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White matter hypertensities

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https://www.readbyqxmd.com/read/28723880/prevalence-and-clinical-characteristics-of-white-coat-hypertension-based-on-different-definition-criteria-in-untreated-and-treated-patients
#1
Alejandro de la Sierra, Ernest Vinyoles, José R Banegas, Julián Segura, Manuel Gorostidi, Juan J de la Cruz, Luis M Ruilope
BACKGROUND AND AIM: The prevalence and associated risks of white-coat hypertension (WCH) are still a matter of debate. We aimed to assess differences in prevalence and associated conditions of WCH defined on the basis of the normality of all daytime, night-time, and 24-h blood pressure (BP), only daytime, or only 24-h BP. METHODS: We selected 115 708 patients (45 020 untreated and 70 688 treated) from the Spanish Ambulatory BP Monitoring Registry. WCH was estimated in patients with elevated office BP (≥140 and/or 90 mmHg) by using normal daytime (<135/85) BP, normal 24-h BP (<130/80), or normal daytime, night-time (<120/70) and 24-h BP...
July 18, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28697838/-hypertension-and-intermittent-convulsions-for-one-month-in-a-school-age-child
#2
Mao-Qiang Tian, Shu-Yi Liu, Juan Li, Xiao-Mei Shu
Childhood polyarteritis nodosa (PAN) is a rare systemic vasculitis and the delayed diagnosis and treatment will cause high incidence of sequelae and high mortality. This article reports a girl with childhood PAN due to posterior reversible encephalopathy syndrome (PRES). The girl aged ten years was admitted to the hospital due to hypertension and convulsions for one month. She had complaints of headache, vomiting, and blurred vision before convulsions. At six months before admission, a mass was observed in the neck...
July 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28681535/microbleeds-in-the-secondary-prevention-of-small-subcortical-strokes-trial-stroke-mortality-and-treatment-interactions
#3
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/28680884/white-matter-injury-and-recovery-after-hypertensive-intracerebral-hemorrhage
#4
REVIEW
Shilun Zuo, Pengyu Pan, Qiang Li, Yujie Chen, Hua Feng
Hypertensive intracerebral hemorrhage (ICH) could very probably trigger white matter injury in patients. Through the continuous study of white matter injury after hypertensive ICH, we achieve a more profound understanding of the pathophysiological mechanism of its occurrence and development. At the same time, we found a series of drugs and treatment methods for the white matter repair. In the current reality, the research paradigm of white matter injury after hypertensive ICH is relatively obsolete or incomplete, and there are still lots of deficiencies in the research...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28663254/blood-pressure-and-heart-rate-measures-associated-with-increased-risk-of-covert-brain-infarction-and-worsening-leukoaraiosis-in-older-adults
#5
Lester Y Leung, Traci M Bartz, Kenneth Rice, James Floyd, Bruce Psaty, Jose Gutierrez, W T Longstreth, Kenneth J Mukamal
OBJECTIVE: In people without previous stroke, covert findings on serial magnetic resonance imaging (MRI) of incident brain infarcts and worsening leukoaraiosis are associated with increased risk for ischemic stroke and dementia. We evaluated whether various measures of blood pressure (BP) and heart rate are associated with these MRI findings. APPROACH AND RESULTS: In the CHS (Cardiovascular Health Study), a longitudinal cohort study of older adults, we used relative risk regression to assess the associations of mean, variability, and trend in systolic BP, diastolic BP, and heart rate measured at 4 annual clinic visits between 2 brain MRIs with incident covert brain infarction and worsening white matter grade (using a 10-point scale to characterize leukoaraiosis)...
June 29, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28658309/microstructural-integrity-of-white-matter-tracts-amongst-older-fallers-a-dti-study
#6
Yoke Queen Wong, Li Kuo Tan, Pohchoo Seow, Maw Pin Tan, Khairul Azmi Abd Kadir, Anushya Vijayananthan, Norlisah Ramli
OBJECTIVES: This study assesses the whole brain microstructural integrity of white matter tracts (WMT) among older individuals with a history of falls compared to non-fallers. METHODS: 85 participants (43 fallers, 42 non-fallers) were evaluated with conventional MRI and diffusion tensor imaging (DTI) sequences of the brain. DTI metrics were obtained from selected WMT using tract-based spatial statistics (TBSS) method. This was followed by binary logistic regression to investigate the clinical variables that could act as confounding elements on the outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28648301/associations-of-early-kidney-disease-with-brain-magnetic-resonance-imaging-and-cognitive-function-in-african-americans-with-type-2-diabetes-mellitus
#7
Barry I Freedman, Kaycee M Sink, Christina E Hugenschmidt, Timothy M Hughes, Jeff D Williamson, Christopher T Whitlow, Nicholette D Palmer, Michael E Miller, Laura C Lovato, Jianzhao Xu, S Carrie Smith, Lenore J Launer, Joshua I Barzilay, Robert M Cohen, Mark D Sullivan, R Nick Bryan, Benjamin C Wagner, Donald W Bowden, Joseph A Maldjian, Jasmin Divers
BACKGROUND: Relationships between early kidney disease, neurocognitive function, and brain anatomy are poorly defined in African Americans with type 2 diabetes mellitus (T2DM). STUDY DESIGN: Cross-sectional associations were assessed between cerebral anatomy and cognitive performance with estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) in African Americans with T2DM. SETTING & PARTICIPANTS: African Americans with cognitive testing and cerebral magnetic resonance imaging (MRI) in the African American-Diabetes Heart Study Memory in Diabetes (AA-DHS MIND; n=512; 480 with MRI) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) MIND (n=484; 104 with MRI) studies...
