Are Cerebral White Matter Lesions Related to the Presence of Bilateral Internal Carotid Artery Stenosis or to the Length of Stenosis Among Patients With Ischemic Cerebrovascular Events?

We examined the relation between the presence of bilateral ICAS as well as the degree and length of stenosis and ipsi-, contralateral as well as mean white matter lesion load (MWMLL). Methods: In a retrospective cohort, patients with ischemic stroke or transient ischemic attack (TIA) as well as ipsi- and/or contralateral ICAS were identified. The length and degree of ICAS, as well as plaque morphology (hypoechoic, mixed or echogenic), were assessed on ultrasound scans and if available, the length was also measured in the magnetic resonance angiography (MRA) and/or digital subtraction angiography (DSA). The WMLs were assessed in 4 sites separately, periventricular and deep WMLs on each side, using the Fazekas scale and the MWMLL was calculated as the mean of these four values. Results: One-hundred-thirty-six patients with 177 ICAS were identified. A strong positive correlation between age and MWMLL was observed (Spearman correlation coefficient, ρ=0.41, p
Source: Frontiers in Neurology - Category: Neurology Source Type: research

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Conclusion: The present study suggests that lesion patterns observed from DWI of patients with PFO and SIAD might provide clues to the etiology of infarcts. Single lesions (cortical or subcortical) might be a typical feature of PFO associated strokes, while multiple lesions in one vascular territory might be a specific feature of SIAD associated strokes. Introduction Both patent foramen ovale (PFO) and spontaneous intracranial artery dissection (SIAD) are important stroke risk factors, especially in young and middle-aged adults (1–3). About 25% of patients with ischemic stroke are cryptogenic (4), and PFO is pr...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Ahmed Mohamed Elhfnawy1*, Peter U. Heuschmann2, Mirko Pham3†, Jens Volkmann1† and Felix Fluri1,4 1Department of Neurology, University Hospital Würzburg, Würzburg, Germany 2Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany 3Institute of Diagnostic and Interventional Neuroradiology, University Hospital of Würzburg, Würzburg, Germany 4Department of Neurology, Kantonssptial St. Gallen, St. Gallen, Switzerland Background and Purpose: Internal carotid artery stenosis (ICAS)≥70% is a leading cause of ischemic cerebrovascular event...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
I was shown this ECG with no other information:What do you think?Hint: try to see through the artifact!I answered immediately: " High lateral MI with posterior MI. OMI. " (Occlusion Myocardial Infarction)I asked, " Did the patient present with chest pain? "Here is the history:" A middle-aged male complained of about 18 hours of epigastric pain that radiated to the chest.  He also had an apparently new facial droop of equal duration.  A stroke code was called, NIH stroke scale was only 1, and attention was turned to the chest pain. "  BP was 148/83.How did I make this ECG diagnos...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ConclusionsDoppler ultrasound in our neurosonology laboratory was found to be a useful diagnostic tool for detecting cervical carotid artery stenosis and demonstrated superiority to carotid duplex despite the lack of B-mode. Furthermore, this technique was found to be useful for detecting intracranial stenosis.ResumenIntroducciónLa detección de estenosis arterial cervical e intracraneal es fundamental en el estudio del ictus isquémico, al ser el origen aterotrombótico el más prevalente en nuestro entorno. La ultrasonografía se ha convertido, por su accesibilidad y fiabilidad, en la...
Source: Neurologia - Category: Neurology Source Type: research
Conclusion: The evolution of atherosclerosis imaging and the emergence of new methods to measure atherosclerotic plaque vulnerability, particularly in the field of molecular imaging, have provided new insights into the pathophysiology of atherosclerosis and can be utilized in drug discovery and efficacy trials.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Source Type: research
Rationale: The majority of ischemic strokes are due to cardioembolism, large vessel atherothromboembolism, small vessel occlusive disease, or other unusual mechanisms. In most clinical settings, many strokes without a well-defined etiology requires a thorough diagnostic evaluation, otherwise the underlying cause might be easily overlooked. Here we report on the rare cause of a patient with recurrent stroke. Patient concerns: A 50-year-old female patient had a 4-year history of recurrent acute onset of neurological deficits. Diagnoses: Contrast transcranial Doppler ultrasound detected a typical “curtain”...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionCarotid imaging appears to be underused in patients with TIA and IS. Opportunities of secondary stroke prevention with carotid interventions are likely missed.
Source: Acta Neurologica Scandinavica - Category: Neurology Authors: Tags: ORIGINAL ARTICLE Source Type: research
ConclusionCEST is safe in ischemic stroke patients without intracranial LVO. There were no differences in clinical outcomes between the treatment groups.
Source: Acta Neurologica Scandinavica - Category: Neurology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Neural Analytics today released initial results from the Expedite study of its Transcranial Doppler Tech platform, touting 95% accuracy in the early detection of acute ischemic stroke due to large vessel occlusion. Data from the study was presented at the 26th annual European Stroke Conference this week in Berlin. The 45-subject trial examined the use of TCD scans in patients experiencing computer tomography angiography confirmed acute ischemic stroke due to large vessel occlusion of the internal carotid artery or middle cerebral artery. Scans with the TCD platform were analyzed with 2 different stroke assessment algo...
Source: Mass Device - Category: Medical Devices Authors: Tags: Clinical Trials Diagnostics Neurological Ultrasound Neural Analytics Source Type: news
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