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J Neurol 2019 Jan 8. Epub 2019 Jan 8.

Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, 175 Cambridge Street, #300, Boston, MA, 02114, USA.

Background: Spontaneous cerebellar-intracerebral hemorrhage (ICH) can be associated with both cerebral amyloid angiopathy (CAA) and hypertensive small vessel disease (HTN-SVD, i.e. arteriolosclerosis). Read More

Virchows Arch 2019 Feb 7;474(2):235-245. Epub 2019 Jan 7.

Department of Neuropathology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, Karnataka, 560029, India.

Cerebral amyloid angiopathy (CAA) is the second most common cause of non-traumatic intracerebral haemorrhage (ICH) accounting for 12-15% of lobar haemorrhages in the elderly. Definitive diagnosis of CAA requires histological evaluation. We aimed to evaluate the spectrum of cerebrovascular changes in CAA-related ICH. Read More

Stroke 2018 Dec 7:STROKEAHA118021407. Epub 2018 Dec 7.

From the Normandie University, UNICAEN, Inserm U1237, Caen, France (M.B., M.Z., E.T.).

Background and Purpose- Diffusion-weighted imaging (DWI) hyperintensities in intracerebral hemorrhage (ICH) are associated with increased risk of recurrent ICH, cognitive impairment, and death, but whether these lesions are specific to a subtype of ICH remains uncertain. We investigated the association between DWI lesions and ICH subtype and explored the risk factors for DWI lesions. Methods- In a systematic review of ICH studies, we identified those reporting prevalence of DWI lesions. Read More

Neurol India 2018 Nov-Dec;66(6):1800-1802

Department of Neurology, Indo-American Hospital: Brain and Spine Centre, Vaikom, Kerala, India.

Neurol India 2018 Nov-Dec;66(6):1694-1703

Department of Neurosurgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India.

Introduction: Although there are controversies about the optimal management of spontaneous intracerebral hemorrhage (ICH), benefits of endoscopic procedures in ICH have been reported. This study is aimed to evaluate the result of 270 patients undergoing endoscopic treatment of ICH.

Methods: This was a retrospective study from July 2008 to June 2017. Read More

Front Neurol 2018 12;9:926. Epub 2018 Nov 12.

Department of Neurology, Center for Neuroscience, Donders Institute for Brain Cognition & Behaviour, Radboud University Medical Center, Nijmegen, Netherlands.

Hypertensive vasculopathy and cerebral amyloid angiopathy are the two most common forms of cerebral small vessel disease. Both forms are associated with the development of primary intracerebral hemorrhage, but the pathophysiological mechanisms underlying spontaneous vessel rupture remain unknown. This work constitutes a systematic review on blood-brain barrier dysfunction in the etiology of spontaneous intracerebral hemorrhage due to cerebral small vessel disease. Read More

World Neurosurg 2018 Dec 21;120:430-434. Epub 2018 Sep 21.

Department of Neurosurgery, Maharaja Agrasen Medical College, Agroha, India.

Background: Treatment of arteriovenous malformations (AVMs) is currently performed at specialized neurosurgical centers well equipped with microscopes with green filters, neurosurgical catheterization laboratories, and experienced neurosurgical teams. Patients in whom AVMs are diagnosed at smaller hospitals should be referred to such specialized centers. This case report describes the unavoidable worst-case scenario of an emergency unplanned surgical excision of an undiagnosed ruptured AVM with large hematoma. Read More

Wiad Lek 2018;71(2 pt 2):408-412

Katedra I Klinika Neurologii Uniwersytetu Medycznego W Lublinie, Lublin, Polska.

Brain microbleeds are defined as small, circular hypointense changes in T2-sequensec of brain MRI, well demarcated from the surrounding tissue. They represent the phagocytized products of blood distribution extravasated from pathologically altered vessels. The echo-T2-dependent gradient (GRE) and magnetic susceptibility testing (SWI) sequences are usually used to visualize them. Read More

Front Neurol 2018 2;9:284. Epub 2018 May 2.

