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Lacunar infarct

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https://www.readbyqxmd.com/read/28631309/obstructive-sleep-apnea-and-silent-cerebral-infarction-in-hypertensive-individuals
#1
José Alvarez-Sabín, Odile Romero, Pilar Delgado, Manuel Quintana, Estevo Santamarina, Alex Ferré, Olga Maisterra, Iolanda Riba-Llena, Joan Montaner, Gabriel Sampol
Obstructive sleep apnea syndrome is very prevalent in hypertensive subjects. Moreover, obstructive sleep apnea syndrome activates multiple processes that might be associated with silent cerebral infarct independently of established risk factors. Our aim is to estimate the frequency of obstructive sleep apnea syndrome in hypertensive patients with and without silent cerebral infarct, and to determine whether obstructive sleep apnea syndrome is an independent risk factor of silent cerebral infarct and/or lacunar silent cerebral infarct in patients with hypertension...
June 20, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28628911/a-carasil-patient-from-americas-with-novel-mutation-and-atypical-features-case-presentation-and-literature-review
#2
Muhammad Ibrahimi, Hiroaki Nozaki, Angelica Lee, Osamu Onodera, Raymond Reichwein, Matthew Wicklund, Mohammad El-Ghanem
OBJECTIVE: Reporting a novel mutation in the HTRA1 gene in a CARASIL patient from Americas. METHODS: Clinical presentation and neuroimaging were consistent with CARASIL. HTRA1 DNA sequencing was performed using advanced ("next generation") sequencing technology. The results revealed a homozygous missense mutation as c.616G>A (p.Gly206Arg) in the HTRA1 gene. RESULTS: A 24-year-old man with a history of chronic back pain presented with recurrent ischemic strokes...
June 21, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28620416/antiphospholipid-syndrome-multiple-manifestations-in-a-single-patient-a-high-suspicion-is-still-needed
#3
Uroosa Ibrahim, Shiksha Kedia, Gwenalyn Garcia, Jean Paul Atallah
Antiphospholipid Syndrome (APS) is an autoimmune disorder with clinical and laboratory features of vascular thrombosis, pregnancy loss, and persistent antiphospholipid antibodies (aPLs). The pathophysiology is thought to involve the activation of endothelial cells, monocytes, platelets, and complement by aPLs. Disease can range from asymptomatic to rapidly fatal catastrophic APS. We present a case of a 34-year-old male referred for pancytopenia and splenomegaly. On examination, he had decreased sensation and 4/5 power in the left upper extremity...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28617385/-differential-diagnosis-of-cerebral-autosomal-dominant-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy
#4
A A Moroz, N Yu Abramycheva, M S Stepanova, R N Konovalov, S L Timerbaeva, S N Illarioshkin
Cerebral autosomal dominant arteriopathy with subcortical infarctions and leucoencephalopathy (CADASIL) is an inherited CNS disease, which is caused by mutations in the NOTCH3 gene. Selective disorders of small vessels underlie the disease pathogenesis. Clinically CADASIL is characterized by headaches, multiple stroke-like disorders (in most cases transient ischemic attacks and lacunar strokes), and different focal neurological symptoms and dementia. There are specific MRI signs of the disease: multiple lacunar infarctions located in the basal ganglia, brain steam and cerebellum, focal lesions of temporal poles, capsula externa, periventricular and subcortical areas; diffuse white matter changes and leukoaraiosis can be observed as well...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28596467/-embolic-stroke-of-undetermined-source
#5
Teruyuki Hirano
A new clinical construct, embolic stroke of undetermined source (ESUS) was established as a therapeutically relevant entity, which are defined as a non-lacunar infarction without proximal arterial stenosis or cardioembolic sources, with a clear indication for anticoagulation, especially with direct oral anticoagulant (DOAC). The possible embolic sources include covert atrial fibrillation, arterial stenosis with <50%, low-risk emboligenic cardiac sources, aortic plaque, cancer-associated, and paradoxical embolism...
