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Intracranial stenosis

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https://www.readbyqxmd.com/read/29153338/prevalence-and-prognosis-of-intracranial-stenosis-in-acute-ischemic-stroke-a-single-center-registry-from-turkey
#1
(no author information available yet)
Background/aim: Intracranial stenosis (ICS) is identified in 2.2%?70.4% of patients with ischemic stroke and transient ischemic attack. This study aimed to determine the prevalence of ICS in a single center registry from Turkey. Materials and methods: We reviewed the charts of 619 patients with acute ischemic stroke. ICS was defined as any ICS > 50% on cerebrovascular imaging. The demographic data, risk factors, NIHSS scores and C reactive protein level at admission, mortality in hospital, recurrent stroke, and mRS in the follow-up period were recorded...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29146726/endovascular-rescue-treatment-through-stent-positioning-after-surgical-clipping-of-intracranial-aneurysms-complicated-by-parent-artery-obstruction
#2
Giovanni Vitale, Giacomo Talenti, Joseph Gabrieli, Giacomo Cester, Alessandro Della Puppa, Francesco Causin
During aneurysm clipping, ischemic complications may occur and require a rescue treatment, usually surgical. We present two such cases that required urgent rescue treatment, performed through an endovascular route. Our first case presented with a non-ruptured right posterior inferior cerebellar artery (PICA) aneurysm. After permanent clip positioning, occlusion of the PICA occurred. An unsuccessful attempt of clip repositioning was performed. We therefore positioned a stent obtaining complete flow restoration...
November 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29131102/a-case-of-a-4-year-old-female-with-a-primary-spinal-malignancy-presenting-with-froin-s-syndrome
#3
Andrew T Hale, Gregory P Fricker, Travis W Crook
We report the case of a 4-year-old female with a primary extradural intramedullary atypical teratoid/rhabdoid tumor (AT/RT) leading to a middle cerebral artery (MCA) infarct and Froin's syndrome. She presented with a 6-pound weight loss over the previous week, as well as a decreased urinary output and an altered mental status. She underwent a brain MRI that revealed a left MCA infarct, mild ventriculomegaly, and bilateral internal carotid artery, M1, and A1 stenosis. An external ventricular drain (EVD) was placed due to increased intracranial pressure...
November 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29130668/-analysis-on-clinical-characteristic-and-risk-factors-of-patients-coexistence-of-cerebral-artery-stenosis-with-unruptured-intracranial-aneurysm
#4
Hai-Yan Zhao, Jin-Tao Han, Dong-Sheng Fan
OBJECTIVE: To analyze the incidence of intracranial unruptured aneurysms in patients with intracranial artery stenosis,clinical features,and investigate the risk factors for unruptured intracranial aneurysms. METHODS: Medical records from all patients performed with digital subtraction angiography (DSA) who had been treated at Peking University Third Hospital,China,from January 2012 to December 2015 were retrospectively reviewed to identify cases coexistence with cerebral artery stenosis and unruptured intracranial aneurysm...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29125024/wingspan-stent-delivery-catheter-fracture-and-the-trap-technique-for-endovascular-salvage
#5
Manoj Jagani, Huy M Do, Jeremy J Heit
Background Intracranial atherosclerotic disease may result in ischemic infarction and has a high rate of recurrent ischemic strokes despite medical therapy. Patients who fail medical therapy may undergo endovascular treatment with cerebral artery angioplasty and possible Wingspan stent placement. We present a unique case of Wingspan delivery microcatheter fracture that resulted in a retained foreign body and an endovascular salvage maneuver. Case description An elderly patient presented with an acute ischemic stroke due to a severe stenosis in the proximal left middle cerebral artery (MCA)...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29121660/associations-between-fatty-liver-index-and-asymptomatic-intracranial-vertebrobasilar-stenosis-in-chinese-population
#6
Jing Qiu, Zhiwei Zhou, Jie Wang, Yiying Wang, Chunxing Liu, Xingxiang Liu, Yunfang Xu, Lugang Yu, Hui Zhou, Jie Lin, Zhirong Guo, Chen Dong
Metabolic diseases such as type 2 diabetes mellitus (T2DM) and metabolic syndromes (MetS) have been recognized as the important risk factors for asymptomatic intracranial vertebrobasilar stenosis (IVBS). Although fatty liver index (FLI) is significantly related with these diseases, the association between FLI and IVBS remains unclear. In the present study, 2368 participants (30-75 years) were recruited from a Chinese prospective cohort study of PMMJS. Amongst them, 2281 individuals who did not have IVBS at baseline were enrolled in the 6-year following-up study...
