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Lacunar infarct

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https://www.readbyqxmd.com/read/28104915/visceral-obesity-is-associated-with-white-matter-hyperintensity-and-lacunar-infarct
#1
K W Kim, H Seo, M-S Kwak, D Kim
BACKGROUND: The presences of white matter hyperintensity (WMH) and lacunar infarct are recognized as risk factors of dementia, stroke, and mortality. It is undetermined whether visceral adipose tissue (VAT) area is associated with an increased risk of cerebral small vessel disease. We explored whether VAT area was responsible for cerebral small vessel disease through the identification of WMH and lacunar infarct. SUBJECTS: A total of 2046 subjects free of cerebrovascular disease who underwent brain magnetic resonance imaging (MRI) and abdominal fat computed tomography (CT) during a general health check-up were enrolled...
January 20, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28093369/rehabilitation-of-the-pontine-ataxia-dysmetria-syndrome-a-case-presentation
#2
Stephanie Li, Kasondra Hartman, Krishna Surapaneni, Eric L Altschuler
We present a case of a patient with significant ataxia and dysmetria following a lacunar pontine infarction and review the literature on this uncommon syndrome. The patient had an excellent clinical course with near resolution of symptoms and signs in less than three weeks. We characterize and illustrate with videos of the ataxia and dysmetria. Interestingly, the characteristics of the dysmetria appear to be different than that seen in patients with dysmetria arising from a cerebellar or thalamic lesion. We discuss the likely neurophysiologic mechanisms responsible for the condition and recovery...
January 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28072724/fatal-antiphospholipid-syndrome-following-endoscopic-transnasal-transsphenoidal-surgery-for-a-pituitary-tumor-a-case-report
#3
Chiao-Zhu Li, Chiao-Ching Li, Chih-Chuan Hsieh, Meng-Chi Lin, Dueng-Yuan Hueng, Feng-Chen Liu, Yuan-Hao Chen
INTRODUCTION: The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery. METHODS AND RESULT: A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28064357/ischemic-stroke-experimental-models-and-reality
#4
REVIEW
Clemens J Sommer
The vast majority of cerebral stroke cases are caused by transient or permanent occlusion of a cerebral blood vessel ("ischemic stroke") eventually leading to brain infarction. The final infarct size and the neurological outcome depend on a multitude of factors such as the duration and severity of ischemia, the existence of collateral systems and an adequate systemic blood pressure, etiology and localization of the infarct, but also on age, sex, comorbidities with the respective multimedication and genetic background...
January 7, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28064326/diabetic-patients-are-at-a-higher-risk-of-lacunar-infarction-and-dyslipidemia-results-of-a-comparative-pilot-study-from-king-fahad-hospital-of-the-university-saudi-arabia
#5
Azra Zafar
OBJECTIVE: To describe the various risk factors and identify the characteristics of ischemic stroke in diabetic patients. METHODS: A retrospective study carried out at King Fahd Hospital of the University in Al-Khobar, kingdom of Saudi Arabia from February 2010 to December 2015. Statistical analysis was performed by the Statistical Package for the Social Sciences (version 22.0, SPSS Inc, Chicago, IL, USA). RESULTS: One hundred and twenty-seven diabetic patients with ischemic stroke were compared with 127 non-diabetics...
January 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#6
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, Satoru Takeuchi, Satoshi Tomura, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28031690/reliability-of-two-ankle-brachial-index-methods-to-predict-silent-lacunar-infarcts-a-population-based-study-in-stroke-free-older-adults-the-atahualpa-project
#7
Oscar H Del Brutto, Robertino M Mera, David L Brown, Johnathan L Nieves, Mark J Sedler
Individuals with an abnormal ankle-brachial index (ABI) are four times more likely to have a silent lacunar infarct (SLI), but reliability of ABI in predicting the presence of these lesions has not been estimated yet. We compared two methods of calculating ABI to assess their reliability in predicting SLIs. Stroke-free Atahualpa residents aged ≥ 60 years underwent MRI of the brain and ABI determinations. Persons with ABI ≥ 1.4 were excluded. Using receiver operator characteristic curve analysis, we calculated the reliability of the traditional as well as an alternative ABI method to identify individuals with SLI...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029606/lacunar-infarcts-rather-than-white-matter-hyperintensity-as-a-predictor-of-future-higher-level-functional-decline-the-ohasama-study
#8
Megumi Tsubota-Utsugi, Michihiro Satoh, Naoki Tomita, Azusa Hara, Takeo Kondo, Miki Hosaka, Sho Saito, Kei Asayama, Ryusuke Inoue, Mikio Hirano, Aya Hosokawa, Keiko Murakami, Takahisa Murakami, Hirohito Metoki, Masahiro Kikuya, Shin-Ichi Izumi, Yutaka Imai, Takayoshi Ohkubo
OBJECTIVE: We aimed to determine the associations between silent cerebrovascular lesions, characterized by lacunar infarcts and white matter hyperintensity, and future decline in higher level functional capacity in older community-dwelling adults. MATERIALS AND METHODS: For this observational study, we selected individuals from the general population of Ohasama, a rural Japanese community. Three hundred thirty-one participants who were free of functional decline at baseline and who were at least 60 years old underwent brain magnetic resonance imaging and answered a questionnaire on higher level functional capacity derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence...
