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Lacunar stroke

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https://www.readbyqxmd.com/read/28781057/multiple-lacunar-infarcts-in-paroxysmal-nocturnal-hemoglobinuria
#1
Alex Tiburtino Meira, Gabriel Sampaio Froehner, André Petean Trindade, Silméia Garcia Zanati Bazan, Gabriel Pereira Braga, Rodrigo Bazan
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disease characterized by clonal hematopoietic stem cell disorder, with increased mortality and morbidity. Venous thrombosis is the most common cause of mortality in PNH. The relationship between PNH and cerebrovascular disease is unclear; few cases are reported in the literature, most of them related to cerebral venous thrombosis; In PNH the involvement of intracranial and extracranial arterial sites is very rare. We report a case of a 49-year-old woman who has a medical history of diabetes mellitus, hypertension, and PNH and presented multiple lacunar strokes in a routine consultation with a hematologist...
August 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28776182/progressive-deficit-in-isolated-pontine-infarction-the-association-with-etiological-subtype-lesion-topography-and-outcome
#2
Elif Gökçal, Elvin Niftaliyev, Gözde Baran, Çiğdem Deniz, Talip Asil
It is important to predict progressive deficit (PD) in isolated pontine infarction, a relatively common problem of clinical stroke practice. Traditionally, lacunar infarctions are known with their progressive course. However, few studies have analyzed the branch atheromatous disease subtype as a subtype of lacunar infarction, separately. There are also conflicting results regarding the relationship with the topography of lesion and PD. In this study, we classified etiological subtypes and lesion topography in isolated pontine infarction and aimed to investigate the association of etiological subtypes, lesion topography and clinical outcome with PD...
August 3, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28769863/application-of-texture-analysis-to-study-small-vessel-disease-and-blood-brain-barrier-integrity
#3
Maria Del C Valdés Hernández, Victor González-Castro, Francesca M Chappell, Eleni Sakka, Stephen Makin, Paul A Armitage, William H Nailon, Joanna M Wardlaw
OBJECTIVES: We evaluate the alternative use of texture analysis for evaluating the role of blood-brain barrier (BBB) in small vessel disease (SVD). METHODS: We used brain magnetic resonance imaging from 204 stroke patients, acquired before and 20 min after intravenous gadolinium administration. We segmented tissues, white matter hyperintensities (WMH) and applied validated visual scores. We measured textural features in all tissues pre- and post-contrast and used ANCOVA to evaluate the effect of SVD indicators on the pre-/post-contrast change, Kruskal-Wallis for significance between patient groups and linear mixed models for pre-/post-contrast variations in cerebrospinal fluid (CSF) with Fazekas scores...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28765289/vascular-risk-factor-profiles-differ-between-magnetic-resonance-imaging-defined-subtypes-of-younger-onset-lacunar-stroke
#4
Loes C A Rutten-Jacobs, Hugh S Markus
BACKGROUND AND PURPOSE: Differing associations of vascular risk factors with lacunar infarct have been reported, which is likely because of diagnostic differences and possible heterogeneity in the pathogenesis underlying lacunar infarction. In a large magnetic resonance imaging-verified cohort of lacunar infarct patients, we investigated the risk factor profile of lacunar infarction and magnetic resonance imaging characteristics. METHODS: One thousand twenty-three patients with lacunar infarction (mean age, 56...
August 1, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28760409/development-and-reliability-of-a-user-friendly-multicenter-phenotyping-application-for-hemorrhagic-and-ischemic-stroke
#5
Mayowa Owolabi, Godwin Ogbole, Rufus Akinyemi, Kehinde Salaam, Onoja Akpa, Pattanasak Mongkolwat, Adeleye Omisore, Atinuke Agunloye, Richard Efidi, Joseph Odo, Akintomiwa Makanjuola, Albert Akpalu, Fred Sarfo, Lukman Owolabi, Reginald Obiako, Kolawole Wahab, Emmanuel Sanya, Philip Adebayo, Morenikeji Komolafe, Abiodun Moshood Adeoye, Joshua Akinyemi, Godwin Osaigbovo, Taofiki Sunmonu, Paul Olowoyo, Innocent Chukwuonye, Yahaya Obiabo, Philip Ibinaiye, Abdul Dambatta, Yaw Mensah, Salaam Abdul, Eunice Olabinri, Joyce Ikubor, Olalekan Oyinloye, Femi Odunlami, Ezinne Melikam, Raelle Saulson, Philip Kolo, Adesola Ogunniyi, Bruce Ovbiagele
BACKGROUND: Annotation and Image Markup on ClearCanvas Enriched Stroke-phenotyping Software (ACCESS) is a novel stand-alone computer software application that allows the creation of simple standardized annotations for reporting brain images of all stroke types. We developed the ACCESS application and determined its inter-rater and intra-rater reliability in the Stroke Investigative Research and Educational Network (SIREN) study to assess its suitability for multicenter studies. METHODS: One hundred randomly selected stroke imaging reports from 5 SIREN sites were re-evaluated by 4 trained independent raters to determine the inter-rater reliability of the ACCESS (version 12...
