Reduced Ipsilesional Cortical Volumes in Fetal Periventricular Venous Infarction

Li, Damon; Hodge, Jacquie; Wei, Xing‐Chang; Kirton, Adam

doi:10.1161/strokeaha.111.645077

Cited by 22 publications

(12 citation statements)

References 14 publications

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“…However, this software and its volumetric assessment methods have been shown in numerous studies to have minimal bias and high intrarater and interrater reliabilities. 16,30 conclusions In our cohort of 43 pediatric patients who underwent first-time surgery for the resection of an FCD, complete resection of the radiological abnormality was a significant predictor of seizure freedom. The odds of having good seizure control among those who underwent complete resection was about 6 times higher than those in patients who did not undergo complete resection.…”

Section: Volumetrics and Epileptogenesismentioning

confidence: 87%

“…This software and its volumetric assessment methods have been demonstrated in numerous studies to have minimal bias and high intrarater and interrater reliabilities. 16,30 We then performed manual segmentations of signal changes corresponding to the cortical dysplasia on the preoperative MR scans and the resection cavity on the postoperative MR scans. These data were used to calculate the preoperative lesion volumes and the postoperative resection volumes (Fig.…”

Section: Methodsmentioning

confidence: 99%

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The influence of lesion volume, perilesion resection volume, and completeness of resection on seizure outcome after resective epilepsy surgery for cortical dysplasia in children

Oluigbo¹,

Wang²,

Whitehead

et al. 2015

PED

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OBJECT Focal cortical dysplasia (FCD) is one of the most common causes of intractable epilepsy leading to surgery in children. The predictors of seizure freedom after surgical management for FCD are still unclear. The objective of this study was to perform a volumetric analysis of factors shown on the preresection and postresection brain MRI scans of patients who had undergone resective epilepsy surgery for cortical dysplasia and to determine the influence of these factors on seizure outcome. METHODS The authors reviewed the medical records and brain images of 43 consecutive patients with focal MRI-documented abnormalities and a pathological diagnosis of FCD who had undergone surgical treatment for refractory epilepsy. Preoperative lesion volume and postoperative resection volume were calculated by manual segmentation using OsiriX PRO software. RESULTS Forty-three patients underwent first-time surgery for resection of an FCD. The age range of these patients at the time of surgery ranged from 2 months to 21.8 years (mean age 7.3 years). The median duration of follow-up was 20 months. The mean age at onset was 31.6 months (range 1 day to 168 months). Complete resection of the area of an FCD, as adjudged from the postoperative brain MR images, was significantly associated with seizure control (p = 0.0005). The odds of having good seizure control among those who underwent complete resection were about 6 times higher than those among the patients who did not undergo complete resection. Seizure control was not significantly associated with lesion volume (p = 0.46) or perilesion resection volume (p = 0.86). CONCLUSIONS The completeness of FCD resection in children is a significant predictor of seizure freedom. Neither lesion volume nor the further resection of perilesional tissue is predictive of seizure freedom.

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Section: Volumetrics and Epileptogenesismentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

The influence of lesion volume, perilesion resection volume, and completeness of resection on seizure outcome after resective epilepsy surgery for cortical dysplasia in children

Oluigbo¹,

Wang²,

Whitehead

et al. 2015

PED

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“…Here, volumes for AIS included only the lesion and not associated areas of ex vacuo ventricular dilatation. PVI volumes were calculated using the relative ventricular asymmetry method whereby the volume of the non-lesioned ventricle is subtracted from lesioned ventricle as described previously (Li et al, 2012).…”

Section: Methodsmentioning

confidence: 99%

Thalamic diaschisis following perinatal stroke is associated with clinical disability

