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Cerebral circulation

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https://www.readbyqxmd.com/read/28937325/revascularization-of-the-upper-posterior-circulation-with-the-anterior-temporal-artery-an-anatomical-feasibility-study
#1
Ali Tayebi Meybodi, Michael T Lawton, Dylan Griswold, Pooneh Mokhtari, Andre Payman, Halima Tabani, Sonia Yousef, Arnau Benet
OBJECTIVE In various disease processes, including unclippable aneurysms, a bypass to the upper posterior circulation (UPC) including the superior cerebellar artery (SCA) and posterior cerebral artery (PCA) may be needed. Various revascularization options exist, but the role of intracranial (IC) donors has not been scrutinized. The objective of this study was to evaluate the anatomical feasibility of utilizing the anterior temporal artery (ATA) for revascularization of the UPC. METHODS ATA-SCA and ATA-PCA bypasses were performed on 14 cadaver specimens...
September 22, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28936822/-posterior-reversible-encephalopathy-syndrome-triggerred-by-alcohol-withdrawal
#2
Tuğçe Mengi, Yaprak Seçil, Aysel Çoban, Yeşim Beckmann
INTRODUCTION: Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity characterized by headache, altered mental status, epileptic seizures, visual disturbances and typically transient changes in posterior cerebral circulation areas. In this article, we present a case of alcohol withdrawal accompanied by PRES. CASE PRESENTATION: A 53-year-old male patient presented to the emergency department with visual hallucinations and meaningless speech...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28936085/twin-middle-cerebral-artery-with-aneurysm-a-variant-of-early-bifurcation-or-a-discrete-entity
#3
Sushant Sahoo, Sunil Singh, Anit Parihar
The middle cerebral artery (MCA) usually bifurcates into a superior or frontal and inferior or temporal branch. However, it may have various branching pattern, and there may be additional arteries from the anterior circulation supplying its territory. The majority of them remain asymptomatic. Some cases may have aneurismal dilatation due to turbulent blood flow or the weak arterial wall. The surgical approach in these cases may be challenging due to complex anatomical pattern of MCA. In this report, we have described a distinct pattern of left MCA with an aneurysm which was not clear in computed tomography angiogram and further confirmed on digital subtraction angiography...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28935624/the-brain-thermal-response-as-a-potential-neuroimaging-biomarker-of-cerebrovascular-impairment
#4
C C Fleischer, J Wu, D Qiu, S-E Park, F Nahab, S Dehkharghani
BACKGROUND AND PURPOSE: Brain temperature is critical for homeostasis, relating intimately to cerebral perfusion and metabolism. Cerebral thermometry is historically challenged by the cost and invasiveness of clinical and laboratory methodologies. We propose the use of noninvasive MR thermometry in patients with cerebrovascular disease, hypothesizing the presence of a measurable brain thermal response reflecting the tissue hemodynamic state. MATERIALS AND METHODS: Contemporaneous imaging and MR thermometry were performed in 10 patients (32-68 years of age) undergoing acetazolamide challenge for chronic, anterior circulation steno-occlusive disease...
September 21, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28935549/mini-pterional-and-supraorbital-keyhole-craniotomies-for-ruptured-anterior-circulation-aneurysms-experience-at-a-single-center
#5
Hoanh Tra, Trong Huynh, Ba Nguyen
A keyhole craniotomy is a type of pterional craniotomy that involves a minimally invasive approach for the treatment of cerebral aneurysms. Currently, the mini-pterional keyhole craniotomy (MPKC) and supraorbital keyhole craniotomy (SOKC) procedures are frequently performed. We evaluated the feasibility and safety of SOKCs and MPKCs for the clipping of ruptured intracranial aneurysms in the anterior cerebral circulation as an alternative to the pterional approach in a consecutive series of 25 patients. The rate of intraoperative aneurysmal rupture was 8% (2/25), and all ruptures were safely controlled...
September 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28928740/microbiome-derived-lipopolysaccharide-enriched-in-the-perinuclear-region-of-alzheimer-s-disease-brain
#6
Yuhai Zhao, Lin Cong, Vivian Jaber, Walter J Lukiw
Abundant clinical, epidemiological, imaging, genetic, molecular, and pathophysiological data together indicate that there occur an unusual inflammatory reaction and a disruption of the innate-immune signaling system in Alzheimer's disease (AD) brain. Despite many years of intense study, the origin and molecular mechanics of these AD-relevant pathogenic signals are still not well understood. Here, we provide evidence that an intensely pro-inflammatory bacterial lipopolysaccharide (LPS), part of a complex mixture of pro-inflammatory neurotoxins arising from abundant Gram-negative bacilli of the human gastrointestinal (GI) tract, are abundant in AD-affected brain neocortex and hippocampus...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28927919/results-of-conservative-follow-up-or-surgical-treatment-of-mayamoya-patients-who-present-without-hemorrhage-tia-or-stroke
#7
Rutao Luo, Faliang Gao, Xiaofeng Deng, Dong Zhang, Yan Zhang
OBJECTIVE: The epidemiology of asymptomatic Moyamoya disease (MMD) is still unclear, and the best management remains controversial. The aim of this study is to evaluate the prognosis of these patients with different management, conservative follow-up or surgical treatment. METHODS: This prospective cohort study screened a series of 696 consecutive MMD patients from 2009 to 2015. Patients with any episodes of hemorrhage and ischemic stroke or TIA were excluded. Finally, 61 patients who were followed up for at least 12 months were included, with 52 patients underwent surgical treatment and 9 patients underwent conservative follow-up...
