Cerebral Metabolism of Patients with Stenosis of the Internal Carotid Artery before and after Endarterectomy

Occlusion or severe stenosis, with a reduction in the diameter of more than 70% of the extracranial arteries may lead to hypoperfusion of the brain with an increased risk of cerebral infarction. The aim of this study was to investigate whether endarterectomy of stenosed internal carotid arteries leads to alterations in cerebral metabolism in regions in which no infarcts were visible with magnetic resonance imaging (MRI). We studied 10 healthy control subjects and 20 patients with transient or nondisabling cerebral ischemia with MRI and 1H magnetic resonance spectroscopic imaging. All patients underwent carotid endarterectomy. Patients were examined 1 week before and 3–6 months after carotid endarterectomy. The N-acetyl aspartate (NAA)/choline ratio in the symptomatic hemisphere before endarterectomy (2.29 ± 0.42) was significantly ( p < 0.001) lower than for control subjects (3.18 ± 0.32). In five of the patients lactate was detected preoperatively in regions that were not infarcted. The NAA/choline ratio in the symptomatic hemisphere of these five patients did not increase significantly after endarterectomy (1.99 ± 0.22 vs. 2.23 ± 0.48). The NAA/choline ratio in patients without lactate preoperatively increased significantly ( p < 0.01) after endarterectomy to a normal level (from 2.39 ± 0.42 to 2.92 ± 0.52). These results indicate that the presence of cerebral lactate may predict whether the NAA/choline ratio increases after carotid endarterectomy.

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Validation of cerebral arteriovenous malformation hemodynamics assessed by DSA using quantitative magnetic resonance angiography: preliminary study

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2017-012991 ◽

2017 ◽

Vol 10 (2) ◽

pp. 156-161 ◽

Cited By ~ 19

Author(s):

Sophia F Shakur ◽

Denise Brunozzi ◽

Ahmed E Hussein ◽

Andreas Linninger ◽

Chih-Yang Hsu ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Transit Time ◽

Internal Carotid ◽

Flow Measurements ◽

Quantitative Magnetic Resonance ◽

Transit Times ◽

Before And After ◽

Preliminary Study ◽

The Difference

BackgroundThe hemodynamic evaluation of cerebral arteriovenous malformations (AVMs) using DSA has not been validated against true flow measurements.ObjectiveTo validate AVM hemodynamics assessed by DSA using quantitative magnetic resonance angiography (QMRA).Materials and methodsPatients seen at our institution between 2007 and 2016 with a supratentorial AVM and DSA and QMRA obtained before any treatment were retrospectively reviewed. DSA assessment of AVM flow comprised AVM arterial-to-venous time (A-Vt) and iFlow transit time. A-Vt was defined as the difference between peak contrast intensity in the cavernous internal carotid artery and peak contrast intensity in the draining vein. iFlow transit times were determined using syngo iFlow software. A-Vt and iFlow transit times were correlated with total AVM flow measured using QMRA and AVM angioarchitectural and clinical features.Results33 patients (mean age 33 years) were included. Nine patients presented with hemorrhage. Mean AVM volume was 9.8 mL (range 0.3–57.7 mL). Both A-Vt (r=−0.47, p=0.01) and iFlow (r=−0.44, p=0.01) correlated significantly with total AVM flow. iFlow transit time was significantly shorter in patients who presented with seizure but A-Vt and iFlow did not vary with other AVM angioarchitectural features such as venous stenosis or hemorrhagic presentation.ConclusionsA-Vt and iFlow transit times on DSA correlate with cerebral AVM flow measured using QMRA. Thus, these parameters may be used to indirectly estimate AVM flow before and after embolization during angiography in real time.

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Diagnosing RCVS Without the CV

The Neurohospitalist ◽

10.1177/1941874415599576 ◽

2015 ◽

Vol 6 (3) ◽

pp. NP1-NP4 ◽

Cited By ~ 3

Author(s):

Nuri Jacoby ◽

Ulrike Kaunzner ◽

Marc Dinkin ◽

Joseph Safdieh

Keyword(s):

Magnetic Resonance ◽

Resonance Imaging ◽

Multiple Risk Factors ◽

Mri Brain ◽

Cerebral Vasoconstriction ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Reversible Encephalopathy ◽

Occipital Lobes ◽

The Brain

This is a case of a 52-year-old man with a past medical history of 2 episodes of coital thunderclap headaches as well as recent cocaine, marijuana, and pseudoephedrine use, who presented with sudden, sharp, posterior headache associated with photophobia and phonophobia. His initial magnetic resonance imaging (MRI) of the brain, magnetic resonance angiography (MRA) of the head, and magnetic resonance venography (MRV) of the head were all normal as well as a normal lumbar puncture. Given the multiple risk factors for reversible cerebral vasoconstriction syndrome (RCVS), the patient was treated for suspected RCVS, despite the normal imaging. Repeat MRI brain 3 days after hospital admission demonstrated confluent white matter T2 hyperintensities most prominent in the occipital lobes, typical of posterior reversible encephalopathy syndrome (PRES). Repeat MRA of the head 1 day after discharge and 4 days after the abnormal MRI brain showed multisegment narrowing of multiple arteries. This case demonstrates that RCVS may present with PRES on MRI brain and also exemplifies the need to treat suspected RCVS even if imaging is normal, as abnormalities in both the MRI and the MRA may be delayed.

