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White matter hypertensities

Esther M C van Leijsen, H Bea Kuiperij, Iris Kersten, Mayra I Bergkamp, Ingeborg W M van Uden, Hugo Vanderstichele, Erik Stoops, Jurgen A H R Claassen, Ewoud J van Dijk, Frank-Erik de Leeuw, Marcel M Verbeek
BACKGROUND AND PURPOSE: Cerebral small vessel disease (SVD) is a frequent pathology in aging and contributor to the development of dementia. Plasma Aβ (amyloid β) levels may be useful as early biomarker, but the role of plasma Aβ in SVD remains to be elucidated. We investigated the association of plasma Aβ levels with severity and progression of SVD markers. METHODS: We studied 487 participants from the RUN DMC study (Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort) of whom 258 participants underwent 3 MRI assessments during 9 years...
March 14, 2018: Stroke; a Journal of Cerebral Circulation
Eiichi Katada, Akira Mitsui, Shigeru Sasaki, Norihiko Uematsu, Chise Anan
A 44-year-old woman with advanced metastatic colon cancer received chemotherapies comprising XELOX, FOLFIRI/panitumumab and mFOLFOX6/bevacizumab. Fifteen months later, she presented with the acute onset of a headache, drowsiness and seizure with a fever and hypertension. Brain magnetic resonance imaging (MRI) indicated bilateral regions of signal hyperintensity in the white matter with spasms of bilateral cerebral arteries apparent on magnetic resonance angiography. Posterior reversible encephalopathy syndrome (PRES) was diagnosed, and treatments resulted in improvement of the MRI findings, but the patient experienced cerebral infarction and ultimately died of deterioration of cancer on day 26 after the onset of PRES...
March 9, 2018: Internal Medicine
Bian Liu, Kui Kai Lau, Linxin Li, Caroline Lovelock, Ming Liu, Wilhelm Kuker, Peter M Rothwell
BACKGROUND AND PURPOSE: It has been hypothesized that cerebral small vessel disease (SVD) and chronic renal impairment may be part of a multisystem small-vessel disorder, but their association may simply be as a result of shared risk factors (eg, hypertension) rather than to a systemic susceptibility to premature SVD. However, most previous studies were hospital based, most had inadequate adjustment for hypertension, many were confined to patients with lacunar stroke, and none stratified by age...
March 9, 2018: Stroke; a Journal of Cerebral Circulation
Iain D Croall, Daniel J Tozer, Barry Moynihan, Usman Khan, John T O'Brien, Robin G Morris, Victoria C Cambridge, Thomas R Barrick, Andrew M Blamire, Gary A Ford, Hugh S Markus
Importance: Blood pressure (BP) lowering is considered neuroprotective in patients with cerebral small vessel disease; however, more intensive regimens may increase cerebral hypoperfusion. This study examined the effect of standard vs intensive BP treatment on cerebral perfusion in patients with severe small vessel disease. Objective: To investigate whether standard vs intensive BP lowering over 3 months causes decreased cerebral perfusion in small vessel disease...
March 5, 2018: JAMA Neurology
Masato Ishibashi, Noriyuki Kimura, Yasuhiro Aso, Etsuro Matsubara
OBJECTIVE: To evaluate the effects of white matter lesions on regional cerebral blood flow in subjects with amnestic mild cognitive impairment. PATIENTS AND METHODS: Seventy-five subjects with mild cognitive impairment (36 men and 39 women; mean age, 78.1 years) were included in the study. We used the Mini-Mental State Examination to assess cognitive function. All subjects underwent brain magnetic resonance imaging and99m Tc ethylcysteinate dimer single photon emission computed tomography...
February 24, 2018: Clinical Neurology and Neurosurgery
Aurore Bussat, Maia Proisy, Bertrand Bruneau, Guillaume Bouzillé, Céline Chappé, Laurent Riffaud
OBJECTIVE Tumor-related edema of the optic tract (EOT) corresponds to a preferential posterior distribution of peritumoral edema along the white matter tract of the visual system. To date, the consequences of EOT have never been evaluated specifically in the pediatric population. In this study, the authors attempted to identify clinical and radiological features associated with the development of EOT and the specific influence of this edema on visual function. METHODS A retrospective review was performed of data collected from patients younger than 18 years who underwent surgery for a tumor in the sellar region at the authors' institution between January 2005 and January 2016...
