Abstract This study investigated the effect of maternal care on adolescent ethanol consumption, sensitivity to ethanol‐induced hypnosis, as well as gonadal hormones and γ ‐aminobutyric acid type‐A (GABA A ) systems. Long Evans rat dams were categorized by maternal licking/grooming (LG) frequency into High‐ and Low‐LG mothers. Both female and male offspring from Low‐LG rats demonstrated a greater sensitivity to ethanol‐induced hypnosis in the loss‐of‐righting‐reflex test at ethanol doses of 3.0 and 3.5 g/kg during late‐adolescence (postnatal Day 50) but not at mid‐adolescence (postnatal Day 42). However, we found no effect of maternal care on consumption of a 5% ethanol solution in a two‐bottle choice test. We further investigated the association between the observed variations in sensitivity to ethanol‐induced hypnosis and baseline hormonal levels in males. In male offspring from Low‐LG mothers compared to High‐LG mothers, baseline plasma corticosterone and progesterone levels were higher. GABA A α1 and δ subunit expressions were also higher in the cerebral cortex of Low‐LG males but lower in the cerebellar synaptosomal fraction. Early environmental influences on adolescent sensitivity to ethanol‐induced hypnosis, consumption, and preference may be mediated by gonadal hormones and possibly through GABAergic functions.
Radial loops are rare congenital radial artery anomalies that may pose a significant challenge to successful transradial neuroangiography. In this case series, we describe the anatomy and frequency of radial artery loops and provide a technique for successful navigation of this anatomic anomaly.We reviewed our database of radial diagnostic or interventional neuroangiographic procedures to identify cases in which a radial loop was encountered during the procedure. The loop pattern, the presence of an associated recurrent radial artery branch, navigation technique, and procedure-related complications were recorded. A descriptive analysis was performed.A total of 997 transradial approach procedures were performed over a 9-month period. A radial loop was identified in 10 (1.0%) patients. The average age was 68.6 ± 14.3 years. A microcatheter advanced over a microwire was used to navigate the loop and avoid entry into the recurrent branch. A diagnostic neuroangiographic procedure was performed successfully in 8 cases and an intervention was performed successfully in 1 case. A 360° loop was present in 2 of these cases. In each case, transradial access was performed successfully. In 1 other diagnostic case, transradial access was aborted, and the femoral artery was accessed to perform the procedure.A radial loop was present in 1% of the cases in this series. Our technical results suggest that this anomaly should not be considered a contraindication to transradial neuroangiography because the procedure was successfully performed in most (9 of 10) cases using a microcatheter system to navigate the loop.
Necrobiotic xanthogranuloma is a condition that was first identified in 1980 based on its characteristic histological identity, and it has been known since then as a dermatologic manifestation of an underlying systemic dysproteinemia. Intracranial manifestation is a rare presentation of this condition and has been reported only once in its more than 40 years of existence. Herein and to our knowledge, we report the second observation of an intracranial manifestation and, surprisingly, the first case without the expected dermatologic and systemic dysproteinemia associations. This case identifies an existing knowledge gap in our understanding of necrobiotic xanthogranuloma and emphasises the need for further research into understanding the presentation, comorbidities and management of this condition.
Gallium 68 ( 68 Ga) 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid labelled octreotate ([ 68 Ga]Ga-DOTA-TATE) positron emission tomography (PET) is an established imaging technique for identifying tumours of neuroendocrine origin and meningiomas; the radiotracer binds to somatostatin receptor type 2 (SSTR2), which is richly expressed by these malignancies. Here, we present a rare case hinting at novel ischaemic stroke detection by [ 68 Ga]Ga-DOTA-TATE PET scan. The scan was performed 14 days post resection of an atypical meningioma with the intention to assess the extent of residual tumour for radiosurgical treatment of the operative cavity. Surprisingly, the [ 68 Ga]Ga-DOTA-TATE PET-avid region corresponded to an area of perioperative subacute ischaemic stroke detected by MRI. This case corroborates the two previously reported cases of incidental detection of ischaemic stroke during routine [ 68 Ga]Ga-DOTA-TATE PET imaging, collectively suggesting the need for caution when interpreting the imaging findings. A possible underlying mechanism for [ 68 Ga]Ga-DOTA-TATE uptake in stroke is increased SSTR2 expression by macrophages recruited into infarcted tissue.
Background Radial access has become popular among neurointerventionalists because it has favorable risk profiles compared with femoral access. Difficulties in accessing or navigating the radial artery have been viewed as a reason to convert to femoral access, but ulnar artery access may prevent complications associated with transfemoral procedures. Objective To evaluate the safety and feasibility of ulnar access for neurointerventions and diagnostic neuroangiographic procedures. Methods Consecutive patients who underwent diagnostic angiography or neurointerventional procedures via ulnar access between July 1, 2019 and April 15, 2020 were included. Data recorded were demographics, procedure indication, devices, technique, and complications. Descriptive analysis was performed. Results Ulnar artery access was obtained for 21 procedures in 18 patients (mean age 70.3±7.8 years; nine men). Procedures included 13 diagnostic angiograms and eight neurointerventions (3 left middle meningeal artery embolization, 1 of which was aborted; 2 carotid artery stenting; 2 angioplasty; 1 mechanical thrombectomy for in-stent thrombosis). A right-sided approach with ultrasound guidance was used for all cases except one. Indications included small caliber radial artery (n=9), radial artery occlusion (n=10), and radial artery preservation for potential bypass (n=2). A 5-French slender sheath was used for diagnostic angiography; a 6-French slender sheath was used for neurointerventions. No case required conversion to femoral access. Two patients had minor hematomas after the procedure; one other had ulnar artery occlusion on 30-day ultrasonography. Conclusion Ulnar access is safe and feasible for diagnostic and interventional neuroangiographic procedures. It provides a useful alternative to radial access, potentially avoiding complications associated with femoral access.
