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https://www.readbyqxmd.com/read/28190436/neurologic-complications-of-cardiac-and-vascular-surgery
#1
K N Sheth, E Nourollahzadeh
This chapter will provide an overview of the major neurologic complications of common cardiac and vascular surgeries, such as coronary artery bypass grafting and carotid endarterectomy. Neurologic complications after cardiac and vascular surgeries can cause significant morbidity and mortality, which can negate the beneficial effects of the intervention. Some of the complications to be discussed include ischemic and hemorrhagic stroke, seizures, delirium, cognitive dysfunction, cerebral hyperperfusion syndrome, cranial nerve injuries, and peripheral neuropathies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186430/cerebral-blood-flow-frontal-lobe-oxygenation-and-intra-arterial-blood-pressure-during-sprint-exercise-in-normoxia-and-severe-acute-hypoxia-in-humans
#2
David Curtelin, David Morales-Alamo, Rafael Torres-Peralta, Peter Rasmussen, Marcos Martin-Rincon, Mario Perez-Valera, Christoph Siebenmann, Ismael Pérez-Suárez, Evgenia Cherouveim, A William Sheel, Carsten Lundby, José Al Calbet
Cerebral blood flow (CBF) is regulated to secure brain O2 delivery while simultaneously avoiding hyperperfusion; however, both requisites may conflict during sprint exercise. To determine whether brain O2 delivery or CBF is prioritized, young men performed sprint exercise in normoxia and hypoxia (PIO2 = 73 mmHg). During the sprints, cardiac output increased to ∼22 L min(-1), mean arterial pressure to ∼131 mmHg and peak systolic blood pressure ranged between 200 and 304 mmHg. Middle-cerebral artery velocity (MCAv) increased to peak values (∼16%) after 7...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28153617/the-susceptibility-pathogenesis-of-the-moyamoya-disease
#3
Juntao Hu, Jie Luo, Qianxue Chen
Moyamoya disease (MMD) is a cerebrovascular disease characterized by progressive stenosis of the intracranial internal carotid arteries and their proximal branches. Epidemiologically, MMD is more prevalent in east Asia than any region worldwide, which have been estimated at 0.94 per 100 000 in Japanese and 0.43 per 100,000 in Chinese.However, the etiology of this rare disease remains unknown. Regarding biomarkers of moyamoya disease, moyamoya disease is characterized by an increased expression of angiogenic factors and pro-inflammatory molecules such as vascular endothelial growth factors and matrix metalloproteinase-9, which may partly explain its clinical manifestations of the pathologic angiogenesis, spontaneous hemorrhage, and higher incidence of cerebral hyperperfusion after revascularization surgery...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28105459/mog-antibody-positive-benign-unilateral-cerebral-cortical-encephalitis-with-epilepsy
#4
Ryo Ogawa, Ichiro Nakashima, Toshiyuki Takahashi, Kimihiko Kaneko, Tetsuya Akaishi, Yoshiki Takai, Douglas Kazutoshi Sato, Shuhei Nishiyama, Tatsuro Misu, Hiroshi Kuroda, Masashi Aoki, Kazuo Fujihara
OBJECTIVE: To describe the features of adult patients with benign, unilateral cerebral cortical encephalitis positive for the myelin oligodendrocyte glycoprotein (MOG) antibody. METHODS: In this retrospective, cross-sectional study, after we encountered an index case of MOG antibody-positive unilateral cortical encephalitis with epileptic seizure, we tested for MOG antibody using our in-house, cell-based assay in a cohort of 24 consecutive adult patients with steroid-responsive encephalitis of unknown etiology seen at Tohoku University Hospital (2008-2014)...