September 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28927123/diagnosis-and-surgical-treatment-of-carotid-body-tumor-a-retrospective-analysis-of-58-patients
#8
Qingquan Hua, Zhen Xu, Yang Jiang
The aim of the present study was to illustrate the diagnosis and treatment of carotid body tumor (CBT) based on our experience of previous patients. A total of 58 patients (62 lesions) with CBT who received surgery between October 2003 and October 2013 were included. In total, 17 lesions were categorized into Shamblin grade I, 33 were grade II, and 12 were grade III. Surgical resection of CBT was performed for 52 lesions, resection of CBT and the external carotid artery was performed for 9 lesions, and resection of CBT and the internal carotid artery was performed for 1 lesion...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926839/visualization-of-culprit-perforators-in-anterolateral-pontine-infarction-high-resolution-magnetic-resonance-imaging-study
#9
Sang Hun Lee, Seung Chai Jung, Dong Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: The stroke mechanism for anterolateral pontine infarction (ALPI) is poorly understood. We aimed to investigate the perforator arteries relevant to ALPI using high-resolution MRI (HR-MRI). METHODS: Of 62 patients with ALPI who were admitted to the Asan Medical Center, 13 patients agreed to participate in this study. We used HR-MRI with a 3-Tesla scanner and assessed the perforating branches directly connected with the infarcted area. RESULTS: Perforating arteries penetrating ALPI were identified in all 13 patients...
September 19, 2017: European Neurology
https://www.readbyqxmd.com/read/28925890/the-use-of-hemodynamic-and-cerebral-monitoring-to-study-pharmacodynamics-in-neonates
#10
A Smits, L Thewissen, A Dereymaeker, E Dempsey, A Caicedo, Gunnar Naulaers
BACKGROUND: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. METHODS: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28925323/recanalization-reperfusion-and-recirculation-in-stroke
#11
John H Zhang, Andre Obenaus, David S Liebeskind, Jiping Tang, Richard Hartman, William J Pearce
Recirculation, from arterial inflow routes through venous outflow pathways, was conceptualized in stroke research 50 years ago. As new technologies were developed, blocked arteries could be reopened, capillaries could be reperfused, and the use of recanalization and reperfusion grew to dominate therapeutic strategies. These approaches overwhelmingly focused on restoration of arterial and capillary inflow, but not on veins even though venous disorders may initiate or exacerbate brain injury. In this commentary, we advance the term "recirculation" after "recanalization" and "reperfusion" as a primary concept of stroke pathophysiology that targets the restoration of both the arterial and venous cerebral circulations...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28920182/neovascularization-and-synaptic-function-regulation-with-memantine-and-rosuvastatin-in-a-rat-model-of-chronic-cerebral-hypoperfusion
#12
Nan Zhang, Chenchen Song, Baomin Zhao, Mengya Xing, Lanlan Luo, Marc L Gordon, Yan Cheng
Cerebral hypoperfusion is an important factor in the pathogenesis of cerebrovascular diseases and neurodegenerative disorders. We investigated the effects of memantine and rosuvastatin on both neovascularization and synaptic function in a rat model of chronic cerebral hypoperfusion, which was established by the bilateral common carotid occlusion (2VO) method. We tested learning and memory ability, synaptic function, circulating endothelial progenitor cell (EPC) number, expression of neurotrophic factors, and markers of neovasculogenesis and cell proliferation after memantine and/or rosuvastatin treatment...
