3,434 results match your criteria Lacunar Stroke

From cryptogenic to ESUS: Toward precision medicine?

S Timsit

Rev Neurol (Paris) 2022 May 18. Epub 2022 May 18.

Université Brest, Inserm, EFS, UMR 1078, GGB, 29200 Brest, France; Neurology and Stroke unit Department, CHRU de Brest, Inserm1078, Université de Bretagne Occidentale, 29200 Brest, France. Electronic address:

Cryptogenic infarctions are infarctions without a defined cause, despite a complete work-up. They differ from infarctions of undetermined causes, which may involve overlapping causes or an incomplete investigation. It is also different from uncommon heritable and non-heritable causes. Read More

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Deficiency of Human Adenosine Deaminase Type 2 - A Diagnostic Conundrum for the Hematologist.

Front Immunol 2022 3;13:869570. Epub 2022 May 3.

Pediatric Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Deficiency of adenosine deaminase type 2 (DADA2) was first described in 2014 as a monogenic cause of polyartertitis nodosa (PAN), early onset lacunar stroke and livedo reticularis. The clinical phenotype of DADA2 is, however, very broad and may involve several organ systems. Apart from vasculitis, children may present with i) Hematological manifestations (ii) Lymphoproliferation and iii) Immunodeficiencies. Read More

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Craniocerebral Magnetic Resonance Imaging Features of Benign Paroxysmal Positional Vertigo under Artificial Intelligence Algorithm and the Correlation with Cerebrovascular Disease.

Contrast Media Mol Imaging 2022 26;2022:8952355. Epub 2022 Apr 26.

Department of Neurology, Baoji City People's Hospital, Baoji 721000, Shaanxi, China.

This research aimed to discuss the characteristics of benign paroxysmal positional vertigo (BPPV) and the correlation with cerebrovascular disease. An artificial intelligence algorithm under a parallel dual-domain concatenated convolutional neural network (PDDC-CNN) was proposed to process the images of magnetic resonance imaging (MRI). MRI, magnetic resonance angiography (MRA), and susceptibility weighted imaging (SWI) were performed on all 60 research objects with a 3. Read More

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The FAST VAN for Field Identification of Large Vessel Occlusion in Acute Stroke.

Can J Neurol Sci 2022 May 18:1-4. Epub 2022 May 18.

Division of Neurology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

Background: There is definitive evidence for effectiveness of thrombectomy for acute stroke with large vessel occlusion (LVO). A clinical tool to identify patients with LVO is therefore required for effective triage and prehospital decision making. We developed the FAST VAN tool, which follows from the Heart and Stroke Foundation FAST stroke screen, with the addition of cortical features of vision, aphasia, and neglect, to differentiate from lacunar syndromes. Read More

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Brain structural alterations and clinical features of cognitive frailty in Japanese community-dwelling older adults: the Arao study (JPSC-AD).

Sci Rep 2022 May 17;12(1):8202. Epub 2022 May 17.

Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Cognitive frailty (CF) is a clinical condition defined by the presence of both mild cognitive impairment (MCI) and physical frailty (PF). Elderly with CF are at greater risk of dementia than those with MCI or PF alone, but there are few known clinical or neuroimaging features to reliably distinguish CF from PF or MCI. We therefore conducted a population-based cross-sectional study of community elderly combining physical, cognitive, neuropsychiatric, and multisequence magnetic resonance imaging (MRI) evaluations. Read More

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Asymptomatic cerebral findings on 3-Tesla MRI in patients with severe carotid artery stenoses.

J Clin Neurosci 2022 May 14;101:106-111. Epub 2022 May 14.

Department of Neurosurgery, Sapporo Shiroishi Memorial Hospital, Sapporo City, Hokkaido, Japan.

Background And Purpose: Small vessel diseases (SVDs) are often asymptomatic. However, SVDs significantly influence the prognosis in patients with large vessel diseases (LVDs). We investigated asymptomatic cerebral findings on 3-Tesla MRI in patients with severe carotid artery (CA) stenoses, compared to peoples without a past history of neurological disorders, including strokes. Read More

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Transient Ischemic Attack Due to Unruptured Basilar Artery Aneurysm.

Cureus 2022 Apr 13;14(4):e24102. Epub 2022 Apr 13.

Neurology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

Intracranial aneurysms are typically asymptomatic. They are usually incidentally detected or detected only after rupture. Ischemic stroke or transient ischemic attack (TIA) due to unruptured intracranial aneurysms (UIAs) is rare. Read More

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Pattern and Severity of Leukoaraiosis and Microvascular Resistance- Inputs from a TCD Study from South Asia.

