Revascularization experience and results in ischaemic cerebrovascular disease: Moyamoya disease and carotid occlusion

2018 ◽  
Vol 29 (4) ◽  
pp. 170-186
Author(s):  
Fuat Arikan ◽  
Marta Rubiera ◽  
Joaquín Serena ◽  
Ana Rodríguez-Hernández ◽  
Darío Gándara ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Moyamoya Disease ◽  
Carotid Occlusion ◽  
Ischaemic Cerebrovascular Disease

scholarly journals Hyperhomocysteinemia in a Patient with Moyamoya Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Durga Shankar Meena ◽  
Gopal Krishana Bohra ◽  
Mahadev Meena ◽  
Bharat Kumar Maheshwari
Keyword(s):  
Cerebrovascular Disease ◽  
Moyamoya Disease ◽  
Cerebral Angiography ◽  
Rare Case ◽  
Homocysteine Level ◽  
Case Reports ◽  
Circle Of Willis

Moyamoya disease is a chronic progressive cerebrovascular disease characterized by bilateral occlusion or stenosis of arteries around circle of Willis. We report a case of 18-year-old female presented with recurrent episodes of headache and vertigo. On cerebral angiography, the patient was diagnosed to have moyamoya disease. On further evaluation, thrombophilia profile showed increased homocysteine level. The patient was treated conservatively with cobalamin and aspirin and advised for revascularization. According to the literature, there are few case reports of moyamoya disease with thrombotic disorders. Hence, we are reporting this interesting and rare case.

Association of homocysteine (but not of MTHFR 677 C>T, MTR 2756 A>G, MTRR 66 A>G and TCN2 776 C>G) with ischaemic cerebrovascular disease in Sicily

2006 ◽  
Vol 96 (08) ◽  
pp. 154-159 ◽  
Author(s):  
Rosa-Maria Guéant-Rodriguez ◽  
Guido Anello ◽  
Rosario Spada ◽  
Antonino Romano ◽  
Adrian Fajardo ◽  
...  
Keyword(s):  
Cerebrovascular Disease ◽  
Vitamin B12 ◽  
Methylenetetrahydrofolate Reductase ◽  
Methionine Synthase ◽  
Italian Population ◽  
Significant Independent Predictor ◽  
Methionine Synthase Reductase ◽  
Ischaemic Cerebrovascular Disease ◽  
Folate And Vitamin B12 ◽  
Neutral Effect

SummaryAssociation between methylenetetrahydrofolate reductase polymorphism (MTHFR 677 C>T), a determinant of homocysteine plasma level (t-Hcys), with ischaemc cerebrovascular disease (iCVD) seems to be neutral in North Europe and North America. The association of 2756 A>G of methionine synthase (MTR), 66 A>G of methionine synthase reductase (MTRR) and 776 C>G of transcobalamin (TCN2) needs to be evaluated further. It was the objective of this study to evaluate the association of these polymorphisms, t-Hcys, vitamin B12 and folate levels with iCVD, in an Italian population from Sicily. We investigated the association of these polymorphisms, t-Hcys, vitamin B12 and folate with iCVD in 252 subjects, including 131 cases and 121 sexand agematched healthy controls. t-Hcys was higher in the iCVD group than in controls [15.3 (11.5–17.9) vs. 11.6 (9.4–14.5) µM; P=0. 0007] and also in subjects withTCN2 776CG genotype, compared to homozygous genotypes [13.5 (9.9± 16.9) vs. 11.7 (9.6 ± 14.4) µM; P=0. 0327]. The folate level in cases and controls was consistent with an adequate dietary intake [12.7 (9.0–15.3) vs. 12.5 (9.6–16.9) nM; P=0. 7203]. In multivariate analysis, t-Hcys was a significant independent predictor of iCVD with an odds ratio of 1.14 (95% C.I. : 1.06–1.24; P=0. 0006). No association was found between MTHFR, MTR, MTRR and TCN2 polymorphisms and iCVD risk. We have found an influence of t-Hcys and a neutral effect of MTHFR, MTR, MTRR and TCN2 on iCVD risk in Sicily. The neutral influence of these polymorphisms may be explained by adequate status in folate and vitamin B12. Other factors underlying the increased t-Hcys need further investigations.

scholarly journals Extracranial-intracranial bypass for ischemic cerebrovascular disease: what have we learned from the Carotid Occlusion Surgery Study?

2014 ◽  
Vol 36 (1) ◽  
pp. E9 ◽  
Author(s):  
Matthew R. Reynolds ◽  
Colin P. Derdeyn ◽  
Robert L. Grubb ◽  
William J. Powers ◽  
Gregory J. Zipfel
Keyword(s):  
Cerebrovascular Disease ◽  
Lessons Learned ◽  
Carotid Occlusion ◽  
Current Evidence ◽  
Extracranial Carotid Artery ◽  
Arterial Bypass ◽  
Ischemic Cerebrovascular Disease ◽  
Randomized Controlled ◽  
Intracranial Atherosclerotic Disease ◽  
The Subject

Extracranial-intracranial (EC-IC) arterial bypass has been used in the treatment of various neurosurgical pathologies including skull base tumors requiring sacrifice of a large intracranial artery; complex intracranial aneurysms requiring trapping; and distal revascularization, moyamoya disease, and symptomatic cerebrovascular stenoocclusive disease. The latter indication has been the subject of intense investigations in several large randomized controlled trials, most recently the Carotid Occlusion Surgery Study (COSS). In the present literature review and synthesis, the authors examine the current evidence available for EC-IC arterial bypass for the treatment of ischemic cerebrovascular disease including both extracranial carotid artery occlusive disease and intracranial atherosclerotic disease. They focus particular attention on EC-IC arterial bypass for the treatment of symptomatic hemodynamic cerebral ischemia and how lessons learned from the COSS might guide future investigations into the treatment of this disease.

