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https://www.readbyqxmd.com/read/28727355/-perfusion-imaging-of-acute-ischemic-stroke
#1
Carlo W Cereda, Patrik Michel, Karl-Olof Lovblad, Emmanuel Carrera
Multi-modal imaging in acute ischemic stroke includes structural imaging, perfusion imaging and angiographic assessment of brain arteries. Perfusion imaging discriminates brain tissue that is critically hypo-perfused but salvageable (ischemic penumbra) from irreversibly injured tissue (ischemic core). In acute reperfusion therapies (intravenous or endovascular), patients who have substantial penumbra and a small core (target mismatch pattern) are most likely to have a good clinical outcome. Patient selection based on multi-modal imaging is not proven mandatory for acute treatment in patients admitted within the established time-window...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727192/current-evidence-for-endovascular-therapy-in-stroke-and-remaining-uncertainties-r1
#2
REVIEW
Ronan Motyer, Hamed Asadi, John Thornton, Patrick Nicholson, Hong Kuan Kok
Class 1 level A evidence now supports endovascular thrombectomy as best practice in the management of large vessel occlusion acute ischemic stroke. However, significant questions pertaining to initial imaging, radiological assessment, patient selection and therapeutic limits remain unanswered. A specific cohort of patients who benefit from endovascular thrombectomy has been established, although current uncertainties regarding selection of those not meeting top-tier evidence criteria may potentially deny certain patients the benefit of intervention...
July 20, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28726587/repair-of-tympanic-membrane-perforations-with-customized-bioprinted-ear-grafts-using-chinchilla-models
#3
Che-Ying Kuo, Emmanuel Wilson, Andrew Fuson, Nidhi Gandhi, Reza Monfaredi, Audrey Jenkins, Maria Romero, Marco Santoro, John P Fisher, Kevin Cleary, Brian Reilly
The goal of this work is to develop an innovative method that combines bioprinting and endoscopic imaging to repair tympanic membrane perforations (TMPs). TMPs are a serious health issue because they can lead to both conductive hearing loss and repeated otitis media. TMPs occur in 3 to 5% of cases after ear tube placement as well as in cases of acute otitis media (the second most common infection in pediatrics), chronic otitis media with or without cholesteatoma, or as a result of barotrauma to the ear. About 55,000 tympanoplasties, the surgery performed to reconstruct TMPs, are performed every year and the commonly used cartilage grafting technique has a success rate between 43% to 100%...
July 20, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28726122/beta-ketothiolase-deficiency-presenting-with-metabolic-stroke-after-a-normal-newborn-screen-in-two-individuals
#4
Monica H Wojcik, Klaas J Wierenga, Lance H Rodan, Inderneel Sahai, Sacha Ferdinandusse, Casie A Genetti, Meghan C Towne, Roy W A Peake, Philip M James, Alan H Beggs, Catherine A Brownstein, Gerard T Berry, Pankaj B Agrawal
Beta-ketothiolase (mitochondrial acetoacetyl-CoA thiolase) deficiency is a genetic disorder characterized by impaired isoleucine catabolism and ketone body utilization that predisposes to episodic ketoacidosis. It results from biallelic pathogenic variants in the ACAT1 gene, encoding mitochondrial beta-ketothiolase. We report two cases of beta-ketothiolase deficiency presenting with acute ketoacidosis and "metabolic stroke." The first patient presented at 28 months of age with metabolic acidosis and pallidal stroke in the setting of a febrile gastrointestinal illness...
July 20, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28725199/heart-performance-determination-by-visualization-in-larval-fishes-influence-of-alternative-models-for-heart-shape-and-volume
#5
Prescilla Perrichon, Martin Grosell, Warren W Burggren
Understanding cardiac function in developing larval fishes is crucial for assessing their physiological condition and overall health. Cardiac output measurements in transparent fish larvae and other vertebrates have long been made by analyzing videos of the beating heart, and modeling this structure using a conventional simple prolate spheroid shape model. However, the larval fish heart changes shape during early development and subsequent maturation, but no consideration has been made of the effect of different heart geometries on cardiac output estimation...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28724315/persistent-atrial-fibrillation-vs-paroxysmal-atrial-fibrillation-differences-in-management
#6
Andrei D Margulescu, Lluis Mont Girbau
Atrial fibrillation (AF) is the most common human arrhythmia. AF is a progressive disease, initially being nonsustained and induced by trigger activity, and progressing towards persistent AF through alteration of the atrial myocardial substrate. Treatment of AF aims to decrease the risk of stroke and improve the quality of life, by preventing recurrences (rhythm control) or controlling the heart rate during AF (rate control). In the last 20 years, catheter-based and, less frequently, surgical and hybrid ablation techniques have proven more successful compared with drug therapy in achieving rhythm control in patients with AF...
July 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28724035/spontaneous-carotid-dissection
#7
Carolina Dutra Queiroz Flumignan, Ronald Luiz Gomes Flumignan, Luis Carlos Uta Nakano, Jorge Eduardo de Amorim
Carotid dissection is a rare occurrence but it is the main cause of stroke in individuals aged less than 45 years, and can be the etiology in up to 25% of strokes in young adults. We report a case with classic image of ying yang on vascular ultrasound, which was treated according to the best available medical evidence, yielding a favorable outcome.
