Relationship between Vertebral Artery Hypoplasia and Posterior Circulation Ischemia

Fejér

Journal of Neuroimaging

et al. 2017

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vertebral Artery Diameter and Flow: Nature or Nurture

Fejér

Journal of Neuroimaging

et al. 2017

“…(4) Arterial dissection was determined when the patient presented with concurrent neck or occipital pain and typical imaging features such as pearl and string sign, tapered stenosis or occlusion, intimal flap, double lumen, fusiform aneurysm, or intramural hematoma. VA hypoplasia detected by carotid ultrasound and/or MRA were defined if an asymmetry ratio of ≤ 1:1.7 of both VAs ( 26 ) and/or VA diameter ≤ 2.5 mm ( 27 ) was present.…”

Section: Methodsmentioning

confidence: 99%

Lesion Topography and Its Correlation With Etiology in Medullary Infarction: Analysis From a Multi-Center Stroke Study in China

et al. 2018

Objectives: The lesion topography of medullary infarction (MI) is heterogeneous and its correlation with stroke etiology remains elusive. We aim to clarify the lesion pattern of MI and to assess its correlation with stroke etiology.Material and Methods: Of 1129 subjects with available DWI in SMART study (a multi-center trial concerning secondary stroke prevention in China) between April 2008 and December 2010, 43 patients with DWI confirmed MI (3.8%) were retrospectively evaluated. Lesions were categorized as lateral and medial medullary infarction (LMI and MMI, 33 and 10 subjects respectively) at 3 levels rostro-caudally and correlated with the stroke etiology. Clinical profiles and long-term prognosis were analyzed.Results: Large artery atherosclerosis, small vessel occlusion, cardiogenic embolism and artery dissection accounted for 29, 11, 1, and 2 infarcts, respectively. Large artery disease was the most common cause in LMI (24 of 33, 72.7%) whereas small vessel occlusion was not uncommon in MMI (5 of 10, 50.0%). Though the difference of infarct pattern between large artery atherosclerosis and small vessel occlusion was insignificant, two distinct lesion patterns were considered to be relevant: (1) Rostral MMI with continuous medial pontine infarctions were more likely attributed to small vessel occlusion than large artery atherosclerosis. Kameda et al. (2) MMI with ventral to dorsal extension were more often caused by large artery disease than small vessel occlusion. Median NIHSS at admission was 4. During a median follow-up of 17 months, 2 patients died and 2 experienced recurrent ischemic events, 39 of 41 subjects (95.1%) were functional independent (mRS 0–2).Conclusions: This multi-center study demonstrates that MI has distinct lesion pattern depending on various stroke etiologies and mechanisms. Future investigations with larger sample size should establish the lesion pattern of MI and validate its correlation with the stroke etiology and mechanisms, which might improve stroke management.

“…In these patients, the median length and width of the LSA ostium were 13 mm (range 10-20) and 15 mm (range 11-24), respectively ( Table 1). The median aortic diameter proximal to the LSA was 31 mm (range [26][27][28][29][30][31][32][33][34][35][36][37]. The median distance between the LSA and LCCA was 10 mm (range 5-18).…”

Section: Resultsmentioning

confidence: 99%

A Feasibility Study of Off-the-Shelf Scalloped Stent-Grafts in Acute Type B Aortic Dissection

et al. 2017

In this single-center imaging-based study, involvement of the LSA in the setting of acute type B aortic dissection was seen in 80% of patients treated with TEVAR. Three off-the-shelf stent-grafts would suffice to treat one-third of these acute type B aortic dissections and may offer a relatively simple solution to preserve LSA flow, thereby lowering the risk of malperfusion of the (posterior) cerebrum, spinal cord, and left arm in an urgent/emergent setting.