2017: PloS One
https://www.readbyqxmd.com/read/29118803/multimodal-therapy-for-non-superacute-vertebral-basilar-artery-occlusion
#7
Xiongjun He, Liang Zhang, Juan Yang, Hui Zheng, Kaifeng Li, Yajie Liu
Objective: The aim of this study was to evaluate the feasibility and safety of multimodal therapy for patients with non-superacute vertebral basilar artery occlusion. Method: We performed a retrospective analysis of multimodal therapy for patients with vertebral basilar artery occlusion. All patients who were beyond the time window to receive intravenous thrombolysis and who had deterioration of symptoms after drug treatment received small-balloon dilatation of the occlusive artery to estimate vascular occlusion aetiology...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29118794/safety-and-efficacy-of-low-profile-self-expandable-stents-for-treatment-of-intracranial-aneurysms-initial-and-midterm-results-a-systematic-review-and-meta-analysis
#8
Su-Yeon Park, Jae-Sang Oh, Hyuk-Jin Oh, Seok-Mann Yoon, Hack-Gun Bae
Low-profile stents seem to be associated with a higher incidence of thromboembolic events compared with preexisting stents. We conducted a systematic review of 11 eligible reports and a meta-analysis of 7 reports with respect to the clinical efficacy and safety of low-profile stents. There were 217 intracranial aneurysms reported; 22% were ruptured aneurysms. In all, 72% were treated using single stenting, 19% were treated using overlapping stenting, and 6% were treated using balloon angioplasty followed by stenting; 3% were used to assess the flow diverter effect in a dissecting aneurysm or were treated using unexpected subtotal coil packing...
October 2017: Interventional Neurology
https://www.readbyqxmd.com/read/29114973/internal-jugular-vein-stenosis-induced-intracranial-hypertension-can-be-resolved-by-stenting
#9
Da Zhou, Ran Meng, Xuxiang Zhang, Linlin Guo, Sijie Li, Weijuan Wu, Jiangang Duan, Haiqing Song, Yuchuan Ding, Xunming Ji
BACKGROUND: Idiopathic intracranial hypertension (IIH) is characterized by abnormally elevated intracranial pressure (ICP) without identifiable etiology. Recently, however, a subset of patients with presumed IIH have been found with isolated internal jugular vein (IJV) stenosis in the absence of intracranial abnormalities. METHODS: Fifteen consecutive patients were screened from 46 patients suspected as IIH and were finally confirmed as isolated IJV stenosis. The stenotic IJV was corrected with stenting when a trans-stenotic mean pressure gradient (∆MPG) was equal or higher than 5...
November 8, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29113853/hyperkinetic-transient-ischemic-attacks-preceding-deep-ganglionic-infarction-in-a-patient-with-a-treated-parasellar-chondrosarcoma
#10
Michael W Ruff, Adip G Bhargav, Stephen W English, James P Klaas
A 44-year-old right-handed female with a past medical history of parasellar chondrosarcoma status post-surgical debulking and proton beam therapy (70 Gy) three years prior to presentation experienced several hours of brief, repetitive episodes of transient hemiballism and dystonia; this was followed by abrupt onset of fixed hemiparesis and dysarthria weeks later, ipsilateral to her prior hyperkinetic movements. She was found to have total occlusion of the right middle cerebral artery with focal stenosis of the proximal right A-1 segment of the anterior cerebral artery adjacent to the remnants of the chondrosarcoma...
