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isolated middle cerebral artery stenosis

Ying Liu, Xueying Wu, Zhaoyang Fan, Jingdan Cheng, Lele Zhong, Yongzhong Lin, Xiaofeng Qu
OBJECTIVE: We report a rare case of atherosclerotic-moyamoya syndrome (A-MMS) in an adult female with genetic variant of both ring finger 213 (RNF213) p.R4810K and p.T1727M. CASE REPORT: A 46-year-old previously healthy, right-handed woman displayed transient slurred speech, which started to worsen four years ago. Initial magnetic resonance angiography (MRA) revealed stenosis in left middle cerebral artery (MCA), bilateral anterior cerebral artery (ACA), and left posterior cerebral artery (PCA)...
May 2018: Clinical Neurology and Neurosurgery
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
Xiaowei Song, Sufang Xue, Jian Wu, Yi Ren
BACKGROUND AND PURPOSE: To investigate the clinical prognosis and vascular outcome of ischemic stroke patients with isolated symptomatic middle cerebral artery stenosis, and further analysis of the predictors associated with the results. METHODS: Ischemic stroke patients aged 18-55 years old with isolated symptomatic middle cerebral artery stenosis were evaluated and followed up prospectively for six months. Logistic regression was used to detect predictors of ipsilateral stroke recurrence, and factors associated with the dynamic changes of lesion vascular were analyzed...
July 2017: International Journal of Neuroscience
Oh Young Bang, Jong-Won Chung, Sookyung Ryoo, Gyeong Joon Moon, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee
AIMS: Besides carotid or cardiac embolism, stroke can occur via microangiopathy (small arterial disease [SAD]) and macroangiopathy (intracranial atherosclerotic stroke [ICAS]) of the intracranial vasculature. There have been efforts to identify risk factors specific to microangiopathy and macroangiopathy, including vascular risk factors, and protein and genetic biomarkers. We hypothesized that despite the anatomic and pathophysiological differences between microvessels and macrovessels, microangiopathy and macroangiopathy share common risk factors during disease progression...
March 2016: Atherosclerosis
Ajit S Puri, Matthew J Gounis, Francesco Massari, Mary Howk, John Weaver, Ajay K Wakhloo
Isolated middle cerebral artery dissection is a rare clinical entity, with descriptions limited to a few case reports and case series. Symptomatic dissection in the anterior circulation can present as an ischemic stroke in a young population; however, it is rarely associated with subarachnoid hemorrhage. We describe a young patient who presented with acute headache from a subarachnoid hemorrhage that was ultimately determined to be due to a vascular dissection in the middle cerebral artery. The initial angiogram showed vascular irregularities in this area with stenosis...
April 2016: Journal of Neurointerventional Surgery
Ajit S Puri, Matthew J Gounis, Francesco Massari, Mary Howk, John Weaver, Ajay K Wakhloo
Isolated middle cerebral artery dissection is a rare clinical entity, with descriptions limited to a few case reports and case series. Symptomatic dissection in the anterior circulation can present as an ischemic stroke in a young population; however, it is rarely associated with subarachnoid hemorrhage. We describe a young patient who presented with acute headache from a subarachnoid hemorrhage that was ultimately determined to be due to a vascular dissection in the middle cerebral artery. The initial angiogram showed vascular irregularities in this area with stenosis...
April 1, 2015: BMJ Case Reports
Sung-Ho Ahn, Jookyung Lee, Yeon-Jung Kim, Sun U Kwon, Deokhee Lee, Seung-Chai Jung, Dong-Wha Kang, Jong S Kim
BACKGROUND AND PURPOSE: Diagnosis of intracranial artery atherosclerosis remains often uncertain. The high-resolution magnetic resonance imaging (HR-MRI) enables vessel wall assessment for more precise diagnoses. The aim of the present study was to investigate the etiologies of middle cerebral artery steno-occlusive disease in young adult patients with few atherosclerotic risk factors using HR-MRI. METHODS: We prospectively studied patients who visited a tertiary hospital in Seoul, Korea, and had (1) unilateral middle cerebral artery disease (≥50% stenosis or occlusion), (2) were ≤55 years old and had no or minimal (≤1) atherosclerotic risk factors...
March 2015: Stroke; a Journal of Cerebral Circulation
Thomas G Devlin, Sachin V Phade, Rodney K Hutson, Mark W Fugate, Grant R Major, Gregory W Albers, Abdelazim A Sirelkhatim, Biggya L Sapkota, Steven D Quartfordt, Blaise W Baxter
Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA...
