血栓通治疗脑梗塞26例疗效观察

脑血管意外（中风）是中老年人常见病、多发病，现已公认为世界各国成人三大死亡原因之一，严重危害人民健康，且近年来发病年龄有越来越年轻趋势。我院应用血栓通治疗脑梗塞26例（观察组）与20例应用血管扩张剂及血液稀释剂小分子右旋糖酥（对照组）治疗对比。现报道如下。1临床资料全部患者均经头部CT检查确诊，随机分两组。观察组（Ⅰ组）：26例、男19例，女7例，年龄40～79岁，平均年龄61岁。发病到开始治疗时间1－28天，平均3天。原发病，脑血栓形成24例，脑栓塞2例。对照组（Ⅱ组）：20例，男14例、女6例，年龄45－82岁。平均年龄64…     

95例蛛网膜下腔出血死亡病例分析

我科自1973～1988年共收治蛛网膜下腔出血病人487例,现将其中死亡的95例分析如下:临床资料一、一般资料:男67例,女28例,男女之比为2.4∶1。年龄0～9岁1例,10～19岁9例,20～29岁7例,30～39岁13例,40～49岁19例,50～59岁24例,60～69岁14例,70～79岁5例,80岁以上3例。年龄最小2.5岁,最大90岁,其中以40～59     

126例精神分裂症病人的TCD检测结果

目的 分析精神分裂症的TCD特征。方法 将126例精神分裂症病人分为19－39岁和40－49岁两组，并检测病人的脑动脉血流速度（包括收缩峰血流速度和舒张末期的血流程度）、脉动指数及阻力指数。结果 19－39岁组的TCD阳性率为77．27％，40－49岁组为81．55％。两组差异无显著性（P＞0．05）。两组MCA的收缩峰血流速度与正常人比较明显降低，有非常显著性差异（P＜0．01）。结论 脑动脉供血不足是精神分裂症病人在TCD检测中有意义的表现之一。     

结核性脑膜炎CSf-Ig系列指标的变化

脑脊液免疫球蛋白（csf-Ig)、白蛋白（Alb）、csf－IgG／Alb比值、csf－IgG指数及补体C3、C4等（下称csf-Ig系列指标）的测定,对于判定中枢神经系统（CNS）疾病的血脑屏障（BBB）功能状态及其病理过程中的免疫应激反应,具有一定的意义[1]。为了解在结核性脑膜炎（TBM）中,csf－ig系列指标变化的特点,现就我们检测的40例TBM的结果分析如下。1对象和方法1.1TBM组自1990年~1995年住院的结脑患者40例,男19例,女21例,年龄12－63岁,平均年龄39岁,病程3天~40天。40例结脑的临床诊断标准根据实用结核病学［2］的标准确定：①有结…     

颅脑损伤并脑疝的治疗体会

脑疝是颅脑损伤的严重并发症,是导致患者死亡的重要原因之一。现将我科1995年10月～1998年10月诊治的175例重型颅脑损伤合并脑疝病例报道如下：1临床资料1．1一般资料　男136例,女39例;年龄79岁,平均年龄39．6岁,GCS计分：3－5分73例,死亡40例（54．8％）。6－8分102例,死亡27例（26．5％）。一侧瞳孔缩小,或大小瞬间变化,或瞳孔散大经脱水后立即回缩29例,死亡3例（11．2％）,一侧瞳孔散大100例,死亡29例（29％）。双侧瞳孔散大46例,死亡37例（80．1％）。CT表现：硬膜外血肿37例;硬膜下血肿98例;颅内血肿40例。血肿量＜50…     

重症肌无力患者红细胞免疫功能的变化(论著摘要)

为探讨重症肌无力（MG）患者红细胞免疫功能的变化，测定201例MG患者RBC－Cb受体花环率（RBC－C3bRR）和RBC－IC花环率（RBC－ICR），并与50名正常人进行对照。对照组年龄22～45岁。实验组201例患者均有MG典型临床表现，新斯的明或腾喜龙试验阳性，年龄1～75岁，平均18．46岁，其中强的松治疗组45例，RBC－C3bRR测定按Siegel建立的检测红细胞免疫粘附试验法，参照郭峰等红细胞免疫粘附功能进行；RBC刁CR测定方法基本同上。实验结果表明，MG患者的RBC－C。bRR（7．58f3．40）％明显低于正常对照组（12．87I5．07）％（P…     

