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Cerebral circulation

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https://www.readbyqxmd.com/read/28333037/cerebral-hemodynamic-with-intra-aortic-balloon-pump-business-as-usual
#1
Juliana Caldas, Ronney B Panerai, Edson Bor-Seng-Shu, Juliano Almeida, Graziela Ferreira, Ligia Cunha, Ricardo Nogueira, Marcelo Oliveira, Fabio Jatene, Thompson Robinson, Ludhmila Hajjar
Intra-aortic balloon pump (IABP) is commonly used as mechanical support after cardiac surgery or cardiac shock. Although its benefits for cardiac function have been well documented, its effects on cerebral circulation are still controversial. We hypothesized that transfer function analysis (TFA) and continuous estimates of dynamic cerebral autoregulation (CA) provide consistent results in the assessment of cerebral autoregulation in patients with IABP. Continuous recordings of blood pressure (BP, intra-arterial line), end-tidal CO2, heart rate and cerebral blood flow velocity (CBFV, transcranial Doppler) were obtained i) 5 minutes with IABP ratio 1:3, ii) 5 minutes, starting 1 minute with the IABP-ON, and continuing for another 4 minutes without pump assistance (IABP-OFF)...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28330415/novel-detection-of-placental-insufficiency-by-magnetic-resonance-imaging-in-the-nonhuman-primate
#2
Jamie O Lo, Victoria H J Roberts, Matthias C Schabel, Xiaojie Wang, Terry K Morgan, Zheng Liu, Colin Studholme, Christopher D Kroenke, Antonio E Frias
The placenta is a vital organ necessary for healthy fetal development. Placental insufficiency creates an in utero environment where the fetus is at risk of insufficient oxygen or nutrient exchange. This is primarily caused by impairment of either maternal or fetal circulation or vascular thrombosis such as placental infarction. As a result of placental dysfunction, affected fetuses may be growth restricted, neurologically impaired, and at risk of increased morbidity and mortality. In a cohort of 4 pregnant Rhesus macaques, we describe antenatal detection of naturally occurring intrauterine growth restriction (IUGR) and aberrant fetal neurodevelopment in 1 animal...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28330015/contact-aspiration-versus-stent-retriever-front-line-for-recanalisation-in-acute-cerebral-infarction-the-aster-trial
#3
Bertrand Lapergue, Julien Labreuche, Michel Piotin
RATIONALE: Mechanical thrombectomy (MT) with a stent retriever (SR), in association with intravenous (IV) rtPA, is now the standard of care in anterior circulation ischemic stroke caused by large vessel occlusion (LVO). Favorable outcome is strongly associated with the successful reperfusion status. New techniques for MT such as contact aspiration (CA) seem promising to increase reperfusion status and clinical outcome in retrospective studies. We aim at ascertaining whether CA is more efficient than stent retriever as a front-line endovascular procedure...
March 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28327889/hemodynamic-changes-after-unilateral-revascularization-for-moyamoya-disease-serial-assessment-by-quantitative-magnetic-resonance-angiography
#4
Tackeun Kim, Jae Seung Bang, O-Ki Kwon, Gyojun Hwang, Jeong Eun Kim, Hyun-Seung Kang, Won-Sang Cho, Cheolkyu Jung, Chang Wan Oh
BACKGROUND: Ultrasonic flow meters and quantitative magnetic resonance angiography quantitatively assess flow during hemodynamic evaluation of cerebral ischemia. Although their reliability and reproducibility have been verified, their clinical impact in moyamoya disease has rarely been reported. OBJECTIVE: To investigate flow measurement outcomes in moyamoya disease patients pre- and postoperatively through a retrospective observational study. METHODS: We evaluated 41 patients undergoing their first revascularization surgery who were followed ≥6 mo...
