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https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#1
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29776790/-modern-treatment-of-mesenteric-ischemia
#2
Alexandre Nuzzo, Audrey Huguet, Olivier Corcos
Acute mesenteric ischemia is a highly morbid affliction which requires urgent care. Acute mesenteric ischemia consists in an ischemia injury of the small bowel, secondary to vascular insufficiency, either occlusive (thrombosis, embolism, arterial, venous) or non-occlusive (low flow or vasospasm). Given that the superior mesenteric artery supplies the small bowel as well as the right part of the colon, any ischemic process involving the right colon should be considered an acute mesenteric ischemia until proven otherwise...
May 15, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29776764/-transient-monocular-blindness-vascular-causes-and-differential-diagnoses
#3
REVIEW
S Bidot, D Biotti
Transient monocular blindness is an acute episode of ischemic origin in which one eye has profound visual loss, followed by full recovery within one hour. Transient monocular blindness most often occurs in the setting of retinal ischemia secondary to carotid embolism, but other mechanisms have been reported, including thrombosis (most often in the setting of giant cell arteritis), hemodynamic disorders (secondary to severe carotid stenosis) or vasospasm. Transient monocular blindness is considered a transient ischemic attack originating in the carotid arteries and must benefit from the same management as transient ischemic attack involving the brain, in order to prevent a subsequent stroke...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29776555/sudden-coronary-death-in-the-young-evidence-of-contractile-phenotype-of-smooth-muscle-cells-in-the-culprit-atherosclerotic-plaque
#4
Stefania Rizzo, Matteo Coen, Antonija Sakic, Monica De Gaspari, Gaetano Thiene, Giulio Gabbiani, Cristina Basso, Marie-Luce Bochaton-Piallat
BACKGROUND: Culprit coronary atherosclerotic plaques (APs) from young sudden cardiac death (SCD) victims are mostly non-atheromatous, i.e., consisting of proliferative smooth muscle cells (SMCs). Coronary vasospasm has been advocated to explain plaque instability in the absence of thrombosis. Our aim was to characterize the SMC phenotype in the intima and media of coronary arteries from young SCD victims. METHODS AND RESULTS: A total of 38 coronary artery segments were studied: (a) 18 APs from young (≤40 years old) SCD patients, (b) 9 APs from old (>40 years old) SCD patients, (c) 11 non-atherosclerotic coronary arteries from young patients (≤40 years old)...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#5
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29770487/inhibitory-effect-of-melatonin-on-necroptosis-via-repressing-the-ripk3-pgam5-cypd-mptp-pathway-attenuates-cardiac-microvascular-ischemia-reperfusion-injury
#6
Hao Zhou, Dandan Li, Pingjun Zhu, Qiang Ma, Toan Sam, Jin Wang, Shunying Hu, Yundai Chen, Yingmei Zhang
The molecular features of necroptosis in cardiac ischemia reperfusion (IR) injury have been extensively explored. However, there have been no studies investigating the physiological regulatory mechanisms of melatonin acting on necroptosis in cardiac IR injury. This study was designed to determine the role of necroptosis in microvascular IR injury, and investigate the contribution of melatonin in repressing necroptosis and preventing IR-mediated endothelial system collapse. Our results demonstrated that Ripk3 was primarily activated by IR injury and consequently aggravated endothelial necroptosis, microvessel barrier dysfunction, capillary hyperpermeability, the inflammation response, microcirculatory vasospasms and microvascular perfusion defects...
May 16, 2018: Journal of Pineal Research
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#7
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29765390/preclinical-evaluation-of-the-nevatm-stent-retriever-safety-and-efficacy-in-the-swine-thrombectomy-model
#8
Arthur J Ulm, Tigran Khachatryan, Arthur Grigorian, Raul G Nogueira
Background: A novel stent retriever device with an enhanced radial force profile, enlarged offset openings, and a closed distal end has been developed. Objective: Evaluate the safety and effectiveness of the NeVaTM thrombectomy device in animal model of thrombo-occlusive disease. Materials and Methods: Seven swine were used in safety and efficacy studies. Thrombo-occlusive disease was modeled using 4 emboli morphologies; 2 distinct models of autologous whole blood thrombi, plasma-enriched thrombi, and Onyx® emboli...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#9
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29760013/severity-of-cerebral-vasospasm-associated-with-development-of-collaterals-following-aneurysmal-subarachnoid-hemorrhage
#10
Fawaz Al-Mufti, Jens Witsch, Nathan Manning, Michael Crimmins, Krishna Amuluru, Sachin Agarwal, Soojin Park, Joshua Z Willey, Hooman Kamel, E Sander Connolly, Philip M Meyers, Jan Claassen
INTRODUCTION: Cerebral collateral circulation has been studied extensively in ischemic stroke where it has been shown to be a predictor of reperfusion, final infarct size, and outcome. Little is known about the significance of the collaterals in the setting of aneurysmal subarachnoid hemorrhage (aSAH). We sought to evaluate the effect of cerebral vasospasm on the development of cerebral collaterals following aneurysmal subarachnoid hemorrhage and the effects of the latter on delayed cerebral ischemia (DCI)...
