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[PMID]:28455321
[Au] Autor:Derdeyn CP; Fiorella D; Lynn MJ; Turan TN; Cotsonis GA; Lane BF; Montgomery J; Janis LS; Chimowitz MI; SAMMPRIS Investigators
[Ad] Endereço:From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta,
[Ti] Título:Nonprocedural Symptomatic Infarction and In-Stent Restenosis After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis).
[So] Source:Stroke;48(6):1501-1506, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The purpose of this study was to investigate the frequency of symptomatic in-stent restenosis (ISR) and its contribution to nonprocedural symptomatic infarction in the SAMMPRIS trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis). METHODS: Patients without a periprocedural primary end point were followed up to determine the occurrence of any of the following events: ischemic stroke, cerebral infarct with temporary signs, or transient ischemic attack in the territory of the stented artery. Vascular imaging performed after these events was reviewed for ISR. Annual rates for symptomatic ISR were calculated using Kaplan-Meier estimates. RESULTS: Of 183 patients in the stenting group without a periprocedural primary end point, 27 (14.8%) had a symptomatic infarction (stroke or cerebral infarct with temporary signs) and 16 (8.7%) had transient ischemic attack alone in the territory during a median follow-up of 35.0 months. Of the 27 patients with infarctions, 17 (9.3%) had an ischemic stroke and 10 (5.5%) had a cerebral infarct with temporary signs alone. Adequate vascular imaging to evaluate ISR was available in 24 patients with infarctions (showing ISR in 16 [66.7%]) and in 10 patients with transient ischemic attack alone (showing ISR in 8 [80%]). The 1-, 2-, and 3-year rates (with 95% confidence limits) for symptomatic ISR in the SAMMPRIS stent cohort were 9.6% (6.1%-14.9%), 11.3% (7.5%-17.0%), and 14.0% (9.6%-20.2%), respectively. CONCLUSIONS: Symptomatic ISR occurred in at least 1 of 7 patients in SAMMPRIS by 3 years of follow-up and was likely responsible for the majority of nonprocedural cerebral infarctions. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT00576693.
[Mh] Termos MeSH primário: Angioplastia com Balão/estatística & dados numéricos
Isquemia Encefálica/epidemiologia
Constrição Patológica/epidemiologia
Doenças Arteriais Intracranianas/epidemiologia
Doenças Arteriais Intracranianas/terapia
Complicações Pós-Operatórias/epidemiologia
Stents/estatística & dados numéricos
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Assistência ao Convalescente
Idoso
Angioplastia com Balão/efeitos adversos
Isquemia Encefálica/diagnóstico
Angiografia Cerebral
Infarto Cerebral/diagnóstico por imagem
Infarto Cerebral/epidemiologia
Constrição Patológica/diagnóstico por imagem
Feminino
Seres Humanos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Ataque Isquêmico Transitório/diagnóstico por imagem
Ataque Isquêmico Transitório/epidemiologia
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Complicações Pós-Operatórias/diagnóstico por imagem
Recidiva
Risco
Stents/efeitos adversos
Acidente Vascular Cerebral/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.014537


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[PMID]:28463782
[Au] Autor:Zhang Q; Wang A; Zhang S; Li N; Chen S; Zhang Y; Zhou Y; Wu S; Zhao X
[Ad] Endereço:Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, China; Center of Stroke, Beijing Institute for Brain Disorders, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascula
[Ti] Título:Asymptomatic polyvascular disease and the risks of cardiovascular events and all-cause death.
[So] Source:Atherosclerosis;262:1-7, 2017 Jul.
