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stroke inflammation intracranial hemorrhage

Gaurav Saigal, Natalya Nagornaya, M Judith D Post
Imaging is useful in the diagnosis and management of infections of the central nervous system. Typically, imaging findings at the outset of the disease are subtle and nonspecific, but they often evolve to more definite imaging patterns in a few days, with less rapidity than for stroke but faster than for neoplastic lesions. This timing is similar to that of noninfectious inflammatory brain disease, such as multiple sclerosis. Fortunately, imaging patterns help to distinguish the two kinds of processes. Other than for sarcoidosis, the meninges are seldom involved in noninfectious inflammation; in contrast, many infectious processes involve the meninges, which then enhance with contrast on computed tomography (CT) or magnetic resonance imaging (MRI)...
2016: Handbook of Clinical Neurology
Melanie Dittmeier, Kathrin Wassmuth, Michael K Schuhmann, Peter Kraft, Christoph Kleinschnitz, Felix Fluri
Dabigatran etexilate (DE), a direct-acting, oral inhibitor of thrombin, significantly reduces the risk of stroke compared with traditional anticoagulants, without increasing the risk of major bleeding. However, studies on the fate of cerebral tissue after ischemic stroke in patients receiving DE are sparse and the role of dabigatran-mediated reduction of thrombin in this context has not yet been investigated. Here, we investigated whether pretreatment with DE reduces thrombin-mediated pro-inflammatory mechanisms and leakage of the blood-brain barrier (BBB) following ischemic stroke in rats...
2016: Current Neurovascular Research
Haiping Zheng, Chunli Chen, Jie Zhang, Zhiping Hu
BACKGROUND: Intracerebral hemorrhage (ICH) is a subtype of stroke with a severe high mortality and disability rate and accounts for about 10-15% of all strokes. The oppression and destruction by hematoma to brain tissue cause the primary brain injury. The inflammation and coagulation response after ICH would accelerate the formation of brain edema around hematoma, resulting in a more severe and durable injury. Currently, treatments for ICH are focusing on the primary injury including reducing intracranial hypertension, blood pressure control, and rehabilitation...
2016: Cerebrovascular Diseases
Maurizio Acampa, Pietro Enea Lazzerini, Francesca Guideri, Rossana Tassi, Giuseppe Martini
Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder...
May 2016: Journal of Stroke
Anastasia Orlova Lorentzen, Terje Nome, Søren Jacob Bakke, David Scheie, Vidar Stenset, Anne Hege Aamodt
Flow diverter stents are new important tools in the treatment of large, giant, or wide-necked aneurysms. Their delivery and positioning may be difficult due to vessel tortuosity. Common adverse events include intracranial hemorrhage and ischemic stroke, which usually occurs within the same day, or the next few days after the procedure. We present a case where we encountered an unusual intracerebral complication several months after endovascular treatment of a large left internal carotid artery aneurysm, and where brain biopsy revealed foreign body reaction to hydrophilic polymer fragments distally to the stent site...
February 2016: Interventional Neuroradiology
Hamza M Pasha, David M Mirsky, Sven O Streubel
Cerebral artery infarction as a complication of acute otitis media is a rare complication. The mechanism appears to be the spread of meningeal inflammation to involve the walls of intracranial vessels, resulting in arterial thrombosis with ischemia or rupture with hemorrhage. We report the case of a 3 year old female with a history of global developmental delay who sustained a large left hemispheric stroke after middle cerebral artery infarction as a complication of an acute otitis media.
October 2015: International Journal of Pediatric Otorhinolaryngology
Daniel Agustin Godoy, Gustavo Rene Piñero, Patricia Koller, Luca Masotti, Mario Di Napoli
Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurological-neurosurgical emergency...
August 4, 2015: World Journal of Critical Care Medicine
Howard S Kirshner, Michael Bradshaw
Cerebral amyloid angiopathy-related inflammation (CAARI) is a recently recognized syndrome of reversible encephalopathy seen in a subset of patients with cerebral amyloid angiopathy (CAA). CAA is a disorder of the elderly in which amyloid peptides are deposited in the walls of cerebral arteries, leading to microhemorrhages, macrohemorrhages, and eventually dementia. In a few cases, the amyloid deposition is accompanied by inflammation or edema. The clinical syndrome of CAARI is distinguished by subacute neurobehavioral symptoms, headaches, seizures, and stroke-like signs, contrasting the acute intracranial hemorrhage typically seen in CAA...
