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Sample records for brain infarction

  1. Brain protection therapy in acute cerebral infarction.

    Science.gov (United States)

    Katsura, Ken-ichiro; Suda, Satoshi; Abe, Arata; Kanamaru, Takuya; Toda, Yusuke; Katayama, Yasuo

    2012-01-01

    Many drugs for cerebral infarction that were shown to be effective in animal experiments have shown negative results in human clinical trials. For this reason, a completely new approach is needed to develop brain protection therapies against cerebral infarction. Brain protection therapies can be categorized into 3 types: 1) lengthening the therapeutic time window for thrombolytic therapy, 2) reducing the side effects of thrombolytic therapy, and 3) brain protection drug therapy for patients with contraindications for thrombolytic therapy (including combination therapy). Here, we show our recent results of brain protection therapy. First, combination therapy with 2 effective drugs was tried, and time-lag administration was performed. Combination therapy was effective and lengthened the therapeutic time window. Next, a completely new approach to improve cerebral ischemic damage, namely, H2 gas inhalation therapy, was tried. This therapy was also effective, even in the ischemic core. PMID:22687352

  2. MR imaging of acute hemorrhagic brain infarction

    International Nuclear Information System (INIS)

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author)

  3. MR imaging of acute hemorrhagic brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Ohnari, Norihiro; Ohno, Masato (Kyushu Rosai Hospital, Fukuoka (Japan))

    1989-11-01

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author).

  4. Evaluation of cat brain infarction model using microPET

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    Lee, Jong Jin; Lee, Dong Soo; Kim, Yun Hui; Hwang, Do Won; Kim, Jin Su; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Lim, Sang Moo [Korea Institite of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2004-12-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCI. A burr hole was made at 1 cm right lateral to the bregma. Collagenase type IV 10 {mu}l was injected using 30 G needle for 5 minutes to establish the infarction model. {sup 18}F-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, {sup 18}F-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using {sup 18}F-FDG microPET scanner.

  5. Evaluation of cat brain infarction model using microPET

    International Nuclear Information System (INIS)

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCI. A burr hole was made at 1 cm right lateral to the bregma. Collagenase type IV 10 μl was injected using 30 G needle for 5 minutes to establish the infarction model. 18F-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, 18F-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using 18F-FDG microPET scanner

  6. Brain infarcts due to scorpion stings in children: MRI

    International Nuclear Information System (INIS)

    We report two children with severe neurological complications after having been stung by a scorpion. Clinical and MRI findings suggested brain infarcts. The lesions seen were in pons in one child and the right hemisphere in the other. The latter also showed possible hyperemia in the infarcted area. No vascular occlusions were observed and we therefore think the brain infarcts were a consequence of the scorpion sting. The cause of the infarct may be hypotension, shock or depressed left ventricular function, all of which are frequent in severe poisoning by scorpion sting. (orig.)

  7. Brain infarcts due to scorpion stings in children: MRI

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Bouzas, A.; Ballesteros-Maresma, A. [Univ. Nacional Autonoma de Mexico, Mexico (Mexico); Morales-Resendiz, M.L. [Hospital General de Queretaro, Mexico (Mexico); Llamas-Ibarra, F. [Clinica Neurologica de Queretaro, Mexico (Mexico); Martinez-Lopez, M. [Fundacion Clinica Medica Sur., Mexico (Mexico)

    2000-02-01

    We report two children with severe neurological complications after having been stung by a scorpion. Clinical and MRI findings suggested brain infarcts. The lesions seen were in pons in one child and the right hemisphere in the other. The latter also showed possible hyperemia in the infarcted area. No vascular occlusions were observed and we therefore think the brain infarcts were a consequence of the scorpion sting. The cause of the infarct may be hypotension, shock or depressed left ventricular function, all of which are frequent in severe poisoning by scorpion sting. (orig.)

  8. Evaluation of cat brain infarction model using microPET

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. J.; Lee, D. S.; Kim, J. H.; Hwang, D. W.; Jung, J. G.; Lee, M. C [College of Medicine, Seoul National University, Seoul (Korea, Republic of); Lim, S. M [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2004-07-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advance of microPET scanner, it is possible to image small animals. However, the image quality was not so much satisfactory as human image. As cats have relatively large sized brain, cat brain imaging was superior to mice or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCl. A burr hole was made at 1cm right lateral to the bregma. Collagenase type IV 10 ul was injected using 30G needle for 5 minutes to establish the infarction model. F-18 FDG microPET (Concorde Microsystems Inc., Knoxville. TN) scans were performed 1. 11 and 32 days after the infarction. In addition. 18F-FDG PET scans were performed using Gemini PET scanner (Philips medical systems. CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infraction lesion improved with time. An infarction lesion was also distinguishable in the Gemini PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using F-18 FDG microPET scanner.

  9. CONTRAST STUDY ON CT AND BA IN DIAGNOSIS OF PATIENTS WITH ATHEROTHROMBOTIC BRAIN INFARCTION

    Institute of Scientific and Technical Information of China (English)

    Mingshun Liu; Haixiang Gao; Xiaomei Fu; Po Ma

    2007-01-01

    Objectives: To explore applied value on CT and BA in diagnosis of patients with atherothrombotic brain infarction. Methods:CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The different change of CT and BA were showed in 246 patients with atherothrombotic brain infarction. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of atherothrombotic brain infarction. The value of clinical application of BA was important in diagnosis of atherothrombotic brain infarction.

  10. Generalised brain edema and brain infarct in ergotamine abuse: Visualization by CT, MR and angiography

    International Nuclear Information System (INIS)

    Abuse of ergotamine can release a generalised brain edema and brain infarctions. This can be visualized by CT, MR and angiography. The reason, however, can only be found in the patients history. (orig.)

  11. Lacunar infarcts: no black holes in the brain are benign.

    Science.gov (United States)

    Norrving, Bo

    2008-08-01

    Lacunar infarcts--small subcortical infarcts that result from occlusion of a single penetrating artery--account for about one quarter of all ischaemic strokes. However, there are many diagnostic pitfalls, and causes other than penetrating small vessel disease in up to one third of cases. Recent studies have shown that the prognosis after lacunar infarcts is not benign; the risk of recurrent stroke is no lower than for other ischaemic stroke subtypes, and there is an increased risk for cognitive decline, dementia and death in the long term. Furthermore, silent small vessel disease in the brain at the time of an index stroke has significant prognostic implications. In the acute phase, response to intravenous thrombolysis appears to be similar to other subtypes of ischaemic strokes. Antiplatelet drugs, careful blood pressure control, statins and modification of lifestyle risk factors are key elements in secondary prevention after lacunar infarcts. PMID:18644908

  12. Correlation between increased platelet ADP aggregability and silent brain infarcts

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the correlation between platelet aggregability and silent brain infarcts. The study subjects were 445 people (264 men, 181 women; mean age, 53±14 years) with no neurologic signs, history of brain tumor, trauma, cerebrovascular disease, or antiplatelet medications. Adenosine diphosphate (ADP)-induced platelet aggregation was measured by the aggregation-size analytic method. Platelet aggregability was classified into 9 classes. The presence of headache/vertigo, hypertension, diabetes mellitus, hyperlipidemia, or smoking was elicited by questioning or blood sampling. A head MRI scan was performed, and if marked atherosclerosis or obvious stenosis in the intracranial vessels was detected, it was defined as a positive MR angiography (MRA) finding. Silent brain infarcts were detected in 26.3% of subjects. Hyperaggregability defined as that above class 6, 7, and 8 was present in 43.8%, 30.8%, and 15.7% of subjects, respectively. The risk factors for silent brain infarcts by multiple logistic regression analysis were aging, hypertension, positive MRA findings, and hyperaggregability. Platelet ADP hyperaggregability might be a risk factor for silent brain infarcts. (author)

  13. Complete middle cerebral artery block without brain infarction

    Directory of Open Access Journals (Sweden)

    Sunil Pradhan

    2016-01-01

    Full Text Available We report a patient with progressive supranuclear palsy and incidentally detected the absence of right middle cerebral artery (MCA without any old or acute infarct in its territory. The magnetic resonance angiography and computed tomography angiography failed to detect any significant collateral circulation. We discuss the embryogenesis of brain circulation and offer a possible explanation for the nonvisualization of the right MCA in our patient.

  14. Actions of alcohol and ischaemic brain infarction

    OpenAIRE

    Numminen, H. (Heikki)

    2000-01-01

    Abstract Alcohol drinking may exercise both beneficial and untoward effects on the haemostatic and fibrinolytic systems. It may also predispose individuals to arterial thrombosis and trigger embolism in the brain. The aim here is to examine these problems. Methods used for evaluating platelet function were platelet aggregation and associated thromboxane B2 release, shear-induced platelet aggregation, and measurement of urinary prostaglandins. Changes in fibrinolytic s...

  15. Frequency and pathogenesis of silent subcortical brain infarction in acute first-ever ischemic stroke

    International Nuclear Information System (INIS)

    We have often observed silent subcortical brain lesions on CT or MRI in first-ever ischemic stroke, but there is little published information on the relationship of these lesions to stroke subtypes. Here, we describe the incidence of MRI-detected silent subcortical brain lesions, including infarctions and white matter lesions, in a series of patients with first-ever ischemic stroke classified according to stroke subtypes. We also discuss the pathogenesis of these silent subcortical lesions. We evaluated 171 patients with acute first-ever ischemic stroke. The subjects were divided into three groups: lacunar, atherothrombotic and cardioembolic infarction groups. We evaluated silent subcortical brain infarction (SSBI), enlargement of perivascular space (EPS), and other white-matter lesions using MRI. Hypertension was observed in 67.6% of lacunar infarction, 57.1% of atherosclerotic infarction, and 54.1% of cardioembolic infarction. SSBI was more frequently observed in lacunar infarction than the others (lacunar vs. atherothrombotic vs. cardiogenic infarction, 81.5% vs. 44.4% vs. 42.1%, p=0.006). High-grade EPS (grade 2 or higher) was also observed more frequently in lacunar infarction than in the others (lacunar vs. atherothrombotic vs. cardiogenic infarction, 63.3% vs. 24.2% vs. 0%, p<0.001). Scheltens' score of silent subcortical lesions was significantly higher in lacunar infarction than in the others. The frequency of silent subcortical ischemic brain lesions was significantly higher in lacunar infarction than in atherosclerotic or cardioembolic infarction. We suggest that the pathogenesis of silent subcortical ischemic brain lesions is common to that of lacunar infarction, that is, small-vessel vasculopathy. (author)

  16. Chromium supplementation improved post-stroke brain infarction and hyperglycemia.

    Science.gov (United States)

    Chen, Wen-Ying; Mao, Frank Chiahung; Liu, Chia-Hsin; Kuan, Yu-Hsiang; Lai, Nai-Wei; Wu, Chih-Cheng; Chen, Chun-Jung

    2016-04-01

    Hyperglycemia is common after acute stroke and is associated with a worse outcome of stroke. Thus, a better understanding of stress hyperglycemia is helpful to the prevention and therapeutic treatment of stroke. Chromium is an essential nutrient required for optimal insulin activity and normal carbohydrate and lipid metabolism. Beyond its nutritional effects, dietary supplement of chromium causes beneficial outcomes against several diseases, in particular diabetes-associated complications. In this study, we investigated whether post-stroke hyperglycemia involved chromium dynamic mobilization in a rat model of permanent focal cerebral ischemia and whether dietary supplement of chromium improved post-stroke injury and alterations. Stroke rats developed brain infarction, hyperglycemia, hyperinsulinemia, glucose intolerance, and insulin resistance. Post-stroke hyperglycemia was accompanied by elevated secretion of counter-regulatory hormones including glucagon, corticosterone, and norepinephrine, decreased insulin signaling in skeletal muscles, and increased hepatic gluconeogenesis. Correlation studies revealed that counter-regulatory hormone secretion showed a positive correlation with chromium loss and blood glucose increased together with chromium loss. Daily chromium supplementation increased tissue chromium levels, attenuated brain infarction, improved hyperglycemia, and decreased plasma levels of glucagon and corticosterone in stroke rats. Our findings suggest that stroke rats show disturbance of tissue chromium homeostasis with a net loss through urinary excretion and chromium mobilization and loss might be an alternative mechanism responsible for post-stroke hyperglycemia. PMID:26477944

  17. Clinical application of MR imaging in the acute stage of brain infarction

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the clinical usefulness of diffusion weighted image (DWI) and perfusion image (PI) using echo planar imaging in the acute stage of cerebral infarction. Eighteen patients with cerebral infarction were imaged with magnetic resonance angiography, fast fluid attenuated inversion recovery (FLAIR), DWI, and PI. With PI, time-Δ R2 curve can calculate hemodynamics of relative regional cerebral blood volume (rCBV) and mean transit time (MTT). All regions of acute stage of brain infarction in 18 patients were demonstrated with DWI clearly. The lesion, in one case, was visible only 1.5 hour after the onset. The infarct lesions, which included lacunas, infarct, cortical infarct, and cardioembolic infarct, were distinguished from old infarct or leukoariosis. Time intensity curves, regional CBV maps, and relative MTT maps of perfusion study revealed low cerebral perfusion in the area of the infarct. The rMTT map demonstrated a perfusion abnormality much larger than the rCBV map abnormality. According to PI studies, one case had collateral flow in ischemic area, while five other cases had cardioembolic infarctions and received thrombolytic therapy. In conclusion, diffusion weighted image was useful for diagnosis of cytotoxic edema in cerebral infarction during the hyperacute stage. Perfusion image was useful as a simple modality of cerebral hemodynamics in cerebral infarction. These neuroimaging of magnetic resonance can help in deciding thrombolytic and neuroprotective therapies for brain ischemia. (author)

  18. Brain Infarction: Rare Neurological Presentation of African Bee Stings

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    Hernando Raphael Alvis- Miranda

    2014-01-01

    Full Text Available Bee stings are commonly encountered worldwide. Various manifestations after bee sting have been described including local reactions which are common, systemic responses such as anaphylaxis, diffuse intravascular coagulation and hemolysis. We report a case of a 74-year-old man who developed neurologic deficit 5 hours after bee stings, which was confirmed to be left frontal infarction on brain CT-scan. The case does not follow the reported pattern of hypovolemic or anaphylactic shock, hemolysis and/or rhabdomyolysis, despite the potentially lethal amount of venom injected. Diverse mechanisms have been proposed to give an explanation to all the clinical manifestation of both toxic and allergic reactions secondary to bee stings. Currently, the most accepted one state that victims can develop severe syndrome characterized by the release of a large amount of cytokines.

  19. Brain Infarction: Rare Neurological Presentation of African Bee Stings.

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Duarte-Valdivieso, Nancy Carolina; Alcala-Cerra, Gabriel; Moscote-Salazar, Luis Rafael

    2014-01-01

    Bee stings are commonly encountered worldwide. Various manifestations after bee sting have been described including local reactions which are common, systemic responses such as anaphylaxis, diffuse intravascular coagulation and hemolysis. We report a case of a 74-year-old man who developed neurologic deficit 5 hours after bee stings, which was confirmed to be left frontal infarction on brain CT-scan. The case does not follow the reported  pattern  of hypovolemic or anaphylactic shock, hemolysis and/or  rhabdomyolysis, despite the potentially lethal amount of venom injected. Diverse mechanisms have been proposed to give an explanation to all the clinical manifestation of both toxic and allergic reactions secondary to bee stings. Currently, the most accepted one state that victims can develop severe syndrome characterized by the release of a large amount of cytokines. PMID:27162866

  20. Cerebral infarction mimicking brain tumor on Tc-99m tetrofosmin brain SPECT imaging

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    Kim, Soon [College of Medicine, Dongguk Univ., Gyeongju (Korea, Republic of); Zeon, Seok Kil; Won, Kyoung Sook [School of Medicine, Keimyung Univ., Daegu (Korea, Republic of)

    2004-06-01

    A 43-year-old man was presented with persistent headache for two weeks. T2 weighted MR imaging showed high signal intensity with surrounding edema in the left frontal lobe. These findings were considered with intracranial tumor such as glioma or metastasis. Tc-99m tetrofosmin SPECT showed focal radiotracer accumulation in the left frontal lobe. The operative specimen contained cerebral infarction with organizing leptomeningeal hematoma by pathologist. Another 73-year-old man was hospitalized for chronic headache. Initial CT showed ill-defined hypodensity with mass effect in the right parietal lobe. Tc-99m tetrofosmin SPECT showed focal radiotracer uptake in the right parietal lobe. These findings were considered with low-grade glioma or infarction. Follow-up CT after 5 months showed slightly decreased in size of low density in the right parietal lobe, and cerebral infarction is more likely than others. Tc-99m tetrofosmin has been proposed as a cardiotracer of myocardial perfusion imaging and an oncotropic radiotracer. Tc-99 tetrofosmin SPECT image provides a better attractive alternative agent than TI-201 as a tumor-imaging agent, with characteristics such as high-energy flux, short half-life, favorable biodistribution, dosimetry and lower background radioactivity. We have keep in mind on the analysis of Tc-99m tetrofosmin imaging when cerebral infarction is being differentiated from brain tumor.

  1. Histologic assessment of the age of recent brain infarcts in man.

    Science.gov (United States)

    Chuaqui, R; Tapia, J

    1993-09-01

    In order to design a dating system based on the microscopic picture of brain infarcts of recent onset, we performed the histological examination of 31 infarcts covering the first 4 weeks of evolution in 30 autopsy cases. The date of the cerebral vascular accident was clinically established in every case. There were 13 men and 17 women with a mean age of 65 years. Hemorrhagic infarcts were found in 15 cases and anemic infarcts in 16 cases. Based on the histological features four periods were identified: the first period, from day 1 through day 4, was characterized by the predominance of eosinophilic neurons and necrotic oligodendrocytes; the second period, from day 5 through day 7, differed from the first by the appearance of macrophages and of newly formed blood vessels; the third period, from day 8 through day 14, showed neuronal ghosts, macrophages, astrocytic proliferation, gemistocytes, and absence of neutrophils; and in the fourth period, from day 15 through day 27, there were no eosinophilic neurons, and neither necrotic oligodendrocytes nor myelin in the central portion of the infarct were identified. By assessing the histological features and accurately correlating the findings with the corresponding clinical data, we have been able to describe four distinct microscopic patterns of the first month of evolution of brain infarcts. The present findings may be considered useful morphological clues to better characterize the early evolutional phase of brain infarcts in humans. PMID:8360701

  2. The study of low level laser irradiation therapy on brain infarction with SPECT

    Institute of Scientific and Technical Information of China (English)

    Xiao Xuechang; Jia Shaowei; Zleng Xiyuan

    2000-01-01

    Objective: Effect of rCBF and brain function on ILIB treating brain infarction will be investigated by SPECT brain perfusion imaging. Method: 3 1 patients with brain infarction, 17 patients were treated by ILIB on standard pharmaceutial treatment. SPECT brain perfusion imaging was performed before and after ILIB therapy with comparison of oneself. They were quantified with BFCR% model effect during ILIB in 14 patients were observed. Result: ILIB 30 rnme SPECT showed the improvement of rCBF and cerebral function in 14 patients with brain infarction, and in 17 patients locus were prominence than mirror regions att er ILIB therapy, both are higher singnitficant difference ( t=4.4052, P<0.0001 ), but mirror regions were not singnificant difference before and after ILIB (t=1.6995, P>0.05). BFCR% quantitative results of locus were higher mirror regions, and higher singnificant difference (t=4.5278 p<0.0001 )。 Conclusion: ILIB can improve the rCBF and cerebral function of patients with brain infarction, and provoke function of brain cells. Some new evidence was provided for ILIB treatment of cerebral ischemia

  3. Concealment of neonatal cerebral infarction on MRI by normal brain water

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) is highly sensitive in detecting cerebral infarction in adults, both in the acute and chronic stages. Cytotoxic and vasogenic edema produce an increase in the water content of acutely ischemic brain, resulting in good tissue contrast from adjacent normal brain on spin density, T1 and T2 weighted MR images. Gliosis and other chronic brain changes are well seen in later stages. We recently encountered a case of remote cerebral infarction in an infant, however, which was not evident on the initial MR examination at 7 weeks of age but which was clearly seen on a follow-up scan at 9 1/2 months. Our contention is that the infarct was masked by the known increased water content of the neonatal brain, which results in lengthened spin density and relaxation times; edema and gliosis may thus be obscured. This age-related concealment of ischemic brain changes on MR has not to our knowledge been reported, and we present this case as a caveat in the detection of cerebral infarction in neonates. (orig.)

  4. A new approach to ischemic brain edema and infarct

    Institute of Scientific and Technical Information of China (English)

    Zhai Yu; Jin Jia Xing; Liu De Ha

    2000-01-01

    Objective: To study the feasibility and efficiency of treatment in the patients with acute moderate and severe ischemic stroke with Neurotropin for its principle of inhibiting cerebral edema and repairing injured neurons. Methods: A randomized controlled trial with Neurotropin was performed in 50 patients admitted within 48h after an acute internal carotid artery infarction, Neurological deficits score ( Europe Stroke Scale-ESS ) <80 marks and the area of infarct and edema>2.25cm2. There were 31 patients in the Neurotropin group and 19 patients in the control group. Basic treatment was Troxerutin 250 mg intravenous drip per day for 21 days in two groups. Additionally, the patients in the Neurotropin group were intravenous injected 106 ampoule Neurotropin (3.6 unit per ampoule), divided into 11 days. We evaluated Neurological deficits score (ESS), ability of daily living (ADL)- Barthel Index, the size and average CT density of infarct and edema area on CT scan during different treatment stage and analyzed.them with statistics. Results: The percentage of improved patients (complete and partial recovery) reaches 64.5% in the Neurotropin group and 31.6% in the control group. The size of the infarct and edema area on CT scan is significantly reduced only in the Neurotropin group after treatment. The average range reduced is 28% on day 11 and 41.5% on day 21, and the average CT density in the Neurotropin group is more advanced than in the control group after onset. Conclusion: Neurotropin can be used as an effective therapy in acute ischemic stroke and ischemic cerebral edema.

  5. Validation of a simple and inexpensive method for the quantitation of infarct in the rat brain.

    Science.gov (United States)

    Schilichting, C L R; Lima, K C M; Cestari, L A; Sekiyama, J Y; Silva, F M; Milani, H

    2004-04-01

    A gravimetric method was evaluated as a simple, sensitive, reproducible, low-cost alternative to quantify the extent of brain infarct after occlusion of the medial cerebral artery in rats. In ether-anesthetized rats, the left medial cerebral artery was occluded for 1, 1.5 or 2 h by inserting a 4-0 nylon monofilament suture into the internal carotid artery. Twenty-four hours later, the brains were processed for histochemical triphenyltetrazolium chloride (TTC) staining and quantitation of the schemic infarct. In each TTC-stained brain section, the ischemic tissue was dissected with a scalpel and fixed in 10% formalin at 0 masculine C until its total mass could be estimated. The mass (mg) of the ischemic tissue was weighed on an analytical balance and compared to its volume (mm(3)), estimated either by plethysmometry using platinum electrodes or by computer-assisted image analysis. Infarct size as measured by the weighing method (mg), and reported as a percent (%) of the affected (left) hemisphere, correlated closely with volume (mm(3), also reported as %) estimated by computerized image analysis (r = 0.88; P < 0.001; N = 10) or by plethysmography (r = 0.97-0.98; P < 0.0001; N = 41). This degree of correlation was maintained between different experimenters. The method was also sensitive for detecting the effect of different ischemia durations on infarct size (P < 0.005; N = 23), and the effect of drug treatments in reducing the extent of brain damage (P < 0.005; N = 24). The data suggest that, in addition to being simple and low cost, the weighing method is a reliable alternative for quantifying brain infarct in animal models of stroke. PMID:15064814

  6. Validation of a simple and inexpensive method for the quantitation of infarct in the rat brain

    Directory of Open Access Journals (Sweden)

    Schilichting C.L.R.

    2004-01-01

    Full Text Available A gravimetric method was evaluated as a simple, sensitive, reproducible, low-cost alternative to quantify the extent of brain infarct after occlusion of the medial cerebral artery in rats. In ether-anesthetized rats, the left medial cerebral artery was occluded for 1, 1.5 or 2 h by inserting a 4-0 nylon monofilament suture into the internal carotid artery. Twenty-four hours later, the brains were processed for histochemical triphenyltetrazolium chloride (TTC staining and quantitation of the schemic infarct. In each TTC-stained brain section, the ischemic tissue was dissected with a scalpel and fixed in 10% formalin at 0ºC until its total mass could be estimated. The mass (mg of the ischemic tissue was weighed on an analytical balance and compared to its volume (mm³, estimated either by plethysmometry using platinum electrodes or by computer-assisted image analysis. Infarct size as measured by the weighing method (mg, and reported as a percent (% of the affected (left hemisphere, correlated closely with volume (mm³, also reported as % estimated by computerized image analysis (r = 0.88; P < 0.001; N = 10 or by plethysmography (r = 0.97-0.98; P < 0.0001; N = 41. This degree of correlation was maintained between different experimenters. The method was also sensitive for detecting the effect of different ischemia durations on infarct size (P < 0.005; N = 23, and the effect of drug treatments in reducing the extent of brain damage (P < 0.005; N = 24. The data suggest that, in addition to being simple and low cost, the weighing method is a reliable alternative for quantifying brain infarct in animal models of stroke.

  7. Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months

    International Nuclear Information System (INIS)

    Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. There was a statistically significant association between all sites of infarction (P = 0.0001-0.001), other than hemispheric (P = 0.35), and outcome score. There was also a statistically significant association between all types of infarction (P = 0.0001-0.02), other than hemispheric (P = 0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. (orig.)

  8. Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months

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    Andronikou, Savvas [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. Box 19063, Tygerberg (South Africa); Wilmshurst, Jo; Hatherill, Mark [University of Cape Town, Pediatric Neurology, Red Cross Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); VanToorn, Ronald [University of Stellenbosch, Department of Pediatric Neurology, Tygerberg Hospital, Cape Town (South Africa)

    2006-12-15

    Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. There was a statistically significant association between all sites of infarction (P = 0.0001-0.001), other than hemispheric (P = 0.35), and outcome score. There was also a statistically significant association between all types of infarction (P = 0.0001-0.02), other than hemispheric (P = 0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. (orig.)

  9. Imaging diagnosis--magnetic resonance imaging findings in a dog with sequential brain infarction.

    Science.gov (United States)

    Major, Alison C; Caine, Abby; Rodriguez, Sue B; Cherubini, Giunio B

    2012-01-01

    An adult greyhound was evaluated on three occasions for acute, intracranial neurologic signs. Based on magnetic resonance (MR) imaging, there were T2-hyperintense and T1-hypointense, noncontrast enhancing lesions in the cerebellum, and brain stem. Using diffusion-weighted imaging (DWI), the lesions were characterized initially by restricted water diffusion. The presumptive diagnosis on each occasion was acute ischemic cerebrovascular accident leading to infarction. This allowed us to characterize the changes in appearance of infarcted neural tissue on the standard MR sequences over time, and to confirm that the DWI could be successfully used in low-field imaging. © 2012 Veterinary Radiology & Ultrasound. PMID:22731883

  10. False positive Tc-99m tetrofosmin brain tumor SPECT imaging in cerebral infarction

    International Nuclear Information System (INIS)

    Aim: The Tc-99m tetrofosmin brain SPECT imaging is known to be useful for the therapeutic efficacy evaluation of brain tumor, follow-up study for the detection of tumor recurrence and differential diagnosis between radiation necrosis and recurred brain tumor. We would like to report two cases of brain infarction in the brain tumor SPECT with Tc-99m tetrofosmin. Materials and Methods: Thirty-one patients with suspected brain tumor underwent Tc-99m tetrofosmin SPECT from March, 1997 to July, 2001. Each patient received 800 MBq tetrofosmin intravenously followed by SPECT using a dual-head gamma camera after the rest of 30 minutes. Regions of interest were outlined in the tumor area using a computer-automated program to include all counts above background activity. Mean tumor activity were obtained from this region of interest. The tumor region of interest was mirrored to the contralateral uninvolved cerebral hemisphere to obtain background control count activity. Then tumor to background activity ratios were calculated. Results: Two of 31 patients were cerebral infarction. In these patients the clinical and radiological findings necessitated more information about the nature of the lesion before treatment planning. One of two patients was 43 year-old male and the other patient was 73 year-old male. Both patients complained continuous severe headache for two weeks. Their MRI and CT findings suggested inconclusive brain tumor. Thus Tc-99m tetrofosmin brain SPECT was performed that revealed an abnormal uptake in the left frontal lobe in one patient and in the right parietal lobe in the other patient. The tumor to background activity ratios were 10.0 and 3.35, respectively. Cerebral infarction was finally confirmed by excisional biopsy in the former patient and by follow-up CT after 5 months in the other patient. Conclusion: Two cases of intracranial Tc-99m tetrofosmin uptake, reported as positive tumor activity in patients with a final diagnosis of cerebral infarction

  11. Polyhydroxylated fullerene nanoparticles attenuate brain infarction and oxidative stress in rat model of ischemic stroke

    Science.gov (United States)

    Vani, Javad Rasouli; Mohammadi, Mohammad Taghi; Foroshani, Mahsa Sarami; Jafari, Mahvash

    2016-01-01

    Oxidative stress is the common underlying mechanism of damage in ischemic stroke. Therefore, we aimed to evaluate the possible protective effects of polyhydroxylated fullerene derivatives on brain infarction and oxidative/nitrosative stress in a rat model of ischemic stroke. The experiment was performed by four groups of rats (each; n=12); Sham, Control ischemia, and ischemic treatment groups (Pretreatment and Posttreatment). Brain ischemia was induced by 90 min middle cerebral artery occlusion (MCAO) followed by 24 hours reperfusion. Rats received fullerene nanoparticles at dose of 1 mg/kg 30 min before MCAO and immediately after beginning of reperfusion. Infarct volume, contents of malondialdehyde (MDA), glutathione (GSH) and nitrate as well as superoxide dismutase (SOD) activity were assessed 24 hours after termination of MCAO. Brain infarct volume was 310 ± 21 mm3 in control group. Administration of fullerene nanoparticles before and after MCAO significantly decreased the infarct volume by 53 % (145 ± 45 mm3) and 81 % (59 ± 13 mm3), respectively. Ischemia also enhanced MDA and nitrate contents of ischemic hemispheres by 45 % and 25 % , respectively. Fullerene nanoparticles considerably reduced the MDA and nitrate contents of ischemic hemispheres before MCAO by 58 % and 17 % , respectively, and after MCAO by 38 % and 21 % , respectively. Induction of MCAO significantly decreased GSH content (19 % ) and SOD activity (52 % ) of ischemic hemispheres, whereas fullerene nanoparticles increased the GSH content and SOD activity of ischemic hemispheres by 19 % and 52 % before MCAO, respectively, and 21 % and 55 % after MCAO, respectively. Our findings indicate that fullerene nanoparticles, as a potent scavenger of free radicals, protect the brain cells against ischemia/reperfusion injury and inhibit brain oxidative/nitrosative damage.

  12. Migraine with aura and risk of silent brain infarcts and white matter hyperintensities: an MRI study.

    Science.gov (United States)

    Gaist, David; Garde, Ellen; Blaabjerg, Morten; Nielsen, Helle H; Krøigård, Thomas; Østergaard, Kamilla; Møller, Harald S; Hjelmborg, Jacob; Madsen, Camilla G; Iversen, Pernille; Kyvik, Kirsten O; Siebner, Hartwig R; Ashina, Messoud

    2016-07-01

    A small number of population-based studies reported an association between migraine with aura and risk of silent brain infarcts and white matter hyperintensities in females. We investigated these relations in a population-based sample of female twins. We contacted female twins ages 30-60 years identified through the population-based Danish Twin Registry. Based on questionnaire responses, twins were invited to participate in a telephone-based interview conducted by physicians. Headache diagnoses were established according to the International Headache Society criteria. Cases with migraine with aura, their co-twins, and unrelated migraine-free twins (controls) were invited to a brain magnetic resonance imaging scan performed at a single centre. Brain scans were assessed for the presence of infarcts, and white matter hyperintensities (visual rating scales and volumetric analyses) blinded to headache diagnoses. Comparisons were based on 172 cases, 34 co-twins, and 139 control subjects. Compared with control subjects, cases did not differ with regard to frequency of silent brain infarcts (four cases versus one control), periventricular white matter hyperintensity scores [adjusted mean difference (95% confidence interval): -0.1 (-0.5 to 0.2)] or deep white matter hyperintensity scores [adjusted mean difference (95% confidence interval): 0.1 (-0.8 to 1.1)] assessed by Scheltens' scale. Cases had a slightly higher total white matter hyperintensity volume compared with controls [adjusted mean difference (95% confidence interval): 0.17 (-0.08 to 0.41) cm(3)] and a similar difference was present in analyses restricted to twin pairs discordant for migraine with aura [adjusted mean difference 0.21 (-0.20 to 0.63)], but these differences did not reach statistical significance. We found no evidence of an association between silent brain infarcts, white matter hyperintensities, and migraine with aura. PMID:27190013

  13. Aggravation of brain infarction through an increase in acrolein production and a decrease in glutathione with aging.

    Science.gov (United States)

    Uemura, Takeshi; Watanabe, Kenta; Ishibashi, Misaki; Saiki, Ryotaro; Kuni, Kyoshiro; Nishimura, Kazuhiro; Toida, Toshihiko; Kashiwagi, Keiko; Igarashi, Kazuei

    2016-04-29

    We previously reported that tissue damage during brain infarction was mainly caused by inactivation of proteins by acrolein. This time, it was tested why brain infarction increases in parallel with aging. A mouse model of photochemically induced thrombosis (PIT) was studied using 2, 6, and 12 month-old female C57BL/6 mice. The size of brain infarction in the mouse PIT model increased with aging. The volume of brain infarction in 12 month-old mice was approximately 2-fold larger than that in 2 month-old mice. The larger brain infarction in 12 month-old mice was due to an increase in acrolein based on an increase in the activity of spermine oxidase, together with a decrease in glutathione (GSH), a major acrolein-detoxifying compound in cells, based on the decrease in one of the subunits of glutathione biosynthesizing enzymes, γ-glutamylcysteine ligase modifier subunit, with aging. The results indicate that aggravation of brain infarction with aging was mainly due to the increase in acrolein production and the decrease in GSH in brain. PMID:27037020

  14. INFARCT DETECTION IN BRAIN MRI USING IMPROVED SEGMENTATION ALGORITHM AND VOLUME VISUALIZATION

    OpenAIRE

    Praveen Kumar E; Sumithra M G; Sunil Kumar P

    2013-01-01

    In the present days, for the human body anatomical study and for the treatment planning medicalscience very much depend on the medical imaging technology and medical images. Specifically for thehuman brain, MRI widely prefers and using for the imaging. But by nature medical images are complex andnoisy.This leads to the necessity of processes that reduces difficulties in analysis and improves quality ofoutput.This paper discuss about an improved segmentation algorithm for infarct detection in ...

  15. Brain Infarction and Hemorrhage in Young and Middle-aged Adults

    OpenAIRE

    Lacy, Joseph R.; Filley, Christopher M.; Earnest, Michael P.; Graff-Radford, Neill R

    1984-01-01

    Of 131 young (17 to 44 years) and middle-aged (45 to 55 years) adults who had brain infarction or hemorrhage, the most common etiologic factors were rheumatic heart disease, migraine and oral contraceptive use among the younger group. In contrast, atherosclerotic, hypertensive and diabetes-associated cerebrovascular were the most common causes in the middle-aged group. Patients who have a stroke before age 45 should have prompt, complete laboratory and radiologic testing to define a possible ...

  16. Strategic infarcts in vascular dementia. A clinical and brain imaging experience.

    Science.gov (United States)

    Tatemichi, T K; Desmond, D W; Prohovnik, I

    1995-03-01

    The mechanisms of dementia resulting from small deep infarctions are incompletely understood. The thesis underlying the concept of "multi-infarct dementia" is that multiple lesions have a synergistic effect on mental functions, resulting in dementia irrespective of specific location or volume. In this report, we summarize our experience with six patients reported previously along with additional patients examined subsequently, whose clinical features and brain imaging findings allow an alternative formulation for dementia resulting from lacunar stroke. The six initial patients presented with an abrupt change in behavior after acute infarction involving the inferior genu of the internal capsule documented by computed tomography (CT) and magnetic resonance imaging (MRI). The acute syndrome featured fluctuating alertness, inattention, memory loss, apathy, abulia, and psychomotor retardation suggesting frontal lobe dysfunction. Contralateral hemiparesis and dysarthria were generally mild, except when the infarct extended into the posterior limb. Neuropsychological testing in five patients with left-sided infarcts revealed severe verbal memory loss. Additional cognitive deficits consistent with dementia were evident in four patients. A right-sided infarct caused transient impairment in visuospatial memory. Functional brain imaging in three patients using 133xenon regional cerebral blood flow (rCBF) and single photon emission computed tomography (SPECT) showed focal reduction in hemispheric perfusion most prominent in the ipsilateral inferior and medial frontal cortex. Perfusion was also defective in the medial and laterial temporal cortex. Important pathways of the limbic system traverse the inferior capsule in the region of the genu. Corticothalamic and thalamocortical fibers form the thalamic peduncles which detach from the internal capsule and enter the thalamus at its rostral and caudal poles and along its dorsal surface. The anterior thalamic peduncle, conveys

  17. Pharmacoepidemiological analysis of the drugs used for secondary prevention of brain infarction on dispensary stage

    Directory of Open Access Journals (Sweden)

    Miheyeva N.V.

    2014-03-01

    Full Text Available Aim. The secondary prevention of cerebral infarction on dispensary stage to current clinical guidelines was analyzed. Adherence of patients to prescribe medications was evaluated. Material and methods. 106 patients of hospital neurologic department with brain infarction were included in prospective pharmacoepidemiological study of the drugs used for secondary prevention of brain infarction on dispensary stage since 1 January 2009 to 31 December 2009. Duration of outpatient observation was 3 years. Results. All of the patients were of 64,9 ± 10,3 years old. Hypertension was diagnosed in 102 of them (96.2%, atrial fibrillation — in 33 (31.1% patients. 39 (36.8% patients died during 3 years after discharge from the hospital. ACE inhibitors/angiotensin II receptor antagonist were prescribed for 83 (78.3% patients, antiplatelet- 76 (71,7%, statins — 16 (15,1% patients in discharge from hospital. Warfarin was prescribed only for 1 (3.05% patient with atrial fibrillation and ischemic stroke.consumption of drugs with evidence efficiency were diminished already after one year of observation in outpatient clinics. Conclusion.Therapy for secondary stroke prevention is not fully comply with current clinical guidelines

  18. Prospective study of serum uric acid and risk of brain infarction

    Institute of Scientific and Technical Information of China (English)

    孟令民

    2014-01-01

    Objective To prospectively investigate the association between serum uric acid concentration and the risk of brain infarction in Chinese adults.Methods In this prospective cohort study,a total of 95 738 participants(aged 18-98 years old)were included and were categorized into sex-specific quintiles according to serum uric acid concentration which were collected during 2006—2007 by health examinations.The study was followed up for an average of 4 years.We used Cox regression models to

  19. A study of whole brain perfusion CT and CT angiography in hyperacute and acute cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic value of whole-brain perfusion blood volume-weighted CT imaging (PWCT) and simultaneous CT angiography (CTA) on early stage of cerebral ischemic infarction. Methods: Non-contrast CT (NCCT), CT perfusion-weighted imaging (PWCT) and delayed CT (DCT) were conducted on 20 cases of early ischemic infarction of whose onset time ranged from 2 to 24 hours. All cases were reexamined with CT or MRI one week to one month later. CT values and perfusion blood volume (PBV) of central and peripheral low perfusion areas as well as those of collateral side were measured. CTA was reconstructed with PWCT as source images to evaluate occlusion or stenosis of blood vessel, and DCT was used to detect the collateral circulation. Results: Of the 20 cases, NCCT, PWCT and CTA were negative in 10 cases in which 6 were confirmed as Transient Ischemic Attack (TIA) on reexamined CT and clinical features, and the other 4 were confirmed as lacunar infarction. For the remaining 10 cases, a comparison was made with ANOVA between low perfusion area (central, peripheral inside and outside) and collateral side. The difference was significant (P<0.01). However, no significant difference was revealed in the central, peripheral inside and outside areas. PBV values were significant in low perfusion area and collateral side (P<0.05). The area of the final infarction was larger than that of the low perfusion area, and the percentage of enlargement exhibited medium negative correlation to the time of ischemia. CTA indicated that 2 cases suffered from left middle cerebral artery occlusion, meanwhile anterior and middle branches of MCA in the other 3 cases were not identified. The sensitivity of NCCT, PWCT and CTA were 28.5%, 71.4% and 35.7% respectively. DCT indicated that 5 cases had asymmetrical blood vessels. Conclusion: The whole-brain perfusion-weighted CT imaging and simultaneous CT angiography (CTA) is p roved to be a simple, timesaving and effective method for the

  20. Development of an automated method for the detection of chronic lacunar infarct regions in brain MR images

    International Nuclear Information System (INIS)

    The purpose of our study is to develop an algorithm that would enable the automated detection of lacunar infarct on T1- and T2-weighted magnetic resonance (MR) images. Automated identification of the lacunar infarct regions is not only useful in assisting radiologists to detect lacunar infarcts as a computer-aided detection (CAD) system but is also beneficial in preventing the occurrence of cerebral apoplexy in high-risk patients. The lacunar infarct regions are classified into the following two types for detection: ''isolated lacunar infarct regions'' and ''lacunar infarct regions adjacent to hyperintensive structures.'' The detection of isolated lacunar infarct regions was based on the multiple-phase binarization (MPB) method. Moreover, to detect lacunar infarct regions adjacent to hyperintensive structures, we used a morphological opening processing and a subtraction technique between images produced using two types of circular structuring elements. Thereafter, candidate regions were selected based on three features -area, circularity, and gravity center. Two methods were applied to the detected candidates for eliminating false positives (FPs). The first method involved eliminating FPs that occurred along the periphery of the brain using the region-growing technique. The second method, the multi-circular regions difference method (MCRDM), was based on the comparison between the mean pixel values in a series of double circles on a T1-weighted image. A training dataset comprising 20 lacunar infarct cases was used to adjust the parameters. In addition, 673 MR images from 80 cases were used for testing the performance of our method; the sensitivity and specificity were 90.1% and 30.0% with 1.7 FPs per image, respectively. The results indicated that our CAD system for the automatic detection of lacunar infarct on MR images was effective. (author)

  1. Moringa Oleifera Lam Mitigates Oxidative Damage and Brain Infarct Volume in Focal Cerebral Ischemia

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    Woranan Kirisattayakul

    2012-01-01

    Full Text Available Problem statement: At present, the therapeutic outcome of cerebral ischemia is still not in the satisfaction level. Therefore, the preventive strategy is considered. Based on the protective effect against oxidative damage of Moringa oleifera Lam. Leaves extract, we hypothesized that this plant extract might protect against cerebral ischemia, one of the challenge problems nowadays. In order to test this hypothesis, we aimed to determine the protective effect of M.oleifera leaves extract in animal model of focal cerebral ischemia induced by permanent occlusion of right middle cerebral artery. Approach: Male Wistar rats, weighing 300-350 g, were orally given the extract once daily at doses of 100, 200 and 400 mg kg-1 BW at a period of 2 weeks, then, they were permanently occluded the right Middle Cerebral Artery (MCAO. The animals were assessed the cerebral infarction volume and oxidative damage markers including MDA level and the activities of SOD, CAT and GSHPx enzymes at 24 h after occlusion. Results: Rats subjected to M.oleifera extract at all doses used in this study significantly decreased brain infarct volume both at cortical and subcortical structures in accompany with the elevation of SOD activity in both hippocampus and striatum while only the rats exposed to the extract at doses of 100 and 400 mg kg-1 BW showed the increased GSHPx activity in hippocampus. No the changes were observed. Therefore, our results demonstrates the potential benefit of M.oleifera leaves to decrease oxidative stress damage and brain infarct volume. Conclusion: This study is the first study to demonstrate the neuroprotective effect against focal cerebral ischemia of M.oleifera leaves. It suggests that M.oleifera may be served as natural resource for developing neuroprotectant against focal cerebral ischemia. However, the precise underlying mechanism and possible active ingredient are still required further study.

  2. INFLUENCE OF ACUPUNCTURE ON BRAIN-TAXIS OF TETRAMETHYLPYRAZINE IN ACUTE CEREBRAL INFARCTION RATS

    Institute of Scientific and Technical Information of China (English)

    崔荣秀; 陈以国; 谷雨

    2003-01-01

    Purpose: To observe the effect of acupuncture on the brain-taxis of tetrarmethylpyrazine (TMP) and toexplore into the underlying mechanisms of combined action of acupuncture and medicine in the treatment of acute cere-bral ischemia. Methods: 37 male Wistar rats were randomly divided into normal control group (n= 10), sham-operationgroup (n= 10), acute cerebral ischemia (ACI) + drug group (model group, n=8)and ACl+drug+acupuncture group(acupuncture group, n=9). Rat ACl model was established by using photochemical method. "Neiguan"(PC 6) and"Shuigou"(GV 26) were punctured and stimulated with both hand manipulation and electroacupuncture, 30 min and16hrs after ACI. TMP was given to the rats of the later 2 groups using gastric perfusion method. High pressure chro-matography (HPLC) was used to detect the target absorption level of TMP in the brain. Results: The content of TMP inthe brain in acupuncture group was significantly higher than that in model group (P<0.01), suggesting that acupunc-ture can strengthen the brain-taxis of TMP in ACl rats, and combined administration of acupuncture and Chinese drugmaybe work better for treatment of acute cerebral infarction. Conclusion: Acupuncture can strengthen the chano-taxisof TMP to the brain in ACl rats.

  3. New role of MR imaging in the acute stage of brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Okumura, Ayumi; Nakagawa, Masanori; Furuichi, Masahiro; Nishimura, Yasuaki; Sakai, Noboru [Gifu Univ. (Japan). School of Medicine; Araki, Yuzo

    2000-12-01

    The purpose of this study was to evaluate the clinical utility of 3D-Contrast MR Angiography (MRA) with an automated bolus-detection algorithm (SmartPrep) in combination with diffusion-weighted imaging (DWI) and perfusion imaging (PI) of acute cerebral infarctions. Thirty-nine patients with brain attack were imaged with 3D-Contrast MRA, DWI and PI in the acute stage. For 3D-Contrast MRA, tracker volume was placed in the upper aorta. After bolus injection of gadolinium, an increase in signal that corresponded to the arrival of gadolinium was used to trigger centric reordered spoiled gradient echo arterial selective MRA. This technique provided images of craniocervical arteries from the aortic arch to the circle of Willis, similar to those obtained with conventional angiography. Furthermore, with this technique, it was possible to evaluate briefly the collateral pathway in a large field of view. This technique, in combination with DWI and PI, was useful in evaluating hemodynamics of acute cerebral infarction and in classifying the subtype of brain attack in relation to the treatment. (author)

  4. Risk reduction of brain infarction during carotid endarterectomy or stenting using sonolysis - Prospective randomized study pilot data

    Science.gov (United States)

    Kuliha, Martin; Školoudík, David; Martin Roubec, Martin; Herzig, Roman; Procházka, Václav; Jonszta, Tomáš; Krajča, Jan; Czerný, Dan; Hrbáč, Tomáš; Otáhal, David; Langová, Kateřina

    2012-11-01

    Sonolysis is a new therapeutic option for the acceleration of arterial recanalization. The aim of this study was to confirm risk reduction of brain infarction during endarterectomy (CEA) and stenting (CAS) of the internal carotid artery (ICA) using sonolysis with continuous transcranial Doppler (TCD) monitoring by diagnostic 2 MHz probe, additional interest was to assess impact of new brain ischemic lesions on cognitive functions. Methods: All consecutive patients 1/ with ICA stenosis >70%, 2/ indicated to CEA or CAS, 3/ with signed informed consent, were enrolled to the prospective study during 17 months. Patients were randomized into 2 groups: Group 1 with sonolysis during intervention and Group 2 without sonolysis. Neurological examination, assessment of cognitive functions and brain magnetic resonance imaging (MRI) were performed before and 24 hours after intervention in all patients. Occurrence of new brain infarctions (including infarctions >0.5 cm3), and the results of Mini-Mental State Examination, Clock Drawing and Verbal Fluency tests were statistically evaluated using T-test. Results: 97 patients were included into the study. Out of the 47 patients randomized to sonolysis group (Group 1) 25 underwent CEA (Group 1a) and 22 CAS (Group 1b). Out of the 50 patients randomized to control group (Group 2), 22 underwent CEA (Group 2a) and 28 CAS (Group 2b). New ischemic brain infarctions on follow up MRI were found in 14 (29.8%) patients in Group 1-4 (16.0%) in Group 1a and 10 (45.5%) in Group 1b. In Group 2, new ischemic brain infarctions were found in 18 (36.0%) patients-6 (27.3%) in Group 2a and 12 (42.9%) in Group 2b (p>0.05 in all cases). New ischemic brain infarctions >0.5 cm3 were found in 4 (8.5 %) patients in Group 1 and in 11 (22.0 %) patients in Group 2 (p= 0.017). No significant differences were found in cognitive tests results between subgroups (p>0.05 in all tests). Conclusion: Sonolysis seems to be effective in the prevention of large ischemic

  5. Diffusion-weighted MR imaging in animal modil with acute ischemic brain infarction : evaluation of reversible brain injury

    International Nuclear Information System (INIS)

    To determine whether the analysis of abnormally high signal intensities in ischemic tissue, as revealed by diffusion-weighted MR imaging (DWI) can be used to evaluate reversible brain lesions in a cat model of acute ischemia. Ten cats were divided into two groups of five (Group I and Group II), and in all animals the middle cerebral artery was temporarily occluded. Group I underwent T2-DWI 30 minutes after occlusion, and Group II 120 minutes after occlusion. In both groups, DWI was performed one hour and 24 hours after reperfusion (at one hour, non-T2-weighted; at 24 hours, T2-weighted). Both occlusion and reperfusion were monitored by 99mTC-ECD brain perfusion SPECT. All animals were sacrificed 24 hours later and their brain tissue was stained with TTC. Signal intensity ratios (SIR, signifying average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region) of the two groups, as seen on DWI were compared. The percentage of hemispheric lesions occurring in the two groups was also compared. SIR after occlusion of the middle cerebral artery was 1.29 in Group I and 1.59 in Group II. Twenty-four hours after reperfusion, SIR in Group I was higher than in Group II (p<0.01). After occlusion and reperfusion, the percentage of hemispheric lesions in Group I was less than in Group II. For the latter, the percentage of these lesions revealed by TTC staining and T2-weighted imaging was 48% and 59%, respectively, findings distinctly different from those for Group I. In addition, in group I, infarction was revealed by neither TTC staining nor T2-weighted imaging (p<0.01). The use of DWI to evaluate signal intensity ratios can help determine whether or not brain injury after temporary cerebral ischemia is reversible

  6. Findings of bedside swallowing assessment and brain computerized tomography in patients with chronic cerebral infarction, and their outcome

    International Nuclear Information System (INIS)

    To estimate the usefulness of the bedside swallowing assessment proposed by Smithard et al and neuroimaging findings characteristic for dysphagia, we studied the outcome of 102 patients with chronic cerebral infarction after assessment of swallowing by this test with brain computerized tomography (CT). All patients had a variety of motor disturbance and were admitted on a long-term medicare basis. They were divided into two groups according to the findings: the positive group (n=33), who showed any of the listed types of difficulty in swallowing water, and the negative group (n=69). Followed up to 2.2 years, their outcomes were studied. CT findings were studied on type of infarction, number and laterality of infarction, grade of periventricular lucency (PVL), presence of ventricular dilatation (VD), and severity of cortical atrophy (CA). The mean age was 76.4 years at registration and 61 were men. The frequency of severe dementia and disturbed ADL were significantly higher in the positive group. Eighteen patients died during the observation period and 15 of those were in the positive group, indicating higher, annual death rate (29.9% vs 2.2% in the negative group). All of the 15 patients in the positive group died of pneumonia. CT findings showed high incidence of multiple infarction, bilateral hemispheric lesion, severe PVL, VD, and severe CA in the positive group. These findings indicated that this evaluation method was useful in screening swallow function for patients with cerebral infarction in the chronic phase. Furthermore, CT findings suggested that severe white matter lesion, VD, and severe CA as well as multiple infarction seen in bilateral hemisphere was related to dysphagia, probably due to multiple factors involving pyramidal- and extrapyramidal-tracts with higher brain function. (author)

  7. Findings of bedside swallowing assessment and brain computerized tomography in patients with chronic cerebral infarction, and their outcome

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Koshibu, Junko; Kikawada, Masayuki; Yoneda, Youichi; Uno, Masanobu; Takasaki, Masaru [Tokyo Medical Coll. (Japan); Imamura, Toshiharu

    2001-09-01

    To estimate the usefulness of the bedside swallowing assessment proposed by Smithard et al and neuroimaging findings characteristic for dysphagia, we studied the outcome of 102 patients with chronic cerebral infarction after assessment of swallowing by this test with brain computerized tomography (CT). All patients had a variety of motor disturbance and were admitted on a long-term medicare basis. They were divided into two groups according to the findings: the positive group (n=33), who showed any of the listed types of difficulty in swallowing water, and the negative group (n=69). Followed up to 2.2 years, their outcomes were studied. CT findings were studied on type of infarction, number and laterality of infarction, grade of periventricular lucency (PVL), presence of ventricular dilatation (VD), and severity of cortical atrophy (CA). The mean age was 76.4 years at registration and 61 were men. The frequency of severe dementia and disturbed ADL were significantly higher in the positive group. Eighteen patients died during the observation period and 15 of those were in the positive group, indicating higher, annual death rate (29.9% vs 2.2% in the negative group). All of the 15 patients in the positive group died of pneumonia. CT findings showed high incidence of multiple infarction, bilateral hemispheric lesion, severe PVL, VD, and severe CA in the positive group. These findings indicated that this evaluation method was useful in screening swallow function for patients with cerebral infarction in the chronic phase. Furthermore, CT findings suggested that severe white matter lesion, VD, and severe CA as well as multiple infarction seen in bilateral hemisphere was related to dysphagia, probably due to multiple factors involving pyramidal- and extrapyramidal-tracts with higher brain function. (author)

  8. Neuroprotective mechanisms of puerarin in middle cerebral artery occlusion-induced brain infarction in rats

    Directory of Open Access Journals (Sweden)

    Chang Yi

    2009-01-01

    Full Text Available Abstract Puerarin, a major isoflavonoid derived from the Chinese medical herb Radix puerariae (kudzu root, has been reported to be useful in the treatment of various cardiovascular diseases. In the present study, we examined the detailed mechanisms underlying the inhibitory effects of puerarin on inflammatory and apoptotic responses induced by middle cerebral artery occlusion (MCAO in rats. Treatment of puerarin (25 and 50 mg/kg; intraperitoneally 10 min before MCAO dose-dependently attenuated focal cerebral ischemia in rats. Administration of puerarin at 50 mg/kg, showed marked reduction in infarct size compared with that of control rats. MCAO-induced focal cerebral ischemia was associated with increases in hypoxia-inducible factor-1α (HIF-1α, inducible nitric oxide synthase (iNOS, and active caspase-3 protein expressions as well as the mRNA expression of tumor necrosis factor-α (TNF-α in ischemic regions. These expressions were markedly inhibited by the treatment of puerarin (50 mg/kg. In addition, puerarin (10~50 μM concentration-dependently inhibited respiratory bursts in human neutrophils stimulated by formyl-Met-Leu-Phe. On the other hand, puerarin (20~500 μM did not significantly inhibit the thiobarbituric acid-reactive substance reaction in rat brain homogenates. An electron spin resonance (ESR method was conducted on the scavenging activity of puerarin on the free radicals formed. Puerarin (200 and 500 μM did not reduce the ESR signal intensity of hydroxyl radical formation. In conclusion, we demonstrate that puerarin is a potent neuroprotective agent on MCAO-induced focal cerebral ischemia in vivo. This effect may be mediated, at least in part, by the inhibition of both HIF-1α and TNF-α activation, followed by the inhibition of inflammatory responses (i.e., iNOS expression, apoptosis formation (active caspase-3, and neutrophil activation, resulting in a reduction in the infarct volume in ischemia-reperfusion brain injury. Thus

  9. The influence of meteorological and geomagnetic factors on acute myocardial infarction and brain stroke in Moscow, Russia

    Science.gov (United States)

    Shaposhnikov, Dmitry; Revich, Boris; Gurfinkel, Yuri; Naumova, Elena

    2014-07-01

    Evidence of the impact of air temperature and pressure on cardiovascular morbidity is still quite limited and controversial, and even less is known about the potential influence of geomagnetic activity. The objective of this study was to assess impacts of air temperature, barometric pressure and geomagnetic activity on hospitalizations with myocardial infarctions and brain strokes. We studied 2,833 myocardial infarctions and 1,096 brain strokes registered in two Moscow hospitals between 1992 and 2005. Daily event rates were linked with meteorological and geomagnetic conditions, using generalized linear model with controls for day of the week, seasonal and long-term trends. The number of myocardial infarctions decreased with temperature, displayed a U-shaped relationship with pressure and variations in pressure, and increased with geomagnetic activity. The number of strokes increased with temperature, daily temperature range and geomagnetic activity. Detrimental effects on strokes of low pressure and falling pressure were observed. Relative risks of infarctions and strokes during geomagnetic storms were 1.29 (95 % CI 1.19-1.40) and 1.25 (1.10-1.42), respectively. The number of strokes doubled during cold spells. The influence of barometric pressure on hospitalizations was relatively greater than the influence of geomagnetic activity, and the influence of temperature was greater than the influence of pressure. Brain strokes were more sensitive to inclement weather than myocardial infarctions. This paper provides quantitative estimates of the expected increases in hospital admissions on the worst days and can help to develop preventive health plans for cardiovascular diseases.