September 17, 2017: Journal of Molecular Neuroscience: MN
https://www.readbyqxmd.com/read/28919314/24-hour-alberta-stroke-program-early-ct-score-assessment-in-post-stroke-spasticity-development-in-patients-with-a-first-documented-anterior-circulation-ischemic-stroke
#13
Ondrej Volny, Maria Justanova, Petra Cimflova, Linda Kasickova, Ivana Svobodova, Jan Muzik, Martin Bares
BACKGROUND: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. METHODS: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry)...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28913611/prospective-intraindividual-comparison-of-gadoterate-and-gadobutrol-for-cervical-and-intracranial-contrast-enhanced-magnetic-resonance-angiography
#14
Philip Hoelter, Stefan Lang, Marina Weibart, Manuel Schmidt, Michael F X Knott, Tobias Engelhorn, Marco Essig, Stephan Kloska, Arnd Doerfler
PURPOSE: Gadobutrol (GB) is reported to provide improved relaxivity and concentration compared to gadoterate (GT). This study was designed to intraindividually compare quantitative and qualitative enhancement characteristics of GB to GT in cervicocranial magnetic resonance angiography (MRA) of patients with cerebrovascular disease (CVD). METHODS: Patients (n = 54) with CVD underwent two identical contrast-enhanced magnetic resonance angiography (CE-MRA) examinations of the cervical and intracranial vasculature in randomized order, using GB and GT in equimolar dose...
September 14, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28912279/differences-in-morphologic-and-hemodynamic-characteristics-for-phases-based-intracranial-aneurysm-locations
#15
N Varble, H Rajabzadeh-Oghaz, J Wang, A Siddiqui, H Meng, A Mowla
BACKGROUND AND PURPOSE: Several recent prospective studies have found that unruptured intracranial aneurysms at various anatomic locations have different propensities for future rupture. This study aims to uncover the lack of understanding regarding rupture-prone characteristics, such as morphology and hemodynamic factors, associated with different intracranial aneurysm location. MATERIALS AND METHODS: We investigated the characteristics of 311 unruptured aneurysms at our center...
September 14, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28911510/long-term-prognostic-value-of-gasping-during-out-of-hospital-cardiac%C3%A2-arrest
#16
Guillaume Debaty, Jose Labarere, Ralph J Frascone, Marvin A Wayne, Robert A Swor, Brian D Mahoney, Robert M Domeier, Michael L Olinger, Brian J O'Neil, Demetris Yannopoulos, Tom P Aufderheide, Keith G Lurie
BACKGROUND: Gasping is a natural reflex that enhances oxygenation and circulation during cardiopulmonary resuscitation (CPR). OBJECTIVES: This study sought to assess the relationship between gasping during out-of-hospital cardiac arrest and 1-year survival with favorable neurological outcomes. METHODS: The authors prospectively collected incidence of gasping on all evaluable subjects in a multicenter, randomized, controlled, National Institutes of Health-funded out-of-hospital cardiac arrest clinical trial from August 2007 to July 2009...
September 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28904450/acute-ischemic-stroke-treatment-using-mechanical-thrombectomy-a-study-of-137-patients
#17
Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
BACKGROUND: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. METHODS: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28902813/-surgical-decision-making-during-treatment-of-a-patient-with-multifocal-atherosclerosis-based-on-intraoperative-epiaortic-scanning
#18
A V Marchenko, P A Mialiuk, A S Vronskiĭ
The article deals with a clinical case report regarding surgical management of a patient presenting with multifocal atherosclerosis. Taking into consideration critical stenoses of the anterior interventricular artery (80%) and circumflex artery (80%), as well as subocclusion of the left internal carotid artery and stenosis of the right internal carotid artery (60%), there were high risks for intraoperative cerebral circulation impairment. It was decided to perform a two-stage operation on the coronary and carotid beds...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28898484/pre-hospital-supraglottic-airway-was-associated-with-good-neurological-outcome-in-cardiac-arrest-victims-especially-who-received-prolonged-cardiopulmonary-resuscitation
#19
Min Ji Park, Woon Yong Kwon, Kyuseok Kim, Gil Joon Suh, Jonghwan Shin, You Hwan Jo, Kyung Su Kim, Hui Jai Lee, Joonghee Kim, Se Jong Lee, Jeong Yeon Kim, Jun Hwi Cho
INTRODUCTION: We performed this study to investigate the association of pre-hospital supraglottic airway (SGA) on neurological outcome in cardiac arrest victims with adjustment of post-resuscitation variables as well as pre-hospital and resuscitation variables. METHODS: This study was a retrospective study based on a multicenter prospective cohort registry from December 2013 to April 2016. According to the 28-day cerebral performance categories (CPC) scale, patients were divided into good outcome group (CPC 1-2) and poor outcome group (CPC 3-5)...
September 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28894887/-endovascular-thrombectomy-for-ischemic-stroke
#20
REVIEW
B Kallmünzer, M Köhrmann
The standard of care for patients with acute stroke of the anterior circulation and large vessel occlusion is the combined treatment with intravenous rt-PA (recombinant tissue-type plasminogen activator) and endovascular thrombectomy. The therapy is highly effective while reducing functional deficits and long-term disability. International guidelines recommend thrombectomy during the first 6 h after symptom onset, but new evidence supports its use in selected patients within a time window of up to 24 h...
September 11, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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