产后颅内静脉窦血栓形成三例报告

颅内静脉窦血栓形成(CVST)是一种独特的脑缺血病,死亡率高.初步探索认为CVST介入治疗是一种安全、有效的治疗手段[1].我们于2009年1月至2010年1月对3例CVST患者实施静脉窦血栓接触溶栓、机械碎栓并结合动脉内溶栓治疗,术后患者临床症状消失,报告如下.     

颅内静脉窦血栓形成16例临床分析

颅内静脉窦血栓形成(CVST)是一种特殊类型脑血管病,发病率约为3/100万～4/100万,临床表现复杂多变,早期诊断、及时治疗可使致死、致残率明显降低.我科2006年7月～2009年1月收治16例CVST患者,现报告如下.     

颅内静脉窦血栓形成的研究进展

颅内静脉窦血栓形成(cranial venous sinus thrombosis,CVST)是脑血管疾病中的一种特殊类型,其病因复杂,起病形式多样,临床表现复杂而无特异性,常被误诊漏诊,若不能及时明确诊断和有效治疗,常常引起死亡等严重并发症.近些年来随着临床医生对该病的重视及影像学的发展,使本病确诊率不断提高,而且大部分病例能得到早期诊断、治疗,大大改善了预后.     

颅内静脉窦血栓形成14例分析

颅内静脉窦血栓形成(CVST)是脑血管病的特殊形式,临床表现复杂多变,缺乏特异性,临床误珍率高,往往延误治疗导致不良预后.近年随着影象诊断技术,尤其是磁共振成像(MRl)的不断进步,对本病的认识也日益提高,患者致死、致残率明显下降.现将我科2001年1月～2005年10月收治的14例CVST报道如下:     

低颅压综合征并发脑静脉窦血栓形成1例报告

脑静脉窦血栓形成(cerebral venous and sinusthrombosis,CVST)是缺血性脑血管病的一种特殊类型,由于其病因多样,临床症状各异,体征不典型且多变,因此常被漏诊和误诊,病死率较高.近年来由于影像学技术的发展和临床医生的重视,对CVST的认识、诊断和治疗水平都有了较大的提高,但低颅压综合征并发静脉窦血栓形成在国内外文献尚无相关报道.现报道我科收治1例低颅压综合征并发脑静脉窦血栓形成患者.     

成人脑静脉窦血栓形成16例临床分析

目的 探讨脑静脉窦血栓形成(CVST)的病因、临床和影像学特征、诊断及治疗.方法 对2004-02～2009-05在本院收治16例成人CVST患者临床资料进行分析,总结CVST的临床特点、影像学特征、诊断、治疗及转归.结果 本组CVST好发于青壮年,多为急性或亚急性起病,大部分可找到相关病因,最常见的首发症状为头痛(8...     

脑静脉窦血栓形成24例临床分析

目的探讨脑静脉窦血栓形成（CVST）的临床的特点、诊断和治疗。方法回顾性分析武汉协和医院2007年1月~2010年11月24例CVST患者的发病年龄、起病形式、主要症状、实验室检查、影像学特征以及治疗情况。结果 CVST临床表现以颅内高压症状多见如头痛、恶心、呕吐（约占71%）,约67%患者存在局灶性神经系统损害的表现。CVST最常累及横窦和乙状窦,其次是上矢状窦。磁共振静脉造影（MRV）的影像质量高,能清晰显示病灶。9例患者接受抗凝治疗症状明显缓解,均未发生出血。死亡2例（约占8.3%）。结论 CVST是一种可能致命的神经系统急症,MRV是CVST较好的诊断方法,抗凝治疗安全有效。     

28例重症颅内静脉窦血栓患者抗凝治疗与联合血管内治疗预后分析

目的 分析重症颅内静脉窦血栓(Cerebral Venous Sinus Thrombosis,CVST)患者二种治疗方法的短期预后,探讨重症CVST患者的最佳治疗方法.方法 回顾分析2013年1月至2019年1月昆明市第一人民医院神经外科28例确诊为CVST重症患者,分为单纯抗凝治疗组与抗凝联合血管内治疗组,分析比较...     

脑静脉窦血栓形成25例临床分析

目的 探讨脑静脉窦血栓形成（CVST）的临床特点、影像诊断和治疗方法.方法 回顾性分析我院2009-10-2013-05收治的25例CVST患者的发病年龄、起病形式、主要症状、影像学特征、实验室检查以及治疗等情况.结果 CVST临床表现无特异性,多以亚急性起病,以颅内高压症状多见（头痛、恶心、呕吐,约占80%）,约40%患者有视乳头水肿,少部分患者存在局灶性神经系统损害的表现.CVST最常累及横窦和乙状窦,其次是上矢状窦.磁共振平扫（MRI）加静脉显影（MRV）能清晰显示病灶.抗凝治疗后症状明显改善,一般不增加出血风险.结论 CVST是一种可能危及生命的神经科急症,症状无特异性,易造成漏诊和误诊,MRI＋MRV是CVST较好的诊断方法,抗凝治疗安全有效.     

产后静脉窦血栓形成早期康复的临床疗效

产后静脉窦血栓(PCVST)是产妇较少见的严重并发症,多发于产后2~3w,预后不良,病死率高达20%～50% ,早期诊断困难,部分患者常伴遗留肢体活动或智能障碍,早诊断、早治疗、早康复,可降低病死率和致残率.我科对2002年1月～2009年1月收治的PCVST伴有肢体功能障碍者在抗凝、溶栓、脱水降颅压治疗基础上进行早期康复治疗,疗效显著现报告如下.     

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.     

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.     

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     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.     

Summary of Legislation of 1933 of interest to the Department of Mental Hygiene

Psychiatric Quarterly -