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1.
Article in English | WPRIM | ID: wpr-878338

ABSTRACT

Objective@#Exposure to microgravity results in postflight cardiovascular deconditioning in astronauts. Vascular oxidative stress injury and mitochondrial dysfunction have been reported during this process. To elucidate the mechanism for this condition, we investigated whether mitochondrial oxidative stress regulates calcium homeostasis and vasoconstriction in hindlimb unweighted (HU) rat cerebral arteries.@*Methods@#Three-week HU was used to simulate microgravity in rats. The contractile responses to vasoconstrictors, mitochondrial fission/fusion, Ca @*Results@#An increase of cytoplasmic Ca @*Conclusion@#The present results suggest that mitochondrial oxidative stress enhances cerebral vasoconstriction by regulating calcium homeostasis during simulated microgravity.


Subject(s)
Animals , Calcium/metabolism , Cerebral Arteries , Homeostasis , Male , Mitochondria/physiology , Myocytes, Smooth Muscle/physiology , Oxidative Stress , Rats , Rats, Sprague-Dawley , Vasoconstriction/physiology , Weightlessness Simulation
2.
Pesqui. vet. bras ; 40(9): 733-737, Sept. 2020. tab, ilus
Article in English | ID: biblio-1143418

ABSTRACT

Paca (Cuniculus paca Linnaeus, 1766), rodent belong to the Cuniculidae family, has encouraged numerous scientific researches and for this reason could be an experimental model in both human and veterinary areas. And recently, the economic exploitation of the meat cuts, has being direct implication in its zootechnical importance. However, no anatomical descriptions regarding the vascularization of the base of the brain in this rodent has being found. Thus, the aim of the present study was to describe the arteries and the pattern of the vasculature and to compare it with the other species already established in the literature. For this, five pacas, donated by the Unesp Jaboticabal Wildlife Sector, were euthanized followed by the vascular arterial system was injected with red-stained-centrifuged latex by the common carotid artery. After craniectomy, the brains were removed and the arteries were identified and, in addition, compared with those described in other animal species. The presence of the right and left vertebral arteries, close to the medulla oblongata, was detected, originating the basilar artery, which divided into the terminal branches of the right and left basilar artery. Ventral to the optic tract there was the right internal carotid artery and the left, dividing the middle cerebral artery and left rostral and right; dorsal to the optic chiasm, the medial branch of the rostral cerebral arteries was identified. Based on the results, it is concluded that the vascularization of the paca brain base is supplied by the carotid and vertebrobasilar system.(AU)


A paca (Cuniculus paca Linnaeus 1766), roedor da família Cuniculidae, tem encorajado inúmeras pesquisas científicas, tornando-a modelo experimental tanto na área humana quanto na veterinária, além da recente exploração econômica de seus cortes cárneos, que favoreceu diretamente sua importância zootécnica. No entanto, não há até o momento, descrições anatômicas referentes à padronização da vascularização da base do encéfalo neste roedor. Assim, o objetivo do presente trabalho foi realizar tal delineamento arterial nessa região do sistema nervoso central e compará-lo com as demais espécies já estabelecidas na literatura. Para isso, foram eutanasiadas cinco pacas doadas pelo setor de Animais Silvestres da Unesp Jaboticabal, as quais foram submetidas posteriormente à injeção de látex centrifugado e corante líquido xadrez vermelho, pela artéria carótida comum. Após craniectomia e segregação do encéfalo de todos os cadáveres, realizou-se a identificação das artérias presentes na base deste órgão e, ademais, comparação destas com as descritas cientificamente em outras espécies animais. Detectou-se a presença das artérias vertebral direita e esquerda, próximas à medula oblonga, originando a artéria basilar, que se dividiu nos ramos terminais da artéria basilar direito e esquerdo. Ventral ao trato óptico verificou-se a artéria carótida interna direita e esquerda dividindo-se na artéria cerebral média e rostral direita e esquerda; ainda, dorsal ao quiasma óptico, identificou-se o ramo medial das artérias cerebrais rostrais. Com base nos resultados obtidos, conclui-se que a vascularização da base do encéfalo da paca é suprida pelo sistema carotídeo e vertebro-basilar.(AU)


Subject(s)
Animals , Brain/blood supply , Cerebral Arteries/anatomy & histology , Cuniculidae/anatomy & histology
4.
Pesqui. vet. bras ; 40(6): 484-492, June 2020. ilus
Article in English | ID: biblio-1135642

