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2. ARTERIAL STIFFNESS AS A RISK FACTOR FOR CEREBRAL VASCULAR LESIONS

Author

D. Gasecki

Subjects
musculoskeletal diseases, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, animal structures, lcsh:Specialties of internal medicine, business.industry, General Medicine, medicine.disease, equipment and supplies, lcsh:RC581-951, lcsh:RC666-701, Internal medicine, Arterial stiffness, Cardiology, Medicine, Risk factor, business
Abstract

Increased arterial stiffness, a biomarker of vascular aging, is a recognized subclinical organ damage, and may thus serve as predictor of cardiovascular disease. The predictive value of arterial stiffness is higher in patients with higher baseline cardiovascular risk, such as in patients with hypertension. According to European Society of Hypertension, increased arterial stiffness should be recommended as a negative prognostic factor in the management of patients with hypertension. Arterial stiffness, an important determinant of transition of pulse wave energy from the heart into the periphery, could improve our understanding of the consequences of the hemodynamic-related vascular stress, especially in low-impedance organs, including the brain. Epidemiological studies have demonstrated arterial stiffness as a risk factor for silent cerebral lesions, stroke, and cognitive impairment. Arterial stiffness was found to be independently associated with all components of cerebral small vessel disease including silent lacunar infarcts, white matter hyperintensities, and microbleeds, although there are some methodological differences between the various surrogate markers. Arterial stiffness may be important also in recovery after ischemic stroke. Aortic stiffness was found to be an independent predictor of both short-term clinical improvement and long-term functional outcome after ischemic stroke. Furthermore, increased aortic stiffness has been shown to be linked to acute hypertensive response after ischemic stroke. However, the vascular, physiological, and metabolic roles of arterial stiffness in cerebrovascular diseases remain unclear. Better understanding of the hemodynamic consequences of arterial stiffness on brain damage is necessary, not only to select the most appropriate therapeutic management but also to optimize prevention, which should be started early in individuals at high risk of developing cerebral vascular lesions.

