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Small brain infarct

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https://www.readbyqxmd.com/read/27909472/a-patient-with-asymptomatic-cerebral-lesions-during-af-ablation-how-much-should-we-worry
#1
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/27893680/the-value-of-ezis-analysis-of-tc-99m-ecd-spect-on-identifying-cerebellar-hypoperfusion-in-a-patient-with-superficial-siderosis-a-case-report
#2
Cheng-Yu Wei, Tai-Yi Chen, Ian Shih, Pai-Yi Chiu, Guang-Uei Hung, Hiroshi Matsuda
INTRODUCTION: Brain perfusion single photon computed tomography (SPECT) is a functional imaging modality and has been widely utilized in evaluation of various kinds of neurological disorders. Easy z-score imaging system (eZIS) is a computer-assisted statistical analysis, based on the comparison with age-classified ethyl cysteinate dimer (ECD) normal database, which provides objectively interpretation of Tc-99m ECD brain perfusion SPECT.Here we presented a 64-year-old male with dizziness, spin sensation, nausea, and vomiting in the emergency room, and brain computed tomography scan showed only small hypodensity lesion in cerebellum...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27881154/targeted-next-generation-sequencing-identifies-novel-notch3-gene-mutations-in-cadasil-diagnostics-patients
#3
Neven Maksemous, Robert A Smith, Larisa M Haupt, Lyn R Griffiths
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic, hereditary, small vessel disease of the brain causing stroke and vascular dementia in adults. CADASIL has previously been shown to be caused by varying mutations in the NOTCH3 gene. The disorder is often misdiagnosed due to its significant clinical heterogeneic manifestation with familial hemiplegic migraine and several ataxia disorders as well as the location of the currently identified causative mutations...
November 24, 2016: Human Genomics
https://www.readbyqxmd.com/read/27878274/regulatory-t-cells-exhibit-neuroprotective-effect-in-a-mouse-model-of-traumatic-brain-injury
#4
Yunhu Yu, Fang Cao, Qishan Ran, Xiaochuan Sun
Traumatic brain injury (TBI) is a major health and socioeconomic problem as it is associated with high rates of mortality and morbidity worldwide. Regulatory T cells (Tregs) have been reported to reduce inflammatory response in several diseases, including myasthenia gravis, viral myocarditis and cerebral infarction. The present study investigated the role of Tregs in mediating neuro‑protective effects in a mouse model of TBI. Initially, Treg levels were determined, and compared between the controlled cortical impact (CCI) model for moderate TBI and the sham group, by using flow cytometry and ELISA...
November 18, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#5
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
November 3, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27815649/magnetic-resonance-imaging-detection-of-multiple-ischemic-injury-produced-in-an-adult-rat-model-of-minor-stroke-followed-by-mild-transient-cerebral-ischemia
#6
Ursula I Tuor, Min Qiao
OBJECTIVES: To determine whether cumulative brain damage produced adjacent to a minor stroke that is followed by a mild transient ischemia is detectable with MRI and histology, and whether acute or chronic recovery between insults influences this damage. MATERIALS AND METHODS: A minor photothrombotic (PT) stroke was followed acutely (1-2 days) or chronically (7 days) by a mild transient middle cerebral artery occlusion (tMCAO). MRI was performed after each insult, followed by final histology...
November 4, 2016: Magma
https://www.readbyqxmd.com/read/27802487/cerebral-small-vessel-disease-in-branch-retinal-artery-occlusion
#7
Kwan Hyuk Cho, Chi Kyung Kim, Se Joon Woo, Kyu Hyung Park, Sang Jun Park
Purpose: We investigated the pathophysiology of branch retinal artery occlusion (BRAO) by evaluating the retina, brain, and carotid artery in patients with BRAO. Methods: This study was a retrospective registry study. We used 46 eyes from 46 patients with acute BRAO and evaluated the medical history, including previous cardiovascular disease, and compared brain magnetic resonance images (MRI) and carotid artery stenosis state between the embolic BRAO group and nonembolic BRAO group...
