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J Magn Reson Imaging 2022 Jun 24. Epub 2022 Jun 24.

Department of Neuroimaging, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: Perihematomal edema (PHE) is an important determinant of outcome in spontaneous intracerebral hemorrhage (ICH) due to cerebral small vessel disease (CSVD). However, it is not known to date whether the severity of CSVD is associated with the extent of PHE progression in the acute phase.

Purpose: To investigate the association between the magnetic resonance imaging (MRI) marker of severe chronic-ischemia cerebral small vessel changes (sciSVC) and PHE growth or hematoma absorption among ICH patients with hypertension. Read More

Cureus 2022 May 11;14(5):e24918. Epub 2022 May 11.

Department of Radiology, Dr. D Y Patil Medical College, Hospital and Research Centre, Pune, IND.

Aim: To evaluate the utility of susceptibility-weighted imaging (SWI) sequence in stroke imaging and assess supplemental information provided by SWI in an acute stroke scenario.

Materials And Methods: In this study, the appearance of cerebrovascular stroke on the SWI images were analyzed in 50 patients who presented with acute-onset neurological symptoms.

Results: Brain MRI with SWI was performed on 50 patients presenting with acute neurological symptoms. Read More

J Clin Neurosci 2022 Jun 18;100:108-112. Epub 2022 Apr 18.

Johns Hopkins School of Medicine, Department of Neurology, Baltimore, MD, United States. Electronic address:

Hypertension is a common cause of intracerebral hemorrhage (ICH). The work up typically involves neuroimaging of the brain and blood vessels to determine etiology. However, extensive testing may be unnecessary for presumed hypertensive hemorrhages, and instead prolong hospital stay and increase costs. Read More

Surg Neurol Int 2022 11;13:90. Epub 2022 Mar 11.

Department of Neurosurgery, Fortis Memorial Research Institute, Gurgaon, Haryana, India.

Background: Several neurological manifestations have been described in the literature, in patients affected with COVID-19 infection. Some common forms include ischemic stroke, cardioembolic stroke, intraparenchymal hemorrhage, and multicompartmental hemorrhage. Concurrent brain infarct and intraventricular hemorrhage (IVH) have not been described in the literature previously. Read More

BMJ Case Rep 2022 Apr 6;15(4). Epub 2022 Apr 6.

Department of Neuroanaesthesiology, The Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark.

A man in his mid-30s was admitted with a thunderclap headache. He was conscious and hypertensive. A decade earlier, severe hypertension had been diagnosed and extensively investigated without revealing an underlying cause. Read More

AJNR Am J Neuroradiol 2022 04 24;43(4):540-546. Epub 2022 Mar 24.

Department of Radiology (T.A., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands.

Background And Purpose: Cerebral small vessel disease contributes to stroke and cognitive impairment and interacts with Alzheimer disease pathology. Because of the small dimensions of the affected vessels, in vivo characterization of blood flow properties is challenging but important to unravel the underlying mechanisms of the disease.

Materials And Methods: A 2D phase-contrast sequence at 7T MR imaging was used to assess blood flow velocity and the pulsatility index of the perforating basal ganglia arteries. Read More

Brain Behav 2022 Apr 2;12(4):e2530. Epub 2022 Mar 2.

Department of Neurology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong Province, China.

Background: Whether the circadian rhythms of blood pressure (BP) contribute to the presence of cerebral microbleeds (CMBs) remains unknown. This study aimed to assess the relationship between nocturnal BP and CMBs in hypertensive patients.

Methods: This prospective case-control study recruited 51 hypertensive patients with CMBs and 51 hypertensive patients without CMBs, matched with age and gender, serving as controls. Read More

Comput Math Methods Med 2022 18;2022:7156598. Epub 2022 Feb 18.

The Second People's Hospital of Jingdezhen City, Jiangxi Province 333000, China.

Objective: To explore the 3D-slicer software-assisted endoscopic treatment for patients with hypertensive cerebral hemorrhage.

