Masahiro Uemura, Hiroaki Nozaki, Taisuke Kato, Akihide Koyama, Naoko Sakai, Shoichiro Ando, Masato Kanazawa, Nozomi Hishikawa, Yoshinori Nishimoto, Kiran Polavarapu, Atchayaram Nalini, Akira Hanazono, Daisuke Kuzume, Akihiro Shindo, Mohammad El-Ghanem, Arata Abe, Aki Sato, Mari Yoshida, Takeshi Ikeuchi, Ikuko Mizuta, Toshiki Mizuno, Osamu Onodera
Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is clinically characterized by early-onset dementia, stroke, spondylosis deformans, and alopecia. In CARASIL cases, brain magnetic resonance imaging reveals severe white matter hyperintensities (WMHs), lacunar infarctions, and microbleeds. CARASIL is caused by a homozygous mutation in high-temperature requirement A serine peptidase 1 ( HTRA1 ). Recently, it was reported that several heterozygous mutations in HTRA1 also cause cerebral small vessel disease (CSVD)...
2020: Frontiers in Neurology
X Ayrignac, N Gaillard, C Carra-Dallière, P Labauge
Small vessel disease of the brain is commonly identified among ageing people. It causes almost 25% of strokes and is associated with cognitive impairment and dementia as well as gait difficulties. Its diagnosis is usually made on MRI in the presence of deep white matter and basal ganglia hyperintensities as well as deep lacunar infarcts (lacunes), microbleeds and enlarged perivascular spaces. MRI is also of importance to identify the main differential diagnoses including inflammatory disorders, cerebral amyloid angiopathy and other genetic causes of microangiopathy...
July 24, 2020: La Revue de Médecine Interne
Huijin Huang, Zikang Niu, Gang Liu, Mengdi Jiang, Qingxia Jia, Xiaoli Li, Yingying Su
BACKGROUND: Large hemispheric infarction (LHI) is an ischemic stroke affecting at least two-thirds of the middle cerebral artery territory, with or without involvement of the anterior cerebral artery or posterior cerebral artery, and approximately 77% of LHI patients have early consciousness disorder (ECD). We constructed a functional brain network for LHI patients with an acute consciousness disorder to identify new diagnostic markers related to ECDs by analyzing brain network characteristics and mechanisms...
July 23, 2020: Neurocritical Care
Jinhee Han, Harin Yang, Jeong Hoon Bae, Hyun Young Kim, Young Seo Kim
RATIONALE: Computed tomography plays a key role in the initial evaluation of suspected acute stroke by ruling out the possibility of hemorrhage before thrombolysis. Recently, many reports have described cases of symptomatic microbleeds, and there may also have been a case of computed tomography- negative intracerebral hemorrhage. PATIENT CONCERNS: A 70-year-old female patient who had a history of lacunar infarction and severe small vessel disease developed dysarthria...
July 17, 2020: Medicine (Baltimore)
Yuguo Xia, Xiaozheng Ling, Guowen Hu, Qingwei Zhu, Juntao Zhang, Qing Li, Bizeng Zhao, Yang Wang, Zhifeng Deng
BACKGROUND: Small extracellular vesicles (sEV) secreted by mesenchymal stem cells (MSC) derived from human induced pluripotent stem cells (iPSC, iMSC-sEV) are considered to have great potential in treating ischemic diseases. Angiogenesis play an important role in post-stroke recovery. However, no studies have yet been conducted to systemically examine the effect and the underlying mechanism of iMSC-sEV on angiogenesis under brain ischemia conditions. METHODS: Ischemic stroke model was performed in rats induced by middle cerebral artery occlusion (MCAO), and the pro-angiogenic capacity of iMSC-sEV was measured...
July 22, 2020: Stem Cell Research & Therapy
Yoko Kimura, Kaori Miwa, Junji Takasugi, Naoki Oyama, Kenichi Todo, Manabu Sakaguchi, Hideki Mochizuki, Tsutomu Sasaki
BACKGROUND: Individual cerebral small vessel disease (SVD) markers are independent predictors for poor prognosis following intracerebral hemorrhage (ICH), however, the impact of the cumulative SVD burden on outcomes remains unclear. We aimed to investigate the association between the global SVD burden and functional outcomes following ICH. METHODS: We retrospectively evaluated a consecutive cohort of patients with ICH who underwent brain magnetic resonance imaging and magnetic resonance angiography, from a prospective registry...
August 2020: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jozef Chovanec, Michal Chovanec, Michal Mego
BACKGROUND: Natriuretic factors are peptidic substances produced by atrial and ventricular myocardium. Primary stimulus to the synthesis of these factors is intramural pressure of atriums by the increase of venous return during intravascular hypervolemia. They may serve as useful cardiac markers in clinical practice. The elevation of N-terminal fragment of atrial natriuretic peptide is characteristic for cardiac failure. Troponin T is a basic component of muscle and is specific for myocardial cell...
