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Cerebrovascular Diseases Extra

Courtney L Fisher, Stacie L Demel
BACKGROUND: Saccular intracranial aneurysms (IAs) are outpouchings of the vessel wall of intracranial arteries. Rupture of IAs results in subarachnoid hemorrhage which is associated with high morbidity and mortality. Surgical interventions, such as clipping and coiling, have associated risks. Currently, there are no proven pharmacological treatments to prevent the growth or rupture of IAs. Infiltration of proinflammatory cytokines in response to increased wall sheer stress is a hallmark of IA...
April 30, 2019: Cerebrovascular Diseases Extra
Karl Georg Haeusler, Christoph Jensen, Jan F Scheitz, Thomas Krause, Christian Wollboldt, Bernhard Witzenbichler, Heinrich J Audebert, Ulf Landmesser, Jochen B Fiebach, Christian H Nolte, Matthias Endres, Hans-Christian Mochmann
BACKGROUND: Elevated high-sensitive cardiac troponin (hs-cTn) can be found in more than 50% of the patients with acute ischemic stroke. The observational TRoponin ELevation in Acute ischemic Stroke (TRELAS) study revealed that about 25% of all stroke patients with elevated troponin had a coronary angiography-detected culprit lesion affording immediate intervention, and about 50% of all patients did not have any obstructive coronary artery disease. Given the risk of procedure-related complications, the identification of stroke patients in urgent need of invasive coronary angiography is desirable...
April 30, 2019: Cerebrovascular Diseases Extra
Toshiyasu Ogata, Shinya Dohgu, Koichi Takano, Tooru Inoue, Hisatomi Arima, Fuyuko Takata, Yasufumi Kataoka, Yoshio Tsuboi
BACKGROUND/PURPOSE: Because atherosclerotic factors and antithrombotic agents sometimes induce cerebral microbleeds (CMBs), patients with cerebral large artery disease (CLAD) tend to have more CMBs than control subjects. On the other hand, VEGF contributes to the disruption of the blood-brain barrier, and it may induce parenchymal edema and bleeding. We conducted a study to evaluate the role of vascular endothelial growth factor (VEGF) in the occurrence of CMBs in patients with CLAD. METHODS: CLAD is defined as stenosis or occlusion of either the carotid artery or the middle cerebral artery of 50% or more...
April 30, 2019: Cerebrovascular Diseases Extra
Neghal Kandiyil, Shane T MacSweeney, Stan Heptinstall, Jane May, Susan C Fox, Dorothee P Auer
BACKGROUND AND PURPOSE: In order to assess the association of microparticles derived from activated platelets (PMP) or endothelial cells (EMP) with risk markers for recurrent embolic events in patients with symptomatic carotid artery disease, we studied the associations between PMP/EMP and three risk markers: plaque haemorrhage (PH), micro-embolic signals and cerebral diffusion abnormalities. METHODS: Patients with recently symptomatic high-grade carotid artery stenosis (60-99%, 42 patients, 31 men; mean age 75 ± 8 years) and 30 healthy volunteers (HV, 11 men; mean age 56 ± 12 years) were prospectively recruited...
April 3, 2019: Cerebrovascular Diseases Extra
Alexis Valenzuela Espinoza, Stephane Steurbaut, Alain Dupont, Pieter Cornu, Robbert-Jan van Hooff, Raf Brouns, Koen Putman
BACKGROUND: In the first 5 years after their stroke, about a quarter of patients will suffer from a recurrent stroke. Digital health interventions facilitating interactions between a caregiver and a patient from a distance are a promising approach to improve patient adherence to lifestyle changes proposed by secondary prevention guidelines. Many of these interventions are not implemented in daily practice, even though efficacy has been shown. One of the reasons can be the lack of clear economic incentives for implementation...
January 7, 2019: Cerebrovascular Diseases Extra
Blake F Giarola, James Leyden, Sally Castle, Jim Jannes, Craig Anderson, Jonathan Newbury, Timothy Kleinig
BACKGROUND: Ischaemic stroke is reportedly preceded by transient ischaemic attack (TIA) in 15-30% of all cases. The risk of stroke following TIA is highest in the presence of unstable atherosclerotic plaques in large arteries. The recent population-based Adelaide Stroke Incidence Study describes a population with a low proportion (16%) of stroke attributable to large artery atherosclerosis (LAA). We hypothesized that this population-based ischaemic stroke cohort would have a lower rate of preceding TIA than previously reported...
