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Stroke Pathophysiology

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1. A case of retrograde venous air embolism causing cerebral infarction following upper gastrointestinal endoscopy: A novel pathophysiological mechanism Full Text available with Trip Pro

A case of retrograde venous air embolism causing cerebral infarction following upper gastrointestinal endoscopy: A novel pathophysiological mechanism The incidence of cerebral infarction following upper gastrointestinal endoscopic procedures is well described in the existing literature, with most mechanisms involving arterial travel of the embolus. We describe a case of cerebral infarction not explained by previously described mechanisms and detail the proposed occurrence of retrograde venous (...) air embolism causing cerebral infarction following an upper gastrointestinal endoscopic procedure.

2018 Radiology Case Reports

2. Functional Magnetic Resonance Imaging of Inhibitory Control Reveals Decreased Blood Oxygen Level Dependent Effect in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy. Full Text available with Trip Pro

Functional Magnetic Resonance Imaging of Inhibitory Control Reveals Decreased Blood Oxygen Level Dependent Effect in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy. Background and Purpose- Small-vessel damage in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is associated with impaired vascular constriction and dilation. We used a functional magnetic resonance imaging task with an event-related (...) in executive functions possibly reflecting the altered hemodynamic response secondary to small-vessel changes. Our observation extends the role of MR in demonstrating one of the fundamental pathophysiological changes of CADASIL.

2018 Stroke

3. Spatial and temporal identification of cerebral infarctions based on multiphoton microscopic imaging Full Text available with Trip Pro

Spatial and temporal identification of cerebral infarctions based on multiphoton microscopic imaging Ischemic stroke is a leading cause of death and permanent disability worldwide. Middle cerebral artery occlusion (MCAO) of variable duration times could be anticipated to result in varying degrees of injury that evolve spatially over time. Therefore, investigations following strokes require information concerning the spatiotemporal dimensions of the ischemic core as well as of perilesional areas (...) . In the present study, multiphoton microscopy (MPM) based on two-photon excited fluorescence (TPEF) and second harmonic generation (SHG) was applied to image such pathophysiological events. The ischemic time-points for evaluation were set at 6, 24, 48, and 72 hours after MCAO. Our results demonstrated that MPM has the ability to not only identify the normal and ischemic brain regions, but also reveal morphological changes of the cortex and striatum at various times following permanent MCAO. These findings

2018 Biomedical optics express

4. Idiopathic basal ganglia calcification associated with cerebral micro-infarcts: a case report. Full Text available with Trip Pro

reactivity in the whole brain, despite the absence of evidence for steno-occlusive changes in proximal arteries.Cerebrovascular insufficiency due to the lack of elasticity caused by microvascular calcification might have been one of the pathophysiological features of IBGC in this case. Thus, vascular calcification may cause cerebrovascular disturbance and could lead to ischemic stroke in patients with IBGC. (...) Idiopathic basal ganglia calcification associated with cerebral micro-infarcts: a case report. Idiopathic basal ganglia calcification (IBGC) is a rare neurodegenerative disorder characterized by symmetric intracranial calcium deposition. We report a patient with IBGC associated with cerebral infarction due to impairment of cerebrovascular reactivity based on single-photon emission computed tomography (SPECT) with acetazolamide challenge.A 66-year-old male presented with right conjugate

2018 BMC Neurology

5. Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling

suffer neurological deterioration attributable to cerebral swelling after ischemia. Hemispheric Stroke Patients with significant swelling typically have occlusions of the internal carotid artery, MCA, or both. The natural history of a large infarction after internal carotid artery versus MCA infarction is not clear, especially when independent of ante- rior cerebral artery territory infarction. Infarctions from MCA branch occlusions typically do not result in swelling with clinically significant mass (...) Recommendations for the Management of Cerebral and Cerebellar Infarction with Swelling 1222 Background and Purpose—There are uncertainties surrounding the optimal management of patients with brain swelling after an ischemic stroke. Guidelines are needed on how to manage this major complication, how to provide the best comprehensive neurological and medical care, and how to best inform families facing complex decisions on surgical intervention in deteriorating patients. This scientific statement

2014 Congress of Neurological Surgeons

6. Downregulation of microRNA-195 promotes angiogenesis induced by cerebral infarction via targeting VEGFA Full Text available with Trip Pro

