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Umit Kervan, Sinan Sabit Kocabeyoglu, Dogan Emre Sert, Emre Aygün, Kemal Kavasoglu, Mehmet Karahan, Ertekin Utku Unal, Mustafa Pac
OBJECTIVES: The common femoral artery is the standard site for immediate vascular access when initiating adult venoarterial extracorporeal membrane oxygenation. However, this approach is fraught with problems such as femoral artery occlusion, distal limb ischemia, reperfusion injury resulting in compartment syndrome, retroperitoneal hemorrhage, thrombosis, embolization, and most importantly, pulmonary edema. Here, we show our preference of using the subclavian artery with a side graft as a different cannulation technique for outflow of extracorporeal membrane oxygenation, which can avoid complications associated with different access techniques...
October 14, 2016: Experimental and Clinical Transplantation
Hidehito Kimura, Masaaki Taniguchi, Tatsuya Mori, Kohkichi Hosoda, Eiji Kohmura
We present a rare case of a patient suffering temporary aphasia after an extracranial-to-intracranial (EC-IC) bypass surgery, which was shown as a transient hypointense lesion on diffusion-weighted imaging (DWI) with increased apparent diffusion coefficient (ADC) value, evidence of postoperative hyperperfusion. Postoperative hyperperfusion syndrome after EC-IC bypass causing temporary neurological deterioration has been reported rarely as isosignal intensity on DWI with hyperintense lesion on T2-weighted image and fluid-attenuated inversion recovery (FLAIR) image as an expression of vasogenic edema...
October 14, 2016: World Neurosurgery
A Venkatraman, A Khawaja, A K Bag, M Mirza, J P Szaflarski, S Pati
Lateralized Periodic Discharges (LPDs) are commonly seen on EEG in critically-ill patients. They are often associated with seizures, but some patients may have them without seizures. Therefore, they are considered to lie in the ictal-interictal continuum. When ictal, they require multiple antiepileptic drugs to treat effectively, which can expose the patient to iatrogenic complications. Therefore, optimal management is controversial. We present here two cases where perfusion-weighted Magnetic Resonance Imaging (pMRI) was useful in distinguishing ictal from interictal LPDs...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Chia-Ju Liu, Hsin-Hsi Tsai, Kuan-Yin Ko, Ching-Chu Lu, Ruoh-Fang Yen
A 68-year-old man with diabetes mellitus type 2 presented himself with visual distortion and apraxia. Nonketotic hyperglycemic seizure with both motor and sensory components was suspected. Tc-ECD perfusion SPECT demonstrated hyperperfusion at right parieto-occipital lobe during ictal phase. Normalization of hyperperfused area was noted on follow-up perfusion SPECT after intense glucose control. In nonketotic hyperglycemic state, the depletion of GABA in cerebral neurons lowers the seizure threshold. We demonstrated that ictal phase perfusion SPECT contributed to not only diagnosis but also served as a follow-up tool...
October 5, 2016: Clinical Nuclear Medicine
Dao P Zhang, Hong T Zhang, Suo Yin, Fu L Yan
This series case report aimed to elucidate the underlying pathology and outcomes of lateral medullary infarction (LMI) using perfusion weighted imaging (PWI). Four patients were diagnosed with LMI based on high-field diffusion-weighted magnetic resonance imaging (MRI-DWI) and PWI. The national institutes of health stroke scale (NIHSS) scores were recorded on days 1, 7, and 30, and the Barthel index was assessed on days 7 and 30. Three patients exhibited relative regional hypoperfusion of medullary lesion in the perfusion maps...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Yash V Tiwari, Jianfei Lu, Qiang Shen, Bianca Cerqueira, Timothy Q Duong
Diffusion-weighted arterial spin labeling magnetic resonance imaging has recently been proposed to quantify the rate of water exchange (Kw) across the blood-brain barrier in humans. This study aimed to evaluate the blood-brain barrier disruption in transient (60 min) ischemic stroke using Kw magnetic resonance imaging with cross-validation by dynamic contrast-enhanced magnetic resonance imaging and Evans blue histology in the same rats. The major findings were: (i) at 90 min after stroke (30 min after reperfusion), group Kw magnetic resonance imaging data showed no significant blood-brain barrier permeability changes, although a few animals showed slightly abnormal Kw Dynamic contrast-enhanced magnetic resonance imaging confirmed this finding in the same animals...
October 14, 2016: Journal of Cerebral Blood Flow and Metabolism
Sebastian Walther, Lea Schäppi, Andrea Federspiel, Stephan Bohlhalter, Roland Wiest, Werner Strik, Katharina Stegmayer
Catatonia is a psychomotor syndrome that not only frequently occurs in the context of schizophrenia but also in other conditions. The neural correlates of catatonia remain unclear due to small-sized studies. We therefore compared resting-state cerebral blood flow (rCBF) and gray matter (GM) density between schizophrenia patients with current catatonia and without catatonia and healthy controls. We included 42 schizophrenia patients and 41 controls. Catatonia was currently present in 15 patients (scoring >2 items on the Bush Francis Catatonia Rating Scale screening)...
