合并偏头痛的肺动静脉瘘1例报告

1病例介绍患者女性,52岁,因“反复头痛20年,再发1周”于2019年7月4日入院。患者20年前开始反复出现头痛,多于睡眠或情绪不佳时出现,头痛为双侧额颞部搏动样胀痛,每次头痛发作前伴有视物变形和闪光先兆,持续15~20 min后出现头痛,头痛每次持续数小时至1 d,可服用止痛药物缓解或自行缓解,过程中伴有畏光畏声。     

偏头痛伴发的皮肤异常

偏头痛是一种反复发作的,以单侧或双侧头痛为特征的神经功能紊乱性疾病[1].在偏头痛患者中,反复发作的头痛是困扰患者的最主要症状,然而除头痛外,还伴有多种多样的非头痛症状,这些非头痛症状也在一定程度上影响着患者的生活质量.     

貌似“颅内肿瘤”的病例讨论（三）

病例资料患者住院号：113×××,女性,41岁,汉族,居住地为牧区。因反复阵发性头痛和反复发作短暂抽搐6年,伴右侧肢体无力1周于2011年5月11日入住新疆医科大学第一附属医院。     

表现为颅高压的慢性颅内静脉窦血栓形成1例

<正>颅内静脉窦血栓形成(CVST)为临床上不太常见的脑血管病,近几年已经逐步引起神经科医生的重视,但由于其临床表现不典型,极易误诊、漏诊,现报告1例表现为颅高压的慢性CVST如下。1病例女,30岁。因"反复头晕头痛6年、时有晕厥3年,加重伴眼胀2 d"入院。患者6年前始无明显诱因出现反复发作性头晕头痛,劳累后、月经期加重,休息减轻,反复发作,未治疗。3年前头晕头痛逐渐加重,表现为时有晕厥,经疼痛刺     

脑膜癌合并静脉窦血栓一例

1 病例介绍患者,男,49岁,主因“反复头痛伴呕吐、一过性视物不清1个月余”于2007年7月收入院.患者1个月来反复头部胀痛,以后枕颈部为著,每次持续数分钟,发作时常伴喷射性呕吐,为胃内容物,偶有一过性双眼视物不清.     

神经白塞病1例报告

白塞病是一种多系统血管炎,当侵犯神经系统时称神经白塞病(NBD),常因病史不详、查体不细致及缺乏对该病的认识而延误诊断。我院诊治1例MRI表现酷似脑干脓肿,且病程反复的NBD患者,现报告如下。1病例女,29岁。因反复发热、头痛1年,左半身无力1d于2001年9月27日入院。患者1年来反复出现发热,约     

巨大混合性胶质瘤一例

患者女,12岁。因反复发作肢体抽搐伴神志不清6年,头痛伴左侧肢体无力、右眼视力下降1年入院。6年前因发作肢体抽搐伴神志不清在外院行头颅CT检查,发现右额颞区钙化灶,诊断不明,仅予抗癫痫治疗,仍长期反复发作,入院前1年出现头痛伴左侧肢体无力、右眼视力下降。     

硬脑膜动静脉瘘3例报告及文献复习

正1病例介绍1.1病例1患者女性,53岁,因"反复头痛伴头昏、胡言乱语1月余"于2018年1月10日入院。患者1个月前开始无明显诱因出现头痛,以左侧额部、头顶部为主,呈阵发性针刺样,每次发作时间数小时不等,程度可耐受,且伴有头昏沉,并多次出现发作性胡言乱语、答非所问、行走缓慢,无恶心呕吐、视物模糊、肢体抽搐等。既往近30年来有反复发作头痛病史,平时涂抹风油精或清凉油可稍缓解,未诊治。有青     

MRI环形增强的颅内占位病例讨论

病例资料患者住院号:699×××,女性,42岁,汉族,福建省人。因"头痛1个月,反复肢体抽搐25 d"于2011年4月11日入住复旦大学附属华山医院(我院)神经科。现病史1个月前(2011-03-10)患者因过度疲劳后出现持续性头痛,为弥漫性胀痛,伴恶心、呕吐1次(非喷射性,为胃内容物)。疼痛可忍受,无畏光、畏声,无视物变形,无发热。2011-03-15患者头痛加重,伴畏寒、     

难于手术的巨大囊形基底动脉瘤一例

1病例简介患者,男,64岁,因“头痛2年加重5个月、双下肢无力1d”于2005-05-18入院。患者2年前因“持续性头痛”于外院行颅脑强化CT示基底动脉瘤,给予药物治疗(具体不详)后症状好转。此后头痛反复发作,近5个月来头痛发作频繁,伴有饮水呛咳、精神不振、头晕、偶伴视物成双,无恶心呕     

