Blood-brain barrier breakdown in brain ischemia: Insights from MRI perfusion imaging.

Brain ischemia is a major cause of neurological dysfunction and mortality worldwide. It occurs not only acutely, such as in acute ischemic stroke (AIS), but also in chronic conditions like cerebral small vessel disease (cSVD). Any other conditions resulting in brain hypoperfusion can also lead to ischemia.

Reliability of post-contrast deep learning-based highly accelerated cardiac cine MRI for the assessment of ventricular function.

Objective: The total examination time can be reduced if high-quality two-dimensional (2D) cine images can be collected post-contrast to minimize non-scanning time prior to late gadolinium-enhanced imaging. This study aimed to assess the equivalency of the pre-and post-contrast performance of 2D deep learning-based highly accelerated cardiac cine (DL cine) imaging by evaluating the image quality and the quantification of biventricular volumes and function in the clinical setting.

Material And Methods: Thirty patients (20 men, mean age 53.

Dorsolateral pontine lesions produce distinct ocular motor abnormalities with anatomical correlations.

Background And Purpose: The dorsolateral portion of the caudal pons contains the vestibular nucleus (VN) and inferior cerebellar peduncle (ICP) that play important roles in conveying and processing vestibular and ocular motor signals. This study aimed to characterize ocular motor abnormalities along with their anatomical correlations in dorsolateral pons (DLP) lesions.

Methods: We analyzed clinical features, and results of neuro-otological evaluations and neuroimaging of 18 patients with unilateral DLP lesions (17 with DLP infarction and 1 with cavernous malformation) from among 506 patients with pontine infarction in a stroke registry.

Benefits of early MR-Imaging in patients with acute spontaneous intracerebral hemorrhage: a retrospective study.

Background: Neuroimaging plays a vital role in the diagnosis of intracerebral hemorrhage (ICH) and in identifying the underlying etiology for appropriate therapeutic approach. This study aims to determine the significance and potential advantages of using early magnetic resonance imaging (MRI) as a diagnostic tool for ICH.

Methods: This retrospective study included 359 patients with ICH treated at the Department of Neurology, Mannheim University Hospital between January 2017 and December 2021.

Effect of IV Thrombolysis With Alteplase in Patients With Vessel Occlusion in the WAKE-UP Trial.

Background And Objectives: Data from randomized trials on the treatment effect of pure thrombolysis in patients with vessel occlusion are lacking. We examined data from a corresponding subsample of patients from the multicenter, randomized, placebo-controlled WAKE-UP trial to determine whether MRI-guided IV thrombolysis with alteplase in unknown-onset ischemic stroke benefits patients presenting with vessel occlusion.

Methods: Patients with an acute ischemic lesion visible on MRI diffusion-weighted imaging but no marked parenchymal hyperintensity on fluid-attenuated inversion recovery images were randomized to treatment with IV alteplase or placebo.

Cerebral Hemodynamic Responses to Disease-Modifying and Curative Sickle Cell Disease Therapies.

Background And Objectives: Sickle cell disease (SCD) is a hemoglobinopathy resulting in hemoglobin-S production, hemolytic anemia, and elevated stroke risk. Treatments include oral hydroxyurea, blood transfusions, and hematopoietic stem cell transplantation (HSCT). Our objective was to evaluate the neurologic relevance of these therapies by characterizing how treatment-induced changes in hemoglobin (Hb) affect brain health biomarkers.

Bilateral thalamic infarction with posterior cerebral artery variant (the arcade artery): A case report.

Rationale: Bilateral thalamic infarction is a rare type of posterior circulation stroke, and it often presents with a reduced level of consciousness in the elderly. Arteriosclerosis is the primary etiology of bilateral thalamic infarction, including conditions such as native vessel stenosis or arterial-to-arterial embolism. Cardiogenic or paradoxical embolism can also lead to thrombosis of the perforator branches innervating the thalamus, and these emboli tend to disintegrate and lead to multiple lesions, even in elderly patients.

Transcranial Cortex-Wide Imaging of Murine Ischemic Perfusion With Large-Field Multifocal Illumination Microscopy.

Background: Ischemic stroke is a common cause of death worldwide and a main cause of morbidity. Presently, laser speckle contrast imaging, x-ray computed tomography, and magnetic resonance imaging are the mainstay for stroke diagnosis and therapeutic monitoring in preclinical studies. These modalities are often limited in terms of their ability to map brain perfusion with sufficient spatial and temporal resolution, thus calling for development of new brain perfusion techniques featuring rapid imaging speed, cost-effectiveness, and ease of use.

