intracranial embolism and thrombosis


Summary: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures.

Top Publications

  1. Gregory P, Kuhlemeier K. Prevalence of venous thromboembolism in acute hemorrhagic and thromboembolic stroke. Am J Phys Med Rehabil. 2003;82:364-9 pubmed
    ..60; 95% confidence interval, 1.49-4.55; P = 0.0008). DVT prevalence and risk was higher among patients with hemorrhagic strokes in comparison with patients with thromboembolic strokes. ..
  2. Jahan R. Hyperacute therapy of ischemic stroke: intravenous thrombolysis. Tech Vasc Interv Radiol. 2005;8:81-6 pubmed
    ..In this article we review the major intravenous thrombolysis trials leading to approval of intravenous recombinant tissue plasminogen activator, the only FDA approved treatment available today for acute ischemic stroke. ..
  3. Imai K, Mori T, Izumoto H, Takabatake N, Kunieda T, Yamamoto S, et al. Successful stenting seven days after atherothrombotic occlusion of the intracranial internal carotid artery. J Endovasc Ther. 2006;13:254-9 pubmed
    ..This experience suggests that short atherothrombotic intracranial ICA occlusions can be opened in the subacute stroke stage without distal migration of thrombi under proximal protection and flow reversal. ..
  4. Jacobs A, Neveling M, Horst M, Ghaemi M, Kessler J, Eichstaedt H, et al. Alterations of neuropsychological function and cerebral glucose metabolism after cardiac surgery are not related only to intraoperative microembolic events. Stroke. 1998;29:660-7 pubmed
  5. Martin Gonzalez R. [Vertebrobasilar ischemia of thrombotic and embolic origin]. Rev Neurol. 1998;26:118-21 pubmed
    ..This permits not only individualized, correct treatment of each patient but also a more complete knowledge of the mechanisms of ischemia in this territory. ..
  6. Takeo S, Tanonaka R, Miyake K, Tanonaka K, Taguchi T, Kawakami K, et al. Naftidrofuryl oxalate improves impaired brain glucose metabolism after microsphere-induced cerebral embolism in rats. J Pharmacol Exp Ther. 1991;257:404-10 pubmed
    ..abstract truncated at 250 words) ..
  7. Ghandehari K, Izadi Mood Z. Etiology of young adult onset brain infarction in Iran. Arch Iran Med. 2006;9:240-3 pubmed
    ..5 preventable stroke cases per 100,000 young adults per year. Rheumatic valvular heart disease is the most common cause and a preventable etiology of stroke in Iranian young adults. ..
  8. Chung E, Fan L, Degg C, Evans D. Detection of Doppler embolic signals: psychoacoustic considerations. Ultrasound Med Biol. 2005;31:1177-84 pubmed
    ..We conclude that the current fixed choice of threshold does not provide a good approximation to the true threshold of detection across the full range of embolic signal parameters. ..
  9. Mullges W, Berg D, Toyka K. Bilateral cerebral emboli monitoring during extracorporeal circulation. Ultrasound Med Biol. 1999;25:755-8 pubmed
    ..The total embolic load to the brain during extracorporeal circulation cannot be precisely predicted from unilateral transcranial insonation alone. ..

More Information


  1. Curb J, Abbott R, MacLean C, Rodriguez B, Burchfiel C, Sharp D, et al. Age-related changes in stroke risk in men with hypertension and normal blood pressure. Stroke. 1996;27:819-24 pubmed
    ..However, it appears that other unidentified factors have an increasing role in the causation of stroke with advancing age. ..
  2. Palomeras E, Roquer J, Pou A. [Oral anticoagulation in the secondary prevention of cerebrovascular disease. Long-term follow-up of 169 patients]. Rev Neurol. 1998;27:772-6 pubmed
    ..There is a low incidence of relapse and of complications (usually mild) following AO for the secondary prevention of CVD of cardio-embolic origin. Efficacy and security are maintained in the long term. ..
  3. Garcia Garcia J. [The influence of oral anticoagulants in the natural history of cardioembolic cerebral infarctions]. Rev Neurol. 2007;44:319-20 pubmed
  4. Kuge Y, Yokota C, Tagaya M, Hasegawa Y, Nishimura A, Kito G, et al. Serial changes in cerebral blood flow and flow-metabolism uncoupling in primates with acute thromboembolic stroke. J Cereb Blood Flow Metab. 2001;21:202-10 pubmed
    ..Positron emission tomography investigations using this model will provide better understanding of the pathophysiology of thromboembolic stroke in humans. ..