  10. NeuroSPECT assessment of ischemic penumbra in acute brain infarct: control of intra-arterial thrombolysis

    International Nuclear Information System (INIS)

    Introduction: Brain infarct is the most common cause of incapacity in adults, the second cause of dementia and the 2nd or 3rd cause of death. Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis in the first hours of evolution. Thrombolysis is now an approved and efficacious method of treatment for acute ischemic stroke. During the first 3 hours of evolution, intravenous administration of plasminogen activator (tPA) can be performed. The window of time of treatment is expanded to 6 hours with the intra-arterial super selective route for thrombolysis. Aim: The aim of this study was to define levels of reversible ischemia (penumbra) demonstrated by statistically evaluated HMPAO Tc99m NeuroSPECT performed before and after intra-arterial thrombolysis in the treatment of acute infarct. Materials and Methods: 21 patients were treated during the first 6 hours of evolution of an acute ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan to rule hemorrhage or established infarct. 3) I.V injection of 1100MBq Tc99m HMPAO (Ceretec tm) 4) Conventional cerebral angiography and intra-arterial thrombolysis and/or angioplasty/stenting if necessary. 5) NeuroSPECT assessment of ischemic penumbra. 6) Control at 24 hrs with NeuroSPECT. NeuroSPECT image acquisition is performed immediately following arterial thrombolysis with a dual Head Camera, SHR collimators and conventional protocol. Image processing was performed using the Segami Software, as previously reported in Alasbimn Journal2 (7): April 2000. http://www.alasbimnjournal.cl. The analysis consists of 1) Tallairach brain volume normalization. 2) Voxel by voxel comparison of the individual brain cortex uptake normalized to the maximum in the cortex with a normal database of 24 age-matched controls. Results: The results are expressed in standard deviations (S.D.) below the normal mean. Normal mean is 72% + 6. Only voxels between

  11. Late-onset Depression in the Absence of Stroke: Associated with Silent Brain Infarctions, Microbleeds and Lesion Locations

    OpenAIRE

    Wu, Ri-Han; Feng, Chao; Xu, Yu; Hua, Ting; Liu, Xue-Yuan; Fang, Min

    2014-01-01

    Background: Late-onset depression (LOD) is a frequent mood disorder among elderly. Previous studies have proved that LOD is associated with cerebral silent lesions especially white matter lesions (WML) and yielded the “vascular depression” hypothesis to explain the pathogenesis of LOD. However, there were relatively few studies about the association between silent brain infarctions (SBIs), microbleeds (MBs) and the prevalence of LOD. In this study we sought to evaluate the presence, accumulat...

  12. Comparison of ADC map with trace map in the normal and infarct areas of the brains of stroke patients

    International Nuclear Information System (INIS)

    To compare ADC mapping with trace mapping in normal and infarct areas of the brains of stroke patients. Eighteen patients diagnosed on the basis of clinical and brain MRI examinations as suffering from brain infarction were included in this study (hyperacute-1, acute-4, subacute-12, chronic-1). Diffusion weighted images of three orthogonal directions of a patient's brain were obtained by means of a single shot EPI pulse sequence, using a diffusion gradient with four serial b-factors. Three ADC maps were then reconstructed by post-image processing and were summed pixel by pixel to yield a trace map. ROIs were selected in the normal areas of white matter, gray matter and CSF of one hemisphere, and other ROIs of the same size were selected at the same site of the contralateral hemisphere. ADC and trace values were measured and right/left ratios of ADC and trace values were calculated. Using these values, we then compared the ADC map with the trace map, and compared the degree of anisotropic diffusion between white matter, gray matter and CSF. Except for three, whose infarct lesions were small and lay over white and gray matter, patients were divided into two groups. Those with infarct in the white matter (n=10) were assigned to one group, and those with infarct in the gray matter (n=5) to the other. ROIs were selected in the infarct area and other ROIs of the same size were selected at the same site of the contralateral hemisphere. ADC and trace values were measured and infarct/contralateral ratios were calculated. We then compared ADC ratio with trace ratio in white matter and gray matter infarct. In normal white matter, the Dxx ratio was 0.980±0.098, the Dyy ratio 1.019±0.086, the Dzz ratio 0.999±0.111, and the trace ratio 0.995±0.031. In normal gray matter, the Dxx ratio was 1.001±0.058, the Dyy ratio 0.996±0.063, Dzz ratio 1.005±0.070, and the trace ratio 1.001±0.028. In CSF, the Dxx ratio was 1.002±0.064, the Dyy ratio 1.023±0.055, the Dzz ratio 0.999

  13. Three-dimensional anisotropy contrast MRI and functional MRI of the human brain. Clinical application to assess pyramidal tract in patients with brain tumor and infarction

    International Nuclear Information System (INIS)

    We describe and evaluate the findings of three-dimensional anisotropy contrast MR axonography (3DAC MRX) and functional MRI (fMRI) in brain tumor and infarction. We obtained diffusion-weighted images (DWI) in 28 patients including 23 brain tumors and 15 acute infarctions located in or near pyramidal tract. Three anisotropic DWIs were transformed into graduations color-coded as red, green and blue, and then composed to form a combined color 3DAC MRX. We also performed functional MRI in 7 of the 28 patients and compared with cortical mapping of 3DAC MRX. 3DAC MRX with 23 brain tumors showed that the ipsilateral pyramidal tract was either discontinuous due to impaired anisotropy (n=8) or compressed due to mass effect (n=15). In 10 patients of acute infarction with motor impairment, pyramidal tract involvement was visually more conspicuous on 3DAC MRX compared to standard DWI. On functional MRI, hand motor activation was observed between blue vertical directional colors of pre- and post central gyrus. In conclusion, 3DAC MRX is a new noninvasive approach for visualization of the white matter neuronal tract and provides the information concerning pyramidal tract involvement. (author)

  14. Detection of lacunar infarction in brain CT-scans: No evidence of bias from accompanying patient information

    International Nuclear Information System (INIS)

    Interobserver agreement in assessing brain CT-scans is, in general, high. The extent, however, to which such agreement is caused by bias through knowledge of other clinical details remains uncertain. The hypothesis that observers are somehow prejudiced before assessing ambiguous, CT-scans in this particular situation was tested. Sixteen neurologists and 16 radiologists volunteered to interpret two ambiguous brain CT-scans, with regard to the presence or absence of a lacunar infarct in the region of the internal capsule. The scans were accompanied by 'patient' information that was or was not suggestive of a stroke. These scans were camouflaged by a variety of other scans, to be assessed in the same way, to mask the purpose of the study. I was assumed that the observers, in their assessments of the scans, would somehow let their ratings of the likelihood of a lacunar infarction in or near the internal capsule be subject to the accompanying information. Results showed lower ratings produced by neurologists (i.e., less likelihood of an infarction) than by radiologists in the majority of all assessments, but no bias by the accompanying information. (orig.)

  15. Evaluation of the effects of rehabilitation exercise on cerebral infarction with 99Tcm-ECD SPECT brain imaging

    International Nuclear Information System (INIS)

    Objective: To investigate the therapeutic effects of motor therapy on hemiplegia with SPECT brain perfusion imaging. Methods: The study population consisted of 59 patients with cerebral infarction, and all patients were treated with motor therapy. Among them, 30 cases were assigned to undertake single bridging exercise and 29 cases passive exercise. SPECT brain perfusion imaging was performed before and after motor therapy under the same condition, and the regional cerebral blood flow (rCBF) changes were compared and analysed with visual and semi-quantitative methods; in addition, the relationship between rCBF changes and scores of Fugl-Meyer or Barthel index were also analysed. Results: After motor therapy, various degrees of radioactivity increase were compared with the pretreatment radioactivity hypoperfusion in patients with cerebral infarction, and showed that motor therapy could evidently improve rCBF of regional hypoperfusion. The posttreatment rCBF was higher than the pretreatment level (P<0.01), and the rCBF of group of single bridging was higher than that of passive exercise group. And the changes of rCBF were all significant after motor therapy. In addition, the variation of the rCBF after motor therapy was positively correlated with the variation of Fugl-Meyer and Barthel score. Conclusions: SPECT brain perfusion imaging can serve as a useful method for evaluating the effectiveness of motor therapy in cerebral infarction rehabilitation. The single bridging exercise and the passive exercise are both beneficial to brain rehabilitation, but the former improves the rCBF in lesions better than the later does

  16. The use of MRI apparent diffusion coefficient (ADC in monitoring the development of brain infarction

    Directory of Open Access Journals (Sweden)

    Yuan Jian-Jun

    2011-01-01

    Full Text Available Abstract Background To study the rules that apparent diffusion coefficient (ADC changes with time and space in cerebral infarction, and to provide the evidence in defining the infarction stages. Methods 117 work-ups in 98 patients with cerebral infarction (12 hyperacute, 43 acute, 29 subacute, 10 steady, and 23 chronic infarctions were imaged with both conventional MRI and diffusion weighted imaging. The average ADC values, the relative ADC (rADC values, and the ADC values or rADC values from the center to the periphery of the lesion were calculated. Results The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously. rADC values in hyperacute and acute stage was minimized, and increased progressively as time passed and appeared as "pseudonormal" values in approximately 8 to 14 days. Thereafter, rADC values became greater than normal in chronic stage. There was positive correlation between rADC values and time (P Conclusion The ADC values of infarction lesions have evolution rules with time and space. The evolution rules with time and those in space can be helpful to decide the clinical stage, and to provide the evidence in guiding the treatment or judging the prognosis in infarction.

  17. Effects of recombinant human brain natriuretic peptide on renal function in patients with acute heart failure following myocardial infarction

    OpenAIRE

    Wang, Yanbo; Gu, Xinshun; Fan, Weize; Fan, Yanming; Li, Wei; FU, XIANGHUA

    2016-01-01

    Objective: To investigate the effect of recombinant human brain natriuretic peptide (rhBNP) on renal function in patients with acute heart failure (AHF) following acute myocardial infarction (AMI). Methods: Consecutive patients with AHF following AMI were enrolled in this clinical trial. Eligible patients were randomly assigned to receive rhBNP (rhBNP group) or nitroglycerin (NIT group). Patients in the rhBNP group received rhBNP 0.15 μg /kg bolus injection after randomization followed by an ...

  18. The use of MRI apparent diffusion coefficient (ADC) in monitoring the development of brain infarction

    International Nuclear Information System (INIS)

    To study the rules that apparent diffusion coefficient (ADC) changes with time and space in cerebral infarction, and to provide the evidence in defining the infarction stages. 117 work-ups in 98 patients with cerebral infarction (12 hyperacute, 43 acute, 29 subacute, 10 steady, and 23 chronic infarctions) were imaged with both conventional MRI and diffusion weighted imaging. The average ADC values, the relative ADC (rADC) values, and the ADC values or rADC values from the center to the periphery of the lesion were calculated. The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously. rADC values in hyperacute and acute stage was minimized, and increased progressively as time passed and appeared as 'pseudonormal' values in approximately 8 to 14 days. Thereafter, rADC values became greater than normal in chronic stage. There was positive correlation between rADC values and time (P < 0.01). The ADC values and the rADC values in hyperacute and acute lesions had gradient signs that these lesions increased from the center to the periphery. The ADC values and the rADC values in subacute lesions had adverse gradient signs that these lesions decreased from the center to the periphery. The ADC values of infarction lesions have evolution rules with time and space. The evolution rules with time and those in space can be helpful to decide the clinical stage, and to provide the evidence in guiding the treatment or judging the prognosis in infarction

  19. Influence of mild hypothermia on vascular endothelial growth factor and infarct volume in brain tissues after cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    Fei Ye; Gangming Xi; Biyong Qin; Shifeng Wang; Chengyan Li

    2006-01-01

    BACKGROUND: It has been demonstrated that mild hypothermia has obvious protective effect on both whole and local cerebral ischemia. However, the definite mechanism is still unclear for the brain protection of mild hypothermia on cerebral edema, inhibiting inflammatory reaction, stabilizing blood brain barrier, etc.OBJECTIVE: To investigate the effect of mild hypothermia on the expression of vascular endothelial growth factor and the infarct volume after cerebral ischemia in rats, and analyze the brain protective mechanism of mild hypothermia.DESIGN: A randomized grouping and controlled animal trial.SETTING: Department of Neurology, People's Hospital of Yunyang Medical College.MATERIALS: Twenty adult male SD rats of clean degree, weighing (250±30) g, were provided by the animal experimental center, School of Medicine, Wuhan University. The kits for SP immunohistochemistry were purchased from Beijing Zhongshan Golden Bridge Biotechnology Co., Ltd.METHODS: The experiments were carried out in the laboratory of Department of Neurology, Renmen Hospital of Wuhan University from May to July 2005. ① The 20 rats were divided randomly into normal temperature group (n =10) and mild hypothermia group (n =10). Models of permanent middle cerebral artery occlusion were established with modified nylon suture embolization. The rats were assessed with the Longa standards: O point for without nerve dysfunction; 1 for mild neurological deficit (fore claws could no extend completely); 2 for moderate neurological deficit (circling towards the affected side); 3 for severe neurological deficit (tilting towards the affected side); 4 for coma and unconscious; 1 -3 points represented that models were successfully established. The rats of the normal temperature group were fed at room temperature, and those in the mild hypothermia group were induced by hypothermia from 2 hours postoperatively, and the rectal temperature was kept at 34-35 ℃ for 72 hours. ② Measurement of infarct volume

  20. Time course of lesion development in patients with acute brain stem infarction and correlation with NIHSS score

    International Nuclear Information System (INIS)

    Background and purpose: diffusion weighted magnetic resonance imaging (MRI) is highly sensitive in detecting acute supratentorial cerebral ischemia and Diffusion Weighted Imaging (DWI) lesion size has been shown to correlate strongly with the neurologic deficit in middle cerebral artery territory stroke. However, data concerning infratentorial strokes are rare. We examined the size and evolution of acute brain stem ischemic lesions and their relationship to neurological outcome. Methods: brain stem infarctions of 11 patients were analyzed. We performed DWI in all patients and in 7/11 patients within 24 h, T2W sequences within the first 2 weeks (10/11 patients) and follow-up MRI (MR2) within 3-9 months (median 4.8 months) later (12/12 patients). Lesion volumes were compared with early and follow-up neurologic deficit as determined by National Institutes of Health Stroke Scale (NIHSS) score. Results: the relative infarct volumes--with MR2 lesion size set to 100%--decreased over the time (P<0.02) with a mean shrinking factor of 3.3 between DWI (MR0) and the follow-up MRT (P<0.02), and 1.6 between early T2W (MR1) and MR2 (P<0.04). The mean DWI volume size (MR0) was larger than the early T2W (P<0.02). Although neurological outcome was good in all patients (mean NIHSS score of 1.3 at follow-up), early NIHSS and follow-up NIHSS scores were strongly correlated (r=0.9, P<0.00). NIHSS score at follow-up was highly correlated with lesion size of DWI (MR0; r=0.71, P<0.04) and T2W of MR1 (r=0.86, P<0.001). Conclusions: in this study, we saw a shrinking of the brain stem infarct volume according to clinical improvement of patients. Great extension of restricted diffusion in the acute stage does not necessarily implicate a large resulting infarction or a bad clinical outcome

  1. Adipose-derived mesenchymal stem cells markedly attenuate brain infarct size and improve neurological function in rats

    Directory of Open Access Journals (Sweden)

    Sun Cheuk-Kwan

    2010-06-01

    Full Text Available Abstract Background The therapeutic effect of adipose-derived mesenchymal stem cells (ADMSCs on brain infarction area (BIA and neurological status in a rat model of acute ischemic stroke (IS was investigated. Methods Adult male Sprague-Dawley (SD rats (n = 30 were divided into IS plus intra-venous 1 mL saline (at 0, 12 and 24 h after IS induction (control group and IS plus intra-venous ADMSCs (2.0 × 106 (treated interval as controls (treatment group after occlusion of distal left internal carotid artery. The rats were sacrificed and brain tissues were harvested on day 21 after the procedure. Results The results showed that BIA was larger in control group than in treatment group (p Conclusions ADMSC therapy significantly limited BIA and improved sensorimotor dysfunction after acute IS.

  2. Analysis of metabolites in human brain tumors and cerebral infarctions using 31P- and 1H-magnetic resonance spectroscopy

    International Nuclear Information System (INIS)

    31P- and 1H-MRS with a 2.0 tesla MRI/S system was used to monitor the cerebral energy levels, phospholipid metabolism, intracellular pH, and lactate and amino acid levels in patients with brain tumors and cerebral infarctions. Studies of human brain tumors have suggested that the 31P-MRS of malignant brain tumors show low concentrations of phosphocreatine (PCr) and β-ATP, high levels of phosphomonoester (PME) and inorganic Pi, and an alkaline pH. The Pi, PME, and intracellular pH of malignant lymphoma were higher than those of other brain tumors. 1H-MRS showed an increase of lactate in malignant brain tumors and epidermoids. After ACNU administration, the tumor 31P-MRS showed transient reduction and elevation of Pi on five patients with malignant gliomas. Intracellular pH also showed a transient reduction during radiotherapy. 1H-MRS showed a reduction of lactate at the beginning of therapy and showed a marked re-elevation of lactate with tumor regrowth. After radiotherapy, the normal brain 31P-MRS showed transient elevation and reduction of Pi. Intracellular pH also showed a transient elevation during radiotherapy. To investigate the mechanism of hyperbaric oxygen therapy (HBO) in cerebral ischemia, changes of brain lactate level were estimated by 1H-MRS. Although the Lactate/Creatine ratio decreased consistently over time in all patients, it decreased more rapidly in the patients receiving HBO therapy than in those without such therapy. 1H-MRS demonstrated that HBO therapy may improve metabolism in the ischemic brain and reduces the lactate levels. 31P- and 1H-MRS are practical tools for the clinical analysis of cerebral disorders as well as for deciding on therapeutic procedures and evaluating the response. (K.H.)

  3. Focal cerebral ischemia induces increased myelin basic protein and growth-associated protein-43 gene transcription in peri-infarct areas in the rat brain

    DEFF Research Database (Denmark)

    Gregersen, R; Christensen, Thomas; Lehrmann, E;

    2001-01-01

    Although oligodendrocytes are vulnerable to focal cerebral ischemia, remyelination of denuded or regenerating axons in the peri-infarct area has been observed in the central nervous system. We studied the expression of myelin basic protein (MBP), a major component of central nervous system myelin......, in peri-infarct areas in adult rat brain after transient middle cerebral artery occlusion (MCAO) and correlated it to the expression of the growth-associated protein-43 (GAP-43), a marker for axonal regeneration and sprouting, using non-radioactive in situ hybridization techniques. Within the infarct......, MBP messenger RNA (mRNA) had disappeared by 24 h, whereas myelin protein, identified by MBP and myelin oligodendrocyte glycoprotein (MOG) immunohistochemistry, appeared structurally intact until day 3. Peri-infarct oligodendrocytes increased their expression of MBP mRNA from 24 h to maximal levels at...

  4. Brain Stem Infarction Due to Basilar Artery Dissection in a Patient with Moyamoya Disease Four Years after Successful Bilateral Revascularization Surgeries.

    Science.gov (United States)

    Abe, Takatsugu; Fujimura, Miki; Mugikura, Shunji; Endo, Hidenori; Tominaga, Teiji

    2016-06-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease with an unknown etiology and is characterized by intrinsic fragility in the intracranial vascular walls such as the affected internal elastic lamina and thinning medial layer. The association of MMD with intracranial arterial dissection is extremely rare, whereas that with basilar artery dissection (BAD) has not been reported previously. A 46-year-old woman developed brain stem infarction due to BAD 4 years after successful bilateral superficial temporal artery-middle cerebral artery anastomosis with indirect pial synangiosis for ischemic-onset MMD. She presented with sudden occipitalgia and subsequently developed transient dysarthria and mild hemiparesis. Although a transient ischemic attack was initially suspected, her condition deteriorated in a manner that was consistent with left hemiplegia with severe dysarthria. Magnetic resonance (MR) imaging revealed brain stem infarction, and MR angiography delineated a double-lumen sign in the basilar artery, indicating BAD. She was treated conservatively and brain stem infarction did not expand. One year after the onset of brain stem infarction, her activity of daily living is still dependent (modified Rankin Scale of 4), and there were no morphological changes associated with BAD or recurrent cerebrovascular events during the follow-up period. The association of MMD with BAD is extremely rare. While considering the common underlying pathology such as an affected internal elastic lamina and fragile medial layer, the occurrence of BAD in a patient with MMD in a stable hemodynamic state is apparently unique. PMID:27068774

  5. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y. A.; Kim, S. H.; Sohn, H. S.; Jeong, S. G. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract.

  6. Therapeutic effects of human multilineage-differentiating stress enduring (MUSE cell transplantation into infarct brain of mice.

    Directory of Open Access Journals (Sweden)

    Tomohiro Yamauchi

    Full Text Available Bone marrow stromal cells (BMSCs are heterogeneous and their therapeutic effect is pleiotropic. Multilineage-differentiating stress enduring (Muse cells are recently identified to comprise several percentages of BMSCs, being able to differentiate into triploblastic lineages including neuronal cells and act as tissue repair cells. This study was aimed to clarify how Muse and non-Muse cells in BMSCs contribute to functional recovery after ischemic stroke.Human BMSCs were separated into stage specific embryonic antigen-3-positive Muse cells and -negative non-Muse cells. Immunodeficient mice were subjected to permanent middle cerebral artery occlusion and received transplantation of vehicle, Muse, non-Muse or BMSCs (2.5×104 cells into the ipsilateral striatum 7 days later.Motor function recovery in BMSC and non-Muse groups became apparent at 21 days after transplantation, but reached the plateau thereafter. In Muse group, functional recovery was not observed for up to 28 days post-transplantation, but became apparent at 35 days post-transplantation. On immunohistochemistry, only Muse cells were integrated into peri-infarct cortex and differentiate into Tuj-1- and NeuN-expressing cells, while negligible number of BMSCs and non-Muse cells remained in the peri-infarct area at 42 days post-transplantation.These findings strongly suggest that Muse cells and non-Muse cells may contribute differently to tissue regeneration and functional recovery. Muse cells may be more responsible for replacement of the lost neurons through their integration into the peri-infarct cortex and spontaneous differentiation into neuronal marker-positive cells. Non-Muse cells do not remain in the host brain and may exhibit trophic effects rather than cell replacement.

  7. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    International Nuclear Information System (INIS)

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract

  8. Chronological changes in nonhaemorrhagic brain infarcts with short T1 in the cerebellum and basal ganglia

    International Nuclear Information System (INIS)

    Our purpose was to investigate nonhaemorrhagic infarcts with a short T1 in the cerebellum and basal ganglia. We carried out repeat MRI on 12 patients with infarcts in the cerebellum or basal ganglia with a short T1. Cerebellar cortical lesions showed high signal on T1-weighted spin-echo images beginning at 2 weeks, which became prominent from 3 weeks to 2 months, and persisted for as long as 14 months after the ictus. The basal ganglia lesions demonstrated slightly high signal from a week after the ictus, which became more intense thereafter. Signal intensity began to fade gradually after 2 months. High signal could be seen at the periphery until 5 months, and then disappeared, while low or isointense signal, seen in the central portion from day 20, persisted thereafter. (orig.)

  9. The preliminary study of Ultraviolet-Irradiated and Oxygenated Blood Transfusion Therapy(UOBT) for Experimental Cerebral Infarction of Animal Brain Model

    Institute of Scientific and Technical Information of China (English)

    Su Xiu-Chu; Feng You-Qi; Zhou gang; Wu jun-yi

    2000-01-01

    In this presented study, we have developed a photochemical model of cerebral in farction in rabbit with stable and reproducible infarct size and extent. This model is similar to the pathological changes in human cerebral infarction. Using this model, therapeutic effects and mechanisms of UOBT on brain ischemic injury were invetigated in rabbits following the photochemical infarcnon The results showed that UOBT could significantly reduce the mtarcted size, and improve the cerebral blood flow compared with the control animals treated with non-u-radiated ad non-oxygenated blood transfusion. These data suggest that the UOBT may have a therapeutic potential for clinical rehabilitation effect in stroke treatment

  10. Sex differences in the risk profile and male predominance in silent brain infarction in community-dwelling elderly subjects. The Sefuri brain MRI study

    International Nuclear Information System (INIS)

    Although brain infarction is more common in men, the male predominance of silent brain infarction (SBI) was inconsistent in the earlier studies. This study was to examine the relationship between sex differences in the risk profile and SBI. We conducted a population-based, cross-sectional analysis of cardiovascular risk factors and SBI on MRI. We asked all the female participants about the age at natural menopause and parity. SBI was detected in 77 (11.3%) of 680 participants (266 men and 414 women) with a mean age of 64.5 (range 40-93) years. In the logistic analysis, age (odds ratio (OR)=2.760/10 years, 95% confidence interval (CI)=2.037-3.738), hypertension (OR=3.465, 95% CI=1.991-6.031), alcohol intake (OR=2.494, 95% CI=1.392-4.466) and smoking (OR=2.302, 95% CI=1.161-4.565) were significant factors concerning SBI. Although SBI was more prevalent among men, this sex difference disappeared on the multivariate model after adjustment for other confounders. In 215 women aged 60 years or older, age at natural menopause, early menopause, duration of menopause, number of children and age at the last parity were not significantly associated with SBI after adjustment for age. Hypertension and age were considered to be the major risk factors for SBI in community-dwelling people. Male predominance in SBI was largely due to higher prevalence of alcohol habit and smoking in men than in women in our population. (author)

  11. Effect of percutaneous coronary intervention on ventricular systolic synchrony and brain natriuretic peptide in acute myocardial infarction patients with aneurysm

    International Nuclear Information System (INIS)

    Objective: To evaluate the reversed effect on the left ventricular aneurysm (LVA) formation and influence on systolic performance and synchrony using percutaneous coronary intervention (PCI) therapy in patients with acute myocardial infarction (AMI) at different time intervals equilibrium radionuclide angiography (ERNA). Methods: A total of 326 patients with primary anterior AMI accompanied LVA diagnosed by left ventricular graphy were enrolled in this study from January 2001 to July 2004. They were divided into 4 groups according to the time accepting PCI. Group A ( 1 week, n=76). The parameters of the paradox volume image of ventricular movement on the dynamic cine of cardiac blood pool, and the paradox volume index (PVI) as well as the parameters of left ventricular systolic function (LVSF), left ventricular diastolic function (LVDF) and left ventricular systolic synchrony (LVSS) were measured by ERNA with the ventricular phase analysis (PA) at 1st week and 6th month after AMI. The plasma brain natriuretic peptide (BNP) was measured in 18th hour, 5th day and 24th week after AMI. During 3-year follow-up, the major adverse cardiac events (MACE) were recorded.Analysis of variance and χ2-test were used. Results: At 6th month post AMI, the left ventricular ejection fraction (LVEF) in group A, B and C was increased than that in group D, hut phase shift (PS) and full width at half maximum (FWHM) were decreased (F=5.90, 6.80, all P 2=10.05, P<0.05). Conclusion: The early, fully and permanently opening of infarction related artery can effectively inhibit the left ventricular remodeling process, improve its function, prevent LVA formation, and finally improve the prognosis. (authors)

  12. Effect of recombinant human brain natriuretic peptide-assisted interventional treatment on prognosis of acute myocardial infarction patients complicated with cardiogenic shock

    Institute of Scientific and Technical Information of China (English)

    Xi-Zhou Chen

    2016-01-01

    Objective:To analyze the effect of recombinant human brain natriuretic peptide-assisted interventional treatment on prognosis of acute myocardial infarction patients complicated with cardiogenic shock.Methods: A total of 112 cases of inpatients treated in Cardiology Department of our hospital from March 2013 to March 2015 were selected, all of whom had acute myocardial infarction within 12 hours of onset and received direct PCI treatment. They were divided into observation group and control group according to random number table, each group with 56 cases, control group received conventional interventional treatment and observation group received recombinant human brain natriuretic peptide-assisted interventional treatment. Then differences of regional myocardial deformability, myocardial enzyme spectrum indicators, brain natriuretic peptide and inflammatory factors, blood sugar and stress hormones as well as myocardial infarction prognosis-associated indexes, etc, between two groups after treatment were compared.Results:After treatment, LVEF, SRs, SRe and Sra levels of observation group were higher than those of control group, WMSI level was lower than that of control group; serum myocardial enzyme spectrum indicators CK, CK-MB, AST and LDH values were lower than those of control group; serum BNP, CRP, TNF-α and IL-6 levels were lower than those of control group; serum cortisol, growth hormone and glucagon levels were lower than those of control group, insulin level was higher than that of control group; FT3 and IGF-1 levels were higher than those of control group, sPLA2 and Hcy levels were lower than those of control group.Conclusion: Recombinant human brain natriuretic peptide-assisted interventional treatment for acute myocardial infarction patients complicated with cardiogenic shock can reduce myocardial function injury, protect normal myocardial function and optimize patients' long-term prognosis; it has active clinical significance.

  13. Segmental sensory disturbance in brain stem infarctions of the lateral lower pons and lateral medulla

    International Nuclear Information System (INIS)

    We reported on seven cases of brainstem infarctions of the lateral lower pons and lateral medulla, the sensory deficit manifested over the trunk or the leg namely segmental sensory disturbances. All patients showed dissociated sensory disturbance of pain and temperature with retained deep sensations except two cases in which touch was also slightly impaired. The sensory distribution was classified into two types. The first ''crossed type'', ipsilatral face and contralateral trunk and leg below the level was involved in 4 cases, and the second ''unilateral type'' contralateral face and trunk above the level in 3 cases. Clinico-anatomical evaluation was executed by MRI. Lesions were detected in the lateral lower pons in two cases and in the lateral medulla in one case. The location of lesions by MRI revealed more lateral lesions showed ''crossed type'' of segmental sensory disturbance and more medial lesions ''unilateral type''. It was shown that the segmental sensory disturbance could be explained by the partial involvement of the lateral spinothalamic tract, which is arranged with the fibers from the sacral segments most lateral. We considered it very important to differentiate the segmental sensory disturbance by brainstem lesion in practical clinical diagnosis. We also emphasize the type of segmental sensory disturbance could be a localizing sign in the lateral brainstem as such, ''crossed type'' indicating the lesion of the lateral portion and ''unilateral type'' the medial portion of the lateral lower brainstem. (author)

  14. Systemic inflammatory challenges compromise survival after experimental stroke via augmenting brain inflammation, blood- brain barrier damage and brain oedema independently of infarct size

    OpenAIRE

    Dénes Ádám; Ferenczi Szilamér; Kovács Krisztina J.

    2011-01-01

    Abstract Background Systemic inflammation impairs outcome in stroke patients and experimental animals via mechanisms which are poorly understood. Circulating inflammatory mediators can activate cerebrovascular endothelium or glial cells in the brain and impact on ischaemic brain injury. One of the most serious early clinical complications of cerebral ischaemia is brain oedema, which compromises survival in the first 24-48 h. It is not understood whether systemic inflammatory challenges impair...

  15. Plasticity of Adult Sensorimotor System in Severe Brain Infarcts: Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Annette Sterr

    2012-01-01

    Full Text Available Functional reorganization forms the critical mechanism for the recovery of function after brain damage. These processes are driven by inherent changes within the central nervous system (CNS triggered by the insult and further depend on the neural input the recovering system is processing. Therefore these processes interact with not only the interventions a patient receives, but also the activities and behaviors a patient engages in. In recent years, a wide range of research programs has addressed the association between functional reorganization and the spontaneous and treatment-induced recovery. The bulk of this work has focused on upper-limb and hand function, and today there are new treatments available that capitalize on the neuroplasticity of the brain. However, this is only true for patients with mild to moderated impairments; for those with very limited hand function, the basic understanding is much poorer and directly translates into limited treatment opportunities for these patients. The present paper aims to highlight the knowledge gap on severe stroke with a brief summary of the literature followed by a discussion of the challenges involved in the study and treatment of severe stroke and poor long-term outcome.

  16. Optimal delivery route of bone marrow stromal cells for rat infarct brain – A study using non-invasive optical imaging

    Directory of Open Access Journals (Sweden)

    Tamaki N

    2010-01-01

    Full Text Available BACKGROUND - Recent studies have indicated that bone marrow stromal cells (BMSC have the potential to improve neurological function when transplanted into animal model of central nervous system (CNS disorders. However, there still exist several questions to solved prior to clinical application. In this study, therefore, we aimed to clarify the optimal delivery route of BMSC transplantation over a reasonable time window.MATERIALS AND METHODS - The rats were subjected to permanent middle cerebral artery occlusion. The BMSC were labeled with quantum dot (QD 800. The labeled BMSC were transplanted into the infarct brain directly or intravenously at 7 days after the insult. Motor function was serially assessed. The BMSC were also tracked using near infrared (NIR fluorescence imaging technique every week. The fate of the transplanted BMSC was examined at 5 weeks after transplantation, using Immunohistochemistry. RESULTS - Direct, but not intravenous, transplantation of BMSC significantly enhanced functional recovery. NIR fluorescence imaging could visualize their migration towards cerebral infarct in directly, but not intravenously, injected animals. The findings were supported on histological analysis. Thus, the BMSC were widely engrafted in the infarct brain in the directly injected animals, but few BMSC were observed in the intravenously injected ones. CONCLUSION - This study strongly suggests that direct transplantation of BMSC may be more beneficial in treating patients with ischemic stroke than their intravenous transplantation. Therapeutic time window must be called into account when considering the route of BMSC transplantation.

  17. Analysis of metabolites in human brain tumors and cerebral infarctions using {sup 31}P- and {sup 1}H-magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Hirakawa, Wataru [Kagoshima Univ. (Japan). Faculty of Medicine

    1996-08-01

    {sup 31}P- and {sup 1}H-MRS with a 2.0 tesla MRI/S system was used to monitor the cerebral energy levels, phospholipid metabolism, intracellular pH, and lactate and amino acid levels in patients with brain tumors and cerebral infarctions. Studies of human brain tumors have suggested that the {sup 31}P-MRS of malignant brain tumors show low concentrations of phosphocreatine (PCr) and {beta}-ATP, high levels of phosphomonoester (PME) and inorganic Pi, and an alkaline pH. The Pi, PME, and intracellular pH of malignant lymphoma were higher than those of other brain tumors. {sup 1}H-MRS showed an increase of lactate in malignant brain tumors and epidermoids. After ACNU administration, the tumor {sup 31}P-MRS showed transient reduction and elevation of Pi on five patients with malignant gliomas. Intracellular pH also showed a transient reduction during radiotherapy. {sup 1}H-MRS showed a reduction of lactate at the beginning of therapy and showed a marked re-elevation of lactate with tumor regrowth. After radiotherapy, the normal brain {sup 31}P-MRS showed transient elevation and reduction of Pi. Intracellular pH also showed a transient elevation during radiotherapy. To investigate the mechanism of hyperbaric oxygen therapy (HBO) in cerebral ischemia, changes of brain lactate level were estimated by {sup 1}H-MRS. Although the Lactate/Creatine ratio decreased consistently over time in all patients, it decreased more rapidly in the patients receiving HBO therapy than in those without such therapy. {sup 1}H-MRS demonstrated that HBO therapy may improve metabolism in the ischemic brain and reduces the lactate levels. {sup 31}P- and {sup 1}H-MRS are practical tools for the clinical analysis of cerebral disorders as well as for deciding on therapeutic procedures and evaluating the response. (K.H.)

  18. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  19. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

    International Nuclear Information System (INIS)

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  20. The broad-spectrum cation channel blocker pinokalant (LOE 908 MS) reduces brain infarct volume in rats

    DEFF Research Database (Denmark)

    Christensen, Thomas; Wienrich, Marion; Ensinger, Helmut A;

    2005-01-01

    Activation of cation channels conducting Ca2+, Na+ and K+ is involved in the pathogenesis of infarction in experimental focal cerebral ischaemia. Pinokalant (LOE 908 MS) is a novel broad-spectrum inhibitor of several subtypes of such channels and has previously been shown to improve the metabolic...

  1. Caudal brain infarctions in a kitten – case reportInfartos em região encefálica caudal em gata filhote – relato de caso

    Directory of Open Access Journals (Sweden)

    Lucas Alécio Gomes

    2013-05-01

    Full Text Available Stroke is uncommon in animals compared with humans because of the lower incidence of atherosclerosis and primary hypertension. However with advanced imaging, vascular disease is being recognized with increasing frequency in veterinary medicine. Cerebrovascular disease can be subdivided into infarction and hemorrhage, although the two categories overlap in the case of hemorrhagic infarcts. The aim of thisarticle is to report the neurological manifestations associated with stroke (infarctions in at two-month old, domestic shorthair cat. Neurological evaluation revealed head tilt, tetraparesis, proprioceptive deficits in all four limbs, and decreased pupillary light reflex. Further, manifestations of neurological dysfunctions were acute and progressive. At the necropsy, grossly there were hemorrhage and necrosis at mid-brain and cerebellum. Histopathology confirmed liquefactive necrosis at the mid-brain and cerebellum. The neurological manifestations associated with the pathological findings are suggestive of an anoxic infarction probably due to vascular occlusion. Em animais é baixa a incidência de arterosclerose e hipertensão primária. Devido a tal característica, infarto cerebral é incomum nos mesmos. Entretanto, com o avanço das modalidades de imagem, doença vascular está sendo reconhecida com maio frequência na medicina veterinária. Doença cerebrovascular pode ser subdividida em infarto e hemorragia, embora as duas categorias se interponham no caso de infartos hemorrágicos. Assim sendo, o objetivo deste artigo é descrever as manifestações neurológicas associadas a acidente vascular (infartos em uma gata de dois meses de idade, sem raça definida e domiciliada. Na avaliação neurológica observou-se inclinação de cabeça, tetraparesia, déficits proprioceptivos nos quatro membros e diminuição do reflexo pupilar a luz. Além disso, os problemas neurológicos foram agudos e progressivos. Na necropsia macroscopicamente

  2. Effects of recombinant human brain natriuretic peptide on renal function in patients with acute heart failure following myocardial infarction

    Science.gov (United States)

    Wang, Yanbo; Gu, Xinshun; Fan, Weize; Fan, Yanming; Li, Wei; Fu, Xianghua

    2016-01-01

    Objective: To investigate the effect of recombinant human brain natriuretic peptide (rhBNP) on renal function in patients with acute heart failure (AHF) following acute myocardial infarction (AMI). Methods: Consecutive patients with AHF following AMI were enrolled in this clinical trial. Eligible patients were randomly assigned to receive rhBNP (rhBNP group) or nitroglycerin (NIT group). Patients in the rhBNP group received rhBNP 0.15 μg /kg bolus injection after randomization followed by an adjusted-dose (0.0075-0.020 μg/kg/min) for 72 hours, while patients in NIT received infusion of nitroglycerin with an adjusted-dose (10-100 μg/kg/min) for 72 hours in NIT group. Standard clinical and laboratory data were collected. The levels of serum creatinine (SCr), urea, β-2 microglobulin and cystatin C were measured at baseline and repeated at the end of the 24, 48 and 72 hours after infusion. The primary end point was the incidence of acute renal dysfunction, which was defined as an increase in SCr > 0.5 mg/dl (> 44.2 μmol/L) or 25% above baseline SCr value. The occurrence of major adverse cardiac event (MACE) was followed up for 1 month. Results: Of the 50 patients enrolled, 26 were randomly assigned to rhBNP and 24 to nitroglycerin (NIT). There were no significant differences in baseline characteristics between the two groups (all P > 0.05). The baseline concentrations of SCr, urea, β-2 microglobulin and cystatin C at admission were similar in the two groups. However, the concentrations of SCr and urea were significantly higher in rhBNP group than those in NIT group at hour 24 and 48 after treatments (all P < 0.01). For both groups, the concentrations of SCr, urea, β-2 microglobulin and cystatin C were not significant changed compared with baseline levels. The levels of systolic blood pressure (SBP) and diastolic blood pressures (DBP) at admission were also similar between the two groups. In rhBNP group, levels of SBP and DBP decreased significantly at hour 24

  3. [Bilateral caudate head infarcts].

    Science.gov (United States)

    Kuriyama, N; Yamamoto, Y; Akiguchi, I; Oiwa, K; Nakajima, K

    1997-11-01

    We reported a 67-year-old woman with bilateral caudate head infarcts. She developed sudden mutism followed by abulia. She was admitted to our hospital 2 months after ictus for further examination. She showed prominent abulia and was inactive, slow and apathetic. Spontaneous activity and speech, immediate response to queries, spontaneous word recall and attention and persistence to complex programs were disturbed. Apparent motor disturbance, gait disturbance, motor aphasia, apraxia and remote memory disturbance were not identified. She seemed to be depressed but not sad. Brain CT and MRI revealed bilateral caudate head hemorrhagic infarcts including bilateral anterior internal capsules, in which the left lesion was more extensive than right one and involved the part of the left putamen. These infarct locations were thought to be supplied by the area around the medial striate artery including Heubner's arteries and the A1 perforator. Digital subtraction angiography showed asymptomatic right internal carotid artery occlusion. She bad had hypertension, diabetes mellitus and atrial fibrillation and also had a left atrium with a large diameter. The infarcts were thought to be caused by cardioembolic occlusion to the distal portion of the left internal carotid artery. Although some variations of vasculature at the anterior communicating artery might contribute to bilateral medial striate artery infarcts, we could not demonstrate such abnormalities by angiography. Bilateral caudate head infarcts involving the anterior internal capsule may cause prominent abulia. The patient did not improve by drug and rehabilitation therapy and died suddenly a year after discharge. PMID:9503974

  4. Effects of ketamine-midazolam anesthesia on the expression of NMDA and AMPA receptor subunit in the peri-infarction of rat brain

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yue-lin; ZHANG Peng-bo; QIU Shu-dong; LIU Yong; TIAN Ying-fang; WANG Ying

    2006-01-01

    Background Activation of N-methyl-D-aspartate (NMDA) receptors and alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors play an important role in the neurons death induced by ischemia.The mitigating effect of intravenous anesthetics on ischemic neuron injury is related to their influence on NMDA receptors. This study was performed to investigate the effect of ketamine-midazolam anesthesia on the NMDA and AMPA receptor subunits expression in the peri-infarction of ischemic rat brain and explore its potential mechanism of neuroprotection.This study was supported by National Natural Science Foundation of China (NSFC) (No.30200291).Methods Thirty Sprague Dawley (SD) rats were subjected to permanent middle cerebral artery occlusion under ketamine/atropine (100/0.05 mg/kg) or ketamine-midazolam/atropine (60/50/0.05 mg/kg) intraperitoneal anesthesia (n=15 each). Twenty-four hours after ischemia, five rats in each group were killed by injecting the above dosage of ketamine or ketamine-midazolam intraperitoneally and infarct size was measured. Twenty-four and 72 hours after ischemia, four rats in each group were killed by injecting the above dosage of ketamine or ketamine-midazolam intraperitoneally. After staining the brain tissue slices with toluidine blue, the survived neurons in the peri-infarction were observed. Also, the expression level of NMDA receptors 1 (NR1), NMDA receptors 2A (NR2A), NMDA receptors 2B (NR2B) and AMPA (GluR1 subunit) were determined by grayscale analysis in immunohistochemical stained slices.Results Compared with ketamine anesthesia, ketamine-midazolam anesthesia produced not only smaller infarct size [(24.1±4.6)% vs (38.4±4.2)%, P<0.05], but also higher neuron density (24 hours: 846± 16 vs 756±24,P<0.05; 72 hours: 882±22 vs 785± 18, P<0.05) and lower NR2A (24 hours: 123.0±4.9 vs 95.0±2.5, P<0.05; 72 hours: 77.8±4.1 vs 54.2±3.9, P<0.05) and NR2B (24 hours: 98.5±2.7 vs 76.3±2.4, P<0.05; 72hours: 67.2

  5. Study on correlation between circulating endothelial progenitor cells and brain natriuretic peptide in patients with myocardial infarction complicated heart failure after stem cell mobilization

    Directory of Open Access Journals (Sweden)

    Zi-lin ZHAO

    2014-06-01

    Full Text Available Objective: It is to observe the correlation between circulating endothelial progenitor cells (endothelial progenitor cells, EPCs and brain natriuretic peptide (BNP in patients with myocardial infarction and heart failure after stem cell mobilizer granulocyte colony stimulating factor (granulocyte colony stimulating factor, G-CSF.Methods: Patients were divided into the control group(37 and the observation group (38. The observation group took injection of G-CSF, 10μg/kg, for 7d. The Two groups were observed the amount of circulating EPCs , the levels of BNP, TNF- α and other indicators, and make clinical analysis. Results: Compared with control group, the amount of EPCs were significantly increased, the level of BNP, TNF- α were decreased, the difference between the observation group and control group is statistical significant (P < 0.05; the amount of  EPCs had negative correlation with BNP. Conclusion: The application of stem cell mobilization of circulating EPCs can improve the clinical curative effect of myocardial infarction patients and heart failure, cyclic EPCs and BNP detection can effectively evaluate the heart function and prognosis.

  6. 颅脑损伤术后并发脑梗死的相关因素分析%Related factors of postoperative infarction after traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    彭华; 邱俊; 丁常云

    2015-01-01

    目的:探讨颅脑损伤术后并发脑梗死的相关因素。方法回顾性分析颅脑损伤手术治疗患者89例的临床资料,根据是否出现术后脑梗死分为脑梗死组和对照组。比较两组患者的临床资料,分析患者发生术后脑梗死的相关因素。结果术后脑梗死组患者年龄≥61岁的比例、脑内血肿的比例、患者有高血压、糖尿病、房颤病史的比例、受伤至入院时间跃12 h的患者比例、吸烟饮酒的患者比例也显著高于对照组(P12 h,smoking and drinking of infarction group were higher than control group (P<0.05 or P<0.01). Conclusion Postoperative infarction is serious complications of traumatic brain injury,and advanced age, intracerebral hematoma,a long time from injury to admission, patients with hypertension, diabetes and atrial fibrillation, and smoking and drinking history are related factors of postoperative cerebral.

  7. Partially silencing brain toll-like receptor 4 prevents in part left ventricular remodeling with sympathoinhibition in rats with myocardial infarction-induced heart failure.

    Directory of Open Access Journals (Sweden)

    Kiyohiro Ogawa

    Full Text Available BACKGROUND: Left ventricular (LV remodeling and activation of sympathetic nervous system (SNS are cardinal features of heart failure. We previously demonstrated that enhanced central sympathetic outflow is associated with brain toll-like receptor 4 (TLR4 probably mediated by brain angiotensin II type 1 receptor in mice with myocardial infarction (MI-induced heart failure. The purpose of the present study was to examine whether silencing brain TLR4 could prevent LV remodeling with sympathoinhibition in MI-induced heart failure. METHODOLOGY/PRINCIPAL FINDINGS: MI-induced heart failure model rats were created by ligation of left coronary artery. The expression level of TLR4 in brainstem was significantly higher in MI-induced heart failure treated with intracerebroventricular (ICV injection of hGAPDH-SiRNA than in sham. TLR4 in brainstem was significantly lower in MI-induced heart failure treated with ICV injection of TLR4-SiRNA than in that treated with ICV injection of hGAPDH-SiRNA. Lung weight, urinary norepinephrine excretion, and LV end-diastolic pressure were significantly lower and LV dimension was significantly smaller in MI-induced heart failure treated with TLR4-SiRNA than in that treated with hGAPDH-SiRNA for 2 weeks. CONCLUSIONS: Partially silencing brain TLR4 by ICV injection of TLR4-SiRNA for 2 weeks could in part prevent LV remodeling with sympathoinhibition in rats with MI-induced heart failure. Brain TLR4 has a potential to be a target of the treatment for MI-induced heart failure.

  8. Brain-derived neurotrophic factors increase the proliferation and differentiation of endogenous neural stem cells in mouse models of cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Dawei Zang; Juan Liu; Xianhua Zuo; Surindar Cheema

    2007-01-01

    BACKGROUND: It has been confirmed that brain-derived neurotrophic factor (BDNF) can promote the proliferation of neural stem cells (NSCs) and protect neuron-like cells in vitro. However, its effect on endogenous NSCs in vivo is still unclear.OBJECTIVE: To evaluate whether BDNF can induce the endogenous NSCs to proliferate and differentiate into the neurons in the mice model of cerebral infarction.DESIGN: A synchronal controlled observation.SETTINGS: Department of Neurology, Microbiology Division of the Department of Laboratory, Tianjin First Central Hospital; Howard Florey Institute, Medical College, the University of Melbourne.MATERIALS: Twenty-four pure breed C57BL/6J mice at the age of 10 weeks old (12 males and 12 females)were divided into saline control group and BDNF-treated group, 6 males and 6 females in each group.METHODS: The experiments were performed at the University of Melbourne from July 2004 to February 2005. ① The left middle cerebral artery (MCA) was ligated in both groups to establish models of cerebral infarction and the Matsushita measuring method was used to monitor the blood flow of the lesioned region supplied by MCA. 75% reduction of blood flow should be reached in the lesioned region. ② At 24 hours after infarction, mice in the BDNF-treated group were administrated with BDNF, which was slowly delivered using an ALZET osmium pump design. BDNF was dissolved in saline at the dosage of 500 mg/kg and injected into the pump, which could release the solution consistently in the following 28 days. The mice in the saline control group accepted the same volume of saline at 24 hours after infarction. ③ The Rotarod function test began at 1 week preoperatively, the time stayed on Rotarod was recorded. The mice were tested once a day till the end of the experiment. At 4 weeks post cerebral infarction, double labeling of Nestin and GFAP, BⅢ tubulin and CNPase immunostaining was performed to observe the differentiation directions of the re

  9. Correlation between special brain area and blood perfusion in patients with cerebral infarction at convalescent period Feasibility for quantitative determination and estimation of learning and memory function

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies,and the influence of difference in measurement condition of individuals exists.OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period,and to try to find out a method which can quantitatively evaluate learning ability.DESIGN: Case observation, and correlation analysis.SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College.PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Departtment of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3) years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives.METHODS: When the patients were at convalescent period, their learning and memory ability were measured with" clinic memory scale (set A)". The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale,temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis.MAIN OUTCOME MEASURES

  10. 脑干听觉诱发电位在脑干梗死诊断中的应用%Application of brain stem auditory evoked potential machine in diagnosis of brain stem infarction

    Institute of Scientific and Technical Information of China (English)

    蒙凌

    2015-01-01

    目的 对脑干听觉诱发电位(BAEP)检测在脑干梗死诊断中的应用价值进行分析探讨.方法 30例脑干梗死患者作为观察组, 对其分别进行头颅CT或核磁共振(MRI)及BAEP检查, 对比3种检查方法 检测阳性率.以30例健康志愿者作为对照组, 对比两组研究对象的BAEP检测结果 .结果 BAEP检测阳性率为83.33%, MRI检测阳性率为56.67%, CT检测阳性率为46.67%, BAEP检测阳性率明显高于MRI及CT, 差异有统计学意义(P<0.05).观察组患者Ⅲ波及Ⅴ波潜伏期(PL), Ⅰ~Ⅲ波及Ⅲ~Ⅴ波峰间潜伏期(IPL)延长同对照组比较, 差异有统计学意义(P<0.05).结论 对脑干梗死患者采用BAEP检查敏感性较高, 可为该病的早期诊断提供依据.%Objective To analyze and investigate application value of brain stem auditory evoked potential machine (BAEP) in diagnosis of brain stem infarction.Methods There were 30 patients with brain stem infarction as observation group. They received head CT or magnetic resonance imaging (MRI) and BAEP for examination. Comparison was made on positive rate across the 3 examination methods. Another 30 healthy volunteers were taken as control group. BAEP detection outcomes were compared between the two groups.Results Positive rate of BAEP was 83.33%, that of MRI was 56.67%, and that of CT was 46.67%. BAEP had much higher positive rate than MRI and CT, and the difference had statistical significance (P<0.05). The difference of prolonged Ⅲ wave and Ⅴ wave peak latencies (PL), Ⅰ~Ⅲ wave and Ⅲ~Ⅴ wave interpeak latencies (IPL) had statistical significance between the observation group and the control group (P<0.05).Conclusion Implement of BAEP for brain stem infarction patients shows high sensitivity in detection, and it can provide reference for early diagnosis.