Downregulation of microRNA-195 promotes angiogenesis induced by cerebral infarction via targeting VEGFA Angiogenesis, the formation of new blood vessels from preexisting endothelium, is a process that involves a series of interassociated and mutually interactive pathophysiological processes. It is accepted that microRNAs (miRNAs) regulate endothelial cell behavior, including their involvement in angiogenesis. However, it remains unclear whether miRNAs are involved in the regulation (...) of angiogenesis following cerebral ischemia. Therefore, the present study aimed to investigate the role of miRNAs in angiogenesis and the underlying mechanism following cerebral ischemia. Expression profiles of miRNAs in rat brain samples following middle cerebral artery occlusion (MCAO) were investigated using a miRNA microarray. The expression of candidate miRNA, miR‑195 was further validated using reverse transcription‑quantitative polymerase chain reaction. Then, the effects of miR‑195 on cell migration

2017 Molecular medicine reports

7. A Successfully Treated Case of Gastrointestinal Stromal Tumor Causing Severe Anemia and Localized Peritonitis Showing Angina Pectoris Resulting in Watershed Cerebral Infarction Full Text available with Trip Pro

A Successfully Treated Case of Gastrointestinal Stromal Tumor Causing Severe Anemia and Localized Peritonitis Showing Angina Pectoris Resulting in Watershed Cerebral Infarction Ischemic stroke following acute myocardial infarction is a rare but a serious complication. Because the pathophysiology of stroke is dynamic, it is often hard to identify the cause of stroke. Here, we present the case of a 75-year-old man with ischemic stroke following angina pectoris caused by severe anemia (...) and middle cerebral arteries area and stenosis of distal portion of right middle cerebral artery. The computed tomography of abdomen showed a mass of small intestine. We decided to perform curative surgery after transfusion and successfully resected the mass of the small intestine, which was revealed to be a gastrointestinal stromal tumor (GIST). This is a successfully treated case of GIST in which the complicated pathophysiology of watershed cerebral infarction following angina pectoris might be clearly

2017 Case reports in medicine

8. Differentiation of Deep Subcortical Infarction Using High-Resolution Vessel Wall MR Imaging of Middle Cerebral Artery Full Text available with Trip Pro

Differentiation of Deep Subcortical Infarction Using High-Resolution Vessel Wall MR Imaging of Middle Cerebral Artery To evaluate the utility of high-resolution vessel wall imaging (HR-VWI) of middle cerebral artery (MCA), and to compare HR-VWI findings between striatocapsular infarction (SC-I) and lenticulostriate infarction (LS-I).This retrospective study was approved by the Institutional Review Board, and informed consent was waived. From July 2009 to February 2012, 145 consecutive patients (...) with deep subcortical infarctions (SC-I, n = 81; LS-I, n = 64) who underwent HR-VWI were included in this study. The degree of MCA stenosis and the characteristics of MCA plaque (presence, eccentricity, location, extent, T2-high signal intensity [T2-HSI], and plaque enhancement) were analyzed, and compared between SC-I and LS-I, using Fisher's exact test.Stenosis was more severe in SC-I than in LS-I (p = 0.040). MCA plaque was more frequent in SC-I than in LS-I (p = 0.028), having larger plaque extent

2017 Korean Journal of Radiology

9. Pharyngolaryngeal Sensory Deficits in Patients with Middle Cerebral Artery Infarction: Lateralization and Relation to Overall Dysphagia Severity Full Text available with Trip Pro

Pharyngolaryngeal Sensory Deficits in Patients with Middle Cerebral Artery Infarction: Lateralization and Relation to Overall Dysphagia Severity Dysphagia is a frequent and dangerous complication of acute stroke. Apart from a well-timed oropharyngeal muscular contraction pattern, sensory feedback is of utmost importance for safe and efficient swallowing. In the present study, we therefore analyzed the relation between pharyngolaryngeal sensory deficits and post-stroke dysphagia (PSD) severity (...) in a cohort of acute stroke patients with middle cerebral artery (MCA) infarction.Eighty-four first-ever MCA stroke patients (41 left, 43 right) were included in this trial. In all patients, fiberoptic endoscopic evaluation of swallowing (FEES) was performed according to a standardized protocol within 96 h after stroke onset. PSD was classified according to the 6-point fiberoptic endoscopic dysphagia severity scale. Pharyngolaryngeal sensation was semi-quantitatively evaluated by a FEES-based touch

2017 Cerebrovascular Diseases Extra

10. Isolated Striatocapsular Infarcts after Endovascular Treatment of Acute Proximal Middle Cerebral Artery Occlusions: Prevalence, Enabling Factors, and Clinical Outcome Full Text available with Trip Pro