Biological brain age and resilience in cognitively unimpaired 70-year-old individuals.

Introduction: This study investigated the associations of brain age gap (BAG)-a biological marker of brain resilience-with life exposures, neuroimaging measures, biological processes, and cognitive function.

Methods: We derived BAG by subtracting predicted brain age from chronological age in 739 septuagenarians without dementia or neurological disorders. Robust linear regression models assessed BAG associations with life exposures, plasma inflammatory and metabolic biomarkers, magnetic resonance imaging, and cerebrospinal fluid biomarkers of neurodegeneration and vascular brain injury, and cognitive performance.

Safety and Efficacy of Intravenous Thrombolysis by Infarct Type in Patients with No Visible Occlusion: A Secondary Analysis of the AcT Trial.

Background: About 25% of patients with acute ischemic stroke have lacunar infarct on follow-up imaging. In this secondary analysis from the AcT (Alteplase Compared With Tenecteplase) trial, we assessed if there is variation in safety or efficacy of intravenous thrombolysis by infarct type in patients with no visible occlusion. We also determined if this effect differed between tenecteplase and alteplase.

Early infarct growth rate is associated with symptomatic intracranial hemorrhage after endovascular thrombectomy.

Background: Time elapsed from stroke onset and baseline infarct volume is influential on endovascular thrombectomy (EVT) outcomes.

Objectives: This study aimed to explore the utility of early infarct growth rate (EIGR) measured by apparent diffusion coefficient (ADC) in predicting symptomatic intracranial hemorrhage (sICH) of ischemic stroke patients after EVT.

Methods: We retrospectively analyzed patients from the prospectively maintained stroke registry admitted between January 2019 and March 2023, presenting with large vessel occlusive stroke in the anterior circulation.

Atherosclerotic plaque evolution predicts cerebral ischemic events in patients with intracranial atherosclerosis: a multicentre longitudinal study using high-resolution MRI.

Background: Intracranial atherosclerosis (ICAS) is the leading cause of ischemic stroke in Asians and the recurrent rate remains high despite the optimal medical treatment. This study aimed to confirm that follow-up high-resolution magnetic resonance imaging (hrMRI) provided essential values in predicting subsequent cerebral ischemic events in patients with ICAS.

Methods: Patients with moderate to severe stenosis in the middle cerebral artery (MCA) defined by magnetic resonance (MRA) or computed tomography angiography (CTA) were recruited from three centers retrospectively.

Cardiac magnetic resonance imaging in repaired tetralogy of Fallot: A longitudinal midterm follow-up study.

Background: Biventricular dysfunction is frequent in patients with repaired tetralogy of Fallot, necessitating routine imaging to monitor for worsening conditions and determine whether procedures like pulmonary valve replacement (PVR) are needed. This study aimed to highlight the parameters of cardiac magnetic resonance imaging (CMR) and their association with adverse outcomes in the midterm follow-up of these patients.

Methods: This longitudinal study recruited all patients with a history of tetralogy of Fallot total correction (TFTC) who had two CMR images at a minimum three-month interval at Rajaie Center from 2007 through 2017.

Association between perforator stroke after middle cerebral artery elective stenting and arterial remodeling patterns: a high-resolution MRI-based retrospective cohort study.

Background: Patterns of arterial remodeling may be associated with outcomes in patients with severe middle cerebral artery (MCA) stenosis after endovascular treatment (EVT). This study aims to investigate the potential correlation between arterial remodeling patterns in patients with severe MCA stenosis, and plaque characteristics and procedure-related perforator stroke (PS).

Methods: Consecutive patients with MCA atherosclerotic disease who underwent EVT at the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2023 were retrospectively enrolled in this study.

Diffusion-derived vessel density (DDVD) for penumbra delineation in brain acute ischemic stroke: initial proof-of-concept results using single NEX DWI.

Neuroimaging is a cornerstone in the diagnosis and treatment decision-making for brain acute ischemic stroke. A rapid and accurate diagnosis is the key, specifically for time-critical reperfusion therapies. Successful reperfusion of salvageable penumbra can reduce the extent of ischemic stroke and thus improve clinical outcomes, whereas reperfusion of irreversibly affected brain tissue is thought to be futile and may result in harm due to the risk of hemorrhagic transformation.

St-RegSeg: an unsupervised registration-based framework for multimodal magnetic resonance imaging stroke lesion segmentation.