October 28, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28008091/lacunar-infarcts-and-intracerebral-hemorrhage-differences-a-nested-case-control-analysis-in-the-fhs-framingham-heart-study
#9
Vasileios-Arsenios Lioutas, Alexa Beiser, Jayandra Himali, Hugo Aparicio, Jose Rafael Romero, Charles DeCarli, Sudha Seshadri
BACKGROUND AND PURPOSE: Lacunar stroke (LS) and intracerebral hemorrhage (ICH) are 2 diverse manifestations of small vessel disease. What predisposes some patients to ischemic stroke and others to hemorrhage is not well understood. METHODS: We performed a nested case-control study within the FHS (Framingham Heart Study) comparing people with incident ICH and lacunar ischemic stroke, to age- and sex-matched controls for baseline prevalence and levels of cardiovascular risk factors...
December 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27999136/human-muse-cells-reconstruct-neuronal-circuitry-in-subacute-lacunar-stroke-model
#10
Hiroki Uchida, Kuniyasu Niizuma, Yoshihiro Kushida, Shohei Wakao, Teiji Tominaga, Cesario V Borlongan, Mari Dezawa
BACKGROUND AND PURPOSE: Multilineage-differentiating stress-enduring (muse) cells are endogenous nontumorigenic stem cells with pluripotency harvestable as pluripotent marker SSEA-3(+) cells from the bone marrow from cultured bone marrow-mesenchymal stem cells. After transplantation into neurological disease models, muse cells exert repair effects, but the exact mechanism remains inconclusive. METHODS: We conducted mechanism-based experiments by transplanting serum/xeno-free cultured-human bone marrow-muse cells into the perilesion brain at 2 weeks after lacunar infarction in immunodeficient mice...
December 20, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27994572/examining-subcortical-infarcts-in-the-era-of-acute-multimodality-ct-imaging
#11
Mindy Y Q Tan, Shaloo Singhal, Henry Ma, Ronil V Chandra, Jamie Cheong, Benjamin B Clissold, John Ly, Velandai Srikanth, Thanh G Phan
BACKGROUND: Lacunar infarct has been characterized as small subcortical infarct. It is postulated to occur from "in situ microatheroma or lipohyalinosis" in small vessel or lacunar mechanism. Based on this idea, such infarcts by lacunar mechanism should not be associated with large area of perfusion deficits that extend beyond the subcortical region to the cortical region. By contrast, selected small subcortical infarcts, as defined by MR imaging in the subacute and chronic stage, may initially have large perfusion deficit or related large vessel occlusions...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27994354/role-of-brain-natriuretic-peptide-as-a-novel-prognostic-biomarker-in-acute-ischemic-stroke
#12
Bindu Menon, Krishnana Ramalingam, Jyoti Conjeevaram, K Munisusmitha
AIM: We investigated to study the prognostic importance of brain natriuretic peptide (BNP) in ischemic stroke. MATERIALS AND METHODS: We prospectively enrolled 100 patients with acute ischemic stroke and measured plasma BNP levels and compared with age- and sex-matched healthy controls. Risk factors, biochemical parameters, lipid profile, carotid and vertebral Doppler, imaging, and cardiac evaluation were done. Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS) score on admission and functional disability by Barthel Index (BI) at 3 months...
October 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27978784/correlation-between-decreased-parasympathetic-activity-and-reduced-cerebrovascular-reactivity-in-patients-with-lacunar-infarct
#13
Kannakorn Intharakham, Kesorn Suwanprasert, Sombat Muengtaweepongsa
Reduced cerebrovascular reactivity (CVR) was found in patients with recent lacunar infarct. However, its mechanisms were controversial. The breath holding maneuver as vasodilatory stimulus is clinically useful for an estimation of cerebrovasomotor reactivity in well co-operative patients. Patients with lacunar infarct have no higher cortical dysfunction and remain well co-operation. The breath holding maneuver is feasible and safe to perform in patients with lacunar infarct. Autonomic nervous system regulates systemic vascular activity...
