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1.
Żanna Pastuszak Zbigniew Czernicki Waldemar Koszewski Adam Stępień Anna Piusińska-Macoch 《Neurologia i neurochirurgia polska》2018,52(3):311-317
Introduction
Malignant ischemic stroke of the middle cerebral artery (MCA) territory causes neurological deterioration due to the effects of space occupying cerebral edema. The prognosis is poor, and death usually occurs as a result of brainstem compression. There is no information on ischemic stroke, especially the malignant ones, in patients over 85 years old.Aim
The aim of this retrospective study was to evaluate the disease course, risk factors, survival rate and treatment of MCA malignant infarction in people over 85 years old.Method
The medical history of 66 patients with malignant MCA stroke was analyzed. The frequency of the occurrence of the risk factors like hypertension, hyperlipidemia, atrial fibrillation, heart failure, diabetes was evaluated. Disability was measured with the use of the National Institutes of Health Stroke Scale (NIHSS). Safety and effectiveness of the anticoagulants used in the group of patients with atrial fibrillation were analyzed. Chi-quadrat test and Mann–Whitney U test were used for statistical analysis of data. We also described 85 year-old patient with malignant brain stroke who was treated neurosurgically with a positive effect.Results
Atrial fibrillation was diagnosed in 65% of patients of the investigated group. There were no statistically significant changes in the survival rate between the group of patients treated with the use of mannitol and patients without this treatment.Conclusion
The key risk factor in this group is the atrial fibrillation. The elderly patients require an intensive monitoring of the health condition by reference to brain stroke risk factors, especially atrial fibrillation. 相似文献2.
V. Constantinescu D. Matei V. Costache D. Cuciureanu C. Arsenescu-Georgescu 《Neurologia i neurochirurgia polska》2018,52(2):194-206
Introduction
Cardiovascular system presents cortical modulation. Post-stroke outcome can be highly influenced by autonomic nervous system disruption. Heart rate variability (HRV) analysis is a simple non-invasive method to assess sympatho-vagal balance.Objectives
The purpose of this study was to investigate cardiac autonomic activity in ischemic stroke patients and to asses HRV nonlinear parameters beside linear ones.Methods
We analyzed HRV parameters in 15 right and 15 left middle cerebral artery ischemic stroke patients, in rest condition and during challenge (standing and deep breathing). Data were compared with 15 age- and sex-matched healthy controls.Results
There was an asymmetric response after autonomic stimulation tests depending on the cortical lateralization in ischemic stroke patients. In resting state, left hemisphere stroke patients presented enhanced parasympathetic control of the heart rate (higher values for RMSSD, pNN50 and HF in normalized units). Right hemisphere ischemic stroke patients displayed a reduced cardiac parasympathetic modulation during deep breathing test. Beside time and frequency domain, using short-term ECG monitoring, cardiac parasympathetic modulation can also be assessed by nonlinear parameter SD1, that presented strong positive correlation with time and frequency domain parameters RMSSD, pNN50, HFnu, while DFA α1 index presented negative correlation with the same indices and positive correlation with the LFnu and LF/HF ratio, indicating a positive association with the sympatho-vagal balance.Conclusions
Cardiac monitoring in clinical routine using HRV analysis in order to identify autonomic imbalance may highlight cardiac dysfunctions, thus helping preventing potential cardiovascular complications, especially in right hemisphere ischemic stroke patients with sympathetic hyperactivation. 相似文献3.
