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Intracranial stenosis

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https://www.readbyqxmd.com/read/28925313/hemodynamics-and-oxygen-extraction-in-chronic-large-artery-steno-occlusive-disease-clinical-applications-for-predicting-stroke-risk
#1
Colin P Derdeyn
Depending on the adequacy of collateral sources of blood flow, arterial stenosis or occlusion may lead to reduced perfusion pressure and ultimately reduced blood flow in the distal territory supplied by that vessel. There are two well-defined compensatory mechanisms to reduced pressure or flow - autoregulatory vasodilation and increased oxygen extraction fraction. Other changes, such as metabolic downregulation, are likely. The positive identification of autoregulatory vasodilation and increased oxygen extraction fraction in humans is an established risk factor for future ischemic stroke in some disease states such as atherosclerotic carotid stenosis and occlusion...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28922154/atrial-fibrillation-is-independently-associated-with-cognitive-impairment-after-ischemic-stroke
#2
Russell Jude Chander, Levinia Lim, Sagarika Handa, Shaun Hiu, Angeline Choong, Xuling Lin, Rajinder Singh, Daniel Oh, Nagaendran Kandiah
BACKGROUND: While atrial fibrillation (AF) is an important risk factor for ischemic strokes and mild cognitive impairment (MCI) in Alzheimer's disease, the association between AF and post-stroke cognitive impairment (PSCI), and the factors mediating this association, is unclear. OBJECTIVE: To investigate the role of AF in PSCI, especially in relation to other markers of cerebrovascular disease. METHODS: 445 subjects with mild ischemic stroke without pre-stroke cognitive decline were assessed 3-6 months post-stroke for cognitive deficits...
September 7, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28915443/cerebral-white-matter-hyperintensity-is-associated-with-intracranial-atherosclerosis-in-a-healthy-population
#3
Ki-Woong Nam, Hyung-Min Kwon, Han-Yeong Jeong, Jin-Ho Park, Sang Hyuck Kim, Su-Min Jeong, Tae Gon Yoo, Shinhye Kim
BACKGROUND AND AIMS: Cerebral white matter hyperintensity (WMH) is commonly found in ischemic stroke patients, especially when accompanied by intracranial atherosclerosis (ICAS). However, the relationship between WMH and ICAS in a healthy population has not been evaluated. METHODS: A total of 3159 healthy subjects who underwent health checkups, including brain magnetic resonance imaging and angiography, were enrolled. ICAS was defined as an occlusion or more than 50% stenosis of intracranial vessels on magnetic resonance angiography...
September 7, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28893252/association-between-carotid-plaque-characteristics-and-acute-cerebral-infarction-determined-by-mri-in-patients-with-type-2-diabetes-mellitus
#4
Beibei Sun, Xiao Li, Xiaosheng Liu, Xiaoqian Ge, Qing Lu, Xihai Zhao, Jun Pu, Jianrong Xu, Huilin Zhao
BACKGROUND: Type 2 diabetes mellitus (T2DM) might aggravate the carotid plaque vulnerability, and increase the risk for ischemic stroke. Few studies reported the acute stroke subtype with carotid plaque characteristics in T2DM patients. This study aimed to investigate the association between carotid plaque characteristics and acute cerebral infarct (ACI) lesion features determined by MRI in T2DM patients. METHODS: Patients with acute cerebrovascular syndrome in internal carotid artery territory were recruited...
September 11, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28884026/idiopathic-intracranial-hypertension-prognostic-factors-and-multidisciplinary-management
#5
Claire Chagot, Marie Blonski, Jean-Loup Machu, Serge Bracard, Jean-Christophe Lacour, Sébastien Richard
BACKGROUND: Idiopathic intracranial hypertension (IIH) mostly affects young obese women and can lead to permanent visual impairment. However, prognostic factors and therapeutic strategy remain unclear. METHODS: We retrospectively collected data from all patients diagnosed and managed for IIH in our university center from January 2001 to December 2016. RESULTS: Seventy-nine patients were diagnosed with IIH. Bilateral transverse sinus stenosis (TSS) was found in 74% of the population...