小脑出血34例临床分析

我院自lop年以来共收治小脑出血34例,现报告如下：1临床资料1．1一册资料本组34例,男20例,女14例年龄12－83岁,平均578岁;10－19岁1例,刀一29岁2冽,刀一39岁1例;硼一49岁3例50－59岁5例,to－69岁16例,刀岁以上6例以ho岁以上多见,共22例（64．7％）。12临床表现主要有：呕吐对例（67．of％）;头痛里例（64．71％）;头晕19例（67．64％）;共济失调门例（50％）,其中肢体共济失调12例,躯干共济失调2例,3例既有肢体共济失调又有躯干共济失调;意识障碍14例（41．18％）;言语障碍8例（刀．53％）,其中暴发性及吟诗样言语5例,…     

经CT证实的丘脑出血59例临床分析

自CT应用以来,丘脑出血的发病率已明显增高,约占所有脑出血20～35％。本文将经CT证实的59例丘脑出血作一临床分析,以供参考。临床资料一、一般资料:男性37例,女性22例,发病年龄25—77岁。21～20岁2例,31—40岁3例。41～50岁8例,51～60岁39例,61～70岁5例,71～77岁2例。59例丘脑出血者均为急性发病,有37例在活动中发病,其余是看电视下棋或情绪激动下发病。本组     

甘露醇川芎嗪治疗急性脑梗死134例疗效观察

急性脑梗死约占脑卒中的75％,致残率高,治疗方法多,效果欠佳。自1991．1－1997．7对134例急性脑梗塞病人采用甘露醇川芎嗪联合治疗,效果较满意。报告如下：1临床资料与方法11诊断标准：（1）全部选择第一次发作的“颈内动脉系统脑梗塞”病例。（2）病史明确,神经系统局灶体征恒定并持续24小时以上。（3）经CT证实。（4）年龄45岁以上,无严重其它合并症。12一般资料：治疗组134例。男84例,女50例,年龄45－sl岁,平均62．13t7．99岁。对照组86例,男59例,女27例,年龄45．83岁,平均63．19上下肺岁。两组平均年龄相似（P＞0．05）…     

脑血管病甲状腺激素变化规律初探

报道脑血管病患者共88例，除外甲状腺病史。男59例，女29例，年龄34－78岁，平均62岁。经头颅CT确诊。脑梗塞＜10天m例，10－30天23例，＞30天对例；脑出血＜10天8例，10－30天8例，＞30天6例。正常对照60例，男37例，女23例，年龄40－72岁，平均56岁。方法：采空腹静脉血，按L、FT3、厂动各药盒程序，用放射免疫法测定。结果：飞、厂马在各组均降低，而在脑出血＜ic天组降低最为显著；L、厂已、在脑出血＜ic天组显著降低（P＜0．01），而在ic－30天组增高（L与正常组比较P＜o．05，r凡与正常组比较P＜o．01），在＞30天组正常。本组显…     

The development of optokinetic nystagmus in strabismic and monocularly enucleated subjects.

Assymmetries of monocular optokinetic nystagmus (OKN) following anomalous visual experience are thought to be due to disruption at the cortical level. Visual disruption usually results from eye suture (in animals), unilateral dense and central cataracts or strabismus (in humans). Many form-deprived animals and humans frequently show a residual strabismus after lid opening (animals) or cataract extraction and optical correction (humans). We wanted to determine whether strabismus was unique in causing monocular asymmetries of OKN. Two independent observers rated eye movement videotapes of 20 normal subjects, the non-deviating eye of 25 unilateral strabismic subjects and 29 unilaterally eye-enucleated subjects, who were watching either a nasally directed square wave grating, a temporally directed square wave grating, or a blank field. Observers rated the proportion of trials where OKN occurred, the duration of OKN in each trial and the number of beats of OKN within each trial. Monocular OKN was symmetrical in normal subjects for the proportion and duration measures, but half the normal group showed small but significant asymmetries for the beats measure. Subjects in both enucleate and strabismic groups showed asymmetries of OKN favouring nasally directed stimulation, but only the early onset strabismics (as a group) showed asymmetries that were significantly greater (P less than 0.05) than the normal group. Asymmetry scores correlated significantly with age of diagnosis of strabismus for the strabismic group but not with age of enucleation for the enucleate group. The results are discussed in terms of binocular competition.     

