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Lacunar infarct

Hui Zhu, Zhixing Li, Jinglei Lv, Renliang Zhao
OBJECTIVE: Cerebral small vessel disease (CSVD) describes a syndrome of neuroimaging, pathological, and associated clinical features caused by small intracranial vascular lesions, which commonly coexists with large artery atherosclerosis (LAA) and has been identified as a major cause of motor impairment over time. In this review, we aim to summarize the relationship between CSVD and LAA, and discuss the effects of CSVD on the clinical outcome of patients with ischemic stroke caused by LAA...
March 15, 2018: Neurological Research
X X Zhao, C Z Shen, X X Xie, Q Q Xu, X Zhou, Z W Sun
Objective: To explore the change and value of platelet aggregability(PA)in patients with subcortical ischemic vascular disease (SIVD). Methods: A total of 108 patients with SIVD hospitalized in the Department of Neurology of the First Affiliated Hospital of Anhui Medical University from October 2015 to July 2017 were enrolled as SIVD group and 30 healthy cases were also in cluded as normal controlgroup (NC). According to magnetic resonance imaging(MRI), the SIVD group was further divided into two subtypes: lacunar infarction(LI) ( n =31)and leukoaraiosis(LA) ( n =77)...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Niko Sillanpää, Juha-Pekka Pienimäki, Sara Protto, Janne Seppänen, Heikki Numminen, Harri Rusanen
BACKGROUND: The impact of lacunar and cortical chronic ischemic lesions (CILs) on the clinical outcome of mechanical thrombectomy (MT) has been little studied. Clinical trials suggest that older patients benefit from MT. We investigated the effect of CILs on the clinical outcome of sexagenarian and older patients with acute middle cerebral artery (MCA) or distal internal carotid artery (ICA) stroke who received MT to treat large-vessel occlusion (LVO). METHODS: We prospectively collected the clinical and imaging data of 130 consecutive MT patients of which 68 met the inclusion criteria...
March 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yoshinori Hashimoto, Takanori Fukuta, Hiromi Omura, Takayuki Tanaka
Although the life expectancy if patients with essential thrombocythemia (ET) is considered to be almost similar to that of the general population, advanced age, leukocytosis, and a previous history of thrombosis are poor prognostic factors, and it is important to prevent thrombohemorrhagic events, leukemic transformation, and secondary malignancies. We report an 85-year-old ET patient with a history of asymptomatic lacunar infarction, who developed symptomatic cerebral infarction and even chronic subdural hematoma...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Naohisa Hosomi, Kazuo Kitagawa, Yoji Nagai, Yoko Nakagawa, Shiro Aoki, Tomohisa Nezu, Tatsuo Kagimura, Hirofumi Maruyama, Hideki Origasa, Kazuo Minematsu, Shinichiro Uchiyama, Masayasu Matsumoto
BACKGROUND AND PURPOSE: To define desirable target low-density lipoprotein (LDL) cholesterol levels for the prevention of stroke recurrence, a post hoc analysis was performed in the J-STARS study (Japan Statin Treatment Against Recurrent Stroke). METHODS: Subjects (n=1578) were divided into groups based on mean value of postrandomized LDL cholesterol levels until the last observation in 20 mg/dL increments. Adjusted hazard ratios (HRs) and 95% confidence intervals were analyzed for each group, with adjustments for baseline LDL cholesterol, baseline body mass index, hypertension, diabetes mellitus, and statin usage...
March 6, 2018: Stroke; a Journal of Cerebral Circulation
Iain D Croall, Daniel J Tozer, Barry Moynihan, Usman Khan, John T O'Brien, Robin G Morris, Victoria C Cambridge, Thomas R Barrick, Andrew M Blamire, Gary A Ford, Hugh S Markus
Importance: Blood pressure (BP) lowering is considered neuroprotective in patients with cerebral small vessel disease; however, more intensive regimens may increase cerebral hypoperfusion. This study examined the effect of standard vs intensive BP treatment on cerebral perfusion in patients with severe small vessel disease. Objective: To investigate whether standard vs intensive BP lowering over 3 months causes decreased cerebral perfusion in small vessel disease...
March 5, 2018: JAMA Neurology
Satoshi Yashiro, Hiroyuki Kameda, Ai Chida, Yusuke Todate, Yutaka Hasegawa, Kan Nagasawa, Ikuko Uwano, Makoto Sasaki, Kuniaki Ogasawara, Yasushi Ishigaki
AIM: Progress in neuroimaging techniques allows us to investigate the microvasculature characteristics including lenticulostriate arteries (LSA), which are closely associated with lacunar infarction. Because ischemic stroke is a more critical health problem in East Asian than in other populations, in order to clarify pathological changes underlying cerebral small vessel disease (SVD), we projected an imaging analysis of LSA using high-resolution brain magnetic resonance imaging (MRI) in middle-aged Japanese subjects with type 2 diabetes...
