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Stroke Perfusion

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https://www.readbyqxmd.com/read/27919792/the-role-of-posturography-in-assessing-the-process-of-rehabilitation-in-poststroke-patients-a-case-study
#1
Witold Rongies, Bartosz Słomka, Angelika Duczek, Włodzimierz Dolecki
Stroke is one of the most common causes of death and disability both in Poland and around the world. Each year, 250 out of 100,000 people in Europe are diagnosed with a disruption of cerebral perfusion in the form of stroke. In Poland, approximately 65,000-70,000 people are affected each year, with the incidence steadily increasing. Stroke survivors suffer from impaired cognitive and motor functions. Moreover, they exhibit severe gait pattern abnormalities, which together with balance disorders, constitute the main factors increasing the risk of falls in this patient group...
December 2, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27917312/a-4d-ct-digital-phantom-of-an-individual-human-brain-for-perfusion-analysis
#2
Rashindra Manniesing, Christoph Brune, Bram van Ginneken, Mathias Prokop
Brain perfusion is of key importance to assess brain function. Modern CT scanners can acquire perfusion maps of the cerebral parenchyma in vivo at submillimeter resolution. These perfusion maps give insights into the hemodynamics of the cerebral parenchyma and are critical for example for treatment decisions in acute stroke. However, the relations between acquisition parameters, tissue attenuation curves, and perfusion values are still poorly understood and cannot be unraveled by studies involving humans because of ethical concerns...
2016: PeerJ
https://www.readbyqxmd.com/read/27909476/atrial-fibrillation-and-risk-of-dementia-cognitive-decline
#3
REVIEW
Anand D Shah Md, Faisal M Merchant Md, David B Delurgio Md
Emerging evidence suggests a link between atrial fibrillation and subsequent development of dementia. While a majority of risk can be attributed to cardioembolic stroke secondary to atrial fibrillation, additional risk is apparent, and may be driven by vascular inflammation and changes in cerebral perfusion. Medical therapies including anticoagulation, statin therapy, and angiotensin-renin-aldosterone axis antagonists may reduce dementia risk. Procedural therapies such as atrial fibrillation catheter ablation and left atrial appendage closure may also prove to be important mediators of acute and long-term risk...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909265/prevention-of-the-collapse-of-pial-collaterals-by-remote-ischemic-perconditioning-during-acute-ischemic-stroke
#4
Junqiang Ma, Yonglie Ma, Bin Dong, Mischa V Bandet, Ashfaq Shuaib, Ian R Winship
Collateral circulation is a key variable determining prognosis and response to recanalization therapy during acute ischemic stroke. Remote ischemic perconditioning (RIPerC) involves inducing peripheral ischemia (typically in the limbs) during stroke and may reduce perfusion deficits and brain damage due to cerebral ischemia. In this study, we directly investigated pial collateral flow augmentation due to RIPerC during distal middle cerebral artery occlusion (MCAo) in rats. Blood flow through pial collaterals between the anterior cerebral artery (ACA) and the MCA was assessed in male Sprague Dawley rats using in vivo laser speckle contrast imaging (LSCI) and two photon laser scanning microscopy (TPLSM) during distal MCAo...