Methods: A total of 120 patients with hypertensive cerebral hemorrhage were selected and randomly divided into control group and 3D-slicer group with 60 cases each. Patients in the control group underwent traditional imaging positioning craniotomy, and patients in the 3D-slicer group underwent 3D-slicer followed by precision puncture treatment. Read More

Acta Neurochir (Wien) 2022 03 9;164(3):811-821. Epub 2022 Feb 9.

Department of Neurosurgery, Neurozentrum, Kantonsspital Aarau, Aarau, Switzerland.

Purpose: Intravenous and intra-arterial milrinone as a rescue measure for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) has been adopted by several groups, but so far, evidence for the clinical benefit is unclear and effect on brain perfusion is unknown. The aim of the actual analysis was to define cerebral hemodynamic effects and outcome of intravenous milrinone plus norepinephrine supplemented by intra-arterial nimodipine as a rescue strategy for DCI following aneurysmal SAH.

Methods: Of 176 patients with aneurysmal SAH treated at our neurosurgical department between April 2016 and March 2021, 98 suffered from DCI and were submitted to rescue therapy. Read More

Clin Neuropathol 2022 May-Jun;41(3):128-134

The Wernekinck commissure syndrome is extremely rare in a clinical setting. This condition has been previously reported in association with midbrain infarction, midbrain hemorrhage, demyelinating pseudotumor, and optic neuromyelitis spectrum disease, but not with Hashimoto's encephalopathy. Herein, we report the case of a 44-year-old hypertensive man who developed cerebellar ataxia, internuclear ophthalmoplegia, and cognitive decline. Read More

J Stroke Cerebrovasc Dis 2022 Mar 8;31(3):106293. Epub 2022 Jan 8.

Department of Neurology, Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, Carrer Sant Quintí 89, Barcelona 08041, Spain.

Objectives: Some patients with deep intracerebral hemorrhage (ICH) have a transient hypertensive response and they may be erroneously classified as secondary to hypertension. We investigated frequency, risk factors, and outcomes for patients with deep ICH without hypertension.

Materials And Methods: We consecutively recruited patients with spontaneous ICH attending two Spanish stroke centers (January 2015-June 2019). Read More

BMC Emerg Med 2022 01 10;22(1). Epub 2022 Jan 10.

Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG5 1PB, UK.

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial (RIGHT-2).

Methods: RIGHT-2 was a prospective, multicentre, paramedic-delivered, ambulance-based, sham-controlled, participant-and outcome-blinded, randomised-controlled trial of transdermal glyceryl trinitrate (GTN) in adults with ultra-acute presumed stroke in the UK. Read More

Biomedicines 2021 Dec 4;9(12). Epub 2021 Dec 4.

Division of Cardiology, Department of Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27514, USA.

The patient presenting with stroke often has cardiac-related risk factors which may be involved in the mechanism of the stroke. The diagnostic assessment is predicated on recognition of this potential relationship. Naturally, an accurate history is of utmost importance in discerning a possible cause and effect relationship. Read More

Sci Rep 2021 12 9;11(1):23729. Epub 2021 Dec 9.

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, 00029, Helsinki, Finland.

The prevalence of unruptured intracranial aneurysms (UIAs) is around 2-3% in the general population. We hypothesized that the prevalence of small UIAs is higher among 50 to 60-year-old female smokers, since the incidence of aneurysmal subarachnoid hemorrhage (aSAH) is exceptionally high in 60 to 70-year-old female smokers. Ethics approval for this pilot study of 50 women was obtained from the hospital ethics committee. Read More

BMC Neurol 2021 Dec 6;21(1):473. Epub 2021 Dec 6.

Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Sichuan Province, 610072, Chengdu, P R China.

Background: We examined for the first time the imaging characteristics of Holmes tremor (HT) through multimodal 3D medical imaging.

Case Presentation: Three patients with Holmes tremor who visited the Affiliated Hospital of Chengdu University of TCM from August 2018 to April 2021 were retrospectively investigated to summarize their clinical and imaging data.

Results: Holmes tremor in two of the three patients was caused by hypertensive cerebral hemorrhage and in the third patient induced by hemorrhage due to ruptured brain arteriovenous malformations. Read More

J Pharm Technol 2021 Apr 2;37(2):127-132. Epub 2020 Dec 2.

The University of Texas at Tyler, TX, USA.

