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排序方式: 共有197条查询结果,搜索用时 15 毫秒
1.
目的: 研究脑小血管病(cerebral small vessel disease,CSVD)亚型与颅外颈动脉粥样硬化及血管性认知障碍(vascular cognitive impairment,VCI)的相关性。 方法: 收集200例无卒中CSVD患者的人口学、用药等资料,行颈动脉超声并使用颅外颈动脉硬化评分评估颈动脉粥样硬化程度,行头颅磁共振(magnetic resonance imaging,MRI)并评估各类CSVD亚型病变程度。采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)筛查认知功能异常患者,根据MoCA总分<23分将患者分成VCI组和无VCI组。采用单因素分析和多因素logistic回归筛选无卒中患者VCI的独立危险因素。建立模型并使用受试者工作特征曲线(receiver operating characteristic,ROC)评估独立危险因素,计算临界值等。根据独立危险因素中的CSVD评分最佳界值计算脑小血管性认知负荷评分并使用ROC曲线评估。 结果: Logistic回归分析得出腔隙性脑梗死(lacunar infarction,LI)+腔隙灶个数之和、Fazekas评分、全脑皮层萎缩(global cortical atrophy,GCA)评分与VCI显著正相关(P<0.05),颅外颈动脉硬化评分与VCI无明显相关性(P>0.05);所建立预测模型和脑小血管性认知负荷评分曲线下面积(area under the curve,AUC)>0.7。 结论: 部分CSVD亚型与VCI存在明显相关性,颅外轻度颈动脉粥样硬化与VCI无明显相关性;可通过CSVD建立模型或使用临床更方便的脑小血管性认知负荷评分筛查无卒中患者的小血管性认知障碍。 相似文献
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Ken Uekawa Yasuyuki Kaku Toshihiro Amadatsu Hiroaki Matsuzaki Yuki Ohmori Takayuki Kawano Shinya Hirata Tomomi Yamaguchi Tomoki Kosho Akitake Mukasa 《Interventional neuroradiology》2021,27(2):212
ObjectiveWe describe a case of intracranial and extracranial multiple arterial dissecting aneurysms in rheumatoid arthritis (RA).Case PresentationA 29-year-old man with a medical history of RA since 18 years of age was admitted to our hospital for vomiting, dysarthria, and conscious disturbance. At 23, he underwent ligation of the left internal carotid artery (ICA) with superficial temporal artery to middle cerebral artery anastomosis because of acute infarct of the left hemisphere caused by arterial dissection of the left ICA. During the current admission, computed tomography (CT) revealed subarachnoid hemorrhage, and digital subtraction angiography (DSA) demonstrated dissecting aneurysms of the left intracranial vertebral artery (VA) and right extracranial VA. We diagnosed him with a ruptured dissecting aneurysm of the left intracranial VA and performed endovascular parent artery occlusion on the left VA. For the right unruptured VA aneurysm, we performed coil embolization simultaneously. At 2 weeks after the endovascular treatment, follow-up DSA revealed that multiple de novo dissecting aneurysms developed on the origin of the left VA and left and right internal thoracic arteries. Those aneurysms were treated with coil embolization. Other remaining aneurysms on the left thyrocervical trunk, right transverse cervical artery, and both common iliac arteries were treated by conservative therapy. While continuing medical treatment for RA, the patient recovered and was discharged to a rehabilitation hospital.ConclusionConsidering that RA-induced vasculitis can be a potential risk of vascular complications including multiple arterial dissections, physicians should carefully perform endovascular interventional procedures for patients with long-term RA. 相似文献
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目的分析颅外动脉狭窄与脑卒中含短暂性脑缺血发作(TIA)危险因素的关系,为脑血管病防治提供依据。方法选择既往有脑卒中(含TIA)病史的1 784例脑卒中高危人群,将其分为非颅外动脉狭窄组和颅外动脉狭窄组,比较2组人群脑卒中危险因素及中医症状、舌象、脉象。结果非颅外动脉狭窄组既往TIA患者比例、锻炼少或轻体力劳动者所占比例高于颅外动脉狭窄组。颅外动脉狭窄组既往脑卒中患者比例、空腹血糖升高检出率、吸烟比例高于非颅外动脉狭窄组(P0.05或P0.01)。2组患者中医证候要素比较差异无统计学意义(P0.05),单一中医症状分布方面,口唇紫暗、肢体笨拙、小便清长等发生率有显著差异(P0.05或P0.01)。结论颅外动脉狭窄与脑卒中、空腹血糖升高发生相关。脑卒中(含TIA)患者中医证候要素以火、气虚、阴虚、血瘀、痰、阳虚为主,颅外动脉狭窄与否并不影响中医证候要素类型及分布。 相似文献
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《Paediatrics & Child Health》2014,24(4):148-154
Germ cell tumours (GCTs) comprise a heterogeneous group of tumours believed to arise from the totipotent primordial germ cell. While uncommon, they may present at any age from in-utero to young adulthood. Prognosis is generally good and considering them in the differential diagnosis of midline as well as gonadal masses may prevent diagnostic delay and/or escalation of potentially harmful treatment. In childhood, approximately 50% are gonadal and 50% extragonadal (20% intracranial/30% extracranial). Clinical presentation relates to mass effect at tumour site. Teratomas account for 50% of paediatric GCTs and while considered benign may recur if not completely excised. Malignant GCTs often secrete the tumour markers alpha-fetoprotein and human chorionic gonadotrophin, which may help in diagnosis and follow-up. Outcomes are generally good with more than 90% 5-year overall survival. Management involves complete surgical resection for teratomas and non-metastatic gonadal tumours. In the UK, chemotherapy is reserved for stage 2–4 extracranial malignant GCTs. Intracranial tumours typically occur in the midline in the pineal and/or suprasellar regions. Intracranial germinomas are cured in more than 90% cases with radiotherapy or combined chemo-radiotherapy. About two-thirds of non-germinomatous intracranial tumours are cured with combined chemo-radiotherapy. Current issues relating to the diagnosis and management of teenagers and young adults with GCTs are highlighted. 相似文献
