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Lacunar stroke

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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
#1
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...
March 17, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28302914/new-insights-into-mechanisms-of-small-vessel-disease-stroke-from-genetics
#2
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
#3
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-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#4
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
OBJECTIVE: To report the prevalence of Silent Brain Infarcts (SBI) at MRI before and after surgery for asymptomatic high grade carotid stenosis. DESIGN: Single-center retrospective observational study METHODS: Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a CT scan dating less than 3 months. A neurological examination was performed during the anesthesia consultation and in the 15 days before surgery...
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
#5
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
https://www.readbyqxmd.com/read/28265034/extracellular-matrix-inflammation-in-vascular-cognitive-impairment-and-dementia
#6
REVIEW
Gary A Rosenberg
Vascular cognitive impairment and dementia (VCID) include a wide spectrum of chronic manifestations of vascular disease related to large vessel strokes and small vessel disease (SVD). Lacunar strokes and white matter (WM) injury are consequences of SVD. The main vascular risk factor for SVD is brain hypoperfusion from cerebral blood vessel narrowing due to chronic hypertension. The hypoperfusion leads to activation and degeneration of astrocytes with the resulting fibrosis of the extracellular matrix (ECM)...
March 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28263202/daytime-blood-pressure-surges-following-hypoxic-episodes-in-a-case-of-pneumoconiosis-with-lacunar-stroke-recurrences
#7
Yuki Imaizumi, Kazuomi Kario, Kazuo Eguchi, Akira Taketomi
No abstract text is available yet for this article.
March 3, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28254515/hereditary-cerebral-small-vessel-disease-and-stroke
#8
REVIEW
Christian Baastrup Søndergaard, Jørgen Erik Nielsen, Christine Krarup Hansen, Hanne Christensen
Cerebral small vessel disease is considered hereditary in about 5% of patients and is characterized by lacunar infarcts and white matter hyperintensities on MRI. Several monogenic hereditary diseases causing cerebral small vessel disease and stroke have been identified. The purpose of this systematic review is to provide a guide for determining when to consider molecular genetic testing in patients presenting with small vessel disease and stroke. CADASIL, CARASIL, collagen type IV mutations (including PADMAL), retinal vasculopathy with cerebral leukodystrophy, Fabry disease, hereditary cerebral hemorrhage with amyloidosis, and forkhead box C1 mutations are described in terms of genetics, pathology, clinical manifestation, imaging, and diagnosis...
February 22, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28251292/lipidomic-analysis-of-plasma-in-patients-with-lacunar-infarction-using-normal-phase-reversed-phase-two-dimensional-liquid-chromatography-quadrupole-time-of-flight-mass-spectrometry
#9
Li Yang, Pu Lv, Wanpeng Ai, Linnan Li, Sensen Shen, Honggang Nie, Yabing Shan, Yu Bai, Yining Huang, Huwei Liu
Stroke is a major cause of mortality and long-term disability worldwide. The study of biomarkers and pathogenesis is vital for early diagnosis and treatment of stroke. In the present study, a continuous-flow normal-phase/reversed-phase two-dimensional liquid chromatography-quadrupole time-of-flight mass spectrometry (NP/RP 2D LC-QToF/MS) method was employed to measure lipid species in human plasma, including healthy controls and lacunar infarction (LI) patients. As a result, 13 lipid species were demonstrated with significant difference between the two groups, and a "plasma biomarker model" including glucosylceramide (38:2), phosphatidylethanolamine (35:2), free fatty acid (16:1), and triacylglycerol (56:5) was finally established...
March 1, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28215260/moderate-to-severe-obstructive-sleep-apnea-is-associated-with-cerebral-small-vessel-disease
#10
Tae-Jin Song, Jung-Hyun Park, Kang Hyun Choi, Yoonkyung Chang, Jangsup Moon, Ju-Hee Kim, Yunseo Choi, Yong-Jae Kim, Hyang Woon Lee
BACKGROUND: Cerebral small vessel disease (SVD) is associated with increased risk of cerebral infarction and hemorrhage. Obstructive sleep apnea (OSA) is known to increase the risk of cerebrovascular disease. This study aimed to investigate the association between cerebral SVD and severity of OSA. METHODS: A total of 170 patients were included from the patient registry at the present Sleep Center; these patients underwent both magnetic resonance imaging (MRI) of the brain and polysomnography (PSG) for suspected OSA...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28213191/microneurosurgical-management-of-posterior-communicating-artery-aneurysm-a-contemporary-series-from-helsinki
#11
Peeraphong Thiarawat, Behnam Rezai Jahromi, Danil A Kozyrev, Patcharin Intarakhao, Mario K Teo, Joham Choque-Velasquez, Juha Hernesniemi
OBJECTIVE: Our purposes are to analyze microsurgical techniques and to determine correlations between microsurgical techniques with the radiographic findings in the microneurosurgical treatment of the posterior communicating artery aneurysms (PCoAAs). METHODS: The authors retrospectively analyzed radiographic findings and videos of surgery in 64 patients with PCoAAs who underwent microsurgical clipping by the senior author from August 2010-2014. RESULTS: From 64 aneurysms, 30 (47%) had SAH that necessitated the lamina terminalis fenestration (odds ratio [OR], 67...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190604/the-fate-of-acute-lacunar-lesions-in-terms-of-shape-and-size
#12
Ki Jeong Lee, Hyeyoung Jung, Yoon-Sang Oh, Eun Ye Lim, A-Hyun Cho
BACKGROUND: The description of lacunar infarcts on imaging is widely variable. In particular, there are fewer agreements on lacunar lesion size and the presence of cavitation. In this regard, we investigated the changes in size and shape of acute ischemic lesion that is possibly considered as small vessel occlusion on long-term follow-up. METHODS: Patients with acute single subcortical ischemic lesion on penetrating arterial territories and without definite cause of cardioembolism and large vessel disease were included...
