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尼麦角林是一种麦角生物碱衍生物,广泛应用于脑血管病患者认知障碍的治疗。多项临
床前研究显示,尼麦角林对于认知障碍的改善可能与以下因素有关:尼麦角林除能够改善脑循环,
促进神经递质释放外,还具有营养神经及抗氧化等作用。目前的研究认为,尼麦角林能够改善患者
卒中后抑郁相关的情绪障碍以及有效改善血管性痴呆,提高患者的日常生活能力。同时,尼麦角林具
有良好的安全性,目前暂无尼麦角林治疗导致纤维化或麦角中毒的研究报道。本文就尼麦角林在神
经系统的作用机制、临床疗效及安全性进行综述,以期为临床应用提供参考。 相似文献
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A case of MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) which presented as migraine
complicated by stroke is reported. Strokes associated with migraine have often been reported, but the mechanism remains unclear
and may include a variety of pathologies. MELAS also presents with migrainous headache, vomiting, and stroke-like symptoms.
Magnetic resonance imaging demonstrates characteristic findings. MELAS should be considered in the differential diagnosis
of infarct-like lesions with migrainous headaches in young adults, especially if the symptoms fluctuate and are accompanied
by a homonymous hemianopia.
Received: 23 September 1996 Accepted: 19 February 1997 相似文献
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The treatment of neoplasia with interleukin-2 (IL-2) can be complicated by neurological deficits resembling transient Ischemic attack and stroke. We investigated whether interleukin-2 contributes to the natural course of cerebrovascular ischemia and particularly to the pathogenesis of infection-associated stroke. Plasma levels of interleukin-2 were below the level of detectability in almost all measurements. Patients with and without previous infection (n = 11, 805 ±445 U/ml vs n = 19, 824 ± 501 U/ml) did not have significantly higher levels of soluble interleukin-2 receptors than control subjects with (n = 14, 667 ± 229 U/ml) or without vascular risk factors (n = 17, 567 ± 176 U/ml). Receptor levels increased in patients during the first week after stroke (n = 15, 1157 ± 1013, p < 0.02). Levels of soluble T8 antigen (sT8) were higher in patients (n – 26, 320 ± 112 U/ml) than in healthy control subjects (n = 15, 246 ± 92 U/ml; p < 0.05) and sT8 levels increased during the first week after stroke (p < 0.05). These results reflect an immunological response to the cerebral infarct; they do not indicate a general role of the IL-2 system in the pathogenesis of ischemic stroke with or without previous infection. 相似文献
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Edward H.C. Wong MRCP Thomas W.H. Leung MRCP K.S. Lawrence Wong FRCP 《Journal of neuroimaging》2007,17(1):87-88
We report a 33-year-old man with seronegative arthritis who had an acute infarct at the left lentiform nucleus while taking etoricoxib and thalidomide regularly. Extensive investigations did not find any evidence of large artery atherosclerosis, vasculitis, cardioembolic source or anti-phospholipid antibodies. While it is possible that a short smoking history, hyperlipidemia, and the use of thalidomide could have contributed to the thrombosis of a small penetrator vessel, we postulated that the prolonged use of etoricoxib is another possible contributing factor. 相似文献
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目的总结探索在基层医院组建卒中小组,治疗急性脑卒中的模式。方法组建包括社区网络在内的院内卒中小组,对脑卒中患者进行动态的全面评估和系统的个体化治疗。结果规范了急性脑卒中的临床治疗行为,改善了患者预后。结论在基层医院建立卒中小组是一种可行的治疗模式。 相似文献
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Residual Flow Signals Predict Complete Recanalization in Stroke Patients Treated With TPA 总被引:4,自引:0,他引:4
Lise A. Labiche MD Marc Malkoff MD Andrei V. Alexandrov MD 《Journal of neuroimaging》2003,13(1):28-33
BACKGROUND: Residual blood flow around thrombus prior to treatment predicts success of coronary thrombolysis. The authors aimed to correlate the presence of residual flow signals in the middle cerebral artery (MCA) with completeness of recanalization after intravenous tissue plasminogen activator (TPA). METHODS: The authors studied consecutive patients treated with intravenous TPA therapy who had a proximal MCA occlusion on pretreatment transcranial Doppler (TCD). Patients were continuously monitored for 2 hours after TPA bolus. Absent residual flow signals correspond to the thrombolysis in brain ischemia (TIBI) 0 grade, and the presence of residual flow signals was determined as TIBI 1-3 flow grades. Complete recanalization was defined as flow improvement to TIBI grades 4-5. RESULTS: Seventy-five patients with a proximal MCA occlusion had median pre-bolus NIHSS 16 (85% with > or = 10 points). TPA bolus was given at 141 +/- 56 minutes (median 120 minutes). Complete recanalization was observed in 25 (33%), partial in 23 (31%), and no early recanalization was seen in 27 (36%) patients within 2 hours after TPA bolus. Only 19% with absent residual flow signals (TIBI grade 0, n = 26) on pretreatment TCD had complete early recanalization. If pretreatment TCD showed the presence of any residual flow (TIBI 1-3, n = 49), 41% had complete recanalization within 2 hours of TPA bolus (P = .03). CONCLUSIONS: Patients with detectable residual flow signals before IV TPA bolus are twice as likely to have early complete recanalization. Those with no detectable residual flow signals have less than 20% chance for complete early recanalization with intravenous TPA and may be candidates for intra-arterial therapies. 相似文献