Published
2018

3. Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Author

Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi Mundl, Stuart J Connolly, Robert G Hart, N Abdelhamid, D Abdul Rahman, M Abdul-Saheb, P Abreu, M Abroskina, F Abu Ahmad, S Accassat, M Acciaresi, A Adami, N Ahmad, F Ahmed, M Alberto Hawkes, F Alemseged, A Ali, R Altavilla, L Alwis, P Amarenco, S Amaro, LE Amaya Sanchez, A Amelia Pinto, SF Ameriso, H Amin, T Amino, AK Amjad, E Anagnostou, G Andersen, C Anderson, DC Anderson, M Andrea Falco, F Andres Mackinnon, D Andreu, M Androulakis, M Angel Gamero, G Angel Saredo, R Angeles Diaz, M Angels Font, S Anticoli, A Arauz, AA Arauz Gongora, P Araya, JF Arenillas Lara, S Arias Rivas, M Arnold, S Augustin, W Avelar, E Azevedo, V Babikian, A Bacellar, K Badalyan, HJ Bae, EM Baez Martinez, H Bagelmann, P Bailey, Z Bak, M Baker, A Balazs, D Baldaranov, I Balogun, T Balueva, Z Bankuti, M Bar, A Baranowska, J Bardutzky, S Barker Trejo, J Barlinn, F Baronnet, C Barroso, M Barteys, T Bartolottiova, A Barulin, M Bas, S Bashir, V Basile, R Bathe-Peters, R Bathula, C Batista, H Batur Caglayan, P Baumgartner, R Bazan, O Bazhenova, M Beaudry, J Beer, Y Behnam, C Beilei, A Beinlich, Y Bejot, A Belkin, OR Benavente, A Benjamin, V Berardi, D Bereczki, SD Berkowitz, J Berlingieri, W Berrios, J Berrouschot, M Bhandari, M Bhargavah, H Bicker, T Bicsak, M Bilik, D Bindila, J Birchenall, L Birnbaum, T Black, D Blacker, D Blacquiere, C Blanc-Labarre, C Blank, B Blazejewska-Hyzorek, S Bloch, E Bodiguel, E Bogdanov, L Boos, L Borcsik, N Bornstein, S Bouly, G Braga, I Bragado, MC Bravi, C Brokalaki, W Brola, R Brouns, D Bruce, J Brzoska-Mizgalska, B Buck, M Buksinska-Lisik, J Burke, M Burn, G Bustamante, L Cabrejo, K Cai, S Cajaraville, M Calejo, D Calvet, J Campillo, E Campos Costa, P Camps, H Can Alaydin, E Candeloro, C Canepa, CG Cantu Brito, M Cappellari, C Carcel, P Cardona Portela, F Cardoso, M Carek, M Carletti, J Carlos Portilla, P Caruso, I Casado-Naranjo, P Castellini, D Castro, F Castro Meira, A Cavallini, N Cayuela Caudevilla, S Cenciarelli, C Cereda, P Cerrone, A Chakrabarti, P Chaloulos-Iakovidis, A Chamorro, D Chandrasena, DI Chang, C Che, J Chembala, J Chen, Z Chen, T Chen, H Chen, X Chen, G Chen, L Chen, S Chen, B Cheripelli, M Chin, E Chiquete Anaya, M Chorazy, H Christensen, T Christensen, L Christian, F Chu, CS Chung, W Clark, R Clarke, S Claverie, E Clemente Agostoni, B Clissold, J Coelho, D Cohen, S Colakoglu, D Collas, R Condurso, SJ Connolly, D Consoli, C Constantin, AB Constantino Silva, L Contardo, A Corlobe, M Correia, C Correia, E Cortijo Garcia, B Coull, S Coutts, S Coveney, P Cras, R Crols, S Crozier, A Csanyi, L Csiba, K Csontos, R Csuha, L Cui, L Cunha, S Curtze, M Czerska, A Czlonkowska, M Czurko, M Czuryszkiewicz, M Dagnino, C Dai, A Daineko, G Dalek, D Damgaard, A Danese, K Dani, V Danku, W Dario Toledo, A Dávalos, A De Havenon, J De Keyser, N De Klippel, J De La Torre, A De Pauw, A De Smedt, R De Torres, MM De Vries Basson, J Dearborn, R Deganutto, M Degeorgia, I Deguchi, A Del Giudice, C Delcourt, R Delgado-Mederos, G Della Marca, B Delpont, S Deltour, DL Demets, M Dennis, J Desai, J Devine, I Dhollander, MT Di Mascio, M Diaconu, F Diaz Otero, J Dietzel, E Diez-Tejedor, N Ding, J Ding, M Diomedi, P Dioszeghy, M Distefano, V Domigo, E Dorodnicov, D Dossi, F Doubal, I Druzenko, P Du, J Du, T Duman, Y Duodu, D Dutta, L Dylewicz, J Eckstein, E Ehrensperger, S Ehrlich, G Einer Allende, B Elena Halac, S Elyas, M Endres, JM Engelbrecht, S Engelter, M Epinat, F Eren, M Esbjornsson, B Escribano, I Escudero, B Esisi, B Essa, M Esterbauer, N Evans, D Eveson, S Fabio, L Fang, S Fanta, M Fares, M Fatar, K Faust, A Favate, F Fazekas, M Federica Denaro, A Fedin, P Felipe Amaya, J Feng, K Ferencova, M Fernanda Gilli, MD Fernandez, PN Fernandez Pirrone, J Fernandez Vera, J Ferrari, A Ferreira, G Ferreira Junior, M Fidler, D Field, T Field, C Figueroa, J Fiksa, A Filipov, A Firstenfeld, L Fisch, U Fischer, M Fisselier, U Fiszer, F Fluri, G Fortea, K Fotherby, A Fraczek, E France, G Freitas, S Frey, M Frick, A Friedman, M Friedrich, G Frisullo, W Fryze, B Fuentes Gimeno, H Fujigasaki, K Fukuyama, A Furlan, G Furlanis, J Furnace, M Gabriel, E Gabriel Reich, RJ Gagliardi, F Galati, E Galli Giqueauk, A Gallina, E Gallinella, J Gallo, S Gangadharan, Y Gao, R Garcia Lopez, A Garcia Pastor, SM Garcia Sanchez, M Garnauf, P Garnier, D Gasecki, K Gasic, K Gasiorek, S Gasser, M Gaugg, M Gebreyohanns, K Gebura, J Geng, M Geniz Clavijo, K Georg Haeusler, R Geran, M Geremek, Z Gerocs, D Ghia, D Giannandrea, F Giatsidis, JA Gien Lopez, A Gil Nunez, L Gimenez, E Giralt, A Glabinski, D Gladstone, M Gliem, M Gluszkiewicz, R Goddeau, E Gogoleva, M Gokce, D Goldemund, K Golikov, A Gomes Neto, M Gomez Schneider, M Gomez-Choco, M Gomis, JF Gongora-Rivera, Y Gonysheva, L Gonzalez, ME Gonzalez Toledo, M Gottschal, I Gozdzik, S Grabowski, S Graf, D Green, D Greer, T Gregorio, S Greisenegger, I Greshnova, M Griebe, M Grzesik, J Guan, S Guarda, A Gueguen, C Guidoux, P Guillermo Povedano, B Guillon, V Guiraudg, G Gunathilagan, N Guryanova, V Gusev, G Gustavo Persi, R Gutiérrez, P Guyler, N Gyuker, V Hachinski, A Hajas, H Hallevi, G Hankey, GJ Hankey, L Hanouskova, L Hao, K Haraguchi, Y Haralur Sreekantaiah, S Haratz, D Hargroves, K Harkness, P Harmel, M Harrasser, RG Hart, M Harvey, R Hasan, Y Hasegawa, A Hassan, M Hattori, A Hatzitolios, M Hauk, T Hayashi, H Hayhoe, VS Hedna, M Heine, V Held, S Hellwig, J Henkner, N Henninger, S Hermans, J Hernandez, D Herrero, M Hervieu-Begue, R Herzig, L Hicken, M Hieber, M Hill, M Hirose, MC Hobeanu, B Hobson, M Hochstetter, J Hoe Heo, M Hoffmann, C Holmstedt, P Hon, KS Hong, Y Honma, A Horev, G Horgan, L Horvath, M Horvath, C Hoyer, D Huang, H Huang, B Huber, J Huhtakangas, M Hussain, S Igarashi, AM Iglesias Mohedano, J Ignacio Tembl, M Impellizzeri, Y Inanc, P Ioli, A Irina Aniculaesei, K Ishida, R Itabashi, H Iversen, A Jagolino, K Jakab, S Jander, H Janka, J Jankovych, J Jansen, L Jasek, M Javier Alet, L Javor, X Jin, P Jing, B Joachim, M Joan Macleod, M Johnson, J Jose Martin, C Joyner, K Judit Szabo, A Jun-Oconnell, R Jura, B Kaczorowska, J Kadlcikova, T Kahles, N Kakaletsis, I Kakuk, K Kalinowska, K Kaminska, C Kaneko, I Kanellos, P Kapeller, K Kapica-Topczewska, O Karasz, M Karlinski, JE Karlsson, K Kasa, E Kashaeva, SE Kasner, M Kaste, J Kasza, A Katalin Iljicsov, M Katsurayama, S Kaur, M Kawanishi, S Kaygorodtseva, K Ke, A Kei, J Keilitz, J Kellner, P Kelly, S Kelly, D Kemlink, M Kerekgyarto, I Keskinarkaus, D Khairutdinova, A Khanna, A Khaw, M Kholopov, C Khoumri, S Kirpicheva, H Kirshner, K Kitagawa, S Kittner, R Kivioja, F Klein, D Kleindorfer, T Kleinig, P Klivenyi, S Knecht, Y Kobayashi, A Kobayashi, M Koch, L Koehler, M Koivu, V Kolianov, I Koltsov, T Kondo, I Konkov, S Kopecky, E Korompoki, J Korpela, K Kosarz-Lanczek, A Koutroubi, K Kovacs, T Kovacs, H Kovacs, K Kowalczyk, M Kowalska, D Krajickova, M Kral, C Krarup Hansen, J Kraska, S Krebs, V Krejci, C Kremer, R Kreuzpointer, M Krzyzanowska, D Kucken, A Kulakowska, J Kunzmann, N Kurenkova, A Kuris, I Kurkowska-Jastrzebska, N Kurtenkova, O Kurushina, G Kusnick, M Kustova, T Kuwashiro, J Kwan Cha, A Lago, M Lagutenko, B Lajos, J Lambeck, C Lamy, A Landolfi, S Lanfranconi, W Lang, LB Lara Lezama, B Lara Rodriguez, T Largo, A Lasek-Bal, L Latte, V Lauer, P Lavados, R Le Bouc, R Leal Cantu, H Lechner, K Lecouturier, S Leder, J Lee, BC Lee, A Leger, E Leira, I Leisse, R Leker, G Lembo, L Lenskaya, J Leyden, G Li, M Li, S Li, J Li, G Liamis, H Liang, Z Liang, N Ligot, H Lin, R Lindert, A Lindgren, M Linna, T Litwin, K Liu, X Liu, L Llull, B Lohninger, M Longoni, C Loomis, D Lopes, M Lopez Fernandez, N Lopez Garza, A Lord, S Louw, R Lovasz, T Lowenkopf, Z Lu, SC Lubke-Detring, R Luder, S Lujan, B Luo, L Lupinogina, G Luschin, H Lutsep, A Lvova, J Ly, G.M. Grosse, H Ma, C Ma, M Machado, C Machado, S Macher, J Machetanz, F Macian-Montoro, E Mackey, A Mackey, G Maclean, J Maestre-Moreno, A Magadan, T Magyar, A Mahagney, A Majid, A Majjhoo, K Makaritsis, J Mandzia, M Mangas Guijarro, D Mangion, E Manios, S Mann, L Manning, C Manno, J Manuel Garcia, V Maqueda, M Mar Castellanos, M Mar Freijo, C Marando, S Marcela Lepera, J Marcos Couto, G Maria Bruera, L Maria Greco, A Maria Lorenzo, S Maria Obmann, A Maria Roa, C Marini, I Marinkovic, G Mario Sumay, C Mario Torres, M Marko, S Markova, H Markus, R Marsh, E Marsili, M Marta Esnaola, J Marta Moreno, J Marti-Fabregas, S Martina Angelocola, P Martínez Sánchez, N Martinez-Majander, S Martins, O Marzelik, S Mastrocola, G Matamala, A Matoltsy, B Matosevic, S Matsumoto, A Maud, G Mauri Cabdevila, Z May, Y Mayasi, A Mayr, T Mazzoli, K Mcarthur, L Mccullough, CE Medina Pech, F Medlin, M Mehdiratta, S Mehta, D Mehta, B Mehta, M Melis, E Melnikova, B Mendez, T Mendonca, JJ Mengual Chirifie, N Menon, A Mensch, E Meseguer, S Messe, K Metcalf, N Meyer, F Michas, N Micheletti, R Mikulik, H Milionis, B Miller, T Milling, C Minelli, J Minhas, M Minns, D Mircea, S Mishra, A Mismas, A Mistri, N Mitrovic, H Miyake, B Modrau, A Moey, C Molina, J Molina, A Molis, J Moller, S Molnar, F Moniche, C Monosi, V Monzani, M Moonis, R Morais, L Morales, A Morales, D Morar-Precup, F Moreton, C Moro, E Morozova, M Morton, T Morvan, E Morvan, T Motko, A Mowla, E Mozhejko, G Muddegowda, O Mudhar, T Mueller, C Muhl, KW Muir, H Mundl, S Munoz, C Murphy, S Murphy, A Murtuzova, T Musuka, J Mutzenbach, M Myint, W Mysliwy, M Naccarato, G Naeije, Y Nagakane, I Natarajan, D Navaratnam, A Nave, B Nazliel, K Nedeltchev, J Nel, H Nell, R Nemeth, L Nemeth, O Neto, K Ng, J Ngeh, L Nicolas Chialvo, T Nieminen, M Nikkanen, J Nikl, M Nikoforova, S Nishino, Y Nishiyama, X Njovane, S Nogawa, F Nombela, B Norrving, K Nosek, B Nowak, E Nowakowska-Sledz, G Ntaios, H Numminen, F Nunez, M Obadia, S Oberndorfer, A Obrezan, J Ochiai, W Oczkowski, MJ O'Donnell, A Odyniec, K Oh, M Ohira, Y Okamoto, M Okpala, S Okubo, L Olah, V Olavarria, J Oleszek, N Onat Demirci, V Ondar, G Ongun, K Ooyama, V Orosz, R Ortiz, G Osseby, E Österlund-Tauriala, C Ovesen, S Ozcekic Demirhan, J Ozdoba-Rot, S Ozturk, E Ozyurt, M Pablo Grecco, G Pablo Povedano, M Paciaroni, C Padiglioni, J Pagola, W Palasik, G Panczel, L Panos, G Papadopoulos, E Papadopoulou, A Papagiannis, V Papavasileiou, M Papina, JR Pardo De Donlebun, V Parisi, JM Park, J Pasten, N Patel, O Pavlik, M Pawelczyk, WF Peacock, H Pei, T Peisker, LF Pena Sedna, A Penn, S Pentek, E Pepper, L Pereira, K Perera, Y Perez, S Perez, P Perez Leguizamon, M Pernicka, R Perry, A Persico, Y Pesant, S Peska, D Peters, G Peters, L Pettigrew, T Phan, S Philippi, T Phinney, F Pico, A Pidal, B Piechowski-Jozwiak, A Pieroni, S Pineiro, V Piras, N Pizova, J Polanco, M Polin, A Polyakov, E Polychronopoulou, A Polymeris, D Popov, A Poppe, P Postorino, C Pozzerese, M Pradhan, L Prats, E Prazdnichkova, B Prendl, M Pretorius, P Profice, S Prokopenko, E Pudov, V Pujol Lereis, G Punzo Bravo, F Purroy, J Qiu, X Qu, V Quenardelle, H Quesada Garcia, L Radrizzani, A Radtke, T Raffelsberger, JM Ramirez Moreno, C Ramos-Estebanez, A Rani, P Rapantova, K Rashed, A Rasheed Nihara, J Rasmussen, L Redondo Robles, M Reif, P Reiner, P Rekova, A Renu, M Repetto, P Reyes, S Reyes Morales, JH Rha, J Ribeiro, S Ricci, C Richard, R Rigual, C Rinaldi, C Riveira Rodriguez, B Rizzato, TG Robinson, A Rocco, M Rodrigues, G Rodriguez, A Rodriguez Campello, F Rodriguez Lucci, M Rodriguez Yanez, C Roesler, C Roffe, R Roine, S Roine, A Roldan, F Romana Pezzella, M Romano, JS Roos, C Rosso, C Rostrup Kruuse, Y Roth, R Roukens, L Roveri, D Rozanski, J Rozniecki, C Rozsa, S Rudilosso, G Ruiz Ares, A Ruiz Franco, G Rum, J Ruuskanen, I Rybinnik, K Ryota, J Saarinen, V Saavedra, C Sabben, A Sabet, D Sagris, J Sahlas, N Sakai, P Salamanca, P Salgado, S Salig, T Salletmayr, M Salnikov, O Samoshkina, Y Samson, D Sanak, M Sànchez Cerón, P Santalucia, M Santamaria Cadavid, P Santiago, G Santo, B Sanz Cuesta, J Sargento, A Sarraj, K Sas, A Sas, O Satoshi, S Satsoglou, N Sattar, S Savitz, C Savopoulos, J Saw, M Sawicka, R Sawyer, T Scandura, N Schillinger, J Schindler, F Schlachetzki, I Schneider, R Schuppner, J Schurig, CJ Schwarzbach, M Sebejova, G Seidel, L Sekaran, D Selcuk, J Selvarajah, A Semerano, J Semjen, D Semushina, S Sen, M Seok Park, J Serena, O Serhat Tokgoz, W Serles, F Serrano, M Sevin, L Seynaeve, S Shah, N Shamalov, T Shang, M Sharma, A Sharrief, M Shazam Hussain, I Shchukin, W Shen, E Shepeleva, I Shinsuke, A Shmonin, A Shoamanesh, A Shuaib, A Shulga, G Sibolt, I Sibon, I Sicilia, M Siebert, E Sieczkowska, C Sila, AA Silva, D Silva, P Silva, Y Silva, M Silvestrini, Z Simony, A Simpkins, B Singh, D Sinha, I Sipos, O Skoda, P Skowron, M Skowronska, B Sliwinska, J Slonkova, A Smolkin, A Smyth, P Sobolewski, A Sobota, SI Sohn, M Soldatov, I Solganov, L Soloveva, E Solovyeva, N Sonntag, P Soors, M Sorgun, C Soriano, D Spence, K Spengos, L Sposato, G Staaf, K Stadler, L Stakhovskaya, K Stamatelopoulos, S Steinert, I Stetkarova, M Stiehm, R Stocker, J Stoinski, A Stoll, G Stotts, A Stumpp, P Sucapane, T Suenaga, X Sun, S Sundararajan, J Sung Kim, H Suzuki, N Svaneborg, G Szasz, W Szczuchniak, S Szczyrba, N Szegedi, A Szekely, Z Szewczyk, G Szilagyi, S Szlufik, K Szoboszlai, L Szpisjak, R Sztajzel, L Sztriha, SE Ta Wil, J Taggeselle, K Takamatsu, M Takao, W Taki, S Takizawa, M Talahma, A Tamayo, J Tan, D Tanne, A Tapanainen, T Tapiola, J Tarasiuk, T Tatlisumak, A Tayal, S Tcvetkova, P Teal, J Tejada Garcia, H Tejada Meza, D Tenora, M Terceno, A Terentiou, S Tezcan, D Thaler, A Thomson, E Thouvenot, M Tiainen, I Timberg, S Timsit, A Tinchon, D Tirschwell, C Togay Isikay, K Tokunaga, M Tolino, C Toloza, G Tomelleri, K Tomoyuki, LM Tomppo, Z Tong, L Tong, D Toni, J Torres, C Tossavainen, G Toth, A Tountopoulou, E Touze, M Tovar, K Toyoda, S Trillo, A Trommer, D Tropepi, D Tryambake, H Tu, S Tuetuencue, R Tumova, O Tumpula, G Turc, A Tutaj, J Tynkkynen, S Uchiyama, U Uchwat, L Uhrinyakova, R Ulku Acar, D Uluduz Ugurlu, X Urra, S Urui, M Usero Ruiz, D Vaclavik, K Vahedi, A Valikovics, J Valpas, P Van Acker, W Van Daele, G Vanderschueren, L Vanina Jure, R Varela, Z Varga, J Varvat, N Varvyanskaya, A Vasco Salgado, P Vasko, L Vass, S Vassilopoulou, I Vastagh, P Vazquez, L Vecsei, R Veltkamp, M Venti, M Verdugo, V Verocai, M Veronica Marroquin, C Veronica Simonsini, T Veverka, M Vigl, A Vila, C Vilar, JA Villanueva Osorio, J Virta, E Vitkova, B Voglsperger, J Volna, PA Von Weitzel-Mudersbach, N Vora, I Voznyuk, A Wach-Klink, A Wacongne, D Walters, Y Wang, J Wang, L Wang, X Wang, W Wang, N Wang, D Wang, H Wang, W Warnack, K Wartenberg, R Waters, M Waters, T Webb, J Weber, G Weiss, K Weissenborn, JI Weitz, B Weller, G Wen, G Weng, P Werner, D Werring, P Wester, W Whiteley, R Whiting, T Wijeratne, C Willems, L Wilson, C Wilson, T Winder, J Windt, A Winkler, A Winska-Tereszkiewicz, A Wisniewska, M Wittayer, A Wlodek, A Wojnarowska-Arendt, M Wolf, V Wolff, C Wolter, A Wong, H Wook Nah, H Worthmann, W Wu, S Wu, S Wunderlich, H Wurzinger, DG Wyse, B Xiao, W Xiaopeng, A Ximenez-Carrillo, L Xiong, Y Xiong, W Xiong, Y Xu, J Xu, Z Xu, B Yalo, T Yamada, M Yamasaki, L Yang, Y Yang, X Yang, Q Yang, B Yang, J Yang, I Yasuhiro, M Yee Lam, C Yegappan, S Yip, E Ylikallio, P Ylikotila, A Yongwon Jin, BW Yoon, Y Yoshida, L Yperzeele, H Yuan, H Yuasa, J Zalewska, C Zanferrari, E Zapata, D Zboznovits, I Zelenka, C Zhang, B Zhang, S Zhang, M Zhang, X Zhang, J Zhang, L Zhao, O Zhirnova, L Zhou, J Zielinska-Turek, I Zinchenko, M Ziomek, A Zitzmann, R Zweifler, J Zwiernik, Yperzeele, Laetitia, and NAVIGATE ESUS Investigators