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Background: Chronic kidney disease (CKD) has been closely associated with hypertension and stroke. Although studies have reported the relationship between CKD and cerebral small vessel disease (SVD), the link between CKD, hypertension, and SVD is uncertain. The aim of this study was to investigate the association between CKD and SVD in patients with strictly hypertensive intracerebral hemorrhage (ICH). Read More

Stroke 2018 Jun 25;49(6):1515-1517. Epub 2018 Apr 25.

Department of Neurology (H.-H.T., L.-K.T., S.-C.T., J.-S.J.).

Background And Purpose: We evaluated whether lacunes in centrum semiovale (lobar lacunes) were associated with cerebral amyloid angiopathy (CAA) markers in an Asian intracerebral hemorrhage (ICH) population.

Methods: One hundred ten patients with primary ICH were classified as CAA-ICH (n=24; mean age, 70.9±13. Read More

Harefuah 2018 03;157(3):158-161

Department of Neurology, Hadassah Medical Center, Jerusalem Israel.

Introduction: Non-traumatic intracranial hemorrhage (ICH) is a devastating event associated with a high rate of morbidity and mortality. Patient age, hemorrhage location, number of foci, and underlying diseases are important clues to the etiology. Non-contrast head CT, given its availability and high sensitivity in detecting blood products, is frequently the first tool to readily detect ICH; however, different types of hemorrhages may share a common appearance on CT and the optimal therapeutic approach varies depending on etiology. Read More

J Stroke Cerebrovasc Dis 2018 Jul 20;27(7):1878-1884. Epub 2018 Mar 20.

Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore, Singapore.

Background And Purpose: Hypertension is an important etiology of intracerebral hemorrhage (ICH) in neurosurgical practice. Contrast extravasation on computed tomography angiography, known as the "spot sign", has been described as an independent predictor of hematoma progression and clinical deterioration. However, its role in hypertensive ICH alone has not been determined and is the primary aim of this study. Read More

Cerebrovasc Dis 2018 20;45(3-4):124-131. Epub 2018 Mar 20.

INSERM LVTS (Laboratory for Vascular Translational Science) 1148 and Paris-Diderot University, Sorbonne Paris Cité, Paris, France.

Background: Risk factors for intracerebral hemorrhage (ICH) include hypertension and cerebral amyloid angiopathy (CAA). The objective of this study was to determine the autopsy prevalence of CAA and the potential overlap with other risk factors among patients who died from ICH and also the correlation of CAA with cerebral microbleeds.

Methods: We analyzed 81 consecutive autopsy brains from patients with ICH. Read More

Clin Nucl Med 2018 Jun;43(6):396-401

From the Department of Neurosurgery and Cyclotron Research Center, Iwate Medical University, Morioka, Japan.

Purpose: Whereas SPECT images obtained 180 minutes after administration of I-iomazenil (IMZ) (late images) are proportional to the distribution of central benzodiazepine receptor-binding potential, SPECT images obtained within 30 minutes after I-IMZ administration (early images) correlate with regional brain perfusion. The aim of the present study was to determine whether crossed cerebellar tracer uptake on acute-stage I-IMZ SPECT imaging predicts 3-month functional outcome in patients with nonfatal hypertensive putaminal or thalamic hemorrhage.

Methods: Forty-six patients underwent early and late SPECT imaging with I-IMZ within 7 days after the onset of hemorrhage. Read More

Medicine (Baltimore) 2018 Mar;97(10):e0106

Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Jilin, P.R. China.

Rationale: Hemorrhage rarely occurs in a solitary brain metastasis from lung carcinoma.

Patient Concerns: We report on a 54-year-old man who presented with a severe headache for 4 days.

Diagnoses: Based on computed tomography and magnetic resonance imaging enhancement, the patient was diagnosed with a suspected hemorrhagic brain metastasis from lung carcinoma. Read More

Curr Treat Options Neurol 2018 Feb 3;20(1). Epub 2018 Feb 3.