ABSTRACT

The nutria (Myocastor coypus) is a medium-sized, semi-aquatic rodent valued by the skin and meat industry. This study aimed to describe and systematize the caudal cerebral artery on the brain surface in nutria, establishing a standard model and its main variations in this species. The thirty animals used were euthanized according to animal welfare rules. The vessels were filled with latex stained with red pigment and the samples were fixed in formaldehyde. In nutria, the brain was vascularized by the vertebral basilar system. The terminal branches of the basilar artery originated the rostral cerebellar, caudal cerebral, rostral choroidal and middle cerebral arteries, and its terminal branch, the rostral cerebral artery. The terminal branch of the basilar artery projected the caudal cerebral artery, which is usually a single medium-caliber vessel, into the transverse fissure of the brain. The caudal cerebral artery was presented as a single (66.7% of the cases to the right and 76.7% to the left) and double vessel (33.3% of the cases to the right and 23.3% to the left). It originated the rostral mesencephalic artery, the proximal component, and the caudal inter-hemispheric artery. The terminal branches of the rostral and caudal tectal mesencephalic arteries formed a typical anastomotic network. The caudal inter-hemispheric artery emitted central branches, the caudal choroidal artery, hemispherical occipital arteries, rostral tectal mesencephalic branches and distal components, and anastomosed "in osculum" with the terminal branches of the rostral inter-hemispheric artery. The caudal choroidal artery anastomosed with the rostral choroidal artery, where it branched out on the thalamic mass, vascularizing all diencephalic structures and the hippocampus. The caudal cerebral artery and its terminal branches anastomosed with the terminal branches of the rostral and middle cerebral arteries in a restricted region of the caudal pole of the cerebral hemisphere. The vascularization area of the caudal cerebral artery and its central branches in the paleopallial of the piriform lobe is extremely restricted, caudomedially.(AU)


A nutria (Myocastor coypus) é um roedor semi-aquático de tamanho mediano, apreciado na indústria de peles e carne. Este trabalho tem por objetivo descrever e sistematizar a artéria cerebral caudal na superfície do cérebro em nutria, estabelecendo um modelo padrão e suas principais variações e territórios nesta espécie. Os trinta animais utilizados foram eutanasiados segundo as regras de bem-estar animal, os vasos foram preenchidos com látex, corado em vermelho e as peças foram fixadas em formoldeído. O cérebro foi vascularizado exclusivamente pelo sistema vértebro-basilar. Os ramos terminais da artéria basilar originaram as artérias cerebelar rostral, cerebral caudal, corióidea rostral, cerebral média e seu ramo terminal, a artéria cerebral rostral. O ramo terminal da artéria basilar lançou a artéria cerebral caudal, um vaso normalmente único, de médio calibre, para o interior da fissura transversa do cérebro. A artéria cerebral caudal foi um vaso único em 66,7% à direita e em 76,7% à esquerda e mostrou-se dupla em 33,3% à direita e em 23,3% à esquerda. Ela lançou a artéria tectal mesencefálica rostral, componente proximal e a artéria inter-hemisférica caudal. Os ramos terminais das artérias tectais mesencefálicas, rostral e caudal, formavam uma rede anastomótica típica. A artéria inter-hemisférica caudal lançou ramos centrais, a artéria corióidea caudal, as artérias hemisféricas occipitais, os ramos tectais mesencefálicos rostrais, componentes distais e anastomosou-se "em ósculo" com o ramo terminal da artéria inter-hemisférica rostral. A artéria corióidea caudal anastomosava-se com a artéria corióidea rostral, onde ramificavam-se sobre a massa talâmica, vascularizando todas as estruturas do diencéfalo e hipocampo. A artéria cerebral caudal com seus ramos terminais apresenta anastomoses com os ramos terminais das artérias cerebrais rostral e média em uma região restrita do pólo caudal do hemisfério cerebral. A área de vascularização da artéria cerebral caudal com seus ramos centrais no páleo-palio do lobo piriforme é extremamente restrita, caudo-medialmente ao mesmo.(AU)


Subject(s)
Animals , Otters/anatomy & histology , Basilar Artery/anatomy & histology , Cerebral Arteries/anatomy & histology
5.
Rev. chil. neuro-psiquiatr ; 57(4): 357-364, dic. 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-1092732

ABSTRACT

Resumen Introducción: El síndrome de vasoconstricción cerebral reversible es una entidad clínica y radiológica caracterizada por cefalea en estallido recurrente y vasoconstricción segmental multifocal de las arterias cerebrales, acompañado o no de otros déficits neurológicos, el cual resuelve espontáneamente en uno a tres meses. Métodos: Se reporta el caso clínico de una paciente que fue diagnosticada de síndrome de vasoconstricción cerebral reversible secundario a fármacos vasoactivos. Se plantea una búsqueda bibliográfica y una puesta al día de las últimas actualizaciones en relación a esta patología. Conclusión: Al menos la mitad de los casos de este síndrome son secundarios, sobre todo postparto y/o por la exposición a sustancias vasoactivas tales como drogas ilícitas, simpaticomiméticos y serotoninérgicos. Es trascendental identificar este cuadro a fin de retirar los posibles agentes causales, o evitar las complicaciones potenciales