June 22, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28617385/-differential-diagnosis-of-cerebral-autosomal-dominant-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy
#8
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/28608454/accelerated-atherosclerosis-in-anca-associated-vasculitis
#9
I González-Suárez, J J Ríos-Blanco, J Arpa
OBJECTIVES: Cardiovascular disease, including myocardial infarction and stroke, is a major cause of mortality in ANCA-associated vasculitis (AAV). Although AAV affects small vessels, an accelerated atherosclerosis not explained by traditional cardiovascular risk factors (CVRF) has been demonstrated. We aimed to investigate the association of atherosclerosis measured by carotid intima-media thickness (CIMT) and cerebral small vessel disease in AAV-patients. MATERIALS & METHODS: Twenty-three AAV-patients in complete remission were recruited...
June 12, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28606731/cognitive-function-and-kidney-disease-baseline-data-from-the%C3%A2-systolic-blood-pressure-intervention-trial-sprint
#10
Daniel E Weiner, Sarah A Gaussoin, John Nord, Alexander P Auchus, Gordon J Chelune, Michel Chonchol, Laura Coker, William E Haley, Anthony A Killeen, Paul L Kimmel, Alan J Lerner, Suzanne Oparil, Mohammad G Saklayen, Yelena M Slinin, Clinton B Wright, Jeff D Williamson, Manjula Kurella Tamura
BACKGROUND: Chronic kidney disease is common and is associated with cardiovascular disease, cerebrovascular disease, and cognitive function, although the nature of this relationship remains uncertain. STUDY DESIGN: Cross-sectional cohort using baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT). SETTING & PARTICIPANTS: Participants in SPRINT, a randomized clinical trial of blood pressure targets in older community-dwelling adults with cardiovascular disease, chronic kidney disease, or high cardiovascular disease risk and without diabetes or known stroke, who underwent detailed neurocognitive testing in the cognition substudy, SPRINT-Memory and Cognition in Decreased Hypertension (SPRINT-MIND)...
June 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28600443/prevalence-risk-factors-and-consequences-of-cerebral-small-vessel-diseases-data-from-three-asian-countries
#11
Saima Hilal, Vincent Mok, Young Chul Youn, Adrian Wong, Mohammad Kamran Ikram, Christopher Li-Hsian Chen
BACKGROUND: Cerebral small vessel disease (SVD) has been suggested to be more common in Asians compared with Caucasians. However, data from population-based studies in Asia are lacking. We report on the prevalence, risk factors and consequences of SVD from contemporary studies in three Asian countries using 3-Tesla MRI for the evaluation of SVD. METHODS: Clinical, cognitive and 3-Tesla brain MRI assessments were performed among participants of three studies from Singapore, Hong Kong and Korea...
