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S Dehkharghani, M Bowen, D C Haussen, T Gleason, A Prater, Q Cai, J Kang, R G Nogueira
BACKGROUND AND PURPOSE: The neuronal substrate is highly sensitive to temperature elevation; however, its impact on the fate of the ischemic penumbra has not been established. We analyzed interactions between temperature and penumbral expansion among successfully reperfused patients with acute ischemic stroke, hypothesizing infarction growth and worse outcomes among patients with fever who achieve full reperfusion. MATERIALS AND METHODS: Data from 129 successfully reperfused (modified TICI 2b/3) patients (mean age, 65 ± 15 years) presenting within 12 hours of onset were examined from a prospectively collected acute ischemic stroke registry...
October 6, 2016: AJNR. American Journal of Neuroradiology
Yun Zhao, Qiongyi Pang, Meixia Liu, Jingzi Pan, Bingwu Xiang, Tingting Huang, Fengxia Tu, Chan Liu, Xiang Chen
Using a model of middle cerebral artery occlusion (MCAO), we have previously demonstrated that treadmill exercise promotes angiogenesis in the ischemic penumbra through caveolin-1/VEGF signaling pathways. However, the function of caveolin-1/VEGF signaling in neurogenesis after MCAO has not been determined. In this study, we aimed to investigate the potential of treadmill exercise to promote neurogenesis after MCAO and whether caveolin-1/VEGF signaling pathways are involved. After MCAO, rats were subjected to a program of treadmill exercise...
October 17, 2016: Neurochemical Research
Edgar Gerardo Ordónez-Rubiano, Christian Von-Diemling, William Cortes-Lozano, Nelson Oswaldo Lobelo-Garcia
Giant aneurysms have been treated with endovascular approaches like general, balloon-assisted and stent-assisted coiling, and flow diverter stent-assisted techniques. Few cases have been reported to be treated with both normal and large coils. Despite the mass effect, an adequate revascularization has been reported. An initial use of these coils is being reported in the current study. This is a case which has been successfully treated using a stent-assisted coiling with both small and large coils i.e., Penumbra Coil 400 (Penumbra, Inc...
August 31, 2016: Curēus
Clara Ferreira, Daniel Johnson, Karl Rasmussen, Clinton Leinweber, Salahuddin Ahmad, Jae Won Jung
PURPOSE: To develop a novel conformal superficial brachytherapy (CSBT) device as a treatment option for the patient-specific radiation therapy of conditions including superficial lesions, postsurgical positive margins, Dupuytren's contractures, keloid scars, and complex anatomic sites (eyelids, nose, ears, etc.). METHODS AND MATERIALS: A preliminary CSBT device prototype was designed, built, and tested using readily available radioactive seeds. Iodine-125 ((125)I) seeds were independently guided to the treatment surface to conform to the target...
October 3, 2016: Brachytherapy
Kentaro Suzuki, Junya Aoki, Yuki Sakamoto, Takuya Kanamaru, Arata Abe, Satoshi Suda, Seiji Okubo, Kazumi Kimura
OBJECTIVE: This study was performed to investigate whether the Penumbra 5MAX ACE is superior to other Penumbra systems. MATERIALS AND METHODS: We performed a retrospective, single center analysis of patients with acute ischemic stroke with occlusion of the internal carotid artery or middle cerebral artery (M1 segment) who underwent endovascular therapy using a Penumbra system. The reperfusion success rate, puncture-to-revascularization time, and number of passes were assessed...
October 4, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Siyu Chen, Qi Liu, Xiao Shu, Brian Soetikno, Shanbao Tong, Hao F Zhang
Visible-light optical coherence tomography (Vis-OCT) is an emerging technology that can image hemodynamic response in microvasculature. Vis-OCT can retrieve blood oxygen saturation (sO2) mapping using intrinsic optical absorption contrast while providing high-resolution anatomical vascular structures at the same time. To improve the accuracy of Vis-OCT oximetry on vessels embedded in highly scattering medium, i.e., brain cortex, we developed and formulated a novel dual-depth sampling and normalization strategy that allowed us to minimize the detrimental effect of ubiquitous tissue scattering...