  6. Thorell W, Rasmussen P, Perl J, Masaryk T, Mayberg M. Balloon-assisted microvascular clipping of paraclinoid aneurysms. Technical note. J Neurosurg. 2004;100:713-6 pubmed
    ..Endovascular balloon stenting of complex paraclinoid aneurysms during microvascular clipping may provide an adjunctive therapy that facilitates safe and accurate clip placement. ..
  7. Gottesman R, Wityk R. Brain injury from cardiac bypass procedures. Semin Neurol. 2006;26:432-9 pubmed
    ..Other techniques such as the use of an arterial filter are discussed, as are their potential benefits in the prevention of neurological complications. ..
  8. Patel V, Sacoor Z, Francis P, Bill P, Bhigjee A, Connolly C. Ischemic stroke in young HIV-positive patients in Kwazulu-Natal, South Africa. Neurology. 2005;65:759-61 pubmed
    ..HIV-positive and HIV-negative groups did not differ in angiographic, cardiac, or serologic tests. A positive HIV test does not provide causal information or diagnosis. ..
  9. Kong R, Butterworth J, Aveling W, Stump D, Harrison M, Hammon J, et al. Clinical trial of the neuroprotectant clomethiazole in coronary artery bypass graft surgery: a randomized controlled trial. Anesthesiology. 2002;97:585-91 pubmed
    ..2 microm. There was no difference between the clomethiazole and placebo group in the postoperative change in neuropsychological test scores. Clomethiazole did not improve cerebral outcome following coronary artery bypass surgery. ..
  10. Lascault G, Durr A, Juillard J, Thomas D, Frank R, Gautier J, et al. [VVI mode cardiac pacing: cause or risk factor of cerebral embolism?]. Arch Mal Coeur Vaiss. 1992;85:1527-31 pubmed
    ..These preliminary retrospective data should be interpreted cautiously taking into account the small population size. Prospective studies on pacemaker patients with cerebral embolism are required. ..
  11. Hudgins R, Boydston W, Gilreath C. Urokinase in the treatment of shunt malfunctions caused by thrombus. Pediatr Neurosurg. 1996;25:315-20 pubmed
    ..We conclude the intrashunt urokinase can be of value in the treatment of shunts by blood and blood products. ..
  12. Hartung E, Ender J, Sgouropoulou S, Bierl R, Engelhardt W, Engemann R. Severe air embolism caused by a pulmonary artery introducer sheath. Anesthesiology. 1994;80:1402-3 pubmed
  13. Lewis R, Gutmann L. Post-traumatic paradoxical embolism in patent foramen ovale. Neurology. 2002;59:1611 pubmed
  14. Ahlsen E. Body communication as compensation for speech in a Wernicke's aphasic--a longitudinal study. J Commun Disord. 1991;24:1-12 pubmed
    ..The role of pronouns and gestures for turnkeeping at an intermediate stage, when the patient is shifting from gestures to words for factual content, is also discussed. ..
  15. Diehl R, Samii C, Diehl A. Dynamics and embolic activity of symptomatic intra-cranial cerebral artery stenoses. Acta Neurol Scand. 2002;106:173-81 pubmed
    ..The high prevalence of MES and sudden velocity changes in acute intracranial cerebral artery stenoses indicates that acute intracranial stenoses may be formed at least in part by mobile thrombotic material. ..
  16. Cochran R, Kunzelman K, Vocelka C, Akimoto H, Thomas R, Soltow L, et al. Perfluorocarbon emulsion in the cardiopulmonary bypass prime reduces neurologic injury. Ann Thorac Surg. 1997;63:1326-32 pubmed
    ..The addition of perfluorocarbon emulsion to the cardiopulmonary bypass prime solution leads to a reduction in the incidence and severity of neurologic injury after the formation of a massive air embolism during bypass. ..
  17. Miyake K, Takagi N, Takeo S. Effects of naftidrofuryl oxalate on microsphere embolism-induced decrease in regional blood flow of rat brain. Br J Pharmacol. 1994;112:226-30 pubmed
  18. Kahn S, Solymoss S, Flegel K. Increased tissue plasminogen activator levels in patients with nonvalvular atrial fibrillation. CMAJ. 1997;157:685-9 pubmed
    ..A prospective, longitudinal study involving NVAF patients is required to determine whether high baseline tPA levels are associated with, and perhaps causally related to, an increased risk of stroke. ..
