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Intracranial stenosis

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https://www.readbyqxmd.com/read/28073989/patency-of-the-vein-of-labb%C3%A3-after-venous-stenting-of-the-transverse-and-sigmoid-sinuses
#1
Daniel M S Raper, Dale Ding, Ching-Jen Chen, Thomas J Buell, R Webster Crowley, Kenneth C Liu
BACKGROUND: Venous sinus stenting is an emerging treatment for patients with idiopathic intracranial hypertension and evidence of venous stenosis. Stents placed across the transverse and sigmoid sinuses often cover the vein of Labbé (VOL), a major anastomotic vein draining the cerebral hemisphere. The patency of the VOL after stenting and its clinical implications are poorly understood. METHODS: A retrospective analysis was performed of a prospectively collected database of patients undergoing venous sinus stenting...
January 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#2
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28065234/quantitative-measurement-of-cerebral-blood-flow-in-enhanced-psedo-continuous-arterial-spin-labeling-perfusion-imaging-in-patients-with-intracranial-atherosclerotic-stenosis
#3
Yang Xu, Jin-Hao Lü, Lin Ma, Wei-Jun Chen, Xin Lou
<strong>Objective</strong> To acquire cerebral blood flow (CBF) in patients with severe intracranial atherosclerotic stenosis with enhanced pseudo-continuous arterial spin labeling (e-pCASL) and compare it with the findings of dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC PWI) and pseudo-continuous arterial spin labeling (pCASL). <strong>Methods</strong> A total of 39 consecutive patients with severe intracranial atherosclerotic stenosis were enrolled in this study...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28064332/the-endovascular-treatment-of-bilateral-infarction-of-middle-cerebellar-peduncles-etiology-and-endovascular-treatment-analysis
#4
Qihao Dong, Guoxian Jing, Ju Han
Infarction of the symmetrical middle cerebellar peduncles is often induced by ischemic cerebrovascular disease. Adams described the anterior inferior cerebellar artery (AICA) syndrome as early as 1943, but clinical and imaging studies following this failed to shed more light regarding the condition until the advent of magnetic resonance imaging that comprehension regarding AICA improved significantly. Infarction of the middle cerebellar peduncles (MCP) is uncommon and the endovascular treatment of this condition is even more rare...
January 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28061015/impact-of-vessel-wall-lesions-and-vascular-stenoses-on-cerebrovascular-reactivity-in-patients-with-intracranial-stenotic-disease
#5
Petrice M Cogswell, Taylor L Davis, Megan K Strother, Carlos C Faraco, Allison O Scott, Lori C Jordan, Matthew R Fusco, Blaise deB Frederick, Jeroen Hendrikse, Manus J Donahue
PURPOSE: To compare cerebrovascular reactivity (CVR) and CVR lagtimes in flow territories perfused by vessels with vs. without proximal arterial wall disease and/or stenosis, separately in patients with atherosclerotic and nonatherosclerotic (moyamoya) intracranial stenosis. MATERIALS AND METHODS: Atherosclerotic and moyamoya patients with >50% intracranial stenosis and <70% cervical stenosis underwent angiography, vessel wall imaging (VWI), and CVR-weighted imaging (n = 36; vessel segments evaluated = 396)...
January 6, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28059705/emergent-endovascular-management-of-long-segment-and-flow-limiting-carotid-artery-dissections-in-acute-ischemic-stroke-intervention-with-multiple-tandem-stents
#6
S A Ansari, A L Kühn, A R Honarmand, M Khan, M C Hurley, M B Potts, B S Jahromi, A Shaibani, M J Gounis, A K Wakhloo, A S Puri
BACKGROUND AND PURPOSE: Although most cervical dissections are managed medically, emergent endovascular treatment may become necessary in the presence of intracranial large-vessel occlusions, flow-limiting and long-segment dissections with impending occlusion, and/or hypoperfusion-related ischemia at risk of infarction. We investigated the role of emergent endovascular stenting of long-segment carotid dissections in the acute ischemic stroke setting. MATERIALS AND METHODS: We retrospectively studied long-segment carotid dissections requiring stent reconstruction with multiple tandem stents (≥3 stents) and presenting with acute (<12 hours) ischemic stroke symptoms (NIHSS score, ≥4)...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28057635/in-vivo-assessment-of-the-impact-of-regional-intracranial-atherosclerotic-lesions-on-brain-arterial-3d-hemodynamics
#7
C Wu, S Schnell, P Vakil, A R Honarmand, S A Ansari, J Carr, M Markl, S Prabhakaran
BACKGROUND AND PURPOSE: Intracranial atherosclerosis induces hemodynamic disturbance, which is not well-characterized, particularly in cerebral flow redistribution. We aimed to characterize the impact of regional stenotic lesions on intracranial hemodynamics by using 4D flow MR imaging. MATERIALS AND METHODS: 4D flow MR imaging was performed in 22 symptomatic patients (mean age, 68.4 ± 14.2 years) with intracranial stenosis (ICA, n = 7; MCA, n = 9; basilar artery, n = 6) and 10 age-appropriate healthy volunteers (mean age, 60...