13, 2016: Current Neurovascular Research
https://www.readbyqxmd.com/read/27960164/clinical-stroke-syndromes
#14
Jong S Kim, Louis R Caplan
The main mechanism of stroke in patients who have extracranial atherosclerosis is artery to artery embolism, occasionally associated with hemodynamic disturbances. Although these mechanisms are also important in patients with intracranial atherosclerosis, branch occlusion and in-situ thrombotic occlusion play a relatively more important role in these patients. Accordingly, clinical stroke syndromes differ between extracranial atherosclerosis and intracranial atherosclerosis. In anterior circulation, middle cerebral artery atherosclerosis frequently produces subcortical infarction by way of branch occlusion...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/27933697/total-magnetic-resonance-imaging-burden-of-cerebral-small-vessel-disease-is-associated-with-post-stroke-depression-in-patients-with-acute-lacunar-stroke
#15
X Zhang, Y Tang, Y Xie, C Ding, J Xiao, X Jiang, H Shan, Y Lin, C Li, D Hu, T Li, L Sheng
BACKGROUND AND PURPOSE: Despite extensive studies on post-stroke depression (PSD), the role of the total burden of cerebral small-vessel disease (cSVD) in its pathogenesis remains unclear. METHODS: We conducted a magnetic resonance imaging (MRI)-based cohort study to investigate the relationship between total MRI burden of cSVD and PSD among patients with first-ever lacunar stroke. From June 2013 to January 2016, 374 patients were consecutively recruited. PSD was identified using the Chinese version of the Structured Clinical Interview for DSM-IV...
February 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/27889950/retinopathy-a-sign-of-cerebral-small-vessel-disease-in-diabetes
#16
Toshitaka Umemura, Takahiko Kawamura
Cardio-cerebrovascular disease greatly influences the prognosis of diabetic patients. Silent lacunar infarcts, white matter lesions (WMLs), and cerebral microbleeds are magnetic resonance imaging (MRI) markers of cerebral small vessel disease (SVD) and as they are associated with stroke and dementia, prevention of their incidence and progression is important in clinical practice. The findings of previous autopsy and clinical studies suggest that lacunar infarcts are more prevalent in diabetic patients. On the other hand, the findings of studies on an association between diabetes and WMLs have been inconsistent...
November 27, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27881850/relationship-between-asymptomatic-intra-cranial-lesions-and-brachial-ankle-pulse-wave-velocity-in-coronary-artery-disease-patients-without-stroke
#17
Noriaki Tabata, Daisuke Sueta, Takayoshi Yamashita, Daisuke Utsunomiya, Yuichiro Arima, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto
Little is known about the significance of asymptomatic intra-cranial lesions (ICL) identified by brain MRI in coronary artery disease (CAD) patients. Silent cerebral lesions are suggested to be associated with arterial stiffness in healthy subjects. We investigated whether subclinical ICL are associated with arterial stiffness and the prognosis in CAD patients without medical history of cerebrovascular diseases. We recruited CAD patients who required percutaneous coronary intervention (PCI), did not meet exclusion criteria, and agreed with MRI before PCI...
November 24, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27876311/circulating-biomarkers-in-cerebral-autosomal-dominant-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy-patients
#18
Francesca Pescini, Ida Donnini, Francesca Cesari, Serena Nannucci, Raffaella Valenti, Valentina Rinnoci, Anna Poggesi, Anna Maria Gori, Betti Giusti, Angela Rogolino, Alessandra Carluccio, Silvia Bianchi, Maria Teresa Dotti, Antonio Federico, Maurizio Balestrino, Enrico Adriano, Rosanna Abbate, Domenico Inzitari, Leonardo Pantoni
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebral microangiopathy presenting with variable features, including migraine, psychiatric disorders, stroke, and cognitive decline and variable disability. On neuroimaging, CADASIL is characterized by leukoencephalopathy, multiple lacunar infarcts, and microbleeds. Previous studies suggest a possible role of endothelial impairment in the pathogenesis of the disease...
November 18, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27863873/a-case-of-transient-global-amnesia-with-small-left-putamen-infarction
#19
Kosuke Yoshida
A 67-year-old right-handed woman experienced a sudden anterograde and retrograde short-term memory deficit that recovered on the next day. Magnetic resonance imaging (MRI) showed a spotty high-intensity lesion in the left putamen in the diffusion-weighted and fluid-attenuated inversion recovery images. Transient global amnesia due to lacunar infarction of the left putamen was diagnosed. Transient global amnesia is characterized by a sudden onset of anterograde amnesia that disappears within 24 hours. The cause of transient global amnesia is still uncertain...
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27861154/presence-of-lacunar-infarctions-is-associated-with-the-spatial-navigation-impairment-in-patients-with-mild-cognitive-impairment-a-dti-study
#20
Yan-Feng Wu, Wen-Bo Wu, Qing-Ping Liu, Wen-Wen He, Hong Ding, Zuzana Nedelska, Jakub Hort, Bing Zhang, Yun Xu
Lacunar cerebral infarction (LI) is one of risk factors of vascular dementia and correlates with progression of cognitive impairment including the executive functions. However, little is known on spatial navigation impairment and its underlying microstructural alteration of white matter in patients with LI and with or without mild cognitive impairment (MCI). Our aim was to investigate whether the spatial navigation impairment correlated with the white matter integrity in LI patients with MCI (LI-MCI). Thirty patients with LI were included in the study and were divided into LI-MCI (n=17) and non MCI (LI-Non MCI) groups (n=13) according neuropsychological tests...
November 16, 2016: Oncotarget
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