Galen静脉血栓形成致双侧基底节梗死1例报道及相关文献复习

目的 探讨Galen静脉血栓形成的诊断和治疗。方法 回顾性收集1例Galen静脉血栓形成患者的临床资料、实验室及影像学检查,并结合相关文献进行分析。结果 患者,男,69岁,临床表现为头痛和意识障碍,实验室检验基本正常,头颅MRI提示双侧基底节梗死,颅脑MRV提示横窦、乙状窦充盈缺损,考虑为Galen静脉血栓形成致双侧基底节梗死,患者被给予积极抗凝及对症支持治疗后最终好转出院。结论 Galen静脉血栓形成是一种临床少见的脑血管病,其特点为起病急、发病凶险,重者可危及生命。因此,了解其诊治方法对于改善患者预后,减少后遗症的发生具有重要意义。     

可逆性后部白质脑病综合征的临床和影像学特征

目的探讨可逆性后部白质脑病综合征(RPLS)的临床特点及影像学特征。方法回顾性总结分析本院2000年9月~2010年6月收治的12例可逆性后部白质脑病综合征患者的临床和影像学资料。结果本组12例患者中原发病为子间痫3例(25%),高血压脑病4例(33.3%),尿毒症2例(16.7%),系统性红斑狼疮2例(16.7%),肺癌术后化疗1例(8.3%),临床表现多样,主要为头痛、呕吐、意识障碍、抽搐、眼震、视力异常等。多数患者头颅MRI表现为双侧大脑后部白质对称性T1WI呈低或等信号,T2WI和FLAIR像呈高信号。经脱水、降低颅内压、加强补液等对症支持治疗2~3周后神经系统症状消失,复查MRI病灶完全或大部分消失。结论可逆性后部白质脑病综合征的临床特点和影像学具有一定特征性,提高对本病的认识,早期明确诊断十分重要,经及时治疗后一般预后良好。     

Galen静脉血栓(附6例报告)

本文报告6例Galen静脉血栓,均有发病诱因。临床表现为意识障碍及尿便失禁(6例),高颅压(4例),抽搐或去脑强直(3例),智能障碍(3例),中枢热(2例),偏瘫或四肢瘫(2例),精神症状及不自主运动(1例)。头CT示双侧丘脑及底节区对称性低密度,MRI为长T_1、长T_2异常信号,急性期可见CT为高密度,MRI的T_1W、T_2W像均呈高信号的静脉与静脉窦血栓。经内科治疗3例死亡,1例痴呆、2例痊愈。     

Ⅰ型神经纤维瘤病六例磁共振成像特点分析

目的总结Ⅰ型神经纤维瘤病患者T_2WI不明原因亮点的特点、分布和年龄相关性,以为疾病早期诊断提供依据。方法与结果对2014年6月至2017年12月就诊的3个Ⅰ型神经纤维瘤病家系中3例患者和3例散发患者临床资料的分析提示,广泛分布于全身皮肤的咖啡牛奶斑为其首发症状;T_2WI存在不明原因亮点(2例)的患者年龄18岁(14和16岁),病灶呈多发性,以丘脑受累为主,临床表现为智力发育迟缓、癫癎发作、头痛。结论 T_2WI不明原因亮点是年龄18岁的Ⅰ型神经纤维瘤病患者的特征性影像学改变,对青少年患者的早期诊断具有提示意义。     

脑静脉血栓形成的诊断与治疗分析

目的本文探讨脑静脉血栓的临床及影像学诊断与治疗方法。方法回顾26例脑静脉血栓的临床症状及各种影像学表现，并分析其病因，总结各种治疗方法。结果26例患者主要临床表现头痛、视盘水肿、偏瘫、癫痫发作等。10例CT显示3例上矢状窦血栓；16例MRI（SE序列）显示8例脑静脉血栓；12例MRV显示10例脑静脉血栓；26例均做DSA检查予以确诊。确诊后给予抗凝药物治疗或溶栓治疗，病情显著缓解，最后均达到临床治愈标准。结论结合脑静脉血栓的临床症状及各种影像学表现，并辅以病因分析能对本病作出准确的诊断；治疗原则应采取抗凝溶栓、病因和对症等多种方法治疗。     