January 2015: Annals of Vascular Surgery
P H Gao, L Yang, G Wang, L Guo, X Liu, B Zhao
PURPOSE: Isolated middle cerebral artery dissection (MCAD) is a rare but important clinical entity. The purpose of this study is to demonstrate the clinical and magnetic resonance imaging (MRI) features of symptomatic unruptured isolated MCAD. METHODS: We retrospectively analyzed clinical characteristics and MRI features of eight consecutive ischemic stroke patients diagnosed with unruptured isolated MCAD over a 1-year period. RESULTS: All the patients had symptoms of cerebral infarction, whereas one patient was presented as transient ischemic attack...
March 2016: Clinical Neuroradiology
Valérie Wolff, Jean-Paul Armspach, Rémy Beaujeux, Monica Manisor, Olivier Rouyer, Valérie Lauer, Nicolas Meyer, Christian Marescaux, Bernard Geny
BACKGROUND: Leading aetiologies of ischaemic stroke in young adults are cervico-cerebral arterial dissections and cardio-embolism, but the causes remain undetermined in a considerable proportion of cases. In a few reports, intracranial arterial stenosis has been suggested to be a potential cause of ischaemic stroke in young adults. The aim of our work was to evaluate the frequency, characteristics and risk factors of intracranial arterial stenosis in a prospective series of young ischaemic stroke patients...
2014: Cerebrovascular Diseases
Seok Jong Chung, Hyung Seok Lee, Han Soo Yoo, Kyung Min Kim, Ki Jeong Lee, Jong-Soo Kim, Jae-Wook Lee, Jong Hun Kim, Jeong Hee Cho, Gyu Sik Kim, Jun Hong Lee, Sun-Ah Choi
Isolated middle cerebral artery (MCA) stenosis in young patients with no other medical condition may be a unique pathologic entity with a benign long-term course. Generally, moyamoya disease shows a progression of stenosis from internal cerebral artery (ICA) to other intracranial vessel. A 26-year-old woman was admitted for choreic movements of the right arm and leg. Brain magnetic resonance imaging showed no stroke. Conventional angiography revealed 48% stenosis of the left M1 without ICA stenosis. Single photon emission computed tomography revealed perfusion asymmetry after acetazolamide injection, suggesting decreased uptake in the left basal ganglia and the cerebral cortex...
May 2013: Journal of Movement Disorders
Michal Arkuszewski, Jaroslaw Krejza, Rong Chen, Rebecca Ichord, Janet L Kwiatkowski, Michel Bilello, Robert Zimmerman, Kwaku Ohene-Frempong, Elias R Melhem
PURPOSE: Children with sickle cell anemia (SCA), who have mean blood flow velocities <170 cm/s in the terminal internal carotid (tICA) or middle cerebral (MCA) arteries on transcranial Doppler ultrasonography (TCD), are considered to be at low risk of stroke. The prevalence of intracranial stenosis, which raises the risk of stroke, is not known in these children. Here, we estimated the prevalence of stenosis and explored its association with silent cerebral infarcts determined based on Magnetic Resonance (MR) scans...
March 2014: Advances in Medical Sciences
Peyman Zirak, Raquel Delgado-Mederos, Lavinia Dinia, Joan Martí-Fàbregas, Turgut Durduran
RATIONALE AND OBJECTIVES: In patients with severe internal carotid artery steno-occlusive lesions (ISOL), impaired cerebrovascular reactivity (CVR) is predictive of future ischemic stroke (IS) or transient ischemic attack (TIA). Therefore, the evaluation of CVR in ISOL patients may be a means to evaluate the risk for IS/TIA and decide on an intervention. Our aim was (1) to explore the feasibility of concurrent near-infrared spectroscopy (NIRS-DOS), diffuse correlation spectroscopy, and transcranial Doppler for CVR assessment in ISOL patients, and (2) to compare macrovascular and microvascular CVR in ISOL patients and explore its potential for IS/TIA risk stratification...
February 2014: Academic Radiology
R Turkoz, B Saritas, E Ozker, C Vuran, U Yoruker, S Balci, D Altun, A Turkoz
BACKGROUND: The deep hypothermic circulatory arrest (DHCA) technique has been used in aortic arch and isthmus hypoplasia for many years. However, with the demonstration of the deleterious effects of prolonged DHCA, selective cerebral perfusion (SCP) has started to be used in aortic arch repair. For SCP, perfusion via the innominate artery route is generally preferred (either direct innominate artery cannulation or re-routing of the cannula in the aorta is used). Herein, we describe our technique and the result of arch reconstruction in combination with selective cerebral and myocardial perfusion (SCMP) and short-term total circulatory arrest (TCA) (5-10 min) through ascending aortic cannulation...