Anetta Lasek-Bal Teresa Kowalewska-Twardela Aldona Warsz-Wianecka Przemysław Puz Aleksandra Krzan Aleksandra Cieślik 《Neurologia i neurochirurgia polska》2018,52(2):156-161
Background
The efficacy and safety of thrombolytic therapy in stroke depend on multiple factors. The aim of this study was to evaluate the significance of atrial fibrillation the prognosis in terms of the functional status in patients with stroke treated with intravenous thrombolysis. An additional aim was also to assess the potential significance of reduced ejection fraction (EF) and enlarged left atrium (LA) of the heart for the prognosis in patients with stroke who underwent thrombolytic therapy.Methodology
A prospective study involved enrollment of 222 patients, mean age of 72 years with first-in-life ischemic stroke. In all participants there were realized procedures as follows: neurological status before administering rt-PA (NIHSS), selected echocardiographic parameters, functional status on the 14th day from the onset (mRankin scale) and analysis the bleeding events.Results
Atrial fibrillation was significantly more frequent in women than men; females had higher CHA2DS2VASc scores and heavier neurological conditions on day 1 of stroke. Two independent factors for poor prognosis (3–5 points by mRankin) were found: the NIHSS score and the CHA2DS2VASc score ≥3. We identified 2 independent factors for death within 14 days from the onset: the result by NIHSS and the EF. The NIHSS score turned out to be the only independent predictor of hemorrhage during hospitalization: RR 1.19; CI [1.06–1.33]; p = 0.003; p for model = 0.0025.Conclusions
The presence of atrial fibrillation worsens the patient's prognosis in terms of the functional status and survival during the acute period of stroke in patients treated with intravenous thrombolysis.Higher NIHSS and CHA2DS2VASc scores and reduced EF in patients with stroke treated with thrombolysis are the predictors of unfavorable short-term prognosis. 相似文献4.
Malgorzata Pawelczyk Andrzej Glabiński Beata Kaczorowska Zbigniew Baj 《Neurologia i neurochirurgia polska》2018,52(5):599-605
Background
Activation of platelets and endothelial cells plays an important role in the pathogenesis of atherosclerosis and thrombotic disorders.The aim of our study was to assess the relationship between the metabolic disorders and markers of platelet activity and vascular injury in patient with acute ischemic stroke.Material and methods
The study group consisted of 84 patients with acute non-lacunar ischemic stroke divided into four subgroups with: (1) normolipidemia and normoglycemia, (2) normolipidemia and hyperglycemia, (3) hyperlipidemia and normoglycemia, (4) hyperlipidemia and hyperglycemia. 21 healthy subjects served as controls. We analyzed the concentration of adhesion molecules sP-selectin and sE-selectin in serum collected from all studied groups using ELISA method.Results
We observed significantly higher sE- and sP-selectin concentration in patients with hyperglycemia and hyperlipidemia compared to both control subjects and patients with normolipidemia and normoglycemia. We did not observe additional effect of comorbid hyperlipidemia and hyperglycemia on studied markers. Soluble E- and P-selectin concentration correlated positively with LDL, TC and HbA1c level in all stroke patients.Conclusion
Soluble E- and P-selectin, blood markers of vascular injury and platelet activation, could be useful in the assessment of atherothrombotic properties of hyperglycemia and hyperlipidemia in stroke patients. 相似文献5.
Izabela Monika Rozmilowska Monika Helena Adamczyk-Sowa Damian Czyzewski 《Neurologia i neurochirurgia polska》2018,52(3):368-373
Introduction
The Myasthenia Gravis-Activities of Daily Living scale (MG-ADL) is a short, and easy to use disease-specific quality of life during daily routine tool in myasthenia gravis.Objectives
The purpose of our work was to evaluate neurological condition patients with myasthenia gravis using the form MG-ADL in order to enable the introduction in common use of an instrument which allows for the assessment of patients with myasthenia gravis.Patients and Methods
The total number of 50 patients with MG were qualified for the examination. Each patient underwent neurological examination and completed the quality of life evaluation questionnaire MQ-ADL. Additionally, each patient was asked to evaluate the quality of his/her life by means of questionnaire MG-QOL 15 and MG Composite in Polish language version.Results
Our analysis showed a positive correlation with other scales used - MG-QOL 15, MGFA, MG Composite. The intensification of neurological symptoms showed significant relation with obtained higher number of points in MG-ADL questionnaire. The MG-ADL was found to have high internal consistency, test–retest reliability, and concurrent validity.Conclusion
We confirmed reliability and dependability of the questionnaire in the the test-retest assessment. The MG-ADL is accepted to be a reliable and valuable tool for measuring disease-specific QOL in Polish patients with MG. 相似文献6.