January 2, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28319240/two-paradigms-for-endovascular-thrombectomy-after-intravenous-thrombolysis-for-acute-ischemic-stroke
#5
Gaspard Gerschenfeld, Ioan-Paul Muresan, Raphael Blanc, Michael Obadia, Marie Abrivard, Michel Piotin, Sonia Alamowitch
Importance: Intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) is recommended to treat acute ischemic stroke (AIS) with a large vessel occlusion (LVO). Most hospitals do not have on-site MT facilities, and most patients need to be transferred secondarily after IVT (drip and ship), which may have an effect on the neurologic outcome. Objective: To compare the functional independence at 3 months between patients treated under the drip-and-ship paradigm and those treated on site (mothership)...
March 20, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28317235/astrocyte-specific-insulin-like-growth-factor-1-gene-transfer-in-aging-female-rats-improves-stroke-outcomes
#6
Andre K Okoreeh, Shameena Bake, Farida Sohrabji
Middle aged female rats sustain larger stroke infarction and disability than younger female rats. This older group also shows age-related reduction of insulin like growth factor (IGF)-1 in serum and in astrocytes, a cell type necessary for poststroke recovery. To determine the impact of astrocytic IGF-1 for ischemic stroke, these studies tested the hypothesis that gene transfer of IGF-1 to astrocytes will improve stroke outcomes in middle aged female rats. Middle aged (10-12 month old), acyclic female rats were injected with recombinant adeno-associated virus serotype 5 (AAV5) packaged with the coding sequence of the human (h)IGF-1 gene downstream of an astrocyte-specific promoter glial fibrillary acidic protein (GFAP) (AAV5-GFP-hIGF-1) into the striatum and cortex...
March 20, 2017: Glia
https://www.readbyqxmd.com/read/28316123/the-msc-adhesion-cascade-insights-into-homing-and-transendothelial-migration
#7
Franziska Nitzsche, Claudia Müller, Barbara Lukomska, Jukka Jolkkonen, Alexander Deten, Johannes Boltze
Mesenchymal stem cells (MSC) are promising candidates for adult cell therapies in regenerative medicine. To fully exert their potential, efficient homing and migration towards lesion sites plays an important role. Local transplantation deposits MSC in spatial proximity to the lesion, but often requires invasive procedures. Systemic administration routes are favored, but require the targeted extravasation of the circulating MSC at the site of injury. Transplanted MSC can indeed leave the blood flow and transmigrate through the endothelial barrier, and reach the lesion site...
March 18, 2017: Stem Cells
https://www.readbyqxmd.com/read/28316083/energy-metabolism-in-the-rat-cortex-under-thiopental-anaesthesia-measured-in-vivo-by-13-c-mrs
#8
Sarah Sonnay, João M N Duarte, Nathalie Just, Rolf Gruetter
Barbiturates, commonly used as general anaesthetics, depress neuronal activity and thus cerebral metabolism. Moreover, they are likely to disrupt the metabolic support of astrocytes to neurons, as well as the uptake of nutrients from circulation. By employing (13) C magnetic resonance spectroscopy (MRS) in vivo at high magnetic field, we characterized neuronal and astrocytic pathways of energy metabolism in the rat cortex under thiopental anaesthesia. The neuronal tricarboxylic acid (TCA) cycle rate was 0.46 ± 0...
March 19, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28315727/increasing-or-fluctuating-bispectral-index-values-during-post-resuscitation-targeted-temperature-management-can-predict-clinical-seizures-after-rewarming
#9
Kanae Ochiai, Atsushi Shiraishi, Yasuhiro Otomo, Yuuichi Koido, Takashi Kanemura, Masato Honma
AIM: To investigate whether an increasing bispectral index (BIS) value during targeted temperature management (TTM) correlates with increased clinical seizures after TTM or worse neurological prognoses after TTM. METHODS: We performed a retrospective prognostication study of patients who were treated with TTM after recovery of spontaneous circulation from cardiac arrest at a tertiary care hospital. We recorded the BIS regularly during TTM and calculated the correlations of the mean BIS values, standard deviations of the BIS values, and linear regression coefficient of the trend of the BIS values over time as index tests...