早年创伤对认知功能影响的研究进展

早年创伤是一个全球普遍存在的问题,严重影响儿童、青少年的大脑发育,继而导致认知功能、人格水平、社会行为的改变。早年创伤主要是父母、监护人或其他年长者对孩子施加躯体虐待、躯体忽视、情感虐待、情感忽视或性虐待。美国一项调查显示：儿童虐待事件的发生率高达1．2％[1]。早年创伤影响认知功能的多个领域,包括学习／工作记忆、视觉空间能力、执行功能、言语智能、复杂推理搜决策、学业表现等比]。创伤造成的认知功能改变是目前国内外神经科学和精神医学领域研究的热点,但其发病机制仍不明确,鉴于早年创伤与认知功能的关系问题,现就早年创伤对大脑发育、神经认知的影响加以综述。     

Chaotic electrical stimulation of the subthalamic nucleus – mossy fiber sprouting, epileptic seizures, and brain electrical activity in pentylenetetrazol-kindled rats★

BACKGROUND： Previous studies have demonstrated that appropriate interventions can alter brain electrical activity of epileptic patients prior to and during a seizure, leading to maintenance of a highly chaotic state, thereby inhibiting abnormal epileptic discharges, and eventually controlling epileptic seizure. OBJECTIVE： This study was designed to observe the effects of chaotic electrical stimulation to the subthalamic nucleus on mossy fiber sprouting, epileptic seizures, and electrical discharges, and to summarize the most suitable intervention. DESIGN, TIME AND SETTING： This randomized grouping, neuroelectrophysiological study was performed at the Laboratory of Neurology, Union Hospital Affiliated to Fujian Medical University in September 2007. MATERIALS： Fifty-five healthy, male, Sprague Dawley rats were subjected to an epileptic model by an intraperitoneal injection of pentylenetetrazol. The YC-2 programmed electrical stimulator was provided by Chengdu Instrument Factory, China; the video electroencephalographic system （KT-88-2400） and 24-hour active electroencephalographic system were products of Contec Medical System Co., Ltd., China; pentylenetetrazol was purchased from Sigma, USA. METHODS： The present interventional method consisted of electrical stimulation to the subthalamic nucleus with an intensity of 500 μA, pulse width 0.05 ms, frequency 30 Hz, and a duration of 20 minutes for 14 successive days. Fifty-five rats were divided into 6 groups： （1） pre-stimulation （n = 10）, pentylenetetrazol was administered and 30 minutes later, chaotic electrical stimulation was performed; （2） synchronous stimulation （n = 10）, rats received pentylenetetrazol and chaotic electrical stimulation concurrently; （3） post-administration stimulation （n = 10）, after pentylenetetrazol administration, chaotic electrical stimulation was performed immediately after cessation of a seizure; （4） sham-stimulation （n = 10）, following pentylenetetrazol administration, an electrode was con     

氧化应激与认知功能障碍的研究进展

氧化应激（Oxidative Stress）不仅在糖尿病、高血压病等身心疾病中起着重要作用,而且对阿尔茨海默病（AlzheimerDisease,AD）、帕金森病（Parkin-son Disease,PD）等神经精神障碍的认知功能也有一定影响。强烈或持续性的氧化应激可通过诱导细胞凋亡和炎性反应导致细胞、组织损害。流行病学及动物研究均表明,母孕期遭受应激可能会影响胎儿的神经心理发育过程,造成胎儿大脑某区域的缺陷,引起持续性认知改变、神经内分泌和行为反应,增加后代精神疾病的患病风险。现对氧化应激与认知功能障碍的机制进行综述。     

Intrathecal MK-801 inhibits formalin-induced activation of spinal p38-MAPK in rats**★