Isolated Striatocapsular Infarcts after Endovascular Treatment of Acute Proximal Middle Cerebral Artery Occlusions: Prevalence, Enabling Factors, and Clinical Outcome Striatocapsular infarcts (SCIs) are defined as large subcortical infarcts involving the territory of more than one lenticulostriate artery. SCI without concomitant ischemia in the more distal middle cerebral artery (MCA) territory [isolated SCI (iSCI)] has been described as a rare infarct pattern. The purpose of this study (...) iSCI patients, in general, had a more favorable outcome, considerable heterogeneity in outcome was observed.High rates of successful reperfusion (TICI 2b/3) and in particular, complete reperfusion (TICI 3) are associated with iSCIs. The high prevalence of iSCI in successfully reperfused patients with good collaterals corroborates previous concepts of iSCI pathogenesis. iSCI, once considered a rare pattern of cerebral ischemia, is likely to become more prevalent with increases in endovascular stroke

2017 Frontiers in neurology

11. Promoter hypomethylation of microRNA223 gene is associated with atherosclerotic cerebral infarction. (Abstract)

Promoter hypomethylation of microRNA223 gene is associated with atherosclerotic cerebral infarction. microRNA223 (miR-223) plays an important role in the development of atherosclerosis and ischemic stroke. It is involved in regulation of multiple physiological and pathophysiological processes such as cholesterol metabolism, endothelial cell (EC) function, and thrombosis. Here we investigated the role of methylation regulation of MIR-223 promoter region in atherosclerotic cerebral infarction (...) with atherosclerotic cerebral infarction.Copyright © 2017. Published by Elsevier B.V.

2017 Atherosclerosis

12. Exacerbation of Thromboinflammation by Hyperglycemia Precipitates Cerebral Infarct Growth and Hemorrhagic Transformation. Full Text available with Trip Pro

Exacerbation of Thromboinflammation by Hyperglycemia Precipitates Cerebral Infarct Growth and Hemorrhagic Transformation. Admission hyperglycemia is associated with a poor outcome in acute ischemic stroke. How hyperglycemia impacts the pathophysiology of acute ischemic stroke remains largely unknown. We investigated how preexisting hyperglycemia increases ischemia/reperfusion cerebral injury.Normoglycemic and streptozotocin-treated hyperglycemic rats were subjected to transient middle cerebral (...) artery occlusion. Infarct growth and brain perfusion were assessed by magnetic resonance imaging. Markers of platelet, coagulation, and neutrophil activation were measured in brain homogenates and plasma. Downstream microvascular thromboinflammation (DMT) was investigated by intravital microscopy.Hyperglycemic rats had an increased infarct volume with an increased blood-brain barrier disruption and hemorrhagic transformation rate compared with normoglycemic rats. Magnetic resonance imaging scans

2017 Stroke

13. Pathophysiology of acute middle cerebral artery infarct by multimodal computed tomography: A pilot study in Thai patients Full Text available with Trip Pro

Pathophysiology of acute middle cerebral artery infarct by multimodal computed tomography: A pilot study in Thai patients The purpose of this study was to study pathophysiology of acute middle cerebral artery infarct using multimodal CT and to evaluate the safety and feasibility of this method in our center.Patients who had moderate to severe stroke (NIHSS score > 10), suspected of anterior circulation infarct and presented within 4 hours after stroke onset were prospectively included (...) . Multimodal CTs, using low-osmolar contrast agents, were performed in all patients.Twenty-two patients were included. Mean NIHSS was 16. All patients received intravenous thrombolysis. Favorable outcome was found in nine patients (41%). CTP was unable to identify ischemic lesions in three patients with small subcortical infarct. Most patients (82%) with large middle cerebral artery infarct still had some salvageable brain (penumbra) which partly recovered in a follow-up imaging. Eleven patients (50%) had

2015 Journal of neurosciences in rural practice

14. Canadian Stroke Best Practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; 6th edition update 2019

be costly, or forgo super- vised therapy and potentially not meet their rehabilita- tion and recovery potential. The 2019 update of the Canadian Stroke Best Practice Recommendations (CSBPR): Rehabilitation and Recovery following Stroke module is a comprehen- sive summary of current evidence-based recommenda- tions, focusing primarily on the management of people who have already had a moderately or severely dis- abling stroke. People with milder stroke or transient ischemic attack may not require (...) for select patients with acute stroke (for instance, people with more mild strokesor transient ischemic attack) butcautionisadvised, andclinical judgmentshouldbeused(Evidence Level C). (iv) Once deemed to be medically and neurologically stable, patients should receive a recommended three hours perdayof directtask-specific therapy, five days aweek, delivered by the interdisciplinary stroke team (Evidence Level C); more therapy results in better outcomes (Evidence Level A). (v) Individualized

