scholarly journals The diagnostic value of 3D-ASL in vertebral artery stenosis among individuals at risk of stroke

2019 ◽  
Author(s):  
DanDan Xu ◽  
XinMing Huang ◽  
GuoEn Cai ◽  
XiaoXia Yang ◽  
YingQing Wang ◽  
...  
Keyword(s):  
At Risk ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Vertebral Artery ◽  
Occipital Lobe ◽  
Brain Regions ◽  
Artery Stenosis ◽  
Vertebral Artery Stenosis ◽  
Left And Right ◽  
The Difference

Abstract Background: This study explored the predictive value of 3D-ASL for vertebral artery stenosis (VAS) in individuals at risk of stroke. Methods: A total of 43 participants at risk of stroke were enrolled in our study. All participants underwent 3D-ASL and carotid artery computed tomography angiography (CTA) or cervical vascular ultrasound. Cerebral blood flow (CBF) was measured in the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, basal ganglia, thalamus, cerebellum, and hippocampus. Calculate the CBF BI (CBF BI means: The absolute value of the difference in cerebral blood flow in the corresponding brain regions on the left and right sides of the enrolled personnel) of the corresponding brain regions of the left and right between the VAS group and the non-VAS group respectively. To evaluate the predictive value of 3D-ASL for vascular stenosis in participants at risk of stroke, we used two-sample t-tests to determine if there were significant differences in BI. Results: Among 43 participants at risk of stroke we recruited, 20 participants with vertebral artery stenosis (the VAS group) and 23 without vertebral artery stenosis (the non-VAS group). There were significant differences in BI of the occipital lobe between the VAS group and the non-VAS group (p < 0.05). According to the occipital lobe BI value, the receiver operating characteristic curve (ROC) demonstrated best diagnostic limits of 10.46 ml/(100g×min). Conclusion: Using 3D-ASL to detect cerebral blood flow and calculate the difference of bilateral occipital cerebral blood flow which can help to diagnose vertebral artery stenosis in high risk population of stroke.

Abstract 196: Sanguinate (PEGylated-carboxyhemoglobin-bovine) Improves Cerebral Blood Flow and Oxygen Extraction to Vulnerable Brain Regions in Patients at Risk for Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Rajat Dhar ◽  
Hemant Misra ◽  
Michael Diringer
Keyword(s):  
At Risk ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Delayed Cerebral Ischemia ◽  
Brain Regions ◽  
Oxygen Extraction ◽  
Patients At Risk ◽  
Higher Doses

Introduction: Sanguinate is a dual-action oxygen transfer and carbon monoxide-releasing agent with efficacy in animal models of focal brain ischemia and established safety in health volunteers. We performed a dose-escalation study in subarachnoid hemorrhage (SAH) patients at risk for delayed cerebral ischemia (DCI) to evaluate tolerability and explore efficacy in improving cerebral blood flow (CBF) and flow-metabolism balance to vulnerable brain regions. Methods: 12 subjects were studied over three dose tiers: 160mg/kg, 240 mg/kg, and 320 mg/kg, with close safety evaluation prior to proceeding to higher doses. After baseline 15 O-PET measurement of global and regional CBF and oxygen extraction fraction (OEF), Sanguinate was infused over two hours; PET was repeated immediately after and again at 24-hours. Vulnerable brain regions were defined as those with baseline OEF ≥ 0.5. Results: Sanguinate infusion resulted in a significant but transient rise in mean arterial pressure (115±15 to 127±13 mm Hg) that was not dose-dependent. No adverse physiologic or clinical effects were observed with infusion at any dose. Global CBF did not rise significantly after Sanguinate (42.6±7 to 45.9±9 ml/100g/min, p=0.18). However, in the 28% of regions classified as vulnerable, Sanguinate resulted in a significant rise in CBF (42.2±11 to 51.2±18) and reduction in OEF (0.6±0.1 to 0.5±0.11, both p<0.001). The increase in regional CBF was only seen with the two higher doses but OEF improved in all tiers. However, response was attenuated at 24-hours. Conclusions: We safely administered a novel oxygen transport and vasodilating agent to a cohort of patients with SAH. Sanguinate infusion appeared to improve CBF and flow-metabolism balance in vulnerable brain regions and warrants further study in those at-risk for DCI. Higher or repeat dosing may be required for sustained efficacy.

