Nanoscale intracortical iron injection induces chronic epilepsy in rodent

We studied the electrophysiological, hemodynamic, and cytomorphological consequences of microhemorrhagic brain injury induced by a nanoscale iron injection. Of particular interest were the etiology, development, and treatment of epilepsy associated with this injury. We developed an animal model of chronic epilepsy using nanoscale injection into the adult mouse cortex. Although injection of nanoamounts of iron did not cause clear cell death or damage in the cortex, it elicited varying degrees of spontaneous epileptiform events that could be recorded under anesthesia 3 months postinjection. The influence of these chronic epileptiform events on neurovascular coupling was probed by directly stimulating the cortex ipsilateral to the epileptic focus and by measuring cerebral blood volume simultaneously in both hemispheres using intrinsic signal optical imaging. The ipsilateral hemodynamic response was dramatically lower in animals that exhibited longer, more frequent epileptiform events, but it was unchanged in animals displaying infrequent, short events. In contrast, the contralateral hemodynamic response was augmented in all iron‐injected animals compared with the control group. These abnormal hemodynamic responses in chronically epileptic animals were correlated with the degree of reduction in the number of GABAergic interneurons. Therefore, nanoscale iron injection, which mimics some aspects of microhemorrhagic brain injury, generated chronic, yet varying, degrees of spontaneous epileptiform events. Moreover, the severity of the epileptiform events corresponded to the degree of reduction in GABAergic interneurons in the iron‐injected hemisphere and the level of autoregulatory dysfunction of cerebral blood flow. © 2013 Wiley Periodicals, Inc.     

Variable Significance of Brain MRI Findings in Infective Endocarditis and Its Effect on Surgical Decisions

ObjectiveTo determine how brain magnetic resonance imaging (MRI) findings impact clinical outcomes in patients with infective endocarditis (IE) and to propose a management algorithm for patients with neurologic symptoms who are candidates for valve surgery (VS).Patients and MethodsData from our center were retrospectively reviewed for patients hospitalized with IE between January 1, 2007, and December 31, 2014. Outcomes were postoperative intracerebral hemorrhage (ICH), 6-month mortality, and functional outcome at last follow-up as described by the modified Rankin Scale (mRS) score. Good outcome was defined as an mRS score of 2 or less.ResultsA total of 361 patients with IE were identified, including 127 patients (35%) who had MRI. One hundred twenty-six of 361 patients (35%) had neurologic symptoms, which prompted MRI in 79 of 127 patients (62%); 74 of 79 (94%) had acute or subacute MRI abnormalities. One patient with subarachnoid and multifocal ICH on MRI developed postoperative ICH. Patients with VS despite MRI abnormalities had lower 6-month mortality (odds ratio [OR], 0.17; 95% CI, 0.06-0.48; P<.001) and better functional outcome (OR, 4.43; 95% CI, 1.51-13.00; P=.005). Irrespective of VS, lobar or posterior fossa ICH on MRI was associated with 6-month mortality (OR, 3.58; 95% CI, 1.22-10.50; P=.02) and territorial ischemic stroke was inversely associated with good mRS (OR, 0.29; 95% CI, 0.13-0.66; P=.002). In neurologically asymptomatic patients who had VS, MRI findings did not impact 6-month mortality or functional outcomes.ConclusionMagnetic resonance imaging detects a large number of abnormalities in patients with IE. Preoperative lobar hematoma and large territorial stroke determine outcome irrespective of VS. When indicated, VS increases the odds of a good outcome despite MRI abnormalities.     

磁共振SWI在未破裂脑动静脉畸形隐匿性出血中的应用及文献复习

目的 探讨磁共振磁敏感加权成像（SWI）诊断未破裂脑动静脉畸形（AVM）隐匿性出血的有效性。方法 前瞻性搜集2016年1~12月就诊于我院的20例AVM,术前行磁共振常规序列及SWI序列扫描。计算机检索PubMed、Science Direct、中国知网、万方数据等数据库,对未破裂AVM隐匿性出血相关研究进行总结。结果 20例中,5例（25%）隐匿性出血阳性,其中3例为单发,2例为多发。共检索出5篇论著及1篇评论,这些研究均为病理学研究,隐匿性出血阳性率在28.6%~37.0%;常规MRI对隐匿性出血的检出率约为6.6%,高分辨MRI检出率约为20%。结论 SWI在检测未破裂AVM隐匿性出血中具有较高的效能。     

原发性高血压合并脑微出血患者血压水平及危险因素分析

目的 探讨原发性高血压合并脑微出血患者血压水平及危险因素.方法 选取2016年2月—2019年6月在榆林市第一医院治疗的原发性高血压患者218例,其中合并脑微出血患者88例(观察组),无脑微出血患者130例(对照组),检测两组24 h动态血压等,比较两组临床资料.结果 观察组昼间收缩压(dSBP)、夜间收缩压(nSBP...     

