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T A Polyakova, A V Arablinsky, O S Levin
The role of the cerebral microbleeds (CMB) as a potential predictor of hemorrhagic complications of thrombolytic therapy is discussed. CMB are small perivascular hemosiderin deposits in the brain detected by magnetic resonance imaging in gradient echo T2* or SWI sequences. They are associated (along with leukoaraiosis or lacunes) with cerebral microangiopathies. Most often CMB are associated with hypertensive arteriopathy (the main cause of CMB localization) or cerebral amyloid angiopathy (the main cause of cerebral CMB)...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
T A Polyakova, O S Levin
AIM: To study a role of cerebral microbleeds (CMB) in the diagnosis of main cerebrovascular and neurodegenerative diseases with cognitive impairment. MATERIAL AND METHODS: CMB were studied in 120 patients with Alzheimer's disease (AD), dementia with Lewy bodies (DLB) and vascular dementia using 1.5T MRI in T2 * gradient echo. An impact of CMB on cognitive functions and the relationship with signs of vascular and neurodegenerative lesions of the brain were studied as well...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
William K Karlsson, Caspar G Sørensen, Christina Kruuse
Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of L-arginine and N(G) -monomethyl-L-arginine (L-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to L-arginine or L-NMMA in human subjects with vascular risk factors or ischemic cerebrovascular disease...
October 5, 2016: Clinical and Experimental Pharmacology & Physiology
Maurizio Paciaroni, Leonardo Pantoni
The administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke may be controversial, because the reported risk of rt-PA associated intracerebral hemorrhage in these patients is higher compared with that of patients without dementia and because these patients are already disabled. Moreover, there are known risk factors for hemorrhagic transformation in patients with dementia: amyloid angiopathy, leukoaraiosis and the presence of microbleeds. In this review, we describe the impact of dementia on functional outcome following thrombolytic therapy for acute ischemic stroke and discuss some of the issues related to the use of this therapy in this specific patient's population...
October 3, 2016: Neurological Sciences
L Yang, L Yu, W Qin, X Y Zhang, Y Li, J H Xu, X Z Hu, J L Yuan, H Gu, W L Hu
Objective: To explore the clinical characteristics of single subcortical cerebral infarction of middle cerebral artery (MCA) territory and the possible pathogenesis. Methods: A total of 344 cases diagnosed as single subcortical cerebral infarction of MCA territory were enrolled in the study and divided into the parent artery disease (PAD) group and the non-PAD group according to whether the MCA stenosis was presented or not. A total of 312 cases diagnosed as single subcortical cerebral infarction of MCA territory were divided into the BAD group and the SVD group according to the relationship between the lesion sites and MCA...
October 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
M Edip Gurol, J Alex Becker, Panagiotis Fotiadis, Grace Riley, Kristin Schwab, Keith A Johnson, Steven M Greenberg
OBJECTIVE: We hypothesized that florbetapir, a Food and Drug Administration-approved PET tracer, could distinguish cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage (ICH) from hypertensive ICH (HTN-ICH). METHODS: We prospectively enrolled survivors of primary ICH related to probable CAA (per Boston Criteria, n = 10) and HTN-ICH (n = 9) without dementia. All patients underwent florbetapir-PET and multimodal MRI, and patients with CAA had additional Pittsburgh compound B (PiB) PET...
September 7, 2016: Neurology
Tieli Liu, Yunpeng Han, Lemei Tang, Jianlin Wu, Yanwei Miao, Bingbing Gao, Jin Shang
The aim of the study was to evaluate the performance of parameters obtained from diffusion-weighted imaging (DWI) with multiple b values in the detection of chronic brain damage in patients with type 2 diabetes.We enrolled 30 patients with or without abnormalities on brain magnetic resonance imaging (lacunar infarction, leukoaraiosis, and/or brain atrophy) and 15 nondiabetic controls; obtained DWI parameters that included apparent diffusion coefficient (ADC), fast ADC (ADCfast), slow ADC (ADCslow), fraction of fast ADC (f), distributed diffusion coefficient (DDC), and stretched exponential (α); and performed receiver operating characteristic (ROC) analysis to evaluate the performance of parameters for the detection of chronic brain damage...
August 2016: Medicine (Baltimore)
Wen-Qing Huang, Hui-Ming Ye, Fang-Fang Li, Ke-Hui Yi, Ya Zhang, Liang-Liang Cai, Hui-Nuan Lin, Qing Lin, Chi-Meng Tzeng
Leukoaraiosis (LA) is a frequent neuroimaging finding commonly observed on brain MRIs of elderly people with prevalence ranging from 50% to 100%. Multiple susceptibility genes or genetic risk factors for LA have been identified in subjects of European descent. Here, we report the first replication study on several common and novel genetic variations in the Chinese population. In this study, a total of 244 subjects (201 LA patients and 43 controls) were enrolled according to our new and strict definition for LA...