Introduction: Reversible cerebral vasoconstriction syndrome is a clinical-radiologic syndrome characterized by recurrent thunderclap headache, with or without other acute neurological symptoms, and diffuse segmental constriction of cerebral arteries that resolves spontaneously within 3 months. Methods: It is described a clinic case of a woman, who was diagnosed with reversible cerebral vasoconstriction syndrome. A literature search and an update of the latest updates regarding this disease was done. Conclusion: At least half of the cases of this syndrome are secondary, especially postpartum and/or exposure to vasoactive substances such as illicit drugs, sympathomimetics and serotonergic drugs. It is crucial to identify this disorder in order to remove possible causative agents, or avoid potential complications.


Subject(s)
Humans , Female , Middle Aged , Syndrome , Vasoconstriction , Illicit Drugs , Cerebral Arteries , Neurologic Manifestations
6.
Acta méd. colomb ; 44(3): 34-38, July-Sept. 2019. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1098024

ABSTRACT

Abstract Reversible vasoconstriction syndrome is a group of clinical-radiological alterations that are characterized by severe sudden-onset headaches and reversible multifocal narrowing of the cerebral arteries. Most patients do not present with focal neurological deficit, although it can be seen in a small group, associated with cerebral edema, stroke or seizures. It is considered to be a benign process that causes disability and death in a minority of patients. The term 'reversible vasoconstriction syndrome' has been proposed to unify a variety of clinical syndromes which are similar, but have different etiologies, and have originated various eponyms. The apparently low frequency of reversible vasoconstriction syndrome and the way it presents make it a diagnostic challenge in the emergency room, and it may go unnoticed without an adequate medical history. A case probably related to the use of isometeptene is presented. (Acta Med Colomb 2019; 44. DOI: https://doi.org/10.36104/amc.2019.1213)


Resumen El síndrome de vasoconstricción reversible es un grupo de alteraciones clínico-radiológicas que se caracterizan por cefaleas intensas de inicio brusco y estrechamiento multifocal reversible de las arterias cerebrales. La mayoría de los pacientes no presentan déficit neurológico focal, aunque puede verse en un grupo reducido asociándose con edema cerebral, ataque cerebrovascular o convulsiones. Es considerado un proceso benigno, en pocos casos originan discapacidad y muerte en una minoría de pacientes. El término de síndrome de vasoconstricción reversible se ha propuesto para unificar a una variedad de síndromes clínicos similares, pero de etiología diferentes y han originados diversos epónimos. La aparente baja frecuencia del síndrome de vasoconstricción reversible y su forma de presentación hace que se convierta en un reto diagnóstico en los servicios de urgencias y puede pasar desapercibido si no se tiene una historia clínica adecuada. Presentamos un caso probablemente relacionado al uso de isometepteno. (Acta Med Colomb 2019; 44. DOI:https://doi.org/10.36104/amc.2019.1213)


Subject(s)
Humans , Female , Middle Aged , Syndrome , Vasoconstriction , Brain Edema , Cerebral Arteries , Stroke , Headache
7.
Int. j. morphol ; 37(3): 997-1002, Sept. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1012387

ABSTRACT

La arteria estriada medial distal hace parte de la circulación encefálica, nace de la arteria cerebral anterior generalmente a nivel de la arteria comunicante anterior, aunque según distintos estudios su origen varía, siendo así difícil de determinar con exactitud. Su importancia clínica radica en la prevalencia de aneurismas encontrados en esta arteria, que posteriormente podrían causar complicaciones debido a la región que irrigan, siendo estas las secuelas somático-vitales y neuropsicológicas, además de su inadecuado abordaje quirúrgico sin prever las alteraciones que puedan ser ocasionados; a causa de lo anterior es de vital importancia que los profesionales de la salud tengan previo conocimiento de la anatomía y la prevalencia de esta arteria en la población. Se realizó un estudio observacional de tipo descriptivo en donde se analizó la arteria estriada medial distal en 70 encéfalos, piezas de los anfiteatros de Medicina de la Universidad de Ciencias Aplicadas y Ambientales U.D.C.A. (Bogotá), la Universidad Científica del Sur UCSUR (Lima); fijados en formol al 10 %, se realizaron mediciones morfométricas mediante calibrador digital y se tomó el registro fotográfico con una cámara Canon. Posteriormente se ejecutó el análisis estadístico mediante el programa IBM SPSS Stadistics 24. Se encontró una prevalencia del 88,6 % de al menos una arteria estriada medial distal en población colombiana y un 97,1 % de la población peruana. Se identificó un diámetro externo promedio de 0,64 mm en población colombiana y de 0,68 mm en población peruana. Se observó una longitud promedio de 2,5 cm en ambas poblaciones. Se evidenció el mayor lugar de origen en la porción A2 de la ACA con un 37,1 % de población colombiana y un 51,4 % de población peruana. Se debe conocer adecuadamente la anatomía y las correspondientes variaciones anatómicas de esta arteria para así poder realizar un adecuado abordaje neurológico y neuroquirúrgico.