Circulatory Reflexes in Cerebral Ischaemia Involving Different Vascular Territories

1970 ◽  
Vol 38 (4) ◽  
pp. 491-502 ◽  
Author(s):  
M. Gross
Keyword(s):  
Statistical Analysis ◽  
Arterial Pressure ◽  
Cerebrovascular Disease ◽  
Internal Carotid ◽  
Transient Ischaemic Attacks ◽  
Vasoconstrictor Response ◽  
Ischaemic Cerebrovascular Disease ◽  
Significant Difference ◽  
Valsalva's Manoeuvre ◽  
Circulatory Reflexes

1. Circulatory reflex function was assessed in a series of subjects with chronic ischaemic cerebrovascular disease and compared with a group of subjects with no known cerebrovascular disease by intra-arterial pressure responses to Valsalva's manoeuvre. 2. Circulatory reflexes were impaired in the patients with cerebrovascular disease as compared with controls, but statistical analysis indicated that age was a more important factor than chronic cerebrovascular disease in producing the deterioration. 3. No significant difference was found in the circulatory reflex function of subjects with ischaemia in the internal carotid territory when compared with those having ischaemia in the vertebrobasilar territory. 4. Combined ischaemia in both carotid and vertebrobasilar territories significantly impaired the cardioaccelerator but not the vasoconstrictor response to Valsalva's manoeuvre. 5. No significant difference was found in circulatory reflex function in subjects who had suffered cerebral infarction as opposed to transient ischaemic attacks.

Effects of Bezafibrate on Low HDL-Cholesterol in Patients with Ischaemic Cerebrovascular Disease: A Pilot Study

1981 ◽  
Vol 9 (5) ◽  
pp. 319-323 ◽  
Author(s):  
L Noring ◽  
K G Kjellin ◽  
H Ledermann
Keyword(s):  
Heart Disease ◽  
Pilot Study ◽  
Cerebrovascular Disease ◽  
Hdl Cholesterol ◽  
Lipid Lowering ◽  
Ischaemic Cerebrovascular Disease ◽  
Low Hdl ◽  
Preliminary Study ◽  
Lipid Lowering Agent

Bezafibrate is a new lipid-lowering agent that quite consistently increases low HDL-cholesterol values in hyperlipoproteinaemic patients. The possible role of HDL-cholesterol as an anti-atherogenic factor has been frequently discussed, mainly in patients with ischaemic heart disease but recently also in ischaemic cerebrovascular disease (ICD). This is the first pilot study in six selected patients suffering from ICD who had at the same time low HDL-cholesterol values (< = 1.1 mmol/l) with otherwise normal lipids. After a wash-out period of 2 months duration these patients were treated with 200 mg bezafibrate t.i.d. for 2 months. They were then followed up for another 8 months. Bezafibrate therapy increased HDL-cholesterol (range 45–130%). Eight months after cessation of therapy five patients have returned to pathologically low HDL-levels and the sixth patient also has a relatively low value of 1.2 mmol/l. This small preliminary study cannot, however, provide evidence about the possible beneficial role of increasing HDL-cholesterol in patients with ICD. Further investigations are therefore in progress.

Treatment of moyamoya disease with STA-MCA anastomosis

1978 ◽  
Vol 49 (5) ◽  
pp. 679-688 ◽  
Author(s):  
Jun Karasawa ◽  
Haruhiko Kikuchi ◽  
Seiji Furuse ◽  
Junichiro Kawamura ◽  
Toshisuke Sakaki
Keyword(s):  
Cerebrovascular Disease ◽  
Effective Treatment ◽  
Moyamoya Disease ◽  
Neurological Deficits ◽  
Unknown Etiology ◽  
Transient Ischemic Attacks ◽  
Content Type ◽  
Fine Print ◽  
Temporal Middle

✓ Moyamoya disease is a chronic occlusive cerebrovascular disease of unknown etiology for which no effective treatment has been found. The authors report the results of 23 superficial temporal-middle cerebral artery (STA-MCA) anastomoses and seven encephalomyosynangioses, performed on 13 cases with moyamoya disease and on four additional atypical cases. There were 10 children and seven adults in this study. The follow-up period ranged from 1 year and 4 months to 4 years and 1 month postoperatively; nine patients had excellent results, five good, and one fair; two patients were unchanged. The anastomotic procedure was most effective for transient ischemic attacks, reversible ischemic neurological deficits, and even minor or moderate neurological symptoms. The STA-MCA anastomosis appears to be an effective treatment for moyamoya disease.

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