[Is] ISSN:1879-1484
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Atherosclerosis is a diffuse and systemic disease. We aimed to assess prevalence and outcome of extracoronary polyvascular disease (polyVD) in the asymptomatic Chinese community population. METHODS: A random sample of 5440 participants aged 40 years or older were enrolled in the Asymptomatic Polyvascular Abnormalities Community Study from 2010 to 2011. Intracranial artery stenosis, extracranial artery stenosis, and lower extremity artery disease were detected by transcranial Doppler and duplex sonography, and by calculating the ankle brachial index. The study endpoints included the first occurrence of stroke, myocardial infarction (MI) and all-cause death. RESULTS: PolyVD (two or three affected vascular territories) was found in 3.0% of the participants, and was significantly higher in men (4.3%). Over a median follow-up of 4.1 years, we identified a total of 247 events (4.7%), including 83 strokes (68 ischemic), 45 MIs and 134 all-cause deaths. After adjusting for age, gender and other potential confounders, we found a significant increase in risk of major cardiovascular events as well as all-cause death in participants with polyVD. In multivariate Cox regression analyses, the adjusted hazard ratios (HR) (95% confidence interval, CI) for the composite of stroke, MI and all-cause death for single and poly-vascular disease (compared with 0 vascular disease) increased from 1.58 (1.19-2.12) to 1.95 (1.26-3.03). Similarly, the adjusted HR (95% CI) for all-cause death for single and poly-vascular disease increased from 1.53 (1.03-2.29) to 2.22 (1.27-3.86). CONCLUSIONS: PolyVD significantly increased the risk of major cardiovascular events and all-cause death in the asymptomatic community population. Performing invasive screening tests for polyVD is useful in the high-risk asymptomatic population.
[Mh] Termos MeSH primário: Arteriopatias Oclusivas/epidemiologia
Doenças Arteriais Intracranianas/epidemiologia
Extremidade Inferior/irrigação sanguínea
Infarto do Miocárdio/epidemiologia
Doença Arterial Periférica/epidemiologia
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Índice Tornozelo-Braço
Arteriopatias Oclusivas/diagnóstico por imagem
Arteriopatias Oclusivas/mortalidade
Doenças Assintomáticas
Causas de Morte
Distribuição de Qui-Quadrado
China/epidemiologia
Progressão da Doença
Feminino
Seres Humanos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Doenças Arteriais Intracranianas/mortalidade
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Análise Multivariada
Infarto do Miocárdio/diagnóstico
Infarto do Miocárdio/mortalidade
Doença Arterial Periférica/diagnóstico
Doença Arterial Periférica/mortalidade
Valor Preditivo dos Testes
Prognóstico
Modelos de Riscos Proporcionais
Estudos Prospectivos
Fatores de Risco
Acidente Vascular Cerebral/diagnóstico
Acidente Vascular Cerebral/mortalidade
Fatores de Tempo
Ultrassonografia Doppler Dupla
Ultrassonografia Doppler Transcraniana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29261469
[Au] Autor:Lindenholz A; van der Kolk AG; Zwanenburg JJM; Hendrikse J
[Ad] Endereço:From the Department of Radiology, Imaging Division, University Medical Center Utrecht, Heidelberglaan 100, 3508GA Utrecht, the Netherlands.
[Ti] Título:The Use and Pitfalls of Intracranial Vessel Wall Imaging: How We Do It.
[So] Source:Radiology;286(1):12-28, 2018 Jan.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intracranial vessel wall magnetic resonance (MR) imaging has gained much attention in the past decade and has become part of state-of-the-art MR imaging protocols to assist in diagnosing the cause of ischemic stroke. With intracranial vessel wall imaging, vessel wall characteristics have tentatively been described for atherosclerosis, vasculitis, dissections, Moyamoya disease, and aneurysms. With the increasing demand and subsequently increased use of intracranial vessel wall imaging in clinical practice, radiologists should be aware of the choices in imaging parameters and how they affect image quality, the clinical indications, methods of assessment, and limitations in the interpretation of these images. In this How I do It article, the authors will discuss the technical requirements and considerations for vessel wall image acquisition in general, describe their own vessel wall imaging protocol at 3 T and 7 T, show a step-by-step basic assessment of intracranial vessel wall imaging as performed at their institution-including commonly encountered artifacts and pitfalls-and summarize the commonly reported imaging characteristics of various intracranial vessel wall diseases for direct clinical applicability. Finally, future technical and clinical considerations for full implementation of intracranial vessel wall imaging in clinical practice, including the need for histologic validation and acquisition time reduction, will be discussed.
