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Cerebrovascular anatomy

Hiramani Dhungana, Mikko T Huuskonen, Taina Pihlajaniemi, Ritva Heljasvaara, Denis Vivien, Katja M Kanninen, Tarja Malm, Jari Koistinaho, Sighild Lemarchant
Collagens are key structural components of basement membranes, providing a scaffold for other components or adhering cells. Collagens and collagen-derived active fragments contribute to biological activities such as cell growth, differentiation and migration. Here, we report that collagen XV knock-out (ColXV KO) mice are resistant to experimental ischemic stroke. Interestingly, the infarcts of ColXV KO mice were as small as those of wild-type (WT) mice thrombolysed with recombinant tissue plasminogen activator (rtPA), the actual treatment for ischemic stroke...
January 12, 2017: Cell Death & Disease
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
Evan Kurniawan, Feng-Hua Ding, Qi Zhang, Zhen-Kun Yang, Jian Hu, Wei-Feng Shen, Rui-Yan Zhang
OBJECTIVE: To evaluate the predictive value of SYNTAX Score II (SS-II) for percutaneous coronary intervention (PCI) in octogenarian (≥ 80 years old) undergoing PCI. METHODS & RESULTS: Data from three consecutive years of octogenarian undergoing PCI from Ruijin Hospital (Shanghai, China) was retrospectively collected (n = 308). Follow up clinical data at one year including all cause mortality, cardiac mortality and main adverse cardiovascular and cerebrovascular events (MACCE) were collected...
September 2016: Journal of Geriatric Cardiology: JGC
Curtis Edward Offiah, Emily Day
: Imaging of the blunt traumatic injuries to the craniocervical junction can be challenging but central to improving morbidity and mortality related to such injury. The radiologist has a significant part to play in the appropriate management of patients who have suffered injury to this vital junction between the cranium and the spine. Knowledge of the embryology and normal anatomy as well as normal variant appearances avoids inappropriate investigations in these trauma patients. Osseous injury can be subtle while representing important radiological red flags for significant underlying ligamentous injury...
November 4, 2016: Insights Into Imaging
Rui Machado, Gabriela Teixeira, Pedro Oliveira, Luís Loureiro, Carlos Pereira, Rui Almeida
Introduction: Abdominal aortic aneurysm has a lower incidence in the female population, but a higher complication rate. It was been hypothesized that some anatomical differences of abdominal aortic aneurysm in women could be responsible for that. We proposed to analyze our data to understand the differences in the clinical and anatomical characteristics and the outcomes of patients undergoing endovascular aneurysm repair, according to gender. Methods: A retrospective analysis of patients undergoing endovascular aneurysm repair between 2001-2013 was performed...
May 2016: Brazilian Journal of Cardiovascular Surgery
Stephen L Lambert, Frank J Williams, Zhora Z Oganisyan, Lionel A Branch, Edward C Mader
Fetal-type or fetal posterior cerebral artery (FPCA) is a variant of cerebrovascular anatomy in which the distal posterior cerebral artery (PCA) territory is perfused by a branch of the internal carotid artery (ICA). In the presence of FPCA, thromboembolism in the anterior circulation may result in paradoxical PCA territory infarction with or without concomitant infarction in the territories of the middle (MCA) or the anterior (ACA) cerebral artery. We describe 2 cases of FPCA and concurrent acute infarction in the PCA and ICA territories-right PCA and MCA in Patient 1 and left PCA, MCA, and ACA in Patient 2...
July 2016: Journal of Investigative Medicine High Impact Case Reports
Charlie Chia-Tsong Hsu, Gigi Nga Chi Kwan, Dalveer Singh, Jit Pratap, Trevor William Watkins
Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imaging cerebrovascular diseases, which includes: (1) Identification of active extravasation of iodinated contrast in various types of intracranial hemorrhage; (2) differentiation between hemorrhagic transformation and iodine staining in acute ischemic stroke following diagnostic and/or therapeutic catheter angiography; (3) identification of culprit lesions in intra-axial hemorrhage; (4) calcium subtraction from atheromatous plaque for the assessment of plaque morphology and improved quantification of luminal stenosis; (5) bone subtraction to improve the depiction of vascular anatomy with more clarity, especially at the skull base; (6) metal artifact reduction utilizing virtual monoenergetic reconstructions for improved luminal assessment postaneurysm coiling or clipping...
