Strokes in the subinsular territory

Kumral, Emre; Özdemirkıran, T.; Alper, Y.

doi:10.1212/01.wnl.0000147261.22630.f8

Cited by 20 publications

(29 citation statements)

References 8 publications

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“…Changes in cardiac rhythm have been demonstrated in association with electrical stimulation of the insular and temporal cortices by other investigators (18,44). It should be noted that not all investigators have been able to demonstrate cardiovascular effects in response to disturbances of function in the temporal lobe and insula (58–60).…”

Section: Discussionmentioning

confidence: 99%

The Ictal Bradycardia Syndrome: Localization and Lateralization

et al. 2006

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Summary:Purpose: Previous studies have established the importance of the insular cortex and temporal lobe in cardiovascular autonomic modulation. Some investigators, based on the results of cortical stimulation response, functional imaging, EEG recordings of seizures, and lesional studies, have suggested that cardiac sympathetic and parasympathetic function may be lateralized, with sympathetic representation lateralized to the right insula, and parasympathetic, to the left. These studies have suggested that ictal bradycardia is most commonly a manifestation of activation of the left temporal and insular cortex. However, the evidence for this is inconsistent. We sought to assess critically the predictable value of ictal bradycardia for seizure localization and lateralization.Methods: In this study, we reviewed the localization of seizure activity in 13 consecutive patients with ictal bradycardia diagnosed during prolonged video-EEG monitoring at Mayo Clinic Rochester. The localization of electrographic seizure activity at seizure onset and bradycardia onset was identified in all patients. In addition, we performed a comprehensive review of the ictal bradycardia literature focusing on localization of seizure activity in ictal bradycardia cases.Results: All occurrences of ictal bradycardia in the 13 identified patients were associated with temporal lobe-onset seizures. However, no consistent lateralization of seizure activity was found at onset of seizure activity or at onset of bradycardia in this population. Seizure activity was bilateral at bradycardia onset in nine of 13 patients. The results from the literature review also showed that a predominance of patients had bilateral activity at bradycardia onset; however, more of the ictal bradycardia cases from the literature had left hemispheric localization of seizure onset.Conclusions: Ictal bradycardia most often occurs in association with bilateral hemispheric seizure activity and is not a consistent lateralizing sign in localizing seizure onset. Our data do not support the existence of a strictly unilateral parasympathetic cardiomotor representation in the left hemisphere, as has been suggested.

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Section: Discussionmentioning

confidence: 99%

The Ictal Bradycardia Syndrome: Localization and Lateralization

et al. 2006

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“…Intracranial perforating arteries and small branches of the circle of Willis provide blood supply to the brain stem and deep grey and white matter structures of the brain [1, 2]. Acute occlusion of these perforating arteries may cause infarctions with profound clinical symptoms, while chronic small vessel disease of the perforating arteries may cause chronic white matter lesions in the pons and the cerebrum [3–7].…”

Section: Introductionmentioning

confidence: 99%

High-Resolution Postcontrast Time-of-Flight MR Angiography of Intracranial Perforators at 7.0 Tesla

et al. 2015

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Background and PurposeDifferent studies already demonstrated the benefits of 7T for precontrast TOF-MRA in the visualization of intracranial small vessels. The aim of this study was to assess the performance of high-resolution 7T TOF-MRA after the administration of a gadolinium-based contrast agent in visualizing intracranial perforating arteries.Materials and MethodsTen consecutive patients (7 male; mean age, 50.4 ± 9.9 years) who received TOF-MRA at 7T after contrast administration were retrospectively included in this study. Intracranial perforating arteries, branching from the parent arteries of the circle of Willis, were identified on all TOF-MRA images. Provided a TOF-MRA before contrast administration was present, a direct comparison between pre- and postcontrast TOF-MRA was made.ResultsIt was possible to visualize intracranial perforating arteries branching off from the entire circle of Willis, and their proximal branches. The posterior cerebral artery (P1 and proximal segment of P2) appeared to have the largest number of visible perforating branches (mean of 5.1 in each patient, with a range of 2–7). The basilar artery and middle cerebral artery (M1 and proximal segment M2) followed with a mean number of 5.0 and 3.5 visible perforating branches (range of 1–9 and 1–8, respectively). Venous contamination in the postcontrast scans sometimes made it difficult to discern the arterial or venous nature of a vessel.ConclusionHigh-resolution postcontrast TOF-MRA at 7T was able to visualize multiple intracranial perforators branching off from various parts of the circle of Willis and proximal intracranial arteries. Although confirmation in a larger study is needed, the administration of a contrast agent for high-resolution TOF-MRA at 7T seems to enable a better visualization of the distal segment of certain intracranial perforators.

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“…Hypoxic ischemic brain injury is known to lead to mental retardation and deficits in cognitive abilities, such as learning and memory. Impairment of the performance of hypoxic ischemic rats in a water maze task was unlikely to be due to changes in motivation, sensorimotor function, or visual impairment (Kumral et al 2004). A previous study suggested that impairment of performance in hypoxic ischemia rats was due to learning and memory deficits (Anderson and Arciniegas 2010).…”

Section: Discussionmentioning

confidence: 91%

Hypothermia alleviates hypoxic ischemia-induced dopamine dysfunction and memory impairment in rats

Cho

Kim

et al. 2011

Animal Cells and Systems

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(2011) Hypothermia alleviates hypoxic ischemia-induced dopamine dysfunction and memory impairment in rats, Animal Cells and Systems, 15:4, 279-286, DOI: 10.1080/19768354.2011.607514 To link to this article: https://doi.org/10. 1080/19768354.2011 Hypoxic ischemia injury is a common cause of functional brain damage, resulting from a decrease in cerebral blood flow and oxygen supply to the brain. The main problems associated with hypoxic ischemia to the brain are memory impairment and dopamine dysfunction. Hypothermia has been suggested to ameliorate the neurological impairment induced by various brain insults. In this study, we investigated the effects of hypothermia on memory function and dopamine synthesis following hypoxic ischemia to the brain in rats. For this purpose, a step-down avoidance task, a radial eight-arm maze task, and immunohistochemistry for tyrosine hydroxylase (TH) and 5-bromo-2?-deoxyuridine (BrdU) were performed. The present results indicated that the hypoxic ischemia-induced disturbance of the animal's performances and spatial working memory was associated with a decrement in TH expression in the substantia nigra and striatum, and an increase in cell proliferation in the hippocampal dentate gyrus. Hypothermia treatment improved the animals' performance and spatial working memory by suppressing the decrement in TH expression in the substantia nigra and striatum and the increase in cell proliferation in the dentate gyrus. We suggest that hypothermia can be an efficient therapeutic modality to facilitate recovery following hypoxic ischemia injury to the brain, presumably by modulating the dopaminergic cell loss.

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Strokes in the subinsular territory

Cited by 20 publications

References 8 publications

The Ictal Bradycardia Syndrome: Localization and Lateralization

The Ictal Bradycardia Syndrome: Localization and Lateralization

High-Resolution Postcontrast Time-of-Flight MR Angiography of Intracranial Perforators at 7.0 Tesla

Hypothermia alleviates hypoxic ischemia-induced dopamine dysfunction and memory impairment in rats

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