December 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27909230/the-protective-role-of-sex-hormones-in-females-and-exercise-prehabilitation-in-males-on-sternotomy-induced-cranial-hypoperfusion-in-aortic-banded-mini-swine
#5
T Dylan Olver, Jessica A Hiemstra, Jenna C Edwards, Brian S Ferguson, Harold Laughlin, Craig A Emter
During cardiac surgery, specifically sternotomy, cranial hypoperfusion is linked to cerebral ischemia, increased risk of perioperative watershed stroke and other neurocognitive complications. The purpose of this study was to retrospectively examine the effect of sex hormones in females and exercise prehabilitation in males on median sternotomy-induced changes in cranial perfusion in a large animal model of heart failure. Cranial blood flow (CBF) before, 10- and 60 min post-sternotomy was analyzed in eight groups of Yucatan mini-swine: female-control, aortic-banded, ovariectomized, and ovariectomized+aortic-banded; male-control, aortic-banded, aortic-banded+continuous exercise trained, and aortic-banded+interval exercise trained...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27909201/infarct-pattern-and-collateral-status-in-adult-moyamoya-disease-a-multimodal-magnetic-resonance-imaging-study
#6
Dong Yeop Kim, Jeong Pyo Son, Je Young Yeon, Gyeong-Moon Kim, Jong-Soo Kim, Seung-Chyul Hong, Oh Young Bang
BACKGROUND AND PURPOSE: Moyamoya disease (MMD) is a unique cerebrovascular disease characterized by the progressive stenosis of large intracranial arteries and a hazy network of basal collaterals, called moyamoya vessels. Although hemodynamic studies have been applied in MMD patients, the mechanisms of stroke in MMD are still unclear. The present study evaluated the infarct pattern and collateral status using multimodal magnetic resonance imaging in MMD patients. METHODS: Adult MMD patients with acute ischemic stroke were prospectively recruited, and infarct pattern on diffusion-weighted imaging was evaluated...
December 1, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27902857/quantitative-assessment-of-hyperacute-cerebral-infarction-with-intravoxel-incoherent-motion-mr-imaging-initial-experience-in-a-canine-stroke-model
#7
Qian-Qian Gao, Shan-Shan Lu, Xiao-Quan Xu, Cheng-Jiang Wu, Xing-Long Liu, Sheng Liu, Hai-Bin Shi
PURPOSE: To evaluate the feasibility of intravoxel incoherent motion (IVIM) for the measurement of diffusion and perfusion parameters in hyperacute strokes. MATERIALS AND METHODS: An embolic ischemic model was established with an autologous thrombus in 20 beagles. IVIM imaging was performed on a 3.0 Tesla platform at 4.5 h and 6 h after embolization. Ten b values from 0 to 900 s/mm(2) were fitted with a bi-exponential model to extract perfusion fraction f, diffusion coefficient D, and pseudo-diffusion coefficient D*...
November 30, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27895299/optimal-computed-tomographic-perfusion-scan-duration-for-assessment-of-acute-stroke-lesion-volumes
#8
Aimen S Kasasbeh, Søren Christensen, Matus Straka, Nishant Mishra, Michael Mlynash, Roland Bammer, Gregory W Albers, Maarten G Lansberg
BACKGROUND AND PURPOSE: The minimal scan duration needed to obtain reliable lesion volumes with computed tomographic perfusion (CTP) has not been well established in the literature. METHODS: We retrospectively assessed the impact of gradual truncation of the scan duration on acute ischemic lesion volume measurements. For each scan, we identified its optimal scan time, defined as the shortest scan duration that yields measurements of the ischemic lesion volumes similar to those obtained with longer scanning, and the relative height of the fitted venous output function at its optimal scan time...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27895105/robot-assisted-mechanical-therapy-attenuates-stroke-induced-limb-skeletal-muscle-injury
#9
Chandan K Sen, Savita Khanna, Hallie Harris, Richard Stewart, Maria Balch, Mallory Heigel, Seth Teplitsky, Surya Gnyawali, Cameron Rink
The efficacy and optimization of poststroke physical therapy paradigms is challenged in part by a lack of objective tools available to researchers for systematic preclinical testing. This work represents a maiden effort to develop a robot-assisted mechanical therapy (RAMT) device to objectively address the significance of mechanical physiotherapy on poststroke outcomes. Wistar rats were subjected to right hemisphere middle-cerebral artery occlusion and reperfusion. After 24 h, rats were split into control (RAMT(-)) or RAMT(+) groups (30 min daily RAMT over the stroke-affected gastrocnemius) and were followed up to poststroke d 14...