Michal A. Karlinski Jan P. Bembenek Anna Baranowska Iwona Kurkowska-Jastrzebska Anna Czlonkowska 《Neurologia i neurochirurgia polska》2018,52(2):168-173
Background
Medical complications often worsen the prognosis after stroke. Our aim was to investigate the association between particular noninfectious complications and hospital mortality of acute stroke patients admitted to an urban Polish stroke center, and changes in their occurrence from 1995 to 2015.Methods
This is a retrospective analysis of 5174 consecutive patients admitted for acute ischemic stroke or cerebral hemorrhage to a Polish urban stroke center between 1995 and 2015. The occurrence of complications was reported for years 1995–2000 (n = 883), 2001–2006 (n = 1567), 2006–2010 (n = 1539) and 2011–2015 (n = 1183). Odds ratios (OR) with 95% confidence interval (95% CI) for stroke unit death were calculated after adjustment for age, congestive heart failure (CHF), pre-existing disability, stroke type and baseline neurological deficit in three different time periods.Results
Over time there was a significant decrease in the occurrence of myocardial infarction (MI) (2.2%, 1.4%, 1.0% and 0.3%, respectively), exacerbated CHF (4.6%, 5.1%, 2.6% and 2.0%) and deep vein thrombosis (DVT) (4.6%, 2.7%, 1.2% and 1.1%). Adjusted odds for stroke unit death were increased by myocardial infarction (MI) (OR 17.5, 95% CI: 8.5–35.7), exacerbated CHF (OR 15.0, 95% CI: 9.8–23.0), pulmonary embolism (PE) (OR 11.5, 95% CI: 6.1–21.6), gastrointestinal bleeding (OR 9.2, 95% CI: 4.4–18.9) and recurrent stroke (OR 5.4, 95% CI: 3.1–9.3).Conclusions
Over the last two decades Polish urban stroke units may have achieved a significant reduction of the occurrence of some noninfectious complications (i.e. MI, exacerbated CHF and DVT). However, the list of conditions associated with stroke unit mortality includes not only MI and exacerbated CHF but also PE, gastrointestinal bleeding and recurrent stroke. 相似文献7.
Beata Łabuz-Roszak Anna Starostka-Tatar Anetta Lasek-Bal Marek Gierlotka Mariusz Gąsior Michał Skrzypek 《Neurologia i neurochirurgia polska》2018,52(2):235-242
Background
The available data on diagnostics and treatment of ischemic stroke (IS) in Poland come mainly from non-representative cohorts or are outdated.Objective
Therefore, the current study was done to access the most recent data on IS in the industrial region that covers 12% of the country's population.Materials & methods
Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to acute stroke and administered by the National Health Fund (the only public health insurer in Poland) between 2009 and 2015 (n = 81,193).Results
The number of hospitalizations due to IS in the Silesian Province was 69,403 and constituted 85.5% of all stroke cases reported to the NHF between 2009 and 2015. Neuroimaging of the brain (CT/MRI) was performed in 68,696 (99%) subjects, while ultrasonography of extra- and/or intracranial arteries in 57,886 (83.4%). The rtPA therapy was applied in 3282 patients (4.7% of all IS subjects). The rate of patients treated with rtPA gradually increased (1.2% in 2009, 9.3% in 2015). Among all patients with IS, 57,636 (83.1%) subjects were administered antiplatelet drugs, 16,199 (23.3%) – oral anticoagulants, and 55,971 (80.7%) – antihypertensive drugs. Also, 2260 (3.3%) patients were referred for vascular intervention. In subjects with cardioembolic stroke etiology, 37.8% were treated with anticoagulants.Conclusions
There has been observed a significant improvement in the quality of diagnosis and treatment of acute ischemic stroke during recent years. However, further actions are required both in terms of reperfusion treatment (thrombolysis and/or thrombectomy) and secondary prevention of stroke. 相似文献8.
Anna Sulek Anna Lusakowska Wioletta Krysa Marta Rajkiewicz Anna Kaminska Monika Nojszewska Anna Kostera-Pruszczyk Elzbieta Zdzienicka Jolanta Kubalska Maria Rakowicz Walentyna Szirkowiec Hubert Kwiecinski Jacek Zaremba 《Neurologia i neurochirurgia polska》2018,52(6):736-742
Introduction
Myotonic dystrophies (DMs) type 1 (DM1) and type 2 (DM2) are autosomal dominant, multisystem disorders, considered the most common dystrophies in adults. DM1 and DM2 are caused by dynamic mutations in the DMPK and CNBP genes, respectively.Methods
Molecular analyses were performed by PCR and the modified RP-PCR in patients, in their at-risk relatives and prenatal cases.Results
The analysis of Polish controls revealed the range of 5-31 CTG repeats for DM1 and 110-228 bp alleles for DM2. Among 318 confirmed probands - 196 (62%) were DM1 and 122 (38%) – DM2. Within DM1families, 10 subjects carried a low expanded CTG tract (< 100 repeats), which resulted in a full mutation in subsequent generations. Two related individuals had unstable alleles–188 bp and 196 bp without common interruptions.Conclusion
The relative frequencies of DM1/DM2 among Polish patients were 68% and 32%, respectively, with a relatively high proportion of DM2 mutations (1.6:1). 相似文献9.