The distal medial striate artery is part of the brain circulation, born from the anterior cerebral artery generally at the level of the anterior communicating artery, although according to different studies its origin varies, being thus difficult to determine with accuracy. Its clinical importance lies in the prevalence of aneurysms found in this artery, which could later cause complications due to the region they irrigate, these being the somatic-vital and neuropsychological sequelae, in addition to its inadequate surgical approach without foreseeing the alterations that may be caused; Because of the above it is of vital importance that health professionals have prior knowledge of the anatomy and prevalence of this artery in the population. An observational descriptive study was carried out in which the distal medial striated artery in 70 brain cells, pieces from the Medicine amphitheatres of the Universidad de Ciencias Aplicadas y Ambientales U.D.C.A. (Bogotá), the Universidad Científica del Sur UCSUR (Lima); fixed in 10 % formalin, morphometric measurements were made by automatic calibrator and the photographic record was taken with a Canon camera. Subsequently, the statistical analysis was executed through the IBM SPSS Statistics program 24. A prevalence of 88.6 % of at least one distal medial striate artery was found in the Colombian population and 97.1 % of the Peruvian population. An average external diameter of 0.64 mm was identified in the Colombian population and 0.68 mm in the Peruvian population. An average length of 2.5 cm was observed in both populations. The largest place of origin was evidenced in the A2 portion of the ACA with 37.1 % of the Colombian population and 51.4 % of the Peruvian population. The anatomy and the corresponding anatomical variations of this artery must be adequately known to be able to perform an adequate neurological and neurosurgical approach.


Subject(s)
Humans , Brain/blood supply , Anterior Cerebral Artery/anatomy & histology , Peru , Cerebral Arteries/anatomy & histology , Prevalence , Cross-Sectional Studies , Colombia
8.
Int. j. morphol ; 37(3): 1095-1100, Sept. 2019. graf
Article in English | LILACS | ID: biblio-1012402

ABSTRACT

This study investigated the anatomy of the arteries of the brain, including the arterial circle of the brain, its branches and junctions, in five camel (Camelus dromedarius, Linnaeus 1758) following intravascular injection of colored latex via common carotid artery. The course and distribution of the arterial supply to the brain was described and morphological analysis was made. The basilar artery contributed to the blood supply of the brain in the camel in contrast to the situation in other Artiodactyla order.


En presente estudio se analizó la anatomía de las arterias del encéfalo en cinco camellos (Camelus dromedarius, Linnaeus 1758). Después de administrar una inyección intravascular de látex coloreado en la arteria carótida común se estudiaron las arterias incluyendo al círculo arterial del cerebro, sus ramas y uniones. Fueron descritos en detalle el curso y la distribución del suministro arterial al encéfalo y se realizó un análisis morfológico. La arteria basilar contribuyó al suministro de sangre del encéfalo del camello, diferenciando este aspecto en otras especies de Artiodactyla.


Subject(s)
Animals , Brain/blood supply , Camelus/anatomy & histology , Circle of Willis/anatomy & histology , Cerebral Arteries/anatomy & histology
9.
Article in English | WPRIM | ID: wpr-785633

ABSTRACT

OBJECTIVE: This study aimed to analyze intracranial vessels using brain computed tomography angiography (CTA) and scoring systems to diagnose brain death and predict poor neurologic outcomes of postcardiac arrest patients.METHODS: Initial brain CTA images of postcardiac arrest patients were analyzed using scoring systems to determine a lack of opacification and diagnose brain death. The primary outcome was poor neurologic outcome, which was defined as cerebral performance category score 3 to 5. The frequency, sensitivity, specificity, positive predictive value, negative predictive value, and area under receiver operating characteristic curve for the lack of opacification of each vessel and for each scoring system used to predict poor neurologic outcomes were determined.RESULTS: Patients with poor neurologic outcomes lacked opacification of the intracranial vessels, most commonly in the vein of Galen, both internal cerebral veins, and the mid cerebral artery (M4). The 7-score results (P=0.04) and 10-score results were significantly different (P=0.04) between outcome groups, with an area under receiver operating characteristic of 0.61 (range, 0.48 to 0.72). The lack of opacification of each intracranial vessel and all scoring systems exhibited high specificity (100%) and positive predictive values (100%) for predicting poor neurologic outcomes.CONCLUSION: Lack of opacification of vessels on brain CTA exhibited high specificity for predicting poor neurologic outcomes of patients after cardiac arrest.


