scholarly journals Doppler Impedance Changes at the Fetal Brain Vessels in a Pregnancy Affected with a Multiple Combination of Uteroplacental Anomalies

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
José Morales-Roselló ◽  
Núria Peralta Llorens
Keyword(s):  
Cerebral Arteries ◽  
Fetal Brain ◽  
Vascular Changes ◽  
Cervical Dilation ◽  
Brain Vessels ◽  
Short Cervix ◽  
Vaginal Progesterone ◽  
Middle Cerebral Arteries ◽  
Unknown Reason ◽  
Umbilical Cord Insertion

A fetus with a very rare five-fold combination of uteroplacental anomalies, bicornuate uterus, short cervix with cervical incompetence, multilobed placenta succenturiata, accessory cotyledon within the cervical funneling, and umbilical cord insertion into the anomalous cervical cotyledon, presented an early and marked decrease at the vertebral and middle cerebral arteries Doppler resistances. This cerebral low-impedance state, usually found before labor, and considered an adaptive mechanism developed to protect the fetus at term from labor asphyxia, was present for an unknown reason at 20 weeks. After the patient was treated with vaginal progesterone, the cervix shortening improved and markedly, at the same time, the cerebral vascular resistances increased and maintained an adequate for gestational age impedance until delivery at 34 weeks. As the described uteroplacental anomalies determined a high risk of preterm delivery, due to cervical dilation, cord compresion, and placental haemorrhage, these fluctuating brain vascular changes might be the result of the fetal adaptation to the changes preceding an imminent delivery.

Pathomorphological examination of hippocampus in the persons of the second period of mature age with cerebral atherosclerosis

10.12737/5023 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-6
Author(s):  
Горелик ◽  
E. Gorelik
Keyword(s):  
Cerebral Arteries ◽  
Middle Part ◽  
Brain Vessels ◽  
Cerebral Arteriosclerosis ◽  
Middle Cerebral Arteries ◽  
Left Hippocampus ◽  
Subsequent Calculation ◽  
The Right ◽  
Second Period ◽  
The Brain

The purpose of this research is to study the morphology of the hippocampus in the patients with cerebro-vascular disease with age, sex and somatic types. The study was conducted from autopsy material. The hippocampus male (n=20) and female (n=15) of the patients of the second period of mature age were taken for study. Pathological and anatomical examination showed that all dead people had pathology of brain vessels. Changes specific to the 1 and 2 stages of atherosclerosis were detected in the basilar and middle cerebral arteries. Somatotype was defined with the subsequent calculation of the index by the method of Rees-Eysenck. The morphometric research of right and left hippocampus of the brain has been conducted. The parameters of the hippocampus with the sex were determined. There are presented the results of quantitative and qualitative morphological study of the hippocampus in persons of the second period of adulthood with cerebral arteriosclerosis in various somatotypes. The comparative analysis, of morphometric parameters of the hippocampus of the right and left hemispheres of the human brain, showed, that most significant are the length of the hippocampus width of middle part and width region of legs. On microscopic examination of the hippocampus, the individuals of the second period of mature age, even at the early stages of atherosclerosis of cerebral arteries, are detected dystrophic changes of neurons in the CA1 and CA3 regions, showing their ischemic damage.

Cerebral vascular changes associated with hemorrhagic stroke in hypertension

1992 ◽  
Vol 70 (4) ◽  
pp. 552-564 ◽  
Author(s):  
John S. Smeda
Keyword(s):  
Blood Flow ◽  
Hemorrhagic Stroke ◽  
Cerebral Arteries ◽  
Cerebral Vasculature ◽  
Vascular Changes ◽  
Hypertensive Rats ◽  
Spontaneously Hypertensive ◽  
Upper Limit ◽  
Middle Cerebral Arteries ◽  
Wistar Kyoto

There are a number of alterations that protect the cerebrovasculature from hemorrhagic stroke development during hypertension. The upper limit of cerebral blood flow autoregulation is shifted to higher blood pressure levels; this allows a constant blood flow to be maintained during hypertension. Studies we have performed have indicated that the middle cerebral arteries (MCA) of Wistar–Kyoto stroke-prone spontaneously hypertensive rats (spSHR) lose their ability to constrict in response to elevations in transmural pressure. The decline in such function precedes stroke development and totally disappears at an age where there is a 100% mortality from stroke. Prior to stroke development, spSHR also develop uremic conditions and signs of renal failure. The induction of uremia in stroke-resistant SHR (srSHR) via nephrectomy induces these animals to develop stroke. Like prestroke spSHR, prestroke uremic srSHR also have MCA with attenuated pressure-dependent myogenic function. It is hypothesized that the inability to increase vascular resistance in response to elevations in pressure might promote overperfusion of the more distal vasculature leading to cerebral hemorrhage formation. Since uremia promotes bleeding tendencies, such alterations along with the loss of cerebrovascular myogenic function could initiate or aggrevate hemorrhage formation.Key words: stroke-prone SHR, stroke, cerebral vasculature, myogenic response, autoregulation.