  19. Lunt M, Hanrahan A, Kerr D, Jenkinson D. Measuring caffeine-induced changes in middle cerebral artery blood velocity using transcranial Doppler in patients recovering from ischaemic stroke. Physiol Meas. 2002;23:375-83 pubmed
    ..001). The clinical implications are unclear at present, and imaging techniques will be required to establish whether caffeine does reduce flow to hypo-perfused regions. ..
  20. Barasch E, Kaushik V, Ahn C. Aortic sinotubular atherosclerotic debris associated with cerebral embolic events can be identified by transthoracic echocardiography. Cardiology. 1998;90:253-7 pubmed
    ..s.). STAD was associated with </=40% carotid artery stenosis. STAD detected by TTE is strongly associated with embolic strokes. Our findings expand the role of TTE in the evaluation of patients with embolic strokes. ..
  21. Georgiadis D, Preiss M, Lindner A, Gybels Y, Zierz S, Zerkowski H. Doppler microembolic signals in children with prosthetic cardiac valves. Stroke. 1997;28:1328-9 pubmed
  22. Farina E, Magni E, Ambrosini F, Manfredini R, Binda A, Sina C, et al. Neuropsychological deficits in asymptomatic atrial fibrillation. Acta Neurol Scand. 1997;96:310-6 pubmed
    ..These deficits could be produced by minor ischemic lesions due to microembolization, or by diffuse hypoxic damage due to hypoperfusion. ..
  23. Santonja J, Vicent V, Pareja A, Lainez J, Sancho Rieger J. [Cerebrovascular disease in young adults. A study of its course in 167 patients]. Rev Neurol. 1998;26:787-9; discussion 789-90 pubmed
    ..As in the other series, the two groups with the worst prognosis were the HIP and the cardioembolic infarcts. Patients with HSA and HIV made outstandingly good progress. ..
  24. Silvestrini M, Cupini L, Matteis M, De Simone R, Bernardi G. Migraine in patients with stroke and antiphospholipid antibodies. Headache. 1993;33:421-6 pubmed
    ..Further studies are needed to fully elucidate the association of migraine and antiphospholipid antibodies. A better knowledge of this association could allow an early identification of patients at high risk of stroke. ..
  25. Sch√ľnemann S, Werner G, Schulz R, Bitsch A, Prange H, Kreuzer H. [Embolic complications in bacterial endocarditis]. Z Kardiol. 1997;86:1017-25 pubmed
    ..However, the high rate of embolic complications before hospital admission indicates a need for improving the diagnostic delay in the prehospital phase. ..
  26. Kay R, Chung H, Wong K, Li H, Wong A, Woo K, et al. Transcranial Doppler evaluation of microembolism immediately after direct-current cardioversion for atrial fibrillation in anticoagulated patients. Am J Cardiol. 1999;84:937-8, A7 pubmed
    ..Transcranial Doppler monitoring showed no evidence of microemboli for 10 minutes after direct-current cardioversion for atrial fibrillation. ..
  27. Iga K, Izumi C, Konishi T. Formation of a left atrial ball thrombus from a large mural thrombus 4 days after an embolic episode. Int J Cardiol. 1999;70:83-6 pubmed
    ..The thrombus was large and attached to the posterior left atrial wall, but decreased in size and detached forming a ball type thrombus over the next 4 days without anticoagulant and/or antifibrinolytic therapy. ..
  28. Aydin N, Padayachee S, Markus H. The use of the wavelet transform to describe embolic signals. Ultrasound Med Biol. 1999;25:953-8 pubmed
    ..The wavelet transform appears well suited to the analysis of embolic signals offering superior time resolution and time localization to the FFT. ..
  29. de Borst G, Moll F, van de Pavoordt H, Mauser H, Kelder J, Ackerstaf R. Stroke from carotid endarterectomy: when and how to reduce perioperative stroke rate?. Eur J Vasc Endovasc Surg. 2001;21:484-9 pubmed
    ..In our experience most strokes from CEA developed after a symptom-free interval and mainly due to thromboembolism of the operated artery. We suggest the introduction of additional TCD monitoring during the immediate postoperative phase. ..
  30. Daffertshofer M, Ries S, Schminke U, Hennerici M. High-intensity transient signals in patients with cerebral ischemia. Stroke. 1996;27:1844-9 pubmed
    ..Thus, the detection of HITS may substantially support the classification of the individual pathogenesis of cerebral ischemia, particularly when multiple risk constellations for stroke coexist. ..