Subject(s)
Angiography , Brain Death , Brain , Cerebral Arteries , Cerebral Veins , Heart Arrest , Humans , Hypothermia , ROC Curve , Sensitivity and Specificity
10.
Article in English | WPRIM | ID: wpr-719301

ABSTRACT

BACKGROUND AND PURPOSE: We investigated whether the intracranial arterial calcification status reflects the overall cerebral atherosclerosis burden. METHODS: Patients with acute cerebral infarction who were admitted to a single university hospital stroke center and underwent brain computed tomography angiography (CTA) between May 2011 and December 2015 were included. We reviewed their demographic, clinical, and imaging data. Cerebral artery calcification was assessed from the cavernous portion of both internal carotid arteries, and patients were categorized into three groups according to the calcification status. The cerebral atherosclerosis score was calculated as the sum of the degree of stenosis of the major intracranial and extracranial arteries on brain CTA. RESULTS: In total, 1,161 patients were included (age=67±13 years, mean±standard deviation), of which 517 were female. Intracranial arterial calcification and atherosclerosis were detected in 921 patients. The cerebral atherosclerosis score tended to increase with the calcification status (no calcification=2.0±3.0, mild=3.8±3.8, severe=6.5±4.8; p < 0.001 in analysis of variance followed by the Bonferroni test). Multivariable logistic regression analysis including age, sex, vascular risk factors, body mass index, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and calcification status showed that intracranial calcification was independently associated with an advanced cerebral atherosclerosis burden in a dose-dependent manner (compared to no calcification: odds ratio=2.0 and 95% confidence interval=1.1–3.4 for mild calcification, and odds ratio=4.7 and 95% confidence interval=2.7–8.3 for severe calcification). CONCLUSIONS: This study found that the calcification status of the cavernous portion of an internal carotid artery can reflect the overall cerebral atherosclerosis burden.


Subject(s)
Angiography , Arteries , Atherosclerosis , Body Mass Index , Brain , C-Reactive Protein , Carotid Artery, Internal , Cerebral Arteries , Cerebral Infarction , Constriction, Pathologic , Female , Glomerular Filtration Rate , Humans , Intracranial Arteriosclerosis , Logistic Models , Risk Factors , Stroke , Vascular Calcification
11.
Acta Physiologica Sinica ; (6): 395-404, 2019.
Article in Chinese | WPRIM | ID: wpr-777174

ABSTRACT

The present study was designed to examine whether Ramipril (an inhibitor of angiotensin-converting enzyme) affected spontaneous hypertension-induced injury of cerebral artery by regulating connexin 43 (Cx43) expression. Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR) were randomly divided into WKY, WKY + Ramipril, SHR, and SHR + Ramipril groups (n = 8). The arterial pressure was monitored by the tail-cuff method, and vascular function in basilar arteries was examined by pressure myography. Hematoxylin-eosin (HE) staining was used to show vascular remodeling. The expression and distribution of Cx43 was determined by using immunofluorescence and immunohistochemistry analysis. The protein and mRNA levels of Cx43 were examined by Western blot and real-time PCR analysis, respectively. The results showed that chronic Ramipril treatment significantly attenuated blood pressure elevation (P < 0.01, n = 8) and blood vessel wall thickness in SHR (P < 0.01, n = 8). The cerebral artery contraction rate in the SHR group was higher than that in the WKY group (P < 0.05, n = 8). The cerebral artery contraction rate in the SHR + Ramipril group was lower than that in the SHR group (P < 0.05, n = 8). Pretreatment with 2-APB (Cx43 non-specific blocker) or Gap26 (Cx43 specific blocker) significantly decreased the vasoconstriction rate, while pretreatment with AAP10 (Cx43 non-specific agonist) significantly increased the vasoconstriction in the SHR + Ramipril group (P < 0.05, n = 8). In addition, the expression of Cx43 mRNA and protein in cerebral arteries of SHR group was higher than that of WKY group (P < 0.05, n = 8). The mRNA and protein expression of Cx43 in cerebral arteries of SHR + Ramipril group was significantly lower than that of SHR group (P < 0.05, n = 8). These results suggest that Ramipril can down-regulate the expression of Cx43 mRNA and protein in cerebral arterial cells of SHR, lower blood pressure, promote vasodilation, and improve arterial damage and vascular dysfunction caused by hypertension.


