Research progress in ultrasound use for the diagnosis and treatment of cerebrovascular diseases

Cerebrovascular diseases pose a serious threat to human survival and quality of life and represent a major cause of human death and disability. Recently, the incidence of cerebrovascular diseases has increased yearly. Rapid and accurate diagnosis and evaluation of cerebrovascular diseases are of great importance to reduce the incidence, morbidity and mortality of cerebrovascular diseases. With the rapid development of medical ultrasound, the clinical relationship between ultrasound imaging technology and the diagnosis and treatment of cerebrovascular diseases has become increasingly close. Ultrasound techniques such as transcranial acoustic angiography, doppler energy imaging, three-dimensional craniocerebral imaging and ultrasound thrombolysis are novel and valuable techniques in the study of cerebrovascular diseases. In this review, we introduce some of the new ultrasound techniques from both published studies and ongoing trials that have been confirmed to be convenient and effective methods. However, additional evidence from future studies will be required before some of these techniques can be widely applied or recommended as alternatives

Cerebral blood flow autoregulation is impaired in schizophrenia

Patients with schizophrenia have a higher risk of cardiovascular diseases and higher mortality from them than does the general population; however, the underlying mechanism remains unclear. Impaired cerebral autoregulation is associated with cerebrovascular diseases and their mortality. Increased or decreased cerebral blood flow in different brain regions has been reported in patients with schizophrenia, which implies impaired cerebral autoregulation. This study investigated the cerebral autoregulation in 21 patients with schizophrenia and 23 age- and sex-matched healthy controls. None of the participants had a history of cardiovascular diseases, hypertension, or diabetes. All participants underwent 10-min blood pressure and cerebral blood flow recording through finger plethysmography and Doppler ultrasonography, respectively. Cerebral autoregulation was assessed by analyzing two autoregulation indices: the mean blood pressure and cerebral blood flow correlation coefficient (Mx), and the phase shift between the waveforms of blood pressure and cerebral blood flow determined using transfer function analysis. Compared with the controls, the patients had a significantly higher Mx (0.257 vs. 0.399, p = 0.036) and lower phase shift (44.3° vs. 38.7° in the 0.07–0.20 Hz frequency band, p = 0.019), which indicated impaired maintenance of constant cerebral blood flow and a delayed cerebrovascular autoregulatory response. Impaired cerebral autoregulation may be caused by schizophrenia and may not be an artifact of coexisting medical conditions. The mechanism underlying impaired cerebral autoregulation in schizophrenia and its probable role in the development of cerebrovascular diseases require further investigation

The roles of endoglin gene in cerebrovascular diseases.

Endoglin (ENG, also known as CD105) is a transforming growth factor β (TGFβ) associated receptor and is required for both vasculogenesis and angiogenesis. Angiogenesis is important in the development of cerebral vasculature and in the pathogenesis of cerebral vascular diseases. ENG is an essential component of the endothelial nitric oxide synthase activation complex. Animal studies showed that ENG deficiency impairs stroke recovery. ENG deficiency also impairs the regulation of vascular tone, which contributes to the pathogenesis of brain arteriovenous malformation (bAVM) and vasospasm. In human, functional haploinsufficiency of ENG gene causes type I hereditary hemorrhagic telangiectasia (HHT1), an autosomal dominant disorder. Compared to normal population, HHT1 patients have a higher prevalence of AVM in multiple organs including the brain. Vessels in bAVM are fragile and tend to rupture, causing hemorrhagic stroke. High prevalence of pulmonary AVM in HHT1 patients are associated with a higher incidence of paradoxical embolism in the cerebral circulation causing ischemic brain injury. Therefore, HHT1 patients are at risk for both hemorrhagic and ischemic stroke. This review summarizes the possible mechanism of ENG in the pathogenesis of cerebrovascular diseases in experimental animal models and in patients

Increasing Public Perceptions of Stroke

Analysis of publicly available data for the selected county of Rutland Vermont was performed to understand the underlying health problems affecting the county. Although VT overall has better health status indicators, including better access to care, and lower rates of chronic diseases than the nation, pockets of the state have higher rates of chronic diseases including obesity, DM, and cerebrovascular accidents. Increasing awareness of stroke risk factors and symptoms is a cost-effective method to reduced stroke burden and provide successful treatment.https://scholarworks.uvm.edu/fmclerk/1621/thumbnail.jp