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876 Disorders of the Brain Revealed by Magnetic Resonance Imaging (MRI) in Infants with Severe Congenital Cytomegaly

Pediatric Research ◽

10.1203/00006450-201011001-00876 ◽

2010 ◽

Vol 68 ◽

pp. 440-440

Author(s):

B Milewska-Bobula ◽

B Lipka ◽

J Zebrowska ◽

E Jurkiewicz ◽

I Pakula-Kosciesza ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri ◽

The Brain

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Magnetic Resonance Imaging of the Brain in Infants and Children Before and After Cardiac Surgery; A Prospective Study

Impact of Cardiac Surgery on the Quality of Life ◽

10.1007/978-1-4613-0647-4_16 ◽

1990 ◽

pp. 121-128 ◽

Cited By ~ 1

Author(s):

James R. McConnell ◽

William H. Fleming ◽

Lynne B. Sarafian

Keyword(s):

Magnetic Resonance Imaging ◽

Cardiac Surgery ◽

Magnetic Resonance ◽

Prospective Study ◽

Infants And Children ◽

Resonance Imaging ◽

Before And After ◽

A Prospective Study ◽

The Brain ◽

In Infants And Children

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Genotoxicity in Patients on Long-term Proton Pump Inhibitor Therapy in Korea: A Nested Case-control, Prospective, Pilot Study

The Korean Journal of Helicobacter and Upper Gastrointestinal Research ◽

10.7704/kjhugr.2019.0027 ◽

2020 ◽

Vol 20 (1) ◽

pp. 47-53 ◽

Cited By ~ 1

Author(s):

Youn I Choi ◽

Jun-Won Chung ◽

Dong Kyun Park ◽

Kyoung Oh Kim ◽

Kwang An Kwon ◽

...

Keyword(s):

Pilot Study ◽

Medical History ◽

Proton Pump ◽

Serum Levels ◽

Self Report ◽

Healthy Controls ◽

Control Subjects ◽

Increased Risk ◽

Healthy Control

Background/Aims: Although proton pump inhibitors (PPIs) remain a mainstay for the suppression of gastric acid secretion, long-term PPI use is associated with side effects. However, the genotoxicity associated with long-term PPI use is unclear.Materials and Methods: This prospective observational pilot study enrolled patients who had been on PPIs for >1 year and healthy controls from July 2015 to August 2016. The subjects completed self-report questionnaires pertaining to their drug and medical history, and only those with no medical history and a ≥2-year wash-out period (for drugs other than PPIs) were included. We collected peripheral-blood lymphocytes from long-term PPI users and healthy controls and analyzed the genotoxicity by using the cytokinesis-block micronucleus cytome assay; we also determined the fasting serum levels of pyridoxine, folate, cobalamin, and homocysteine.Results: Ten long-term PPI users and 40 healthy control subjects were enrolled. The median serum pyridoxine, folate, cobalamin, and homocysteine levels were not significantly different between the groups. The median frequencies of micronuclei (MNi), nucleoplasmic bridges (NPBs), and nuclear buds (Nbuds) per 1,000 binucleated cells, in long-term PPI users and healthy controls, were 30.3 and 16.3 (P<0.005), 2.5 and 1.8 (P<0.005), and 9.3 and 5.0 (P<0.005), respectively. Even after adjustment for confounding factors, the OR of the MNi, NPBs, and Nbuds for long-term PPI users compared with healthy control subjects were 14.1 (P<0.001), 2.0 (P=0.001), and 1.3 (P=0.3), respectively.Conclusions: Long-term PPI use was significantly associated with an increased risk of genotoxicity after adjustment for age, sex, body mass index, medical history, drug history, and the serum levels of vitamins.

