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1.
Anna Starostka-Tatar Beata Łabuz-Roszak Michał Skrzypek Anetta Lasek-Bal Mariusz Gąsior Marek Gierlotka 《Neurologia i neurochirurgia polska》2018,52(2):252-262
Introduction
The available data on acute stroke (AS) in Poland come mainly from non-representative cohorts or are outdated. Therefore, the current study was done to access the most recent data on AS in the industrial region that covers 12% (4.6 mln) of the country's population.Objective
To evaluate the epidemiological data of AS in the Silesian Province, Poland.Patients and methods
Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to AS and administered by the only public health insurer in Poland (the National Health Fund) between 2009 and 2015 (n = 81,193).Results
The annual number of hospitalizations due to AS in the analyzed period was between 239 and 259 per 100,000 inhabitants of the Silesian Province. Haemorrhagic stroke constituted 13.3%, ischaemic stroke – 85.5%, and unspecified stroke – 1.2%. The average age of patients was 71.6 ± 12.2 years (M 68.2 ± 11.9, F 74.8 ± 11.9, P < 0.05). The mean duration of hospitalization was 17 ± 16 days for haemorrhagic stroke, and 14 ± 11 days for ischaemic stroke. Large-artery atherosclerosis (36.1%) and cardioembolism (18.7%) constituted the main causes of ischaemic stroke. Overall hospital mortality for AS was 18% (haemorrhagic – 40.8%, ischaemic – 14.9%). A decreasing trend in mortality was observed in ischaemic but not in haemorrhagic stroke. In-hospital mortality was significantly higher in women than in men (P < 0.05).Conclusions
This comprehensive long-term analysis of the epidemiological situation related to AS in the industrial region of Poland should encourage further development of educational and treatment programmes for improvement in the health status of the population. 相似文献2.
A. Skalli E.H. Ait Ben Haddou R. El Jaoudi R. Razine G.A. Mpandzou H. Tibar E. El Fahime N. Bouslam A. Alami A. Benomar K. Hajjout M. Yahyaoui A. Bouhouche 《Revue neurologique》2018,174(3):150-156
Background
Growing evidence suggests that hypovitaminosis D contributes to the pathogenesis of multiple sclerosis (MS).Objective
This study aimed to evaluate whether vitamin D levels are associated with having MS and some of its characteristics in the Moroccan population.Methods
Using liquid chromatography-tandem mass spectrometry, the 25(OH)D3 metabolite was measured to quantify vitamin D serum levels (DSLs) in 113 patients with MS and 146 healthy controls matched for gender and age. DSLs were then compared between patients and controls, with correlations sought between DSLs and gender, age at onset, disease duration, MS type, degree of disability (EDSS score) and disease severity (MSSS) in patients.Results
Hypovitaminosis D (DSL < 30 ng/mL) was observed in 97.3% of MS patients and in 98.6% of controls. Although the mean DSL was slightly lower in patients (11.69 ± 6.97 ng/mL) than in controls (12.98 ± 6.58 ng/mL), there was no significant association between DSL and MS status (P = 0.131). Similarly, among patients, no apparent association was found between DSL and MS type (P = 0.214), EDSS score (P = 0.076) or MSSS (P = 0.772).Conclusion
Our study suggests that DSL is not associated with having MS nor with MS type, degree of disability or disease severity in the Moroccan population. On the other hand, DSL was lower in women and decreased with age. 相似文献3.
I. López-de-Uralde-Villanueva A. Gil-Martínez P. Candelas-Fernández J. de Andrés-Ares H. Beltrán-Alacreu R. La Touche 《Neurología (Barcelona, Spain)》2018,33(8):505-514
Introduction
The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features.Objective
To assess the validity and reliability of the Spanish-language version of the S-LANSS scale.Methods
Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively.Results
The optimal cut-off point for S-LANSS was ≥ 12 points (AUC = .89; sensitivity = 88.7; specificity = 76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P < .05). The S-LANSS showed a significant correlation with ID-Pain (r = .734, α = .71).Conclusion
The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features. 相似文献4.
