6186例脑卒中患者发病时间的季节性分析

目的探讨青岛市区脑出血(CH)、脑梗死(CI)、蛛网膜下腔出血(SAH)发病时间的季节规律。方法收集青岛市1998年～2002年脑卒中患者6186例,其中CH1179人,CI4821人,SAH186人。圆分布分析探讨脑卒中患者发病时间的季节规律。结果CH冬季高发,平均角在1月份(P<0.05),男性患者的平均角在2月份(P<0.05),女性患者的平均角在1月份(P<0.05);CI秋季高发,男、女间无差别,平均角在10月份(P<0.05);SAH秋季高发,平均角在10月份(P<0.05),男性患者的平均角在9月份(P<0.05),女性患者的平均角在10月份(P<0.05)。结论青岛市的脑卒中发病具有季节性,在脑卒中预防工作中要充分考虑其发病的季节特点,并采取相应的措施。     

脑血管病患者胃动素的临床研究

目的：观察脑出血（ＣＨ）、脑梗死（ＣＩ）、蛛网膜下腔出血（ＳＡＨ）患者胃动素（ＭＴＬ）水平的动态变化及其临床意义。方法：选择脑血管病（ＣＶＤ）患者１３８例。用放免法检测血浆ＭＴＬ浓度。结果：ＣＶＤ各组ＭＴＬ水平显著高于对照组,发病２４ｈ内即升高;ＣＩ组、ＳＡＨ组４～７ｄ达峰水平,ＣＨ组１～３ｄ达峰水平,８～１５ｄ降低,１５ｄ仍在较高水平;随病情严重程度的加重ＭＴＬ水平升高;高血糖组显著高于正常血糖     

脑血管病患者神经肽Y的临床研究

目的观察脑出血（CH）、脑梗死（CI）、蛛网膜下腔出血（SAH）患者神经肽Y（NPY）水平动态变化及其临床意义。方法选择脑血管病（CVD）患者138例,其中CH组46例,CI组62例,SAH组30例。用放免法检测血浆NPY浓度。结果CI组、CH组、SAH组NPY水平显著高于对照组,于发病后24h内均显著升高,1～3d或4～7d达高峰,8～15d开始下降,15d后仍在较高水平;重型与大灶组显著高于中、轻型与小灶组;发病积分≥6分组显著高于<6分组,伴高血压组显著高于不伴高血压;伴消化道出血组显著高于不伴消化道出血组。结论NPY参与了CVD及其伴发病的病理生理过程。     

中国大陆妊娠相关性脑卒中314例临床资料分析

目的：探讨中国大陆地区妊娠相关性脑卒中和蛛网膜下腔出血的危险因素及临床特点。方法：计算机检索中文生物医学数据库（CBMdisc）、万方数据库、维普数据库及中国知网数据库,检索年限均为2000年1月至2012年6月,对中国大陆地区已发表的与妊娠相关的脑卒中文献进行总结分析。结果：检索到18篇文献中314例符合纳入标准的病例。314例中脑出血179例,脑梗死110例,蛛网膜下腔出血25例。于妊娠晚期脑出血为102／179例,发病率为57．0％;妊娠中期脑梗死49／110例,发病率为44．5％;蛛网膜下腔出血25例,占总发病数的8．0％。子痢前期／子痫导致的脑出血42．4％（76／179例）;动脉瘤破裂导致的蛛网膜下腔出血56．0％（14／25例）;心源性栓塞导致的脑梗死29．1％（32／110例）。结论：妊娠相关性脑卒中好发于妊娠晚期及产褥期。脑梗死好发于妊娠中期,脑出血好发于妊娠晚期。脑出血常见病因为子痫前期／子痫,蛛网膜下腔出血常见病因为动脉瘤破裂（多发于妊娠晚期）,脑梗死则为心源性栓塞。     

急性脑血管病患者血浆神经降压素的临床研究

目的 观察脑出血（ＣＨ）、脑梗死（ＣＩ）、蛛网膜下腔出血（ＳＡＨ）患者血浆神经降压素（ＮＴ）水平改变及其动态变化。方法 选择ＣＨ组４６例、ＣＩ组６２例、ＳＡＨ组３０例,用放免法检测血浆ＮＴ浓度。结果 ＣＩ组、ＣＨ组、ＳＡＨ组ＮＴ水平均显著高于对照组,于发病后２４小时内显著升高,１￣３天或４￣７天达高峰,８￣１５天开始下降,１５天后仍在较高水平;随病情加重与病灶扩大显著升高;ＣＩ与ＣＨ伴高血压糖组均显著高于正常血糖组,ＣＨ伴高血压组、伴消化道出血组显著高于正常血压组与无消化道出血组。ＳＡＨ组伴ＤＩＤ组明显高于非ＤＩＤ组。结论 ＮＴ分泌异常参与了ＣＩ、ＣＨ、ＳＡＨ的病理生理过程。     