Subjects
Male, International Cooperation, 030204 cardiovascular system & hematology, antiplatelet therapy, law.invention, Neurology (clinical), ischemic stroke, anticoagulation, Cohort Studies, 0302 clinical medicine, Randomized controlled trial, Rivaroxaban, law, Stroke, education.field_of_study, Aspirin, Anticoagulant, Settore BIO/14, Middle Aged, 3. Good health, Treatment Outcome, N/A, Cardiology, Platelet aggregation inhibitor, Settore MED/26 - Neurologia, Female, medicine.drug, medicine.medical_specialty, medicine.drug_class, MEDLINE, Population, Foramen Ovale, Patent, Subgroup analysis, Article, Statistics, Nonparametric, 03 medical and health sciences, Double-Blind Method, Internal medicine, medicine, Humans, education, Aged, business.industry, medicine.disease, Human medicine, business, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors, Factor Xa Inhibitors
Abstract

Background: \ud Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial.\ud \ud Methods: \ud NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy.\ud \ud Findings: \ud Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity.\ud \ud Interpretation: \ud Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted.\ud \ud Funding: \ud Bayer and Janssen.

Published
2018
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4. SHORT-TERM FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE IS RELATED TO BLOOD PRESSURE VARIABILITY

Author

D. Gasecki, B. Jablonski, Bartosz Karaszewski, Krzysztof Narkiewicz, Kamil Kowalczyk, and Mariusz Kwarciany

Subjects
medicine.medical_specialty, Blood pressure, Physiology, business.industry, Internal medicine, Ischemic stroke, Internal Medicine, Cardiology, medicine, Cardiology and Cardiovascular Medicine, business, Outcome (game theory), Term (time)
Published
2018
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6. AORTIC STIFFNESS IS NOT ONLY ASSOCIATED WITH STRUCTURAL BUT ALSO WITH FUNCTIONAL PARAMETERS OF MICROCIRCULATION

Author

S. Laurent, D. Gasecki, J.M. Harazny, E. Dabrowska, Agnieszka Rojek, Anna Szyndler, E. Swierblewska, Krzysztof Narkiewicz, R.E. Schmieder, Eliza Miszkowska-Nagórna, Katarzyna Kunicka, Beata Graff, and Adrian Stefański

Subjects
medicine.medical_specialty, Physiology, business.industry, Retinal, Blood flow, Essential hypertension, medicine.disease, Microcirculation, chemistry.chemical_compound, chemistry, Internal medicine, Retinal capillary, Internal Medicine, medicine, Arterial stiffness, Cardiology, Aortic stiffness, Cardiology and Cardiovascular Medicine, business
Abstract

Objective:The aim of the study was to test the hypothesis if arterial stiffness is linked to reduction of retinal capillary blood flow and development of retinal microvascular remodelling.Design and method:The study group comprised of 88 patients with essential hypertension (n = 88, 54.3 ± 8.3 years

Published
2019
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7. PULSE WAVE VELOCITY CHANGES AFTER ACUTE ISCHEMIC STROKE

Author

Bartosz Karaszewski, Krzysztof Narkiewicz, Mariusz Kwarciany, B. Jablonski, Kamil Kowalczyk, and D. Gasecki

Subjects
musculoskeletal diseases, medicine.medical_specialty, animal structures, Physiology, business.industry, equipment and supplies, medicine.disease, Blood pressure, Internal medicine, Internal Medicine, medicine, Cardiology, Arterial stiffness, Cardiology and Cardiovascular Medicine, business, Stroke, Pulse wave velocity, Acute ischemic stroke
Abstract