Jin Wook Choi Miran Han Ji Man Hong Jin Soo Lee Sun Yong Kim Sam Soo Kim 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(3):186-191
Background and purpose
This study was to evaluate the diagnostic value of improved motion-sensitized driven-equilibrium (iMSDE)-prepared 3D T1-weighted magnetic resonance imaging (MRI) (iMSDE-3DMRI) in intracranial vertebrobasilary dissection (VBD) and to compare iMSDE-3DMRI images with those obtained using 2D high-resolution (HR) MRI with respect to their diagnostic performance in VBD.Materials and methods
We retrospectively reviewed 105 lesions from 102 patients who underwent multimodal imaging and contrast-enhanced iMSDE-3DMRI (CE-iMSDE-3DMRI). The 2D-HRMRI protocol comprised four axial HR images. The CE-iMSDE-3DMRI images were reformatted in the axial, coronal, and sagittal planes. The 2D-HRMRI-based diagnosis was compared with the final diagnosis. The 2D-HRMRI and CE-iMSDE-3DMRI images were examined independently for the diagnosis performance of dissection.Results
VBD was confirmed in 66 lesions in 63 patients; 17 patients had confirmed atherosclerosis, and 22 had no lesions in the vertebrobasilar artery. Diagnostic performances of 2D-HRMRI (AUC, 0.839 ± 0.04; sensitivity, 94.0; specificity, 79.5; diagnostic accuracy, 88.6) CE-iMSDE-3DMRI (AUC, 0.847 ± 0.04; sensitivity, 84.8; specificity, 84.6; diagnostic accuracy, 84.7) and 2D-HRMRI + CE-iMSDE-3DMRI (AUC, 0.893 ± 0.03; sensitivity, 97.0; specificity, 85.0; diagnostic accuracy, 92.5) were good. Comparisons of the diagnostic performance of 2D-HRMRI andCE-iMSDE-3DMRI showed that combined interpretation of 2D-HRMRI and iMSDE-3DMRI yields a significantly higher diagnostic performance than that of 2D-HRMRI (P = 0.042).Conclusions
CE-iMSDE-3DMRI showed good diagnostic performance for the diagnosis of intracranial VBD. These results suggest that CE-iMSDE-3DMRI can be used in combination with 2D-HRMRI for the diagnosis of intracranial VBD. 相似文献5.
Ewa Sobieszczuk Justyna Kubiszewska Marta Lipowska Piotr Szczudlik Beata Szyluk Małgorzata Dutkiewicz Anna Kostera-Pruszczyk 《Neurologia i neurochirurgia polska》2018,52(3):364-367
Aim
To assess interleukin 15 (IL-15) serum levels in patients with seropositive myasthenia gravis (MG); searching for potential relationship between IL-15 levels and clinical features such as gender, age at onset, clinical presentation or treatment received.Background
IL-15 plays pivotal role in T-cell dependent autoimmunity. Increased IL-15 serum levels have been reported in several autoimmune diseases including MG patients from Japan.Patients and methods
Sera of 42 seropositive MG patients (66.7% women), mean age 50.6 ± 23.7 years) have been tested by ELISA for IL-15 levels.Results
There were no statistically significant differences between IL-15 serum levels in MG patients in comparison with controls as well as between subgroups of MG patients (early vs. late onset and thymoma MG). Mean/median IL-15 serum levels were similar in MG patients treated with corticosteroids (CS) and CS naïve. Outliers (very high values) were seen only in untreated generalized MG patients.Conclusions
Serum interleukin 15 levels in patients with seropositive myasthenia gravis do not correlate with disease severity. 相似文献6.