Subject(s)
Animals , Blood Pressure , Cerebral Arteries , Metabolism , Connexin 43 , Metabolism , Hypertension , Drug Therapy , Ramipril , Pharmacology , Random Allocation , Rats , Rats, Inbred SHR , Rats, Inbred WKY , Vascular Remodeling
12.
Article in English | WPRIM | ID: wpr-785919

ABSTRACT

BACKGROUND: Achondroplasia is one of the most common types of dwarfism and is inherited as an autosomal dominant disease. The patients with achondroplasia suffer from various complications such as craniofacial, central nervous system, spinal, respiratory and cardiac anomalies.CASE DESCRIPTION: We report a case of a 35-year-old man with achondroplasia who visited the emergency room with right hemiplegia and aphasia within 6 hours after onset. An Initial CT angiography showed the total occlusion of a left internal cerebral artery due to the thrombus. We treated the patient with endovascular thrombectomy using “Solumbra technique” with balloon guiding catheter. The procedure was successful and result was completely recanalized with Thrombolysis in Cerebral Infarction (TICI) scale 3 and the weakness also improved from grade II to grade IV.CONCLUSION: Acute ischemic stroke patients with achondroplasia could be treated with mechanical thrombectomy.


Subject(s)
Achondroplasia , Adult , Angiography , Aphasia , Catheters , Central Nervous System , Cerebral Arteries , Cerebral Infarction , Dwarfism , Emergency Service, Hospital , Hemiplegia , Humans , Stroke , Thrombectomy , Thrombosis
13.
Neurointervention ; : 129-132, 2018.
Article in English | WPRIM | ID: wpr-730253

ABSTRACT

A 64-year-old female presented with an incidentally-discovered right posterior inferior cerebral artery (PICA) aneurysm, initially treated in 2015 by simple coiling. Follow-up demonstrated significant coil compaction that required retreatment. Retreatment was done uneventfully using a Pipeline embolization device (PED) shield deployed starting from the basilar artery and ending at the V4 segment of the vertebral artery. Eight-weeks post-deployment, a follow-up digital subtraction imaging (DSA) and intravascular imaging with optical coherence tomography were obtained. The intravascular imaging demonstrated that the flow diverter had good wall apposition and concentric neointimal growth over the braid with exception to the areas that the PED was not in contact with the endothelial wall, such as at the right PICA ostium and at the vertebrobasilar junction. The entire procedure was safe, and the patient had no complications. In this article, we describe for the first time the assessment of the status of endothelial “healing” of the PED shield at 8-weeks.


Subject(s)
Aneurysm , Basilar Artery , Cerebral Arteries , Female , Follow-Up Studies , Humans , Middle Aged , Pica , Retreatment , Tomography, Optical Coherence , Vertebral Artery
14.
Article in Korean | WPRIM | ID: wpr-713746

ABSTRACT

PURPOSE: The prefrontal lobe, supplementary motor area, cerebellum, and basal ganglia are activated during gait. In addition, gait is controlled by nerves, such as the corticospinal tract (CST) and corticoreticular pathway (CRP). In this study, the presence of an injury to the CST and CRP was identified by diffusion tensor imaging and the characteristics of the gait pattern were investigated according to inferior cerebral artery infarction. METHODS: One patient and six control subjects of a similar age participated. A 69-year-old female patient had an injury to the left basal ganglia, insular gyrus, corona radiata, dorsolateral prefrontal cortex, and postcentral gyrus due to an inferior cerebral artery infarction. Diffusion tensor imaging (DTI) data was acquired 4 weeks after the stroke. The kinematic and spatio-temporal parameters of gait were collected using a three-dimensional gait analysis system. RESULTS: On 4 weeks DTI, the CST and CRP in the affected hemisphere did not show injury to the affected and unaffected hemisphere. Gait analysis showed that the cadence of spatio-temporal parameter was decreased significantly in the patient. The angle of the knee joint was decreased significantly in the affected and unaffected sides compared to the control group. CONCLUSION: The results of diffusion tensor imaging showed that although the patient was evaluated to be capable of an independent gait, the quality and quantity of gait might be reduced. This study could help better understand the gait ability analysis of stroke patients and the abnormal gait pattern of patients with a brain injury.