Objective:Arterial stiffness is associated with the risk of stroke and its clinical sequelae as well. Arterial stiffness is pressure-dependent, and blood pressure still oscillates, especially in acute period of stroke. The aim of our study was to assess the short- and long-term variations of blood p

Published
2019
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8. CLINICAL CHARACTERISTICS OF PATIENTS WITH SPONTANEOUS CERVICAL ARTERY DISSECTION - THE POLISH REGISTRY FOR FIBROMUSCULAR DYSPLASIA (ARCADIA-POL STUDY)

Author

A. Czlonkowska, Aleksander Prejbisz, J. Antoniewicz, I. Kurkowska-Jastrzebska, Małgorzata Szczerbo-Trojanowska, Ewa Warchoł-Celińska, P. Talarowska, L. Swiatlowski, M. Skowronska, K. Jozwik-Plebanek, A. Kleinrok, K. Hanus, D. Gasecki, Andrzej Januszewicz, A. Kostera-Pruszczyk, B. Blazejewska-Hyzorek, Elżbieta Florczak, Olgierd Rowiński, and Magdalena Januszewicz

Subjects
medicine.medical_specialty, biology, Physiology, Cervical Artery, business.industry, Fibromuscular dysplasia, Dissection (medical), medicine.disease, biology.organism_classification, Arcadia, Internal Medicine, medicine, Radiology, Cardiology and Cardiovascular Medicine, business
Published
2018
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9. HEART RATE VARIABILITY, LARGE VESSEL REMODELLING AND METABOLIC PARAMETERS IN STAGE 1 HYPERTENSION ACCORDING TO THE ACC/AHA 2017 GUIDELINES

Author

Beata Graff, Agnieszka Sabisz, Edyta Szurowska, Krzysztof Narkiewicz, Anna Shalimova, and D. Gasecki

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Internal Medicine, medicine, Cardiology, Heart rate variability, Large vessel, Stage (cooking), Cardiology and Cardiovascular Medicine, business
Published
2018
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10. Imaging Techniques for the Detection and Diagnosis of Brain Damage in Hypertension

Author

Krzysztof Jodzio, Edyta Szurowska, and D. Gasecki

Subjects
Pathology, medicine.medical_specialty, business.industry, Large vessel, Brain damage, Neurovascular bundle, Functional neuroimaging, Parenchyma, Medicine, Brain lesions, Cerebral tissue, Small vessel, medicine.symptom, business
Abstract

Hypertension is the major causal factor of neurovascular pathology including both vascular and parenchymal lesions. These lesions are the consequence of large vessel and small vessel ischaemic infarctions, macrohaemorrhages and microbleeds (MBs), as well as vascular and parenchymal brain alterations leading to cerebral tissue disintegration and secondary effects on brain metabolism and function. This chapter includes a description of the images of different brain lesions, silent and clinical, induced by hypertension. Also recent advances in functional neuroimaging for characterizing the effects of hypertension on the brain integrity are described.

Published
2016
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11. Pathophysiology of Subclinical Brain Damage in Hypertension: Large Artery Disease

Author

Pierre Boutouyrie, D. Gasecki, Krzysztof Narkiewicz, and Stéphane Laurent

Subjects
medicine.medical_specialty, business.industry, Hemodynamics, Brain damage, medicine.disease, Pathophysiology, law.invention, Randomized controlled trial, law, Internal medicine, Cardiology, medicine, Arterial stiffness, medicine.symptom, Cognitive decline, business, Stroke, Subclinical infection
Abstract

Hypertension induces subclinical damage in the large elastic arteries and in the small brain arteries. Better understanding of the haemodynamic consequences of hypertension on brain damage is necessary, not only to select the most appropriate therapeutic management but also to optimize prevention, which should be started early in individuals at high risk of developing brain damage. This chapter proposes an integrated pathophysiological approach in order to better understand how large artery damage influences pressure wave transmission, exaggerates subclinical brain damage and leads to cerebrovascular complications. Measurement of arterial stiffness and central blood pressure by non-invasive methods in epidemiological studies and randomized clinical trials may improve our understanding of the haemodynamic consequences of hypertension on the brain, including stroke and cognitive decline.

Published
2016
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12. Management of High Blood Pressure in Acute Ischaemic Stroke

Author

Krzysztof Narkiewicz, Bartosz Karaszewski, and D. Gasecki

Subjects
medicine.medical_specialty, business.industry, Infarction, medicine.disease, Pathophysiology, Blood pressure, Neuroimaging, Time windows, Internal medicine, Ischaemic stroke, medicine, Cardiology, In patient, cardiovascular diseases, business, Stroke
Abstract

Increased blood pressure (BP) is a common problem in acute ischaemic stroke (AIS). The acute hypertensive response in stroke is of prognostic relevance. The pathophysiology of high BP in stroke is complex and poorly understood. The available evidence is insufficient to guide therapeutic decisions and does not show that lowering BP reduces mortality or disability in patients with subacute ischaemic stroke. There are some hints of the possible efficacy of very early BP lowering (within 6 h after stroke onset). Nevertheless, the management of BP immediately after stroke onset is largely empiric. It is reasonable to withhold BP-lowering drugs until patients are medically and neurologically stable. Immediately restarting pre-stroke BP-lowering drugs may increase disability. The timing of the BP intervention might be crucial. However, more research is needed to identify patients most likely to benefit from lowering BP in acute stroke, as well as the time window in which the response to treatment is likely to be favourable. Subtyping of stroke according to the underlying cause, advanced neuroimaging tools visualizing tissue at risk of infarction and complete cerebral infarctions, as well as a detailed individual history of the patient’s comorbidities, including identification of signs and symptoms of hypertensive target organ damage, might all help to stratify BP policy in AIS in the future trials that are required.

Published
2016
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13. 3.6 AORTIC STIFFNESS IS RELATED TO CEREBRAL LESION GROWTH IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Author

Pierre Boutouyrie, Anna Gójska-Grymajło, Edyta Szurowska, D. Gasecki, Stéphane Laurent, Tomasz Nowicki, Bartosz Karaszewski, Mariusz Kwarciany, Krzysztof Narkiewicz, and Kamil Kowalczyk

Subjects
medicine.medical_specialty, business.industry, Specialties of internal medicine, General Medicine, Cerebral lesion, RC581-951, Internal medicine, RC666-701, medicine, Cardiology, Diseases of the circulatory (Cardiovascular) system, In patient, Aortic stiffness, cardiovascular diseases, business, Acute ischemic stroke
Abstract

Objective: Cerebral lesion growth in acute ischemic stroke leads to secondary neurological deterioration and poor outcome. Whether cSBP and arterial stiffness are related to the early brain infarct growth in patients after ischemic stroke is unknown. Design and Methods: We enrolled 65 patients (43 males, age 62.9 ± 12.2 years, mean ± SD) with acute ischemic stroke (NIHSS at admission 6.0 ± 4.6 points). Carotid-femoral pulse wave velocity (CF-PWV), central systolic blood pressure (cSBP) and central augmentation index (cAIx) were measured (Sphygmocor®) within few (5 ± 2) days after stroke onset. Serial brain MRI were analysed. Cerebral lesion growth was assessed on diffusion-weighted imaging (DWI) by comparing baseline and follow-up scans. Marked cerebral lesion growth was determined as the highest tertile in a standardized measure of DWI lesion volume increase, and compared with the lowest tertile used as the reference group. Data were analysed with multivariate logistic regression. Results: CF-PWV was higher in patients with marked cerebral lesion growth than that in patients of the reference group (10.9 ± 3.1 vs. 9.1 ± 1.9 m/s, P = 0.035). By contrast, cAIx, as well as none of central and peripheral BP-derived parameters were significantly associated with cerebral lesion growth in univariate analysis. In multivariable regression logistic model, CF-PWV predicted cerebral lesion growth with an odds ratio of 1.43 [1.00–2.04], independently of age, and peripheral pulse pressure. Conclusions: Increased aortic stiffness is independently associated with cerebral lesion growth in patients with acute ischemic stroke. Its deleterious effect is more important than that of BP.

Published
2015

14. [Untitled]

Author

Maria Debiec-Rychter, Bartosz Wasag, Agnieszka Wozniak, D. Gasecki, Jerzy Lasota, Ewa Izycka-Swieszewska, Jacek Bartkowiak, Janusz Limon, and Katarzyna Plata-Nazar

Subjects
Cancer Research, Pathology, medicine.medical_specialty, breakpoint cluster region, Biology, medicine.disease, Loss of heterozygosity, Neurology, Oncology, Primitive neuroectodermal tumor, Atypical teratoid rhabdoid tumor, medicine, Missense mutation, Neurology (clinical), Teratoma, Neuroectodermal tumor, Chromosome 22
Abstract

This report describes the clinical, pathological, immunohistochemical and genetic data of two rare malignant neoplasms of the central nervous system (CNS)--a cerebral atypical teratoid/rhabdoid tumor (AT/RT) in a 5-month-old girl and a spinal canal primitive neuroectodermal tumor (PNET) in her father. Despite aggressive treatment, both tumors were fatal, displaying extensive local recurrence and diffuse neoplastic dissemination. The paraffin-embedded tumor tissue samples were analyzed using a dual-color FISH with a locus specific LSI22q (BCR) probe. In the AT/RT tissue, a loss of BCR locus was observed in a significant proportion of the cells in contrast to the PNET specimen where the majority of nuclei did not reveal any loss of the BCR region. No mutations in exon 5 and no changes in SNP of intron 5 of hSNF/INI1 gene were found. In addition, analysis of loss of heterozygosity (LOH) was performed using a panel of 15 microsatellite markers of chromosome 22. No LOH were found in both tumor tissues. In both cases no constitutional mutations of gene TP53 were found. Analysis of the TP53 mutations in the tumor tissues revealed that the PNET, not the AT/RT tumor, was homozygous for a missense mutation at codon 175 (CGC ==> CAC). Thus, our findings emphasize the genetic differences between the two specimens and suggest that the occurrence of these two aggressive tumors of CNS in one family could be coincidental.