The influence of age on optokinetic nystagmus

Summary The influence of age on optokinetic nystagmus (OKN) was studied in 63 healthy subjects, who were divided into three groups according to their age, group I (20–39 years), 11 (40–59 years) and III (60–82 years). It was found that on average maximal OKN velocity decreases considerably with age, from 114°/s in group I to 93°/s in group II and 73°/s in group III.Two mechanisms participate in the generation of OKN, the so-called fast component and velocity storage component. The fast component leads to immediate changes in slow phase nystagmus velocity and is related to smooth pursuit eye movements. The velocity storage component causes more gradual velocity changes and expresses itself during optokinetic afternystagmus (OKAN). To study the relative contribution of these two components, maximal smooth pursuit and OKAN velocity were determined in addition to the maximal OKN velocity for the same individuals. It was found that both smooth pursuit and OKAN performance decrease with age. Consequently the maximal OKN velocity, which depends on both factors, is even more affected than smooth pursuit eye movements.Supported by Deutsche Forschungsgemeinschaft SFB 200, A2     

Auditory event-related potentials in well-characterized groups of children

Sixty-eight subjects ranging in age from 6 to 23 years were studied in an 'auditory oddball' event-related potential (ERP) paradigm. Our results replicate other studies, finding P3 as the most consistent component of ERPs since childhood, although great variability of this component was found in the 6-year-old group. Separate age/ERP component latency and amplitude linear regressions were computed for subjects 6-14 and 6-23 years old. Our data show in both groups a significant negative and positive correlation between age and P3 latency and N1-P2 amplitude respectively. The age/P3 latency slope for the subjects under 15 years old was -19.00 msec/year versus 8.15 msec/year for all subjects (6-23 years old). Our results indicate that P3 latency during childhood decreases with age, reaching an asymptote after or during the second decade of life. No curvilinear relationship between age and P3 latency was found over the child groups, although a significant curvilinear relationship was found over the entire age range. This study showed no significant gender differences in latency at any age group. However, in the adult group females showed significantly larger amplitudes than males.     

Factor analysis of Zung Scale scores in a Japanese general population

The purpose of the present paper was to investigate the distribution of Zung Self-rating Depression Scale (SDS) scores in a general population and its factor structure. Questionnaires on SDS items were sent to 7136 randomly selected residents aged 20-79 years who lived in districts in Japan with high rates of suicide. Valid responses were received from 5547 residents (response rate: 77.7%). Factor analysis of the SDS scores was conducted. The SDS scores of the male subjects were significantly lower than those of the female subjects in all age groups. A reverse-J-shaped relationship was found between age groups and mean SDS scores for the male and female subjects. The highest mean score was in the age group of 20-39 years, and the lowest mean score was in the age group of 60-69 years for the male and female subjects. In factor analysis, two factors consisting of 12 items were extracted, and 10 of those 12 items covered six Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria describing psychological disturbances of depression. The distribution of SDS scores differed depending on the age group. Major components of SDS in the subjects covered the DSM-IV criteria for psychological disturbances of depression.     

Cognitive functions in adult Down's syndrome

Cognitive profiles of performances were obtained from a selected group of adult Down syndrome (DS) subjects (n = 20; mean age: 34.5 years; s.d.: 7.7) by means of an ad hoc neuropsychological battery. With the aim of examining, from a neuropsychological point of view, the modifications that increasing age produces in this group of patients, cognitive performances of younger DS subjects (mean age: 28 years; s.d.: 4.77) were compared with analogous performances obtained by the older ones (mean age: 39.8 years; s.d.: 5.11). Subsequently, to clarify qualitative aspects of cognitive patterns in the subgroups of young and old DS subjects, two different groups of control patients were utilised. Neuropsychological data collected from a group of adult mentally retarded subjects were compared with cognitive performances demonstrated by young DS subjects, while the old group of DS subjects was analyzed in comparison with a group of patients affected by initial form of Alzheimer disease (AD). Altogether, the results of our study do not seem to support, from a neuropsychological point of view, the hypothesis that mental decline observed in DS subjects reproduces the cognitive patterns of impairment observed in AD patients.     

Optokinetic nystagmus as an assessment of visual attention to divided stimuli.

Attentional resources are finite and decline with age. We measured subjects' abilities to generate optokinetic nystagmus (OKN), to suppress it with fixation and to continue to suppress it when fixating while simultaneously paying covert attention to a feature of the optokinetic (OK) stimulus. During fixation with a red laser spot, OKN was almost fully suppressed. When subjects suppressed the OKN while simultaneously paying covert attention to a feature of the OK stimulus, suppression of the OKN was less well suppressed. The active OKN was vigorous. Age affected only the divided attention task, perhaps reflecting a diminution in resources of attention with age. The neural pathways serving attention and those serving eye movements appear to be closely related. We suggest the test presented here represents an objective measurement of the ability to divide attention, and that it has the potential to be developed for much more widespread, possibly clinical, use.     

Analysis of monocular optokinetic nystagmus in normal and visually deprived kittens

The asymmetry of monocular OKN was assessed in normal, monocularly deprived (non-deprived eye) and strabismic cats. No significant differences were observed between the responses of these 3 groups. In young kittens, the gain of OKN for nasalward stimulus was larger than that for temporalward. This asymmetry declined to a low residual level by about one year of age. Neurophysiological recordings indicated that the symmetry of OKN is not related to cortical binocularity.     

