3,514 results match your criteria Lacunar Syndromes

Identification of novel proteins for lacunar stroke by integrating genome-wide association data and human brain proteomes.

BMC Med 2022 Jun 23;20(1):211. Epub 2022 Jun 23.

Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Background: Previous genome-wide association studies (GWAS) have identified numerous risk genes for lacunar stroke, but it is challenging to decipher how they confer risk for the disease. We employed an integrative analytical pipeline to efficiently transform genetic associations to identify novel proteins for lacunar stroke.

Methods: We systematically integrated lacunar stroke genome-wide association study (GWAS) (N=7338) with human brain proteomes (N=376) to perform proteome-wide association studies (PWAS), Mendelian randomization (MR), and Bayesian colocalization. Read More

View Article and Full-Text PDF

Recurrent Strokes in Patients With Atrial Fibrillation Treated With Direct Oral Anticoagulant Agents.

Angiology 2022 Jun 12:33197221108394. Epub 2022 Jun 12.

Department of Vascular Neurology, University Clinical Centre Ljubljana, Slovenia.

Recurrent ischemic strokes (IS) in patients treated with direct oral anticoagulant agents (DOACs) are rare. Knowledge regarding the type of recurrent IS and predisposing factors is insufficient. We analyzed a cohort of 1001 patients (77. Read More

View Article and Full-Text PDF

Strokelore: Therapeutic relevance of lacunar infarcts.

William J Powers

J Stroke Cerebrovasc Dis 2022 Jun 9;31(8):106594. Epub 2022 Jun 9.

Department of Neurology, University of North Carolina School of Medicine, Room 2133, CB#7025, 170 Manning Drive, Chapel Hill, NC, United States. Electronic address:

View Article and Full-Text PDF

Population-based prevalence of infarctions on 3D fluid-attenuated inversion recovery (FLAIR) imaging.

J Stroke Cerebrovasc Dis 2022 Jun 8;31(8):106583. Epub 2022 Jun 8.

Department of Neurology, Mayo Clinic.

Objectives: To report population-based, age-specific prevalence of infarctions as identified via 3D fluid-attenuated inversion recovery (FLAIR) imaging.

Materials And Methods: Participants without dementia in the Mayo Clinic Study of Aging (MCSA), a population-based study in Olmsted County, MN, age 50-89 who underwent 3D FLAIR imaging between 2017 and 2020 were included. Infarctions per participant were determined via visual interpretation. Read More

View Article and Full-Text PDF

A Novel Rodent Model of Hypertensive Cerebral Small Vessel Disease with White Matter Hyperintensities and Peripheral Oxidative Stress.

Int J Mol Sci 2022 May 25;23(11). Epub 2022 May 25.

Felsenstein Medical Research Center, Department of Human Genetics and Biochemistry, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

Cerebral small vessel disease (CSVD) is the second most common cause of stroke and a major contributor to dementia. Manifestations of CSVD include cerebral microbleeds, intracerebral hemorrhages (ICH), lacunar infarcts, white matter hyperintensities (WMH) and enlarged perivascular spaces. Chronic hypertensive models have been found to reproduce most key features of the disease. Read More

View Article and Full-Text PDF

Automated CT Perfusion Detection of the Acute Infarct Core in Ischemic Stroke: A Systematic Review and Meta-Analysis.

Cerebrovasc Dis 2022 Jun 3:1-13. Epub 2022 Jun 3.

Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.

Introduction: In patients with acute ischemic stroke, the location and volume of an irreversible infarct core determine prognosis and treatment. We aimed to determine if automated CT perfusion (CTP) is non-inferior to diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) in predicting the acute infarct core.

Methods: In this systematic review and meta-analysis, we searched MEDLINE and EMBASE from 1960 to December 2020. Read More

View Article and Full-Text PDF

A Prospective Comparative Study of Health Inequalities and the Epidemiology of Stroke in French Guiana and Dijon, France.

Front Public Health 2022 13;10:849036. Epub 2022 May 13.

CIC Inserm 1424, Centre d'investigation Clinique, Centre Hospitalier de Cayenne, Cayenne, French Guiana.

