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We report the case of a 6-year-old girl with Moyamoya disease and Alagille syndrome (JAGGED1 mutation). She presented left hemiparesis and central left facial paralysis due to an ischemic stroke in the right middle cerebral artery territory. Basal/acetazolamide stress brain perfusion SPECT showed decreased cerebral perfusion and cerebrovascular reserve in all the carotid artery territory, which can be improved by indirect bypass surgery. Ten months after surgery, the child no longer had a stroke, general condition has improved significantly, as has her school performance. Control SPECT showed successful revascularization visualized by significant improvement in cerebral perfusion and cerebrovascular reserve.
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http://dx.doi.org/10.1097/RLU.0000000000005864 | DOI Listing |
Front Neurol
August 2025
Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Introduction: Reperfusion failure (RF) describes a condition in which patients suffering a large vessel occlusion (LVO) stroke present insufficient tissue reperfusion and recovery despite optimal mechanical thrombectomy (MT) results. Approximately 50% of patients suffering from LVO are affected. Our current understanding of the underlying pathomechanisms is limited and mostly based on rodent models.
View Article and Find Full Text PDFCardiovasc Drugs Ther
September 2025
Department of Cardiology of The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
Backgrounds: The management of non-culprit vessels (NCV) among individuals with acute myocardial infarction (AMI) remains an unsolved problem. Angiography-derived physiological assessments developed recently may help address this issue. Our study aims to measure angiography-derived fractional flow reserve (Angio-FFR) and angiography-derived index of microcirculatory resistance (Angio-IMR) in NCVs of AMI patients and explore their prognostic values and necessity.
View Article and Find Full Text PDFNeurosurgery
September 2025
Department of Neurosurgery, CHU Lille, Lille, France.
Background And Objectives: Cerebrovascular reserve (CVR) is a key physiological mechanism allowing the brain to adapt to fluctuating perfusion, particularly relevant in the management of neurovascular disorders such as idiopathic (iMM) and syndromic moyamoya (sMM). Although 99mTc-HMPAO SPECT with acetazolamide is commonly used for CVR assessment, it faces limitations including low spatial resolution, artifacts, and variability in interpretation. This study primarily aims to evaluate a novel, semiautomated, and more objective method for interpreting HMPAO SPECT in CVR assessment.
View Article and Find Full Text PDFAm Heart J
August 2025
Cardiovascular Center Aalst, AZORG, Belgium; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland. Electronic address:
Introduction: Coronary microvascular dysfunction (CMD) is increasingly recognized as an important cause of anginal symptoms and poor outcomes. Angina with non-obstructive coronary arteries (ANOCA) is often related to CMD. While physiological assessment of microcirculatory function by coronary bolus thermodilution is widely practiced, more precise and reproducible methodology as well as systematic assessment are necessary.
View Article and Find Full Text PDFJACC Asia
August 2025
Case Western Reserve University School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA; School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK; Surgical Services, Louis Stokes Veteran Affairs Cleveland, Cleveland, Ohio, USA. Electronic address:
Background: Atherosclerotic cardiovascular disease (ASCVD) disproportionately impacts low-middle income countries, such as those in South Asia and understanding future ASCVD rates can inform public policy.
Objectives: This study aimed to project the burden of ASCVD in South Asia till 2040.
Methods: Yearly ischemic heart disease (IHD), stroke, and peripheral artery disease (PAD) counts for South Asia (Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) and mid-year population were obtained from Global Burden of Disease (1990-2021) in 5-year age brackets (40-79 years) and estimated mid-year national population (2022-2040) was collected.