Stroke; a journal of cerebral circulation
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The middle cerebral artery (MCA) "dot" sign consists of hyperdensity of an arterial structure, seen as a dot in the sylvian fissure. The MCA dot sign has been proposed to indicate thrombosis of M2 or M3 MCA branches, analogous to the hyperdense middle cerebral artery (HMCA) sign indicating M1 thrombosis. The MCA dot sign has not been validated previously against the gold standard of conventional cerebral angiography. ⋯ The MCA dot sign is a highly specific and moderately sensitive indicator of acute thrombus in the M2/M3 MCA branches, as validated by catheter angiography. The MCA dot sign is a useful additional acute stroke CT marker.
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The goal of this work was to determine the effect of age at initial presentation on clinical and morphological characteristics in patients with brain arteriovenous malformation (AVM). ⋯ Our data suggest a significant interaction of patient age and clinical and morphological AVM features and argue against uniform AVM characteristics across different age classes at initial presentation. In particular, AVM patients diagnosed at a higher age show a higher fraction of AVM hemorrhage and are more likely to harbor additional risk factors such as concurrent arterial aneurysms and small AVM diameter. Longitudinal population-based AVM data are necessary to confirm these findings.
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Although several studies have demonstrated the effectiveness of specialist Stroke Unit (SU) care of stroke patients, there is still disagreement over how these units are best organized. We sought to clarify the role of continuous monitoring of physiological parameters in acute ischemic stroke. ⋯ Admission of acute stroke patients to a monitoring SU may positively influence their outcome at discharge. Confirmation of our findings in larger trials will indicate the need for a revision of the minimum requirements of SUs, with the addition of monitoring as a new requirement.
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Case Reports
Risk of ischemic stroke in patients with symptomatic vertebrobasilar stenosis undergoing surgical procedures.
There is little information to provide an estimate for stroke risk in patients with established stenosis or occlusion in the basilar or intracranial vertebral arteries undergoing surgical procedures. The objective of this study was to determine the ischemic stroke risk in this specific patient population. ⋯ The risk of perioperative stroke in patients with vertebrobasilar stenosis undergoing surgery under general anesthesia is 6.0%, which is notably higher than the risk for patients with other patterns of cerebrovascular disease.
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We have previously shown that delivery of brain-derived neurotrophic factor (BDNF) through direct intrahippocampal gene transduction with a viral vector suppresses the formation of new dentate granule cells triggered by global forebrain ischemia. Here, we investigated whether inhibition of endogenous BDNF alters ischemia-induced neurogenesis in the dentate gyrus. ⋯ Our findings provide evidence that endogenous BDNF counteracts neuronal differentiation, but not cell proliferation or survival, in ischemia-induced dentate gyrus neurogenesis.