July 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28736698/impact-of-automated-ica-based-denoising-of-fmri-data-in-acute-stroke-patients
#6
D Carone, R Licenik, S Suri, L Griffanti, N Filippini, J Kennedy
Different strategies have been developed using Independent Component Analysis (ICA) to automatically de-noise fMRI data, either focusing on removing only certain components (e.g. motion-ICA-AROMA, Pruim et al., 2015a) or using more complex classifiers to remove multiple types of noise components (e.g. FIX, Salimi-Khorshidi et al., 2014 Griffanti et al., 2014). However, denoising data obtained in an acute setting might prove challenging: the presence of multiple noise sources may not allow focused strategies to clean the data enough and the heterogeneity in the data may be so great to critically undermine complex approaches...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28716287/kidney-dysfunction-and-silent-brain-infarction-in-generally-healthy-adults
#7
Sang Hyuck Kim, Dong Wook Shin, Jae Moon Yun, Ji Eun Lee, Jae-Sung Lim, Be Long Cho, Hyung-Min Kwon, Jin-Ho Park
BACKGROUND: The association between silent brain infarction (SBI) and estimated glomerular filtration rate (eGFR)-based kidney dysfunction has not yet been definitively confirmed. This study aimed to investigate the association in generally healthy adults without a previous history of stroke or overt kidney disease. METHODS: The data from the screening health check-up program in the Seoul National University Hospital Health Promotion Center from January 1, 2009 to December 31, 2013 were used...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28707135/secondary-stroke-prevention-in-cryptogenic-stroke-and-embolic-stroke-of-undetermined-source-esus
#8
REVIEW
Hans-Christoph Diener, Richard Bernstein, Robert Hart
PURPOSE OF THE REVIEW: The purpose of the study was to review the literature on cryptogenic stroke and embolic stroke of undetermined stroke (ESUS). Cryptogenic stroke according to TOAST criteria is a stroke which is not due to cardiogenic embolism, small vessel disease with lacunes or large vessel disease of brain supplying arteries. In the context of secondary stroke prevention studies, cryptogenic stroke is not operationally defined. RECENT FINDINGS: The new concept of "embolic stroke of undetermined source" (ESUS) provides an operational definition...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28687237/the-pulvinar-nucleus-is-associated-with-the-presence-of-dysarthria-in-patients-with-basal-ganglia-hemorrhage
#9
Dae Hyun Kim, Sunghyon Kyeong, Sung Jun Ahn, Yoon Ghil Park
Dysarthria is a frequent symptom in patients with stroke. The anatomical structures responsible for dysarthria have been reported in patients with lacunar infarcts, but the related lesions in patients with basal ganglia hemorrhage (BGH) have not been investigated. The aim of this study was to identify associations between the lesion location and the presence/absence of dysarthria in patients with BGH using voxel-based lesion symptom mapping (VLSM) analyses. A retrospective analysis was conducted on 26 patients with acute BGH (mean age, 54...
August 10, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28684376/the-association-between-arterial-stiffness-initial-stroke-severity-and-3-week-outcomes-in-patients-with-ischemic-stroke
#10
Emma Ormerod, Khalid Ali, James Cameron, Muzaffar Malik, Richard Lee, Spas Getov, Chakravarthi Rajkumar
OBJECTIVES: Vascular compliance is emerging as a useful cardiovascular risk factor. The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and 3 weeks. METHODS: Forty two patients with acute ischemic stroke (55% male, mean age 71 years) were recruited over 15-months. Stroke subtypes were classified into lacunar circulation infarct (LACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI)...
July 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28681535/microbleeds-in-the-secondary-prevention-of-small-subcortical-strokes-trial-stroke-mortality-and-treatment-interactions
#11
Ashkan Shoamanesh, Lesly A Pearce, Carlos Bazan, Luciana Catanese, Leslie A McClure, Mukul Sharma, Joan Marti-Fabregas, David C Anderson, Carlos S Kase, Robert G Hart, Oscar R Benavente
OBJECTIVE: To characterize cerebral microbleeds (CMBs) in lacunar stroke patients in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial and to assess their relationship with recurrent stroke and death, and response to assigned treatment. METHODS: SPS3 is a randomized, clinical trial conducted between 2003 and 2011. Patients with recent magnetic resonance imaging (MRI)-documented lacunar infarcts were randomly assigned in a factorial design to target levels of systolic blood pressure (130-149mmHg vs <130mmHg; open label) and to antiplatelet treatment (aspirin/clopidogrel vs aspirin/placebo; double-blinded)...
July 6, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28628911/a-carasil-patient-from-americas-with-novel-mutation-and-atypical-features-case-presentation-and-literature-review
#12
Muhammad Ibrahimi, Hiroaki Nozaki, Angelica Lee, Osamu Onodera, Raymond Reichwein, Matthew Wicklund, Mohammad El-Ghanem
OBJECTIVE: Reporting a novel mutation in the HTRA1 gene in a CARASIL patient from Americas. METHODS: Clinical presentation and neuroimaging were consistent with CARASIL. HTRA1 DNA sequencing was performed using advanced ("next generation") sequencing technology. The results revealed a homozygous missense mutation as c.616G>A (p.Gly206Arg) in the HTRA1 gene. RESULTS: A 24-year-old man with a history of chronic back pain presented with recurrent ischemic strokes...