  11. The detection of surfactant proteins A, B, C and D in the human brain and their regulation in cerebral infarction, autoimmune conditions and infections of the CNS.

    Directory of Open Access Journals (Sweden)

    Stefan Schob

    Full Text Available Surfactant proteins (SP have been studied intensively in the respiratory system. Surfactant protein A and surfactant protein D are proteins belonging to the family of collectins each playing a major role in the innate immune system. The ability of surfactant protein A and surfactant protein D to bind various pathogens and facilitate their elimination has been described in a vast number of studies. Surfactant proteins are very important in modulating the host's inflammatory response and participate in the clearance of apoptotic cells. Surfactant protein B and surfactant protein C are proteins responsible for lowering the surface tension in the lungs. The aim of this study was an investigation of expression of surfactant proteins in the central nervous system to assess their specific distribution patterns. The second aim was to quantify surfactant proteins in cerebrospinal fluid of healthy subjects compared to patients suffering from different neuropathologies. The expression of mRNA for the surfactant proteins was analyzed with RT-PCR done with samples from different parts of the human brain. The production of the surfactant proteins in the brain was verified using immunohistochemistry and Western blot. The concentrations of the surfactant proteins in cerebrospinal fluid from healthy subjects and patients suffering from neuropathologic conditions were quantified using ELISA. Our results revealed that surfactant proteins are present in the central nervous system and that the concentrations of one or more surfactant proteins in healthy subjects differed significantly from those of patients affected by central autoimmune processes, CNS infections or cerebral infarction. Based on the localization of the surfactant proteins in the brain, their different levels in normal versus pathologic samples of cerebrospinal fluid and their well-known functions in the lungs, it appears that the surfactant proteins may play roles in host defense of the brain

  12. The Impact of Trimetazidine Treatment on Left Ventricular Functions and Plasma Brain Natriuretic Peptide Levels in Patients with Non-ST Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

    OpenAIRE

    Demirelli, Selami; KARAKELLEOĞLU, Şule; Gündoğdu, Fuat; TAŞ, Muhammed Hakan; KAYA, Ahmet; Duman, Hakan; Değirmenci, Hüsnü; Hamur, Hikmet; Şimşek, Ziya

    2013-01-01

    Background and Objectives The aim of this study was to investigate the impact of treatment with oral trimetazidine (TMZ) applied before and after percutaneous coronary interventions (PCI) on short-term left ventricular functions and plasma brain natriuretic peptide (BNP) levels in patients with non-ST segment elevation myocardial infarction (NSTEMI) undergoing PCI. Subjects and Methods The study included 45 patients who were undergoing PCI with the diagnosis of NSTEMI. The patients were rando...

  13. Migrainous infarction

    DEFF Research Database (Denmark)

    Laurell, K; Artto, V; Bendtsen, L;

    2011-01-01

    Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included......Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included...

  14. 脑梗死急性期合并抑郁障碍的康复与功能预后%Rehabilitation and functional prognosis of acute brain infarct complicated with depression

    Institute of Scientific and Technical Information of China (English)

    戴慧寒; 张纯

    2001-01-01

    Objective To observe rehabilitation and functional prognosis of patients suffered from brain infarction of acute phase complicated by depression. Method We selected 38 cases of acute brain infarct complicated with depression disorder as depression group, 40 cases of non- depression patient admitted at the same period were selected as non depression group.Antidepressants drugs administration and rehabilitation therapy were performed.We evaluated patients according to functional independence measure(FIM)of Chinese edition. HAMD grading comparison was carried out in depression group. Result Before treatment,two groups score nearly the same,compared with pretreatment. After treatment,patients in depression group and non depression group showed significant improvement esp non- depression group (P<0.01).11 cases with severe depression in the depression showed no changes in FIM score before and after treatment. Conclusion Compared with non- depression patients,functional recovery of patients with depression following brain infarction of acute stage is much slower,especially for patients with severe depression.

  15. Tumour-like thallium-201 accumulation in brain infarcts, an unexpected finding on single-photon emission tomography

    International Nuclear Information System (INIS)

    In the present study our purpose was to investigate whether or not foci of 201Tl accumulation occur in reperfused areas with sustained morphological integrity indicated by computed tomography (CT) scans not showing hypodensity in the acute or sub-acute period. In 16 stroke patients with possible cortical embolic infarction, dual 201Tl and technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) SPET was performed in both the acute and the subacute period. 99mTc-HMPAO SPET was performed to detect reperfusion. Follow-up CT scans from the same period were also available. In five cases 99mTc-HMPAO SPET ruled out reperfusion and 201Tl SPET was also negative. In four cases 99mTc-HMPAO studies indicated reperfusion early in the acute phase (24-72 h), and comparative CT, without showing hypodensity in the acute or subacute period, also favoured the possibility of sustained metabolic activity. In these cases 201Tl SPET was negative in both the acute and the subacute period. In seven cases CT already showed necrosis in 99mTc-HMPAO hypoperfused areas in the acute period, with negative results on corresponding 201Tl SPET. Later reperfusion occurred in the subacute period (8-14 days) as indicated by 99mTc-HMPAO SPET, at which time an unexpected focal accumulation of 201Tl was detected. (orig./MG)

  16. Embolic brain infarction related to posttraumatic occlusion of vertebral artery resulting from cervical spine injury: a case report

    OpenAIRE

    Nakao, Yaoki; Terai, Hiroshi

    2014-01-01

    Introduction The frequency of vertebrobasilar ischemia in patients with cervical spine trauma had been regarded as low in many published papers. However, some case reports have described cervical spine injury associated with blunt vertebral artery injury. Many aspects of the management of vertebral artery injuries still remain controversial, including the screening criteria, the diagnostic modality, and the optimal treatment for various lesions. The case of a patient who had a brain infarctio...

  17. Left ventricular remodeling in the first year after acute myocardial infarction and the predictive value of N-terminal pro brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nilsson, Jens C; Groenning, Bjoern A; Nielsen, Gitte; Fritz-Hansen, Thomas; Trawinski, Jürgen; Hildebrandt, Per R; Jensen, Gorm B; Larsson, Henrik B W; Sondergaard, Lars

    2002-01-01

    BACKGROUND: Left ventricular (LV) remodeling after myocardial infarction (MI) has received much attention because of its severe impact on morbidity and mortality rates. However, the incidence and extent of LV remodeling in a modern infarct population who were offered antiremodeling treatment in c...

  18. Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage

    International Nuclear Information System (INIS)

    We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/μL and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia

  19. Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju; Lee, Young Jun; Lee, Seung Ro; Park, Dong Woo; Kim, Hyun Young [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2009-10-15

    We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/{mu}L and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia.

  20. Development of an assisting detection system for early infarct diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Sim, K. S.; Nia, M. E.; Ee, C. S. [Faculty of Engineering and Technology, Multimedia University, Melaka (Malaysia)

    2015-04-24

    In this paper, a detection assisting system for early infarct detection is developed. This new developed method is used to assist the medical practitioners to diagnose infarct from computed tomography images of brain. Using this assisting system, the infarct could be diagnosed at earlier stages. The non-contrast computed tomography (NCCT) brain images are the data set used for this system. Detection module extracts the pixel data from NCCT brain images, and produces the colourized version of images. The proposed method showed great potential in detecting infarct, and helps medical practitioners to make earlier and better diagnoses.

  1. Development of an assisting detection system for early infarct diagnosis

    International Nuclear Information System (INIS)

    In this paper, a detection assisting system for early infarct detection is developed. This new developed method is used to assist the medical practitioners to diagnose infarct from computed tomography images of brain. Using this assisting system, the infarct could be diagnosed at earlier stages. The non-contrast computed tomography (NCCT) brain images are the data set used for this system. Detection module extracts the pixel data from NCCT brain images, and produces the colourized version of images. The proposed method showed great potential in detecting infarct, and helps medical practitioners to make earlier and better diagnoses

  2. Recirculation usually precedes malignant edema in middle cerebral artery infarcts

    DEFF Research Database (Denmark)

    Nielsen, T H; Ståhl, N; Schalén, W;

    2012-01-01

    In patients with large middle cerebral artery (MCA) infarcts, maximum brain swelling leading to cerebral herniation and death usually occurs 2-5 days after onset of stroke. The study aimed at exploring the pattern of compounds related to cerebral energy metabolism in infarcted brain tissue....

  3. Vertigo as the first symptom of brain stem infarction:Reprot of 23 cases%以眩晕为首发症状的脑干梗死23例报告

    Institute of Scientific and Technical Information of China (English)

    李宁

    2014-01-01

    目的:探讨以眩晕为首发症状的脑干梗死早期确诊对疾病预后的意义。方法:回顾性分析23例以眩晕为首发症状的急性脑干梗死患者的临床表现及影像学资料。结果:脑干梗死以眩晕起病者早期头颅CT未发现梗死灶,头颅MRI+DWI阳性率为100%,给予积极治疗后多数患者预后良好。结论:首发症状表现为眩晕的脑干梗死患者多见于有脑血管病危险因素的老年人,严重时可导致死亡,即使表现为孤立性眩晕而无后期颅神经损害的定位体征,均应尽早完善头颅MRI+DWI检查明确有无急性期脑干梗死。%Objective:To investigate the prognostic significance of early diagnosis of patients with brainstem infarction characterized by vertigo as the first symptom.Methods:The clinical and neuro-imaging data were retrospectively examined in 23 patients with acute brainstem infaction with vertigo as the first symptom.Results:At the early stage of brainstem infarction,all infarction lesions were not detectable by brain CT,but detected with brain MRI in diffusion weighted imaging( DWI) .Timely and active treatment ensured the good recovery for majority of the patients .Conclusion:Brainstem infarctions with vertigo as the first symptom are common in the elderly with cerebral vascular risk factors.Patients with vertigo,even if the vertigo is isolated one with no neurologi-cal damage signs of posterior cranial nerve,should receive MRI+DWI scanning as early as possible to clarify the diagnosis of acute brainstem infarction.

  4. Brain

    Science.gov (United States)

    ... will return after updating. Resources Archived Modules Updates Brain Cerebrum The cerebrum is the part of the ... the outside of the brain and spinal cord. Brain Stem The brain stem is the part of ...

  5. Variations of brain edema and neurological function of rat models of cerebral infarction after hyperbaric oxygen therapy%高压氧干预脑梗死模型大鼠脑水肿及神经功能变化

    Institute of Scientific and Technical Information of China (English)

    田烜

    2015-01-01

    the edema of brain tissue in rats with cerebral infarction.

  6. Multi-Infarct Dementia

    Science.gov (United States)

    ... Diversity Find People About NINDS NINDS Multi-Infarct Dementia Information Page Synonym(s): Dementia - Multi-Infarct Table of ... Additional resources from MedlinePlus What is Multi-Infarct Dementia? Multi-infarct dementia (MID) is a common cause ...

  7. In vivo relaxation of N-acetyl-aspartate, creatine plus phosphocreatine, and choline containing compounds during the course of brain infarction: a proton MRS study

    DEFF Research Database (Denmark)

    Gideon, P; Henriksen, O

    1992-01-01

    course of infarction can be explained by changes in T1 and T2 relaxation times, eight patients with acute stroke were studied. STEAM sequences with varying echo delay times and repetition times were used to measure T1 and T2 of N-acetyl-aspartate (NAA), creatine plus phosphocreatine (Cr+PCr) and choline...

  8. Rhizoma Chuanxiong regulates vascular endothelial growth factor production in hypoxic human umbilical vein endothelial cells in vitro and in peri-infarct rat brain tissue

    Institute of Scientific and Technical Information of China (English)

    Muke Zhou; Mi Yang; Ning Chen; Yucai Wang; Jian Guo; Xue Yang; Zhijian Zhang; Dong Zhou; Li He

    2009-01-01

    BACKGROUND: Vascular endothelial growth factor (VEGF) acts as "molecular bridge" following ischemic stroke to improve and restore blood supply and reduce infarction volume. Clinical studies have demonstrated the efficacy of Rhizoma Chuanxiong (Chuanxiong) in the treatment of ischemic cerebrovascular diseases. However, whether it promotes endogenous VEGF expression in ischemic stroke remains unknown.OBJECTIVE: To investigate the influence of Rhizoma Chuanxiong on VEGF production in vitro cultured human umbilical vein endothelial cells and on VEGF expression in ischemic cerebral tissues to explore its role in angiogenesis.DESIGN, TIME AND SE'B'ING: In vitro basic comparison of traditional Chinese drug-containing serum pharmacology; in vivo randomized, controlled, animal experiment. This study was performed at the Medical Laboratory of West China Hospital, Sichuan University between December 2002 and April 2004.MATERIALS: Two Chinese rabbits were selected. One was intragastrically perfused with 5.8 g/kg Rhizoma Chuanxiong extract twice per day for three consecutive days to prepare Rhizoma Chuanxiong extract-containing serum. The remaining rabbit was intragastdcally perfused with the same volume of normal saline twice per day for three consecutive days. Rhizoma Chuanxiong extract was provided by Beijing Traditional Chinese Medicine Research Institute, predominantly composed of ligustrazine, ligustilide, and ferulic acid. ChemiKineTM human VEGF Kit was purchased from Chemicon, USA; mouse anti-VEGF monoclonal antibody and biotin-goat anti-mouse IgG were purchased from Santa Cruz Biotechnology. Inc., USA.METHODS: (1) In vitro experiment: in vitro cultured human umbilical vein endothelial cells were separately incubated in rabbit serum with 10% Rhizoma Chuanxiong extract, normal medium without rabbit serum, and rabbit serum without Rhizoma Chuanxiong extract (blank control). In addition, cells from the three groups were incubated under normoxia (5% CO2, 95% air) and

  9. Clinical study of cerebral infarction in hemodialysis patients

    International Nuclear Information System (INIS)

    Stroke is one of the leading causes of death in patients undergoing chronic dialysis. However, few clinical studies have so far examined stroke, especially brain infarction, under such conditions. We retrospectively evaluated the clinical features and risk factors for brain infarction in 33 patients undergoing hemodialysis (hemodialysis, 29 patients; continuous ambulatory peritoneal dialysis, 4 patients; male:female ratio, 25:8) between May 2003 and August 2006. The mean age was 68.5±10.9 (mean±standard deviation (SD)) years. The basal renal diseases were chronic glomerulonephritis (n=16), diabetes mellitus (n=10) and other diseases (n=7). The mean duration of maintenance dialysis before the onset of stroke was 5.6±5.2 years. All 33 patients developed brain infarction, including the atherothrombotic (n=13), lacunar (n=9) and cardioembolic (n=11) types. The complications included a high frequency of hypertension (79%) in all groups, diabetes mellitus (36%) and atrial fibrillation (21%). Four of the patients, 2 with lacunar and 2 with atherothrombotic infarction, developed brain infarction within 3 hours after hemodialysis. Hemodynamic changes might have caused the infarction in these patients. The proportion of patients with a modified Rankin Scale grade of 4-6 at discharge was 42%, and the mortality rate was high (15%). The prognosis of brain infarction was poorer in patients with hemodialysis than in those without. (author)

  10. Clinical study on local brain mild hypothermia in the treatment of acute cerebral infarctions%脑局部亚低温治疗急性脑梗塞的临床研究

    Institute of Scientific and Technical Information of China (English)

    胡以慧; 朱双成; 岑跃南

    2013-01-01

    目的 观察脑局部亚低温治疗在脑梗死急性期的疗效,并评估其应用的安全性.方法 40例急性脑梗死患者随机分为A、B两组,A组在常规治疗的基础上给予脑局部亚低温治疗72小时,疗程为14天.两组在治疗开始、结束时分别行临床神经功能缺损(NIHSS)评分和日常生活活动能力量表(BI)评分,同时观察生命体征、内环境各项指标变化及并发症的发生情况.结果 治疗结束时A组NIHSS、BI评分明显优于B组(P<0.05),各项指标及并发症无统计学差异.结论 脑局部亚低温治疗对改善急性期脑梗死患者的神经功能缺损具有积极意义,疗效确切,不良反应较少,可作为目前基层医院的治疗选择.%Objective To evaluate the clinical efficacy of brain mild hypothermia treatment in the patients with acute cerebral infarctions,and evaluate the safety of its application.Methods 40 cases of acute cerebral infarction were randomly divided into group A and B,on the basis of routine treatment,group A was treated with local mild hypothermia treatment in 72 hours,14 days for a course.At the beginning and the end of treatment two groups were all evaluted respectively with clinical neurological function deficit scale (NIHSS) and activities of daily living scale (BI) score,simultaneous observation of vital signs,environmental indicators change and complications were also observed.Results At the end of treatment,NIHSS and the BI score in group A were significantly lower than those in group B (P<0.05),no significant difference of each index and complications was found.Conclusion Local brain mild hypothermia treatment has positive curative effect in improving neurological function in acute cerebral infarction patients,with less adverse reaction,which can be used as the treatment of choice for primary hospitals.

  11. Dynamic CT scan in cerebral infarction

    International Nuclear Information System (INIS)

    62 Dynamic CT studies were performed on 40 patients with cerebral infarction (11 to 75 years of age), and the perfusion patterns of low-density areas on plain CT were evaluated. The examinations were performed 1.5 hours to 60 days after acute onset. The procedures were as follows: 65 % amidotrizomeglumin (1 ml/kg) was injected upon the initiation of the second scanning over 5 seconds through an 18 G needle placed in the antecubital vein. A total of 8 and 10 serial high-speed scans were performed with the SOMATOM 2 and CT/T 8800 apparatuses respectively. The perfusion pattern was evaluated by comparing the two time-density curves obtained from the infarcted area and the same region on the contralateral side. The following results were obtained: 1) The perfusion patterns of the infarcted area may be classified into 5 groups: ''absent,'' ''hypo,'' ''normal,'' ''hyper,'' and ''absent + late'' perfusion patterns. 2) In most cases, a dynamic CT reveals absent perfusion pattern at the acute stage in the infarcted area when no abnormal findings are obtained on plain CT. 3) Repeat dynamic CT revealed that the perfusion pattern varied with the time, and in some cases we could know the development of the hemorrhagic infarction in advance. 4) The perfusion pattern or change in the perfusion pattern did not correlate with the outcome of the patient. For the patients in whom recanalization has already taken place, the main point of treatment is to protect the brain against severe brain edema and hemorrhagic infarction. On the other hand, if recanalization has not yet taken place, revascularization therapy might be worth trying unless 6 hours or more have passed since onset. While it is safe, less invasive, and convenient, dynamic CT is also very useful for the early diagnosis of cerebral infarction, for the determination of the treatment at the acute stage and for the forecasting of hemorrhagic infarction. (J.P.N.)

  12. Clinical analysis of children massive cerebral infarction after traumatic brain injury%儿童脑外伤后大面积脑梗死的临床分析

    Institute of Scientific and Technical Information of China (English)

    许尚虞; 林中啸; 蔡铭; 盛汉松; 林坚; 张弩

    2016-01-01

    目的 总结分析儿童脑外伤后大面积脑梗死的临床特点.方法 回顾性研究33例儿童脑外伤后大面积脑梗死患儿的临床资料.结果 致伤原因:坠落伤21例,交通车祸伤10例,打击伤1例,重物砸伤1例.大面积脑梗死在伤后l d内出现9例,伤后1~3 d出现14例,伤后4~7 d出现7例,伤后>7 d出现3例.手术治疗18例,主要行颅内血肿清除术、去骨瓣减压术等.患儿在无出血倾向后均接受抗血小板聚集、预防脑血管痉挛及扩容等对症支持治疗.随访6~24个月,根据格拉斯哥预后评分判定预后:恢复良好18例,轻度残疾6例,重残1例,植物生存1例,死亡7例.结论 儿童脑外伤后大面积脑梗死患儿以坠落伤和交通车祸伤为主,经过积极治疗后,等病情稳定后再行积极的康复综合治疗,存活患儿仍可获得相对满意的预后.%Objective To analyze the clinical characteristics of children massive cerebral infarction after traumatic brain injury. Methods The clinical data of 33 children with massive cerebral infarction after traumatic brain injury were retrospectively analyzed. Results Among the 33 children, 24 cases suffered from falling, 10 cases were involved in traffic accidents, 1 case suffered from violence and 1 case was hit by falling object. The massive cerebral infarction occurred in all objects: 9 cases in 1 day after head trauma, 14 cases in 1 - 3 days, 7 cases in 4 - 7 days, and 3 cases after 7 days. Eighteen patients were performed operation to evacuate the intracranial hematoma and decompression. Antiplatelet agents, calcium antagonist and low molecular dextran were administered in all patients after exclusion of bleeding tendency. The follow-up period of all children ranged from 6 months to 24 months. According to Glasgow outcome score (GOS):18 cases showed a good outcome, 6 cases were moderately disabled, 1 case was severely disabled, 1 case survived in a permanent vegetative state and 7 cases died. Conclusions

  13. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth;

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand and...

  14. SPECT analysis of recent cerebral infarction

    DEFF Research Database (Denmark)

    Raynaud, C; Rancurel, G; Tzourio, N; Soucy, J P; Baron, J C; Pappata, S; Cambon, H; Mazoyer, B; Lassen, N A; Cabanis, E

    1989-01-01

    We measured regional cerebral blood flow and [123I]iodoamphetamine (IMP) uptake in 16 patients with unilateral brain infarcts during the subacute period (Day 3 to Day 50) and again after 3 months. Our results show that the central and peripheral areas described earlier in the chronic period were ...

  15. Acute myocardial infarct imaging

    International Nuclear Information System (INIS)

    A brief review is presented of radiopharmaceuticals used for imaging acute myocardial infarction and instrumentation using the rectilinear scanner and the scintillation camera. Clinical experience indicates that myocardial imaging with /sup 99 m/Tc pyrophosphate is a useful adjunct to the electrocardiogram and serum enzyme activity in managing patients with myocardial infarction. The technique allows rapid diagnosis, accurate localization, and an estimate of the size of acute infarcts. It can also be used to document infarct extension and in association with myocardial perfusion imaging can help differentiate fresh from old myocardial infarction

  16. Correlative factors of cognitive impairment in patients with lacunar infarcts

    Institute of Scientific and Technical Information of China (English)

    Zhang Qiujuan; Yao Xiaoxin; Guo Youmin; Zhang Gejuan; Yang Junle

    2007-01-01

    Objective To study the relationships between cognitive impairment in patients with lacunar infarcts and quantitative CT measures and to determine the independent correlative factors of cognitive impairment. Methods Neuropsychological examination was conducted for 128 patients with acute lacunar infarct. Number, location, and volume of infarcts, cerebral atrophy index and severity of white matter lesions (WMLs) were measured and recorded. Results The number of lacunar infarcts in cognitive impairment (CI) group was significantly larger than that in cognitive normal (CN) group. Mean width of sulcus and sylvian fissure, index of frontal horn and ventricular-brain ratio (VBR) were significantly different in both groups. There were more patients with 3 grades or 4 grades WMLs in CI group (62%) than those in CN group (22%). The total volume of lacunar infarcts showed no statistically significant difference. Logistic regression analysis indicated that the number of lacunar infarcts in frontal subcortex and thalamus, the volume of infarcts in anterior periventricular white matter, width of cerebral sulcus and sylvian fissure were correlated with cognitive impairment respectively. Additionally, age and education were correlative factors of cognitive impairment in patients with lacunar infarct. Conclusion Correlative factors of cognitive impairment in patients with lacunar infarct are not merely one feature, but a combination of infarct features (number, location, and volume), cortical atrophy and host factors (age and education).

  17. Xenon contrast CT-CBF scanning of the brain differentiates normal age-related changes from multi-infarct dementia and senile dementia of Alzheimer type

    International Nuclear Information System (INIS)

    Local cerebral blood flow (LCBF) and partition coefficients (L lambda) were measured during inhalation of stable xenon gas with serial CT scanning among normal volunteers (N . 15), individuals with multi-infarct dementia (MID, N . 10), and persons with senile dementia of Alzheimer type (SDAT, N . 8). Mean gray matter flow values were reduced in both MID and SDAT. Age-related declines in LCBF values in normals were marked in frontal cortex and basal ganglia. LCBF values were decreased beyond normals in frontal and temporal cortices and thalamus in MID and SDAT, in basal ganglia only in MID. Unlike SDAT and age-matched normals, L lambda values were reduced in fronto-temporal cortex and thalamus in MID. Multifocal nature of lesions in MID was apparent. Coefficients of variation for LCBFs were greater in MID compared with SDAT and/or age-matched normals

  18. Dynamic CT scan in cerebral infarction

    International Nuclear Information System (INIS)

    Forty-two dynamic CT studies were performed on 27 patients with cerebral infarction (11 to 75 years of age), and perfusion patterns of low density areas on plain CT were evaluated. The initial studies were performed 1.5 hours to 60 days after acute onset. The following results were obtained. 1) The perfusion pattern in the low density area on plain CT varies among patients at any periods after onset, ranging from absent perfusion pattern to hyperfusion pattern. No consisitent perfusion pattern was obtained at any given time after onset. 2) Repeat dynamic CT revealed that the perfusion pattern in the low density area changed with time variously. 3) The perfusion pattern or change of perfusion pattern did not correlate with outcome of the patient. 4) At an acute stage, when no abnormal findings were obtained on plain CT, dynamic CT revealed abnormal perfusion pattern, enabling early diagnosis of cerebral infarction and estimation of blood perfusion in the infarcted area. In determining the treatment for the cerebral infarction at an acute stage, it is important to know the condition of the blood perfusion in the infarcted area. For the patients in whom recanalization has already taken place, mannitol or steroid might be effective, providing protection against severe brain edema and hemorrhagic infarction. On the other hand, if recanalization has not taken place, revascularization therapy might be worth trying within 6 hours since the onset. It has been said that ischemic brain damage may not be reversed by the revascularization after 6 hours. Dynamic CT is safe, less invasive, convenient and very useful for early diagnosis of the cerebral infarction and determination of the treatment at the acute stage. (J.P.N.)

  19. Predictors of Pulmonary Infarction.

    Science.gov (United States)

    Miniati, Massimo; Bottai, Matteo; Ciccotosto, Cesario; Roberto, Luca; Monti, Simonetta

    2015-10-01

    In the setting of acute pulmonary embolism (PE), pulmonary infarction is deemed to occur primarily in individuals with compromised cardiac function.The current study was undertaken to establish the prevalence of pulmonary infarction in patients with acute PE, and the relationship between infarction and: age, body height, body mass index (BMI), smoking habits, clot burden, and comorbidities.The authors studied prospectively 335 patients with acute PE diagnosed by computed tomographic angiography (CT) in 18 hospitals throughout central Italy. The diagnosis of pulmonary infarction on CT was based on Hampton and Castleman's criteria (cushion-like or hemispherical consolidation lying along the visceral pleura). Multivariable logistic regression was used to model the relationship between covariates and the probability of pulmonary infarction.The prevalence of pulmonary infarction was 31%. Patients with infarction were significantly younger and with significantly lower prevalence of cardiovascular disease than those without (P < 0.001). The frequency of infarction increased linearly with increasing height, and decreased with increasing BMI. In logistic regression, the covariates significantly associated with the probability of infarction were age, body height, BMI, and current smoking. The risk of infarction grew with age, peaked at approximately age 40, and decreased afterwards. Increasing body height and current smoking were significant amplifiers of the risk of infarction, whereas increasing BMI appeared to confer some protection.Our data indicate that pulmonary infarction occurs in nearly one-third of the patients with acute PE. Those with infarction are often young and otherwise healthy. Increasing body height and active smoking are predisposing risk factors. PMID:26469892

  20. Thalamic infarcts and hemorrhages.

    Science.gov (United States)

    Amici, Serena

    2012-01-01

    The anatomy and supply of thalamic arteries are briefly described here. Thalamic infarcts and small-size hemorrhages are classified according to their sites: (1) posterolateral, (2) anterolateral, (3) medial, and (4) dorsal. (1) Posterolateral hemorrhages or lateral thalamic infarcts are usually characterized by severe motor impairment and sensory loss. Transient reduced consciousness, vertical-gaze abnormalities, and small fixed pupils may be evidenced. (2) Patients with anterolateral hemorrhages or tuberothalamic artery infarcts present frontal-type neuropsychological symptoms associated with mild hemiparesis and hemihypesthesia. (3) Medially located hemorrhages or paramedian artery infarcts have decreased levels of consciousness, vertical- and horizontal-gaze abnormalities, amnesia, and abulia. (4) Dorsal hemorrhages or posterior choroidal artery infarcts present with minimal transient hemiparesis and hemihypesthesia; apraxia, aphasia, and amnesia have also been described. PMID:22377880

  1. Cerebral infarctions due to CNS infection with Enterobacter sakazakii

    International Nuclear Information System (INIS)

    Recent reports have implicated Enterobacter sakazakii, a gram-negative enteric bacillus, in neonatal sepsis and meningitis. Cases of severe central nervous system involvement, including ventriculitis, brain abscess, infarction, and cyst formation, have been described. We present serial head CT findings in a case of neonatal E. sakazakii meningitis complicated by a ring enhancing cerebral infarction which mimicked abscess formation. In meningitis secondary to this agent, a recognized pattern of cerebral hypodensity with or without cystic degeneration late in the course of the infection is likely to represent cerebral infarction rather than an abscess especially if there is a lack of culture evidence of a bacterial infection. (orig.)

  2. Bilateral anterior choroidal artery infarction presenting with progressive somnolence.

    Science.gov (United States)

    van Son, Brechtje; Vandevenne, Jan; Viaene, Pieter

    2014-09-01

    A 55-year-old woman was admitted with a 3 days history of increasing lethargy with bradyphrenia and apathy. She progressively developed severe somnolence with marked abulia, right hemiparesis, right hemianopsia, and pseudobulbar palsy. Brain magnetic resonance imaging showed the rare image of bilateral acute anterior choroidal artery infarction. Pseudobulbar mutism and in rare cases abulia have been described in acute anterior choroidal artery infarction contralateral to an older lesion in mirror position. Although neurologic deterioration is not infrequent in anterior choroidal artery territory infarcts, the absence of focal neurologic signs on admission is rare and did not raise suspicion of acute stroke. PMID:25106836

  3. Omental Infarction Mimicking Cholecystitis

    Directory of Open Access Journals (Sweden)

    David Smolilo

    2015-01-01

    Full Text Available Omental infarction can be difficult to diagnose preoperatively as imaging may be inconclusive and patients often present in a way that suggests a more common surgical pathology such as appendicitis. Here, a 40-year-old Caucasian man presented to casualty with shortness of breath and progressive right upper abdominal pain, accompanied with right shoulder and neck pain. Exploratory laparoscopy was eventually utilised to diagnose an atypical form of omental infarction that mimics cholecystitis. The vascular supply along the long axis of the segment was occluded initiating necrosis. In this case, the necrotic segment was adherent with the abdominal wall, a pathology not commonly reported in cases of omental infarction.

  4. Cerebral infarction secondary to temporal lobe herniation in head trauma: a CT study

    International Nuclear Information System (INIS)

    Cerebral infarction is a known complication of temporal lobe herniation caused by a traumatic intracranial lesion. To ascertain the frequency, time of recognition, and influence on mortality of posttraumatic cerebral infarction secondary to temporal lobe herniation, we retrospectively reviewed brain CT scans and clinical records of 55 patients who had CT and clinical signs of temporal lobe herniation on admission date. Cerebral infarctions were recognized in seven (12.7%) patients on CT scans taken within two days after admission (mean: 1.3 days). Cerebral infarctions were in the terrtiories of the posterior cerebral artery in all seven patients, two of whom had infarctions of the anterior choroidal artery as well. Mortality (71.4%) for these seven patients was not statistically significant from that (50%) of patients without cerebral infarction admitted with the same range of Glasgow Coma Scale score. The result suggests that such cerebral infarction dose not greatly influence patient's mortality

  5. Time course of the apparent diffusion coefficient after cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Ahlhelm, F.; Backens, M.; Reith, W.; Hagen, T. [Department of Neuroradiology, University of Saarland, 66424 Homburg/Saar (Germany); Schneider, G. [Department of Radiology, University of Saarland, 66424 Homburg/Saar (Germany)

    2002-09-01

    The purpose of this study was to evaluate quantitative apparent diffusion changes in the center of infarction by measurement of the apparent diffusion coefficient (ADC), and to investigate the influence of ischemia on the contralateral hemisphere. By diffusion echo-planar imaging (EPI) 52 patients showing cerebral infarction were studied within 5 h to >12 months after onset of clinical symptoms. Using three diffusion gradient strengths (b1=30 s/mm{sup 2}; b2=300 s/mm{sup 2}, b3=1100 s/mm{sup 2}) ADC maps were generated. After onset of ischemia, ADC in the center of infarction was lower than in the contralateral regions of human brain. At first ADC declined for approximately 28 h to a minimum of approximately 150 x 10{sup -8} cm{sup 2}/s. Then the ADC reincreased and reached a ''pseudonormalization'' after approximately 5 days. Chronic infarctions did show much higher ADC values (2000 x 10{sup -8} cm{sup 2}/s) than unaffected areas. Neither localization nor size of infarctions showed a significant influence on this time course. In the center of infarction diffusion is isotropic. Even brain regions of the contralateral hemisphere are influenced by cerebral ischemia. In these regions ADC is higher than for physiological conditions. The ADC also declines especially for the first 2-3 days after onset of symptoms, also followed by reincrease. The ADC calculation enables determination of the onset of infarction more exactly than is possible using only diffusion-weighted imaging. Diffusion in the center of infarction is isotropic; hence, orientation of the diffusion gradients has no significant influence on sensitivity of measurements. The calculation of the ADC ratio based on data derived from the center of infarction and the contralateral hemisphere seems to be critical because the ADC in the unaffected contralateral hemisphere also changes. (orig.)

  6. Time course of the apparent diffusion coefficient after cerebral infarction

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate quantitative apparent diffusion changes in the center of infarction by measurement of the apparent diffusion coefficient (ADC), and to investigate the influence of ischemia on the contralateral hemisphere. By diffusion echo-planar imaging (EPI) 52 patients showing cerebral infarction were studied within 5 h to >12 months after onset of clinical symptoms. Using three diffusion gradient strengths (b1=30 s/mm2; b2=300 s/mm2, b3=1100 s/mm2) ADC maps were generated. After onset of ischemia, ADC in the center of infarction was lower than in the contralateral regions of human brain. At first ADC declined for approximately 28 h to a minimum of approximately 150 x 10-8 cm2/s. Then the ADC reincreased and reached a ''pseudonormalization'' after approximately 5 days. Chronic infarctions did show much higher ADC values (2000 x 10-8 cm2/s) than unaffected areas. Neither localization nor size of infarctions showed a significant influence on this time course. In the center of infarction diffusion is isotropic. Even brain regions of the contralateral hemisphere are influenced by cerebral ischemia. In these regions ADC is higher than for physiological conditions. The ADC also declines especially for the first 2-3 days after onset of symptoms, also followed by reincrease. The ADC calculation enables determination of the onset of infarction more exactly than is possible using only diffusion-weighted imaging. Diffusion in the center of infarction is isotropic; hence, orientation of the diffusion gradients has no significant influence on sensitivity of measurements. The calculation of the ADC ratio based on data derived from the center of infarction and the contralateral hemisphere seems to be critical because the ADC in the unaffected contralateral hemisphere also changes. (orig.)

  7. Hyperfixation of Tc-99m ECD in subacute cortical infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Kweon, Sun Uck; Ryu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2001-07-01

    It has been known that hyperfixation of Tc-99m ECD (HF) is not shown in subacute cerebral infarction because the brain distribution of Tc-99m ECD reflects not only perfusion but also the metabolic status of brain tissue. However, we observed several cases with HF in the subacute pure cortical infarction. To find out the cause of HF in subacute cortical infarction. We assessed the difference in associated cerebral hemodynamics and clinical findings between the subacute cortical infarctions with and without HF. We reviewed 16 patients (63.8{+-}8.6 yr, M/F: 15/1) with pure cortical infarction not involving adjacent subcortical white matter on MRI. All patients underwent acetazolamide stress brain perfusion SPECT using Tc-99m ECD and MRI at subacute period (7.3{+-}4.4 days from ictus). Uptake of Tc-99m ECD in infarcted cortex was assessed visually comparing the contralateral side. To assess the difference in associate clinical findings between the infarctions with and without HF, rCVR of the cerebral territory including infarcted cortex, extent of Gd-enhancement on MRI. Intervals between SPECT and ictus, and the presence of associated ICA stenosis were evaluated. Infarctions were focal (n=8) or multifocal (n=8) and located in frontoparietal cortices on MRI. Twelve patients were accompanied with ipsilateral ICA stenosis. Resting SPECT showed increased cortical uptake (=HF) in 7 patients and decreased in 9. rCVR of the MCA territory was preserved in all of the 7 patients with HF, compared with 4 of the 9 patients without HF (p=0.03). Gd-enhancement was minimal in all of the 7 patients with HF, compared with of the 0 patients without HF (p=0.03). Presence of ipsilateral ICA stenosis and intervals from ictus were not different (p>0.1) Subacute cerebral cortical infarction with HF was more frequently associated with preserved rCVR and minimal destruction of the blood-brain barrier than that without HF. Our findings suggest that HF may result from luxury perfusion of

  8. Brain atrophy during aging

    International Nuclear Information System (INIS)

    Age-related brain atrophy was investigated in thousands of persons with no neurologic disturbances using X-CT and NMR-CT. Brain atrophy was minimal in 34-35 years old in both sexes, increased exponentially to the increasing age after 34-35 years, and probably resulted in dementia, such as vascular or multi-infarct dementia. Brain atrophy was significantly greater in men than in women at all ages. Brain volumes were maximal in 34-35 years old in both sexes with minimal individual differences which increased proportionally to the increasing age. Remarkable individual differences in the extent of brain atrophy (20 - 30 %) existed among aged subjects. Progression of brain atrophy was closely related to loss of mental activities independently of their ages. Our longitudinal study has revealed that the most important factors promoting brain atrophy during aging was the decrease in the cerebral blood flow. We have classified brain atrophy into sulcal and cisternal enlargement type (type I), ventricular enlargement type (type II) and mixed type (type III) according to the clinical study using NMR-CT. Brain atrophy of type I progresses significantly in almost all of the geriatric disorders. This type of brain atrophy progresses significantly in heavy smokers and drinkers. Therefore this type of brain atrophy might be caused by the decline in the blood flow in anterior and middle cerebral arteries. Brain atrophy of type II was caused by the disturbance of cerebrospinal fluid circulation after cerebral bleeding and subarachnoid bleeding. Brain atrophy of type III was seen in vascular dementia or multi-infarct dementia which was caused by loss of brain matter after multiple infarction, and was seen also in dementia of Alzheimer type in which degeneration of nerve cells results in brain atrophy. NMR-CT can easily detect small infarction (lacunae) and edematous lesions resulting from ischemia and hypertensive encephalopathy. (J.P.N.)

  9. Pure dysarthria due to cerebral infarction

    International Nuclear Information System (INIS)

    No large case series of pure dysarthria due to stroke has been reported. We investigated the anatomical lesions in patients with pure dysarthria by examining findings on brain magnetic resonance imaging (MRI), including diffusion-weighted imaging. We reviewed the admission records of 835 consecutive patients who presented for treatment between April 2003 and March 2008. We selected the patients with pure dysarthria and investigated findings from magnetic resonance imaging (MRI), 3-dimensional magnetic resonance angiography (3-D MRA), single photon emission computed tomography (SPECT), and carotid artery echography, as well as the prothrombin time-international ratio (PT-INR) and D-dimer measurement. A total of 20 patients had pure dysarthria (17 men, 3 women; frequency, 2.4%). Facial nerve paresis was noted in 8 patients and poor tongue movement in 7. Seven patients had more than 2 cerebrovascular risk factors for stroke. Twelve patients initially visited other departments; 6 initially presented to the otorhinolaryngology department. Brain MRI revealed that in 15 patients, left-side lesions had caused the pure dysarthria. The corresponding lesions were located in the internal capsule in 8 patients, in the cerebral cortex in 4, in the corona radiata in 4, in the putamen in 2, in the cerebral peduncle in 1, and in the pons in 1. Three-dimensional MRA showed marked stenosis of the middle cerebral artery in 1 patient. Sixteen patients had lacunar infarction, and cerebral emboli were implicated in the pathogenesis of infarction in 4 patients. Brain SPECT data showed significant hypoperfusion in the central and pre-central regions on the side of the infarct. Carotid artery echograms and MR imaging of lesions were not correlated. PT-INR and D-dimer were not associated with the clinical type of cerebral infarction. Although pure dysarthria is likely a rare condition, it should be considered in patients with cerebral infarction. Brain MRI revealed that the topographically

  10. Prognostic significance of MR angiography in patients with cerebral infarction

    International Nuclear Information System (INIS)

    This study was designed to evaluate the prognostic significance of Magnetic resonance angiography(MRA) in patients with cerebral infarction. Magnetic Resonance Imaging(MRI) and 2 dimensional or 3 dimensional Time-of-Flight MRA were performed subsequently in 83 patients with cerebral infarction proven by brain CT and clinical manifestations, using GE Signa Advantage 1.5 T. We classified the size of infarction on MRI as Extent I( 6 cm) and classified the intracranial vascular occlusion according to visualizations of intracranial vascular branches on MRA as Grade 0, Grade I, Grade II, Grade III. And we evaluated clinical outcomes of these patients according to Rankin's disability scale, compared with MRI and MRA. In 72 cases(86.8%), the larger the size of infarction on MRI, the more severe vascular occlusion on MRA, the worse the clinical outcomes were noted(p < 0.01). However, in 7 cases(8.4%) who showed huge cerebral infarction on MRI with low grade intracranial vascular occlusion on MRA, the clinical outcomes were improved. In 4 cases(4.8%) who noted small sized cerebral infarction on MRI with high grade vascular occlusion on MRA, the clinical outcomes were worsened. MRA provides additional useful information to that provided by MRI in predicting the prognosis of patients with cerebral infarction

  11. Heroin Abuse and Myocardial Infarction

    OpenAIRE

    Tatli, Ersan; Aktoz, Meryem

    2010-01-01

    Information concerning acute myocardial infarction after heroin usage is limited and the actual mechanism of heroin-induced myocardial infarction is not well known. Only one report has been described noting the association between usage heroin and acute myocardial infarction in a young man with normal coronary arteries. We also reported a patient with normal coronary arteries and acute myocardial infarction after heroin abuse. Eroin kullanımı sonrası akut miyokard inf...

  12. Clinical features of predominantly sensory stroke due to brainstem infarction

    International Nuclear Information System (INIS)

    We report 13 patients presenting with predominantly sensory strokes due to brainstem infarction, without any other brainstem symptoms such as hemiparesis, dysarthria or vertigo. All of them had lacunar infarctions localized at the medial lemniscus and/or spinothalamic tract, at the pontine (12 patients) or midbrain (1 patient) tegmentum. The presenting symptom was dysesthesia with a variety of distributions for all cases, and a thalamic-pain-like unpleasant dysesthesia persisted in 4 patients. The lesion on brain MRI was usually very small, and was sometimes overlooked by radiological evaluation, which led to a long delay in the correct diagnosis of a stroke in two cases. Median nerve somatosensory evoked potentials showed a depressed N20 amplitude or a loss of the P15 potential unilaterally with preserved P13/14 potential in 7 out of 10 cases examined, and was useful in localizing the lesion intracranially. During the 4-year study period, 10 patients with brainstem infarctions were admitted to our department as acute sensory stroke cases (2.1% of all acute strokes), whereas 11 patients with thalamic infarctions (2.3%) were admitted due to similar symptoms. Cases with brainstem infarctions had sensory symptoms localized below the neck more frequently (5/10) than cases with thalamic infarctions (1/11), thus would be more likely to be confused with cervical or peripheral nerve disorders. The relative frequency of brainstem infarction as compared to thalamic infarction was higher than that in previous reports, implying that some cases with brainstem infarction might have been overlooked due to difficulty in obtaining the correct diagnosis. One should always keep this syndrome in mind when assessing patients with acute-onset sensory symptoms. (author)

  13. Digital subtraction angiography in cerebral infarction

    International Nuclear Information System (INIS)

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered

  14. Healing process of infarcted myocardium

    International Nuclear Information System (INIS)

    Healing process of infarcts and morphology of left ventricular aneurysms were examined with ECG-gated magnetic resonance imaging (MRI) in 41 patients with myocardial infarction. According to the time of MRI, the patients fell into Group I - within one month after the onset of myocardial infarction, Group II - between 2 and 3 months, Group III - between 4 and 12 months, and Group IV - more than one year. In Groups I and II, T2 relaxation time for infarcts was significantly prolonged when compared with non-infarcts. It gradually decreased in the following order: Groups I>II>III>IV. Groups IV had the lowest ratio of infarcts to non-infarcts (I/N ratio), followed by Groups II and III, and then Group I. MR imaging had a sensitivity of 70% in morphologically evaluating left ventricular aneurysms. Left ventricular aneurysms tended to be detected when the I/N ratio was 0.6 or less. Acute infarcts had increased signal intensities and a prolonged T2 relaxation time, probably resulting from protons increased by edemas. These appearances returned to normal 2 to 3 months after the onset; and simultaneously, the infarcted wall was becoming thin. These MRI findings seem representative of healing process of infarcts. In cases of associated left ventricular aneurysms, the infarcted wall was remarkably thinned, which was likely affected by an excessive expansion due to an increased tension of the infarcted wall. (Namekawa, K)

  15. Early detection of cerebral infarction by 31P spectroscopic imaging

    International Nuclear Information System (INIS)

    Recent advances in magnetic resonance spectroscopy permit noninvasive study of brain metabolism in vivo, 31P spectroscopic imaging being the method for evaluation of localized phosphorous metabolism. Experimentally, an ischemic-hypoxic brain insult is characterized by depletion of high energy metabolites. These changes are seen immediately after an ischemic insult. We had the opportunity of carrying out 31P spectroscopic imaging of hyperacute cerebral infarction, while MRI and CT were negative. Cerebral infarction of the middle cerebral artery territory was suggested by 31P spectroscopic imaging, which was closely consistent with a later-developing region of low density on CT. In cerebral infarction, early detection of the lesion is a useful pointer to the patient's prognosis, making 31P spectroscopic imaging a potential tool. (orig.)

  16. Electrocardiogram changes in acute cerebral infarction patients

    Institute of Scientific and Technical Information of China (English)

    Jing Fang; Weihong Yan

    2006-01-01

    BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history.OBJECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people.DESIGN: Contrast observation.SETrING: Shanghai Ninth People's Hospital.PARTICIPANTS: A total of 57 patients with cerebral infarction were selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm3, medium-sizegroup (n = 13) with size between 1.5-3.5 cm3, and small-size group (n = 34) with size smaller than 1.5 cm3.Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40-82 years. All these cases knew and agreed of the examination.METHODS: Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups.MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction lccations and sizes. RESULTS: All 57 patients and 50 healthy subjects were involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with

  17. Perfusion MRI in cerebral infarction

    International Nuclear Information System (INIS)

    Purpose: To investigate the hemodynamic changes in patients with acute cerebral stroke by perfusion MRI. Materials and methods: In 12 patients with acute stroke in the territory of the middle cerebral artery, perfusion MRI was performed. Peak time, mean transit time, regional cerebral blood volume and regional cerebral blood flow were calculated in the infarction, the peri-infarction area and the contralateral hemisphere. Results: In the infarction the mean blood flow was 29 ml/100 g/min, compared to about 40 ml/100 g/min in the peri-infarction area and the contralateral hemisphere. In two patients increased cortical blood flow was found in the infarction due to luxury perfusion. The cerebral blood volume was reduced in the infarction, but significantly increased, to 7.3 ml/100 g, in the peri-infarction tissue. Conclusion: Perfusion MRI allows one to differentiate various patterns of perfusion disorders in patients with acute cerebral stroke. (orig./AJ)

  18. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Tohru; Sasamori, Yumiko; Takahashi, Hachisaburou; Mikami, Juniti; Ishii, Yuuko; Okada, Kinya; Shirafuji, Naoko; Kashiwakura, Takeshi [Takahashi Neurosurgical Hospital, Sapporo (Japan)

    2000-09-01

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  19. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    International Nuclear Information System (INIS)

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  20. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem [Baskent University Faculty of Medicine, Department of Radiology, Konya (Turkey)

    2015-05-01

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

  1. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

    International Nuclear Information System (INIS)

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

  2. 3.0T MRI磁敏感加权成像在老年人急性脑梗死伴出血的诊断价值%The application of 3.0T MRI susceptibility weighted imaging in evaluation of acute brain infarction with hemorrhage in elderly patients

    Institute of Scientific and Technical Information of China (English)

    朱震方; 嵇鸣; 林光武; 叶春涛; 臧雪如; 刘伟

    2013-01-01

    目的 探讨3.0T MRI磁敏感加权成像在老年人急性脑梗死伴出血的诊断价值.方法 对128例疑似急性脑梗死的老年患者全部进行常规MRI扫描、弥散加权(DWI)扫描及磁敏感加权(SWI)扫描.结合常规MRI、DWI、SWI检查图像,判断SWI在老年人急性脑梗死伴微出血的观测价值.结果 本组128例临床疑似急性脑梗死的患者中,SWI发现急性脑梗死46例,其中伴出血19例;DWI发现急性脑梗死73例,其中伴出血的13例;常规MRI发现急性脑梗死67例,其中伴出血的12例.按大脑半球、小脑半球、脑干发病部位分类,SWI检出急性脑梗死伴微出血分别为14例、2例、3例;DWI检出急性脑梗死伴微出血分别为11例、1例、1例;常规MRI检出急性脑梗死伴微出血分别为9例、1例、2例.结论 诊断急性脑梗死伴出血,SWI明显优于DWI及常规MRI,对脑干和小脑半球的急性脑梗死伴出血灶,由于接近颅底,SWI序列伪影干扰较大,病变显示效果欠佳.%Objective To investigate the value of 3.0T MRI susceptibility weighted imaging (SWI) in the diagnosis of acute brain infarction with hemorrhage in elderly patients.Methods Patients with suspected acute brain infarction received MRI examination using routine sequences,diffusion-weighted imaging (DWI) and SWI sequences for imaging evaluation of infarction as well as detection of possible micro-hemorrhage.Results Among 128 suspected cases,acute infarction was diagnosed in 67,73 and 46 patients based on routine MRI imaging,DWI and SWI,respectively.Further analysis revealed 12,13 and 19 hemorrhagic lesions in routine MRI imaging,DWI and SWI,respectively.With regard to intracranial distribution,cererbral region predominated.Conclusions For assessment of acute brain infarction with hemorrhage,SWI is more sensitive than DWI and routine MRI.However,the value of SWI is limited in evaluating lesions located in cerebellum and brain stem due to imaging artifacts from skull base.

  3. Difference in MRI findings and risk factors between multiple infarction without dementia and multi-infarct dementia

    International Nuclear Information System (INIS)

    MRI findings and risk factors for vascular dementia were evaluated with multi-variate analysis in 96 multi-infarct patients without dementia and 40 multi-infarct patients with dementia (MID). Only subjects with small infarcts in the territory of the perforator artery or deep white matter were studied. The diagnosis of MID was diagnosed according to DMS-III criteria and Hachinski's ischemia score. Location and area of patchy high-intensity areas including small infarcts, the degree of periventricular high intensity (PVH), and the degree of brain atrophy were examined with MR images. Independent variables were: history of hypertension, diabetes mellitus, other complications; systolic and diastolic blood pressure, atherosclerotic index, hematocrit, history of smoking, level of education, and activities of daily life (ADL). Hayashi's quantification method II was used to analyze the data. The most significant correlation was found between history of hypertension and dementia (partial correlation coefficient: 0.39). Significant correlations were also found between ADL and dementia (0.32), between thalamic infarction and dementia (0.31), and between PVH and dementia (0.27). Age, brain atrophy index, and history of diabetes mellitus contributed little to dementia. The contribution to dementia did not differ significantly between right and left patchy high-intensity areas on MR images. Location of infarcts, except for bilateral thalamic infarcts and large PVH, contributed little to dementia. Thus it would be difficult to base a prediction of the prevalence of vascular dementia on MRI findings. However, both hypertention and ADL contribute to vascular dementia and both are treatable, which may be significant for the prevention of dementia. (author)

  4. Bilateral caudate infarct--a case report.

    Science.gov (United States)

    Lim, J K; Yap, K B

    1999-07-01

    Caudate strokes comprise only a small proportion of all subtypes of strokes. Bilateral caudate infarcts are even rarer and only a few cases have been reported in the literature. We report an 86-year-old woman with bilateral caudate infarcts. She had no past medical history of note. She presented with headache for several days and drowsiness on day of admission. Clinical examination revealed abulia, inability to comprehend or verbalize (acute mutism), right-sided neglect and right-sided hemiparesis. Computed tomographic (CT) scan brain revealed decreased attenuation in both heads of both caudate nuclei with extension across the anterior limb of both internal capsules to involve the lentiform nuclei. Echocardiography showed aortic valve sclerosis, mild mitral and aortic regurgitation and normal left ventricular function. Carotid ultrasound revealed mild stenosis of proximal right internal carotid and left distal common carotid and adjacent proximal internal carotid arteries. She showed initial improvement in the first week, but subsequently had a progressive downward course despite rehabilitation and died 44 days after her stroke. A patient with bilateral caudate infarcts is likely to have poor prognosis for rehabilitation and survival. PMID:10561773

  5. Secondary SUNCT syndrome caused by dorsolateral medullary infarction.

    Science.gov (United States)

    Jin, Di; Lian, Ya-Jun; Zhang, Hai-Feng

    2016-12-01

    Short-lasting unilateral neuralgiform headaches with conjunctival injection and tearing (SUNCT) is a rare headache syndrome which belongs to trigeminal autonomic cephalalgias. Though the majority of SUNCT syndrome is idiopathic, more and more cases of secondary SUNCT syndrome have been reported recently. In this study, we present a case of symptomatic SUNCT syndrome caused by acute dorsolateral medullary infarction which was verified by brain MRI(magnetic resonance imaging). Up to now, there is not absolutely effective treatment for SUNCT syndrome. However, in our case, SUNCT was completely resolved after conventional treatment for cerebral infarction without specific drug intervention. PMID:26885826

  6. P-31 MR spectroscopy of cerebral infarction in rats

    International Nuclear Information System (INIS)

    Sequential P-31 magnetic resonance (MR) spectroscopy was performed in an experimental rat model of cerebral infarction from the acute to the chronic stage. In the acute stage, acidosis, an increase in inorganic phosphate, and depletion of high-energy phosphates were observed. This acute pattern gradually evolved into a chronic pattern that was similar to that of normal brain, with certain quantitative differences, namely, an increase in the relative levels of phosphomonoester and phosphodiester. Histopathologic studies of the chronic lesions revealed gliosis. The MR spectroscopic findings in the chronic stage are similar to those found in clinical cerebral infarction and appear to reflect the bioenergetics of gliosis

  7. Acute myocardial infarction.

    Science.gov (United States)

    Rischpler, Christoph

    2016-09-01

    Inflammatory processes after myocardial infarction have gained major interest in recent cardiovascular research. It is believed that not only the degree of cell recruitment to the heart plays a pivotal role in the quality of wound healing after myocardial infarction, but also the balance between different types or even subtypes of cells. It is also this balance which is thought to control key processes in tissue repair, such as apoptosis and neoangiogenesis. In this paper, we aim to review imaging strategies (with a special focus on nuclear molecular imaging strategies) that target cells and processes involved in postischemic inflammation and that have a high potential to be translated into clinic or that are already being used and evaluated in humans. PMID:27225319

  8. An unusual myocardial infarction

    OpenAIRE

    Di Michele, Sara; MIRABELLI, FRANCESCA; Galzerano, Domenico; Mankad, Sunil

    2014-01-01

    Summary We present a 74-year-old male with a chondrosarcoma, who presented with chest pain. The history, electrocardiogram (ECG), and biomarkers established the diagnosis of myocardial infarction (MI); angiography did not show coronary atherosclerosis and, both initial transthoracic echocardiogram and chest computed tomography (CT), did not demonstrate any cardiac abnormalities. A second echocardiogram following a routine ECG showed presence of a mass involving the right ventricle and the car...