November 28, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27891826/ct-brain-perfusion-a-static-phantom-study-of-contrast-to-noise-ratio-and-radiation-dose
#10
Stewart M Midgley, Damien L Stella, Bruce Cv Campbell, Francesca Langenberg, Paul F Einsiedel
INTRODUCTION: Computed tomography perfusion (CTP) is increasingly employed in the diagnosis and management of ischaemic stroke but radiation dose can be significant and optimising contrast-to-noise ratio (CNR) is challenging. This study aimed to quantify and optimise the balance between CNR as a surrogate for image quality and radiation dose. METHODS: A perspex head phantom with vials of dilute contrast agent was scanned using a Siemens Definition Flash 128-slice scanner...
November 27, 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27886985/efficacy-of-lens-protection-systems-dependency-on-different-cranial-ct-scans-in-the-acute-stroke-setting
#11
Nika Guberina, Michael Forsting, Adrian Ringelstein
To evaluate the dose-reduction potential with different lens protectors for patients undergoing cranial computed tomography (CT) scans. Eye lens dose was assessed in vitro (α-Al2O3:C thermoluminescence dosemeters) using an Alderson-Rando phantom(®) in cranial CT protocols at different CT scanners (SOMATOM-Definition-AS+(®)(CT1) and SOMATOM-Definition-Flash(®) (CT2)) using two different lens-protection systems (Somatex(®) (SOM) and Medical Imaging Systems(®) (MIS)). Summarised percentage of the transmitted photons: (1) CT1 (a) unenhanced CT (nCT) with gantry angulation: SOM = 103%, MIS = 111%; (2) CT2 (a) nCT without gantry angulation: SOM = 81%, MIS = 91%; (b) CT angiography (CTA) with automatic dose-modulation technique: SOM = 39%, MIS = 74%; (c) CTA without dose-modulation technique: SOM = 22%, MIS = 48%; (d) CT perfusion: SOM = 44%, MIS = 69%...
November 24, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27884959/cardiac-responses-to-exercise-distinguish-postural-orthostatic-tachycardia-syndrome-variants
#12
Paolo T Pianosi, Darrell R Schroeder, Philip R Fischer
We previously showed that one-third of adolescents with postural orthostatic tachycardia syndrome (POTS) have hyperkinetic circulation. In a subsequent cohort, we compare participants with POTS grouped according to cardiac output (Q˙) versus oxygen uptake (V˙O2) function, whose circulatory response to exercise lay at the lower end of this distribution. We hypothesized that such grouping determines the circulatory response to incremental-protocol, upright, cycle ergometry by whatever blend of flow and resistance adjustments best maintains normal blood pressure...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27879446/quantification-of-serial-cerebral-blood-flow-in-acute-stroke-using-arterial-spin-labeling
#13
George W J Harston, Thomas W Okell, Fintan Sheerin, Ursula Schulz, Phil Mathieson, Ian Reckless, Kunal Shah, Gary A Ford, Michael A Chappell, Peter Jezzard, James Kennedy
BACKGROUND AND PURPOSE: Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset. METHODS: Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month...
November 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27879445/agreement-among-stroke-faculty-and-fellows-in-treating-ischemic-stroke-patients-with-tissue-type-plasminogen-activator-and-thrombectomy
#14
Ahmad-Riad Ramadan, Mary Carter Denny, Farhaan Vahidy, Jose-Miguel Yamal, Tzu-Ching Wu, Amrou Sarraj, Sean Savitz, James Grotta
BACKGROUND AND PURPOSE: The aim of this study is to determine agreement among vascular neurology fellows and faculty in treating patients with acute ischemic stroke with intravenous tissue-type plasminogen activator and intra-arterial thrombectomy (IAT). METHODS: Patients were evaluated simultaneously by at least 2 vascular neurology. Agreement was determined using kappa (κ) and intraclass correlation coefficients. RESULTS: In 60 patients, agreement was substantial for tissue-type plasminogen activator (κ=0...
November 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27879370/validation-of-mri-determination-on-pet-measurements-in-ischemic-stroke
#15
Wolf-Dieter Heiss, Olivier Zaro Weber
The concept of the ischemic penumbra was formulated based on animal experiments showing functional impairment and electrophysiological disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with blood supply further decreased (the threshold for infarction). The perfusion range between these thresholds was termed "penumbra", and restitution of flow above the functional threshold was able to reverse the deficits without permanent damage...