A. Kachouchi M. Sebbani S. Salim I. Adali F. Manoudi M. Amine F. Asri 《L'Encéphale》2018,44(5):409-414
Background
Persons with schizophrenia are thought to be at increased risk of committing violent crime – 4 to 6 times the level of general population individuals without this disorder. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link.Objectives
The objectives of this study were to describe the characteristics of homicide in Moroccan patients suffering from schizophrenia and to determine the correlated sociodemographic, clinical and toxic variables.Methods
The study included two groups of patients with a DSM IV diagnosis of schizophrenia who attended the “Ibn Nafis” university psychiatric hospital of Marrakech in Morocco. The first group was composed of 30 patients hospitalized for homicide in the forensic unit between 1 January 2005 and 31 August 2015. The second group included 90 patients without any criminal record. These two groups have been matched according to age and gender. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups.Results
Data analysis has objectified the following results: the mean of age in the first group was 37.03 (± 9.09) and in the second group was 31.4 (± 8.76). No significant differences were found between the two groups regarding the different sociodemographic variables and the age of onset of disease. Significant differences were found between the two groups regarding: personal antecedents of attempt of homicide (P = 0.003), personal antecedents of attempt of suicide (P < 0.001), a history of previous violence (P = 0.005), untreated psychosis before the act (P < 0.001), poor medication compliance and a low familial support (P < 0.001), antisocial behavior (P < 0.001) and addictive behavior (P = 0.005).Discussion
Several studies identified some possible predictor factors for violent behavior: poor compliance, lack of insight impulsivity and paranoid–hallucinatory symptoms, systematized delusions and addictive behavior seem to considerably increase the risk of turning to violence. Demographic variables as suggested by other studies are less valuable predictors of homicide in patients with schizophrenia.Conclusion
Awareness of these factors will allow us to provide improved prevention of violence within schizophrenic subjects. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease and an improvement of medication compliance. 相似文献7.
Hélène Raoult François Eugène Anthony Le Bras Géraldine Mineur Béatrice Carsin-Nicol Jean-Christophe Ferré Jean-Yves Gauvrit 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(6):343-348
Background and purpose
The WEB is an innovative flow disruption device for cerebral aneurysm embolization with rapidly expanding indications. Our purpose was to evaluate the diagnostic performance of computed tomography angiography (CTA) at 1-year follow-up of aneurysms treated with the WEB.Materials and methods
Between April 2014 and May 2016, the study prospectively included patients treated with the WEB at our institution, and followed up within 24 hours by CTA and at 1 year by CTA, time-of-flight magnetic resonance angiography (TOF MRA) and digital subtraction angiography (DSA). The diagnostic quality of imaging data was assessed based on the confidence index, artifacts, and WEB shape depiction. The imaging diagnostic performance was assessed using 3 criteria at 1 year: aneurysm occlusion status and worsening, and WEB shape compression. Interobserver and intermodality agreement was determined by calculating κ values.Results
The study ultimately included 16 patients (9 women, mean age 53 ± 7.6 years). CTA quality confidence was scored as 2/2, artifacts 0.4/2 and WEB shape depiction 1.9/2, superior to TOF MRA for the latter two criteria. Aneurysm occlusion was adequate in 93.7% of patients, with CTA showing excellent interobserver reproducibility and agreement with DSA on a 4-grade scale (κ = 1.00), while TOF MRA yielded good reproducibility (κ = 0.76) and agreement with DSA (κ = 0.69). CTA also identified aneurysm occlusion worsening (43.7%) and WEB compression (81.2%) in excellent agreement with DSA (κ = 0.85 and 1.00).Conclusions
CTA is a reproducible and reliable technique for the follow-up of aneurysms treated with the WEB device. 相似文献8.