2020 CPG Infobase

15. The Silent Cortical Infarcts in the Cerebral Amyloid Angiopathy: Is There a Link With Subarachnoid Hemorrhage?

Infarction Cerebral Amyloid Angiopathy Cerebral Amyloid Angiopathy, Familial CADASIL Pathologic Processes Intracranial Hemorrhages Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Ischemia Necrosis Cerebral Arterial Diseases Intracranial Arterial Diseases Amyloidosis Proteostasis Deficiencies Metabolic Diseases Brain Diseases, Metabolic, Inborn Brain Diseases, Metabolic Cerebral Small Vessel Diseases Amyloidosis (...) The Silent Cortical Infarcts in the Cerebral Amyloid Angiopathy: Is There a Link With Subarachnoid Hemorrhage? The Silent Cortical Infarcts in the Cerebral Amyloid Angiopathy: Is There a Link With Subarachnoid Hemorrhage? - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved

2016 Clinical Trials

16. Cerebrovascular Accident in Sickle Cell Anemia

Administration 4 Cerebrovascular Accident in Sickle Cell Anemia Cerebrovascular Accident in Sickle Cell Anemia Aka: Cerebrovascular Accident in Sickle Cell Anemia , CVA in Sickle Cell Disease , Silent Cerebral Infarction in Sickle Cell Anemia From Related Chapters II. Epidemiology: Prevalence is the most common cause of Children: 5% Highest risk at ages 2 to 5 years old with Clinically apparent stroke occurs in 10% by age 5 years old Silent cerebral infarct occurs in up to 25% of children by age 6 years old (...) May result in gradual cognitive decline Young adult (age <20): 11% Age 45 years old: 24% Lifetime risk: 25% III. Pathophysiology Silent Silent CVA may occur in up to 25% of children with by age 6 years old May present as cognitive deficits or learning difficulties May be prevented with regular s (see below) Most common in children and teens thrombosis Most common in ages 20 to 30 years old IV. Risk Factors Prior Chronic low baseline (below typical levels) Recent Mean cerebral arterial flow

2018 FP Notebook

17. Identification the Cause of Cerebral Infarction in Patients With Cancer

MeSH terms: Layout table for MeSH terms Infarction Cerebral Infarction Ischemia Pathologic Processes Necrosis Brain Infarction Brain Ischemia Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Stroke Vascular Diseases Cardiovascular Diseases (...) , 2014 Sponsor: Samsung Medical Center Information provided by (Responsible Party): suk jae kim, Samsung Medical Center Study Details Study Description Go to Brief Summary: Although there has been increasing interest in the association between cancer and cerebrovascular disease, the underlying pathophysiology of stroke in cancer patients is still not fully understood. The aim of this study is to investigate the stroke mechanisms in patients with cancer-associated stroke. Condition or disease

2014 Clinical Trials

18. CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Overview)

CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Overview) CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy): Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do (...) . FLAIR MRI of the brain showing hyperintensities involving the temporal poles in a patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). (Reprinted with permission from Mayo Clin Proc, Meschia, 2005.) Next: Pathophysiology CADASIL is caused by a mutation in the NOTCH3 gene on chromosome 19q12. The gene mutation was first identified in 1996. [ ] NOTCH3 codes for a transmembrane receptor protein whose function is not precisely known

2014 eMedicine.com

19. CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Diagnosis)

CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy) (Diagnosis) CADASIL (Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy): Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do (...) . FLAIR MRI of the brain showing hyperintensities involving the temporal poles in a patient with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). (Reprinted with permission from Mayo Clin Proc, Meschia, 2005.) Next: Pathophysiology CADASIL is caused by a mutation in the NOTCH3 gene on chromosome 19q12. The gene mutation was first identified in 1996. [ ] NOTCH3 codes for a transmembrane receptor protein whose function is not precisely known

2014 eMedicine.com

20. A functional polymorphism at miR-491-5p binding site in the 3'-UTR of MMP-9 gene confers increased risk for atherosclerotic cerebral infarction in a Chinese population. (Abstract)

A functional polymorphism at miR-491-5p binding site in the 3'-UTR of MMP-9 gene confers increased risk for atherosclerotic cerebral infarction in a Chinese population. and purpose: Matrix metalloproteinases 9 (MMP-9) has been reported to play a critical role in the pathophysiology of atherosclerotic cerebral infarction (ACI). Here we assessed association of MMP-9 polymorphisms with ACI susceptibility and the function of SNPs through microRNA mediated regulation.Genotyping was performed using (...) MALDI-TOF mass spectrometry. Reporter gene plasmids with the MMP-9 3'UTR carrying either the mutant or the wild-type MMP-9 allele were constructed. Also, we constructed pcDNA-3.1-miR-491-5p recombinant plasmid, which transiently co-transfected human umbilical vein endothelial cells (HUVEC) with the reporter plasmids. Reporter plasmids, miR-491-5p mimics and inhibitor were transfected into HUVE cells line by lipofectamine. MMP-9 mRNA expression in HUVEC was detected by RT-PCR and protein level

2012 Atherosclerosis

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