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Lacunar stroke

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https://www.readbyqxmd.com/read/28493898/apathy-but-not-depression-is-associated-with-executive-dysfunction-in-cerebral-small-vessel-disease
#1
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
https://www.readbyqxmd.com/read/28463214/-clinical-predictors-of-hemorrhagic-transformation-in-non-lacunar-ischemic-stroke
#2
Natalia R Balian, Claudia B Alonzo, María Cristina Zurrú, Laura Brescacin, Santiago G Pigretti, Pedro E Colla Machado, Gabriel D Waisman, Edgardo Cristiano
Hemorrhagic transformation is a complex phenomenon where brain tissue bleeds, which could be associated or not to an increase in the neurological deficit after the acute ischemic stroke. The aim of our study was to evaluate clinical predictors of hemorrhagic transformation in patients with non-lacunar ischemic stroke. We performed a prospective analysis of the clinical records and images of patients with non-lacunar ischemic stroke. Demographics, vascular risk factors, previous medications and the information of the event in patients with and without hemorrhagic transformation were here compared...
2017: Medicina
https://www.readbyqxmd.com/read/28449276/the-efficacy-of-thrombolysis-in-lacunar-stroke-evidence-from-the-austrian-stroke-unit-registry
#3
C C J Eggers, C Bocksrucker, L Seyfang
BACKGROUND AND PURPOSE: Intravenous thrombolysis (ivT) with recombinant tissue plasminogen activator is established in acute ischaemic stroke. Little is known, however, about its efficacy in different stroke subtypes. METHODS: A retrospective analysis of 128 733 patients from the Austrian Stroke Unit Registry was performed. Patients were classified as lacunar (LacS) or non-lacunar ischaemic stroke (nonLacS) by use of the clinical syndrome and technical findings...
April 27, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28446537/post-hoc-analyses-of-randomized-clinical-trial-for-the-effect-of-clopidogrel-added-to-aspirin-on-kidney-function
#4
Jesse C Ikeme, Pablo E Pergola, Rebecca Scherzer, Michael G Shlipak, Oscar R Benavente, Carmen A Peralta
BACKGROUND AND OBJECTIVES: Despite the high burden of CKD, few specific therapies are available that can halt disease progression. In animal models, clopidogrel has emerged as a potential therapy to preserve kidney function. The effect of clopidogrel on kidney function in humans has not been established. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Secondary Prevention of Small Subcortical Strokes Study randomized participants with prior lacunar stroke to treatment with aspirin or aspirin plus clopidogrel...
April 26, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28428977/19th-workshop-of-the-international-stroke-genetics-consortium-april-28-29-2016-boston-massachusetts-usa-2016-001-mri-defined-cerebrovascular-genomics-the-charge-consortium
#5
S Debette, Y Saba, D Vojinovic, X Jian, H Adams, G Chauhan, M Sargurupremraj, S Kaffashian, J Ding, J C Bis, P Nyquist, K Mather, C Van Duijn, L J Launer, M A Ikram, H Schmidt, W T Longstreth, M Fornage, S Seshadri
The CHARGE consortium is an investigator-initiated collaboration to facilitate meta-analyses of genome-wide association studies (GWAS) and genomic analyses based on next generation sequencing (NGS), among multiple large and well-phenotyped population-based cohort studies around the world (http://www.chargeconsortium.com). Within the neuro-CHARGE working group, we are presenting an update of ongoing genomic studies on MRI-markers of cerebrovascular disease. Large population-based studies have shown that the burden of cerebrovascular disease extends far beyond that of clinical stroke...
March 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28420817/association-of-kidney-dysfunction-with-asymptomatic-cerebrovascular-abnormalities-in-a-japanese-population-with-health-checkups
#6
Kaori Hayashi, Michiyo Takayama, Takeshi Kanda, Kazuhiro Kashiwagi, Akihito Hishikawa, Yasushi Iwao, Hiroshi Itoh
BACKGROUND: Cerebrovascular disease is a major cause of mortality and morbidity. Chronic kidney disease (CKD) is prevalent in stroke patients. This study evaluated the correlation between kidney dysfunction and asymptomatic findings on carotid ultrasonography (US) and brain magnetic resonance imaging (MRI) in a Japanese population with health checkups.Methods and Results:In total, 1,716 subjects aged 40-80 years, who received health checkups from January 1 to December 31, 2015, were included...
