Spontaneous or nontraumatic intracerebral hemorrhage (ICH) is an important cause of mortality and morbidity worldwide.1 Management of patients presenting with spontaneous ICH includes medical therapy and, if indicated, surgical intervention.1,2 Acute reduction of elevated blood pressure is an important component of the initial medical management of such patients. This can be justified by the fact that elevated blood pressure in the setting of ICH may lead to hematoma expansion and is therefore associated with poor clinical outcome.3-5 A question that remains unanswered, however, is whether an early and rapid reduction in systolic blood pressure (SBP) could worsen outcome by causing ischemia in perihematoma brain tissue.6,7 To study this important issue, Butcher et al conducted a prospective randomized clinical trial in which 75 patients presenting with spontaneous ICH were randomized into two different target treatment groups.8,9 The study focused on evaluating the perihematoma relative cerebral blood flow (CBF) and the clinical outcome associated with each target treatment. The results were published in the March 2013 issue of Stroke.8
BACKGROUND: Stent-assisted coiling (SAC) and balloon-assisted coiling (BAC) are 2 well-established techniques for the treatment of complex and wide-necked intracranial aneurysms. Most clinicians are reluctant to perform SAC in the setting of subarachnoid hemorrhage because of the need for dual antiplatelet therapy.
BACKGROUND: Treatment of unruptured intracranial aneurysms (UIAs) involves endovascular coiling or aneurysm clipping. While many studies have compared these treatment modalities with respect to various clinical outcomes, few studies have investigated the economic costs associated with each procedure.
Purpose: To report subgroup analyses of an updated systematic review on endovascular treatment of intracranial unruptured aneurysms (UAs); to compare types of embolic agents, adjunct techniques, and newer devices; and to identify potential risk factors for poor outcomes.
BACKGROUND AND PURPOSE: The carotid bulb is innervated by the sinus nerve of Hering, a branch of the glossopharyngeal nerve, derived from the third pharyngeal arch. The aim of this study was to determine the frequency, predictors, and outcome of the carotid BR after carotid stent placement according to the location of the plaque lesion.
BACKGROUND AND PURPOSE: Recanalization is the important outcome measure for acute stroke therapy. Several methods of recanalization assessment are used in clinical practice, but few studies have addressed their reliability. We, therefore, sought to assess interobserver reliability of the diagnosis of intracranial artery recanalization following intervention by using TIMI criteria.
BACKGROUND AND PURPOSE: Adjacent VCF frequently occurs after percutaneous vertebroplasty. Our aim was to evaluate PrVP in the prevention of PVNO-adjacent VCF.
BACKGROUND AND PURPOSE: Serial in vivo imaging of atherosclerosis is important for understanding plaque progression and is potentially useful in predicting cardiovascular events and monitoring treatment efficacy. This prospective study aims to quantify temporal changes in carotid atherosclerotic plaque volume and plaque composition using MDCTA.
BACKGROUND AND PURPOSE: 4D MRA has been evolving as a noninvasive supplement for DSA. The purpose of this study was to evaluate the feasibility of a newly developed blood flow visualization technique for the classification of cerebral AVMs. We hypothesized that 4D-hMRA allows detection of different flow patterns within the nidus as well as differentiation of feeders and draining veins and has very good agreement with DSA regarding the Spetzler-Martin grade.
BACKGROUND AND PURPOSE: VBD can trigger various clinical symptoms, especially ischemic stroke in the posterior circulation, but there is no effective treatment for their prevention. We aimed to validate the feasibility of coil-assisted stent reconstruction in the vascular lumen for the treatment of VBD and to evaluate its long-term effectiveness in preventing ischemic events.
BACKGROUND AND PURPOSE: Patients with ruptured brain AVMs are at considerable risk of repeat hemorrhage, particularly when associated intranidal or flow-related aneurysms are present. There is controversy about the timing of diagnosis and treatment of patients with hemorrhagic stroke. We present our results of endovascular treatment of ruptured AVMs in the acute phase.
BACKGROUND AND PURPOSE: A new curative embolization technique with Onyx for selected small and medium-sized superficially located brain AVMs was developed, which consists of obliteration of the nidus, including incremental occlusion of the draining veins. We report our first clinical results.
BACKGROUND AND PURPOSE: EL associated with ruptured aneurysms is higher than that for unruptured aneurysms. In this study, the effect of arterial morphologic variation of bifurcation aneurysms on EL was investigated in idealized models of middle cerebral artery aneurysms.
BACKGROUND AND PURPOSE: Cerebral venous thrombosis is a rare entity that can be difficult to manage. Most patients with cerebral sinus thrombosis recover after treatment with heparin, but a subgroup of severe cerebral venous sinus thrombosis has a poor prognosis. Those patients may benefit from intrasinus thrombolysis. The purpose of this research was to carry out a retrospective analysis of patients with severe cerebral venous sinus thrombosis, and to study the safety and efficacy of intrasinus thrombolysis in patients with cerebral venous sinus thrombosis unresponsive to conventional heparin therapy.
SUMMARY: As stroke is one of the leading causes of death and long-term morbidity worldwide, the research community has studied cardiac embolic sources, as well as vessel wall pathologies. For the latter, attention has been focused on defining morphologic tissue features associated with catastrophic events stemming from the carotid artery. Multiple noninvasive imaging modalities are currently being used to image and classify carotid atherosclerotic plaques, such as MR imaging, CT, and sonography, in an effort to provide clinically relevant predictive metrics for use in patient risk stratification and to define appropriate treatment options. This article compares and contrasts these existing clinical imaging modalities along with discussion of a new endovascular technique originally developed for cardiology, OCT, with which 3D comprehensive high-resolution images of the arterial wall can be acquired.
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