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Ischemic malignant infarct

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https://www.readbyqxmd.com/read/28989934/takotsubo-cardiomyopathy-with-a-rapidly-resolved-left-ventricular-thrombus
#1
Abdel Anabtawi, Paola C Roldan, Carlos A Roldan
This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28963681/decompressive-craniectomy-icp-monitoring-and-secondary-necrosectomy-as-treatment-options-in-patients-presenting-with-malignant-ischemic-infarctions-extending-beyond-the-middle-cerebral-artery-territory
#2
EDITORIAL
https://www.readbyqxmd.com/read/28962946/mitochondrial-dna-common-deletion-in-post-fna-infarcted-oncocytic-thyroid-tumors
#3
Luca Conti, Simona Vatrano, Luca Bertero, Lavinia Masu, Donatella Pacchioni, Lorenzo Daniele, Giovanni De Rosa, Paola Cassoni, Marco Volante, Mauro Papotti
Thyroid fine needle aspiration (FNA) can rarely induce morphological changes potentially hindering the histopathological diagnosis, especially in Hurthle cell tumors (HCT), which may easily undergo post-FNA infarction or necrosis. HCTs contain mitochondrion (mt)-rich cells that may bear mtDNA mutations, the most frequent being the so-called "common deletion" (CD). The aim of this study was to determine the presence and extent of the mtDNA CD in a series of thyroid HCT that underwent extensive infarction following FNA procedure, in comparison with a control series of HCT lacking post-FNA ischemic/hemorrhagic alterations...
September 26, 2017: Human Pathology
https://www.readbyqxmd.com/read/28855390/tissue-selective-salvage-of-the-white-matter-by-successful-endovascular-stroke-therapy
#4
Justus F Kleine, Mirjam Kaesmacher, Benedikt Wiestler, Johannes Kaesmacher
BACKGROUND AND PURPOSE: White matter (WM) is less vulnerable to ischemia than gray matter. In ischemic stroke caused by acute large-vessel occlusion, successful recanalization might therefore sometimes selectively salvage the WM, leading to infarct patterns confined to gray matter. This study examines occurrence, determinants, and clinical significance of such effects. METHODS: Three hundred twenty-two patients with acute middle cerebral artery occlusion subjected to mechanical thrombectomy were included...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#5
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28798267/pretreatment-predictors-of-malignant-evolution-in-patients-with-ischemic-stroke-undergoing-mechanical-thrombectomy
#6
Alessandro Davoli, Caterina Motta, Giacomo Koch, Marina Diomedi, Simone Napolitano, Angela Giordano, Marta Panella, Daniele Morosetti, Sebastiano Fabiano, Roberto Floris, Roberto Gandini, Fabrizio Sallustio
BACKGROUND: Few data exist on malignant middle cerebral artery infarction (MMI) among patients with acute ischemic stroke (AIS) after endovascular treatment (ET). Numerous predictors of MMI evolution have been proposed, but a comprehensive research of patients undergoing ET has never been performed. Our purpose was to find a practical model to determine robust predictors of MMI in patients undergoing ET. METHODS: Patients from a prospective single-center database with AIS secondary to large intracranial vessel occlusion of the anterior circulation, treated with ET, were retrospectively analyzed...
August 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28790400/prediction-of-infarction-volume-and-infarction-growth-rate-in-acute-ischemic-stroke
#7
Saadat Kamran, Naveed Akhtar, Ayman Alboudi, Kainat Kamran, Arsalan Ahmad, Jihad Inshasi, Abdul Salam, Ashfaq Shuaib, Uvais Qidwai
The prediction of infarction volume after stroke onset depends on the shape of the growth dynamics of the infarction. To understand growth patterns that predict lesion volume changes, we studied currently available models described in literature and compared the models with Adaptive Neuro-Fuzzy Inference System [ANFIS], a method previously unused in the prediction of infarction growth and infarction volume (IV). We included 67 patients with malignant middle cerebral artery [MMCA] stroke who underwent decompressive hemicraniectomy...
August 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28746427/decompressive-craniotomy-for-the-treatment-of-malignant-infarction-of-the-middle-cerebral-artery-mortality-and-outcome
#8
Gianise Toboliski Bongiorni, Marjeane Cristina Jaques Hockmuller, Cristini Klein, Ápio Cláudio Martins Antunes
Objective: To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA) ischemic stroke, who underwent decompressive craniotomy (DC) within the first 30 days. Methods: A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period...