Piotr Sobolewski Grzegorz Kozera Wiktor Szczuchniak Anna Sobota Kamil Chwojnicki Marcin Gruchała Walenty M. Nyka 《Neurologia i neurochirurgia polska》2018,52(5):593-598
Background
Heart failure (HF) is common among patients with ischemic stroke (IS), however its impact on outcome after iv-thrombolysis has not been fully determined. Moreover, definition of HF has been recently modified, but majority of stroke studies classified patients regarding an old HF criteria. Thus, the aim of our study was to evaluate the relationship between both, newly and formerly defined HF and the long-term outcome, mortality and the presence of hemorrhagic complications in patients with acute IS treated with iv-thrombolysis.Methods
We retrospectively evaluated data from 328 Caucasian patients with IS consecutively treated with iv-thrombolysis. HF was defined according to old and new definition; long-term outcome was assessed with modified Rankin Scale (mRS) score and mortality rate on 90th days after IS.Results
The incidence of HF did not differ between patients with favorable (mRS 0–2) and unfavorable (mRS 3–6) functional outcome respectively for the old and for the new definition (10.4% vs. 15.5, p?=?0.17; 17.4% vs. 18.1%, p?=?0.88) and between those who survived and died within 90 days after IS (11.7% vs. 20.0%, p?=?0.27; 17.2% vs. 25.0%, p?=?0.38, respectively). Multivariate analysis showed no impact of HF diagnosis on outcome (p?=?0.94) or mortality (p?=?0.64).Conclusion
The presence of systolic HF, defined according to an old and a new definition, does not determine safety and efficacy of cerebral iv-thrombolysis in patients with IS. 相似文献10.
R. Bourcier D. Abed M. Piotin H. Redjem J.C. Ferré F. Eugène H. Raoult M. Mirza R. Chapot H. Desal H. Nordmeyer 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(4):230-235
Background and purpose
Mechanical thrombectomy predominantly using stent retrievers effectively restores cerebral blood flow and improves functional outcomes in patients with acute ischemic stroke. We sought to determine the safety and efficacy of mechanical thrombectomy using the EmboTrap device.Materials and methods
We identified 80 consecutive patients from 4 centers with acute ischemic stroke treated with EmboTrap from June 2015 to December 2016. All patients had confirmed large vessel occlusions in the anterior circulation using CT or MR angiography with salvageable tissue. We assessed baseline characteristics and treatment related parameters including onset-to-treatment time, recanalization success (mTICI 2b or greater), complications, and good clinical outcome (mRS 0 to 2).Results
Successful recanalization was achieved in 72 patients (90%). When considering the use of a second thrombectomy device as failure, the EmboTrap successfully recanalized 65 patients (81%), with complete (mTICI 3) recanalization in 40 patients (50%) within 1 or 2 passes. Median procedure time (groin to recanalization) was 35 minutes (8–161 minutes). During the procedure, distal emboli in previously unaffected territories were found in 5 (6%) patients. There were 3 vasospasms (4%) and no vessel perforations. Intracranial hemorrhage on CT at day 1 was found in 18 17 (2321%) patients, none with subarachnoid hemorrhages, and 5 were symptomatic (6%). Good clinical outcome occurred in 4749/68 78 patients (6963%).Conclusions
In this multicenter retrospective study, the EmboTrap device achieved high recanalization rates, good clinical outcomes and was safe in treating acute stroke patients with large vessel occlusions. 相似文献11.