Division of Neurosciences Critical Care, Departments of Neurology, Neurosurgery, and Anesthesiology/Critical Care Medicine, The Johns Hopkins Hospital, 1800 Orleans Street/Phipps 455, Baltimore, MD, 21287, USA.

Purpose Of Review: Spontaneous intraparenchymal hemorrhage (IPH) is a prominent challenge faced globally by neurosurgeons, neurologists, and intensivists. Over the past few decades, basic and clinical research efforts have been undertaken with the goal of delineating biologically and evidence-based practices aimed at decreasing mortality and optimizing the likelihood of meaningful functional outcome for patients afflicted with this devastating condition. Here, the authors review the medical and surgical approaches available for the treatment of spontaneous intraparenchymal hemorrhage, identifying areas of recent progress and ongoing research to delineate the scope and scale of IPH as it is currently understood and treated. Read More

BMC Ophthalmol 2018 Feb 2;18(1):25. Epub 2018 Feb 2.

Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand.

Background: Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i. Read More

Sci Rep 2018 01 24;8(1):1492. Epub 2018 Jan 24.

Department of Epidemiology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute, Barcelona, Spain.

We investigated whether pre-treatment with statins is associated with surrogate markers of amyloid and hypertensive angiopathies in patients who need to start long-term oral anticoagulation therapy. A prospective multicenter study of patients naive for oral anticoagulants, who had an acute cardioembolic stroke. MRI was performed at admission to evaluate microbleeds, leukoaraiosis and superficial siderosis. Read More

Neth J Med 2017 Dec;75(10):448-450

Quantitative Neuroimaging Group, Academic Unit of Neurology, Trinity College Dublin, Ireland.

Khat consumption is an under-recognised cause of hypertensive encephalopathy and intraparenchymal brain haemorrhage. We report the radiological findings of extensive periventricular, subcortical and brain stem white matter pathology of a patient who had consumed excessive amounts of Khat. The Khat plant contains cathinone, an amphetamine-like alkaloid which has been associated with chronic hypertensive end-organ damage, but is seldom considered a cause of cerebrovascular events in northern Europe. Read More

Neurology 2018 Jan 15;90(2):e119-e126. Epub 2017 Dec 15.

From the Hemorrhagic Stroke Research Program (M.P., A.C., G.B., E.A., A.A., K.M.S., A.V., S.M.G., M.E.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston; NEUROFARBA Department (M.P., L.P.), Neuroscience Section, University of Florence, Italy; Université Paris-Descartes (G.B.), INSERM UMR 894, Department of Neuroradiology, Centre Hospitalier Sainte-Anne, France; and Division of Neurocritical Care and Emergency Neurology (J.N.G., J.R.), Massachusetts General Hospital, Harvard Medical School, Boston.

Objective: To assess the predominant type of cerebral small vessel disease (SVD) and recurrence risk in patients who present with a combination of lobar and deep intracerebral hemorrhage (ICH)/microbleed locations (mixed ICH).

Methods: Of 391 consecutive patients with primary ICH enrolled in a prospective registry, 75 (19%) had mixed ICH. Their demographics, clinical/laboratory features, and SVD neuroimaging markers were compared to those of 191 patients with probable cerebral amyloid angiopathy (CAA-ICH) and 125 with hypertensive strictly deep microbleeds and ICH (HTN-ICH). Read More

Brain Behav 2017 11 16;7(11):e00856. Epub 2017 Oct 16.

Department of Neurology Mie University Graduate School of Medicine Tsu Mie Japan.

Objectives: Cerebral microbleeds (CMBs) are often observed in memory clinic patients. It has been generally accepted that deep CMBs (D-CMBs) result from hypertensive vasculopathy (HV), whereas strictly lobar CMBs (SL-CMBs) result from cerebral amyloid angiopathy (CAA) which frequently coexists with Alzheimer's disease (AD). Mixed CMBs (M-CMBs) have been partially attributed to HV and also partially attributed to CAA. Read More

Stroke 2017 12 3;48(12):3384-3386. Epub 2017 Nov 3.