  9. Acute myocardial infarction

    OpenAIRE

    De la Vega-Vélez Henrique

    2012-01-01

    The prevalence of the myocardial infarction (MI) was increasing according to the decadesof the 20th century. In the second decade, the electrocardiogram was introduced, animportant diagnostic tool which still has full validity. The professor of the Facultadde Medicina of the Universidad de Cartagena, Colombia, Henrique de la Vega Vélezpublished in 1942 a thematic review that includes three clinical cases of MI. The textallows observing the conceptualization that was managed seventy years ago ...

  10. Acute Myocardial Infarction 19922001

    OpenAIRE

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  11. Bilateral posterior cerebral artery infarction.

    Science.gov (United States)

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  12. Autosomal dominant arteriopathy with sub cortical infarcts and leucoencephalopathy (CADASIL)

    International Nuclear Information System (INIS)

    Cerebral autosomal dominant arteriopathy with sub cortical infarcts and leucoencephalopathy (CASADIL) is a systemic hereditary, vascular disease that involves small arteries. Recurrent ischemia, pseudo bulbar paralysis and dementia are characteristic. Other manifestations include migraine and depression. We report an Argentine family with VI generations with evidence of disease in IV. MR examinations were performed on 21 family members (both symptomatic and asymptomatic). The main findings on MR on symptomatic and asymptomatic patients were small lesions with high signal on T2 localised in periventricular white matter, brain stem, basal ganglia and thalamus, and confluent patches on white matter although with high signal on T2 images, usually symmetric. In conclusion we can assess that diffuse myelin loss and small infarcts occurring in cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy well demonstrated with MR. In addition, some of the abnormalities in pre symptomatic patients can be identified on MR images. (author)

  13. Personal peculiarities in patients with middle cerebral artery infarction

    Directory of Open Access Journals (Sweden)

    Antonova N.A.

    2013-12-01

    Full Text Available The purpose of the work is to reveal personal peculiarities in patients who have suffered middle cerebral artery infarction. Material and Methods. 39 patients with middle cerebral artery infarction have been under the study. All patients have received clinical instrumental inspection (neurologic survey, duplex ultrasound investigation of vessels of neck, head and brain, the research CT or MRT. Personal peculiarities have been studied by "The standard multiple-factor method of research of the personality" (PITCHES. Results. Psychological reactions for the disease have been determined. They include hypochondria, depression, psychasthenia and anxiety. Conclusion. Personal peculiarities in patients suffered from middle cerebral artery infarction may be characterized by the appearance of psychological response to the psychotraumatic situation. Therefore it is necessary to give psychotherapeutic aid.

  14. Multimodality imaging of pulmonary infarction

    International Nuclear Information System (INIS)

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis

  15. Multimodality imaging of pulmonary infarction

    Energy Technology Data Exchange (ETDEWEB)

    Bray, T.J.P., E-mail: timothyjpbray@gmail.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); Mortensen, K.H., E-mail: mortensen@doctors.org.uk [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); University Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 318, Cambridge CB2 0QQ (United Kingdom); Gopalan, D., E-mail: deepa.gopalan@btopenworld.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom)

    2014-12-15

    Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis.

  16. Valsartan after myocardial infarction.

    Science.gov (United States)

    Güleç, Sadi

    2014-12-01

    One of the important problems of the patients undergoing acute myocardial infarction (MI) is early development of heart failure. It has been revealed in various studies that renin-angiotensin-aldosterone system (RAAS) has a significant role in this process. The studies conducted with angiotensin converting enzyme (ACE) inhibitors have resulted in decreased mortality rate. Another RAAS blocker which was discovered about ten years later than other ACE inhibitors in historical process is angiotensin receptor blockers (ARB) inhibiting the efficiency of angiotensin 2 by binding to angiotensin 1 receptor. Valsartan is one of the molecules of this group, which has higher number of large-scale randomized clinical studies. In this review, following presentation of a general overview on heart failure after acute MI, the efficiency of ARBs in this patient group will be discussed. This discussion will mostly emphasize the construction, outcomes and clinical importance of VALIANT (VALsartan In Acute myocardial iNfarcTion), which is the study on valsartan after acute MI heart failure. PMID:25604205

  17. DI-3-butylphthalide-enhanced hematopoietic stem cell transplantation and endogenous stem cell mobilization for the treatment of cerebral infarcts

    Institute of Scientific and Technical Information of China (English)

    Baoquan Lu; Xiaoming Shang; Yongqiu Li; Hongying Ma; Chunqin Liu; Jianmin Li; Yingqi Zhang; Shaoxin Yao

    2011-01-01

    Exogenous stem cell transplantation and endogenous stem cell mobilization are both effective for the treatment of acute cerebral infarction. The compound dl-3-butylphthalide is known to improve microcirculation and help brain cells at the infarct loci. This experiment aimed to investigate the effects of dl-3-butylphthalide intervention based on the transplantation of hematopoietic stem cells and mobilization of endogenous stem cells in a rat model of cerebral infarction, following middle cerebral artery occlusion. Results showed that neurological function was greatly improved and infarct volume was reduced in rats with cerebral infarction. Data also showed that dl-3-butylphthalide can promote hematopoietic stem cells to transform into vascular endothelial cells and neuronal-like cells, and also enhance the therapeutic effect on cerebral infarction by hematopoietic stem cell transplantation and endogenous stem cell mobilization.

  18. Contralateral Cerebral Infarction after Stent Placement in Carotid Artery: An Unexpected Complication

    OpenAIRE

    Park, Seong-Ho; Lee, Chang Young

    2008-01-01

    Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondar...

  19. Auditory extinction and dichotic listening cv task in cerebral infarction preliminary report

    Directory of Open Access Journals (Sweden)

    Mauro Muszkat

    1990-06-01

    Full Text Available Six stroke patients were studied using a dichotic listening¹ CV task, 4 with left hemisphere infarction, 2 with right hemisphere infarction. It was observed a «lesion--effect», a shift of hemisphere prevalence to the side opposite a brain lesion. The authors suggest that the lesion-effect can be explained by the auditory extinction phenomenon at the linguistic level.

  20. Fluorodeoxyglucose 18F scan in Alzheimer's disease and multi-infarct dementia

    International Nuclear Information System (INIS)

    Patients with Alzheimer's disease and multi-infarct dementia were studied with scans using fluorodeoxyglucose tagged with fluorine 18. The rates of glucose metabolism were calculated. Patients with Alzheimer's dementia showed decreased metabolism in all areas of the brain but with preferential sparing of the primary motor and sensory cortex. Patients with multi-infarct dementia also had global reductions in glucose metabolic rates when compared with normal control subjects, but the areas of hypometabolism were focal and asymmetric

  1. Bilateral caudate nucleus infarction associated with a missing A1 segment.

    Science.gov (United States)

    Fukuoka, Takuya; Osawa, Aiko; Ohe, Yasuko; Deguchi, Ichiro; Maeshima, Shinichiro; Tanahashi, Norio

    2012-11-01

    We describe a case of bilateral caudate nucleus infarction caused by cardioembolic stroke associated with a variant circle of Willis. The patient was an 81-year-old man with atrial fibrillation who presented with a sudden disturbance of consciousness. When he became more alert a few days later, he was abulic with no spontaneous speech or activity. A magnetic resonance imaging scan of the brain revealed cerebral infarction of bilateral caudate nucleus heads and the left frontal lobe. The left A1 segment was absent on 3-dimensional computed tomography angiography. One year later, abulia had completely resolved. Bilateral caudate nucleus infarction with variant circle of Willis is rare. PMID:22177927

  2. Effects of exercise after focal cerebral cortex infarction on basal ganglion.

    Science.gov (United States)

    Mizutani, Kenmei; Sonoda, Shigeru; Karasawa, Nobuyuki; Yamada, Keiki; Shimpo, Kan; Chihara, Takeshi; Takeuchi, Terumi; Hasegawa, Yoko; Kubo, Kin-Ya

    2013-06-01

    Identification of functional molecules in the brain related to improvement of motor dysfunction after stroke will contribute to establish a new treatment strategy for stroke rehabilitation. Hence, monoamine changes in basal ganglion related to motor control were examined in groups with/without voluntary exercise after cerebral infarction. Cerebral infarction was produced by photothrombosis in rats. Voluntary exercise using a running wheel was initiated from 2 days after surgery. Motor performance was measured by the accelerated rotarod test. Monoamine concentrations in striatum were analyzed using HPLC and immunohistochemical staining performed with anti-tyrosine hydroxylase antibody. In behavioral evaluation, the mean latency until falling from the rotating rod in the group with exercise (infarction-EX group) was significantly longer than that in the group without exercise (infarction-CNT group). When concerning the alteration of monoamine concentration between before and 2 days after infarction, dopamine level showed a significant increase 2 days after infarction. Subsequently, dopamine level was significantly decreased in the infarction-EX group at 10 days after infarction; in contrast, both norepinephrine and 5-HT concentrations were significantly higher in the infarction-EX group than in the infarction-CNT group. Furthermore, duration of rotarod test showed a significant inverse correlation with dopamine levels and a significant positive correlation with 5-HT levels. In immunohistochemical analysis, tyrosine hydroxylase immunoreactivity in substantia nigra pars compacta was shown to increase in the infarction-CNT group. In the present study, at least some of the alterations of monoamines associated with the improvement of paralysis in the basal ganglion related to motor control might have been detected. PMID:22718437

  3. MYOCARDIAL INFARCTION TYPE 2. MYTH OR REALITY?

    OpenAIRE

    V. V. Zhelnov; N. V. Dyatlov; L. I. Dvoretsky

    2016-01-01

    According to The Third Definition of Myocardial Infarction there are five types of myocardial infarction depending on pathogenesis. This review provides actual data about myocardial infarction type 2 mechanism including diagnosis management, epidemiological characteristic and patient prognosis. Previously published data shows discordant information about myocardial infarction type 2 frequency, treatment and diagnostic options. Our clinical observation illustrates these severities in diagnosis...

  4. Cerebral infarction showed hyperperfusion pattern on radionuclide cerebral angiography

    International Nuclear Information System (INIS)

    Four patients of middle cerebral infarctin showed hyperperfusion on radionuclide cerebral angiography and fan-shape accumulation at the area of middle cerebral artery on early and delayed brain scan. In these patients, bone scanning agents such as sup(99m)Tc-EHDP or sup(99m)Tc-MDP also prominently accumulated at the area of infarction. These findings were observed on the study when it was performed within seventeen days after attack, but reexamination tended to show normal or decreased perfusion on radionuclide cerebral angiography and improve abnormal accumulation on brain scans. The clinical diagnosis of these three patients were cerebral embolism with heart disease, but one patient was internal carotid artery occlusion. The prognosis of all patients were very good. The hyperperfusion on radionuclide cerebral angiography of these patients represents the luxury perfusion in the lesion and these infarction has been called hot stroke by Yarnell et al. (author)

  5. Magnetic resonance imaging (MRI) of cerebral infarction

    International Nuclear Information System (INIS)

    Fifty-five patients with cerebral infarction were studied with magnetic resonance imaging (MRI) and correlative CT scans. MRI was more sensitive than CT for detecting cerebral infarction, and T2-weighted spin-echo (SE) pulse sequence was most sensitive for detecting cerebral infarction except for some subcortical infarction. The size of infarcted areas on MRI was larger than that on CT in 29 of 51 infarcted areas, equal in 22. The pulse sequence using long repetition time (TR) and double echo delay time (TE), such as SE (2000/30, 90), improved the detectability of cerebral infarction. (author)

  6. ST Elevation Myocardial Infarction Due to Carbon Monoxide Poisoning

    OpenAIRE

    2011-01-01

    Carbon monoxide is formed as a result of combustion of any carbon compound and can lead to hypoxia in many organs including the brain and the heart. Carbon monoxide poisoning in the United States is the leading cause of the fatal poisonings. In this study we present a case with no-known accompanying disease in the light of literature where myocardial infarction was developed as a result of carbon monoxide poisoning.

  7. ST Elevation Myocardial Infarction Due to Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Hayriye Gonullu

    2011-08-01

    Full Text Available Carbon monoxide is formed as a result of combustion of any carbon compound and can lead to hypoxia in many organs including the brain and the heart. Carbon monoxide poisoning in the United States is the leading cause of the fatal poisonings. In this study we present a case with no-known accompanying disease in the light of literature where myocardial infarction was developed as a result of carbon monoxide poisoning.

  8. CURRENT REPERFUSION THERAPY POSSIBILITIES IN MYOCARDIAL INFARCTION AND ISCHEMIC STROKE

    OpenAIRE

    E. V. Konstantinova; N A Shostak; M. Yu. Gilyarov

    2015-01-01

    Myocardial infarction and ischemic stroke remain to be of the greatest medical and social importance because of their high prevalence, disability, and mortality rates. Intractable thrombotic occlusion of the respective artery leads to the formation of an ischemic lesion focus in the tissue of the heart or brain. Emergency reperfusion serves to decrease a necrotic focus, makes its formation reversible, and reduces patient death rates. The paper considers main reperfusion therapy lines: medical...

  9. Depression following myocardial infarction

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær

    2013-01-01

    Myocardial infarction (MI) is a severe life event that is accompanied by an increased risk of depression. Mounting evidence suggests that post-MI depression is associated with adverse outcomes, but the underlying mechanisms of this association remain unclear, and no previous studies have examined...... whether the mental burden of MI is so heavy that it increases the risk of suicide. Although post-MI depression is common and burdensome, the condition remains under-recognised and under-treated. The development of new strategies to improve the quality of care for people with post-MI depression requires...... thorough understanding of the mechanisms that influence the prognosis as well as knowledge of the present care provided. The purpose of this PhD thesis is accordingly subdivided into four specific aims: 1. To estimate the prevalence of depression in people with MI after three months, and to estimate the...

  10. Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

    OpenAIRE

    Chen, Po-Chuan; Tsai, Shih-Hung; Chen, Yu-Long; Liao, Wen-I

    2014-01-01

    Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompress...

  11. infarction in rats

    Directory of Open Access Journals (Sweden)

    Keyvan Yousefi

    2014-03-01

    Full Text Available Introduction: Nowadays, finding new therapeutic compounds from natural products for treatment and prevention of a variety of diseases including cardiovascular disorders is getting a great deal of attention. This approach would result in finding new drugs which are more effective and have fewer side effects than the conventional medicines. The present study was designed to investigate the anti-inflammatory effect of the methanolic extract of Marrubium vulgare, a popular traditional medicinal herb, on isoproterenol-induced myocardial infarction (MI in rat model. Methods: Male Wistar rats were assigned to 6 groups of control, sham, isoproterenol, and treatment with 10, 20, and 40 mg/kg/12h of the extract given orally concurrent with MI induction. A subcutaneous injection of isoproterenol (100 mg/kg/day for two consecutive days was used to induce MI. Then, histopathological changes and inflammatory markers were evaluated. Results: Isoproterenol injection increased inflammatory response, as shown by a significant increase in peripheral neutrophil count, myocardial myeloperoxidase (MPO activity and serum levels of creatinine kinase-MB (CK-MB and TNF-α (pM.vulgare extract serum CK-MB was subsided by 55.4%, 52.2% and 69%, respectively. Also treatment with the extract (40 mg/kg significantly reduced (p<0.001 MPO activity in MI group. The levels of TNF-α was also considerably declined in the serums of MI group (p<0.001. In addition, peripheral neutrophil count, was significantly lowered by all doses of the extract (p<0.001. Interstitial fibrosis significantly was attenuated in treated groups compared with control MI group.Conclusion:The results of study demonstrate that the M. vulgare extract has strong protective effects against isoproterenol-induced myocardial infarction and it seems possible that this protection is due to its anti-inflammatory effects.

  12. National registry of myocardial infarction

    OpenAIRE

    Amin Daemi; Mehdi Jafari

    2016-01-01

    The Registry of Myocardial Infarctions (MI Registry) is a national registry in Iran that collects and reports the data on myocardial infarctions. Its main advantage is that it covers the whole country and is mandatory for hospitals to register the MI cases in it. Then, the qualified individuals at the provincial and national levels can get intended reports and make appropriate decisions. Such reports, further to the policy makers and managers, can be very valuable for researchers. The regi...

  13. Rapid and long-term induction of effector immediate early genes (BDNF, Neuritin and Arc) in peri-infarct cortex and dentate gyrus after ischemic injury in rat brain

    DEFF Research Database (Denmark)

    Rickhag, Karl Mattias; Teilum, Maria; Wieloch, Tadeusz

    2007-01-01

    The genomic response following brain ischemia is very complex and involves activation of both protective and detrimental signaling pathways. Immediate early genes (IEGs) represent the first wave of gene expression following ischemia and are induced in extensive regions of the ischemic brain...... including cerebral cortex and hippocampus. Brain-derived neurotrophic factor (BDNF), Neuritin and Activity-regulated cytoskeleton-associated protein (Arc) belong to a subgroup of immediate early genes implicated in synaptic plasticity known as effector immediate early genes. Here, we investigated the...... at 0-6 h of reperfusion for Neuritin and 0-12 h of reperfusion for Arc while BDNF was induced 0-9 h of reperfusion. Our study demonstrates a rapid and long-term activation of effector immediate early genes in distinct brain areas following ischemic injury in rat. Effector gene activation may be part...

  14. Tocilizumab inhibits neuronal cell apoptosis and activates STAT3 in cerebral infarction rat model

    Science.gov (United States)

    Wang, Shaojun; Zhou, Jun; Kang, Weijie; Dong, Zhaoni; Wang, Hezuo

    2016-01-01

    Cerebral infarction is a severe hypoxic ischemic necrosis with accelerated neuronal cell apoptosis in the brain. As a monoclonal antibody against interleukin 6, tocilizumab (TCZ) is widely used in immune diseases, whose function in cerebral infarction has not been studied. This study aims to reveal the role of TCZ in regulating neuronal cell apoptosis in cerebral infarction. The cerebral infarction rat model was constructed by middle cerebral artery occlusion and treated with TCZ. Cell apoptosis in hippocampus and cortex of the brain was examined with TUNEL method. Rat neuronal cells cultured in oxygen-glucose deprivation (OGD) conditions and treated with TCZ were used to compare cell viability and apoptosis. Apoptosis-related factors including B-cell lymphoma extra large (Bcl-xL) and Caspase 3, as well as the phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in brain cortex were analyzed from the protein level. Results indicated that TCZ treatment could significantly prevent the promoted cell apoptosis caused by cerebral infarction or OGD (P < 0.05 or P < 0.01). In brain cortex of the rat model, TCZ up-regulated Bcl-xL and down-regulated Caspase 3, consistent with the inhibited cell apoptosis. It also promoted tyrosine 705 phosphorylation of STAT3, which might be the potential regulatory mechanism of TCZ in neuronal cells. This study provided evidence for the protective role of TCZ against neuronal cell apoptosis in cerebral infarction. Based on these fundamental data, TCZ is a promising option for treating cerebral infarction, but further investigations on related mechanisms are still necessary. PMID:26773188

  15. 高压氧治疗脑梗死疗效观察%Observation of therapeutic effect of hyperbaric oxygen on cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    马维艳; 杨丽

    2002-01-01

    Background:Hypoxia and ischemia resulting from cerebral infarction can further cause a series of pathological changes such as hydrocephallus.Drug therapy can improve cerebral blood circulation and enhance flow volume and decrease infarction area.If hyperbaric oxygen is added,pathophysiological changes such as ischemia and hypoxia can be improved and normal metabolism of brain cells be restored.

  16. Lacunar infarcts in childhood

    International Nuclear Information System (INIS)

    Nine cases, ranging in age from 6 months to 9 years, were diagnosed as lacunar infarcts on computed tomography (CT). Hemiplegia developed rapidly or gradually in 8 cases. Three of 8 cases had transient ischemic attacks of hemiplegia. Other neurological deficits were dysarthria, aphasia, confusion and coarse tremor. One case was asymptomatic. Each of 8 cases had single lacuna and one case two lacunae on CT. These lacunae were localized in the internal capsule, the putamen or the caudate nucleus. Lacunae involving the internal capsule were associated with contralateral hemiplegia, whereas asymptomatic lacunae did not iovolve it. Severity of hemiplegia in the acute stage did not correlate with localization or size of lacunae. Moderate neurological sequelae were noticed in 3 cases, mild sequelae in two and none in three. The sequelae were related to the lacunae which involved the lateral lenticulostriate branch zone of the middle cerebral artery or larger areas. Prognosis did not correlate with the mode of onset or the severity of neurological signs in the acute stage. There were 2 cases with the occlusion of the left internal carotid artery or congenital heart disease, but the etiology of lacunae was unknown in the other cases. (author)

  17. Curvilinear T1 hyperintense lesions representing cortical necrosis after cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, Toshibumi; Tamura, Hajime; Kado, Hirotsugu; Okudera, Toshio [Research Institute of Brain and Blood Vessels-Akita, Department of Radiology, Akita (Japan); Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Yonago, Tottori (Japan); Yoshida, Yasuji [Research Institute of Brain and Blood Vessels-Akita, Department of Pathology, Akita (Japan)

    2005-09-01

    Curvilinear T1 hyperintense lesions in the cerebral cortex in patients with subacute infarction were investigated for: (1) the presence or absence of T2* hypointensity and (2) correlations with neuropathologic findings. Thirty-six consecutive patients with subacute to chronic embolic infarction, in whom curvilinear hyperintense lesions in the infarcted cortex were seen on T1-weighted images, underwent echo-planar gradient-echo (GRE-EPI) T2*-weighted imaging. GRE-EPI T2*-weighted imaging revealed no evidence of hemorrhage within the curvilinear T1 hyperintense lesions of the cerebral cortex in all of the patients. In 11 of the 36 patients, focal hypointense lesions were seen in the depth of infarcted gyri on GRE-EPI T2*-weighted images. In the remaining 25 patients, no T2* hypointensities were seen in the infarct zone. Pathological correlation was performed in a patient with middle cerebral artery infarction and curvilinear hyperintense lesions on postmortem T1-weighted images. In the autopsied brain, curvilinear T1 hyperintense lesions corresponded to necrosis of all the cortical layers on histological examination. These data suggest that curvilinear hyperintense lesions in the cerebral cortex on T1-weighted images during the subacute to chronic period of cerebral infarction may not represent hemorrhage. (orig.)

  18. Aquaporin-4 gene silencing protects injured neurons after early cerebral infarction

    Directory of Open Access Journals (Sweden)

    Zhan-ping He

    2015-01-01

    Full Text Available Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffusion-weighted imaging (DWI. We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and siRNA-aquaporin-4 was immediately injected via the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefficient value on T2-weighted imaging (T2WI and DWI gradually increased within 0.5-6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2WI and DWI reduced, relative apparent diffusion coefficient value was increased, and cellular edema was obviously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefficient value was similar between treatment and model groups, but angioedema was still obvious in the treatment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefficient value and the area of high signal intensity on T2WI and DWI can reflect therapeutic effects of aquaporin-4 gene silencing on cellular edema.

  19. CT findings in hemorrhagic infarction

    International Nuclear Information System (INIS)

    7 cases of hemorrhagic infarction in which a high-density area in a low-density area were revealed on follow-up CT scan are reported. Symptomatically, 4 cases were completed strokes, while 3 cases were RIND. Recanalization of the occluded vessel was seen in all 5 cases on which follow-up angiography was performed. Hemorrhagic infarction was recognized between the 6th and 21st day after onset. CT scan revealed various patterns of hemorrhagic infarction - massive hematoma, watershed hemorrhage, diffuse petechial hemorrhage, etc. Clinical prognoses of these cases were provided in two groups. 3 cases whose clinical symptoms deteriorated at the time of hemorrhage died. On the other hand, 4 cases whose clinical symptoms were stationary, but who nevertheless had hemorrhagic infarction, had good or excellent prognoses. Hemorrhagic infarction of the former group took place during the acute stage of cerebral ischemia(6-8th day after onset), but that of the latter group took place during the subacute stage of cerebral ischemia (12-21st day after onset). Contrast enhancement was seen in all the cases except for one case of the acute stage. Contrast enhancement in the acute stage was recognized in 2 cases on the 4th day after onset. (author)

  20. MRI of acute cerebral infarction

    International Nuclear Information System (INIS)

    Sequential changes of magnetic resonance imaging (MRI) in sixteen patients with acute cerebral infarction are studied in comparison with the findings of computed tomography (CT). The sixteen patients were examined within 36 hours from the onset of syptoms on resistive type MRI (0.15T) using T1 weighted image (IR2000/500) and T2 weighted image (SE2000/80), and on CT. In general, large infarcted lesions of the cortexsubcortex seemed to be visualized earlier than small lesions of the basal ganglia and brainstem. In 8 patients, the infarcted lesions were detected on MRI earlier than on CT. For example, early detecting time within 12 hours were 2, 6, 7, and 10 hours after onset. In two patients of this group, lesions were detected on T2 weighted image earlier than on T1-weighted image. In two cases, small lesions of the brainstem were detected only on MRI. The size of abnormal findings gradually developed and reached a maximum on days 5 to 7 sequentially. The difference between infarction and perifocal edema was not clear even on MRI. The changes gradually subsided and assumed a stable size after about 2 months. Contrast enhancement effect was observed in four patients. In two of these cases, the signal intensity of T2-weighted imaging was decreased just at the region which was enhanced with contrast medium. MRI is useful for early diagnosis of ischemic cerebral infarction, and may eludidate some aspects of the pathophysiology of ischemic stroke. (author)

  1. Presentation of bilateral thalamic infarction on CT, MRI and PET

    International Nuclear Information System (INIS)

    Paramedian thalamic structures and part of the upper midbrain are frequently supplied by posterior thalamoperforating arteries originating from one common trunk. Local impairment of flow entails a bilateral more or less symmetric thalamic infarction with varying involvement of the midbrain. Diagnosis usually can neither be firmly established on clinical grounds nor by angiography alone. In the present series of four patients the two cases observed before the CT era were diagnosed correctly only at autopsy. Only one patient presented the classical syndrome of hypersomnia, thalamic dementia, and occulomotor nerve paralysis, while in the others clinical signs probably were masked by serious impairment of consciousness. In two cases X-ray computed tomography and magnetic resonance tomography (one case) afforded precise definition of infarct localization and size. Infarction in the described terminal vascular supply territory may be detected more often by these modern diagnostic techniques than anticipated from previous clinico-pathological experience as the underlying cause of coma in the elderly - a group of patients at particular risk for low-flow states. Positron emission tomography repeat studies with 18F-2-fluorodeoxyglucose (one case) revealed complex disturbances of brain energy metabolism; correlative analysis of clinical function and metabolic patterns during the course of the disease may not only advance individual prognostication but also contribute to the understanding and localization of brain function. (orig.)

  2. Risk Factors for Silent Lacunar Infarction in Patients with Transient Ischemic Attack.

    Science.gov (United States)

    Li, Ying; Liu, Nan; Huang, Yonghua; Wei, Wei; Chen, Fei; Zhang, Weiwei

    2016-01-01

    BACKGROUND Lacunar infarctions represent 25% of ischemic strokes. Lacunar stroke and transient ischemic attack (TIA) share a number of symptoms. This study aimed to assess the potential risk factors for lacunar infarction in patients with TIA. MATERIAL AND METHODS This was a retrospective study performed at the Beijing Military General Hospital in patients with TIA admitted between March 2010 and December 2011. Patients were grouped according to lacunar vs. no lacunar infarction. All patients were diagnosed using diffusion-weighted imaging (DWI) on brain magnetic resonance imaging (MRI). Brain angiography (computed tomography and MRI) was used to measure intracranial stenosis. Carotid artery stenosis was measured by ultrasound. RESULTS Patients with TIA and lacunar infarction (n=298) were older than those without lacunar infarction (n=157) (69.4±10.0 vs. 58.9±9.0 years, Pdiabetes (32.6% vs. 21.0%, P=0.010), hyperlipidemia (53.4% vs. 29.3%, P<0.001), carotid stenosis (73.2% vs. 40.1%, P<0.001), and intracranial stenosis (55.6% vs. 31.9%, P<0.001), but a lower frequency of alcohol drinking (8.1% vs. 14.0%, P=0.045). Lacunar infarction mostly involved the anterior circulation (62.8%). Multivariate analysis showed that age (odds ratio (OR)=1.085, 95% confidence interval (95%CI): 1.054-1.117, P<0.001), hypertension (OR=1.738, 95%CI: 1.041-2.903, P=0.035), hyperlipidemia (OR=2.169, 95%CI: 1.307-3.601, P=0.003), and carotid stenosis (OR=1.878, 95%CI: 1.099-3.206, P=0.021) were independently associated with lacunar infarction. CONCLUSIONS Age, hypertension, hyperlipidemia, and carotid stenosis were independently associated with silent lacunar infarction in patients with TIA. PMID:26864634

  3. Myocardial infarction in children: Two interesting cases

    Directory of Open Access Journals (Sweden)

    Suryawanshi Suresh

    2011-01-01

    Full Text Available Myocardial infarction in children is extremely rare and can have various etiologies. The following two case reports highlight rare but important causes of myocardial infarction in children.

  4. Clinical, MRI and perfusion SPECT findings in strategic infarct dementia

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Park, Kyung Won; Cha, Jae Kwan; Kim, Sang Ho; Kim, Jae Woo [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2002-07-01

    Strategic infarct dementia (SID) is characterized by focal ischemic lesions involving specific sites that are critical for higher cortical functions. The mechanism of SID are not well understood. We evaluate lesion sites, neuropsychiatric symptoms, brain perfusion SPECT and neuropsychological findings in patients with SID. Eleven patients with SID according to NINDS-AIREN criteria for vascular dementia were included. All patients performed brain MR and MRA, Tc-99m HMPAO brain perfusion SPECT. Various sites were responsible for SID; thalamus(n=3), medial temporal lobe(n=3), medial frontal lobe(n=1), genu of internal capsule(n=1), caudate nucleus(n=1), angular gyrus(n=1) and temporooccipital lobe(n=1). The most common neuropsychiatric symptoms were apathy and indifference by K-NPI. Brain perfusion SPECT revealed ipsilateral cortical hypoperfusion, mainly in frontal and temporal lobe area, in patients with subcortical strategic infarct. On neuropsychological assessment, cognitive deficits on attention and frontal executive function were prominent. The thalamus and medial temporal lobe were the most common sites responsible for SID. It was suggested that strategic disruption of frontal-subcortical circuit be an important role to produce SID in patients with subcortical strategic lesions.

  5. Clinical, MRI and perfusion SPECT findings in strategic infarct dementia

    International Nuclear Information System (INIS)

    Strategic infarct dementia (SID) is characterized by focal ischemic lesions involving specific sites that are critical for higher cortical functions. The mechanism of SID are not well understood. We evaluate lesion sites, neuropsychiatric symptoms, brain perfusion SPECT and neuropsychological findings in patients with SID. Eleven patients with SID according to NINDS-AIREN criteria for vascular dementia were included. All patients performed brain MR and MRA, Tc-99m HMPAO brain perfusion SPECT. Various sites were responsible for SID; thalamus(n=3), medial temporal lobe(n=3), medial frontal lobe(n=1), genu of internal capsule(n=1), caudate nucleus(n=1), angular gyrus(n=1) and temporooccipital lobe(n=1). The most common neuropsychiatric symptoms were apathy and indifference by K-NPI. Brain perfusion SPECT revealed ipsilateral cortical hypoperfusion, mainly in frontal and temporal lobe area, in patients with subcortical strategic infarct. On neuropsychological assessment, cognitive deficits on attention and frontal executive function were prominent. The thalamus and medial temporal lobe were the most common sites responsible for SID. It was suggested that strategic disruption of frontal-subcortical circuit be an important role to produce SID in patients with subcortical strategic lesions

  6. [Fibrinolysis in acute myocardial infarct].

    Science.gov (United States)

    Bleifeld, W

    1987-10-24

    Fibrinolysis has opened up a new avenue in the treatment of acute myocardial infarction (AMI). In principle, the rate of reperfusion depends on the type of compound used, the mode of administration and the time between onset of symptoms and the beginning of treatment. With intracoronary streptokinase the reperfusion rate is of the order of 85%. Intravenous urokinase administered as a bolus results in a reopening rate of 50-60%; a similar rate of reperfusion is achieved with rt-PA as infusion, while i.v. streptokinase produces about 50% reopened coronary vessels. The final infarct size is decreased in 70% of patients if fibrinolysis is initiated within 2.5 hours after the onset of symptoms and followed by reopening of the occluded vessel. This results in a lowering of in-hospital mortality, which in various studies is of the order of 45-60%.- Bearing in mind the contraindications, fibrinolysis should be initiated within 3 hours. Hemodynamic improvement by a decrease of infarct size may also be achieved beyond 3 hours in large anterior myocardial infarctions and in posterior infarctions with cardiogenic shock. Early initiation of thrombolysis is of major importance in improving left ventricular function and lowering mortality following acute myocardial infarction. Therefore, prehospital thrombolytic therapy should be considered. - In the postinfarction phase coronary angiography is indicated in patients with angina at rest, stable angina of ECG signs of ischemia. In this situation transfer to a specialized cardiology division for possible percutaneous transluminal angioplasty is indicated. - Reocclusion after successful thrombolysis occurs in 20-30%, and it is therefore important to avoid reinfarction to improve the long term prognosis after AMI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3321420

  7. The Artery of Percheron Infarction after Coronary Angiography

    Science.gov (United States)

    Mazek, Haitham; Sherif, Khaled; Suarez, Jose; Wischmeyer, Jason

    2016-01-01

    Coronary angiography is the golden choice for coronary artery disease evaluation and management. However, as with any invasive procedures, there is a risk of complications. We are reporting a case of 69-year-old male with past medical history of cardiac bypass surgery, CHF, hypertension, and hyperlipidemia who was admitted to the hospital to evaluate his chest pain. He had treadmill stress test that showed ischemic induced exercise. Patient underwent coronary angiography that showed proximal complete occlusion of the RCA with a patent graft. At the end of the procedure, the patient did not wake up and remained minimally responsive. An urgent brain MRI was ordered and showed infarctions consistent with an artery of Percheron infarction. Later, patient has improved slowly and was discharged home. We briefly here discuss this rare complication including the risk factor, clinical presentation, and the management.

  8. 运动想象疗法对急性脑梗死患者上肢瘫痪的效果及脑功能MRI的改变%Effects and changes of brain functional MRI of motor imagery therapy on acute cerebral infarction patients with upper limb paralysis

    Institute of Scientific and Technical Information of China (English)

    冉茂胜; 叶建军; 马东兵; 张莉; 胡杰杰; 杨旭君; 乔小民; 姜晓萍

    2013-01-01

    Objective To investigate the effects and changes of brain functional MRI (fMRI) of motor imagery therapy on acute cerebral infarction ( ACI) patients with upper limb paralysis. Methods Seventy cases of ACI patients with hemiplegia were randomly divided into the control group (drug therapy + exercise) and motor imagery therapy group, each group had 35 cases. The treatment of motor imagery therapy group was on the basis of control group, add into motor imagery therapy, 2 times a day, for 30 d. Before and 30 d after treatment, the patients were scored by Fugl-Meyer scale (FMA) and functional independence measure scale (FIM) , the active range of motion ( AROM) of ipsilateral wrist was measured by a protractor, and the brain movement activation range was measured by blood oxygen level dependent fMRI. Results After treatment, the FMA, FIM scores of paralysis upper extremity, the AROM and range of brain activation were significantly higher or bigger than before treatment in the two groups (P<0. 05 -0.01). And these indicators of motor imagery therapy group were significantly higher or bigger than those in the control group (P<0. 05 —0.01). Conclusions Motor imagery therapy can promote the recovery of the upper limb motor function in acute cerebral infarction patients with hemiplegia, and expand the brain movement activation range on fMRI.%目的 研究运动想象疗法对急性脑梗死患者上肢瘫痪的效果及脑功能MRI(fMRI)的改变.方法 70例脑梗死偏瘫患者,随机分为对照组(药物治疗+运动)和运动想象治疗组,每组35例.运动想象治疗组在对照组的治疗基础上,进行运动想象疗法,每天2次,连续30 d.在治疗前和治疗后30 d,给患者进行Fugl-Meyer量表(FMA)、功能独立性评定量表(FIM)评分,用量角器测定患侧手腕主动活动范围(AROM);用血氧水平依赖性fMRI测定脑运动激活区范围.结果 两组患者治疗后瘫痪上肢的FMA、FIM评分、AROM及脑激活区的范围均明

  9. Physical Activitiea Associted with Angina Pectoris Before Myocardial Infarction and the Onset of Myocardial Infarction

    OpenAIRE

    Matsuda, Masako

    1984-01-01

    One hundred and ninety-seven patients with a history of myocardeal infarction were interviewed to evaluate the incidence of angina pectoris and the physical activity precipitating angina before myocardial infarction, and the mode of physical activity at the onset of myocardial infarction. Ninety-ewo patients had no angina before infarction, whereas 105 did, In 105 patients, 58 had a chronic stable angina without a change of pattern of angina before infarction, while 22 noticed worsening of th...

  10. Solar activity and myocardial infarction.

    Science.gov (United States)

    Szczeklik, E; Mergentaler, J; Kotlarek-Haus, S; Kuliszkiewicz-Janus, M; Kucharczyk, J; Janus, W

    1983-01-01

    The correlation between the incidence of myocardial infarction, sudden cardiac death, the solar activity and geomagnetism in the period 1969-1976 was studied, basing on Wrocław hospitals material registered according to WHO standards; sudden death was assumed when a person died within 24 hours after the onset of the disease. The highest number of infarctions and sudden deaths was detected for 1975, which coincided with the lowest solar activity, and the lowest one for the years 1969-1970 coinciding with the highest solar activity. Such an inverse, statistically significant correlation was not found to exist between the studied biological phenomena and geomagnetism. PMID:6851574

  11. Brain MRI of diabetes Mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Yutaka; Tanaka, Hisashi; Ohtani, Masatoshi; Yamamoto, Hiroshi; Yamamoto, Tadashi; Tsukaguchi, Isao (Osaka Rosai Hospital, Sakai (Japan))

    1993-11-01

    One hundred and fifty-nine patients with diabetes mellitus (DM) and 2,566 patients without DM were studied on brain MRI. The results taught us that the incidence of cerebral atrophy was significantly higher in DM patients than in controls. Unexpectedly, the incidence of cerebral infarction showed no significant difference between the two groups. (author).

  12. Brain MRI of diabetes Mellitus

    International Nuclear Information System (INIS)

    One hundred and fifty-nine patients with diabetes mellitus (DM) and 2,566 patients without DM were studied on brain MRI. The results taught us that the incidence of cerebral atrophy was significantly higher in DM patients than in controls. Unexpectedly, the incidence of cerebral infarction showed no significant difference between the two groups. (author)

  13. Spreading depolarizations and late secondary insults after traumatic brain injury

    DEFF Research Database (Denmark)

    Hartings, Jed A; Strong, Anthony J; Fabricius, Martin;

    2009-01-01

    Here we investigated the incidence of cortical spreading depolarizations (spreading depression and peri-infarct depolarization) after traumatic brain injury (TBI) and their relationship to systemic physiologic values during neurointensive care. Subdural electrode strips were placed on peri...

  14. Correlation between MRI findings, blood pressure and mental ability in patients with multiple lacunar infarcts

    International Nuclear Information System (INIS)

    We studied the association between mental ability as rated by Hasegawa's scale, the severity of hypertension, the severity of brain atrophy, and the severity of lesions in the cerebral white matter on magnetic resonance imaging in 34 patients with multiple cerebral infarcts but without obvious cortical lesions. Data were analyzed using multiple regression analysis. The patients having both marked brain atrophy and severe white matter lesions showed an impairment of mental ability. Brain atrophy was correlated with aging and the severity of white matter lesions. There was a significant positive correlation between the diastolic blood pressure and the severity of white matter lesions. These findings suggest that the white matter lesions in patients with multiple cerebral infarcts are correlated with brain atrophy and mental deterioration, and that uncontrolled hypertension is an important risk factor in exacerbating the lesions in the cerebral white matter. (author)

  15. Short-term prognosis evaluation of plasma brain natriuretic peptide concentration on the non-diabetic acute myocardial infarction patients with stress hyperglycemia%血浆脑钠肽水平对非糖尿病急性心肌梗死并发应激性高血糖患者近期预后评价

    Institute of Scientific and Technical Information of China (English)

    李永东; 董春花; 刘丹

    2012-01-01

    目的:观察非糖尿病急性心肌梗死(AMI)并发应激性高血糖患者血浆脑钠肽(BNP)水平变化,探讨血浆BNP在非糖尿病AMI并发应激性高血糖患者近期预后评估中的作用.方法:将60例AMI患者根据空腹血糖值分为2组,非糖尿病AMI并发应激性高血糖组(试验组)(血糖≥7.0 mmol/L) 36例,AMI未并发应激性高血糖组(对照组)(血糖<7.0 mmol/L)24例,对AMI患者在发病后24 h时测定血浆BNP水平.所有入选患者入院后2周行心脏彩超检查,测定和计算左室舒张末期内径(LVDd)、左室收缩末期内径(LVSd)、左室射血分数(LVEF);同时行24 h动态心电图检测,记录2组患者心律失常发生率;并观察住院2周内心绞痛、心力衰竭、心源性休克、心源性猝死等主要不良心血管事件(MACE)发生率.结果:①发病后24 h血浆BNP浓度试验组明显高于对照组[(671.87±631.71)ng/L∶(299.53±455.67)ng/L,P<0.01].②试验组LVDd、LVSd均高于对照组[(53.01±4.00)mm∶(50.50±3.20)mm,(45.32±5.92)mm∶ (42.52±3.27)mm,均P<0.05],LVEF低于对照组[(52.86±5.79)%∶(61.00±7.54)%,P<0.05].③试验组室性心律失常、室上性心律失常、严重窦性心动过缓和房室传导阻滞发生率均高于对照组(分别为66.67%∶41.67%,63.89%∶37.50%,47.22%∶20.83%,均P<0.05).④试验组与对照组住院2周内MACE发生率,包括心力衰竭(36.11%∶ 12.50%)、心源性休克(16.67%∶0.00%)、梗死后心绞痛(25.00%∶4.17%)均差异有统计学意义(均P<0.05);死亡率(2.78%∶0.00%)差异无统计学意义(P>0.05).结论:非糖尿病AMI并发应激性高血糖患者近期预后差,血浆BNP水平升高更为明显.%Objective:To observe the change of plasma brain natriuretic peptide concentration in the non-diabetic acute myocardial infarction patients with stress hyperglycemia, and to study its role in prognosis evaluation. Method:Sixty patients with acute myocardial

  16. Isolated left posterior insular infarction and convergent roles in verbal fluency, language, memory, and executive function

    OpenAIRE

    Julayanont, Parunyou; Ruthirago, Doungporn; DeToledo, John C.

    2016-01-01

    The posterior insular cortex—a complex structure interconnecting various brain regions for different functions—is a rare location for ischemic stroke. We report a patient with isolated left posterior insular infarction who presented with multiple cognitive impairment, including impairment in semantic and phonemic verbal fluency.

  17. Pathophysiologic study of chronic infarcts with I-123 isopropyl iodo-amphetamine (IMP)

    DEFF Research Database (Denmark)

    Raynaud, C; Rancurel, G; Samson, Y;

    1987-01-01

    Seventeen chronic cerebral infarcts were investigated by a highly sensitive, dedicated brain single photon emission computerized tomography system using 123I-isopropyl iodoamphetamine (IMP) and 133Xe. IMP uptake was measured 10 minutes, 2 hours, and 5 hours after injection, and regional cerebral ...

  18. Acupuncture and Medicated Oxygen Therapy for Multiple Infarctional Dementia

    Institute of Scientific and Technical Information of China (English)

    HOU An-le; WANG Lei; BO Yuan; XIAO Yuan-chun

    2003-01-01

    Purpose To observe the clinical efficacy of acupuncture and medicated oxygen therapy in the treatment of multiple infarctional dementia(MID). Methods 150 cases of MID were randomized into three groups: group A in which 50 cases were treated by acupuncture and medicated oxygen, group B in which 50 cases were treated by acupuncture and inhaled oxygen and group C in which 50 cases were simply treated by acupuncture. Results The clinical effects were obviously better in group A than those in group B and group C ( P < 0.05, P < 0.01 ). Conclusion Chinese medicine together with oxygen and acupuncture can improve brain blood circulation, activate brain cells, increase the volume of brain blood flow and its blood supply, and enhance the clinical effects.

  19. Thrombotic thrombocytopenic purpura: MRI demonstration of persistent small cerebral infarcts after clinical recovery

    International Nuclear Information System (INIS)

    Abnormalities in the brain of patients with thrombotic thrombocytopenic purpura (TTP) are infrequent on MRI, often reversible and mainly limited to symptomatic stages of the disease. We report a case in which high-resolution MRI demonstrated multiple persistent small cortical infarcts after clinical remission. High-resolution MRI investigations may detect clinically latent but permanent brain damage, and complement clinical judgement in guiding therapeutic decisions. (orig.)

  20. Bilateral posterior cerebral artery infarction

    OpenAIRE

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA

  1. [Clinical investigation of striatocapsular infarction].

    Science.gov (United States)

    Tei, H; Uchiyama, S; Maruyama, S

    1993-03-01

    We investigated the clinical profile, etiological factors, neuropsychological features and radiological characteristics of 17 cases of striatocapsular infarction (SCI). SCI was defined as the following CT criteria: the area of infarction included the internal capsule and striatum, the maximum diameter of the lesion exceeded 2.0 cm without cortical involvement. There were 9 men and 8 women with mean age of 58 years. Five patients had lesions mainly involving the caudate head (anterior type) and the other 12 had lesions mainly involving the putamen (lateral type), 6 with left side lesion and 6 with right side lesion. Motor weakness was observed in all patients, and the upper extremities were preferentially involved, while in 9 patients face, upper and lower extremities were simultaneously involved. Etiological investigation revealed that 8 patients were cardioembolic stroke, 2 were artery-to-artery embolism and 2 were MCA stem occlusive disease, while the remaining 5 were undetermined. When compared with patients with lacunar infarction (LI), patients with SCI had significantly more frequent cardioembolic sources (47% vs 17%, p abulia, depression and agitation, while left lateral type patients had aphasia and right lateral type patients had hemispatial neglect or anosognosia. These symptoms gradually improved, although in most patients subtle abnormalities lasted over chronic phase. In 11 out of 13 patients who underwent SPECT using 99mTc-HMPAO, blood flow was decreased in overlying cerebral cortex besides the infarcted area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8334792

  2. Mortality rate in type 2 myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt;

    2014-01-01

    BACKGROUND: The classification of myocardial infarction into 5 types was introduced in 2007. The prognostic impact of this universal definition, with particular focus on type 2 myocardial infarction, has not been studied prospectively in unselected hospital patients. METHODS: During a 1-year period......, all hospitalized patients having cardiac troponin I measured were considered. The diagnosis of a myocardial infarction was according to the universal definition, and specified criteria were used in the classification of type 2 myocardial infarction. Follow-up was at least 1 year, with mortality as the...... 2 myocardial infarction. CONCLUSIONS: Mortality in patients with type 2 myocardial infarction is high, reaching approximately 50% after 2 years. Further descriptive and survival studies are needed to improve the scientific evidence on which treatment of type 2 myocardial infarction is based....

  3. 预运动训练对大鼠脑梗死后脑内谷氨酸水平动态变化的影响%Effects of preconditioning treadmill exercise on the dynamic changes of brain glutamate level after cerebral infarction in rats

    Institute of Scientific and Technical Information of China (English)

    贾杰; 胡永善; 吴毅; 刘罡; 于惠贤; 夏春梅; 曹志娟

    2008-01-01

    目的 研究预先电动跑台运动训练对大鼠脑梗死后大脑中枢兴奋性氨基酸水平变化的影响,探讨预运动对缺血脑损伤保护作用的机制.方法 将Sprague-Dawley大鼠随机分为5组(每组实验用时均为4周):运动1周组(运动训练1周,在第4周实施)、运动2周组(运动训练2周,在后2周实施)、运动4周组(运动训练4周)、假手术组和缺血组.各组大鼠在实验4周后,于脑内纹状体留置微透析管,进行大脑中动脉缺血术,采用微透析技术收集大鼠缺血前、缺血期间(40,80和120 min)和再灌注后(40,80,120,160,200和240 min)的脑细胞外液.测定大脑兴奋性氨基酸含量的变化,选取谷氨酸(Glu)含量作为兴奋性氨基酸的主要参考值.同时测量缺血再灌注24 h时的脑梗死体积.结果 缺血再灌注24 h时不同组间脑梗死体积变化差异有统计学意义(P<0.05).2周和4周的预先电动跑台运动训练可显著下调因缺血而过度升高的Glu浓度(P<0.01).结论 至少2周的预运动训练对随后发生的脑损伤缺血期及再灌注期间,大脑内重要的兴奋性氨基酸递质--Glu的过度释放有一定程度的抑制作用,这可能是运动对早期脑缺血损伤的保护机制之一.%Objective To study the effects of preconditioning treadmill exercise on excitatory amino vacid changes in rats after the cerebral infarction and the protective effects against cerebral isehemia brain injury. Methods Thirty Sprague-Dawley rats were used in this study. Twenty-five rats were subject to an operation to establish the animal model of middle cerebral artery occlusion and divided into a isehemia group, an 1-week ex- ercise group (trained in the 4th week) , a 2-week exercise group (trained in the 3rd and 4th weeks) and a 4- week exercise group (trained for 4 weeks) , while the remaining 5 rats were subject to sham operation, and served as the controls. After 4 weeks of experiment, all the the rats were fixed on stereotactie

  4. MRI of acute cerebral infarcts: increased contrast enhancement with continuous infusion of gadolinium

    International Nuclear Information System (INIS)

    We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop. (orig.)

  5. Development and Characterization of a Macaque Model of Focal Internal Capsular Infarcts.

    Science.gov (United States)

    Murata, Yumi; Higo, Noriyuki

    2016-01-01

    Several studies have used macaque monkeys with lesions induced in the primary motor cortex (M1) to investigate the recovery of motor function after brain damage. However, in human stroke patients, the severity and outcome of motor impairments depend on the degree of damage to the white matter, especially that in the posterior internal capsule, which carries corticospinal tracts. To bridge the gap between results obtained in M1-lesioned macaques and the development of clinical intervention strategies, we established a method of inducing focal infarcts at the posterior internal capsule of macaque monkeys by injecting endothelin-1 (ET-1), a vasoconstrictor peptide. The infarcts expanded between 3 days and 1 week after ET-1 injection. The infarct volume in each macaque was negatively correlated with precision grip performance 3 days and 1 week after injection, suggesting that the degree of infarct expansion may have been a cause of the impairment in hand movements during the early stage. Although the infarct volume decreased and gross movement improved, impairment of dexterous hand movements remained until the end of the behavioral and imaging experiments at 3 months after ET-1 injection. A decrease in the abundance of large neurons in M1, from which the descending motor tracts originate, was associated with this later-stage impairment. The present model is useful not only for studying neurological changes underlying deficits and recovery but also for testing therapeutic interventions after white matter infarcts in primates. PMID:27149111

  6. Protein Synthesis Inhibition in the Peri-Infarct Cortex Slows Motor Recovery in Rats

    Science.gov (United States)

    Schubring-Giese, Maximilian; Leemburg, Susan; Luft, Andreas Rüdiger; Hosp, Jonas Aurel

    2016-01-01

    Neuroplasticity and reorganization of brain motor networks are thought to enable recovery of motor function after ischemic stroke. Especially in the cortex surrounding the ischemic scar (i.e., peri-infarct cortex), evidence for lasting reorganization has been found at the level of neurons and networks. This reorganization depends on expression of specific genes and subsequent protein synthesis. To test the functional relevance of the peri-infarct cortex for recovery we assessed the effect of protein synthesis inhibition within this region after experimental stroke. Long-Evans rats were trained to perform a skilled-reaching task (SRT) until they reached plateau performance. A photothrombotic stroke was induced in the forelimb representation of the primary motor cortex (M1) contralateral to the trained paw. The SRT was re-trained after stroke while the protein synthesis inhibitor anisomycin (ANI) or saline were injected into the peri-infarct cortex through implanted cannulas. ANI injections reduced protein synthesis within the peri-infarct cortex by 69% and significantly impaired recovery of reaching performance through re-training. Improvement of motor performance within a single training session remained intact, while improvement between training sessions was impaired. ANI injections did not affect infarct size. Thus, protein synthesis inhibition within the peri-infarct cortex impairs recovery of motor deficits after ischemic stroke by interfering with consolidation of motor memory between training sessions but not short-term improvements within one session. PMID:27314672

  7. Detection of acute cerebral infarction by dual echo subtraction technique in MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Kengo; Nishimaru, Eiji; Yukutomo, Takeharu [Hiroshima City Hospital (Japan); Ishida, Takayuki [Hiroshima International Univ., Kurose (Japan). Faculty of Health Sciences

    2003-05-01

    The purpose of this study was to develop an image enhancement technique to detect acute cerebral infarct regions in brain MR images. Transverse relaxation times for abnormal changes tend to be longer than those for normal tissues. In order to obtain MR images with two different echo times, we employed the fast spin echo sequence. We then employed the image subtraction technique using two T{sub 2}-weighted images to enhance acute cerebral infarct regions. As a result, the areas of acute cerebral infarct regions were enhanced as regions of higher signal than normal regions of brain tissue. Further, high signal areas in dual echo subtraction images corresponded to cerebral infarct regions of high signal areas in diffusion weighted images (DWI). We found that the image subtraction technique is useful to enhance very subtle regions of acute cerebral infarction in MR images. Because we employ the difference between transverse relaxation times for normal and abnormal tissues, which does not depend on the strength of the magnetic field, the dual echo subtraction method can be used in many hospitals. (author)

  8. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [Melbourne Brain Centre rate at The Royal Melbourne Hospital, Departments of Medicine and Neurology, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid; Donnan, Geoffrey A. [The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2016-01-15

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies. (orig.)