October 11, 2016: Schizophrenia Bulletin
Grace J Wang, Adam W Beck, Randall R DeMartino, Philip P Goodney, Caron B Rockman, Ronald M Fairman
BACKGROUND: Cerebral hyperperfusion syndrome (CHS), characterized by severe ipsilateral headache, seizures, and intracranial hemorrhage, is a rare, poorly understood complication that can be fatal following carotid endarterectomy (CEA). The purpose of the study was to determine the factors associated with CHS as captured in the Vascular Quality Initiative. METHODS: Analysis was conducted on 51,001 procedures captured from the CEA module of the Vascular Quality Initiative from 2003 to 2015...
October 1, 2016: Journal of Vascular Surgery
Paul Pang, Molly Abbott, Steven L Chang, Malyun Abdi, Nikita Chauhan, Murti Mistri, Joshua Ghofrani, Quynh-Anh Fucci, Colleen Walker, Corey Leonardi, Samuel Grady, Arvin Halim, Ryan Hoffman, Tzongshi Lu, Huixia Cao, Stefan G Tullius, Sayeed Malek, Sanjaya Kumar, Graeme Steele, Adam Kibel, Benjamin S Freedman, Sushrut S Waikar, Andrew M Siedlecki
Vascular progenitor cells show promise for the treatment of microvasculature endothelial injury. We investigated the function of renal artery progenitor cells derived from radical nephrectomy patients, in animal models of acute ischemic and hyperperfusion injuries. Present in human adventitia, CD34positive/CD105negative cells were clonal and expressed transcription factors Sox2/Oct4 as well as surface markers CXCR4 (CD184)/KDR(CD309) consistent with endothelial progenitor cells. Termed renal artery-derived vascular progenitor cells (RAPC), injected cells were associated with decreased serum creatinine after ischemia/reperfusion, reduced albuminuria after hyperperfusion, and improved blood flow in both models...
September 29, 2016: Kidney International
Na-Rae Yang, Pyoung Jeon, Byungjun Kim, Keon Ha Kim, Kyungil Jo
BACKGROUND: While carotid angioplasty and stenting (CAS) has become an established procedure, outcomes of early CAS for symptomatic extracranial carotid stenosis (SECS) remain poorly understood. The present study aimed at determining the effectiveness of early CAS in SECS. METHODS: Herein, 224 SECS patients underwent elective CAS between January 2008 and June 2015. The study population was stratified based on the time from symptom onset to the procedure (early CAS group: within 14 days; delayed CAS group: later than 14 days)...
September 15, 2016: World Neurosurgery
Rosa Maria Cerbo, Simona Orcesi, Luigia Scudeller, Martina Borellini, Carolina Croci, Claudia Ravelli, Giulia Masa, Piermichele Paolillo, Paolo Manzoni, Umberto Balottin, Mauro Stronati
Objective We aimed at assessing the association between superior vena cava flow (SVCf), regional (cerebral) tissue oxygen saturation (rSO2), and cerebral fractional oxygen extraction (CFOE) during the first 48 hours of life and 2-years neurodevelopmental outcome of very low-birth-weight infants (VLBW). Methods We prospectively studied 60 VLBW infants admitted to our neonatal intensive care unit; rSO2 was continuously monitored with near-infrared spectroscopy during the first 48 hours of life, SVCf was measured at 4 to 6, 12, 24, and 48 hours, and CFOE was calculated...
September 2016: American Journal of Perinatology
Muhammad U Farooq, Christopher Goshgarian, Jiangyong Min, Philip B Gorelick
Cerebral hyperperfusion is a relatively rare syndrome with significant and potentially preventable clinical consequences. The pathophysiology of cerebral hyperperfusion syndrome (CHS) may involve dysregulation of the cerebral vascular system and hypertension, in the setting of increase in cerebral blood flow. The early recognition of CHS is important to prevent complications such as intracerebral hemorrhage. This review will focus on CHS following carotid endarterectomy and carotid artery stenting. We will discuss the typical clinical features of CHS, risk factors, pathophysiology, diagnostic modalities for detection, identification of patients at risk, and prevention and treatment...
2016: Experimental & Translational Stroke Medicine
I E Panova, E M Ermak, T A Shaimova, V A Shaimova
UNLABELLED: Ocular circulation disorders are an important factor in the development of primary open-angle glaucoma (POAG) and age-related macular degeneration (AMD). To date, however, there have been no studies on choroidal blood flow peculiarities in case of concurrent AMD and POAG. AIM: to determine distinctive features of choroidal blood flow characteristic of concurrent AMD and POAG and to assess their role in disease pathogenesis. MATERIAL AND METHODS: Macular choroidal blood flow, including blood supply, was assessed in 54 patients (102 eyes) by means of Doppler ultrasound...