August 2015: Current Neurology and Neuroscience Reports
Ran Meng, Yuchuan Ding, Karam Asmaro, David Brogan, Lu Meng, Meng Sui, Jingfei Shi, Yunxia Duan, Zhishan Sun, Yang Yu, Jianping Jia, Xunming Ji
UNLABELLED: Symptomatic intracranial arterial stenosis (SIAS) is very common in octo- and nonagenarians, especially in the Chinese population, and is likely the most common cause of stroke recurrence worldwide. Clinical trials demonstrate that endovascular treatment, such as stenting, may not be suitable for octogenarians with systemic diseases. Hence, less invasive methods for the octogenarian patients are urgently needed. Our previous study (unique identifier: NCT01321749) showed that repetitive bilateral arm ischemic preconditioning (BAIPC) reduced the incidence of stroke recurrence by improving cerebral perfusion (confirmed by single photon emission computed tomography and transcranial Doppler sonography) in patients younger than 80 years of age; however, the safety and effectiveness of BAIPC on stroke prevention in octo- and nonagenarians with SIAS are still unclear...
July 2015: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Damon Klebe, Devin McBride, Jerry J Flores, John H Zhang, Jiping Tang
Cerebral hemorrhages account for 15-20 % of stroke sub-types and have very poor prognoses. The mortality rate for cerebral hemorrhage patients is between 40 and 50 %, of which at least half of the deaths occur within the first 2 days, and 75 % of survivors are incapable of living independently after 1 year. Current emergency interventions involve lowering blood pressure and reducing intracranial pressure by controlled ventilations or, in the worst case scenarios, surgical intervention. Some hemostatic and coagulatherapeutic interventions are being investigated, although a few that were promising in experimental studies have failed in clinical trials...
December 2015: Journal of Neuroimmune Pharmacology: the Official Journal of the Society on NeuroImmune Pharmacology
Xiang Fan, Yinghua Jiang, Zhanyang Yu, Jing Yuan, Xiaochuan Sun, Shuanglin Xiang, Eng H Lo, Xiaoying Wang
To date, tissue type plasminogen activator (tPA)-based thrombolytic stroke therapy is the only FDA-approved treatment for achieving vascular reperfusion and clinical benefit, but this agent is given to only about 5% of stroke patients in the USA. This may be related, in part, to the elevated risk of symptomatic intracranial hemorrhage, and consequently limited therapeutic time window. Clinical investigations demonstrate that poststroke hyperglycemia is one of the most important risk factors that cause intracerebral hemorrhage and worsen neurological outcomes...
2014: Advances in Pharmacology
Sitara Roy, Satrupa Das, Anjana Munshi, Subhash Kaul, Akka Jyothy
BACKGROUND: CCL11 (Eotaxin-1) is an important inflammatory cytokine belonging to the CC family of chemokines associated with a number of infection or inflammation-related diseases such as atherosclerosis and stroke. We investigated the association of CCL11 gene polymorphism rs4795895-1382A>G with ischemic and hemorrhagic stroke. MATERIALS AND METHODS: Six hundred and twenty ischemic stroke patients, 620 age- and sex-matched healthy controls, and 220 hemorrhagic stroke patients, 220 age- and sex-matched healthy controls were included in the present study...
July 2014: Neurology India
Fanxia Shen, Vincent Degos, Pei-Lun Chu, Zhenying Han, Erick M Westbroek, Eun-Jung Choi, Douglas Marchuk, Helen Kim, Michael T Lawton, Mervyn Maze, William L Young, Hua Su
BACKGROUND AND PURPOSE: Endoglin deficiency causes hereditary hemorrhagic telangiectasia-1 and impairs myocardial repair. Pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia-1 are associated with a high incidence of paradoxical embolism in the cerebral circulation and ischemic brain injury. We hypothesized that endoglin deficiency impairs stroke recovery. METHODS: Eng heterozygous (Eng+/-) and wild-type mice underwent permanent distal middle cerebral artery occlusion (pMCAO)...
July 2014: Stroke; a Journal of Cerebral Circulation
Sandy Zuleica Navas-Marrugo, Hernando Raphael Alvis-Miranda, Luis Rafael Moscote-Salazar
Spontaneous cerebral hemorrhage or intracranial hemorrhage represents between 10 and 15% of all cerebrovascular events. Intracerebral hemorrhage is far less frequent than ischemic stroke, but leads to increased morbidity and mortality, one of the leading causes of severe disability. Several changes have been identified in the field of intracerebral hemorrhage, including endocrine. These stress-mediated mechanisms exacerbate secondary injury. Deep knowledge of the injuries that are directly involved in the alterations of glucose in the context of an intracerebral hemorrhage, offers a vision of how the cytotoxicity, neuronal death and metabolic disturbances alter the prognosis of patients with spontaneous intracerebral hemorrhage...