October 1, 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/27773545/cadasil-mimicking-multiple-sclerosis-the-importance-of-clinical-and-mri-red-flags
#8
Stuti Joshi, Wayne Yau, Allan Kermode
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited small vessel disease, manifesting as recurrent ischaemic events, migraine with aura, behavioural disturbance and cognitive decline. We report two patients with CADASIL masquerading as multiple sclerosis (MS). A 23year old female presented with a visual scotoma and was discovered to have a corresponding retinal cotton wool spot. MRI brain revealed diffuse T2 hyperintensities suggestive of demyelination...
October 20, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27754293/br-09-3-at2r-stimulation-and-its-effect-on-target-organ-damage-therapeutic-implications
#9
Thomas Unger
The renin-angiotensin system (RAS) plays an important role in the initiation and progression of tissue injuries in the cardiovascular and nervous systems. The detrimental actions of the AT1 receptor (AT1R) in hypertension and vascular injury, myocardial infarction and brain ischemia are well established. In the past twenty-five years, protective actions of the RAS, not only in the cardiovascular- but also in the nervous system, have been demonstrated. The so-called protective arm of the RAS includes AT2- and Mas receptors (AT2R and MasR) and is characterized by effects different from and often opposing those of the AT1R...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754138/os-27-02-cerebral-microbleeds-and-asymptomatic-cerebral-infarctions-in-patients-with-atrial-fibrillation
#10
Tsukasa Saito, Yuichiro Kawamura, Nobuyuki Sato, Naoyuki Hasebe
OBJECTIVE: Atrial fibrillation (AF) is a cardiac arrhythmia that does not infrequently induce ischemic strokes; however, little research has been reported on focal cerebral microangiopathic lesions in patients with AF. Recently cerebral microbleeds (CMBs) have been noticed for their potential implication in cerebral small vessel dis- ease. Therefore, we had 2 goals in the present study: (1) to compare the prevalence of CMBs in patients with AF with that in patients without AF, and (2) to prove that CMBs could be a clinical predictive factor for the development of future cerebral microangiopathy in patients with AF without a history of symptomatic cerebral infarction in a prospective manner...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754109/os-22-05-variability-of-urinary-salt-excretion-in-treated-hypertensive-patients-during-several-years
#11
Kimika Arakawa, Ai Ibaraki, Yuki Kawamoto, Minako Inoue, Emi Oishi, Mitsuhiro Tominaga, Takuya Tsuchihashi
OBJECTIVE: To investigate the average and variability in urinary salt excretion in treated hypertensive outpatients during several years (median follow-up is 2 years). DESIGN AND METHOD: In our previous research, the subjects were 200 hypertensive patients who underwent at least three measurement of USALT from Sep 2012 to Mar 2013. We extended the follow-up period until Aug 2015 and the subjects were 68 hypertensive patients who were measured USALT 10 times over (65...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753809/ssa-03-4-the-brain-screening-in-patients-with-hypertension
#12
Yuda Turana
Observational studies have conveyed the connection between hypertension and cognitive impairment. Several forms of dementia are more frequent in hypertensive subjects or those with previous history of hypertension compared to subjects with normal blood pressure.In many studies, hypertension occuring in mid-life is a risk factor of dementia occuring in later age. Long-standing hypertension will induce structural damages in the brain. It is also widely known that hypertension attributes to small vessel diseases causing lacunar infarcts and white matter lesions associated with cognitive decline...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27742469/loss-of-pink1-inhibits-apoptosis-by-upregulating-%C3%AE-synuclein-in-inflammation-sensitized-hypoxic-ischemic-injury-in-the-immature-brains
#13
Jianghu Zhu, Yi Qu, Zhenlang Lin, Fengyan Zhao, Li Zhang, Yang Huang, Changan Jiang, Dezhi Mu
The incidence of preterm birth is rising worldwide. Among preterm infants, many face a lifetime of neurologic impairments. Recent studies have revealed that systemic inflammation can sensitize the immature brain to hypoxic-ischemic (HI) injury. Therefore, it is important to identify the mechanisms involved in inflammation-sensitized HI injury in immature brains. PTEN-induced putative kinase 1 (PINK1) is a regulatory protein that is highly expressed in the brain. We have previously found that PINK1 gene knockout can protect matured brains from HI injury in postnatal day 10 mice...