July 2016: Vestnik Oftalmologii
Ken Kazumata, Khin Khin Tha, Haruto Uchino, Tohru Shiga, Hideo Shichinohe, Masaki Ito, Naoki Nakayama, Takeo Abumiya
OBJECTIVE After revascularization surgery, hyperperfusion and ischemia are associated with morbidity and mortality in adult moyamoya disease (MMD). However, structural changes within the brain following revascularization surgery, especially in the early postsurgical period, have not been thoroughly studied. Such knowledge may enable improved monitoring and clinical management of hyperperfusion and ischemia in MMD. Thus, the objective of this study was to investigate the topographic and temporal profiles of cerebral perfusion and related white matter microstructural changes following revascularization surgery in adult MMD...
September 2, 2016: Journal of Neurosurgery
Young-Do Kim, Hyeonseok S Jeong, In-Uk Song, Yong-An Chung, Eun Namgung, Yong-Duk Kim
OBJECTIVE: Although Parkinson's disease (PD) is frequently accompanied by depression, brain perfusion deficits in PD with depression remain unclear. This study aimed to assess alterations in regional cerebral blood flow (rCBF) in depressed PD patients using (99m)Tc hexamethyl-propylene-amine-oxime single-photon emission computed tomography (SPECT). METHODS: Among 78 patients with PD, 35 patients were classified into the depressed PD group, while the rest (43 patients) was assigned to the nondepressed PD group based on the scores of the Geriatric Depressive Scale (GDS)...
August 26, 2016: Annals of Nuclear Medicine
Hiroshi Enaida, Shinji Nagata, Atsunobu Takeda, Shintaro Nakao, Yasuhiro Ikeda, Tatsuro Ishibashi
PURPOSE: To investigate the changes in chorioretinal blood flow velocity and cerebral blood after carotid endarterectomy (CEA). METHODS: Nine patients with moderate to severe internal carotid artery stenosis underwent CEA. Chorioretinal blood flow velocity was measured by laser speckle flowgraphy (LSFG), while cerebral blood flow (CBF) was measured by single-photon emission computed tomography (SPECT), on the affected side both before and after CEA. LSFG was evaluated in five areas to determine mean blur rate, while CBF was calculated from regional CBF and cerebrovascular reactivity (CVR), at the middle cerebral artery (MCA) region of each patient...
August 26, 2016: Japanese Journal of Ophthalmology
Christina Mørup Jørgensen, Toke Bek
BACKGROUND: Diabetic retinopathy is characterised by morphological lesions in the ocular fundus related to disturbances in retinal blood flow. The two vision threatening forms of retinopathy show specific patterns of distribution of retinal lesions with proliferative diabetic retinopathy (PDR) developing secondary to ischaemia and hypoxia in the retinal periphery and diabetic maculopathy (DM) developing secondary to hyperperfusion and increased vascular permeability in the macular area...
August 23, 2016: British Journal of Ophthalmology
Motohiro Nomura, Akira Tamase, Tomoya Kamide, Kentaro Mori, Syunsuke Seki, Yu Iida, Kei-Ichiro Suzuki, Takae Aoki, Ken-Ichi Hirano, Mitsuyuki Takahashi, Yuichi Kawabata, Tatsu Nakano, Hiroki Taguchi
We report a patient with a traumatic middle cerebral artery dissection, which showed hyperperfusion in the territory supplied by the left middle cerebral artery. A 45-year-old man experienced speech disturbance and motor weakness in his right hemibody on the day following mild head trauma. His symptoms worsened on the fourth day. Magnetic resonance imaging showed narrowing in the left M1 portion of the middle cerebral artery. Angiography showed narrowing and dilatation in the left middle cerebral artery trunk...
October 2016: Neuroradiology Journal
M Bliksøen, A Rutkovskiy, J Vaage, K-O Stensløkken
AIM: The isolated, retrogradely perfused heart (modified Langendorff model) is a widely used method in experimental heart research. The presence of an intraventricular balloon is necessary to get functional measurements. We have previously shown that the balloon induces phosphorylation of some suggested cardioprotective mitogen-activated protein kinases (MAPK): P38-MAPK, ERK 1/2 and JNK. We hypothesized that the balloon could influence cardioprotection, protect against ischaemia reperfusion injury and interfere with coronary flow...
August 20, 2016: Acta Physiologica
Eric Nyberg, Justin Honce, Bette K Kleinschmidt-DeMasters, Brian Shukri, Sarah Kreidler, Lidia Nagae
BACKGROUND: Standard of care for high-grade gliomas (HGGs) includes surgical debulking and adjuvant chemotherapy and radiation. Patients under treatment require frequent clinical and imaging monitoring for therapy modulation. Differentiating tumor progression from treatment-related changes can be challenging on conventional MRI, resulting in delayed recognition of tumor progression. Arterial spin labeling (ASL) may be more sensitive for tumor progression. MATERIALS AND METHODS: ASL and associated conventional MR images obtained in patients previously treated for HGGs and before biopsy or re-resection were reviewed by three neuroradiologists who were blinded to the histopathologic results...
October 2016: Neuroradiology Journal
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