179 research outputs found
Structural peculiarities of word combinations denoting names of medicinal plants
The rapid development of modern society requires quality medicine. Recently, research interest in the role of medicinal plants in the medical field has intensified
Predictors of highly prevalent brain ischemia in intracerebral hemorrhage
Objective: This study was undertaken to determine the prevalence, characteristics, risk factors, and temporal profile of concurrent ischemic lesions in patients with acute primary intracerebral hemorrhage (ICH). Methods: Patients were recruited within a prospective, longitudinal, magnetic resonance imaging (MRI)‐based study of primary ICH. Clinical, demographic, and MRI data were collected on all subjects at baseline and 1 month. Results: Of the 138 patients enrolled, mean age was 59 years, 54% were male, 73% were black, and 84% had a history of hypertension. At baseline, ischemic lesions on diffusion‐weighted imaging (DWI) were found in 35% of patients. At 1 month, lesions were present in 27%, and of these lesions, 83% were new and not present at baseline. ICH volume ( p = 0.025), intraventricular hemorrhage ( p = 0.019), presence of microbleeds ( p = 0.024), and large, early reductions in mean arterial pressure ( p = 0.003) were independent predictors of baseline DWI lesions. A multivariate logistical model predicting the presence of 1‐month DWI lesions included history of any prior stroke ( p = 0.012), presence of 1 or more microbleeds ( p = 0.04), black race ( p = 0.641), and presence of a DWI lesion at baseline ( p = 0.007). Interpretation: This study demonstrates that >⅓ of patients with primary ICH have active cerebral ischemia at baseline remote from the index hematoma, and ¼ of patients experience ongoing, acute ischemic events at 1 month. Multivariate analyses implicate blood pressure reductions in the setting of an active vasculopathy as a potential underlying mechanism. Further studies are needed to determine the impact of these lesions on outcome and optimal management strategies to arrest vascular damage. Ann Neurol 2012;71:199–205Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90250/1/22668_ftp.pd
Silent Microbleeds and Hemorrhagic Conversion of an Embolic Infarction
We report a patient with multiple simultaneous embolic infarctions with localized hemorrhagic conversion. A 75-year-old male patient had several silent microbleeds (SMBs) exclusively in the cerebral cortex, and underwent angioplasty and stenting for bilateral carotid stenosis. He subsequently experienced embolic infarctions in the cortex and the striatum: the cortical infarction, where an SMB had been present, showed hemorrhagic conversion, whereas the striatal infarction did not. This case suggests that SMBs are indicators of an underlying hemorrhage-prone state
Effect of High-Dose Simvastatin on Cerebral Blood Flow and Static Autoregulation in Subarachnoid Hemorrhage
Statins may promote vasodilation following subarachnoid hemorrhage (SAH) and improve the response to blood pressure elevation. We sought to determine whether simvastatin increases cerebral blood flow (CBF) and alters the response to induced hypertension after SAH
Poor Correlation Between Perihematomal MRI Hyperintensity and Brain Swelling After Intracerebral Hemorrhage
The perihematomal hyperintensity is commonly interpreted to represent cerebral edema following ICH, but the accuracy of this interpretation is unknown. We therefore investigated the relationship between changes in PHH and changes in hemispheric brain volume as a measure of edema during the first week after ICH
Autoregulation after ischaemic stroke
Absent outcome data from randomized clinical trials, management of hypertension in acute ischaemic stroke remains controversial. Data from human participants have failed to resolve the question whether cerebral blood flow (CBF) in the peri-infarct region will decrease due to impaired autoregulation when systemic mean arterial pressure (MAP) is rapidly reduced
Lack of association between acute stroke, post-stroke dementia, race, and β-amyloid status
INTRODUCTION: Stroke and Alzheimer disease share risk factors and often co-occur, and both have been reported to have a higher prevalence in African Americans as compared to non-Hispanic whites. However, their interaction has not been established. The objective of this study was to determine if preclinical Alzheimer disease is a risk factor for stroke and post-stroke dementia and whether racial differences moderate this relationship.
METHODS: This case-control study was analyzed in 2019 using retrospective data from 2007 to 2013. Participants were adults age 65 and older with and without acute ischemic stroke. Recruitment included word of mouth and referrals in Saint Louis, MO, with stroke participants recruited from acutely hospitalized patients and non-stroke participants from community living older adults who were research volunteers. Our assessment included radiologic reads of infarcts, microbleeds, and white matter hyperintensitites (WMH); a Pittsburgh Compound B PET measure of cortical β-amyloid binding; quantitative measures of hippocampal and WMH volume; longitudinal Mini Mental State Examination (MMSE) scores; and Clinical Dementia Rating (CDR) 1 year post-stroke.
RESULTS: A total of 243 participants were enrolled, 81 of which had a recent ischemic stroke. Participants had a mean age of 75, 57% were women, and 52% were African American. Cortical amyloid did not differ significantly by race, stroke status, or CDR post-stroke. There were racial differences in MMSE scores at baseline (mean 26.8 for African Americans, 27.9 for non-Hispanic whites, p = 0.03), but not longitudinally. African Americans were more likely to have microbleeds (32.8% vs 22.6%, p = 0.04), and within the acute stroke group, African Americans were more likely to have small infarcts (75.6% vs 56.8%, p = 0.049).