[Mh] Termos MeSH primário: Encéfalo/irrigação sanguínea
Encéfalo/diagnóstico por imagem
Interpretação de Imagem Assistida por Computador/métodos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Angiografia Cerebral
Meios de Contraste
Feminino
Seres Humanos
Imagem Tridimensional
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017162096


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[PMID]:29095279
[Au] Autor:Yang F; Yue H; Wu L; Qin X; Shi L; Qu W
[Ad] Endereço:aDepartment of Neurology bDepartment of Public Health, Rizhao People's Hospital, Rizhao, China.
[Ti] Título:Ischemic stroke due to intracranial arterial dolichoectasia coexisting with spontaneous dissection of the basilar artery: A case report.
[So] Source:Medicine (Baltimore);96(44):e8422, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: We present a rarely seen case of cerebral infarction due to intracranial dolichoectasia coexisting with spontaneous dissection of the basilar artery. A definition of dolichoectasia, its pathology, and imaging findings, as well as the clinical management and prognosis are briefly reviewed. CONCLUSION: We discuss in general terms the diagnosis of basilar artery dissection and its probable relationship with the occurrence of dolichoectasia.
[Mh] Termos MeSH primário: Artéria Basilar
Infarto Cerebral/etiologia
Doenças Arteriais Intracranianas/complicações
Dissecação da Artéria Vertebral/complicações
Insuficiência Vertebrobasilar/complicações
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171103
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008422


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[PMID]:28679853
[Au] Autor:Stence NV; Pabst LL; Hollatz AL; Mirsky DM; Herson PS; Poisson S; Traystman RJ; Bernard TJ
[Ad] Endereço:From the Department of Radiology (N.V.S., D.M.M.) and Departments of Pediatrics and Pediatric Neurology (T.J.B.), Children's Hospital Colorado, Aurora; and Hemophilia and Thrombosis Center (L.L.P., A.L.H., T.J.B.), Department of Anesthesiology (P.S.H., R.J.T.), and Department Neurology (S.P.), Unive
[Ti] Título:Predicting Progression of Intracranial Arteriopathies in Childhood Stroke With Vessel Wall Imaging.
[So] Source:Stroke;48(8):2274-2277, 2017 Aug.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Childhood arterial ischemic stroke is frequently associated with an intracranial arteriopathy that often progresses in the first 3 to 6 months post stroke. We hypothesized that children with enhancing arteriopathies on vessel wall imaging (VWI) would have a higher risk of arteriopathy progression than those without enhancement. METHODS: Our institutional radiographic database was searched for cases of childhood stroke with VWI. Inclusion criteria consisted of age ranging from 1 month through 20 years, diagnosis of arterial ischemic stroke, available VWI, and follow-up magnetic resonance angiogram. Imaging was reviewed to systematically describe VWI findings, categorize arteriopathies, steroid therapy, and identify progressive arteriopathies using CACADE definitions. RESULTS: Sixteen cases of childhood stroke at Children's Hospital Colorado between January 1, 2010 and July 1, 2016 were reviewed. Strong vessel wall enhancement at presentation was associated with progressive arteriopathy in 83% of cases (10/12), when compared with 0% (0/4) without strong enhancement ( =0.008). CONCLUSIONS: Our case series demonstrates the potential benefit of VWI in children with stroke because it may identify patients who will have progressive arterial disease.
