Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2012
Case ReportsEfficacy of prophylactic blood pressure lowering according to a standardized postoperative management protocol to prevent symptomatic cerebral hyperperfusion after direct revascularization surgery for moyamoya disease.
Cerebral hyperperfusion is a potential complication of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis for moyamoya disease, but the optimal postoperative management has not been determined. Aggressive blood pressure lowering is controversial because of the risk of ischemic complications. ⋯ Prophylactic blood pressure lowering prevents symptomatic cerebral hyperperfusion after STA-MCA anastomosis in patients with moyamoya disease. Accurate diagnosis of cerebral hyperperfusion and blood pressure lowering, and considering the severity of hemodynamic compromise in the contralateral and/or remote areas are essential for postoperative management of moyamoya disease.
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Cerebrovascular diseases · Jan 2012
VAP-1/SSAO plasma activity and brain expression in human hemorrhagic stroke.
Vascular adhesion protein-1 (VAP-1) is a cell surface and circulating enzyme that belongs to the semicarbazide-sensitive amine oxidase (SSAO) family, which oxidatively deaminates primary amines and is implicated in leukocyte extravasation. Our aim was to investigate the alteration of soluble VAP-1/SSAO activity in plasma samples after acute intracerebral hemorrhage (ICH) and its presence in human ICH brain tissue. ⋯ Our data demonstrate that plasma VAP-1/SSAO activity is increased in ICH and predicts neurological outcome, suggesting a possible contribution of the soluble protein in secondary brain damage. Furthermore, anti-VAP-1/SSAO strategies might be a promising approach to prevent neurological worsening following ICH.
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Little is known about the burden of stroke in sub-Saharan Africa that may increase with the ongoing demographic and socioeconomic transition. This study aims to assess the prevalence of stroke, its related disability rate and consequences in the quality of daily life in an urban door- to-door survey in Cotonou, Benin. ⋯ The stroke prevalence in urban areas of Cotonou is higher than that reported in other sub-Saharan countries, and the majority of stroke survivors present with good functional recovery and without severe disability in their everyday life.
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Cerebrovascular diseases · Jan 2012
Hyperintensity of distal vessels on FLAIR is associated with slow progression of the infarction in acute ischemic stroke.
Hyperintensity of distal vessels on FLAIR-MRI has been associated with a higher grade of arterial collaterals and a smaller infarct volume in acute stroke patients. No studies analyze the influence of the hyperintense vessel (HV) sign on the speed of the ischemia progression during the first hours. Our aim was to study the association of the HV sign with progression of infarction in acute stroke patients. ⋯ HV sign on FLAIR, especially if prominent, is associated with a slow progression of the ischemic area in acute stroke patients with cerebral artery occlusion of the anterior circulation. This radiological sign may predict the speed of the ischemia progression, opening an opportunity for reperfusion therapies in longer time windows.
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Cerebrovascular diseases · Jan 2012
Prediction of motor function outcome after intracerebral hemorrhage using fractional anisotropy calculated from diffusion tensor imaging.
The efficacy of surgical evacuation in patients with intracerebral hemorrhage (ICH) remains unclear for recovery of motor function. The relationship between improvement of motor function outcome and sequential change of fractional anisotropy (FA) values was investigated in patients with ICH, to explore whether motor function outcome can be predicted in the early phase. Indication of the surgical hematoma evacuation was also considered. ⋯ The main finding of this study was that the FA values of the cerebral peduncle on the pathological side in patients with ICH on day 3 could predict the motor function outcome on day 90.