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cerebrovascular reserve

Fuat Arikan, Marta Rubiera, Joaquín Serena, Ana Rodríguez-Hernández, Darío Gándara, Carles Lorenzo-Bosquet, Alejandro Tomasello, Ivette Chocrón, Maximiliano Quintana-Corvalan, Juan Sahuquillo
INTRODUCTION: Cerebral revascularization techniques are an indispensable tool in the current armamentarium of vascular neurosurgeons. We present revascularization surgery experience and results in both moyamoya disease and occlusive cerebral ischaemia. PATIENTS AND METHODS: Patients with ischaemic occlusive disease and moyamoya disease who underwent microsurgical revascularization between October 2014 and September 2017 were analysed. RESULTS: In the study period, 23 patients with occlusive ischaemic disease underwent microsurgical revascularization...
March 14, 2018: Neurocirugía
Jackson J Liang, Melissa A Elafros, Michael T Mullen, Daniele Muser, Tatsuya Hayashi, Andres Enriquez, Rajeev K Pathak, Erica S Zado, Pasquale Santangeli, Jeffrey S Arkles, Robert D Schaller, Gregory E Supple, David S Frankel, Fermin C Garcia, Rajat Deo, David Lin, Michael P Riley, Saman Nazarian, Sanjay Dixit, Francis E Marchlinski, David J Callans
INTRODUCTION: Whether successful catheter ablation for atrial fibrillation (AF) reduces risk of cerebrovascular events (CVEs) remains controversial and whether oral anticoagulation therapy (OAT) can be safely discontinued in patients rendered free of AF recurrences remains unknown. We evaluated OAT use patterns and examined long-term rates of CVEs (stroke/TIA) and major bleeding episodes (MBEs) in patients with nonparoxysmal AF treated with catheter ablation. METHODS AND RESULTS: Four hundred patients with nonparoxysmal AF (200 persistent, 200 longstanding persistent; mean age 60...
March 7, 2018: Journal of Cardiovascular Electrophysiology
Anthony R Bain, Ivan Drvis, Zeljko Dujic, David B MacLeod, Philip N Ainslie
NEW FINDINGS: What is the topic of this review? This review provides an up-to-date assessment of the physiology involved with extreme static dry-land breath holding in trained apneists. What advances does it highlight? We specifically highlight the recent findings involved with the cardiovascular, cerebrovascular, and metabolic function during a maximal breath hold in elite apneists. ABSTRACT: Breath hold related activities have been performed for centuries, but only recently within the last ∼30 years has it emerged as an increasingly popular competitive sport...
March 7, 2018: Experimental Physiology
Takuya Konno, Takeshi Miura, Andrea M Harriott, Naomi Mezaki, Emily S Edwards, Rosa Rademakers, Owen A Ross, James F Meschia, Takeshi Ikeuchi, Zbigniew K Wszolek
BACKGROUND AND PURPOSE: Mutations in colony stimulating factor 1 receptor (CSF1R) cause adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP). Patients with ALSP can be misdiagnosed as having acute ischemic stroke due to hyperintensity lesions on diffusion-weighted magnetic resonance imaging. Mutant CSF1R proteins identified in ALSP show a complete loss of autophosphorylation of CSF1R. METHODS: We conducted mutation screening of CSF1R in 123 patients with definite acute ischemic cerebrovascular syndrome and positive family history of stroke...
March 6, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Sam C Tyagi, Matthew J Dougherty, Shinichi Fukuhara, Douglas A Troutman, Danielle M Pineda, Hong Zheng, Keith D Calligaro
BACKGROUND: Carotid artery occlusive disease can cause stroke by embolization, thrombosis, and hypoperfusion. The majority of strokes secondary to cervical carotid atherosclerosis are believed to be of embolic etiology. However, cerebral hypoperfusion could be an important factor in perioperative stroke. We retrospectively reviewed the stump pressure (SP) of carotid endarterectomy (CEA) of patients at Pennsylvania Hospital to identify whether physiologic perfusion differences account for differences in perioperative stroke rates, particularly in octogenarians...
February 23, 2018: Journal of Vascular Surgery
Igor A Fernandes, Marcos P Rocha, Monique O Campos, João D Mattos, Daniel E Mansur, Helena N M Rocha, Paulo A C Terra, Vinícius P Garcia, Natália G Rocha, Niels H Secher, Antonio C L Nóbrega
KEY POINTS: Hypoxaemia evokes a repertoire of homeostatic adjustments that maintain oxygen supply to organs and tissues including the brain and skeletal muscles. Because hypertensive patients have impaired endothelial-dependent vasodilatation and an increased sympathetic response to arterial oxygen desaturation, we investigated whether hypertension impairs isocapnic hypoxia-induced cerebral and skeletal muscle hyperaemia to an extent that limits oxygen supply. In middle-aged hypertensive men, vertebral and femoral artery blood flow do not increase in response to isocapnic hypoxia, limiting brain and peripheral hyperaemia and oxygen supply...