[Mh] Termos MeSH primário: Artérias Cerebrais/diagnóstico por imagem
Progressão da Doença
Doenças Arteriais Intracranianas/diagnóstico por imagem
Angiografia por Ressonância Magnética/tendências
Acidente Vascular Cerebral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seguimentos
Seres Humanos
Doenças Arteriais Intracranianas/complicações
Angiografia por Ressonância Magnética/métodos
Masculino
Valor Preditivo dos Testes
Estudos Retrospectivos
Acidente Vascular Cerebral/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017922


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[PMID]:28448235
[Au] Autor:Chung MS; Jung SC; Kim SO; Kim HS; Choi CG; Kim SJ; Kwon SU; Kang DW; Kim JS
[Ad] Endereço:From the Department of Radiology and Research Institute of Radiology (M.S.C., S.C.J., H.S.K., C.G.C., S.J.K.), Department of Clinical Epidemiology and Biostatistics (S.O.K.), and Department of Neurology (S.U.K., D.W.K., J.S.K.), University of Ulsan College of Medicine, Asan Medical Center, 88 Olympi
[Ti] Título:Intracranial Artery Steno-Occlusion: Diagnosis by Using Two-dimensional Spatially Selective Radiofrequency Excitation Pulse MR Imaging.
[So] Source:Radiology;284(3):834-843, 2017 Sep.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose To determine whether magnetic resonance (MR) imaging by using two-dimensional spatially selective radiofrequency (RF) excitation pulses (zoomed MR imaging) is a reliable method for the diagnosis of intracranial artery steno-occlusion compared with full-field-of-view (FOV) MR imaging. Materials and Methods The institutional review board approved this retrospective study and informed consent was waived. From December 2014 to August 2015, 88 patients who underwent both full-FOV MR imaging and zoomed MR imaging for further evaluation of intracranial artery steno-occlusion at prior luminal evaluation were included. Two neuroradiologists independently diagnosed the diseases (atherosclerosis, dissection, moyamoya disease, vasculitis, undetermined diagnosis, and no vascular pathologic condition) based on both clinical information and MR imaging features and assessed diagnosis-related parameters (diameter, length, eccentricity index, eccentricity, signal intensity ratio, vessel wall hemorrhage, and the total number of lesions), as well as image quality parameters (signal-to-noise ratio and image quality scale) with full-FOV MR imaging and zoomed MR imaging. Parametric measurements were compared between full-FOV MR imaging and zoomed MR imaging by using paired t test and McNemar test. The criterion for intermethod reliability was that the upper limit of the 95% confidence interval (CI) in the difference of agreement was less than 10% based on a noninferiority test. Results The pooled agreement for diagnosing the disease between full-FOV MR imaging and zoomed MR imaging was 93% (164 of 176 lesions). The difference of agreement was 2.84% (one-sided 95% CI: -0.49%, 6.17%). The diagnosis-related parameters were not significantly different between both methods (all P > .05), with good to excellent agreement (both intraclass correlation coefficient and κ value ≥0.61). However, full-FOV MR imaging had better image quality parameters than zoomed MR imaging, including precontrast signal-to-noise ratio and image quality scale (both P < .05). Conclusion Zoomed MR imaging is a reliable method for the diagnosis of intracranial artery steno-occlusion compared with full-FOV MR imaging. RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on May 2, 2017.
[Mh] Termos MeSH primário: Arteriopatias Oclusivas/diagnóstico por imagem
Interpretação de Imagem Assistida por Computador/métodos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Ondas de Rádio
Reprodutibilidade dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017161490


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[PMID]:28320162
[Au] Autor:Park MG; Shin JH; Lee SW; Park HR; Park KP
[Ad] Endereço:Departments of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
[Ti] Título:RNF213 rs112735431 polymorphism in intracranial artery steno-occlusive disease and moyamoya disease in Koreans.
[So] Source:J Neurol Sci;375:331-334, 2017 Apr 15.