2018: Cerebrovascular Diseases Extra
Taku Sato, Mudathir Bakhit, Kyouichi Suzuki, Jun Sakuma, Masazumi Fujii, Yuta Murakami, Yuhei Ito, Ulrich Sure, Kiyoshi Saito
BACKGROUND: Intraoperative indocyanine green videoangiography (ICG-VA) has been reported to be utilized in various cerebrovascular surgeries, wherein the blood flow is noticeably shown in white with a black background. ICG flow alone, but not other structures, can be observed using ICG-VA. We developed a novel high-resolution intraoperative imaging system using laser light source for simultaneously visualizing both visible light and near-infrared (NIR) fluorescence images of ICG-VA. METHODS: We used a novel system for 14 cerebrovascular cases...
2018: Cerebrovascular Diseases Extra
Ying Man Law, Lan Fang Feng, Qui Liang, Li Jiao Meng, Peng Shen, Shuai Jiang Yu, Wing Yi Pao
INTRODUCTION: Locked-in syndrome (LIS) results from a brainstem lesion in the pons. Ischemic stroke is the most common etiology of LIS. People with LIS have poor mobility with serious complications due to immobilization. Benefits of exercise after stroke have been widely reported. However, little is known about what and how much exercise should be prescribed for these patients. OBJECTIVES: To explore and evaluate the effect of exercise on the physical recovery of people with LIS after stroke...
2018: Cerebrovascular Diseases Extra
Osian Llwyd, Angela S M Salinet, Ronney B Panerai, Man Y Lam, Nazia P Saeed, Fiona Brodie, Edson Bor-Seng-Shu, Thompson G Robinson, Ricardo C Nogueira
BACKGROUND: Acute ischaemic stroke (AIS) patients often show impaired cerebral autoregulation (CA). We tested the hypothesis that CA impairment and other alterations in cerebral haemodynamics are associated with stroke subtype and severity. METHODS: AIS patients (n = 143) were amalgamated from similar studies. Data from baseline (< 48 h stroke onset) physiological recordings (beat-to-beat blood pressure [BP], cerebral blood flow velocity (CBFV) from bilateral insonation of the middle cerebral arteries) were calculated for mean values and autoregulation index (ARI)...
2018: Cerebrovascular Diseases Extra
Lydia Kaduka, Erastus Muniu, Chrispine Oduor, Jane Mbui, Robai Gakunga, Judith Kwasa, Sylvanus Wabwire, Nathan Okerosi, Anne Korir, Scot Remick
BACKGROUND: Despite the increasing global burden of stroke, there are limited data on stroke from Kenya to guide in decision-making. Stroke occurrence in sub-Saharan Africa has been associated with poor health outcomes. This study sought to establish the stroke incidence density and mortality in Kenya's leading public tertiary hospitals for purposes of informing clinical practice and policy. METHODS: This is a prospective study conducted at Kenya's leading referral hospitals, namely, Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH)...
2018: Cerebrovascular Diseases Extra
Ken Yasuda, Shunichi Fukuda, Michikazu Nakamura, Ryo Ohtani, Yasuhiro Kuwata, Masaki Takata, Makoto Sainouchi, Masahiro Gotou, Yuichi Masuda, Satoru Kawarazaki, Yasuhiro Kawabata, Nagako Murase, Tomokazu Aoki, Naohiro Yonemoto, Masaharu Akao, Tetsuya Tsukahara
BACKGROUND: Large-scale clinical trials have analyzed risk factors for any ischemic stroke in patients with atrial fibrillation (AF). However, the risk factors for cardioembolic stroke (CES), specifically, have not been reported. To clarify the risk factors for CES and clinically significant cardioembolic infarction, we examined the incidence of CES and larger infarct volume (IV) (> 30 mL) CES, employing the Fushimi AF Registry, a community-based prospective cohort of AF patients in the Fushimi ward, Kyoto, Japan...
2018: Cerebrovascular Diseases Extra
Fidel Meira, Daiane Magalhães, Luiz Sérgio da Silva, Ana Clara Mendonça E Silva, Gisele Sampaio Silva
BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho-rizonte, Brazil. METHODS: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video...
2018: Cerebrovascular Diseases Extra
Rajath Sasidharan Pillai, Kiran Iyer, Rubens Spin-Neto, Simple Futarmal Kothari, Jørgen Feldbæk Nielsen, Mohit Kothari
BACKGROUND: To systematically review the current literature investigating the association between oral health and acquired brain injury. METHODS: A structured search strategy was applied to PubMed, Embase, Web of Science, and CENTRAL electronic databases until March 2017 by 2 independent reviewers. The preferred reporting items for systematic review and meta-analysis guidelines were used for systematic review. RESULTS: Even though the objective was to assess the association between oral health and acquired brain injury, eligible studies focused solely on different forms of stroke and stroke subtypes...