February 20, 2018: Journal of Physiology
Swati Rane, Natalie Koh, Peter Boord, Tara Madhyastha, Mary K Askren, Suman Jayadev, Brenna Cholerton, Eric Larson, Thomas J Grabowski
Cerebrovascular disease, especially small vessel pathology, is the leading comorbidity in degenerative disorders. We applied arterial spin labeling and cerebrovascular reserve (CVR) imaging to quantify small vessel disease and study its effect on cognitive symptoms in nondemented older adults from a community-based cohort. We evaluated baseline cerebral blood flow (CBF) using arterial spin labeling and percent signal change as a marker of CVR using blood-oxygen level-dependent imaging following a breath-hold stimulus...
January 31, 2018: Neurobiology of Aging
J Bradley Layton, Dongmei Li, Christoph R Meier, Julie L Sharpless, Til Stürmer, M Alan Brookhart
CONTEXT: Exogenous testosterone administration may affect blood clotting, polycythemia, and may increase atherosclerosis, though any association with cardiovascular events is unclear. While the literature is inconclusive, some studies have suggested testosterone use may increase short-term risk of cardiovascular events and stroke, and injection testosterone may convey higher risks than other dosage forms. OBJECTIVE: We sought to evaluate the short-term cardiovascular risk of receiving injection testosterone...
February 15, 2018: Clinical Endocrinology
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
Steven Brooks, Kayla Branyan, Evan DeVallance, Roy Skinner, Kent Lemaster, J Whitney Sheets, Christopher R Pitzer, Shinichi Asano, Randall Bryner, I Mark Olfert, Jefferson C Frisbee, Paul D Chantler
Chronic unresolvable stress leads to the development of depression and cardiovascular disease (CVD). There is a high prevalence of depression with the metabolic syndrome (MetS), however, to what extent the MetS concurrent with psychological stress affects cerebrovascular function is unknown. We investigated the differential effect of MetS on cerebrovascular structure/function in rats (16-17-wk-old) following 8 wk of unpredictable chronic mild stress (UCMS), and whether exercise training could limit any cerebrovascular dysfunction...
February 13, 2018: Experimental Physiology
Baofeng Xu, Chao Li, Yunbao Guo, Kan Xu, Yi Yang, Jinlu Yu
At present, there is limited understanding of chronic total occlusion (CTO) of the internal carotid artery (ICA). Therefore, the present report collected related cases from PubMed and reviewed the literature. Cerebral vessels may form collateral circulation immediately or gradually following CTO of the ICA. The natural history of CTO of the ICA includes a variety of outcomes, all of which are biased toward a non-benign progressive process and are characterized by insufficient cerebral perfusion, embolus detachment and cognitive dysfunction...
February 2018: Biomedical Reports
Yuang-Seng Tsuei, Ying-Erh Chou, Wen-Hsien Chen, Chao-Bao Luo, Shun-Fa Yang
BACKGROUND: Dural arteriovenous fistula (DAVF) is a rare but important cerebrovascular disorder in adults. Little is known about the molecular genetic pathogenesis underlying the development of DAVF. OBJECTIVES: The present study was conducted to investigate the associations of gene polymorphisms and DAVF. MATERIALS AND METHODS: Using real-time polymerase chain reaction (PCR) genotyping, 7 single-nucleotide polymorphisms (SNPs) of angiogenesis-related genes were analyzed in 72 DAVF patients...
February 12, 2018: Journal of Thrombosis and Haemostasis: JTH
Alex B Hansen, Ryan L Hoiland, Nia C S Lewis, Michael M Tymko, Joshua C Tremblay, Michael Stembridge, Daniela Nowak-Flück, Howard H Carter, Damian M Bailey, Philip N Ainslie
Hypoxia is associated with an increased systemic and cerebral formation of free radicals and associated reactants that may be linked to impaired cerebral vascular function a neurological sequela. To what extent oral antioxidants prophylaxis impacts cerebrovascular function in humans throughout the course of acclimatization to the hypoxia of terrestrial high-altitude has not been examined. Thus, the purpose of the current study was to examine the influence of orally ingested antioxidants at clinically relevant doses (vitamin C, E, and alpha-lipoic acid) on cerebrovascular regulation at sea-level (344 m; n = 12; female n = 2 participants), and at high altitude (5050 m; n = 9; female n = 2), in a randomized, placebo-controlled, and double-blinded crossover design...