可逆性后部白质脑病综合征临床影像学特征

目的探讨可逆性后部白质脑病综合征(reversible posterior leukoencephalopathy syndrome,RPLS)的临床和影像学特点。方法回顾性分析8例可逆性后部白质脑病综合征患者的发病原因、临床症状、影像学特征、治疗及预后。结果8例患者中,女5例,男3例;发病原因多样,系统性红斑狼疮2例,妊娠子痫2例,高血压病1例,真菌性脑炎1例,多发性骨髓瘤1例,肾移植1例;其中使用免疫抑制剂3例,化疗药物1例,使用抗真菌药物1例。以头痛、癫痫发作、视觉障碍、意识和精神障碍为主要临床症状。多数患者头颅MRI表现为双侧大脑后部白质对称性T1WI呈低或等信号,T2WI和FLAIR像呈高信号;经采取降压、脱水及对症等治疗2~3周后患者神经系统症状消失,MRI复查病灶完全或大部分消失。结论RPLS是以可逆性后部白质损害为主要神经影像学表现的临床综合征,及时、准确的诊断和治疗可使其临床症状和影像学改变完全可逆。     

可逆性胼胝体压部病变综合征四例分析

目的总结可逆性胼胝体压部病变综合征的临床表现和影像学特点,探讨其病因和发病机制。方法回顾分析4例可逆性胼胝体压部病变综合征患者的临床表现、影像学特点和病因。结果4例患者中2例(例1和例2)有颅脑创伤史,1例(例3)于饮酒后出现发作性双眼视物模糊,1例(例4)于感冒后出现头痛、晕厥,伴间断性视物模糊和慢性肾功能衰竭;MRI表现为胼胝体压部孤立性圆形或类圆形、边界清晰的病变,呈T_1WI等或稍低信号,T_2WI、扩散加权成像和FLAIR成像高信号,表观扩散系数低信号,无明显水肿和占位效应,1例(例2)除胼胝体压部病变外,磁敏感加权成像可见额叶出血。均经对因和对症支持治疗后症状完全缓解,病程8~15 d。复查MRI,3例胼胝体异常信号消失,1例(例2)病变信号范围和强度较前明显好转,均未遗留神经功能障碍。结论可逆性胼胝体压部病变综合征是一种临床影像学综合征,病因多样,癫及其相关疾病是最常见病因,颅脑创伤也可以引起可逆性胼胝体压部病变综合征,临床表现无特异性,经对因治疗后预后良好。     

12例可逆性后部白质脑病综合征的临床特点

目的探讨可逆性后部白质脑病综合征(RPLS)的临床特点。方法回顾性分析2015-06—2016-09于河南省人民医院诊治的12例可逆性后部白质脑病综合征患者的临床特征、影像学特点、实验室检查并复习相关文献。结果临床特征:本组女11例,男1例。子痫10例,合并血小板减少7例;原发性高血压2例。10例出现癫痫发作,7例出现头痛,6例视物障碍。影像学特点:病灶大多为对称性,主要位于双侧大脑后部白质,少数位于额顶叶、基底节区、胼胝体、小脑及其他部位。在CT呈低密度影,MRI呈长T_1、长T_2,FLAIR呈高信号,DWI大部分呈低信号,ADC大部分呈高信号。4例复查后病灶完全恢复,呈完全可逆性。实验室检查:LDH升高11例,其中血小板减少伴白细胞升高、肌酸激酶升高7例。结论 RPLS是一种女性好发,以头痛、癫痫发作、视觉障碍、意识障碍为主要表现,影像学表现为可逆的血管源性水肿的神经系统疾病,血小板减少可能为其病因之一,经积极治疗,大部分预后良好。     

单纯大脑皮层静脉血栓形成2例及文献回顾分析

目的总结分析单纯大脑皮层静脉血栓形成(isolated cortical vein thrombosis,ICoVT)的病例特点。方法报道2例ICoVT病例,并回顾文献报道的47例同类病例,分析其病因、临床影像学特征以及治疗预后。结果 49例患者多为中青年,女性多见;多为急性或亚急性起病;临床表现主要为癫痫发作33例(67.3%)、局灶性神经功能缺损症状22例(44.8%)、头痛19例(38.8%),首发症状以癫痫发作最多(21例,42.8%),大多数不伴有意识障碍和颅内高压症状;影像学检查可有不同程度地显示皮层静脉血栓的直接征象和间接征象;大多数患者经抗凝治疗后预后良好。结论 ICoVT临床和影像表现变异较大,仔细分析影像资料以及多种影像检查手段相结合可以提高诊断的准确率,临床上充分重视并给予抗凝治疗。     