October 11, 2016: Brain Research
https://www.readbyqxmd.com/read/27732148/cerebrospinal-fluid-metabolomics-after-natural-product-treatment-in-an-experimental-model-of-cerebral-ischemia
#14
Tao Huan, Jia Wen Xian, Wing Nang Leung, Liang Li, Chun Wai Chan
Cerebrospinal fluid (CSF) is an important biofluid for diagnosis of and research on neurological diseases. However, in-depth metabolomic profiling of CSF remains an analytical challenge due to the small volume of samples, particularly in small animal models. In this work, we report the application of a high-performance chemical isotope labeling (CIL) liquid chromatography-mass spectrometry (LC-MS) workflow for CSF metabolomics in Gastrodia elata and Uncaria rhynchophylla water extract (GUW)-treated experimental cerebral ischemia model of rat...
October 12, 2016: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/27659190/influence-of-small-vessel-disease-and-microstructural-integrity-on-neurocognitive-functioning-in-older-individuals-the-dante-study-leiden
#15
J E F Moonen, J C Foster-Dingley, A A van den Berg-Huijsmans, W de Ruijter, A J M de Craen, J van der Grond, R C van der Mast
BACKGROUND AND PURPOSE: Small vessel disease is a major cause of neurocognitive dysfunction in the elderly. Small vessel disease may manifest as white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and atrophy, all of which are visible on conventional MR imaging or as microstructural changes determined by diffusion tensor imaging. This study investigated whether microstructural integrity is associated with neurocognitive dysfunction in older individuals, irrespective of the conventional features of small vessel disease...
September 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27651328/diagnostic-accuracy-of-whole-brain-ct-perfusion-in-the-detection-of-acute-infratentorial-infarctions
#16
Christine Bollwein, Annika Plate, Wieland H Sommer, Kolja M Thierfelder, Hendrik Janssen, Maximilian F Reiser, Andreas Straube, Louisa von Baumgarten
INTRODUCTION: Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. METHODS: Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes...
November 2016: Neuroradiology
https://www.readbyqxmd.com/read/27647674/peri-procedural-silent-cerebral-infarcts-after-left-atrial-appendage-occlusion
#17
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/27643291/br-09-3-at2r-stimulation-and-its-effect-on-target-organ-damage-therapeutic-implications
#18
Thomas Unger
The renin-angiotensin system (RAS) plays an important role in the initiation and progression of tissue injuries in the cardiovascular and nervous systems. The detrimental actions of the AT1 receptor (AT1R) in hypertension and vascular injury, myocardial infarction and brain ischemia are well established. In the past twenty-five years, protective actions of the RAS, not only in the cardiovascular- but also in the nervous system, have been demonstrated. The so-called protective arm of the RAS includes AT2- and Mas receptors (AT2R and MasR) and is characterized by effects different from and often opposing those of the AT1R...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643255/ssa-03-4-the-brain-screening-in-patients-with-hypertension
#19
Yuda Turana
Observational studies have conveyed the connection between hypertension and cognitive impairment. Several forms of dementia are more frequent in hypertensive subjects or those with previous history of hypertension compared to subjects with normal blood pressure.In many studies, hypertension occuring in mid-life is a risk factor of dementia occuring in later age. Long-standing hypertension will induce structural damages in the brain. It is also widely known that hypertension attributes to small vessel diseases causing lacunar infarcts and white matter lesions associated with cognitive decline...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643065/os-27-02-cerebral-microbleeds-and-asymptomatic-cerebral-infarctions-in-patients-with-atrial-fibrillation
#20
Tsukasa Saito, Yuichiro Kawamura, Nobuyuki Sato, Naoyuki Hasebe
OBJECTIVE: Atrial fibrillation (AF) is a cardiac arrhythmia that does not infrequently induce ischemic strokes; however, little research has been reported on focal cerebral microangiopathic lesions in patients with AF. Recently cerebral microbleeds (CMBs) have been noticed for their potential implication in cerebral small vessel dis- ease. Therefore, we had 2 goals in the present study: (1) to compare the prevalence of CMBs in patients with AF with that in patients without AF, and (2) to prove that CMBs could be a clinical predictive factor for the development of future cerebral microangiopathy in patients with AF without a history of symptomatic cerebral infarction in a prospective manner...
September 2016: Journal of Hypertension
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