January 5, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28056282/-diagnostic-value-of-clot-burden-score-of-susceptibility-vessel-sign-in-arterial-thrombosis-of-acute-ischemic-stroke-and-its-association-with-prognosis
#8
Y Huang, W L Mei, H Q Liu, Y L Li, Z Z Chen, D D Li, J W Zhang
Objective: To analysis the value of susceptibility vessel sign (SVS) in susceptibility weighted imaging (SWI) in detecting thrombogenesis in middle cerebral artery (MCA) and its association with clinical prognosis. Methods: From December 2014 to December 2015 in People's Hospital of Zhengzhou University, we retrospectively examined clinical, imaging and experimental datafrom 104 consecutive patients with acute ischemic strokeand compared the consistency of detecting thrombus between SWI and magnetic resonance angiography (MRA) using Kappa analysis...
January 3, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28045690/clinical-case-of-the-month-a-49-year-old-man-who-presents-with-left-sided-weakness-an-update-on-ischemic-stroke
#9
Najy Masri, Rikki Weems, Falon Brown, Ben Andres, Fred Lopez
A 49 year-old man with a past medical history significant for essential hypertension, hyperlipidemia, and coronary artery disease status post percutaneous coronary intervention and stent placement in the right coronary artery in 2010 presented for evaluation of left hemiplegia. He was feeling well until three hours prior to presentation, at which time he fell while walking from his bedroom into the kitchen. After falling, he noticed that his left upper and lower extremities felt weak. He denied any symptoms preceding the fall or any loss of consciousness...
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28029271/hemodynamic-mechanisms-underlying-elevated-oxygen-extraction-fraction-oef-in-moyamoya-and-sickle-cell-anemia-patients
#10
Jennifer M Watchmaker, Meher R Juttukonda, Larry T Davis, Allison O Scott, Carlos C Faraco, Melissa C Gindville, Lori C Jordan, Petrice M Cogswell, Angela L Jefferson, Howard S Kirshner, Manus J Donahue
Moyamoya is a bilateral, complex cerebrovascular condition characterized by progressive non-atherosclerotic intracranial stenosis and collateral vessel formation. Moyamoya treatment focuses on restoring cerebral blood flow (CBF) through surgical revascularization, however stratifying patients for revascularization requires abilities to quantify how well parenchyma is compensating for arterial steno-occlusion. Globally elevated oxygen extraction fraction (OEF) secondary to CBF reduction may serve as a biomarker for tissue health in moyamoya patients, as suggested in patients with sickle cell anemia (SCA) and reduced oxygen carrying capacity...
January 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28017750/the-pulserider%C3%A2-for-the-treatment-of-wide-neck-bifurcation-intracranial-aneurysms-6-months-results
#11
Benjamin Gory, Alejandro M Spiotta, Franscesco di Paola, Salvatore Mangiafico, Leonardo Renieri, Arturo Consoli, Alessandra Biondi, Roberto Riva, Paul-Emile Labeyrie, Francis Turjman
BACKGROUND/OBJECTIVE: PulseRider® is a new endovascular stent dedicated to treat bifurcation intracranial aneurysms with a wide neck. Our purpose is to evaluate 6-months clinical and anatomical results of the device when used to facilitate endovascular coiling of wide-neck bifurcation aneurysms. METHODS: Unruptured intracranial aneurysms coiled with PulseRider®, in 6 European centers and 1 US center, were retrospectively reviewed from June 2014 to October 2015...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017227/comparison-of-stent-versus-medical-therapy-for-symptomatic-patients-with-intracranial-atherosclerotic-stenosis-a-meta-analysis
#12
Qian Zhang, Kai Dong, Haiqing Song
PURPOSE: To compare the outcomes of intracranial stent implantation and medical therapy for treatment of severe intracranial stenosis. METHODS: Articles were identified from Medline, Cochrane, EMBASE, and Google Scholar published up to August 25, 2016. Eligible studies reported stroke occurrence, transient ischemic attack (TIA), and event-free survival rates in patients who suffered recent TIA or stroke caused by stenosis of a major intracranial artery and treated with either medical therapy or stenting...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28017177/maintenance-of-balance-between-airway-pressure-and-intracranial-pressure-in-a-patient-with-tracheal-stenosis-undergoing-craniotomy-a-case-report
#13
Çiğdem Yıldırım Güçlü, Başak Ceyda Meço, Meltem Karamustafa, Yüksel Keçik
BACKGROUND AND OBJECTIVES: Tracheal stenosis is a rare but a life-threatening condition and anesthesia of a patient with tracheal stenosis is challenging for anesthesiologists. Maintaining stable hemodynamics and ventilation parameters are important issues in neuroanesthesia. Any increase in airway peak pressure and ETCO2 will result in increase in intracranial pressure which must be avoided during craniotomies. Tracheal stenosis could be a reason for increased airway pressure. CASE REPORT: We described a patient undergoing craniotomy with tracheal stenosis...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28009240/venous-sinus-stenting-for-reduction-of-intracranial-pressure-in-iih-a-prospective-pilot-study
#14
Kenneth C Liu, Robert M Starke, Christopher R Durst, Tony R Wang, Dale Ding, R Webster Crowley, Steven A Newman