February 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28169884/mri-progression-of-cerebral-small-vessel-disease-and-cognitive-decline-in-patients-with-hypertension
#13
Renske Uiterwijk, Julie Staals, Marjolein Huijts, Peter W de Leeuw, Abraham A Kroon, Robert J van Oostenbrugge
OBJECTIVE: Hypertension is associated with cognitive deficits, probably because it is a major risk factor for the development of white matter hyperintensities (WMH), lacunes, and cerebral microbleeds, which are MRI markers of cerebral small vessel disease. Studies into associations between presence or progression of these MRI markers and cognitive decline in hypertensive patients are rare. We investigated the association of baseline presence and progression of MRI markers of cerebral small vessel disease with cognitive decline over 4 years in patients with hypertension...
February 6, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#14
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28151400/factors-associated-with-new-onset-depression-following-ischemic-stroke-the-women-s-health-initiative
#15
Joel Salinas, Roberta M Ray, Rami Nassir, Kamakshi Lakshminarayan, Christina Dording, Jordan Smoller, Sylvia Wassertheil-Smoller, Jonathan Rosand, Erin C Dunn
BACKGROUND: Psychosocial characteristics have a strong effect on risk of depression, and their direct treatment with behavioral interventions reduces rates of depression. Because new-onset poststroke depression (NPSD) is frequent, devastating, and often treatment-resistant, novel preventive efforts are needed. As a first step toward developing behavioral interventions for NPSD, we investigated whether prestroke psychosocial factors influenced rates of NPSD in a manner similar to the general population...
February 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28127679/motion-illusion-evidence-towards-human-vestibulo-thalamic-projections
#16
Aasef G Shaikh, Dominik Straumann, Antonella Palla
Contemporary studies speculated that cerebellar network responsible for motion perception projects to the cerebral cortex via vestibulo-thalamus. Here, we sought for the physiological properties of vestibulo-thalamic pathway responsible for the motion perception. Healthy subjects and the patient with focal vestibulo-thalamic lacunar stroke spun a hand-held rheostat to approximate the value of perceived angular velocity during whole-body passive earth-vertical axis rotations in yaw plane. Vestibulo-ocular reflex was simultaneously measured with high-resolution search coils (paradigm 1)...
January 27, 2017: Cerebellum
https://www.readbyqxmd.com/read/28127514/interhemispheric-characterization-of-small-vessel-disease-imaging-markers-after-subcortical-infarct
#17
Maria Del C Valdés Hernández, Xinyi Qiu, Xin Wang, Stewart Wiseman, Eleni Sakka, Lucy C Maconick, Fergus Doubal, Cathie L M Sudlow, Joanna M Wardlaw
BACKGROUND: In structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown. MATERIALS AND METHODS: From brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)-positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28104915/visceral-obesity-is-associated-with-white-matter-hyperintensity-and-lacunar-infarct
#18
K W Kim, H Seo, M-S Kwak, D Kim
BACKGROUND: The presences of white matter hyperintensity (WMH) and lacunar infarct are recognized as risk factors of dementia, stroke, and mortality. It is undetermined whether visceral adipose tissue (VAT) area is associated with an increased risk of cerebral small vessel disease. We explored whether VAT area was responsible for cerebral small vessel disease through the identification of WMH and lacunar infarct. SUBJECTS: A total of 2046 subjects free of cerebrovascular disease who underwent brain magnetic resonance imaging (MRI) and abdominal fat computed tomography (CT) during a general health check-up were enrolled...
January 20, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28072724/fatal-antiphospholipid-syndrome-following-endoscopic-transnasal-transsphenoidal-surgery-for-a-pituitary-tumor-a-case-report
#19
Chiao-Zhu Li, Chiao-Ching Li, Chih-Chuan Hsieh, Meng-Chi Lin, Dueng-Yuan Hueng, Feng-Chen Liu, Yuan-Hao Chen
INTRODUCTION: The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery. METHODS AND RESULT: A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28064357/ischemic-stroke-experimental-models-and-reality
#20
REVIEW
Clemens J Sommer
The vast majority of cerebral stroke cases are caused by transient or permanent occlusion of a cerebral blood vessel ("ischemic stroke") eventually leading to brain infarction. The final infarct size and the neurological outcome depend on a multitude of factors such as the duration and severity of ischemia, the existence of collateral systems and an adequate systemic blood pressure, etiology and localization of the infarct, but also on age, sex, comorbidities with the respective multimedication and genetic background...
February 2017: Acta Neuropathologica
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