Neurol India 2022 Mar-Apr;70(2):699-703

Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

Background And Purpose: Leukoaraiosis is thought to be related to long-standing microvascular ischemia. The pathogenic mechanisms and hemodynamic changes could be different for periventricular and deep white matter leukoaraiosis. In this cross-sectional study, we examined whether the Pulsatility Index (PI) in Transcranial Doppler ultrasonography (TCD), which can give indirect information regarding downstream microvascular resistance and compliance, is different for leukoaraiosis in periventricular and deep locations. Read More

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Association of inflammatory markers with cerebral small vessel disease in community-based population.

J Neuroinflammation 2022 May 6;19(1):106. Epub 2022 May 6.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.

Background: This study investigated the relationships of neutrophil count (NC), neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) with cerebral small vessel disease (CSVD).

Methods: A total of 3052 community-dwelling residents from the Poly-vasculaR Evaluation for Cognitive Impairment and vaScular Events (PRECISE) study were involved in this cross-sectional study. CSVD burden and imaging markers, including white matter hyperintensity (WMH), lacunes, cerebral microbleeds (CMBs) and enlarged perivascular spaces in basal ganglia (BG-EPVS), were assessed according to total CSVD burden score. Read More

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Risk Factors of Recurrent Stroke in Young and Middle-Aged Stroke Patients after Interventional Therapy.

Comput Math Methods Med 2022 25;2022:5728991. Epub 2022 Apr 25.

Nursing Department, The Fifth Central Hospital of Tianjin, 300450 Tianjin, China.

Objective: To explore the risk factors of recurrent stroke in young and middle-aged stroke patients after interventional therapy.

Methods: Retrospective analysis was conducted on the data of 300 young and middle-aged stroke patients treated in our hospital (February 2015-February 2017). All patients received interventional therapy. Read More

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Usefulness of the Atherosclerosis Risk Score for Patients With Acute Infarction in the Lenticulostriate Artery Region.

Cureus 2022 Mar 28;14(3):e23591. Epub 2022 Mar 28.

Neurosurgery, Nagasaki Prefecture Shimabara Hospital, Shimabara, JPN.

Background and purpose Internal carotid artery intima-media thickness (IMT) and pulse wave velocity (PWV) are risk factors of cerebrovascular disease and coronary artery disease. They are known as independent predictors of arteriosclerotic disease. It has been reported that IMT and PWV are useful factors for predicting stroke subtype and/or outcome. Read More

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Extent of vascular plaque predicts future cardiovascular events in patients with systemic lupus erythematosus.

Rheumatology (Oxford) 2022 Apr 28. Epub 2022 Apr 28.

Centre for Rheumatology Research, Division of Medicine, University College London, London, UK.

Objective: Patients with systemic lupus erythematosus (SLE) have increased prevalence of clinical cardiovascular disease (CVD) and subclinical atherosclerosis. Although 30-40% of patients with SLE have vascular plaque on ultrasound scanning, this study is the first to consider the relationship between total burden of plaque and subsequent CVD risk.

Methods: One hundred patients with SLE and without any previous clinical CVD underwent vascular ultrasound scans of both carotid and both common femoral bifurcations between 2011 and 2013. Read More

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A critical assessment of the current pharmacotherapy for the treatment of embolic strokes of undetermined source.

Expert Opin Pharmacother 2022 May 6:1-11. Epub 2022 May 6.

Stroke Unit, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.

Introduction: 'Embolic stroke of undetermined source' (ESUS) is a term coined to identify non-lacunar stroke whose mechanism is likely to be embolic, and the source remains unidentified. The best antithrombotic treatment for preventing stroke recurrence in this population has not been delineated.

Areas Covered: The authors summarize and critically appraise the currently available evidence about the antithrombotic treatment for preventing stroke recurrence in patients with ESUS. Read More

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Diagnostic Value of Hcy Combined with Blood Pressure Variability Index in the Severity of Hypertension Complicated with CSVD and Its Correlation with Cognitive Function and CysC Expression.

J Healthc Eng 2022 14;2022:9003537. Epub 2022 Apr 14.

Drug Clinical Experimental Center, The First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing, Jiangsu 210029, China.

This paper explores the diagnostic value of Hcy combined with the blood pressure variability index in the severity of hypertension complicated with CSVD and its correlation with cognitive function and CysC expression. 200 patients with ischemic small cerebral vessels are selected as the research object. According to the MRI findings, they are divided into 48 cases of white matter lesions (WML), 44 cases of lacunar infarction (LI), 44 cases of enlarged perivascular spaces (EPVs), and 46 cases in the mixed group (referring to two or more types of ischemic cerebrovascular disease on imaging). Read More

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Clinical Prediction Model for Screening Acute Ischemic Stroke Patients With More Than 10 Cerebral Microbleeds.

Front Neurol 2022 7;13:833952. Epub 2022 Apr 7.

Department of Neurology, Tangshan Gongren Hospital, Tangshan, China.

