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Silent Cerebral Infarction

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https://www.readbyqxmd.com/read/27933697/total-magnetic-resonance-imaging-burden-of-cerebral-small-vessel-disease-is-associated-with-post-stroke-depression-in-patients-with-acute-lacunar-stroke
#1
X Zhang, Y Tang, Y Xie, C Ding, J Xiao, X Jiang, H Shan, Y Lin, C Li, D Hu, T Li, L Sheng
BACKGROUND AND PURPOSE: Despite extensive studies on post-stroke depression (PSD), the role of the total burden of cerebral small-vessel disease (cSVD) in its pathogenesis remains unclear. METHODS: We conducted a magnetic resonance imaging (MRI)-based cohort study to investigate the relationship between total MRI burden of cSVD and PSD among patients with first-ever lacunar stroke. From June 2013 to January 2016, 374 patients were consecutively recruited. PSD was identified using the Chinese version of the Structured Clinical Interview for DSM-IV...
December 9, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27909472/a-patient-with-asymptomatic-cerebral-lesions-during-af-ablation-how-much-should-we-worry
#2
REVIEW
Giovanni B Forleo Md PhD, Domenico G Della Rocca Md, Carlo Lavalle Md, Massimo Mantica Md, Lida P Papavasileiou Md, Valentina Ribatti Md, Germana Panattoni Md, Luca Santini Md PhD, Andrea Natale Md PhD, Luigi Di Biase Md PhD
Silent brain lesions due to thrombogenicity of the procedure represent recognized side effects of atrial fibrillation (AF) catheter ablation. Embolic risk is higher if anticoagulation is inadequate and recent studies suggest that uninterrupted anticoagulation, ACT levels above 300 seconds and administration of a pre-transeptal bolus of heparin might significantly reduce the incidence of silent cerebral ischemia (SCI) to 2%. Asymptomatic new lesions during AF ablation should suggest worse neuropsychological outcome as a result of the association between silent cerebral infarcts and increased long-term risk of dementia in non-ablated AF patients...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27889950/retinopathy-a-sign-of-cerebral-small-vessel-disease-in-diabetes
#3
Toshitaka Umemura, Takahiko Kawamura
Cardio-cerebrovascular disease greatly influences the prognosis of diabetic patients. Silent lacunar infarcts, white matter lesions (WMLs), and cerebral microbleeds are magnetic resonance imaging (MRI) markers of cerebral small vessel disease (SVD) and as they are associated with stroke and dementia, prevention of their incidence and progression is important in clinical practice. The findings of previous autopsy and clinical studies suggest that lacunar infarcts are more prevalent in diabetic patients. On the other hand, the findings of studies on an association between diabetes and WMLs have been inconsistent...
November 27, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27881850/relationship-between-asymptomatic-intra-cranial-lesions-and-brachial-ankle-pulse-wave-velocity-in-coronary-artery-disease-patients-without-stroke
#4
Noriaki Tabata, Daisuke Sueta, Takayoshi Yamashita, Daisuke Utsunomiya, Yuichiro Arima, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto
Little is known about the significance of asymptomatic intra-cranial lesions (ICL) identified by brain MRI in coronary artery disease (CAD) patients. Silent cerebral lesions are suggested to be associated with arterial stiffness in healthy subjects. We investigated whether subclinical ICL are associated with arterial stiffness and the prognosis in CAD patients without medical history of cerebrovascular diseases. We recruited CAD patients who required percutaneous coronary intervention (PCI), did not meet exclusion criteria, and agreed with MRI before PCI...
November 24, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27881833/apixaban-for-treatment-of-embolic-stroke-of-undetermined-source-atticus-randomized-trial-rationale-and-study-design
#5
Tobias Geisler, Sven Poli, Christoph Meisner, Juergen Schreieck, Christine S Zuern, Thomas Nägele, Johannes Brachmann, Werner Jung, Georg Gahn, Elisabeth Schmid, Hansjörg Bäezner, Timea Keller, Gabor C Petzold, Jan-Wilko Schrickel, Jan Liman, Rolf Wachter, Frauke Schön, Martin Schabet, Alfred Lindner, Albert C Ludolph, Hubert Kimmig, Sebastian Jander, Uwe Schlegel, Meinrad Gawaz, Ulf Ziemann
RATIONALE: Optimal secondary prevention of embolic stroke of undetermined source is not established. The current standard in these patients is acetylsalicylic acid, despite high prevalence of yet undetected paroxysmal atrial fibrillation. AIM: The ATTICUS randomized trial is designed to determine whether the factor Xa inhibitor apixaban administered within 7 days after embolic stroke of undetermined source, is superior to acetylsalicylic acid for prevention of new ischemic lesions documented by brain magnetic resonance imaging within 12 months after index stroke...
