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Cerebrovascular Malformations

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https://www.readbyqxmd.com/read/28507836/microsurgical-removal-of-microcatheter-in-the-middle-cerebral-artery-during-resection-of-an-arteriovenous-malformation-resection
#1
Pejma Shazadeh Safavi, Sohum Desai, Daniel Branch, Juan R Ortega-Barnett
Surgical resection is the current standard of therapy for the treatment of arteriovenous malformation (AVM). Endovascular embolization is commonly used as an adjunct prior to surgical resection because it is believed to reduce the risk of intraoperative bleeding. Embolization has been associated with other complications including visual deficits, vessel perforation, and catheter adhesion. Catheter adhesion in which retained segments are contained within the embolization cast are not necessarily cause for concern, but retention of larger portions may confer an increased risk of thrombus formation...
April 13, 2017: Curēus
https://www.readbyqxmd.com/read/28492296/italian-consensus-in-neuroradiological-anaesthesia-icona-managing-anaesthesia-during-endovascular-procedures
#2
Carlo A Castioni, Andrea Amadori, Federico Bilotta, Moreno Bolzon, Edoardo Barboni, Anselmo Caricato, Guido Dall'acqua, Francesco DI Paola, Andrea Forastieri Molinari, Paolo Gritti, Italia LA Rosa, Marcello Longo, Carla Maglione, Pietro Martorano, Marina Munari, Valerio Perotti, Frank Rasulo, Maria Ruggiero, Antonio Santoro, Luigia Scudeller, Miriam Tumolo, Anna T Mazzeo
Anaesthetic management of patients undergoing endovascular procedures for treating intracranial aneurysms or cerebrovascular malformations must consider a number of specific challenges, in addition to those associated with anaesthesia for other specialties. In addition to maintenance of physiological stability, manipulation of systemic and cerebral haemodynamic parameters may be required to treat any sudden unexpected catastrophic neurological events. A multidisciplinary group including neuro- and pediatric anaesthesiologists, interventional neuroradiologists, neurosurgeons, and a clinical methodologist contributed to this document...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28489816/endothelial-tlr4-and-the-microbiome-drive-cerebral-cavernous-malformations
#3
Alan T Tang, Jaesung P Choi, Jonathan J Kotzin, Yiqing Yang, Courtney C Hong, Nicholas Hobson, Romuald Girard, Hussein A Zeineddine, Rhonda Lightle, Thomas Moore, Ying Cao, Robert Shenkar, Mei Chen, Patricia Mericko, Jisheng Yang, Li Li, Ceylan Tanes, Dmytro Kobuley, Urmo Võsa, Kevin J Whitehead, Dean Y Li, Lude Franke, Blaine Hart, Markus Schwaninger, Jorge Henao-Mejia, Leslie Morrison, Helen Kim, Issam A Awad, Xiangjian Zheng, Mark L Kahn
Cerebral cavernous malformations (CCMs) are a cause of stroke and seizure for which no effective medical therapies yet exist. CCMs arise from the loss of an adaptor complex that negatively regulates MEKK3-KLF2/4 signalling in brain endothelial cells, but upstream activators of this disease pathway have yet to be identified. Here we identify endothelial Toll-like receptor 4 (TLR4) and the gut microbiome as critical stimulants of CCM formation. Activation of TLR4 by Gram-negative bacteria or lipopolysaccharide accelerates CCM formation, and genetic or pharmacologic blockade of TLR4 signalling prevents CCM formation in mice...