March 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28101162/correlation-between-high-perfusion-syndrome-and-stent-restenosis-after-stent-implantation
#5
Yingyi Li, Lingtao Tang, Dong Qi, Chunlei Wang, Suxia Zhang, Pengfei Hu, Yun Wang, Bogang Zhang, Kunxi Zhang
The present study was conducted to determine the correlation between high perfusion syndrome and stent restenosis after cerebral vascular stent implantation. A total of 146 patients diagnosed with cerebral vascular stenosis and stent implantation were selected. A total of 55 cases (37.67%) of cerebral hyperperfusion syndrome patients were diagnosed by xenon-enhanced computer tomography (Xe-CT) examination and clinical symptoms within 3 days after surgery and were chosen as the observation group. A total of 91 cases were selected as the control group...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28093563/asymptomatic-mild-hyperperfusion-for-the-prediction-of-clinical-outcome-in-postoperative-patients-after-subarachnoid-hemorrhage
#6
Manabu Nakagawa, Tatsushi Mutoh, Shunsuke Takenaka, Tomoko Mutoh, Tomoko Totsune, Yasuyuki Taki, Tatsuya Ishikawa
BACKGROUND Delayed cerebral ischemia (DCI) is one of the main causes of poor outcomes after subarachnoid hemorrhage (SAH). The early identification of DCI by noninvasive imaging modalities would provide valuable information of therapeutic intervention for improving the patient outcomes. We aimed to describe the clinical features of cerebral blood flow (CBF) data obtained from the single-photon emission computed tomography (SPECT) during the risk period for DCI after SAH. MATERIAL AND METHODS Clinical data from 94 SAH patients who underwent surgical clipping of anterior circulation aneurysms were reviewed retrospectively...
January 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28057413/upper-extremity-blood-pressure-difference-in-patients-undergoing-carotid-revascularisation
#7
A Huibers, J Hendrikse, M M Brown, S A Pegge, M Arnold, F L Moll, L J Kapelle, G J de Borst
INTRODUCTION: Blood pressure (BP) regulation is important in patients with carotid artery atherosclerotic disease. Concomitant subclavian artery stenosis (SAS) might lead to an underestimation of the true systemic BP in the monitoring of these patients. This study aimed to assess the prevalence of the inter-arm BP difference in patients undergoing carotid intervention and its association with ipsilateral significant subclavian stenosis and clinical outcome. METHODS: Bilateral BP measurements and vascular imaging (CTA and MRA) of both subclavian arteries and the innominate artery were assessed in 182 symptomatic patients with carotid artery stenosis undergoing revascularisation in the International Carotid Stenting Study (ICSS)...
January 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28033272/intraoperative-dexmedetomidine-and-postoperative-cerebral-hyperperfusion-syndrome-in-patients-who-underwent-superficial-temporal-artery-middle-cerebral-artery-anastomosis-for-moyamoya-disease-a-retrospective-observational-study
#8
Hyungseok Seo, Ho-Geol Ryu, Je Do Son, Jeong-Soo Kim, Eun Jin Ha, Jeong-Eun Kim, Hee-Pyoung Park
Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease.The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28017753/amplitude-of-tissue-oxygenation-index-change-predicts-cerebral-hyperperfusion-syndrome-during-carotid-artery-stenting
#9
Hun Soo Park, Ichiro Nakagawa, Shohei Yokoyama, Yasushi Motoyama, Young Su Park, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
OBJECTIVE: Hyperperfusion syndrome (HPS) following carotid artery stenting (CAS) is a rare but serious complication. HPS is associated with preoperative hemodynamic impairment due to poor collateral flow and intraoperative cerebral ischemia. Filter-type embolic protection devices (EPDs) maintain anterograde carotid flow during CAS and somewhat prevent HPS. Early treatment of patients undergoing CAS and at risk for HPS is essential. Near-infrared spectroscopy (NIRS) allows non-invasive, real-time measurement of frontal lobe regional cerebral O2 saturation (TOI; tissue oxygenation index)...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017224/hemorrhagic-transformation-and-cerebral-edema-in-acute-ischemic-stroke-link-to-cerebral-autoregulation
