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Stroke Perfusion

Anthony R Mawson, Nola T Radford, Binu Jacob
Stuttering affects about 1% of the general population and from 8 to 11% of children. The onset of persistent developmental stuttering (PDS) typically occurs between 2 and 4 years of age. The etiology of stuttering is unknown and a unifying hypothesis is lacking as of now. Clues to the pathogenesis of stuttering include the following observations: PDS is associated with adverse perinatal outcomes and birth-associated trauma; stuttering can recur or develop in adulthood following traumatic events such as brain injury and stroke; PDS is associated with structural and functional abnormalities in the brain associated with speech and language; and stuttering resolves spontaneously in a high percentage of affected children...
October 18, 2016: European Neurology
Dao P Zhang, Hong T Zhang, Suo Yin, Fu L Yan
This series case report aimed to elucidate the underlying pathology and outcomes of lateral medullary infarction (LMI) using perfusion weighted imaging (PWI). Four patients were diagnosed with LMI based on high-field diffusion-weighted magnetic resonance imaging (MRI-DWI) and PWI. The national institutes of health stroke scale (NIHSS) scores were recorded on days 1, 7, and 30, and the Barthel index was assessed on days 7 and 30. Three patients exhibited relative regional hypoperfusion of medullary lesion in the perfusion maps...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Jiahong Wang, Lan Zhao, Jiarui Wei, Shaoheng Zhang, Nannan Chen, Dongxing Ding, Qunlin Gong, Feng Su, Jian Yan, Pengxiang Zheng
BACKGROUND: Various therapies have been used to improve the symptoms and prognosis of patients with coronary artery disease. However, comparative studies showing more suitable choices for patients with ischaemic dilated cardiomyopathy (IDCM) and who smoke cigarettes are lacking. METHODS: A total of 338 patients were divided into four groups according to whether they received complete revascularisation (CR), and/or underwent smoking cessation (SC). They were followed prospectively for 12 months...
September 26, 2016: Heart, Lung & Circulation
Ursula I Tuor, Min Qiao, Manasi Sule, Melissa Morgunov, Tadeusz Foniok
Stroke is a major cause of disability in adults and children. Recently, we have developed an adult rat model of minor stroke containing a peri-infarct region with a modest T2 increase and mild ischemic damage. We hypothesized that a neonatal minor stroke with mild peri-ischemic changes could also be produced, but with potential ontogenic differences. Using our minor photothrombosis method, we produced a range of severities of ischemic lesions (mini, minor, moderate and severe) within magnetic resonance imaging (MRI) slices of adult and neonatal rats...
October 12, 2016: NMR in Biomedicine
Tao Yan, Poornima Venkat, Michael Chopp, Alex Zacharek, Ruizhuo Ning, Cynthia Roberts, Yi Zhang, Mei Lu, Jieli Chen
BACKGROUND AND PURPOSE: Comorbidity of diabetes mellitus and stroke results in worse functional outcome, poor long-term recovery, and extensive vascular damage. We investigated the neurorestorative effects and mechanisms of stroke treatment with human bone marrow-derived mesenchymal stromal cells (hMSCs) in type 2 diabetes mellitus (T2DM) rats. METHODS: Adult male Wistar rats were induced with T2DM, subjected to 2 hours of middle cerebral artery occlusion (MCAo) and treated via tail-vein injection with (1) PBS (n=8) and (2) hMSCs (n=10; 5×10(6)) at 3 days after MCAo...
October 11, 2016: Stroke; a Journal of Cerebral Circulation
Wolfgang G Kunz, Wieland H Sommer, Lukas Havla, Franziska Dorn, Felix G Meinel, Olaf Dietrich, Grete Buchholz, Birgit Ertl-Wagner, Kolja M Thierfelder
OBJECTIVES: To determine the detection rate of intracranial vessel occlusions using CT perfusion-based wavelet-transformed angiography (waveletCTA) in acute ischemic stroke patients, in whom single-phase CTA (spCTA) failed to detect an occlusion. METHODS: Subjects were selected from a cohort of 791 consecutive patients who underwent multiparametric CT including whole-brain CT perfusion. Inclusion criteria were (1) significant cerebral blood flow (CBF) deficit, (2) no evidence of vessel occlusion on spCTA and (3) follow-up-confirmed acute ischemic infarction...