May 14, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29753899/co-adjuvant-treatment-of-vasospasm-in-ruptured-unsecured-cerebral-aneurysms-with-aggressive-angioplasty-intra-arterial-nimodipine-and-aneurysm-embolization
#11
Ching-Chang Chen, Alvin Yi-Chou Wang, Chun-Ting Chen, Po-Chuan Hsieh
BACKGROUND: Vasospasm is a major cause of morbidity and mortality in patients following aneurysmal subarachnoid hemorrhage (SAH). Although early treatment of ruptured aneurysms is advocated, delayed intervention complicates the treatment strategy and leading to significant vasospasm and a poor prognosis. We report our experience of endovascular protocol for occlusion of the unsecured aneurysm and angioplasty for vasospasm in a single session. METHODS: A total of 24 cases with significant vasospasm and unsecured ruptured cerebral aneurysm were reviewed among 660 aneurysmal SAH patients between January 2011 and May 2017...
May 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29749915/continuous-infusion-of-low-dose-unfractionated-heparin-after-aneurysmal-subarachnoid-hemorrhage-a-preliminary-study-of-cognitive-outcomes
#12
Robert F James, Nicolas K Khattar, Zaid S Aljuboori, Paul S Page, Elaine Y Shao, Lacey M Carter, Kimberly S Meyer, Michael W Daniels, John Craycroft, John R Gaughen, M Imran Chaudry, Shesh N Rai, D Erik Everhart, J Marc Simard
OBJECTIVE Cognitive dysfunction occurs in up to 70% of aneurysmal subarachnoid hemorrhage (aSAH) survivors. Low-dose intravenous heparin (LDIVH) infusion using the Maryland protocol was recently shown to reduce clinical vasospasm and vasospasm-related infarction. In this study, the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive changes in aSAH patients treated with the Maryland LDIVH protocol compared with controls. METHODS A retrospective analysis of all patients treated for aSAH between July 2009 and April 2014 was conducted...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29742711/pituitary-apoplexy-following-lumbar-fusion-surgery-in-prone-position-a-case-report
#13
Chunghee Joo, Geol Ha, Yeon Jang
RATIONALE: Pituitary apoplexy (PA) is a syndrome caused by acute hemorrhage or infarction of the pituitary gland, generally within a pituitary adenoma. PA following spinal surgery is a very rare complication and may be difficult to diagnose. However, early diagnosis of PA is essential for the timely treatment of pan-hypopituitarism and prevention of severe neurologic complications. PATIENT CONCERNS: A 73-year-old man had a posterior lumbar fusion surgery over a period of 8 hours on prone position...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29735721/relation-of-rhoa-in-peripheral-blood-mononuclear-cells-with-severity-of-aneurysmal-subarachnoid-hemorrhage-and-vasospasm
#14
María Del Carmen González-Montelongo, Juan José Egea-Guerrero, Francisco Murillo-Cabezas, Rafaela González-Montelongo, Zaida Ruiz de Azúa-López, Ana Rodríguez-Rodríguez, Angel Vilches-Arenas, Antonio Castellano, Juan Ureña
BACKGROUND AND PURPOSE: Rho-kinase, an effector of RhoA, is associated with various cardiovascular diseases in circulating blood cells. However, the role of RhoA/Rho-kinase in peripheral blood mononuclear cells from patients with spontaneous aneurysmal subarachnoid hemorrhage (aSAH) has not yet been studied in relation to the severity of this disease. Therefore, we analyzed the expression and activity of RhoA as a possible biomarker in aSAH. METHODS: Twenty-four patients with aSAH and 15 healthy subjects were examined...