#10
Pedro Castro, Elsa Azevedo, Jorge Serrador, Isabel Rocha, Farzaneh Sorond
BACKGROUND: Hemorrhagic transformation and cerebral edema are feared complications of acute ischemic stroke but mechanisms are poorly understood and reliable early markers are lacking. Early assessment of cerebrovascular hemodynamics may advance our knowledge in both areas. We examined the relationship between dynamic cerebral autoregulation (CA) in the early hours post ischemia, and the risk of developing hemorrhagic transformation and cerebral edema at 24h post stroke METHODS: We prospectively enrolled 46 patients from our center with acute ischemic stroke in the middle cerebral artery territory...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27960175/moyamoya-disease
#11
Miki Fujimura, Oh Young Bang, Jong S Kim
Moyamoya disease (MMD) is a chronic occlusive cerebrovascular disease characterized by progressive stenosis at the terminal portion of the internal carotid artery and an abnormal vascular network at the base of the brain. Although its etiology is unknown, recent genetic studies have identified RNF213 in the 17q25-ter region as an important susceptibility gene of MMD among East Asian populations. A c.14576G>A polymorphism in RNF213 was identified in 95% of MMD patients with a family history and in 79% of sporadic cases, and patients carrying this polymorphism exhibited significantly earlier disease onset and a more-severe form of MMD...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27942771/evaluation-of-cerebral-hyperperfusion-after-carotid-artery-stenting-using-c%C3%A2-arm-ct-measurements-of-cerebral-blood-volume
#12
Michio Fujimoto, Hiroshi Itokawa, Masao Moriya, Noriyoshi Okamoto, Jinichi Sasanuma
PURPOSE: Hyperperfusion syndrome (HPS) after carotid artery stenting (CAS) causes serious symptoms; therefore, early evaluation after CAS is considered to be important. Measurement of cerebral blood volume using C‑arm computed tomography (C-arm CBV) has recently become possible. Here, the usefulness of C‑arm CBV for the evaluation of hyperperfusion was investigated. METHODS: C-arm CBV was measured before and immediately after CAS in 30 patients. The regions of interest (ROI) were set in the bilateral middle cerebral artery perfused regions, and the affected/healthy side ratio of measured C‑arm CBV (CBV ratios) was determined to evaluate cerebral perfusion...
December 11, 2016: Clinical Neuroradiology
https://www.readbyqxmd.com/read/27918961/the-promise-of-subtraction-ictal-spect-co-registered-to-mri-for-improved-seizure-localization-in-pediatric-epilepsies-affecting-factors-and-relationship-to-the-surgical-outcome
#13
Catherine Stamoulis, Nishant Verma, Himanshu Kaulas, Jonathan J Halford, Frank H Duffy, Phillip L Pearl, S Ted Treves
OBJECTIVE: Ictal SPECT is promising for accurate non-invasive localization of the epileptogenic brain tissue in focal epilepsies. However, high quality ictal scans require meticulous attention to the seizure onset. In a relatively large cohort of pediatric patients, this study investigated the impact of the timing of radiotracer injection, MRI findings and seizure characteristics on ictal SPECT localizations, and the relationship between concordance of ictal SPECT, scalp EEG and resected area with seizure freedom following epilepsy surgery...
January 2017: Epilepsy Research
https://www.readbyqxmd.com/read/27861605/differentiation-of-glioblastoma-from-brain-metastasis-qualitative-and-quantitative-analysis-using-arterial-spin-labeling-mr-imaging
#14
Leonard Sunwoo, Tae Jin Yun, Sung-Hye You, Roh-Eul Yoo, Koung Mi Kang, Seung Hong Choi, Ji-Hoon Kim, Chul-Ho Sohn, Sun-Won Park, Cheolkyu Jung, Chul-Kee Park
PURPOSE: To evaluate the diagnostic performance of cerebral blood flow (CBF) by using arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging to differentiate glioblastoma (GBM) from brain metastasis. MATERIALS AND METHODS: The institutional review board of our hospital approved this retrospective study. The study population consisted of 128 consecutive patients who underwent surgical resection and were diagnosed as either GBM (n = 89) or brain metastasis (n = 39)...