April 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28413864/evaluation-of-intracranial-microvessel-visualization-in-mouse-and-dog-models-by-using-a-new-rotating-cerium-anode-x-ray-system
#7
Chiharu Tanaka, Toru Shizuma, Yoshiro Shinozaki, Kikue Todoroki, Yoshimori Ikeya, Naoto Fukuyama, Toshihiko Ueda, Hidezo Mori
OBJECTIVE: Lacunar stroke may be caused by infarction of small perforating branches of the middle cerebral artery. We developed a microangiographic X-ray system using a cerium anode to evaluate the perforating branches. METHODS: Iodine has K-edges at 33.2 kilo electron volts. Cerium yields a characteristic X-ray of 34.6 kilo electron volts, therefore, the cerium anode X-ray system could detect tiny amounts of contrast material. First, an X-ray chart was used to evaluate the resolution...
April 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28406586/total-cerebral-small-vessel-disease-score-is-associated-with-mortality-during-follow-up-after-acute-ischemic-stroke
#8
Tae Jin Song, Jinkwon Kim, Dongbeom Song, Joonsang Yoo, Hye Sun Lee, Yong Jae Kim, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim
BACKGROUND AND PURPOSE: The recently developed total cerebral small-vessel disease (CSVD) score might appropriately reflect the total burden or severity of CSVD. We investigated whether the total CSVD score is associated with long-term outcomes during follow-up in patients with acute ischemic stroke. METHODS: In total, 1,096 consecutive patients with acute ischemic stroke who underwent brain magnetic resonance imaging were enrolled. We calculated the total CSVD score for each patient after determining the burden of cerebral microbleeds (CMBs), high-grade white-matter hyperintensities (HWHs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs)...
April 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28394756/progression-of-cerebral-white-matter-hyperintensities-and-the-associated-sonographic-index
#9
Woo-Jin Lee, Keun-Hwa Jung, Young Jin Ryu, Keon-Joo Lee, Jeong-Min Kim, Soon-Tae Lee, Kon Chu, Manho Kim, Sang Kun Lee, Jae-Kyu Roh
Purpose To evaluate the relationship between penetrating arterial pulsation and the progression of white matter hyperintensities (WMHs) by using the sonographic resistance index (RI) along the M1 segment of the middle cerebral artery (MCA). Materials and Methods The study design was approved by the institutional review board of Seoul National University Hospital. The study included 450 individuals who had undergone initial transcranial Doppler (TCD) sonography and magnetic resonance imaging, with follow-up imaging performed within 34-45 months, and who had no stenosis of 30% or more in the internal carotid artery or MCA or a history of stroke other than an old lacunar infarction...