Normal values for single fiber EMG parameters of frontalis muscle in healthy subjects older than 70 years.

OBJECTIVE: Single fiber EMG (SFEMG) is a potent electrophysiological method to evaluate impaired neuromuscular transmission, and allows sensitive diagnosis of neuromuscular transmission abnormalities such as myasthenia gravis. The jitter and fiber density values are different for various muscles and age groups and the reference values increase with age. In this study, we evaluated the reference values of jitter and fiber density of frontalis muscle in healthy subjects older than 70 years. METHODS: We evaluated the jitter and fiber density of frontalis muscle in 32 healthy subjects. Twenty-two of them were between 70 and 79 years old (mean +/- SD, 73.9 +/- 1.7), and 10 of them were older than 80 years (mean +/- SD, 82.2 +/- 1.2). RESULTS: Normal limit of jitter (95% confidence limit) was calculated as 40.4 micros for healthy subjects between 70 and 79 years old and 43.7 micros for healthy subjects older than 80 years and normal limit of fiber density (95% confidence limit) were calculated as 1.90 for subjects between 70 and 79 years old and 2.14 for subjects older than 80 years. CONCLUSIONS: We designated the reference values of jitter and fiber density for frontalis muscle in healthy subjects older than 70 years. Our reference values may have value to diagnose neuromuscular transmission abnormalities in elderly patients. SIGNIFICANCE: SFEMG is sensitive for neuromuscular transmission abnormalities and it is important to know the reference values of frontalis muscle in healthy subjects older than 70 years.     

Transcranial color Doppler estimation of blood flow parameters in respective basal cerebral arteries in healthy subjects

Transcranial colour-coded Doppler sonography enables estimation of blood flow parameters in the basal cerebral arteries. Reference values as well as age and gender dependence of these parameters are not sufficiently established in transcranial Doppler studies. There are no reports regarding blood flow in the respective arteries of the circle of Willis. Therefore we examined 185 healthy volunteers--82 men (mean age 47, range 20-78 years old) and 103 women (mean age 47, range 22-86 years old). The subjects were divided into three age groups: 20-40 years old (group I), 41-60 years old (group II) and more than 60 years old (group III). The examinations were performed via the temporal acoustic window with a 2.5 MHz probe. Angle-corrected peak systolic, mean and end-diastolic velocities as well as impedance indices were determined in the anterior, middle and posterior cerebral arteries. In the group I mean velocity values (mean +/- SD) for the anterior, middle and posterior arteries amounted to 56 +/- 14 cm/s, 81 +/- 20 cm/s and 52 +/- 12 cm/s, respectively. In group II the values were 53 +/- 16 cm/s, 73 +/- 19 cm/s and 51 +/- 12 cm/s, and in group III the values were 44 +/- 11 cm/s, 59 +/- 11 cm/s and 40 +/- 9 cm/s. Decline in the blood flow velocities and increase in the impedance indices were found in all vessels with advancing age. This was most pronounced in subjects who were more than 40 years old. The decrease with age in blood flow velocities was more substantial in the middle cerebral arteries than in the anterior and posterior cerebral arteries. In contrast, the impedance indices increased more distinctly in the anterior cerebral arteries than in the middle and posterior cerebral arteries. We have demonstrated that the blood flow Doppler parameters are age and, in the group I (20-40 years old), also gender dependent. The range of the normal reference values of these parameters has proved to be wide. Decrease with age in blood flow velocities was found to be varied in the major cerebral arteries.     

Visual function in children with hemiplegia in the first years of life

The aim of this study was to evaluate the incidence of visual function abnormalities in children with infantile hemiplegia, and the relation between visual abnormalities and type of lesion, as shown by brain MRI. Visual function was tested (grating acuity, visual field size, binocular optokinetic nystagmus [OKN], and ocular movements) in a group of 47 children with congenital or early acquired hemiplegic cerebral palsy (mean age 25 months, range 8 to 52 months). The cohort was subdivided into four groups according to MRI findings: brain malformations (n=5), abnormalities of the periventricular white matter (n=20), cortical-subcortical lesions (n=16), and non-progressive postnatal brain injuries (n=6). More than 80% of the children showed abnormal results in at least one visual test: acuity was the least impaired function, while visual field and OKN were abnormal in more than 50% of the cohort. No specific correlation could be identified between the type and timing of the lesions and visual function. Unlike adults with stroke, visual field defects were not always related to contralateral damage in the optic radiations or in the visual cortex. These results indicate that visual abnormalities are common in children with hemiplegia, and that they cannot always be predicted by MRI. All children with hemiplegia need a detailed assessment of visual function.