磁敏感加权成像在弥漫性轴索损伤中的临床价值

[摘要] 目的: 探讨SWI序列对于DAI的诊断价值,并比较SWI与T2*序列对于诊断DAI合并出血的敏感性。方法: 对20例临床确诊DAI有颅内少量出血的患者进行T2*序列及SWI序列扫描。结果: 20例DAI的颅内微小出血,对病变显示、静脉血管显示的评分上SWI分别为2.8,2.8;T2*为2.0,2.3;T2为2.2,0;T1为1.7,0。SWI分别与T2*,T2,T1的评分结果比较,差异有统计学意义(P值<0．01)。所有病灶出血SWI序列均得到明确显示,磁敏感加权成像检测到一个平均76 ± 52的参差不齐低信号病灶,而在T2*加权成像则为21 ± 19。(P<0.01,配对t检验) 结论: SWI序列对检测DAI合并出血的敏感性明显高于T2*序列。 [关键词] 磁敏感加权成像;弥漫性轴索损伤;微出血;     

Follicular microhemorrhage: A unique dermoscopic sign for the detection of coexisting trichotillomania in alopecia areata

The diagnosis of trichotillomania (TT) is often difficult as it presents similar clinical manifestations with other hair loss diseases, especially alopecia areata (AA). As TT often coexists with AA, the methodology enabling reliable detection of TT in AA needs to be developed. Recently, characteristic dermoscopic findings of TT have been reported, yet, they were most clearly detectable by conventional immersion dermoscopy, not by dry dermoscopy, a technique more easily adoptable in daily practice. In addition, the usefulness of those signs for differentiating TT from AA has not been sufficiently assessed. Through intensive scanning of hair loss lesions by dry dermoscopy in AA patients with TT, we found a sign potentially useful for detecting hidden TT. The sign we named “follicular microhemorrhage” (FMH) represents a red dot corresponding to a follicular ostia capped or stuffed with blood clot and suggests a history of traumatic forced plucking. So far, we have detected FMH in four TT patients with moderate to severe AA. Although further accumulation of cases is necessary, FMH would be beneficial to dissect complicated pathophysiology of hair loss in AA patients with TT.     

磁共振联合磁敏感加权成像评估急性脑梗死的临床价值

目的:探讨磁共振成像（MRI）联合磁敏感加权成像（SWI）评估急性脑梗死预后的临床价值。方法:采用随机数字表法将100例急性脑梗死患者分为观察组（n=50）和对照组（n=50）。对照组行MRI检查,观察组行MRI联合SWI检查。比较两组患者的疾病检出率、脑微出血检出情况。结果:观察组疾病检出率显著高于对照组（96.0% vs 78.0%, P<0.05）;观察组脑微出血检出率显著高于对照组（64.0% vs 12.0%, P<0.05）;观察组的出血检出面积为（972.83±110.54） mm2,显著高于对照组的（532.71±110.53） mm2（P<0.05）。观察组脑梗死面积诊断评分显著小于对照组（P<0.05）。入院15 d后,观察组神经功能缺损程度评分明显低于对照组（P<0.05）;观察组神经功能缺损程度稳定率及好转率显著高于对照组（P<0.05）。结论:MRI联合SWI检查对急性脑梗死疾病的检出率明显较高,能够准确预测脑微出血,有助于制定正确的临床治疗方案,改善急性脑梗死患者的预后。     

急性脑梗死患者脑微出血影响因素分析

目的 探讨脑微出血（CMB）可能的影响因素及其机制。方法 选择铜陵市人民医院神经内科2011年1月至2014年2月收治的74例急性脑梗死患者,进行常规序列（T₁WI、T₂WI、FLAIR）、DWI及T₂-GRE扫描,对CMB进行分区、计数、分级。根据有无CMB,分为CMB组（36例）与无CMB组（38例）。回顾性分析两组患者年龄、吸烟饮酒史、血糖、血压、低密度脂蛋白、同型半胱氨酸水平等情况。结果 CMB组高血压、腔隙性脑梗死患者比例高于无CMB组,差异有统计学意义（χ²=11.013,P=0.010;χ²=6.121,P=0.012）。两组患者血浆生化检查结果进行比较,除了UA,Cr之外,差异无统计学意义（P>0.05）;logistic回归分析显示,高血压（OR=4.66,95% CI：1.22~17.64,P=0.010）、腔隙性脑梗死（OR=4.321,95% CI：1.19~16.75,P=0.012）是CMB的危险因素。结论 CMB与高血压、腔隙性脑梗死密切相关,其中高血压为CMB最重要的可控危险因素,腔隙性脑梗死与CMB可能具有类似的发病机制。     

高血压脑微出血患者不同护理模式的效果比较

 目的 观察及比较不同护理模式在高血压脑微出血患者中的综合护理效果。方法 选取2011-05至2014-01我院收治的70例高血压脑微出血患者为研究对象,随机分为脑微出血常规护理组(A组)和针对性护理组(B组);每组35例,分别统计两组患者护理干预前与护理干预后1周、2周及4周的疾病认知度、治疗依从性及生活质量,并进行比较分析。结果 B组护理干预后1周、2周及4周的疾病认知度分别为65.71%、82.86%、97.14%,治疗完全依从性比例分别为94.29%、97.14%、100.00%,均高于A组,两组对比差异有统计学意义(P＜0.05)。B组生活质量评分也明显高于A组,两组对比差异有统计学意义(P＜0.05)。结论 针对性护理能更为有效地改善高血压脑微出血患者的状态,对本病是一种更为适用的护理方法。