November 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29107636/impact-of-side-branches-on-the-computation-of-fractional-flow-in-intracranial-arterial-stenosis-using-the-computational-fluid-dynamics-method
#11
Haipeng Liu, Linfang Lan, Xinyi Leng, Hing Lung Ip, Thomas W H Leung, Defeng Wang, Ka Sing Wong
BACKGROUND: Computational fluid dynamics (CFD) allows noninvasive fractional flow (FF) computation in intracranial arterial stenosis. Removal of small artery branches is necessary in CFD simulation. The consequent effects on FF value needs to be judged. METHODS: An idealized vascular model was built with 70% focal luminal stenosis. A branch with one third or one half of the radius of the parent vessel was added at a distance of 5, 10, 15 and 20 mm to the lesion...
October 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29102392/brachiocephalic-arterial-occlusive-disease-presenting-as-limb-shaking-transient-ischemic-attacks
#12
Eric D Goldstein, Rocco Cannistraro, Stephen English, Rocio Vazquez Do Campo, Benjamin Eidelman
Limb-shaking transient ischemic attacks (LSTIAs) are a phenomenon that occurs due to transient hypoperfusion to a cerebral motor territory with a chronically outstripped autoregulatory vascular reserve. First described in 1962 by Miller Fisher, the pathogenesis and the global understanding of this presentation have undergone a significant advancement throughout the years. Typically, patients will present with this syndrome of transient hypoperfusion in the context of extracranial carotid intrinsic vessel stenosis or by intracranial vascular stenosis to select motor pathways...
October 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29101614/visual-outcome-after-endoscopic-third-ventriculostomy-for-hydrocephalus
#13
Ji-Ho Jung, Yong-Hyun Chai, Shin Jung, In-Young Kim, Woo-Youl Jang, Kyung-Sub Moon, Seul-Kee Kim, Sangjoon Chong, Seung-Ki Kim, Tae-Young Jung
PURPOSE: Hydrocephalus-related symptoms are mostly improved after successful endoscopic third ventriculostomy (ETV). However, visual symptoms can be different. This study was focused on visual symptoms. We analyzed the magnetic resonance images (MRI) of the orbit and visual outcomes. METHODS: From August 2006 to November 2016, 50 patients with hydrocephalus underwent ETV. The male-to-female ratio was 33:17, and the median age was 61 years (range, 5-74 years). There were 18 pediatric and 32 adult patients...
November 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29098320/iatrogenic-vessel-dissection-in-endovascular-treatment-of-acute-ischemic-stroke
#14
Barbara Goeggel Simonetti, Justine Hulliger, Etienne Mathier, Simon Jung, Urs Fischer, Hakan Sarikaya, Johannes Slotboom, Gerhard Schroth, Pasquale Mordasini, Jan Gralla, Marcel Arnold
PURPOSE: Knowledge about the localization and outcome of iatrogenic dissection (ID) during endovascular treatment of acute ischemic stroke (AIS) is limited. We aimed to determine the frequency, clinical aspects and morphology of ID in endovascular AIS treatment and to identify predictors of this complication. METHODS: Digital subtraction angiography (DSA) of ID carried out during endovascular treatment between January 2000 and March 2012 have been re-evaluated. The ID localization and morphology were analyzed and related to the interventional techniques...
November 2, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29097132/cavernous-carotid-stenosis-following-stereotactic-radiosurgery-for-cushing-s-disease-a-rare-complication-and-review-of-the-literature
#15
Mohana Rao Patibandla, Zhiyuan Xu, David Schlesinger, Jason P Sheehan
Intracranial carotid stenosis or occlusion after SRS is an extraordinarily rare event. Because of the rarity of this event, increased awareness within the neurosurgical community is required. For those with post-radiosurgical carotid stenosis who are asymptomatic, longitudinal follow up is recommended. Management depends on whether the patient is symptomatic or asymptomatic. Those who are symptomatic may require balloon angioplasty, stenting, or bypass surgery.