Craig

Carlson

Kirton

2019

NeuroImage: Clinical

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BackgroundPerinatal stroke causes most hemiparetic cerebral palsy and leads to lifelong disability. Understanding developmental neuroplasticity following early stroke is increasingly translated into novel therapies. Diaschisis refers to alterations brain structures remote from, but connected to, stroke lesions. Ipsilesional thalamic diaschisis has been described following adult stroke but has not been investigated in perinatal stroke. We hypothesized that thalamic diaschisis occurs in perinatal stroke and its degree would be inversely correlated with clinical motor function.MethodsPopulation-based, controlled cohort study. Participants were children (<19 years) with unilateral perinatal stroke (arterial ischemic stroke [AIS] or periventricular venous infarction [PVI]), anatomical magnetic resonance imaging (MRI) >6 months of age, symptomatic hemiparetic cerebral palsy, and no additional neurologic disorders. Typically developing controls had comparable age and gender proportions. T1-weighted anatomical scans were parcellated into 99 regions of interest followed by generation of regional volumes. The primary outcome was thalamic volume expressed as ipsilesional (ILTV), contralesional (CLTV) and thalamic ratio (CLTV/ILTV). Standardized clinical motor assessments were correlated with thalamic volume metrics.ResultsFifty-nine participants (12.9 years old ±4.0 years, 46% female) included 20 AIS, 11 PVI, and 28 controls. ILTV was reduced in both AIS and PVI compared to controls (p < .001, p = .029, respectively). Ipsilesional thalamic diaschisis was not associated with clinical motor function. However, CLTV was significantly larger in AIS compared to both controls and PVI (p = .005, p < .001, respectively). CLTV was inversely correlated with all four clinical motor assessments (all p < .003).ConclusionBilateral thalamic volume changes occur after perinatal stroke. Ipsilesional volume loss is not associated with clinical motor function. Contralesional volume is inversely correlated with clinical motor function, suggesting the thalamus is involved in the known developmental plasticity that occurs in the contralesional hemisphere after early unilateral injury.

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“…A single expert made the visual volumetric computer tomography (CT) analyses that were performed using OsiriX imaging software, a Mac‐based multimodality software demonstrated to have minimal bias and high intra‐rater and inter‐rater reliabilities (Li, Hodge, Wei, & Kirton, ; Oluigbo et al., ). The same expert visually checked for the possible involvement of the insular regions.…”

Section: Methodsmentioning

confidence: 99%

Cardiac autonomic dynamics during sleep are lost in patients with TIA and stroke

Tobaldini

Proserpio

Oppo

et al. 2019

Journal of Sleep Research

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Ischaemic stroke is accompanied by important alterations of cardiac autonomic control, which have an impact on stroke outcome. In sleep, cardiac autonomic control oscillates with a predominant sympathetic modulation during REM sleep. We aimed to assess cardiac autonomic control in different sleep stages in patients with ischaemic stroke. Forty‐five patients enrolled in the prospective, multicentre SAS‐CARE study but without significant sleep‐disordered breathing (apnea–hypopnea index < 15/hr) and without atrial fibrillation were included in this analysis. The mean age was 56 years, 68% were male, 76% had a stroke (n = 34, mean National Institutes of Health Stroke Scale [NIHSS] score of 5, 11 involving the insula) and 24% (n = 11) had a transitory ischaemic attack. Cardiac autonomic control was evaluated using three different tools (spectral, symbolic and entropy analysis) according to sleep stages on short segments of 250 beats in all patients. Polysomnographic studies were performed within 7 days and 3 months after the ischaemic event. No significant differences in cardiac autonomic control between sleep stages were observed in the acute phase and after 3 months. Predominant vagal modulation and decreased sympathetic modulation were observed across all sleep stages in ischaemic stroke involving the insula. Patients with ischaemic stroke and transitory ischaemic attack present a loss of cardiac autonomic dynamics during sleep in the first 3 months after the ischaemic event. This change could represent an adaptive phenomenon, protecting the cardiovascular system from the instabilities of autonomic control, or a risk factor for stroke, which precedes the ischaemic event.

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Reduced Ipsilesional Cortical Volumes in Fetal Periventricular Venous Infarction

Cited by 22 publications

References 14 publications

The influence of lesion volume, perilesion resection volume, and completeness of resection on seizure outcome after resective epilepsy surgery for cortical dysplasia in children

The influence of lesion volume, perilesion resection volume, and completeness of resection on seizure outcome after resective epilepsy surgery for cortical dysplasia in children

Thalamic diaschisis following perinatal stroke is associated with clinical disability

Cardiac autonomic dynamics during sleep are lost in patients with TIA and stroke

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