  9. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke

    International Nuclear Information System (INIS)

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies. (orig.)

  10. Fractional arm weakness as presentation of stroke due to posterior borderzone infarct: A report of two cases

    Directory of Open Access Journals (Sweden)

    Hassan Kaukab

    2010-01-01

    Full Text Available A 41-year-old male presented with acute onset weakness of the left hand. Magnetic resonance imaging (MRI of the brain showed hyperacute infarct in the right middle cerebral artery (MCA-posterior cerebral artery (PCA watershed territory. Magnetic resonance angiography (MRA, Doppler ultrasonography, and digital subtraction angiography revealed severe right internal carotid artery (ICA stenosis. The patient underwent carotid endarterectomy. The second patient was a 48-year-old male with acute onset right wrist drop. MRI of brain showed acute infarct in the left MCA-PCA watershed territory. MRA of brain and neck, Doppler ultrasonography of the neck vessels, and echocardiography were normal. Both the cases were not initially considered strokes by the referring physicians. Isolated hand palsy is a rare presentation of stroke, often mistaken for peripheral lesion. Fractional limb weakness as a presentation of acute ischemic stroke due to borderzone infarction involving parietal lobe is a rarely reported entity.

  11. Myocardial infarction and cerebral infarction in a Danish suburban community

    DEFF Research Database (Denmark)

    Lyngborg, K; Marquardsen, J; Trautner, F;

    1985-01-01

    females; the rates for CI were 2.4 and 2.5, respectively. The age-incidence curves, particularly those for AMI, were significantly steeper in the females than in the males. Correspondingly, the male predominance in the AMI-group subsided with age. Age-specific incidence-rates rose exponentially with...... advancing age; for each sex and diagnosis the relationship can thus be expressed as a simple mathematical formula, which may facilitate comparisons of incidence patterns in different communities. Theories explaining the similarities and differences of the age-incidence curves for AMI and CI are discussed.......A comparison was made of 485 cases of cerebral infarction (CI), registered prospectively in Frederiksberg, Copenhagen, with 495 cases of myocardial infarction (AMI), recorded retrospectively in the same population. The overall annual incidence of AMI was 6.5 per 1,000 population for males, 3.8 for...

  12. Brain MRI findings of carbon disulfide poisoning

    International Nuclear Information System (INIS)

    To evaluate the findings of brain MRI in patients with carbon disulfide poisoning. Ninety-one patients who had suffered carbon disulfide poisoning [male:female=87:4; age, 32-74 (mean 53.3) years] were included in this study. To determine the extent of white matter hyperintensity (Grade 0-V) and lacunar infarction, T2-weighted MR imaging of the brain was performed. T2-weighted images depicted white matter hyperintensity in 70 patients (76.9%) and lacunar infarcts in 27 (29.7%). In these patients, the prevalent findings at T2-weighted MR imaging of the brain were white matter hyperintensity and lacunar infarcts. Disturbance of the cardiovascular system by carbon disulfide might account for these results

  13. Circulatory and metabolic effects of glycerol infusion in patients with recent cerebral infarction.

    Science.gov (United States)

    Meyer, J S; Itoh, Y; Okamoto, S; Welch, K M; Mathew, N T; Ott, E O; Sakaki, S; Miyakawa, Y; Chabi, E; Ericsson, A D

    1975-04-01

    The effect of intravenous infusion of 10 per cent glycerol on regional cerebral blood flow (using hydrogen bolus and Xenon-133 (133Xe) clearance methods) and metabolism was investigated in 57 patients with recent cerebral infarction. Hemispheric blood flow (HBF) increased, together with increase in regional cerebral blood flow (rCBF) and cerebral blood volume (rCBV), in foci of brain ischemia. Hemispheric oxygen consumption (HMIO2) decreased together with hemispheric respiratory quotient. Systemic blood levels of glucose, lactate, pyruvate, and triglycerides also increased after glycerol while free fatty acids (FFA) and inorganic phosphate (Pi) decreased. Hemispheric glucose consumption was unaltered after glycerol so that hemispheric glucose to oxygen ratio tended to rise. Pyruvate and lactate production by brain was unchanged. Glycerol moved across the blood brain barrier into brain and cerebrospinal fluid (CSF). Release of FFA and Pi from infarcted brain was reversed by glycerol. Total phosphate balance was maintained actoss brain both before and after glycerol infusion. Triglycerides increased in CSF after glycerol, originating either from cerebral blood or as a result of lipogenesis in cerebral tissue. The EEG Recording and neurological status of the patients improved despite decreased brain oxygen consumption. Results of this study suggest that after intravenous infusion of 10 per cent glycerol in patients with recent cerebral infarction, glycerol rapidly enters the CSF and brain compartments and favorably affects the stroke process in two ways: first, by redistribution of cerebral blood flow with increase in rCBF and rCBV in ischemic brain secondary to reduction in focal cerebral edema; and second glycerol may become an alternative source of energy either by being directly metabolized by the brain, or indirectly, by enhancing lipogenesis, or by both processes. Involvement of glycerol in lipogenesis with esterification to accumulated FFA might lead to

  14. Decompressive surgery for malignant supratentorial infarction remains underutilized after guideline publication.

    Science.gov (United States)

    Bar, Michal; Mikulik, Robert; Skoloudik, David; Czerny, Daniel; Lipina, Radim; Sames, Martin; Choc, Milan; Novak, Zdenek; Stary, Marian; Benes, Vladimir; Smrcka, Martin; Filip, Michal; Vondrackova, Denisa; Chlouba, Vladimir; Suchomel, Petr; Haninec, Pavel; Brzezny, Richard; Juran, Vilem

    2011-09-01

    Decompressive surgery <48 h from stroke onset reduces the prevalence of mortality and morbidity from malignant supratentorial infarction. We investigated if utilization of decompressive surgery changed in the Czech Republic (CZ) after the release of new guidelines regarding treatment of malignant brain infarction. The volume of decompressive surgery in 2009 in all centers in the CZ was assessed using the same methodology as in 2006. All neurosurgery departments in the CZ were asked to complete a questionnaire and asked to identify all cases of decompressive surgery for malignant brain infarction through a combination of discharge codes for "brain infarction" and "decompressive surgery" from electronic hospital charts. Data for 56 patients were obtained from 15 of the 16 neurosurgery departments in the CZ. The average age was 53 ± 13; number of males 20; median time to surgery was 48 h (range 24-62); median NIHSS score was 25 (IQR, 20-30); median infarct volume was 300 cm(3) [interquartile (IQR, 250-350)]; mean shift on CT was 10.6 ± 3.6 mm and size of hemicraniectomy was 125 cm(2) (IQR, 110-154). A favorable outcome was achieved in 45% of the patients. The number of procedures increased from 39 in 2,006 to 2,056 in 2009. Based on data from one stroke center, 10% suffered from malignant supratentorial infarction and 2.3% met the criteria for decompressive surgery. In 2009, as compared to 2006, the volume of decompressive surgery carried out moderately increased. However, procedures remained underutilized because only ~10% of those who needed decompressive surgery underwent surgery. PMID:21431893

  15. Apathy, cognitive dysfunction and impaired social cognition in a patient with bilateral thalamic infarction.

    Science.gov (United States)

    Ioannidis, Anestis E; Kimiskidis, Vasilios K; Loukopoulou, Eleni; Geroukis, Triantafyllos; Vlaikidis, Nikolaos; Kosmidis, Mary H

    2013-01-01

    We describe the case of a patient with bilateral thalamic lesions due to brain infarcts in the paramedian thalamic artery territories. The patient demonstrated symptoms of apathy (e.g., loss of initiative and interest in others, poor motivation, flattened affect). Neuropsychological assessment 3 and 5 years post-infarct revealed severe deficits in verbal and non-verbal immediate and delayed memory, attention, and executive functioning, with minimal improvement over time. Also, he demonstrated difficulties in social cognition (i.e., perception of facial expressions of others and of sarcasm). These findings are discussed and interpreted in light of current theories regarding the neurobiological substrate of apathy. PMID:22816313

  16. Diffusion- and T2-weighted MR imagings of cerebral infarction in rabbit: time course of imaging findings and histologic correlation

    International Nuclear Information System (INIS)

    To correlate the serial findings obtained by diffusion-and T2-weighted imaging with histologic findings obtained from 30 minutes to 31 days after the development of cerebral infarction in rabbits. Nineteen male New Zealand white rabbits were subjected to intracerebral embolic infarction. Diffusion- and T2-weighted imagings were performed at 30 min, 2, 4 and 6 hours, and 1, 3, 5, 7, 11, 21 and 31 days. Apparent diffusion coefficient (ADC) ratios and T2 signal intensity ratios of infarcted and normal brain were calculated. Microphotographic or electron microscopic (EM) examinations were performed during hyperacute, acute and chronic infarctions. During hyperacute infarction, diffusion-weighted images showed high signal intensity in the infarcted area, and ADC ratios ranged from 0.81 to 0.56. High signal intensity on diffusion-weighted images continued until day 3, decreasing thereafter. The ADC ratio increased continuously after day 1. High signal intensity on T2-weighted images was noted from 6 hours and continued until day 7, decreasing thereafter. Microphotographic findings at 6 hours were normal, but EM examination revealed cellular swelling with intact basement membrane, suggesting cytotoxic edema. During acute infarction, abnormal dilatation of the perineural space, cell destruction, and loosening of the neuropil matrix were revealed by microphotography. During chronic infarction, microphotographic and EM findings revealed liquefaction necrosis. These data indicated that in cases of hyperacute infarction, diffusion-weighted images reflect cytotoxic edema more accurately than do T2-weighted images. A gradually increasing ADC ratio during the course of infarction may be associated with vasogenic edema and cell lysis

  17. ST elevation without myocardial infarction.

    Science.gov (United States)

    Bitar, Zouheir Ibrahim; Swede, Mohammad; Almerri, Khaled

    2014-01-01

    Acute myocarditis may mimic myocardial infarction because the affected patients report 'classical' chest pain; the ECG changes and echocardiography are identical to those observed in acute coronary syndromes, and serum markers are increased. We describe a case with ST segment elevation on admission ECG, and coronary angiography was normal. Cardiac magnetic resonance with myocardial delayed enhancement sequences is a non-invasive alternative for diagnosing myocarditis. PMID:24711464

  18. Myocardial infarction and subsequent pregnancy

    Directory of Open Access Journals (Sweden)

    Tedoldi Citânia Lúcia

    2000-01-01

    Full Text Available We report the case of a 40-year-old woman with 2 previous myocardial infarctions, revascularization surgery, and an ongoing pregnancy complicated with preeclampsia and fetal hypoxia. Her follow-up performed by a multidisciplinary team made possible the birth through cesarean section of a premature infant of the female sex with a very low birth weight, but without severe respiratory distress of the hyaline membrane disease type. Three months after the delivery, mother and daughter were healthy.

  19. Clinical studies on cerebral infarction

    International Nuclear Information System (INIS)

    Hemorrhagic infarction (HI) is termed as the infarction in which a large part of the necrotic tissue is stippled with small hemorrhage. The pathogenetic mechanism of this disease still remains controversial. Cerebral infarction has long been divided into two subtypes-thrombosis and embolism-according to the pathogenetic mechanisms. Clinical studies were carried out in 31 cases of HI with cerebral thrombosis. CT findings of these cases were classified into five groups according to both size of low density area which indicates regions of infarction and distribution of arterial supply. The low density area of Type I-Type III were observed in the area of the middle cerebral artery. That of Type IV was observed in the area of the internal capsule and basal ganglia. That of Type V was observed in the area of the posterior cerebral artery. CT reveals two patterns of HI -pattern A and pattern B-. The CT finding of pattern A is appearance of high density area in the low density area. The CT finding of pattern B is appearance of iso density area in the low density area. rCBF was measured by 133Xe inhalation technique in 21 patients with CT type I, II and III. Thereafter, with regard to the various findings in CT, the clinical findings and CBF findings, a comparative study was carried out on these ten groups. From the results of present studies, it is concluded that sequential changes of CBF in cases with pattern A are different from those with pattern B, and that CBF measurement does not permit an estimation of a patient's chance for functionary recovery after a stroke in acute and subacute stage but permits estimation of functional outcome in chronic stage. (J.P.N.)

  20. Enteroviruses in Acute Myocardial Infarction

    OpenAIRE

    A Gholoobi; MS Nabavinia; T Mohamadpoor; MS Alavi; Z Meshkat

    2012-01-01

    Background: Human enteroviruses (EVs) may have a role as a possible risk factor in the pathogenesis of MI. The aim of this study was to evaluate the presence of enterovirus genomic RNA in peripheral blood samples of patients with acute myocardial infarction (MI). Methods: We investigated the presence of enterovirus genomic RNA in the peripheral blood of 115 patients with acute MI hospitalized in the Coronary Care Unit of Imam Reza and Ghaem University Hospitals (Mashhad, Iran) by RT-PCR using...

  1. Ventricular Stimulation After Myocardial Infarction

    OpenAIRE

    Béatrice Brembilla-Perrot

    2011-01-01

    Ventricular stimulation after myocardial infarction (MI) is still recommended (class IB) in patients with syncope and left ventricular ejection fraction (LVEF) more than 30-35%, in asymptomatic patients with a LVEF between 30-40% and with non sustained ventricular tachycardia (VT) patients at Holter monitoring. It can also identify patients at high risk of arrhythmic events in the early post-MI period. Combined with imaging methods PVS could be widely used again during VT ablation.

  2. Comparison of stroke infarction between CT perfusion and diffusion weighted imaging: preliminary results

    Science.gov (United States)

    Abd. Rahni, Ashrani Aizzuddin; Arka, Israna Hossain; Chellappan, Kalaivani; Mukari, Shahizon Azura; Law, Zhe Kang; Sahathevan, Ramesh

    2016-03-01

    In this paper we present preliminary results of comparison of automatic segmentations of the infarct core, between that obtained from CT perfusion (based on time to peak parameter) and diffusion weighted imaging (DWI). For each patient, the two imaging volumes were automatically co-registered to a common frame of reference based on an acquired CT angiography image. The accuracy of image registration is measured by the overlap of the segmented brain from both images (CT perfusion and DWI), measured within their common field of view. Due to the limitations of the study, DWI was acquired as a follow up scan up to a week after initial CT based imaging. However, we found significant overlap of the segmented brain (Jaccard indices of approximately 0.8) and the percentage of infarcted brain tissue from the two modalities were still fairly highly correlated (correlation coefficient of approximately 0.9). The results are promising with more data needed in future for clinical inference.

  3. Right ventricle infarction and its characteristics

    OpenAIRE

    Nozari Y

    1997-01-01

    Right ventricular (RV) infarction presents with clinical spectrum from a rather being, uncomplicated disorder to a serious event. A total of one hundred patients with inferior myocardial infarction (MI) retrospectively were studied to determine clinical significance and characteristics of RV infarction in our patients. Data and variables such as demographic features, chief-complain, clinical findings on arrival and during hospitalization, major risk factors, history of corpulmonale, and elect...

  4. Molecular Imaging of Healing After Myocardial Infarction

    OpenAIRE

    Naresh, Nivedita K; Ben-Mordechai, Tamar; Leor, Jonathan; Epstein, Frederick H

    2011-01-01

    The progression from acute myocardial infarction (MI) to heart failure continues to be a major cause of morbidity and mortality. Potential new therapies for improved infarct healing such as stem cells, gene therapy, and tissue engineering are being investigated. Noninvasive imaging plays a central role in the evaluation of MI and infarct healing, both clinically and in preclinical research. Traditionally, imaging has been used to assess cardiac structure, function, perfusion, and viability. H...

  5. Orbital infarction in sickle cell disease

    International Nuclear Information System (INIS)

    Bone infarction is common in sickle cell disease; however, involvement of the orbit is not. Only four cases have been reported in the English literature. We describe a patient who presented with headache, proptosis and lid edema due to infarction of the sphenoid bone. The combination of radionuclide bone imaging and computed tomography (CT) of the orbit were useful in differentiating bone infarction from other etiologies of proptosis. (orig.)

  6. SERUM MAGNESIUM IN ACUTE MYOCARDIAL INFARCTION

    OpenAIRE

    Nambakam Tanuja; Girish P

    2015-01-01

    BACKGROUND: In myocardial infarction, there occurs functional deficit of available magnesium due to trapping of free magnesium in adipocytes. Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complications. Magnesium ions are considered essential for the maintenance of functional integrity of myocardium. The serum magnesium concentration was found to have g reat significance in acute myocardial infarction. The present study was un...

  7. Leukocytosis: a risk factor for myocardial infarction

    OpenAIRE

    Kotla SK

    2012-01-01

    Suman K KotlaDepartment of Internal Medicine, Memorial Medical Center, Johnstown, PA, USAAbstract: Myocardial infarction commonly results from atherosclerotic lesions in the coronary arteries. Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic disease. In this case report, we present an unusual leukostatic complication in a patient with acute myeloblastic leukemia and extreme hyperleukocytosis who presented with an acute myocardial infarction that resolv...

  8. Locations of cerebral infarctions in tuberculous meningitis

    International Nuclear Information System (INIS)

    The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.)

  9. Computational modeling of acute myocardial infarction.

    Science.gov (United States)

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size. PMID:26583449

  10. Cerebellar infarct patterns: The SMART-Medea study

    Directory of Open Access Journals (Sweden)

    Laurens J.L. De Cocker, MD

    2015-01-01

    Conclusions: Small cerebellar infarcts proved to be much more common than larger infarcts, and preferentially involved the cortex. Small cortical infarcts predominantly involved the posterior lobes, showed sparing of subcortical white matter and occurred in characteristic topographic patterns.

  11. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

    OpenAIRE

    Joshi, Nikhil V; Toor, Iqbal; Shah, Anoop S V; Carruthers, Kathryn; Alex T. Vesey; Alam, Shirjel R; Sills, Andrew; Hoo, Teng Y; Melville, Adam J; Langlands, Sarah P; Jenkins, William S A; Uren, Neal G; Mills, Nicholas L.; Fletcher, Alison M; van Beek, Edwin J.R.

    2015-01-01

    BACKGROUND: Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans.METHODS AND RESULTS: Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonv...

  12. Frequency of risk factors of cerebral infarction in stroke patients. a study of 100 cases in naseer teaching hospital, peshawar

    International Nuclear Information System (INIS)

    To study the risk factors of cerebral infarction in stroke patients. It is a descriptive hospital based study conducted at the Department of Medicine, Naseer Teaching Hospital, Peshawar from January 2005 to December 2005. One hundred patients of stroke with cerebral infarction confirmed on C.T. scan brain and more than twenty years of age were included. Risk factors for cerebral infarction were defined in terms of hypertension, diabetes mellitus, ischemic heart disease, smoking, dyslipidaemia, TIAs (transient ischemic attacks), carotid artery stenosis and family history of stroke. Data of 100 cases with cerebral infarction was recorded. Most of the patients had more than one risk factors for cerebral infarction. hypertension was commonest risk factor (55%), smoking (30%), ischemic heart disease (34%), diabetes mellitus) (26%), hyperlipedaemia (30%), atrial fibrillation (25%), carotid artery stenosis (27%), obesity (15%) and family history of stroke (12%). 39% of patients had physical inactivity. Males were slightly predominant than females (51% vs 49%) and mean age was 50 years. females were rather older with mean age of 53 years. Cerebral infarction accounts for 80% to 85% of cases of stroke, which is a common neurological disorder. It increases a burden of disability and misery for patients and their families. Most of the risk factors of cerebral infarction are modifiable, its prevention should be the main cause of concern for the community. (author)

  13. CT findings and pathogenetic mechanisms of hemorrhagic infarction

    International Nuclear Information System (INIS)

    Twenty-five patients were diagnosed as having hemorrhagic infarction by autopsy (4 cases), by an operation (3 cases), or by the combination of CT and a spinal tap (18 cases). Angiography was repeated to identify the recanalization as far as possible. The progression or resolution of the mass sign (brain edema) and the contrast enhancement were observed by CT, which was performed at intervals of from one to seven days in almost all cases. The CT findings of hemorrhagic infarction were as follows: 1) Appearance of the foci of an increased density in the low-density area; Generally the foci were indicated as a high-density area, but sometimes they were presented as isodensity in the acute stage of a stroke. Adjacent severe brain edema in the acute stage was supposed to be the main cause of the reduction in the CT number. 2) Ring-formed contrast enhancement in the subacute stage; a ring-formed contrast enhancement was seen on post-contrast scans after the resorption of the hemorrhage. According to our data, hemorrhagic infarction was found not only in the acute stage (within 4 days of the stroke, 9 cases) but also in the subacute stage (over 7 days after the stroke, 19 cases). The acute type of hemorrhage was usually associated with marked cerebral edema. On the other hand, the subacute type of hemorrhage usually appeared when enhancement after contrast infusion was observed and the cerebral edema was being resolved. On angiograms, a recanalization of the occlusion was frequently observed (18 cases, 68%). A comparative study of angiography and CT revealed the difference in the timing of the hemorrhage between the acute and subacute types of hemorrhages. The acute type of hemorrhage usually appeared in response to the angiographical recanalization, but the subacute type of hemorrhage sometimes occurred unrelated to that of angiographical recanalization. (author)

  14. Positron emission tomography in human hemispheric infarction: a study with 150 continuous inhalation technique

    International Nuclear Information System (INIS)

    Non-invasive tomographic imaging of cerebral blood flow and oxygen metabolism has now become possible with the 15O continuous inhalation technique coupled with positron emission tomography (PET). We have for the first time applied this procedure in a large scale study of human hemispheric infarction. From this study, it may be concluded that: various hitherto undescribed patterns of disturbances in the perfusion/metabolism couple that occur in cerebral infarction have been documented by PET imaging of CBF and EO2. The EO2 appears as an important physiological parameter in the study of recent cerebral infarction, and specific patterns of the CBF/EO2 relationship are now emerging that may have important pathophysiologic, prognostic and therapeutic implications. Despite some limitations, the non invasive 15O inhalation technique has a number of major specific advantages that make it particularly suited for the study of ischemic brain disorders

  15. Diagnosis of Alzheimer's disease and multiple infarct dementia by tomographic imaging of iodine-123 IMP

    International Nuclear Information System (INIS)

    Tomographic imaging of the brain was performed using a rotating slant hole collimator and [123I]N-isopropyl p-iodoamphetamine (IMP) in normal subjects (n = 6) and patients with either Alzheimer's disease (n = 5) or multiple infarct dementia (n = 3). Four blinded observers were asked to make a diagnosis from the images. Normal subjects and patients with multiple infarct dementia were correctly identified. Alzheimer's disease was diagnosed in three of the five patients with this disease. One patient with early Alzheimer's disease was classified as normal by two of the four observers. Another patient with Alzheimer's disease had an asymmetric distribution of IMP and was incorrectly diagnosed as multiple infarct dementia by all four observers. Limited angle tomography of the cerebral distribution of 123I appears to be a useful technique for the evaluation of demented patients

  16. Magnetic resonance imaging in posterior circulation infarction: impact on diagnosis and management

    International Nuclear Information System (INIS)

    To compare the diagnostic yield of magnetic resonance imaging (MRI) with computed tomography (CT) in posterior circulation infarction, we used proton MRI with a 0.3 Tesla magnet and a 3rd generation CT scanner in 25 patients. Age-matched controls were compared in a blinded fashion. Seventeen patients (68%) showed relevant pathology on MRI not seen on CT, 11 with normal CT and six with more extensive lesions, chiefly in the brain stem. Evidence of abnormal vertebrobasilar blood flow was seen in 8/25 (32%) of patients, suggested by vascular high intensity signals on MRI. Two tissue and one flow abnormality were seen in the control group. MRI provides additional information concerning infarct site, extent and pathogenesis in posterior circulation infarction. 21 refs., 5 figs., 3 tabs

  17. Successful repair of a syphilitic aortic arch aneurysm accompanied by serious cerebral infarction.

    Science.gov (United States)

    Sato, Katsutoshi; Chiba, Kiyoshi; Koizumi, Nobusato; Ogino, Hitoshi

    2014-01-01

    We present a 52-year-old male with a syphilitic aortic arch aneurysm accompanied by relevant extensive cerebral infarction. He was admitted to a local hospital for sudden loss of consciousness, where he was diagnosed with serious cerebral infarction. During his treatment, a multilocular aortic arch aneurysm involving the arch vessels was found incidentally. He was transferred to our hospital for surgical treatment. A preoperative routine laboratory test for syphilis was highly positive, which suggested that the aneurysm was likely caused by syphilis and the cerebral infarction was also induced by the involvement of syphilitic aortitis or arteritis. After 2 weeks of antibiotic therapy for syphilis, total arch replacement was performed successfully using meticulous brain protection with antegrade selective cerebral perfusion and deep hypothermia. He recovered without any further cerebral deficits. The pathological examination of the surgical specimen showed some characteristic changes of syphilitic aortitis. PMID:24492165

  18. Urgent decisions and a tight spot: embolic infarction of a herniated cerebellar tonsil.

    Science.gov (United States)

    Mc Donagh, Ruth; Bradley, David; Harbison, Joseph Augustine

    2016-01-01

    A previously well 30-year-old woman presented at 17:30 with a sudden onset of dizziness, ataxia and headache. She was initially investigated with a CT scan of the brain and lumbar puncture, which yielded no diagnosis. Subsequent MR scan revealed multiple posterior circulation infarcts, along with a previously undiagnosed Arnold-Chiari 2 malformation with an associated syrinx of her cervical and thoracic spine. The infarct involved one of the herniated cerebellar tonsils. Oedema of an infarct in the herniated tonsils caused compression of the medulla at the foramen magnum, with associated neurological symptoms including Lhermitte's phenomenon and headache on valsalva manoeuvre. Owing to these symptoms a surgical decompression was performed. The most likely aetiology of her stroke was determined to be a paradoxical embolus via patent foramen ovale. PMID:27489065

  19. Surgical outcome after decompressive craniectomy in patients with extensive cerebral infarction

    International Nuclear Information System (INIS)

    Extensive cerebral hemispheric infarction is a devastating condition leading to early death in nearly 80% of cases due to the rapid rise of intracranial pressure in spite of maximum medical treatment for brain edema and swelling. Recently, decompressive craniectomy has been reevaluated to prevent the brain herniation caused by extensive hemispheric cerebral infarction. We studied the surgical results after decompressive craniectomy for extensive cerebral infarction. Between December 1997 and August 2006, 13 consecutive patients (7 males and 6 females aged from 39 to 73 with a mean age of 59 years) with massive cerebral infarction of internal carotid (IC) (11 patients) and middle cerebral artery (MCA) (2 patients) territory were treated with decompressive craniectomy and dural plasty. Five patients had a left-sided stroke with severe aphasia. The cardioembolic source of stroke was seen in 5 patients. Surgery was performed at the point of neurological deterioration, anisocoria, and effacement of perimesencephalic cistern on CT findings. The mean time between stroke onset and surgery was 39.8 hr and ranged from 13 to 102 hr. Glasgow outcome scale (GOS) on discharge was moderately disabled (MD) 1, severe disabled (SD) 5, vegetative state (VS) 1, and dead (D) 3 (mortality rate 30.8%). Severe pneumoniae were the causes of death. All survivors underwent cranioplasty and were transferred with the aim of rehabilitation. In this study, we showed that the decompressive craniectomy reduced mortality after extensive cerebral infarction. However, the functional outcome and level of independence are poor. It seems that the early decompressive craniectomy should be aggressively performed for extensive cerebral infarction before neurological deterioration such as worsening of consciousness disturbance or pupil abnormalities. Further investigations will be needed to clarify the surgical indications, timing, and functional outcomes. (author)

  20. A clinical study of acute cerebral infarction with a midline shift on the CT scan

    International Nuclear Information System (INIS)

    Twenty-one cases of acute cerebral infarction with a midline shift on the CT scan were studied with respect to the development of the midline shift, the angiographic findings, the clinical pictures and the outcome of these patients. The CT findings of hemorrhagic infarction were also studied. No cases showed a midline shift on a CT scan taken within 6 hours after the onset. A midline shift was, however, noted as early as 9 hours after the onset, and it reached its peak between the 2nd and 7th day of the onset. It gradually disappeared by the end of the third week. Hemorrhagic infarction was diagnosed in 6 patients by either spinal tap or autopsy. The CT findings of these hemorrhagic infarction were divided into two types, solid hemorrhages with an unequivocal high density within the low-density area, and small, scattered hemorrhagic of almost the same density as normal brain tissue within the low-density area. In 19 of 21 patients, an round-edged occlusion and/or embolus were observed on the initial angiograms. The recanalization of the occluded vessels was proved in 10 of 14 patients by subsequent angiographic studies. Twenty of 21 patients showed a sudden development of neurological symptoms, and 15 patients had a history of various kinds of heart disease, such as atrial fibrillation, valvular heart disease and myocardial infarction. The patients had atrial fibrillation on EKG on admission. These angiographic findings and clinical pictures strongly suggest that the infarction with a midline shift on the CT scan may be caused by a cerebral embolism of cardiac origin. Eight patients died of cerebral herniation between the 2nd and 6th day of the onset. Taking these poor outcomes into consideration, surgical as well as medical decompression of the brain would seem to be most important when the CT scan shows a midline shift. (author)

  1. Clinical study of the relationship between arteriosclerosis obliterans (ASO) and cerebral infarction

    International Nuclear Information System (INIS)

    To clarify the relationship between arteriosclerosis obliterans (ASO) and cerebral infarction (CI), brain CT was performed and the risk factors for atherosclerosis were assessed. Thirty-five male and 5 female patients with intermittent claudication and/or leg ulceration were angiographically diagnosed as having ASO. According to CT findings, these patients were divided into three groups [no low-density areas (NLDA), hemorrhage, and infarction (CI)]. CI was subdivided as lacunar, cortical, and watershed infarction. Thirteen patients were in the NLDA group and 26 in the CI group (17 lacunar, 3 cortical and 6 mixed infarcts), indicating a CI incidence of 65%. Comparing the risk factors of the CI group with those of the NLDA group, hypertension (53.8%), diabetes (34.6%), and cigarette smoking (69.2%) was often seen in the CI group, although hypercholesterolemia (53.8%) and ischemic heart disease (42.3%) was the same in both groups. Multivariate analysis revealed that smoking had the strongest effect on the occurrence of CI in ASO patients. Furthermore, the number of combined risk factors (hypertension, diabetes, smoking, hypercholesterolemia) had a significant positive correlation with cortical infarction. As to the chronological relationship between the onset of ASO and CI, CI was present in 14 of 27 ASO patients on CT when the ischemic leg symptoms appeared, while symptomatic cortical infarction preceded ASO in 5 patients. CI patients increased gradually over a decade to 26 out of 40, among whom 16 patients with lacunae had silent infarcts. These findings suggested that ASO is frequently associated with CI, not only due to atherosclerosis of the main trunks of the cerebral vessels, but also due to arteriolosclerosis of the perforating arteries. (author)

  2. Do episodes of anger trigger myocardial infarction?

    DEFF Research Database (Denmark)

    Möller, J; Hallqvist, J; Diderichsen, Finn;

    1999-01-01

    Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility.......Our objectives were to study anger as a trigger of acute myocardial infarction (MI) and to explore potential effect modification by usual behavioral patterns related to hostility....

  3. Acute Myocardial Infarction Due To Electrical Injury

    OpenAIRE

    Uzkeser M et al.

    2011-01-01

    Rhythm abnormalities (conduction defects, tachycardia, and arrhythmia)due to electric shock are common. Rarely, myocardial infarction may beseen in these patients. This situation is generally caused by coronaryartery vasospasm and direct myocardial damage. In this report, wepresent a rare case of myocardial infarction due to electric shock.

  4. Primary coronary angioplasty in acute myocardial infarction.

    OpenAIRE

    Grech, E. D.; Ramsdale, D. R.

    1996-01-01

    It is well established that recanalisation of the infarct-related artery is of great benefit in the early hours after acute myocardial infarction. This can be achieved by the use of thrombolytic agents and/or by percutaneous transluminal coronary angioplasty (PTCA). This article reviews data on the role of primary PTCA and summarises current opinion on its use.

  5. Comparative study of SPECT and X-CT in examining elderly patients with acute cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To investigate the differences of brain 99Tcm-ECD SPECT and X-CT in examining elderly patients with acute cerebral infarction thus to guide clinical diagnosis and treatment. Methods: 100 elderly patients with acute cerebral infarction underwent 99Tcm-ECD SPECT and X-CT between 1996 and 1997. On each patient, the two procedures were performed sequentially within three days. Results: The positive rate of X-CT was 54%, while the positive rate of SPECT was 92%. The results of X-CT correlated with the results of SPECT (x2 = 0.953, P>0.1), and the positive rate of SPECT was higher (x2 = 30.422, P99Tcm-ECD SPECT is better at predictive diagnosis of elderly acute cerebral infarction and gain valuable time for in-time treating, and it is more sensitive for detecting and localizing the lesions and makes the interpretation of clinical symptoms and signs easier. X-CT is more sensitive to detect basal ganglionic lacunar infarction and to distinguish cerebral infarction from cerebral hemorrhage. SPECT and X-CT can not be used in place of each other

  6. Failure of collateral blood flow is associated with infarct growth in ischemic stroke.

    Science.gov (United States)

    Campbell, Bruce C V; Christensen, Søren; Tress, Brian M; Churilov, Leonid; Desmond, Patricia M; Parsons, Mark W; Barber, P Alan; Levi, Christopher R; Bladin, Christopher; Donnan, Geoffrey A; Davis, Stephen M

    2013-08-01

    Changes in collateral blood flow, which sustains brain viability distal to arterial occlusion, may impact infarct evolution but have not previously been demonstrated in humans. We correlated leptomeningeal collateral flow, assessed using novel perfusion magnetic resonance imaging (MRI) processing at baseline and 3 to 5 days, with simultaneous assessment of perfusion parameters. Perfusion raw data were averaged across three consecutive slices to increase leptomeningeal collateral vessel continuity after subtraction of baseline signal analogous to digital subtraction angiography. Changes in collateral quality, Tmax hypoperfusion severity, and infarct growth were assessed between baseline and days 3 to 5 perfusion-diffusion MRI. Acute MRI was analysed for 88 patients imaged 3 to 6 hours after ischemic stroke onset. Better collateral flow at baseline was associated with larger perfusion-diffusion mismatch (Spearman's Rho 0.51, P<0.001) and smaller baseline diffusion lesion volume (Rho -0.70, P<0.001). In 30 patients without reperfusion at day 3 to 5, deterioration in collateral quality between baseline and subacute imaging was strongly associated with absolute (P=0.02) and relative (P<0.001) infarct growth. The deterioration in collateral grade correlated with increased mean Tmax hypoperfusion severity (Rho -0.68, P<0.001). Deterioration in Tmax hypoperfusion severity was also significantly associated with absolute (P=0.003) and relative (P=0.002) infarct growth. Collateral flow is dynamic and failure is associated with infarct growth. PMID:23652626

  7. Role of neuronal NADPH oxidase 1 in the peri-infarct regions after stroke.

    Directory of Open Access Journals (Sweden)

    Dong-Hee Choi

    Full Text Available The molecular mechanism underlying the selective vulnerability of neurons to oxidative damage caused by ischemia-reperfusion (I/R injury remains unknown. We sought to determine the role of NADPH oxidase 1 (Nox1 in cerebral I/R-induced brain injury and survival of newborn cells in the ischemic injured region. Male Wistar rats were subjected to 90 min middle cerebral artery occlusion (MCAO followed by reperfusion. After reperfusion, infarction size, level of superoxide and 8-hydroxy-2'-deoxyguanosine (8-oxo-2dG, and Nox1 immunoreactivity were determined. RNAi-mediated knockdown of Nox1 was used to investigate the role of Nox1 in I/R-induced oxidative damage, neuronal death, motor function recovery, and ischemic neurogenesis. After I/R, Nox1 expression and 8-oxo-2dG immunoreactivity was increased in cortical neurons of the peri-infarct regions. Both infarction size and neuronal death in I/R injury were significantly reduced by adeno-associated virus (AAV-mediated transduction of Nox1 short hairpin RNA (shRNA. AAV-mediated Nox1 knockdown enhanced functional recovery after MCAO. The level of survival and differentiation of newborn cells in the peri-infarct regions were increased by Nox1 inhibition. Our data suggest that Nox-1 may be responsible for oxidative damage to DNA, subsequent cortical neuronal degeneration, functional recovery, and regulation of ischemic neurogenesis in the peri-infarct regions after stroke.

  8. Contrast MR imaging of acute cerebral infarction

    International Nuclear Information System (INIS)

    Thirty patients with acute and subacute cerebral infarction (13 and 17 deep cerebral infarction) were studied with 0.5 T MR unit before and after intravenous injection of Gd-DTPA. Thirteen patients were studied within 7 days after neurological ictus, 17 patients were studied between 7 and 14 days. Two types of abnormal enhancement, cortical arterial and parenchymal enhancement, were noted. The former was seen in 3 of 4 cases of very acute cortical infarction within 4 days after clinical ictus. The latter was detected in all 7 cases of cortical infarction after the 6th day of the ictus, and one patient with deep cerebral infarction at the 12th day of the ictus. Gd-DTPA enhanced MR imaging seems to detect gyral enhancement earlier compared with contrast CT, and depict intra-arterial sluggish flow which was not expected to see on contrast CT scans. (author)

  9. Artery of Percheron infarction: review of literature with a case report

    International Nuclear Information System (INIS)

    Clinical features indicating an ischemic infarction in the territory of posterior cerebral circulation require a comprehensive radiologic examination, which is best achieved by a multi-modality imaging approach (computed tomography [CT], CT-perfusion, computed tomography angiography [CTA], magnetic resonance imaging [MRI] and diffusion weighted imaging [DWI]). The diagnosis of an acute ischemic infarction, where the damage of brain tissue may still be reversible, enables selection of appropriate treatment and contributes to a more favourable outcome. For these reasons it is essential to recognize common neurovascular variants in the territory of the posterior cerebral circulation, one of which is the artery of Percheron. A 69 year-old woman, last seen awake 10 hours earlier, presented with two typical clinical features of the artery of Percheron infarction, which were vertical gaze palsy and coma. Brain CT and CTA of neck and intracranial arteries upon arrival were interpreted as normal. A new brain CT scan performed 24 hours later revealed hypodensity in the medial parts of thalami. Other imaging modalities were not performed, due to the presumption that the window for the application of effective therapy was over. The diagnosis of an artery of Percheron infarction was therefore made retrospectively with the re-examination of the CTA of neck and intracranial arteries. A multi-modality imaging approach is necessary in every patient with suspicion of the posterior circulation infarction immediately after the onset of symptoms, especially in cases where primary imaging modalities are unremarkable and clinical features are severe, where follow-up examinations are indicated

  10. Microvascular basis for growth of small infarcts following occlusion of single penetrating arterioles in mouse cortex.

    Science.gov (United States)

    Taylor, Zachary J; Hui, Edward S; Watson, Ashley N; Nie, Xingju; Deardorff, Rachael L; Jensen, Jens H; Helpern, Joseph A; Shih, Andy Y

    2016-08-01

    Small cerebral infarcts, i.e. microinfarcts, are common in the aging brain and linked to vascular cognitive impairment. However, little is known about the acute growth of these minute lesions and their effect on blood flow in surrounding tissues. We modeled microinfarcts in the mouse cortex by inducing photothrombotic clots in single penetrating arterioles. The resultant hemodynamic changes in tissues surrounding the occluded vessel were then studied using in vivo two-photon microscopy. We were able to generate a spectrum of infarct volumes by occluding arterioles that carried a range of blood fluxes. Those resulting from occlusion of high-flux penetrating arterioles (flux of 2 nL/s or higher) exhibited a radial outgrowth that encompassed unusually large tissue volumes. The gradual expansion of these infarcts was propagated by an evolving insufficiency in capillary flow that encroached on territories of neighboring penetrating arterioles, leading to the stagnation and recruitment of their perfusion domains into the final infarct volume. Our results suggest that local collapse of microvascular function contributes to tissue damage incurred by single penetrating arteriole occlusions in mice, and that a similar mechanism may add to pathophysiology induced by microinfarcts of the human brain. PMID:26661182

  11. OCCLUSION OF ARTERY OF PERCHERON: A RARE AETIOLOGY OF BILATERAL THALAMIC INFARCT

    Directory of Open Access Journals (Sweden)

    Mane Makarand, Mane Priyanka, Mohite Rajsinh , Bhattad Prashant, Bangar Kushal, Mahajani Anup

    2015-10-01

    Full Text Available The Artery of Percheron, a rare anatomical variant of brain vascularisation, arises from the posterior cerebral artery. Occlusion of this artery leads to bilateral paramedian thalamic infarct leads to dysfunction of central nervous system. Incidence of bilateral thalamic infarct secondary to occlusion of artery of Percheron is unknown because of its rarity. Here we report a case of 35 year old female presented with altered state of consciousness and the underlying cause was occlusion of Artery of Percheron which leads to bilateral thalamic infarct detected on MRI scanning. It showed hyperintensities on T2W1 and FLAIR, and hypointensity on T1W1, restricted to bilateral ventromedial thalami showing corresponding area of high signal intensity on diffusion weighted images and hypointensity on apparent diffusion coefficient images indicating diffusion restriction, suggestive of infarct. On further investigation magnetic resonance arteriogram (MRA of the brain demonstrated a single common artery arising from the left P1 segment which divided into two branches distally supplying bilateral thalami. Patient became alright after 2 weeks of medical line of treatment.

  12. Circadian influences on myocardial infarction.

    Science.gov (United States)

    Virag, Jitka A I; Lust, Robert M

    2014-01-01

    Components of circadian rhythm maintenance, or "clock genes," are endogenous entrainable oscillations of about 24 h that regulate biological processes and are found in the suprachaismatic nucleus (SCN) and many peripheral tissues, including the heart. They are influenced by external cues, or Zeitgebers, such as light and heat, and can influence such diverse phenomena as cytokine expression immune cells, metabolic activity of cardiac myocytes, and vasodilator regulation by vascular endothelial cells. While it is known that the central master clock in the SCN synchronizes peripheral physiologic rhythms, the mechanisms by which the information is transmitted are complex and may include hormonal, metabolic, and neuronal inputs. Whether circadian patterns are causally related to the observed periodicity of events, or whether they are simply epi-phenomena is not well established, but a few studies suggest that the circadian effects likely are real in their impact on myocardial infarct incidence. Cycle disturbances may be harbingers of predisposition and subsequent response to acute and chronic cardiac injury, and identifying the complex interactions of circadian rhythms and myocardial infarction may provide insights into possible preventative and therapeutic strategies for susceptible populations. PMID:25400588

  13. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    International Nuclear Information System (INIS)

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  14. Clinical discriminators between acute brain hemorrhage and infarction: a practical score for early patient identification Características clínicas diferenciais entre hemorragia e infarto cerebral: uma escala prática para identificação precoce do paciente

    Directory of Open Access Journals (Sweden)

    Ayrton R. Massaro

    2002-06-01

    Full Text Available New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF and 237 had parenchymatous hemorrhage (HEM verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score Novas perspectivas no tratamento do acidente vascular cerebral (AVC requerem um método de triagem rápido para seleção dos pacientes. Nosso objetivo foi criar uma escala com informações clínicas simples para diferenciar hematoma intra-parenquimatoso (HEM entre os pacientes com AVC. Estudamos 1.273 pacientes com AVC isquêmico (INF e 237 com HEM do Stroke Data Bank. Variáveis independentes para o diagnóstico de INF e HEM foram determinadas pela análise de regressão logística e utilizadas para criar uma escala. Através da curva ROC foi escolhido o nível de corte para discriminar HEM (<= 2 , com sensibilidade de 76%, especificidade de 83%. Foi realizada validação externa utilizando os pacientes do estudo NOMASS. Embora o uso de uma escala de fácil aplicação pelas equipes de emergência não possa substituir os métodos de imagem na diferenciação entre INF e HEM para a indicação de trombolítico, a escala proposta pode ser útil para selecionar pacientes para estudos clínicos e tratamento pré-hospitalar, alertar técnicos de tomografia e as equipes médicas sobre a chegada de pacientes, contribuindo para reduzir atrasos cruciais no tratamento.

  15. Concentration of labelled polyphosphates in soft tissue lesions. Application to the study of cerebral and myocardial infarction

    International Nuclear Information System (INIS)

    The biological behavior and tissue localization of phosphorus compounds used in Nuclear Medicine are reviewed. The mechanism of skeletal localization is emphasized. Labeled pyrophosphate compounds have proved extremely useful for skeletal imaging, however the mechanism of increased accumulation of these agents has been observed also in soft tissues. They localize in the acutely infarcted myocardium and in brain lesions. Clinical results obtained with sup(99m)Tc stannous pyrophosphate in brain and myocardium imaging are reported

  16. Migraine and structural changes in the brain

    DEFF Research Database (Denmark)

    Bashir, Asma; Lipton, Richard B; Ashina, Sait;

    2013-01-01

    To evaluate the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions....

  17. Ophthalmic Artery Obstruction and Cerebral Infarction Following Periocular Injection of Autologous Fat

    OpenAIRE

    Lee, Chang Mok; Hong, In Hwan; Park, Sung Pyo

    2011-01-01

    We report a case of ophthalmic artery obstruction combined with brain infarction following periocular autologous fat injection. The patient, a 44-year-old woman, visited our hospital for decreased visual acuity in her left eye and dysarthria one hour after receiving an autologous fat injection in the periocular area. Her best corrected visual acuity for the concerned eye was no light perception. Also, a relative afferent pupillary defect was detected in this eye. The left fundus exhibited wid...

  18. Acute myocardial infarction and cerebrovascular accident in a young girl after a viper bite.

    OpenAIRE

    Aravanis, C; Ioannidis, P J; Ktenas, J

    1982-01-01

    A 17-year-old girl developed an acute myocardial infarction immediately after being bitten by a viper and four days later she had a cerebrovascular accident. The close clinical and laboratory follow-up of this case suggested that myocardial damage could be attributed to a direct cardiotoxic effect of the venom, while the brain injury that subsequently appeared was probably the result of a disseminated intravascular coagulopathy, possibly in conjunction with vasculitis.

  19. Cerebral Aspergillus arteritis with bland infarcts: A report of two patients with poor outcome

    Directory of Open Access Journals (Sweden)

    Uppin Megha

    2007-01-01

    Full Text Available Two patients with cerebrovascular aspergillosis, in the form of arteritis, thrombosis and bland infarcts are reported. One patient had systemic lupus erythematosus with disseminated aspergillosis in lungs, kidneys and brain. The other patient was immunocompetent and had sphenoid sinusitis. Both the patients were diagnosed at autopsy only, despite extensive imaging and laboratory studies. High index of clinical suspicion and early aggressive antifungal therapy are required since definite diagnostic modalities are not available.

  20. Magnetic resonance imaging of brain in cardiogenic insults

    International Nuclear Information System (INIS)

    MRI characteristic of stroke in patients with different forms of atrial fibrillation with the account of main vascular risk factors was described. The most frequent type of MRI picture in cardio embolic stroke is a wedge-shaped area in the cortical subcortical portions of the frontoparietal or patient temporal lobe. Hemorrhagic transformation of the brain infarct was diagnosed in 33,3% of the patient with cardio embolic insult. Small lacunar infarcts were visualized mainly in the patients with arterial hypertension

  1. Pontine Infarct Presenting with Atypical Dental Pain: A Case Report.

    Science.gov (United States)

    Goel, Rajat; Kumar, Sanjeev; Panwar, Ajay; Singh, Abhishek B

    2015-01-01

    Orofacial pain' most commonly occurs due to dental causes like caries, gingivitis or periodontitis. Other common causes of 'orofacial pain' are sinusitis, temporomandibular joint(TMJ) dysfunction, otitis externa, tension headache and migraine. In some patients, the etiology of 'orofacial pain' remains undetected despite optimal evaluation. A few patients in the practice of clinical dentistry presents with dental pain without any identifiable dental etiology. Such patients are classified under the category of 'atypical odontalgia'. 'Atypical odontalgia' is reported to be prevalent in 2.1% of the individuals. 'Atypical orofacial pain' and 'atypical odontalgia' can result from the neurological diseases like multiple sclerosis, trigeminal neuralgia and herpes infection. Trigeminal neuralgia has been frequently documented as a cause of 'atypical orofacial pain' and 'atypical odontalgia'. There are a few isolated case reports of acute pontine stroke resulting in 'atypical orofacial pain' and 'atypical odontalgia'. However, pontine stroke as a cause of atypical odontalgia is limited to only a few cases, hence prevalence is not established. This case is one, where a patient presented with acute onset atypical dental pain with no identifiable dental etiology, further diagnosed as an acute pontine infarct on neuroimaging. A 40 years old male presented with acute onset, diffuse teeth pain on right side. Dental examination was normal. Magnetic resonance imaging(MRI) of the brain had an acute infarct in right pons near the trigeminal root entry zone(REZ). Pontine infarct presenting with dental pain as a manifestation of trigeminal neuropathy, has rarely been reported previously. This stresses on the importance of neuroradiology in evaluation of atypical cases of dental pain. PMID:26464604

  2. Periventricular hyperintensity lesions and dementia in multiple cerebral infarction

    International Nuclear Information System (INIS)

    To examine the relationship between the presence of periventricular hyperintensity (PVH), as shown on MR-T2 weighted images, and both ischemia and dementia, regional cerebral blood flow (rCBF), oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen (CMRO2), and cerebral blood volume (CBV) were determined by positron emission computed tomography using the 15O and 11CO inhalation technique. Thirty-three patients with subcortical cerebral infarction were classified according to the presence of PVH: the PVH (+) group with severe PVH (n=17) and the PVH (-) group without PVH (n=16). In the PVH (+) group of patients with no association of dementia and the PVH (-) group, both decreased rCBF and increased OEF were significantly observed in the frontal cingulate gyrus and PVH area, when compared with the normal controls. In the PVH (+) group of dementia patients, on the other hand, rCBF was significantly decreased in the PVH lesion and each cortical region; and CMRO2 was significantly decreased and OEF was increased in the PVH lesion and all cortical regions, especially the frontal cingulate gyrus. Moreover, the PVH(+) group had a significantly decreased rCBF and rCBF/CBV ratio in PVH lesion. These results showed that 'compensated hypoperfusion' existed in PVH lesion and cortical regions, especially the frontal cingulate gyrus, in multiple infarction patients without dementia and that 'ischemic hypoperfusion' was observed when associated with dementia. These changes, which seemed to be caused by cerebroarteriosclerosis, not only preceded the occurrence of mental deterioration, but also still persisted after dementia had occurred. PVH also reflected severe ischemic changes of the brain in multiple cerebral infarction, irrespective of the association of dementia. (N.K.)

  3. Therapeutic Hypothermia for Cardioprotection in Acute Myocardial Infarction

    OpenAIRE

    Kang, In Sook; Fumiaki, Ikeno; Pyun, Wook Bum

    2016-01-01

    Mild therapeutic hypothermia of 32–35℃ improved neurologic outcomes in outside hospital cardiac arrest survivor. Furthermore, in experimental studies on infarcted model and pilot studies on conscious patients with acute myocardial infarction, therapeutic hypothermia successfully reduced infarct size and microvascular resistance. Therefore, mild therapeutic hypothermia has received an attention as a promising solution for reduction of infarction size after acute myocardial infarction which are...

  4. Myocardial infarction and nocturnal hypoxaemia

    Directory of Open Access Journals (Sweden)

    Penčić Biljana

    2007-01-01

    Full Text Available Introduction: There is an increased risk of cardiovascular morbidity and mortality in patients with nocturnal intermittent hypoxaemia. Objecive. The aim of this study was to evalute the influence of nocturnal hypoxaemia on ventricular arrhythmias and myocardial ischaemia in patients with myocardial infarction (MI. Method. We studied 77 patients (55.8±7.9 years with MI free of complications, chronic pulmonary diseases, abnormal awake blood gases tension. All patients underwent overnight pulse oximetry and 24-hour electrocardiography. Patients were divided into two groups according to nocturnal hypoxaemia. Total number of ventricular premature complex (VPC; maximal VPC/h; incidence of VPC Lown class>2 and occurrence of ST-segment depression were analyzed for nocturnal (10 PM to 6 AM, daytime (6 AM to 22 PM periods and for the entire 24 hours. Results. Both groups were similar in age, gender, standard risk factors, myocardial infarction size and did not differ in VPC during the analyzed periods. The number of nocturnal maximal VPC/h was insignificantly greater in group 1 (with hypoxaemia compared to group 2 (without hypoxaemia, (p=0.084. Maximal VPC/h did not differ significantly either for daytime or for 24 hours among the groups. Nocturnal VPC Lown>2 were significantly more frequent in group 1 (25% vs 0%, p=0.002. The incidence of VPC Lown>2 was similar during the daytime, and during 24 hrs in both groups. Occurrence of ST-segment depression did not differ between groups 1 and 2. Conclusion. Nocturnal hypoxaemia was associated with complex nocturnal ventricular arrhythmias in patients with MI. .

  5. Brain Basics

    Medline Plus

    Full Text Available ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  6. Brain Basics

    Science.gov (United States)

    ... News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  7. Brain Basics

    Medline Plus

    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... learning more about how the brain grows and works in healthy people, and how normal brain development ...

