Journal of neurosurgery
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Journal of neurosurgery · Oct 2010
Assessment of necrotic core with intraplaque hemorrhage in atherosclerotic carotid artery plaque by MR imaging with 3D gradient-echo sequence in patients with high-grade stenosis. Clinical article.
The aim of this study was to assess the histopathological differences between advanced atherosclerotic carotid artery (CA) plaques with signal hyperintensity on T1-weighted MR images and those without, focusing on necrotic core size and intraplaque hemorrhage (IPH). ⋯ Atherosclerotic CA plaques with high signal intensity on MPRAGE sequences had large necrotic cores with IPH in patients with high-grade stenosis; MPRAGE is useful for the evaluation of CA plaque progression.
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Journal of neurosurgery · Oct 2010
Scar formation in the carotid sheath identified during carotid endarterectomy in patients with previous cardiac surgery: significance of history of intraoperative Swan-Ganz catheter insertion. Clinical article.
Scar formation in the carotid sheath is often identified during carotid endarterectomy (CEA) in patients with previous cardiac surgery, and dissection of the carotid sheath and exposure of the carotid arteries in such patients are difficult. The purpose of the present study was to investigate factors related to scar formation identified during CEA in patients with previous cardiac surgery. ⋯ A history of Swan-Ganz catheter insertion during previous cardiac surgery is associated with the presence of scar tissue in the ipsilateral carotid sheath and a higher risk of complications during CEA.
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Journal of neurosurgery · Oct 2010
Toll-like receptor 4 expression during cerebral aneurysm formation. Laboratory investigation.
The pathophysiological origin of cerebral aneurysms is closely associated with chronic inflammation in arterial walls. Recently, the authors identified nuclear factor-kappa B (NF-κB) as a key mediator of cerebral aneurysm formation and progression. Because Toll-like receptor 4 (TLR4) stimulates NF-κB activation in arterial walls in atherosclerosis, the authors hypothesize that TLR4 expresses in cerebral aneurysms and contributes to the activation of NF-κB in cerebral aneurysm walls. ⋯ Toll-like receptor 4 was expressed in cerebral aneurysm walls both in rats and humans. This receptor may play a crucial role in cerebral aneurysm formation through NF-κB activation in endothelial cells. The results of the present study will shed new light on the pathogenesis of cerebral aneurysm formation.