October 8, 2016: European Radiology
Marcel T H Oei, Frederick J A Meijer, Willem-Jan van der Woude, Ewoud J Smit, Bram van Ginneken, Mathias Prokop, Rashindra Manniesing
OBJECTIVES: We present a novel One-Step-Stroke protocol for wide-detector CT scanners that interleaves cerebral CTP with volumetric neck CTA (vCTA). We evaluate whether the resulting time gap in CTP affects the accuracy of CTP values. METHODS: Cerebral CTP maps were retrospectively obtained from 20 patients with suspicion of acute ischemic stroke and served as the reference standard. To simulate a 4 s gap for interleaving CTP with vCTA, we eliminated one acquisition at various time points of CTP starting from the bolus-arrival-time(BAT)...
October 7, 2016: European Radiology
Bhawna Gupta, Ali Dodge-Khatami, Juan Tucker, Mary B Taylor, Douglas Maposa, Miguel Urencio, Jorge D Salazar
BACKGROUND: Antegrade cerebral perfusion (ACP) typically is used with deep hypothermia for cerebral protection during aortic arch reconstructions. The impact of ACP on cerebral oxygenation and serum creatinine at a more tepid 25 °C was studied in newborns and children. METHODS: Between 2010 and 2014, 61 newborns and children (<5 years old) underwent aortic arch reconstruction using moderate hypothermia (25.0±0.9 °C) with ACP and a pH-stat blood gas management strategy...
July 2016: Translational pediatrics
Nicolas K Khattar, Robert M Friedlander, Rabih A Chaer, Efthymios D Avgerinos, Eric S Kretz, Jeffrey R Balzer, Donald J Crammond, Miguel H Habeych, Parthasarathy D Thirumala
BACKGROUND: Carotid endarterectomy (CEA) is the procedure of choice for reducing the risk of stroke in both symptomatic and asymptomatic carotid artery stenoses. Stroke is associated with significant morbidity and mortality peri-operatively (2-3 %). Our primary aim is to evaluate the etiology of these strokes after CEA and their impact on morbidity by comparing the length of stay in the hospital. METHODS: A total of 584 patients with documented neurological status evaluations who underwent CEAs were included in the study...
September 30, 2016: Acta Neurochirurgica
Michael Rudnicki, Johannes A Mayr, Johannes Zschocke, Herwig Antretter, Heinz Regele, René G Feichtinger, Martin Windpessl, Gert Mayer, Gerhard Pölzl
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS syndrome) represents one of the most frequent mitochondrial disorders. The majority of MELAS cases are caused by m.3243A>G mutation in the mitochondrial MT-TL1 gene, which encodes the mitochondrial tRNA(Leu(UUR)). Kidney involvement usually manifests as Fanconi syndrome or focal segmental glomerulosclerosis. We describe a patient with MELAS mutation, cardiomyopathy, and chronic kidney disease without Fanconi syndrome, proteinuria, or hematuria...
September 24, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Evelyn M R Lake, Paolo Bazzigaluppi, James Mester, Lynsie A M Thomason, Rafal Janik, Mary Brown, JoAnne McLaurin, Peter L Carlen, Dale Corbett, Greg J Stanisz, Bojana Stefanovic
Brain plasticity following focal cerebral ischemia has been observed in both stroke survivors and in preclinical models of stroke. Endogenous neurovascular adaptation is at present incompletely understood yet its potentiation may improve long-term functional outcome. We employed longitudinal MRI, intracranial array electrophysiology, Montoya Staircase testing, and immunofluorescence to examine function of brain vessels, neurons, and glia in addition to forelimb skilled reaching during the subacute stage of ischemic injury progression...
September 21, 2016: NeuroImage
Zahra Keshavarz-Motamed, Farhad Rikhtegar Nezami, Ramon A Partida, Kenta Nakamura, Pedro Vinícius Staziaki, Eyal Ben-Assa, Brian Ghoshhajra, Ami B Bhatt, Elazer R Edelman
OBJECTIVES: This study sought to investigate the impact of transcatheter intervention on left ventricular function and aortic hemodynamics in patients with mild coarctation of the aorta (COA). BACKGROUND: The optimal method and timing of transcatheter intervention for COA remains unclear, especially when the severity of COA is mild (peak-to-peak transcoarctation pressure gradient <20 mm Hg). Debate rages regarding the risk/benefit ratio of intervention versus long-term effects of persistent minimal gradient in this heterogeneous population with differing blood pressures, ventricular function, and peripheral perfusion...