BACKGROUND： p38 mitogen-activated protein kinase （MAPK） plays an instrumental role in signal transduction from the cell surface to the nucleus, while subcutaneous injection of formalin can induce increased activation of spinal p38 MAPK. However, the mechanisms underlying the formalin-induced activation of spinal p38 MAPK in rats are unclear. OBJECTIVE： To observe the effects of N-methyl-D-aspartic acid （NMDA） receptor antagonist MK-801 on the formalin-induced activation of spinal p38 MAPK in rats. DESIGN, TIME AND SETTING： This randomized grouping, controlled animal experiment was performed at the Department of Physiology and Neurobiology, Shanxi Medical University between May and November 2007. MATERIALS： Forty eight healthy, adult Wistar rats were randomly divided into two groups： formalin ＋ normal saline （n = 12） and formalin ＋ MK-801 （n = 36）. The formalin ＋ MK-801 group was further divided into three subgroups according to the dosage of MK-801 （10, 50, and 100 nmol/L, 12 rats for each subgroup） METHODS： Following anesthesia, polyethylene tubing filled with sterile normal saline was implanted into the subarachnoid cavity. On postoperative days 5-8, rats received a 15 minute perfusion of normal saline or MK-801 （10, 50, and 100 nmol/L） in the formalin ＋ normal saline and formalin ＋ MK-801 groups, respectively, followed by formalin injection for the induction of nociceptive behavior. MAIN OUTCOME MEASURES： Detection of total p38 MAPK and of phosphorylated p38 MAPK by western Blot analysis; observation of nociceptive behaviors in the 1 hour after formalin injection. RESULTS： Western Blot analysis revealed that injection of formalin had no effect on total p38 MAPK expression but resulted in increased phosphorylation of p38 MAPK in the spinal cord. This increase was apparent after 5 minutes, peaked at 20 minutes, and thereafter descended and reached control levels after 45 minutes. Pretreatment with MK-801 （10, 50, 100 nmol/L） resulted in a dose-dependent reduc     

Brain network markers of abnormal cerebral glucose metabolism and blood flow in Parkinson＇s disease

Neuroimaging of cerebral glucose metabolism and blood flow is ideally suited to assay widely-distributed brain circuits as a result of local molecular events and behavioral modulation in the central nervous system. With the progress in novel analytical methodology, this endeavor has succeeded in unraveling the mechanisms underlying a wide spectrum of neurodegenerative diseases. In particular, statistical brain mapping studies have made significant strides in describing the pathophysiology of Parkinson＇s disease （PD） and related disorders by providing signature biomarkers to determine the systemic abnormalities in brain function and evaluate disease progression, therapeutic responses, and clinical correlates in patients. In this article, we review the relevant clinical applications in patients in relation to healthy volunteers with a focus on the generation of unique spatial covariance patterns associated with the motor and cognitive symptoms underlying PD. These characteristic biomarkers can be potentially used not only to improve patient recruitment but also to predict outcomes in clinical trials.     

Effects of acrous gramineus and its component, alpha-asarone, on apoptosis of hippocampal neurons after seizure in immature rats**☆

BACKGROUND： α-asarone and acrous gramineus have been shown to play a necessary function in enhancing the reactivity and convulsant threshold to electric stimulation of immature rats. They have also been shown to effectively suppress epileptic seizures induced by pentylenetetrazol in young rats. However, the mechanisms for these roles have been still unclear. OBJECTIVE： To observe the effects in immature rats of acrous gramineus and α -asarone on apoptosis of hippocampal neurons after epileptic seizure at the protein level, and to analyze the mechanism for these effects. DESIGN： A randomized controlled animal experiment. SETTINGS： Department of Pediatrics, First Hospital of Jilin University; Department of Histology and Embryology, Norman Bethune Medical School of Jilin University; Department of Internal Medicine, Children＇s Hospital of Changchun City; Department of Neurology, First Clinical Hospital affiliated to Harbin Medical University. MATERIALS： Fifty 3-week old Wistar rats, 34-40 g, irrespective of gender, were provided by Gaoxin Research Center of Medical Animal Experiment, Changchun. The animals were treated according to the animal ethical standards. The following chemicals were used for this study： acrous gramineus powders or infusion （Batch No, 0307113, Tianjiang Medicine Company Limited, Jiangyin）, α-asarone tablets （Batch No. 030219, Tianwei Pharmaceutical Factory, Shenyang）, and phenobarbital sodium tablets （Batch No. 020608, Xinya Medicine Company Limited, Shanghai）. The animals were divided into five groups randomly. First, ten rats were chosen as the normal controls. The remaining rats were treated with i.p. injections of pentylenetetrazol to stimulate an epileptic model. METHODS： The experiments were performed at the Neurological Laboratory of the First Hospital of Jilin University between October and December 2004. The rats were treated with i.p. injections of pentylenetetrazol （60 mg/kg） to establish an epileptic model. According to Racine＇ s standard, animal     

Effect of Ganoderma lucidum spore on expression of insulin-like growth factor-1, nuclear factor-kappa B, and neuronal apoptosis in the epileptic rat brain*★