R.M. Sreedharan R. Sheelakumari K.M. Anila C. Kesavadas S.V. Thomas 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(6):380-385
Background and purpose
Children of Women with Epilepsy with antenatal exposure to antiepileptic drugs (CAED) have reduced neuropsychological functions. We aimed to explore the anatomical basis for this impairment by comparing the brain volumes of CAED with that of matched healthy children without antenatal AED exposure (COAED).Materials and methods
CAED aged 8–12 years were recruited from the Kerala Registry of epilepsy and pregnancy that prospectively follows up children of women with epilepsy and COAED from children attending the imaging department for minor illnesses. Maternal clinical details and the neuropsychological data including IQ of CAED and COAED were obtained. Total intracranial volume (TBV), grey matter volume (GMV), white matter volume (WMV) and volumes of deep grey matter were measured by Voxel Based Morphometry.Results
We studied 30 CAED (mean age 10.8 + 1.11 years) and 35 COAED (mean age 10.64 + 1.26). The antenatal AED exposure for the CAED was monotherapy for 8 children and polytherapy for 22 children. The CAED had significantly lower (P < 0.001) IQ (77.5 + 13.8), TBV(1259.55 ± 169.85 mL) and GMV (672.51 ± 85.42 mL) compared to the IQ (87.0 + 13.5), TBV(1405.37 ± 161 mL) and GMV (745.427 ± 86.69 mL) of COAED. CAED had lower volumes for Lt Inferior Triangular Gyrus, and hippocampi on both sides, when compared to COAED. Group analysis CAED showed less GMV (P < 0.05) for left inferior and middle frontal gyri relative to COAED.Conclusions
These observations point towards an anatomical basis of lower GMV for the lower neuropsychological functions in children with antenatal AED exposure. 相似文献9.
Background
In spite of their extensive use, the ecological relevance of tasks dedicated to assessing real-world decision-making in a laboratory setting remains unclear.Objectives
Our study aimed to evaluate the relationship between decision-making and behavioral competency and awareness of limitations.Methods
A total of 20 patients with Alzheimer's disease (AD), 20 with amnestic mild cognitive impairment (aMCI) and 20 healthy controls (HC) were assessed for decision-making using the Iowa Gambling Task (IGT). Behavioral competency was evaluated by the Patient Competency Rating Scale (PCRS), which requires each participant and a relative to answer the same 30 questions on participant's competency and to rate each item, while awareness of limitations was evaluated by subtracting the self-rated score from the relative-rated score.Results
Using the median-split approach, the proportion of disadvantageous decision-makers was higher in both the MCI and AD groups than in HC (P = 0.02 and P = 0.03, respectively), with no differences between clinical groups. The percentage of participants with poorer behavioral competency was also higher in the MCI and AD than in the HC (self-rated: P = 0.025 and P = 0.01, respectively; relative-rated: P = 0.008 and P = 0.008, respectively), again with no differences between MCI and AD. All groups were comparable in awareness. For all participants, disadvantageous decision-making was associated with both reduced behavioral competency and poor awareness of limitations (OR: 3.47, P = 0.03 and OR: 5.4, P = 0.004, respectively).Conclusion
Our findings support the ecological relevance of the IGT. Behavioral competency integrity and awareness of limitations are both associated with advantageous decision-making profiles. 相似文献10.
Keju Ju Lingling Zhong Xiaoyu Ni Hua Cao Guanliang Cheng Lianshu Ding 《Neurologia i neurochirurgia polska》2018,52(3):374-378
Objective
To investigate the relationship between cerebral vasomotor reactivity (VMR) and acute stroke in patients with internal carotid artery stenosis.Methods
54 patients with internal carotid artery stenosis were enrolled. VMR was calculated by transcranial Doppler monitoring of the velocity of blood flow. 3-Dimensional dynamic contrast enhanced magnetic resonance angiography was used to detect stenosis, and diffusion weighted imaging was used to detect infarction.Results
VMR value was significantly lower in patients with carotid artery stenosis than in control group (T = 3.112, P = 0.002), and significantly lower in patients with aortic atherosclerotic stroke than in non-infarct group (T = 10.930, P = 0.000). However, VMR value was significantly higher in patients with new-onset small-artery occlusion stroke than in non-infarction group (T = ?2.538, P = 0.013). Scatter plots showed that aortic atherosclerotic stroke occurred mainly in patients with severe internal carotid artery stenosis, and VMR value in cerebral artery significantly decreased.Conclusion
Decreased VMR value is an important prognostic factor for the occurrence of aortic atherosclerotic stroke, and can be used as a reference for preoperative hemodynamic evaluation in patients with internal carotid artery stenosis. 相似文献11.
