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Lacunar infarct

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https://www.readbyqxmd.com/read/28213191/microneurosurgical-management-of-posterior-communicating-artery-aneurysm-a-contemporary-series-from-helsinki
#1
Peeraphong Thiarawat, Behnam Rezai Jahromi, Danil A Kozyrev, Patcharin Intarakhao, Mario K Teo, Joham Choque-Velasquez, Juha Hernesniemi
OBJECTIVE: Our purposes are to analyze microsurgical techniques and to determine correlations between microsurgical techniques with the radiographic findings in the microneurosurgical treatment of the posterior communicating artery aneurysms (PCoAAs). METHODS: The authors retrospectively analyzed radiographic findings and videos of surgery in 64 patients with PCoAAs who underwent microsurgical clipping by the senior author from August 2010-2014. RESULTS: From 64 aneurysms, 30 (47%) had SAH that necessitated the lamina terminalis fenestration (odds ratio [OR], 67...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190604/the-fate-of-acute-lacunar-lesions-in-terms-of-shape-and-size
#2
Ki Jeong Lee, Hyeyoung Jung, Yoon-Sang Oh, Eun Ye Lim, A-Hyun Cho
BACKGROUND: The description of lacunar infarcts on imaging is widely variable. In particular, there are fewer agreements on lacunar lesion size and the presence of cavitation. In this regard, we investigated the changes in size and shape of acute ischemic lesion that is possibly considered as small vessel occlusion on long-term follow-up. METHODS: Patients with acute single subcortical ischemic lesion on penetrating arterial territories and without definite cause of cardioembolism and large vessel disease were included...
February 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#3
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28151400/factors-associated-with-new-onset-depression-following-ischemic-stroke-the-women-s-health-initiative
#4
Joel Salinas, Roberta M Ray, Rami Nassir, Kamakshi Lakshminarayan, Christina Dording, Jordan Smoller, Sylvia Wassertheil-Smoller, Jonathan Rosand, Erin C Dunn
BACKGROUND: Psychosocial characteristics have a strong effect on risk of depression, and their direct treatment with behavioral interventions reduces rates of depression. Because new-onset poststroke depression (NPSD) is frequent, devastating, and often treatment-resistant, novel preventive efforts are needed. As a first step toward developing behavioral interventions for NPSD, we investigated whether prestroke psychosocial factors influenced rates of NPSD in a manner similar to the general population...
February 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28142144/do-lacunar-infarcts-have-different-aetiologies-risk-factor-profiles-of-lacunar-infarcts-in-deep-white-matter-and-basal-ganglia-the-second-manifestations-of-arterial-disease-magnetic-resonance-study
#5
Raoul P Kloppenborg, Paul J Nederkoorn, Anne M Grool, Laurens J L De Cocker, Willem P T M Mali, Yolanda van der Graaf, Mirjam I Geerlings
BACKGROUND: Evidence suggests that lacunar infarcts have different etiologies, possibly related to their anatomical location and vascular territory. We investigated the risk factor profiles of patients with new lacunar infarcts in the basal ganglia and deep white matter. METHODS: Within the Second Manifestations of ARTerial disease-Magnetic Resonance study, a prospective cohort on brain changes on MRI in patients with symptomatic atherosclerotic disease, 679 patients (57 ± 9 years) had vascular screening and MRI at baseline and after a mean follow-up of 3...
January 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28127514/interhemispheric-characterization-of-small-vessel-disease-imaging-markers-after-subcortical-infarct
#6
Maria Del C Valdés Hernández, Xinyi Qiu, Xin Wang, Stewart Wiseman, Eleni Sakka, Lucy C Maconick, Fergus Doubal, Cathie L M Sudlow, Joanna M Wardlaw
BACKGROUND: In structural Magnetic Resonance Imaging (MRI) of patients with a recent small subcortical infarct (RSSI) and small vessel disease (SVD) imaging markers coexist. However, their spatial distribution and prevalence with respect to the hemisphere of the RSSI remain unknown. MATERIALS AND METHODS: From brain MRI in 187 patients with an acute lacunar ischemic stroke clinical syndrome and a relevant diffusion weighted imaging (DWI)-positive lesion, we semiautomatically extracted the RSSI, microbleeds, lacunes, old cortical infarcts, and white matter hyperintensities (WMH) using optimized thresholding in the relevant sequences, and rated the load of perivascular spaces...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28126975/-cerebral-autosomal-recessive-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy-carasil
#7
Masahiro Uemura, Hiroaki Nozaki, Osamu Onodera
Cerebral small vessel disease (CSVD) is frequently observed among the elderly and is known to cause dementia and gait disturbance associated with white matter lesions, lacunar infarcts, and cerebral hemorrhage. Molecular mechanistic studies promise to provide new insights into the pathogenesis of hereditary CSVD. Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is one of the hereditary CSVDs caused by a mutation in the high-temperature requirement serine peptidase A1 (HTRA1) gene...
January 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28104915/visceral-obesity-is-associated-with-white-matter-hyperintensity-and-lacunar-infarct
#8
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
#9
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 3 weeks. We illustrate the patient's ataxia and dysmetria with videos and also use the videos to demonstrate and characterize the features of the dysmetria. Interestingly, the characteristics of the dysmetria appear to be different from those seen in patients with dysmetria arising from a cerebellar or thalamic lesion...
January 16, 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
#10
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
#11
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...
February 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
#12
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
#13
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
#14
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
#15
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
#16
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...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27999136/human-muse-cells-reconstruct-neuronal-circuitry-in-subacute-lacunar-stroke-model
#17
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...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27994572/examining-subcortical-infarcts-in-the-era-of-acute-multimodality-ct-imaging
#18
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
#19
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
#20
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
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