Subject(s)
Aged , Basal Ganglia , Brain Injuries , Cerebellum , Cerebral Arteries , Diffusion Tensor Imaging , Female , Gait , Humans , Infarction , Knee Joint , Motor Cortex , Prefrontal Cortex , Pyramidal Tracts , Somatosensory Cortex , Stroke
15.
Article in English | WPRIM | ID: wpr-713494

ABSTRACT

Concurrent involvement of bilateral renal and cerebral arteries, usually incurred as stenosis, is rare in childhood-onset Takayasu arteritis (c-TA). We report the case of a 14-year-old girl, with c-TA, presenting with transient ischemic attack after endovascular revascularization for renal artery stenosis and cerebrovascular stroke after surgical revascularization for cerebral artery stenosis associated with childhood-onset moyamoya syndrome. We deem that decrease of blood pressure by endovascular revascularization and improvement of cerebral perfusion by surgical revascularization may have jeopardized the cerebral deep watershed zone to cerebral ischemia followed by cerebral hyperperfusion syndrome and caused transient ischemic attack and cerebrovascular stroke in our patient. Revascularization could be a double-edge sword for c-TA patients presenting with concomitant renal artery stenosis and cerebral artery stenosis, and should be performed with caution. Quantitative analysis of cerebral blood flow by brain magnetic resonance imaging and angiography should be performed within 48 hours after surgical revascularization in c-TA.


Subject(s)
Adolescent , Angiography , Blood Pressure , Brain , Brain Ischemia , Cerebral Arteries , Cerebrovascular Circulation , Constriction, Pathologic , Female , Humans , Hypertension, Renovascular , Ischemic Attack, Transient , Magnetic Resonance Imaging , Moyamoya Disease , Perfusion , Renal Artery Obstruction , Stroke , Takayasu Arteritis
16.
Journal of Stroke ; : 342-349, 2018.
Article in English | WPRIM | ID: wpr-717271

ABSTRACT

BACKGROUND AND PURPOSE: Vasa vasorum (VV) have been believed to be rare or non-existent in small-caliber intracranial arteries. In a series of human cerebral artery specimens, we identified and examined the distribution of VV in association with co-existing intracranial atherosclerosis. METHODS: We obtained cerebral artery specimens from 32 consecutive autopsies of subjects aged 45 years or above. We scrutinized middle cerebral artery (MCA), vertebral artery (VA), and basilar artery (BA) for the presence of adventitial VV. We described the distribution of VV, and the characteristics of co-existing atherosclerotic lesions. RESULTS: Among 157 intracranial arteries, adventitial VV were present in 74 of the 157 specimens (47%), involving MCA (n=13, 18%), BA (n=14, 19%), and VA (n=47, 64%). Although qualitatively these 74 adventitial VV distributed similarly in arteries with or without atherosclerotic lesions (disease-free arteries n=4/8; arteries of pre-atherosclerosis n=17/42; and arteries of progressive atherosclerosis n=53/107), the presence of adventitial VV in intracranial VA was associated with a heavier plaque load (1.72±1.66 mm2 vs. 0.40±0.32 mm2, P < 0.001), severer luminal stenosis (25%±21% vs. 12%±9%, P=0.002), higher rate of concentric lesions (79% vs. 36%, P=0.002), and denser intraplaque calcification (44% vs. 0%, P=0.003). Histologically, intracranial VA with VV had a larger diameter (3.40±0.79 mm vs. 2.34±0.58 mm, P < 0.001), thicker arterial wall (0.31±0.13 mm vs. 0.23±0.06 mm, P=0.002), and a larger intima-media (0.19±0.09 mm vs. 0.13± 0.04 mm, P=0.003) than VA without VV. CONCLUSIONS: Our study demonstrated the distribution of adventitial VV within brain vasculature and association between vertebral VV and progressive atherosclerotic lesions with a heavier plaque load and denser intraplaque calcification.


Subject(s)
Arteries , Atherosclerosis , Autopsy , Basilar Artery , Brain , Cerebral Arteries , Constriction, Pathologic , Humans , Intracranial Arteriosclerosis , Middle Cerebral Artery , Phenobarbital , Vasa Vasorum , Vertebral Artery
17.
Article in Korean | WPRIM | ID: wpr-758419

ABSTRACT

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe thunderclap headache with multifocal segmental vasoconstriction of the cerebral arteries. RCVS can be diagnosed if the cerebral angiogram shows segmental stenosis and spontaneously resolves within weeks to months. RCVS is reversible, but might cause brain lesions such as subarachnoid hemorrhage or cerebral infarction. We report a 45-year-old woman with severe sudden onset frontal headache who was identified with reversible cerebral vasoconstriction syndrome.