March 2, 2018: Journal of Neurosurgery. Pediatrics
Linda K McEvoy, Christine Fennema-Notestine, Jeremy A Elman, Lisa T Eyler, Carol E Franz, Donald J Hagler, Sean N Hatton, Michael J Lyons, Matthew S Panizzon, Anders M Dale, William S Kremen
Heavy alcohol consumption is associated with deleterious changes in the brain but associations of moderate alcohol intake are not well understood. We examined the association of alcohol consumption with brain white matter health in 377 middle-aged men (56-66 years old; mean 61.8 ± 2.6 years) who were participants in the Vietnam Era Twin Study of Aging (VETSA). T1-, T2-, proton density-, and diffusion-weighted magnetic resonance images were obtained. Diffusion measures were quantified from 12 major white matter tracts...
2018: NeuroImage: Clinical
Yi Yang, Shihoko Kimura-Ohba, Jeffrey F Thompson, Victor M Salayandia, Melissa Cosse, Limor Raz, Fakhreya Y Jalal, Gary A Rosenberg
Vascular cognitive impairment is a major cause of dementia caused by chronic hypoxia, producing progressive damage to white matter (WM) secondary to blood-brain barrier (BBB) opening and vascular dysfunction. Tight junction proteins (TJPs), which maintain BBB integrity, are lost in acute ischemia. Although angiogenesis is critical for neurovascular remodeling, less is known about its role in chronic hypoxia. To study the impact of TJP degradation and angiogenesis during pathological progression of WM damage, we used the spontaneously hypertensive/stroke prone rats with unilateral carotid artery occlusion and Japanese permissive diet to model WM damage...
February 24, 2018: Neurobiology of Disease
Yang Liu, Yan-Hong Dong, Pei-Yuan Lyu, Wei-Hong Chen, Rui Li
Objective: Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment. Data Sources: We searched and scanned the PubMed database for recently published literatures up to December 2017...
March 5, 2018: Chinese Medical Journal
Oscar H Del Brutto, Robertino M Mera
INTRODUCTION: Recent guidelines suggest that a blood pressure cutoff of 130/80 mmHg should be used to define arterial hypertension. This contrasts with the previously accepted cutoff of 140/90 mmHg. AIM: Using the Atahualpa Project cohort, we aimed to assess the cutoff that better correlates with signatures of cerebral small vessel disease (SVD), which are related to arterial hypertension. METHODS: Of 437 Atahualpa residents aged ≥ 60 years, 363 (83%) underwent brain MRI and blood pressure determinations...
February 23, 2018: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
Takuya Kobayashi, Masafumi Kubota, Toshiyuki Takahashi, Ayaka Nakasato, Taro Nomura, Junichi Furuya, Hisatomo Kondo
PURPOSE: One of the most prominent issues in a super-aging society is the rapid increase in dementia patients. Cross-sectional studies in dentistry have indicated that patients with dementia have worse oral health compared to healthy people. The purpose of this study was to clarify the influence of tooth loss on brain structure by comparing the volumes of gray matter (GM) and white matter (WM) between edentulous and dentulous subjects. METHODS: Subjects were recruited from the Denture Clinic at Iwate Medical University Hospital Dental Center...
February 20, 2018: Journal of Prosthodontic Research
M Yigit, E Yigit, K A Turkdogan
Posterior reversible encephalopathy syndrome (PRES) is an entity characterized by headache, altered mental status, seizures, visual disturbances, and focal neurological signs. The most common etiologies of PRES are hypertension and renal failure, and the most frequent pathophysiology is hyperperfusion. PRES is generally symmetrical, often in the occipital and parietal lobes, and is typically characterized by vasogenic edema in the subcortical white matter. This study involves a 38-year-old female patient who had hypertension, used immunosuppressive drugs and was also found to have nephropathy...
February 2018: Nigerian Journal of Clinical Practice
Nathalie Thorin-Trescases, Olivia de Montgolfier, Anthony Pinçon, Adeline Raignault, Laurie Caland, Pauline Labbé, Eric Thorin
Aging is a modern concept: human life expectancy has more than doubled in less than 150 years in Western countries. Longer lifespan, however, reveals age-related diseases, including cerebrovascular diseases. The vascular system is a prime target of aging: the "wear and tear" of large elastic arteries exposed to a life-long pulsatile pressure causes arterial stiffening by fragmentation of elastin fibers and replacement by stiffer collagen. This arterial stiffening increases in return the amplitude of the pulse pressure (PP), its wave penetrating deeper into the microcirculation of low resistance, high flow organs such as the brain...