2018: Cerebrovascular Diseases Extra
Richard B Olatunji, Ademola J Adekanmi, Ayotunde O Ogunseyinde
BACKGROUND: Intracranial arterial calcification (IAC), a recognized marker of atherosclerosis on cranial computed tomography (CT), is an independent risk factor for ischaemic stroke. This study aimed to determine the prevalence, distribution, severity, and associations of IAC in adults with acute ischaemic stroke (AIS) at the University College Hospital, Ibadan, Nigeria. METHODS: Cranial CT images of 130 consecutive adults who presented with AIS were acquired on a 64-slice multi-detector Toshiba Aquilion scanner and evaluated for IAC in bone window on Vitrea® software using a semi-quantitative scoring method for extent, thickness, and length of calcifications in the large intracranial arteries...
2018: Cerebrovascular Diseases Extra
Kota Maekawa, Masunari Shibata, Hideki Nakajima, Akane Mizutani, Yotaro Kitano, Masaru Seguchi, Masayoshi Yamasaki, Kazuto Kobayashi, Takanori Sano, Genshin Mori, Tadashi Yabana, Yutaka Naito, Shigetoshi Shimizu, Fumitaka Miya
BACKGROUND: Only few studies have investigated the relationship between the histopathology of retrieved thrombi and clinical outcomes. This study aimed to evaluate thrombus composition and its association with clinical, laboratory, and neurointerventional findings in patients treated by mechanical thrombectomy due to acute large vessel occlusion. METHODS: At our institution, 79 patients were treated by mechanical thrombectomy using a stent retriever and/or aspiration catheter between August 2015 and August 2016...
2018: Cerebrovascular Diseases Extra
Sanela Halak, Gerd Östling, Andreas Edsfeldt, Cecilia Kennbäck, Magnus Dencker, Isabel Gonçalves, Giuseppe Asciutto
BACKGROUND: Echolucent carotid plaques have been related to an increased risk of ischemic cerebrovascular events. The aim of the present study was to evaluate whether a new objective ultrasonographic parameter, the statistical geometric feature (SGF), reflecting spottiness of carotid plaques, can be associated with cerebrovascular symptoms and with a rupture-prone plaque phenotype. METHODS: The plaques of 144 patients who underwent carotid endarterectomy were included in this study...
2018: Cerebrovascular Diseases Extra
Zeljka Calic, Cecilia Cappelen-Smith, Ramesh Cuganesan, Craig S Anderson, Miriam Welgampola, Dennis J Cordato
BACKGROUND AND PURPOSE: Strokes due to small (<2 cm) cerebellar infarction are under-recognised, and their profile and aetiology have not been well characterised. We aimed to determine the frequency, clinical features, aetiology, and outcome of small as compared to large cerebellar infarction. METHODS: This study is a retrospective analysis of clinical and imaging features of a prospectively assessed series of 108 consecutive patients with acute cerebellar infarction admitted to Liverpool Hospital, Sydney, NSW, Australia, during 2011-2015...
2017: Cerebrovascular Diseases Extra
Chun Chien, Feng-Chi Chang, Hui-Chi Huang, Jui-Yao Tsai, Chih-Ping Chung
BACKGROUND: With the popularity of MRI use, vertebrobasilar artery dissection (VBD) has been found more frequently in patients with posterior circulation ischemic stroke (PCS). The relationship between VBD and atherosclerosis is unknown. The present study aimed to prove the hypothesis that PCS with pure VBD (p-VBD) and with VBD and accompanied cervical or cerebral artery atherosclerosis (a-VBD) have distinct manifestations. METHODS: Patients with VBD-related PCS who were prospectively enrolled in the Taipei Veterans General Hospital Stroke Registry between January 1, 2010 and August 31, 2014 were recruited for the present study...
2017: Cerebrovascular Diseases Extra
Tomoya Shibahara, Masahiro Yasaka, Yoshiyuki Wakugawa, Koichiro Maeda, Takeshi Uwatoko, Takahiro Kuwashiro, Gregory Y H Lip, Yasushi Okada
BACKGROUND: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. METHODS: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement...
2017: Cerebrovascular Diseases Extra
Astrid M Hooghiemstra, Anne Suzanne Bertens, Anna E Leeuwis, Esther E Bron, Michiel L Bots, Hans-Peter Brunner-La Rocca, Anton J M de Craen, Rob J van der Geest, Jacoba P Greving, L Jaap Kappelle, Wiro J Niessen, Robert J van Oostenbrugge, Matthias J P van Osch, Albert de Roos, Albert C van Rossum, Geert Jan Biessels, Mark A van Buchem, Mat J A P Daemen, Wiesje M van der Flier
BACKGROUND: Hemodynamic balance in the heart-brain axis is increasingly recognized as a crucial factor in maintaining functional and structural integrity of the brain and thereby cognitive functioning. Patients with heart failure (HF), carotid occlusive disease (COD), and vascular cognitive impairment (VCI) present themselves with complaints attributed to specific parts of the heart-brain axis, but hemodynamic changes often go beyond the part of the axis for which they primarily seek medical advice...
2017: Cerebrovascular Diseases Extra
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