From the Departments of Neuroradiology (C.H., S.N., M.B.), Medical Biometry and Informatics (L.U.), and Neurology (M.S., T.S.), University of Heidelberg, Germany; Department of Neurology, Frankfurt Hoechst Hospital, Frankfurt am Main, Germany (T.S.); and Department of Neurology, St. John's Hospital Vienna, Austria (M.S.).

Background And Purpose: Numerous studies have investigated the influence of meteorologic factors and seasons on the incidence of spontaneous intracerebral hemorrhage (ICH) with ambiguous results. In the present study, data from a large, international multicenter trial in patients with ICH were used to identify seasonal and meteorologic determinants for hypertensive-ICH with greater applicability.

Methods: Patients were grouped according to the presumptive ICH cause, that is, hypertensive when located in the basal ganglia brain stem as well as cerebellum and nonhypertensive when located lobar. Read More

Stroke 2017 11 10;48(11):2964-2972. Epub 2017 Oct 10.

From the Departments of Neurology (J.G.R., D.S.K.) and Radiology (K.K., C.R.J., P.V.), Mayo Clinic, Rochester, MN; Department of Data Science, Gertrude Ford MIND Center (J.S., M.E.G.) and Department of Medicine (T.H.M., B.G.W.), University of Mississippi Medical Center, Jackson; Department of Neurology (M.S.A., R.F.G.), Johns Hopkins University, Baltimore, MD; and Department of Epidemiology (A.R.S., R.F.G.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

Background And Purpose: Cerebral microbleed (CMB) location (deep versus strictly lobar) may elucidate underlying pathology with deep CMBs being more associated with hypertensive vascular disease and lobar CMBs being more associated with cerebral amyloid angiopathy. The objective of this study was to determine whether neuroimaging signs of vascular disease and Alzheimer pathology are associated with different types of CMBs.

Methods: Among 1677 nondemented ARIC (Atherosclerosis Risk in Communities) participants (mean age=76±5 years; 40% men; 26% black) with 3-Tesla MRI scans at the fifth examination (2011-2013), we fit multinomial logistic regression models to quantify relationships of brain volumes (Alzheimer disease signature regions, total gray matter, frontal gray matter, and white matter hyperintensity volumes), infarct frequencies (lacunar, nonlacunar, and total), and apolipoprotein E (number of ε4 alleles) with CMB location (none, deep/mixed, or strictly lobar CMBs). Read More

Cureus 2017 Aug 1;9(8):e1532. Epub 2017 Aug 1.

Creighton University Medical Center, CHI Creighton University.

Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. Read More

JMIR Res Protoc 2017 Aug 31;6(8):e173. Epub 2017 Aug 31.

Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.

Background: Dramatic hemodynamic changes occur upon removal of an arteriovenous malformation of the brain (bAVM) with a number of potentially serious perioperative complications, such as intracranial hemorrhage and venous occlusive hypertensive syndrome. As these complications largely occur in the postoperative inpatient period, a rapid, repeatable noninvasive investigation to serially monitor relevant intracranial hemodynamics may be of benefit. Though, transcranial Doppler (TCD) and transcranial color duplex (TCCD) are techniques used and available to provide hemodynamic measurements postoperatively, the time course of hemodynamic sequences following bAVM resection remains uncertain. Read More

World Neurosurg 2017 Nov 24;107:877-880. Epub 2017 Aug 24.

Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China; Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China.

Background: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is a benign form of subarachnoid hemorrhage (SAH) with a favorable prognosis. The risk of recurrent hemorrhage of this benign entity is extremely low.

Case Description: We describe a rare case of recurrent, spontaneous PNSAH in a 56-year-old man. Read More

JAMA Neurol 2017 09;74(9):1048-1055

Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston.

Importance: Reemergence of previous stroke-related deficits (or poststroke recrudescence [PSR]) is an underrecognized and inadequately characterized phenomenon.