June 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28617385/-differential-diagnosis-of-cerebral-autosomal-dominant-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy
#13
A A Moroz, N Yu Abramycheva, M S Stepanova, R N Konovalov, S L Timerbaeva, S N Illarioshkin
Cerebral autosomal dominant arteriopathy with subcortical infarctions and leucoencephalopathy (CADASIL) is an inherited CNS disease, which is caused by mutations in the NOTCH3 gene. Selective disorders of small vessels underlie the disease pathogenesis. Clinically CADASIL is characterized by headaches, multiple stroke-like disorders (in most cases transient ischemic attacks and lacunar strokes), and different focal neurological symptoms and dementia. There are specific MRI signs of the disease: multiple lacunar infarctions located in the basal ganglia, brain steam and cerebellum, focal lesions of temporal poles, capsula externa, periventricular and subcortical areas; diffuse white matter changes and leukoaraiosis can be observed as well...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28608185/substitutions-of-dairy-product-intake-and-risk-of-stroke-a-danish-cohort-study
#14
Anne Sofie Dam Laursen, Christina Catherine Dahm, Søren Paaske Johnsen, Anne Tjønneland, Kim Overvad, Marianne Uhre Jakobsen
Low fat dairy products are part of dietary guidelines to prevent stroke. However, epidemiological evidence is inconclusive with regard to the association between dairy products and stroke. We therefore investigated associations for substitutions between dairy product subgroups and risk of total stroke and stroke subtypes. We included 55,211 Danish men and women aged 50-64 years without previous stroke. Baseline diet was assessed by a food frequency questionnaire. Cases were identified through a national register and subsequently verified...
June 12, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/28603219/central-hemodynamics-for-management-of-arteriosclerotic-diseases
#15
Junichiro Hashimoto
Arteriosclerosis, particularly aortosclerosis, is the most critical risk factor associated with cardiovascular, cerebrovascular, and renal diseases. The pulsatile hemodynamics in the central aorta consists of blood pressure, flow, and stiffness and substantially differs from the peripheral hemodynamics in muscular arteries. Arteriosclerotic changes with age appear earlier in the elastic aorta, and age-dependent increases in central pulse pressure are more marked than those apparent from brachial pressure measurement...
August 1, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28596467/-embolic-stroke-of-undetermined-source
#16
Teruyuki Hirano
A new clinical construct, embolic stroke of undetermined source (ESUS) was established as a therapeutically relevant entity, which are defined as a non-lacunar infarction without proximal arterial stenosis or cardioembolic sources, with a clear indication for anticoagulation, especially with direct oral anticoagulant (DOAC). The possible embolic sources include covert atrial fibrillation, arterial stenosis with <50%, low-risk emboligenic cardiac sources, aortic plaque, cancer-associated, and paradoxical embolism...
June 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28592775/blood-pressure-management-for-stroke-prevention-and-in-acute-stroke
#17
REVIEW
Keun-Sik Hong
Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28549667/epidemiology-of-cerebrovascular-disease-among-chinese-canadians-with-diabetes
#18
REVIEW
Susy Lam, Joseph Y Chu
BACKGROUND: First-generation Chinese Canadians have usually maintained different lifestyles before immigration to North America, and the question of whether Chinese Canadians with type 2 diabetes have a different stroke profile than that of non-Chinese Canadians remains unanswered. OBJECTIVES: To determine whether 1) Chinese Canadians who have had a stroke within the last 15 years are more likely to have diabetes than non-Chinese Canadians and 2) to explore differences in stroke profiles between the 2 cohorts...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28543314/subclinical-hypothyroidism-and-risk-of-cerebral-small-vessel-disease-a-hospital-based-observational-study
#19
Xiaohao Zhang, Yi Xie, Caixia Ding, Jing Xiao, Yinyan Tang, Xuemei Jiang, Hua Shan, Yuankai Lin, Yujia Zhu, Chuanyou Li, Dan Hu, Zhixiang Ling, Gelin Xu, Lei Sheng
OBJECTIVE: Subclinical hypothyroidism (SCH) has been associated with atherosclerosis and increased risk of ischaemic stroke. However, whether SCH is associated with cerebral small vessel disease (cSVD) remains largely unexplored. This study aimed to investigate the relationship between SCH and total cSVD burden, a composite measurement detected with magnetic resonance imaging (MRI), in patients with minor ischaemic stroke or transient ischaemic attack (TIA). DESIGN: This was a prospective observational cohort study conducted in a tertiary referral hospital...
May 25, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28493898/apathy-but-not-depression-is-associated-with-executive-dysfunction-in-cerebral-small-vessel-disease
#20
Valerie Lohner, Rebecca L Brookes, Matthew J Hollocks, Robin G Morris, Hugh S Markus
OBJECTIVE: To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD), and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed. METHODS: 196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation...
2017: PloS One
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