November 23, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27827330/insulin-resistance-is-a-risk-factor-for-silent-lacunar-infarction
#6
Ji Eun Lee, Dong Wook Shin, Jae Moon Yun, Sang Hyuck Kim, You-Seon Nam, BeLong Cho, Jae-Sung Lim, Han-Yeong Jeong, Hyung-Min Kwon, Jin-Ho Park
BACKGROUND AND PURPOSE: This study aims to investigate the association between insulin resistance (IR) and silent lacunar infarction (SLI) in healthy adults. METHODS: We recruited 2326 healthy Korean adults who took health checkups, including a brain magnetic resonance imaging. SLI was defined as an infarction measuring 0.3 to 1.5 cm in diameter that was localized in the territory of perforating branches of cerebral arteries, as seen in the brain magnetic resonance imaging...
November 8, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27793532/prognostic-relationships-between-microbleed-lacunar-infarction-white-matter-lesion-and-renal-dysfunction-in-acute-ischemic-stroke-survivors
#7
Jae Woong Jeon, Hye Seon Jeong, Dae Eun Choi, Young Rok Ham, Ki Ryang Na, Kang Wook Lee, Jong Wook Shin, Jei Kim
BACKGROUND: It is well known that renal dysfunction and cerebral small-vessel disease (SVD), including microbleed, lacunar infarction, and white matter lesion (WML), are associated with poor prognosis after ischemic stroke. However, the prognostic relationship between renal dysfunction and SVD has not been well evaluated in acute ischemic stroke survivors. Therefore, in this study, we evaluated the prognostic relationships between estimated glomerular filtration rate (eGFR) and cerebral SVD after acute ischemic stroke...
October 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27753852/ed-04-4-retinal-arteriolar-structure-as-a-maker-of-vascular-health
#8
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
https://www.readbyqxmd.com/read/27702854/incidence-of-silent-cerebral-infarctions-after-catheter-ablation-of-atrial-fibrillation-utilizing-the-second-generation-cryoballoon
#9
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
https://www.readbyqxmd.com/read/27647674/peri-procedural-silent-cerebral-infarcts-after-left-atrial-appendage-occlusion
#10
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
https://www.readbyqxmd.com/read/27643070/ed-04-4-retinal-arteriolar-structure-as-a-maker-of-vascular-health
#11
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
https://www.readbyqxmd.com/read/27637966/sickle-cell-disease
#12
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
https://www.readbyqxmd.com/read/27637289/embolic-protection-devices-during-tavi-current-evidence-and-uncertainties
#13
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
https://www.readbyqxmd.com/read/27618802/cranial-epidural-hematomas-a-case-series-and-literature-review-of-this-rare-complication-associated-with-sickle-cell-disease
#14
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
https://www.readbyqxmd.com/read/27604981/hydroxycarbamide-treatment-and-brain-mri-mra-findings-in-children-with-sickle-cell-anaemia
#15
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
https://www.readbyqxmd.com/read/27598351/dural-venous-sinus-diameters-in-children-with-sickle-cell-disease-correlation-with-history-of-stroke-in-a-case-control-study
#16
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
https://www.readbyqxmd.com/read/27568989/carotid-atherosclerosis-silent-ischemic-brain-damage-and-brain-atrophy-a-systematic-review-and-meta-analysis
#17
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
https://www.readbyqxmd.com/read/27547248/atrial-fibrillation-cognitive-decline-and-dementia
#18
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
https://www.readbyqxmd.com/read/27538890/high-serum-alkaline-phosphatase-levels-in-relation-to-multi-cmbs-in-acute-ischemic-stroke-patients-with-atrial-fibrillation-and-or-rheumatic-heart-disease
#19
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
https://www.readbyqxmd.com/read/27435205/ten-year-risk-of-stroke-in-patients-with-previous-cerebral-infarction-and-the-impact-of-carotid-surgery-in-the-asymptomatic-carotid-surgery-trial
#20
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
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