1,2-二氯乙烷中毒性脑病19例临床特点分析

目的探讨1,2-二氯乙烷(1,2-DCE)中毒性脑病的临床及影像学特征。方法回顾性分析2009年7月~2015年7月收治的19例1,2-DCE中毒性脑病病例,对其临床特点及影像学资料进行总结分析。结果所有患者均有职业暴漏史,其主要表现为头痛、头晕、恶心、睡眠障碍,乏力、记忆下降、意识障碍、癫痫发作等症状。头颅MRI检查示在皮质下白质、双侧苍白球和小脑齿状核广泛的脑水肿,双侧大脑白质内对称性大片状异常信号影,T_1WI呈低信号,T_2WI高信号,DWI序列上见病灶呈高异常信号,脑水肿、脑肿胀明显。结论根据典型的临床和神经影像学特点,结合职业接触含有l,2-DCE的物质,可诊断1,2-DCE中毒性脑病。     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

帕金森病运动症状进展分析

目的分析帕金森病(PD)患者运动症状进展特点。方法采用PD统一评分量表(UPDRS)Ⅲ对912例PD患者进行评估。结果与病程1年的患者比较,除病程1~2年的患者外,其他病程患者的UPDRSⅢ评分、强直分、姿势或步态异常分、轴性症状总分、言语分、步态分显著升高(均P0.05),病程5~6年及14年患者的震颤分,病程5~6年、7~8年、9~13年、14年患者的运动迟缓分、姿势分显著升高(P0.05~0.01)。轴性症状进展速度高于UPDRSⅢ评分。结论 PD患者病程早期UPDRSⅢ评分进展快,震颤症状进展独立于其他症状,轴性症状评分较UPDRSⅢ更敏感地反映疾病加重趋势。     

Frequency of accumulation of filaments in adaxonal cytoplasm of Schwann cells of myelinated fibers of rat spinal roots

Summary The frequency of accumulation of 6-nm filaments in the adaxonal cytoplasm of Schwann cells in the 6th lumbar dorsal and ventral roots was evaluated in 4-, 8-, 26- and 45-week-old Sprague-Dawley rats. The frequency was higher in 4- and 8-week-old (growing) rats than in 26- and 45-week old (mature) rats, and also higher in ventral than in dorsal roots in 4-, 8- and 26-week old rats. There were no clusters on certain groups of myelinated fibers according to the size of transverse axonal area, in both the ventral and dorsal roots. Therefore, this accumulation may reflect certain functions of the adaxonal cytoplasm of Schwann cell during natural growth and maturation of the axon and myelin sheath.     

Function of circle of Willis

Nearly 400 years ago, Thomas Willis described the arterial ring at the base of the brain (the circle of Willis, CW) and recognized it as a compensatory system in the case of arterial occlusion. This theory is still accepted. We present several arguments that via negativa should discard the compensatory theory. (1) Current theory is anthropocentric; it ignores other species and their analog structures. (2) Arterial pathologies are diseases of old age, appearing after gene propagation. (3) According to the current theory, evolution has foresight. (4) Its commonness among animals indicates that it is probably a convergent evolutionary structure. (5) It was observed that communicating arteries are too small for effective blood flow, and (6) missing or hypoplastic in the majority of the population. We infer that CW, under physiologic conditions, serves as a passive pressure dissipating system; without considerable blood flow, pressure is transferred from the high to low pressure end, the latter being another arterial component of CW. Pressure gradient exists because pulse wave and blood flow arrive into the skull through different cerebral arteries asynchronously, due to arterial tree asymmetry. Therefore, CW and its communicating arteries protect cerebral artery and blood–brain barrier from hemodynamic stress.     