Background: In French Guiana poverty is widespread and specialized care is lacking. We aimed to compare strokes between precarious and non-precarious patients within French Guiana and to compare the epidemiology of ischemic strokes and their outcomes between French Guiana and mainland France.

Methods: A multicenter prospective cohort examined the influence of social inequalities on stroke characteristics. Read More

View Article and Full-Text PDF

Can CHADS-VASc and HAS-BLED Foresee the Presence of Cerebral Microbleeds, Lacunar and Non-Lacunar Infarcts in Elderly Patients With Atrial Fibrillation? Data From Strat-AF Study.

Front Neurol 2022 13;13:883786. Epub 2022 May 13.

NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy.

Anticoagulants reduce embolic risk in atrial fibrillation (AF), despite increasing hemorrhagic risk. In this context, validity of congestive heart failure, hypertension, age ≥ 75 years, diabetes, stroke, vascular disease, age 65-74 years and sex category (CHADS-VASc) and hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly (HAS-BLED) scales, used to respectively evaluate thrombotic and hemorrhagic risks, is incomplete. In patients with AF, brain MRI has led to the increased detection of "asymptomatic" brain changes, particularly those related to small vessel disease, which also represent the pathologic substrate of intracranial hemorrhage, and silent brain infarcts, which are considered risk factors for ischemic stroke. Read More

View Article and Full-Text PDF

Common Shared Pathogenic Aspects of Small Vessels in Heart and Brain Disease.

Biomedicines 2022 Apr 27;10(5). Epub 2022 Apr 27.

Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI) and University of Trieste, 34100 Trieste, Italy.

Small-vessel disease (SVD), also known as microvascular endothelial dysfunction, is a disorder with negative consequences for various organs such as the heart and brain. Impaired dilatation and constriction of small vessels in the heart lead to reduced blood flow and ischemia independently of coronary artery disease (CAD) and are associated with major cardiac events. SVD is usually a silent form of subcortical vascular burden in the brain with various clinical manifestations, such as silent-lacunar-ischemic events and confluent white-matter hyperintensities. Read More

View Article and Full-Text PDF

REM sleep and muscle atonia in brainstem stroke: A quantitative polysomnographic and lesion analysis study.

J Sleep Res 2022 May 24:e13640. Epub 2022 May 24.

Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.

Important brainstem regions are involved in the regulation of rapid eye movement sleep. We hypothesized that brainstem stroke is associated with dysregulated rapid eye movement sleep and related muscle activity. We compared quantitative/qualitative polysomnography features of rapid eye movement sleep and muscle activity (any, phasic, tonic) between 15 patients with brainstem stroke (N = 46 rapid eye movement periods), 16 patients with lacunar/non-brainstem stroke (N = 40 rapid eye movement periods), 15 healthy controls (N = 62 rapid eye movement periods), and patients with Parkinson's disease and polysomnography-confirmed rapid eye movement sleep behaviour disorder. Read More

View Article and Full-Text PDF

Progressive Lacunar Strokes: A Predictive Score

J Stroke Cerebrovasc Dis 2022 05 20;31(8):106510. Epub 2022 May 20.

Cerebrovascular Pathology Research Group, Department of Neurology, Girona Biomedical Research Institute (IDIBGI), Girona, Spain.

Background And Purpose: Progressive lacunar syndromes (PLS) occur in up to 20-30% of patients with lacunar strokes, increasing the risk of long term dependency. Our aim is to develop a predictive score to identify patients at high risk of presenting PLS.

Methods: We derived a risk score for PLS in a cohort of consecutive patients (n=187) presenting with one of the five classic lacunar syndromes (LS) and absence of vascular occlusion, perfusion deficit or symptomatic stenosis. Read More

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

J Clin Neurosci 2022 Jul 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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

Expert Opin Pharmacother 2022 Jun 6;23(8):905-915. 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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

View Article and Full-Text PDF

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

J Neuroimmunol 2022 06 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

View Article and Full-Text PDF

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

View Article and Full-Text PDF