March 15, 2017: Resuscitation
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#10
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28297066/cerebral-hyperperfusion-and-other-consequences-of-hemodialysis-central-vein-catheters
#11
Haimanot Wasse
While central venous stenosis is a common consequence of protracted central venous catheter use, intracardiac device transvenous leads, and central venous instrumentation, the majority of patients who develop symptomatic central venous stenosis present with characteristic venous hypertension. However, some patients may develop an abnormal intracranial venous circulation and present with neurologic symptoms. This paper will summarize findings from case reports that describe the neurologic sequelae that can develop as a result of central venous stenosis/occlusion in end-stage renal disease patients with a functional arteriovenous access...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#12
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28292867/vessel-patency-at-24-hours-and-its-relationship-with-clinical-outcomes-and-infarct-volume-in-revascat-trial-randomized-trial-of-revascularization-with-solitaire-fr-device-versus-best-medical-therapy-in-the-treatment-of-acute-stroke-due-to-anterior-circulation
#13
Mònica Millán, Sebastià Remollo, Helena Quesada, Arturo Renú, Alejandro Tomasello, Priyanka Minhas, Natalia Pérez de la Ossa, Marta Rubiera, Laura Llull, Pedro Cardona, Fahad Al-Ajlan, María Hernández, Zarina Assis, Andrew M Demchuk, Tudor Jovin, Antoni Dávalos
BACKGROUND AND PURPOSE: Higher rates of target vessel patency at 24 hours were noted in the thrombectomy group compared with control group in recent randomized trials. As a prespecified secondary end point, we aimed to assess 24-hour revascularization rates by treatment groups and occlusion site as they related to clinical outcome and 24-hour infarct volume in REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset)...
March 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28285147/protective-roles-of-nanomelatonin-in-cerebral-ischemia-reperfusion-of-aged-brain-matrixmetalloproteinases-as-regulators
#14
Sibani Sarkar, Abhishek Mukherjee, Nirmalendu Das, Snehasikta Swarnakar
Cerebral ischemia-reperfusion (CIR) injury occurs as a result of oxygen occlusion in the carotid artery through embolus or thrombus formation or cerebrovascular hemorrhage. The oxygen thrust during reperfusion causes the generation of reactive oxidative species (ROS) which exert a potential threat to neuronal survival. ROS may possibly be arrested by antioxidants. After CIR, extracellular matrix remodeling takes place, which is governed by matrix metalloproteinases (MMPs). Augmentation of lipid per oxidation, perturbation of antioxidant enzyme activities and the loss of pyramidal neuronal cells in rat brain were attributed to CIR injury...
March 8, 2017: Experimental Gerontology
https://www.readbyqxmd.com/read/28284901/the-application-and-neuroprotective-mechanisms-of-cerebral-ischemic-post-conditioning-a-review
#15
REVIEW
Zhixing Li, Hanlin Chen, Jinglei Lv, Renliang Zhao
Ischemic stroke is a serious cerebrovascular disease that leads to death and/or severe disability, and extensive research has been directed in search of appropriate treatment measures. One such potential treatment is the use of cerebral ischemic post-conditioning (IPostC), and its neuroprotective effects and controllability have been widely confirmed and validated. Numerous studies have indicated that cerebral IPostC can suppress the inflammatory reaction in ischemia reperfusion injury, improve cerebral circulation, reduce infarct volume, and promote both neurogenesis and angiogenesis...