To review and consider risk factors associated with the accumulation of and toxicity from manganese in patients receiving total parenteral nutrition (TPN). A 66-year-old female presented to the emergency department with right facial and arm weakness that initiated 1 hour prior to admission. Past medical history includes oral cancer with chronic aspiration and gastroparesis secondary to chemotherapy, TPN for 9 months, and a previous episode of right facial and arm parasthesias due to hypertensive emergency 4 years prior. Read More

BMC Cardiovasc Disord 2021 10 9;21(1):485. Epub 2021 Oct 9.

Department of Internal Medicine, Midcentral District Health Board, Palmerston North, New Zealand.

Background: Left ventricular hypertrophy is a pathophysiological response often due to chronic uncontrolled hypertension. Our primary aim was to investigate the magnitude, correlates and outcomes of left ventricular hypertrophy as a surrogate maker for chronic uncontrolled hypertension in young adults ≤ 45 years with stroke. Our secondary aim was to determine the accuracy of electrocardiography using Sokolow-Lyon and Cornell criteria in detecting left ventricular hypertrophy compared to echocardiography. Read More

J Clin Hypertens (Greenwich) 2021 11 5;23(11):1992-1999. Epub 2021 Oct 5.

Department of Emergency Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China.

The authors sought to explore whether hypertension classification was risk factor for lobar and non-lobar hypertensive intracerebral hemorrhage (HICH) and the prognosis in patients with hematoma. This retrospective cohort study was conducted on HICH patients admitted at the First Affiliated Hospital of Soochow University. Observations with first-ever intracerebral hemorrhage (ICH) were recruited. Read More

Stroke 2022 02 30;53(2):523-531. Epub 2021 Sep 30.

Department of Neurology (J.P.C., M.P., P.K., J.R.A., A.C., C.K., Z.D., K.S., C.D.A., M.E.G., S.M.G., J.R., A.V., A.B.), Massachusetts General Hospital, Boston.

Background And Purpose: Intracerebral hemorrhage (ICH) is an acute manifestation of cerebral small vessel disease (CSVD), usually cerebral amyloid angiopathy or hypertensive arteriopathy. CSVD-related imaging findings are associated with increased depression incidence in the general population. Neuroimaging may, therefore, provide insight on depression risk among ICH survivors. Read More

Australas J Ageing 2022 Mar 27;41(1):126-137. Epub 2021 Sep 27.

Emergency Medicine Department, Tours University Hospital, Tours, France.

Objective: To describe the characteristics, assessment and management of older emergency department (ED) patients with non-traumatic headache.

Methods: Planned sub-study of a prospective, multicentre, international, observational study, which included adult patients presenting to ED with non-traumatic headache. Patients aged ≥75 years were compared to those aged <75 years. Read More

J Stroke Cerebrovasc Dis 2021 Dec 17;30(12):106118. Epub 2021 Sep 17.

Departments of Neurology, Boston University School of Medicine and Boston Medical Center, United States; Departments of Neurosurgery, Boston University School of Medicine and Boston Medical Center, United States; Departments of Medicine Infectious Diseases, Boston University School of Medicine and Boston Medical Center, United States. Electronic address:

Background And Objectives: RCVS (Reversible Cerebral Vasoconstrictive Syndrome) is a condition associated with vasoactive agents that alter endothelial function. There is growing evidence that endothelial inflammation contributes to cerebrovascular disease in patients with coronavirus disease 2019 (COVID-19). In our study, we describe the clinical features, risk factors, and outcomes of RCVS in a multicenter case series of patients with COVID-19. Read More

Brain 2021 12;144(11):3371-3380

Department and Graduate Institute of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan.

Cerebral small vessel disease is one of the most common causes of cognitive decline and stroke. While several lines of evidence have established a relationship between inflammation and cerebrovascular pathology, the mechanistic link has not yet been elucidated. Recent studies suggest activation of immune mediators, including the soluble form of triggering receptor expressed on myeloid cells 2 (TREM2), may be critical regulators. Read More

Cureus 2021 Aug 4;13(8):e16889. Epub 2021 Aug 4.

Emergency Medicine, Ocala Regional Medical Center, Ocala, USA.