May 7, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29735411/vasospastic-myocardial-infarction-complicated-with-bilateral-femoral-arteries-vasospasm
#15
Chengzhi Gao, Huapeng Yu, Daixu Li, Qiang Liu
Coronary vasospasm is an infrequent cause of acute coronary syndrome. Additionally, femoral artery spasm is not frequently encountered clinically. Here we present a case of a patient with an acute ST segment elevation myocardial infarction, secondary to a documented right coronary artery vasospasm, complicated with left coronary artery and femoral artery vasospasm. Intravenous ultrasound showed calcification at the sites of spasm. This case report indicates that coronary vasospasm should be regularly considered as part of the work up of myocardial infarction...
April 17, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#16
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29730271/intraventricular-extension-of-an-aneurysmal-subarachnoid-hemorrhage-is-an-independent-predictor-of-a-worse-functional-outcome
#17
Mario Zanaty, Daichi Nakagawa, Robert M Starke, Enrique C Leira, Edgar A Samaniego, Waldo R Guerrero, James Torner, Yasunori Nagahama, Olatilewa Awe, Jeremy Greenlee, Joseph S Hudson, Lauren Allan, Reem Elwy, Nohra Chalouhi, Pascal Jabbour, Royce Woodroffe, Anthony Piscopo, David Hasan
OBJECTIVE: The objective of this study is to determine the impact of intraventricular hemorrhage (IVH) on the cognitive prognosis of subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysm, independent of the presence of intraparenchymal hemorrhage, hydrocephalus or vasospasm. PATIENT AND METHODS: A Retrospective review of a prospectively collected database of patients with aneurysmal SAH from July 2009 to November 2016 was performed. Patients were included if they had a saccular aneurysm with a Hunt-Hess grade (HHG) 1-3...
April 30, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29726784/association-of-copeptin-a-surrogate-marker-of-arginine-vasopressin-with-cerebral-vasospasm-and-delayed-ischemic-neurologic-deficit-after-aneurysmal-subarachnoid-hemorrhage
#18
Sandra J Fernandez, Ibraham Barakat, James Ziogas, Tony Frugier, Stanley S Stylli, John D Laidlaw, Andrew H Kaye, Alexios A Adamides
OBJECTIVE Delayed ischemic neurological deficit (DIND) is a leading cause of mortality and morbidity after aneurysmal subarachnoid hemorrhage (aSAH). Arginine vasopressin (AVP) is a hormone released by the posterior pituitary. It is known to cause cerebral vasoconstriction and has been implicated in hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion. Direct measurement of AVP is limited by its short half-life. Copeptin, a cleavage product of the AVP precursor protein, was therefore used as a surrogate marker for AVP...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29725664/successful-use-of-continuous-vasodilator-infusion-to-treat-critical-vasospasm-threatening-a-distal-bypass
#19
Gregory A Magee, Anastasia Plotkin, Jeniann A Yi, Kathryn E Bowser, David P Kuwayama
Vasospasm immediately after lower extremity arterial bypass may represent an uncommon cause of early graft failure. We report a successful case of catheter-directed, intra-arterial continuous vasodilator infusion to salvage a bypass graft threatened by severe, refractory vasospasm after incomplete response to nicardipine, verapamil, and nitroglycerin boluses. A continuous nitroglycerin infusion was administered for 24 hours, by which time the vasospasm resolved. At 12 months postoperatively, the graft remained patent with normal results of vascular laboratory studies...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29719553/47-consecutive-cases-of-pipeline-flex-flow-diversion-utilizing-a-novel-large-bore-intracranial-intermediate-catheter-nuances-and-institutional-experience-with-the-syphontrak
#20
Li-Mei Lin, Bowen Jiang, Matthew T Bender, Erick M Westbroek, Jessica K Campos, Rafael J Tamargo, Judy Huang, Alexander L Coon, Geoffrey P Colby
Background: The increasing complexity of modern neurointerventions has necessitated a shift in intracranial access techniques towards more robust distal support platforms. Here we present our experience with the Syphontrak Support Catheter (Codman Neuro, Raynham, MA, USA) in the triaxial platform for the implantation of the second-generation Pipeline Flex embolization device (PED Flex; Medtronic Neurovascular, Irvine, CA, USA). Methods: We retrospectively identified patients who underwent PED Flex treatment utilizing the Syphontrak at a single institution...
April 2018: Interventional Neurology
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