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Charlotte Zerna, Amy Y X Yu, Jayesh Modi, Shiel K Patel, Jonathan I Coulter, Eric E Smith, Shelagh B Coutts
BACKGROUND AND PURPOSE: White matter lesions (WML) are associated with cognitive decline, increased stroke risk, and disability in old age. We hypothesized that superimposed acute cerebrovascular occlusion on chronic preexisting injury (leukoaraiosis) leads to worse outcome after minor cerebrovascular event, both using quantitative (volumetric) and qualitative (Fazekas scale) assessment, as well as relative total brain volume. METHODS: WML volume assessment was performed in 425 patients with high-risk transient ischemic attack (TIA; motor/speech deficits >5 minutes) or minor strokes from the CATCH study (CT and MRI in the Triage of TIA and Minor Cerebrovascular Events to Identify High Risk Patients)...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Rong Xing, Wangmi Liu, Xilei Li, Libo Jiang, Mumingjiang Yishakea, Jian Dong
BACKGROUND: The cervical sagittal parameters of the normal population and the impact of disc degeneration on cervical sagittal alignment have not been clearly defined yet. This study is applied to investigate the characteristics and relationships of cervical sagittal parameters in normal adults and patients with cervical disc degeneration. METHODS: We reviewed 50 normal control subjects (normal group, NG) and 50 patients with cervical disc degeneration (degeneration group, DG), who had both cervical MRI and radiographs obtained together, between January 2010 and September 2015...
February 2, 2018: BMC Musculoskeletal Disorders
Ki-Woong Nam, Chi Kyung Kim, Tae Jung Kim, Kyungmi Oh, Moon-Ku Han, Sang-Bae Ko, Byung-Woo Yoon
OBJECTIVE: To evaluate the relationship between fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) and early ischemic lesion recurrence (follow-up diffusion-weighted imaging [FU-DWI] [+]) in patients with lesion-negative TIA. METHODS: We recruited consecutive patients with lesion-negative TIA within 24 hours of symptom onset, who underwent follow-up MRI during the acute period. FVH was defined as a focal or serpentine high signal intensity on FLAIR images...
February 27, 2018: Neurology
Seungho Lee, Jun Soo Byun, Mi Sun Jung, Jeong-Min Kim, Taek-Kyun Nam
RATIONALE: Patients with transient ischemic attack (TIA) have the possibility of developing stroke in the future. To prevent recurrent TIA or future stroke, identifying the cause of TIA is important. However, about two-third of patients with TIA have negative findings on diffusion-weighted imaging (DWI).We present a case of TIA, the cause of which was identified using multiphase computed tomography angiography (MCTA) in the hyperacute phase of the disease. PATIENT CONCERNS: The patient was a 57-year-old man who was admitted to the emergency department for right-side weakness persisting for 1 hour...
December 2017: Medicine (Baltimore)
Inger Havsteen, Christian Ovesen, Lasse Willer, Janus Damm Nybing, Karen Ægidius, Jacob Marstrand, Per Meden, Sverre Rosenbaum, Marie Norsker Folke, Hanne Christensen, Anders Christensen
OBJECTIVES: To find determining factors for persistent infarction signs in patients with transient ischaemic attack (TIA), herein initial diffusion lesion size, visibility on apparent diffusion coefficient (ADC) or fluid-attenuated inversion recovery (FLAIR) and location. DESIGN: Prospective cohort study of patients with clinical TIA receiving 3T-MRI within 72 hours of symptom onset and at 8-week follow-up. SETTING: Clinical workflow in a single tertiary stroke centre between February 2012 and June 2014...
January 21, 2018: BMJ Open
Andreas Charidimou, Sara Shams, Jose R Romero, Jie Ding, Roland Veltkamp, Solveig Horstmann, Gudny Eiriksdottir, Mark A van Buchem, Vilmundur Gudnason, Jayandra J Himali, M Edip Gurol, Anand Viswanathan, Toshio Imaizumi, Meike W Vernooij, Sudha Seshadri, Steven M Greenberg, Oscar R Benavente, Lenore J Launer, Ashkan Shoamanesh
Background Cerebral microbleeds can confer a high risk of intracerebral hemorrhage, ischemic stroke, death and dementia, but estimated risks remain imprecise and often conflicting. We investigated the association between cerebral microbleeds presence and these outcomes in a large meta-analysis of all published cohorts including: ischemic stroke/TIA, memory clinic, "high risk" elderly populations, and healthy individuals in population-based studies. Methods Cohorts (with > 100 participants) that assessed cerebral microbleeds presence on MRI, with subsequent follow-up (≥3 months) were identified...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Xiao-Mei Ren, Shu-Wei Qiu, Ren-Yuan Liu, Wen-Bo Wu, Yun Xu, Hong Zhou
BACKGROUND: White matter lesions (WMLs) are common findings in brain magnetic resonance imaging (MRI) and are strongly associated with stroke incidence, recurrence, and prognosis. However, the relationship between WMLs and transient ischemic attacks (TIAs) is not well established. This study aimed to determine the clinical significance of WMLs in patients with TIA. METHODS: A total of 181 consecutive inpatients with first-ever TIA were enrolled. Brain MRIs within 2 days of symptom onset were used to measure WML volumes...