Subject(s)
Angiography , Brain , Cerebral Arteries , Cerebral Infarction , Constriction, Pathologic , Female , Headache , Headache Disorders, Primary , Humans , Middle Aged , Subarachnoid Hemorrhage , Swimming , Vasoconstriction
18.
Article in Korean | WPRIM | ID: wpr-766714

ABSTRACT

Ischemic stroke caused by the cerebral vasculopathy is a rare complication of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. We present a case of recurrent ischemic strokes caused by cerebral vasculopathy in a patient with POEMS syndrome. A 34-year-old man presented with gait disturbance and dizziness. Brain magnetic resonance imaging demonstrated acute ischemic stroke in the middle cerebral artery-anterior cerebral artery (MCA-ACA) border zones of bilateral hemispheres. Repeated angiographic studies showed progressive worsening of the left distal internal carotid artery, ACA, and MCA stenoses, along with sustained steno-occlusion of right MCA.


Subject(s)
Adult , Brain , Carotid Artery, Internal , Cerebral Arteries , Constriction, Pathologic , Dizziness , Gait , Humans , Magnetic Resonance Imaging , Paraproteinemias , POEMS Syndrome , Polyneuropathies , Skin , Stroke , Vascular Diseases
19.
Article in English | WPRIM | ID: wpr-714855

ABSTRACT

Intravenous thrombolysis (IVT) and endovascular treatment (EVT) are currently the main treatments for reperfusion in acute ischemic stroke. Although the EVT recanalization rate has increased, unsuccessful recanalization is still observed in 10-30% cases. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass is considered a rescue therapy in such cases, but in most centers it is not usually performed for acute ischemic stroke. Graft occlusion is rare following STA-MCA bypass, but it might lead to recurrent ischemic stroke. We hereby report on a patient with right MCA infarction and in whom EVT failed due to complete proximal internal carotid artery occlusion. He underwent an emergency STA-MCA bypass, resulting in a full recovery of his motor weakness. However, six months later, the patient experienced recurrent acute ischemic stroke due to bypass graft occlusion. His EVT failed again but revision bypass surgery, using STA remnant branch, was successful with full motor weakness recovery. We recommend a revision bypass surgery as a feasible therapeutic option for recurrent cerebral infarction caused by delayed STA graft occlusion.


Subject(s)
Carotid Artery, Internal , Cerebral Arteries , Cerebral Infarction , Cerebral Revascularization , Emergencies , Graft Occlusion, Vascular , Humans , Infarction, Middle Cerebral Artery , Reoperation , Reperfusion , Stroke , Transplants
20.
Braz. j. med. biol. res ; 51(5): e6714, 2018. tab, graf
Article in English | LILACS | ID: biblio-889083

ABSTRACT

This study aimed to investigate the protective effect of salvinorin A on the cerebral pial artery after forebrain ischemia and explore related mechanisms. Thirty Sprague-Dawley rats received forebrain ischemia for 10 min. The dilation responses of the cerebral pial artery to hypercapnia and hypotension were assessed in rats before and 1 h after ischemia. The ischemia reperfusion (IR) control group received DMSO (1 µL/kg) immediately after ischemia. Two different doses of salvinorin A (10 and 20 µg/kg) were administered following the onset of reperfusion. The 5th, 6th, and 7th groups received salvinorin A (20 µg/kg) and LY294002 (10 µM), L-NAME (10 μM), or norbinaltorphimine (norBIN, 1 μM) after ischemia. The levels of cGMP in the cerebrospinal fluid (CSF) were also measured. The phosphorylation of AKT (p-AKT) was measured in the cerebral cortex by western blot at 24 h post-ischemia. Cell necrosis and apoptosis were examined by hematoxylin-eosin staining (HE) and TUNEL staining, respectively. The motor function of the rats was evaluated at 1, 2, and 5 days post-ischemia. The dilation responses of the cerebral pial artery were significantly impaired after ischemia and were preserved by salvinorin A treatment. In addition, salvinorin A significantly increased the levels of cGMP and p-AKT, suppressed cell necrosis and apoptosis of the cerebral cortex and improved the motor function of the rats. These effects were abolished by LY294002, L-NAME, and norBIN. Salvinorin A preserved cerebral pial artery autoregulation in response to hypercapnia and hypotension via the PI3K/AKT/cGMP pathway.


Subject(s)
Animals , Male , Rats , Cerebral Arteries/drug effects , Brain Ischemia/metabolism , Phosphatidylinositol 3-Kinases/metabolism , Diterpenes, Clerodane/pharmacology , Signal Transduction , Cerebral Arteries/physiopathology , Brain Ischemia/drug therapy , Morpholines/administration & dosage , Chromones/administration & dosage , Rats, Sprague-Dawley , Cyclic GMP/cerebrospinal fluid , Cyclic GMP/metabolism , NG-Nitroarginine Methyl Ester , Diterpenes, Clerodane/antagonists & inhibitors , Disease Models, Animal , Naltrexone/administration & dosage , Naltrexone/analogs & derivatives
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