scholarly journals Effects of tDCS Dose and Electrode Montage on regional cerebral blood flow and motor behavior

2021 ◽  
Author(s):  
Anant Shinde ◽  
Karl Lerud ◽  
Fanny Munsch ◽  
David C Alsop ◽  
Gottfried Schlaug
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Brain Regions ◽  
Regional Cerebral Blood ◽  
Left Hand ◽  
Motor Region ◽  
Left And Right ◽  
The Right ◽  
Sequence Performance

AbstractWe used three dose levels (Sham, 2mA and 4mA) and two different electrode montages (unihemispheric or bihemispheric) to examine DOSE and MONTAGE effects on regional cerebral blood flow (rCBF) as a surrogate marker of neural activity, and on a finger sequence task, as a surrogate behavioral measure drawing on brain regions targeted by transcranial direct current stimulation (tDCS). We placed the anodal electrode over the right motor region (C4) while the cathodal or return electrode was placed either over a left supraorbital region (unihemispheric montage) or over the left motor region (C3 in the bihemispheric montage). Performance changes in the finger sequence task for both hands (left hand: p = 0.0026, and right hand: p = 0.0002) showed a linear tDCS dose response, but no effect of montage. rCBF in the the right hemispheric perirolandic area increased with dose under the anodal electrode (p = 0.027), while in the perirolandic ROI in the left hemisphere, rCBF showed a trend to increase with dose (p = 0.053), and significant effect of montage (p = 0.00004). The bihemispheric montage showed additional rCBF increases in frontomesial regions in the 4mA condition but not in the 2mA condition. Furthermore, we found correlations between rCBF changes in the right perirolandic region and improvements in the finger sequence task performance (FSP) for left and right hand. Our data support not only a strong direct tDCS dose effect for rCBF and FSP as surrogate measures of targeted brain regions, but also indirect effects on rCBF in functionally connected regions (e.g., frontomesial regions), particularly in the higher dose condition, and on FSP of the ipsilateral hand (to the anodal electrode). At higher dose and irrespective of polarity, a wider network of sensorimotor regions is positively affected by tDCS.Graphical AbstractHighlightstDCS-DOSE had linear effect on finger sequence performance for both handsrCBF changes in both perirolandic ROIs demonstrated tDCS-DOSE effects and left perirolandic ROI demonstrated tDCS-MONTAGE effects.Simulated current intensity in the left and right perirolandic ROI strongly correlated with the contralateral hand’s finger sequence performance.tDCS-Tolerability scores did not correlate with change in rCBF or finger sequence performance of the left hand.

scholarly journals Cerebral Blood Flow in Posterior Cortical Nodes of the Default Mode Network Decreases with Task Engagement but Remains Higher than in Most Brain Regions

2010 ◽  
Vol 21 (1) ◽  
pp. 233-244 ◽  
Author(s):  
A. Pfefferbaum ◽  
S. Chanraud ◽  
A.-L. Pitel ◽  
E. Muller-Oehring ◽  
A. Shankaranarayanan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Default Mode Network ◽  
Brain Regions ◽  
Task Engagement ◽  
Default Mode

Impact of transient hypotension on regional cerebral blood flow in humans

2015 ◽  
Vol 129 (2) ◽  
pp. 169-178 ◽  
Author(s):  
Nia C.S. Lewis ◽  
Kurt J. Smith ◽  
Anthony R. Bain ◽  
Kevin W. Wildfong ◽  
Tianne Numan ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
Regional Cerebral Blood Flow ◽  
Internal Carotid ◽  
Regional Cerebral Blood

Diameter reductions in the internal carotid artery (ICA) and vertebral artery (VA) contribute to the decline in brain blood with hypotension. The decline in vertebral blood flow with hypotension was greater when carbon dioxide was low; this was not apparent in the ICA.

scholarly journals Transcranial Doppler Evaluation of the Cerebral Vasculature in Women Patients who Have Migraine with Aura

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3012-3017
Author(s):  
Igor Petrušić ◽  
Ana Podgorac ◽  
Aleksandra Radojičić ◽  
Jasna Zidverc-Trajković
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Migraine With Aura ◽  
Transcranial Doppler ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Transcranial Doppler Sonography ◽  
Cerebrovascular Reactivity ◽  
Breath Holding ◽  
Left And Right