Background: Hemorrhagic transformation is one of the most serious complications in intravenous thrombolysis. Studies show that the existence of more than 10 cerebral microbleeds is strongly associated with hemorrhagic transformation. The current study attempts to develop and validate a clinical prediction model of more than 10 cerebral microbleeds. Read More

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Genetic associations of adult height with risk of cardioembolic and other subtypes of ischemic stroke: A mendelian randomization study in multiple ancestries.

PLoS Med 2022 04 22;19(4):e1003967. Epub 2022 Apr 22.

Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

Background: Taller adult height is associated with lower risks of ischemic heart disease in mendelian randomization (MR) studies, but little is known about the causal relevance of height for different subtypes of ischemic stroke. The present study examined the causal relevance of height for different subtypes of ischemic stroke.

Methods And Findings: Height-associated genetic variants (up to 2,337) from previous genome-wide association studies (GWASs) were used to construct genetic instruments in different ancestral populations. Read More

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Not All That Is Droopy Post Ad26.COV2.S (JNJ) Vaccine Is Bell's Palsy: A Rare Case of Isolated Dorsal Pontine Stroke Causing Ipsilateral Complete Hemi-Facial Palsy.

Cureus 2022 Mar 15;14(3):e23195. Epub 2022 Mar 15.

Internal Medicine, Coliseum Medical Centers, Macon, USA.

The Ad26.COV2.S vaccine, developed by Janssen (Beerse, Belgium), the pharmaceutical wing of Johnson & Johnson (JNJ), is one of the three vaccines approved for use against coronavirus disease 2019 (COVID-19) infection in the United States. Read More

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Characterization of cerebral small vessel disease by neutrophil and platelet activation markers using artificial intelligence.

J Neuroimmunol 2022 Jun 9;367:577863. Epub 2022 Apr 9.

Department of Biochemistry, CARIM School for cardiovascular diseases, Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address:

Cerebral small vessel disease (cSVD) accounts for 25% of ischemic strokes and is a major cause of cognitive decline. Inflammatory processes, involving immune cells and platelets might drive development and progression of cSVD. The aim of the study was to identify potential novel biomarkers for cSVD, gaining new insights into its pathophysiology. Read More

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Acute Neurological Manifestations of COVID-19 Patients From Three Tertiary Care Hospitals in Qatar.

Cureus 2022 Mar 14;14(3):e23150. Epub 2022 Mar 14.

Neurosciences, Hamad General Hospital, Doha, QAT.

Introduction Worldwide, there are more than 424 million confirmed cases of COVID-19. Most of the hospitalized critical COVID-19 patients manifested neurological signs and symptoms and higher mortality. The majority of COVID-19 fatalities occurred mostly in patients with advanced age and underlying medical comorbidities. Read More

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Scattered cerebral infarction in the corona radiata predicts worse outcomes.

Acta Neurol Scand 2022 Apr 16. Epub 2022 Apr 16.

Department of Neurosurgery, Ina Central Hospital, Ina, Japan.

Objectives: Intracranial branch atheromatous disease often results in progressive motor deficits in the lenticulostriate arteries (LSA). In some patients with LSA infarction, magnetic resonance imaging (MRI) revealed single lesions at the LSA origin from the middle cerebral artery spreading in a scattered manner toward the distal area. This study aimed to elucidate the clinical characteristics of such cases. Read More

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Predictive Analysis of Serum NO, PGI2, and Ox-LDL Levels on Disease Progression in Patients with Lacunar Cerebral Infarction.

Comput Math Methods Med 2022 4;2022:1221810. Epub 2022 Apr 4.

Department of Neurology, The First People's Hospital of Wenling, Wenling, Zhejiang, China 317500.

Objective: To analyze and predict the progress of patients with lacunar infarction by analyzing the levels of serum NO, PGI2, and Ox-LDL produced by endothelial cells.

Methods: 138 patients with lacunar infarction and 34 healthy people were selected. The selected samples were divided into progressive group, nonprogressive group, and control group for biochemical test and endothelial function test. Read More

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Neurological deterioration and computed tomography perfusion changes with increased time to peak in lacunar stroke.

Brain Circ 2022 Jan-Mar;8(1):17-23. Epub 2022 Mar 21.

Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA.

Objectives: Lacunar strokes can have fluctuations and progression in the acute period leading to poor outcomes. Our study sought to evaluate if, in lacunar strokes, neurological deterioration (ND) was associated with blood pressure (BP) variations, stroke size, or increased time to peak (TTP) on admission computed tomography perfusion (CTP).

Methods: Patients with lacunar stroke who had magnetic resonance imaging and CTP performed were enrolled in the study. Read More

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Association of Platelet-to-Lymphocyte Ratio with Stroke-Associated Pneumonia in Acute Ischemic Stroke.

Wei Li Cailian He

J Healthc Eng 2022 18;2022:1033332. Epub 2022 Mar 18.

Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

A common consequence of acute ischemic stroke (AIS), stroke-associated pneumonia (SAP), might result in a poor prognosis after stroke. Based on the critical position of inflammation in SAP, this study aimed to explore the correlation between platelet-to-lymphocyte ratio (PLR) and the occurrence of SAP. We included 295 patients with acute ischemic stroke, 40 with SAP, and 255 without SAP. Read More

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The Value of Brain Structural Magnetic Resonance Imaging Combined with APOE--4 Genotype in Early Diagnosis and Disease Progression of Senile Vascular Cognitive Impairment No Dementia.

Contrast Media Mol Imaging 2022 5;2022:8613024. Epub 2022 Mar 5.

Department of Neurology, Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.

Objective: To explore the value of brain structure magnetic resonance imaging combined with APOE-4 genotype in the early diagnosis and disease progression of elderly patients with vascular cognitive impairment no dementia (VCIND).

Methods: The first stroke patients admitted to our hospital from March 2017 to December 2018 were collected, including 130 cases of vascular cognitive impairment no dementia (VCIND group) and 50 cases of the control group (NC group). The basic information of all subjects was recorded, and APOE-4 alleles of all subjects were detected. Read More

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Thyroid Function Affects the Risk of Post-stroke Depression in Patients With Acute Lacunar Stroke.

Front Neurol 2022 3;13:792843. Epub 2022 Mar 3.

Stroke Center and Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

Objective: This study aimed to investigate whether thyroid function profiles are associated with post-stroke depression (PSD) and evaluate the mediation effect of cerebral small vessel disease (cSVD) on the association of thyroid function profiles and PSD in patients with acute ischemic lacunar stroke.

Methods: In this study, 372 patients with confirmed acute ischemic lacunar stroke within 3 days of onset were consecutively recruited. Serum levels of thyroid hormones and thyroid antibodies were detected on admission. Read More

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Long-term mortality and recurrent vascular events in lacunar versus non-lacunar ischaemic stroke: A cohort study.

Eur Stroke J 2022 Mar 30;7(1):57-65. Epub 2021 Dec 30.

Usher Institute, University of Edinburgh, Edinburgh, Scotland.

Introduction: Studies of differences in very long-term outcomes between people with lacunar/small vessel disease (SVD) versus other types of ischaemic stroke report mixed findings, with limited data on myocardial infarction (MI). We investigated whether long-term mortality, recurrent stroke and MI risks differ in people with versus without lacunar/SVD ischaemic stroke.

Patients And Methods: We included first-ever strokes from a hospital-based stroke cohort study recruited in 2002-2005. Read More

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Diagnostic accuracy of major stroke types in Chinese adults: A clinical adjudication study involving 40,000 stroke cases.

Lancet Reg Health West Pac 2022 Apr 5;21:100415. Epub 2022 Mar 5.

Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Oxford OX3 7LF, UK.

Background: Widespread use of brain imaging in suspected stroke cases in Chinese adults has prompted the need for clinical adjudication studies of stroke types. We conducted a clinical adjudication study to assess the reporting and diagnostic accuracy of major stroke types.

Methods: The prospective China Kadoorie Biobank recruited >512,000 adults (mean age 52 years, 59% women) from 10 urban and rural areas in China during 2004-2008, and recorded 45,859 first-ever incident stroke cases during an 11-year follow-up. Read More

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Prevalence of Clinical and Neuroimaging Markers in Cerebral Amyloid Angiopathy: A Systematic Review and Meta-Analysis.

Stroke 2022 Mar 10:STROKEAHA121035836. Epub 2022 Mar 10.

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

Background: Limited data exist regarding the prevalence of clinical and neuroimaging manifestations among patients diagnosed with cerebral amyloid angiopathy (CAA). We sought to determine the prevalence of clinical phenotypes and radiological markers in patients with CAA.

Methods: Systematic review and meta-analysis of studies including patients with CAA was conducted to primarily assess the prevalence of clinical phenotypes and neuroimaging markers as available in the included studies. Read More

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Diffusion-weighted imaging as predictor of acute ischemic stroke etiology.

Arq Neuropsiquiatr 2022 Feb 28. Epub 2022 Feb 28.

Clínica Alemana de Santiago, Department of Neurology and Psychiatry, Vascular Neurology Service, Neurology Unit, Santiago, Chile.

Background: Topographic patterns may correlate with causes of ischemic stroke.

Objective: To investigate the association between diffusion-weighted imaging (DWI) and Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification.

Methods: We included 1019 ischemic stroke patients. Read More

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February 2022

Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy: A Woman With Lacunar Stroke.

Stroke 2022 04 3;53(4):e162-e164. Epub 2022 Mar 3.

Case Western Reserve School of Medicine (C.K., S.S.), University Hospitals Cleveland Medical Center, OH.

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