Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0220723 (PCA)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We experienced a case of successful acute revascularization using a long vein graft. A 68-year-old man was admitted to our department due to transient ischemic attack of the left hemiparesis. CT scan showed no infarction, but PAO-SPECT revealed moderate hypoperfusion in the right ACA and MCA area. Cerebral angiography demonstrated right IC occlusion at its origin and moderate collateral circulation via leptomeningeal anastomosis from the PCA area, and via the external carotid system, especially directly from STA. But the STA was very narrow. Three days after admission, left hemiparesis appeared again and deteriorated severely. This time the hemiparesis persisted. Although MRI demonstrated little infarction in the right frontal lobe, we decided to carry out revascularization on the same day. Right saphenous vein was harvested for a graft because of the narrow STA. The facial artery and angular artery was selected as a donor and a recipient respectively, to avoid a clamp of the EC and a craniotomy of the STA running area. Finally we performed a facial artery-vein graft-angular artery (M4) bypass. The patient showed no complication and the left hemiparesis improved enough to allow the patient to walk by himself. Revascularization using vein graft is dangerous for acute ischemia due to the possibility of a complication such as brain edema and hemorrhagic infarction. The usual style of vein graft bypass is an EC-vein graft-M2 or M3 bypass. Using this style, high pressure inside the EC is carried intracranially.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[A case of successful acute revascularization using a long vein graft]. 775 28

The aim of the study was to evaluate the diagnostic potential of galactose-based microbubble suspension (Levovist) in patients with acute cerebrovascular disease and inadequate transtemporal acoustic window, when examined by transcranial Doppler (TCD). We studied 10 patients with either transient ischemic attack (no. = 3) or stroke (no. = 7). Inadequate transtemporal acoustic window was unilateral in 3 patients and bilateral in the remaining 7 patients. Signals from middle, anterior, and posterior cerebral arteries (MCA, ACA, PCA) were recorded after injecting Levovist 300 mg/ml. Six patients needed 3 injections of Levovist, 1 patient two, and 3 patients one. Mean +/- SD duration of optimal signal enhancement was 175.2 +/- 53.2 s, range 70-290 s. Doppler waveform analysis was possible in 14 (82.3%) MCA, 11 (65%) ACA, and 9 (53%) PCA. Levovist improved the reliability of TCD in patients with acute cerebrovascular disease and insufficient transtemporal insonation.
 ...
PMID:Contrast-enhanced transcranial Doppler sonography in patients with acute cerebrovascular diseases. 1139 66

Spontaneous intracranial artery dissection (SIAD), leading to occlusion or stenosis of arterial lumen is a frequent but less studied cause of ischemic stroke especially in young adults. We studied 17 patients (10 men, 7 women, mean age 27.5 +/- 8.5 years) with SIAD. All the patients have undergone magnetic resonance imaging of the head, magnetic resonance angiography (MRA) (in 16 patients--follow-up MRA), 1 patient--conventional cerebral angiography. SIAD was located in the middle cerebral artery (MCA, 14 patients); posterior cerebral artery (PCA, 2 patients) and basilar artery (BA, 1 patient). Fifteen patients (88%) with SIAD developed ischemic stroke, 2 patients (12%)--a transient ischemic attack (TIA). The appearance of the local brain ischemia symptoms was combined with headache in 93% cases. The course of ischemic stroke was favorable in most cases with complete or good functional recovery in 66% of patients. A fatal outcome was observed in 1 patient (7%) with massive brain infarct. The initial cerebral angiography carried out in most cases (76%) within 3 weeks after the disease onset revealed occlusion (71%) or stenosis (29%) of corresponding cerebral arteries (MCA, PCA, BA). The last cerebral angiography conducted in 90% cases 4,5 months or later showed positive dynamics--appearance or improvement of the blood flow in these arteries--in 82% patients. The factors provoking SIAD were alcohol, contraceptive drugs and less frequent recent infection. None of patients had atherosclerosis, vasculitis or arterial hypertension. Clinical manifestations of connective tissue weakness were in 71% of patients, hypotension--65%, mitral valve prolapse--46%. In conclusion, SIAD is one of the causes of ischemic stroke and TIA in young adults and characteristic clinical manifestations and follow-up MRA have a great diagnostic importance. The development of SIAD appears to be related to weakness of connective tissue of arterial wall.
 ...
PMID:[Spontaneous intramural intracranial artery dissection and ischemic stroke]. 1819 22

We reviewed the clinical prognosis and therapeutic aspects in the management of pediatric moyamoya disease from our data base for the last 8 years since establishment of our institution. We found 99 cerebrovascular disease cases among the total of 1,159 cases, and 20 out of them were moyamoya disease. Only 13 cases were analyzed as the rest were not available for follow up. Nine girls and 4 boys were admitted with an average age of 5 years-old 4 months. Initial symptom were TIA in 5, cerebral infarction in 5, migraine in 2, and epilepsy in one. The type of moyamoya disease was bilateral type in 10 cases, and unilateral type in 3 cases. Clinical condition and investigations, as well as the effect of conservative management, required surgery in 9 cases (8 indirect revascularization and one direct-bypass surgery), and the rest 4 cases were managed conservatively. Only 10 cases were followed-up, 9 operated cases and one conservatively managed case. In 6 of 9 of the operated cases, there was recurrence: cerebral infarction in 3, TIA recurrence in 2 and epileptic seizure in one. On MRA a steno-occlusive lesion of PCA was found in 4 of the 6 recurrence patients, and improvement was achieved by additional surgery in one of them. All of the cases developed good postoperative collateral circulation. The conservatively treated patient did not show neither steno-occlusive lesion of PCA, nor a clinical recurrence for 7 years observation. Therefore, posterior circulation system in moyamoya disease is important as a collateral circulation in addition to the revascularization procedures, and we believe that the progression of the steno-occlusive lesion of PCA is an important indicator, predicting recurrence.
 ...
PMID:[Clinical prognosis and therapeutic aspects in management of pediatric moyamoya disease]. 2007 89