Effects of prevention of afferentation of the development of the chick optic lobe

BONDY, S. C., M. E. HARRINGTON AND C. L. ANDERSON. Effects of prevention of afferentation on the developmentof the chick optic lobe. BRAIN RES. BULL. 3(5) 411–413, 1978.—The effects of unilateral extirpation of the right optic cup of the three-day incubated chick embryo upon the rate of synthesis and the stability of DNA in the non-innervated optic lobe, have been studied. This surgical procedure prevents innervation of the optic lobe contralateral to the removed eye, while the other optic lobe is normally innervated by retinal ganglion cells of the remaining eye. At the 20th day of incubation, the DNA content of the non-innervated lobe was below that of the paired lobe receiving normal innervation. This deficiency of cell number was caused by two events; death of an excess number of neurons formed early in embryogenesis and a reduced rate of glial proliferation in the later stages of incubation.     

Modelling of movement of the lamprey: Control of oscillators

This article discusses the control methods of the central pattern generator (CPG). First a control model of the CPG is presented using 2 oscillators, and we suggest that phasic modulation to the CPG by means of phasic information is effective for controlling the phase difference between oscillators. Next, two models for controlling the CPG of a lamprey are proposed. One model describes a control system from the brain stem, in which the reticulospinal neurons control the CPG by receiving feedback signals and sending control signals to the neck region of the CPG. The other is a model for learning an localized control system to generate a desired motor pattern. By means of these models, a role of the efference copy is suggested.     

腺垂体功能减退症临床特征变化分析

目的探讨腺垂体功能减退症患者的病因结构变化及临床表现。方法回顾性分析我院2013-01—2016-12住院及门诊78例腺垂体功能减退症患者的临床资料。结果男32例(41.03%),女46例(58.97%);诊断时年龄11~89岁,平均62.5岁;鞍区占位(包括术前及术后)52例(66.67%),席汉综合征8例(10.26%),空泡蝶鞍9例(11.65%),病因不明8例(10.26%),垂体-下丘脑发育不良1例(1.28%)。首次就诊科室:纳差厌食、恶心呕吐就诊于消化内科36例(46.15%)最常见。ACTH+TSH+Gn+G激素缺乏为19例最多,占24.36%,ACTH+TSH+Gn缺乏15例,占19.23%。结论腺垂体功能减退症病因结构发生变化,发病人群、首发症状及受累激素也不同,患者女性多于男性,发病年龄偏高,症状不典型,分布于临床多个科室,其中以低钠血症为首发临床表现就诊消化内科最多。     

Standards of instrumentation of EMG

Standardization of Electromyography (EMG) instrumentation is of particular importance to ensure high quality recordings. This consensus report on “Standards of Instrumentation of EMG” is an update and extension of the earlier IFCN Guidelines published in 1999. First, a panel of experts in different fields from different geographical distributions was invited to submit a section on their particular interest and expertise. Then, the merged document was circulated for comments and edits until a consensus emerged.The first sections in this document cover technical aspects such as instrumentation, EMG hardware and software including amplifiers and filters, digital signal analysis and instrumentation settings. Other sections cover the topics such as temporary storage, trigger and delay line, averaging, electrode types, stimulation techniques for optimal and standardised EMG examinations, and the artefacts electromyographers may face and safety rules they should follow. Finally, storage of data and databases, report generators and external communication are summarized.     

利培酮对精神分裂症患者生活质量的影响

目的：比较利培酮与氟哌啶醇对精神分裂症患者生活质量的影响。方法：对门诊72例服用氟哌啶醇及74例服用利培酮的精神分裂症患者用生活质量综合评定问卷（GQOLI）、阳性与阴性症状量表（PANSS）、副反应量表（TESS）进行评定。结果：利培酮组患者治疗后生活质量有所提高,而氟哌啶醇组患者生活质量有所下降。结论：利培酮治疗有利于患者提高生活质量。     

Effect of high simple dose of cisplatinum and of radiation on the brain of rabbit

Abstract

In former studies of intracarotid and intravenous administration of cisplatinum, separate and combined with brain irradiation, we found no cerebral damage. In this study! gradually increasing high doses (above the therapeutic ones) of cisplatinum were administered intravenously to one series of rabbits arid increasing high amounts of irradiation (above the therapeutic amounts) were given to another series. Although the rabbits that received highest doses of irradiation developed areas of alopecia and skin ulcers on the head! the general clinical and histopathologic examination of the rabbits brains in both series was normal. The purpose of this study was to establish the effects of high doses of intravenous cisplatinum and irradiation on the rabbits brains. [Neural Res 1997; 19: 216–218]