June 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28596452/effect-of-long-term-vascular-care-on-progression-of-cerebrovascular-lesions-magnetic-resonance-imaging-substudy-of-the-prediva-trial-prevention-of-dementia-by-intensive-vascular-care
#6
Jan Willem van Dalen, Eric P Moll van Charante, Matthan W A Caan, Philip Scheltens, Charles B L M Majoie, Aart J Nederveen, Willem A van Gool, Edo Richard
BACKGROUND AND PURPOSE: This study aimed to evaluate the effect of a nurse-led multidomain cardiovascular intervention on white matter hyperintensity (WMH) progression and incident lacunar infarcts in community-dwelling elderly with hypertension. METHODS: The preDIVA trial (Prevention of Dementia by Intensive Vascular Care) was an open-label, cluster-randomized controlled trial in community-dwelling individuals aged 70 to 78 years. General practices were assigned by computer-generated randomization to 6-year nurse-led, multidomain intensive vascular care or standard care...
June 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28592775/blood-pressure-management-for-stroke-prevention-and-in-acute-stroke
#7
REVIEW
Keun-Sik Hong
Elevated blood pressure (BP) is the leading modifiable risk factor for stroke and the benefit of BP lowering therapy on the stroke risk reduction is well established. The optimal BP target for preventing stroke and other vascular events have been controversial, but the evidences from epidemiological studies and randomized controlled trials (RCTs) support intensive BP lowering for greater vascular protection, particularly for stroke prevention. For secondary stroke prevention, the evidence of intensive BP lowering benefit is limited since only a single RCT for patients with lacunar infarctions was conducted and most data were driven by exploratory analyses...
May 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28548298/total-cerebral-small-vessel-disease-score-and-cognitive-performance-in-community-dwelling-older-adults-results-from-the-atahualpa-project
#8
Victor J Del Brutto, Jorge G Ortiz, Oscar H Del Brutto, Robertino M Mera, Mauricio Zambrano, José Biller
OBJECTIVE: Cerebral small vessel disease (SVD) is inversely associated with cognitive performance. However, whether the total SVD score is a better predictor of poor cognitive performance than individual signatures of SVD is inconclusive. We aimed to estimate the combined and independent predictive power of these MRI findings. METHODS: Atahualpa residents aged ≥60 years underwent brain MRI. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA)...
May 26, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28543314/subclinical-hypothyroidism-and-risk-of-cerebral-small-vessel-disease-a-hospital-based-observational-study
#9
Xiaohao Zhang, Yi Xie, Caixia Ding, Jing Xiao, Yinyan Tang, Xuemei Jiang, Hua Shan, Yuankai Lin, Yujia Zhu, Chuanyou Li, Dan Hu, Zhixiang Ling, Gelin Xu, Lei Sheng
OBJECTIVE: Subclinical hypothyroidism (SCH) has been associated with atherosclerosis and increased risk of ischemic stroke. However, whether SCH is associated with cerebral small vessel disease (cSVD) remains largely unexplored. This study aimed to investigate the relationship between SCH and total cSVD burden, a composite measurement detected with magnetic resonance imaging (MRI), in patients with minor ischemic stroke or transient ischemic attack (TIA). DESIGN: This was a prospective observational cohort study conducted in a tertiary referral hospital...
May 25, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28540482/linear-sign-in-cystic-brain-lesions-%C3%A2-5-mm-a-suggestive-feature-of-perivascular-space
#10
Jinkyeong Sung, Jinhee Jang, Hyun Seok Choi, So-Lyung Jung, Kook-Jin Ahn, Bum-Soo Kim
OBJECTIVE: To determine the prevalence of a linear sign within enlarged perivascular space (EPVS) and chronic lacunar infarction (CLI) ≥ 5 mm on T2-weighted imaging (T2WI) and time-of-flight (TOF) magnetic resonance angiography (MRA), and to evaluate the diagnostic value of the linear signs for EPVS over CLI. METHODS: This study included 101 patients with cystic lesions ≥ 5 mm on brain MRI including TOF MRA. After classification of cystic lesions into EPVS or CLI, two readers assessed linear signs on T2WI and TOF MRA...
