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Lacunar stroke

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https://www.readbyqxmd.com/read/29468632/autonomic-function-test-in-progressive-lacunar-infarction
#1
S Y Ha, K M Park, J Park, S E Kim, B I Lee, K J Shin
OBJECTIVE: Neurological progression is a major problem in managing the patients with acute lacunar infarction. The purpose of this was to investigate whether autonomic dysfunction is associated with neurological progression in patients with acute lacunar infarction. MATERIALS AND METHODS: The study comprised 60 patients with acute lacunar infarction. All enrolled subjects underwent autonomic function tests including the 30° head-up tilt test, Valsalva test, heart rate response to deep breathing, and sympathetic skin response...
February 21, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29460889/-cerebral-infarctions-in-vertebrobasilar-artery-atherosclerosis
#2
P L Anufriev, A N Evdokimenko, T S Gulevskaya
AIM: to obtain more specific information on the morphology and pathogenesis of cerebral infarctions occurring in vertebrobasilar artery (VBA) atherosclerosis. MATERIAL AND METHODS: Macro- and microscopic investigations of the brain, its arterial system, and heart were conducted in 69 autopsy cases with infarctions located in the vertebrobasilar system (VBS) in atherosclerosis. RESULTS: 69 cases were found to have 206 VBA infarctions of various extent and locations...
2018: Arkhiv Patologii
https://www.readbyqxmd.com/read/29459114/high-dietary-glycemic-load-was-associated-with-the-presence-and-burden-of-cerebral-small-vessel-diseases-in-acute-ischemic-stroke-patients
#3
Tae-Jin Song, Yoonkyung Chang, A-Ram Kim, Yuri Kim, Yong-Jae Kim
Cerebral small vessel diseases (SVDs) are closely associated with stroke. Elevated postprandial blood glucose is also an important risk factor for stroke. Dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of postprandial blood glucose response used as an estimator of the overall glycemic effect of the diet. We hypothesized that high dietary GL or GI will be associated with presence of cerebral SVDs in patients with acute ischemic stroke. We prospectively included 263 patients who had experienced first-ever symptomatic cerebral infarction within 7 days after symptom onset and who submitted a fully filled-in semi-quantitative food frequency questionnaire...
December 27, 2017: Nutrition Research
https://www.readbyqxmd.com/read/29445058/nonfasting-glucose-and-incident-stroke-and-its-types-the-circulatory-risk-in-communities-study-circs
#4
Hironori Imano, Hiroyasu Iso, Akihiko Kitamura, Kazumasa Yamagishi, Mina Hayama-Terada, Isao Muraki, Takeo Okada, Mitsumasa Umesawa, Tetsuya Ohira, Tomoko Sankai, Renzhe Cui, Takeshi Tanigawa, Masahiko Kiyama
BACKGROUND: The effect of postprandial glucose on the risk of cardiovascular disease has been emphasized, but it is controversial whether nonfasting glucose is related to incident stroke and its types.Methods and Results:We investigated the associations of nonfasting glucose with incident stroke and its types among 7,198 participants aged 40-74 years from the Circulatory Risk in Communities Study, enrolled in 1995-2000. We estimated multivariable hazard ratios (HR) using Cox proportional hazard models...
February 14, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29438074/lacunar-infarcts-but-not-perivascular-spaces-are-predictors-of-cognitive-decline-in-cerebral-small-vessel-disease
#5
Philip Benjamin, Sarah Trippier, Andrew J Lawrence, Christian Lambert, Eva Zeestraten, Owen A Williams, Bhavini Patel, Robin G Morris, Thomas R Barrick, Andrew D MacKinnon, Hugh S Markus
BACKGROUND AND PURPOSE: Cerebral small-vessel disease is a major cause of cognitive impairment. Perivascular spaces (PvS) occur in small-vessel disease, but their relationship to cognitive impairment remains uncertain. One reason may be difficulty in distinguishing between lacunes and PvS. We determined the relationship between baseline PvS score and PvS volume with change in cognition over a 5-year follow-up. We compared this to the relationship between baseline lacune count and total lacune volume with cognition...