August 2016: Medicine (Baltimore)
M Turk, M Zaletel, J Pretnar Oblak
OBJECTIVE: Leukoaraiosis (ILA) is believed to be ischaemic in origin due its association with cerebrovascular risk factors and similar location as lacunar infarctions. Its pathophysiology is not well understood and its diagnosis is still based on magnetic resonance imaging (MRI) as well as exclusion of other causes of white matter hyperintensities (WMH). So far there are no known confirming or screening diagnostic tests of ILA. Ultrasound studies have recently shown increased large artery stiffness, increased cerebrovascular resistance and lower cerebral blood flow in ILA patients...
September 2016: Journal of Hypertension
Wei Wei, Zhenxi Xia, Hongyan Gao, Jingjing Gong, Liping Yan, Yonghua Huang, Fei Chen, Weiwei Zhang
Although retinal and cerebral microvessels share similar embryological, anatomical and physiological characteristics, the correlation between retinopathy and leukoaraiosis (LA), a type of brain microvascular disease, is unclear. In the present study, the sample included 213 patients admitted to the department of neurology from January 2012 through October 2012. MRI and retinal photography were performed within 48hours of hospitalization, and patient demographics, comorbidities, preadmission medications and laboratory data were collected...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
K Sam, A P Crawley, J Poublanc, J Conklin, O Sobczyk, D M Mandell, J Duffin, L Venkatraghavan, J A Fisher, S E Black, D J Mikulis
BACKGROUND AND PURPOSE: The pathogenesis of leukoaraiosis has long been debated. This work addresses a less well-studied mechanism, cerebrovascular reactivity, which could play a leading role in the pathogenesis of this disease. Our aim was to evaluate blood flow dysregulation and its relation to leukoaraiosis. MATERIALS AND METHODS: Cerebrovascular reactivity, the change in the blood oxygen level-dependent 3T MR imaging signal in response to a consistently applied step change in the arterial partial pressure of carbon dioxide, was measured in white matter hyperintensities and their contralateral spatially homologous normal-appearing white matter in 75 older subjects (age range, 50-91 years; 40 men) with leukoaraiosis...
August 4, 2016: AJNR. American Journal of Neuroradiology
Andreas Charidimou, Marco Pasi, Marco Fiorelli, Sara Shams, Rüdiger von Kummer, Leonardo Pantoni, Natalia Rost
BACKGROUND AND PURPOSE: We performed a meta-analysis to assess whether leukoaraiosis on brain computed tomographic scans of acute ischemic stroke patients treated with intravenous thrombolysis is associated with an increased risk of symptomatic intracerebral hemorrhage (sICH) or poor functional outcome at 3 to 6 months after stroke, or both. METHODS: We searched PubMed and pooled relevant data in meta-analyses using random effects models. Using odds ratios (OR), we quantified the strength of association between the presence and severity of leukoaraiosis and post-thrombolysis sICH or 3- to 6-month modified Rankin Score >2...
September 2016: Stroke; a Journal of Cerebral Circulation
Norbert Nighoghossian, Fatima Abbas, Tae-Hee Cho, Ana Filipa Geraldo, Vincent Cottaz, Elie Janecek, Laura Mechtouff, Magali Bischoff, Carlos El Khoury, Anne Marie Schott, Laurent Derex, Marc Hermier, Louis Guy Tisserand, Roxana Amelie, Leila Chamard, Yves Berthezene
INTRODUCTION: Severity of vascular damage of white matter may predict hemorrhagic transformation (HT). We assess the relationship between leukoaraiosis (LA) severity and the type of hemorrhagic transformation in elderly patients treated with thrombolysis. METHODS: We retrospectively analyzed the clinical data and pretreatment magnetic resonance imaging (MRI) of 180 consecutive ischemic stroke patients aged over 75 years. LA severity was graded according to the Fazekas scale, and acute diffusion-weighted-imaging (DWI) lesion volumes were semi-automatically outlined...
July 22, 2016: Neuroradiology
Alireza Atri
This chapter reviews clinical applications and imaging findings useful in medical practice relating to neurodegenerative cognitive/dementing disorders. The preponderance of evidence and consensus guidelines support an essential role of multitiered neuroimaging in the evaluation and management of neurodegenerative cognitive/dementia syndrome that range in severity from mild impairments to frank dementia. Additionally, imaging features are incorporated in updated clinical and research diagnostic criteria for most dementias, including Alzheimer's disease (AD), Dementia with Lewy bodies (DLB), Frontotemporal Lobar Degenerations/Frontotemporal Dementia (FTD), and Vascular Cognitive Impairment (VCI)...