Introduction
In recent years, the integration of resilience in several psychological and medical studies underscores a need for resilience assessment measures with robust psychometric properties. This study aimed to evaluate the underlying structure of the French version of the Resilience Scale (RS-14), a widely used measure to assess resilience both in general and clinical population.Method
A sample of 2195 college students from France (18.68% of male; Mean age = 20.09 years old (± 1.21) completed the RS-14, the Child and Youth Resilience Measure, the Social Support Questionnaire and the Kessler Psychological Distress Scale. EFA with parallel analysis was conducted to assess the factorial structure of the RS-14 while CFA was performed to investigate the goodness-of-fit. Internal consistency, concurrent and convergent validity were evaluated.Results
A one-dimensional-factorial-solution emerged from the EFA, its goodness-of-fit was adequate and it presented good internal consistency. As expected, the RS-14 score correlated positively to the CYRM and SSQ scores and negatively to the psychological distress score, supporting the validity of the scale.Conclusion
The one-dimensional-factor corroborates the initial and many languages versions of the RS-14. The results showed that the French version of the RS-14 presents adequate psychometric properties and that is a reliable and valid scale in evaluating resilience. 相似文献12.
E.D. Goldstein N. Ertekin-Taner A. Stephens M.M. Carrasquillo B. Boeve W.O. Tatum A.M. Feyissa 《Neurologia i neurochirurgia polska》2018,52(6):690-694
Aim of the study
The aim of this study is to evaluate standard scalp EEG findings in patients with posterior cortical atrophy (PCA), an atypical variant of Alzheimer's disease (AD).Clinical rationale
PCA is a topographically selective variant of AD. Patients with typical AD have an increased likelihood of seizures, which may negatively impact overall functional performance and cognition. It is currently unknown what the typical EEG findings are for patients with PCA.Materials and methods
A retrospective chart review was performed on patients identified either with autopsy confirmed (n = 13) or clinically (n = 126) as PCA.Results
139 patients were included though only 23 (16.5%) had undergone EEG recording. The EEG was normal in 6 (26%), while an abnormal EEG was present in 17 (74%). Interictal epileptic discharges (IEDs) were found in 2 of the 23 patients (9%).Conclusions
This study of limited sample size suggests that there may be an increased predilection to find IEDs within PCA when compared to typical AD. Larger cohorts are required to determine frequency of abnormal EEGs in PCA, roles of AEDs in therapy, and in the selection of preferred AED.Clinical implications
Patients with PCA would potentially benefit from an EEG for assessment of IEDs which may provide the clinician with a therapeutic opportunity. 相似文献13.
Paweł Daszkiewicz Paweł Kowalczyk Marcin Roszkowski 《Neurologia i neurochirurgia polska》2018,52(1):2-8
Background
Neuronal-glial tumors (ganglioglioma and dysembryoplastic neuroepithelial tumor) are a frequent cause of focal, drug-resistant and epilepsy in children and young adults, that is amenable for surgical treatment.Aim of paper
Assessment of late outcome of surgical treatment and degree of seizure control, as well as prognostic significance of selected clinical factors.Material and method
52 Pediatric patients presenting with epilepsy, lesion of mesio-basal temporal lobe and histologically verified neuronal-glial tumor treated at our facility since 2000–2011.Results
After the mean follow-up of 2.94 years, satisfactory treatment outcome (Engel classes I and II) was obtained in 92% of the patients (n = 48). Poor outcome (Engel class III) was seen in 8% of patients (n = 4). New neurological deficits appeared in 28% of the patients (n = 20) but in most of them resolved over time.Conclusions
In patients with drug-resistant epilepsy and a lesion of mesial-basal part of temporal lobe suggestive of a glial-neuronal tumor, surgical treatment is strongly recommended, aiming at excision of tumor and elimination of seizures. Histological verification of the lesion is a pre-requisite for optimal treatment planning. In most patients, both treatment goals may be reached. Short duration of epilepsy prior to surgery and young age are favorable prognostic factors. Histological diagnosis of GG, co-existence of cortical dysplasia and location of tumor extending beyond mesial-basal temporal structures are associated with a higher risk of postoperative complications. These may out-weight expected benefits of surgery. 相似文献14.
