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Silent Cerebral Infarction

Tien Wong
The vasculature in the retina can be viewed directly and non-invasively in vivo, offers a unique perspective of the human microvasculature, and therefore the ability to understand early changes, processes, pathways and consequences of hypertension. In the past 15 years, advances in high resolution digital retinal photography and automated or semi-automated computer image software have been applied to measure and quantify a variety of retinal microvascular parameter, including retinal arteriolar and venular caliber, tortuosity, branching patterns and fractal dimensions...
September 2016: Journal of Hypertension
Tomofumi Nakamura, Kaoru Okishige, Toshiro Kanazawa, Mitsumi Yamashita, Naohiko Kawaguchi, Nobutaka Kato, Hideshi Aoyagi, Yasuteru Yamauchi, Tetsuo Sasano, Kenzo Hirao
AIMS: Pulmonary vein (PV) isolation (PVI) utilizing a cryoballoon (CB) has become one of the standard therapeutic options for atrial fibrillation (AF). However, it connotes a potential risk of cerebral ischaemic events (CIEs). This study aimed to clarify the prevalence of CIEs after PVI using second-generation CBs assessed by magnetic resonance imaging (MRI) of the brain. METHODS: This prospective observational study consisted of 160 patients that underwent PVI with second-generation CBs for drug-refractory AF...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
M Laible, M Möhlenbruch, S Horstmann, J Pfaff, N A Geis, S Pleger, S Schüler, T Rizos, M Bendszus, R Veltkamp
BACKGROUND AND PURPOSE: To determine the rate of peri-interventional silent brain infarcts after left atrial appendage occlusion (LAAO). METHODS: In this prospective, uncontrolled single-center pilot study, consecutive patients with atrial fibrillation undergoing LAAO between July 2013 and January 2016 were included. The Amplatzer Cardiac Plug, WATCHMAN or Amulet device was used. A neurological examination and cranial magnetic resonance imaging (MRI) were performed within 48 h before and after the procedure...
September 19, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Tien Wong
The vasculature in the retina can be viewed directly and non-invasively in vivo, offers a unique perspective of the human microvasculature, and therefore the ability to understand early changes, processes, pathways and consequences of hypertension. In the past 15 years, advances in high resolution digital retinal photography and automated or semi-automated computer image software have been applied to measure and quantify a variety of retinal microvascular parameter, including retinal arteriolar and venular caliber, tortuosity, branching patterns and fractal dimensions...
September 2016: Journal of Hypertension
J Strouse
Sickle cell disease (SCD) is an inherited hemoglobinopathy caused by a mutation in the sixth amino acid of the β-globin gene (HBB). It is the most common serious genetic diseases in childhood, affecting approximately 1 in 2500 births and 100 000 individuals in the USA, in addition to 300 000 new cases globally each year. Central nervous system injury is the most debilitating frequent complication of SCD and includes stroke, silent cerebral infarct (SCI), and cognitive impairment. Among children with sickle cell anemia (HbSS), 11% had a stroke by age 18 years before the implementation of transcranial Doppler screening...
2016: Handbook of Clinical Neurology
Omar Abdul-Jawad Altisent, Rishi Puri, Josep Rodés-Cabau
Transcatheter aortic valve implantation (TAVI) is now the principal therapeutic option in patients with severe aortic stenosis deemed inoperable or at high surgical risk. Implementing TAVI in a lower risk profile population could be limited by relatively high cerebrovascular event rates related to the procedure. Diffusion-weighted magnetic resonance imaging studies have demonstrated the ubiquitous presence of silent embolic cerebral infarcts after TAVI, with some data relating these lesions to subsequent cognitive decline...
October 2016: Revista Española de Cardiología
Jennifer Hamm, Nisha Rathore, Pearlene Lee, Zachary LeBlanc, Jeffrey Lebensburger, Emily Riehm Meier, Janet L Kwiatkowski
BACKGROUND: Patients with sickle cell disease (SCD) may experience many complications of the central nervous system (CNS) including stroke, silent cerebral infarcts, and neuropsychological deficits. Cranial epidural hematoma is a rare but potentially serious complication. PROCEDURE: Case series of cranial epidural hematomas in children with SCD from three different institutions is considered, along with a literature review of cranial epidural hematomas in this population...