March 5, 2018: Journal of Atherosclerosis and Thrombosis
Limei Zhang, Yanhui Wu, Lili Qiu, Yanhong Liu, Qiang Li
BACKGROUND To determine whether the levels of b2-glycoprotein I (b2-GPI)/oxidized low-density lipoprotein (oxLDL) complexes are correlated with cerebral infarction in patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS The levels of β2-GPI/oxLDL complexes, oxLDL, routine lipid/lipoprotein parameters, oxidative stress molecules, and inflammatory factors were measured in 78 healthy controls, 82 diabetics without cerebral infarction, and 79 diabetics with cerebral infarction. Correlation, multiple linear regression, and logistic regression analyses were performed...
February 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Yang Liu, Yan-Hong Dong, Pei-Yuan Lyu, Wei-Hong Chen, Rui Li
Objective: Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment. Data Sources: We searched and scanned the PubMed database for recently published literatures up to December 2017...
March 5, 2018: Chinese Medical Journal
Dan Su, Anqi Song, Bin Yan, Qi Guo, Ya Gao, Yanhua Zhou, Fuling Zhou, Guang Yang, Chaoying Zhang
The abnormalities of blood pressure (BP) nocturnal decline have been found to be predictive for carotid plaque and lacunar infarction in patients with hypertension. In this study, BP dipping patterns in postmenopausal females with hypertension were investigated. The nocturnal decline of systolic BP (SBP) was evaluated using 24-hour ambulatory BP monitoring (ABPM). A total of 163 postmenopausal females were eventually included in our study. The prevalence of reverse-dipper BP pattern was 32.3% in females with menopause age in their 40s and 40% in their 50s...
February 23, 2018: International Heart Journal
Oscar H Del Brutto, Robertino M Mera
INTRODUCTION: Recent guidelines suggest that a blood pressure cutoff of 130/80 mmHg should be used to define arterial hypertension. This contrasts with the previously accepted cutoff of 140/90 mmHg. AIM: Using the Atahualpa Project cohort, we aimed to assess the cutoff that better correlates with signatures of cerebral small vessel disease (SVD), which are related to arterial hypertension. METHODS: Of 437 Atahualpa residents aged ≥ 60 years, 363 (83%) underwent brain MRI and blood pressure determinations...
February 23, 2018: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
S Y Ha, K M Park, J Park, S E Kim, B I Lee, K J Shin
OBJECTIVE: Neurological progression is a major problem in managing the patients with acute lacunar infarction. The purpose of this was to investigate whether autonomic dysfunction is associated with neurological progression in patients with acute lacunar infarction. MATERIALS AND METHODS: The study comprised 60 patients with acute lacunar infarction. All enrolled subjects underwent autonomic function tests including the 30° head-up tilt test, Valsalva test, heart rate response to deep breathing, and sympathetic skin response...
February 21, 2018: Acta Neurologica Scandinavica
P L Anufriev, A N Evdokimenko, T S Gulevskaya
AIM: to obtain more specific information on the morphology and pathogenesis of cerebral infarctions occurring in vertebrobasilar artery (VBA) atherosclerosis. MATERIAL AND METHODS: Macro- and microscopic investigations of the brain, its arterial system, and heart were conducted in 69 autopsy cases with infarctions located in the vertebrobasilar system (VBS) in atherosclerosis. RESULTS: 69 cases were found to have 206 VBA infarctions of various extent and locations...
2018: Arkhiv Patologii
Ruriko Seto-Yukimura, Emiko Ogawa, Takashi Hisamatsu, Sayuki Torii, Akihiko Shiino, Kazuhiko Nozaki, Akira Fujiyoshi, Katsuyuki Miura, Yasutaka Nakano, Hirotsugu Ueshima
AIM: We aimed to investigate the association between reduced lung function and cerebral small vessel diseases via cranial magnetic resonance imaging (MRI) in the cross-sectional study of the general Japanese population. METHODS: We recruited participants aged ≥40 years from the general population of a single city in Japan. We clarified the comorbidities and treatments, smoking habits, second-hand smoke exposure, current alcohol consumption, education level, exercise habits, and occupation...