564例SAH患者发病时间及诱发因素分析

国内外文献对出血性脑血管病或脑出血发病时间及诱因已有报道,但对蛛网膜下腔出血(SAH)却缺少单独分析。本文对我院自1972～1990年收治自发性SAH 564例的发病时间及诱因进行分析,以便采取必要的预防措施,减少发病及复发。     

卒中后早期癫的临床分析

目的　对卒中后早期癫的临床研究。方法　通过回顾性病例和随访观察。结果　卒中后早期癫的发生率为11 94% ,癫发作常发生在卒中后 2 4h内 ,占 75 5 %。癫发作与卒中CT所见部位密切相关 ,皮质病灶较皮质下病灶更易发生癫。结论　卒中后早期癫发作是迟发性癫的危险因素。     

卒中后早期癫癎的临床分析

目的对卒中后早期癫癎的临床研究.方法通过回顾性病例和随访观察.结果卒中后早期癫癎的发生率为11.94%,癫癎发作常发生在卒中后24h内,占75.5%.癫癎发作与卒中CT所见部位密切相关,皮质病灶较皮质下病灶更易发生癫癎.结论卒中后早期癫癎发作是迟发性癫癎的危险因素.     

脑血管病患者急性期血清缺血修饰白蛋白的变化研究

缺血修饰白蛋白(ischaemia-modified albumin,IMA)也称钴结合蛋白,最早在急性心肌缺血发作患者血清中发现,IMA的形成可能与白蛋白N-末端Asp-Ala-His-Lys肽链片段在缺血缺氧环境下与二价金属离子的结合力增高有关[1].目前IMA已经成为急性冠状动脉综合征、癫痫和终末期肾病患者重要的辅助诊断指标[2-3],然而关于IMA在急性脑血管病中的研究较少,且报道的结论存在一定差异[4-5].本研究初步探讨了IMA在急性期脑血管病患者血清中的变化规律.     

原因不明的蛛网膜下腔出血

原因不明的蛛网膜下腔出血李庆彬，路剑在自发性蛛网膜下腔出血（ＳＡＨ）的病人中，有相当一部分患者；即使通过近代神经影像学的检查，依然不能查明原因。临床上对此类病人如何处理，尚缺乏深入研究。本文拟就临床资料，结合文献进行初步探讨。临床资料与结果一、一般资...     

精神分裂症患者首次发病高峰时间的圆形分布分析

目的　探讨精神分裂症发病与季节的关系 ,为此病防治措施的制订提供参考依据。方法　采用圆形分布统计法 ,对 1997年 1月～ 2 0 0 2年 12月 6年间首次发病住院的 196 6例精神分裂症患者的发病高峰时间进行统计分析。结果　精神分裂症患者的发病高峰时间具有显著性差异 (r =0 .16 2 3,P <0 .0 1) ,发病高峰时间约为 2月 2 2日左右 ,按季节推算应为冬末春初。结论　此季节加强精神疾病的防治工作是降低精神分裂症发病的主要措施之一     

脑卒中病人睡眠-觉醒昼夜节律紊乱的影像学研究

目的探讨睡眠-觉醒昼夜节律紊乱脑卒中患者的脑结构改变,了解生物钟系统与其他脑组织之间可能的联系。方法收集存在睡眠-觉醒昼夜节律紊乱脑卒中患者(观察组)21例和无睡眠-觉醒昼夜节律紊乱脑卒中病人(对照组)92例影像学资料,比较两者之间的差别,寻找最可能引起睡眠-觉醒昼夜节律紊乱的脑区损害。结果通过比较发现,位于侧脑室枕角前部、丘脑外侧、岛叶后方、颞叶内侧的脑区脑组织损害可能与睡眠-觉醒昼夜节律紊乱有关。结论脑卒中病人中睡眠-觉醒昼夜节律紊乱的出现可能与特定的脑区损害有关。     

MRI-based intravenous thrombolysis in stroke patients with unknown time of symptom onset

Background: Currently, stroke patients with unknown time of symptom onset (UTOS) are excluded from therapy with intravenous tissue Plasminogen Activator. We hypothesized that MRI‐based intravenous thrombolysis is safe in UTOS. Methods: We analyzed radiological and clinical data as well as outcomes of stroke patients (including UTOS) who received intravenous thrombolytic therapy after MRI. Results: Compared to patients with known time of symptom onset (n = 131), UTOS (n = 17) were older (81, 71–88 vs. 75 years, 66–82, P = 0.03), had a longer median time between last‐seen‐well and thrombolysis (12.3 h, IQR 11.5–15.2 h vs. 2.1 h, 1.8–2.8 h, P < 0.01), had a longer median door‐to‐needle time (86 min, 49–112 vs. 60 min, 49–76, P = 0.02), and a higher rate of arterial obstruction on MR‐angiography (82.4% vs. 56.5%, P = 0.04). No symptomatic intracerebral hemorrhage occurred in UTOS. After 3 months, there was no significant difference between groups concerning good functional outcome (modified Rankin Scale 0–2; 35.3% vs. 49.6%, P = 0.26) or mortality (0% vs. 15.3%, P = 0.08). In multivariate analyses including age, gender, baseline NIHSS, and atrial fibrillation UTOS did not have an independent effect on good functional outcome after 3 months (OR 1.16; 0.32–4.12, P = 0.81). Conclusions: Thrombolysis after MRI seems safe and effective in UTOS. This observation may encourage those who plan prospective placebo‐controlled trials of thrombolytics in this subgroup of stroke patients.     