DIFFICULTIES IN DIAGNOSING MOYA-MOYA DISEASE (CLINICAL CASE)

2020 ◽  
pp. 48-53
Author(s):  
Novikova I.N. ◽  
Popova T.F. ◽  
Gribacheva I.A. ◽  
Petrova E.V. ◽  
Marushchak A.A. ◽  
...  
Keyword(s):  
Cerebral Angiography ◽  
Neurological Disorders ◽  
Clinical Case ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Moya Moya Disease ◽  
Middle Cerebral Arteries ◽  
Internal Carotid Arteries ◽  
Made In

Moya-Moya disease is a rare progressive chronic cer-ebrovascular disease characterized by a narrowing of the lumen of the intracranial segments of the internal carotid arteries, as well as the initial segments of the anterior and middle cerebral arteries with the devel-opment of a network of small vascular anastomoses. Violations of blood supply due to occlusion lead to the development of ischemic strokes in the correspond-ing pools, and ruptures of vascular anastomoses - to the development of hemorrhagic strokes, causing a variety of neurological disorders. The article presents a clinical case of Moya-Moya disease in a 31-year-old patient. The disease was manifested by acute disorders of cerebral circulation in ischemic and hemorrhagic types. The diagnosis was made in accordance with the diagnostic criteria of the disease based on the data of endovascular cerebral angiography.

Modulation of cerebral arterial tone by endothelium-derived relaxing factor

1993 ◽  
Vol 264 (4) ◽  
pp. H1245-H1250 ◽  
Author(s):  
J. E. Brian ◽  
R. H. Kennedy
Keyword(s):  
Nitric Oxide ◽  
Muscle Tone ◽  
Cerebral Arteries ◽  
Maximum Tension ◽  
Relaxing Factor ◽  
Middle Cerebral Arteries ◽  
Endothelium Derived Relaxing Factor ◽  
Vascular Smooth Muscle Tone ◽  
Dose Dependent ◽  
Arterial Tone

This study was designed to further elucidate the role of the endothelium in regulation of cerebral vascular smooth muscle tone. Dose-dependent vasoconstrictive effects of serotonin (5-HT) were examined in endothelium-intact and endothelium-denuded ring segments prepared from canine basilar and middle cerebral arteries. Some preparations were pretreated with 10(-5) M N omega-nitro-L-arginine (L-NNA), an agent that inhibits the production of L-arginine-derived nitric oxide, one of the compounds proposed to be endothelium-derived relaxing factor. L-NNA alone elicited marked dose-dependent increases in tension in endothelium-intact preparations; a significantly smaller response was seen in endothelium-denuded preparations. The effects of L-NNA on endothelium-intact preparations were partially reversed by washing and treatment with L-arginine. The maximum tension induced by 5-HT was approximately doubled by removal of the endothelium as well as by L-NNA treatment of endothelium-intact preparations; a slight increase in maximum tension occurred in endothelium-denuded preparations treated with L-NNA. The concentration of 5-HT producing half-maximal contraction (ED50) was not affected by L-NNA. These data suggest that L-arginine-derived nitric oxide modulates canine cerebral arterial tone in both the resting state and during contraction with 5-HT.

scholarly journals Cerebral Hemodynamics and Intracranial Compliance Impairment in Critically Ill COVID-19 Patients: A Pilot Study

2021 ◽  
Vol 11 (7) ◽  
pp. 874
Author(s):  
Sérgio Brasil ◽  
Fabio Silvio Taccone ◽  
Sâmia Yasin Wahys ◽  
Bruno Martins Tomazini ◽  
Filippo Annoni ◽  
...  
Keyword(s):  
Critically Ill ◽  
Cerebral Arteries ◽  
Receiver Operating Curve ◽  
Severe Illness ◽  
Mean Flow ◽  
Non Invasive ◽  
Intracranial Compliance ◽  
Middle Cerebral Arteries ◽  
Primary Composite Outcome ◽  
Cerebrovascular Hemodynamics