CONCLUSION: Preclinical Alzheimer disease did not show evidence of being a risk factor for stroke nor predictive of post-stroke dementia. We did not observe racial differences in β-amyloid levels. However, even after controlling for several vascular risk factors, African Americans with clinical stroke presentations had greater levels of vascular pathology on MRI
QUantitative Imaging of eXtraction of oxygen and TIssue consumption (QUIXOTIC) using venular-targeted velocity-selective spin labeling
available in PMC 2012 December 1While oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) are fundamental parameters of brain health and function, a robust MRI-based mapping of OEF and CMRO2 amenable to functional MRI (fMRI) has not been established. To address this issue, a novel method called QUantitative Imaging of eXtraction of Oxygen and TIssue Consumption, or QUIXOTIC, is introduced. The key innovation in QUIXOTIC is the use of velocity-selective spin labeling to isolate MR signal exclusively from postcapillary venular blood on a voxel-by-voxel basis. Measuring the T2 of this venular-targeted blood allows calibration to venular oxygen saturation (Yv) via theoretical and experimental T2 versus blood oxygen saturation relationships. Yv is converted to OEF, and baseline CMRO2 is subsequently estimated from OEF and additional cerebral blood flow and hematocrit measurements. Theory behind the QUIXOTIC technique is presented, and implications of cutoff velocity (VCUTOFF) and outflow time parameters are discussed. Cortical gray matter values obtained with QUIXOTIC in 10 healthy volunteers are Yv = 0.73 ± 0.02, OEF = 0.26 ± 0.02, and CMRO2 = 125 ± 15 μmol/100 g min. Results are compared to global measures obtained with the T2 relaxation under spin tagging (TRUST) technique. The preliminary data presented suggest that QUIXOTIC will be useful for mapping Yv, OEF, and CMRO2, in both clinical and functional MRI settings.National Institutes of Health (U.S.) (NIH Neuroimaging Training Program Grant, 5-T32-EB001680)National Institutes of Health (U.S.) (NIH Neuroimaging Training Program Grant, 5-R01-EB002066-20)National Institutes of Health (U.S.) (Center for Functional Neuroimaging Technologies; Grant number: P41RR14075S10RR023401)Siemens Aktiengesellschaft (Siemens Medical Solutions)Harvard University--MIT Division of Health Sciences and Technology (Martinos Catalyst Fund)National Cancer Institute (U.S.) (NIH Grant number RO1 EB007942)National Institutes of Health (U.S.) (NIH Medical Scientist Training Program Fellowship, grant no. T32-GM07753
The Persisting Burden of Intracerebral Haemorrhage: Can Effective Treatments Be Found?
Colin Josephson, Rustam Al-Shahi Salman, and colleagues discuss the effectiveness of treatments for intracerebral haemorrhage
Dynamic cerebral autoregulation after intracerebral hemorrhage: A case-control study
<p>Abstract</p> <p>Background</p> <p>Dynamic cerebral autoregulation after intracerebral hemorrhage (ICH) remains poorly understood. We performed a case-control study to compare dynamic autoregulation between ICH patients and healthy controls.</p> <p>Methods</p> <p>Twenty-one patients (66 ± 15 years) with early (< 72 hours) lobar or basal ganglia ICH were prospectively studied and compared to twenty-three age-matched controls (65 ± 9 years). Continuous measures of mean flow velocity (MFV) in the middle cerebral artery and mean arterial blood pressure (MAP) were obtained over 5 min. Cerebrovascular resistance index (CVR<sub>i</sub>) was calculated as the ratio of MAP to MFV. Dynamic cerebral autoregulation was assessed using transfer function analysis of spontaneous MAP and MFV oscillations in the low (0.03-0.15 Hz) and high (0.15-0.5 Hz) frequency ranges.</p> <p>Results</p> <p>The ICH group demonstrated higher CVR<sub>i </sub>compared to controls (ipsilateral: 1.91 ± 1.01 mmHg·s·cm<sup>-1</sup>, <it>p </it>= 0.04; contralateral: 2.01 ± 1.24 mmHg·s·cm<sup>-1</sup>, <it>p </it>= 0.04; vs. control: 1.42 ± 0.45 mmHg·s·cm<sup>-1</sup>). The ICH group had higher gains than controls in the low (ipsilateral: 1.33 ± 0.58%/mmHg, <it>p </it>= 0.0005; contralateral: 1.47 ± 0.98%/mmHg, <it>p </it>= 0.004; vs. control: 0.82 ± 0.30%/mmHg) and high (ipsilateral: 2.11 ± 1.31%/mmHg, <it>p </it>< 0.0001; contralateral: 2.14 ± 1.49%/mmHg, <it>p </it>< 0.0001; vs. control: 0.66 ± 0.26%/mmHg) frequency ranges. The ICH group also had higher coherence in the contralateral hemisphere than the control (ICH contralateral: 0.53 ± 0.38, <it>p </it>= 0.02; vs. control: 0.38 ± 0.15) in the high frequency range.</p> <p>Conclusions</p> <p>Patients with ICH had higher gains in a wide range of frequency ranges compared to controls. These findings suggest that dynamic cerebral autoregulation may be less effective in the early days after ICH. Further study is needed to determine the relationship between hematoma size and severity of autoregulation impairment.</p
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