2017: Journal of Obesity
https://www.readbyqxmd.com/read/28881113/cerebral-arterial-stenosis-in-patients-with-spontaneous-intracerebral-hemorrhage
#6
Pil-Wook Chung, Yu Sam Won
OBJECTIVE: Spontaneous intracerebral hemorrhage (ICH) and ischemic stroke share common vascular risk factors such as aging and hypertension. Previous studies suggested that the rate of recurrent ICH and ischemic stroke might be similar after ICH. Presence of cerebral arterial stenosis is a potential risk factor for future ischemic stroke. This study investigated the prevalence and factors associated with cerebral arterial stenosis in Korean patients with spontaneous ICH. METHODS: A total of 167 patients with spontaneous ICH were enrolled...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28872565/sinus-pericranii-in-achondroplasia-a-case-report-and-review-of-the-literature
#7
Abbey A Scott, Katelyn D Hodge, Wilfredo Torres-Martinez, Stephen R Dlouhy, Jodi L Smith, David D Weaver
In the field of dysmorphology, achondroplasia is a well-known disorder. Sinus pericranii (SP), however, is not. The latter condition is a rare vascular malformation characterized by abnormal connections between the intracranial and the extracranial venous drainage pathways. The etiology of SP remains unclear, and yet, these defects can be present at birth, develop spontaneously later, or evolve following head trauma. Here, we report on a 2-year-old male with achondroplasia, SP, and craniocervical junction stenosis...
October 2017: Clinical Dysmorphology
https://www.readbyqxmd.com/read/28868187/tumor-cerebri-metastatic-renal-cell-carcinoma-with-dural-venous-sinus-compression-leading-to-intracranial-hypertension-a-case-report
#8
Eric Marvin, Jordan Synkowski, Michael Benko
BACKGROUND: Pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension (IIH), is a condition associated with increased intracranial pressure (ICP) in the absence of radiographic findings such as mass lesions or cerebral edema. CASE DESCRIPTION: We describe a case of progressive headache and visual disturbances attributed to PTC that resulted from subacute superior sagittal sinus (SSS) stenosis by a metastatic tumor. CONCLUSIONS: Venous outflow obstruction often presents with an acute symptomatology including infarcts, hemorrhages, and seizures, but only rarely does it cause the progressive development of raised ICP...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28867358/radiation-induced-large-vessel-cerebral-vasculopathy-in-pediatric-patients-with-brain-tumors-treated-with-proton-radiation-therapy
#9
Stephen F Kralik, Gordon A Watson, Chie-Schin Shih, Chang Y Ho, Whitney Finke, Jeffrey Buchsbaum
PURPOSE: The purpose of this research was to evaluate the incidence, time to development, imaging patterns, risk factors, and clinical significance of large vessel cerebral vasculopathy in pediatric patients with brain tumors treated with proton radiation therapy. METHODS AND MATERIALS: A retrospective study was performed on 75 consecutive pediatric patients with primary brain tumors treated with proton radiation therapy. Radiation-induced large vessel cerebral vasculopathy (RLVCV) was defined as intracranial large vessel arterial stenosis or occlusion confirmed on magnetic resonance angiography, computed tomographic angiography, catheter angiography, or a combination of these within an anatomic region with previous exposure to proton beam therapy and not present before radiation therapy...
