Stroke; a journal of cerebral circulation
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Aging and vascular risk factors contribute to arterial stiffening. Increased arterial stiffness exposes the small vessels in the brain to abnormal flow pulsations and, as such, may contribute to the pathogenesis of cerebral small vessel disease. In a population-based study, we investigated the association between arterial stiffness, as measured by aortic pulse wave velocity (aPWV), and small vessel disease. ⋯ In our study, increased arterial stiffness is associated with a larger volume of white matter lesions.
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Poststroke pneumonia is a potentially preventable complication after stroke associated with poor outcome. We developed and externally validated a prognostic score for predicting risk of pneumonia after ischemic stroke. ⋯ The A(2)DS(2) score is a valid tool for predicting poststroke pneumonia based on routinely available data. A(2)DS(2) might be useful for guiding monitoring of high-risk patients or prophylactic pneumonia management in clinical routine.
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We explored the association between pulsatility index (PI) as derived from transcranial Doppler ultrasound with various measures of small vessel disease in the community. ⋯ PI correlates with WML severity. With a high negative predictive value, the chance of having severe WML with a normal PI is low. Transcranial Doppler may guide selective magnetic resonance imaging scanning for the detection of WML in the community.
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The purpose of this study was to define the risk of rebleeding after stereotactic radiosurgery (SRS) for hemorrhagic arteriovenous malformations with or without associated intracranial aneurysms. ⋯ When an aneurysm is identified in patients with arteriovenous malformations selected for SRS, additional endovascular or surgical strategies should be considered to reduce the risk of bleeding during the latency interval.
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MRI can be used to assess structural damage to the brain after aneurysmal subarachnoid hemorrhage. We tuned, validated, and applied k-Nearest Neighbor-based segmentation to quantify cerebral volumes on MRI 6 months after aneurysmal subarachnoid hemorrhage. ⋯ k-Nearest Neighbor-based segmentation provides accurate cerebral volume measurements after aneurysmal subarachnoid hemorrhage. In this proof-of-principle study of this volumetric technique, we demonstrated volume changes relative to controls, which correlated with functional outcome.