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Lacunar infarct

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https://www.readbyqxmd.com/read/28717604/central-vestibular-syndrome-in-a-red-fox-vulpes-vulpes-with-presumptive-right-caudal-cerebral-artery-ischemic-infarct-and-prevalent-midbrain-involvement
#1
Mario Ricciardi, Floriana Gernone, Antonio De Simone, Pasquale Giannuzzi
A wild young male red fox (Vulpes vulpes) was found in the mountainous hinterland of Rome (Italy) with a heavily depressed mental status and unresponsive to the surrounding environment. Neurological examination revealed depression, left circling, right head tilt, ventromedial positional strabismus and decreased postural reactions on the left side. Neurological abnormalities were suggestive of central vestibular syndrome. Two consecutive MRIs performed with 30 days interval were compatible with lacunar ischemic infarct in the territory of right caudal cerebral artery and its collateral branches...
2017: Open veterinary journal
https://www.readbyqxmd.com/read/28716371/detection-risk-factors-and-functional-consequences-of-cerebral-microinfarcts
#2
REVIEW
Susanne J van Veluw, Andy Y Shih, Eric E Smith, Christopher Chen, Julie A Schneider, Joanna M Wardlaw, Steven M Greenberg, Geert Jan Biessels
Cerebral microinfarcts are small lesions that are presumed to be ischaemic. Despite the small size of these lesions, affected individuals can have hundreds to thousands of cerebral microinfarcts, which cause measurable disruption to structural brain connections, and are associated with dementia that is independent of Alzheimer's disease pathology or larger infarcts (ie, lacunar infarcts, and large cortical and non-lacunar subcortical infarcts). Substantial progress has been made with regard to understanding risk factors and functional consequences of cerebral microinfarcts, partly driven by new in-vivo detection methods and the development of animal models that closely mimic multiple aspects of cerebral microinfarcts in human beings...
July 14, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28716287/kidney-dysfunction-and-silent-brain-infarction-in-generally-healthy-adults
#3
Sang Hyuck Kim, Dong Wook Shin, Jae Moon Yun, Ji Eun Lee, Jae-Sung Lim, Be Long Cho, Hyung-Min Kwon, Jin-Ho Park
BACKGROUND: The association between silent brain infarction (SBI) and estimated glomerular filtration rate (eGFR)-based kidney dysfunction has not yet been definitively confirmed. This study aimed to investigate the association in generally healthy adults without a previous history of stroke or overt kidney disease. METHODS: The data from the screening health check-up program in the Seoul National University Hospital Health Promotion Center from January 1, 2009 to December 31, 2013 were used...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28709046/ankle-brachial-index-mri-markers-and-cognition-the-epidemiology-of-dementia-in-singapore-study
#4
Muhammad Amin Shaik, Narayanaswamy Venketasubramanian, Ching-Yu Cheng, Tien Yin Wong, Henri Vrooman, Mohammad Kamran Ikram, Saima Hilal, Christopher Chen
BACKGROUND AND AIMS: Previous studies showed an independent association of low ankle-brachial index (ABI) with cognitive impairment. However, the association between low ABI and cognition in the presence of both cerebrovascular disease (CeVD) and neurodegeneration is lacking. We aimed at investigating a) the association of low ABI with markers of CeVD and cortical thickness, and b) whether the association of low ABI with cognition is influenced by these markers. METHODS: Data was drawn from the Epidemiology of Dementia In Singapore (EDIS) study where all participants (n = 832) underwent neuropsychological tests and 3T brain magnetic resonance imaging (MRI) to assess CeVD markers as well as cortical thicknesses...
July 5, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28705824/carotid-plaque-morphology-and-ischemic-vascular-brain-disease-on-mri
#5
Q J A van den Bouwhuijsen, M W Vernooij, B F J Verhaaren, H A Vrooman, W J Niessen, G P Krestin, M A Ikram, O H Franco, A van der Lugt
BACKGROUND AND PURPOSE: Vulnerable carotid plaque components are reported to increase the risk of cerebrovascular events. Yet, the relation between plaque composition and subclinical ischemic brain disease is not known. We studied, in the general population, the association between carotid atherosclerotic plaque characteristics and ischemic brain disease on MR imaging. MATERIALS AND METHODS: From the population-based Rotterdam Study, 951 participants underwent both carotid MR imaging and brain MR imaging...