2014: Boletín de la Asociación Médica de Puerto Rico
Qing Zhou, Dan Yang, Amanda K Ombrello, Andrey V Zavialov, Camilo Toro, Anton V Zavialov, Deborah L Stone, Jae Jin Chae, Sergio D Rosenzweig, Kevin Bishop, Karyl S Barron, Hye Sun Kuehn, Patrycja Hoffmann, Alejandra Negro, Wanxia L Tsai, Edward W Cowen, Wuhong Pei, Joshua D Milner, Christopher Silvin, Theo Heller, David T Chin, Nicholas J Patronas, John S Barber, Chyi-Chia R Lee, Geryl M Wood, Alexander Ling, Susan J Kelly, David E Kleiner, James C Mullikin, Nancy J Ganson, Heidi H Kong, Sophie Hambleton, Fabio Candotti, Martha M Quezado, Katherine R Calvo, Hawwa Alao, Beverly K Barham, Anne Jones, James F Meschia, Bradford B Worrall, Scott E Kasner, Stephen S Rich, Raphaela Goldbach-Mansky, Mario Abinun, Elizabeth Chalom, Alisa C Gotte, Marilynn Punaro, Virginia Pascual, James W Verbsky, Troy R Torgerson, Nora G Singer, Timothy R Gershon, Seza Ozen, Omer Karadag, Thomas A Fleisher, Elaine F Remmers, Shawn M Burgess, Susan L Moir, Massimo Gadina, Raman Sood, Michael S Hershfield, Manfred Boehm, Daniel L Kastner, Ivona Aksentijevich
BACKGROUND: We observed a syndrome of intermittent fevers, early-onset lacunar strokes and other neurovascular manifestations, livedoid rash, hepatosplenomegaly, and systemic vasculopathy in three unrelated patients. We suspected a genetic cause because the disorder presented in early childhood. METHODS: We performed whole-exome sequencing in the initial three patients and their unaffected parents and candidate-gene sequencing in three patients with a similar phenotype, as well as two young siblings with polyarteritis nodosa and one patient with small-vessel vasculitis...
March 6, 2014: New England Journal of Medicine
Fred Rincon, Stephan A Mayer
Intracerebral hemorrhage is by far the most destructive form of stroke. Apart from the management in a specialized stroke or neurological intensive care unit (NICU), no specific therapies have been shown to consistently improve outcomes after ICH. Current guidelines endorse early aggressive optimization of physiologic derangements with ventilatory support when indicated, blood pressure control, reversal of any preexisting coagulopathy, intracranial pressure monitoring for certain cases, osmotherapy, temperature modulation, seizure prophylaxis, treatment of hyerglycemia, and nutritional support in the stroke unit or NICU...
July 2012: Translational Stroke Research
Masahito Yamada
Cerebral amyloid angiopathy (CAA) is cerebrovascular amyloid deposition. It is classified into several types according to the cerebrovascular amyloid proteins involved. Sporadic amyloid β-protein (Aβ)-type CAA is commonly found in elderly individuals and patients with Alzheimer disease. CAA-related disorders include hemorrhagic and ischemic stroke and dementia. CAA-related hemorrhages include intracerebral lobar macrohemorrhages, cortical microhemorrhages, and focal subarachnoidal hemorrhages/superficial siderosis...
November 2013: Seminars in Thrombosis and Hemostasis
Juergen Konczalla, Stefan Wanderer, Jan Mrosek, Patrick Schuss, Johannes Platz, Erdem Güresir, Volker Seifert, Hartmut Vatter
Investigations have shown a multifactorial process as cause for the poor outcome after subarachnoid hemorrhage (SAH), including inflammation, early brain injury, cortical spreading depression, lack of cerebral autoregulation and the cerebral vasospasm (CVS) itself. Losartan may have a beneficial effect after SAH - preventing CVS, restoring cerebral autoregulation, reducing inflammation and early brain injury. Also some data is available for an AT1-receptor-upregulation and upregulated gene expression after subarachnoid hemorrhage, but the functional role of angiotensin on the cerebrovascular contractility is still not completely understood...
November 2013: Current Neurovascular Research
Maxime Gauberti, Axel Montagne, Oscar A Marcos-Contreras, Audrey Le Béhot, Eric Maubert, Denis Vivien
BACKGROUND AND PURPOSE: Our aim was to assess the spatiotemporal evolution of the cerebrovascular inflammation occurring after ischemic and hemorrhagic strokes using a recently developed, fast, and ultra-sensitive molecular MRI method. METHODS: We first assessed longitudinally the cerebrovascular inflammation triggered by collagenase-induced hemorrhage and by permanent/transient middle cerebral artery occlusion in mice, using MRI after injection of microparticles of iron oxide targeted to vascular cell adhesion molecule-1 (MPIOs-αVCAM-1)...
July 2013: Stroke; a Journal of Cerebral Circulation
S V Komissarova, I P Dubrovin, S A Turygin, A A Pal'tsyn, V M Baranov, A A Kubatiev
A hemorrhagic stroke model that provides the long-term presence of test materials in the focus has been constructed. A lesion is induced in the motor cerebral cortical region. The lesion location and locomotor dysfunction are reproducible. The presence of platelets in the focus reduces the extent and volume of hemorrhages, increases the number and diameter of newly formed vessels, and attracts a macrophage population not found in the control, which is identified from green granules and perivascular location...
November 2012: Arkhiv Patologii
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