  8. Effects of mindfulness cognitive behavioral training on self-perception burden and self-efficacy of patients with shoulder-hand syndrome after brain infarction%正念认知行为训练对脑梗死肩手综合征患者自我感受负担及自我效能的影响

    Institute of Scientific and Technical Information of China (English)

    范亚霞; 郝正玮; 王红阳

    2016-01-01

    Objective To investigate the effects of mindfulness cognitive behavioral training on self -perception burden and self-efficacy of patients with shoulder-hand syndrome ( SHS ) after brain infarction . Methods A total of 65 cases with SHS were randomly divided by coin-tossing into two groups:control group (n=32) and experimental group (n =33).Patients in control group received routine rehabilitation , while patients in experimental group were given mindfulness cognitive behavioral training for 6 weeks consecutively based on routine rehabilitation;both groups of patients were evaluated using Barthel index (BI), self-perceived burden scale ( SPB ) , general self-efficacy scale ( GSES ) , mindful attention awareness scale ( MAAS ) and quality of life short-form 36(SF-36) before and after 6 weeks of intervention.Results There was no significant difference in the scores of BI,SPB,GSES,MAAS and SF-36 between two groups before the intervention (P>0.05).After the intervention, scores of BI,GSES and MAAS in experimental group were (72.4 ±11.6), (7.3 ±1.3),(79.9 ±11.8) respectively,which all higher than that of control group significantly (t=3.38, 6.50,5.41;P<0.05), while the score of SPBS was (38.2 ±5.7) lower than that of control group (47.3 ± 6.6) significantly (t=5.72;P<0.05); The scores of SF-36 for each dimension of experimental group were higher than that of control group significantly (P<0.05).Furthermore, MAAS score was correlated positively with scores of general health , vitality, social function , emotional function , mental health in SF-36 with significant difference ( P<0.05 ) .Conclusions The cognitive behavioral training based on mindfulness can weaken the self-perceived burden and strengthen self-efficacy of patients with SHS after brain infarction greatly , so as to improve the life quality of patients .%目的:探讨以正念为基础的认知行为训练对脑梗死肩手综合征患者自我感觉负担及自我效能的影响。方法投

  9. Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction by Biomarkers

    Science.gov (United States)

    2016-01-25

    Acute Myocardial Infarction (AMI); Acute Coronary Syndrome (ACS); ST Elevation (STEMI) Myocardial Infarction; Ischemic Reperfusion Injury; Non-ST Elevation (NSTEMI) Myocardial Infarction; Angina, Unstable

  10. Follow-up CT of hemorrhagic cerebral infarction

    International Nuclear Information System (INIS)

    The computed tomography (CT) findings in cases of hemorrhagic cerebral infarction were divided into the following two different patterns: (1) The precontrast scan showed small high-density spots, mainly at the cortico-subcortical junctions. These appeared to represent a small amount of hemorrhage. The contrast enhancements were remarkable around these high-density areas as observed by the plain CT. (2) The precontrast scan showed only low-density areas, but the contrast scan showed an enhancement at the border zone of the gray and white junction, similar to those observed in Type 1 CT. Three (20%) of the 15 patients presented Type 1, and 12 patients (80%), Type 2. In the cases of Type 1, a positive CE was seen within a few days after the insult. This CE demonstrated the disturbance of the blood-brain barrier (B B B) during the stage of vasogenic edema. In the cases of Type 2, the positive CE was further divided into two subtypes: the early stage (2 to 3 weeks) and the late stage (4 weeks) after the stroke. The positive CE at the early stage, might be explainable to a significant extent by an extravasation of the contrast medium resulting from permeability changes in the vessels located in the boundary zones of the gray and white matter. On the contrary, the CE enhancement observed in the late stage might result chiefly from newly formed vessels with a defective BBB in and around the infarcted area. (author)

  11. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    International Nuclear Information System (INIS)

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  12. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Schaaf, Irene C. van der; Velthuis, Birgitta K.; Dankbaar, Jan Willem [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands)

    2015-09-15

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  13. Perfusion scintigraphy in acute myocardial infarction

    International Nuclear Information System (INIS)

    The Tc-99m sestamibi perfusion SPECT scintigraphy in acute myocardial infarction is a feasible method to assess the size of area at risk and the residual blood flow to this area as the most important determinants of final infarct size without any delay in treatment. In combination with a follow-up study final infarct size as well as myocardial salvage can be quantified. Clinical indications for the use of Tc-99m sestamibi scintigraphy are the noninvasive identification of arterial occlusion in patients suspected to acute myocardial infarction without electrocardiographic ST-elevation and the assessment of reperfusion success. In clinical trials Tc-99m sestamibi scintigraphy has proven to be a useful method to assess the impact of varying reperfusion therapies. The present review article discusses the indication, the study protocol, the interpretation of results and the clinical and scientifically importance of this method. (orig.)

  14. Scorpion bite and multiple cerebral infarcts.

    OpenAIRE

    Thacker A; Lal R; Misra M

    2002-01-01

    Multiple cerebral infarcts, bilateral optic neuropathy with limb ischemia, following scorpion bite is documented. Vasospasm and autonomic storm due to envenomation is a plausible explanation for this symptom complex.

  15. [Family experiences post-acute myocardial infarction].

    Science.gov (United States)

    Garcia, Raquel Pötter; Budó, Maria de Lourdes Denardin; Simon, Bruna Sodré; Wünsch, Simone; Oliveira, Stefanie Griebeler; Barbosa, Mariane da Silva

    2013-09-01

    This study aimed to describe the family experiences post-infarction. Qualitative, descriptive and exploratory research, carried out with six families of post-infarction patients. Data collection was conducted in families' homes, in the period of February to May of 2012, through observation and interviews with the family. The software Atlas Ti 6.2 was used to code the interviews and the data were explored with thematic analysis. Two categories emerged "Difficult times": immediate consequence of acute myocardial infarction for the families; and "We reeducate ourselves--we can adapt ourselves": current experience of families. The immediate post-infarction experience is permeated by several feelings, with the need for families to adapt to fit into the needs. The current experience shows changes in families due to the disease. The family is the main responsible for the care giving, although Nursing should exchange and share knowledge. PMID:24344600

  16. Secondary Prevention in Acute Myocardial Infarction

    OpenAIRE

    IRMAK, Yrd.Doç.Dr. Zöhre; FESCİ, Doç.Dr. Hatice

    2005-01-01

    Recent studies on patients who had an acute myocardial infarction have shown that risk factors are decreased, atherosclerosis regressed, and re-infarction and mortality rates are reduced as a result of drug therapy in combination with the changes in the lifestyle. This treatment called as secondary prevention, requires a behavioral change in the lifestyle that includes stopping smoking, making healthy food choices, and increasing physical activity. Risk factors related with lifestyle, wh...

  17. Acute myocardial infarction following a hornet sting

    OpenAIRE

    Cvetković-Matić Danica; Ašanin Milika; Matić Dragan; Ivanović Branislava; Simić Dragan; Kalezić Nevena; Stojanov Vesna

    2009-01-01

    Background. The occurrence of an acute myocardial infarction following a hornet sting has been very rarely reported in the previous literature. Pathogenetic mechanisms include direct action of the venom components on the coronary endothelium and allergic reaction with mediators released from mast cells. The anaphylactic reaction and venom components can produce acute coronary artery thrombosis. Case report. We reported a 45-year-old man with acute myocardial infarction after a hornet sting in...

  18. Headache: A Symptom of Acute Myocardial Infarction

    OpenAIRE

    Yasmine Elgharably; Cesar Iliescu; Stefano Sdringola; Syed Wamique Yusuf

    2013-01-01

    ABSTRACT:We present a case of 55 year old man, with myocardial infarction and coronary thrombosis, whose initial presentation was with severe headache and review the literature.INTRODUCTION:Coronary ischemia typically presents with retrosternal pain that radiates to left arm (1). present atypically in various forms like indigestion (2), otalgia (3), facial pain (4) and syncope (5). Headache as the sole presentation of myocardial infarction (MI) is rare; however it has been reported previously...

  19. CT findings of early acute cerebral infarction

    International Nuclear Information System (INIS)

    The CT findings of the acute cerebral infarction are well known. However the CT findings of early stroke within 24 hours of the onset have not been sufficiently reported. The purpose of this study is to evaluate early acute cerebral infarction on CT within 24 hours after ictus. The early and accurate CT diagnosis could lead to the appropriate therapy and improved outcome of the patients. Authors retrospectively analyzed 16 patients with early acute cerebral infarction. Acute cerebral infarction was confirmed by follow-up CT in 11 patients, SPECT in 4 patients, and MRI in 1 patient. The CT findings of early acute cerebral infarction include effacement of cortical sulci or cistern (n = 16, 100%), hyperattenuation of MCA (n = 3), obscuration of lentiform nucleus (n = 6), loss of insular ribbon (n = 6) and subtle low density in hemisphere (n = 5). The most frequent finding was effacement of cortical sulci in our study, and it was thought to be the most important sign of early acute cerebral infarction

  20. Influence of PCI on levels of brain natriuretic peptide and aldosterone and short-term prognosis in patients with acute myocardial infarction%冠脉介入治疗对急性心梗患者脑利钠肽、醛固酮水平和近期预后的影响

    Institute of Scientific and Technical Information of China (English)

    林佩璜

    2015-01-01

    目的:探讨冠脉介入治疗(PCI)对急性左室下壁和前壁心肌梗死患者血浆脑利钠肽(BNP)、醛固酮(Ald)水平及近期预后的影响。方法:分析治疗前212例急性下壁(140例)、前壁(72例)心肌梗死患者血浆BNP、Ald水平及与冠脉病变的关系;比较两组患者直接、延迟PCI治疗后血浆BNP、Ald水平的变化及对近期预后的影响。结果:PCI治疗前,与急性下壁梗死组比较,急性前壁梗死组患者血浆 BNP[(642.06±235.08) ng/L比(856.54±223.50) ng/L]、Ald[(50.26±5.23) ng/dl比(88.34±8.52) ng/dl ]水平、冠脉狭窄程度[(82.28±7.65)%比(90.64±7.54)%]及3支病变发生率(22.52%比39.66%)均明显升高(P均<0.05);直接和延迟PCI治疗后,血浆BNP、Ald水平明显下降(P均<0.01),且直接PCI组较延迟PCI组血浆BNP[急性下壁梗死组:(216.93±119.86) ng/L比(453.75±107.54) ng/L ,急性前壁梗死组:(245.754±121.52) ng/L比(483.04±164.65) ng/L]、Ald[急性下壁梗死组:(40.09±6.55) ng/dl比(45.34±8.15) ng/dl ,急性前壁梗死组:(43.65±3.50) ng/dl比(50.43±9.21) ng/dl]水平下降更显著(P均<0.01);未行PCI治疗的患者近期死亡发生率明显高于行直接 PCI及延迟PCI治疗的患者(11.63%比2.78%比3.28%,P均<0.05)。结论:急性前壁心肌梗死患者血浆BNP、Ald水平高,冠脉病变严重;直接PCI较延迟PCI治疗血浆BNP、Ald浓度下降幅度更大,未行PCI治疗的患者死亡率较高。%Objective:To explore the influence of percutaneous coronary intervention (PCI) on plasma levels of brain natri‐uretic peptide (BNP) and aldosterone (Ald) and short‐term prognosis in patients with acute left ventricular inferior and an‐terior wall myocardial infarction .Methods:A total of 212 patients were divided into acute inferior myocardial infarction

  1. Effect of myocardial infarction on the function and metabolism of the non-infarcted muscle

    International Nuclear Information System (INIS)

    Rat hearts were infarcted in vivo by ligation of the left ventricular coronary artery. After one or three weeks, the hearts were isolated and perfused in vitro. Despite the onset of hypertrophy, ventricular function was more depressed in the one- and three-week infarcted hearts than in acutely ligated hearts. These data suggested that the depressed mechanical function was due not only to the loss of viable tissue, but also to alterations occurring in the non-infarcted tissue. The inotropic response to extracellular calcium was depressed in infarcted hearts, such that the mechanical performance of the infarcted heart was likely to be limited by the availability of extracellular calcium under physiological conditions. No limitation in energy production was found as indicated by the maintenance of ATP levels, the creatine phosphate/creatine ratio and normal lactate concentrations in the infarcted hearts. Comparison of the rates of substrate oxidation with MVO2 revealed that, in both the sham and infarcted hearts, substrate oxidation, as estimated by 14CO2 production, could not account for the observed MVO2. It was found that the rate of 14CO2 production from exogenous labeled palmitate underestimated the actual rate of fatty acid oxidation. This resulted from incomplete equilibration of added [14C]-palmitate with the fatty acyl moieties present in acyl carnitine. However, the rate of 14CO2 production from exogenous palmitate was lower in the infarcted than sham hearts

  2. Brain herniation

    Science.gov (United States)

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  3. Retrospective analyses of super acute cerebral infarction on plain CT scan

    International Nuclear Information System (INIS)

    Objective: To discuss the diagnostic value of plain CT scan on super acute cerebral infarction. Method 23 patients were retrospective studied, which were confirmed suffering from super acute cerebral infarction. CT scans were performed within 6 hours after onset. TCT-300SCT was used, with slice thickness and distance 10mm. Results 14 patients showed cerebral shape abnormal on CT imaging. Among them, 4 patients showed locally narrowed or disappeared sulci, 8 patients displayed cistern asymmetry of both sides, 2 patients showed lateral ventricle distortion, 5 patients showed slight lower density, 6 cases showed blurry basal nuclei structure. 7 patients showed normal on CT scans. Only 7 patients were diagnosed as super acute cerebral infarction, with the accurate ratio 30.43%. Conclusion: Brain edema and blurry basal nuclei structure are very important features for diagnosing super acute cerebral infarction on plain CT scan, but these features are easily ignored. So we should pay more attention to the CT exhibitions combined with clinical information in order to diagnose correctly and provide useful information for clinical treatment. (authors)

  4. Fast FLAIR MR imaging finidngs of cerebral infarction : comparison with T2-weighted spin echo imaging

    International Nuclear Information System (INIS)

    To evaluate the utility of FLAIR(Fluid Attenuated Inversion Recovery) MR imaging in cerebral infarction by comparing its results with those of T2-weighted spin-echo imaging. We retrospectively evaluated fast FLAIR images and conventional spin echo images of 82 patients (47 men and 20 women ; median age 60.9 years) with cerebral infarction. MR imaging used a 1.5T MR unit with conventional T2(TR 3900, TE 90) and fast FLAIR sequence (TR 8000, TE 105, TI 2400). We analysed the size of the main lesion and number of lesions, and discrimination between old and new lesions and between small infarction and perivascular space. When T2-weighted and FLAIR imaging were compared, the latter showed that the main lesion was larger in 38 cases (46%), similar in 38 (46%), and smaller in six (7%). The number of lesions was greater in 23 cases(28%), similar in 52 (63%), and fewer in seven (9%). FLAIR images discriminated between old and new lesions in 31 cases ; perivascular space and small infarotion were differentiated in eight cases, and CSF inflowing artifact was observed in 66 (80%). In the diagnosis of cerebral infaretion, fast FLAIR provides images that are equal or superior to T2-weighted images. The fast FLAIR sequence may therefore be used as a part of routine MR brain study in the diagnosis of cerebral infarction

  5. [Cervical cord infarction associated with unilateral vertebral artery dissection due to golf swing].

    Science.gov (United States)

    Tokumoto, Kazuki; Ueda, Nobuhiko

    2014-01-01

    A-68-year-old man experienced nuchal pain and bilateral shoulder weakness that occurred suddenly after he performed a golf swing. He was conscious. His cranial nerves were normal, but bilateral deltoid and biceps muscle strengths weakened. Magnetic resonance image (MRI) showed no brain stem infarctions or cervical epidural hematoma. We tentatively diagnosed him with concussion of the spinal cord because of mild recovery of his bilateral upper limb weakness after several hours; he was later discharged. The next day, he suddenly developed serious tetraplegia and was admitted to the emergency department. His breathing was controlled by a respirator as he had expectoration difficulty and respiratory muscle paralysis. A lesion in the cervical cord became apparent on MRI; the right vertebral artery was not detected on magnetic resonance angiography. Cervical MRI showed the intimal flap and a lack of flow void in the right vertebral artery. These findings revealed a right vertebral artery dissection. Cervical cord infarction due to unilateral vertebral artery dissection is rarer than posterior cerebral infarction due to the same pathogenesis; however, some such cases have been reported. We consider the present case to be caused by cervical cord infarction associated with unilateral vertebral artery dissection resulting from golf swing. PMID:24583591

  6. Effect of Acupuncture on the Expression of Glucose Transporter 1 in the Brain of Multiple Infarction Dementia Rat%针刺对多发性梗塞痴呆大鼠脑葡萄糖转运蛋白1表达的影响

    Institute of Scientific and Technical Information of China (English)

    杨宏波; 张雪竹; 韩景献; 于建春

    2011-01-01

    目的:观察"益气调血,扶本培元"针法对多发性梗塞痴呆(MID)模型认知功能的改善作用.方法:采用栓子注入法制作MID模型,将雄性Wistar大鼠随机分为正常组、假手术组、模型组、针刺组和非穴组,每组15只.针刺组选取膻中、中脘、气海及双侧血海、足三里;非穴组选取双侧肋下各2个固定非穴点,每日1次,治疗6天,休息1天,共治疗3周.采用Morris水迷宫检测造模后大鼠的学习记忆功能;免疫组化法观察各组大鼠海马CA1区、CA3区、DG区及大脑皮层葡萄糖转运蛋白1(GLUT1)的表达.结果:模型组大鼠学习记忆能力显著下降(P<0.05);而与模型组与非穴组比较,针刺组大鼠发现平台所需时间明显缩短(P<0.05或P<0.01),跨越原平台次数和原平台区域的停留时间均明显增加(P<0.05).模型组大鼠各脑区GLUT1的表达量明显高于正常组和假手术组(P<0.05);除皮层外,针刺组大鼠海马CA1、CA3、DG区的GLUT1表达量与模型组及非穴组比较差异均有统计学意义(P<0.05).结论:"益气调血,扶本培元"针法能够上调GLUT1表达,促进葡萄糖的跨膜转运,从而增强血管性痴呆大鼠脑组织的葡萄糖代谢,改善脑组织的缺血缺氧,进而改善认知功能.%Objective To observe the cognitive-improving effect of acupuncture for Yiqi Tiaoxue (replenishing qi and regulating blood) and Fuben Peiyuan (reinforcing the anti-pathogenic qi and consolidating the body resistance) on multiple infarction dementia (MID) model rat.Methods The embolic suspension was injected to induce multiple infarct dementia.The male Wistar rats were randomized into the normal group, sham operation group, model group, acupuncture group, and sham acupuncture group, with 15 in each.The acupuncture group was treated with acupuncture at Shanzhong (CV 17), Zhongwan (CV 12), Qihai (CV 6), Xuehai (SP 10), and Zusanli (ST 36).The sham acupuncture group was treated with acupuncture at the two

  7. Application of radionuclide infarct scintigraphy to diagnose perioperative myocardial infarction following revascularization

    International Nuclear Information System (INIS)

    To evaluate the application of radionuclide infarct scintigraphy to diagnose myocardial infarction after revascularization, we obtained postoperative technetium 99m pyrophosphate myocardial scintigrams, serial electrocardiograms and CPK-MB isoenzymes in ten control and 51 revascularized patients. All control patients had negative electrocardiograms and scintigrams, but eight had positive isoenzymes. Eight revascularized patients had positive electrocardiograms, images and enzymes and two had positive scintigrams and enzymes with negative electrocardiograms. Thirty-four patients with negative electrocardiograms and scintigrams had positive isoenzymes; in only seven patients were all tests negative. Our data suggest radionuclide infarct scintigraphy is a useful adjunct to the electrocardiogram in diagnosing perioperative infarction. The frequent presence of CPK-MB in postoperative patients without other evidence of infarction suggests that further studies are required to identify all factors responsible for its release

  8. Acute myocardial infarction. Clinical application of technetium 99m stannous pyrophosphates infarct scintigraphy

    International Nuclear Information System (INIS)

    Acute myocardial infarction is being recognized as a spectrum of clinical subsets. This appreciation has been brought about to a large degree by the development of several new tools that can be applied clinically to aid in evaluation of patients with acute infarction, and in some cases to provide short- and long-term prognostic information. In the realm of noninvasive methods, several tests utilizing radiopharmaceuticals and scintillation cameras have emerged and are rapidly becoming reliable diagnostic parameters in patients with coronary disease and infarction. Technetium-99m (stannous) pyrophosphate (TcPYP) scintigraphy, one of the first of these techniques to find clinical use, has been shown to be an accurate indicator of acute transmural myocardial infarction and provides added sensitivity and specificity to the diagnosis. Increased diagnostic accuracy, the dimension of visible localization, and the potential for infarct sizing promise physicians better understanding of a patient's clinical presentation and a more rational approach to management

  9. [Occupational stress and myocardial infarction].

    Science.gov (United States)

    Consoli, Silla M

    2015-01-01

    Besides the best-known role of depressed mood, occupational stress deserves to be taken as a coronary risk factor. There are two basic models to define occupational stress: Karasek's model (high job psychological demands associated with low decision latitude, or even low social support at work) and Siegrist's model (imbalance between efforts and rewards received). The combination of the two models better reflects the coronary risk than each model alone. Occupational stress appears both as a risk factor and a prognostic factor after the occurrence of myocardial infarction. The relevance of the models is best in men or in younger age subjects. In women, role conflicts (occupational/domestic), the existence of excessive "intrinsic" efforts (job over investment) and association with marital stress provide more specific information. Burnout, particularly among health professionals, and bullying at work are also linked to cardiovascular risk. Occupational stress is a collective indicator of health at work, valuable to the employer. At an individual level, it can lead to therapeutic preventive approaches. PMID:26150284

  10. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  11. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    International Nuclear Information System (INIS)

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy

  12. 早期康复训练对急性心肌梗死患者N端脑利钠肽前体水平的影响%Effect of early rehabilitation training on N in patients with acute myocardial infarction terminal pro brain natriuretic peptide levels

    Institute of Scientific and Technical Information of China (English)

    陈昌云

    2014-01-01

    目的:观察进行早期康复训练的急性心肌梗死(aMi)患者血清 n 端脑利钠肽前体(nt-pro BnP)水平。方法选取我院176例急性心肌梗死(aMi)患者,分为康复组和对照组,每组均给予相应基础药物治疗,康复组按要求进行早期康复干预训练,入选时及6个月随访时对各组进行血压测量、心电图检查和血清 nt-pro BnP 水平测定。结果入选时各组血压、心电图检及血清 nt-pro BnP 水平差异均无统计学意义,6个月随访时,康复组再次住院例数和其中因心功能恶化再次住院比率明显低于对照组(P<0.05),心电图 st-t 段改善率亦明显高于对照组。与训练前比较,康复组血清 nt-pro BnP 显著下降。结论早期康复干预安全性较好,可降低 nt-pro BnP 水平,改善心功能。%Objective To investigate the influence of early exercise rehabilitation on serum level of NT-pro brain natriuretic peptide(nt-pro BnP) in patients with acute myocardial infarction.(aMi) . Methods 178 cases of patients with aMi followed up for 6 moths were divided into two groups, 96 with early exercise rehabilitation and 82 only accepted conventional treatment as control. Blood pressure, electrocardiogram and the levels of serum nt-pro BnP were detected.Results during the 6 moths of treatment, the risk of total cardiovascular events in the rehabilitation group was significant less than the control group (P<0.05). after 6 moths of treatment, levels of nt-pro BnP were significant decreased in both of the groups (P<0.01, P<0.01) and significant lower in the rehabilitation group (P<0.05), and the improvement rate of st-t of ecG were higher in the rehabilitation group (P<0.05). Conclusion the early exercise rehabilitation is security for aMi patients, and may improve cardiac function and decrease the levels of serum nt-pro BnP.

  13. Nasal feeding case of a brain stem infarction patient in a vegetative state for ten years%一例脑干梗死植物生存状态十年患者营养支持状况分析

    Institute of Scientific and Technical Information of China (English)

    姚雪华; 陈雪珍; 赵金凤

    2016-01-01

    Objective To investigate a nasal feeding case of a brain stem infarction patient in a vegetative state for ten years and its application effects in clinical practice, in order to explore better nutritional support of nasal feeding with reasonable food selection and production, and to maintain and improve patients′nutritional status. Methods With the guidance of nurses and nutritionists, nasal feeding homogenate diet were used to support gastrointestinal nutrition and were made by family members of the patient, which contained cereals, cooked wheaten food, poultry, fish, shellfish, vegetables, milk, fruit, oil and salt. The diet were ground into paste by pounding machine and infused to the patient several times. According to the patient′s condition, the diet were 1680 kcal/day and contained 15% 20% proteins, 20% 25% fat, and 55% 60%carbohydrate. Results During the ten years of high nutrition and quality nasal feeding homogenate diet, the patient was in a very stable condition, with normal function of heart, lung, liver, kidney and other viscera. The blood lipid and blood cells were in normal range with normal urination and defecation, and had no obvious weight loss. Conclusions Homemade homogenate diet is not only very cost-efficient, safe and convenient, but also very easy to digest. It will play a significant role in maintaining patients′physical health and prolonging life if combined with effective clinical treatment.%目的 通过对一例植物生存状态10年患者鼻饲食疗配方的分析研究,并结合对患者应用效果的临床观察,探讨如何合理选择、搭配和制作鼻饲膳食,做好植物生存状态患者的营养支持,保持和改善患者的营养状况.方法 在护士及营养师的指导下,采用患者家属自制鼻饲匀浆膳食进行胃肠内营养支持,匀浆膳食由谷类、面食、禽类、鱼虾类、甲壳类、蔬菜类、牛奶、水果及油、盐等组成,由捣碎机研磨成糊状后为患者分次输入.

  14. Supply-demand mismatch transients in susceptible peri-infarct hot zones explain the origin of spreading injury depolarizations

    Science.gov (United States)

    von Bornstädt, Daniel; Houben, Thijs; Seidel, Jessica; Zheng, Yi; Dilekoz, Ergin; Qin, Tao; Sandow, Nora; Kura, Sreekanth; Eikermann-Haerter, Katharina; Endres, Matthias; Boas, David A.; Moskowitz, Michael A.; Lo, Eng H.; Dreier, Jens P.; Woitzik, Johannes; Sakadžić, Sava; Ayata, Cenk

    2015-01-01

    SUMMARY Peri-infarct depolarizations (PIDs) are seemingly spontaneous spreading depression-like waves that negatively impact tissue outcome in both experimental and human stroke. Factors triggering PIDs are unknown. Here, we show that somatosensory activation of peri-infarct cortex triggers PIDs when the activated cortex is within a critical range of ischemia. We show that the mechanism involves increased oxygen utilization within the activated cortex, worsening the supply-demand mismatch. We support the concept by clinical data showing that mismatch predisposes to PIDs in human stroke as well. Conversely, transient worsening of mismatch by episodic hypoxemia or hypotension also reproducibly triggers PIDs. Therefore, PIDs are triggered upon supply-demand mismatch transients in metastable peri-infarct hot zones due to increased demand or reduced supply. Based on the data, we propose that minimizing sensory stimulation and hypoxic or hypotensive transients in stroke and brain injury would reduce PID incidence and their adverse impact on outcome. PMID:25741731

  15. Brain Basics

    Medline Plus

    Full Text Available ... Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of the brain's structure, studies show that brain growth in children with autism ...

  16. Multispectral optoacoustic tomography of myocardial infarction

    Science.gov (United States)

    Taruttis, Adrian; Wildgruber, Moritz; Kosanke, Katja; Beziere, Nicolas; Licha, Kai; Haag, Rainer; Aichler, Michaela; Walch, Axel; Rummeny, Ernst; Ntziachristos, Vasilis

    2012-01-01

    Objectives To investigate the feasibility of a high resolution optical imaging strategy for myocardial infarction. Background Near-infrared approaches to imaging cardiovascular disease enable visualization of disease-associated biological processes in vivo. However, even at the scale of small animals, the strong scattering of light prevents high resolution imaging after the first 1–2 mm of tissue, leading to degraded signal localization. Methods Multispectral optoacoustic tomography (MSOT) was used to non-invasively image myocardial infarction (MI) in a murine model of coronary artery ligation at resolutions not possible with current deep-tissue optical imaging methods. Post-MI imaging was based on resolving the spectral absorption signature of a dendritic polyglycerol sulfate-based (dPGS) near-infrared imaging agent targeted to P- and L-selectin. Results In vivo imaging succeeded in detection of the agent in the injured myocardium after intravenous injection. The high anatomic resolution (<200 μm) achieved by the described method allowed signals originating in the infarcted heart to be distinguished from uptake in adjacent regions. Histological analysis found dPGS signal in infarcted areas, originating from leukocytes and endothelial cells. Conclusions MSOT imaging of myocardial infarction provides non-invasive visualization of optical contrast with a high spatial resolution that is not degraded by the scattering of light. PMID:25327410

  17. Postoperative omental infarction following colonic resection

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, S.F., E-mail: skerr44@doctors.org.uk [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom); Hyland, R.; Rowbotham, E.; Chalmers, A.G. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom)

    2012-02-15

    Aim: To illustrate the computed tomography (CT) appearances and natural history of postoperative omental infarction following colonic resection and to highlight the important clinical implications of this radiological diagnosis. Materials and methods: Over a 3 year period, 15 patients with a history of colonic resection were identified as having a CT diagnosis of postoperative omental infarction. Relevant clinical and pathological data were retrospectively collected from the institution's electronic patient records system and all relevant imaging was reviewed, including serial CT images in 10 patients. Results: A diagnosis of postoperative omental infarction was made in symptomatic and asymptomatic patients who had undergone open or laparoscopic colonic resection for benign or malignant disease. CT appearances ranged from diffuse omental stranding to discrete masses, which typically appeared within weeks of surgery and could persist for years. In four (36%) of the patients with colorectal cancer, the CT appearances raised concern for recurrent malignancy, but percutaneous biopsy and/or serial CT allowed a confident diagnosis of omental infarction to be made. Although most cases were self-limiting, three (20%) cases were complicated by secondary infection and required radiological or surgical intervention. Conclusion: Postoperative omental infarction is an under-recognized complication of colonic resection. It has the potential to mimic recurrent malignancy and may require radiological or surgical intervention for secondary infection.

  18. Postoperative omental infarction following colonic resection

    International Nuclear Information System (INIS)

    Aim: To illustrate the computed tomography (CT) appearances and natural history of postoperative omental infarction following colonic resection and to highlight the important clinical implications of this radiological diagnosis. Materials and methods: Over a 3 year period, 15 patients with a history of colonic resection were identified as having a CT diagnosis of postoperative omental infarction. Relevant clinical and pathological data were retrospectively collected from the institution’s electronic patient records system and all relevant imaging was reviewed, including serial CT images in 10 patients. Results: A diagnosis of postoperative omental infarction was made in symptomatic and asymptomatic patients who had undergone open or laparoscopic colonic resection for benign or malignant disease. CT appearances ranged from diffuse omental stranding to discrete masses, which typically appeared within weeks of surgery and could persist for years. In four (36%) of the patients with colorectal cancer, the CT appearances raised concern for recurrent malignancy, but percutaneous biopsy and/or serial CT allowed a confident diagnosis of omental infarction to be made. Although most cases were self-limiting, three (20%) cases were complicated by secondary infection and required radiological or surgical intervention. Conclusion: Postoperative omental infarction is an under-recognized complication of colonic resection. It has the potential to mimic recurrent malignancy and may require radiological or surgical intervention for secondary infection.

  19. Thrombolytic therapy in acute myocardial infarction.

    Science.gov (United States)

    Woo, K S; White, H D

    1994-07-01

    Thrombolytic therapy has revolutionized the treatment of acute myocardial infarction by reducing mortality and preserving left ventricular function. It is relatively safe and cost-effective. However, it is currently underused in most countries. Patients in whom thrombolysis is indicated include those with ST elevation on the electrocardiogram or bundle branch block pattern who present within 12 hours of myocardial infarction; the indications should be widened to include the elderly, patients who have undergone nontraumatic cardiopulmonary resuscitation, and women during menstruation. The risk-benefit ratio should be assessed for the individual patient. Prehospital thrombolytic treatment has been shown to be feasible with the support of well-trained staff and resuscitation equipment, and may be cost-effective in communities with time delays before hospitalization greater than 1 hour. The most important strategy is to shorten the "door to needle" time in hospital. The importance of full infarct-related artery flow (Thrombolysis in Myocardial Infarction [TIMI] grade 3 flow) for preservation of ventricular function and survival has been documented in the second Thrombolysis Trial of Eminase in Acute Myocardial Infarction (TEAM 2) and the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) studies. Aspirin and heparin are beneficial adjunctive regimens to thrombolytic therapy but optimal epicardial reperfusion is achieved in only about half of patients. Improved thrombolytic, adjunctive antiplatelet, and antithrombotic regimens are required to achieve early full reperfusion, which is crucial to improve survival and quality of life. PMID:7919592

  20. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures

    Science.gov (United States)

    Yoon, Sang-Youl; Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2016-01-01

    We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit in the acute stage to prevent extent of stroke. Aspirin was started for antiplatelet therapy in the chronic stage. The possibility of symptomatic cerebral infarctions due to traumatic VAD following cervical fracture should be considered.

  1. Ischemic stroke and incomplete infarction

    DEFF Research Database (Denmark)

    Garcia, Javier; Lassen, N A; Weiller, C;

    1996-01-01

    The concept of selective vulnerability or selective loss o f individual neurons, with survival of glial and vascular elements as one of the consequences of a systemic ischemic-hypoxic insult (eg, transient cardiac arrest or severe hypotension), has been recognized for decades. In contrast, select......, selective neuronal death as one of the lesions that may develop in the brain after occluding an intracranial artery is an idea not readily acknowledged in the current medical literature dealing with human stroke....

  2. Neuroimaging of Ischemia and Infarction

    OpenAIRE

    Sá de Camargo, Erica C.; Koroshetz, Walter J.

    2005-01-01

    Summary: Since the introduction of thrombolytic therapy as the foundation of acute stroke treatment, neuroimaging has rapidly advanced to empower therapeutic decision making. Diffusion-weighted imaging is the most sensitive and accurate method for stroke detection, and, allied with perfusion-weighted imaging, provides information on the functional status of the ischemic brain. It can also help to identify a response to thrombolytic and neuroprotective therapies. Additionally, multimodal magne...

  3. Usefulness of CT perfusion in the selection of patients with hyperacute cerebral infarction for intravenous t-PA treatment

    International Nuclear Information System (INIS)

    We investigated the usefulness of CT perfusion (CT-P) for assessing whether or not intravenous t-PA treatment is indicated for hyperacute cerebral infarction within 3 hours after onset. Between April 2007 and March 2008, 40 cerebral infarction patients were brought to our hospital within 3 hours of occurrence (28 men, 12 women; average age, 71 years; average time from onset to hospital admission, 93 min). Among these 40 patients, 14 patients who underwent brain CT, brain MRI (diffusion weighted images (DWI)/MR angiography (MRA)), and CT-P were investigated. The clinical types included 7 cardioembolic infarction (CE) cases, 6 atherothrombotic infarction (AT) cases, and 1 lacunar infarction (LC) case. Among the 14 patients who underwent CT-P, no perfusion abnormalities were noted in 6 of 8 patients with an National Institute of Health Stroke Scale (NIHSS) score of 11 points or less at the time of hospital arrival. Of these 6 patients, 1 had LC, 3 had CE, and 2 had AT. In 2 patients (CE: M2 occlusion; AT: M1 stenosis), an area of abnormal perfusion was recognized, but no difference was observed in the high signal area on DWI. In all patients with an NIHSS score of 15 points or more, diffusion-CT perfusion mismatch (DPM) was seen. In addition, main artery lesions were found on MRA in 5 of 6 patients with DPM. t-PA was given to 10 of the 14 patients. In the hyperacute phase of cerebral infarction within 3 hours of occurrence, mild cases and those without main cerebral artery lesions have little need for CT-P. In moderate and severe cases, CT-P appears to be effective for evaluating DPM. (author)

  4. Hyper-accumulation of 123I-iodoamphetamine in the infarcted area during subacute phase of ischemic stroke

    International Nuclear Information System (INIS)

    High uptake of N-isopropyl-123I-iodoamphetamine (123-IMP) in the infarcted area on delayed images remains to be elucidated. The present study was thus performed to investigate the mechanism and temporal profile of this phenomenon and to elucidate the tracer kinetics in the pathological tissue. In a total of 22 patients with embolism (E, n=14) or thrombosis (T, n=8) during the acute stage of cerebral infarction, cerebral blood flow was determined by single photon emission computed tomography (SPECT) using 123I-IMP. SPECT images were obtained at 15 minutes (early images) and 4 hours (delayed images) after iv injection of 111 MBq of 123-IMP. During the subacute period (Days 8 to 28), IMP uptake in the infarcted area was significantly higher on delayed images in the E group (79%), as compared with the T group (10%). Uptake patterns of IMP in the two groups differed, in that IMP uptake was seen over the whole infarcted area (diffuse pattern) in the E group and was confined to the marginal area (peripheral pattern) in the T group. Abnormal uptake of IMP was not seen in acute (before Day 8) or chronic (after Day 40) periods, regardless of either E or T group. These findings were not related to recanalization or hemorrhagic infarction. In conclusion, IMP taken up by the infarcted area on delayed images may reflect pathophysiological differences between the two types of cerebral infarction. Delayed SPECT images may provide not only statistic but also dynamic information, i.e. viability of amphetamine receptors and alterations of pharmacokinetics of IMP in the damaged brain tissue. (N.K.)

  5. Hyper-accumulation of sup 123 I-iodoamphetamine in the infarcted area during subacute phase of ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Ikuo (Tokyo Saiseikai Central Hospital (Japan))

    1991-10-01

    High uptake of N-isopropyl-{sup 123}I-iodoamphetamine ({sup 123}-IMP) in the infarcted area on delayed images remains to be elucidated. The present study was thus performed to investigate the mechanism and temporal profile of this phenomenon and to elucidate the tracer kinetics in the pathological tissue. In a total of 22 patients with embolism (E, n=14) or thrombosis (T, n=8) during the acute stage of cerebral infarction, cerebral blood flow was determined by single photon emission computed tomography (SPECT) using {sup 123}I-IMP. SPECT images were obtained at 15 minutes (early images) and 4 hours (delayed images) after iv injection of 111 MBq of {sup 123}-IMP. During the subacute period (Days 8 to 28), IMP uptake in the infarcted area was significantly higher on delayed images in the E group (79%), as compared with the T group (10%). Uptake patterns of IMP in the two groups differed, in that IMP uptake was seen over the whole infarcted area (diffuse pattern) in the E group and was confined to the marginal area (peripheral pattern) in the T group. Abnormal uptake of IMP was not seen in acute (before Day 8) or chronic (after Day 40) periods, regardless of either E or T group. These findings were not related to recanalization or hemorrhagic infarction. In conclusion, IMP taken up by the infarcted area on delayed images may reflect pathophysiological differences between the two types of cerebral infarction. Delayed SPECT images may provide not only statistic but also dynamic information, i.e. viability of amphetamine receptors and alterations of pharmacokinetics of IMP in the damaged brain tissue. (N.K.).

  6. Regional Mechanics Determine Collagen Fiber Structure in Healing Myocardial Infarcts

    OpenAIRE

    Fomovsky, Gregory M.; Rouillard, Andrew D.; Holmes, Jeffrey W.

    2012-01-01

    Following myocardial infarction, the mechanical properties of the healing infarct are an important determinant of heart function and the risk of progression to heart failure. In particular, mechanical anisotropy (having different mechanical properties in different directions) in the healing infarct can preserve pump function of the heart. Based on reports of different collagen structures and mechanical properties in various animal models, we hypothesized that differences in infarct size, shap...

  7. Renal infarction in patients presenting with suspected renal colic *

    OpenAIRE

    Seetho, Ian W.; Bungay, Peter M.; Taal, Maarten W.; Fluck, Richard J.; Leung, Janson C. H.

    2009-01-01

    Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when ...

  8. Transient myocardial ischemia after myocardial infarction

    DEFF Research Database (Denmark)

    Mickley, H

    1995-01-01

    Ambulatory ST-segment monitoring is a relatively new device in the evaluation of myocardial ischemia. The method is unique in allowing us to continuously examine the patient over an extended period of time in a changing environmental milieu. In survivors of acute myocardial infarction the...... prevalence of ambulatory or transient myocardial ischemia is lower than in patients with chronic, stable coronary artery disease. A greater proportion of ischemic episodes, however, are silent than in other subgroups with ischemic heart disease. Early after the infarction, transient myocardial ischemia...... exhibits a circadian variation with a peak activity occurring in the late evening hours. Patients with non-Q wave infarction have more transient myocardial ischemia, whereas thrombolytic therapy seems to result in less residual ischemia. Exercise testing is more sensitive than ambulatory monitoring in the...

  9. Right thalamic infarction after closed head injury

    International Nuclear Information System (INIS)

    We reported a case of right thalamic infarction after a closed head injury. A 12-year-old boy was hit by an autotruck. He was semi-comatose, with left temporal scalp swelling and excoriation in the left lower limb. Three days after the accident, he exhibited left hemiparesis. CT scans on the day of the accident showed no abnormality, but on the following day, right thalamic infarction appeared. Right carotid angiography showed only an irregular vascular shadow in the cisternal segment of the right internal carotid artery. Vascular obstruction after closed head injury is rare, especially in the intracranial vessels, and several pathogeneses may be postulated. The right thalamic infarction in this case was supposed to be due to the damage of the perforators from the right posterior communicating artery and the right posterior cerebral artery, which were struck as a contre-coup by the force from the left side. (author)

  10. Acute myocardial infarction in a young patient

    International Nuclear Information System (INIS)

    Myocardial infarction (MI) is considered to be the disease of the fifth and sixth decade as seen in the West but an earlier age incidence is not infrequently encountered in the South Asian population. However, occurrence of MI in the teen-age still remains a rare happening. We are reporting a case of a teenager, who suffered a myocardial infarction with cardiogenic shock and pulmonary edema on two separate occasions with ECG and biochemical evidence of myocardial infarction. An exercise stress test done in between the two episodes was negative at a workload of 13.5 METs. A coronary angiogram done after the second event revealed normal coronary arteries and a preserved left ventricular systolic and segmental function. Except for low HDL (high density lipoprotein) and mildly raised homocysteine levels, the patient did not have other conventional or novel risk factors for coronary artery disease. (author)

  11. Microglia protect against brain injury and their selective elimination dysregulates neuronal network activity after stroke

    OpenAIRE

    Szalay, Gergely; Martinecz, Bernadett; Lénárt, Nikolett; Környei, Zsuzsanna; Orsolits, Barbara; Judák, Linda; Császár, Eszter; Fekete, Rebeka; West, Brian L.; Katona, Gergely; Rózsa, Balázs; Dénes, Ádám

    2016-01-01

    Microglia are the main immune cells of the brain and contribute to common brain diseases. However, it is unclear how microglia influence neuronal activity and survival in the injured brain in vivo. Here we develop a precisely controlled model of brain injury induced by cerebral ischaemia combined with fast in vivo two-photon calcium imaging and selective microglial manipulation. We show that selective elimination of microglia leads to a striking, 60% increase in infarct size, which is reverse...

  12. Patterns of damage in the mature neonatal brain

    International Nuclear Information System (INIS)

    Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography. (orig.)

  13. Transient global amnesia associated with an acute infarction at the cingulate gyrus.

    Science.gov (United States)

    Gallardo-Tur, Alejandro; Romero-Godoy, Jorge; de la Cruz Cosme, Carlos; Arboix, Adriá

    2014-01-01

    Background. Transient global amnesia (TGA) is a syndrome of sudden, unexplained isolated short-term memory loss. In the majority of TGA cases, no causes can be identified and neuroimaging, CSF studies and EEG are usually normal. We present a patient with TGA associated with a small acute infarct at the cingulate gyrus. Case Report. The patient, a 62 year-old man, developed two episodes of TGA. He had hypertension and hypercholesterolemia. He was found to have an acute ischemic stroke of small size (15 mm of maximal diameter) at the right cerebral cingulate gyrus diagnosed on brain magnetic resonance imaging. No lesions involving other limbic system structures such as thalamus, fornix, corpus callosum, or hippocampal structures were seen. The remainder of the examination was normal. Conclusion. Unilateral ischemic lesions of limbic system structures may result in TGA. We must bear in mind that TGA can be an associated clinical disorder of cingulate gyrus infarct. PMID:25126430

  14. Characterization of nontransmural myocardial infarction by positron-emission tomography

    International Nuclear Information System (INIS)

    The present study was performed to determine whether positron emission tomography (PET) performed after i.v. 11C-palmitate permits detection and characterization of nontransmural myocardial infarction. PET was performed after the i.v. injection of 11C-palmitate in 10 normal subjects, 24 patients with initial nontransmural myocardial infarction (defined electrocardiographically), and 22 patients with transmural infarction. Depressed accumulation of 11C-palmitate was detected with sagittal, coronal and transverse reconstructions, and quantified based on 14 contiguous transaxial reconstructions. Defects with homogeneously intense depression of accumulation of tracer were detected in all 22 patients with transmural infarction (100%). Abnormalities of the distribution of 11C-palmitate in the myocardium were detected in 23 patients with nontransmural infarction (96%). Thallium scintigrams were abnormal in only 11 of 18 patients with nontransmural infarction (61%). Tomographically estimated infarct size was greater among patients with transmural infarction (50.4 +/- 7.8 PET-g-Eq/m2 [+/- SEM SEM]) compared with those with nontransmural infarction (19 +/- 4 PET-g-Eq, p less than 0.01). Residual accumulation of 11C-palmitate within regions of infarction was more intensely depressed among patients with transmural compared to nontransmural infarction (33 +/- 1 vs 39 +/- 1% maximal myocardial radioactivity, p less than 0.01). Thus, PET and metabolic imaging with 11C-palmitate is a sensitive means of detecting, quantifying and characterizing nontransmural and transmural myocardial infarction

  15. RAMIPRIL IN THERAPY OF PATIENTS AFTER MYOCARDIAL INFARCTION

    OpenAIRE

    I. V. Szirov; E. V. Malichenko

    2015-01-01

    Angiotensin converting enzyme inhibitors are the first line medicine for the treatment of the most of cardiovascular diseases. There is no class-effect for these drugs in myocardial infarction therapy. Moreover in myocardial infarction angiotensin converting enzyme inhibitors have significant intra-group differences. Ramipril is the one of the most studied drug of this group recommended for patients after acute myocardial infarction.

  16. Healing process of infarcted myocardium. Evaluation by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nakatou, Hideaki; Murakami, Eiji; Takekoshi, Noboru; Matsui, Sinobu; Emoto, Jirou; Matoba, Munetoshi; Fukuoka, Takumi; Enyama, Hiroto; Aoyama, Takahiko

    1989-01-01

    Healing process of infarcts and morphology of left ventricular aneurysms were examined with ECG-gated magnetic resonance imaging (MRI) in 41 patients with myocardial infarction. According to the time of MRI, the patients fell into Group I - within one month after the onset of myocardial infarction, Group II - between 2 and 3 months, Group III - between 4 and 12 months, and Group IV - more than one year. In Groups I and II, T2 relaxation time for infarcts was significantly prolonged when compared with non-infarcts. It gradually decreased in the following order: Groups I>II>III>IV. Groups IV had the lowest ratio of infarcts to non-infarcts (I/N ratio), followed by Groups II and III, and then Group I. MR imaging had a sensitivity of 70% in morphologically evaluating left ventricular aneurysms. Left ventricular aneurysms tended to be detected when the I/N ratio was 0.6 or less. Acute infarcts had increased signal intensities and a prolonged T2 relaxation time, probably resulting from protons increased by edemas. These appearances returned to normal 2 to 3 months after the onset; and simultaneously, the infarcted wall was becoming thin. These MRI findings seem representative of healing process of infarcts. In cases of associated left ventricular aneurysms, the infarcted wall was remarkably thinned, which was likely affected by an excessive expansion due to an increased tension of the infarcted wall. (Namekawa, K).

  17. Clinical significance of urine ferritin in patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    周慧

    2013-01-01

    Objective To find an indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction (CI) ,with ratio ofmales to females

  18. Acute myopericarditis masquerading as acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  19. Focal hepatic infarction with bile lake formation

    International Nuclear Information System (INIS)

    Venous thrombosis associated with oral contraceptives is a well recognized phenomenon. Arterial thrombosis, while less common, is also a known risk, as evidenced by the increased incidence of cerebral vascular accidents and myocardial ischemia or infarction. The liver is relatively protected from the usual consequences of arterial thrombosis because of its dual blood supply. The authors present an unusual case of a young woman with a history of oral contraceptive and cigarette use who developed hepatic artery thrombosis and had focal liver lesions on computed tomography (CT) due to hepatic infarction and bile lake formation despite an intact portal venous system

  20. Prevalence and extent of infarct and microvascular obstruction following different reperfusion therapies in ST-elevation myocardial infarction

    OpenAIRE

    Khan, Jamal N; Razvi, Naveed; Nazir, Sheraz A; Singh, Anvesha; Masca, Nicholas GD; Gershlick, Anthony H.; Squire, Iain; McCann, Gerry P.

    2014-01-01

    Background Microvascular obstruction (MVO) describes suboptimal tissue perfusion despite restoration of infarct-related artery flow. There are scarce data on Infarct Size (IS) and MVO in relation to the mode and timing of reperfusion. We sought to characterise the prevalence and extent of microvascular injury and IS using Cardiovascular magnetic resonance (CMR), in relation to the mode of reperfusion following acute ST-Elevation Myocardial Infarction (STEMI). Methods CMR infarct characteristi...

  1. Treatment with the gap junction modifier rotigaptide (ZP123) reduces infarct size in rats with chronic myocardial infarction

    DEFF Research Database (Denmark)

    Haugan, Ketil; Marcussen, Niels; Kjølbye, Anne Louise; Nielsen, Morten Schak; Hennan, James K; Petersen, Jørgen Søberg

    2006-01-01

    Treatment with non-selective drugs (eg, long-chain alcohols, halothane) that reduce gap junction intercellular communication (GJIC) is associated with reduced infarct size after myocardial infarction (MI). Therefore, it has been suggested that gap junction intercellular communication stimulating...... what was predicted, our data demonstrates that rotigaptide treatment was associated with a significant infarct size reduction. We conclude that whereas treatment with non-selective inhibitors of gap junction intercellular communication cause a reduction in infarct size, this information cannot be...

  2. 小脑梗死31例致残特点分析及CT、MRI确诊率比较%Mutilation characteristics analysis and CT, MRI dignosis rate comparison in 31 cerebellar infarction cases

    Institute of Scientific and Technical Information of China (English)

    杨光宇; 陈伟群; 谢道俊

    2002-01-01

    Background: Functional disturbance caused by cerebellar infarction are diversified according to lesion site and size, mutilation characteristics are different. it is difficult to diagnose because its manifestation is complicated. It can show symptoms like vestibule disease, Compartmental syndrome or be masked by brain stem or occipital lobe infarction. In recent years, Diagnosis rate of this disease increase as utilization of CT and MRI. But CT is influenced by bone structure of posterior cranial fossa, so it can't exam small infarction focus. MRI is better.

  3. Whole brain CT perfusion in acute anterior circulation ischemia: coverage size matters

    International Nuclear Information System (INIS)

    Our aim was to compare infarct core volume on whole brain CT perfusion (CTP) with several limited coverage sizes (i.e., 3, 4, 6, and 8 cm), as currently used in routine clinical practice. In total, 40 acute ischemic stroke patients with non-contrast CT (NCCT) and CTP imaging of anterior circulation ischemia were included. Imaging was performed using a 320-multislice CT. Average volumes of infarct core of all simulated partial coverage sizes were calculated. Infarct core volume of each partial brain coverage was compared with infarct core volume of whole brain coverage and expressed using a percentage. To determine the optimal starting position for each simulated CTP coverage, the percentage of infarct coverage was calculated for every possible starting position of the simulated partial coverage in relation to Alberta Stroke Program Early CT Score in Acute Stroke Triage (ASPECTS 1) level. Whole brain CTP coverage further increased the percentage of infarct core volume depicted by 10 % as compared to the 8-cm coverage when the bottom slice was positioned at the ASPECTS 1 level. Optimization of the position of the region of interest (ROI) in 3 cm, 4 cm, and 8 cm improved the percentage of infarct depicted by 4 % for the 8-cm, 7 % for the 4-cm, and 13 % for the 3-cm coverage size. This study shows that whole brain CTP is the optimal coverage for CTP with a substantial improvement in accuracy in quantifying infarct core size. In addition, our results suggest that the optimal position of the ROI in limited coverage depends on the size of the coverage. (orig.)

  4. Whole brain CT perfusion in acute anterior circulation ischemia: coverage size matters

    Energy Technology Data Exchange (ETDEWEB)

    Emmer, B.J. [Erasmus Medical Centre, Department of Radiology, Postbus 2040, Rotterdam (Netherlands); Rijkee, M.; Walderveen, M.A.A. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Niesten, J.M.; Velthuis, B.K. [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Wermer, M.J.H. [Leiden University Medical Centre, Department of Neurology, Leiden (Netherlands)

    2014-12-15

    Our aim was to compare infarct core volume on whole brain CT perfusion (CTP) with several limited coverage sizes (i.e., 3, 4, 6, and 8 cm), as currently used in routine clinical practice. In total, 40 acute ischemic stroke patients with non-contrast CT (NCCT) and CTP imaging of anterior circulation ischemia were included. Imaging was performed using a 320-multislice CT. Average volumes of infarct core of all simulated partial coverage sizes were calculated. Infarct core volume of each partial brain coverage was compared with infarct core volume of whole brain coverage and expressed using a percentage. To determine the optimal starting position for each simulated CTP coverage, the percentage of infarct coverage was calculated for every possible starting position of the simulated partial coverage in relation to Alberta Stroke Program Early CT Score in Acute Stroke Triage (ASPECTS 1) level. Whole brain CTP coverage further increased the percentage of infarct core volume depicted by 10 % as compared to the 8-cm coverage when the bottom slice was positioned at the ASPECTS 1 level. Optimization of the position of the region of interest (ROI) in 3 cm, 4 cm, and 8 cm improved the percentage of infarct depicted by 4 % for the 8-cm, 7 % for the 4-cm, and 13 % for the 3-cm coverage size. This study shows that whole brain CTP is the optimal coverage for CTP with a substantial improvement in accuracy in quantifying infarct core size. In addition, our results suggest that the optimal position of the ROI in limited coverage depends on the size of the coverage. (orig.)