Laura Milanese Chiara Martini Carla Scaroni Francesca Dassie Filippo Ceccato Alessandro Della Puppa Luca Denaro Giulia Bommarito Valentina Citton Mario Ermani Pietro Maffei Renzo Manara 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(5):323-328
Background
Radiation therapy (RT) effectiveness on hormonal reduction is proven in acromegaly; however, collateral long-term effects are still undetermined. This transversal neuroimaging study on a large cohort of acromegalic patients aimed to investigate the rate of parenchymal and vascular changes after RT.Materials and methods
Thirty-six acromegalic patients underwent RT (RT+) after unsuccessful surgery and were compared to RT? acromegalic patients matched for age, gender, adenoma features, clinical and surgical history. All patients underwent magnetic resonance angiography (MRA) to investigate intracranial artery abnormalities and FLAIR sequence to assess white matter changes according to the Wahlund scale.Results
RT+ acromegalic patients had a higher rate of controlled disease (29/36 vs. 12/36, P < 0.001). RT+ acromegalic patients had MRI/MRA evaluation 15.3 ± 9.6 years after RT. RT+ acromegalic patients had a significantly higher Wahlund score than RT? acromegalic patients (6.03 ± 6.41 vs. 2.53 ± 3.66, P = 0.006) due to increased white matter signal abnormalities at the level of the temporal lobes, the basal ganglia (insula) and the infratentorial regions, bilaterally. Among RT+ patients one died because of temporo-polar anaplastic astrocytoma, one suffered from a stroke due to right internal carotid artery occlusion, one presented with cystic degeneration of the temporal poles. Long-dated RT (> 10 years before MR evaluation) was associated with a higher rate of RT-related white matter changes (P = 0.0004).Conclusions
RT seems to have created a cohort of patients with brain parenchymal changes whose clinical and cognitive impact is still unknown. These patients might require a prolonged MRI and MRA follow-up to promptly detect delayed RT-related complications and minimize their clinical consequences. 相似文献15.
Association of depression,anxiety and post-traumatic stress disorder with migraine: Data from Kosovo
Introduction
Migraine is ranked as the seventh leading cause of disability worldwide, and it is characterized by a manifestation of combined neurological, gastrointestinal, and autonomic symptoms linked with different provoking factors.Aim of the study
This study investigates the association between migraine and PTSD, depression and anxiety in the Kosovo population during the post-war period.Material and methods
273 war survivors with headache were enrolled in the study and were divided into two groups: 153 individuals with confirmed migraine (the study group) and 120 individuals with non-migraine headaches (control group). All individuals were evaluated using the ICHD-II 2004 diagnostic criteria for migraine, as well as the mini-test for PTSD, MMPI (Minnesota Multiphasic Personality Inventory) for psychological evaluation, PAI (Personality Assessment Inventory) and Hamilton Scale for Depression.Results
Among migraine patients, depressive disorders were present in 27.5% of patients, anxiety was found in 60.8%, and PTSD was present in 39.2%. While the prominence of depression was not different between groups, anxiety was significantly more common (p < 0.05) in women from the control group. PTSD was significantly more common (p < 0.001) in migraine patients overall, whereas the difference in PTSD prevalence between women from the migraine and control groups came close to significance (p = 0.05). Females in the migraine group had higher incidences of aura (50% vs. 25.5%), whereas the incidence of aura in males in each group was approximately equal (9.8% vs. 7.84%).Conclusion
Based on our data, we can confirm an association between PTSD and migraine in a sample of patients from Kosovo. 相似文献16.
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17.
