Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · May 2014
Comparative StudyFactors associated with proximal carotid axis occlusion in patients with acute stroke and atrial fibrillation.
Patients with atrial fibrillation (AF) are more likely to exhibit proximal carotid axis occlusion than those without AF. However, clinical characteristics associated with proximal arterial occlusion (PAO) in acute stroke patients with AF are not fully known. This study was aimed to elucidate the factors correlated with PAO. ⋯ Female sex, advanced age, history of systemic embolism, and higher BNP level were independently associated with more proximal carotid axis occlusion. Patients with AF having these factors may be prone to have relatively large thrombi in the heart.
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J Stroke Cerebrovasc Dis · May 2014
Comparative StudyDoes modern ischemic stroke therapy in a large community-based dedicated stroke center improve clinical outcomes? A two-year retrospective study.
To compare modern endovascular therapies in the acute ischemic stroke patients leading to more comprehensive acute stroke algorithm. ⋯ Modern endovascular therapies for acute ischemic stroke do improve clinical outcomes when implemented in the setting of a dedicated comprehensive stroke team.
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J Stroke Cerebrovasc Dis · May 2014
Multicenter Study Comparative StudyWhite matter hyperintensities in mild cognitive impairment: clinical impact of location and interaction with lacunes and medial temporal atrophy.
This study was to evaluate the influence on cognition and activities of daily living (ADL) by white matter hyperintensities (WMHs) based on the severity and location, as well as the interactions among WMHs, lacunes, and medial temporal atrophy (MTA). In 150 patients with amnestic mild cognitive impairment, WMHs were quantified with the use of a semiautomated volumetric method. Lacune counting and MTA assessment were performed by visual rating. ⋯ Anterior PVWMHs demonstrated the most powerful impact on frontal executive dysfunction and poor performance of IADL. WMHs had synergistic effects with the number of lacunes on them. Therefore, it is desirable to consider WMHs and lacunes simultaneously as potential imaging biomarkers for predicting cognition and IADL in aMCI.
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J Stroke Cerebrovasc Dis · May 2014
Case ReportsCerebral perfusion change of venous hypertension on near-infrared spectroscopy signals after operation for dural arteriovenous fistula.
A dural arteriovenous fistula (AVF) is an arteriovenous shunt in the dura and is associated with a risk of intracranial hemorrhage and neurologic deficit. The morbidity of this disease depends on venous hypertension, and the classification of this disease is based on the pattern of venous drainage. The pattern of venous drainage relates to the clinical features of the disease, especially to the probability of intracranial hemorrhage. ⋯ After complete embolization (stage 2), fNIRS showed a pattern similar to that of a normal adult. The patient's symptoms improved gradually, and angiography showed a reduction of the retrograde venous drainage and venous congestion after this 2-stage operation. The reduction in venous hypertension may be the underlying mechanism behind the changes observed with fNIRS.
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J Stroke Cerebrovasc Dis · May 2014
ReviewSearching for salvageable brain: the detection of ischemic penumbra using various imaging modalities?
Various imaging modalities are used to identify the ischemic penumbra in patients with acute ischemic stroke. Although single-photon emission computed tomography (CT), perfusion-weighted magnetic resonance imaging (MRI), and perfusion CT are used to evaluate residual cerebral blood flow in the ischemic area, validation of the perfusion threshold for the penumbra has not been established. ⋯ A mismatch of these abnormalities is thought to correspond to the ischemic penumbra and has been used in clinical trials. Although new ligands, such as (18)F-fluoromisonidazole, that bind to hypoxic but viable ischemic tissue are currently available, positron emission tomography has yet to be developed as a clinical tool.