2020: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Yan Zhang, Tong Ma, Haijie Hu, Jiakai Wang, Shanshan Zhou
Objectives Although vascular endothelial growth factor (VEGF) is a well-known molecule involved with neuronal survival and angiogenesis. there are no prospective studies directed at evaluating a potential association between serum VEGF and minor ischemic stroke. The goal of this study was to investigate the utility of serum VEGF as an index for assessing the 90-day prognosis of minor ischemic stroke patients. Methods Records of acute minor stroke patients (N = 225) and those of age- and gender-matched healthy control subjects (N = 225) were prospectively reviewed...
July 1, 2020: Clinical Neurology and Neurosurgery
Michael A Thomas, Saman Hazany, Benjamin M Ellingson, Peng Hu, Kim-Lien Nguyen
Diagnostic imaging technology in vascular disease has long focused on large vessels and the pathologic processes that impact them. With improved diagnostic techniques, investigators are now able to uncover many underlying mechanisms and prognostic factors for microvascular disease. In the heart and brain, these pathologic entities include coronary microvascular disease and cerebral small vessel disease, both of which have significant impact on patients, causing angina, myocardial infarction, heart failure, stroke, and dementia...
July 8, 2020: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Neal S Parikh, Nicole Dueker, Dalila Varela, Victor J Del Brutto, Tatjana Rundek, Clinton B Wright, Ralph L Sacco, Mitchell S V Elkind, Jose Gutierrez
INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) has been associated with greater cerebral white matter hyperintensity (WMH) volume and microbleeds. The adiponutrin (PNPLA3) rs738409 G variant, a robust NAFLD susceptibility variant, has been variably associated with carotid atherosclerosis. We hypothesized that this variant is associated with WMH volume, microbleeds, covert brain infarction (CBI), and small perivascular spaces. METHODS: We performed a cross-sectional analysis of the Northern Manhattan Study-MRI Substudy...
June 20, 2020: Journal of the Neurological Sciences
Yuto Uchida, Hirohito Kan, Keita Sakurai, Nobuyuki Arai, Shohei Inui, Susumu Kobayashi, Daisuke Kato, Yoshino Ueki, Noriyuki Matsukawa
OBJECTIVE: To assess the relationship between iron accumulation, blood-brain barrier (BBB) damage, and cognitive function in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). METHODS: We enrolled 21 patients with NOTCH3 mutations and 21 age-matched healthy controls in this cross-sectional study. All participants underwent global physical and cognitive assessments and brain MRI, using voxel-based quantitative susceptibility mapping (QSM; iron deposition measure) and dynamic contrast enhanced MRI (DCE-MRI; BBB permeability measure)...
June 25, 2020: Neurology
Minyoul Baik, Kyung Min Kim, Chang-Myung Oh, Dongbeom Song, Ji Hoe Heo, Yoo Seok Park, Jin Wi, Young Sam Kim, Jeongmin Kim, Sung Soo Ahn, Kyoo Ho Cho, Yang-Je Cho
BACKGROUND: Cumulative evidence regarding the use of brain magnetic resonance imaging (MRI) for predicting prognosis of unconscious out-of-hospital cardiac arrest (OHCA) survivors treated with targeted temperature management (TTM) is available. Theoretically, these patients are at a high risk of developing cerebral infarction. However, there is a paucity of reports regarding the characteristics of cerebral infarction in this population. Thus, we performed a pilot study to identify the characteristics and risk factors of cerebral infarction and to evaluate whether this infarction is associated with clinical outcomes...
June 24, 2020: Neurocritical Care
Jie Wang, Li-Rong Wu, Xin Xie
BACKGROUND: Aortic dissection (AoD) is a disease with a high mortality rate. Its clinical manifestations are diverse and covert, which makes diagnosis and treatment challenging. Here, we report a very rare case of aortic dissection leading to bilateral cerebral cortex ischaemia and epilepsy. CASE PRESENTATION: A 54-year-old man was admitted to the hospital with acute onset of right limb weakness accompanied by slurred speech. He had a history of hypertension as well as tobacco and alcohol use...
June 23, 2020: BMC Neurology
Zaid Aljuboori, Dale Ding, Brian J Williams
The coexistence of brain tumors and unruptured intracranial aneurysms is uncommon, so there is limited data regarding management strategies for these cases. Tumor, aneurysm, and patient factors must be considered in the decision-making process. We present a case of a dural-based left temporal brain tumor with an incidental ipsilateral unruptured anterior cerebral artery (ACA) proximal A1 segment aneurysm. A 56-year-old female presented with progressive headaches and convulsions without focal neurological deficits...