February 2, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29436255/coronary-tortuosity-is-associated-with-an-elevated-high-sensitivity-c-reactive-protein-concentration-and-increased-risk-of-ischemic-stroke-in-hypertensive-patients
#6
Yang Li, Abdul Qadir Nawabi, Yi Feng, Genshan Ma, Jiayi Tong, Chengxing Shen, Naifeng Liu
Objective The clinical implication of coronary tortuosity is unclear. The present study was conducted to determine the relationships between coronary tortuosity and the high-sensitivity C-reactive protein (hs-CRP) concentration and between coronary tortuosity and cerebrovascular accident in hypertensive patients without coronary artery disease. Methods In total, 236 patients with normal coronary angiography findings were categorized into 3 different groups: control participants (n = 58), who had neither hypertension nor coronary tortuosity; patients with hypertension but no coronary tortuosity (H-NCT group, n = 93); and patients with both hypertension and coronary tortuosity (H-CT group, n = 85)...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29434154/the-clinical-features-of-ischemic-stroke-patients-for-whom-smoking-was-considered-the-sole-risk-factor-for-ischemic-stroke
#7
Takuya Fukuoka, Yoshihiko Nakazato, Hitoshi Kawasaki, Kei Ikeda, Tomotsugu Furuya, Akifumi Miyake, Takashi Mitsufuji, Yasuo Ito, Kazushi Takahashi, Nobuo Araki, Norio Tahahashi, Toshimasa Yamamoto
Objective The purpose of this study was to clarify the clinical features of ischemic patients for whom cigarette smoking was the sole risk factor for ischemic stroke. Methods Among the 1,329 patients (male, n=833; female, n=496) with acute ischemic stroke who were admitted to our hospital between April 2005 and September 2016, 346 (26%) were smokers (male, n=308 [36.9%]; female, 38 [7.6%]). In 42 (3.1%; male, n=41; female, n=1) cases, cigarette smoking was considered to be the sole risk factor for ischemic stroke...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29426678/low-yield-of-extensive-workup-for-embolic-sources-in-lacunar-stroke-patients
#8
Yan Wang, Yoon Choi, Joshuae Gallardo, Ifeoma Nwaneri, James R Brorson
OBJECTIVE: We aimed to evaluate the yield of extensive etiologic workup in lacunar stroke patients. BACKGROUND: As lacunar strokes are infrequently caused by thromboembolism, the clinical relevance of extensive workup for thromboembolic sources is questioned. METHODS: Among consecutive stroke admissions to a single center over 3 years, the 100 cases initially classified as lacunar stroke and a sample of 100 cases classified as non-lacunar ischemic strokes were studied...
February 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29422904/emerging-role-of-immunity-in-cerebral-small-vessel-disease
#9
REVIEW
Ying Fu, Yaping Yan
Cerebral small vessel disease (CSVD) is one of the main causes of vascular dementia in older individuals. Apart from risk containment, efforts to prevent or treat CSVD are ineffective due to the unknown pathogenesis of the disease. CSVD, a subtype of stroke, is characterized by recurrent strokes and neurodegeneration. Blood-brain barrier (BBB) impairment, chronic inflammatory responses, and leukocyte infiltration are classical pathological features of CSVD. Understanding how BBB disruption instigates inflammatory and degenerative processes may be informative for CSVD therapy...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29406922/a-nomogram-to-predict-the-probability-of-mortality-after-first-ever-acute-manifestations-of-cerebral-small-vessel-disease
#10
Manuel Cappellari, Cecilia Zivelonghi, Gianni Turcato, Stefano Forlivesi, Nicola Micheletti, Giampaolo Tomelleri, Paolo Bovi, Bruno Bonetti
BACKGROUND AND PURPOSE: Symptomatic lacunar stroke (LS) and deep intracerebral hemorrhage (dICH) represent the acute manifestations of type 1 cerebral small vessel disease (cSVD). Recently, two studies showed that the risk factor profile of dICH differs from that associated with LS in subjects with biologically plausible cSVD; however, the prognostic predictors after acute manifestations are currently lacking. We aimed to develop a nomogram for individualized prediction of the mortality probability in a cohort of patients with a first-ever acute manifestation of biologically plausible cSVD...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29406889/endothelial-progenitor-cells-influence-acute-and-subacute-stroke-hemodynamics