Żanna Pastuszak Renata Piusińska-Macoch Adam Stępień Zbigniew Czernicki 《Neurologia i neurochirurgia polska》2018,52(2):281-284
Background
Post polio syndrome is a rare disease that occurs decades after polio virus infection. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness in drug resistant depression. Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome.Objective
To describe a case of patient diagnosed with post polio syndrome who was treated with rTMS stimulation with a good effect.Methods
Patient had rTMS stimulation of left prefrontal cortex twice a week for an eight weeks. Patient's health status was evaluated before treatment, after last rTMS session and after three months from the end of the treatment.Results
Improvement of fatigue score, mood disturbances and motor functions was observed after treatment.Conclusion
rTMS can be an effective method in treatment of post polio syndrome but further studies with larger group need to be done to confirm that data. 相似文献12.
P. Net F. Karnycheff M. Vasse F. Bourdain B. Bonan B. Lapergue 《Revue neurologique》2018,174(3):145-149
Introduction
Urinary catheterization and acute urinary retention increase the risk of urinary tract infection (UTI). Our study aimed to investigate the incidence of UTI following acute stroke at our stroke center (SC) and to assess urinary catheter-care practices among French SCs.Methods
Stroke patients hospitalized within 24 h of stroke onset were prospectively enrolled between May and September 2013. Neurological deficit level was assessed on admission using the US National Institutes of Health Stroke Scale (NIHSS). Patients were followed-up until discharge. Indwelling urinary catheterization (IUC) was the only technique authorized during the study. An electronic survey was also conducted among French SCs to assess their practices regarding urinary catheterization in acute stroke patients.Results
A total of 212 patients were included, with 45 (21.2%) receiving indwelling urinary catheters. The overall estimated incidence of UTI was 14.2%, and 18% among patients receiving IUC. On univariate analysis, IUC was significantly associated with older age, longer hospital stays and higher NIHSS scores. Of the 30 SCs that responded to our survey, 19 (63.3%) declared using IUC when urinary catheterization was needed. The main argument given to justify its use was that it was departmental policy to adopt this technique. Also, 27 participants (90%) stated that conducting a study to assess the impact of urinary catheterization techniques on UTI rates in acute stroke patients would be relevant.Discussion
Our results are in accord with previously reported data and confirm the high burden of UTI among acute stroke subjects. However, no association was found between IUC and UTI on univariate analysis due to a lack of statistical power. Also, our survey showed high heterogeneity in catheter-use practices among French SCs, but offered no data to help determine the best urinary catheterization technique.Conclusion
Urinary catheterization is common after acute stroke and a well-known risk factor of UTI. However, as high heterogeneity in catheter-use practices is found among French SCs, randomized studies comparing the efficacy of urinary catheterization techniques in terms of UTI prevention in acute stroke patients are now warranted. 相似文献13.
Anetta Lasek-Bal Joanna Kidoń Monika Błaszczyszyn Bartłomiej Stasiów Amadeusz Żak 《Neurologia i neurochirurgia polska》2018,52(3):341-346
Functional magnetic resonance imaging (fMRI) allows for the assessment of neuronal activity through the blood-level-dependent signal. The purpose of study was to evaluate the pattern of brain activity in fMRI in patients with ischemic stroke and to assess the potential relationship between the activity pattern and the neurological/functional status.
Methods
The fMRI was performed in patients up to 4th day of stroke. All the patients were analyzed according to NIHSS on 1st day and mRankin scale on 14th day of stroke, followed by analyzing of fMRI signal.Results
The study enrolled 13 patients at a mean age of 64.3 years. Eight (61.5%) showed cerebellar activation and 2 (15.38%)- insular activation. In those who scored 0–2 on mRankin scale, the most frequently observed activity was located in the regions: the M1, SMA and PMC in the stroke hemisphere and the cerebellum. In those cases, the non-stroke hemisphere was more frequently involved in the areas: the M1 and PMC. There was a tendency for a better prognosis in relation to age <65 years and activation of the SMA in the stroke hemisphere.Conclusion
There are differences observed in the activation areas of the cerebral cortex both in the stroke and non-stroke hemispheres. More than half of the patients with hemispheric stroke but all with good outcome showed cerebellar activation. There is probable positive correlation between the BOLD-signal size, young age, activation of supplementary motor area in stroke hemisphere and good functional status of patients in the subacute period of stroke. 相似文献14.
