WordNet

put in the middle
time between the beginning and the end of a temporal period; "the middle of the war"; "rain during the middle of April"
the middle area of the human torso (usually in front); "young American women believe that a bare midriff is fashionable" (同)midriff, midsection
an intermediate part or section; "A whole is that which has beginning, middle, and end"- Aristotle
between an earlier and a later period of time; "in the middle years"; "in his middle thirties"
of a stage in the development of a language or literature between earlier and later stages; "Middle English is the English language from about 1100 to 1500"; "Middle Gaelic"
of or relating to the cerebrum or brain; "cerebral hemisphere"; "cerebral activity"
involving intelligence rather than emotions or instinct; "a cerebral approach to the problem"; "cerebral drama" (同)intellectual
a major thoroughfare that bears important traffic
a blood vessel that carries blood from the heart to the body (同)arteria, arterial blood vessel
any commodity of intermediate quality or size (especially when coarse particles of ground wheat are mixed with bran)
abnormal narrowing of a bodily canal or passageway (同)stricture

PrepTutorEJDIC

(空間的に)『まん中の』 / (時間・順序・数量などが)『中間の』,まん中の / 『平均の』,中ぐらいの / 《M-》(言語史で)中期の / 《the~》(場所・地域の)『まん中』,『中央』《+『of』+『名』》 / (時間・順序などの)まん中,(行為などの)最中《+『of』+『名』+(do『ing』)》 / 《話》《the~,one's~》(人の)胴,腰
大脳の,脳の / 頭脳的な,知的な
動脈 / (道路・水路・鉄道などの)勘線,(通信の)主チャンネル
(大きさ・質・程度などが)中位の,普通の / 中ぐらいに,かなり

UpToDate Contents

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1. 頭蓋内大血管の動脈硬化 intracranial large artery atherosclerosis
2. 虚血性脳卒中および一過性脳虚血発作の特定の原因に対する二次予防 secondary prevention for specific causes of ischemic stroke and transient ischemic attack
3. 頚動脈狭窄の評価 evaluation of carotid artery stenosis
4. もやもや病：病因、臨床的特徴、および診断 moyamoya disease etiology clinical features and diagnosis
5. 頸動脈硬化の症状の病態生理 pathophysiology of symptoms from carotid atherosclerosis

English Journal

Contralateral hyperacute intracerebral hemorrhage after carotid artery stenting with contralateral internal carotid artery occlusion.

Takami H1, Hanakawa K2, Sato H3, Tsutsumi K2, Murao M2, Ide T2.Author information 1Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. Electronic address: takami-tky@umin.ac.jp.2Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.3Department of Neuroendovascular Therapy, Tokyo Metropolitan Police Hospital, Tokyo, Japan.AbstractAn 87-year-old man sustained an intracerebral hemorrhage in the watershed area of the contralateral frontal lobe immediately after carotid artery stenting (CAS) for severe cervical internal carotid artery (ICA) stenosis. The contralateral cervical ICA was occluded. CAS resulted in increased cross-flow through the anterior communicating artery and increased flow in the contralateral middle cerebral artery. This case demonstrates that CAS in patients with contralateral ICA occlusion and insufficient collateral flow can cause dramatically increased collateral flow through the circle of Willis and result in contralateral hyperperfusion. In patients with severely compromised cerebral perfusion, measures should be taken to prevent hyperperfusion-related complications.
Journal of vascular surgery.J Vasc Surg.2014 Mar;59(3):821-4. doi: 10.1016/j.jvs.2013.04.051. Epub 2013 Jun 14.
An 87-year-old man sustained an intracerebral hemorrhage in the watershed area of the contralateral frontal lobe immediately after carotid artery stenting (CAS) for severe cervical internal carotid artery (ICA) stenosis. The contralateral cervical ICA was occluded. CAS resulted in increased cross-fl
PMID 23769942

Prehospital stroke diagnostics based on neurological examination and transcranial ultrasound.

Herzberg M, Boy S, Hölscher T, Ertl M, Zimmermann M, Ittner KP, Pemmerl J, Pels H, Bogdahn U, Schlachetzki F.AbstractBACKGROUND: Transcranial color-coded sonography (TCCS) has proved to be a fast and reliable tool for the detection of middle cerebral artery (MCA) occlusions in a hospital setting. In this feasibility study on prehospital sonography, our aim was to investigate the accuracy of TCCS for neurovascular emergency diagnostics when performed in a prehospital setting using mobile ultrasound equipment as part of a neurological examination.
Critical ultrasound journal.Crit Ultrasound J.2014 Feb 27;6(1):3. [Epub ahead of print]
BACKGROUND: Transcranial color-coded sonography (TCCS) has proved to be a fast and reliable tool for the detection of middle cerebral artery (MCA) occlusions in a hospital setting. In this feasibility study on prehospital sonography, our aim was to investigate the accuracy of TCCS for neurovascular
PMID 24572006

Carotid Artery Stenting Improves Cerebral Hemodynamics Regardless of the Flow Direction of Ophthalmic Artery.

Liu CH1, Chang CH, Chang TY, Huang KL, Lin JR, Chen YW, Yip BS, Ryu SJ, Chang YJ, Lee TH.Author information 11Stroke Center and Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan, Taiwan.AbstractWe enrolled 221 patients with elective carotid artery stenting (CAS). Patients with contralateral carotid stenosis exceeding 50%, insufficient vertebral artery (VA) flows, or angioplasty at subclavian artery were excluded. All patients underwent serial cerebral ultrasound studies. Of the 116 included patients, the direction of ophthalmic artery (OA) flow was forward in 74 patients while reversed in 42. The reversed flow group had worse ipsilateral stenosis, higher hemoglobin, and cardiac output. After CAS, the reversed flow group had an immediate recovery of ipsilateral internal carotid artery flow volume (FV; P < .0001), time average velocity (TAV) of middle cerebral artery (P = .02), and normalization of OA flow. The forward flow group had gradual decrement in TAV of contralateral anterior cerebral artery (P = .01) and total FV of VA (P = .001). Our results suggest CAS improves cerebral hemodynamics through different ways regardless of the direction of OA flow.
Angiology.Angiology.2014 Feb 24. [Epub ahead of print]
We enrolled 221 patients with elective carotid artery stenting (CAS). Patients with contralateral carotid stenosis exceeding 50%, insufficient vertebral artery (VA) flows, or angioplasty at subclavian artery were excluded. All patients underwent serial cerebral ultrasound studies. Of the 116 include
PMID 24569514