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28723787/late-emergence-of-macular-sparing-in-a-stroke-patient-clinical-case-report
#8
Hye-Young Shin, So Hee Kim, Mee Yon Lee, Su Young Kim, Young Chun Lee
RATIONALE: Occlusive cerebrovascular disease is the most common cause of homonymous hemianopia (HH) with macular sparing. PATIENT CONCERNS: A 61-year-old man came to our ophthalmology clinic complaining of right-side hemianopia. Ophthalmic examination, visual field (VF) examination, and brain magnetic resonance imaging (MRI) were performed. DIAGNOSES: He had right HH without macular sparing on the initial VF test. And brain MRI 6 days after the visual symptoms began revealed a left occipital infarction...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28722247/left-ventricular-function-and-regional-strain-with-subtly-tagged-steady-state-free-precession-feature-tracking
#9
Eric M Schrauben, Brett R Cowan, Andreas Greiser, Alistair A Young
PURPOSE: To provide regional strain and ventricular volume from a single acquisition, using subtly tagged steady-state free precession (SubTag SSFP) feature tracking. MATERIALS AND METHODS: The effects on regional strain of tag strength in gradient recalled echo (GRE) tagging, flip angle in untagged balanced SSFP, and both in SubTag SSFP were examined in the mid left ventricle of 15 healthy volunteers at 3T. Optimal parameters were determined from varying both tag strength and SSFP flip angle using full tag saturation GRE as the reference standard...
July 19, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28722240/an-mri-hyperintense-acute-reperfusion-marker-is-related-to-elevated-peripheral-monocyte-count-in-acute-ischemic-stroke
#10
Zurab Nadareishvili, Marie Luby, Richard Leigh, Jignesh Shah, John K Lynch, Amie W Hsia, Richard T Benson, Lawrence L Latour
BACKGROUND AND PURPOSE: Blood-brain barrier (BBB) disruption detected on magnetic resonance imaging (MRI) in acute ischemic stroke as a hyperintense acute reperfusion marker (HARM) is associated with upregulation of matrix metalloproteinase-9 (MMP-9). Although activated leukocytes, including monocytes, are the main source of MMPs, limited data exist to support relationship between leukocyte activation and BBB disruption in patients with acute ischemic stroke. The goal of this study is to investigate the relationship between neutrophils, lymphocytes, and monocytes with BBB disruption detected as HARM (+) in patients with acute ischemic stroke...
July 19, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28721356/targeted-ischemic-stroke-induction-and-mesoscopic-imaging-assessment-of-blood-flow-and-ischemic-depolarization-in-awake-mice
#11
Matilde Balbi, Matthieu P Vanni, Gergely Silasi, Yuki Sekino, Luis Bolanos, Jeffrey M LeDue, Timothy H Murphy
Despite advances in experimental stroke models, confounding factors such as anesthetics used during stroke induction remain. Furthermore, imaging of blood flow during stroke is not routinely done. We take advantage of in vivo bihemispheric transcranial windows for longitudinal mesoscopic imaging of cortical function to establish a protocol for focal ischemic stroke induction in target brain regions using photothrombosis in awake head-fixed mice. Our protocol does not require any surgical steps at the time of stroke induction or anesthetics during either head fixation or photoactivation...
July 2017: Neurophotonics
https://www.readbyqxmd.com/read/28720981/cerebral-reorganization-in-subacute-stroke-survivors-after-virtual-reality-based-training-a-preliminary-study
#12
Xiang Xiao, Qiang Lin, Wai-Leung Lo, Yu-Rong Mao, Xin-Chong Shi, Ryan S Cates, Shu-Feng Zhou, Dong-Feng Huang, Le Li
BACKGROUND: Functional magnetic resonance imaging (fMRI) is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET) training in subacute stroke survivors. METHODS: Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28720119/calcified-amorphous-tumor-of-the-heart-with-mitral-annular-calcification-a-case-report
#13
Ryo Nakamaru, Hiroki Oe, Katsuomi Iwakura, Takafumi Masai, Kenshi Fujii
BACKGROUND: Calcified amorphous tumor of the heart is a rare, non-neoplastic cardiac mass characterized by nodular calcium in the background of amorphous degenerating fibrinous material. Clinical diagnosis of calcified amorphous tumor can be difficult, and current single imaging techniques do not specifically differentiate calcified amorphous tumor from other cardiac tumors such as calcified atrial myxoma, calcified thrombi, or vegetation. Complete surgical resection is the treatment of choice for both symptom improvement and prevention of embolization, as well as for pathological diagnosis...
