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Perivascular spaces mediate a relationship between diabetes and other cerebral small vessel disease markers in cerebrovascular and neurodegenerative diseases
Cerebral small vessel disease (SVD) is used to describe heterogeneous pathological changes in perforating arterioles, venules, and capillaries that supply blood to subcortical structures.1 These pathological changes manifest on magnetic resonance imaging (MRI) as quantifiable volumetric measures. Established markers of SVD identified on MRI include deep white matter hyperintensities (dWMH) and periventricular white matter hyperintensities (pWMH) of presumed vascular origin and lacunes, and MRI visible enlarged perivascular spaces (PVS) in the white matter (wmPVS) or basal ganglia (bgPVS).
Source: Journal of Stroke and Cerebrovascular Diseases - August 3, 2023 Category: Neurology Authors: Julia Zebarth, Radia Kamal, George Perlman, Michael Ouk, Lisa Y. Xiong, Di Yu, William Z. Lin, Joel Ramirez, Mario Masellis, Maged Goubran, Bradley J. MacIntosh, Sandra E. Black, Hugo Cogo-Moreira, Christopher J.M. Scott, Robert Bartha, Sean Symons, Seyye Source Type: research

Total Cerebral Small Vessel Disease Burden Predicts the Outcome of Acute Stroke Patients after Intra-Arterial Thrombectomy
Conclusions: The total cSVD burden score was independently associated with the clinical outcomes of AIS patients after IAT treatment and it may be a reliable predictor for poor outcomes of AIS patients after IAT treatment.Cerebrovasc Dis
Source: Cerebrovascular Diseases - March 13, 2023 Category: Neurology Source Type: research

Sex differences and risk factors in recurrent ischemic stroke
ConclusionHypertension and dyslipidemia were significant risk factors of recurrent ischemic stroke in both genders. Smoking and alcohol drinking were significant risk factors associated with ischemic stroke recurrence in males. Therefore, smoking cessation and alcohol abstinence are recommended after the first stroke to prevent recurrent ischemic stroke especially for males. Diabetes was a significant risk factor of ischemic stroke recurrence in females. More extensive studies are needed to understand the causal relationship of each factors with ischemic stroke recurrence according to sex differences and specification of p...
Source: Frontiers in Neurology - January 26, 2023 Category: Neurology Source Type: research

Dizziness in a tertiary neurological department: A cross ‐sectional study
ConclusionThe diagnosis and management of dizziness remain a challenge for clinicians. Vertigo and light-headedness were the most common symptoms among different types of dizziness. Benign paroxysmal positional vertigo and stroke/transient ischemic attack were among the leading causes for common dizziness disorders. The prognosis of most dizzy patients was good.
Source: Brain and Behavior - December 30, 2022 Category: Neurology Authors: Youjin Shen, Wentao Liu, Xiaokun Qi Tags: ORIGINAL ARTICLE Source Type: research

Global Cortical Atrophy Is Associated with an Unfavorable Outcome in Stroke Patients on Oral Anticoagulation
Conclusion: GCA was associated with our composite outcome also after adjusting for other cSVD markers (i.e., CMB, WMH) and age, indicating that GCA may potentially serve as a prognostic marker for stroke patients with atrial fibrillation on oral anticoagulation.Cerebrovasc Dis
Source: Cerebrovascular Diseases - December 13, 2022 Category: Neurology Source Type: research

Case report: Bilateral posterior ischemic optic neuropathy in a patient with atrial fibrillation and multifocal embolic stroke
An 80-year-old female with a history of diabetes mellitus (DM) and hypertension presented with sudden onset of sequential bilateral visual loss. The best visual acuity was light perception in the right eye and finger counting in the left eye, however, bilateral fundus did not reveal optic disc edema. Diffusion-weighted magnetic resonance imaging (MRI) of the brain revealed acute embolic stroke and diffusion restriction in the posterior portion of both optic nerves. The 24-h Holter monitor showed persistent atrial fibrillation (AF) with rapid ventricular response. The presence of painless and severe visual loss at onset una...
Source: Frontiers in Neurology - December 2, 2022 Category: Neurology Source Type: research

Heart rate variability is associated with cerebral small vessel disease in patients with diabetes
ConclusionsLower HRV was associated with total burden of CSVD and each MRI markers of CSVD separately among diabetic patients, but not among non-diabetic patients.
Source: Frontiers in Neurology - November 10, 2022 Category: Neurology Source Type: research