September 1, 2016: Biomedical Optics Express
Akihiro Watanabe, Tsutomu Sasaki, Toshiro Yukami, Hideaki Kanki, Manabu Sakaguchi, Takemori Hiroshi, Kazuo Kitagawa, Hideki Mochizuki
There are no effective neuroprotectant drugs for acute cerebral ischemia. Serine racemase (SR) synthesizes d-serine, which is involved in N-methyl-d-aspartate (NMDA) receptor-induced neurotoxicity. Recently, SR deletion was reported to protect against focal cerebral ischemia. However, regulatory mechanisms controlling SR-activity in the neurovascular unit (NVU) during cerebral ischemia remain to be clarified. We investigated the effects of SR inhibition on neurovascular protection after ischemia. The SR inhibitor phenazine methosulfate (PMS) alleviated neuronal damage in an ex vivo ischemic model (oxygen glucose deprivation [OGD]) using primary neuronal cultures, and in an in vivo mouse model of ischemia (middle cerebral artery occlusion [MCAO])...
September 28, 2016: Neuroscience
William T C Yuh, Matthew David Alexander, Toshihiro Ueda, Masayuki Maeda, Toshiaki Taoka, Kei Yamada, Norman J Beauchamp
OBJECTIVE: Advanced stroke imaging has generated much excitement for the early diagnosis of acute ischemic stroke (AIS) and facilitation of intervention. However, its therapeutic impact has not matched its diagnostic utility; most notably, lacking significant contributions to recent major AIS clinical trials. It is time to reexamine the fundamental hypotheses from the enormous body of imaging research on which clinical practices are based and reassess the current standard clinical and imaging strategies, or golden rules, established over decades for AIS...
September 28, 2016: AJR. American Journal of Roentgenology
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
September 24, 2016: Advances in Experimental Medicine and Biology
Kota Kurisu, Takeo Abumiya, Masaki Ito, Masayuki Gekka, Toshiya Osanai, Hideo Shichinohe, Naoki Nakayama, Ken Kazumata, Kiyohiro Houkin
The robust neuroprotective effects of transarterial regional hypothermia have been demonstrated in the typical transient middle cerebral artery occlusion (tMCAO) model, but have not yet been tested in other ischemic stroke models, even though clinical ischemic conditions are diverse. In order to clarify these effects in a different ischemic stroke model, we employed a rat model of permanent MCAO (pMCAO) with transient collateral hypoperfusion (tCHP), which was achieved by direct MCA ligation through craniotomy and 1-hour bilateral common carotid artery occlusion at the beginning of pMCAO...
September 20, 2016: Brain Research
Fabrizio Sallustio, Caterina Motta, Silvia Pizzuto, Marina Diomedi, Angela Giordano, Vittoria Carla D'Agostino, Domenico Samà, Salvatore Mangiafico, Valentina Saia, Jacopo Maria Legramante, Daniel Konda, Enrico Pampana, Roberto Floris, Paolo Stanzione, Roberto Gandini, Giacomo Koch
BACKGROUND: Collateral flow (CF) is an effective predictor of outcome in acute ischemic stroke (AIS) with potential to sustain the ischemic penumbra. However, the clinical prognostic value of CF in patients with AIS undergoing mechanical thrombectomy has not been clearly established. We evaluated the relationship of CF with clinical outcomes in patients with large artery anterior circulation AIS treated with mechanical thrombectomy. METHODS: Baseline collaterals of patients with AIS (n=135) undergoing mechanical thrombectomy were independently evaluated by CT angiography (CTA) and conventional angiography and dichotomized into poor and good CF...
September 23, 2016: Journal of Neurointerventional Surgery
Jin Hwan Lee, Zheng Z Wei, Wenyuan Cao, Soonmi Won, Xiaohuan Gu, Megan Winter, Thomas A Dix, Ling Wei, Shan Ping Yu
Stroke is a leading threat to human life and health in the US and around the globe, while very few effective treatments are available for stroke patients. Preclinical and clinical studies have shown that therapeutic hypothermia (TH) is a potential treatment for stroke. Using novel neurotensin receptor 1 (NTR1) agonists, we have demonstrated pharmacologically induced hypothermia and protective effects against brain damages after ischemic stroke, hemorrhage stroke, and traumatic brain injury (TBI) in rodent models...
September 19, 2016: Neurobiology of Disease
Guo-Zhu Sun, Fen-Fei Gao, Zong-Mao Zhao, Hai Sun, Wei Xu, Li-Wei Wu, Yong-Chang He
Neuronal apoptosis is mediated by intrinsic and extrinsic signaling pathways such as the membrane-mediated, mitochondrial, and endoplasmic reticulum stress pathways. Few studies have examined the endoplasmic reticulum-mediated apoptosis pathway in the penumbra after traumatic brain injury, and it remains unclear whether endoplasmic reticulum stress can activate the caspase-12-dependent apoptotic pathway in the traumatic penumbra. Here, we established rat models of fluid percussion-induced traumatic brain injury and found that protein expression of caspase-12, caspase-3 and the endoplasmic reticulum stress marker 78 kDa glucose-regulated protein increased in the traumatic penumbra 6 hours after injury and peaked at 24 hours...