May 10, 2017: Nature
https://www.readbyqxmd.com/read/28432261/ccm2-and-pak4-act-downstream-of-atrial-natriuretic-peptide-signaling-to-promote-cell-spreading
#4
Koichi Miura, Takashi Nojiri, Yoshiharu Akitake, Koji Ando, Shigetomo Fukuhara, Masahiro Zenitani, Toru Kimura, Jun Hino, Mikiya Miyazato, Hiroshi Hosoda, Kenji Kangawa
Atrial natriuretic peptide (ANP) is a cardiac hormone released by the atrium in response to stretching forces. Via its receptor, guanylyl cyclase-A (GC-A), ANP maintains cardiovascular homeostasis by exerting diuretic, natriuretic, and hypotensive effects mediated in part by endothelial cells. Both in vivo and in vitro , ANP enhances endothelial barrier function by reducing RhoA activity and reorganizing the actin cytoskeleton. We established mouse endothelial cells that stably express GC-A, and used them to analyze the molecular mechanisms responsible for actin reorganization...
April 21, 2017: Biochemical Journal
https://www.readbyqxmd.com/read/28366753/the-position-and-role-of-4d-cta-in-the-diagnosis-and-treatment-of-spinal-arteriovenous-fistulas
#5
Satoshi Yamaguchi, Kohei Takemoto, Masaaki Takeda, Yosuke Kajihara, Takafumi Mitsuhara, Manish Kolakshyapati, Kazutoshi Mukada, Kaoru Kurisu
BACKGROUND: Localization of the arteriovenous fistula (AVF) is a crucial step in the diagnosis and treatment of spinal vascular malformations (VMs). Non-invasive angiographic techniques such as dynamic magnetic resonance angiography (MRA) and 3-dimensional computed tomography angiography (3D-CTA) have been used as standard modalities to localize AVF. With the increasing prevalence of high-spec CT scanner, 4D-CTA is being increasingly utilized in the evaluation of cerebrovascular disorders...
March 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28338447/vein-of-galen-malformation-treated-with-the-micro-vascular-plug-system-case-report
#6
Woojin Joo, Philippe Mercier, Shiva Kheradmand, Peyman Shirani, Ahmed Sarhan, Samer K Elbabaa, Randall C Edgell
This case report describes the use of the Micro Vascular Plug (MVP) system in a mural-type vein of Galen aneurysmal malformation, resulting in successful occlusion of the cerebrovascular fistula. This result was confirmed with immediate cessation in blood flow and 6-month follow-up angiography. The unique characteristics of the MVP provide potential advantages over current embolic techniques for occlusion of high-flow, fistulous, intracranial vessels such as those seen in the vein of Galen aneurysmal malformation, and may represent a valuable addition to the currently available options...
March 24, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28323878/microsurgery-for-intracranial-arteriovenous-malformation-long-term-outcomes-in-445-patients
#7
Qingqing Ren, Min He, Yunhui Zeng, Zhiyong Liu, Hao Liu, Jianguo Xu
BACKGROUND: The management of intracranial arteriovenous malformations(AVMs) poses challenges to the cerebrovascular specialists. OBJECTIVE: To review the long-term outcomes of intracranial AVMs treated with microsurgical resections. METHODS: We performed a retrospective review of 445 patients with intracranial AVMs treated in our hospital from January 1st, 2008 to December 31st, 2014. The extracted data included demographic characteristics, clinical presentations, Spetzler-Martin (SM) grades, Supplemented Spetzler-Martin (SM-Supp) Grades, treatment modalities, long-term outcomes, and obliteration rates...
2017: PloS One
https://www.readbyqxmd.com/read/28318403/familial-cerebral-cavernous-malformations-are-associated-with-adrenal-calcifications-on-ct-scans-an-imaging-biomarker-for-a-hereditary-cerebrovascular-condition
#8
Corinne D Strickland, Steven C Eberhardt, Mary R Bartlett, Jeffrey Nelson, Helen Kim, Leslie A Morrison, Blaine L Hart
Purpose To determine if adrenal calcifications seen at computed tomography (CT) are associated with familial cerebral cavernous malformations (fCCMs) in carriers of the CCM1 Common Hispanic Mutation. Materials and Methods This study was approved by the institutional review board. The authors retrospectively reviewed abdominal CT scans in 38 patients with fCCM, 38 unaffected age- and sex-matched control subjects, and 13 patients with sporadic, nonfamilial cerebral cavernous malformation (CCM). The size, number, and laterality of calcifications and the morphologic characteristics of the adrenal gland were recorded...
