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Association between Intracranial Atherosclerotic Calcium Burden and Angiographic Luminal Stenosis Measurements ADULT BRAIN
CONCLUSIONS: There is a weak correlation between intracranial atherosclerotic calcium scores and luminal narrowing, which may be explained by the greater sensitivity of CT than angiography in detecting the presence of measurable atherosclerotic disease. Future studies are warranted to evaluate the relationship between stenosis and calcium burden in predicting stroke risk.
Source: American Journal of Neuroradiology - September 8, 2017 Category: Radiology Authors: Baradaran, H., Patel, P., Gialdini, G., Giambrone, A., Lerario, M. P., Navi, B. B., Min, J. K., Iadecola, C., Kamel, H., Gupta, A. Tags: ADULT BRAIN Source Type: research

Success of Intravenous Infusion of Verapamil for Refractory Vasospasm in aneurysmal Subarachnoid Hemorrhage (P2.291)
Conclusions:This report indicates that intravenous continuous infusion of verapamil may be used for rescue therapy in transiently responsive cerebral vasospasm to IA verapamil. This therapy did not seem to compromise hemodynamic stability or increase ICP.Disclosure: Dr. Mehta has nothing to disclose. Dr. Kulhari has nothing to disclose. Dr. Z Arango has nothing to disclose. Dr. Suhan has nothing to disclose. Dr. DeCarvalho has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Kirmani has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Mehta, S., Kulhari, A., Arango, A., Suhan, L., DeCarvalho, B., Patel, A., Kirmani, J. F. Tags: Subarachnoid Hemorrhage, Intracranial Aneurysm, and Other Cerebrovascular Malformations Source Type: research

Coronary Artery Calcium Score Improves the Prediction of Occult Coronary Artery Stenosis in Ischemic Stroke Patients Stroke
BackgroundCoronary heart disease is a significant cause of morbidity and mortality in stroke patients. The coronary artery calcium score (CACS) has emerged as a robust and noninvasive predictor of coronary events. We assessed the predictive ability of CACS to identify stroke patients with severe (≥50%) occult coronary artery stenosis in a stroke/transient ischemic attack population, in addition to the PRECORIS score, based on Framingham Risk Score and presence of cervicocephalic artery stenosis, which was derived and validated for that purpose.Methods and ResultsWe enrolled consecutive patients aged 45 to 75 years refer...
Source: JAHA:Journal of the American Heart Association - October 30, 2016 Category: Cardiology Authors: Beigneux, Y., Sablayrolles, J.-L., Varenne, O., Mas, J.-L., Calvet, D. Tags: Computerized Tomography (CT), Ischemic Stroke, Transient Ischemic Attack (TIA), Atherosclerosis, Coronary Artery Disease Original Research Source Type: research

Cost-effectiveness analysis of new generation coronary CT scanners for difficult-to-image patients
ConclusionThe use of NGCCT might be considered cost-effective in both populations since it is cost-saving compared to ICA and generates similar effects.
Source: The European Journal of Health Economics - September 19, 2016 Category: Health Management Source Type: research

Reversible cerebral vasoconstriction syndrome: A rare pediatric cause of thunderclap headaches.
We report on a case of a 13-year-old boy presenting with acute severe headaches, triggered by physical exertion. His past medical history was uneventful. Moderate headache persisted between exacerbations for 4 weeks. He secondarily presented with signs of intracranial hypertension. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries. A glucocorticoid treatment was started based on the hypothesis of primary angiitis of the CNS. The symptoms rapidly improved, and repeat angiography at 3 months showed no vasoconstriction. Although pediatric cases are rare, RCVS should be considere...
Source: Archives de Pediatrie - September 13, 2016 Category: Pediatrics Authors: Trolliet M, Sevely A, Albucher JF, Nasr N, Hachon Lecamus C, Deiva K, Cheuret E Tags: Arch Pediatr Source Type: research

The Need for a Rational Approach to Vasoconstrictive Syndromes: Transcranial Doppler and Calcium Channel Blockade in Reversible Cerebral Vasoconstriction Syndrome
Conclusion: Though small, our cohort demonstrates potential utility of TCD to monitor RCVS, and relative superiority of extended-release verapamil over other calcium channel blockers, illustrating the need for larger randomized trials. Case Rep Neurol 2016;8:161 –171
Source: Case Reports in Neurology - July 29, 2016 Category: Neurology Source Type: research

E-043 Reversible Cerebral Vasoconstriction Syndrome: Non-invasive Imaging Findings and Angiographic Evaluation
We present indirect findings on non-invasive imaging, such as transient cerebral edema, convexal subarachnoid hemorrhage, intraparenchymal hemorrhage and cerebral. Direct signs of single or multivessel arterial vasoconstriction are seen on CTA, MRA and confirmed on DSA. Reversibility of the vasoconstriction is demonstrated after intra-arterial administration of calcium channel blocker. Conditions such as diffuse atherosclerotic arterial narrowing, vasculitis, posterior reversible encephalopathy, cerebral edema secondary to venous congestion and vasospasm secondary to aneurysmal subarachnoid hemorrhage were among the pathol...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: de Macedo Rodrigues, K., Hito, R., Takhtani, D., Lozano, J., Wakhloo, A., Puri, A. Tags: Electronic poster abstracts Source Type: research