Objective: To investigate the clinical features, triggers, and risk factors for PSR.

Design, Setting, And Participants: This retrospective study incorporated a crossover cohort study to identify triggers and a case-control study to identify risk factors. Read More

J Stroke Cerebrovasc Dis 2017 Nov 29;26(11):2662-2670. Epub 2017 Jul 29.

Medical University of South Carolina, Charleston, South Carolina.

Background: Annotation and Image Markup on ClearCanvas Enriched Stroke-phenotyping Software (ACCESS) is a novel stand-alone computer software application that allows the creation of simple standardized annotations for reporting brain images of all stroke types. We developed the ACCESS application and determined its inter-rater and intra-rater reliability in the Stroke Investigative Research and Educational Network (SIREN) study to assess its suitability for multicenter studies.

Methods: One hundred randomly selected stroke imaging reports from 5 SIREN sites were re-evaluated by 4 trained independent raters to determine the inter-rater reliability of the ACCESS (version 12. Read More

World Neurosurg 2017 Oct 8;106:462-469. Epub 2017 Jul 8.

Department of Internal Medicine, University of Rwanda, Kigali, Rwanda.

Background: Cerebrovascular accidents or stroke constitute the second leading cause of mortality worldwide. Low- and middle-income countries bear most of the stroke burden worldwide. The main objective of this study is to determine the burden of stroke in Rwanda. Read More

G Ital Nefrol 2017 Apr;34(2):100-109

Struttura Complessa di Nefrologia e Dialisi IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italia.

Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, usually reversible, characterized by vasogenic oedema in cerebral posterior regions in patients with autoimmune diseases, nephropathies, hypertensive crisis, eclampsia and exposure to cytotoxic drugs. The main symptoms are: headache, nausea, vomiting, seizures, visual disturbance and altered consciousness. Complications as cerebral hemorrhage and recurrences are rare. Read More

PLoS One 2017 22;12(6):e0178284. Epub 2017 Jun 22.

Servei de neuorlogia, Hospital de la Santa Creu i Sant Pau (Biomedical Research Institute, IIB-Sant Pau), Barcelona, Spain.

Background And Purpose: Remote parenchymal haemorrhage (rPH) after intravenous thrombolysis is defined as hemorrhages that appear in brain regions without visible ischemic damage, remote from the area of ischemia causing the initial stroke symptom. The pathophysiology of rPH is not clear and may be explained by different underlying mechanisms. We hypothesized that rPH may have different risk factors according to the bleeding location. Read More

Neuroradiol J 2017 Aug 20;30(4):385-388. Epub 2017 Jun 20.

1 Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Background We report a case of hypertensive microbleeds strategically located at the attached segment (AS) and root entry zone (REZ) at the left facial nerve causing facial paralysis. Case Report A 60-year-old woman presented with sudden onset left facial paralysis. Medical history was significant for poorly controlled hypertension secondary to bilateral adrenal hyperplasia (primary hyperaldosteronism). Read More

World Neurosurg 2017 Sep 29;105:348-358. Epub 2017 Jun 29.

Department of Neurosurgery, Qiannan People's Hospital, Qiannan, Guizhou, China.

Objective: Therapeutic efficacy of patients with hypertensive intracerebral hemorrhage (HICH) with large hematoma volume is poor. This study aimed to explore the efficacy of minimally invasive surgery for patients with HICH with large hematoma volume.

Methods: A total of 104 patients with HICH with a hematoma volume >50 mL were treated with different surgical approaches. Read More

Neuroimage Clin 2017 5;15:247-263. Epub 2017 May 5.