The use of balloon guide catheters (BGCs) for proximal flow arrest during neurointerventional procedures is limited due to incompatibility of these catheters with large-bore aspiration catheters and difficulty in device navigation. The objective of our study was to describe the use of Walrus (Q'Apel Medical, Fremont, CA), a new 8-French (F) BGC, with a variety of aspiration catheters and procedures requiring flow arrest.
Methods
Consecutive cases using Walrus BGCs for proximal flow arrest during mechanical thrombectomy for acute stroke cases was recorded. Procedure indication, vessel occlusion site, technique, first-pass effect (modified thrombolysis in cerebral infarction score of 2C or 3 after first recanalization attempt), and complications were recorded and evaluated statistically.
Results
Our study included 57 patients: all (100%) underwent mechanical thrombectomy. Besides mechanical thrombectomy, the Walrus BGC was used in conjunction with the following techniques: stent retrieval in 2 patient (3.5%), Solumbra in 41 (71.9%), and aspiration-first in 14 (24.6%). Eight different aspiration catheters were used in 56 of these 57 procedures. First-pass effect was achieved in 36 (63.2%) of 57 procedures. Four cases (7.0%) experienced intraoperative complications and 2 (3.5%) died during in-hospital stay.
Conclusion
Our study demonstrates Walrus BCG as an excellent 8F navigable guide catheter compatible with most available aspiration catheters. With a larger inner diameter and compatibility with most available aspiration catheters, it can be used to achieve proximal flow arrest during mechanical thrombectomy and possibly for other neurointervention procedures in the future.
ADAPT, a direct aspiration first pass technique; BGC, balloon guide catheter; F, French; FPE, first-pass effect; ICA, internal carotid artery; ID, inner diameter; mFPE, modified first-pass effect; mRS, modified Rankin scale; mTICI, modified thrombolysis in cerebral infarction; OD, outer diameter; STRATIS, Systematic Evaluation of Patients Treated with Neurothrombectomy Devices for Acute Ischemic Stroke
Disclosures
R. Dossani: None. M. Waqas: None. A. Baig: None. D. Popoola: None. J. Cappuzzo: None. H. Rai: None. A. Monteiro: None. A. Levy: None. E. Hashmi: None. J. Davies: None. E. Levy: None. A. Siddiqui: None.
Abstract Methylphenidate (MP) is a commonly prescribed psychostimulant to individuals with Attention Deficit Hyperactivity Disorder, and is often used illicitly among healthy individuals with intermittent breaks to coincide with breaks from school. This study examined how intermittent abstinence periods impact the physiological and behavioral effects of chronic oral MP self‐administration in rats, and whether these effects persist following prolonged abstinence from the drug. Rats were treated orally with water, low‐dose (LD), or high‐dose (HD) MP, beginning at PND 28. This daily access continued for three consecutive weeks followed by a 1‐week abstinence; after three repeats of this cycle, there was a 5‐week abstinence period. Throughout the study, we examined body weight, food intake, locomotor activity, and anxiety‐ and depressive‐like behaviors. During the treatment phase, HD MP decreased body weight, food intake, and depressive‐ and anxiety‐like behaviors, while it increased locomotor activity. During intermittent abstinence, the effects of MP on locomotor activity were eliminated. During prolonged abstinence, most of the effects of HD MP were ameliorated to control levels, with the exception of weight loss and anxiolytic effects. These findings suggest that intermittent exposure to chronic MP causes physiological and behavioral effects that are mostly reversible following prolonged abstinence.
Few studies have explored the association between stroke thrombectomy (ST) volume and hospital accreditation with clinical outcomes.To assess the association of ST case volume and accreditation status with in-hospital mortality and home discharge disposition using the national Medicare Provider Analysis and Review (MEDPAR) database.Rates of hospital mortality, home discharge disposition, and hospital stay were compared between accredited and non-accredited hospitals using 2017-2018 MEDPAR data. The association of annual ST case volume with mortality and home disposition was determined using Pearson's correlation. Median rate of mortality and number of ST cases at hospitals within the central quartiles were estimated.A total of 29 355 cases were performed over 2 years at 847 US centers. Of these, 354 were accredited. There were no significant differences between accredited and non-accredited centers for hospital mortality (14.8% vs 14.5%, p=0.34) and home discharge (12.1% vs 12.0%, p=0.78). A significant positive correlation was observed between thrombectomy volume and home discharge (r=0.88; 95% CI 0.58 to 0.97, p=0.001). A significant negative relationship was found between thrombectomy volume and mortality (r=-0.86; 95% CI -0.97 to -0.49, p=0.002). Within the central quartiles, the median number of ST cases at hospitals with mortality was 24/year, and the median number of ST cases at hospitals with home discharge rate was 23/year.A higher volume of ST cases was associated with lower mortality and higher home discharge rate. No significant differences in mortality and discharge disposition were found between accredited and non-accredited hospitals.
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