颅内静脉窦血栓形成误诊为原发性蛛网膜下腔出血1例报道并文献复习

目的 探讨颅内静脉窦血栓形成的临床症状、治疗方法,颅内静脉窦血栓形成继发蛛网膜下腔出血的影像学表现.方法 报道本院收治的1例颅内静脉窦血栓形成误诊为原发性蛛网膜下腔出血患者的临床资料,并复习国内外相关文献.结果 颅内静脉窦血栓形成是一种少见疾病,致继发性蛛网膜下腔出血更为罕见.其主要临床表现为头痛、局部定位体征、癫向.CT对其诊断阳性率低,头部MRI及MRV的敏感性、特异性及可接受性最高.抗凝治疗安全有效,且并非颅内并发出血的禁忌证.结论 颅内静脉窦血栓形成的发病率低,临床表现多样而不典型;对急、慢性头痛,影像学表现为大脑皮层不规则出血、大脑凸面的蛛网膜下腔出血,癫苘发作的患者要警惕颅内静脉窦血栓形成的可能.     

颅内静脉窦血栓形成的临床及影像学诊断25例报道

目的 研究颅内静脉窦血栓形成的病因、临床特点、特别是影像学的表现。方法 回顾性分析25例已确诊的静脉窦血栓形成患者（男2例，女23例）的临床资料及影像学特点，包括发病原因、临床表现、实验室检查及影像学头部CT、磁共振成像（MRI）和磁共振血管成像（MRA）的异常表现。结果 25例本病患者除2例男性外，余23例均有明确病因，如妊娠期、产褥期、口服避孕药等，临床表现以亚急性颅压高症状为主；部分头部CT可见条索征及空三征，MRI特征性表现为T1、T2加权像窦内异常高信号，MRA示栓塞的静脉窦未显影。结论 颅内静脉窦血栓形成患者多可找到明确病因，临床表现多样，无特异性，MRI/MRA可帮助确诊。     

颅内静脉窦血栓形成14例

目的探讨颅内静脉窦血栓形成的早期诊断与治疗。方法回顾性分析2005年1月-2010年1月来我院就诊的14名颅内静脉窦血栓形成患者的病因、临床表现、影像学、诊断、治疗和预后。结果 14例患者中表现为头痛的有12例,伴有呕吐者2例,癫疒间发作者5例,伴有意识障碍者6例,伴有肢体瘫痪2例,伴有失语者1例。所有患者MRV均提示静脉窦显影不佳或不显影。给予抗凝治疗后,出院时9例症状好转,4例复诊痊愈,1例死亡。结论颅内静脉窦血栓形成(CVST)临床表现多样,缺乏特异性,诊断依赖影像学检查,特别是血管成像,抗凝是首选治疗。     

经静脉窦接触性rt-PA溶栓治疗颅内静脉窦血栓形成1例并文献复习

目的探讨经静脉窦接触性rt-PA溶栓治疗颅内静脉窦血栓形成的效果。方法分析1例经静脉窦接触性rt-PA溶栓治疗的颅内静脉窦血栓形成病例的临床及影像学资料,并结合文献进行探讨。结果采用介入方法经静脉窦直接注入rt-PA接触性溶栓后,患者的临床症状显著缓解,静脉窦再通良好。结论经静脉窦接触性rt-PA溶栓是治疗颅内静脉窦血栓形成的有效方法。     

育龄期女性颅内静脉窦血栓形成临床分析

颅内静脉窦血栓形成为一种罕见的脑血管疾病,随着非侵入性检查技术的发展,使得该病在早期即被发现并得到治疗[1].本文回顾2000-01～2006-04我院收治的年龄18～45岁育龄期女性颅内静脉窦血栓形成患者26例,现就其易发因素、临床表现、影像学特点及治疗进行分析.     

颅内静脉窦血栓形成的临床与磁共振诊断5例报告

目的分析颅内静脉窦血栓形成的临床特点,磁共振成像及磁共振血管造影对其诊断的价值。方法分析5例磁共振检查确诊的颅内静脉窦血栓形成病人的临床资料及影像学特点,其中男1例,女4例,年龄22～40岁。病后3～19天行磁共振检查,主要观察水肿、静脉性便死或出血、静脉窦内异常信号,部分病人复查时可见再通。结果5例颅内静脉窦血栓形成皆有明确原因,临床表现多样,主要为亚急性颅内压增高、抽搐、肢体瘫痪或昏迷。MRI常规SE序列T1、T2加权示窦内高信号,脑实质水肿或合并出血、硬死。磁共振脑血管造影（MRA）的PC法示静脉窦高血流信号丢失,2例分别于病后24、31天复查MRI,结果示再通。经降颅内压、抗凝、合并感染者予抗生素、激素治疗,5例均治愈。结论颅内静脉窦血栓形成是较为少见的脑血管病,且病情重,MRI／MRA可帮助确诊。早期治疗能明显改善预后。     