November 22, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27875262/autoregulation-of-cardiac-output-is-overcome-by-adrenergic-stimulation-in-the-anaconda-heart
#16
William Joyce, Michael Axelsson, Tobias Wang
Most vertebrates increase cardiac output during activity by elevating heart rate with relatively stable stroke volume. However, several studies have demonstrated 'intrinsic autoregulation' of cardiac output where artificially increased heart rate is associated with decreased stroke volume, leaving cardiac output unchanged. We explored the capacity of noradrenaline to overcome autoregulation in the anaconda heart. Electrically pacing in situ perfused hearts from the intrinsic heart rate to the maximum attainable resulted in a proportional decrease in stroke volume...
November 10, 2016: Journal of Experimental Biology
https://www.readbyqxmd.com/read/27869849/optical-coherence-tomography-imaging-of-capillary-reperfusion-after-ischemic-stroke
#17
Jonghwan Lee, Yasemin Gursoy-Ozdemir, Buyin Fu, David A Boas, Turgay Dalkara
Although progress has been made for recanalization therapies after ischemic stroke, post-treatment imaging studies show that tissue reperfusion cannot be attained despite satisfactory recanalization in a significant percentage of patients. Hence, investigation of microcirculatory changes in both surface and deep cortical levels after ischemia reperfusion is important for understanding the post-stroke blood flow dynamics. In this study, we applied optical coherence tomography (OCT) imaging of cerebral blood flow for the quantification of the microcirculatory changes...
November 20, 2016: Applied Optics
https://www.readbyqxmd.com/read/27864774/comparison-of-an-automatic-analysis-and-a-manual-analysis-of-conjunctival-microcirculation-in-a-sheep-model-of-haemorrhagic-shock
#18
Philip-Helge Arnemann, Michael Hessler, Tim Kampmeier, Andrea Morelli, Hugo Karel Van Aken, Martin Westphal, Sebastian Rehberg, Christian Ertmer
BACKGROUND: Life-threatening diseases of critically ill patients are known to derange microcirculation. Automatic analysis of microcirculation would provide a bedside diagnostic tool for microcirculatory disorders and allow immediate therapeutic decisions based upon microcirculation analysis. METHODS: After induction of general anaesthesia and instrumentation for haemodynamic monitoring, haemorrhagic shock was induced in ten female sheep by stepwise blood withdrawal of 3 × 10 mL per kilogram body weight...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27854084/impacts-of-cigarette-smoking-and-basilar-artery-flow-on-1-year-recovery-in-3-month-survivors-of-intracranial-vertebrobasilar-artery-dissection-related-ischemic-stroke
#19
Chih-Ping Chung, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Yung-Yang Lin
OBJECTIVE: Intracranial vertebrobasilar artery dissection (iVBD) is an important etiology for posterior circulation ischemic stroke (PCS); however, its long-term functional outcome has been seldom reported. The present study aimed to elucidate the functional outcomes and the predictors of poor functional recovery at 1-year after iVBD-caused PCS. METHODS: Patients with iVBD-caused PCS who had been recruited in the Stroke Registry of Taipei Veterans General Hospital between January 1, 2012 to February 28, 2014 were included...
September 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27847771/emergent-double-barrel-bypass-shortly-after-intravenous-administration-of-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke
#20
Joon-Ho Choi, Hyun-Seok Park
Although intravenous recombinant tissue plasminogen activator (IV rt-PA) is effective in many cases of acute ischemic stroke, the neurologic symptoms can worsen after IV rt-PA because of sustained vessel occlusion. For such cases, several reperfusion modalities are available, including intra-arterial thrombolysis (IAT), carotid endarterectomy, and superficial temporal artery-middle cerebral artery (STA-MCA) bypass. Invasive procedures, such as major surgery, should be generally avoided within 24 hours after the administration of IV rt-PA...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
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