Jeremy Hofmeister Zsolt Kulcsar Gianmarco Bernava Alain Pellaton Hasan Yilmaz Gorislav Erceg Maria Isabel Vargas Karl-Olof Lövblad Paolo Machi 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(5):305-309
Objective
Mechanical thrombectomy (MTB) is a treatment of reference for acute ischemic stroke due to large brain vessel occlusion but some concerns remain about its use in small distal branches. In the present study, we assessed the efficacy and the safety of distal MTB using the Catch Mini (CM) stent retriever.Methods
We retrospectively reviewed a prospectively maintained database of all consecutive patients who underwent MTB for a distal intracranial occlusion with the Catch Mini device at our hospital.Results
Forty-one patient underwent MTB for distal intracranial occlusions using the CM stent retriever. Good capillary reperfusion (TICT ≥ 2b) was observed in 32 out of 41 patients (78%). Focal ischemia within the territory vascularized by the artery addressed by the CM was observed in 8 patients (19.5%). Post-procedural vasospasm was observed in 8 patients, all responding rapidly to vasodilatator administration. Two asymptomatic hemorrhages (4.9%) were noted on follow-up imaging (one patechial hemorrhage and one parenchymal hematoma) in patients with M2 occlusions. No vessel rupture were observed. Overall, good neurological outcome at three months (mRS ≤ 2) was observed in 28 (out of 34 patients followed; 82.4%) of patients.Conclusions
Our single-center experience shows that the CM stent retriever is safe and effective for the recanalization of small diameter distal branches feeding eloquent brain areas. 相似文献15.
Claudia Stöllberger Nicolas DeCillia Josef Finsterer 《Neurologia i neurochirurgia polska》2018,52(3):394-396
Background
Embolic stroke is a complication of Tako-Tsubo-cardiomyopathy (TTC), transient left ventricular dysfunction mimicking myocardial infarction without coronary culprit lesion explaining the whole left ventricular dysfunction. Transient global amnesia (TGA) is characterized by sudden onset of anterograde amnesia without compromise of other neurologic functions.Case report
A 57 years old female was admitted because of sudden confusion and loss of her memory after emotional stress. TGA was diagnosed. Because of chest pain and laboratory tests indicating myocardial ischemia, she underwent coronary angiography which was normal. Within the following 24 h her memory improved. She complained about severe vertigo and cerebral magnetic resonance imaging showed a recent ischemia in the left cerebellum.Conclusions
TGA is not a disease for the neurologists exclusively but also cardiac comorbidities have to be considered and cardiologists should be involved in the acute care of these patients in order not to overlook life-threatening diseases. 相似文献16.
Mikiya Beppu Yohei Mineharu Hirotoshi Imamura Hidemitsu Adachi Chiaki Sakai Shoichi Tani Koichi Arimura So Tokunaga Nobuyuki Sakai 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(6):357-361
Background and purpose
Although in-stent protrusion is a potential risk factor for thromboembolism following carotid artery stenting, the correlation between in-stent protrusion and postoperative ipsilateral stroke has not been well examined.Materials and methods
We retrospectively reviewed 342 consecutive carotid artery lesions in 319 patients who underwent carotid artery stenting between April 2008 and April 2015. After excluding cases with carotid artery dissection and acute occlusion, 301 lesions in total of 277 patients were included in the analysis. We examined the association between in-stent protrusion, which was detected by intravascular ultrasound, and postoperative ipsilateral stroke within 30 days.Results
In-stent protrusion was observed in 47 (15.6%) lesions, of which postoperative ipsilateral stroke within 30 days occurred with 4 (8.5%) lesions. All these events occurred within 10 days after treatment. On the other hand, only 1 (0.39%) of the 256 lesions without in-stent protrusion showed this symptom, and the event occurred at 30 days after treatment. Thus, lesions with in-stent protrusion had a higher cumulative risk of ipsilateral stroke than those without in-stent protrusion (8.5% vs 0.4% at 30 days, log-rank P < 0.001). In-stent protrusion, which was more often seen in symptomatic lesions, was associated with a vulnerable plaque assessed by MRI. After adjustment for postoperative stroke risks such as symptomatic lesions, plaque vulnerability, age or sex, in-stent protrusion was still significantly associated with postoperative ipsilateral stroke within 30 days (OR = 27.03, P = 0.001).Conclusions
Postoperative ipsilateral stroke was observed more frequently in patients with demonstrated in-stent protrusion (ISP) following CAS. 相似文献17.