February 10, 2018: Experimental Physiology
Francesco Baratta, Daniele Pastori, Mario Fabiani, Valerio Fabiani, Fabrizio Ceci, Rossella Lillo, Valeria Lolli, Marco Brunori, Gaetano Pannitteri, Elena Cravotto, Corrado De Vito, Francesco Angelico, Maria Del Ben
BACKGROUND: Previous studies suggested obstructive sleep apnea syndrome (OSAS) as a major risk factor for incident cardiovascular events. However, the relationship between OSAS severity, the use of continuous positive airway pressure (CPAP) treatment and the development of cardiovascular disease is still matter of debate. STUDY OBJECTIVES: The aim was to test the association between OSAS and cardiovascular events in patients with concomitant cardio-metabolic diseases and the potential impact of CPAP therapy on cardiovascular outcomes...
February 9, 2018: European Journal of Clinical Investigation
Babak Hooshmand, Tuomo Polvikoski, Miia Kivipelto, Maarit Tanskanen, Liisa Myllykangas, Mira Mäkelä, Minna Oinas, Anders Paetau, Alina Solomon
BACKGROUND: CAIDE Dementia Risk Score is a tool for estimating dementia risk in the general population. Its longitudinal associations with Alzheimer or vascular neuropathology in the oldest old are not known. AIM: To explore the relationship between CAIDE Dementia Risk Score at baseline and neuritic plaques, neurofibrillary tangles, cerebral infarcts, and cerebral amyloid angiopathy (CAA) after up to 10 years follow-up in the Vantaa 85+ population. METHODS: Study population included 149 participants aged ≥85 years, without dementia at baseline, and with available clinical and autopsy data...
January 25, 2018: Journal of Internal Medicine
Qingxia Zhao, Zheng Ji, Xia Li, Yali Di, Haojun An, Bin Wei, Liming Yang, Wensheng Chen
We investigated the clinical value of fractional flow reserve (FFR) for the prognostic evaluation of patients with percutaneous coronary intervention. We enrolled 120 patients who were admitted to the hospital to undergo percutaneous coronary intervention for acute coronary syndromes between May 2014 and June 2015. The 120 patients were divided into two groups, the observation group and the control group, according to the post-surgery level of FFR. Each cohort contained 60 patients. These patients were divided into the occurrence group (n=45) and the non-occurrence group (n=75), classified according to the occurrence of major adverse cardiovascular events (MACE)...
January 2018: Experimental and Therapeutic Medicine
Izabella Uchmanowicz, Anna Chudiak, Beata Jankowska-Polańska, Robbert Gobbens
Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease...
November 2017: Cardiac failure review
Marcel Baschin, Sixten Selleng, Astrid Hummel, Stephan Diedrich, Henry W Schroeder, Thomas Kohlmann, Antje Westphal, Andreas Greinacher, Thomas Thiele
BACKGROUND: Patients receiving antiplatelet therapy (APT) have an increased risk of perioperative bleeding and cardiac adverse events (CAE). Preoperative platelet transfusions may reduce the bleeding risk but may also increase the risk of CAE, particularly coronary thrombosis in patients after recent stent implantation. OBJECTIVES: To analyse the incidence of perioperative CAE and bleeding in patients undergoing non-cardiac surgery using a standardized management of transfusing two platelet concentrates pre-operatively and restart of APT within 24-72 hours after surgery...
January 31, 2018: Journal of Thrombosis and Haemostasis: JTH
Harry V Vinters, Chris Zarow, Ewa Borys, Jeffrey D Whitman, Spencer Tung, William G Ellis, Ling Zheng, Helena C Chui
The incidence and severity of cerebrovascular disease (CVD) increase with advancing age, as does the risk of developing Alzheimer disease (AD). Not surprisingly, heterogeneous forms of CVD may coexist with AD changes in the 'aging brain'. These include angiopathies (affecting both large and small arteries) that result from 'classical' risk factors (hypertension, smoking, diabetes) and others (cerebral amyloid angiopathy) that are biochemically closely linked to AD. The morphologic consequences of these various vascular diseases are infarcts and/or haemorrhages of varying sizes within the brain, which lead to neurocognitive decline that may mimic AD-though the vascular abnormalities are usually detectable by neuroimaging...
January 30, 2018: Neuropathology and Applied Neurobiology
Yoshitaka Kubo, Takahiro Koji, Ryushi Kondo, Kenji Yoshida, Kuniaki Ogasawara
BACKGROUND: Balloon test occlusion (BTO) is a useful examination to evaluate the indications and methods for revascularization when treating unclippable internal carotid artery (ICA) aneurysms by parent artery occlusion. The purpose of the present study was to investigate the relationship between intraoperative monitoring of cerebral cortical blood flow (CoBF) and middle cerebral artery (MCA) pressure during surgical parent artery occlusion and the findings of BTO. METHODS: Eleven patients with an ICA aneurysm in the cavernous portion underwent preoperative BTO with brain perfusion single-photon emission tomography...
January 29, 2018: Acta Neurochirurgica
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