July 13, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28688982/the-effects-of-striatal-silent-lacunar-infarction-on-the-substantia-nigra-and-movement-disorders-in-parkinson-s-disease-a-follow-up-study
#6
Guohua Zhang, Chengguo Zhang, Yuhu Zhang, Yukai Wang, Kun Nie, Bin Zhang, Haiqun Xie, Jiancong Lu, Lijuan Wang
OBJECTIVE: Striatal silent lacunar infarction (SSLI) is associated with structural changes to the substantia nigra (SN), detectable by diffusion kurtosis imaging (DKI). In this follow-up study, we investigated the effects of SSLI on the SN and movement disorders in patients with Parkinson's disease (PD). METHODS: A total of 60 untreated patients with early-stage PD, divided into control and SSLI groups, were enrolled in this study. All participants underwent conventional MRI and DKI twice; at baseline and after a 1-year period...
June 27, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28687237/the-pulvinar-nucleus-is-associated-with-the-presence-of-dysarthria-in-patients-with-basal-ganglia-hemorrhage
#7
Dae Hyun Kim, Sunghyon Kyeong, Sung Jun Ahn, Yoon Ghil Park
Dysarthria is a frequent symptom in patients with stroke. The anatomical structures responsible for dysarthria have been reported in patients with lacunar infarcts, but the related lesions in patients with basal ganglia hemorrhage (BGH) have not been investigated. The aim of this study was to identify associations between the lesion location and the presence/absence of dysarthria in patients with BGH using voxel-based lesion symptom mapping (VLSM) analyses. A retrospective analysis was conducted on 26 patients with acute BGH (mean age, 54...
July 4, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28684376/the-association-between-arterial-stiffness-initial-stroke-severity-and-3-week-outcomes-in-patients-with-ischemic-stroke
#8
Emma Ormerod, Khalid Ali, James Cameron, Muzaffar Malik, Richard Lee, Spas Getov, Chakravarthi Rajkumar
OBJECTIVES: Vascular compliance is emerging as a useful cardiovascular risk factor. The aim of this study was to investigate the association between arterial stiffness and stroke severity at presentation and 3 weeks. METHODS: Forty two patients with acute ischemic stroke (55% male, mean age 71 years) were recruited over 15-months. Stroke subtypes were classified into lacunar circulation infarct (LACI), partial anterior circulation infarct (PACI), and posterior circulation infarct (POCI)...
July 3, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28681535/microbleeds-in-the-secondary-prevention-of-small-subcortical-strokes-trial-stroke-mortality-and-treatment-interactions
#9
Ashkan Shoamanesh, Lesly A Pearce, Carlos Bazan, Luciana Catanese, Leslie A McClure, Mukul Sharma, Joan Marti-Fabregas, David C Anderson, Carlos S Kase, Robert G Hart, Oscar R Benavente
OBJECTIVE: To characterize cerebral microbleeds (CMBs) in lacunar stroke patients in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial and to assess their relationship with recurrent stroke and death, and response to assigned treatment. METHODS: SPS3 is a randomized, clinical trial conducted between 2003 and 2011. Patients with recent magnetic resonance imaging (MRI)-documented lacunar infarcts were randomly assigned in a factorial design to target levels of systolic blood pressure (130-149mmHg vs <130mmHg; open label) and to antiplatelet treatment (aspirin/clopidogrel vs aspirin/placebo; double-blinded)...
July 6, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28631309/obstructive-sleep-apnea-and-silent-cerebral-infarction-in-hypertensive-individuals
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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 ischaemic 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 ischaemic stroke or transient ischaemic 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
#19
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
#20
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
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