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Stroke Perfusion

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https://www.readbyqxmd.com/read/28446746/peripheral-blood-akap7-expression-as-an-early-marker-for-lymphocyte-mediated-post-stroke-blood-brain-barrier-disruption
#1
Grant C O'Connell, Madison B Treadway, Ashley B Petrone, Connie S Tennant, Noelle Lucke-Wold, Paul D Chantler, Taura L Barr
Our group recently identified 16 genes whose peripheral blood expression levels are differentially regulated in acute ischemic stroke. The purpose of this study was to determine whether the early expression levels of any of these 16 genes are predictive for post-stroke blood brain barrier (BBB) disruption. Transcriptional expression levels of candidate genes were measured in peripheral blood sampled from ischemic stroke patients at emergency department admission, and BBB permeability was assessed at 24 hour follow up via perfusion-weighted imaging...
April 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28446625/use-of-noncontrast-computed-tomography-and-computed-tomographic-perfusion-in-predicting-intracerebral-hemorrhage-after-intravenous-alteplase-therapy
#2
Connor Batchelor, Pooneh Pordeli, Christopher D d'Esterre, Mohamed Najm, Fahad S Al-Ajlan, Mari E Boesen, Connor McDougall, Lisa Hur, Enrico Fainardi, Jai Jai Shiva Shankar, Marta Rubiera, Alexander V Khaw, Michael D Hill, Andrew M Demchuk, Tolulope T Sajobi, Mayank Goyal, Ting-Yim Lee, Richard I Aviv, Bijoy K Menon
BACKGROUND AND PURPOSE: Intracerebral hemorrhage is a feared complication of intravenous alteplase therapy in patients with acute ischemic stroke. We explore the use of multimodal computed tomography in predicting this complication. METHODS: All patients were administered intravenous alteplase with/without intra-arterial therapy. An age- and sex-matched case-control design with classic and conditional logistic regression techniques was chosen for analyses. Outcome was parenchymal hemorrhage on 24- to 48-hour imaging...
April 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28445478/delayed-histochemical-alterations-within-the-neurovascular-unit-due-to-transient-focal-cerebral-ischemia-and-experimental-treatment-with-neurotrophic-factors
#3
Dominik Michalski, Roman Pitsch, Deepu R Pillai, Bianca Mages, Susanne Aleithe, Jens Grosche, Henrik Martens, Felix Schlachetzki, Wolfgang Härtig
Current stroke therapy is focused on recanalizing strategies, but neuroprotective co-treatments are still lacking. Modern concepts of the ischemia-affected neurovascular unit (NVU) and surrounding penumbra emphasize the complexity during the transition from initial damaging to regenerative processes. While early treatment with neurotrophic factors was shown to result in lesion size reduction and blood-brain barrier (BBB) stabilization, cellular consequences from these treatments are poorly understood. This study explored delayed cellular responses not only to ischemic stroke, but also to an early treatment with neurotrophic factors...
2017: PloS One
https://www.readbyqxmd.com/read/28442482/a-bag3-coding-variant-in-mice-determines-susceptibility-to-ischemic-limb-muscle-myopathy-by-directing-autophagy
#4
Joseph M McClung, Timothy J McCord, Terence E Ryan, Cameron A Schmidt, Thomas D Green, Kevin W Southerland, Jessica L Reinardy, Sarah B Mueller, Talaignair N Venkatraman, Christopher D Lascola, Sehoon Keum, Douglas A Marchuk, Espen E Spangenburg, Ayotunde O Dokun, Brian H Annex, Christopher D Kontos
Background -Critical limb ischemia (CLI) is a manifestation of peripheral artery disease (PAD) that carries significant mortality and morbidity risk in humans, although its genetic determinants remain largely unknown. We previously discovered two overlapping quantitative trait loci (QTL) in mice, Lsq-1 and Civq-1, that affected limb muscle survival and stroke volume following femoral artery or middle cerebral artery ligation, respectively. Here we report that a Bag3 variant (Ile81Met) segregates with tissue protection from hindlimb ischemia (HLI)...
April 25, 2017: Circulation
https://www.readbyqxmd.com/read/28439614/internal-carotid-artery-stenosis-and-collateral-recruitment-in-stroke-patients
#5
Jan W Dankbaar, Kelly G P Kerckhoffs, Alexander D Horsch, Irene C van der Schaaf, L Jaap Kappelle, Birgitta K Velthuis
PURPOSE: Leptomeningeal collaterals improve outcome in stroke patients. There is great individual variability in their extent. Internal carotid artery (ICA) stenosis may lead to more extensive recruitment of leptomeningeal collaterals. The purpose of this study was to evaluate the association of pre-existing ICA stenosis with leptomeningeal collateral filling visualized with computed tomography perfusion (CTP). METHODS: From a prospective acute ischemic stroke cohort, patients were included with an M1 middle cerebral artery (MCA) occlusion and absent ipsilateral, extracranial ICA occlusion...
