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Ischaemic Lesions (ischaemic + lesion)

Distribution by Scientific Domains

Medical Sciences	90%

Selected Abstracts

Overexpression of APP provides neuroprotection in the absence of functional benefit following middle cerebral artery occlusion in rats

EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 7 2007
Jared Clarke
Abstract Cerebral ischaemia leads to a transient accumulation of ,-amyloid precursor protein (APP) and ,-amyloid (A,) peptides adjacent to the ischaemic lesion. There is conflicting evidence that APP/A, fragments may either enhance neuronal plasticity or be neurotoxic. The aim of the current study was to assess the effect of overexpression of human APP in rats on functional recovery following cerebral ischaemia. Adult APP-overexpressing (hAPP695 Tg) rats subjected to transient middle cerebral artery occlusion (MCAO) had significantly smaller infarct volumes than non-transgenic littermates, yet did not perform better on a series of sensorimotor or learning tests during a 6-month follow-up period. In fact, transgenic animals were found to be significantly more impaired in both the beam-walking and Morris water maze tests following MCAO. Immunohistochemistry showed human A,-positive staining in the cortex and hippocampus of APP transgenic rats. The present data suggest that while overexpression of APP in rats may provide some histological neuroprotection in the event of cerebral ischaemia, this does not translate into significant functional recovery. [source]

Arterial structural and functional alterations in uraemia

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2005
A. P. Guérin
Abstract Epidemiological and clinical studies have shown that cardiovascular disease in patients with end-stage renal disease (ESRD) is frequently related to damage of large conduit arteries. Arterial disease is responsible for the high incidence of ischaemic heart disease, peripheral artery diseases, left ventricular hypertrophy and congestive heart failure. The vascular complications in ESRD are ascribed to two different but associated mechanisms, namely atherosclerosis and arteriosclerosis. Whereas the former principally affects the conduit function with ischaemic lesions being the most characteristic consequence, the latter primarily disturbs the dampening function of large arteries. Arteriosclerosis in ESRD patients is characterized by diffuse dilation and wall hypertrophy of large conduit arteries and stiffening of arterial walls. These changes represent a clinical form of an accelerated ageing process. The main clinical characteristics due to arterial stiffening are isolated increase in systolic blood pressure with normal or lower diastolic pressure resulting in an increased pulse pressure. The consequences of these alterations are: (i) an increased left ventricular afterload with development of left ventricular hypertrophy and increased myocardial oxygen demand; and (ii) altered coronary perfusion and subendocardial blood flow distribution. Epidemiological studies have identified arterial remodelling and stiffening as independent predictors of overall and cardiac mortality in ESRD patients. [source]

Cardiological diagnostic work-up in stroke patients , a comprehensive study of test results and therapeutic implications

EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2009
B. Schaer
Background and purpose:, In some Western countries, many stroke patients undergo routine tests including ECG, echocardiography, carotid ultrasound and Holter monitoring, even though they have been shown to express limited value in unselected patients. Comprehensive data on yield of tests, especially on consequences taken from positive test results, are scanty. Methods:, Consecutive stroke patients with evidence of ischaemic lesions by imaging techniques were included. Aetiology was determined using TOAST-classifications. Rates of positive test results and their impact on drug therapy, especially anticoagulation were evaluated. Results:, Two hundred and forty-one consecutive patients, age 69 ± 13 years were included. Positive test results were documented in 19% with 12-lead ECG, 24% with carotid ultrasound, 24% with echocardiography and never with Holter monitoring. Overall, in 41% positive test results were present. Apart from echocardiography (37%), a change of therapy resulted in 51,56% of patients with a positive test result. Conclusions:, Even though 12-lead ECG, carotid ultrasound and echocardiography only had relatively low incidences of positive findings, their impact on management in case of positive test results was quite high. Nevertheless, future studies to select patients more appropriately are needed. In contrast, Holter monitoring had no impact and should not be used in routine evaluation of stroke patients. [source]

Severity of cerebral white matter lesions and infarcts in patients with transient or moderately disabling cerebral ischaemia: reproducibility of grading by neurologists

EUROPEAN JOURNAL OF NEUROLOGY, Issue 8 2006
E. L. L. M. De Schryver
Diffuse or multifocal ischaemic white matter lesions increase the risk of intracranial haemorrhage in patients using oral anticoagulants for secondary prevention after cerebral ischaemia of arterial origin. We studied whether neurologists could reliably assess the presence of these white matter abnormalities. As part of the European/Australian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT), the severity of white matter lesions and presence of ischaemic lesions were twice assessed in a consensus meeting of three neurologists (from a pool of nine) as absent, moderate or severe, in a sample of 126 randomly selected CT or MRI scans. The neurologists were not aware of the duplicate grading. The degree of agreement between the first and second observation was calculated with kappa statistics. The kappa value for agreement between the first and second assessment of white matter lesions was 0.58 (95% CI 0.40,0.76). The kappa value for the presence of clinically relevant and/or irrelevant ischaemic lesions was 0.68 (95% CI 0.58,0.78). Clinicians can assess the presence of white matter lesions with sufficient reliability. Such assessment may prevent unnecessary risk with oral anticoagulation in secondary prevention after cerebral ischaemia of arterial origin, of which the efficacy is currently being assessed in ESPRIT. [source]