September 26, 2016: JACC. Cardiovascular Interventions
Christine Bollwein, Annika Plate, Wieland H Sommer, Kolja M Thierfelder, Hendrik Janssen, Maximilian F Reiser, Andreas Straube, Louisa von Baumgarten
INTRODUCTION: Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. METHODS: Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes...
September 20, 2016: Neuroradiology
Marcel T H Oei, Frederick J A Meijer, Willem-Jan van der Woude, Ewoud J Smit, Bram van Ginneken, Rashindra Manniesing, Mathias Prokop
OBJECTIVES: Feasibility evaluation of the One-Step Stroke Protocol, which is an interleaved cerebral computed tomography perfusion (CTP) and neck volumetric computed tomography angiography (vCTA) scanning technique using wide-detector computed tomography, and to assess the image quality of vCTA. METHODS: Twenty patients with suspicion of acute ischaemic stroke were prospectively scanned and evaluated with a head and neck CTA and with the One-Step Stroke Protocol...
September 21, 2016: European Radiology
Clive Rosendorff
Many guidelines for the management of hypertension have recommended that the goal of antihypertensive treatment in the elderly (usually specified as 80 years or above) should be less than 150/90 mmHg. SPRINT included subjects 50 years or above, and a substantial proportion of subjects 75 years and older. These are individuals at high risk for adverse cardiovascular events because of high prevalence of hypertension and atherosclerotic disease. The less stringent BP goals have been based on a percieved danger of lowering BP to levels that threaten vital organ pefusion (myocardium, brain, kidney)...
September 2016: Journal of Hypertension
Tien Wong
The vasculature in the retina can be viewed directly and non-invasively in vivo, offers a unique perspective of the human microvasculature, and therefore the ability to understand early changes, processes, pathways and consequences of hypertension. In the past 15 years, advances in high resolution digital retinal photography and automated or semi-automated computer image software have been applied to measure and quantify a variety of retinal microvascular parameter, including retinal arteriolar and venular caliber, tortuosity, branching patterns and fractal dimensions...
September 2016: Journal of Hypertension
Kazuyuki Shimada
Stroke is known to frequently recur in patients with a history of cerebrovascular disease, and the control of hypertension is extremely important for the treatment of those patients. The robust relationship between the recurrent cerebrovascular disease and blood pressure control has been demonstrated in large-scale clinical studies. The antihypertensive drug therapy significantly reduces the recurrence rate of all types of cerebrovascular disease, incidences of myocardial infarction and all vascular events...
September 2016: Journal of Hypertension
Hong Liu, Qian Chang, HaiTao Zhang, CunTao Yu
BACKGROUND: Early mortality and cerebral injury are severe complications of aortic arch surgery, but data from Asian countries are scarce. We reviewed the results of patients who underwent aortic arch replacement with deep hypothermic circulatory arrest (DHCA) and antegrade selective cerebral perfusion (ASCP) at our institution to analyse pre- and intraoperative predictors of early death and neurological complications. METHODS: Clinical data of adult patients who underwent aortic arch surgery with DHCA plus ASCP between January 2005 and December 2011 were retrospectively analysed...
March 5, 2016: Heart, Lung & Circulation
Myron D Ginsberg
This review surveys the efforts taken to achieve clinically efficacious protection of the ischemic brain and underscores the necessity of expanding our purview to include the essential role of cerebral perfusion and the collateral circulation. We consider the development of quantitative strategies to measure cerebral perfusion at the regional and local levels and the application of these methods to elucidate flow-related thresholds of ischemic viability and to characterize the ischemic penumbra. We stress that the modern concept of neuroprotection must consider perfusion, the necessary substrate upon which ischemic brain survival depends...
September 13, 2016: Progress in Neurobiology
Conrad Johanson, Nancy Johanson
Robust modeling of CNS transport integrates molecular fluxes at the microvascular blood-brain barrier and epithelial choroid plexus blood-CSF barrier. Normal activity of solute transporters, channels and aquaporins, in the cerebral endothelium and choroidal epithelium, sets the microenvironment composition for neurons and glia. Conversely, perturbed transport/permeability at the barrier interfaces causes interstitial fluid dyshomeostasis (e.g. edema) arising in neural disorders. Critically-important transependymal solute/water distribution between brain and CSF needs more attention...
September 15, 2016: CNS & Neurological Disorders Drug Targets
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