Published
2003
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15. [PP.29.26] AORTIC STIFFNESS IS INDEPENDENTLY RELATED TO INTRACRANIAL ATHEROSCLEROSIS IN PATIENTS WITH ISCHEMIC STROKE

Author

S. Laurent, T. Nowicki, P. Botouyrie, Agnieszka Rojek, K. Narkiewicz, Mariusz Kwarciany, Edyta Szurowska, D. Gasecki, Bartosz Karaszewski, and Kamil Kowalczyk

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Ischemic stroke, Internal Medicine, medicine, Cardiology, Aortic stiffness, In patient, Intracranial Atherosclerosis, Cardiology and Cardiovascular Medicine, business
Published
2017
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16. PP.34.20

Author

Bartosz Karaszewski, Kamil Kowalczyk, Mariusz Kwarciany, K. Narkiewicz, D. Gasecki, T. Nowicki, and Edyta Szurowska

Subjects
medicine.medical_specialty, Blood pressure, Physiology, business.industry, Internal medicine, Lesion growth, Internal Medicine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, medicine.disease, Stroke
Published
2015
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17. [OP.3C.06] DIFFERENCE IN SUBACUTE BLOOD PRESSURE BETWEEN OFFICE AND AMBULATORY VALUES PREDICTS FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE

Author

S. Laurent, Agnieszka Rojek, Kamil Kowalczyk, D. Gasecki, M. Skrzypek-Czerko, Bartosz Karaszewski, Pierre Boutouyrie, Mariusz Kwarciany, and K. Narkiewicz

Subjects
medicine.medical_specialty, Blood pressure, Physiology, business.industry, Ischemic stroke, Ambulatory, Internal Medicine, medicine, Cardiology and Cardiovascular Medicine, Intensive care medicine, business, Outcome (game theory)
Published
2016
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18. Risk factors of sensorineural hearing loss in patients with ischemic stroke

Author

D. Gasecki, Tomasz Przewoźny, Waldemar Narozny, and Walenty M. Nyka

Subjects
Male, medicine.medical_specialty, Pediatrics, Neurology, Hearing loss, Hearing Loss, Sensorineural, MEDLINE, Audiology, Brain Ischemia, Brain ischemia, Tinnitus, Risk Factors, medicine, Humans, In patient, Stage (cooking), business.industry, Middle Aged, medicine.disease, Sensory Systems, Otorhinolaryngology, Hypertension, Sensorineural hearing loss, Female, Neurology (clinical), medicine.symptom, business
Abstract

We investigated risk factors of sensorineural hearing loss (SHL) in patients with early stage of ischemic stroke (IS).Our study consisted of 60 patients with IS who were treated at Department of Neurology, Medical University of Gdansk between 2006 and 2007. A multivariate stepwise linear regression was used to identify the risk factors that were related to SHL as measured by pure-tone average (0.5, 1, and 2 kHz), the high-tone average (4, 6, and 8 kHz), the pure-tone middle-tone average (0.5, 1, 2, and 4 kHz), and the overall average (0.5, 1, 2, 4, 6, and 8 kHz). The following factors were included in the analysis: age, sex, smoking habit, addiction to alcohol, presence of tinnitus and vestibular symptoms, arterial hypertension, cardiac ischemic disease, hyperlipidemia, diabetes, number of risk factors, neurologic state at the admission, localization of stroke, cause of stroke, number of ischemic focuses, the side and diameter of ischemic focuses, the result of directional hearing acuity angle test, results of certain laboratory tests, blood morphology parameters, and coagulogram. Values for p less than 0.05 were considered significant.Our analysis suggests the presence of the following risk factors of SHL in patients with IS: 1) older age (60 yr); 2) male sex; 3) presence of tinnitus; 4) arterial hypertension; 5) lacunar type of stroke; 6) presence of multiple ischemic focuses; 7) presence of bilateral ischemic focuses; 8) changes in blood cell count; and 9) disturbances of agglutination.The highest risk of hearing loss in the group of IS patients occurred at older people, particularly men with tinnitus, lacunar stroke, multiple, bilateral ischemic focuses, and arterial hypertension. A negative statistically significant influence of decreased level of red cells, platelets, and hematocrit value on hearing loss was found. Abnormally lowered levels of activated partial thromboplastin time, activated partial thromboplastin time ratio, prothrombin index, and abnormal lowered level of international normalized ratio statistically impaired hearing.

Published
2008

19. Periodic breathing in short-term day-time recordings in hypertensive and normotensive individuals alters blood pressure parameters

Author

D. Gasecki, M. Skrzypek-Czerko, Marta Witkowska, Patrycja Naumczyk, Krzysztof Jodzio, Beata Graff, Agnieszka Sabisz, Krzysztof Narkiewicz, and Edyta Szurowska

Subjects
Cellular and Molecular Neuroscience, medicine.medical_specialty, Blood pressure, Endocrine and Autonomic Systems, business.industry, Internal medicine, Periodic breathing, Cardiology, Medicine, Neurology (clinical), business, Term (time)
Published
2015
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20. 4C.08

Author

D. Gasecki, M. Skrzypek-Czerko, S. Laurent, Pierre Boutouyrie, Kamil Kowalczyk, K. Narkiewicz, Edyta Szurowska, Mariusz Kwarciany, Agnieszka Rojek, and T. Nowicki

Subjects
medicine.medical_specialty, Physiology, business.industry, Brain damage, Internal medicine, Internal Medicine, Cardiology, Medicine, Biomarker (medicine), Aortic stiffness, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Acute ischemic stroke, Subclinical infection
Published
2015
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21. PP.34.24

Author

D. Gasecki, Agnieszka Sabisz, Beata Graff, K. Narkiewicz, Krzysztof Jodzio, Patrycja Naumczyk, Edyta Szurowska, and Marta Witkowska

Subjects
Physiology, business.industry, Internal Medicine, Medicine, Cognition, Cardiology and Cardiovascular Medicine, business, Essential hypertension, medicine.disease, Neuroscience
Published
2015
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22. The contribution of the left and right hemispheres to early recovery from aphasia: a SPECT prospective study

Author

Piotr Lass, D. Gasecki, Krzysztof Jodzio, Denise Allison Drumm, and Walenty M. Nyka

Subjects
Adult, Male, medicine.medical_specialty, Statistics as Topic, Lateralization of brain function, Arts and Humanities (miscellaneous), Communication disorder, Internal medicine, Aphasia, medicine, Humans, Language disorder, Dominance, Cerebral, Stroke, Applied Psychology, Aged, Language, Aged, 80 and over, Tomography, Emission-Computed, Single-Photon, Boston Diagnostic Aphasia Examination, Rehabilitation, Recovery of Function, Middle Aged, medicine.disease, Surgery, Neuropsychology and Physiological Psychology, Cerebral blood flow, Cerebrovascular Circulation, Cerebral hemisphere, Cardiology, Female, medicine.symptom, Psychology
Abstract

This prospective study examined the relationship between post-stroke recovery of aphasia and changes in cerebral blood flow (CBF). To address the question of right hemisphere (RH) involvement in restitution of language, we tested the hypothesis that the increase in perfusion of the RH is crucial for early recovery from aphasia. Twenty-four right-handed patients with acute aphasia following left hemisphere (LH) ischaemic stroke were examined twice with a six-month interval. At each session CBF and language scores were measured on the same stroke patients. Language was measured by selected tasks derived from the Boston Diagnostic Aphasia Examination (BDAE). The SPECT scans were obtained using (99m)Tc-ECD on a triple-head gamma camera Multispect-3. Although initial CBF measured for the whole group of aphasic patients was not a predictor for future language recovery for either hemisphere, increased perfusion of the RH during a six-month interval was found to parallel the recovery of aphasic disorders. There was a correlation between the change in the right parietal CBF (but not the left) and a change in numerous language abilities. Nevertheless, only CBF values on the left predicted performance on the language tests at initial and follow-up examinations. When the area damaged on structural imaging was excluded from perfusion analysis, only subcortical CBF change on the left showed a positive correlation with language improvement. Thus, the cerebral mechanism associated with early recovery from aphasia is a dynamic and complex process that may involve both hemispheres. Probably this mechanism involves functional reorganisation in the speech-dominant (damaged) hemisphere and regression of haemodynamic disturbances in the non-dominant (structurally intact) hemisphere.

Published
2005

23. [Unusual history of the chemodectoma of parapharyngeal space]

Author

W, Sierszeń, D, Gasecki, W, Narozny, and C, Stankiewicz

Subjects
Paraganglioma, Extra-Adrenal, Paresis, Hypopharyngeal Neoplasms, Humans, Female, Neoplasm Invasiveness, Vagus Nerve, Middle Aged, Intraoperative Complications, Embolization, Therapeutic, Magnetic Resonance Imaging
Abstract

A case of chemodectoma in 58 year old woman is presented. The tumour was located in the parapharyngeal space. During preoperative arteriography and embolization a hemiparesis was noticed, probably caused by the thrombus in the cerebral medial artery. Early radiological examination of brain arteries allowed to perform specific treatment in only two hours time from the onset of the paresis. The treatment was successful--neurological symptoms have receded after 24 hours. Few days later patient was operated on--the tumour was removed with part of the vagus nerve. No serious postoperative complications were observed.

