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Pre-existing Small Vessel Disease in Patients with Acute Stroke from the Middle East, Southeast Asia, and Philippines
AbstractAsymptomatic small vessel disease (SVD), including white matter hyperintensities (WMHIs), periventricular hyperintensities (PVHIs), silent stroke (SS), and cerebral microbleeds (CMBs), increases the risk of stroke. There are limited studies of SVD in subjects from the Middle East and Southeast Asia (SA). All patients admitted to stroke service between 2014 and 2015 were reviewed for presence of “pre-existing” SVD. Stroke mimics with no previous history of stroke were used as controls. There were 1727 patients admitted with stroke. Analysis was done on 988 subjects (914 strokes and 74 controls) who had MRI scan ...
Source: Translational Stroke Research - November 3, 2017 Category: Neurology Source Type: research

MRI Guiding of the Middle Cerebral Artery Occlusion in Rats Aimed to Improve Stroke Modeling
AbstractThe middle cerebral artery occlusion (MCAO) model in rats closely imitates ischemic stroke and is widely used. Existing instrumental methods provide a certain level of MCAO guidance, but monitoring of the MCA-occluding intraluminal filament position and possible complications can be improved. The goal of this study was to develop a MRI-based method of simultaneous control of the filament position, blood flow in the intracranial vessels, and hemorrhagic complications. Rats were subjected to either MRI-guided MCAO (group 1,n = 51) or MCAO without MRI control (group 2,n = 38). After operation, group 1 rats wer...
Source: Translational Stroke Research - November 25, 2017 Category: Neurology Source Type: research

Neuroimaging as a Selection Tool and Endpoint in Clinical and Pre-clinical Trials
AbstractStandard imaging in acute stroke enables the exclusion of non-stroke structural CNS lesions and cerebral haemorrhage from clinical and pre-clinical ischaemic stroke trials. In this review, the potential benefit of imaging (e.g., angiography and penumbral imaging) as a translational tool for trial recruitment and the use of imaging endpoints are discussed for both clinical and pre-clinical stroke research. The addition of advanced imaging to identify a “responder” population leads to reduced sample size for any given effect size in phase 2 trials and is a potentially cost-efficient means of testing interventions...
Source: Translational Stroke Research - August 19, 2016 Category: Neurology Source Type: research

ASPECT Score and Its Application to Vasospasm in Aneurysmal Subarachnoid Haemorrhage: a Case –Control Study
AbstractDelayed cerebral ischaemia (DCI) is a significant complication of aneurysmal subarachnoid haemorrhage (aSAH) and is strongly associated with poorer outcome. The Alberta Stroke Program Early Computer Tomography (ASPECT) score is an established scoring tool, used in acute ischaemic stroke, to quantify early ischaemic changes on CT head scans. We aim to identify if ASPECT scoring correlates with functional outcome in DCI following aSAH. Retrospective case –control study. Inclusion criteria: admission to the Department of Neurosurgery at Leeds Teaching Hospitals NHS Trust (a tertiary neurosurgical centre in the Unite...
Source: Translational Stroke Research - August 9, 2022 Category: Neurology Source Type: research

Apolipoprotein E Exerts a Whole-Brain Protective Property by Promoting M1? Microglia Quiescence After Experimental Subarachnoid Hemorrhage in Mice
We reported thatApoe deficiency resulted in a more extensive EBI at 48  h after SAH in mice demonstrated by MRI scanning and immunohistochemical staining and exhibited more extensive white matter injury and neuronal apoptosis than WT mice. These changes were associated with an increase in NADPH oxidase 2 (NOX2) expression, an important regulator of both oxidative stre ss and inflammatory cytokines. Furthermore, immunohistochemical analysis revealed that NOX2 was abundantly expressed in activated M1 microglia. The JAK2/STAT3 signaling pathway, an upstream regulator of NOX2, was increased in WT mice and activated to an even...
Source: Translational Stroke Research - September 17, 2018 Category: Neurology Source Type: research

Minimally Invasive Intracerebral Hemorrhage Evacuation Improves Pericavity Cerebral Blood Volume
This study aims to quantify blood volume changes in the perihematomal parenchyma and pericavity parenchyma after minimally invasive intracerebral hemorrhage evacuation (MIS for ICH). Thirty-two patients underwent MIS for ICH with pre- and post-operative CT imaging and intraoperative perfusion imaging (DynaCT PBV Neuro, Artis Q, Siemens). The pre-operative and post-operative CT scans were segmented using ITK-SNAP software to calculate hematoma volumes and to delineate the pericavity tissue. Helical CT segmentations were registered to cone beam CT data using elastix software. Mean blood volumes were computed inside subvolume...
Source: Translational Stroke Research - May 17, 2023 Category: Neurology Source Type: research

Correlating Cerebral 18 FDG PET-CT Patterns with Histological Analysis During Early Brain Injury in a Rat Subarachnoid Hemorrhage Model
Abstract Early brain injury (EBI) plays a significant role in poor outcomes for subarachnoid hemorrhage (SAH) patients. Further investigations are required to characterize the cellular metabolic and related histological changes that may contribute to EBI following SAH. We investigated the image patterns of 18-fluorodeoxyglucose positron emission tomography-computed tomography (18FDG PET-CT) during EBI and correlated histopathological changes utilizing a rat SAH model. SAH was induced in six adult male Sprague-Dawley rats by endovascular perforation, and animals were randomly assigned to receive 18FDG PET-CT imagin...
Source: Translational Stroke Research - April 3, 2015 Category: Neurology Source Type: research

