PubMed Health⌕ Search

Biomedical subjects

M G Hennerici

Publications and source records attributed to M G Hennerici.

At least 19 recordsLinked to original sources
PubMed2006

Mannheim carotid intima-media thickness consensus (2004-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006.

Intima-media thickness (IMT) is increasingly used as a surrogate end point of vascular outcomes in clinical trials aimed at determining the success of interventions that lower risk factors for atherosclerosis and associated diseases (stroke, myocardial infarction and peripheral artery diseases). The necessity to promote further criteria to distinguish early atherosclerotic plaque formation from thickening of IMT and to standardize IMT measurements is expressed through this updated consensus. Plaque is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness >1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. Standard use of IMT measurements is based on physics, technical and disease-related principles as well as agreements on how to perform, interpret and document study results. Harmonization of carotid image acquisition and analysis is needed for the comparison of the IMT results obtained from epidemiological and interventional studies around the world. The consensus concludes that there is no need to 'treat IMT values' nor to monitor IMT values in individual patients apart from exceptions named, which emphasize that inside randomized clinical trials should be performed. Although IMT has been suggested to represent an important risk marker, according to the current evidence it does not fulfill the characteristics of an accepted risk factor. Standardized methods recommended in this consensus statement will foster homogenous data collection and analysis. This will help to improve the power of randomized clinical trials incorporating IMT measurements and to facilitate the merging of large databases for meta-analyses.

Adult↗
PubMed2006

[The consequences of stroke for the artist Lovis Corinth].

The artist Lovis Corinth suffered a right-hemispheric stroke at the age of 53 years but only died 14 years later. The huge amount of work he produced after this life threatening disease allows detailed analysis of his post-stroke artwork in comparison to pre-stroke. When performing this analysis as a neurologist, an enormous diversity of subtle stroke sequelae can be discovered that are mostly explained by left-sided hemi-neglect. These findings clearly go far beyond pure psychological processes. Moreover, Corinth is a motivating example for disabled patients because he was able to produce great artwork after his stroke. He was struggling against a motor disability admittedly not severely affecting his artistic production, but also against severe neuropsychological deficits that did have clear consequences. Lovis Corinth left us the credo "True art means to use unreality". Taken together with the often cited phrase "Drawing means to leave out (details)", a clear-cut interpretation for neurologists can be derived from the understanding of right-hemisphere lesions and subsequent left-sided neglect.

Persons with Disabilities↗
PubMed2006

[Asymptomatic carotid stenoses. Course and discussion of their treatment].

Asymptomatic carotid stenoses are common. They are associated with the risk factors for arteriosclerosis and are a specific risk factor for coronary artery disease, with an annual morbidity/mortality (MM) rate of 8-10%. Detection of a carotid stenosis should therefore be followed by a complete risk factor analysis and modification, if appropriate; a thorough cardiological diagnostic investigation is particularly important. Individual risk indicators for stroke (annual MM 1-2%) are a rapid progression of the degree of stenosis, certain morphological patterns and the presence of extra- and intracranial multi-vessel disease. Trials available so far on the treatment of asymptomatic carotid stenosis have not revealed any significant parameters that would justify individual decisions on whether or not surgery is appropriate. There is therefore a danger that many patients will be exposed to a severe risk of stroke, which cannot be justified unless the centres where such interventions are performed have proven MM complication rates of <3%, the life expectancy of the patients treated is not restricted as the result of other illnesses and the patients explicitly request surgery after a thorough explanation of the risks. Conservative treatment strategies provide the best protection for the majority of patients.

Carotid Stenosis↗
PubMed2006

Gadofluorine m uptake in stem cells as a new magnetic resonance imaging tracking method: an in vitro and in vivo study.

OBJECTIVES: Cell tracking using ultrasmall iron particles is well established in magnetic resonance imaging (MRI). However, in experimental models, intrinsic iron signals derived from erythrocytes mask the labeled cells. Therefore, we evaluated Gadofluorine M with other gadolinium chelates for a T1-weighted positive enhancement for cell tracking in vitro. In addition, Gadofluorine M was tested in vivo. MATERIAL AND METHODS: Gadofluorine M and other gadolinium chelates were used to label stem cells with and without uptake-mediating agents in vitro and in vivo using a 1.5 T MRI. In addition, histology and molecular modeling was investigated. RESULTS: Gadofluorine M revealed comparable properties to an uptake mediating agent in molecular modeling. Without an uptake-mediating agent Gadofluorine M-labeled cells were detected as a T1-weighted positive contrast in vitro and in vivo. Histology confirmed a 100% success rate for intracellular labeling. CONCLUSION: This study describes a novel contrast agent with the capability of intracellular accumulation without an uptake mediator providing a T1-positive MRI signal at 1.5 T and may be suitable for cell tracking in animal models with intraparenchymal hemorrhages such as stroke or malignant tumors.

Adipose Tissue↗
PubMed2004

Mannheim intima-media thickness consensus.

Intima-media thickness (IMT) is increasingly used in clinical trials as a surrogate end point for determining the success of interventions that lower risk factors for atherosclerosis. The necessity for unified criteria to distinguish early atherosclerotic plaque formation from thickening of IMT and to standardize IMT measurements is addressed in this consensus statement. Plaque is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness of > or =1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. Standard use of IMT measurements is recommended in all epidemiological and interventional trials dealing with vascular diseases to improve characterization of the population investigated. The consensus concludes that there is no need to 'treat IMT values' nor to monitor IMT values in individual patients apart from few exceptions. Although IMT has been suggested to represent an important risk marker, it does not fulfill the characteristics of an accepted risk factor. Standardized methods recommended in this consensus statement will foster homogenous data collection and analysis. This will help to improve the power of studies incorporating IMT measurements and to facilitate the merging of large databases for meta-analyses.