U894, Centre Hospitalier Sainte Anne, Sorbonne Paris Cité, Paris, France. Electronic address:

Sporadic cerebral amyloid angiopathy (CAA) is a very common small vessel disease of the brain, showing preferential and progressive amyloid-βdeposition in the wall of small arterioles and capillaries of the leptomeninges and cerebral cortex. CAA now encompasses not only a specific cerebrovascular pathological trait, but also different clinical syndromes - including spontaneous lobar intracerebral haemorrhage (ICH), dementia and 'amyloid spells' - an expanding spectrum of brain parenchymal MRI lesions and a set of diagnostic criteria - the Boston criteria, which have resulted in increasingly detecting CAA during life. Although currently available validated diagnostic criteria perform well in multiple lobar ICH, a formal diagnosis is currently lacking unless a brain biopsy is performed. Read More

Neurology 2017 Jun 5;88(23):2162-2168. Epub 2017 May 5.

From the Hemorrhagic Stroke Research Program (M.P., G.B., P.F., E.A., A.C., K.H., A.A., K.M.S., A.V., S.M.G., M.E.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston; NEUROFARBA Department (M.P., L.P.), Neuroscience Section, University of Florence, Italy; Université Paris-Descartes (G.B.), INSERM UMR 894, Department of Neuroradiology, Centre Hospitalier Sainte-Anne, Paris, France; and Division of Neurocritical Care and Emergency Neurology (J.N.G., J.R.), Massachusetts General Hospital, Harvard Medical School, Boston.

Objective: To evaluate whether the burden of deep and lobar lacunes differs between patients with intracerebral hemorrhage (ICH) with definite/probable cerebral amyloid angiopathy (CAA) per the Boston criteria and hypertensive small vessel disease (HTN-SVD; ICH in basal ganglia, thalami, brainstem).

Methods: We defined lobar and deep lacunes similar to the topographic distribution used for ICH and cerebral microbleeds (CMBs). We then compared their distribution between patients with CAA-ICH and those with strictly deep CMB and ICH (HTN-ICH). Read More

Neurology 2017 May 3;88(22):2089-2097. Epub 2017 May 3.

From the Laboratory of Epidemiology and Population Sciences (J.D., O.M., L.J.L.), National Institute on Aging, NIH, Bethesda, MD; Icelandic Heart Association (S.S., G.E., O.K., V.G.), Kopavogur; Faculty of Medicine (P.V.J., V.G.), University of Iceland, Reykjavik; Department of Psychiatry and Neurology (O.L.L.), University of Pittsburgh, Pennsylvania; and Department of Radiology (M.A.v.B.), Leiden University Medical Center, the Netherlands.

Objective: To assess the association of the number and anatomic location of cerebral microbleeds (CMBs), visible indicators of microvascular damage on MRI, with incident cognitive disease in the general population of older people.

Methods: In the longitudinal population-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, 2,602 participants 66 to 93 years of age and free of prevalent dementia underwent brain MRI and cognitive testing of verbal memory, processing speed, and executive function at baseline and a mean of 5.2 years later. Read More

Neurobiol Aging 2017 06 6;54:94-99. Epub 2017 Mar 6.

Department of Neurology, School of Public Health at Boston University, Boston, MA, USA; NHLBI's Framingham Heart Study, Framingham, MA, USA.

Cerebral microbleeds (CMBs) are MRI markers attributed to the most common cerebral angiopathies in the elderly and in patients with dementia: hypertensive and cerebral amyloid angiopathy. CMB detection in asymptomatic persons may help identify those at risk for dementia and may influence preventive strategies and design of clinical trials testing treatments for dementia. We studied the association of CMB with risk of incident dementia in community dwelling individuals. Read More

Front Aging Neurosci 2017 7;9:49. Epub 2017 Mar 7.

Department of Neurology and Institute of Neurology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, China.

Cerebral microbleeds are an intracerebral microangiopathy with bleeding tendency found in intracerebral hemorrhage patients. However, studies about cerebral microbleed effects on the prognosis of hypertensive intracerebral hemorrhage patients are rare. We performed a prospective study to discuss not only the risk factors of cerebral microbleed incidence in hypertensive intracerebral hemorrhage patients but also the relevance of cerebral microbleeds with silent brain infarction, hemorrhage and prognosis. Read More

Pol J Radiol 2017 7;82:64-70. Epub 2017 Feb 7.