Background: Stroke is one of the leading causes of disability and death worldwide. Ischemic stroke accounts for 75-90% of all stroke incidents. Assessing the size and location of the stroke lesion is crucial for treatment decisions, especially those related to urgent vascular reconstruction surgery.

7-Tesla magnetic resonance imaging for monitoring microstructural changes in the lenticulostriate artery-neural complex in patients with hypertension.

Background: The lenticulostriate artery-neural complex (LNC), which includes the lenticulostriate artery (LSA) and surrounding neural structure, is a new concept proposed by neurologists and plays a pivotal role in hypertension-induced stroke. Conventional low-magnitude magnetic resonance imaging (MRI) has not been successfully used to reveal the microstructural changes of the LNC. This study aimed to evaluate the microstructural changes of the LNC in patients with prestroke hypertension using 7-Tesla (7-T) MRI and to identify the potential MRI biomarkers for monitoring hypertension-related neurological disorders.

Correlation between P2-PCA volume flow rate and BOLD cerebrovascular reactivity in patients with symptomatic carotid artery occlusion.

Background And Purpose: Identifying and assessing hemodynamic and flow status in patients with symptomatic internal carotid artery (ICA) occlusion is crucial for evaluating recurrent stroke risk. The aim of this study was to analyze the correlation between two quantitative imaging modalities: (1) blood oxygenation level-dependent (BOLD) cerebrovascular reactivity (CVR) and (2) quantitative magnetic resonance angiography (qMRA) with non-invasive optimal vessel analysis (NOVA), measuring volume flow rate (VFR). Comparing these modalities is relevant for assessing collateral circulation and hemodynamic impairment.

A pair of two atrial myxomas mimic thrombus in left atrial appendage and cause ischemic stroke in a young adult: a case report.

Background: Stroke is one of the leading causes of mortality and disability and can be rarely caused by cardiac myxoma.

Case Summary: Here, we report about a 56-year-old man who suffered from a stroke presented with acute dysarthria and left hemiparesis. Magnetic resonance imaging (MRI) of the brain revealed an acute stroke.

Cortical Hand Knob Stroke: A Case Report of Isolated Hand Weakness and Recovery.

Cortical hand knob stroke is a rare form of stroke that affects the motor cortex responsible for controlling fine hand movements. This condition, most commonly caused by ischemia in the "hand knob" region of the precentral gyrus, can present with isolated hand weakness, often mimicking peripheral neuropathies and leading to diagnostic delays. We report a case of a 65-year-old right-handed woman who experienced a sudden onset of left-hand weakness, along with resolving slurred speech and facial droop, while she was working at her office.

Isolated Shoulder Weakness as a Manifestation of Acute Ischemic Stroke: A Rare Presentation.

There is somatotopic organization of body in motor and sensory cortex of brain. Distal parts of a limb have a much larger area of presentation as compared to proximal parts. So, isolated distal hand muscle weakness as a manifestation of stroke is not so uncommon, but isolated shoulder muscle weakness as a manifestation of stroke is very rare.

Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.

Background: The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque characteristics, microvascular disease, coronary vasomotor tone, and genetic factors. Among chronic coronary disease participants with site-determined moderate or severe ischemia, we investigated associations between ischemia severity on stress testing and the extent of CAD on coronary computed tomography angiography.

Methods: Clinically indicated stress testing included nuclear imaging, echocardiography, cardiac magnetic resonance imaging, or nonimaging exercise tolerance test.

Double strike without stroke: a postpartum headache with too many causes.

Introduction: Pregnancy and postpartum are phases in the women's life where the thrombotic risk is increased both on the venous and on the arterial side.

Methods: We are presenting the case of a young woman at the third pregnancy, carried out without complications until delivery, whose postpartum was characterized by the occurrence of headache. Neuroimaging studies were performed, firstly brain computed tomography (CT) with CT Angiography and after brain Magnetic Resonance Imaging (MRI) with MR Angiography.

Predictive factors for lack of neurological improvement in acute stroke patients without large vessel occlusion treated with low-dose thrombolysis and screened with 3T MRI.

Objective: The study evaluated the lack of neurological improvement and the factors influencing it in patients with acute ischemic stroke (AIS) without major arterial occlusion.

Patients And Methods: A cross-sectional study was conducted on patients diagnosed with acute ischemic stroke without significant occlusion of major arteries, with imaging evidence from 3-tesla magnetic resonance imaging (MRI) scans at the S.I.