April 24, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28436705/pharmacologically-increasing-collateral-perfusion-during-acute-stroke-using-a-carboxyhemoglobin-gas-transfer-agent-sanguinate%C3%A2-in-spontaneously-hypertensive-rats
#6
Marilyn J Cipolla, Italo Linfante, Abe Abuchowski, Ronald Jubin, Siu-Lung Chan
Similar to patients with chronic hypertension, spontaneously hypertensive rats (SHR) develop fast core progression during middle cerebral artery occlusion (MCAO) resulting in large final infarct volumes. We investigated the effect of Sanguinate™ (SG), a PEGylated carboxyhemoglobin (COHb) gas transfer agent, on changes in collateral and reperfusion cerebral blood flow and brain injury in SHR during 2 h of MCAO. SG (8 mL/kg) or vehicle ( n = 6-8/group) was infused i.v. after 30 or 90 min of ischemia with 2 h reperfusion...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28432712/stroke-etiology-and-collaterals-atheroembolic-strokes-have-greater-collateral-recruitment-than-cardioembolic-strokes
#7
L C Rebello, M Bouslama, D C Haussen, J A Grossberg, S Dehkharghani, A Anderson, S R Belagaje, N A Bianchi, M Grigoryan, M R Frankel, R G Nogueira
BACKGROUND AND PURPOSE: Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). METHOD: This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included...
April 21, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28431614/permeability-surface-area-product-analysis-in-malignant-brain-edema-prediction-a-pilot-study
#8
O Volny, P Cimflova, T-Y Lee, B K Menon, C D d'Esterre
BACKGROUND AND PURPOSE: Using an extended CT perfusion acquisition (150s), we sought to determine the association between perfusion parameters and malignant edema after ischemic stroke. METHODS: Patients (from prospective study PROVE-IT, NCT02184936) with terminal internal carotid artery±proximal middle cerebral occlusion were involved. CTA was assessed for clot location and status of leptomeningeal collaterals. The following CTP parameters were calculated within the ischemic territory and contralaterally: permeability surface area product (PS), cerebral blood flow (CBF) and cerebral blood volume (CBV)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28428179/adamts13-controls-vascular-remodeling-by-modifying-vwf-reactivity-during-stroke-recovery
#9
Haochen Xu, Yongliang Cao, Xing Yang, Ping Cai, Lijing Kang, Ximin Zhu, Haiyu Luo, Lu Lu, Lixiang Wei, Xiaofei Bai, Yuanbo Zhu, Bing-Qiao Zhao, Wenying Fan
Angiogenic response is essential for ischemic brain repair. However, the mechanisms leading to postischemic neovascularization have not been established, and no therapies have been identified. The VWF-cleaving protease ADAMTS13 is required for endothelial tube formation in vitro However, there is currently no in vivo evidence supporting a function of ADAMTS13 in angiogenesis. Here we show that mice deficient in ADAMTS13 exhibited significantly reduced neovascularization, brain capillary perfusion, pericyte and smooth muscle cell coverage on microvessels, expression of the tight junction and basement membrane proteins, and accelerated blood-brain barrier (BBB) breakdown and extravascular deposits of serum proteins in the peri-infarct cortex at 14 days after stroke...
April 20, 2017: Blood
https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#10
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28424015/susceptibility-weighted-imaging-in-acute-cerebral-ischemia-review-of-emerging-technical-concepts-and-clinical-applications
#11
Charlie Chia-Tsong Hsu, Gigi Nga Chi Kwan, Sachintha Hapugoda, Michelle Craigie, Trevor William Watkins, E Mark Haacke
Susceptibility weighted imaging (SWI) is an essential magnetic resonance imaging sequence in the assessment of acute ischemic stroke. In this article, we discuss the physics principals and clinical application of conventional SWI and multi-echo SWI sequences. We review the research evidence and practical approach of SWI in acute ischemic stroke by focusing on the detection and characterization of thromboembolism in the cerebral circulation. In addition, we discuss the role of SWI in the assessment of neuroparenchyma by depiction of asymmetric hypointense cortical veins in the ischemic territory (surrogate tissue perfusion), detection of existing microbleeds before stroke treatment and monitoring for hemorrhagic transformation post-treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28418189/epileptic-manifestations-in-stroke-patients-treated-with-intravenous-alteplase
#12
C Bentes, H Martins, A R Peralta, C Morgado, C Casimiro, A C Franco, A C Fonseca, R Geraldes, P Canhão, T Pinho E Melo, T Paiva, J M Ferro
BACKGROUND AND PURPOSE: Intravenous alteplase (rtPA) may be associated with seizures and epileptic activity in the electroencephalogram (EEG). The aim of this work was to compare the frequency of seizures and EEG abnormalities between stroke patients treated and not treated with rtPA. METHODS: This was a prospective study of consecutive acute anterior circulation ischaemic stroke patients, with 1-year follow-up. Patients were previously independent, had an admission National Institute of Health Stroke Scale score ≥4, an acute ischaemic lesion and no previous seizures...