October 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29089414/flow-diversion-for-anterior-choroidal-artery-acha-aneurysms-a-multi-institutional-experience
#16
Visish M Srinivasan, Michael George Zaki Ghali, Jacob Cherian, Maxim Mokin, Ajit S Puri, Ramesh Grandhi, Stephen R Chen, Jeremiah N Johnson, Peter Kan
BACKGROUND: Anterior choroidal artery (AChA) aneurysms represent a small subset of cerebral aneurysms. The Pipeline Embolization Device (PED) has been successfully applied to various aneurysms of the supraclinoid internal carotid artery (ICA). The treatment of these aneurysms requires special attention due to the eloquent territory supplied by the AChA. We report the largest and first dedicated series of flow diversion treatment of AChA aneurysms. METHODS: Four institutional neurointerventional databases were reviewed for cases of intracranial aneurysms treated with PED...
October 31, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29084065/recent-advances-in-the-management-of-symptomatic-vertebral-artery-stenosis
#17
Anna M Drazyk, Hugh S Markus
PURPOSE OF REVIEW: Vertebrobasilar stenosis accounts for 20% of posterior circulation strokes and is associated with high risk of early stroke recurrence. We review data from randomized controlled trials examining whether stenting may reduce this risk, including the recently published Vertebral Artery Ischaemia Stenting Trial (VIST). RECENT FINDINGS: VIST and VAST (Vertebral Artery Stenting Trial), having recruited both intracranial and extracranial vertebral stenosis and showed a low rate of perioperative stroke for extracranial (0 and 2%, respectively), but a higher rate for intracranial stenosis (15 and 22%, respectively)...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29083523/mri-of-plaque-characteristics-and-relationship-with-downstream-perfusion-and-cerebral-infarction-in-patients-with-symptomatic-middle-cerebral-artery-stenosis
#18
Shan-Shan Lu, Song Ge, Chun-Qiu Su, Jun Xie, Jian Mao, Hai-Bin Shi, Xun-Ning Hong
BACKGROUND: Intracranial plaque characteristics are associated with stroke events. Differences in plaque features may explain the disconnect between stenosis severity and the presence of ischemic stroke. PURPOSE: To investigate the relationship between plaque characteristics and downstream perfusion changes, and their contribution to the occurrence of cerebral infarction beyond luminal stenosis. STUDY TYPE: Case control. SUBJECTS: Forty-six patients with symptomatic middle cerebral artery (MCA) stenosis (with acute cerebral infarction, n = 30; without acute cerebral infarction, n = 16)...
October 30, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29067093/stent-retriever-thrombectomy-combined-with-local-thrombolytic-therapy-for-cerebral-venous-sinus-thrombosis-a-case-report
#19
Chengwei Chen, Qiujing Wang, Xifeng Li, Ziming Lu, Jian He, Qinrui Fang, Xunchang Ke, Chuanzhi Duan, Tielin Li
The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venography (MRV) or digital subtraction angiography (DSA). Systemic anticoagulation was the initial treatment in all patients following admission. In group A, stent retriever thrombectomy combined with local thrombolytic therapy was performed on 14 patients who met the criteria of endovascular therapy...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29056405/concomitant-asymptomatic-intracranial-atherosclerotic-stenosis-increase-the-30-day-risk-of-stroke-in-patients-undergoing-symptomatic-intracranial-atherosclerotic-stenosis-stenting
#20
Jin Zhao, Xiaohui Li, Lu-Xiang Chi, Bing-Wu Ma, Yan-Hui Du, Gui-Sheng Chen, Hua-Dong Zhou, Jing-Cheng Li, Xiao-Jiang Jiang, Qing-Wu Yang, Xiong-Fei Zhao, Xiao-Feng Yao
BACKGROUND: In the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial, 19.1% of ischemic strokes occurred out of the territory of previously symptomatic stenosis during the mean follow-up period of 23.4 months. However, it is unknown how many ischemic strokes were due to a previously asymptomatic intracranial atherosclerotic stenosis (ICAS). The objective of this study was to investigate whether the concomitant asymptomatic ICAS influences the outcome of patients undergoing symptomatic ICAS stenting...
October 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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