August 2017: Journal of Neurology, Neurosurgery, and Psychiatry
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
#12
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/28575478/the-preservation-of-cognition-1-yr-after-carotid-endarterectomy-in-patients-with-prior-cognitive-decline
#13
Robert J Dempsey, Daren C Jackson, Stephanie M Wilbrand, Carol C Mitchell, Sara E Berman, Sterling C Johnson, Nirvedh H Meshram, Tomy Varghese, Bruce P Hermann
BACKGROUND: Vascular cognitive decline is critically important in the course of atherosclerosis and stroke. OBJECTIVE: To explore the hypothesis that carotid endarterectomy (CEA) by removing an unstable plaque may slow the course of vascular cognitive decline in both symptomatic and asymptomatic patients. METHODS: Patients with clinically significant (>60%) carotid stenosis were studied preop and 1 yr post-CEA for clinical symptoms, vascular cognitive decline, instability of carotid plaque-presence of microemboli, brain white matter changes, and medical risk factors...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28573058/uncommon-etiology-for-seizure-cerebral-hyperperfusion-syndrome
#14
Mohankumar Kurukumbi, Ahn Truong, Naghemeh Pirsaharkhiz
Cerebral hyperperfusion syndrome (CHS) is a rare life-threatening complication of carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery stenosis. The incidence varies between 0 and 3%, depending on the severity of the stenosis, perioperative hypertension, and contralateral carotid stenosis. This case report reports a 53-year-old female patient presenting with decreased alertness and multiple tonic-clonic seizures, in the background of bilateral CEA. She was found to have bilateral carotid stenosis...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28571231/central-variant-of-posterior-reversible-encephalopathy-syndrome-a-rare-case-report
#15
K G Srinivasan, Padhmini Balasubramanian, K R Mayilvaganan, Usha Nandhini Kannan, Mohamed Bilal
Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicoradiological condition associated with headache, altered mental status, dizziness and white matter vasogenic oedema in parieto-occipital region. It is often associated with hypertension but can also occur in diverse clinical settings like immunosuppression, eclampsia, etc. It is due to failure of autoregulatory mechanism of posterior circulation in response to change in blood pressure. We hereby report a rare case of central variant of PRES secondary to severe hypertension diagnosed with 3T MRI...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28559496/magnetic-resonance-imaging-of-cardiovascular-function-and-the-brain-is-dementia-a-cardiovascular-driven-disease
#16
REVIEW
Albert de Roos, Jeroen van der Grond, Gary Mitchell, Jos Westenberg
The proximal aorta acts as a coupling device between heart and brain perfusion, modulating the amount of pressure and flow pulsatility transmitted into the cerebral microcirculation. Stiffening of the proximal aorta is strongly associated with age and hypertension. The detrimental effects of aortic stiffening may result in brain damage as well as heart failure. The resulting cerebral small vessel disease and heart failure may contribute to early cognitive decline and (vascular) dementia. This pathophysiological sequence of events underscores the role of cardiovascular disease as a contributory mechanism in causing cognitive decline and dementia and potentially may provide a starting point for prevention and treatment...
May 30, 2017: Circulation
https://www.readbyqxmd.com/read/28555286/-management-of-arterial-hypertension
#17
J A Wermelt, H Schunkert
Arterial hypertension has a high prevalence and is a major risk factor for the development of cardiovascular diseases. It is a major contributor to worldwide morbidity and mortality and hence poses a huge socioeconomic burden. Despite great progress in perception, diagnosis and treatment of hypertension, blood pressure control is inadequate in less than half of the hypertensive patients (<140/90 mm Hg). The diagnosis of arterial hypertension starts in most patients with the conventional office blood pressure measurement...
May 29, 2017: Herz
https://www.readbyqxmd.com/read/28555103/blood-pressure-control-in-aging-predicts-cerebral-atrophy-related-to-small-vessel-white-matter-lesions
#18
Kyle C Kern, Clinton B Wright, Kaitlin L Bergfield, Megan C Fitzhugh, Kewei Chen, James R Moeller, Nooshin Nabizadeh, Mitchell S V Elkind, Ralph L Sacco, Yaakov Stern, Charles S DeCarli, Gene E Alexander
Cerebral small-vessel damage manifests as white matter hyperintensities and cerebral atrophy on brain MRI and is associated with aging, cognitive decline and dementia. We sought to examine the interrelationship of these imaging biomarkers and the influence of hypertension in older individuals. We used a multivariate spatial covariance neuroimaging technique to localize the effects of white matter lesion load on regional gray matter volume and assessed the role of blood pressure control, age and education on this relationship...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28554961/atrial-fibrillation-is-associated-with-anterior-predominant-white-matter-lesions-in-patients-presenting-with-embolic-stroke
#19
Yunis Mayasi, Johanna Helenius, David D McManus, Richard P Goddeau, Adalia H Jun-O'Connell, Majaz Moonis, Nils Henninger
OBJECTIVE: High white matter hyperintensity (WMH) burden is commonly found on brain MRI among patients with atrial fibrillation (AF). However, whether the link between AF and WMH extends beyond a common vascular risk factor profile is uncertain. We sought to determine whether AF relates to a distinct WMH lesion pattern which may suggest specific underlying pathophysiological relationships. METHODS: We retrospectively analysed a cohort of consecutive patients presenting with embolic stroke at an academic hospital and tertiary referral centre between March 2010 and March 2014...
May 27, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28523320/multifocal-and-multicentric-low-grade-oligoastrocytoma-in-a-young-patient
#20
Florin Grosu, Aurelian Ungureanu, Elettra Bianchi, Bianca Moscu, Liliana Coldea, Adrian LaurenŢiu Stupariu, Ionica Pirici, Carmen Corina Roman-Filip
Multiple primary central nervous system tumors are rarely seen in clinical practice and reported in the literature. The pathogenesis of multicentricity of primary tumors of the central nervous system still remains a debate, this pathology being found in almost two percent of reported tumor cases. Multifocal tumors are often described within the same hemisphere and supposed to be disseminated along the white matter tracts. On the opposite, multicentric tumors are found in the other hemisphere in subtentorial structures and are considered synchronous...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
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