July 12, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28861416/etiology-of-intracranial-stenosis-in-young-patients-a-high-resolution-magnetic-resonance-imaging-study
#10
Yu-Yuan Xu, Ming-Li Li, Shan Gao, Zheng-Yu Jin, Zhao-Yong Sun, Jie Chen, Bo Hou, Hai-Long Zhou, Feng Feng, Wei-Hai Xu
BACKGROUND: Using high-resolution magnetic resonance imaging (HRMRI), we sought to investigate the underlying etiology of intracranial stenosis in young patients. METHODS: We retrospectively studied 122 Chinese young adult patients (from 18 to 45 years old, mean age 36.2±7.5 years) with unilateral middle cerebral artery (MCA) stenosis based on a prospectively established HRMRI database. The eccentricity, degree of stenosis, and remodeling types of MCA lesions were analyzed...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28855886/advanced-imaging-of-intracranial-atherosclerosis-lessons-from-interventional-cardiology
#11
Davor Pavlin-Premrl, Rahul Sharma, Bruce C V Campbell, J Mocco, Nicholas L Opie, Thomas J Oxley
Intracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving periprocedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR), intravascular ultrasound (IVUS), and optical coherence tomography (OCT) are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28841117/transient-resolution-of-venous-sinus-stenosis-after-high-volume-lumbar-puncture-in-a-patient-with-idiopathic-intracranial-hypertension
#12
Thomas J Buell, Daniel M S Raper, I Jonathan Pomeraniec, Dale Ding, Ching-Jen Chen, Davis G Taylor, Kenneth C Liu
Stenosis of the transverse sinus (TS) and sigmoid sinus (SS), with a trans-stenosis pressure gradient, has been implicated in the pathophysiology of idiopathic intracranial hypertension (IIH). MRI has shown improvement in TS and SS stenosis after high-volume lumbar puncture (HVLP) in a subset of patients with IIH. The authors present the first report of an IIH patient with immediate post-HVLP TS and SS trans-stenosis pressure gradient reduction and an attendant increase in TS and SS cross-sectional area confirmed using intravascular ultrasonography (IVUS)...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28840277/head-and-neck-angiography-at-70%C3%A2-kvp-with-a-third-generation-dual-source-ct-system-in-patients-comparison-with-100%C3%A2-kvp
#13
Yu Chen, Xiaobo Zhang, Huadan Xue, Yuanli Zhu, Yun Wang, Yumei Li, Zhuhua Zhang, Zhengyu Jin
PURPOSE: This study was conducted in order to evaluate the image quality of 70 kVp and 25 mL contrast medium (CM) volume for head and neck computed tomographic angiography (CTA) and assess the diagnostic accuracy for arterial stenosis. METHODS: Fifty patients were prospectively divided into two groups randomly: group A (n = 25), 70 kVp with 25 mL CM, and group B (n = 25), 100 kVp with 40 mL CM. CT attenuation values, noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the shoulder, neck, and cerebral arteries were measured for objective image quality...
August 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28835400/stenting-for-symptomatic-vertebral-artery-stenosis-the-vertebral-artery-ischaemia-stenting-trial
#14
Hugh S Markus, Susanna C Larsson, Wilhelm Kuker, Ursula G Schulz, Ian Ford, Peter M Rothwell, Andrew Clifton
OBJECTIVE: To compare in the Vertebral Artery Ischaemia Stenting Trial (VIST) the risks and benefits of vertebral angioplasty and stenting with best medical treatment (BMT) alone for symptomatic vertebral artery stenosis. METHODS: VIST was a prospective, randomized, open-blinded endpoint clinical trial performed in 14 hospitals in the United Kingdom. Participants with symptomatic vertebral stenosis ≥50% were randomly assigned (1:1) to vertebral angioplasty/stenting plus BMT or to BMT alone with randomization stratified by site of stenosis (extracranial vs intracranial)...