Marta Skowronska Anna Piorkowska Anna Czlonkowska 《Neurologia i neurochirurgia polska》2018,52(2):162-167
Objectives
There is little data about sex differences in carotid atherosclerosis in the early phase after an ischemic event. The aim of this study was to examine the carotid artery atherosclerosis differences between men and women in early phase after TIA or stroke.Methods
Consecutive patients with recent ischemic event, admitted during the first week after symptom onset were examined with ultrasound. Sex differences in degree of stenosis, number of plaques and plaque morphology were compared. Plaque morphology was assessed by gray-scale median (GSM), according to which lower values were associated with hemorrhagic/necrotic core indicating plaque instability.Results
Of the 316 patients with ischemic events, 196 (50.5% male) entered the study. Men had more often moderate as well as severe ipsilateral carotid stenosis (12.1% vs 7.2% for moderate and 12.1% vs 2.1% for severe; p = 0.024). Men had more often the largest plaque hypoechogenic contralateral (62.6% vs 37.1%, p = 0.0008), but not ipsilateral. Men had 3 or more hypoechogenic plaques (24.2% vs 4.1%, p = 0.0001; 17.2% vs 4.1%, p < 0.0001) both ipsi and contralateral respectively. Male sex was a risk factor for having 3 or more ipsilateral hypoechogenic plaques (p = 0.002, OR = 20 CI 95% [5.5–75].Conclusions
Men had more often carotid stenosis and higher number of hypoechogenic plaques. 相似文献18.
Objectives
The Generalized Problematic Internet Use Scale-2 (GPIUS-2) is a short self-report questionnaire assessing Internet addiction based on a cognitive behavioral model. Our main goal was to evaluate the psychometric properties of its French version among a sample of students and to appraise the relevance of the generalized problematic Internet use model.Methods
A sample of 563 university students aged between 18 and 35 years (M = 20.8; SD = 2.7) completed several online self-report questionnaires including the GPIUS-2, the Internet Addiction Test (IAT) and the Center for Epidemiologic Study-Depression scale (CES-D).Results
Confirmatory Factorial Analyses revealed a poor but acceptable overall fit for the original five-factor model and the original four-factor model. Path analyses, testing Structural Equation Modeling provided showed a poor fit to the data, suggesting insufficient construct validity. Convergent and concurrent validities analyzed through correlational analyses revealed significant relationships between the GPIUS-2, its factors, the IAT, time spent online and the CES-D.Conclusions
This research highlights the insufficient psychometric properties of the GPIUS-2 in a French sample, similar to previous results. However, this French version appears to be a useful multidimensional tool for assessing problematic Internet use among students, and reveals promise for future research and clinical applications of the measure, given its solid theoretical basis and despite the results of this psychometric study. 相似文献19.
Marcin Wiącek Rafał Kaczorowski Bartosz Sieczkowski Natalia Kanas Halina Bartosik-Psujek 《Neurologia i neurochirurgia polska》2018,52(3):359-363
Background and purpose
Mechanical thrombectomy (MT) is now well-established treatment method for selected patients with acute ischemic stroke (AIS) and efforts are being made to incorporate it into the systems of stroke care. Our objective is to assess the number of AIS individuals eligible for MT in the cohort of single academic stroke center.Methods
We retrospectively reviewed initial non-invasive vascular imaging data of AIS patients presenting within 5 h of symptom onset for the presence of large vessel occlusion (LVO) over 2-year period (2015–2016). Among subjects confirmed with LVO: time-to-presentation, premorbid functional and on-admission neurological state, site of occlusion and initial imaging data were further assessed. Two sets of criteria based on recent trials and recommendations were used to determine MT eligibility. The onset-to-evaluation time limit was set to 5 h allowing ≤60 min procedure initiation delay.Results
895 patients with the final diagnosis of AIS were admitted to our stroke center as the initial treatment facility. 246 (27.5%) presented within 5 h of symptom onset and had non-invasive imaging performed. Among those 102 (41.5%) had causative LVO. The number of ≤5 h presenting patients eligible for MT was 51 (20.7%) when applying restrictive or 80 (32.5%) with more permissive criteria.Conclusion
Among AIS patients, in whom onset-to-arrival time allowed to initiate the endovascular procedure within 6 h of symptom duration, 21% were eligible for MT treatment according to more and 33% to less restrictive criteria. It accounts for about 6% and 9% of all AIS cases, respectively. 相似文献20.