Intracerebral hemorrhage (ICH) is a relatively common condition seen throughout the world, with the vast majority of cases referring to primary ICH. However, secondary ICH from other underlying conditions is also possible. In the present case, the patient presented with severe headaches. Read More

Int J Stroke 2021 Sep 10:17474930211043957. Epub 2021 Sep 10.

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

Background: Although primary intraventricular hemorrhage is frequently due to trauma or vascular lesions, the etiology of idiopathic primary intraventricular hemorrhage (IP-IVH) is not defined.

Aims: Herein, we test the hypothesis that cerebral small vessel diseases (cSVD) including hypertensive cSVD (HTN-cSVD) and cerebral amyloid angiopathy are associated with IP-IVH.

Methods: Brain magnetic resonance imaging from consecutive patients (January 2011 to September 2019) with non-traumatic intracerebral hemorrhage from a single referral center were reviewed for the presence of HTN-cSVD (defined by strictly deep or mixed-location intracerebral hemorrhage/cerebral microbleeds) and cerebral amyloid angiopathy (applying modified Boston criteria). Read More

Medicine (Baltimore) 2021 Aug;100(33):e27022

Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, China.

Rationale: The clinical manifestations of basilar dolichoectasia (BD) are variable. The diagnosis is based on imaging measurements. Digital subtraction angiography displays only the dilated vascular lumen and lacks visualization of the arterial wall. Read More

Am J Forensic Med Pathol 2021 Sep;42(3):258-262

Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, Shanghai, People's Republic of China.

Abstract: Postmortem computed tomography (PMCT), PMCT angiography, and 3-dimensonal (3D) printing technology are increasingly applied to forensic practice. Although their effectiveness is undeniably confirmed, their potential role in practice still needs to be further explored. Here, we report a typical case in which such 4 technologies were applied to a woman found dead with stomach content beneath the head on the pillow in her residence. Read More

Front Immunol 2021 29;12:719462. Epub 2021 Jul 29.

Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Background: Abnormal glucose metabolism was shown to be associated with the occurrence of remote diffusion-weighted imaging lesions (R-DWILs) after primary intracerebral hemorrhage (ICH) onset. Insulin resistance is a metabolic disorder that was regarded as an indicator of chronic systemic inflammation. In this study, we aimed to determine the effect of insulin resistance on the occurrence of R-DWILs in ICH. Read More

Stroke 2021 11 4;52(11):3602-3612. Epub 2021 Aug 4.

Second Department of Neurology (C.Z., A.T., A.H.K., K.V., G.T.), National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece.

Background And Purpose: There are scarce data regarding the prevalence, characteristics and outcomes of intracerebral hemorrhage (ICH) of undetermined (unknown or cryptogenic) etiology. We sought to determine the prevalence, radiological characteristics, and clinical outcomes of undetermined ICH.

Methods: Systematic review and meta-analysis of studies involving patients with spontaneous ICH was conducted to primarily assess the prevalence and clinical-radiological characteristics of undetermined ICH. Read More

Can J Neurol Sci 2021 Jul 29:1-8. Epub 2021 Jul 29.

Neurosurgery and Neuroendovascular Therapy Department, "Dr. José Eleuterio González" University Hospital, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.

Background: Large-sized clinical trials have failed to show an overall benefit of surgery over medical treatment in managing spontaneous intracerebral hemorrhages (ICH); less invasive techniques have shown to decrease brain injury caused by surgical manipulation in the standard open approach improving the clinical outcomes of patients. Thereby, we propose a low-cost 3D-printed endoport for a less invasive ICH evacuation. In this study, the authors compare the clinical outcomes of early surgical evacuation using a 3D-printed endoport vs. Read More

J Med Case Rep 2021 Jul 27;15(1):403. Epub 2021 Jul 27.

Department of Ophthalmology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.

Background: Intravitreal injections of anti-vascular endothelial growth factor are commonly used to treat macular diseases, including diabetic macular edema. Anti-vascular endothelial growth factor drugs can enter the systemic circulation after intravitreal injections and appear to suppress circulating vascular endothelial growth factor levels. However, whether this can cause any systemic adverse events remains unknown. Read More