM) to minimize risks are debated. Our retrospective series examined the sensitivity and specificity of IONM using transcranial motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs), and quantified the safety of temporary clipping by duration and vascular territory...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089423/crossed-cheiro-oral-syndrome-a-warning-sign-for-medullary-involvement-and-neurological-deterioration
#16
Wei-Hsi Chen, Tsung-Pei Yang, Hsin-Ling Yin
Crossed cheiro-oral syndrome (CCOS) is characterized by crossed sensory disturbance confined to the unilateral perioral area and contralateral hand/finger(s). Although a few classical crossed sensory syndromes accurately predict brainstem or spinal involvement, the clinical significance of CCOS remains unclear. In this study, we analyzed the etiology, localization and outcome of CCOS patients. The results showed that ischemic stroke is the exclusive cause of CCOS. The location of responsible stroke is pertinent to the middle or upper level of the lateral medulla oblongata medial to the lateral sulcus...
January 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28088802/interplay-between-cortical-spreading-depolarization-and-seizures
#17
Daniel R Kramer, Tatsuhiro Fujii, Ifije Ohiorhenuan, Charles Y Liu
Cortical spreading depolarization (CSD) is an electrophysiologic phenomenon found mostly in the setting of neurologic injury resulting in the disturbance of ion homeostasis and leading to changes in the local vascular response. The bioelectric etiology of CSD shares similarities to those in epileptic disorders, yet the relationship between seizures and CSD is unclear, with several studies observing cortical depression before, during, and after seizure activity, thus obscuring our understanding of whether CSD activity potentiates or limits seizures and vice versa...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28087172/endothelial-function-impairment-in-stemi-patients-with-out-of-hospital-cardiac-arrest-under-therapeutic-hypothermia-treatment
#18
Salvatore Brugaletta, Giancarla Scalone, Ana Paula Dantas, Luis Ortega-Paz, Manel Garabito, Mercè Roqué, Victoria Martin, Monica Masotti, Xavier Freixa, Manel Sabaté
BACKGROUND: Therapeutic hypothermia (HT) in out-of-hospital cardiac arrest STEMI patients aims to improve their neurological prognosis, but it has been associated with slow coronary flow and cardiac thrombotic events. We sought to serially assess endothelial function during the first 48h after admission in out-of-hospital cardiac arrest STEMI patients, under therapeutic hypothermia (HT). METHODS: From January 2015 to August 2015, eighteen consecutive out-of-hospital cardiac arrest STEMI patients eligible for primary PCI received HT at admission and were included in the study (HT group)...
January 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28074775/axillary-artery-transection-and-bilateral-pulmonary-embolism-after-anterior-shoulder-dislocation-case-report
#19
Betty Leclerc, François Loisel, Maxime Ferrier, Mazen Al Sayed, Simon Rinckenbach, Laurent Obert
INTRODUCTION: Anterior shoulder dislocation can be associated with vascular and neurological complications. However, axillary artery injury associated with shoulder dislocation is rare and extremely rare without bone fracture. An early diagnosis of these complications allows predicting long-term functional outcomes. METHODS: This article reports the case of a 66-year-old patient who presented an anterior shoulder dislocation after a ski fall without any neurological dysfunction or pulse deficit...
2017: SICOT-J
https://www.readbyqxmd.com/read/28070115/proposal-for-a-prospective-registry-for-moyamoya-disease-in-japan
#20
Ken Kazumata, Masaki Ito, Haruto Uchino, Hiroshi Nishihara, Kiyohiro Houkin
The number of clinical research papers published worldwide on moyamoya disease (MMD) has increased recently. However, the majority of the literature comprises retrospective single-center studies collecting data on small numbers of patients. Several multi-center studies are ongoing in Japan; however, the current data are insufficient for comprehensively outlining the various characteristics of MMD. To enhance our knowledge on epidemiologic, vascular, and genetic aspects of MMD, a prospective multicenter registry will be established in Japan that will help to streamline clinical research as well as improve clinical treatments and long-term outcomes...
January 6, 2017: Neurologia Medico-chirurgica
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