#11
João Sargento-Freitas, Sezin Aday, César Nunes, Miguel Cordeiro, Ana Gouveia, Fernando Silva, Cristina Machado, Bruno Rodrigues, Gustavo Cordeiro Santo, Carlos Ferreira, Miguel Castelo-Branco, Lino Ferreira, Luís Cunha
BACKGROUND: Endothelial Progenitor Cells (EPCs) are a circulating stem cell population with in vivo capacity of promoting angiogenesis after ischemic events. Despite the promising preclinical data, their potential integration with reperfusion therapies and hemodynamic evolution of stroke patients is still unknown. Our aim was to determine the association of EPCs with acute, subacute and chronic hemodynamic features. METHODS: In this prospective study, we included consecutive patients with ages between 18 and 80years and non-lacunar ischemic stroke within the territory of a middle cerebral artery...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29396405/the-association-of-telomere-attrition-with-first-onset-stroke-in-southern-chinese-a-case-control-study-and-meta-analysis
#12
Jing Li, Congrui Feng, Liang Li, Shujun Yang, Yu Chen, Rutai Hui, Mei Zhang, Weili Zhang
The relationship between telomere length and stroke was inconsistent mostly due to different pathogenesis of subtypes, environment and genetics. We aimed to assess whether leukocyte telomere contributes to stroke in Southern Chinese by investigating a case-control study comprising 543 cases (224 atherothrombotic stroke, 94 hemorrhagic stroke and 225 lacunar infraction) and 616 controls and replicated the investigation in an independent study comprising 773 cases and 875 controls with the same diagnostic criteria...
February 2, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29386475/ability-of-b-type-natriuretic-peptide-testing-to-predict-cardioembolic-stroke-in-the-general-population%C3%A3-comparisons-with-c-reactive-protein-and-urinary-albumin
#13
Motoyuki Nakamura, Yasuhiro Ishibashi, Fumitaka Tanaka, Shinichi Omama, Toshiyuki Onoda, Tomohiro Takahashi, Shuko Takahashi, Kozo Tanno, Masaki Ohsawa, Kiyomi Sakata, Makoto Koshiyama, Kuniaki Ogasawara, Akira Okayama
BACKGROUND: The ability of cardiovascular biomarkers to predict the incidence of stroke subtypes remains ill-defined in the general population.Methods and Results:The blood levels of B-type natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hs-CRP) and urinary albumin corrected by urinary creatinine (UACR) were determined in a general population (n=13,575). The ability to predict the incidence of ischemic stroke subtypes (lacunar, atherothrombotic, cardioembolic) for each biomarker was assessed based on the area under the receiver-operating characteristic curve (AUC-ROC) and using Cox proportional hazard modeling...
January 30, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29369945/conventional-and-diffusional-magnetic-resonance-imaging-features-of-mitochondrial-encephalomyopathy-lactic-acidosis-and-stroke-like-episodes-in-chinese-patients-a-study-of-40-cases
#14
Weixingzi Xu, Jianbo Wen, Chong Sun, Jiawen Cao, Yuxin Li, Daoying Geng
PURPOSES: The aims of the study were to analyze the conventional and diffusion-weighted MRI (DWI) of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) and to investigate underlying mechanisms. METHODS: Features of 58 acute and 68 chronic stroke-like lesions as well as global brain abnormalities of 40 Chinese MELAS patients were analyzed. RESULTS: Gyriform DWI hyperintensity with decreased apparent diffusion coefficient (ADC) and patchy DWI hyperintensity with normal ADC were noted in 56 of 58 and 2 of 58 cortical regions of acute lesions, respectively...
January 24, 2018: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/29325730/use-of-cardiovascular-polypills-for-the-secondary-prevention-of-cerebrovascular-disease
#15
J Masjuan, J Gállego, J M Aguilera, J F Arenillas, M Castellanos, F Díaz, J C Portilla, F Purroy
INTRODUCTION: There is little control of cardiovascular (CV) risk factors in secondary prevention after an ischaemic stroke, in part due to a lack of adherence to treatment. The CV polypill may contribute to proper treatment adherence, which is necessary for CV disease prevention. This study aimed to establish how and in what cases the CV polypill should be administered. METHODS: A group of 8 neurologists drafted consensus recommendations using structured brainstorming and based on their experience and a literature review...