Published
2001

24. ARTERIAL STIFFNESS AND WAVE REFLECTION ANALYSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE: 3B.06

Author

Mariusz Kwarciany, D. Gasecki, Krzysztof Narkiewicz, Walenty M. Nyka, S. Laurent, W. Kucharska, Pierre Boutouyrie, and Agnieszka Rojek

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Internal Medicine, medicine, Cardiology, Arterial stiffness, In patient, Cardiology and Cardiovascular Medicine, business, medicine.disease, Acute ischemic stroke
Published
2010
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25. TIME-DEPENDENT CHANGES IN CAROTID-FEMORAL PULSE WAVE VELOCITY IN PATIENTS AFTER ISCHEMIC STROKE

Author

S. Laurent, Agnieszka Rojek, D. Gasecki, Walenty M. Nyka, K. Narkiewicz, Pierre Boutouyrie, Mariusz Kwarciany, Kamil Kowalczyk, and R. Nowak

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Ischemic stroke, Internal Medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business, Pulse wave velocity
Published
2011
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26. SUBACUTE BLOOD PRESSURE VARIABILITY AND HEART RATE PREDICT FUNCTIONAL OUTCOME AFTER ISCHEMIC STROKE

Author

Agnieszka Rojek, Walenty M. Nyka, K. Narkiewicz, D. Gasecki, Pierre Boutouyrie, S. Laurent, Mariusz Kwarciany, and Kamil Kowalczyk

Subjects
medicine.medical_specialty, Blood pressure, Physiology, business.industry, Internal medicine, Ischemic stroke, Heart rate, Internal Medicine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business, Outcome (game theory)
Published
2011
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27. SHORT-TERM HEART RATE VARIABILITY AND FUNCTIONAL OUTCOME AFTER ACUTE ISCHEMIC STROKE

Author

Beata Graff, Walenty M. Nyka, K. Narkiewicz, Agnieszka Rojek, Pierre Boutouyrie, S. Laurent, D. Gasecki, and W. Kucharska

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Internal Medicine, Cardiology, medicine, Heart rate variability, Cardiology and Cardiovascular Medicine, business, Acute ischemic stroke, Outcome (game theory), Term (time)
Published
2011
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28. PULSE WAVE VELOCITY IS A PREDICTOR OF OUTCOME IN PATIENTS AFTER ISCHEMIC STROKE: PP.4.134

Author

S. Laurent, Pierre Boutouyrie, M. Kubach, Walenty M. Nyka, Mariusz Kwarciany, Krzysztof Narkiewicz, Agnieszka Rojek, and D. Gasecki

Subjects
medicine.medical_specialty, Physiology, business.industry, Internal medicine, Ischemic stroke, Internal Medicine, Cardiology, Medicine, In patient, Cardiology and Cardiovascular Medicine, business, Outcome (game theory), Pulse wave velocity
Published
2010
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29. EDUCATIONAL PROGRAM IMPROVES PATIENTS COMPLIANCE AND AMBULATORY BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS WITH A HISTORY OF STROKE

Author

Bogdan Wyrzykowski, Barbara Krupa-Wojciechowska, Radosław Szczęch, A. Kosmol, D. Gasecki, Walenty M. Nyka, Krzysztof Narkiewicz, and G. Kozera

Subjects
Compliance (physiology), medicine.medical_specialty, Ambulatory blood pressure, Physiology, business.industry, Internal Medicine, Physical therapy, Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease, Educational program, Stroke
Published
2004
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30. Heterogeneity of extraparenchymal primitive neuroectodermal tumors within the craniospinal axis.

Author

M Debiec-Rychter, D Gasecki, A Woźniak, E Drozyńska, J Stefanowicz, K Plata-Nazar, W Kloc, and E Izycka-Swieszewska

Subjects
Cytology, QH573-671
Abstract

Four cases of primitive neuroectodermal tumors (PNETs) with unusual localization (three intraspinal extramedullary and one pontocerebellar) are reviewed. Histologically, they were small round blue cell tumors with diverse patterns. Immunohistochemically, all tumors were positive for at least two neuronal markers, two cases were Mic-2 positive and one showed glial differentiation. The paraffin-embedded tumor specimens were examined by interphase FISH using dual-color probes specific for EWS, HER-2 and BCR loci. Molecular cytogenetic study revealed the presence of EWS rearrangement in two cases and the presence of i(17q) in one tumor. Three tumors exhibited 22 disomy and one was 22 polyploid. Extraparenchymal PNETs within craniospinal axis are heterogeneous from the clinical, histological, immunohistochemical and molecular point of view. These PNETs can be of a central or peripheral type. Multidisciplinary approach is of a basic importance in differential diagnosis of such cases.

Published
2005
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31. Aortic Stiffness Is Independently Associated with Intracranial Carotid Artery Calcification in Patients with Ischemic Stroke.

Author

Gozdalski J, Nowicki TK, Kwarciany M, Kowalczyk K, Narkiewicz K, and Gasecki D

Subjects
Humans, Pulse Wave Analysis, Risk Factors, Carotid Arteries, Vascular Stiffness, Ischemic Stroke complications, Carotid Artery Diseases complications, Carotid Artery Diseases diagnostic imaging, Stroke diagnostic imaging, Stroke etiology
Abstract

Introduction: Intracranial carotid artery calcification (ICAC), as a strong contributor to the occurrence of ischemic stroke, might be present in the medial or intimal arterial layer. Traditional cardiovascular risk factors (CVRFs) are associated with ICAC; however, its association with new markers of vascular function is less understood. The paper aimed to evaluate the relationship between carotid-femoral pulse wave velocity (CF-PWV) and ICAC subtypes., Methods: We enrolled 65 patients with ischemic stroke. CF-PWV, systolic, diastolic, mean blood pressure, and pulse pressure were measured within 6 ± 2 days after stroke onset, and CT was performed within 24 h. ICAC on the stroke site was classified by two methods: volume and score based. Tertiles of ICAC volume were determined, and low-grade ICAC (T1) was regarded as a reference. According to the score-based method, (dominant) medial and (dominant) intimal ICAC subtypes were determined. Data were analyzed with multivariate logistic regression., Results: Medial and intimal ICAC subtypes were found in 34 (52%) and 24 (37%) patients, respectively. In 11% of patients, no ICAC calcifications were found. CF-PWV was higher in patients with high-grade ICAC (OR = 1.56, 95% CI = 1.03-2.35, p = 0.035). CF-PWV was higher in patients with the medial ICAC subtype (OR = 1.60, 95% CI = 1.00-2.55, p = 0.049) after adjustment for traditional CVRFs., Conclusion: Our study demonstrates that among patients with ischemic stroke, aortic stiffness is independently associated with ICAC and that medial ICAC, compared with intimal ICAC, is accompanied by more advanced aortic stiffness., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Published
2024
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33. Routine assessment of cognitive function in older patients with hypertension seen by primary care physicians: why and how-a decision-making support from the working group on 'hypertension and the brain' of the European Society of Hypertension and from the European Geriatric Medicine Society.

Author

Scuteri A, Benetos A, Sierra C, Coca A, Chicherio C, Frisoni GB, Gasecki D, Hering D, Lovic D, Manios E, Petrovic M, Qiu C, Shenkin S, Tzourio C, Ungar A, Vicario A, Zaninelli A, and Cunha PG

Subjects
Aged, Brain, Cognition, Humans, Societies, Medical, Hypertension diagnosis, Physicians, Primary Care
Abstract

: The guidelines on hypertension recently published by the European Societies of Hypertension and Cardiology, have acknowledged cognitive function (and its decline) as a hypertension-mediated organ damage. In fact, brain damage can be the only hypertension-mediated organ damage in more than 30% of hypertensive patients, evolving undetected for several years if not appropriately screened; as long as undetected it cannot provide either corrective measures, nor adequate risk stratification of the hypertensive patient.The medical community dealing with older hypertensive patients should have a simple and pragmatic approach to early identify and precisely treat these patients. Both hypertension and cognitive decline are undeniably growing pandemics in developed or epidemiologically transitioning societies. Furthermore, there is a clear-cut connection between exposure to the increased blood pressure and development of cognitive decline.Therefore, a group of experts in the field from the European Society of Hypertension and from the European Geriatric Medicine Society gathered together to answer practical clinical questions that often face the physician when dealing with their hypertensive patients in a routine clinical practice. They elaborated a decision-making approach to help standardize such clinical evaluation.

Published
2021
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34. Aortic stiffness predicts functional outcome in patients after ischemic stroke.