March 20, 2017: Radiology
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#9
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28157750/management-of-unruptured-intracranial-aneurysms-and-cerebrovascular-malformations
#10
REVIEW
Kelly D Flemming, Giuseppe Lanzino
PURPOSE OF REVIEW: Unruptured intracranial aneurysms and vascular malformations are detected more frequently because of the increased use and availability of brain imaging. Management of these entities requires knowledge of which patients are at high risk for hemorrhage and what treatment options are available. This article summarizes the epidemiology, natural history, and management strategies for unruptured intracranial aneurysms, arteriovenous malformations, cavernous malformations, developmental venous anomalies, and capillary telangiectasias...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28069909/pregnancy-increases-stroke-risk-up-to-one-year-postpartum-and-reduces-long-term-risk
#11
Chun-An Cheng, Jiunn-Tay Lee, Hung-Che Lin, Hui-Chen Lin, Chi-Hsiang Chung, Fu-Huang Lin, Chang-Huei Tsao, Yung-Fu Wu, Wu-Chien Chien, Hung-Wen Chiu
BackgroundThe incidence of stroke in pregnant women is low but trending upward. There are few studies of the topic in women of Asian ethnicity.AimWe aim to evaluate stroke risk in Asian women during and after pregnancy.DesignUsing the Taiwan National Health Insurance database (NHIRD), we designed a retrospective study that included 18-45-year-old pregnant women between the years 2000 and 2010. We selected a 1:1 age-matched control group of non-pregnant women. The endpoint was any type of stroke during pregnancy or the postpartum period; otherwise, the patients were tracked until December 31, 2010...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28028148/strokes-associated-with-pregnancy-and-puerperium-a-nationwide-study-by-the-japan-stroke-society
#12
Kazumichi Yoshida, Jun C Takahashi, Yohei Takenobu, Norihiro Suzuki, Akira Ogawa, Susumu Miyamoto
BACKGROUND AND PURPOSE: The incidence and cause of strokes associated with pregnancy and the puerperium are still not fully understood. The aim of this study was to characterize pregnancy-related strokes in Japan using a large-scale survey with current imaging techniques. METHODS: A retrospective analysis was conducted based on clinical chart reviews in 736 stroke teaching hospitals certified by the Japan Stroke Society between 2012 and 2013, using a web-based questionnaire requesting the detailed clinical course without any personally identifying information...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28003363/nuclear-localization-of-integrin-cytoplasmic-domain-associated-protein-1-icap1-influences-%C3%AE-1-integrin-activation-and-recruits-krev-interaction-trapped-1-krit1-to-the-nucleus
#13
Kyle M Draheim, Clotilde Huet-Calderwood, Bertrand Simon, David A Calderwood
Binding of ICAP1 (integrin cytoplasmic domain-associated protein-1) to the cytoplasmic tails of β1 integrins inhibits integrin activation. ICAP1 also binds to KRIT1 (Krev interaction trapped-1), a protein whose loss of function leads to cerebral cavernous malformation, a cerebrovascular dysplasia occurring in up to 0.5% of the population. We previously showed that KRIT1 functions as a switch for β1 integrin activation by antagonizing ICAP1-mediated inhibition of integrin activation. Here we use overexpression studies, mutagenesis, and flow cytometry to show that ICAP1 contains a functional nuclear localization signal and that nuclear localization impairs the ability of ICAP1 to suppress integrin activation...
February 3, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/27978768/movement-disorders-and-cerebrovascular-diseases-from-pathophysiology-to-treatment
#14
Stefano Caproni, Carlo Colosimo
Cerebrovascular diseases are one of the most common causes of secondary movement disorders. Hypokinetic or hyperkinetic movement disorders may occur after an ischemic or hemorrhagic stroke, either immediately or thereafter. Such disorders are also known to be caused by diffuse leukoaraiosis, vascular malformations and dural fistulas in the basal ganglia or other brain regions. Area covered: The aim of this review was to describe movement disorders secondary to cerebrovascular diseases, and highlight their pivotal pathophysiological aspects, clinical features, diagnostic criteria and therapeutic options...