Department of Radiodiagnosis, JSS Medical College and Hospital, JSS University, Mysore, India.

Background: Posterior reversible encephalopathy syndrome (PRES), also called the acute hypertensive encephalopathy and reversible posterior leukoencephalopathy syndrome (RPLS), is a neurotoxic syndrome of cerebral vasoregulation classically characterized by bilaterally symmetrical parieto-occipital edema. However, the imaging findings are variable and may occur in other locations such as the frontal lobes, thalami, basal ganglia and brainstem. Most commonly, PRES presents with hyperintense signals on T2 and FLAIR sequences. Read More

Stroke 2017 03;48(3):581-586

From the Department of Medicine and Neurology, Melbourne Brain Centre (T.Y.W., N.Y., D.G.S., M.M., B.C.V.C., B.Y., S.M.D., A.M.) and Department of Radiology (G.S., P.M.D.), the Royal Melbourne Hospital, University of Melbourne, Australia; Department of Neurology, Helsinki University Hospital, Finland (J.P., D.S., T.T., A.M.); Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, People's Republic of China (M.M.); Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden (T.T.); and Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden (T.T.).

Background And Purpose: Simultaneous multiple intracerebral hemorrhages (SMICHs) are uncommon. Few single-center studies have analyzed characteristics and outcome of SMICH. We analyzed clinical characteristics and outcome of SMICH patients from 2 comprehensive stroke centers. Read More

J Cereb Blood Flow Metab 2017 Aug 1;37(8):3065-3076. Epub 2016 Jan 1.

1 Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands.

Estimation of hemorrhagic transformation (HT) risk is crucial for treatment decision-making after acute ischemic stroke. We aimed to determine the accuracy of multiparametric MRI-based predictive algorithms in calculating probability of HT after stroke. Spontaneously, hypertensive rats were subjected to embolic stroke and, after 3 h treated with tissue plasminogen activator (Group I: n = 6) or vehicle (Group II: n = 7). Read More

Neurol India 2016 Nov-Dec;64(6):1323-1326

Department of Neurology, Indo-American Hospital, Brain and Spine Centre, Vaikom, Kerala, India.

Transl Stroke Res 2017 04 25;8(2):174-182. Epub 2016 Oct 25.

Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.

Erythrolysis occurs in the clot after intracerebral hemorrhage (ICH), and the release of hemoglobin causes brain injury, but it is unclear when such lysis occurs. The present study examined early erythrolysis in rats. ICH rats had an intracaudate injection of 100 μl autologous blood, and sham rats had a needle insertion. Read More

Neurology 2016 Oct 14;87(15):1575-1582. Epub 2016 Sep 14.

From the Department of Neurology (Y.J.K.), Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon; Departments of Neurology (H.J.K., D.L.N., S.W.S.) and Nuclear Medicine (Y.S.C., K.-H.L., S.H.M.), Sungkyunkwan University School of Medicine, and Neuroscience Center (H.J.K., D.L.N., S.W.S.), Samsung Medical Center, Seoul; Department of Neurology (J.-H.P.), Semyeong Christianity Hospital, Pohang; Biostatistics Team (S.K., S.-Y.W.), Samsung Biomedical Research Institute; Department of Biomedical Engineering (K.-C.K., J.M.L.), Hanyang University, Seoul; Department of Neurology (N.-Y.J.), Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan; Departments of Nuclear Medicine (J.S.K.) and Neurology (J.-H.L.), University of Ulsan College of Medicine, Asan Medical Center, Seoul; Department of Neurology (Y.J.K.), Ilsong Institute of Life Science, Hallym University, Anyang, Korea; Stroke Research Centre (D.J.W.), Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK; and Departments of Health Sciences and Technology (D.L.N.) and Clinical Research Design & Evaluation (S.W.S.), SAIHST, Sungkyunkwan University, Seoul, Korea.

Objective: To determine whether amyloid and hypertensive cerebral small vessel disease (hCSVD) changes synergistically affect the progression of lobar microbleeds in patients with subcortical vascular mild cognitive impairment (svMCI).