  5. Risk factors for small-vessel disease revealed by magnetic resonance imaging of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Kohriyama, Tatsuo; Yamaguchi, Shinya; Yamamura, Yasuhiro; Nakamura, Shigenobu [Hiroshima Univ. (Japan). School of Medicine; Tanaka, Eiji

    1996-02-01

    In total, 133 patients with asymptomatic or symptomatic cerebral infarction were randomly selected for the study (64 males, 69 females). Among them 91 patients had a history of symptomatic cerebral infarction, 46 patients of hypertension, and 28 patients of diabetes mellitus. The MRI scans were reviewed for areas with increased signal intensity on T2-weighted images. The grade of periventricular lesions, and the number of small infarctions in the subcortical white matter, basal ganglia and brain stem increased significantly with advancing age. It was thus reconfirmed that age is an important risk for demonstrating small-vessel disease on brain MRI. In addition, the degree of small-vessel disease on brain MRI was more extensive in patients with symptomatic cerebral infarction than with asymptomatic cerebral infarction. The detailed results suggest that small-vessel disease on brain MRI in patients with asymptomatic cerebral infarction might represent preclinical lesions for symptomatic cerebral infarction. The numbers of small infarctions in both the subcortical white matter and basal ganglia associated with advancing age, and histories of cerebrovascular accident and hypertension, suggest that common underlying mechanisms may exist in small-vessel disease in both the medullary arteries, which arise from cortical arteries, and perforating arteries. In the subcortical white matter, the number of patchy lesions was more strongly correlated with histories of hypertension and diabetes mellitus than was the number of spotty lesions, suggesting that the risk factors differed depending on the size of the lesions. The present study revealed that the degree of small-vessel disease on brain MRI was not correlated with the serum concentration of total cholesterol, triglyceride or HDL-cholesterol. The data thus indicate that the risk factors for small-vessel disease are distinct from those for large-vessel disease. (J.P.N.)

  6. Risk factors for small-vessel disease revealed by magnetic resonance imaging of the brain

    International Nuclear Information System (INIS)

    In total, 133 patients with asymptomatic or symptomatic cerebral infarction were randomly selected for the study (64 males, 69 females). Among them 91 patients had a history of symptomatic cerebral infarction, 46 patients of hypertension, and 28 patients of diabetes mellitus. The MRI scans were reviewed for areas with increased signal intensity on T2-weighted images. The grade of periventricular lesions, and the number of small infarctions in the subcortical white matter, basal ganglia and brain stem increased significantly with advancing age. It was thus reconfirmed that age is an important risk for demonstrating small-vessel disease on brain MRI. In addition, the degree of small-vessel disease on brain MRI was more extensive in patients with symptomatic cerebral infarction than with asymptomatic cerebral infarction. The detailed results suggest that small-vessel disease on brain MRI in patients with asymptomatic cerebral infarction might represent preclinical lesions for symptomatic cerebral infarction. The numbers of small infarctions in both the subcortical white matter and basal ganglia associated with advancing age, and histories of cerebrovascular accident and hypertension, suggest that common underlying mechanisms may exist in small-vessel disease in both the medullary arteries, which arise from cortical arteries, and perforating arteries. In the subcortical white matter, the number of patchy lesions was more strongly correlated with histories of hypertension and diabetes mellitus than was the number of spotty lesions, suggesting that the risk factors differed depending on the size of the lesions. The present study revealed that the degree of small-vessel disease on brain MRI was not correlated with the serum concentration of total cholesterol, triglyceride or HDL-cholesterol. The data thus indicate that the risk factors for small-vessel disease are distinct from those for large-vessel disease. (J.P.N.)

  7. Global left ventricular longitudinal strain is closely associated with increased neurohormonal activation after acute myocardial infarction in patients with both reduced and preserved ejection fraction

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Valeur, Nana; Mogensen, Ulrik Madvig;

    2012-01-01

    N-terminal pro brain natriuretic peptide (NT-proBNP) is released in response to increased myocardial wall stress and is associated with adverse outcome in acute myocardial infarction. However, little is known about the relationship between longitudinal deformation indices and NT-proBNP....

  8. Local intracranial intraarterial thrombolytic therapy in acute cerebral infarction

    International Nuclear Information System (INIS)

    To evaluate the efficacy of direct intracranial intraarterial thrombolytic therapy in patients with acute atherothrombotic and embolic stroke. Forth-one patients with cerebral thromboembolic disease, all in the area of the middle cerebral artery and including two cases of internal carotid artry occlusion, were treated with microcatheter-directed local intraarterial thrombolysis, using 180,000 to 1,000,000 unit urokinase and 15 to 50 mg of tissue plasminogen activator (tPA). The time elapsed before treatment ranged from 260 to 470 minute (mean : 380 minutes). The effect of treatment was assessed by cerebral angiography, by the clinical outcome. For 25 patients (61%), complete vessel recanalization was successful. In eight and three cases, respectively, the result was partial recanalization and residual stenosis. In 21 patients (51%), both acute neurologic and functional outcomes improved significantly within 24 hours and in 92% of patients, within one month. Hemorrhagic transformations occurred in five patients (12.2%), and in five others there were high density lesions around the basal ganglia and temporal lobe, which was cleared on CT within 24 hours. This suggested transient extrapolation of the contrast media rather than true hemorrhage. tPA showed better results than urokinase in terms of the rate of recanalization (68.7% vs 56.7%) and the occurrence of hemorrhagic infarction(6.3% vs 16.0%). Local intraarterial cerebral thrombolysis is thought be an effective method in the treatment of acute brain infarction, but in some patients may cause intracerebral hemorrhage in some patients

  9. Local intracranial intraarterial thrombolytic therapy in acute cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Yong; Suh, Jung Ho [Ajou Univ. College of Medicine, Suwon (Korea, Republic of)

    1996-06-01

    To evaluate the efficacy of direct intracranial intraarterial thrombolytic therapy in patients with acute atherothrombotic and embolic stroke. Forth-one patients with cerebral thromboembolic disease, all in the area of the middle cerebral artery and including two cases of internal carotid artry occlusion, were treated with microcatheter-directed local intraarterial thrombolysis, using 180,000 to 1,000,000 unit urokinase and 15 to 50 mg of tissue plasminogen activator (tPA). The time elapsed before treatment ranged from 260 to 470 minute (mean : 380 minutes). The effect of treatment was assessed by cerebral angiography, by the clinical outcome. For 25 patients (61%), complete vessel recanalization was successful. In eight and three cases, respectively, the result was partial recanalization and residual stenosis. In 21 patients (51%), both acute neurologic and functional outcomes improved significantly within 24 hours and in 92% of patients, within one month. Hemorrhagic transformations occurred in five patients (12.2%), and in five others there were high density lesions around the basal ganglia and temporal lobe, which was cleared on CT within 24 hours. This suggested transient extrapolation of the contrast media rather than true hemorrhage. tPA showed better results than urokinase in terms of the rate of recanalization (68.7% vs 56.7%) and the occurrence of hemorrhagic infarction(6.3% vs 16.0%). Local intraarterial cerebral thrombolysis is thought be an effective method in the treatment of acute brain infarction, but in some patients may cause intracerebral hemorrhage in some patients.

  10. Nitrendipine binding in congestive heart failure due to myocardial infarction

    International Nuclear Information System (INIS)

    Depressed cardiac pump function is the hallmark of congestive heart failure, and it is suspected that decreased influx of Ca2+ into the cardiac cell is responsible for depressed contractile function. Since Ca2+ channels in the sarcolemmal membrane are considered to be an important route for the entry of Ca2+, we examined the status of Ca2+ receptors/channels in failing rat hearts after myocardial infarction of the left ventricular free wall. For this purpose, the left coronary artery was ligated and hearts were examined 4, 8, and 16 weeks later; sham-operated animals served as controls. Hemodynamic assessment revealed decreased total mechanical energy (left ventricular systolic pressure x heart rate), increased left ventricular diastolic pressure, and decreased positive and negative dP/dt in experimental animals at 4, 8, and 16 weeks. Although accumulation of ascites in the abdominal cavity was evident at 4 weeks, other clinical signs of congestive heart failure in experimental rats were evident from the presence of lung congestion and cardiac dilatation at 8 and 16 weeks after induction of myocardial infarction. The density of Ca2+ receptors/channels in crude membranes, as assessed by [3H]nitrendipine binding assay, was found to be decreased in the uninfarcted experimental left ventricle at 8 and 16 weeks; however, no change in the affinity of nitrendipine was evident. A similar depression in the specific binding of another dihydropyridine compound, [3H]PN200-110, was also evident in failing hearts. Brain and skeletal muscle crude membrane preparations, unlike those of the right ventricle and liver, revealed a decrease in Ca2+ receptors/channels density in experimental animals at 16 weeks

  11. Functional outcome of pontine infarction in a convalescent rehabilitation ward

    International Nuclear Information System (INIS)

    We studied functional outcome of 12 patients with pontine base infarction in our convalescent ward. The mean onset-admission interval is 33.4±14.8 days, and the mean length of stay in the ward is 90.7±53.5 days. The median Brunnstrome stage and Barthel index at discharge was significantly higher compared with those at admission. Functional outcomes of ventromedial pontine infarcts were less favorable than those of ventrolateral pontine infarcts. Infarctions which was considered to involve branch atheromatous disease as the pathogenetic mechanism, tended to demonstrate a poor functional outcome. The areas of infarcts didn't correlate with functional outcome. (author)

  12. Electrocardiographic localization of infarct related coronary artery in acute ST elevation myocardial infarction

    OpenAIRE

    C.S. Thejanandan Reddy; D Rajasekhar; Vanajakshamma, V.

    2013-01-01

    The electrocardiogram (ECG) remains a crucial tool in the identification and management of acute myocardial infarction (MI). A detailed analysis of patterns of ST-segment elevation may influence decisions regarding the use of reperfusion therapy. The early and accurate identification of the infarct-related artery on the ECG can help predict the amount of myocardium at risk and guide decisions regarding the urgency of revascularization. The specificity of the ECG in acute MI is lim...

  13. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, or ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are metastatic, ...

  14. Brain Basics

    Medline Plus

    Full Text Available ... Basics will introduce you to some of this science, such as: How the brain develops How genes and the environment affect the brain The basic structure of the brain How different parts of the brain communicate and work with each other How changes in the brain ...

  15. Brain Tumors

    Science.gov (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...

  16. Brain Fingerprinting

    Directory of Open Access Journals (Sweden)

    ravi kumar

    2012-12-01

    Full Text Available Brain Fingerprinting is a scientific technique to determine whether or not specific information is stored in an individual's brain by measuring a electrical brain wave response to Word, phrases, or picture that are presented on computer screen. Brain Fingerprinting is a controversial forensic science technique that uses electroencephalograph y (EEG to determine whether specific information is stored in a subject's brain

  17. MRI of sickle cell cerebral infarction

    International Nuclear Information System (INIS)

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

  18. CORRELATION BETWEEN FIBRINOGEN LEVEL AND CEREBRAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    Yi-cheng Zhu; Li-ying Cui; Bao-lai Hua; Jia-qi Pan

    2006-01-01

    Objective To investigate the correlation between plasma fibrinogen level and cerebral infarction (CI) as well as the difference of fibrinogen among subtypes of CI.Methods A case-controlled study was conducted with 131 cases of CI and 148 controls. Plasma fibrinogen levels were detected by the Clauss method.Results High fibrinogen level (3.09±0.94 g/L) was correlated with CI (OR=2.47, 95% CI:1.51-4.04,P<0.005) at the onset stage of the disease. Persistent high fibrinogen level (3.14±0.81 g/L) at 6-month after stroke onset was detected and correlated with CI (OR=4.34, 95% CI: 1.80-10. 51,P=0.001). Higher fibrinogen level was correlated with total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), and posterior circulation infarction (POCI) (OR = 4.008, P<0.001). Higher fibrinogen level was correlated with extracranial atherosclerosis (OR=3.220, P<0.05), but not with intracranial atherosclerosis.Conclusion Fibrinogen level may be a risk factor of CI and probably correlates with subtypes of CI and distributions of atherosclerosis.

  19. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    OpenAIRE

    D. P. Sementsov

    2015-01-01

    Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  20. Ondine′s curse after brainstem infarction

    OpenAIRE

    Pedroso Jose; Baiense Robson; Scalzaretto Ana; Neto Pedro; Teixeira de Gois Aecio; Ferraz Maria

    2009-01-01

    This report describes a rare case of acquired Ondine′s curse. The patient developed central sleep apnea syndrome named Ondine′s curse after a brainstem infarction. Lesions involving the descending medullocervical pathways that subserve automatic breathing can result in this syndrome.

  1. Silent Infarcts with Sickle Cell Anemia

    OpenAIRE

    J Gordon Millichap

    2002-01-01

    The effect of transfusion therapy on the risk for new silent infarct or stroke in children with sickle cell anemia and abnormal transcranial Doppler (TCD) ultrasonography was determined at the University of Miami, FL, and other centers in the STOP trial (Stroke Prevention in Sickle Cell Anemia).

  2. A rare cause of small bowel infarction

    OpenAIRE

    Lim, L.; Collier, K; Harland, R; Temperley, D

    2011-01-01

    We report a rare case of small bowel infarction due to superior mesenteric artery occlusion secondary to cardiac tumour embolism. To our knowledge, this has not been previously reported in the literature. This case highlights a rare case and reviews current knowledge on the subject.

  3. Pseudoxanthoma elasticum presenting with myocardial infarction.

    OpenAIRE

    Slade, A K; John, R.M.; Swanton, R H

    1990-01-01

    A 31 year old man presented with an anterior myocardial infarction. He had a history of recurrent gastrointestinal bleeding of obscure cause since childhood and peripheral vascular disease. A clinical diagnosis of the type 1 dominant form of pseudoxanthoma elasticum was supported by histological data from skin biopsy.

  4. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    D. P. Sementsov

    2015-12-01

    Full Text Available Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  5. Right ventricle infarction and its characteristics

    Directory of Open Access Journals (Sweden)

    Nozari Y

    1997-07-01

    Full Text Available Right ventricular (RV infarction presents with clinical spectrum from a rather being, uncomplicated disorder to a serious event. A total of one hundred patients with inferior myocardial infarction (MI retrospectively were studied to determine clinical significance and characteristics of RV infarction in our patients. Data and variables such as demographic features, chief-complain, clinical findings on arrival and during hospitalization, major risk factors, history of corpulmonale, and electrocardiogram were assessed. The mean age was 55±7.4. 16% had RV infarction. 69% were male and 31% female. Silent or atypical presentation was observed in 25%. 36% of men and all of women had previous history of angina pectoris (p=<0.05. In the course of acute inferior MI the frequency of various kinds of complication were higher among patients with RV MI. Early identification can lead to appropriate management and it might contribute to the prevention of some subsequent serious complication. However diagnosis of this condition requires a high degree of suspicion and the early recording of electrocardiagram through right precordial leads

  6. MRI/MRA evaluation of sickle cell disease of the brain

    International Nuclear Information System (INIS)

    Sickle cell disease is a major cause of pediatric stroke. Understanding the disease that affects the brain as infarctions, both clinically apparent and silent, requires an understanding of how the blood vessels are affected, the way in which both the brain and the blood vessels are imaged by MRI and MRA and the mechanism of injury. (orig.)

  7. MRI/MRA evaluation of sickle cell disease of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Zimmerman, Robert A. [Childrens Hospital, Department of Radiology, Philadelphia, PA (United States)

    2005-03-01

    Sickle cell disease is a major cause of pediatric stroke. Understanding the disease that affects the brain as infarctions, both clinically apparent and silent, requires an understanding of how the blood vessels are affected, the way in which both the brain and the blood vessels are imaged by MRI and MRA and the mechanism of injury. (orig.)

  8. Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement

    OpenAIRE

    Horiuchi, Tetsuyoshi; Yamamoto, Yasunaga; Kuroiwa, Masafumi; Rahmah, Nunung Nur; Hongo, Kazuhiro

    2012-01-01

    We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should...

  9. Relationship Between CarotidIntima-Media Thickness and Silent Cerebral Infarction in Japanese Subjects With Type 2 Diabetes

    OpenAIRE

    Nomura, Kazuhiro; Hamamoto, Yoshiyuki; Takahara, Shiho; Kikuchi, Osamu; Honjo, Sachiko; Ikeda, Hiroki; Wada, Yoshiharu; Nabe, Koichro; Okumra, Ryosuke; Koshiyama, Hiroyuki

    2009-01-01

    OBJECTIVE We examined the relationship between intima-media thickness of common carotid artery (CCA-IMT) and silent cerebral infarction (SCI) with the magnetic resonance imaging (MRI) study in Japanese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS The brain MRI study and the carotid ultrasonography were performed in a total of 217 consecutive Japanese subjects with type 2 diabetes. Various risk factors for SCI were examined using multiple logistic analyses. RESULTS The SCI was fo...

  10. Bidirectional encroachment of collagen into the tunica media in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy

    OpenAIRE

    Dong, Hairong; BLAIVAS, MILA; Michael M Wang

    2012-01-01

    Arteries in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are susceptible to smooth muscle loss and fibrosis, but the molecular components underlying these dramatic vascular changes are not well characterized. The purpose of this study was to investigate the distribution of collagen isoforms in the cerebral vessels of North American CADASIL patients with classical NOTCH3 mutations. Expression of type I-VI collagen in brains obtained at au...

  11. 运动锻炼对局灶性脑缺血大鼠脑皮质RGMa表达的影响%Effects of treadmill exercise on the expression of RGMa in infarcted brain cortex of rats after middle cerebral artery occlusion/reperfusion

    Institute of Scientific and Technical Information of China (English)

    郭振委; 秦新月; 孔渝菡

    2011-01-01

    Objective:To observe the expression of RGMa in infarcted brain cortex of rats with middle cerebral artery occlusion ( MCAo ) after experiencing treadmill exercise. Methods: 120 Sprague-Dawley rats were randomly divided into 5 groups:control group, sham-operation group, and 7,14,28 d after ischemia group. Then each group above were randomly divided into four groups:sedentary group, low-intensity,moderate-intensity, high-intensity treadmill exercise group with MCAo. The MCAo/reperfusion model was induced by ligation with nylon monofilament in rats in the study. Results: ①Real-time quantitative PCR ( RT-qPCR ): There are no significant differences between each low-intensity treadmill MCAo group and each sedentary MCAo group for expression of RGMa mRNA ( P>0.05 ). There was down-regulation of it in each moderate-intensity treadmill exercise MCAo group,compared with each sedentary MCAo group ( P<0.05 ). But there was up-regulation in high-intensity treadmill exercise MCAo group ( P<0.05 ) .②The result of immunohistochemistry:There was no significant difference between each sedentary MCAo group and each low-intensity treadmill exercise MCAo group ( P>0.05 ). The expression of R GMa was down-regulated in moderate-intensity treadmill exercise MCAo group,except at 7 d, compared with each sedentary MCAo group ( P<0.05 ). But the opposite result was got in high-intensity treadmill exercise MCAo group ( P<0.05 ). Neurological deficit scores test showed moderate-intensity treadmill exercise improved neurological function in MCAo group ( P<0.05 ).Conclusion: Moderate-intensity treadmill exercise decreased the expression of RGMa in the peri-ischemia cortex after ischemia stroke and the impaired neural function was improved.%目的:探讨运动锻炼对卒中后大鼠缺血侧脑皮质排斥性导向分子A(Repulsive guidance molecule A,RGMa)表达的影响.方法:选用SD大鼠120只,随机分为5组,正常组,假手术组,MCAo模型7、14、28 d组,以上各

  12. Brain computed tomography of the hypertensive patients

    International Nuclear Information System (INIS)

    Now a day, hypertension is more increasing in frequency and ranked the top of the causes of death in Korea and other nations. Most of cerebrovascular accidents in hypertensive patients are composed of vascular occlusive changes and hemorrhages. In cerebral angiogram, we can only detect occlusion of large artery and large mass effect from hematoma or cerebral infarction without identification of its entity. The computed tomogram, however, is the best way for evaluation of cerebrovascular diseases including detection of nature, location, amount, and associated changes. This study includes evaluation of computed tomograms of 106 patients with hypertension during the period of 17 months from Feb. 1979 to June 1980 in the department of radiology, college of Medicine, Hanyang University. The results were as follows. 1. Age distribution of the total 106 patients was broad ranging from 25 years to 76 years. 67.9% of patients were over the age of 50. The male and female sex ratio was 3:2. 2. 28 out of 106 patients were normal and 78 patients revealed abnormal on C. T. findings; those were intracranial hemorrhage (35 patients), cerebral infarction (32 patients) and brain atrophy (11 patients). 3. All of the intracranial hemorrhage except one were intracerebral hemorrhage; those were located in the cerebral hemisphere (19 patients), basal ganglia (15 patients) and brain stem (1 patient). The except one case of intracranial hemorrhage was subdural hematoma. 7 patients of intraventricular hemorrhage and 1 patient of subarachnoid hemorrhage were combined with intracerebral hemorrhage. 2/3 of patients who had hemorrhage in cerebral hemisphere revealed lesions in the parietal and temporal lobes. 4. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (20 cases), and the next was basal ganglia (11 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. The left basal ganglia was more commonly involved

  13. Brain Basics

    Medline Plus

    Full Text Available ... The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of the ... distant nerve cells (via axons) to form brain circuits. These circuits control specific body functions such as ...

  14. Brain Basics

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    Full Text Available ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of the brain's structure, studies ...

  15. Brain Basics

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    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... others live with symptoms of mental illness every day. They can be moderate, or serious and cause ...

  16. Brain Basics

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    Full Text Available ... helps Sarah to better cope with her feelings. Brain Research Modern research tools and techniques are giving scientists ... the treatment for a person's specific conditions. Such brain research help increase the understanding of how the brain ...

  17. Brain Basics

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    Full Text Available ... little dopamine or problems using dopamine in the thinking and feeling regions of the brain may play ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses ...

  18. Brain Basics

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    Full Text Available ... as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are the basic working unit of the brain ... specialized for the function of conducting messages. A neuron has three basic parts: Cell body which includes ...

  19. Brain Malformations

    Science.gov (United States)

    Most brain malformations begin long before a baby is born. Something damages the developing nervous system or causes it ... medicines, infections, or radiation during pregnancy interferes with brain development. Parts of the brain may be missing, ...

  20. Brain Basics

    Medline Plus

    Full Text Available ... brain's structure, studies show that brain growth in children with autism appears to peak early. And as ... grow there are differences in brain development in children who develop bipolar disorder than children who do ...

  1. Brain Basics

    Medline Plus

    Full Text Available ... Basics will introduce you to some of this science, such as: How the brain develops How genes and the environment affect the brain The basic structure of the brain How different parts of ...

  2. Brain Basics

    Medline Plus

    Full Text Available ... understanding of the brain than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures ...

  3. Brain Basics

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    Full Text Available ... science, such as: How the brain develops How genes and the environment affect the brain The basic ... that with brain development in people mental disorders. Genes and environmental cues both help to direct this ...

  4. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  5. 2-Decenoic Acid Ethyl Ester, a Compound That Elicits Neurotrophin-like Intracellular Signals, Facilitating Functional Recovery from Cerebral Infarction in Mice

    Directory of Open Access Journals (Sweden)

    Toru Iwama

    2012-04-01

    Full Text Available In our previous study, we found that trans-2-decenoic acid ethyl ester (DAEE, a derivative of a medium-chain fatty acid, elicits neurotrophin-like signals including the activation of extracellular signal-regulated kinases 1 and 2 (ERK1/2 in cultured mouse cortical neurons. Here, we examined the efficacy of intraperitoneal administration of DAEE on the treatment of a mouse model of the cerebral infarction caused by unilateral permanent middle cerebral artery occlusion (PMCAO. DAEE-treatment (100 µg/kg body weight injected at 0.5, 24, 48, 72 h after PMCAO significantly restored the mice from PMCAO-induced neurological deficits including motor paralysis when evaluated 48, 72, and 96 h after the PMCAO. Furthermore, DAEE facilitated the phosphorylation of ERK1/2 on the infarction side of the brain when analyzed by Western immunoblot analysis, and it enhanced the number of phosphorylated ERK1/2-positive cells in the border areas between the infarction and non-infarction regions of the cerebral cortex, as estimated immunohistochemically. As the infarct volume remained unchanged after DAEE-treatment, it is more likely that DAEE improved the neurological condition through enhanced neuronal functions of the remaining neurons in the damaged areas rather than by maintaining neuronal survival. These results suggest that DAEE has a neuro-protective effect on cerebral infarction.

  6. Schizophrenia-like psychosis following left putamen infarct: a case report

    Directory of Open Access Journals (Sweden)

    Farid Faisal

    2009-07-01

    Full Text Available Abstract Introduction Subcortical structures of the brain have been studied extensively to establish their implication in the development of psychotic symptoms in schizophrenia. Any pathology in these structures of the brain identified on neuroimaging techniques can give us helpful information in learning the neuropsychiatric background of psychotic symptoms in schizophrenia. Case presentation We report an interesting case of a 38-year-old man with new onset psychosis who was found to have a lacunar infarct of the putamen region in the left basal ganglia on a computed tomography scan of his brain. Conclusion It is possible to hypothesize that the psychotic symptoms in our patient may be the direct result of the putamen infarct, as pathology in the basal ganglia at the level of the striatum can result in complex cognitive and behavioural symptoms. Understanding organic causes of psychosis, including cerebrovascular compromises leading to damage of structures in the basal ganglia, can provide important information about the causality of psychosis and ways to treat it.

  7. Brain mapping

    OpenAIRE

    Blaž Koritnik

    2004-01-01

    Cartography of the brain ("brain mapping") aims to represent the complexities of the working brain in an understandable and usable way. There are four crucial steps in brain mapping: (1) acquiring data about brain structure and function, (2) transformation of data into a common reference, (3) visualization and interpretation of results, and (4) databasing and archiving. Electrophysiological and functional imaging methods provide information about function of the human brain. A prere...

  8. Effects ofAstragalus Membranaceus on Ischemia Brain Damage

    Institute of Scientific and Technical Information of China (English)

    Yumin Luo; Zhen Qin

    2000-01-01

    We observed the protective effects of Astragalus Membranaceus on cerebral ischemia. Method: 1. We used intravascular thread rat models with 72hs reperfusion of lh tMCAO for our studies. Astragalus Membranaceus was administrated intraperitoneally in different interval. The rats were sacrificed 72 hours after l h tMCAO. 2. Cerebral infarction volume was determined by TTC staining and image analysis. 3. DTNB method and TBA method were applied to measure the activity of GSH-px and the concentration of MDA respectively. 4. The blood brain barrier damage was evaluated by the area of Evans Blue extravasation. Results:l.The whole brain volume of protective group is larger than its control, but the average infarction volume is significantly less than that of control, and the percentage of average infarction volume to the whole brain is obviously decreased. 2. We found mildly enhanced GSH-px activity and markedly decreased MDA concentration in the protective group compared with its control. But there are no significant changes of GSH-px activity and MDA concentration in the therapy group compared with its control. 3. The area of Evans Blue staining in the protective group is significantly less than that of its control. Conclusion:l.Astragalus Membranaceus can decrease the infarction volume. 2.Astragalus Membranaceus may reduce MDA concentration after cerebral ischemia. 3.Astragalus Membranaceus can protect blood brain barrier.

  9. Methylenetetrahydrofolate reductase homozygous mutation in a young boy with cerebellar infarction

    Directory of Open Access Journals (Sweden)

    Alberto Spalice

    2009-11-01

    Full Text Available Posterior circulation vascular occlusive disease in children is a rare and uncommonly reported event. Among the numerous risk factors, the methylenetetrahydrofolate reductase (MTHFR mutation is considered to be a common genetic cause of thrombosis in adults and children. Recently, a link between the MTHFR mutation and cerebrovascular disorders was reported in children. Diffusion tensor imaging (DTI is a great improvement on magnetic resonance imaging (MRI, making the in vivo anatomical and pathological study of the brain and its fibers possible. In our patient cerebellar infarction was associated with MTHFR mutation and, in a standard neurological examination, DTI revealed normal white matter tracts.

  10. Methylenetetrahydrofolate reductase homozygous mutation in a young boy with cerebellar infarction.

    Science.gov (United States)

    Spalice, Alberto; Del Balzo, Francesca; Perla, Francesco Massimo; Properzi, Enrico; Carducci, Carla; Antonozzi, Italo; Iannetti, Paola

    2009-01-01

    Posterior circulation vascular occlusive disease in children is a rare and uncommonly reported event. Among the numerous risk factors, the methylenetetrahydrofolate reductase (MTHFR) mutation is considered to be a common genetic cause of thrombosis in adults and children. Recently, a link between the MTHFR mutation and cerebrovascular disorders was reported in children. Diffusion tensor imaging (DTI) is a great improvement on magnetic resonance imaging (MRI), making the in vivo anatomical and pathological study of the brain and its fibers possible. In our patient cerebellar infarction was associated with MTHFR mutation and, in a standard neurological examination, DTI revealed normal white matter tracts. PMID:21589820

  11. Effects of Electroacupuncture plus Intra-carotid Drug Injection on Rheoencephalogram in Patients with Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    李江明; 胡永均; 童利民; 王大军; 张道敬

    2004-01-01

    Purpose: To investigate the mechanism of electroacupuncture (EA) plus intra-carotid drug injection for treating cerebral infarction. Methods: Rheoencephalogram was recorded with a RG-2B type of bridge rheoencephalograph and findings were compared before and after the treatment. Results: After the treatment, the prolonged rising time was shortened, and the decreased amplitude obviously elevated. Conclusion: The therapy can dilate cerebral blood vessels, increase the cerebral blood flow, and improve the elasticity of cerebral blood vessels, leading to sufficient blood and oxygen supply in the ischemic brain tissues and to restoration of their functions.

  12. [Prehospital thrombolytic therapy in acute myocardial infarction].

    Science.gov (United States)

    Carlsson, J; Schuster, H P; Tebbe, U

    1997-10-01

    The extent of myocardial damage occurring during acute myocardial infarction is time dependent, and there is abundant evidence from most clinical trials that mortality reduction is greatest in patients treated early with thrombolytic agents, although beneficial effects have been shown with treatment initiated up to 12 h after onset of symptoms. All studies on prehospital thrombolysis have conclusively shown the practicability and safety of patient selection and administration of the thrombolytic agent. The accuracy of diagnosis in the prehospital setting was comparable to trials of in-hospital thrombolysis, e.g., in the Myocardial Infarction Triage and Intervention Project (MITI) 98% of the patients enrolled had subsequent evidence of acute myocardial infarction. With regard to time savings, all randomized studies showed positive results. The smallest time gain was observed in the MITI trial: prehospital-treated patients received thrombolytic therapy an average of 33 min earlier than those treated in hospital. In the European Myocardial Infarction Project (EMIP) the difference in time between prehospital and hospital treatment was a median of 55 min. However, none of these trials was able to show a significant short-term mortality difference between the two groups. Only a meta analysis of five randomized studies with a combined median time gain of about 60 min showed a significant 17% reduction in short-term mortality for patients who received thrombolytic therapy in the prehospital phase. In the Grampian Region Early Anistreplase Trial (GREAT), a study performed in a more rural area than other studies, the time gain by prehospital initiation of thrombolysis was a median of 130 min. GREAT was the only study to date reporting a significant mortality benefit for prehospital-treated patients after 3 months and 1 year. In conclusion, prehospital thrombolysis is feasible and safe. Patients with acute myocardial infarction can be correctly identified and treated with

  13. Acupuncture Therapy for Multiple Infarctional Dementia

    Institute of Scientific and Technical Information of China (English)

    SHEN Wei-dong; XIAO Yuan-chun

    2003-01-01

    Purpose To observe the clinical efficacy of combined electro-acupuncture and moxibustion in the treatment of multiple infarctional dementia. Methods Eighty-eight patients were randomized into two groups:treatment group in which 48 cases were treated by combined electro-acupuncture and moxibustion and control group in which 40 cases were treated by oral administration of Huperzine A. Results The total effective rate was 90% in treatment group and 71% in control group,with a significant difference ( P < 0.05 ); the score of Mini-mental State Examination (MMSE) increased more obviously in treatment group than in control group (P<0.05). Conclusion Combined electro-acupuncture and moxibustion is effective in improving the clinical symptoms of multiple infarctional dementia.

  14. MR imaging of acute myocardial infarction

    International Nuclear Information System (INIS)

    This paper reports on superparamagnetic iron oxide particles (AMI-25) evaluated in comparison with paramagnetic Gd-DOTA for the MR evaluation of acute myocardial infarct size. Twelve openchest dogs underwent 2 hours of LAD occlusion followed by 6 hours of reperfusion. AMI-25 and Gd-DOTA were intravenously injected 1 hour and 10 minutes before euthanasia, respectively, in two groups of six dogs. Gradient-echo and T1- and T2-weighted spin-echo images were obtained in six AMI-25-injected excised hearts, and T1- and T2-weighted images in six Gd-DOTA injected excised hearts. Infarct size was evaluated by planimetry of each 8-mm-thick transverse slice after ex vivo double staining and correlated with the planimetry of each 8-mm-thick transverse MR section

  15. Painless acute myocardial infarction on Mount Kilimanjaro.

    Science.gov (United States)

    Jamal, Nasiruddin; Rajhy, Mubina; Bapumia, Mustaafa

    2016-01-01

    An individual experiencing dyspnoea or syncope at high altitude is commonly diagnosed to have high-altitude pulmonary edema or cerebral edema. Acute myocardial infarction (AMI) is generally not considered in the differential diagnosis. There have been very rare cases of AMI reported only from Mount Everest. We report a case of painless ST segment elevation myocardial infarction (STEMI) that occurred while climbing Mount Kilimanjaro. A 51-year-old man suffered dyspnoea and loss of consciousness near the mountain peak, at about 5600 m. At a nearby hospital, he was treated as a case of high-altitude pulmonary edema. ECG was not obtained. Two days after the incident, he presented to our institution with continued symptoms of dyspnoea, light-headedness and weakness, but no pain. He was found to have inferior wall and right ventricular STEMI complicated by complete heart block. He was successfully managed with coronary angioplasty, with good recovery. PMID:26989121

  16. Repetitive myocardial infarctions secondary to delirium tremens.

    Science.gov (United States)

    Schwartzberg, David; Shiroff, Adam

    2014-01-01

    Delirium tremens develops in a minority of patients undergoing acute alcohol withdrawal; however, that minority is vulnerable to significant morbidity and mortality. Historically, benzodiazepines are given intravenously to control withdrawal symptoms, although occasionally a more substantial medication is needed to prevent the devastating effects of delirium tremens, that is, propofol. We report a trauma patient who required propofol sedation for delirium tremens that was refractory to benzodiazepine treatment. Extubed prematurely, he suffered a non-ST segment myocardial infarction followed by an ST segment myocardial infarction requiring multiple interventions by cardiology. We hypothesize that his myocardial ischemia was secondary to an increased myocardial oxygen demand that occurred during his stress-induced catecholamine surge during the time he was undertreated for delirium tremens. This advocates for the use of propofol for refractory benzodiazepine treatment of delirium tremens and adds to the literature on the instability patients experience during withdrawal. PMID:25197580

  17. Brain Basics

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    Full Text Available ... in Real Life Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video ... early brain development, and may also assist in learning and memory. ... rise to disabilities or diseases. neural circuit —A network of neurons ...

  18. Brain Basics

    Medline Plus

    Full Text Available ... than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of the brain's structure, studies show that brain growth in children with autism appears to peak early. And as ...

  19. Brain Basics

    Medline Plus

    Full Text Available ... Research Modern research tools and techniques are giving scientists a more detailed understanding of the brain than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures of the brain's structure, studies ...

  20. Brain Basics

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    Full Text Available ... Welcome. Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... highly developed area at the front of the brain that, in humans, plays a role in executive functions such as ...

  1. Stroke and myocardial infarction: a terrible association

    OpenAIRE

    Bacci, Marcelo Rodrigues; Santos, Janaina Aparecida Boide

    2012-01-01

    In the USA coronary heart diseases and cerebral vascular accidents together are the major causes of death regardless of race or sex. More specifically, the acute myocardial infarction and the encephalic vascular accident, as final events of atherosclerosis, correspond to a large part of death cases. Such cases could be potentially prevented with a proper follow-up and the identification of the risk factors. We present a case of a 65-year-old black man, diabetic and hypertensive, with ischaemi...

  2. Acute Myocardial Infarction, 1992-2001.

    OpenAIRE

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  3. Myocardial infarction induced by spontaneous pneumothorax

    OpenAIRE

    Clarke, Viktoriya; McWilliams, Eric

    2010-01-01

    Chest pain is a very common condition. Patients may have a benign condition or present with a potentially lethal condition such as acute myocardial infarction, aortic dissection or tension pneumothorax. It is important to remember that patients may present with more than one serious pathology and that other serious conditions may potentially precipitate an acute coronary syndrome in a susceptible individual. We report the case of an elderly man with a background of chronic obstructive pulmona...

  4. Helicobacter Pylori Infection and Acute Myocardial Infarction

    OpenAIRE

    Nakić, Dario; Včev, Aleksandar; Jović, Albino; Patrka, Jogen; Zekanović, Dražen; Klarin, Ivo; Ivanac, Krešimir; Mrđen, Anamarija; Balen, Sanja

    2011-01-01

    The aim of this investigation was to determine whether H. pylori infection is an independent risk factor for acutemyocardial infarction (AMI), determine is there a link between H. pylori infection and severity of disease. In this prospective, single centre study, were enrolled 100 patients with AMI and control group was consisted 93 healthy individuals. The results of this study showed no difference between H. pylori seropositivity distribution in the investigate and control group ...

  5. Early detection of Myocardial Infarction using WBAN

    OpenAIRE

    Hadjem, Medina; Salem, Osman; Naït-Abdesselam, Farid; Ahmed, Mehaoua

    2013-01-01

    Cardiovascular diseases are the leading cause of death in the world, and Myocardial Infarction (MI) is the most serious one among those diseases. Patient monitoring for an early detection of MI is important to alert medical assistance and increase the vital prognostic of patients. With the development of wearable sensor devices having wireless transmission capabilities, there is a need to develop real-time applications that are able to accurately detect MI non-invasively. In this paper, we pr...

  6. Clinical Practice Guidelines for Acute Myocardial Infarction.

    OpenAIRE

    Francisco de Jesús Valladares Carvajal; Arelys Falcón Hernández; Félix Rolando Jorrín Román; Juan Emilio García Rivas

    2009-01-01

    Clinical Practice Guidelines for Acute Myocardial Infarction. It has been defined as the clinical condition caused by the ischemic myocardial necrosis, usually caused by abrupt reduction of coronary blood irrigation affecting one or more myocardial areas. The document includes a review and update of the concept, classification, diagnosis and therapy. Risk stratification and main aspects of rehabilitation are also stressed. It includes assessment guidelines focused on the most important aspect...

  7. Fatigue in Older Adults Post Myocardial Infarction

    OpenAIRE

    Patricia Barton Crane; Jimmy eEfird; Willie Mae Abel

    2016-01-01

    Objective. The purpose of this study was to comprehensively examine putative factors that may independently contribute to fatigue and subsequent persistence of fatigue in elderly adults 6-8 months post myocardial infarction (MI). Studies suggest cardiac function, comorbidities, daytime sleepiness, depression, anemia, interleukins, and social support are correlates of fatigue; however, no studies have systematically examined these factors 6 months post MI in an aging population. Methods. Study...

  8. Fatigue in Older Adults Postmyocardial Infarction

    OpenAIRE

    Crane, Patricia Barton; Jimmy T. Efird; Abel, Willie Mae

    2016-01-01

    Objective The purpose of this study was to comprehensively examine putative factors that may independently contribute to fatigue and subsequent persistence of fatigue in elderly adults 6–8 months post-myocardial infarction (MI). Studies suggest cardiac function, comorbidities, daytime sleepiness, depression, anemia, interleukins, and social support are correlates of fatigue; however, no studies have systematically examined these factors 6 months post-MI in an aging population. Methods Study p...

  9. Acute myocardial infarction after mediastinal radiotherapy

    International Nuclear Information System (INIS)

    Mediastinal radiotherapy can affect the heart and great vessels to different degrees. It may turn up as coronary heart disease and less frequently as acute myocardial infarction. We report the case of a patient without coronary risk factors and an antecedent of mediastinal radiotherapy for Hodgkin's lymphoma. Considerations about mediastinal radiation as a risk factor for early development of coronary heart diseases are exposed. (author)

  10. Methanol intoxication with bilateral basal ganglia infarct

    International Nuclear Information System (INIS)

    Methanol is a toxic agent that affects the central nervous system, especially the optic nerves and basal ganglia. Symmetrical hypodense lesions in the basal ganglia, which can be demonstrated by CT or MRI, is accepted as the most characteristic radiological feature of the disease. A case of a patient with bilateral putaminal hypodense infarcts due tomethanol intoxication is presented. Copyright (2001) Blackwell Science Pty Ltd

  11. Clinical Practice Guidelines for Acute Myocardial Infarction.

    Directory of Open Access Journals (Sweden)

    Francisco De Jesús Valladares Carvajal

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Acute Myocardial Infarction. It has been defined as the clinical condition caused by the ischemic myocardial necrosis, usually caused by abrupt reduction of coronary blood irrigation affecting one or more myocardial areas. The document includes a review and update of the concept, classification, diagnosis and therapy. Risk stratification and main aspects of rehabilitation are also stressed. It includes assessment guidelines focused on the most important aspects to be accomplished.

  12. Brain mapping

    Directory of Open Access Journals (Sweden)

    Blaž Koritnik

    2004-08-01

    Full Text Available Cartography of the brain ("brain mapping" aims to represent the complexities of the working brain in an understandable and usable way. There are four crucial steps in brain mapping: (1 acquiring data about brain structure and function, (2 transformation of data into a common reference, (3 visualization and interpretation of results, and (4 databasing and archiving. Electrophysiological and functional imaging methods provide information about function of the human brain. A prerequisite for multisubject, multidimensional and multimodal mapping is transformation of individual images to match a standard brain template. To produce brain maps, color, contours, and other visual cues are used to differentiate metabolic rates, electrical field potentials, receptor densities, and other attributes of structure or function. Databases are used to organize and archive data records. By relating the maps to cognitive functions and psychological models, brain mapping offers a prerequisite for the understanding of organizational principles of the human brain.

  13. Systemic inflammatory response following acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Lu FANG; Xiao-Lei Moore; Anthony M Dart; Le-Min WANG

    2015-01-01

    Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial in-farction, and heart failure) in patients with AMI.

  14. The tole of ischemic preconditioning in acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ristić Anđelka

    2005-01-01

    Full Text Available Introduction Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Case report Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome-he developed apical necrosis, with greater myocardial viability in the infarct-related area. Conclusion The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias. .

  15. Electrocardiographic localization of infarct related coronary artery in acute ST elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    C.S. Thejanandan Reddy

    2013-07-01

    Full Text Available The electrocardiogram (ECG remains a crucial tool in the identification and management of acute myocardial infarction (MI. A detailed analysis of patterns of ST-segment elevation may influence decisions regarding the use of reperfusion therapy. The early and accurate identification of the infarct-related artery on the ECG can help predict the amount of myocardium at risk and guide decisions regarding the urgency of revascularization. The specificity of the ECG in acute MI is limited by individual variations in coronary anatomy as well as by the presence of preexisting coronary artery disease, particularly in patients with a previous MI, collateral circulation, or previous coronary-artery bypass surgery. The ECG is also limited by its inadequate representation of the posterior, lateral, and apical walls of the left ventricle. Despite these limitations, the electrocardiogram can help in identifying proximal occlusion of the coronary arteries, which results in the most extensive and most severe myocardial infarctions.

  16. An increase in the cerebral infarction area during fatigue is mediated by il-6 through an induction of fibrinogen synthesis

    Directory of Open Access Journals (Sweden)

    Hong Lei

    2014-06-01

    Full Text Available OBJECTIVES:Our study aimed to investigate the impact of fatigue on the severity of stroke and to explore the underlying mechanisms.METHODS:Fatigued male rats underwent middle cerebral artery occlusion and the infarcted brain area was determined. Then, coagulation parameters were assessed in the fatigued group and a control group. In addition, the level of fibrinogen was determined in rats deprived of sleep for various numbers of days. To study whether interleukin-6 was involved in fibrinogen synthesis during fatigue, we also measured levels of interleukin-6 in rats deprived of sleep for various numbers of days. Furthermore, brain injury by middle cerebral artery occlusion was measured in wild-type mice, interleukin-6-/- mice and wild-type mice treated with bezafibrate.RESULTS:More severe cerebral infarction was observed in the fatigued rats, resulting in an infarct ratio of 23.4%. The infarct ratio was significantly increased in the fatigued rats compared with that in the control group (8%, p<0.05. The level of fibrinogen was increased significantly in the fatigued rats compared with that in the control group. In addition, a marked reduction in fibrinogen level was observed in the fatigued interleukin-6-/- mice compared to their wild-type counterparts, whereas no difference was observed between fatigued wild-type mice and interleukin-6-/- rats treated with recombinant human interleukin-6. The reduction in brain injury due to middle cerebral artery occlusion during fatigue was observed in interleukin-6-/- mice and wild-type mice treated with bezafibrate.CONCLUSION:Fatigue could increase stroke severity and was associated with the interleukin-6-induced expression of fibrinogen.

  17. Anti-Cardiolipin Antibody in Acute Myocardial Infarction

    OpenAIRE

    Abdolreza S. Jahromi; Mohammad Shojaie; Samira Dana; Abdoulhossain Madani

    2010-01-01

    Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Data concerning the relation between anti-Phospholipid (aPL) antibodies and myocardial infarction in subjects without evidence of overt autoimmune disease are conflicting. Anticardiolipin antibody is detected in various diseases like rheumatoid arthritis, systemic lupus erythematosus and anti-phospholipid antibody syndrome. The study of Anticardiolipin antibody in Acute Myocardial Infarction...

  18. Acute myocardial infarction related to smoke inhalation and myocardial bridging.

    OpenAIRE

    McCabe, M J; Weston, C. F.; Fraser, A G

    1992-01-01

    A previously healthy 26 year old woman who was exposed to smoke during a house fire developed acute anterior myocardial infarction complicated by ventricular fibrillation. Subsequent left ventriculography confirmed anterior infarction, but coronary arteriography was normal apart from myocardial bridging over a segment of the left anterior descending artery. The development of acute myocardial infarction in this patient suggests that, in the presence of bridging, carbon monoxide inhalation may...

  19. C-Reactive Protein Activates Complement in Infarcted Human Myocardium

    OpenAIRE

    Nijmeijer, Remco; Lagrand, Wim K.; Lubbers, Yvonne T. P.; Visser, Cees A.; Meijer, Chris J.L.M.; Niessen, Hans W. M.; Hack, C. Erik

    2003-01-01

    Circulating levels of C-reactive protein (CRP) constitute a cardiovascular risk marker. Immunohistochemical studies have revealed co-localization of CRP and activated complement in human infarcted myocardium suggesting CRP to enhance inflammation in ischemic myocardium by inducing local complement activation. The aim was to establish whether CRP activates complement in infarcted human myocardium and to assess the relationship between this activation and the duration of infarction. Myocardial ...

  20. Hepatic infarction in HELLP syndrome; a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Jeong; Kim, Hong [Keimyung Univ. School of Medicine, Taegu (Korea, Republic of)

    2000-11-01

    Hepatic infarction is a rare but potentially life-threatening complication of pregnancy-associated preeclampsia or HELLP (hemolysis, elevated liver function tests, low platelets) syndrome. We present a case of hepatic infarction subsequent to HELLP syndrome and occurring during the immediate postpartum, and the associated radiologic findings. Sonography revealed poorly defined hypoechoic zones of infarction. Computed tomography(CT) demonstrated the characteristic features of nonenhancing, low attenuation, relatively well-defined, wedge shaped or geographic hepatic lesions, without mass effect.

  1. Hepatic infarction in HELLP syndrome; a case report

    International Nuclear Information System (INIS)

    Hepatic infarction is a rare but potentially life-threatening complication of pregnancy-associated preeclampsia or HELLP (hemolysis, elevated liver function tests, low platelets) syndrome. We present a case of hepatic infarction subsequent to HELLP syndrome and occurring during the immediate postpartum, and the associated radiologic findings. Sonography revealed poorly defined hypoechoic zones of infarction. Computed tomography(CT) demonstrated the characteristic features of nonenhancing, low attenuation, relatively well-defined, wedge shaped or geographic hepatic lesions, without mass effect

  2. Concurrent Diseases and Conditions in Cats with Renal Infarcts

    OpenAIRE

    Hickey, M.C.; Jandrey, K.; Farrell, K.S.; Carlson‐Bremer, D.

    2014-01-01

    Background Renal infarcts identified without definitive association with any specific disease process. Objective Determine diseases associated with diagnosis of renal infarcts in cats diagnosed by sonography or necropsy. Animals 600 cats underwent abdominal ultrasonography, necropsy, or both at a veterinary medical teaching hospital. Methods Information obtained from electronic medical records. Cats classified as having renal infarct present based on results of sonographic evaluation or necro...

  3. Recombinant Tissue Plasminogen Activator Induces Neurological Side Effects Independent on Thrombolysis in Mechanical Animal Models of Focal Cerebral Infarction: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Mei-Xue Dong

    Full Text Available Recombinant tissue plasminogen activator (rtPA is the only effective drug approved by US FDA to treat ischemic stroke, and it contains pleiotropic effects besides thrombolysis. We performed a meta-analysis to clarify effect of tissue plasminogen activator (tPA on cerebral infarction besides its thrombolysis property in mechanical animal stroke.Relevant studies were identified by two reviewers after searching online databases, including Pubmed, Embase, and ScienceDirect, from 1979 to 2016. We identified 6, 65, 17, 12, 16, 12 and 13 comparisons reporting effect of endogenous tPA on infarction volume and effects of rtPA on infarction volume, blood-brain barrier, brain edema, intracerebral hemorrhage, neurological function and mortality rate in all 47 included studies. Standardized mean differences for continuous measures and risk ratio for dichotomous measures were calculated to assess the effects of endogenous tPA and rtPA on cerebral infarction in animals. The quality of included studies was assessed using the Stroke Therapy Academic Industry Roundtable score. Subgroup analysis, meta-regression and sensitivity analysis were performed to explore sources of heterogeneity. Funnel plot, Trim and Fill method and Egger's test were obtained to detect publication bias.We found that both endogenous tPA and rtPA had not enlarged infarction volume, or deteriorated neurological function. However, rtPA would disrupt blood-brain barrier, aggravate brain edema, induce intracerebral hemorrhage and increase mortality rate.This meta-analysis reveals rtPA can lead to neurological side effects besides thrombolysis in mechanical animal stroke, which may account for clinical exacerbation for stroke patients that do not achieve vascular recanalization with rtPA.

  4. Acute myocardial infarction and infarct size: do circadian variations play a role?

    Directory of Open Access Journals (Sweden)

    Ibáñez B

    2012-08-01

    Full Text Available Aída Suárez-Barrientos,1 Borja Ibáñez1,21Cardiovascular Institute, Hospital Clínico San Carlos, 2Centro Nacional de Investigaciones Cardiovasculares, Madrid, SpainAbstract: The circadian rhythm influences cardiovascular system physiology, inducing diurnal variations in blood pressure, heart rate, cardiac output, endothelial functions, platelet aggregation, and coronary arterial flow, among other physiological parameters. Indeed, an internal circadian network modulates cardiovascular physiology by regulating heart rate, metabolism, and even myocyte growth and repair ability. Consequently, cardiovascular pathology is also controlled by circadian oscillations, with increased morning incidence of cardiovascular events. The potential circadian influence on the human tolerance to ischemia/reperfusion has not been systematically scrutinized until recently. It has since been proven, in both animals and humans, that infarct size varies during the day depending on the symptom onset time, while circadian fluctuations in spontaneous cardioprotection in humans with ST-segment elevation myocardial infarction (STEMI have also been demonstrated. Furthermore, several studies have proposed that the time of day at which revascularization occurs in patients with STEMI may also influence infarct size and reperfusion outcomes. The potential association of the circadian clock with infarct size advocates the acknowledgment of time of day as a new prognostic factor in patients suffering acute myocardial infarction, which would open up a new field for chronotherapeutic targets and lead to the inclusion of time of day as a variable in clinical trials that test novel cardioprotective strategies.Keywords: cardioprotection, circadian rhythm, reperfusion injury, ST-segment elevation myocardial infarction

  5. Correlation between carotid parameters measured by ultrasonography and cerebral infarction or left ventricular diastolic function in chronic hemodialysis patients

    International Nuclear Information System (INIS)

    Many studies have reported that carotid parameters measured by ultrasonography are predictors for cerebral infarction in nondialysis patients. Using a cross-sectional design, this study investigated whether those carotid parameters are also associated with cerebral infarction and left ventricular diastolic function in chronic hemodialysis (HD) patients. We studied 63 HD patients aged 61.4±11.5 years who underwent regular hemodialysis in Hidaka Hospital. All subjects underwent carotid ultrasound measurements when they performed brain magnetic resonance imaging (MRI) or computed tomography (CT). Cerebral infarction was detected significantly more frequently in patients with max intima-media thickness of common carotid artery (IMT) >2.2 mm (Odds ratio=3.14, 95% confidence interval (CI)=1.11-8.92). There was a positive correlation between PS and E/E' (r=0.322, p=0.009). These findings suggest that max IMT is significantly associated with the presence of cerebral infarction, while PS is related to left ventricular diastolic function in chronic HD patients. (author)

  6. Use of rt-PA (Alteplase) for acute cerebral infarction

    International Nuclear Information System (INIS)

    Among those patients with cerebral infarction who were brought to our emergency department from December 2005 through June 2007, 28 satisfied the criteria for indication for alteplase, recombinant tissue plasminogen activator (rt-PA), and served as the subjects of this study. According to the treatment protocol that our group, led by neurologists, had prepared, 0.6 mg/kg of rt-PA was administered following a CT of the head region that negated the presence of a brain hemorrhage. The time that elapsed between onset and rt-PA administration was 41-167 minutes (median 95). For 24 hours after medication, the patients were placed under respiratory and circulatory care and their neurological performances were observed in an intensive care unit (ICU) or a neurological ward. On a modified ranking scale, which indicates the possibility for social rehabilitation, 9 patients (32%) were rated to be between 0 to 1. Four (14%) succumbed during this period. By formulating a treatment protocol, rapid administration of rt-PA and monitoring to prevent complications became possible. (author)

  7. The relationship between cerebral infarction on MR and angiographic findings in moyamoya disease: significance of the posterior circulation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ja; Song, Soon Young [College of Medicine, Kwangdong Univ., Koyang (Korea, Republic of); Yu, Won Jong; Jung, So Lyung; Chung, Bong Gak; Kag, Si Won [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of); Kim, Man Deuk [College of Medicine, Pochon CHA Univ., Pochon (Korea, Republic of)

    2002-06-01

    To investigate the relationship between changes in the posterior and anterior circulation, as seen at angiography, and the frequency and extent of cerebral infarction revealed by MR imaging in moyamoya disease. This study involved 34 patients (22 females and 12 males, aged 2-52 years) in whom cerebral angiography revealed the presence of moyamoya disease (bilateral; unilateral= 24:10; total hemispheres=58) and who also underwent brain MR imaging. To evaluate the angiographic findings, we applied each angiographic staging system to the anterior and posterior circulation. Leptomeningeal collateral circulation from the cortical branches of the posterior cerebral artery (PCA) was also assigned one of four grades. At MR imaging, areas of cerebral cortical or subcortical infarction in the hemisphere were divided into six zones. White matter and basal ganglionic infarction, ventricular dilatation, cortical atrophy, and hemorrhagic lesions were also evaluated. To demonstrate the statistical significance of the relationship between the angiographic and the MR findings, both the Mantel-Haenszel chi-square test for trend and the chi-square test were used. The degree of steno-occlusive PCA change correlated significantly with the internal carotid artery (ICA) stage (p<0.0001). As PCA stages advanced, the degree of leptomeningeal collaterals from the PCA decreased significantly (P<0.0001), but ICA stages were not significant (p>0.05). The prevalence of infarction showed significant correlation with the degree of steno-occlusive change in both the ICA and PCA. The degree of cerebral ischemia in moyamoya patients increased proportionally with the severity of PCA stenosis rather than with that of steno-occlusive lesins of the anterior circulation. Infarctions tended to be distributed in the anterior part of the hemisphere at PCA state I or II, while in more advanced PCA lesions, they were also found posteriorly, especially in the territories of the posterior middle cerebral artery

  8. Imaging Vascular Disease and Amyloid in the Aging Brain: Implications for Treatment

    OpenAIRE

    Villeneuve, Sylvia; Jagust, William J.