Lacunar thalamic stroke proclivity for falls

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2004
Nages Nagaratnam
Summary Small ischaemic lesions strategically placed could give rise to specific clinical manifestations depending on the location and size of the lesion. We present the case of five patients with imbalance and falls with no other neurological findings. The computed tomographic scan showed a lacunar infarct in the right or left thalamus. The tendency to fall may complicate rehabilitation. The possible physiological mechanisms are discussed. [source]

Altered sexual preference and behaviour in a man with vascular ischaemic lesions in the temporal lobe

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2002
Marese Cheasty
No abstract is available for this article. [source]

Molecular neuropathology of MELAS: level of heteroplasmy in individual neurones and evidence of extensive vascular involvement

NEUROPATHOLOGY & APPLIED NEUROBIOLOGY, Issue 4 2006
J. Betts
Mitochondrial DNA (mtDNA) disease is an important genetic cause of neurological disability. A variety of different clinical features are observed and one of the most common phenotypes is MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis and Stroke-like episodes). The majority of patients with MELAS have the 3243A>G mtDNA mutation. The neuropathology is dominated by multifocal infarct-like lesions in the posterior cortex, thought to underlie the stroke-like episodes seen in patients. To investigate the relationship between mtDNA mutation load, mitochondrial dysfunction and neuropathological features in MELAS, we studied individual neurones from several brain regions of two individuals with the 3243A>G mutation using dual cytochrome c oxidase (COX) and succinate dehydrogenase (SDH) histochemistry, and Polymerase Chain Reaction Restriction Fragment Lenght Polymorphism (PCR-RFLP) analysis. We found a low number of COX-deficient neurones in all brain regions. There appeared to be no correlation between the threshold level for the 3243A>G mutation to cause COX deficiency within single neurones and the degree of pathology in affected brain regions. The most severe COX deficiency associated with the highest proportion of mutated mtDNA was present in the walls of the leptomeningeal and cortical blood vessels in all brain regions. We conclude that vascular mitochondrial dysfunction is important in the pathogenesis of the stroke-like episodes in MELAS patients. As migraine is a commonly encountered feature in MELAS, we propose that coupling of the vascular mitochondrial dysfunction with cortical spreading depression (CSD) might underlie the selective distribution of ischaemic lesions in the posterior cortex in these patients. [source]

Diffusion-weighted MRI measurements on stroke patients reveal water-exchange mechanisms in sub-acute ischaemic lesions

NMR IN BIOMEDICINE, Issue 6 2009
J. Lätt
Abstract The aim of this study was to investigate the diffusion time dependence of signal- versus - b curves obtained from diffusion-weighted magnetic resonance imaging (DW-MRI) of sub-acute ischaemic lesions in stroke patients. In this case series study, 16 patients with sub-acute ischaemic stroke were examined with DW-MRI using two different diffusion times (60 and 260,ms). Nine of these patients showed sufficiently large lesions without artefacts to merit further analysis. The signal- versus - b curves from the lesions were plotted and analysed using a two-compartment model including compartmental exchange. To validate the model and to aid the interpretation of the estimated model parameters, Monte Carlo simulations were performed. In eight cases, the plotted signal- versus - b curves, obtained from the lesions, showed a signal,curve split-up when data for the two diffusion times were compared, revealing effects of compartmental water exchange. For one of the patients, parametric maps were generated based on the extracted model parameters. These novel observations suggest that water exchange between different water pools is measurable and thus potentially useful for clinical assessment. The information can improve the understanding of the relationship between the DW-MRI signal intensity and the microstructural properties of the lesions. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Diffusion tensor imaging in spinal cord: methods and applications , a review

NMR IN BIOMEDICINE, Issue 7-8 2002
Chris A. Clark
Abstract The spinal cord is a clinically eloquent site within the central nervous system, containing important sensorimotor tracts confined within a small cross-sectional area. Damage to the spinal cord may be caused by a wide range of pathologies, and can result in profound functional disability. Characterization of the structural integrity of the spinal cord can be assessed using diffusion tensor imaging methods. Development and application of this technique may improve our understanding of the nature and evolution of structural damage in spinal cord disease. Possible developments include improved detection of ischaemic lesions, clarification of the relationship between clinical disability and structural damage to the cord and monitoring of anti-inflammatory or neuroprotective therapies. In this review current technical aspects, clinical applications and the suggested future development of spinal cord diffusion imaging are discussed. Copyright © 2002 John Wiley & Sons, Ltd. [source]