Researchers at the Paulista School of Medicine (EPM/Unifesp) | Figure 1

PedroPharmacist

Pharmacist

Researchers at the Paulista School of Medicine (EPM/Unifesp) and the University of Surrey (UK) have developed an innovative technique to examine and quantify blood vessels in the brain using 3D imaging procedures.

The work published in the Journal of Anatomy will enable scientists to examine circulation in the brain, giving a better understanding of how it works and how brain diseases - dementia, cancer and stroke - can affect the veins and capillaries of this important organ. The procedure can also be used in post-mortem examinations and biopsies of animal and human tissues, making it easier for pathologists to determine the causes of death and the rapid identification of changes in the cerebral circulation, such as the formation of clots or tumors.

In addition, this innovative method will also bring a greater understanding of how physical exercise affects the brain. Scientists will now be able to analyze the circulatory effects of increasing or decreasing heart rate, blood pressure in the brain and the creation of new vessels (angiogenesis).

According to Gutierre (EPM/Unifesp), the new technique of dissolving ink with gelatin has the advantage of providing high image resolution, being of simple execution and with affordable and inexpensive materials. The process of preparing the material is also very fast, about 24 hours.

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Researchers at the Federal University of São Paulo were able to reduce lesions caused by cerebral ischemia in mice using stem cells. The technique can aid in the recovery of victims of ischemic stroke, which can cause serious sequelae, such as loss of movement, and even lead to death. It is not the first time scientists have tried to use stem cells to recover a damaged area of the brain from mice. In previous trials, however, when implanted directly into the lesion, almost no cell survived (0.005%). Those who survived migrated to other regions of the brain. When injected into the bloodstream, they were retained in the kidneys or lungs. What made the difference this time was the use of a material that, in addition to being biocompatible, increases the survival of the stem cells and causes them to remain in the area of the lesion, reducing inflammation. After a few months, with the area largely recovered, the material is fully absorbed by the body. Researchers now want to test the stem cell technique for traumatic brain injury, where there is loss of part of the brain. "Today, when the brain mass is lost, the hemorrhage is controlled and the surgery is performed, but what has been lost is lost. There is no way to improve. This could be a new treatment," explains researcher Laura Zamproni.

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Axial T2 weighted image from MR brain of a 10 year old female with headache. Can you name the lesion, how would you work it up and grade it and what are the different treatment options? #FOAMRad #FOAMPeds #PedsRad

, are the single most common cause of stroke due to bleeding in the brain (known as intracerebral haemorrhage, or ICH) in young adults. Brain AVMs can also leave young people disabled for life and cause epilepsy. How they should be treated, if at all, is highly controversial. The main options are: 1) medical treatment of epileptic seizures and headaches (sometimes known as 'conservative management'); or 2) one or more of the following 'interventional' treatments: neurosurgery, endovascular embolization (glue, coils, or particles are lodged within the AVM via a catheter inserted temporarily in the groin), or radiosurgery (a non-invasive treatment involving focused beams of radiation).

Search date

14 January 2019

Study characteristics

We found one published randomized controlled trial, including 226 adults.

Key results

We found moderate-quality evidence of harm (stroke due to bleeding in the brain, and death or dependency) over one year of follow-up from interventional treatments compared to conservative management for adults who had a brain AVM that had never bled. The long-term risks are unknown.

Quality of the evidence

Overall, the quality of the evidence was moderate because there was just one trial and it did not use blinding. More information will become available from the three trials that are ongoing.

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