2016: Journal of Clinical Imaging Science
Mark A Fletcher, Kathy A Low, Rachel Boyd, Benjamin Zimmerman, Brian A Gordon, Chin H Tan, Nils Schneider-Garces, Bradley P Sutton, Gabriele Gratton, Monica Fabiani
Recent studies suggest that cardiorespiratory fitness (CRF) mitigates the brain's atrophy typically associated with aging, via a variety of beneficial mechanisms. One could argue that if CRF is generally counteracting the negative effects of aging, the same regions that display the greatest age-related volumetric loss should also show the largest beneficial effects of fitness. To test this hypothesis we examined structural MRI data from 54 healthy older adults (ages 55-87), to determine the overlap, across brain regions, of the profiles of age and fitness effects...
2016: Frontiers in Human Neuroscience
Dong Seong Shin, Ali Yilmaz, Ayca Ozkul, Dong Kyu Yeo, Sun-Chul Hwang, Bum-Tae Kim
Objective The transfemoral approach is a common route for catheterization of the supra-aortic vessels in neuroendovascular therapy. However, in some cases, the patient's anatomy prevents transfemoral catheterization or distal access to the carotid s. In such cases, direct carotid exposure (DCE) for neuroendovascular approaches may be used to treat cerebrovascular diseases. Methods We present 11 cases in which we were unable to perform the distal approach and DCE was the preferred neuroendovascular treatment procedure...
November 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Michael S Lee, Evan Shlofmitz, Barry Kaplan, Dragos Alexandru, Perwaiz Meraj, Richard Shlofmitz
OBJECTIVES: We evaluated the safety and efficacy of orbital atherectomy in real-world patients with severe coronary artery calcification (CAC). BACKGROUND: The presence of severe CAC increases the complexity of percutaneous coronary intervention as it may impede stent delivery and optimal stent expansion. Atherectomy may be an indispensable tool for uncrossable or undilatable lesions by modifying severe CAC. Although the ORBIT I and II trials report that orbital atherectomy was safe and effective for the treatment of severe CAC, patients with kidney disease, recent myocardial infarction, long diffuse disease, severe left ventricular dysfunction, and unprotected left main disease were excluded...
August 2016: Journal of Interventional Cardiology
Syed S Mahmood, Anju Nohria
Cancer survivors who receive head and neck radiation are at increased risk for cerebrovascular events. This is mediated via damage to the hypothalamus-pituitary axis leading to the metabolic syndrome and extracranial arterial injury leading to carotid artery stenosis. Head and neck radiation can also lead to intracranial injury that can present as moyamoya, especially in children. Survivors require lifelong periodic follow-up for the development of pan-hypopituitarism or its individual components as well as for dyslipidemia and obesity...
July 2016: Current Treatment Options in Cardiovascular Medicine
Shahin Hajibandeh, Shahab Hajibandeh, Stavros A Antoniou, Francesco Torella, George A Antoniou
BACKGROUND: Controversy exists as to whether revascularisation of the left subclavian artery (LSA) confers improved outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Even though preemptive revascularisation of the LSA has theoretical advantages, including a reduced risk of ischaemic damage to vital organs, such as the brain and the spinal cord, it is not without risks. Current practice guidelines recommend routine revascularisation of the LSA in patients undergoing elective TEVAR where achievement of a proximal seal necessitates coverage of the LSA, and in patients who have an anatomy that compromises perfusion to critical organs...
April 27, 2016: Cochrane Database of Systematic Reviews
Renato De Vecchis, Cesare Baldi
Stating a well-codified and widely accepted therapeutic conduct for patients with patent foramen ovale (PFO) and previous cryptogenic stroke is made difficult and somewhat controversial by several issues remained unresolved so far. In this short review, some aspects of the possible role played by the PFO in the pathogenesis of cryptogenic stroke are succinctly analyzed. First, some aspects of cardiovascular anatomy of the human fetus and the adult are outlined. Subsequently, the three randomized controlled trials (RCTs) that have been accomplished so far to compare the implant of a transeptal occluding device with a simple medical therapy in patients with PFO and history of cryptogenic stroke are briefly examined...