Methods: Among 72 patients with svMCI who underwent brain MRI and [C] Pittsburgh compound B (PiB)-PET, 52 (72.2%) completed the third year of follow-up. Read More

Br J Neurosurg 2017 Apr 20;31(2):217-222. Epub 2016 Oct 20.

a Department of Neurosurgery , Tangdu Hospital, Fourth Military Medical University , Xi'an , China.

Background: Symptomatic intracranial hemorrhage (ICH) may lead to permanent neurological disability of patients and has impeded the extensive clinical application of deep brain stimulation (DBS). The present study was conducted to discuss the incidence, prevention, and treatment of symptomatic ICH after DBS surgery.

Methods: From January 2009 to December 2014, 396 patients underwent DBS with a total of 691 implanted leads. Read More

Neurol Sci 2017 Jan 5;38(1):185-187. Epub 2016 Oct 5.

Department of Neurology, Hospital Miguel Servet, 50009, Saragossa, Spain.

Extra-ischaemic (remote) brain heamorrhages after thrombolysis for ischaemic stroke occur in less than 3 % of treated patients, but it worsens prognosis. Little attention has been paid to the location of the haematomas. Among 12 patients with remote brain haemorrhage after thrombolysis, we report three patients with haemorrhage in the cerebellar vermis (25 %), with poor outcome. Read More

Masui 2016 10;65(10):1043-1047

CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is a rare inherited disease which begins with migraine and later develops repeated cerebral subcortical infarction and dementia. We present an anesthetic experience of an undiagnosed CADASIL woman complicated with preeclampsia. She developed headache, slurred speech, cognitive dysfunction and restlessness at 35 weeks' gestation and was diagnosed as hypertensive encepha- lopathy. Read More

Stroke 2016 10 13;47(10):2497-502. Epub 2016 Sep 13.

From the Department of Neurology (C.-P.C., W.-T.C., P.-N.W.) and Institute of Brain Science (W.-T.C., L.-K.C.), School of Medicine, Institute of Neuroscience (K.-H.C., C.-P.L.), Aging and Health Research Center (L.-K.L., L.-K.C., P.-N.W.), and Brain Research Center (K.-H.C., W.-T.C., L.-K.L., P.-N.W.), National Yang Ming University; Department of Neurology (C.-P.C., W.-T.C., P.-N.W.), Center for Geriatric and Gerontology (L.-K.L., L.-K.C.), Taipei Veterans General Hospital, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan, Taiwan (W.-J.L.).

Background And Purpose: Different distributions of cerebral microbleeds (CMBs) are associated with distinct pathological mechanisms. Lobar CMBs are thought to be related to cerebral amyloid angiopathy, whereas deep or infratentorial CMBs are related to hypertensive vasculopathy. The present study aimed to evaluate the effects of CMBs and their locations on a variety of cognitive domains. Read More

Turk Neurosurg 2017 ;27(3):395-400

Sisli Hamidiye Etfal Research and Training Hospital, Clinic of Neurosurgery, Istanbul, Turkey.

Aim: Computed tomography (CT)-guided stereotactic brain biopsy has been performed in our clinic since March 1998. In this prospective study, we examined the patient data undergoing stereotactic biopsy and the results of biopsies in 500 consecutive patients.

Material And Methods: Between the dates of March 1998 and January 2015, CT-guided stereotactic biopsies were performed by using the Leksell stereotactic frame system (Elekta Instruments EU, Sweden) in 500 patients. Read More

Neurosurg Rev 2016 Oct 25;39(4):711-6. Epub 2016 Jul 25.

Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, 0372, Oslo, Norway.

Unruptured intracranial aneurysms occur in 1-3 % of the general population, and the risk of rupture is generally considered to be low. However, patients with multiple aneurysms and familial predisposition carry a particular risk of subarachnoid hemorrhage (SAH). A 54-year-old hypertensive man underwent screening with a head CT angiography (CTA) because of his comorbidities. Read More