September 13, 2016: Pediatric Blood & Cancer
Kerri A Nottage, Russell E Ware, Banu Aygun, Matthew Smeltzer, Guolian Kang, Joseph Moen, Winfred C Wang, Jane S Hankins, Kathleen J Helton
Silent cerebral infarction (SCI) is the most common neurological abnormality among children with sickle cell anaemia (SCA). The effect of hydroxycarbamide (also termed hydroxyurea) on the development and progression of SCI is unclear. We evaluated brain magnetic resonance imaging/angiography (MRI/MRA) in children with SCA receiving long-term hydroxycarbamide therapy. Fifty participants (median 9·4 years, range 1·1-17·3) enrolled in the Hydroxyurea Study of Long-Term Effects (HUSTLE; NCT00305175) underwent brain MRI/MRA and laboratory evaluations before hydroxycarbamide initiation and after 3 and 6 years of treatment to maximum tolerated dose...
October 2016: British Journal of Haematology
Kalie Adler, Arun Reghunathan, Lisa H Hutchison, Ram Kalpatthi
OBJECTIVES: The purpose of this study was to compare the diameters of the dural venous sinuses (DVSs) in children with sickle cell disease (SCD) with healthy controls and determine whether the size has any correlation to history of cerebral infarct among children with SCD. METHODS: A retrospective review compared demographics, medical history and magnetic resonance venography (MRV) findings in children with SCD with those in controls. Venous sinus diameters were measured on MRV in all subjects by the authors, who were blinded to the children's clinical history...
September 2016: Southern Medical Journal
Francesco Moroni, Enrico Ammirati, Marco Magnoni, Fabrizio D'Ascenzo, Matteo Anselmino, Nicoletta Anzalone, Maria Assunta Rocca, Andrea Falini, Massimo Filippi, Paolo G Camici
BACKGROUND: The widespread use of brain imaging has led to increased recognition of subclinical brain abnormalities, including white matter hyperintensities (WMH) and silent brain infarctions (SBI), which have a vascular origin, and have been associated to a high risk of stroke, disability and dementia. Carotid atherosclerosis (CA) may be causative in the development of WMH, SBI and eventually brain atrophy. Aim of the present systematic review and meta-analysis was to assess the existing evidence linking CA to WMH, SBI and brain atrophy...
November 15, 2016: International Journal of Cardiology
Alvaro Alonso, Antonio P Arenas de Larriva
Atrial fibrillation (AF) is a common cardiac arrhythmia. Growing evidence supports a role for AF as a risk factor for cognitive decline and dementia. In this review, we summarize epidemiologic observations linking AF with cognitive outcomes, describe potential mechanisms, and explore the impact of AF treatments on cognitive decline and dementia. Community-based, observational studies show a consistent higher rate of cognitive decline and risk of dementia in persons with AF. These associations are partly due to the increased risk of clinical stroke in AF, but other mechanisms, including incidence of silent cerebral infarcts, microbleeds, and cerebral hypoperfusion, are likely additional contributors...
2016: European Cardiology
Junfeng Liu, Deren Wang, Jie Li, Yao Xiong, Bian Liu, Chenchen Wei, Simiao Wu, Ming Liu
Background and Objective Elevated alkaline phosphatase (ALP) levels are associated with cerebral small vascular diseases, such as silent brain infarction and cerebral white matter hyperintensity, but few prospective data are available for cerebral microbleeds (CMBs). The aim of the study was to investigate associations between serum ALP levels and CMBs in acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease. Methods This prospective study involved consecutively recruited acute ischemic stroke patients with atrial fibrillation and/or rheumatic heart disease treated at two large tertiary care hospitals in southwestern China...
August 16, 2016: Current Neurovascular Research
Jonathan Y Streifler, Anne G den Hartog, Samuel Pan, Hongchao Pan, Richard Bulbulia, Dafydd J Thomas, Martin M Brown, Alison Halliday
BACKGROUND: Silent brain infarcts are common in patients at increased risk of stroke and are associated with a poor prognosis. In patients with asymptomatic carotid stenosis, similar adverse associations were claimed, but the impact of previous infarction or symptoms on the beneficial effects of carotid endarterectomy is not clear. Our aim was to evaluate the impact of prior cerebral infarction in patients enrolled in the Asymptomatic Carotid Surgery Trial, a large trial with 10-year follow-up in which participants whose carotid stenosis had not caused symptoms for at least six months were randomly allocated either immediate or deferred carotid endarterectomy...