Acute Cerebral Microinfarcts in Acute Ischemic Stroke: Imaging and Clinical Significance
Conclusions: We have shown A-CMIs occur in cortical and subcortical regions in nearly half of AIS patients, where microembolism and CSVD are, respectively, the key presumed etiological mechanism.Cerebrovasc Dis
Source: Cerebrovascular Diseases - April 29, 2022 Category: Neurology Source Type: research

Progressive Ataxia and Downbeat Nystagmus in an Adult
A 63-year-old man presented with a history of vomiting, hypertension, dyslipidemia, type 2 diabetes, dilated ischemic cardiomyopathy, alcohol use, and stroke; physical examination found appendicular dysmetria with truncal ataxia and downbeat nystagmus. Brain magnetic resonance imaging revealed a hyperintensity on T2-weighted and fluid-attenuated inversion recovery sequences without reduced diffusion in the cerebellar nodule. What is your diagnosis?
Source: JAMA Neurology - August 1, 2021 Category: Neurology Source Type: research

Brain Infarction MRI Pattern in Stroke Patients with Intracardiac Thrombus
Conclusions: ICT-related stroke is associated with acute SCCI presence on MRI.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT04456309.Cerebrovasc Dis
Source: Cerebrovascular Diseases - June 17, 2021 Category: Neurology Source Type: research

Progressive Ataxia and Downbeat Nystagmus in the Adult
A 63-year-old man presented with a history of vomiting, hypertension, dyslipidemia, type 2 diabetes, dilated ischemic cardiomyopathy, alcohol use, and stroke; physical examination found appendicular dysmetria with truncal ataxia and downbeat nystagmus. Brain magnetic resonance imaging revealed a hyperintensity on T2-weighted and fluid-attenuated inversion recovery sequences without reduced diffusion in the cerebellar nodule. What is your diagnosis?
Source: JAMA Neurology - May 17, 2021 Category: Neurology Source Type: research

Millard-Gubler Syndrome Associated with Cerebellar Ataxia in a Patient with Isolated Paramedian Pontine Infarction – A Rarely Observed Combination with a Benign Prognosis: A Case Report
We report the case of a 55-year-old male patient having presented to the Yehuleshet Specialty Clinic 6 years back with sudden-onset dysarthria and appendicular ataxia of 10 days duration. He reported having right hemibody weakness and blurred vision, which have significantly improved since then. He had a history of smoking of 30 pack-years. However, he quit smoking 8 years ago. There was no history of prior stroke, transient ischemic attack, diabetes, hypertension, head trauma, or dyslipidemia. On examination, he had horizontal left gaze palsy with horizontal nystagmus suggesting left-sided 6th cranial nerve palsy. He had ...
Source: Case Reports in Neurology - April 13, 2021 Category: Neurology Source Type: research

Association of the CHA2D(S2)-VASc Score and Its Components With Overt and Silent Ischemic Brain Lesions in Patients With Atrial Fibrillation
Conclusions: A higher CHA2D-VASc score was associated with a higher risk of both overt and silent ischemic brain lesions.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02105844.
Source: Frontiers in Neurology - January 12, 2021 Category: Neurology Source Type: research

New Insights Into Vertigo Attack Frequency as a Predictor of Ischemic Stroke
Conclusions: Our findings indicate that the clinical parameters, including arterial stenosis, DM, and magnetic resonance imaging (MRI) findings, differed between the low- and high-frequency groups. We also found that patients in the low-frequency group were more willing to seek medical intervention after the attacks of vertigo. These findings could be valuable for clinicians to focus on specific examination of the patients according to the frequency of vertigo attacks.
Source: Frontiers in Neurology - December 16, 2020 Category: Neurology Source Type: research

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) – Still to be Considered in the Presence of Vascular Risk Factors
We report a 46-year-old male with a 9 and 3-month history of progressive unilateral lower limb weakness and dysarthria, respectively. He had a history of diabetes mellitus but no hypertension, hyperlipidemia, or smoking history. Both parents had a stroke at the age of 65 years. Neurological examination was significant for moderate dysarthria and reduced right upper limb dexterity. Magnetic resonance imaging (MRI) of the brain revealed extensive white matter disease, lacunar infarcts, and a few microhemorrhages. Electron microscopy of his skin biopsy showed electron-dense deposits of extracellular osmiophilic granular mater...
Source: Case Reports in Neurology - December 14, 2020 Category: Neurology Source Type: research

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