Principles and Clinical Application of Dual-energy Computed Tomography in the Evaluation of Cerebrovascular Disease
Charlie Chia-Tsong Hsu, Gigi Nga Chi Kwan, Dalveer Singh, Jit Pratap, Trevor William WatkinsJournal of Clinical Imaging Science 2016 6(1):27-27Dual-energy computed tomography (DECT) simultaneously acquires images at two X-ray energy levels, at both high- and low-peak voltages (kVp). The material attenuation difference obtained from the two X-ray energies can be processed by software to analyze material decomposition and to create additional image datasets, namely, virtual noncontrast, virtual contrast also known as iodine overlay, and bone/calcium subtraction images. DECT has a vast array of clinical applications in imagin...
Source: Journal of Clinical Imaging Science - June 28, 2016 Category: Radiology Authors: Charlie Chia-Tsong HsuGigi Nga Chi KwanDalveer SinghJit PratapTrevor William Watkins Source Type: research

Reversible Cerebral Vasoconstriction Syndrome Presenting as Coma (P4.354)
Conclusions: RCVS rarely can present with coma and multifocal infarctions. Exact pathophysiology remains unknown but disruption of sympathetic tone and endothelial dysfunction have been implicated. A high index of suspicion is required to minimize disease complications and prevent improper withdrawal of care.Disclosure: Dr. Khan has nothing to disclose. Dr. Adcock has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Khan, M., Adcock, A. Tags: Cerebrovascular Case Reports Source Type: research

Collateral Blood Flow Availability in Acute Ischemic Stroke: A Case Report (P4.360)
Conclusion: This case supports earlier autopsy specimen dissections indicating most borderzone collaterals linking to adjacent vascular territories are too small to generate the immediate flow needed to spare tissue proximal to a middle cerebral stem occlusion. Assuming acute vasodilation is possible for these vessels, the acute use of vasodilators such as nitroglycerin or hydralazine and calcium-channel blockers like Nimodipine could provide an area for future study.Disclosure: Dr. Rostanski has nothing to disclose. Dr. Lavine has nothing to disclose. Dr. Mohr has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Rostanski, S., Lavine, S., Mohr, J. Tags: Cerebrovascular Case Reports Source Type: research

Impact of diabetes duration on the extent and severity of coronary atheroma burden and long-term clinical outcome in asymptomatic type 2 diabetic patients: evaluation by Coronary CT angiography
Conclusion In asymptomatic diabetic patients, longer diabetes duration is associated with a higher prevalence, extent, and severity of CAD as well as risk of MACCE. Moreover, greater CAD burden increases the risk of MACCE independent of co-existing CAD risk factors.
Source: European Journal of Echocardiography - September 15, 2015 Category: Cardiology Authors: Kim, J.-J., Hwang, B.-H., Choi, I. J., Choo, E.-H., Lim, S., Kim, J.-K., Koh, Y.-S., Kim, D.-B., Jang, S.-W., Cho, E. J., Lee, J. M., Kim, P.-J., Cho, J.-H., Jung, J. I., Seung, K.-B., Min, J. K., Chang, K. Tags: ORIGINAL ARTICLES Source Type: research

CT Angiogram Helps to Predict Ischemic Stroke in Dizzy Patients, but NOT Better than the Clinical Examination (P3.084)
Conclusions: In patients with subjective dizziness, stroke risk factors and focal exam findings predict acute ischemic stroke. Calcification on CTA is also predictive, but does not significantly improve sensitivity.Disclosure: Dr. Chen has nothing to disclose. Dr. Schneider has nothing to disclose. Dr. Marsh has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Chen, K., Schneider, A., Marsh, E. Tags: Cerebrovascular Disease and Interventional Neurology: Hemorrhagic and Ischemic Stroke Source Type: research

Increased Risk for Intracranial Arterial Stenosis in Subjects With Coronary Artery Calcification Clinical Sciences
Conclusions— The risk for ICAS was significantly increased in middle-aged Korean subjects with CAC compared with that in those without CAC. These findings suggest the possibility of a separate undetected atherosclerotic focus in subjects with 1 atherosclerotic event.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Oh, H.-G., Chung, P.-W., Rhee, E.-J. Tags: Imaging, Coronary imaging: angiography/ultrasound/Doppler/CC, Coronary circulation Clinical Sciences Source Type: research

Prognostic Value of Coronary Computed Tomography Angiography in Stroke Patients
The predictive value of coronary computed tomography angiography (CCTA) in stroke patients has not yet been established. We investigated the prognostic value of coronary artery disease (CAD) detection by CCTA, and determined the incremental risk stratification benefit of CCTA findings as compared to coronary artery calcium scores (CACS) in ischemic stroke patients without chest pain.
Source: Atherosclerosis - November 4, 2014 Category: Cardiology Authors: Jin Hur, Kye Ho Lee, Sae Rom Hong, Young Joo Suh, Yoo Jin Hong, Hye-Jeong Lee, Young Jin Kim, Hye Sun Lee, Hyuk-Jae Chang, Byoung Wook Choi Source Type: research

The Case Files: When a Spade is Not a Spade
Turrin, Danielle DO; Sattler, Steven DO; Amodeo, Dana DO A 25-year-old Hispanic man presented to the emergency department with a complaint of three days of left-sided precordial chest pain. He described the pain as a constant 6/10 with pressure-like discomfort radiating to his left arm and the left side of his neck. He also experienced nausea, but denied any provocative or palliative factors. He said he had not experienced anything similar to this before. He had no family history of heart disease, acute myocardial infarction, or sudden cardiac death. He admitted to a 1.5 pack-per-day smoking history and social alcohol use,...
Source: The Case Files - August 26, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

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