April 10, 2017: Radiology
https://www.readbyqxmd.com/read/28392099/cerebrovascular-dissemination-in-time-and-space-as-a-predictor-of-cardioembolism
#10
João André Sousa, Mafalda Mendes-Pinto, João Sargento-Freitas, Fernando Silva, Carla Cecília, Carmo Macário, Ana Gouveia, Cristina Machado, Bruno Rodrigues, Gustavo C Santo, Ana Lima, Ricardo Veiga, Luís Cunha, António Freire-Gonçalves
BACKGROUND: Cardioembolism has tendency to recur and cause lesions in distinct cerebrovascular territories. Using the imaging characteristics of cerebral lesions to determine dissemination in time and space (DTS) is a concept already used in other neurologic conditions; however, it has never been applied as a diagnostic tool in ischemic stroke etiology. AIM: This study aimed to assess DTS as a diagnostic marker of cardioembolism. METHODS: We enrolled consecutive patients with acute ischemic stroke of various etiologies admitted in a cerebrovascular disease nursery from a university hospital in a retrospective cohort study...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28389611/stroke-in-indigenous-africans-african-americans-and-european-americans-interplay-of-racial-and-geographic-factors
#11
Mayowa Owolabi, Fred Sarfo, Virginia J Howard, Marguerite R Irvin, Mulugeta Gebregziabher, Rufus Akinyemi, Aleena Bennett, Kevin Armstrong, Hemant K Tiwari, Albert Akpalu, Kolawole W Wahab, Lukman Owolabi, Bimbo Fawale, Morenikeji Komolafe, Reginald Obiako, Philip Adebayo, Jennifer M Manly, Godwin Ogbole, Ezinne Melikam, Ruth Laryea, Raelle Saulson, Carolyn Jenkins, Donna K Arnett, Daniel T Lackland, Bruce Ovbiagele, George Howard
BACKGROUND AND PURPOSE: The relative contributions of racial and geographic factors to higher risk of stroke in people of African ancestry have not been unraveled. We compared stroke type and contributions of vascular risk factors among indigenous Africans (IA), African Americans (AA), and European Americans (EA). METHODS: SIREN (Stroke Investigative Research and Educational Network) is a large multinational case-control study in West Africa-the ancestral home of 71% AA-whereas REGARDS (Reasons for Geographic and Racial Differences in Stroke) is a cohort study including AA and EA in the United States...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28372708/acute-stroke-and-transient-ischemic-attack-in-the-outpatient-clinic
#12
REVIEW
Salvador Cruz-Flores
Ischemic stroke is cause of substantial death and disability in the United States. Transient ischemic attack, a precursor to ischemic stroke, conveys a high risk of recurrent stroke within 90 days from event. These conditions are highly preventable and treatable. The cause is heterogenous and includes atherothrombosis, cardioembolism, lacunar disease, or cryptogenic, and some uncommon causes, such as arterial dissection and prothrombotic states. The emergent evaluation includes establishing time of onset, vital signs, glucose level, and severity of the deficit...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28364691/incidence-of-seizures-following-initial-ischemic-stroke-in-a-community-based-cohort-the-framingham-heart-study
#13
Maria Stefanidou, Rohit R Das, Alexa S Beiser, Banu Sundar, Margaret Kelly-Hayes, Carlos S Kase, Orrin Devinsky, Sudha Seshadri, Daniel Friedman
PURPOSE: We examined the incidence of seizures following ischemic stroke in a community-based sample. METHODS: All subjects with incident ischemic strokes in the Framingham Original and Offspring cohorts between 1982 and 2003 were identified and followed for up to 20 years to determine incidence of seizures. Seizure-type was based on the 2010 International League Against Epilepsy (ILAE) classification. Disability was stratified into mild/none, moderate and severe, based on post-stroke neurological deficit documentation according to the Framingham Heart Study (FHS) protocol and functional status was determined using the Barthel Index...
April 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28360808/ischemic-stroke-in-the-elderly-septuagenarians-versus-octogenarians
#14
Birgül Baştan, Sefer Günaydin, Fatma Belgin Balci, Hürtan Acar, Aytül Mutlu, Feriha Özer, Özlem Çokar
INTRODUCTION: Stroke prevalence is known to increase with age. Approximately 50% of acute ischemic stroke patients are aged between 70 and 89 years. METHODS: In this study, records of 770 ischemic stroke patients who were 70-89 years old were retrospectively examined (407 septuagenarians and 363 octogenarians). The demographics, comorbid conditions, ischemic stroke type, and stroke outcome for the two age groups were analyzed. RESULTS: Comorbid hypertension, diabetes mellitus, and HbA1c levels of ≥6...
December 2016: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/28352633/bay%C3%A3-s-syndrome-and-acute-cardioembolic-ischemic-stroke
#15
REVIEW
Adrià Arboix, Lucía Martí, Sebastien Dorison, María José Sánchez
Bayés syndrome is an under-recognized clinical condition characterized by advanced interatrial block. Bayés syndrome is a subclinical disease that manifests electrocardiographically as a prolonged P wave duration > 120 ms with biphasic morphology ± in the inferior leads. The clinical relevance of Bayés syndrome lies in the fact that is a clear arrhythmological syndrome and has a strong association with supraventricular arrhythmias, particularly atypical atrial flutter and atrial fibrillation. Likewise, Bayés syndrome has been recently identified as a novel risk factor for non-lacunar cardioembolic ischemic stroke and vascular dementia...