Abstract Background Previous studies suggest that increased cerebrovascular reactivity might be a feature of patients who have migraine with aura (MwA). The correlation between the clinical presentation of migraine with aura and transcranial Doppler parameters remains unclear. Objective The main aim of this study was to explore cerebral blood flow, vascular resistance, and cerebrovascular reactivity in women MwA. Also, the relationships between hemodynamic conditions and aura characteristics are examined. Design Cross-sectional study. Setting Headache Center, Neurology Clinic, Clinical Center of Serbia. Subjects Fifty-four women MwA and 49 healthy controls (HCs). Methods Transcranial Doppler sonography examination was used to determine blood flow mean velocity (MV) and pulsatility index (PI), as well as breath-holding index (BHI), in 15 arterial segments comprising the circle of Willis. Results A total of 54 women MwA and 49 HCs were studied. The PIs of all segments of the left and right middle cerebral arteries and the left and right anterior cerebral arteries were significantly higher in MwA with regards to HCs. Also, both the left and right BHIs were significantly higher in MwA than HCs. In addition, MVs of the right vertebral artery and the first segment of the basilar artery were significantly lower in MwA than HCs. Longer duration of migraine aura showed a weak negative correlation with the PI of the left posterior cerebral artery. Conclusions Our findings suggest increased vessel pulsatility, abnormal cerebrovascular reactivity, and decreased cerebral blood flow velocity in several arterial segments of the Willis circle in women MwA.

Vertebral artery stenosis

2021 ◽  
Author(s):  
Stephanie M. Madonis ◽  
J. Stephen Jenkins
Keyword(s):  
Vertebral Artery ◽  
Artery Stenosis ◽  
Vertebral Artery Stenosis

Abstract TP127: Prevalence and Clinical Significance of Asymptomatic Extracranial Vertebral Artery Disease in Patients With Symptomatic Internal Carotid Artery Stenosis: Analysis of Stent-protected Angioplasty versus Carotid Endarterectomy (SPACE) Trial

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Saqib A Chaudhry ◽  
Peter A Ringleb
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Vertebral Artery Stenosis ◽  
Extracranial Vertebral Artery ◽  
Artery Disease

Background: Extracranial vertebral artery disease is seen in patients with internal carotid artery stenosis although the clinical significance not well understood. Methods: We analyzed data that was collected as part of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) trial which recruited patients with recently symptomatic internal carotid artery stenosis. We used Cox proportional hazards analysis to compare the relative risk of various endpoints between the three categories of extracranial vertebral artery disease (normal/hypoplastic, moderate/severe stenosis, and occlusion). The multivariate analyses were adjusted for age, gender, basic demographics and severity of carotid stenosis. Results: Of the 1181 subjects who had extracranial vertebral artery ultrasound evaluation, moderate to severe stenosis and occlusion of one of both extracranial vertebral arteries was diagnosed in 152(12.9%) and 57(4.8%) subjects, respectively. During the mean follow up period (±SD) of 22.1±7.1 months 102(8.6%) and 60(5.1%) experienced a stroke or died, respectively. Compared with subjects with normal or hypoplastic vertebral artery, there was a non-significant 30% higher risk of any stroke among subjects with moderate to severe vertebral artery stenosis (relative risk [RR]1.3, 95% confidence interval [CI]0.7-2.3) after adjusting for potential confounders. There was a 40% and 50% higher risk of ipsilateral stroke (RR 1.4, 95% CI0.7-2.5) and death (RR 1.5, 95% CI 0.7-3.1) among subjects with moderate to severe vertebral artery stenosis after adjusting for potential confounders. In Kaplan Meir analysis, the estimated 1 and 2 year stroke free survival for subjects with moderate to severe vertebral artery stenosis was 88% (standard error [SE]2.6%). In comparison, the estimated 1 and 2 year stroke free survival for subjects with normal or hypoplastic vertebral artery was 92.5%(SE0.8%)and 91.6%(SE0.9), respectively. Conclusions: There appears to be an increased risk of stroke and death in patients with symptomatic internal carotid artery stenosis with concurrent asymptomatic extracranial vertebral artery stenosis.

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