Acute treatment and clinical outcome in patients with intracranial arterial dissection
Project/Area Number |
16K09485
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Research Field |
Cardiovascular medicine
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Research Institution | National Cardiovascular Center Research Institute |
Principal Investigator |
Koga Masatoshi 国立研究開発法人国立循環器病研究センター, 病院, 部長 (30512230)
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Project Period (FY) |
2016-04-01 – 2020-03-31
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Project Status |
Completed (Fiscal Year 2019)
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Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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Keywords | 頭蓋内動脈解離 / 若年性脳梗塞 / くも膜下出血 / MRI / 超音波検査 / 抗血栓療法 / 脳梗塞 / MRIのT1 SPACE画像 / 頚部血管エコー / 脳血管造影 / クモ膜下出血 / 好中球・リンパ球比 / 頭痛 / 高解像度3D T1 / 椎骨動脈 / 頸部血管エコー / 3T MRI / T1強調画像 / 抗凝固薬 / 抗血小板薬 |
Outline of Final Research Achievements |
Our observational study of intracranial artery dissection (IAD) showed that the identification of intramural hematoma of dissociated intracranial artery by high-resolution 3D T1-weighted imaging was very useful for diagnosing IAD. Follow-up evaluation of blood flow velocity by carotid ultrasound was useful to identify the appearance and progression of intracranial vertebral artery stenosis. In IAD patients with ischemia stroke or headache alone, the clinical course was generally favorable regardless of antithrombotic treatment. We enrolled 50 patients (500 cases in total) to an international observational study of IAD. We plan to show the pathophysiology and clinical course of IAD, which has been mostly reported by East Asian countries including Japan, and clarify racial differences.
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Academic Significance and Societal Importance of the Research Achievements |
若年性脳梗塞の重要な原因の一つである頭蓋内動脈解離は、画像診断の進歩により診断される機会が増えたが、診断方法や治療方法は確立していない。これまで脳血管撮影による評価が重視されてきたが、非侵襲的画像診断である高分解能3D T1強調画像による壁内血腫同定が一般的になっていく可能性がある。また非侵襲的画像診断である頚部血管エコーのフォローアップで椎骨動脈狭窄出現や進行を同定できることを明らかにした。頭蓋内動脈解離の一部は解離性動脈瘤からくも膜下出血を来し転帰不良の経過をとるが、虚血発症や頭痛のみの症例の多くは経過が良好であった。国際共同研究で多数例を解析し、さらなる検討を行っていく。
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Report
(5 results)
Research Products
(25 results)
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[Journal Article] Clinical and Radiological Characteristics of Intracranial Artery Dissection Using Recently Proposed Diagnostic Criteria2019
Author(s)
Nakamura Y, Yamaguchi Y, Makita N, Morita Y, Ide T, Wada S, Mizoguchi T, Ikenouchi H, Miwa K, Yi K, Irie K, Shimohama S, Ihara M, Toyoda K, Koga M
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Journal Title
J Stroke Cerebrovasc Dis
Volume: Epub
Issue: 6
Pages: 30063-1
DOI
Related Report
Peer Reviewed
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[Journal Article] Detection of stenosis progression in intracranial vertebral artery dissection using carotid ultrasonography2019
Author(s)
Wada S, Koga M, Nakamura Y, Makita N, Miwa K, Ide T, Yi K, Mizoguchi T, Yamaguchi Y, Ihara M, Toyoda K
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Journal Title
J Stroke Cerebrobasc Dis
Volume: in press
Related Report
Peer Reviewed
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[Presentation] Angiographic Findings Associated With Ischemic and Hemorrhagic Stroke in Intracranial Artery Dissection.2019
Author(s)
Tadataka Mizoguchi, Kaori Miwa, Kenichiro Yi, Kenichi Irie, Naoki Makita, Hidekazu Chikuie, Tetsu Satow, Jun C Takahashi, Hiroshi Yamagami, Masafumi Ihara, Kazunori Toyoda, Masatoshi Koga.
Organizer
International Stroke Conference 2019, Honolulu, Hawaii, USA
Related Report
Int'l Joint Research
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[Presentation] Relationship of Neutrophil-to-Lymphocyte Ratio to Stroke Subtype and Functional Outcome in Intracranial Artery Dissection.2019
Author(s)
Yi K, Miwa K, Mizoguchi T, Irie K, Makita N, Chikuie H, Satow T, Takahashi J, Yamagami H, Ihara M, Toyoda K, Koga M.
Organizer
International Stroke Conference 2019, Honolulu, Hawaii, USA
Related Report
Int'l Joint Research
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[Presentation] Clinical and Radiological Characteristics of Intracranial Artery Dissection Using Recently Proposed Diagnostic Criteria.2018
Author(s)
Nakamura Y, Yamaguchi Y, Koga M, Morita Y, Makita N, Ide T, Wada S, Shimohama S, Ihara M, Toyoda K.
Organizer
International Stroke Conference 2018, Los Angeles, USA
Related Report
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