July 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28718666/atrial-cardiopathy-a-mechanism-of-cryptogenic-stroke
#14
Shadi Yaghi, Hooman Kamel, Mitchell S V Elkind
Cryptogenic stroke accounts for approximately 30% of all ischemic strokes. Recently, atrial cardiopathy diagnosed by the presence of one of its serum, imaging, or electrocardiogram biomarkers has been shown to be associated with ischemic stroke, particularly of embolic subtypes. Areas covered: This paper aims to summarize data on occult atrial fibrillation and stroke, provide an overview on mechanisms, such as inflammation and fibrosis, of stroke in atrial cardiopathy, critically review data on biomarkers of atrial cardiopathy and their association with stroke, and suggest therapeutic implications, including directions for future research...
July 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28718616/photo-thermally-driven-refreshable-microactuators-based-on-graphene-oxide-doped-paraffin
#15
Sichao Hou, Miao Wang, Shouwu Guo, Ming Su
Actuators based on phase change materials (paraffin) can simultaneously produce large stroke length and large force due to thermal expansion, but the low thermal conductivity of paraffin requires high power input and long actuation time. The graphene oxide (GO) doped paraffin dynamic actuator addresses the key challenges in the design of thermal phase change actuators: Thermal conductivity and light absorbing is increased and the response time is reduced compared to the standard phase change actuator designed with metal heating resistors...
July 18, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28717939/neonatal-stroke-and-haematuria-answers
#16
Sally Kellett, Mathieu Lemaire, Steven P Miller, Christoph Licht, Grace Yoon, Nomazulu Dlamini, Damien Noone
BACKGROUND: This is a report of an infant born near term with neonatal stroke and haematuria. The renal phenotype, pathogenic genotype and pathological findings on renal biopsy are discussed. CASE-DIAGNOSIS: Prenatal magnetic resonance imaging revealed anomalies which persisted postnatally. Haematuria was detected during follow-up. The posttnatal renal ultrasound scan was normal, and there was no associated proteinuria. A likely pathogenic genetic mutation was detected...
July 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28717936/neonatal-stroke-and-haematuria-questions
#17
Sally Kellett, Mathieu Lemaire, Steven P Miller, Christoph Licht, Grace Yoon, Nomazulu Dlamini, Damien Noone
This is a report of an infant born near term with neonatal stroke and haematuria. Changes were noted on foetal magnetic resonance images, and these persisted postnatally. A routine renal ultrasound scan during follow-up detected haematuria with no associated proteinuria. A likely pathogenic genetic mutation was identified. This case highlights a relatively newly discovered cause for hereditary nephropathy affecting the basement membrane, initially affecting the glomerular but later the renal tubular basement membranes...
July 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28717354/blood-pressure-and-penumbral-sustenance-in-stroke-from-large-vessel-occlusion
#18
REVIEW
Robert W Regenhardt, Alvin S Das, Christopher J Stapleton, Ronil V Chandra, James D Rabinov, Aman B Patel, Joshua A Hirsch, Thabele M Leslie-Mazwi
The global burden of stroke remains high, and of the various subtypes of stroke, large vessel occlusions (LVOs) account for the largest proportion of stroke-related death and disability. Several randomized controlled trials in 2015 changed the landscape of stroke care worldwide, with endovascular thrombectomy (ET) now the standard of care for all eligible patients. With the proven success of this therapy, there is a renewed focus on penumbral sustenance. In this review, we describe the ischemic penumbra, collateral circulation, autoregulation, and imaging assessment of the penumbra...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28717091/thrombolysis-related-multiple-lobar-hemorrhaging-in-cerebral-amyloid-angiopathy-with-extensive-strictly-lobar-cerebral-microbleeding
#19
Makoto Eriguchi, Yusuke Yakushiji, Jun Tanaka, Masashi Nishihara, Hideo Hara
A hemi-paralyzed 86-year-old man was diagnosed with ischemic stroke and underwent thrombolysis. Pre-thrombolysis brain magnetic resonance imaging revealed extensive strictly lobar cerebral microbleeding (CMB). Post-thrombolytic computed tomography revealed asymptomatic multiple intracerebral hemorrhaging (ICH). His age, CMB topography, and decreased cerebral spinal fluid amyloid-β 40 and 42 levels were compatible with a diagnosis of cerebral amyloid angiopathy (CAA). There is no consensus on the safety of thrombolysis for acute stroke patients with CAA...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28716981/prediction-of-clinical-outcome-after-acute-ischemic-stroke-the-value-of-repeated-noncontrast-computed-tomography-computed-tomographic-angiography-and-computed-tomographic-perfusion
#20
Jan W Dankbaar, Alexander D Horsch, Andor F van den Hoven, L Jaap Kappelle, Irene C van der Schaaf, Tom van Seeters, Birgitta K Velthuis
BACKGROUND AND PURPOSE: Early prediction of outcome in acute ischemic stroke is important for clinical management. This study aimed to compare the relationship between early follow-up multimodality computed tomographic (CT) imaging and clinical outcome at 90 days in a large multicenter stroke study. METHODS: From the DUST study (Dutch Acute Stroke Study), patients were selected with (1) anterior circulation occlusion on CT angiography (CTA) and ischemic deficit on CT perfusion (CTP) on admission, and (2) day 3 follow-up noncontrast CT, CTP, and CTA...
July 17, 2017: Stroke; a Journal of Cerebral Circulation
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