2016: PloS One
https://www.readbyqxmd.com/read/27851464/1829-aortic-cannulation-and-cerebral-hyperperfusion-syndrome-a-rare-cause-of-unilateral-brain-edema
#15
Christopher Robinson, Michael Pizzi, Eelco Wijdicks
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27829722/cerebral-hyperperfusion-syndrome-after-intracranial-stenting-of-the-middle-cerebral-artery
#16
Boby Varkey Maramattom
Cerebral hyperperfusion syndrome (CHS) is a rare complication following cerebral revascularization. It presents with ipsilateral headache, seizures, and intracerebral hemorrhage. It has mostly been described following extracranial carotid endarterectomy and stenting and it is very unusual after intracranial stenting. A 71-year-old man with a stuttering stroke was taken up for a cerebral angiogram (digital subtraction angiography), which showed a dissection of the distal left middle cerebral artery. This was recanalized with a solitaire AB stent...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27818371/ictal-spect-is-useful-in-localizing-the-epileptogenic-zone-in-infants-with-cortical-dysplasia
#17
Martin Kudr, Pavel Krsek, Bruno Maton, Stephen Malone, Alena Jahodova, Vladimir Komarek, Prasanna Jayakar, Michael Duchowny
AIMS: To assess the localizing value of ictal SPECT in very young epilepsy surgery candidates when cerebral haemodynamic responses are known to be immature. METHODS: We retrospectively studied 13 infants with intractable focal epilepsy caused by focal cortical dysplasia (FCD). Completeness of resection of the (1) ictal SPECT hyperperfusion zone and (2) cerebral cortex with prominent ictal and interictal abnormalities on intracranial EEG (ECoG or long-term invasive monitoring) and the MRI lesion, when present, were correlated with postoperative seizure outcome...
December 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27798314/cerebral-blood-flow-autoregulation-in-sepsis-for-the-intensivist-why-its-monitoring-may-be-the-future-of-individualized-care
#18
Carrie M Goodson, Kathryn Rosenblatt, Lucia Rivera-Lara, Paul Nyquist, Charles W Hogue
Cerebral blood flow (CBF) autoregulation maintains consistent blood flow across a range of blood pressures (BPs). Sepsis is a common cause of systemic hypotension and cerebral dysfunction. Guidelines for BP management in sepsis are based on historical concepts of CBF autoregulation that have now evolved with the availability of more precise technology for its measurement. In this article, we provide a narrative review of methods of monitoring CBF autoregulation, the cerebral effects of sepsis, and the current knowledge of CBF autoregulation in sepsis...
October 25, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27751927/clinical-implication-of-temporary-hypointense-lesion-on-diffusion-weighted-imaging-after-extracranial-intracranial-bypass-surgery
#19
Hidehito Kimura, Masaaki Taniguchi, Tatsuya Mori, Kohkichi Hosoda, Eiji Kohmura
BACKGROUND: Postoperative hyperperfusion syndrome after extracranial-to-intracranial bypass causing temporary neurologic deterioration has been reported rarely as isosignal intensity on diffusion-weighted imaging (DWI) with hyperintense lesion on T2-weighted image and fluid-attenuated inversion recovery (FLAIR) imaging as an expression of vasogenic edema. We present a rare case of a patient suffering from temporary aphasia after an extracranial-to-intracranial bypass surgery, which was shown as a transient hypointense lesion on DWI with increased apparent diffusion coefficient value, evidence of postoperative hyperperfusion...
January 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27749417/ictal-phase-perfusion-spect-of-nonketotic-hyperglycemia-induced-parieto-occipital-seizure
#20
Chia-Ju Liu, Hsin-Hsi Tsai, Kuan-Yin Ko, Ching-Chu Lu, Ruoh-Fang Yen
A 68-year-old man with diabetes mellitus type 2 presented himself with visual distortion and apraxia. Nonketotic hyperglycemic seizure with both motor and sensory components was suspected. Tc-ECD perfusion SPECT demonstrated hyperperfusion at right parieto-occipital lobe during ictal phase. Normalization of hyperperfused area was noted on follow-up perfusion SPECT after intense glucose control. In nonketotic hyperglycemic state, the depletion of GABA in cerebral neurons lowers the seizure threshold. We demonstrated that ictal phase perfusion SPECT contributed to not only diagnosis but also served as a follow-up tool...
January 2017: Clinical Nuclear Medicine
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