May 18, 2020: Curēus
Rui Lan, Yun-Zhi Ma, Xiao-Ming Shen, Ji-Tao Wu, Chun-Qing Gu, Yong Zhang
BACKGROUND: Cerebral venous sinus thrombosis (CVST), a rare cause of cerebral infarction, is often unrecognized at initial presentation. We report the case of a patient with bilateral corpus callosum and corona radiata infarction due to cerebral venous sinus thrombosis presenting as headache and acute reversible aphasia. CASE PRESENTATION: A 30-year-old female patient presented with headache, vomiting, and motor aphasia. She was 20 days post-partum and had a lower than normal food intake following a normal vaginal delivery...
June 19, 2020: BMC Neurology
Satoshi Koizumi, Masaaki Shojima, Osamu Ishikawa, Hirotaka Hasegawa, Satoru Miyawaki, Hirofumi Nakatomi, Nobuhito Saito
BACKGROUND: Although the embolization of lenticulostriate artery feeders is often warranted in the treatment of brain arteriovenous malformations, it is technically challenging due to steep and repeated angulations. Here, we describe our novel technique of navigating a flow-guided microcatheter into lenticulostriate artery feeders using the strong support provided by an S-shaped distal access catheter. METHODS: We reviewed our retrospective cohort of brain arteriovenous malformations, in which lenticulostriate artery feeders were attempted to embolize...
June 19, 2020: Interventional Neuroradiology
Ivan Dinev, Ivan Zarkov, Gabriela V Goujgoulova, Georgi M Stoimenov, Georgi Georgiev, Dian Kanakov
This article outlines pathomorphologic findings of a study involving commercial mule ducks with confirmed influenza A H5N8 infections after a series of outbreaks in Bulgaria. Examinations were carried out after performing necropsy on dead birds from three different age groups (up to 15, 20 to 30, and 40+ days of age) fattened on different farms. Among birds of all ages, gross lesions were present as lesions affecting the heart. Histologically, the myocardium exhibited severe intermyofibrillar edema, moderate to massive hemorrhages, and degenerative changes...
June 2020: Avian Diseases
Ricky Chen, Gurjeet Singh, J Scott McNally, Cheryl A Palmer, Adam de Havenon
Introduction: Intravascular lymphoma (IVL) is an uncommon and often fatal disease characterized by intraluminal proliferation of lymphomatous cells within blood vessels. Because of a heterogeneous clinical presentation and lack of sensitive diagnostic protocols, diagnosis of IVL is most often made at autopsy. However, with early diagnosis and appropriate chemotherapy, the prognosis is greatly improved and complete remission is possible. In order to broaden the possible presentations of IVL, we present a patient with an atypical manifestation of biopsy-proven intravascular large B-cell lymphoma who suffered dissections of both intracranial and extracranial arteries in addition to progressive intracranial hemorrhages...
2020: Case Reports in Neurological Medicine
Yanosh Sanotsky, Marianna Selikhova, Ludmyla Fedoryshyn, Petro Kuzyk, Yuriy Matviyenko, Orest Semeryak, Dorota Dziewulska, Janice L Holton, Andrew J Lees
BACKGROUND: A number of cases of severe parkinsonism-dystonia have been recognized and reported following the illicit use of ephedrone prepared from pseudoephedrine and potassium permanganate. The pathology associated with ephedrone neurotoxicity has not been described yet in the scientific literature. OBJECTIVES: To report the first neuropathological study of ephedrone toxicity. METHODS: The brain of a 33-year-old Ukrainian female ex-ephedrone addict with a long history of l-dopa-unresponsive parkinsonism with dysarthria, dystonia, profound postural instability, cock-gait, and frequent falls, and on antiretroviral treatment, was examined using routine stains and immunohistochemistry...
June 16, 2020: Movement Disorders: Official Journal of the Movement Disorder Society
Sytze P Rensma, Thomas T van Sloten, Jennifer Ding, Sigurdur Sigurdsson, Coen D A Stehouwer, Vilmundur Gudnason, Lenore J Launer
OBJECTIVE: Type 2 diabetes has been associated with depression. However, the underlying pathophysiological mechanisms remain unknown. Cerebral small vessel disease, a consequence of diabetes, may lead to depression. Therefore, we evaluated whether cerebral small vessel disease mediates the association between type 2 diabetes and higher depressive symptoms. RESEARCH DESIGN AND METHODS: We used longitudinal data from the population-based Age, Gene/Environment Susceptibility-Reykjavik Study, with examinations from 2002 to 2006 and 5 years later...
June 11, 2020: Diabetes Care
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