[Is] ISSN:1878-5883
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The rs112735431 polymorphism of the RNF213, a susceptibility variant for moyamoya disease (MMD), may be associated with non-MMD intracranial artery steno-occlusive disease of non-MMD type (non-MMD ICAD) in Asian. We investigated whether the rs112735431 polymorphism of the RNF213 affect the development of non-MMD ICAD in Koreans compared to MMD and control group. METHODS: We included 31 patients with non-MMD ICAD, 25 patients with MMD, and 100 participants as control group. The rs112735431 polymorphism of the RNF213 was evaluated by polymerase chain reaction amplification of target and detection by restriction fragment length polymorphism analysis. Clinical phenotype was compared between patients with and without the rs112735431 polymorphism in non-MMD ICAD and MMD. RESULTS: The rs112735431 polymorphism of the RNF213 was significantly associated with non-MMD ICAD (p=0.001; odds ratio, 14.3; 95% confidence interval, 2.80-73.2) and MMD (p<0.0001; odds ratio, 126.0; 95% confidence interval, 24.2-656.0). The rate of hypertension was more frequent in MMD with the rs112735431 polymorphism than MMD without polymorphism (p=0.010). CONCLUSIONS: The rs112735431 polymorphism of the RNF213 is highly associated not only with MMD but also with non-MMD ICAD in Koreans. Also, our study suggests that the rs112735431 polymorphism of the RNF213 may be linked to the hypertension in MMD. Further studies are needed to clarify the relationship between the rs112735431 polymorphism of the RNF213 and hypertension in patients with MMD.
[Mh] Termos MeSH primário: Adenosina Trifosfatases/genética
Predisposição Genética para Doença/genética
Doenças Arteriais Intracranianas/genética
Doença de Moyamoya/genética
Polimorfismo de Nucleotídeo Único/genética
Ubiquitina-Proteína Ligases/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Análise Mutacional de DNA
Feminino
Seres Humanos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Angiografia por Ressonância Magnética
Masculino
Meia-Idade
Doença de Moyamoya/diagnóstico por imagem
República da Coreia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.3.2.27 (RNF213 protein, human); EC 2.3.2.27 (Ubiquitin-Protein Ligases); EC 3.6.1.- (Adenosine Triphosphatases)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE


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[PMID]:28264095
[Au] Autor:De Giuli V; Grassi M; Lodigiani C; Patella R; Zedde M; Gandolfo C; Zini A; DeLodovici ML; Paciaroni M; Del Sette M; Azzini C; Toriello A; Musolino R; Calabrò RS; Bovi P; Sessa M; Adami A; Silvestrelli G; Cavallini A; Marcheselli S; Bonifati DM; Checcarelli N; Tancredi L; Chiti A; Lotti EM; Del Zotto E; Tomelleri G; Spalloni A; Giorli E; Costa P; Poli L; Morotti A; Caria F; Lanari A; Giacalone G; Ferrazzi P; Giossi A; Piras V; Massucco D; D'Amore C; Di Lisi F; Casetta I; Cucurachi L; Cotroneo M; De Vito A; Coloberti E; Rasura M; Simone AM; Gamba M; Cerrato P; Italian Project on Stroke in Young Adults Investigators
[Ad] Endereço:Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italia.
[Ti] Título:Association Between Migraine and Cervical Artery Dissection: The Italian Project on Stroke in Young Adults.
[So] Source:JAMA Neurol;74(5):512-518, 2017 May 01.
