Stroke; a journal of cerebral circulation
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Why is carotid plaque often so strikingly asymmetrical within individuals, and why does the extent of disease vary so considerably between individuals with similar systemic risk factors? Variability of carotid bifurcation anatomy is a possible explanation. Flow models suggest that vessel anatomy, in particular vessel diameter and area ratios, affects plaque formation at arterial bifurcations. However, carotid bifurcation anatomy could only be a major risk factor for plaque formation if it was sufficiently variable. Since very few data exist on the extent of interindividual and intraindividual variability of bifurcation anatomy, we studied 5395 angiograms from the European Carotid Surgery Trial. ⋯ We found large interindividual differences in carotid bifurcation anatomy. For example, there was 4-fold variation of the ratio of outflow to inflow area. Intraindividual variation was also considerable. These data highlight the potential importance of anatomic variation as a risk factor for atheroma and provide a firm basis for flow modeling studies.
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Human umbilical cord blood cells (HUCBC) are rich in stem and progenitor cells. In this study we tested whether intravenously infused HUCBC enter brain, survive, differentiate, and improve neurological functional recovery after stroke in rats. In addition, we tested whether ischemic brain tissue extract selectively induces chemotaxis of HUCBC in vitro. ⋯ Intravenously administered HUCBC enter brain, survive, migrate, and improve functional recovery after stroke. HUCBC transplantation may provide a cell source to treat stroke.
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Meta Analysis Comparative Study
Transcranial Doppler versus angiography in patients with vasospasm due to a ruptured cerebral aneurysm: A systematic review.
Transcranial Doppler (TCD) is used for diagnosis of vasospasm in patients with subarachnoid hemorrhage due to a ruptured aneurysm. Our aim was to evaluate both the accuracy of TCD compared with angiography and its usefulness as a screening method in this setting. ⋯ For the middle cerebral artery, TCD is not likely to indicate a spasm when angiography does not show one (high specificity), and TCD may be used to identify patients with a spasm (high PPV). For all other situations and arteries, there is either lack of evidence of accuracy or of any usefulness of TCD. Most of these data are of low methodological quality, bias cannot not be ruled out, and data reporting is often uncritical.