January 20, 2018: Chinese Medical Journal
Fong Poh Ling, T Chevillotte, A Leglise, W Thompson, C Bouthors, Jean-Charles Le Huec
INTRODUCTION: Cervical spine is part of the spine with the most mobility in the sagittal plane. It is important for surgeons to have reliable, simple and reproducible parameters to analyse the cervical. MATERIAL AND METHOD: This study is a systematic review and a critique of current parameters to help improve the study of cervical spinal balance. We conducted a systematic search of PUBMED/MEDLINE for literature published since January 2014. Only studies written in English and containing abstracts were considered for inclusion...
January 13, 2018: European Spine Journal
Lukas Mayer, Julia Ferrari, Stefan Krebs, Christian Boehme, Thomas Toell, Benjamin Matosevic, Alexander Tinchon, Michael Brainin, Thomas Gattringer, Peter Sommer, Peter Thun, Johann Willeit, Wilfried Lang, Stefan Kiechl, Michael Knoflach
Changing definition of TIA from time to a tissue basis questions the validity of the well-established ABCD3-I risk score for recurrent ischemic cerebrovascular events. We analyzed patients with ischemic stroke with mild neurological symptoms arriving < 24 h after symptom onset in a phase where it is unclear, if the event turns out to be a TIA or minor stroke, in the prospective multi-center Austrian Stroke Unit Registry. Patients were retrospectively categorized according to a time-based (symptom duration below/above 24 h) and tissue-based (without/with corresponding brain lesion on CT or MRI) definition of TIA or minor stroke...
January 11, 2018: Journal of Neurology
Gian Marco De Marchis, Mira Katan, Christian Barro, Joachim Fladt, Christopher Traenka, David J Seiffge, Lisa Hert, Henrik Gensicke, Giulio Disanto, Raoul Sutter, Nils Peters, Hakan Sarikaya, Barbara Goeggel-Simonetti, Marwan El-Koussy, Stephan Engelter, Philippe A Lyrer, Mirjam Christ-Crain, Marcel Arnold, Jens Kuhle, Leo H Bonati
BACKGROUND AND PURPOSE: Serum Neurofilaments are markers of axonal injury. We addressed their diagnostic and prognostic role in acute ischemic stroke (AIS) and TIA. METHODS: Nested within a prospective cohort study, we compared serum neurofilament light chain levels (sNfL) drawn within 24 hours from symptom onset in patients with AIS or TIA. Patients without MRI on admission were excluded. We assessed if sNfL are associated with: (i) clinical severity on admission, (ii) diagnosis of AIS vs TIA, (iii) infarct size on admission diffusion weighted imaging (MR-DWI), and (iv) functional outcome at 3 months...
December 27, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Omar Kass-Hout, Tareq Kass-Hout, Ankit Parikh, Michael Hoskins, Stephen D Clements, Srikant Rangaraju, Ali Reza Noorian, Lauren Ayala, Debra Blanke, Laura Bamford, Aaron Anderson, Samir Belagaje, Manuel Yepes, Michael Frankel, Fadi Nahab
Background and Purpose: The objective of our study was to evaluate magnetic resonance imaging (MRI) and echocardiographic characteristics that would identify patients with cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) who subsequently developed paroxysmal atrial fibrillation (PAF) on mobile cardiac outpatient telemetry (MCOT). Methods: All patients with cryptogenic IS or TIA seen at the Emory University Hospital and Emory University Hospital Midtown from January 1, 2009, to June 30, 2013, who underwent MCOT were included in this analysis...
January 2018: Neurohospitalist
Houman Khakpour, Richard J Shemin, Jay M Lee, Eric Buch, Noel G Boyle, Kalyanam Shivkumar, Jason S Bradfield
Background: The incidence of atrioesophageal fistula (AEF) after atrial fibrillation catheter ablation is reported to be 0.015%-0.04%, though it is likely underreported due to a number of factors including misdiagnosis. We report our institutional experience with AEF. Methods: Patients with confirmed diagnosis of AEF between 2004 and 2016 at our institution were identified (n=5) and their clinical characteristics and outcome were analyzed. Results: AEF occurred in 5 patients who underwent AF catheter ablation (3 ablated at our institution; 2 transferred from outside hospitals after diagnosis of AEF)...