2016: Handbook of Clinical Neurology
Luis Prats-Sánchez, Pol Camps-Renom, Javier Sotoca-Fernández, Raquel Delgado-Mederos, Alejandro Martínez-Domeño, Rebeca Marín, Miriam Almendrote, Laura Dorado, Meritxell Gomis, Javier Codas, Laura Llull, Alejandra Gómez González, Jaume Roquer, Francisco Purroy, Manuel Gómez-Choco, David Cánovas, Dolores Cocho, Moises Garces, Sonia Abilleira, Joan Martí-Fàbregas
BACKGROUND AND PURPOSE: Remote parenchymal hemorrhage (rPH) after intravenous thrombolysis with recombinant tissue-type plasminogen activator may be associated with cerebral amyloid angiopathy, although supportive data are limited. We aimed to investigate risk factors of rPH after intravenous thrombolysis with recombinant tissue-type plasminogen activator. METHODS: This is an observational study of patients with ischemic stroke who were treated with intravenous thrombolysis with recombinant tissue-type plasminogen activator and were included in a multicenter prospective registry...
August 2016: Stroke; a Journal of Cerebral Circulation
Edoardo Ferlazzo, Sara Gasparini, Ettore Beghi, Chiara Sueri, Emilio Russo, Antonio Leo, Angelo Labate, Antonio Gambardella, Vincenzo Belcastro, Pasquale Striano, Maurizio Paciaroni, Laura Rosa Pisani, Umberto Aguglia
OBJECTIVE: Seizures may occur in close temporal association with a stroke or after a variable interval. Moreover, epilepsy is often encountered in patients with leukoaraiosis. Although early post-stroke seizures have been studied extensively, less attention has been paid to post-stroke epilepsy (PSE) and to epilepsy associated with leukoaraiosis (EAL). The aim of this paper is to review data concerning pathophysiology, prognosis, and treatment of PSE and EAL. METHODS: We performed an extensive literature search to identify experimental and clinical articles on PSE and EAL...
August 2016: Epilepsia
Sofia Madureira, Ana Verdelho, Carla Moleiro, Catarina Santos, Philip Scheltens, Alida Gouw, José Ferro
AIMS: To describe the contribution of white matter lesions to the long-term neuropsychological profiles of different groups of clinical diagnoses, and to identify neuropsychological predictors of cognitive impairment in a 10-year follow-up. METHODS: The Lisbon subcohort of the Leukoaraiosis and Disability (LADIS) study was re-evaluated performing a clinical, functional and cognitive evaluation [including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and ADAS-Cog with the extension for vascular impairment (VADAS-Cog), the 9-word version of the California Verbal Learning Test (CVLT-9), the Trail-Making test and the Stroop test] as well as an MRI scan...
2016: Dementia and Geriatric Cognitive Disorders
Hamidreza Edrissi, Sarah C Schock, Robert Cadonic, Antoine M Hakim, Charlie S Thompson
Cerebral small vessel disease (CSVD) is a pathological process leading to lacunar infarcts, leukoaraiosis and cerebral microbleeds. Dysfunction of the blood brain barrier (BBB) has been proposed as a mechanism in the progression cerebral small vessel disease. A rodent model commonly used to study some aspects of CSVD is bilateral common carotid artery occlusion (BCCAO) in the rat. In the present study it was determined that gait impairment, as determined by a tapered beam test, and BBB permeability increased following BCCAO...
September 1, 2016: Brain Research
Naveed Malek, Michael A Lawton, Diane M A Swallow, Katherine A Grosset, Sarah L Marrinan, Nin Bajaj, Roger A Barker, David J Burn, John Hardy, Huw R Morris, Nigel M Williams, Nicholas Wood, Yoav Ben-Shlomo, Donald G Grosset
OBJECTIVE: The purpose of this study was to examine the relationship between vascular disease (and vascular risk factors), cognition and motor phenotype in Parkinson's disease (PD). METHODS: Recently diagnosed PD cases were enrolled in a multicenter prospective observational longitudinal cohort study. Montreal cognitive assessment (normal >23, mild cognitive impairment 22 to 23 or lower but without functional impairment, and dementia 21 or less with functional impairment) and Movement Disorder Society Unified PD Rating Scale part 3 (UPDRS 3) scores were analyzed in relation to a history of vascular events and risk factors...
June 21, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Yu Chen, Chunxue Wang, Huazheng Liang, Hongyan Chen, Yanchao Bi, Haixin Sun, Qingli Shi, Yongmei Deng, Jia Li, Yongjun Wang, Yumei Zhang
OBJECTIVES: The aim of the study was to investigate the difference of resting-state default-mode network (DMN) between patients with leukoaraiosis (LA)-associated subcortical vascular cognitive impairment (SVCI) and control subjects, and to provide functional imaging evidence of SVCI. METHODS: All subjects (n = 58) were divided into two groups based on their clinical diagnosis: a LA-associated SVCI group (n = 31, 14 males) and a control group (n = 27, 14 males)...
June 2016: Neurological Research
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