March 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28320635/safety-and-efficacy-of-multipotent-adult-progenitor-cells-in-acute-ischaemic-stroke-masters-a-randomised-double-blind-placebo-controlled-phase-2-trial
#16
RANDOMIZED CONTROLLED TRIAL
David C Hess, Lawrence R Wechsler, Wayne M Clark, Sean I Savitz, Gary A Ford, David Chiu, Dileep R Yavagal, Ken Uchino, David S Liebeskind, Alexander P Auchus, Souvik Sen, Cathy A Sila, Jeffrey D Vest, Robert W Mays
BACKGROUND: Multipotent adult progenitor cells are a bone marrow-derived, allogeneic, cell therapy product that modulates the immune system, and represents a promising therapy for acute stroke. We aimed to identify the highest, well-tolerated, and safest single dose of multipotent adult progenitor cells, and if they were efficacious as a treatment for stroke recovery. METHODS: We did a phase 2, randomised, double-blind, placebo-controlled, dose-escalation trial of intravenous multipotent adult progenitor cells in 33 centres in the UK and the USA...
May 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28302914/new-insights-into-mechanisms-of-small-vessel-disease-stroke-from-genetics
#17
REVIEW
Rhea Tan, Matthew Traylor, Loes Rutten-Jacobs, Hugh Markus
Cerebral small vessel disease (SVD) is a common cause of lacunar strokes, vascular cognitive impairment (VCI) and vascular dementia. SVD is thought to result in reduced cerebral blood flow, impaired cerebral autoregulation and increased blood-brain barrier (BBB) permeability. However, the molecular mechanisms underlying SVD are incompletely understood. Recent studies in monogenic forms of SVD, such as cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and 'sporadic' SVD have shed light on possible disease mechanisms in SVD...
April 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28302243/coexistent-mitral-stenosis-and-multiple-sclerosis-an-unprecedented-case
#18
Ali Zohair Nomani, Irfan Ullah Khatak, Mansoor Iqbal, Haris Majid Rajput, Sumaira Nabi
Mitral stenosis is a valvular heart disease characterised by narrowing of mitral orifice. It can lead to a dilated left atrium with atrial fibrillation culminating into thrombus formation. Patients with mitral stenosis, presenting with stroke-like episodes, most likely experience cardio-embolic phenomenon; but unusual and unprecedented associations do occur. Reported association of cardiac MS with demyelinating CNS MS has never been proven; but authors have speculated theories based on case reports and series...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28300680/evaluation-by-magnetic-resonance-imaging-of-silent-brain-infarcts-in-preoperative-and-postoperative-asymptomatic-carotid-surgery
#19
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
BACKGROUND: To report the prevalence of silent brain infarcts (SBI) at magnetic resonance imaging (MRI) before and after surgery for asymptomatic high grade carotid stenosis. METHODS: This is a single center retrospective observational study. Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a computed tomographic (CT) scan dating less than 3 months...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28284968/recrudescence-of-symptoms-of-remote-ischemic-stroke-after-a-cerebral-angiogram-report-of-a-case
#20
Stephanie R Falatko, Philip G R Schmalz, Mark Harrigan
BACKGROUND: Recrudescence, or reappearance of previously resolved symptoms of ischemic stroke, may occur after physiological stress. Although this syndrome is generally thought to be uncommon, it may actually account for a significant proportion of stroke mimics. CASE DESCRIPTION: A 67-year-old man was admitted with a Hunt-Hess grade II spontaneous subarachnoid hemorrhage. He underwent a digital subtraction cerebral angiogram as part of his imaging evaluation. About 30 minutes after the procedure, he developed dysarthria, right facial droop and a right pronator drift...
March 8, 2017: World Neurosurgery
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