Circadian rhythm of stroke onset during the month of Ramadan

El‐Mitwalli A, Zaher AA, El Menshawi E. Circadian rhythm of stroke onset during the month of Ramadan.
Acta Neurol Scand: 2010: 122: 97–101.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Background and purpose – The onset of acute stroke exhibits a circadian pattern occurring more frequently in late morning hours. The objective of this study was to investigate the diurnal pattern of stroke during the month of Ramadan. Patients and methods – We studied consecutive stroke patients 1 month before Ramadan (BR) and during Ramadan (DR) over two successive years 2007 and 2008. The age, gender, risk factor profiles were analyzed. The National Institute of Health and Stroke Scale Score (NIHSS) was used for clinical assessment at admission. The exact time of stroke onset in both groups was obtained. Results – A total of 507 patients were studied: 245 patients in the DR group and 262 patients in the BR group. The age distribution of patients was not significantly different between the two groups. There was no statistically significant difference in the sex ratio, risk factors, and NIHSS score between the two groups (P > 0.05). The higher frequency of stroke onset time in the BR group was in the time between 6:00 a.m. and noon; whereas the frequency was higher between noon and 6:00 p.m. in the DR group. Conclusion – A significant shift of the circadian pattern of stroke onset time from the period between 6:00 a.m. and noon to that between noon and 6:00 pm has been found during the month of Ramadan.     

蛛网膜下腔出血早期病因检查及治疗结果

目的探讨研究蛛网膜下腔出血患者早期DSA检查和病因治疗的意义。方法将170例经临床确诊的蛛网膜下腔出血患者分为造影组和对照组,造影组64例进行诊断性全脑血管造影,根据造影结果行血管内治疗、开颅夹闭动脉瘤和内科保守治疗;对照组106例仅作内科保守治疗。结果DSA组显示脑动脉瘤47例,其中手术治疗11例,血管内栓塞治疗31例;硬脑膜动静脉瘘1例,烟雾病1例,原因不明15例。共复发7例,复发率为10．9％。死亡5例,死亡率为7、8％。对照组复发31例,复发率为29．2％,死亡21例,死亡率19．8％。两组比较复发率、死亡率均有显著差异性（P〈0、01和P〈0．05）。结论SAH患者早期行DSA检查,可及时明确病因,从而采取相应治疗措施,显著降低复发率和死亡率。     

Somatomotor mu rhythm amplitude correlates with rigidity during deep brain stimulation in Parkinsonian patients

Objective

Parkinsonian patients have abnormal oscillatory activity within the basal ganglia-thalamocortical circuitry. Particularly, excessive beta band oscillations are thought to be associated with akinesia. We studied whether cortical spontaneous activity is modified by deep brain stimulation (DBS) in advanced Parkinson’s disease and if the modifications are related to the clinical symptoms.

Methods

We studied the effects of bilateral electrical stimulation of subthalamic nucleus (STN) on cortical spontaneous activity by magnetoencephalography (MEG) in 11 Parkinsonian patients. The artifacts produced by DBS were suppressed by tSSS algorithm.

Results

During DBS, UPDRS (Unified Parkinson’s Disease Rating Scale) rigidity scores correlated with 6-10 Hz and 12-20 Hz somatomotor source strengths when eyes were open. When DBS was off UPDRS action tremor scores correlated with pericentral 6-10 Hz and 21-30 Hz and occipital alpha source strengths when eyes open.Occipital alpha strength decreased during DBS when eyes closed. The peak frequency of occipital alpha rhythm correlated negatively with total UPDRS motor scores and with rigidity subscores, when eyes closed.

Conclusion

STN DBS modulates brain oscillations both in alpha and beta bands and these oscillations reflect the clinical condition during DBS.

Significance

MEG combined with an appropriate artifact rejection method enables studies of DBS effects in Parkinson’s disease and presumably also in the other emerging DBS indications.     

Alteration of circadian periodicity in core body temperatures of patients with acute stroke

Abstract The effect of brain damage on body temperature rhythm was investigated by spectral analysis using the maximum entropy method. The rectal temperatures of 56 patients with acute stroke were recorded for 1–3 days by actigraphy. Many patients with disturbance of consciousness showed infradian rhythm. Ambulatory patients tended to have circadian rhythm, and non- ambulatory patients tended to show infradian rhythm. The study's findings suggest that impaired physical activity and disturbance of consciousness affect body temperature rhythm in patients with acute stroke.