March 8, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28282456/early-computed-tomography-based-scores-to-predict-decompressive-hemicraniectomy-after-endovascular-therapy-in-acute-ischemic-stroke
#16
Ilko L Maier, Daniel Behme, Marlena Schnieder, Ioannis Tsogkas, Katharina Schregel, Mathias Bähr, Michael Knauth, Jan Liman, Marios-Nikos Psychogios
BACKGROUND: Identification of patients requiring decompressive hemicraniectomy (DH) after endovascular therapy (EVT) is crucial as clinical signs are not reliable and early DH has been shown to improve clinical outcome. The aim of our study was to identify imaging-based scores to predict the risk for space occupying ischemic stroke and DH. METHODS: Prospectively derived data from patients with acute large artery occlusion within the anterior circulation and EVT was analyzed in this monocentric study...
2017: PloS One
https://www.readbyqxmd.com/read/28279774/conscious-sedation-versus-general-anesthesia-for-the-treatment-of-cerebral-aneurysms-with-flow-diversion-a-matched-cohort-study
#17
Christoph J Griessenauer, Hussain Shallwani, Nimer Adeeb, Raghav Gupta, Leonardo Rangel-Castilla, Adnan H Siddiqui, Elad I Levy, Myles D Boone, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Flow diversion has become a popular treatment option for a variety of cerebral aneurysms. We sought to compare conscious sedation and general anesthesia for flow diverter placement in a matched cohort study. MATERIALS AND METHODS: Patients who underwent flow diverter placement under conscious sedation were matched on the basis of age, sex, American Society of Anesthesiologists (ASA) classification, aneurysm location, and aneurysm size with patients who received general anesthesia...
March 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28277907/the-effect-of-maternal-hyperoxygenation-on-fetal-circulatory-system-in-normal-growth-and-iugr-fetuses-what-we-can-learn-from-this-impact
#18
Nizar Khatib, Israel Thaler, Ron Beloosesky, Hanin Dabaja, Nadir Ganem, Philippe Abecassis, Yuval Ginsberg, Zeev Weiner
PURPOSE: The study aims were to assess and compare the effects of maternal hyperoxygenation on fetal circulation, in fetuses with intra-uterine growth retardation and normal fetal growth. METHODS: Twelve singleton pregnant women with normal fetal growth and twelve singleton pregnant women with intrauterine growth restriction were recruited. Mean gestational age of 35.2±3.5 and 34.7±3.9 weeks respectively. Doppler blood flow velocity waveforms were obtained from the middle cerebral artery, umbilical, main and proximal right pulmonary arteries...
March 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28268187/initial-arterial-carbon-dioxide-tension-is-associated-with-neurological-outcome-after-resuscitation-from-cardiac-arrest
#19
Molly L Tolins, Daniel J Henning, David F Gaieski, Anne V Grossestreuer, Alison Jaworski, Nicholas J Johnson
STUDY OBJECTIVES: To determine the relationships between partial pressure of arterial carbon dioxide (PaCO2), prescribed minute ventilation (MV), and neurologic outcome in patients resuscitated from cardiac arrest. METHODS: This was a retrospective cohort study utilizing a multicenter database of adult patients with return of spontaneous circulation (ROSC) after cardiac arrest. The primary outcome was neurologic status at hospital discharge, defined by Cerebral Performance Category (CPC) score: CPC 1-2 was favorable, CPC 3-5 was poor...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28267276/hyponatremia-in-children-with-acute-respiratory-infections-a-reappraisal
#20
REVIEW
Camilla Lavagno, Gregorio P Milani, Peter Uestuener, Giacomo D Simonetti, Carmen Casaulta, Mario G Bianchetti, Pietro B Fare, Sebastiano A G Lava
Hyponatremia (<135 mmol/L), typically associated with an elevated anti-diuretic hormone level, is common among children admitted with bronchiolitis, pneumonia, or pulmonary exacerbation of cystic fibrosis. The main consequences of acute hyponatremia include cerebral edema and Ayus-Arieff pulmonary edema. A widespread belief is that, in children with pneumonia or bronchiolitis, hyponatremia results from inappropriate anti-diuresis. By contrast, the pathogenic role of extracellular fluid volume depletion or decreased effective circulating blood volume is underscored...
March 7, 2017: Pediatric Pulmonology
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