Carlos Salavera Pablo Usán José Luis Antoñanzas Pilar Teruel Orosia Lucha 《Annales médico-psychologiques》2017,175(4):353-357
Objective
Analyze the relation between both these variables (affects and personality).Method
To evaluate the relation between affects and personality, 652 university students were evaluated, through questionnaires PANAS (affects) and ZKPQ-50-CC (personality).Results
The results showed how males presented higher levels of impulsiveness, activity, sociability and aggressiveness, and no differences in handling affects were found. Those people who used positive affects more showed higher levels of activity, sociability and impulsiveness. Personality influenced affects for three of its factors, Anxiety, Activity and Aggressiveness, and was a good predictor of affects. Anxiety also strongly influenced the prognosis of negative affects.Conclusions
We conclude that our research data provide evidence for a relation between both these study variables. 相似文献18.
Payam Sajedi Lydia Chelala Joel Nunez-Gonalez Carolyn Cronin Steven Kittner Jiachen Zhuo Yang Zhang Dheeraj Gandhi Prashant Raghavan 《Journal of neuroradiology. Journal de neuroradiologie》2019,46(2):136-140
Background and purpose
Carotid webs are intraluminal filling defects at the carotid bulb which are considered rare, though possibly underappreciated entities with recent studies demonstrating a likely casual association with ischemic stroke. The purpose of the study is to describe our recent experience with clinical and imaging manifestations of carotid webs.Materials and methods
A retrospective review of CTA neck studies in all adult patients presenting to our institution during the 19-month study interval was performed to determine the presence of carotid webs. Subsequent chart review of these patients with webs was performed to assess their clinical history and to obtain demographic detail.Results
A total of 14 patients were identified with carotid webs in the study population. The mean age of patients with webs was 42.1?years (range: 28–54), consisting mostly of African Americans (86%) and females (64%). Ten (71%) of web patients had a history of ischemic stroke, each ipsilateral to the side of web, and at least four of these patients had recurrent ischemic stroke.Conclusion
We provide one of the largest sample sizes of webs gathered in a single study. Given its association with ischemic stroke, carotid webs should be assessed for in all patients presenting with ischemic stroke, especially younger African Americans. 相似文献19.
N. Ahbeddou K. El Alaoui Taoussi A. Ibrahimi E.H. Ait Ben Haddou W. Regragui A. Benomar M. Yahyaoui 《Revue neurologique》2018,174(5):313-318
Objective
The aim of this study was to describe the clinical, biological and radiological characteristics of patients with syphilitic vasculitis, and to assess the outcome after treatment.Methodology
A retrospective review was carried out based on the records of patients with ischemic stroke, and reactive CSF TPHA and VDRL results. None of these patients showed symptoms of any other diseases or had received high doses of penicillin.Results
A total of 53 patients with stroke met the diagnostic criteria for syphilitic arteritis. Their average age was 41 ± 12 years. Nine patients had a history of genital ulcer (17%), and the median duration of illness after presenting a chancre was 8 [range: 1–14] years. A prodromal syndrome was seen in 27 patients (50.9%) and included changes in mental status in 14 patients (26.4%), seizures in 10 cases (18.9%), headache in eight (15.1%) and memory loss in seven (13.2%). Neurological events included focal motor deficits in 29 cases (54.7%), ataxia in 11 (20.8%) and movement disorders in 15 (28.3%). HIV serology was performed in 31 patients and proved negative in every case. Disease evolution was generally favorable: 12 patients (22.6%) were autonomous at the time of hospital discharge; 29 (54.7%) had partially recovered; and only seven (13.2%) still had signs of severe sequelae.Conclusion
A diagnosis of syphilitic stroke should be suspected in young patients as a manifestation of syphilis, and tests for neurosyphilis should be routine in neurology departments to make a prompt diagnosis, thereby preventing psychological sequelae. 相似文献20.
Marta Skowronska Anna Piorkowska Anna Czlonkowska 《Neurologia i neurochirurgia polska》2018,52(2):162-167