February 16, 2018: Journal of Atherosclerosis and Thrombosis
Tae-Jin Song, Yoonkyung Chang, A-Ram Kim, Yuri Kim, Yong-Jae Kim
Cerebral small vessel diseases (SVDs) are closely associated with stroke. Elevated postprandial blood glucose is also an important risk factor for stroke. Dietary glycemic load (GL) and glycemic index (GI) are frequently used as markers of postprandial blood glucose response used as an estimator of the overall glycemic effect of the diet. We hypothesized that high dietary GL or GI will be associated with presence of cerebral SVDs in patients with acute ischemic stroke. We prospectively included 263 patients who had experienced first-ever symptomatic cerebral infarction within 7 days after symptom onset and who submitted a fully filled-in semi-quantitative food frequency questionnaire...
December 27, 2017: Nutrition Research
Hironori Imano, Hiroyasu Iso, Akihiko Kitamura, Kazumasa Yamagishi, Mina Hayama-Terada, Isao Muraki, Takeo Okada, Mitsumasa Umesawa, Tetsuya Ohira, Tomoko Sankai, Renzhe Cui, Takeshi Tanigawa, Masahiko Kiyama
BACKGROUND: The effect of postprandial glucose on the risk of cardiovascular disease has been emphasized, but it is controversial whether nonfasting glucose is related to incident stroke and its types.Methods and Results:We investigated the associations of nonfasting glucose with incident stroke and its types among 7,198 participants aged 40-74 years from the Circulatory Risk in Communities Study, enrolled in 1995-2000. We estimated multivariable hazard ratios (HR) using Cox proportional hazard models...
February 14, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Philip Benjamin, Sarah Trippier, Andrew J Lawrence, Christian Lambert, Eva Zeestraten, Owen A Williams, Bhavini Patel, Robin G Morris, Thomas R Barrick, Andrew D MacKinnon, Hugh S Markus
BACKGROUND AND PURPOSE: Cerebral small-vessel disease is a major cause of cognitive impairment. Perivascular spaces (PvS) occur in small-vessel disease, but their relationship to cognitive impairment remains uncertain. One reason may be difficulty in distinguishing between lacunes and PvS. We determined the relationship between baseline PvS score and PvS volume with change in cognition over a 5-year follow-up. We compared this to the relationship between baseline lacune count and total lacune volume with cognition...
February 2, 2018: Stroke; a Journal of Cerebral Circulation
Yang Li, Abdul Qadir Nawabi, Yi Feng, Genshan Ma, Jiayi Tong, Chengxing Shen, Naifeng Liu
Objective The clinical implication of coronary tortuosity is unclear. The present study was conducted to determine the relationships between coronary tortuosity and the high-sensitivity C-reactive protein (hs-CRP) concentration and between coronary tortuosity and cerebrovascular accident in hypertensive patients without coronary artery disease. Methods In total, 236 patients with normal coronary angiography findings were categorized into 3 different groups: control participants (n = 58), who had neither hypertension nor coronary tortuosity; patients with hypertension but no coronary tortuosity (H-NCT group, n = 93); and patients with both hypertension and coronary tortuosity (H-CT group, n = 85)...
January 1, 2018: Journal of International Medical Research
Takuya Fukuoka, Yoshihiko Nakazato, Hitoshi Kawasaki, Kei Ikeda, Tomotsugu Furuya, Akifumi Miyake, Takashi Mitsufuji, Yasuo Ito, Kazushi Takahashi, Nobuo Araki, Norio Tahahashi, Toshimasa Yamamoto
Objective The purpose of this study was to clarify the clinical features of ischemic patients for whom cigarette smoking was the sole risk factor for ischemic stroke. Methods Among the 1,329 patients (male, n=833; female, n=496) with acute ischemic stroke who were admitted to our hospital between April 2005 and September 2016, 346 (26%) were smokers (male, n=308 [36.9%]; female, 38 [7.6%]). In 42 (3.1%; male, n=41; female, n=1) cases, cigarette smoking was considered to be the sole risk factor for ischemic stroke...
February 9, 2018: Internal Medicine
Yan Wang, Yoon Choi, Joshuae Gallardo, Ifeoma Nwaneri, James R Brorson
OBJECTIVE: We aimed to evaluate the yield of extensive etiologic workup in lacunar stroke patients. BACKGROUND: As lacunar strokes are infrequently caused by thromboembolism, the clinical relevance of extensive workup for thromboembolic sources is questioned. METHODS: Among consecutive stroke admissions to a single center over 3 years, the 100 cases initially classified as lacunar stroke and a sample of 100 cases classified as non-lacunar ischemic strokes were studied...
February 6, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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