May 24, 2017: European Radiology
https://www.readbyqxmd.com/read/28493898/apathy-but-not-depression-is-associated-with-executive-dysfunction-in-cerebral-small-vessel-disease
#11
Valerie Lohner, Rebecca L Brookes, Matthew J Hollocks, Robin G Morris, Hugh S Markus
OBJECTIVE: To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD), and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed. METHODS: 196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation...
2017: PloS One
https://www.readbyqxmd.com/read/28490287/cheiro-oral-syndrome
#12
Mamoun Saeed, Abdelrahman Abbker, Paul Brenan, Tarig Mohammed Abkur
We describe a 64-year-old man who presented to the emergency department with a two-day history of left perioral and hand numbness. Examination revealed impaired sensation of the left corner of the mouth and ipsilateral fingers. Neuroimaging showed an acute right thalamic lacunar infarct consistent with the diagnosis of cheiro-oral syndrome. In this report, we discuss the importance of recognising this syndrome and instituting appropriate management to prevent further cerebrovascular events.
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28487471/using-dti-to-assess-white-matter-microstructure-in-cerebral-small-vessel-disease-svd-in-multicentre-studies
#13
Iain D Croall, Valerie Lohner, Barry Moynihan, Usman Khan, Ahamad Hassan, John T O'Brien, Robin G Morris, Daniel J Tozer, Victoria C Cambridge, Kirsty Harkness, David J Werring, Andrew M Blamire, Gary A Ford, Thomas R Barrick, Hugh S Markus
Diffusion tensor imaging (DTI) metrics such as fractional anisotropy (FA) and mean diffusivity (MD) have been proposed as clinical trial markers of cerebral small vessel disease (SVD) due to their associations with outcomes such as cognition. However, studies investigating this have been predominantly single-centre. As clinical trials are likely to be multisite, further studies are required to determine whether associations with cognition of similar strengths can be detected in a multicentre setting. One hundred and nine patients (mean age =68 years) with symptomatic lacunar infarction and confluent white matter hyperintensities (WMH) on MRI was recruited across six sites as part of the PRESERVE DTI substudy...
June 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28472611/coexisting-cortical-atrophy-plays-a-crucial-role-in-cognitive-impairment-in-moderate-to-severe-cerebral-small-vessel-disease-patients
#14
Jie Tang, Langfeng Shi, Qianhua Zhao, Miaoyi Zhang, Ding Ding, Bo Yu, Jianhui Fu
Whether white matter lesion (WML) is associated with vascular cognitive impairment in cerebral small vessel disease (CSVD) remains controversial; some severe CSVD patients retain normal cognitive function, and cortical thinning associated with WMLs has also been recently reported. The contribution of cortical atrophy to vascular cognitive impairment in severe CSVD and whether WML affects cortical atrophy remain unknown. From November 2012 to January 2015, 50- to 80-year-old patients with moderate to severe WMLs or more than four lacunar infarctions and cognitive complaints, excluding those with large vascular diseases diagnosed by transcranial cerebral Doppler, were recruited...
March 2017: Discovery Medicine
https://www.readbyqxmd.com/read/28446112/strategic-lacunar-infarction
#15
Takeshi Kondo, Kazuhiko Terada
No abstract text is available yet for this article.
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28434675/cadasil-as-a-useful-medical-model-and-genetic-form-of-vascular-depression
#16
Joon Hyuk Park, Bong-Hee Jeon, Jung Seok Lee, Paul A Newhouse, Warren D Taylor, Brian D Boyd, Ki Woong Kim, Moon-Doo Kim
OBJECTIVE: The main magnetic resonance imaging (MRI) findings of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are white matter hyperintensities (WMHs), lacunar infarctions, and cerebral microbleeds (CMBs). The purpose of this study was to investigate the effects of these three neuroimaging markers of CADASIL on depression to determine whether CADASIL is a useful medical model supporting the vascular depression hypothesis. METHODS: Eighty-four subjects with CADASIL, aged 34-86 years, participated in this study...