May 2016: Journal of Clinical Medicine Research
Ursula G Schulz, Urs Fischer
One in five strokes affects the posterior circulation. Diagnosing posterior circulation stroke can be challenging, as the vascular anatomy can be variable, and because presenting symptoms are often non-specific and fluctuating. Nevertheless, making the correct diagnosis is important, as these strokes have a high chance of recurrence, can be life threatening, and can lead to equally life-threatening complications. Investigation and management largely follow those for stroke in general, although some specific differences exist...
January 2017: Journal of Neurology, Neurosurgery, and Psychiatry
O I Sharipov, M A Kutin, P L Kalinin, D V Fomichev, V A Lukshin, A B Kurnosov
INTRODUCTION: Doppler ultrasound (DUS) has been widely used in neurosurgical practice to diagnose various cerebrovascular diseases. This technique is used in transsphenoidal surgery to identify the localization of intracranial arteries when making an approach or during tumor resection. MATERIAL AND METHODS: To identify the cavernous segment of the internal carotid artery (ICA) and/or basilar artery during endoscopic transsphenoidal surgery, we used a combined device on the basis of a click line curette («Karl Storz») and a 16 MHz Doppler probe (Lassamed)...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Atsushi Kanoke, Miki Fujimura, Kuniyasu Niizuma, Taku Fujimura, Aya Kakizaki, Akira Ito, Hiroyuki Sakata, Mika Sato-Maeda, Shigeo Kure, Teiji Tominaga
Moyamoya disease (MMD) is a chronic, occlusive cerebrovascular disease with an unknown etiology and is characterized by an abnormal vascular network at the base of the brain. Recent studies identified the RNF213 gene (RNF213) as an important susceptibility gene for MMD; however, the mechanisms underlying the RNF213 abnormality related to MMD have not yet been elucidated. We previously reported that Rnf213-deficient mice and Rnf213 p. R4828K knock-in mice did not spontaneously develop MMD, indicating the importance of secondary insults in addition to genetic factors in the pathogenesis of MMD...
March 10, 2016: Brain Research
Ayelet Eran, Adina Hodes, Izlem Izbudak
UNLABELLED: The temporal lobes have unique architecture, and functionality that makes them vulnerable to certain disease processes. Patients presenting with bilateral temporal lobe disease are often confused and have altered consciousness, and are therefore unable to provide cogent histories. For these reasons, imaging plays an important role in their workup and management. Disease entities causing bilateral temporal lobe involvement can be infectious, metabolic, neoplastic, and degenerative aetiologies, as well as trauma and cerebrovascular events...
April 2016: Insights Into Imaging
M Oziel, M Hjouj, C A Gonzalez, J Lavee, B Rubinsky
Monitoring changes in non-ionizing radiofrequency electromagnetic waves as they traverse the brain can detect the effects of stimuli employed in cerebrovascular autoregulation (CVA) tests on the brain, without contact and in real time. CVA is a physiological phenomenon of importance to health, used for diagnosis of a number of diseases of the brain with a vascular component. The technology described here is being developed for use in diagnosis of injuries and diseases of the brain in rural and economically underdeveloped parts of the world...
February 22, 2016: Scientific Reports
Giuseppe Esposito, Jan-Karl Burkhardt, Oliver Bozinov, Luca Regli
BACKGROUND: Superficial temporal artery-to-middle cerebral artery (STA-MCA) bypass remains an essential tool for managing complex cerebrovascular conditions. A crucial surgical step is the identification and safe dissection of the bypass donor artery. If the frontal branch of the STA is used, a curvilinear fronto-temporal scalp flap generally allows for a clean dissection from the underside of the scalp flap. This dissection is sometimes tedious, since the frontal branch is not always easily visible and due to variability of its anatomy...
March 2016: Acta Neurochirurgica
Chih-Yang Hsu, Ben Schneller, Ali Alaraj, Michael Flannery, Xiaohong Joe Zhou, Andreas Linninger
PURPOSE: An image filter designed for reconstructing cerebrovascular trees from MR images is described. Current imaging techniques capture major cerebral vessels reliably, but often fail to detect small vessels, whose contrast is suppressed due to limited resolution, slow blood flow rate, and distortions around bifurcations or nonvascular structures. An incomplete view of angioarchitecture limits the information available to physicians. METHODS: A novel Hessian-based filter for contrast-enhancement in MR angiography and venography for blood vessel reconstruction without introducing dangling segments is presented...
January 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
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