July 19, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
Zhonglun Chen, Wei Li, Wen Sun, Lulu Xiao, Qiliang Dai, Yunfei Han, Wusheng Zhu, Gelin Xu, Xinfeng Liu
AIMS: Cerebral small vessel disease (SVD) refers to a group of pathological processes that affect small arteries, arterioles, venules, and capillaries of the brain. We hypothesized imaging markers of SVD could be associated with neurological deterioration during acute phase of mild/moderate ischemic stroke. METHODS: We performed a prospective cohort with 687 consecutive patients with acute ischemic stroke and also with admission NIHSS score below 12 points. Imaging markers of SVD, include silent lacunar infarction, deep cerebral microbleeds, brain atrophy, periventricular and semiovale white matter hyperintensities, basal ganglia and semiovale enlarged perivascular spaces as well as SVD burden rating scale were evaluated and calculated, respectively...
July 19, 2016: International Journal of Neuroscience
A Kyle Mack, Alexis A Thompson
Children with sickle cell disease (SCD) have numerous acute and chronic complications, including central nervous system (CNS) disease, which can be debilitating over their life span. Recognition of risk factors for CNS disease and overt CNS disease should be properly identified by primary care providers, including physicians, physician assistants, and nurse practitioners. Here, we discuss an emerging and important early indicator of CNS disease in the form of silent cerebral infarcts and review overt stroke in patients with SCD...
July 13, 2016: Journal of Pediatric Health Care
Hideaki Shima, Tatsuhiko Mori, Masayuki Ooi, Mika Sonoda, Tetsuo Shoji, Eiji Ishimura, Mikio Okamura, Nobukazu Ishizaka, Masaaki Inaba
BACKGROUND AND OBJECTIVES: In the general population, the presence of cerebral microbleeds on T2*-weighted magnetic resonance imaging has been reported to be a predictor of future stroke. Patients with CKD have a high prevalence of microbleeds and are at higher risk of ESRD as well as cardiovascular disease, including stroke. Because endothelial dysfunction is the common pathophysiology among microbleeds, CKD, and cardiovascular disease, we hypothesized that the presence of microbleeds would be an important predictor of composite outcome, including both cardiovascular disease and renal events, in those with CKD...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Yorito Hattori, Masafumi Ihara
Silent information regulator 2 homolog 1 (SIRT1), a product of the so called "longevity gene", is a protein deacetylase that has been reported to suppress cardiovascular pathologies such as myocardial infarction, and neurodegenerative diseases such as Alzheimer's disease, amyotrophic lateral sclerosis, and Parkinson's disease via anti-apoptosis, anti-inflammation, or increasing mitochondrial biogenesis in model organisms. In addition, SIRT1 can counter cerebral hypoperfusion and ischemia through deacetylating anti-inflammatory and anti-apoptotic molecules and also through deacetylating endothelial nitric oxide synthase and inducing arterial dilation...
April 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Idit Pazgal, Edna Inbar, Maya Cohen, Ofer Shpilberg, Pinhas Stark
OBJECTIVES: Survival of beta thalassemia major (TM) patients has improved significantly over the past few decades. Consequently, less commonly reported complications are now being recognized. An incidence as high as 60% of silent cerebral infarcts (SCI) has been demonstrated by brain Magnetic Resonance Imaging (MRI) studies in beta thalassemia intermedia (TI). The aim of this study was to determine whether regularly transfused TM adult patients experience less SCI, as compared to the incidence described in TI...
August 2016: Thrombosis Research
Takahiko Kawamura, Toshitaka Umemura, Hiroyuki Umegaki, Rui Imamine, Naoko Kawano, Hajime Mase, Asako Mizoguchi, Makiko Minatoguchi, Minoru Kusama, Yu Kouchi, Atsuko Watarai, Akio Kanai, Eitaro Nakashima, Nigishi Hotta
BACKGROUND/AIMS: We conducted a 3-year longitudinal study concerning factors associated with changes in brain atrophy in elderly diabetic patients. METHODS: We evaluated hippocampal and global brain atrophy using automatic voxel-based morphometry of structural magnetic resonance images, 4 cognitive function tests, and cerebral small vessel disease (SVD) in 66 diabetic patients. RESULTS: During the 3-year follow-up, hippocampal and global brain atrophy advanced, and cognitive functions worsened...
January 2016: Dementia and Geriatric Cognitive Disorders Extra
David Školoudík, Eva Hurtíková, Radim Brát, Roman Herzig
Here, we examined whether intraoperative sonolysis can alter the risk of new ischemic lesions in the insonated brain artery territory during coronary artery bypass grafting (CABG) or valve surgery.Silent brain ischemic lesions could be detected in as many as two-thirds of patients after CABG or valve surgery.Patients indicated for CABG or valve surgery were allocated randomly to sonolysis (60 patients, 37 males; mean age, 65.3 years) of the right middle cerebral artery (MCA) during cardiac surgery and control group (60 patients, 37 males; mean age, 65...
May 2016: Medicine (Baltimore)
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