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目的探讨脑血管病(cerebral vascular disease,CVD)患者的颅内外动脉狭窄情况及其与CVD危险因素和发病率的关系。方法对160例CVD患者行数字减影血管造影(DSA)检测,对颅内外动脉血管的狭窄发生率、狭窄程度、分布特点和危险因素进行统计分析。结果 CVD患者颅内外动脉狭窄的发生率为65%,中、老年组的中重度狭窄的比率明显高于青年组;伴高血压和糖尿病的患者多分布在颅内动脉狭窄组,而伴高血脂和吸烟的患者多分布在颅外动脉狭窄组患者中;中、重度血管狭窄组的脑梗死和TIA的发病率高于脑出血组(P〈0.05)。结论高血压、糖尿病、高脂血症和吸烟易导致颅内外动脉狭窄,而后者是CVD发病的重要因素之一;随血管狭窄程度的增加CVD的发病率升高。 相似文献
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Aashish Patel Bhavraj Khalsa Bryce Lord Kumar Sandrasegaran Chandana Lall 《Journal of Medical Imaging and Radiation Oncology》2013,57(2):207-211
Fiducial marker (FM)‐guided stereotactic body radiation therapy (SBRT) allows for precise targeting and delivery of radiation to a tumor site. In this article, we briefly discuss SBRT, provide examples to describe CT‐guided FM placement to guide SBRT, and discuss some of the associated risks and benefits. This article serves as a pictorial review for body imagers and interventional radiologists who perform CT‐guided procedures and interpret diagnostic studies for oncology patients. CT‐guided FMs were placed in patients who were appropriate candidates for SBRT. One week following placement, patients underwent diagnostic CT and/or MR examinations in order to include the FM data in the development of a treatment plan. From October 2007–November 2009, a total of 89 patients were implanted with FMs. Sites of implantation included lung, liver, bone, chest and abdominal wall, and peritoneum/retroperitoneum. Complications included pneumothorax and FM migration. Twenty‐one patients (33%) with lung FM placement experienced at least a small pneumothorax and 6 patients (9%) required thoracostomy tubes. FM migration occurred in 5 patients (8%) with lung placement. SBRT provides a safer and more effective alternative to conventional radiotherapy, and CT‐guided FM implantation of tumor sites increases the precision of SBRT. Technical improvements in FM placement can limit the complications associated with the procedure and further enable highly localized tumor therapy. 相似文献
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Michele Abbruzzese Emilio Favale Massimo Leandri Sandro Ratto 《Acta neurologica Scandinavica》1978,58(6):325-332
Two new components of the human SEP upon stimulation of the contralateral median nerve at the wrist have been identified. Such components have been called N16 and N17 , according to their polarity and latency. N16 and N17 , as well as the N14 -P15 complex, are generated by separate subcortical dipoles. Particularly, they are supposed to be far-field reflections of the activity of the dorsal columns nuclei or the medial lemniscus (N14 -P15 ), the thalamus (N16 ) and the thalamo-cortical radiation (N17 ). Moreover, it has been established that N14 is the very first intracranial component of the human SEP, the main peak of S wave and the preceding ones being extracranial in origin.
A new classification of SEP intracranial components including early (N14 through N17 ), intermediate (N20 through P30 ) and late events is proposed. 相似文献
A new classification of SEP intracranial components including early (N
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The extracranial blood flow seriously complicates the interpretation of dynamic cerebral studies. To eliminate this, we used a blood pressure cuff placed around the head in 50 patients with no evidence of cerebrovascular disease. The pressure in the headband was increased to 30 mmHg above the patient's systolic pressure, and the first 60 sec static scintigram was taken exactly 3 min after the injection of 99m Tc-pertechnetate. A second 60 sec static scintigram was taken without pressure in the headband at 6 min after injection. After correction for diffusion of tracer into extravascular compartments we could still show 13% reduction in counting rates over the hemispheric regions and 30% over the convexity regions during application of the pressure headband. With the Xenon method, the application of the headband appears to have insignificant influence on the results of cerebral perfusion. We thus recommend that a headband should be used for dynamic 99m Tc-isotope cerebral circulation studies. 相似文献