OBJECTIVE Idiopathic intracranial hypertension (IIH) may cause blindness due to elevated intracranial pressure (ICP). Venous sinus stenosis has been identified in select patients, leading to stenting as a potential treatment, but its effects on global ICP have not been completely defined. The purpose of this pilot study was to assess the effects of venous sinus stenting on ICP in a small group of patients with IIH. METHODS Ten patients for whom medical therapy had failed were prospectively followed. Ophthalmological examinations were assessed, and patients with venous sinus stenosis on MR angiography proceeded to catheter angiography, venography with assessment of pressure gradient, and ICP monitoring...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28003500/relationship-between-risk-factor-control-and-vascular-events-in-the-sammpris-trial
#15
Tanya N Turan, Azhar Nizam, Michael J Lynn, Brent M Egan, Ngoc-Anh Le, Maria F Lopes-Virella, Kathie L Hermayer, Jamie Harrell, Colin P Derdeyn, David Fiorella, L Scott Janis, Bethany Lane, Jean Montgomery, Marc I Chimowitz
OBJECTIVE: The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study is the first stroke prevention trial to include protocol-driven intensive management of multiple risk factors. In this prespecified analysis, we aimed to investigate the relationship between risk factor control during follow-up and outcome of patients in the medical arm of SAMMPRIS. METHODS: Data from SAMMPRIS participants in the medical arm (n = 227) were analyzed...
December 21, 2016: Neurology
https://www.readbyqxmd.com/read/27994695/ct-angiographic-evaluation-of-pattern-and-distribution-of-stenosis-and-its-association-with-risk-factors-among-indian-ischemic-stroke-patients
#16
Amit Shrivastava, Trilochan Srivastava, Richa Saxena
BACKGROUND: Stroke is the major cause of disability and third major cause of death. Ischemia causes about 80% of stroke cases; stenosis and occlusion are the predominant cause of stroke. Our purpose for this study was to evaluate the pattern and distribution of stenosis and its association with risk factors in Indian ischemic stroke patients and in other countries, for comparison. MATERIAL/METHODS: We evaluated 60 patients after ischemic stroke with CT angiography...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27986847/mri-audit-of-complications-in-intracranial-stenosis-treated-with-wingspan-device
#17
Leonard L L Yeo, Y M Wu, Y L Chen, C H Yeh, T H Lee, H F Wong
OBJECTIVES: To evaluate the safety and efficacy of the Wingspan device for the treatment of symptomatic intracranial atherosclerotic stenosis (ICAS). METHODS: We audited a prospective ongoing database of consecutive patients who received Wingspan stenting between January 2013 and December 2015. All patients underwent MRI to audit any complications during the early follow-up period. We focused on the clinical demographics, lesion characteristics, treatment results, and periprocedural complications...
December 16, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27960192/transcranial-doppler
#18
Vijay K Sharma, Ka Sing Wong, Andrei V Alexandrov
Transcranial Doppler ultrasonography (TCD) is the only diagnostic modality that provides a reliable evaluation of intracranial blood flow patterns in real-time. The physiological information obtained from TCD is complementary to the anatomical details obtained from other neuroimaging modalities. TCD is relatively cheap, can be performed bedside, and allows monitoring in acute emergency settings. TCD criteria for intracranial stenosis have been validated against various forms of angiographic studies and serve as reliable tools for screening, diagnostic as well as follow up purposes...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960191/pathological-characteristics
#19
Xiang-Yan Chen, Mark Fisher
Within the intracranial vasculature, atherosclerosis occurs in two distinctive patterns: (1) in Western populations who have severe extracranial and systemic atherosclerosis, the severity of intracranial involvement is consistently less than that within extracranial arteries; and (2) in Asians, Africans, and Hispanics, who often have isolated intracranial arterial disease that is found to be more often accompanied by brain infarction than comparable extracranial atherosclerotic disease. Compared to coronary and extracranial carotid atherosclerosis, intracranial atherosclerosis has distinct pathological characteristics compared to that of extracranial arteries...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27960184/vessel-and-vessel-wall-imaging
#20
Seung Chai Jung, Dong-Wha Kang, Tanya N Turan
Angiography is a useful, important, common imaging method, with digital subtraction angiography (DSA) remaining the gold standard for luminal imaging. Computed tomography angiography (CTA) is minimally invasive and quite accurate in the evaluation of stenosis. Magnetic resonance angiography (MRA) is a good screening tool with the least invasiveness. Angiography mostly represents intracranial artery disease as luminal stenosis, which is often not sufficient to evaluate intracranial vascular pathology. The modalities provide indirect information about vascular pathology because luminal change, such as stenosis, results from the changes of vessel walls...
2016: Frontiers of Neurology and Neuroscience
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