BACKGROUND：It has been reported that Ganoderma lucidum spore powder, a very well known Chinese traditional medicine, can affect immunoregulation, free radical scavenging, and anti-hypoxia responses. OBJECTIVE： To investigate the effect of Ganoderma lucidum spore powder on expression of insulin-like growth factor-1 （IGF-1）, nuclear factor-κB （NF-κB） and neuronal apoptosis in rats with pentylenetetrazol （PTZ）-induced epilepsy. DESIGN, TIME AND SETTING： A cellular and molecular biology experiment with randomized controlled study design was performed at the Central Laboratory of Basic Medical College of Jiamusi University from June to August 2005. MATERIALS： Thirty healthy, adult, male, Wistar rats were selected and randomly divided into 3 groups （10 rats per group）： control, epilepsy model, and Ganoderma lucidum spore powder. A sub-eclampsia PTZ dose （35 mg/kg） was intraperitoneally injected to induce epilepsy in the latter two groups. Wild Ganoderma lucidum spore powder （30 g/L） was provided by the wild Ganoderma lucidum plant nursery at Jiamusi, China. Immunohistochemical detection and terminal deoxynucleotidyl transferase-mediate dUTP nick end-labeling （TUNEL） kits were purchased from Wuhan Boster Biological Technology Co., Ltd., China. METHODS： Ganoderma lucidum spore powder was intragastrically administered at a dose of 10.0 mL/kg, once a day for 28 days. In the epilepsy and control groups, an equivalent volume of normal saline was intragastrically administered. MAIN OUTCOME MEASURES： Immunoreactivity for IGF-1 and NF-κB/P65 were detected by immunohistochemical staining. Neuronal apoptosis was detected using TUNEL methods. RESULTS： The hippocampus and cerebral cortex of rats with PTZ-induced epilepsy exhibited a higher number of apoptotic cells at high magnification （×400）, compared with the control group. Expression of IGF-1 and NF-κB were higher in the epilepsy group, compared with the control group （P 〈 0.01）. In Ganoderma lucidum spore-treated rats,     

Effect of propofol on glutamate-induced activation and related inflammatory cytokines of astrocytes from spinal cord dorsal horn★

BACKGROUND： Astrocytes participate in central nervous system-mediated physiological or pathological processes, such as pain. Activated dorsal horn astrocytes from the spinal cord produce nerve active substances and proinflammatory cytokines, such as interleukin-lbeta （IL-1 β ）, IL-6, and tumor necrosis factor- α （TNF-α ）, which play important roles in pain transduction and regulation. OBJECTIVE： To investigate the effects of different doses of propofol on activation of cultured spinal cord dorsal horn astrocytes induced by glutamate, as well as changes in IL-1β, IL-6, and TNF- α, and 1L-10 （anti-inflammatory cytokine） expression in rats, and to explore the dose relationship of propofol. DESIGN, TIME AND SETTING： The cellular and molecular biology experiment was performed at the Central Laboratory of Yunyang Medical College between March 2006 and December 2007. MATERIALS： Forty healthy, Wistar rats, aged 2-3 days, were selected. Propofol was provided by Zeneca, UK; glutamate by Sigma, USA; EPICS XL flow cytometry by Beckman culture, USA; rabbit-anti-mouse glial fibrillary acidic protein （GFAP） antibody kit and inflammatory cytokine detection kit were provided by Zhongshan Biotechnology Company Ltd., Beijing; multimedia color pathologic image analysis system was a product of Nikon, Japan. METHODS： Astrocytes were harvested from T11- L6 spinal cord dorsal horn of Wistar rats and incubated for 3 weeks. The cells were divided into seven groups, according to various treatment conditions： control group was cells cultured in Hank＇s buffered saline solution; intralipid group was cells cultured in intralipid （0.2 mL/L）; glutamate group was cells cultured with 100 u mol/L glutamate; propofol group was cells cultured with 250 u mol/L propofol; three glutamate plus propofol groups were cultured in 100 11 mol/L of glutamate, followed by 5, 25, and 250 u mol/L of propofol 10 minutes later. MAIN OUTCOME MEASURES： GFAP-labeled astrocytes were analyzed using a multimedia pathology imaging a     

Differential cognitive responses to guqin music and piano music in Chinese subjects： an event-related potential study

Objective To compare the cognitive effects of guqin （the oldest Chinese instrument） music and piano music. Methods Behavioral and event-related potential （ERP） data in a standard two-stimulus auditory oddball task were recorded and analyzed. Results This study replicated the previous results of culture-familiar music effect on Chinese subjects： the greater P300 amplitude in frontal areas in a culture-familiar music environment. At the same time, the difference between guqin music and piano music was observed in NI and later positive complex （LPC： including P300 and P500）： a relatively higher participation of right anterior-temporal areas in Chinese subjects. Conclusion The results suggest that the special features of ERP responses to guqin music are the outcome of Chinese tonal language environments given the similarity between Guqin＇s tones and Mandarin lexical tones.