[Is] ISSN:2168-6157
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Although sparse observational studies have suggested a link between migraine and cervical artery dissection (CEAD), any association between the 2 disorders is still unconfirmed. This lack of a definitive conclusion might have implications in understanding the pathogenesis of both conditions and the complex relationship between migraine and ischemic stroke (IS). Objective: To investigate whether a history of migraine and its subtypes is associated with the occurrence of CEAD. Design, Setting, and Participants: A prospective cohort study of consecutive patients aged 18 to 45 years with first-ever acute ischemic stroke enrolled in the multicenter Italian Project on Stroke in Young Adults was conducted between January 1, 2000, and June 30, 2015. In a case-control design, the study assessed whether the frequency of migraine and its subtypes (presence or absence of an aura) differs between patients whose IS was due to CEAD (CEAD IS) and those whose IS was due to a cause other than CEAD (non-CEAD IS) and compared the characteristics of patients with CEAD IS with and without migraine. Main Outcomes and Measures: Frequency of migraine and its subtypes in patients with CEAD IS vs non-CEAD IS. Results: Of the 2485 patients (mean [SD] age, 36.8 [7.1] years; women, 1163 [46.8%]) included in the registry, 334 (13.4%) had CEAD IS and 2151 (86.6%) had non-CEAD IS. Migraine was more common in the CEAD IS group (103 [30.8%] vs 525 [24.4%], P = .01), and the difference was mainly due to migraine without aura (80 [24.0%] vs 335 [15.6%], P < .001). Compared with migraine with aura, migraine without aura was independently associated with CEAD IS (OR, 1.74; 95% CI, 1.30-2.33). The strength of this association was higher in men (OR, 1.99; 95% CI, 1.31-3.04) and in patients 39.0 years or younger (OR, 1.82; 95% CI, 1.22-2.71). The risk factor profile was similar in migrainous and non-migrainous patients with CEAD IS (eg, hypertension, 20 [19.4%] vs 57 [24.7%], P = .29; diabetes, 1 [1.0%] vs 3 [1.3%], P > .99). Conclusions and Relevance: In patients with IS aged 18 to 45 years, migraine, especially migraine without aura, is consistently associated with CEAD. This finding suggests common features and warrants further analyses to elucidate the underlying biologic mechanisms.
[Mh] Termos MeSH primário: Isquemia Encefálica/epidemiologia
Doenças Arteriais Intracranianas/epidemiologia
Enxaqueca com Aura/epidemiologia
Enxaqueca sem Aura/epidemiologia
Sistema de Registros
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Estudos de Casos e Controles
Feminino
Seres Humanos
Itália/epidemiologia
Masculino
Meia-Idade
Estudos Prospectivos
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170307
[St] Status:MEDLINE
[do] DOI:10.1001/jamaneurol.2016.5704


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[PMID]:28228620
[Au] Autor:Moriyoshi H; Furukawa S; Iwata M; Suzuki J; Nakai N; Nishida S; Ito Y
[Ad] Endereço:Department of Neurology, Stroke Center, TOYOTA Memorial Hospital.
[Ti] Título:A case of intracranial arterial dolichoectasia with 4 repeated cerebral infarctions in 6 months and enlargement of basilar artery.
[So] Source:Rinsho Shinkeigaku;57(3):124-129, 2017 03 28.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 78-year-old man was admitted to our hospital because of sudden right hemiparesis and dysarthria. His cranial MRI showed an area of hyperintensity in left pons on DWI and MRA revealed dilated, elongated and tortuous intracranial artery. We diagnosed as acute phase ischemic stroke and intracranial arterial dolichoectasia (IADE). Intravenous infusion of rt-PA was performed 157 minutes after the onset of symptoms, and his hemiparesis improved. However, he subsequently suffered from cerebral infarction 4 times in 6 months, and we treated him twice with thrombolytic therapy. Although thrombolytic therapy was effective in the short term and antithrombotic therapy was continued, he had bilateral hemiplegia and severe dysphagia because of repeated cerebral infarctions. Hence basilar artery was dilated with intramural hemorrhage over 6 months, and we discontinued antithrombolytic therapy. It is possible that antithrombolytic therapy affects enlargement of IADE. Antithrombolytic therapy for IADE should be done carefully.