  31. del Zoppo G, Higashida R, Furlan A, Pessin M, Rowley H, Gent M. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism. Stroke. 1998;29:4-11 pubmed
    ..In this regimen, heparin dose influenced hemorrhage frequency and recanalization. Although symptomatic hemorrhage remains a concern, this study suggests that recanalization is enhanced with rpro-UK and heparin. ..
  32. Whitaker D, Newman S, Stygall J, Hope Wynne C, Harrison M, Walesby R. The effect of leucocyte-depleting arterial line filters on cerebral microemboli and neuropsychological outcome following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2004;25:267-74 pubmed
    ..These findings suggest that the use of such filters in CABG surgery may offer increased neuroprotection. ..
  33. Kémeny V, Droste D, Hermes S, Nabavi D, Schulte Altedorneburg G, Siebler M, et al. Automatic embolus detection by a neural network. Stroke. 1999;30:807-10 pubmed
    ..However, extreme signal qualities, eg, strong artifacts, lead to misdiagnosis. Similar to other automated embolus detection systems, good signal quality and verification of MES by an experienced investigator is still mandatory. ..
  34. Hannaford P. Cardiovascular events associated with different combined oral contraceptives: a review of current data. Drug Saf. 2000;22:361-71 pubmed
    ..Users may decrease their venous thromboembolic risk by their choice of COC preparation although the effects will be modest. ..
  35. Bernhardt P, Schmidt H, Hammerstingl C, Hackenbroch M, Sommer T, Luderitz B, et al. Fate of left atrial thrombi in patients with atrial fibrillation determined by transesophageal echocardiography and cerebral magnetic resonance imaging. Am J Cardiol. 2004;94:801-4 pubmed
    ..02). Patients with AF and atrial thrombi have a large likelihood of cerebral embolism (16%) and/or death despite oral anticoagulation therapy. Thrombus size may predict thrombus resolution under continued anticoagulation. ..
  36. Carlberg B, Asplund K, Hagg E. Factors influencing admission blood pressure levels in patients with acute stroke. Stroke. 1991;22:527-30 pubmed
    ..We therefore hypothesize that mental stress on hospital admission may be a major factor in the blood pressure elevation seen in acute stroke. ..
  37. Miyake K, Tanonaka K, Nasa Y, Takagi N, Tsuchiya T, Yoshizawa M, et al. Effects of naftidrofuryl oxalate on microsphere embolism-induced changes in tricarboxylic acid cycle intermediates of rats. Eur J Pharmacol. 1993;235:75-81 pubmed
    ..The observed effects provided evidence for a possible site of action of the agent on ischemic brain energy metabolism. ..
  38. Tilvis R, Brommels M. Prognosis of elderly hospital patients with cerebral thrombosis. Compr Gerontol A. 1988;2:49-52 pubmed
    ..In patients over 75 years additional diseases, e.g. diabetes, had no significant effect on case-fatality or long-term prognosis underlining the malignant nature of cerebral thrombosis itself. ..
  39. Bagley R, Anderson W, de Lahunta A, Kallfelz F, Bowersox T. Cerebellar infarction caused by arterial thrombosis in a dog. J Am Vet Med Assoc. 1988;192:785-7 pubmed
    ..A mural thrombus was evident within a large meningeal artery. Although thrombosis of cerebrospinal vessels is rare in the dog, it should be considered in the differential diagnosis as a cause of acute CNS dysfunction. ..
  40. Bednar M, Gross C, Russell S, Fuller S, Ahern T, Howard D, et al. 16(R)-hydroxyeicosatetraenoic acid, a novel cytochrome P450 product of arachidonic acid, suppresses activation of human polymorphonuclear leukocyte and reduces intracranial pressure in a rabbit model of thromboembolic stroke. Neurosurgery. 2000;47:1410-8; discussion 1418-9 pubmed
    ..6 +/- 0.6 to 11.1 +/- 1.2 mm Hg). 16(R)-HETE suppresses the development of increased ICP in a rabbit model of thromboembolic stroke and may serve as a novel therapeutic strategy in ischemic and inflammatory pathophysiological states. ..
  41. Lee C. Cerebral arterial gas embolism in air force ground maintenance crew--a report of two cases. Aviat Space Environ Med. 1999;70:698-700 pubmed
    ..Decompression illness (DCI) generally occurs in occupational groups such as compressed air workers, divers, aviators, and astronauts. This is believed to be the first report of DCI occurring among aircraft's ground maintenance crew. ..