颅内静脉窦血栓形成的临床特点及影像学分析

目的探讨颅内静脉窦血栓形成(CVST)的临床特点与影像学特征,以提高临床医师对颅内静脉窦血栓的早期诊断率,降低误诊与死亡率。方法分析2009年5月至2011年1月本院收治的48例CVST患者临床资料,对其临床表现与影像学特征进行归纳。结果 CVST患者临床表现多样,以头痛为首发症状。其确诊主要依靠CT、MRI、MRV及DSA等影像学进行分析。经抗凝、降低颅内压等对症治疗,患者治疗后的颅内压有明显降低。48例患者中,治愈者26例(54.17%),好转者14例(29.17%),无效8例(16.66%)。结论颅内静脉窦血栓形成的病因多种,发病形式多样,且临床表现无特异性。头痛、呕吐、伴或不伴局灶性神经功能缺损为最常见的临床特征。结合CT、MRI及MRV可对其进行诊断,必要时可行DSA检查。早期使用抗栓治疗可缓解临床症状,改善预后,效果良好。     

颅内静脉窦血栓形成的临床与CT DSA

目的 :探讨颅内静脉窦血栓形成的临床特点与影像学改变。方法 :分析 18例颅内静脉窦血栓形成患者的临床资料 ,CT及 DSA改变。结果 :患者男 3例 ,女 15例 ,其中产后发病 11例 ,贫血 2例 ,化脓性中耳炎 1例 ,口服避孕药 1例。上矢状窦血栓形成 13例 ,横窦血栓形成 2例 ,海绵窦血栓形成 2例 ,上矢状窦合并其它静脉窦血栓形成 1例。 18例中痊愈 10例 ,好转 5例 ,死亡 3例。结论 :颅内静脉窦血栓形成早期诊断困难 ,应借助于脑 CT特别是 DSA,及早诊断及恰当治疗可降低病死率     

颅内静脉窦血栓形成后硬脑膜动静脉瘘(附5例报告)

目的探讨硬脑膜动静脉瘘(DAVF)与静脉窦血栓形成发生的关系,以及其临床表现和治疗方法。方法回顾性分析2005年9月至2009年8月收治的5例继发于或伴发颅内静脉窦血栓形成的DAVF患者的临床资料。结果 5例患者中,3例表现为颅内出血,2例表现为突眼和结膜红肿。3例经开颅手术及1例经血管内介入栓塞治疗,术后均恢复良好;另1例未行外科处理,神经功能障碍呈进行性加重。结论静脉窦血栓形成可继发DAVF,但部分患者先期难以明确静脉窦血栓形成,而表现为DAVF伴静脉窦血栓性闭塞;颅内静脉窦血栓形成后继发的DAVF易发生颅内出血,应积极行血管内栓塞或开颅手术治疗。     

颅内静脉窦血栓形成误诊原因分析

目的 研究颅内静脉窦血栓形成(CVT)的临床特征、影像学表现,分析其误诊原因.方法 回顾性分析8例CVT患者的临床资料及影像学特点,包括发病原因、临床表现、血栓部位及颅脑CT和磁共振成像(MRI/MRA)、数字减影血管造影(DSA)的异常表现.结果 CVT的病因各不相同,多与高凝状态有关.大多数患者表现有头痛、呕吐、视盘水肿、颅内高压征,伴或不伴意识降碍、视力下降、瘫痪及精神障碍.CT扫描可见静脉窦下降部分及窦汇有高密度影,易被误诊为SAH.CVT的好发部位多见于上矢状窦,MRI特征表现为T1、T2加权像窦内高信号.DSA可见受累的一处或多处静脉窦显影不良、静脉循环时间延长.结论 CVT临床表现多样,颅脑CT无特异性,MRI/MRA,DSA可帮助早期确诊及病变部位,并尽早给以低分子肝素、尿激酶治疗,提高了静脉窦血栓的再通率,增加了该病的临床疗效.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -     

Summary of legislation of 1941 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -     

Asymmetry of on- and off-pathways of blue-sensitive cones of the retina of macaques

Macaque retinal ganglion cells whose receptive-field center recieves input from blue-sensitive cones show an overt asymmetry of the frequency of ON-center and OFF-center varieties, an asymmetry not present in ganglion cells whose center receives input from the other two cone types. A similar asymmetry of ON/OFF responses is found in the local electrotetinogram (d-wave) mediated by signals from blue-sensitive cones. ‘Blue-ON-center’ ganglion cells have larger receptive-field centers and shorter conduction latencies than other opponent-color varieties, suggesting an appreciable degree of receptor convergence and presumably large cell bodies. Intracellular stainings of these neurons with Procion Yellow show that they correspond to diffuse stratified (Parasol) ganglion cells whose flat-topped dendritic arborization stratifies in the sclerad half of the inner plexiform layer. In view of the known characteristics of macaque bipolar cells and of the ON/OFF asymmetry, it is proposed that these ganglion cells are postsynaptic to cone-specific flat bipolars possibly mediating sign-inverting synaptic contacts. The results also indicate a reversal, for the blue-cone pathway, of the ON/OFF lamination of the inner plexiform layer that has recently been described in other species.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.