September 19, 2017: Neurology
https://www.readbyqxmd.com/read/28828175/combination-of-dura-turning-over-and-decompressive-craniectomy-a-new-pattern-of-surgery-for-cerebral-infarction-caused-by-craniocerebral-gunshot-injury
#15
Qi-Yong Mei, Yao Li, Chao He, Hong-Wei Shan, Yun-Kun Wang, Yan Dong, Ming-Kun Yu, Li-Jun Hou
BACKGROUND: Craniocerebral gunshot injury refers to a wound caused by a bullet passing through or lodged in brain tissue, resulting in the loss of function of a certain area or other fatal damage to the human brain. Craniocerebral gunshot injury is usually life-threatening and is very common in modern warfare, accounting for the majority of battle casualties. Most of the patients suffer from acute cerebral infarction caused by vascular injury. Lack of early and solid battlefield emergency medical interference adds to the risk of death among the wounded...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28820309/advanced-cone-beam-ct-venous-angiographic-imaging
#16
Visish M Srinivasan, Gouthami Chintalapani, Edward A M Duckworth, Peter Kan
OBJECTIVE The evaluation of the venous neurovasculature, especially the dural venous sinuses, is most often performed using MR or CT venography. For further assessment, diagnostic cerebral angiography may be performed. Three-dimensional rotational angiography (3D-RA) can be applied to the venous system, producing 3D rotational venography (3D-RV) and cross-sectional reconstructions, which function as an adjunct to traditional 2D digital subtraction angiography. METHODS After querying the database of Baylor St...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28816935/perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-caused-by-transverse-sinus-thrombosis-a-case-report-and-review-of-literature
#17
Fang-Wang Fu, Jie Rao, Yuan-Yuan Zheng, Liang Song, Wei Chen, Qi-Hui Zhou, Jian-Guang Yang, Jiang-Qiong Ke, Guo-Qing Zheng
RATIONALE: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is characterized by a pattern of extravasated blood restricted to the perimesencephalic cisterns, normal angiographic findings, and an excellent prognosis with an uneventful course and low risks of complication. The precise etiology of bleeding in patients with PNSAH has not yet been established. The most common hypothesis is that PNSAH is venous in origin. Intracranial venous hypertension has been considered as the pivotal factor in the pathogenesis of PNSAH...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28801558/visceral-adiposity-index-lipid-accumulation-product-and-intracranial-atherosclerotic-stenosis-in-middle-aged-and-elderly-chinese
#18
Rui Li, Qi Li, Min Cui, Zegang Ying, Lin Li, Tingting Zhong, Yingchao Huo, Peng Xie
We investigated the association of the newly established lipid accumulation product (LAP) and visceral adiposity index (VAI) with intracranial atherosclerotic stenosis (ICAS) in middle-aged and elderly Chinese. From June 2012 to January 2013, consecutive patients ≥40 years of age who underwent cerebral vascular imaging for various medical reasons were enrolled in this study. Multivariate logistic regression models were used to evaluate the correlation of VAI and LAP with the risk of ICAS. In total, 845 patients were included in the study...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28799879/the-pathophysiology-of-chronic-noncommunicating-hydrocephalus-lessons-from-continuous-intracranial-pressure-monitoring-and-ventricular-infusion-testing
#19
Per Kristian Eide
OBJECTIVE The pathophysiology of chronic noncommunicating hydrocephalus (ncHC) is poorly understood. This present study explored whether lessons about the pathophysiology of this clinical entity might be retrieved from results of overnight monitoring of pulsatile and static intracranial pressure (ICP) and ventricular infusion testing. METHODS The study cohort included adult patients (> 20 years of age) with chronic ncHC due to aqueductal stenosis in whom symptoms had lasted a minimum of 6 months. A reference cohort consisted of age- and sex-matched patients managed for communicating HC (cHC)...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28796991/epidemiology-of-intracranial-and-extracranial-large-artery-stenosis-in-a-population-based-study-of-stroke-in-the-middle-east
#20
Hamidreza Saber, Amin Amiri, Amanda G Thrift, Saverio Stranges, Reza Bavarsad Shahripour, Mohammad T Farzadfard, Naghmeh Mokhber, Réza Behrouz, Mahmoud Reza Azarpazhooh
BACKGROUND: Intracranial large-artery disease (LAD) is a predominant vascular lesion found in patients with stroke of Asian, African, and Hispanic origin, whereas extracranial LAD is more prevalent among Caucasians. These patterns are not well-established in the Middle East. We aimed to characterize the incidence, risk factors, and long-term outcome of LAD strokes in a Middle-Eastern population. METHODS: The Mashhad Stroke Incidence Study is a community-based study that prospectively ascertained all cases of stroke among the 450,229 inhabitants of Mashhad, Iran between 2006 and 2007...
August 11, 2017: Neuroepidemiology
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