October 2017: Journal of Atrial Fibrillation
Yannick Béjot, Céline Brenière, Mathilde Graber, Lucie Garnier, Jérôme Durier, Christelle Blanc-Labarre, Benoit Delpont, Maurice Giroud
BACKGROUND: We aimed to evaluate the epidemiological features of transient ischemic attack (TIA). METHODS: All TIAs were prospectively collected in Dijon, France, using a population-based registry (2013-2015). TIAs were considered the first-ever in patients who had no previous cerebrovascular events (CVEs); otherwise they were considered recurrent TIAs. Annual incidence (first-ever TIAs) and attack rates (first-ever and recurrent TIAs) were calculated. RESULTS: Four hundred twenty TIAs were registered (255 first-ever and 165 recurrent TIAs, mean age: 74...
November 16, 2017: Neuroepidemiology
Guangzong Li, Chen Zhu, Jing Li, Xiangming Wang, Qingbin Zhang, Hongjia Zheng, Cheng Zhan
BACKGROUND: Procalcitonin (PCT) has been found to be associated with subclinical cerebrovascular damage. The relationship between PCT levels and cerebral small vessel disease (cSVD), especially cSVD burden, has not been fully understood. This study aimed to investigate the association between PCT levels and cSVD in patients with first-ever acute ischemic stroke or transient ischemic attack (TIA). METHODS: Two hundred and seventy-eight consecutive patients were prospectively recruited during Jan 2016 to Jun 2017...
October 20, 2017: Neuroscience Letters
Sung-Min Cho, Abhishek Deshpande, Vinay Pasupuleti, Adrian V Hernandez, Ken Uchino
OBJECTIVE: In a systematic review, we compared ratio of new periprocedural radiographic brain ischemia (RBI) to the number of strokes and TIAs among patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We searched 5 databases for entries related to brain ischemia in CEA or CAS from inception through September 2015. We included articles with CEA or CAS and systematic performance of preprocedural and postprocedural brain MRI and reporting of RBI and stroke incidence...
November 7, 2017: Neurology
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
Xihai Zhao, Rui Li, Daniel S Hippe, Thomas S Hatsukami, Chun Yuan
BACKGROUND: Carotid atherosclerotic plaque is identified as one of the main sources of ischaemic stroke. However, the prevalence of carotid high-risk atherosclerotic plaque in Chinese patients with ischaemic cerebrovascular events has been inconsistently reported and needs to be investigated in a large population. OBJECTIVES: The primary objective of CARE II study was to determine the prevalence and characteristics of high-risk features of atherosclerotic plaques in the carotid arteries in Chinese patients with recent ischaemic stroke or transient ischaemia attack (TIA)...
March 2017: Stroke and Vascular Neurology
Raf H M van Hoof, Floris H B M Schreuder, Patty Nelemans, Martine T B Truijman, Narender P van Orshoven, Tobien H Schreuder, Werner H Mess, Sylvia Heeneman, Robert J van Oostenbrugge, Joachim E Wildberger, M Eline Kooi
BACKGROUND: Patients with a recent ischemic stroke have a higher risk of recurrent stroke compared to (ocular) transient ischemic attack (TIA) patients. Plaque microvasculature is considered as a feature of plaque vulnerability and can be quantified with carotid dynamic contrast-enhanced MRI (DCE-MRI). The purpose of this cross-sectional study was to explore the association between plaque microvasculature and the type of recent cerebrovascular events in symptomatic patients with mild-to-moderate carotid stenosis...
September 26, 2017: Cerebrovascular Diseases
Jia Li, Shuhui Qin, Yongqian Li, Yong Shen
BACKGROUND: The purpose of the research was to evaluate cervical sagittal parameters on magnetic resonance imaging (MRI) in patients with Modic changes and its impact on axial neck pain. METHODS: This study consisted of 266 consecutive asymptomatic or symptomatic patients with Modic changes, whose average age was 50.9±12.6 years from January 2015 to December 2016. Cervical sagittal parameters included sagittal alignment of the cervical spine (SACS), T1 slope, thoracic inlet angle (TIA), and neck tilt (NT)...
2017: Journal of Pain Research
Xiaoyu Dong, Chaobo Bai, Jianfei Nao
PURPOSE: Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is often observed in conjunction with acute ischemic stroke (AIS) of the carotid system. Despite its bearing on patient care outcomes, factors influencing FVH and its clinical significance in patients with transient ischemic attacks (TIAs) of the carotid arterial system have yet to be evaluated. METHODS: Consecutive inpatients (N = 154) diagnosed with TIAs of the carotid system in a 2-year period (2012-2014) were enrolled in our study...
November 2017: Neuroradiology
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