Search results for " cere"
showing 10 items of 1256 documents
Endothelin-1 concentrations in the internal jugular and azygous veins in multiple sclerosis patients: the results of a pilot study
2014
Objectives: In this pilot study we examined the potent vasoconstrictor, endothelin-1, in the blood of multiple sclerosis patients in the context of chronic cerebrospinal venous insufficiency hypothesis. For this purpose we measured endothelin-1 concentrations in blood samples that were obtained during selective catheterisation of the main veins draining the central nervous system: the internal jugular veins and the azygous vein. Material and methods: We measured endothelin-1 concentrations in peripheral blood in nine multiple sclerosis patients and five healthy controls. In multiple sclerosis patients this peptide was also evaluated in blood samples obtained from the internal jugular veins …
Modelling of the Ischemic Penumbra
1999
What happens to the ischemic penumbra – defined as a territory of critically reduced blood flow in the close neighborhood of an ischemic core – determines outcome after stroke. Currently the pathophysiology of the penumbra is studied predominantly in rat models with occlusion of the middle cerebral artery. Here we propose two other rat models with distinct advantages. One produces a large territory of critical flow reduction in the cortex of one hemisphere without presence of an infarct core: this model is suited to study mediator mechanisms that may transform the penumbra into necrotic tissue. It is produced by occluding one carotid artery and in addition reducing arterial pressure to 50mm…
Chronic cerebrospinal venous insufficiency: current perspectives
2014
This review summarizes the research to date on chronic cerebrospinal venous insufficiency (CCSVI). CCSVI was initially defined as a clinical syndrome comprising stenoses of the internal jugular and/or azygos veins, characterized by collateral venous outflows and reduced cerebral blood flow, and was found primarily in patients with multiple sclerosis. However, the published evidence on CCSVI is very discordant. Catheter venography studies gave a regular picture, with the majority of patients with multiple sclerosis presenting with demonstrable outflow abnormalities in the veins draining the central nervous system. The prevalence of these lesions was over 50%, and even higher (about 90%) when…
Clinical Syndromes, Pathogenesis, and Differential Diagnosis
1991
The temporal sequence of signs and symptoms in patients with cerebral ischemia provides important information for the analysis of underlying pathophysiologic mechanisms and in the search for a major hemodynamic or embolic cause. The signs reported and symptoms assessed are useful for localization of the ischemic region of the brain and identification of the affected vascular territories. Even in the case of a typical clinical picture the clinical findings alone are often insufficient for unequivocal anatomic and pathologic identification, however important they may be in the choice of diagnostic and therapeutic measures. In the first few hours after cerebral ischemia, determining the progno…
An overview of randomized controlled trials on endovascular treatment for chronic cerebrospinal venous insufficiency in multiple sclerosis patients
2020
AbstractAbout ten years ago it was hoped that venous angioplasty for abnormal veins, primarily the internal jugular veins, will be a much awaited treatment for multiple sclerosis. Yet, a majority of randomized clinical trials on endovascular treatment for chronic cerebrospinal venous insufficiency did not reveal clinical efficacy of these procedures in multiple sclerosis patients. Still, a detailed analysis of these trials suggests that they were poorly designed, underpowered and endovascular techniques used were often far from being optimal. Nonetheless, even considering weak points of these trials, it can be concluded that venous angioplasty should not be used as a routine treatment modal…
Potential Involvement of Impaired Venous Outflow from the Brain in Neurodegeneration: Lessons Learned from the Research on Chronic Cerebrospinal Veno…
2019
About 10 years ago, the so-called chronic cerebrospinal venous insufficiency syndrome was discovered. This clinical entity, which is associated with extracranial venous abnormalities that impair venous outflow from the brain, was initially found exclusively in multiple sclerosis patients. Currently, we know that such venous lesions can also be revealed in other neurological pathologies, including Alzheimer’s and Parkinson’s diseases. Although direct causative role of chronic cerebrospinal venous insufficiency in these neurological diseases still remains elusive, in this paper, we suggest that perhaps an abnormal venous drainage of the brain affects functioning of the glymphatic system, whi…
Repair of a spinal pseudomeningocele in a delayed postsurgical cerebrospinal fluid leak using titanium U-clips: Technical note
2020
Abstract Introduction Chronic cerebrospinal fluid leak (CCFL) represents a possible event following spine surgery, with an incidence rate ranging from 5 to 18%. In literature have been reported few modification techniques that involved the use of titanium U-clips with the aim to reduce dural traumatism during its closure but only after non-accidental durotomy. Case illustration We report the case of a 47-year-old female with history of L5-S1 microsurgical discectomy. After one year the patient was admitted to our unit because she presented progressive skin swelling in the lumbar region, intermittent headache and recurrent episodes of lipothymia. One-year MRI showed a voluminous subcutaneous…
Activation of the glymphatic system during sleep – is the cerebral venous outflow a missing piece of the puzzle?
2019
Until recently, mechanisms responsible for an activation of the glymphatic system of the brain, the system which is responsible for cleansing of this organ of waste products, were unclear. A recently published paper has finally shed some light on this problem. It has been demonstrated that there is a temporary decrease of the arterial cerebral blood flow during the deep phase of sleep, which is followed by an influx of the cerebrospinal fluid into the cranial cavity, and that this phenomenon is probably responsible for the activation of the glymphatic system. Although, of as yet, this issue has not been studied, it is likely that such a mechanism is not effective in the settings of disturbe…
Antithrombotic therapy of Cerebral cavernous malformations
2020
Abstract Cavernous malformations are recognized as the most common vascular anomalies in the brain, that often lead to hemorrhage with neurological symptoms. Usually the treatment is surgical removal or stereotactic radiotherapy. We present a case of a slow-flow vascular anomaly located in the cavernous sinus with recurrent partial thrombotic areas. Inspired by treatment of peripheral venous anomalies antithrombotic therapy was initiated instead of surgery or stereotactic radiotherapy. This led to complete spontaneous resolution of the lesion and normalization of symptoms within nine months. The patient never showed any symptoms over a period of eight years while continuing antithrombotic t…
Diagnostic accuracy of Doppler sonography and magnetic resonance venography for the assessmentv of impaired outflow from the internal jugular vein in…
2015
Objectives: This prospective study was aimed at evaluation of diagnostic value of Doppler sonography and magnetic resonance (MR) venography in the internal jugular vein territory. Material and methods: There were assessed 126 patients (252 internal jugular veins). The patients were initially diagnosed using Doppler sonography and MR venography, and then catheter venography of the veins was performed. For the purpose of this study catheter venography was regarded the reference test. We interpreted sonographic findings in the context of criteria proposed by Zamboni and criteria by International Society for Neurovascular Disease (ISNVD). We applied MR protocols aimed at flow assessment in the …