April 18, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28416334/a-systematic-approach-to-improve-the-outcomes-of-type-a-aortic-dissection
#13
Hidefumi Nishida, Minoru Tabata, Toshihiro Fukui, Yasunori Sato, Hajime Kin, Shuichiro Takanashi
OBJECTIVES: The aims of this study are to evaluate the outcomes and trends of contemporary emergency surgery for acute type A aortic dissection on the basis of a systematic approach and to assess the impact of temporary aortic crossclamping during systemic cooling on early and late outcomes. METHODS: We retrospectively reviewed 702 consecutive patients who underwent emergency surgery for acute type A aortic dissection between March 2004 and May 2015. Our clinical protocol includes rapid transfer to the operating room, quick establishment of cardiopulmonary bypass, temporary aortic crossclamping during cooling, primary entry resection, and open distal anastomosis...
March 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#14
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28414895/the-impact-of-ct-perfusion-threshold-on-predicted-viable-and-nonviable-tissue-volumes-in-acute-ischemic-stroke
#15
Xuya Huang, Dheeraj Kalladka, Bharath Kumar Cheripelli, Fiona Catherine Moreton, Keith W Muir
BACKGROUND AND PURPOSE: Perfusion imaging is used for patient selection in clinical practice and trials. Postprocessing and definitions of tissue viability are nevertheless not standardized. We compared the lesion volumes generated with two well-recognized perfusion tissue definitions in a single-center phase 2 thrombolysis study. METHODS: We analyzed perfusion imaging data from the Alteplase-Tenecteplase Trial Evaluation for Stroke Thrombolysis (ATTEST) study using two popular tissue viability thresholds (ischemic core definition: (1) cerebral blood volume < 2...
April 17, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28413864/evaluation-of-intracranial-microvessel-visualization-in-mouse-and-dog-models-by-using-a-new-rotating-cerium-anode-x-ray-system
#16
Chiharu Tanaka, Toru Shizuma, Yoshiro Shinozaki, Kikue Todoroki, Yoshimori Ikeya, Naoto Fukuyama, Toshihiko Ueda, Hidezo Mori
OBJECTIVE: Lacunar stroke may be caused by infarction of small perforating branches of the middle cerebral artery. We developed a microangiographic X-ray system using a cerium anode to evaluate the perforating branches. METHODS: Iodine has K-edges at 33.2 kilo electron volts. Cerium yields a characteristic X-ray of 34.6 kilo electron volts, therefore, the cerium anode X-ray system could detect tiny amounts of contrast material. First, an X-ray chart was used to evaluate the resolution...
April 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28412909/prolonged-perfusion-predicts-recurrent-ischemic-stroke-but-not-transient-ischemic-attack-in-patients-with-symptomatic-intracranial-stenosis
#17
Linfang Lan, Xinyi Leng, Vincent Ip, Thomas Leung, Yannie Soo, Jill Abrigo, Ka Sing Wong
BACKGROUND: Intracranial arterial stenosis (ICAS) is the dominant cause for ischemic stroke worldwide, with hemodynamic compromise as a crucial contributor. Prolonged perfusion is commonly observed in ICAS patients on CT perfusion (CTP) maps, while the clinical significance of this perfusion pattern has not been elucidated. METHODS: Patients having symptomatic ICAS of 50-99% stenosis with sustained downstream cerebral blood flow (CBF) were enrolled into this study...
April 13, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28412316/differentiating-stroke-and-seizure-in-acute-setting-perfusion-computed-tomography
#18
Katarzyna Kubiak-Balcerewicz, Urszula Fiszer, Ewa Nagańska, Cezary Siemianowski, Aleksander Sobieszek, Agnieszka Witak-Grzybowska, Aldona Kosińska-Szot
BACKGROUND: Perfusion computed tomography (PCT) is part of acute stroke protocol in many hospitals; however, its clinical utility is still being disputed. Beyond its use in core and penumbra estimation, there is also a question about PCT role in stroke mimics diagnosis. Case series or small, retrospective studies showed equivocal results. This is the first published prospective, comparative study on PCT in differentiating stroke and seizure in acute setting. METHODS: Patients with acute focal neurologic deficits and without acute ischemic lesions on routine CT underwent PCT and electroencephalography (EEG) within 12 hours after symptom onset...
April 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#19
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28400904/extensive-mobile-thrombus-of-the-internal-carotid-discovered-after-intravenous-thrombolysis-what-do-i-do-now
#20
Eugene L Scharf, Jennifer E Fugate, Sara E Hocker
This case report describes a rare presentation of ischemic stroke secondary to an extensive internal carotid artery thrombus, subsequent therapeutic dilemma, and clinical management. A 58-year-old man was administered intravenous (IV) thrombolysis for right middle cerebral artery territory ischemic stroke symptoms. A computed tomography angiogram of the head and neck following thrombolysis showed a longitudinally extensive internal carotid artery thrombus originating at the region of high-grade calcific stenosis...
April 2017: Neurohospitalist
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