Arteriosclerosis↗
PubMed2004

The Stent-Supported Percutaneous Angioplasty of the Carotid Artery vs. Endarterectomy Trial.

The Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy (SPACE) Trial is investigating if both treatment modalities are equivalent in the treatment of severe symptomatic carotid stenoses. Patients with symptomatic (transient ischaemic attack or minor stroke) stenosis (above 50% following the North American Symptomatic Endarterectomy Trial criteria) eligible for both methods can be recruited into this trial. The primary endpoint is the incidence of an ipsilateral stroke or death between randomisation and day 30 after treatment. Surgeons as well as the interventionalists have to demonstrate their expertise prior to participation in the trial. Funding is mostly by public institutions (Federal Ministry of Education and Research and German Research Foundation). An external monitoring is applied. Thirty-two centres are currently taking part in the SPACE Trial that has been running in Germany, Austria and Switzerland for 3 years, and they have been able to recruit a total of around 670 patients. The definitive results of this study cannot be expected before 3-5 years.

Angioplasty↗
PubMed2004

Efficacy of sonothrombolysis in a rat model of embolic ischemic stroke.

The key goal in the treatment of acute ischemic stroke is fast vessel recanalization. Thrombolysis with recombinant tissue plasminogen activator (rt-PA) is efficient in humans but mean time for recanalization is within hours. Ultrasound bio-effects has been shown to facilitate rt-PA mediated thrombolysis in peripheral arteries. We used an embolic stroke model in the rat. In all rats we induced an ischemic stroke by a selective occlusion of the middle cerebral artery with whole blood clots. From an entire collective of 54 rats 47 completed the protocol (n = 7 died early). Four different groups (no treatment n = 6; full dose rt-PA treatment only [10 mg/kg per body weight] n = 14, half dose rt-PA treatment plus ultrasound n = 10, and full dose rt-PA treatment plus ultrasound n = 17) were investigated. We found a significant reduction of absolute as well as relative infarct volume in the full dose rt-PA plus ultrasound group (81+/-72 mm(3); P< 0.05) in comparison to untreated rats (253+/-159 mm(3); P < 0.05) as well as in comparison to rats treated with full dose rt-PA only (167+/-91 mm(3); P < 0.05). There were five intracranial bleedings giving a bleeding rate of 9.3%. In summary: ultrasound treatment in addition to rt-PA is more effective than single rt-PA treatment in reducing infarct volume and safe with regard to bleeding.

Animals↗
PubMed2003

Clinicotopographical correlation of corticospinal tract stroke: a color-coded diffusion tensor imaging study.

UNLABELLED: Background- Small capsular strokes are difficult to assess with regard to the precise location and the extent of pyramidal tract damage with conventional brain imaging. Color-coded diffusion tensor imaging (CDTI) provides a means to visualize the course of the corticospinal tract within the white matter. In addition to T2-weighted MRI, diffusion-weighted MRI and CDTI were used to analyze the topographical patterns of small lacunar corticospinal tract strokes. METHODS: We examined 15 patients with pyramidal tract strokes in the subacute phase (days 3 to 7). Lesions were identified on diffusion-weighted MRI and superimposed on CDTI images. The anatomic location and pattern of the lesion were visualized on CDTI with regard to the corticospinal tract and subsequently compared with the clinical presentation. In addition, infarct areas were evaluated with quantitative parameters: mean diffusivity and lattice anisotropy index of lesions were determined. RESULTS: We identified 5 different patterns of corticospinal tract stroke falling into 2 clinical subgroups: (1) those with marked deficits and minor improvement (6/15) and (2) those with good recovery (9/15). Group 1 had long lesions centered in the pyramidal tract, involving the basal ganglia (anterior choroidal artery); group 2 lesions were very small and/or located anteriorly and medially (periventricular anterior choroidal artery territory; thalamogeniculate, tuberothalamic, and lateral striate branches). Lesions showed a significant increase of mean diffusivity and decrease of lattice anisotropy. CONCLUSIONS: CDTI allows in vivo differentiation of distinct subcortical stroke subtypes. Improved anatomic definition of lesion localization using CDTI may help in better establishing the prognosis for patients after subcortical stroke.

Aged↗
PubMed2003

Bilateral internal carotid artery dissection mimicking inflammatory demyelinating disease.

BACKGROUND AND PURPOSE: Internal carotid artery (ICA) dissection (ICAD) may be extremely difficult to diagnose only on the basis of historical information and clinical signs, and even standard brain imaging (computed tomography [CT], T2-weighted magnetic resonance imaging [MRI]) may not be sufficient to delineate the underlying pathology clearly, as shown in this case. METHODS: The clinical presentation and parenchymal lesion pattern on CT were suggestive of inflammatory demyelinating disease, and additional multiparametric MRI was performed. RESULTS: Diffusion-weighted MRI, magnetic resonance angiography, and perfusion-weighted MRI revealed acute ischemic lesions, bilateral ICA obstruction, and bilateral hypoperfusion in the middle cerebral artery territories. Bilateral ICAD was confirmed by Doppler and duplex ultrasound, and anticoagulation therapy was initiated. A follow-up examination showed recanalization of the obstructed ICAs and the normalization of cerebral perfusion. CONCLUSION: This case illustrates the importance of demonstrating the pathology and the value of multiparametric MRI techniques for the diagnosis and monitoring of ICAD and its hemodynamic consequences.

Carotid Artery, Internal, Dissection↗