Introduction: One of the possible mechanisms by which the new coronavirus (SARS-Cov2) could induce brain damage is the impairment of cerebrovascular hemodynamics (CVH) and intracranial compliance (ICC) due to the elevation of intracranial pressure (ICP). The main objective of this study was to assess the presence of CVH and ICC alterations in patients with COVID-19 and evaluate their association with short-term clinical outcomes. Methods: Fifty consecutive critically ill COVID-19 patients were studied with transcranial Doppler (TCD) and non-invasive monitoring of ICC. Subjects were included upon ICU admission; CVH was evaluated using mean flow velocities in the middle cerebral arteries (mCBFV), pulsatility index (PI), and estimated cerebral perfusion pressure (eCPP), while ICC was assessed by using the P2/P1 ratio of the non-invasive ICP curve. A CVH/ICC score was computed using all these variables. The primary composite outcome was unsuccessful in weaning from respiratory support or death on day 7 (defined as UO). Results: At the first assessment (n = 50), only the P2/P1 ratio (median 1.20 [IQRs 1.00–1.28] vs. 1.00 [0.88–1.16]; p = 0.03) and eICP (14 [11–25] vs. 11 [7–15] mmHg; p = 0.01) were significantly higher among patients with an unfavorable outcome (UO) than others. Patients with UO had a significantly higher CVH/ICC score (9 [8–12] vs. 6 [5–7]; p < 0.001) than those with a favorable outcome; the area under the receiver operating curve (AUROC) for CVH/ICC score to predict UO was 0.86 (95% CIs 0.75–0.97); a score > 8.5 had 63 (46–77)% sensitivity and 87 (62–97)% specificity to predict UO. For those patients undergoing a second assessment (n = 29), after a median of 11 (5–31) days, all measured variables were similar between the two time-points. No differences in the measured variables between ICU non-survivors (n = 30) and survivors were observed. Conclusions: ICC impairment and CVH disturbances are often present in COVID-19 severe illness and could accurately predict an early poor outcome.

scholarly journals Contractile and Endothelium-Dependent Dilatory Responses of Cerebral Arteries at Various Extracellular Magnesium Concentrations

1991 ◽  
Vol 11 (1) ◽  
pp. 161-164 ◽  
Author(s):  
Mária Faragó ◽  
Csaba Szabó ◽  
Eörs Dóra ◽  
Ildikó Horváth ◽  
Arisztid G. B. Kovách
Keyword(s):  
Smooth Muscle ◽  
Vascular Reactivity ◽  
Calcium Influx ◽  
Cerebral Arteries ◽  
Inhibitory Effect ◽  
Contractile Responses ◽  
Middle Cerebral Arteries ◽  
The Right ◽  
Endothelial Receptor

To clarify the effect of extracellular magnesium (Mg2+) on the vascular reactivity of feline isolated middle cerebral arteries, the effects of slight alterations in the Mg2+ concentration on the contractile and endothelium-dependent dilatory responses were investigated in vitro. The contractions, induced by 10−8-10−5 M norepinephrine, were significantly potentiated at low Mg2+ (0.8 m M v. the normal, 1.2 m M). High (1.6 and 2.0 m M) Mg2+ exhibited an inhibitory effect on the contractile responses. No significant changes, however, in the EC50 values for norepinephrine were found. The endothelium-dependent relaxations induced by 108–10−5 M acetylcholine were inhibited by high (1.6 and 2.0 m M) Mg2+. Lowering of the Mg2+ concentration to 0.8 m M or total withdrawal of this ion from the medium failed to alter the dilatory potency of acetylcholine. The changes in the dilatory responses also shifted the EC50 values for acetylcholine to the right. The present results show that the contractile responses of the cerebral arteries are extremely susceptible to the changes of Mg2+ concentrations. In response to contractile and endothelium-dependent dilatory agonists, Mg2+ probably affects both the calcium influx into the endothelial and smooth muscle cells as well as the binding of acetylcholine to its endothelial receptor. Since Mg2+ deficiency might facilitate the contractile but not the endothelium-dependent relaxant responses, the present study supports a role for Mg2+ deficiency in the development of the cerebral vasospasm.

Carotid-Cavernous Fistula Treated with Detachable Balloon during Bilateral Transcranial Doppler Monitoring of Middle Cerebral Arteries

1992 ◽  
Vol 33 (2) ◽  
pp. 145-148 ◽  
Author(s):  
P. H. Nakstad ◽  
J. K. Hald ◽  
W. Sorteberg
Keyword(s):  
Carotid Artery ◽  
Transcranial Doppler ◽  
Cerebral Arteries ◽  
Carotid Cavernous Fistula ◽  
Detachable Balloon ◽  
Cavernous Fistula ◽  
Doppler Technique ◽  
Middle Cerebral Arteries

A traumatic carotid-cavernous fistula was closed with a silicone detachable balloon. Prior to the closure of the fistula, clinical and transcranial Doppler testing was performed in order to evaluate the consequences of a possible occlusion of the carotid artery. A newly developed Doppler technique with bilateral simultaneous velocity recordings of the middle cerebral arteries was useful during the procedure. The detachable balloon was effective in closing the fistula, but collapse of the balloon and the development of an extradural aneurysm was found at control examinations.

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