January 8, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29284569/epidemiology-of-stroke-in-costa-rica-a-7-year-hospital-based-acute-stroke-registry-of-1319-consecutive-patients
#16
Gabriel Torrealba-Acosta, Kenneth Carazo-Céspedes, Sy Han Chiou, Anthony Terrence O'Brien, Huberth Fernández-Morales
BACKGROUND: Limited data on stroke exist for Costa Rica. Therefore, we created a stroke registry out of patients with stroke seen in the Acute Stroke Unit of the Hospital Calderon Guardia. METHODS: We analyzed 1319 patients enrolled over a 7-year period, which incorporated demographic, clinical, laboratory, and neuroimaging data. RESULTS: The mean age of patients with stroke was 68.0 ± 15.5 years. Seven hundred twenty-five were men and the age range was 13-104 years...
December 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29279254/factors-related-to-immediate-response-to-symptoms-in-patients-with-stroke-or-transient-ischaemic-attack
#17
R García Ruiz, J Silva Fernández, R M García Ruiz, M Recio Bermejo, Á Arias Arias, A Santos Pinto, A Lomas Meneses, E Botía Paniagua, J Abellán Alemán
INTRODUCTION: Despite recent advances in the management of acute stroke, fewer than 10% of patients receive reperfusion therapy. One of the main reasons for such a low rate of administration is the delay on the part of patients and their families in seeking medical attention. This study aimed to analyse this delay. METHODS: A prospective observational study was conducted on consecutive stroke or transient ischaemic attack. Data on sociodemographic and clinical parameters, decision delay, pre-hospital delay, and first medical contact were collected...
December 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29239807/an-objective-measurement-of-lacunar-infarct-location-from-the-middle-cerebral-artery-stem
#18
Shanal S Kumar, Bradford A Moffat, Simon Salinas, Leonid Churilov, Bernard Yan
BACKGROUND: There is emerging interest in the relationship between neuroimaging location of lacunar infarcts and underlying stroke risk factors. Recent methods used for localization of lacunar infarcts are affected by high inter-rater variability. We used a novel algorithm-driven method that provided quantitative assessment of the distance of the lacunar infarct from the origins of the lenticulostriate arteries. METHODS: We conducted a retrospective analysis of patients who presented with lacunar infarcts between 2007 and 2011...
November 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29233158/etiology-of-isolated-pontine-infarctions-a-study-based-on-high-resolution-mri-and-brain-small-vessel-disease-scores
#19
Cheng Xia, Hui-Sheng Chen, Shi-Wen Wu, Wei-Hai Xu
BACKGROUND: In this retrospective study, we investigated the main pathogenesis of the two types of isolated pontine infarction: paramedian pontine infarcts (PPIs) and small deep pontine infarcts (SDPIs). METHODS: Acute ischemic stroke patients, comprising 117 PPI patients and 40 SDPI patients, were enrolled. High-resolution magnetic resonance imaging (HR-MRI) and routine MRI sequences were performed for each patient, and clinical data were collected. The following brain small vessel disease (SVD) features of the MRI scans were each rated (0 or 1) separately: asymptomatic lacunar infarcts, white matter lesions (WMLs), deep and infratentorial cerebral microbleeds (CMBs), and enlarged perivascular spaces in the basal ganglia...
December 12, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29221777/prevalence-of-sleep-apnea-at-the-acute-phase-of-ischemic-stroke-with%C3%A2-or-without-thrombolysis
#20
Jaana K Huhtakangas, Juha Huhtakangas, Risto Bloigu, Tarja Saaresranta
OBJECTIVE: The aim of the study was to compare the prevalence, type, and severity of sleep apnea during the acute phase of ischemic stroke among patients either receiving or not receiving thrombolysis. METHODS: We recruited 246 consecutive adult ischemic stroke patients. Patients underwent cardiorespiratory sleep study with portable three-channel device during the first 48 h after the symptom onset of ischemic stroke. RESULTS: We enrolled 110 (65...
December 2017: Sleep Medicine
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