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Dizziness

Concussion Care Manual ◽

10.1093/med/9780190054793.003.0015 ◽

2019 ◽

pp. 101-106

Author(s):

David L. Brody

Keyword(s):

Magnetic Resonance Imaging ◽

Blood Pressure ◽

Physical Therapy ◽

Magnetic Resonance ◽

Attention Deficit ◽

Toxic Substances ◽

Short Course ◽

Magnetic Resonance Imaging Mri ◽

The Brain ◽

Nose And Throat

Dizziness means many different things to different people: lightheadedness, vertigo, poor balance, mental fogginess, and other concerns. Lightheadedness, meaning a feeling like the patient may pass out, is usually due to low blood pressure, often orthostatic hypotension. Vertigo, meaning a sensation of spinning or movement, can be an inner ear problem or a brain problem. Stop toxic substances; if there is nystagmus, refer to an ear, nose, and throat specialist (ENT) for a full evaluation. Perform the Dix Hallpike maneuvers to assess for benign paroxysmal positional vertigo and refer to physical therapy for repositioning maneuvers if positive. Consider vestibular rehabilitation; consider a short course of medication such as scopolamine or meclizine; consider ordering a magnetic resonance imaging (MRI) scan of the brain, because the concussion sometimes unmasks another unrelated problem. Dizziness meaning “mental fogginess” usually turns out to be attention deficit. Dizziness meaning vague and nonspecific malaise usually turns out to be fatigue, depression, or anxiety.

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G05 Alterations in iron content in the brain of Huntington disease mutation carriers in comparison with healthy control subjects

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2012-303524.85 ◽

2012 ◽

Vol 83 (Suppl 1) ◽

pp. A27.3-A28

Author(s):

C Sánchez-Castañeda ◽

M di Paola ◽

F Elifani ◽

V Maglione ◽

A di Pardo ◽

...

Keyword(s):

Huntington Disease ◽

Iron Content ◽

Disease Mutation ◽

Control Subjects ◽

Mutation Carriers ◽

Healthy Control ◽

The Brain

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Magnetic resonance spectroscopic measurement of cerebral gamma-aminobutyric acid concentrations in patients with bipolar disorders

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2006.00132.x ◽

2006 ◽

Vol 18 (2) ◽

pp. 120-126 ◽

Cited By ~ 21

Author(s):

Po W. Wang ◽

Napapon Sailasuta ◽

Rebecca A. Chandler ◽

Terence A. Ketter

Keyword(s):

Bipolar Disorder ◽

Magnetic Resonance ◽

Mood Disorders ◽

Bipolar Disorders ◽

Occipital Lobe ◽

Gabaergic Neurotransmission ◽

Control Subjects ◽

Bipolar Ii ◽

Healthy Control ◽

Cr Concentration

Background:Animal models of depression and psychopharmacological mechanisms of action suggest the importance of the gamma-amino butyric acid (GABA) system in the pathophysiology of mood disorders. Mood stabilizers have overlapping effects on GABAergic neurotransmission, and antidepressant use has been associated with alterations in GABAB receptor function. Magnetic resonance spectroscopy (MRS) provides an opportunity to noninvasively assess cerebral GABA concentrations in anterior paralimbic circuits that have been implicated in mood disorders.Methods:In bipolar disorder patients and healthy control subjects, we used MRS with a modified GABA-edited point resolved spectroscopy sequence (TE 68 ms, TR 1500 ms, 512 averages, total scan time 26 min) to assess GABA in an 18-cm3 occipital voxel. In addition, in another cohort of bipolar disorder patients and healthy control subjects, we similarly assessed GABA in a 12.5-cm3 medial prefrontal/anterior cingulate (MPF/AC) voxel. The concentration of GABA was referenced to creatine (Cr) from unedited spectra.Results:In bipolar patients and controls, we consistently detected 3.0 p.p.m. GABA peaks in occipital lobe and MPF/AC. In 16 bipolar (nine bipolar I and seven bipolar II) disorder patients, compared with six healthy control subjects, mean occipital GABA/Cr concentration was 61% higher. In addition, in 15 bipolar (five bipolar I, nine bipolar II, and one bipolar not otherwise specified) disorder patients, compared with six healthy control subjects, mean MPF/AC GABA/Cr concentration tended to be 41% higher.Conclusions:Patients with bipolar disorders may have increased cerebral GABA concentrations. Although this was more evident in the occipital lobe, MPC/AC GABA disturbance may be of greater potential interest in view the more established role of MPF/AC in affective processing. Additional studies are warranted to assess changes in GABAergic neurotransmission and the influences of diagnosis, mood state, and medication status in bipolar disorder patients.

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Superselective Intracerebral Catheterization of a Branch of the Internal Carotid Artery Coupled with Magnetic Resonance Imaging

Interventional Neuroradiology ◽

10.1177/159101990701300307 ◽

2007 ◽

Vol 13 (3) ◽

pp. 277-280 ◽

Cited By ~ 1

Author(s):

J. Pryor ◽

H. D'Arceuil ◽

M. Phil ◽

J. Liu ◽

J. He ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Brain Region ◽

Internal Carotid ◽

Fluoroscopic Guidance ◽

Resonance Imaging ◽

Assessment And Treatment ◽

The Brain

We used fluoroscopic guidance and over-the-wire techniques to superselectively place a microcatheter into a branch of the MCA of three macaques and MRI bolus tracking techniques to measure perfusion within the selected brain region. Such techniques are likely to be useful in the assessment and treatment of ischemic infarction, cerebral vasospasm, and monitoring local delivery of drugs into the brain.

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