December 16, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27907955/decompressive-craniectomy-in-neurocritical-care
#15
Erik G Hayman, David B Kurland, Zachary Grunwald, Sebastian Urday, Kevin N Sheth, J Marc Simard
Neurosurgeons increasingly use decompressive craniectomy (DC) in neurocritical care. In this review, the authors summarize the topic of DC for the neurointensivist. Following a brief overview of the procedure, the major indications for the procedure are described. This includes a review of the literature regarding well-established indications, such as infarction and traumatic brain injury, as well as lesser known indications, including intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27881343/-surgical-management-of-proximal-anterior-cerebral-artery-a1-aneurysms
#16
Hua-Wei Wang, Zhe Xue, Yu-Dong Ma, Wen-Xin Wang, Chen Wu, Zheng-Hui Sun
OBJECTIVE: To review our experience in surgical management of proximal anterior cerebral artery (A1) aneurysms in 23 patients. METHODS: Between January, 2004 and December, 2014, 23 patients (1.6%) with A1 aneurysms diagnosed by CTA or DSA were treated surgically. The "3H" therapy was adopted for postoperative prevention of cerebrovascular spasm. All the patients were followed up and examined with cerebrovascular CTA at 6, 12, 48 and 60 months after the operation with their Glasgow Outcome Scale score recorded...
November 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27873347/infantile-hemangioma-with-minimal-or-arrested-growth-further-observations-on-clinical-and-histopathologic-findings-of-this-unique-but-underrecognized-entity
#17
Ellen Hui Ma, Susan J Robertson, Chung W Chow, Philip S Bekhor
BACKGROUND: Infantile hemangioma (IH) with minimal or arrested growth (IH-MAG) is becoming increasingly recognized in the literature. It is important to be aware of their existence, because the correct diagnosis is essential for prognostication and treatment and, in the case of facial segmental lesions, the direction of further investigations if PHACE (posterior fossa abnormalities and other structural brain abnormalities; hemangioma(s) of the cervical facial region; arterial cerebrovascular anomalies; cardiac defects, aortic coarctation, and other aortic abnormalities; eye anomalies) syndrome or Sturge-Weber syndrome is suspected...
January 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/27816803/lumen-segmentation-in-magnetic-resonance-images-of-the-carotid-artery
#18
Danilo Samuel Jodas, Aledir Silveira Pereira, João Manuel R S Tavares
Investigation of the carotid artery plays an important role in the diagnosis of cerebrovascular events. Segmentation of the lumen and vessel wall in Magnetic Resonance (MR) images is the first step towards evaluating any possible cardiovascular diseases like atherosclerosis. However, the automatic segmentation of the lumen is still a challenge due to the low quality of the images and the presence of other elements such as stenosis and malformations that compromise the accuracy of the results. In this article, a method to identify the location of the lumen without user interaction is presented...
December 1, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#19
REVIEW
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
December 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27797413/selective-arterial-spin-labeling-in-conjunction-with-phase-contrast-acquisition-for-the-simultaneous-visualization-of-morphology-flow-direction-and-velocity-of-individual-arteries-in-the-cerebrovascular-system
#20
Thomas Lindner, Naomi Larsen, Olav Jansen, Michael Helle
PURPOSE: In various cerebrovascular diseases the visualization of individual arteries and knowledge about their hemodynamic properties, like flow velocity and direction, can become important for an accurate diagnosis. Magnetic resonance angiography methods are intended to acquire this information, but often a single acquisition is not sufficient to retrieve all of this desired information. METHODS: Using selective arterial spin labeling (ASL) methods, a single artery of interest can be tagged and visualized, whereas quantitative information about hemodynamics can be retrieved using phase-contrast techniques that are often limited regarding their selectivity...
October 31, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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