scholarly journals Interventional Management of Intracranial Stenosis

2010 ◽  
Vol 3 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Marc A. Lazzaro ◽  
Michael Chen
Keyword(s):  
Intracranial Stenosis ◽  
Interventional Management

The Effects of Mean of Visit-to-Visit Blood Pressure on Incident Brain Vascular Lesions and Functional-Cognitive Decline

2021 ◽  
pp. 1-12
Author(s):  
Bibek Gyanwali ◽  
Celestine Xue Ting Cai ◽  
Christopher Chen ◽  
Henri Vrooman ◽  
Chuen Seng Tan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Decline ◽  
Hippocampal Volume ◽  
Intracranial Stenosis ◽  
Vascular Lesions ◽  
Linear Regression Models ◽  
Volume Functional ◽  
Mri Scans ◽  
The Mean

Background: Cerebrovascular disease (CeVD) is an underlying cause of cognitive impairment and dementia. Hypertension is a known risk factor of CeVD, but the effects of mean of visit-to-visit blood pressure (BP) on incident CeVD and functional-cognitive decline remains unclear. Objective: To determine the association between mean of visit-to-visit BP with the incidence and progression of CeVD [white matter hyperintensities (WMH), infarcts (cortical infarcts and lacunes), cerebral microbleeds (CMBs), intracranial stenosis, and hippocampal volume] as well as functional-cognitive decline over 2 years of follow-up. Methods: 373 patients from a memory-clinic underwent BP measurements at baseline, year 1, and year 2. The mean of visit-to-visit systolic BP, diastolic BP, pulse pressure, and mean arterial pressure were calculated. Baseline and year 2 MRI scans were graded for WMH, infarcts, CMBs, intracranial stenosis, and hippocampal volume. Functional-cognitive decline was assessed using locally validated protocol. Logistic and linear regression models with odds ratios, mean difference, and 95%confidence interval were constructed to analyze associations of visit-to-visit BP on CeVD incidence and progression as well as functional-cognitive decline. Results: Higher mean of visit-to-visit diastolic BP was associated with WMH progression. Higher tertiles of diastolic BP was associated with WMH progression and incident CMBs. There was no association between mean of visit-to-visit BP measures with incident cerebral infarcts, intracranial stenosis, change in hippocampal volume, and functional-cognitive decline. Conclusion: These findings suggest the possibility of hypertension-related vascular brain damage. Careful monitoring and management of BP in elderly patients is essential to reduce the incidence and progression of CeVD.

scholarly journals Role of PET/CT in patients with unexplained rising alpha fetoprotein post HCC interventional management

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Samar Ramzy Ragheb ◽  
Amr Mahmoud Ahmed Abelsamad ◽  
Moustafa Mahmoud Abelkawy ◽  
Osama Abu Elnaga Khalaf Nasr
Keyword(s):  
Alpha Fetoprotein ◽  
Interventional Management ◽  
Pet Ct

scholarly journals Bypass Surgery for Ischemic Stroke Caused by Intracranial Artery Stenosis or Occlusion

2018 ◽  
Vol 4 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Ismatullah Soufiany ◽  
Khalil Ahmad Hijrat ◽  
Spina Soufiany ◽  
Lukui Chen
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Artery ◽  
Vegetative State ◽  
Superficial Temporal Artery ◽  
Case Series ◽  
Temporal Artery ◽  
Artery Stenosis ◽  
Intracranial Stenosis ◽  
Intracranial Artery ◽  
Intracranial Artery Stenosis

Surgical revascularization may be beneficial in patients with ischemic stroke caused by intracranial stenosis or occlusion who are ineligible for thrombolysis. Objective To evaluate the outcome of superficial temporal artery to middle cerebral artery (STA-MCA) bypass in ischemic stroke caused by intracranial artery stenosis or occlusion. Methods We retrospectively studied successive case series of 19 patients who underwent surgical treatment between 2013–2017 of STA-MCA bypass. Surgical procedure was performed for the patients with acute ischemic stroke who were ineligible for thrombolysis. Results Of the 19 patients enrolled, symptom aggravation occurred during medical treatment, the patients were ineligible for thrombolysis despite being within 8 hours of symptom onset. Bypass significantly improved National Institutes of Health Stroke Scale scores, mean patient age was 78.05 years (range, 39–78 y). However, male 11 (57.95%) out of nineteen patients were presented with left-sided-lesions while female 8 (42%) had right-sided lesions with significant infarction growth by diffusion weighted imaging achieved, after surgical maneuver. No major complications occurred intraoperatively, in contrast to 2 (10.5%) minor manifestation were suffering minor complications probably they included the remote infarction (posterior cerebral artery territory). Pooled analysis with our patients showed a significant neurological improvement and a good outcome in 13 (68.4%) patients without hemorrhage or any other complication, 6 (31.6%) patients with unfavorable outcome (severe disability 2; vegetative state 4, non of them are died 0;). Conclusion STA-MCA bypass may be beneficial to patients with acute stroke or stenosis in progress who are ineligible for medical therapy. Furthermore, it appears safe when the infarction is small. These findings indicate that STA-MCA bypass could be considered as a treatment option in selected patients with ischemic stroke caused by intracranial stenosis or occlusion.

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