Author

Gasecki D, Rojek A, Kwarciany M, Kubach M, Boutouyrie P, Nyka W, Laurent S, and Narkiewicz K

Subjects
Aged, Aorta, Brain Ischemia complications, Brain Ischemia rehabilitation, Carotid Arteries physiology, Female, Femoral Artery physiology, Hemodynamics physiology, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, Stroke etiology, Stroke Rehabilitation, Blood Flow Velocity physiology, Brain Ischemia therapy, Stroke therapy, Vascular Stiffness physiology
Abstract

Background and Purpose: Increased aortic stiffness (measured by carotid-femoral pulse wave velocity) and central augmentation index have been shown to independently predict cardiovascular events, including stroke. We studied whether pulse wave velocity and central augmentation index predict functional outcome after ischemic stroke., Methods: In a prospective study, we enrolled 99 patients with acute ischemic stroke (age 63.7 ± 12.4 years, admission National Institutes of Health Stroke Scale score 6.6 ± 6.6, mean ± SD). Carotid-femoral pulse wave velocity and central augmentation index (SphygmoCor) were measured 1 week after stroke onset. Functional outcome was evaluated 90 days after stroke using the modified Rankin Scale with modified Rankin Scale score of 0 to 1 considered an excellent outcome., Results: In univariate analysis, low carotid-femoral pulse wave velocity (P=0.000001) and low central augmentation index (P=0.028) were significantly associated with excellent stroke outcome. Age, severity of stroke, presence of previous stroke, diabetes, heart rate, and peripheral pressures also predicted stroke functional outcome. In multivariate analysis, the predictive value of carotid-femoral pulse wave velocity (<9.4 m/s) remained significant (OR, 0.21; 95% CI, 0.06-0.79; P=0.02) after adjustment for age, National Institutes of Health Stroke Scale score on admission, and presence of previous stroke. By contrast, central augmentation index had no significant predictive value after adjustment., Conclusions: This study indicates that aortic stiffness is an independent predictor of functional outcome in patients with acute ischemic stroke.

Published
2012
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35. [Report from International Stroke Conference 2010, San Antonio, USA].

Author

Staszewski J, Gasecki D, and Wojczal J

Subjects
Endarterectomy, Carotid, Humans, Stents, Stroke prevention & control, Stroke diagnosis, Stroke therapy
Abstract

During the 35th International Stroke Conference held in February 2010, San Antonio, USA, the new definitions of transient ischemic attack, ischemic stroke, acute neurovascular syndrome, acute hypertensive reaction in stroke have been discussed. Data from recent clinical trials and meta-analysis covering different epidemiological, diagnostic and therapeutic aspects of cerebrovascular diseases discussed during conference has been presented. Results of new trials in primary and secondary stroke prevention assessing efficacy and safety of: stenting vs endarterectomy of carotid arteries (CREST), dabigatran in prevention of cardioembolic stroke in atrial fibrillation (RE-LY), cilostazole in secondary prevention of atherogenic stroke (CSPSS II) have been discussed.

Published
2010

36. Risk factors of sensorineural hearing loss in patients with ischemic stroke.

Author

Przewoźny T, Gasecki D, Narozny W, and Nyka W

Subjects
Female, Humans, Hypertension epidemiology, Male, Middle Aged, Risk Factors, Tinnitus epidemiology, Brain Ischemia epidemiology, Hearing Loss, Sensorineural diagnosis, Hearing Loss, Sensorineural epidemiology
Abstract

Objectives: We investigated risk factors of sensorineural hearing loss (SHL) in patients with early stage of ischemic stroke (IS)., Methods: Our study consisted of 60 patients with IS who were treated at Department of Neurology, Medical University of Gdansk between 2006 and 2007. A multivariate stepwise linear regression was used to identify the risk factors that were related to SHL as measured by pure-tone average (0.5, 1, and 2 kHz), the high-tone average (4, 6, and 8 kHz), the pure-tone middle-tone average (0.5, 1, 2, and 4 kHz), and the overall average (0.5, 1, 2, 4, 6, and 8 kHz). The following factors were included in the analysis: age, sex, smoking habit, addiction to alcohol, presence of tinnitus and vestibular symptoms, arterial hypertension, cardiac ischemic disease, hyperlipidemia, diabetes, number of risk factors, neurologic state at the admission, localization of stroke, cause of stroke, number of ischemic focuses, the side and diameter of ischemic focuses, the result of directional hearing acuity angle test, results of certain laboratory tests, blood morphology parameters, and coagulogram. Values for p less than 0.05 were considered significant., Results: Our analysis suggests the presence of the following risk factors of SHL in patients with IS: 1) older age (>60 yr); 2) male sex; 3) presence of tinnitus; 4) arterial hypertension; 5) lacunar type of stroke; 6) presence of multiple ischemic focuses; 7) presence of bilateral ischemic focuses; 8) changes in blood cell count; and 9) disturbances of agglutination., Conclusion: The highest risk of hearing loss in the group of IS patients occurred at older people, particularly men with tinnitus, lacunar stroke, multiple, bilateral ischemic focuses, and arterial hypertension. A negative statistically significant influence of decreased level of red cells, platelets, and hematocrit value on hearing loss was found. Abnormally lowered levels of activated partial thromboplastin time, activated partial thromboplastin time ratio, prothrombin index, and abnormal lowered level of international normalized ratio statistically impaired hearing.

Published
2008
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37. [The stroke variables assessment as a prognostic factor for post-stroke depression with the emphasis on the cerebral SPECT regional blood flow asymmetry].

Author

Wichowicz H, Gasecki D, Landowski J, Lass P, Nyka WM, and Kozera G

Subjects
Adult, Cerebrovascular Circulation, Depression etiology, Female, Humans, Male, Middle Aged, Prognosis, Regional Blood Flow, Stroke complications, Tomography, Emission-Computed, Single-Photon methods, Brain blood supply, Brain diagnostic imaging, Depression diagnosis, Stroke physiopathology
Abstract

Aim: The aim of this paper was to assess the risk for depression in a 6-month-long post stroke follow up period as related to the stroke variables (i.e. stroke localisation, haemodynamic parameters)., Method: The stroke localisation was determined with CT and/or MRI. Subsequently all the examined individuals underwent SPECT examination. The follow up examinations were performed by the consultant psychiatrist in 6, 12 and 24 weeks subsequent to the stroke episode. The depressive episode diagnosis was established on the basis of ICD-10 diagnostic criteria., Results: Only right-handed patients (43 men aged 57.3 +/- 11.6 and 17 women aged 62.5 +/- 14.4) with unilateral brain lesion were examined. 23 subjects (38%) developed depression in the follow-up period. 5 women (29%) and 18 men (ca. 42%) developed a depressive episode. Only one of the observed depressive episodes met ICD-10 criteria for severe depressive episode. 10 patients suffered from moderate depressive episode and 12 subjects exhibited a mild depressive episode., Conclusions: The results obtained with CT and/or MRI techniques revealed no correlation between the post-stroke depression and stroke lateralisation. However the localisation of the deep brain functional abnormalities revealed with SPECT correlated with the occurrence of the affective disorders as related to the asymmetry in regional blood flow measures.

Published
2006

38. The contribution of the left and right hemispheres to early recovery from aphasia: a SPECT prospective study.

Author

Jodzio K, Drumm DA, Nyka WM, Lass P, and Gasecki D

Subjects
Adult, Aged, Aged, 80 and over, Aphasia diagnostic imaging, Cerebrovascular Circulation physiology, Female, Humans, Male, Middle Aged, Statistics as Topic, Aphasia physiopathology, Dominance, Cerebral physiology, Language, Recovery of Function physiology, Tomography, Emission-Computed, Single-Photon
Abstract

This prospective study examined the relationship between post-stroke recovery of aphasia and changes in cerebral blood flow (CBF). To address the question of right hemisphere (RH) involvement in restitution of language, we tested the hypothesis that the increase in perfusion of the RH is crucial for early recovery from aphasia. Twenty-four right-handed patients with acute aphasia following left hemisphere (LH) ischaemic stroke were examined twice with a six-month interval. At each session CBF and language scores were measured on the same stroke patients. Language was measured by selected tasks derived from the Boston Diagnostic Aphasia Examination (BDAE). The SPECT scans were obtained using (99m)Tc-ECD on a triple-head gamma camera Multispect-3. Although initial CBF measured for the whole group of aphasic patients was not a predictor for future language recovery for either hemisphere, increased perfusion of the RH during a six-month interval was found to parallel the recovery of aphasic disorders. There was a correlation between the change in the right parietal CBF (but not the left) and a change in numerous language abilities. Nevertheless, only CBF values on the left predicted performance on the language tests at initial and follow-up examinations. When the area damaged on structural imaging was excluded from perfusion analysis, only subcortical CBF change on the left showed a positive correlation with language improvement. Thus, the cerebral mechanism associated with early recovery from aphasia is a dynamic and complex process that may involve both hemispheres. Probably this mechanism involves functional reorganisation in the speech-dominant (damaged) hemisphere and regression of haemodynamic disturbances in the non-dominant (structurally intact) hemisphere.

Published
2005
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39. [Cerebral blood flow in patients with various symptoms of hemispatial neglect following ischemic stroke].