  42. Alter M, Sobel E, McCoy R, Francis M, Shofer F, Levitt L, et al. Stroke in the Lehigh Valley: incidence based on a community-wide hospital register. Neuroepidemiology. 1985;4:1-15 pubmed
    ..Finally, an assessment of concordance in diagnosis between attending physicians and a neurologist using standardized criteria was possible for the entire community. ..
  43. Zubkov A, Rabinstein A, Dispenzieri A, Wijdicks E. Primary systemic amyloidosis with ischemic stroke as a presenting complication. Neurology. 2007;69:1136-41 pubmed
    ..Ischemic strokes as an initial presentation of primary amyloidosis carries a worse prognosis. ..
  44. Mohr J, Pessin M, Finkelstein S, Funkenstein H, Duncan G, Davis K. Broca aphasia: pathologic and clinical. Neurology. 1978;28:311-24 pubmed
    ..It is associated with a considerably larger infarct which encompasses the operculum, including the Broca area, insula, and adjacent cerebrum, in the territory supplied by the upper division of the left middle cerebral artery. ..
  45. Garpenstrand H, Ekblom J, von Arbin M, Oreland L, Murray V. Plasma semicarbazide-sensitive amine oxidase in stroke. Eur Neurol. 1999;41:20-3 pubmed
    ..Nevertheless, further studies on tissue-bound SSAO in cerebral vessels would be of great interest. ..
  46. Qu M, Buchkremer Ratzmann I, Schiene K, Schroeter M, Witte O, Zilles K. Bihemispheric reduction of GABAA receptor binding following focal cortical photothrombotic lesions in the rat brain. Brain Res. 1998;813:374-80 pubmed
    ..These postlesional changes may result from lesion-induced alterations in cortical connectivity. ..
  47. Ohue S, Kohno K, Kusunoki K, Sadamoto K, Ohta S, Ueda T, et al. Magnetic resonance angiography in patients with acute stroke treated by local thrombolysis. Neuroradiology. 1998;40:536-40 pubmed
    ..In one patient with reocclusion of the recanalised artery, repeat MRA also demonstrated the reocclusion, confirmed by DSA. These results suggest that MRA may be helpful for noninvasive investigation before and after thrombolysis. ..
  48. He B. [Cerebrospinal fluid (CSF) cytochemistry of acute cerebrovascular diseases with clear CSF: observation of nonspecific esterase activity of mononuclear phagocytes]. Zhonghua Shen Jing Jing Shen Ke Za Zhi. 1992;25:35-7, 62 pubmed
    ..The authors concluded that these results provided a simple inexpensive and relatively accurate method to differentiate hemorrhagic from ischemic cerebrovascular diseases in case of without CT. ..
  49. Shaw C, Alvord E, Berry R. Swelling of the brain following ischemic infarction with arterial occlusion. Arch Neurol. 1959;1:161-77 pubmed
  50. Shimizu H, Kiyohara Y, Kato I, Tanizaki Y, Ueno H, Kimura Y, et al. Plasma homocyst(e)ine concentrations and the risk of subtypes of cerebral infarction. The Hisayama study. Cerebrovasc Dis. 2002;13:9-15 pubmed
    ..These findings suggest that elevated tHcy is an independent risk factor for all subtypes of CI, but that its impact is higher in ATI and probably in CEI than in LI. ..
  51. Hillier C, Collins P, Bowen D, Bowley S, Wiles C. Inherited prothrombotic risk factors and cerebral venous thrombosis. QJM. 1998;91:677-80 pubmed
    ..These results confirm the importance of investigating patients for both clinical predisposing factors and primary prothrombotic states. ..
  52. Juvonen T, Zhang N, Wolfe D, Weisz D, Bodian C, Shiang H, et al. Retrograde cerebral perfusion enhances cerebral protection during prolonged hypothermic circulatory arrest: a study in a chronic porcine model. Ann Thorac Surg. 1998;66:38-50 pubmed
  53. Weiss L, Van Meter K. Cerebral air embolism in asthmatic scuba divers in a swimming pool. Chest. 1995;107:1653-4 pubmed
    ..Two asthmatic patients are presented who sustained cerebral air emboli during Scuba classes in a swimming pool. Such injuries may be more common in asthmatics. Asthma is a contraindication to Scuba diving. ..