March 23, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28430290/frequency-and-topography-of-small-cerebrovascular-lesions-in-vascular-and-in-mixed-dementia-a-post-mortem-7-tesla-magnetic-resonance-imaging-study-with-neuropathological-correlates
#17
Jacques De Reuck, Florent Auger, Nicolas Durieux, Vincent Deramecourt, Claude-Alain Maurage, Charlotte Cordonnier, Florence Pasquier, Didier Leys, Regis Bordet
<i><b>Introduction</b>: Mixed dementia (MixD) refers to a combination of definite Alzheimer's disease (AD) and vascular encephalopathy. The existence of a "pure" type of vascular dementia (VaD) is controversial. There is a need to find magnetic resonance imaging (MRI) characteristics allowing the distinction between VaD and MixD. The present post-mortem 7.0-tesla MRI compares the frequency or severity and the topography of the small cerebrovascular lesions in brains of patients with VaD and with MixD...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28428977/19th-workshop-of-the-international-stroke-genetics-consortium-april-28-29-2016-boston-massachusetts-usa-2016-001-mri-defined-cerebrovascular-genomics-the-charge-consortium
#18
S Debette, Y Saba, D Vojinovic, X Jian, H Adams, G Chauhan, M Sargurupremraj, S Kaffashian, J Ding, J C Bis, P Nyquist, K Mather, C Van Duijn, L J Launer, M A Ikram, H Schmidt, W T Longstreth, M Fornage, S Seshadri
The CHARGE consortium is an investigator-initiated collaboration to facilitate meta-analyses of genome-wide association studies (GWAS) and genomic analyses based on next generation sequencing (NGS), among multiple large and well-phenotyped population-based cohort studies around the world (http://www.chargeconsortium.com). Within the neuro-CHARGE working group, we are presenting an update of ongoing genomic studies on MRI-markers of cerebrovascular disease. Large population-based studies have shown that the burden of cerebrovascular disease extends far beyond that of clinical stroke...
March 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28421878/cerebrovascular-injury-in-cryptococcal-meningitis
#19
Ajay Kumar Mishra, Vanjare Harshad Arvind, Divya Muliyil, Cijoy K Kuriakose, Anu Anna George, Reka Karuppusami, Ronald Albert Benton Carey, Sunithi Mani, Samuel George Hansdak
Background Cryptococcal meningitis continues to be one of the common causes of chronic central nervous system infection worldwide. Individuals with cryptococcal meningitis can occasionally present with small vessel vasculitis causing infarcts primarily in the basal ganglia, internal capsule, and thalamus. Literature regarding patterns of cerebrovascular injury among patients with cryptococcal meningitis is scanty, and outcome following these vascular involvements is unknown. Aim To study the clinical profile, imaging findings, and details of vascular territory involved among patients admitted with cryptococcal meningitis and central nervous system infarct in a tertiary care center from India...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28420817/association-of-kidney-dysfunction-with-asymptomatic-cerebrovascular-abnormalities-in-a-japanese-population-with-health-checkups
#20
Kaori Hayashi, Michiyo Takayama, Takeshi Kanda, Kazuhiro Kashiwagi, Akihito Hishikawa, Yasushi Iwao, Hiroshi Itoh
BACKGROUND: Cerebrovascular disease is a major cause of mortality and morbidity. Chronic kidney disease (CKD) is prevalent in stroke patients. This study evaluated the correlation between kidney dysfunction and asymptomatic findings on carotid ultrasonography (US) and brain magnetic resonance imaging (MRI) in a Japanese population with health checkups.Methods and Results:In total, 1,716 subjects aged 40-80 years, who received health checkups from January 1 to December 31, 2015, were included...
April 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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