Gene Differentiation in Four Subcastes of Brahmins from Visakhapatnam, Andhra Pradesh

Srikumari, C. R.; Rajanikumari, J.; Rao, T. V.

doi:10.1159/000153661

Cited by 8 publications

(23 citation statements)

References 7 publications

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“…TIA was defined as a reversible episode of neurological deficit of ischemic origin that resolved completely within 24 h [12]. Infarct type was analyzed based on diffusion-weighted images taken at the time of patient symptom presentation and was found to consist of borderzone (n = 21), perforator (n = 8) or wedge-shaped cortical (n = 3) infarcts according to the commonly used templates [13,14]. …”

Section: Methodsmentioning

confidence: 99%

Angiographic Pattern of Symptomatic Severe M1 Stenosis: Comparison with Presenting Symptoms, Infarct Patterns, Perfusion Status, and Outcome after Recanalization

Choi¹,

Kim²,

Choi³

et al. 2010

Cerebrovasc Dis

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Background: Several angiographic patterns distal to severe M1 stenosis have been identified. We have assessed the relationship between these angiographic patterns and patient presenting symptoms, infarct patterns, perfusion status and outcome after recanalization. Methods: Three angiographic patterns were retrospectively identified in 60 patients (M:F = 41:19; age range = 34–80 years, mean = 55) who underwent M1 stenting: (1) a normal pattern (n = 22); (2) a shift pattern of the borderzone of the anterior cerebral artery (ACA) and middle cerebral artery (MCA) down to the MCA side with decreased size of MCA branches (n = 16), and (3) a dilatation pattern of the MCA branches with slow flow and minimal shift of borderzone (n = 22). In addition, to analyze interreader agreement, we assessed the correlation between angiographic patterns and gender, presenting symptoms (stroke vs. TIA), infarct patterns on MRI (borderzone vs. non-borderzone infarcts), perfusion results and outcome after stenting by χ² or Fisher’s exact test. Results: Blind review revealed an excellent interreader agreement in the assessment of angiographic patterns (ĸ = 0.681). The shift pattern was more common in women than in men (p = 0.007). The likelihood of stroke (25/60, 42%, p = 0.001), borderzone infarct (21/32, 66%, p = 0.010) and decreased perfusion (p < 0.001) were greatest in the dilatation pattern, followed by shift and normal patterns. The outcomes did not differ by angiographic pattern probably due to the low event rate (4/60, 6.7%) within 6 months. Conclusions: Patients with severe M1 stenosis had 3 different angiographic patterns, which correlated with presenting symptoms, infarct patterns and perfusion status. Differences in patterns may be related to variation in collateral circulation at the ACA-MCA borderzone and hypoperfusion status.

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Section: Methodsmentioning

confidence: 99%

Angiographic Pattern of Symptomatic Severe M1 Stenosis: Comparison with Presenting Symptoms, Infarct Patterns, Perfusion Status, and Outcome after Recanalization

Choi¹,

Kim²,

Choi³

et al. 2010

Cerebrovasc Dis

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“…The border zones, especially those that are subcortical, also vary greatly in patients with different severities of extracranial arterial stenosis [77], and different mechanisms reflect similar topographies in subcortical territories [78]. Thus the original concept of arterial border zones proposed by Zülch [71] and Zülch and Behrend [72] in the mid 1950s and later reinforced by others [73, 74] is probably valid in only a few patients and is likely only rarely explained by hemodynamic compromise alone [79,80,81,82]. …”

Section: Border-zone Infarcts and Hypoperfusionmentioning

confidence: 99%

Is Hypoperfusion an Important Cause of Strokes? If So, How?

et al. 2006

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Traditionally hypoperfusion and embolism are considered separate important causes of stroke in patients with arterial occlusive disease. However, although hypoperfusion and embolism differ in mechanisms and location, they generally coincide in severe obstructive lesions and cause washout disturbances of embolism in low perfusion territories distal to stenosis. Unless the collateral blood supply is sufficient to prevent ischemia, multiple remote spot-like infarctions occur within the hypoperfused brain territory. In border-zone distributed infarction – long suspected to result from hemodynamic compromise alone – complementary interaction of embolisation and hypoperfusion territories has to be considered. Thus hypoperfusion with embolism or embolism alone are the most common explanations for stroke, the former often associated with less severe clinical deficits than the latter.

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“…The observation of infarcts in the parieto-occipito-temporal region in the setting of carotid artery occlusion or systemic hypotension led to the notion of stroke in the border between the arterial territories [8, 9]. Because of the proximity of these strokes to the border of the arterial territory, the postulated mechanism of infarction was distal field perfusion failure.…”

Section: Introductionmentioning

confidence: 99%

“…Because of the proximity of these strokes to the border of the arterial territory, the postulated mechanism of infarction was distal field perfusion failure. This concept was stated as, ‘unilateral borderzone infarction occurs when there is preexisting ipsilateral vascular disease, with focal cerebral hypoperfusion in the farthest periphery during episodes of systemic hypotension’ [9]. This concept was based on the idea that the arterial supply of the border region becomes precarious the further one moves away from the core of the arterial territory [9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Digital Probabilistic Atlas of the Border Region between the Middle and Posterior Cerebral Arteries

et al. 2009

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Background and Purpose: The diagnosis of external borderzone infarction is made when the stroke is located at the border between the arterial territories. Recent studies have raised questions regarding the location of this borderzone given the variability in the arterial territories. We examined the location of this region using a digital approach and its correspondence with the ‘traditional’ template. Methods: Infarcts resulting from occlusion of the middle cerebral artery (MCA) or posterior cerebral artery (PCA) trunk or branches were segmented from T₂-weighted MR images and linearly registered into a common stereotaxic coordinate space. For MCA infarcts and PCA infarcts, maps of voxels in a rim surrounding the infarct were created. The maps of individual rims were averaged to create images of the probability of each voxel lying in the MCA and PCA rims. The MCA and PCA rims were used to create a digital atlas of the probability of each voxel lying concurrently in both rims. Results: The MCA group consisted of 36 patients (16 males) with a median age of 73 (range 25–87) years. The PCA territory group consisted of 30 patients (24 males) with a median age of 61 (range 22–86) years. The probability of involvement in the digital atlas was higher in the posterior putamen (probability 0.12–0.29) and optic tract (probability 0.13–0.0.20) than in the angular gyrus (probability 0.01). Conclusion: We have created a digital model of the border region between the MCA and PCA territories. This approach may be useful for evaluating the likelihood of a stroke mechanism from topography.

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Gene Differentiation in Four Subcastes of Brahmins from Visakhapatnam, Andhra Pradesh

Cited by 8 publications

References 7 publications

Angiographic Pattern of Symptomatic Severe M1 Stenosis: Comparison with Presenting Symptoms, Infarct Patterns, Perfusion Status, and Outcome after Recanalization

Angiographic Pattern of Symptomatic Severe M1 Stenosis: Comparison with Presenting Symptoms, Infarct Patterns, Perfusion Status, and Outcome after Recanalization

Is Hypoperfusion an Important Cause of Strokes? If So, How?

Digital Probabilistic Atlas of the Border Region between the Middle and Posterior Cerebral Arteries

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