August 2016: Neural Regeneration Research
Alejandro M Spiotta, Kyle M Fargen, Jonathan Lena, Imran Chaudry, Raymond D Turner, Aquilla S Turk, Daniel Huddle, David Loy, Richard Bellon, Donald Frei
INTRODUCTION: Traditional platinum coils used for cerebral aneurysm embolization have a uniform degree of softness throughout an individual coil's length. Recently, SMART Coils (Penumbra Inc., Alameda, CA) have been developed, which transition in softness along the length of their coils. We report the initial clinical results with this technology. METHODS: A retrospective study of all patients undergoing aneurysm coiling with SMART Coils at two centers was performed to evaluate the safety and efficacy of this new technology...
September 15, 2016: World Neurosurgery
Myron D Ginsberg
This review surveys the efforts taken to achieve clinically efficacious protection of the ischemic brain and underscores the necessity of expanding our purview to include the essential role of cerebral perfusion and the collateral circulation. We consider the development of quantitative strategies to measure cerebral perfusion at the regional and local levels and the application of these methods to elucidate flow-related thresholds of ischemic viability and to characterize the ischemic penumbra. We stress that the modern concept of neuroprotection must consider perfusion, the necessary substrate upon which ischemic brain survival depends...
September 13, 2016: Progress in Neurobiology
Yi-Hao Deng, Hong-Yun He, Li-Qiang Yang, Peng-Yue Zhang
The temporal dynamics of neuronal autophagy and apoptosis in the ischemic penumbra following stroke remains unclear. Therefore, in this study, we investigated the dynamic changes in autophagy and apoptosis in the penumbra to provide insight into potential therapeutic targets for stroke. An adult Sprague-Dawley rat model of permanent ischemic stroke was prepared by middle cerebral artery occlusion. Neuronal autophagy and apoptosis in the penumbra post-ischemia were evaluated by western blot assay and immunofluorescence staining with antibodies against LC3-II and cleaved caspase-3, respectively...
July 2016: Neural Regeneration Research
Mathilde Chevin, Clémence Guiraut, Caroline Maurice-Gelinas, Jessica Deslauriers, Sylvain Grignon, Guillaume Sébire
BACKGROUND: Despite the recent introduction of hypothermia as a mandatory standard of care, the incidence of neonatal encephalopathy in full-term newborns and its devastating neuro-behavioral outcomes continues to be a major individual, familial and social issue. Neonatal encephalopathy is mainly due to the compounding and interacting effects of hypoxia-ischemia and inflammation resulting from placental and other perinatal infections. It is unclear why hypothermia is effective in alleviating neonatal encephalopathy in some, but not all, full-term newborns...
September 9, 2016: International Journal of Developmental Neuroscience
Christopher J Stapleton, Collin M Torok, Aman B Patel
BACKGROUND: Penumbra SMART coils differ from traditional microcoils used for endovascular coil embolization of intracranial aneurysms (IAs) in that they (1) become progressively softer from their distal to proximal end, rather than being of uniform stiffness, (2) have a tight conformational structure, and (3) have a more robust stretch-resistance platform. These properties aid in preventing microcatheter prolapse and coil herniation during coil deployment and in filling small pockets of the aneurysm sac...
September 8, 2016: Interventional Neuroradiology
Han Gong, Darren Cosker
A user-centric method for fast, interactive, robust, and high-quality shadow removal is presented. Our algorithm can perform detection and removal in a range of difficult cases, such as highly textured and colored shadows. To perform detection, an on-the-fly learning approach is adopted guided by two rough user inputs for the pixels of the shadow and the lit area. After detection, shadow removal is performed by registering the penumbra to a normalized frame, which allows us efficient estimation of nonuniform shadow illumination changes, resulting in accurate and robust removal...
September 1, 2016: Journal of the Optical Society of America. A, Optics, Image Science, and Vision
Mohammad Ejaz Ahmed, Donovan Tucker, Yan Dong, Yujiao Lu, Ningjun Zhao, Ruimin Wang, Quanguang Zhang
Ischemic stroke in rodents stimulates neurogenesis in the adult brain and the proliferation of newborn neurons that migrate into the penumbra zone. The present study investigated the effect of Methylene Blue (MB) on neurogenesis and functional recovery in a photothrombotic (PT) model of ischemic stroke in rats. PT stroke model was induced by photo-activation of Rose Bengal dye in cerebral blood flow by cold fiber light. Rats received intraperitoneal injection of either MB (0.5mg/kg/day) from day 1 to day 5 after stroke or an equal volume of saline solution as a control...
November 12, 2016: Neuroscience
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