Author

Jodzio K, Gasecki D, Nyka W, and Lass P

Subjects
Adult, Aged, Brain Ischemia diagnosis, Cerebrovascular Circulation physiology, Female, Humans, Male, Middle Aged, Perceptual Disorders diagnosis, Severity of Illness Index, Tomography, Emission-Computed, Single-Photon, Brain blood supply, Brain physiopathology, Brain Ischemia complications, Brain Ischemia physiopathology, Perceptual Disorders etiology
Abstract

Background and Purpose: The most common cause of hemispatial neglect (HN) is cerebral infarction. It can be induced by lesions in many different regions of the right hemisphere. The purpose of this article was to determine the prevalence of post-stroke HN, its clinical picture, and neuroanatomical correlates., Material and Methods: Forty-six stroke patients with a focal right-hemisphere lesion were studied. Neglect in visual domain, assessed with a battery of drawing, line bisection and shape cancellation tests, was observed in 20 cases. The single-photon emission-computed tomography (SPECT) images of the brain were obtained with 740 MBq (20 mCi) of Tc-99m-labeled ECD on a triple-headed gamma camera., Results: The most sensitive measure of HN was the cancellation test, which all neglect patients performed poorly. Twelve patients, classified as mildly impaired, showed no significant rightward deviation on line bisection, but they showed left visual neglect on the cancellation test. Reverse dissociation was not noted. Performance on a clock-drawing test revealed HN only in two patients, who showed also evidence of HN on other tests. Thereby, some of the tests seem to be more difficult or more sensitive to impairment. The critical area of perfusion abnormalities in all neglect patients were frontal lobe and striatum on the right. In severe HN, SPECT images evidenced the most extensive hypoperfusion throughout the perisylvian region and subcortical structures of the right hemisphere. Although parietal cortex was affected in patients with moderate to severe HN, it was spared in the rest., Conclusions: HN was a relatively common symptom of vascular right-hemisphere damage (43% of the patient population). HN was a complex disturbance in terms of its clinical manifestation and neuroimaging correlates. Our findings challenge the classical notion that damage to the parietal cortex is critically associated with HN. Instead, our results support the model attributing hemispatial neglect to a defect in a cortico-striato-thalamo-cortical loop. Also, the present study highlights the usefulness of cerebral blood flow SPECT imaging as a diagnostic aid in the post-stroke deficits of cognition following right-hemisphere damage.

Published
2004

40. Heterogeneity of extraparenchymal primitive neuroectodermal tumors within the craniospinal axis.

Author

Izycka-Swieszewska E, Kloc W, Plata-Nazar K, Stefanowicz J, Drozyńska E, Woźniak A, Gasecki D, and Debiec-Rychter M

Subjects
Adolescent, Adult, Biomarkers, Tumor analysis, Biomarkers, Tumor biosynthesis, Central Nervous System Neoplasms chemistry, Child, Cytogenetic Analysis, Diagnosis, Differential, Fatal Outcome, Female, Follow-Up Studies, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence methods, Male, Neuroectodermal Tumors, Primitive chemistry, Polyploidy, Central Nervous System Neoplasms genetics, Central Nervous System Neoplasms pathology, Genetic Heterogeneity, Neuroectodermal Tumors, Primitive genetics, Neuroectodermal Tumors, Primitive pathology, RNA-Binding Protein EWS genetics
Abstract

Four cases of primitive neuroectodermal tumors (PNETs) with unusual localization (three intraspinal extramedullary and one pontocerebellar) are reviewed. Histologically, they were small round blue cell tumors with diverse patterns. Immunohistochemically, all tumors were positive for at least two neuronal markers, two cases were Mic-2 positive and one showed glial differentiation. The paraffin-embedded tumor specimens were examined by interphase FISH using dual-color probes specific for EWS, HER-2 and BCR loci. Molecular cytogenetic study revealed the presence of EWS rearrangement in two cases and the presence of i(17q) in one tumor. Three tumors exhibited 22 disomy and one was 22 polyploid. Extraparenchymal PNETs within craniospinal axis are heterogeneous from the clinical, histological, immunohistochemical and molecular point of view. These PNETs can be of a central or peripheral type. Multidisciplinary approach is of a basic importance in differential diagnosis of such cases.

Published
2004

41. Neuroanatomical correlates of the post-stroke aphasias studied with cerebral blood flow SPECT scanning.

Author

Jodzio K, Gasecki D, Drumm DA, Lass P, and Nyka W

Subjects
Adult, Aged, Aged, 80 and over, Aphasia physiopathology, Aphasia psychology, Aphasia, Broca diagnostic imaging, Aphasia, Broca etiology, Aphasia, Broca physiopathology, Aphasia, Broca psychology, Aphasia, Conduction diagnostic imaging, Aphasia, Conduction etiology, Aphasia, Conduction physiopathology, Aphasia, Conduction psychology, Aphasia, Wernicke diagnostic imaging, Aphasia, Wernicke etiology, Aphasia, Wernicke physiopathology, Aphasia, Wernicke psychology, Brain blood supply, Brain diagnostic imaging, Female, Humans, Language, Magnetic Resonance Imaging, Male, Middle Aged, Stroke physiopathology, Stroke psychology, Tomography, Emission-Computed, Single-Photon, Aphasia diagnostic imaging, Aphasia etiology, Cerebrovascular Circulation, Stroke complications, Stroke diagnostic imaging
Abstract

Background: Researchers are not in complete agreement over the extent to which specific language functions are subserved by certain brain areas. The purpose of this article was to determine neuroanatomical correlates of aphasia following cerebrovascular accident., Material/methods: The participants included 50 stroke patients with a single left-hemisphere lesion and residual mild to severe aphasia. Language, assessed by the Boston Diagnostic Aphasia Examination (BDAE), was affected to various degrees by a wide range of pathologies. Single-photon emission computed tomography (SPECT) images of the brain were acquired with 740 MBq (20 mCi) of Tc-99m-labeled ECD on a triple-headed gamma camera equipped with low-energy, high-resolution collimator. Correlation between reduced cerebral perfusion and the BDAE score was analyzed., Results: The most prominent perfusion abnormalities in Broca's aphasia, as determined by the laterality index, were found in the frontal lobe, and to a lesser degree, the parietal lobe and striatum, whereas the most prominent deficits in Wernicke's aphasia were found in the left temporal and parietal areas. In global aphasia, SPECT images evidenced the most extensive damage throughout the perisylvian region of the left hemisphere., Conclusions: There is need for reinterpretation of the anatomical correlation of selected aphasic syndromes, especially classic Broca's and Wernicke's aphasias. The present study highlights the integrative role of some subcortical structures in language and speech functions. The results support the usefulness of regional cerebral blood flow SPECT imaging as a diagnostic aid in the post-stroke aphasias.

Published
2003

42. Cerebral blood flow SPECT imaging in right hemisphere-damaged patients with hemispatial neglect. A pilot study.

Author

Jodzio K, Lass P, Nyka W, Gasecki D, Bandurski T, and Scheffler J

Abstract

Background: Hemispatial neglect is characterised as a failure by a brain-damaged patient to attend to contralesional space. It is hypothesised to be a result of damage to a network involving the frontal, parietal and cingulated cortices, basal ganglia and thalamus., Material and Methods: The aim of this preliminary study was to verify this model of neglect in 22 right hemisphere-damaged acute stroke patients, using single photon emission-computed tomography (SPECT). The presence of a single right-sided vascular brain lesion was confirmed on CT and/or MRI. Hemispatial neglect, assessed with a battery of drawings, line bisection and line and shape cancellation tests, was observed in 12 cases., Results: Patients with neglect (compared with those without neglect) had more extensive hypoperfusion in the frontal and parietal cortex, as well as striatum and thalamus. Left-sided hypoperfusion in the parietal cortex and the thalamus was also significantly associated with neglect on SPECT imaging. Performance in three out of five psychological tasks commonly used to detect the presence of hemispatial neglect, such as drawing tests and line bisection test, was exclusively linked with damage to the parietal cortex of the right hemisphere, while the line cancellation test might be attributable to the lesion of the right striatum., Conclusions: These findings support the model attributing hemispatial neglect to a unilateral defect in a cortico-striatothalamo-cortical loop. CBF SPECT imaging may provide a reliable description of the brain pathology associated with hemispatial neglect.

Published
2002

43. [Unusual history of the chemodectoma of parapharyngeal space].

Author

Sierszeń W, Gasecki D, Narozny W, and Stankiewicz C

Subjects
Embolization, Therapeutic, Female, Humans, Hypopharyngeal Neoplasms surgery, Intraoperative Complications, Magnetic Resonance Imaging, Middle Aged, Neoplasm Invasiveness, Paraganglioma, Extra-Adrenal surgery, Paresis, Vagus Nerve pathology, Vagus Nerve surgery, Hypopharyngeal Neoplasms pathology, Hypopharyngeal Neoplasms therapy, Paraganglioma, Extra-Adrenal pathology, Paraganglioma, Extra-Adrenal therapy
Abstract

A case of chemodectoma in 58 year old woman is presented. The tumour was located in the parapharyngeal space. During preoperative arteriography and embolization a hemiparesis was noticed, probably caused by the thrombus in the cerebral medial artery. Early radiological examination of brain arteries allowed to perform specific treatment in only two hours time from the onset of the paresis. The treatment was successful--neurological symptoms have receded after 24 hours. Few days later patient was operated on--the tumour was removed with part of the vagus nerve. No serious postoperative complications were observed.

Published
2001

44. [Primitive neuroectodermal tumor of rare localization in two members of one family].

Author

Gasecki D, Izycka-Swieszewska E, Szymkiewicz-Rogowska A, Kopczyński S, and Mechlińska-Baczkowska J

Subjects
Adult, Cervical Vertebrae pathology, Fatal Outcome, Humans, Magnetic Resonance Imaging, Male, Neuroectodermal Tumors, Primitive radiotherapy, Spinal Neoplasms radiotherapy, Neuroectodermal Tumors, Primitive diagnosis, Neuroectodermal Tumors, Primitive genetics, Spinal Neoplasms diagnosis, Spinal Neoplasms genetics
Abstract

A 26-year-old man with primitive neuroectodermal tumour (PNET) is reported. The tumour originated from the cervical spinal cord and was resected partially. Few months later dissemination of the tumour to the meninges occurred. Familial history revealed that the first daughter of the patient had died in age of 14 months three years earlier of a tumour of the right cerebral hemisphere, also diagnosed as PNET.

Published
1999

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