July 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28694110/predictors-of-in-hospital-mortality-after-decompressive-hemicraniectomy-for-malignant-ischemic-stroke
#9
Saadat Kamran, Abdul Salam, Naveed Akhtar, Aymen Alboudi, Arsalan Ahmad, Rabia Khan, Rashed Nazir, Muhammad Nadeem, Jihad Inshasi, Ahmed ElSotouhy, Ghanim Al Sulaiti, Ashfaq Shuaib
OBJECTIVE: The purpose of this retrospective multicenter, pooled-data analysis was to determine the factors associated with in-hospital mortality in decompressive hemicraniectomy (DHC) for malignant middle cerebral artery (MMCA) stroke. PATIENTS AND METHODS: The authors reviewed pooled DHC database from 3 countries for patients with MMCA with hospital mortality in spite of DHC to identify factors that predicted in-hospital mortality after DHC. The identified factors were applied to the group of patients who were selected for DHC but either refused surgery and died or stabilized and did not undergo DHC...
September 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28687640/early-imaging-prediction-of-malignant-cerebellar-edema-development-in-acute-ischemic-stroke
#10
Matthias P Fabritius, Kolja M Thierfelder, Felix G Meinel, Ahmed E Othman, Franziska Dorn, Bastian O Sabel, Pierre Scheffler, Birgit Ertl-Wagner, Wieland H Sommer, Wolfgang G Kunz
BACKGROUND AND PURPOSE: Malignant cerebellar edema (MCE) is a life-threatening complication of acute ischemic stroke that requires timely diagnosis and management. Aim of this study was to identify imaging predictors in initial multiparametric computed tomography (CT), including whole-brain CT perfusion (WB-CTP). METHODS: We consecutively selected all subjects with cerebellar ischemic WB-CTP deficits and follow-up-confirmed cerebellar infarction from an initial cohort of 2635 patients who had undergone multiparametric CT because of suspected stroke...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28545277/-effect-of-the-ischemic-post-conditioning-on-the-prevention-of-the-cardio-renal-damage-in-patients-with-acute-st-segment-elevation-myocardial-infarction-after-primary-percutaneous-coronary-intervention
#11
RANDOMIZED CONTROLLED TRIAL
Y Y Wang, T Li, Y W Liu, B J Liu, X M Hu, Y Wang, W Q Gao, P Wu, L Huang, X Li, W J Peng, M Ning
Objective: To evaluate the effect of the ischemic post-conditioning (IPC) on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI). Methods: A total of 251 consecutive STEMI patients underwent PPCI in the heart center of Tianjin Third Central Hospital from January 2012 to June 2014 were enrolled in this prospective, randomized, control, single-blinded, clinical registry study. Patients were randomly divided into IPC group (123 cases) and control group (128 cases) with random number table...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28518124/direct-re-implantation-of-left-coronary-artery-into-the-aorta-in-adults-with-anomalous-origin-of-left-coronary-artery-from-the-pulmonary-artery-alcapa
#12
Reza Tavakoli, Peiman Jamshidi, Nassrin Yamani, Max Gassmann
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly which is one of leading causes of myocardial ischemia and infarction in children. If left untreated, it results in a 90% mortality rate in the first year of life. In patients who survive to the adulthood, the coronary steal phenomenon and retrograde left-sided coronary flow provide a substrate for chronic subendocardial ischemia, which may lead to left ventricular dysfunction, ischemic mitral regurgitation, malignant ventricular arrhythmias, and sudden cardiac death...
April 24, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28446231/remote-ischemic-preconditioning-differentially-attenuates-post-ischemic-cardiac-arrhythmia-in-streptozotocin-induced-diabetic-versus-nondiabetic-rats
#13
Zhaoyang Hu, Mou Chen, Ping Zhang, Jin Liu, Geoffrey W Abbott
BACKGROUND: Sudden cardiac death (SCD), a leading cause of global mortality, most commonly arises from a substrate of cardiac ischemia, but requires an additional trigger. Diabetes mellitus (DM) predisposes to SCD even after adjusting for other DM-linked cardiovascular pathology such as coronary artery disease. We previously showed that remote liver ischemia preconditioning (RLIPC) is highly protective against cardiac ischemia reperfusion injury (IRI) linked ventricular arrhythmias and myocardial infarction, via induction of the cardioprotective RISK pathway, and specifically, inhibitory phosphorylation of GSK-3β (Ser 9)...