February 16, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Marcin Gruszecki, Magdalena K Nuckowska, Arkadiusz Szarmach, Marek Radkowski, Dominika Szalewska, Monika Waskow, Edyta Szurowska, Andrzej F Frydrychowski, Urszula Demkow, Pawel J Winklewski
In the cerebrospinal fluid (CSF) circulation, two components can be distinguished: bulk flow (circulation) and pulsatile flow (back and forth motion). CSF pulsatile flow is generated by both cardiac and respiratory cycles. Recent years have seen increased interest in cardiac and respiratory-driven CSF pulsatility as an important component of cerebral homeostasis. CSF pulsatility is affected by cerebral arterial inflow and jugular outflow and potentially linked to white matter abnormalities in various diseases, such as multiple sclerosis or hypertension...
February 13, 2018: Advances in Experimental Medicine and Biology
Mercedes Moreiras-Plaza, Francisco Fernández-Fleming, Naiara Azkárate-Ramírez, Walfred Nájera-de la Garza, Isabel Martín-Baez, Maria Hernansanz-Pérez
Posterior reversible encephalopathy syndrome is a clinical and radiological entity with acute or subacute neurological presentation associated with brain lesions that primarily affect the white matter of the posterior regions. It is often associated with the rapid onset of severe hypertension and/or with kidney failure (acute and chronic), but it has also been reported as a neurological complication in several medical conditions. In recent years, there has been an increase in the number of cases and related publications due to the advance of diagnostic imaging techniques...
February 3, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Eric E Smith, Alona Muzikansky, Cheryl R McCreary, Saima Batool, Anand Viswanathan, Bradford C Dickerson, Keith Johnson, Steven M Greenberg, Deborah Blacker
BACKGROUND: Hypertension is the strongest modifiable risk factor for subcortical ischemic changes and is also a risk factor for Alzheimer's dementia. We used neuroimaging to investigate the pathological basis of early cognitive symptoms in patients with hypertension. METHODS: In this cross-sectional cohort study 67 patients age >60 years with hypertension and Clinical Dementia Rating scale score of 0.5 without dementia, and without history of symptomatic stroke, underwent MRI for measurement of subcortical vascular changes and positron emission tomography (PET) scan with Pittsburgh Compound B (PiB-PET) to detect beta-amyloid deposition...
2018: PloS One
W Reith, A Haußmann
Virchow-Robin spaces are perivascular fluid-filled cavities that surround perforating arteries and veins in the brain parenchyma. As a rule in healthy people they are approximately 5 mm in diameter. Typical localizations are brainstem ganglia, mesencephalon and the white matter of the brain. Morphological imaging characteristics of Virchow-Robin spaces are round or tubular, smoothly bordered areas which are hyperintense in T2-weighted sequences. Virchow-Robin spaces represent a physiological structure in normal brain parenchyma...
January 26, 2018: Der Radiologe
Vignesh Gopalan, Adam Rennie, Fergus Robertson, Lakshmi Kanagarajah, Claire Toolis, Sanjay Bhate, Vijeya Ganesan
AIM: To describe presentation, clinical course, and outcome in postneonatal presentations of vein of Galen malformation (VGM). METHOD: Children older than 28 days presenting with VGM (from 2006-2016) were included. Notes/scans were reviewed. Outcome was dichotomized into 'good' or 'poor' using the Recovery and Recurrence Questionnaire. Logistic regression was performed to explore relationships between clinico-radiological features and outcome. RESULTS: Thirty-one children (18 males, 13 females) were included, presenting at a median age of 9...
January 23, 2018: Developmental Medicine and Child Neurology
Renske Uiterwijk, Julie Staals, Marjolein Huijts, Peter W de Leeuw, Abraham A Kroon, Robert J van Oostenbrugge
The Framingham Stroke Risk Profile (FSRP) was developed to predict clinical stroke. We investigated if FSRP is associated with more "silent" effects of cerebrovascular disease, namely progression of cerebral small vessel disease (cSVD)-related brain damage and cognitive performance in hypertensive patients. Ninety patients with essential hypertension underwent a brain MRI scan and FSRP assessment at baseline, and a second brain MRI scan and neuropsychological assessment at 9-year follow-up. We visually rated progression of cSVD-related MRI markers...
January 22, 2018: Journal of Clinical Hypertension
Fanny Herisson, Iris Zhou, Jerome Mawet, E Du, Arnavaz H Barfejani, Tao Qin, Marilyn J Cipolla, Philip Z Sun, Natalia S Rost, Cenk Ayata
Stroke-prone spontaneously hypertensive rats (SHRSP) on high-salt diet are characterized by extremely high arterial pressures, and have been endorsed as a model for hypertensive small vessel disease and vascular cognitive impairment. However, rapidly developing malignant hypertension is a well-known cause of posterior reversible encephalopathy syndrome (PRES) in humans, associated with acute neurological deficits, seizures, vasogenic cerebral edema and microhemorrhages. In this study, we aimed to examine the overlap between human PRES and SHRSP on high-salt diet...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
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