Effect of APOE Gene Polymorphism on Early Cerebral Perfusion After Aneurysmal Subarachnoid Hemorrhage
In this study, we aimed to investigate the association of apolipoprotein E (APOE) genotypes and early cerebral perfusion after aSAH. We collected venous blood of aSAH patients on admission for APOE genotype identification, applying computed tomography perfusion (CTP) scanning within 24 h after onset. The CTP parameters between patients with different APOE genotypes were compared. Then, a positive item was chosen for separate uni- and multivariate logistic regression analyses to seek its risk factors. Our results showed mean transit time (MTT) rather than other parameters was significantly longer in patients with the APOE�...
Source: Translational Stroke Research - September 14, 2015 Category: Neurology Source Type: research

Higher Cerebrospinal Fluid pH may Contribute to the Development of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage
This study revealed higher CSF pH and lower CSF PCO2 as new potential contributors to the development of DCI, which might result from inappropriate CSF drainage that failed to remove clot and acid metabolites in it efficiently. Both of the disturbed CSF gas and inappropriate CSF drainage may cause constriction of the arteries and arterioles, leading to DCI.
Source: Translational Stroke Research - September 13, 2016 Category: Neurology Source Type: research

Inhibition of Blood-Brain Barrier Disruption by an Apolipoprotein E-Mimetic Peptide Ameliorates Early Brain Injury in Experimental Subarachnoid Hemorrhage
This study investigated whether an ApoE-mimetic peptide affords neuroprotection in early brain injury (EBI) following SAH by attenuating BBB disruption. SAH was induced by an endovascular perforation in young, healthy, male wild-type (WT) C57BL/6J mice. Multiple techniques, including MRI with T2-weighted imaging,18 FDG PET-CT scanning and histological studies, were used to examine BBB integrity and neurological dysfunction in EBI following SAH. We found that SAH induced a significant increase of BBB permeability and neuron apoptosis, whereas ApoE-mimetic peptide treatment significantly reduced the degradation of tight junc...
Source: Translational Stroke Research - October 30, 2016 Category: Neurology Source Type: research

MRI Characterization in the Acute Phase of Experimental Subarachnoid Hemorrhage
In conclusion, T2 lesion, WMI, and hydrocephalus were the most prevalent MRI characteristics 24 h after experimental SAH. The T2 lesion area matched with fibrinogen/fibrin positive staining in the acute phase of SAH. SAH induced more s evere brain injury in females compared to males in the acute phase of SAH.
Source: Translational Stroke Research - November 27, 2016 Category: Neurology Source Type: research

Radiological Estimation of Intracranial Blood Volume and Occurrence of Hydrocephalus Determines Stress-Induced Hyperglycemia After Aneurysmal Subarachnoid Hemorrhage
AbstractAcute phase after aneurysmal subarachnoid hemorrhage (aSAH) is associated with several metabolic derangements including stress-induced hyperglycemia (SIH). The present study is designed to identify objective radiological determinants for SIH to better understand its contributory role in clinical outcomes after aSAH. A computer-aided detection tool was used to segment admission computed tomography (CT) images of aSAH patients to estimate intracranial blood and cerebrospinal fluid volumes. Modified Graeb score (mGS) was used as a semi-quantitative measure to estimate degree of hydrocephalus. The relationship between ...
Source: Translational Stroke Research - July 11, 2018 Category: Neurology Source Type: research

Imaging-Based Outcome Prediction of Acute Intracerebral Hemorrhage
AbstractWe hypothesized that imaging-only-based machine learning algorithms can analyze non-enhanced CT scans of patients with acute intracerebral hemorrhage (ICH). This retrospective multicenter cohort study analyzed 520 non-enhanced CT scans and clinical data of patients with acute spontaneous ICH. Clinical outcome at hospital discharge was dichotomized into good outcome and poor outcome using different modified Rankin Scale (mRS) cut-off values. Predictive performance of a random forest machine learning approach based on filter- and texture-derived high-end image features was evaluated for differentiation of functional ...
Source: Translational Stroke Research - February 6, 2021 Category: Neurology Source Type: research

Quantitative Corticospinal Tract Assessment in Acute Intracerebral Hemorrhage
AbstractIntracerebral hemorrhage (ICH) prognostication during the acute phase is often subjective among physicians and often affects treatment decisions. The present study explores objective imaging parameters using quantitative corticospinal tract (CST) fiber reconstruction during the acute phase of ICH and correlates these parameters with functional outcome and patient recovery. We prospectively enrolled nonsurgical spontaneous supratentorial ICH patients and obtained an MRI scan on day 5  ± 1. Q-space diffeomorphic reconstruction was performed using DSI Studio, and quantitative anisotropy (QA) was calculated. The C...
Source: Translational Stroke Research - June 18, 2021 Category: Neurology Source Type: research