Hypertension and cerebrovascular diseases are related to corneal endothelial insufficiency — a retrospective study

Background: Corneal endothelium has an important role on the clarity of the cornea. Cataract surgery may cause corneal endothelial damages and serious vision problems. In this study, we aimed to investigate hypertension, cerebrovascular diseases, and trauma in patients who developed corneal endothelial insufficiency (CEI) after cataract surgery. Material and methods: The study was performed in the Department of Ophthalmology in Adana Ortadogu Hospital between October 2017 and October 2018. 24 patients who developed CEI after cataract surgery and 24 patients who did not develop CEI after cataract surgery were included to the study. Eye trauma, systemic hypertension, cerebrovascular diseases were investigated in the patients’ own history. The findings were compared statistically. Results: The percent of cerebrovascular diseases was 54.2% in patients with CEI and 16.6% in patients without CEI. 58.3% of the patients with CEI had a systemic hypertension history. Hypertension was presented in 25% of the patients who did not develop CEI. The rate of trauma history in patients with CEI was 29.2% and 12.5% in those without CEI. The history of cerebrovascular disease and hypertension were significantly higher in patients with CEI. Conclusion: Hypertension and cerebrovascular diseases appeared to be linked with CEI

An automated multiscale ensemble simulation approach for vascular blood flow

Cerebrovascular diseases such as brain aneurysms are a primary cause of adult disability. The flow dynamics in brain arteries, both during periods of rest and increased activity, are known to be a major factor in the risk of aneurysm formation and rupture. The precise relation is however still an open field of investigation. We present an automated ensemble simulation method for modelling cerebrovascular blood flow under a range of flow regimes. By automatically constructing and performing an ensemble of multiscale simulations, where we unidirectionally couple a 1D solver with a 3D lattice-Boltzmann code, we are able to model the blood flow in a patient artery over a range of flow regimes. We apply the method to a model of a middle cerebral artery, and find that this approach helps us to fine-tune our modelling techniques, and opens up new ways to investigate cerebrovascular flow properties.This work has received funding from the CRESTA project within the EC-FP7 (ICT-2011.9.13) under Grant Agreements no. 287703, and from EPSRC Grants EP/I017909/1 (www.2020science.net) and EP/I034602/1

Cerebrovascular disease at young age is related to mother's health during the pregnancy-The Northern Finland Birth Cohort 1966 study

Background and purpose For prevention of cerebrovascular diseases at younger age, it is important to understand the risk factors occurring early in life. We investigated the relationship between mothers' general health during pregnancy and the offspring's risk of cerebrovascular disease in age of 15 to 52 years. Methods Within the population-based prospective Northern Finland Birth Cohort 1966, 11,926 persons were followed from antenatal period to 52 years of age. Information on their mother's ill health conditions, i.e., hospitalizations, chronic diseases, medications, vitamin or iron supplement, fever, anemia, mood, and smoking was collected from 24th gestational week onwards. Ischemic and hemorrhagic cerebrovascular diseases of the offspring were identified from national registers in Finland. Cox proportional hazard models were used to estimate the association of mother's health conditions with incidence of cerebrovascular disease in the offspring, with adjustments for potential confounders. Results During 565,585 person-years of follow-up, 449 (2.8%) of the offspring had a cerebrovascular disease. Hospitalization during pregnancy was associated with an increased risk of cerebrovascular disease in the offspring (hazard ratio (HR) = 1.49; 95% confidence interval (CI) 1.06-2.08) after adjustment for confounders, as was having more than three ill health conditions (HR = 1.89; CI 1.14-3.11). Not using vitamin or iron supplement was associated with increased risk for cerebrovascular disease in the offspring (HR = 1.39; CI 1.01-1.89). Conclusions The results suggest that the risk of cerebrovascular disease may start as early as during the antenatal period, and the health characteristics of mothers during pregnancy may play a role in cerebrovascular disease risk of the offspring.Peer reviewe