[Mh] Termos MeSH primário: Artéria Basilar/patologia
Infarto Cerebral/etiologia
Doenças Arteriais Intracranianas/complicações
Doenças Arteriais Intracranianas/diagnóstico por imagem
Insuficiência Vertebrobasilar/complicações
Insuficiência Vertebrobasilar/diagnóstico por imagem
[Mh] Termos MeSH secundário: Doença Aguda
Artéria Basilar/diagnóstico por imagem
Infarto Cerebral/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética
Dilatação Patológica/diagnóstico por imagem
Feminino
Seres Humanos
Doenças Arteriais Intracranianas/tratamento farmacológico
Angiografia por Ressonância Magnética
Meia-Idade
Proteínas Recombinantes/administração & dosagem
Proteínas Recombinantes/efeitos adversos
Recidiva
Acidente Vascular Cerebral/complicações
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/tratamento farmacológico
Terapia Trombolítica
Fatores de Tempo
Ativador de Plasminogênio Tecidual/administração & dosagem
Ativador de Plasminogênio Tecidual/efeitos adversos
Insuficiência Vertebrobasilar/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Recombinant Proteins); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-000989


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[PMID]:28114639
[Au] Autor:Uohara MY; Beslow LA; Billinghurst L; Jones BM; Kessler SK; Licht DJ; Ichord RN
[Ad] Endereço:Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania2Perelman School of Medicine, University of Pennsylvania, Philadelphia3The Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
[Ti] Título:Incidence of Recurrence in Posterior Circulation Childhood Arterial Ischemic Stroke.
[So] Source:JAMA Neurol;74(3):316-323, 2017 Mar 01.
[Is] ISSN:2168-6157
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Childhood arterial ischemic stroke (CAIS) affects approximately 1.6 per 100 000 children per year, while stroke recurs in up to 20% of patients at 5 years. Factors determining the risk of recurrence are incompletely understood. Objective: To investigate the incidence of the recurrence of CAIS in the posterior and anterior circulations to determine if the risk differs between the 2 locations. Design, Setting, and Participants: A retrospective analysis of CAIS was conducted among children enrolled in a single-center prospective consecutive cohort at The Children's Hospital of Philadelphia between January 1, 2006, and January 1, 2015. Children with confirmed CAIS occurring between 29 days and 17.99 years were evaluated for inclusion. Patients were excluded if infarcts were located in both the anterior and posterior distributions or if CAIS occurred as a complication of intracranial surgery or brain tumor. Main Outcomes and Measures: Stroke recurrence. Results: The study population included 107 patients (75 boys [70.1%] and 32 girls [29.9%]; median age at AIS, 7.7 years [interquartile range, 3.1-13.6 years]). Sixty-one children had anterior circulation CAIS (ACAIS) and 46 had posterior circulation CAIS (PCAIS). Median follow-up was 20.9 months (interquartile range, 8.7-40.4 months). For ACAIS, recurrence-free survival was 100% at 1 month and 96% (95% CI, 85%-99%) at 1 and 3 years. For PCAIS, recurrence-free survival was 88% (95% CI, 75%-95%) at 1 month and 81% (95% CI, 66%-90%) at 1 and 3 years. The hazard ratio for recurrence after PCAIS compared with ACAIS was 6.4 (95% CI, 1.4-29.8; P = .02) in univariable analysis and 5.3 (95% CI, 1.1-26.4; P = .04) after adjusting for sex and cervical dissection. Conclusions and Relevance: We identified a subgroup of patients that comprise more than 80% of recurrences of CAIS. Three years after incident stroke, 19% of children with PCAIS had a recurrence compared with 4% of patients with ACAIS. Different mechanisms of stroke may account for this difference. Children with PCAIS may warrant increased monitoring. This study highlights the necessity for further research focused on recurrence prevention.
[Mh] Termos MeSH primário: Circulação Cerebrovascular/fisiologia
Doenças Arteriais Intracranianas/complicações
Doenças Arteriais Intracranianas/epidemiologia
Acidente Vascular Cerebral/epidemiologia
Acidente Vascular Cerebral/etiologia
[Mh] Termos MeSH secundário: Adolescente
Infarto Encefálico/etiologia
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Fibrinolíticos/uso terapêutico
Seres Humanos
Incidência
Lactente
Masculino
Recidiva
Acidente Vascular Cerebral/tratamento farmacológico
Acidente Vascular Cerebral/mortalidade
Análise de Sobrevida
Dissecação da Artéria Vertebral/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrinolytic Agents)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170530
[Lr] Data última revisão:
170530
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1001/jamaneurol.2016.5166



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