    2015-01-01

    Vascular risk factors (e.g. hypertension, dyslipidemia and diabetes) are well known risk factors for Alzheimer’ disease. These vascular risk factors lead to vascular brain injuries, which also increase the likelihood of dementia. The advent of amyloid PET imaging has helped establish that vascular risk factors also lead to Alzheimer’s disease via pathways that are independent from vascular brain injuries, at least, when vascular brain injuries are measured as white matter lesions and infarcts...

  9. Application of DWI and DTI in diagnosis of cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To analyze and evaluate the applications of diffusion tensor imaging(DTI) and diffusion weighted imaging (DWI) in cerebral infarction. Methods: 84 cases with different phases cerebral infarction (6 cases in super-acute, 30 cases in acute, 26 cases in sub-acute and 22 cases in chronic phase) were performed by routine MRI, DWI and DTI scan, apparent diffusion coefficient (ADC), fractional anisotropy (FA) and the signal changes of DWI of the leision and the conlateral side were calculated and compared; The relationships among DWI, FA and ADC in different phases of cerebral infarction were analyzed. Results: The leisions of super-acute and acute cerebral infarction showed obviously high signal on DWI images, and low signal in chronic cerebral infarction. The mean relative ADC (rADC) values of sub-acute and chronic cerebral infarction were higher than those of super-acute and acute cerebral infarction (P<0.05). The FA values in 45 cases with different phases cerebral infarction (4 cases in super-acute, 16 cases in acute, 14 cases in sub-acute and 11 cases in chronic phase) were all lower than those in conlateral regions (P<0.05). Conclusion: DWI and DTI can detect superacute and acute lesions, the combination of DWI and conventional MRI can differentiate the phases of cerebral infarction. (authors)

  10. Unexpected Coexisting Myocardial Infarction Detected by Delayed Enhancement MRI

    Directory of Open Access Journals (Sweden)

    Edouard Gerbaud

    2009-01-01

    Full Text Available We report a case of an unexpected coexisting anterior myocardial infarction detected by delayed enhancement MRI in a 41-year-old man following a presentation with a first episode of chest pain during inferior acute myocardial infarction. This second necrotic area was not initially suspected because there were no ECG changes in the anterior leads and the left descending coronary artery did not present any significant stenoses on emergency coronary angiography. Unrecognised myocardial infarction may carry important prognostic implications. CMR is currently the best imaging technique to detect unexpected infarcts.

  11. The prognostic importance of creatinine clearance after acute myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, C R; Brendorp, B; Rask-Madsen, C;

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction. The...

  12. The importance of early patency after acute myocardial infarction.

    Science.gov (United States)

    Grover, A; Rihal, C S

    1995-07-01

    The importance of achieving rapid patency of the infarct-related artery during acute myocardial infarction has become well recognized. Early, sustained patency of the infarct-related vessel correlates with improved left ventricular function, better in-hospital outcomes, and lower mortality. Various strategies designed to improve early patency, including "prehospital" thrombolysis, use of an accelerated recombinant tissue plasminogen activator regimen, and immediate angioplasty have been studied. This paper reviews the importance of achieving early patency, the various strategies employed, and the evidence for their efficacy. Future directions in treatment of acute myocardial infarction are touched upon briefly. PMID:7549077

  13. Enriched environment reduces apolipoprotein E (ApoE) in reactive astrocytes and attenuates inflammation of the peri-infarct tissue after experimental stroke

    DEFF Research Database (Denmark)

    Ruscher, Karsten; Johannesson, Emelie; Brugiere, Elena;

    2009-01-01

    Apolipoprotein E (ApoE), a cholesterol transporter and an immunomodulator, is brain protective after experimental stroke and implicated in brain repair. Here, we study the involvement of ApoE in the restoration of brain function after experimental stroke, by using animal housing conditions that...... differentially improve recovery after occlusion of the middle cerebral artery occlusion (MCAO). We found that after MCAO the ApoE levels increased in the injured hemisphere over a 30 days recovery period. The exception was a proximal narrow peri-infarct rim, in which ApoE was solely localized in S100beta...

  14. MR-visible brain water content in human acute stroke

    DEFF Research Database (Denmark)

    Gideon, P; Rosenbaum, S; Sperling, B; Petersen, P

    1999-01-01

    Quantification of metabolite concentrations by proton magnetic resonance spectroscopy (1H-MRS) in the human brain using water as an internal standard is based on the assumption that water content does not change significantly in pathologic brain tissue. To test this, we used 1H-MRS to estimate...... brain water content during the course of cerebral infarction. Measurements were performed serially in the acute, subacute, and chronic phase of infarction. Fourteen patients with acute cerebral infarction were examined as well as 9 healthy controls. To correlate with regional cerebral blood flow (r......CBF) SPECT-scanning using 99mTc-HMPAO as flow tracer was performed in the patients. Mean water content (SD) in the infarct area was 37.7 (5.1); 41.8 (4.8); 35.2 (5.4); and 39.3 (5.1) mol x [kg wet weight](-1) at 0-3; 4-7; 8-21; and >180 days after stroke, respectively. Water content increased between Day 0...

  15. Osthole, a natural coumarin, improves neurobehavioral functions and reduces infarct volume and matrix metalloproteinase-9 activity after transient focal cerebral ischemia in rats.

    Science.gov (United States)

    Mao, Xuexuan; Yin, Wei; Liu, Mengfei; Ye, Minzhong; Liu, Peiqing; Liu, Jianxin; Lian, Qishen; Xu, Suowen; Pi, Rongbiao

    2011-04-18

    Previously we demonstrated that Osthole, a natural coumarin, protects against focal cerebral ischemia/reperfusion-induced injury in rats. In the present study, the effects of Osthole on neurobehavioral functions, infarct volume and matrix metalloproteinase-9 (MMP-9) in a rat 2h focal cerebral ischemia model were investigated. Osthole (100mg/kg per dose) was administrated intraperitoneally 30min before ischemic insult and immediately after reperfusion. Osthole treatment significantly reduced neurological deficit score and infarct volume by 38.5% and 33.8%, respectively, as compared with the untreated animals. Osthole reversed ischemia-reperfusion-induced increase in MMP-9 protein level/activity as evidenced by Western blotting and gelatin zymography. Taken together, these results for the first time demonstrate that Osthole reduces infarct volume, restores neurobehavioral functions and downregulates MMP-9 protein level/activity in ischemia/reperfused brain. PMID:21316348

  16. Blood flow and vascular reactivity in collaterally perfused brain tissue. Evidence of an ischemic penumbra in patients with acute stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Larsen, B; Herning, M;

    1983-01-01

    infarcted territory. The brain tissue overlying the deep infarcts appeared normal on CT-scan and was supplied by collateral circulation. rCBF was measured in all within 72 hours after the stroke. The intra-carotid Xe-133 injection method and a 254 multidetector camera were used to study rCBF. Relatively...... ischemic low flow areas were a constant finding in the collaterally perfused tissue. In 6 of the patients, the collaterally perfused part of the brain had low flow values comparable to those of an "ischemic penumbra" (viable, but functionally depressed brain tissue due to inadequate perfusion...

  17. A rat model of reproducible cerebral infarction using thrombotic blood clot emboli

    DEFF Research Database (Denmark)

    Overgaard, K.; Sereghy, T.; Boysen, G.; Pedersen, H.; Høyer, S.; Diemer, Nils Henrik

    Neuropathology, experimental thromboembolism, stroke, blood flow, in vitro thrombotic clotting, cerebral infarction, rat......Neuropathology, experimental thromboembolism, stroke, blood flow, in vitro thrombotic clotting, cerebral infarction, rat...

  18. In vivo 1H spectroscopy of the human brain at 1.5 tesla. Preliminary experience at a clinical installation

    DEFF Research Database (Denmark)

    Henriksen, O; Larsson, H; Jensen, K M

    1990-01-01

    In vivo localized water suppressed proton spectroscopy of human brain was carried out on 15 healthy volunteers and 2 patients suffering from a brain tumour and an infarction, respectively. The measurements were performed on a whole body MR system, operating at 1.5 tesla using the stimulated echo...

  19. Noninvasive quantitation of myocardial infarction with technetium-99m pyrophosphate

    International Nuclear Information System (INIS)

    We sought to quantitate infarct size using radioactive imaging techniques. Infarcts were created in closed chest dogs. Using a scintillation camera interfaced to a computer, infarct images were made in the anterior, left lateral, LAO, and RAO projections, 48 hours after infarction and 75 to 90 min following the intravenous injection of 15 mCi of technetium-99m pyrophosphate (Tc-PYP). Images were computer enhanced and area was calibrated with a radioactive grid source of known dimensions. Image radioactivity was normalized for decay and dose corrected for body weight. Animals were sacrificed two hours following the injection of Tc-PYP. Postmortem images were also computer enhanced and calibrated. Gross infarct area and weight were estimated and transmural biopsies were evaluated for Tc-PYP activity and analyzed for creatine phosphokinase (CPK) content. Contiguous biopsies were pathologically analyzed and graded. There was a negative correlation between tissue Tc-PYP activity and CPK content (r = -0.89). Pathologic severity worsened with increased Tc-PYP activity and diminished CPK content. There was a good correlation between gross infarct area and image infarct area, both in vivo (r = 0.79), and at post-mortem examination (r = 0.95). Gross infarct weight also correlated well with image infarct activity in vivo (r = 0.83 in the RAO view) and at postmortem examination (r = 0.87). An additional correlation between gross infarct weight and in vivo image infarct area (r = 0.92 in the LAO view) appeared most promising for future clinical evaluation. These experimental relationships are analyzed and future patient application of these imaging techniques are considered

  20. Initial study of 3D perfused blood volume imaging using 64-detector CT in hyperacute cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of three dimensional CT whole brain perfused blood volume (3D-PBV) based on CTA row data in hyperacute cerebral infarction. Methods: 38 patients with stroke within 12 hours performed plain CT and CTA scans. 3D software Neuro PBV was applied to process the CTA row data and 3D-PBV of brain was obtained. MR examinations were performed within 2 hours after CT scans. The numbers of ischemic lesions on plain CT, 3D-PBV and MRI-DWI were recorded. The volumes of ischemic lesions on 3D-PBV and MR -DWI were measured. Results: In 38 patients, the number of infarct lesion detected by MRI-DWI, PBV, and plain CT was 45, 41, and 16 respectively. Kappa test showed a substantial agreement (κ=0.78) between 3D-PBV and MRI-DWI in detecting ischemic lesions. The detectability of plain CT showed fair or slight agreements to 3D-PBV and MR-DWI (κ=0.24, 0.18, respectively). The lesion volumes did not differ on 3D-PBV and MR-DWI (t=7.249, P>0.05). Conclusion: 3D-PBV combined with CTA can detect ischemic lesion and evaluate perfusion. It had important value in diagnosing hyperacute cerebral infarction. (authors)

  1. CURRENT REPERFUSION THERAPY POSSIBILITIES IN MYOCARDIAL INFARCTION AND ISCHEMIC STROKE

    Directory of Open Access Journals (Sweden)

    E. V. Konstantinova

    2015-01-01

    Full Text Available Myocardial infarction and ischemic stroke remain to be of the greatest medical and social importance because of their high prevalence, disability, and mortality rates. Intractable thrombotic occlusion of the respective artery leads to the formation of an ischemic lesion focus in the tissue of the heart or brain. Emergency reperfusion serves to decrease a necrotic focus, makes its formation reversible, and reduces patient death rates. The paper considers main reperfusion therapy lines: medical (with thrombolytic drugs and mechanical (with primary interventions one and their combination in treating patients with acute myocardial and cerebral ischemia. Each reperfusion procedure is discussed in view of its advantages, disadvantages, available guidelines, and possibilities of real clinical practice. Tenecteplase is assessed in terms of its efficacy, safety, and capacities for bolus administration, which allows its use at any hospital and at the pre-hospital stage. Prehospital thrombolysis permits reperfusion therapy to bring much closer to the patient and therefore aids in reducing time to reperfusion and in salvaging as much the myocardial volume as possible. The rapidest recovery of myocardial and cerebral perfusion results in a decreased necrotic area and both improved immediate and late prognosis. The results of randomized clinical trials studying the possibilities of the medical and mechanical methods to restore blood flow are analyzed in the context of evidence-based medicine. The reason why despite the available contraindications, limited efficiency, and the risk of hemorrhagic complications, thrombolytic therapy remains the method of choice for prehospital reperfusion, an alternative to primary percutaneous coronary intervention (PCI if it cannot be carried out in patients with myocardial infarction at the stated time, and the only treatment ischemic stroke treatment that has proven its efficiency and safety in clinical trials is under

  2. Early association of electrocardiogram alteration with infarct size and cardiac function after myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    陶则伟; 黄元伟; 夏强; 傅军; 赵志宏; 陆贤; BRUCEI.C.

    2004-01-01

    Objective:Myocardial infarction (MI) is the main cause of heart failure, but the relationship between the extent of MI and cardiac function has not been clearly determined.The present study was undertaken to investigate early changes in the electrocardiogram associated with infarct size and cardiac function after MI. Methods: MI was induced by ligating the left anterior descending coronary artery in rats. Electrocardiograms, echocardiographs and hemodynamic parameters were assessed and myocardial infarct size was measured from mid-transverse sections stained with Masson's trichrome. Results:The sum of pathological Q wave amplitudes was strongly correlated with myocardial infarct size (r=0.920, P<0.0001), left ventricular ejection fraction (r=-0.868, P<0.0001) and left ventricular end diastolic pressure (r=0.835, P<0.0004).Furthermore, there was close relationship between MI size and cardiac function as assessed by left ventricular ejection fraction (r=-0.913, P<0.0001) and left ventricular end diastolic pressure (r=0.893, P<0.0001).Conclusion: The sum of pathological Q wave amplitudes after MI can be used to estimate the extent of MI as well as cardiac function.

  3. Brain Basics

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    Full Text Available ... the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions ... basic working unit of the brain and nervous system. These cells are highly specialized for the function ...

  4. Brain Basics

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    Full Text Available ... the brain cannot effectively coordinate the billions of cells in the body, the results can affect many ... unit of the brain and nervous system. These cells are highly specialized for the function of conducting ...

  5. Brain Basics

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    Full Text Available ... Neurons & Neural Circuits Neurons are the basic working unit of the brain and nervous system. These cells ... A nerve cell that is the basic, working unit of the brain and nervous system, which processes ...

  6. Brain Basics

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    Full Text Available ... Trials — Participants Statistics Help for Mental Illnesses Outreach Research Priorities Funding Labs at NIMH News About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The ...

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  20. Brain Diseases

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    The brain is the control center of the body. It controls thoughts, memory, speech, and movement. It regulates the function of many organs. When the brain is healthy, it works quickly and automatically. However, ...

  1. Brain Basics

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  15. Exercise test in acute myocardial infarction.

    Science.gov (United States)

    Hsi, W L; Lai, J S

    1996-01-01

    Although maximal oxygen consumption (VO2max) and oxygen consumption at anaerobic threshold (VO2AT) were used to measure cardiac function, the clinical significance in acute myocardial infarction (MI) has not been reported. The purpose of this study was to compare VO2max and VO2AT between post-MI patients and healthy men and to correlate the parameters to other clinical measures. Forty-three active healthy men, 44 sedentary healthy men, and 43 post-MI patients were studied using incremental cycle exercise test. Their work rates, oxygen consumption, heart rates, oxygen pulses, ventilation, and other parameters at VO2max and VO2AT were determined with spirometer, gas concentration analyzer, and electrocardiograph. Anaerobic threshold was determined by analyzing the ventilatory parameters. Most of the exercise test parameters at VO2max were greatest in the active men, intermediate in the sedentary men, and least in the post-MI patients (P pressure products of the active men and sedentary men were not significantly different from each other and were greater than those of the post-MI patients (P < 0.01). In the post-MI patients, VO2max was inversely correlated to the peak serum level of creatine phosphokinase MB isoenzyme (P < 0.01) and associated with extensive infarction (P < 0.05). Most of the parameters at VO2AT were greater in the active men than in the sedentary men (P < 0.01) but not significantly different between the sedentary men and post-MI patients. In the post-MI patients, VO2AT was significantly correlated to left ventricular ejection fraction (P < 0.01) and associated with heart failure (P < 0.05). The results revealed that VO2max and VO2AT had different clinical significance in post-MI patients; VO2max was related to the infarct size, and VO2AT was related to the pumping function of heart. PMID:8777021

  16. Thrombolysis for acute myocardial infarction: drug review.

    Science.gov (United States)

    Cundiff, David K

    2002-01-01

    The proof of efficacy of thrombolysis for acute myocardial infarction (AMI) depends on 9 randomized placebo-controlled trials totaling 58,511 patients. The meta-analysis of these trials showed an overall survival advantage of about 2% (11.5% vs 9.6%) in favor of thrombolysis. Iatrogenic deaths from thrombolysis complications occur in about 1% of AMI patients. Timely opening of the infarct-related artery (IRA) allowing myocardial reperfusion has been proposed to explain any survival advantage seen with thrombolysis ("open-artery hypothesis"). Angiographic data does not support the open-artery hypothesis as the mechanism of any benefit of thrombolysis. The "early hazard" (ie, increased mortality in the first 12 hours after thrombolysis) also suggests that the supposed survival benefit is due to something other than early reperfusion. The variable use of aspirin in the meta-analysis trials may have confounded the results and conclusions. In the 4 studies of the meta-analysis in which aspirin was used routinely (n = 21,144), the survival benefit was not statistically significant (P =.14). Lack of blinding in some studies and other methodologic problems may also call the conclusions of the meta-analysis into question. AMI registry reports comparing patients with and without thrombolysis have not borne out a significant survival advantage with thrombolysis. The National Registry of Myocardial Infarction (NRMI) registry data suggest that a significant number of AMI patients may be inappropriately receiving thrombolytics. An independent analysis of the NRMI mortality data adjusted for age and other risk factors would help determine whether thrombolysis for AMI improves survival. PMID:11965203

  17. The electrocardiogram in acute myocardial infarction

    International Nuclear Information System (INIS)

    In 2006, 94 years after Eindhoven W. performed the first electrocardiogram (ECG) three derivations, J. Willis Hurst said: The treatment of acute coronary syndrome is based entirely on electrocardiogram a normalities. Therefore, the correct interpretation of the electrocardiogram is needed now more than ever in the history of medicine.This article will address those aspects of the subject that we consider most useful for clinical cardiologists should assist patients with acute myocardial infarction (AMI) in the crucial first minutes or hours of their evolution

  18. Embolic renal infarction mimicking renal colic

    OpenAIRE

    Mahamid M; Francis A.; Abid A; Awawde M; Abu-Elhija O

    2014-01-01

    Mahmud Mahamid,1,3 Adi Francis,2 Ali Abid,1 Mohammed Awawde,1 Omar Abu-Elhija11Department of Internal Medicine, 2Cardiac Care Unit, Holy Family Hospital, Bar-Ilan University, Nazareth, Israel; 3Digestive Disease Institute, Liver Unit, Shaare Zedek Medical Center, Jerusalem, IsraelAbstract: Atrial fibrillation is a major health problem with risk of systemic arterial embolism. Acute embolic renal infarction is a rare condition with symptoms that are often nonspecific. We present a 36-year-old p...

  19. ST Elevation Myocardial Infarction in the elderly

    Institute of Scientific and Technical Information of China (English)

    Marcelo Franken; Amit Nussbacher; Alberto Liberman; Mauricio Wajngarten

    2012-01-01

    Acute coronary syndromes (ACS) are the leading causes of death in the elderly. The suspicion and diagnosis of ACS in this age group is more difficult, since typical angina is less frequent. The morbidity and mortality is greater in older age patients presenting ACS. Despite the higher prevalence and greater risk, elderly patients are underrepresented in major clinical trials from which evidence based recommendations are formulated. The authors describe, in this article, the challenges in the diagnosis and management of ST elevation myocardial infarction in the elderly, and discuss the available evidence.

  20. [Cognitive structure and risk of myocardial infarct].

    Science.gov (United States)

    Günther, C; Günther, R; Reinhardt, F; Meissner, D; Dresler, F; Guhr, R; Hubl, W; Keil, J; Schüttig, R

    1990-08-01

    In a psychophysiological experiment with 18 patients with cardiovascular disorders but without infarction we proved the influence of habituallized cognitive structures on reactivity under mental load. We used the concepts of different causal attribution (Explanatory style: Peterson and Seligman) and psychic regulation of activity and action (Activity style: Günther). It can be shown that patients with pessimistic explanatory style as well as with diffuse psychic activity control show coronary-prone reaction patterns under load (indicators: cortisol and triglycerids in serum). PMID:2267852

  1. Immunoscintigraphy for detecting acute myocardial infarction without electrocardiographic changes.

    OpenAIRE

    Jain, D; Lahiri, A; Raftery, E B

    1990-01-01

    OBJECTIVE--To establish whether immunoscintigraphy with antibody to myosin may detect acute myocardial infarction without electrocardiographic changes. DESIGN--Prospective study of patients with suspected acute myocardial infarction or unstable angina with cardiac imaging with 111indium myosin antibody, estimation of cardiac enzyme concentrations, electrocardiography, 201thallium imaging, and radionuclide ventriculography. SETTING--Coronary care unit in a district general hospital. PATIENTS--...

  2. Massive cerebral infarction as a feature of pituitary apoplexy.

    Directory of Open Access Journals (Sweden)

    Lath R

    2001-04-01

    Full Text Available A patient with pituitary apoplexy is reported who, in addition to the clinical features of apoplexy, developed a cerebral infarct secondary to compression of the internal carotid artery. The mechanisms of a cerebral infarct associated with pituitary apoplexy are discussed.

  3. Nonfasting glucose, ischemic heart disease, and myocardial infarction

    DEFF Research Database (Denmark)

    Benn, Marianne; Tybjaerg-Hansen, Anne; McCarthy, Mark I;

    2012-01-01

    The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI).......The purpose of this study was to test whether elevated nonfasting glucose levels associate with and cause ischemic heart disease (IHD) and myocardial infarction (MI)....

  4. Left ventricular assessment in myocardial infarction - The VALIANT registry

    NARCIS (Netherlands)

    Hernandez, AF; Velazquez, EJ; Solomon, SD; Kilaru, R; Diaz, R; O'Connor, CM; Ertl, G; Maggioni, AP; Rouleau, JL; van Gilst, W; Pfeffer, MA; Califf, RM

    2005-01-01

    Background: How often echocardiography and cardiac catheterization are used to evaluate left ventricular (LV) function in patients with myocardial infarction (MI) and how they are associated with quality of care is unknown. Methods: Patients with MI in the Valsartan in Acute Myocardial Infarction (V

  5. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction

    DEFF Research Database (Denmark)

    Anavekar, Nagesh S; McMurray, John J V; Velazquez, Eric J;

    2004-01-01

    in Acute Myocardial Infarction Trial (VALIANT), we identified 14,527 patients with acute myocardial infarction complicated by clinical or radiologic signs of heart failure, left ventricular dysfunction, or both, and a documented serum creatinine measurement. Patients were randomly assigned to receive...

  6. Anterior Myocardial Infarction And Developing Ventricular Aneurysm After Cannabis Use

    OpenAIRE

    Murat Yalcin

    2014-01-01

        Incidence of drug abuse and cannabis have increased in young adults, recently. Cannabis induced myocardial infarction has rarely been reported in these people. Herein, we reported 20 years old male who had acute anterior myocardial infarction and developing apical ventricular aneurysm after heavy cannabis use.

  7. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    DEFF Research Database (Denmark)

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G;

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  8. MRI findings on lacunar infarction with no clinical symptoms

    International Nuclear Information System (INIS)

    The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it's difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacunar infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses

  9. MRI findings on lacunar infarction with no clinical symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ham Gyum [Ansan College, Ansan (Korea, Republic of)

    2003-12-15

    The purpose of this study was to examine how lacunar infarction developed and what its characteristics were. As this disease had little noticeable clinical symptoms and is likely to draw less attention than other types of cerebrovascular diseases like panhemispheric infarction, it's difficult to make an early diagnosis of it or treat it successfully. The subjects in this study were 196 people who showed no clinical symptoms and took a MRI test. When the MRI test data were analyzed, signal intensity and the part where that disease was detected were primarily taken into account. As a result, it's found that 116 people had no lacunar infarction and 80 people suffered from that disease, including 13 with very mild lacunar infarction, 41 with mild lacunar infarction and 26 with lacunar infarction. However, very mild and mild lacunar infarction could not be viewed as clinically significant cases, and only 26 people, which accounted for 13 percent of the subjects, should be considered to be diagnosed with lacunar infarction. The most common part where that disease was found was white matter and basal ganglia, regardless of gender. Accordingly, those who are exposed to health hazards such as hypertension or diabetes should take a MRI test to prevent cerebrovascular diseases that might be caused by those illnesses.

  10. Accurate demonstration of hepatic infarction in liver transplant recipients

    International Nuclear Information System (INIS)

    Serial HIDA scanning has proven to be a valuable tool in the postoperative management of liver transplant patients. Previous reports have documented its efficacy in detecting biliary leakage, abscess, and rejection. We have also found HIDA scanning to be a sensitive method for detecting early hepatic infarction before ultrasonographic changes occur. Two cases are presented to demonstrate the characteristic findings seen with hepatic infarctions

  11. Thrombotic stroke and myocardial infarction with hormonal contraception

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Løkkegaard, Ellen; Jensen, Aksel Karl Georg;

    2012-01-01

    Although several studies have assessed the risk of venous thromboembolism with newer hormonal contraception, few have examined thrombotic stroke and myocardial infarction, and results have been conflicting.......Although several studies have assessed the risk of venous thromboembolism with newer hormonal contraception, few have examined thrombotic stroke and myocardial infarction, and results have been conflicting....

  12. A case of cerebral infarction showing interesting SPECT images

    International Nuclear Information System (INIS)

    A case of cerebral infarction showing interesting SPECT images was reported. One month after stroke, 81mKr and 99mTc-HMPAO-SPECT were showed post ischemic high flow area as hot lesion, but 123I-IMP-SPECT was showed as cold lesion in early scan. Two months after stroke, all SPECT images showed infarction as cold area. (author)

  13. Occlusive myocardial infarction: cardiac CT perfusion in a rat model

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Hyung Woo; Kim, Dong Hun; Byun, Joo Nam; Kim, Young Sook [Chosun University Hospital, Gwangju (Korea, Republic of)

    2007-03-15

    To test whether cardiac multidetector CT (MDCT) perfusion imaging can accurately delineate an irreversibly damaged myocardium in animals with an occlusive myocardial infarction. In 16 rats, the left anterior descending coronary arteries were ligated distal to its first diagonal artery after a thoracotomy. Thirty minutes after the procedure, 16-slice MDCT (Sensation 16, Siemens, Erlangen, Germany) was performed and delayed images were obtained up to 5 minutes after injecting the contrast agent (0.2 mL/100g, 0.5 mL/sec). The rats were re-examined one week later. After CT scanning, the rats were sacrificed and their hearts were extirpated for 2, 3, 5-triphenyltetrazolium chloride (TTC) histochemical staining. The stained slices were compared with the CT images. The CT number (HU) of the infarct and non-infarct areas were estimated from the contrast ratio (CR). The CT attenuation in the infarct area was significantly lower than that in the normal myocardium. Quantitative analysis of the CT attenuation revealed a significant difference in the CR and CT attenuation of the infarct and reference areas (0.48 {+-} 0.12 vs 0.64 {+-} 0.13, {rho} < 0.05, 163 {+-} 46 HU vs 216 {+-} 56 HU, {rho} < 0.05). However, there were no significant differences in the CT numbers between the infarct and non-infarct areas on the one-week follow-up. A perfusion defect on MDCT indicates the myocardial damage in an animal model with occlusive myocardial infarction.

  14. Stroke and Drug Delivery—In Vitro Models of the Ischemic Blood-Brain Barrier

    DEFF Research Database (Denmark)

    Tornabene, Erica; Brodin, Birger

    2016-01-01

    Stroke is a major cause of death and disability worldwide. Both cerebral hypoperfusion and focal cerebral infarcts are caused by a reduction of blood flow to the brain, leading to stroke and subsequent brain damage. At present, only few medical treatments of stroke are available, with the Food and...... permeation pathways across the barrier in ischemic and postischemic brain endothelium is important for development of new medical treatments. The blood-brain barrier, that is, the endothelial monolayer lining the brain capillaries, changes properties during an ischemic event. In vitro models of the blood...

  15. In vivo measurement of water self diffusion in the human brain by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Thomsen, C; Henriksen, O; Ring, P

    1987-01-01

    between grey and white matter as well as regional differences within the white matter were seen. In two patients with infarction, alternations in water self diffusion were seen in the region of the infarct. Likewise, pronounced changes in brain water self diffusion were observed in a patient with benign...... intracranial hypertension. The results indicate that brain water self diffusion can be measured in vivo with reasonableaccuracy. The clinical examples suggest that diffusion measurements may be clinically useful adding further information about in vivo MR tissue characterization....

  16. Exercise preconditioning reduces ischemia reperfusion-induced focal cerebral infarct volume through up-regulating the expression of HIF-1α.

    Science.gov (United States)

    Wang, Lu; Deng, Wenqian; Yuan, Qiongjia; Yang, Huijun

    2015-03-01

    To study the effect and mechanism of exercise preconditioning on focal cerebral ischemia reperfusion induced cerebral infarction via rat model; Sixty Sprague Dawley rats were divided into three groups at random: ischemia reperfusion group (IR, n=24), sham group (sham, n=12) and exercise preconditioning group (EP, n=24). Group EP carried out moderate exercise preconditioning for 4 weeks (swimming with non-weight bearing, 60 minutes/day, 6 days/week), Rats in Group EP and IR were established cerebral ischemia reperfusion injury model by Zea Longa's thread method. The cerebral infarct volume in rat of different group was evaluated after 2%TTC staining, expression of HIF-1α in rats' brain was detected by real-time RT-PCR, immunohistochmeistry method and western blot. No cerebral infarction and significant expression of HIF-1α in Group sham. Compared with Group IR, there was smaller infarct volume and stronger HIF-1α expression in Group EP (Pexercise preconditioning reduces ischemia reperfusion induced focal cerebral infarct volume through up-regulating the expression of HIF-1α. PMID:25796156

  17. Brain Basics

    Medline Plus

    Full Text Available ... pituitary-adrenal (HPA) axis. Brain Basics in Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah ... having trouble coping with the stresses in her life. She began to think of suicide because she ...

  18. Brain Basics

    Medline Plus

    Full Text Available ... Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a middle-aged woman ... new memories. hypothalmic-pituitary-adrenal (HPA) axis —A brain-body ... stress. impulse —An electrical communication signal sent between neurons ...

  19. Brain Aneurysm

    Science.gov (United States)

    A brain aneurysm is an abnormal bulge or "ballooning" in the wall of an artery in the brain. They are sometimes called berry aneurysms because they ... often the size of a small berry. Most brain aneurysms produce no symptoms until they become large, ...

  20. Brain Basics

    Medline Plus

    Full Text Available ... other cells guide neurons in forming various brain structures. Neighboring neurons make connections with each other and with distant nerve cells (via axons) to form brain circuits. These circuits control specific body functions such as sleep and speech. The brain continues ...

  1. Cerebral infarction following intracranial hemorrhage in pediatric Moyamoya disease - A case report and brief review of literature

    Directory of Open Access Journals (Sweden)

    Soumya Patra

    2012-01-01

    Full Text Available Moyamoya disease is a clinical entity characterized by progressive cerebrovascular occlusion with spontaneous development of a collateral vascular network called Moyamoya vessels. This disease mainly manifests as cerebral ischemia. Intracranial bleeding is another major presentation of patients with Moyamoya disease. We report here a 12-year-old male child who presented with severe headache, vomiting and meningismus. Initial neuroimaging study with noncontrast computed tomography scan revealed fresh intraventricular hemorrhage in right-sided lateral ventricle. Magnetic resonance imaging with angiography of brain was done 5 days later when the child developed right-sided hemiparesis, and the diagnosis of Moyamoya disease was confirmed along with lacunar infarction of right posterior peri and paraventricular area and in the left paraventricular area and centrum semiovale. Simultaneous presence of cerebral infarction along with intraventricular hemorrhage in adult with bleeding-type Moyamoya disease is reported in literature, but it is a rare entity in a child.

  2. Left Brain. Right Brain. Whole Brain

    Science.gov (United States)

    Farmer, Lesley S. J.

    2004-01-01

    As the United States student population is becoming more diverse, library media specialists need to find ways to address these distinctive needs. However, some of these differences transcend culture, touching on variations in the brain itself. Most people have a dominant side of the brain, which can affect their personality and learning style.…

  3. Omental infarction in an obese 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Katerina Kambouri

    2011-09-01

    Full Text Available Primary omental infarction (POI has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

  4. Omental infarction presenting as abdominal pain typical for cholecystitis

    Directory of Open Access Journals (Sweden)

    Pawel Dutkiewicz

    2016-01-01

    Full Text Available To describe a patient who presented to a family medicine clinic with symptoms typical for cholecystitis, but eventually was diagnosed with omental infarction. A 37-year-old Caucasian man reported with right upper quadrant pain suspicious for cholecystitis. In light of negative abdominal ultrasound, computed tomography scan was performed, and omental infarction was identified. The patient was treated conservatively with a good outcome. Omental infarction is rarely described in medical literature, and it is often missed or misdiagnosed. There are increasing numbers of reports that describe omental infarction being diagnosed as various types of acute abdomen. With increased utilization of advanced imaging, omental infarction is being found to be responsible for presentations of the acute abdomen that were misdiagnosed. Proper diagnosis prevents invasive mismanagement and an unnecessarily prolonged hospital stay.

  5. Glycemic Control for Patients With Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    Hai-peng XIAO; Juan CHEN

    2009-01-01

    @@ The risk of myocardial infarction increases in patients with diabetes mellitus. The incidence of myocardial in-farction is similar in patients with type 2 diabetes without history of myocardial infarction and in non-diabetic pa-tients with history of myocardial infarction. Diabetes mellitus was considered as a coronary disease equivalent by the National Cholesterol Education Program. Strict glycemic control can improve the long-term outcome of both type 1 and type 2 diabetes mellitus. Whatever with diabetic or non-diabetic, strict glycemic control with in-tensive insulin therapy can reduce the mortality of criti-cally ill patients in hospital. After myocardial infarction, there would be a worse outcome for patients with poor glycemic control, whatever in diabetic or non-diabetic patients with stress hyperglycemia.

  6. MRI and pathological examination of post-mortem brains: the problem of white matter high signal areas

    International Nuclear Information System (INIS)

    We examined 21 brains from individuals more than 65 years of age by MRI and neuropathological methods to study the frequency and morphology of white matter changes. There were 16 brains from neurologically normal subjects (Group 1) while the remaining 5 (Group 2) had neurological disturbances. In Group 1 MRI showed high signal areas in the periventricular white matter in 12 brains and in the deep white matter in 9. All had focal areas, with confluent zones in 4; 3 cystic infarcts were also detected. Neuropathology in this Group showed periventricular changes of variable extent in all cases, vacuolated myelin around the perivascular spaces in 14 and degenerate myelin in 4. Macroscopic inspection showed 3 cystic lacunar infarcts, while areas of recent infarction were present on histology in 2. Four of the Group 2 brains had periventricular MRI changes; high signal areas in deep white matter were focal in 2 and confluent in 1. Cystic infarcts were detected in 3 cases. Neuropathology showed periventricular changes in all the brains; in 4 myelin around the perivascular spaces was vacuolated while degenerate myelin was demonstrated in 1. There were also old (1) and recent (2) lacunar infarcts. (orig.)

  7. MRI and pathological examination of post-mortem brains: the problem of white matter high signal areas

    Energy Technology Data Exchange (ETDEWEB)

    Scarpelli, M. (Inst. of Pathological Anatomy and Histopathology, Ancona Univ. (Italy)); Salvolini, U. (Magnetic Resonance Research Unit, Ancona Univ. (Italy)); Diamanti, L. (Inst. of Pathological Anatomy and Histopathology, Ancona Univ. (Italy)); Montironi, R. (Inst. of Pathological Anatomy and Histopathology, Ancona Univ. (Italy)); Chiaromoni, L. (Magnetic Resonance Research Unit, Ancona Univ. (Italy)); Maricotti, M. (Magnetic Resonance Research Unit, Ancona Univ. (Italy))

    1994-07-01

    We examined 21 brains from individuals more than 65 years of age by MRI and neuropathological methods to study the frequency and morphology of white matter changes. There were 16 brains from neurologically normal subjects (Group 1) while the remaining 5 (Group 2) had neurological disturbances. In Group 1 MRI showed high signal areas in the periventricular white matter in 12 brains and in the deep white matter in 9. All had focal areas, with confluent zones in 4; 3 cystic infarcts were also detected. Neuropathology in this Group showed periventricular changes of variable extent in all cases, vacuolated myelin around the perivascular spaces in 14 and degenerate myelin in 4. Macroscopic inspection showed 3 cystic lacunar infarcts, while areas of recent infarction were present on histology in 2. Four of the Group 2 brains had periventricular MRI changes; high signal areas in deep white matter were focal in 2 and confluent in 1. Cystic infarcts were detected in 3 cases. Neuropathology showed periventricular changes in all the brains; in 4 myelin around the perivascular spaces was vacuolated while degenerate myelin was demonstrated in 1. There were also old (1) and recent (2) lacunar infarcts. (orig.)

  8. Brain MRI findings of neuropsychiatric lupus

    International Nuclear Information System (INIS)

    To evaluate the brain MRI findings in patients with neuropsychiatric lupus. In 26 patients (M:F = 2:24 ; aged 9-48 years) in whom the presence of systemic lupus erythematosus was clinically or pathologically proven and in whom neuropsychiatric lupus was also clinically diagnosed, the findings of brain MRI were retrospectively evaluated. MR images were analyzed with regard to the distribution, location, size and number of lesions due to cerebral ischemia or infarction, the presence of cerebral atrophy, and the extent and degree of brain parenchymal and intravascular enhancement. The most common MRI findings were lesions due to cerebral ischemia or infarction occurring in 18 patients (69%), and located within deep periventricular white matter (n=10), subcortical white matter (n=8), the cerebral cortex (n=7), basal ganglia (n=7), or brain stem or cerebellum (n=2). The lesions were single (n=3) or multiple (n=15), and in 17 patients were less than 1cm in diameter in regions other than the cerebral cortex. In six of these patients, lesions of 1-4cm in diameter in this region were combined, and one occurred in the cerebral cortex only. Cerebral atrophy was seen in 16 patients (62%), in ten of whom there was no past history of treatment with steroids for more than six months. In 15 patients (58%), contrast-enhanced MR image revealed diffuse enhancement of the basal ganglia or intravascular enhancement. In no case were MRI findings normal. The primary mainfestations of neuropsychiatric lupus are multifocal ischemia or infarctions in the cerebral cortex, and subcortical and deep white matter, and the cerebral atrophy. Contrast-enhanced MR images also demonstrated diffuse enhancement of the basal ganglia and intravascular enhancement, both thought to be related to the congestion due to the stagnation of cerebral blood flow

  9. Comprehensive regional and temporal gene expression profiling of the rat brain during the first 24 h after experimental stroke identifies dynamic ischemia-induced gene expression patterns, and reveals a biphasic activation of genes in surviving tissue

    DEFF Research Database (Denmark)

    Rickhag, Karl Mattias; Wieloch, Tadeusz; Gidö, Gunilla;

    2006-01-01

    In order to identify biological processes relevant for cell death and survival in the brain following stroke, the postischemic brain transcriptome was studied by a large-scale cDNA array analysis of three peri-infarct brain regions at eight time points during the first 24 h of reperfusion followi...

  10. 99mTc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    International Nuclear Information System (INIS)

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  11. AN INTERESTING CASE OF DIABETIC MUSCLE INFARCTION

    Directory of Open Access Journals (Sweden)

    Srichandhanreddy

    2014-08-01

    Full Text Available Diabetic muscle infarction is rare complications of diabetes that occurs in patients with type 1 diabetes (70% of total cases or in patients with poorly controlled type 2 diabetes. Here is a 55 year old male patient was admitted with diabetic ketoacidosis and coma. Two days later following recovery he gave history of pain in the right thigh since 10 days. There was no history of trauma, fever, weight loss. On examination vitals are stable, systemic examination: clinically normal. Examination of right thigh lower one third, showed a tender mass of about 3.4 x8.2 cms, FNAC of which showed muscle fibres with hemorrhagic back ground. MRI scan suggesting of myositis involving vastus group of muscles. This patient had normal renal functions and normal fundus. This patient responded to conservative management and antibiotics. CONCLUSION: A high index of suspicion is needed to make a timely diagnosis of diabetic muscle Infarction, and avoid the use of steroids or surgical intervention.

  12. Medical image of the week: splenic infarction

    Directory of Open Access Journals (Sweden)

    Casey DJ

    2016-08-01

    Full Text Available No abstract available. Article truncated after 150 words. A 52-year-old Hispanic woman with a past medical history significant for Type 1 Diabetes Mellitus, hypertension, and rheumatoid arthritis presented with left upper quadrant pain for one day. Her review of systems was positive for bloating, severe epigastric and left upper quadrant tenderness that radiated to the back and left shoulder, nausea with non-bilious emesis, and diarrhea for one day prior to admission. Physical exam only revealed epigastric and left upper quadrant tenderness to light palpation without rebound or guarding. Abdominal computed tomography of the abdomen demonstrated a new acute or subacute splenic infarct with no clear evidence of an embolic source in the abdomen or pelvis (Figure 1. Echocardiogram with bubble study and contrast did not demonstrate valve abnormalities, cardiac mass, vegetation, valve or wall motion abnormalities and no evidence of patent foramen ovale. Splenic infarction should be suspected when patients present with sharp, acute left upper quadrant pain ...

  13. Clinical studies of cerebral arteriosclerosis in diabetic subjects. Analysis with brain MRI study

    International Nuclear Information System (INIS)

    In order to investigate the clinical characteristics of cerebral arteriosclerosis in diabetic subjects, brain MRI studies were conducted in diabetic patients and healthy subjects. The subjects were 93 diabetic patients without symptoms and signs of cerebral infarction (49 males and 44 females) with a mean age of 59 years and 73 healthy subjects (43 males and 30 females) with a mean age of 57 years. The MRI studies were performed on a General Electric 1.5-T signa system. The spin-echo technique (T2-weighted image) was used with a pulse repetition time (TR) of 2,500 msec and echo time (TE) of 80 msec. The quantitative evaluation of cerebral infarction was assessed using personal computer and image-scanner. By MRI, the incidence of cerebral infarction in diabetic patients was significantly higher than that in healthy subjects (30.1% vs. 13.7%, respectively, p<0.05). The mean age of the diabetic patients with cerebral infarctions was higher than that of those without cerebral infarctions. Hypertension and diabetic nephropathy were present more frequently in the subjects with cerebral infarctions. These data suggest that it is important to delay the onset and slow the progression of cerebral infarction in diabetic patients by strict blood glucose control and management of blood pressure. (author)

  14. The relationship between cerebral infarction on MR and angiographic findings in moyamoya disease: significance of the posterior circulation

    International Nuclear Information System (INIS)

    To investigate the relationship between changes in the posterior and anterior circulation, as seen at angiography, and the frequency and extent of cerebral infarction revealed by MR imaging in moyamoya disease. This study involved 34 patients (22 females and 12 males, aged 2-52 years) in whom cerebral angiography revealed the presence of moyamoya disease (bilateral; unilateral= 24:10; total hemispheres=58) and who also underwent brain MR imaging. To evaluate the angiographic findings, we applied each angiographic staging system to the anterior and posterior circulation. Leptomeningeal collateral circulation from the cortical branches of the posterior cerebral artery (PCA) was also assigned one of four grades. At MR imaging, areas of cerebral cortical or subcortical infarction in the hemisphere were divided into six zones. White matter and basal ganglionic infarction, ventricular dilatation, cortical atrophy, and hemorrhagic lesions were also evaluated. To demonstrate the statistical significance of the relationship between the angiographic and the MR findings, both the Mantel-Haenszel chi-square test for trend and the chi-square test were used. The degree of steno-occlusive PCA change correlated significantly with the internal carotid artery (ICA) stage (p0.05). The prevalence of infarction showed significant correlation with the degree of steno-occlusive change in both the ICA and PCA. The degree of cerebral ischemia in moyamoya patients increased proportionally with the severity of PCA stenosis rather than with that of steno-occlusive lesins of the anterior circulation. Infarctions tended to be distributed in the anterior part of the hemisphere at PCA state I or II, while in more advanced PCA lesions, they were also found posteriorly, especially in the territories of the posterior middle cerebral artery (MCA), the posterior border zone, and the PCA (p0.05). The degree of steno-occlusive lesions of the PCA correlated with the ICA stage. Progressive changes in

  15. [Myocardial infarction and thromboembolism during pregnancy].

    Science.gov (United States)

    Härtel, Dirk; Sorges, Eckhard; Carlsson, Jörg; Römer, Volker; Tebbe, Ulrich

    2003-05-01

    Acute myocardial infarction is a very rare event during pregnancy and bears the problem of misdiagnosis. However, about 150 cases have been published worldwide with a preponderance of anterior wall infarcts. With more women delaying childbearing until an older age and increasing prevalence of smoking in young women, it can be expected that all forms of coronary artery disease--including acute myocardial infarction--will be seen more often in the future. Among the causes of coronary artery occlusion in pregnancy are (1) rupture of very small coronary artery plaques triggered by different events, e.g., hypertension; (2) plain coronary artery disease; (3) dissection of coronary arteries; (4) coronary artery spasms with/without arterial thrombosis. Prompt diagnosis and immediate therapy are necessary to lower the high mortality of mother and fetus. The gold standard in the therapy of acute myocardial infarction during pregnancy is immediate coronary angiography and percutaneous transluminal coronary angioplasty (PTCA) with or without stent implantation. Application of thrombolytics (recombinant tissue plasminogen activator [rt-PA], r-PA, streptokinase [SK], urokinase [UK]) has been reported in single patients but should be limited to cases where acute PTCA is not available and where the infarct occurs before the 14th week of pregnancy because of possible embryopathy. If the patient is in the last 10 weeks of pregnancy, anticipation of delivery should be part of the medical planning. Consultation with an obstetrician must be obtained as soon as the patient enters the hospital. Besides bleeding complications, venous thrombosis with pulmonary embolism is among the most common causes of death during pregnancy. Pregnancy-related changes in physiology - increase in the resistance to flow from the lower extremities to the heart - and congenital coagulation abnormalities are most important to be recognized. This leads to the fact that superficial and deep venous thromboses

  16. Brain effects of melanocortins.

    Science.gov (United States)

    Bertolini, Alfio; Tacchi, Raffaella; Vergoni, Anna Valeria

    2009-01-01

    , overweight/obesity, anorexia, cachexia, haemorrhagic shock, other forms of shock, myocardial infarction, ischemia/reperfusion-induced brain damage, neuropathic pain, rheumathoid arthritis, inflammatory bowel disease, nerve injury, toxic neuropathies, diabetic neuropathy, etc. This review recalls the history of these researches and outlines the pharmacology of the extra-hormonal effects of melanocortins which are produced by an action at the brain level (or mainly at the brain level). In our opinion the picture is still incomplete, in spite of being already so incredibly vast and complex. So, for example, several of their effects and preliminary animal data suggest that melanocortins might be of concrete effectiveness in one of the areas of most increasing concern, i.e., that of neurodegenerative diseases. PMID:18996199

  17. Dietary Virgin Olive Oil Reduces Blood Brain Barrier Permeability, Brain Edema, and Brain Injury in Rats Subjected to Ischemia-Reperfusion

    Directory of Open Access Journals (Sweden)

    Fatemeh Mohagheghi

    2010-01-01

    Full Text Available Recent studies suggest that dietary virgin olive oil (VOO reduces hypoxia-reoxygenation injury in rat brain slices. We sought to extend these observations in an in vivo study of rat cerebral ischemia-reperfusion injury. Four groups, each consisting of 18 Wistar rats, were studied. One group (control received saline, while three treatment groups received oral VOO (0.25, 0.5, and 0.75 mL/kg/day, respectively. After 30 days, blood lipid profiles were determined, before a 60-min period of middle cerebral artery occlusion (MCAO. After 24-h reperfusion, neurological deficit scores, infarct volume, brain edema, and blood brain barrier permeability were each assessed in subgroups of six animals drawn from each main group. VOO reduced the LDL/HDL ratio in doses of 0.25, 0.5, and 0.75 mL/kg/day in comparison to the control group (p < 0.05, and offered cerebroprotection from ischemia-reperfusion. For controls vs. doses of 0.25 vs. 0.5 vs. 0.75 mL/kg/day, attenuated corrected infarct volumes were 207.82 ± 34.29 vs. 206.41 ± 26.23 vs. 124.21 ± 14.73 vs. 108.46 ± 31.63 mm3; brain water content of the infarcted hemisphere was 82 ±± 0.25 vs. 81.5 ± 0.56 vs. 80.5 ± 0.22 vs. 80.5 ± 0.34%; and blood brain barrier permeability of the infarcted hemisphere was 11.31 ± 2.67 vs. 9.21 ± 2.28 vs. 5.83 ± 1.6 vs. 4.43 ± 0.93 µg/g tissue (p < 0.05 for measures in doses 0.5 and 0.75 mL/kg/day vs. controls. Oral administration of VOO reduces infarct volume, brain edema, blood brain barrier permeability, and improves neurologic deficit scores after transient MCAO in rats.

  18. Myocardial infarction in the conscious dog: three dimensional mapping of infarct, collateral flow and region at risk

    International Nuclear Information System (INIS)

    Myocardial infarcts were examined in dogs to determine the spatial distribution of infarction in the region at risk and the relation between infarction and collateral blood flow. Permanent occlusion of the left circumflex (LC) coronary artery at a constant site was made in 27 conscious dogs that were sacrificed 2 days later. The anatomic region at risk was defined by postmortem coronary arteriography as the volume of the occluded LC coronary bed. The masses of the left ventricle (LV), infarct (I) and risk region (R) were calculated from planimetered areas of weighted bread-loaf sections of LV. Infarct size was directly related to the mass of the risk region (I = 0.53 R - 9.87; r = 0.97; p < 0.001). There was no infarction when R was less than about 20 g or 20% of the LV. The infarcts were mainly subendocardial and tapered from base to apex of the LV; 34% of the risk region became infarcted at the base compared with 22% at the apex. In all dogs, a significant rim of noninfarcted myocardium was identified at lateral aspects of the risk region, even at the endocardial surface. Using 9-μ radioactive microspheres, initial postocclusion flow at the margin of the infarct, but well within the risk region, was higher than at the center, and outer flows were higher than inner flows. Postocclusion flow was even higher in the noninfarcted rim within the risk region, but was still significantly less than flow to normal, nonrisk areas. Collateral flows throughout the risk region increased during the first hour after occlusion, and were even higher at 2 days.Epicardially and laterally within the anatomic risk region there is a substantial amount of tissue that does not infarct despite initally reduced blood flow

  19. Evidence that a panel of neurodegeneration biomarkers predicts vasospasm, infarction, and outcome in aneurysmal subarachnoid hemorrhage.

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    Robert Siman

    Full Text Available Biomarkers for neurodegeneration could be early prognostic measures of brain damage and dysfunction in aneurysmal subarachnoid hemorrhage (aSAH with clinical and medical applications. Recently, we developed a new panel of neurodegeneration biomarkers, and report here on their relationships with pathophysiological complications and outcomes following severe aSAH. Fourteen patients provided serial cerebrospinal fluid samples for up to 10 days and were evaluated by ultrasonography, angiography, magnetic resonance imaging, and clinical examination. Functional outcomes were assessed at hospital discharge and 6-9 months thereafter. Eight biomarkers for acute brain damage were quantified: calpain-derived α-spectrin N- and C-terminal fragments (CCSntf and CCSctf, hypophosphorylated neurofilament H,14-3-3 β and ζ, ubiquitin C-terminal hydrolase L1, neuron-specific enolase, and S100β. All 8 biomarkers rose up to 100-fold in a subset of patients. Better than any single biomarker, a set of 6 correlated significantly with cerebral vasospasm, brain infarction, and poor outcome. Furthermore, CSF levels of 14-3-3β, CCSntf, and NSE were early predictors of subsequent moderate-to-severe vasospasm. These data provide evidence that a panel of neurodegeneration biomarkers may predict lasting brain dysfunction and the pathophysiological processes that lead to it following aSAH. The panel may be valuable as surrogate endpoints for controlled clinical evaluation of treatment interventions and for guiding aSAH patient care.

  20. Migraine and structural abnormalities in the brain

    DEFF Research Database (Denmark)

    Hougaard, Anders; Amin, Faisal Mohammad; Ashina, Messoud

    2014-01-01

    PURPOSE OF REVIEW: The aim is to provide an overview of recent studies of structural brain abnormalities in migraine and to discuss the potential clinical significance of their findings. RECENT FINDINGS: Brain structure continues to be a topic of extensive research in migraine. Despite advances in...... neuroimaging techniques, it is not yet clear if migraine is associated with grey matter changes. Recent large population-based studies sustain the notion of increased prevalence of white matter abnormalities in migraine, and possibly of silent infarct-like lesions. The clinical relevance of this association is...... not clear. Structural changes are not related to cognitive decline, but a link to an increased risk of stroke, especially in patients with aura, cannot be ruled out. SUMMARY: Migraine may be a risk factor for structural changes in the brain. It is not yet clear how factors such as migraine sub...