April 26, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28431614/permeability-surface-area-product-analysis-in-malignant-brain-edema-prediction-a-pilot-study
#14
O Volny, P Cimflova, T-Y Lee, B K Menon, C D d'Esterre
BACKGROUND AND PURPOSE: Using an extended CT perfusion acquisition (150s), we sought to determine the association between perfusion parameters and malignant edema after ischemic stroke. METHODS: Patients (from prospective study PROVE-IT, NCT02184936) with terminal internal carotid artery±proximal middle cerebral occlusion were involved. CTA was assessed for clot location and status of leptomeningeal collaterals. The following CTP parameters were calculated within the ischemic territory and contralaterally: permeability surface area product (PS), cerebral blood flow (CBF) and cerebral blood volume (CBV)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28359069/high-risk-of-seizures-and-epilepsy-after-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-stroke%C3%A2
#15
Rosane Brondani, Andrea Garcia de Almeida, Pedro Abrahim Cherubini, Suelen Mandelli Mota, Luiz Carlos de Alencastro, Apio Cláudio Martins Antunes, Marino Bianchin Muxfeldt
BACKGROUND: Decompressive hemicraniectomy (DHC) is a life-saving procedure for treatment of large malignant middle cerebral artery (MCA) strokes. Post-stroke epilepsy is an additional burden for these patients, but its incidence and the risk factors for its development have been poorly investigated. OBJECTIVE: To report the prevalence and risk factors for post-stroke seizures and post-stroke epilepsy after DHC for treatment of large malignant MCA strokes in a cohort of 36 patients...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28353064/radiological-imaging-features-of-the-basal-ganglia-that-may-predict-progression-to-hemicraniectomy-in-large-territory-middle-cerebral-artery-infarct
#16
Asim Z Mian, David Edasery, Osamu Sakai, M Mustafa Qureshi, James Holsapple, Thanh Nguyen
PURPOSE: Predicting which patients are at risk for hemicraniectomy can be helpful for triage and can help preserve neurologic function if detected early. We evaluated basal ganglia imaging predictors for early hemicraniectomy in patients with large territory anterior circulation infarct. METHODS: This retrospective study evaluated patients with ischemic infarct admitted from January 2005 to July 2011. Patients with malignant cerebral edema refractory to medical therapy or with herniating signs such as depressed level of consciousness, anisocoria, and contralateral leg weakness were triaged to hemicraniectomy...
May 2017: Neuroradiology
https://www.readbyqxmd.com/read/28247043/identifying-ischemic-stroke-associated-with-cancer-a-multiple-model-derived-from-a-case-control-analysis
#17
Rebecca Kassubek, Lars Bullinger, Jan Kassubek, Jens Dreyhaupt, Albert C Ludolph, Katharina Althaus, Jan Lewerenz
Ischemic stroke in patients with cancer is thought to be associated with a worse prognosis and might be the initial symptom of an unknown malignancy. However, diagnostic algorithms to reliably identify cancer-associated stroke have not been developed. In this retrospective single-centre analysis, 68 patients with ischemic stroke and an active solid malignancy were identified. Neurological assessment and outcome, cardiovascular risk factors, neuroimaging studies as well as laboratory findings were compared to 68 age- and sex-matched control subjects with ischemic stroke without diagnosis of cancer...
April 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28192386/spectrum-of-magnetic-resonance-imaging-features-in-unilateral-optic-tract-dysfunction
#18
Kristopher M Kowal, Francisco F Rivas Rodriguez, Ashok Srinivasan, Jonathan D Trobe
BACKGROUND: Optic tract dysfunction may be the predominant or only clinical manifestation of an intracranial disorder including mass legion, ischemic infarct, inflammatory disease, and trauma. Documentation of the neuroimaging features of these lesions is limited to reports mostly published before the availability of MRI. This study was undertaken to document the spectrum of MRI features in patients presenting with optic tract dysfunction. METHODS: A retrospective study from 2004 to 2015 at a single tertiary care neuro-ophthalmology service of 24 patients who had unilateral optic tract dysfunction defined by a homonymous hemianopia and a relative afferent pupil defect that could not be attributed to optic neuropathy or retinopathy...
March 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28088349/stroke-biomarkers-in-clinical-practice-a-critical-appraisal
#19
REVIEW
Geelyn J L Ng, Amy M L Quek, Christine Cheung, Thiruma V Arumugam, Raymond C S Seet
Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described...
July 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28068417/preserved-collateral-blood-flow-in-the-endovascular-m2cao-model-allows-for-clinically-relevant-profiling-of-injury-progression-in-acute-ischemic-stroke
#20
Philip Little, Ola Kvist, Rikard Grankvist, Stefan Jonsson, Peter Damberg, Michael Söderman, Fabian Arnberg, Staffan Holmin
Interventional treatment regimens have increased the demand for accurate understanding of the progression of injury in acute ischemic stroke. However, conventional animal models severely inhibit collateral blood flow and mimic the malignant infarction profile not suitable for treatment. The aim of this study was to provide a clinically relevant profile of the emergence and course of ischemic injury in cases suitable for acute intervention, and was achieved by employing a M2 occlusion model (M2CAO) that more accurately simulates middle cerebral artery (MCA) occlusion in humans...
2017: PloS One
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