January 2014: Perfusion
Sumi Otomo, Kengo Maekawa, Tomoko Goto, Tomoko Baba, Atsushi Yoshitake
OBJECTIVES: Delirium is a common and critical clinical syndrome in older patients. We examined whether abnormalities in the brain that could be assessed by magnetic resonance imaging predisposed patients to develop delirium after coronary artery bypass graft surgery. We also analysed the association between delirium and cognitive dysfunction after coronary artery bypass graft surgery. METHODS: Data were collected prospectively on 153 patients aged 60 years or older who consecutively underwent elective isolated coronary artery bypass graft surgery...
November 2013: Interactive Cardiovascular and Thoracic Surgery
Alex Förster, Ingo Nölte, Holger Wenz, Mansour Al-Zghloul, Hans U Kerl, Marc A Brockmann, Christoph Groden
BACKGROUND AND PURPOSE: Bilateral paramedian thalamic infarction is a rare subtype of stroke the etiology of which still remains undetermined in many patients. METHODS: From a computed tomography (CT)/magnetic resonance imaging report database, we identified and analyzed 48 patients with bilateral paramedian thalamic infarction on diffusion-weighted imaging. Vascular pathologies were noted on CT angiography (CTA)/magnetic resonance angiography (MRA) and the P1 segments of the posterior cerebral artery (PCA) described as normal, hypoplastic, or absent...
July 2014: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Aiko Tamura, Yasumasa Yamamoto, Yoshinari Nagakane, Hidesato Takezawa, Takashi Koizumi, Naoki Makita, Masahiro Makino
BACKGROUND: Intracranial atherosclerotic disease is one of the most common causes of ischemic stroke especially in Asians, Hispanics and blacks. Although middle cerebral artery (MCA) stenosis is increasingly being recognized with the advent of magnetic resonance angiography (MRA) or transcranial Doppler ultrasonography, few studies have focused on acute neurological worsening (NW) in patients with MCA stenosis. We investigated the relationship between NW and lesion patterns detected by diffusion-weighted imaging (DWI)...
2013: Cerebrovascular Diseases
Hoyon Sohn, Dong-Wha Kang, Sun U Kwon, Jong S Kim
BACKGROUND: Studies investigating the clinical features and stroke mechanisms of anterior choroidal artery (AchA) infarction have reported inconsistent results. This may be partly due to different degrees of inclusion of patients with isolated posterior limb of the internal capsule (PLIC) lesions, which may be supplied by lenticulostriate arteries rather than AchA. The purpose of this study was to investigate clinical features and stroke mechanisms of AchA infarction, with particular attention to the above problem...
2013: Cerebrovascular Diseases
Guohou He, Hongmei Zhang, Xiaodong Zhang, Ding Li, Yanjun Zeng
To investigate the relationship between the changes in the number and function of the late endothelial progenitor cells (EPC) in peripheral blood and the carotid artery stenosis. 60 cases were selected and were divided into the carotid artery stenosis group of 40 cases (mild stenosis in 20 cases, moderate/severe stenosis in 20 cases), normal control group of 20 cases with the global cerebral angiography. Extracted the blood of femoral artery from the patients during the global cerebral angiography, mononuclear cells were isolated from peripheral blood by density-gradient centrifugation and were cultured to 21 days when they were identified as late endothelial progenitor cells, counted the colony numbers of late EPC...
October 2013: Journal of Thrombosis and Thrombolysis
L A Dobrynina, L A Kalashnikova, E I Kremneva, L N Pavlova
To clarify the mechanism of the development of cerebral infarcts in the internal carotid artery (ICA) dissection, the data of neuroimaging (localization of infarcts) and angiography have been analyzed in 49 patients (19 females 30 males, mean age 35,6 +/- 11,3 years). Four variants of infarct localization have been distinguished: 1 - the whole ICA territory (middle and anterior cerebral arteries - MCA, ACA) - 10%, 2 - the territory of superficial and deep branches of MCA- 37%, 3- the territory of superficial MCA branches and cortical-medullar arteries - 31% (the cortex and underlying white matter - 19%, the periventricular white matter and semiovale center - 6%, combined localization - 6%); 4 - the territory of deep (perforating) MCA branches (the basal ganglia and adjacent white matter) - 22%...
2011: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
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