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Sample records for acute cerebral infarction

  1. MRI of acute cerebral infarction

    Sequential changes of magnetic resonance imaging (MRI) in sixteen patients with acute cerebral infarction are studied in comparison with the findings of computed tomography (CT). The sixteen patients were examined within 36 hours from the onset of syptoms on resistive type MRI (0.15T) using T1 weighted image (IR2000/500) and T2 weighted image (SE2000/80), and on CT. In general, large infarcted lesions of the cortexsubcortex seemed to be visualized earlier than small lesions of the basal ganglia and brainstem. In 8 patients, the infarcted lesions were detected on MRI earlier than on CT. For example, early detecting time within 12 hours were 2, 6, 7, and 10 hours after onset. In two patients of this group, lesions were detected on T2 weighted image earlier than on T1-weighted image. In two cases, small lesions of the brainstem were detected only on MRI. The size of abnormal findings gradually developed and reached a maximum on days 5 to 7 sequentially. The difference between infarction and perifocal edema was not clear even on MRI. The changes gradually subsided and assumed a stable size after about 2 months. Contrast enhancement effect was observed in four patients. In two of these cases, the signal intensity of T2-weighted imaging was decreased just at the region which was enhanced with contrast medium. MRI is useful for early diagnosis of ischemic cerebral infarction, and may eludidate some aspects of the pathophysiology of ischemic stroke. (author)

  2. CT findings of early acute cerebral infarction

    The CT findings of the acute cerebral infarction are well known. However the CT findings of early stroke within 24 hours of the onset have not been sufficiently reported. The purpose of this study is to evaluate early acute cerebral infarction on CT within 24 hours after ictus. The early and accurate CT diagnosis could lead to the appropriate therapy and improved outcome of the patients. Authors retrospectively analyzed 16 patients with early acute cerebral infarction. Acute cerebral infarction was confirmed by follow-up CT in 11 patients, SPECT in 4 patients, and MRI in 1 patient. The CT findings of early acute cerebral infarction include effacement of cortical sulci or cistern (n = 16, 100%), hyperattenuation of MCA (n = 3), obscuration of lentiform nucleus (n = 6), loss of insular ribbon (n = 6) and subtle low density in hemisphere (n = 5). The most frequent finding was effacement of cortical sulci in our study, and it was thought to be the most important sign of early acute cerebral infarction

  3. Contrast MR imaging of acute cerebral infarction

    Thirty patients with acute and subacute cerebral infarction (13 and 17 deep cerebral infarction) were studied with 0.5 T MR unit before and after intravenous injection of Gd-DTPA. Thirteen patients were studied within 7 days after neurological ictus, 17 patients were studied between 7 and 14 days. Two types of abnormal enhancement, cortical arterial and parenchymal enhancement, were noted. The former was seen in 3 of 4 cases of very acute cortical infarction within 4 days after clinical ictus. The latter was detected in all 7 cases of cortical infarction after the 6th day of the ictus, and one patient with deep cerebral infarction at the 12th day of the ictus. Gd-DTPA enhanced MR imaging seems to detect gyral enhancement earlier compared with contrast CT, and depict intra-arterial sluggish flow which was not expected to see on contrast CT scans. (author)

  4. Electrocardiogram changes in acute cerebral infarction patients

    Jing Fang; Weihong Yan

    2006-01-01

    BACKGROUND: Comparison of different stroke locations had been focused in past researches in electrocardiogram (ECG) changes of cerebral stroke patients. Some researches neglected the heart disease in the illness history.OBJECTIVE: To discuss ECG changes in different infarction locations and size of acute cerebral infarction and compare with healthy people.DESIGN: Contrast observation.SETrING: Shanghai Ninth People's Hospital.PARTICIPANTS: A total of 57 patients with cerebral infarction were selected from the Neurological Department of Ninth People's Hospital of Shanghai from March 2003 to September 2005. They were diagnosed according to the criteria revised in the 4th National Cerebral Disease Conference and brain images. Patients who had heart disease were excluded. There were 32 males and 25 females, who were 65-84 years old. Among them, 23 cases were involved in right hemisphere, 34 cases in left one, 23 in base ganglion, 11 in brain stem, 9in frontal lobe and 14 in other parts. According to their infarction size (plus size in every different scan), they were divided into three different groups: large-size group (n = 10) with size larger than 3.5 cm3, medium-sizegroup (n = 13) with size between 1.5-3.5 cm3, and small-size group (n = 34) with size smaller than 1.5 cm3.Another 50 healthy subjects were regarded as control group. There were 29 males and 21 females aged 40-82 years. All these cases knew and agreed of the examination.METHODS: Patients received 12-lead ECG examinations within the first 6-24 hours of onset while control group received it at the same time. The HR, PR, QTc, QRS, T wave and ST changes were compared between the two groups.MAIN OUTCOME MEASURES: The ECG changes and differences in two hemispheres, in different infarction lccations and sizes. RESULTS: All 57 patients and 50 healthy subjects were involved in the final analysis. ① ECG changes in infarction group and control group. There were no differences in HR, QRS time and cases with

  5. Relationship between blood uric and acute cerebral infarction

    Objective: To study the relationship between blood uric acid and acute cerebral infarction. Methods: The level of blood uric acid and prevalence of hyperuricemia (HUA) were compared in 360 patients with acute cerebral infarction and 300 patients without it. According to the level of blood uric acid, 360 acute cerebral infarction patients were divided into HUA and normouricemia (NUA) groups. Age, sex, body mass index (BMI), blood glucose and total cholesterol were compared between the HUA and NUA group. The degree of neurological functional defection was compared between the two groups when patients were attacked by acute cerebral infarction. After a recovery treatment, the neurological functional defection of the two groups was compared a second time. Results: (1)The average blood uric acid level and prevalence of HUA were higher in patients with acute cerebral infarction. (2) The BMI, blood glucose and total cholesterol were higher in HUA group than in NUA group. (3) The neurological functional defection was more serious in HUA group when patients were attacked by acute cerebral infarction and after a recovery treatment. Conclusion: Hyperuricemia is related to acute cerebral infarction. (authors)

  6. Changes of blood serum in acute cerebral infarction after treatment

    Objective: To investigate the changes of serum of HDL, LDL, TXB2, 6-K-PGF1α, TG and β-LP in acute cerebral infarction after treatment. Method: The serum levels of HDL, LDL, TXB2, 6-K-PGF1α, TG and β-LP in 94 acute cerebral infarction patients were detected by RIA and biochemistry assay respectively. Results: The results showed that the serum HDL and 6-K-PGF1α levels in acute cerebral infarction patients were increased (P2 were decreased (P<0.01) after treatment. Conclusion: The Hyper coagulable state and blood fat index in acute cerebral infarction after treatment could improve obviously. (authors)

  7. Brain protection therapy in acute cerebral infarction.

    Katsura, Ken-ichiro; Suda, Satoshi; Abe, Arata; Kanamaru, Takuya; Toda, Yusuke; Katayama, Yasuo

    2012-01-01

    Many drugs for cerebral infarction that were shown to be effective in animal experiments have shown negative results in human clinical trials. For this reason, a completely new approach is needed to develop brain protection therapies against cerebral infarction. Brain protection therapies can be categorized into 3 types: 1) lengthening the therapeutic time window for thrombolytic therapy, 2) reducing the side effects of thrombolytic therapy, and 3) brain protection drug therapy for patients with contraindications for thrombolytic therapy (including combination therapy). Here, we show our recent results of brain protection therapy. First, combination therapy with 2 effective drugs was tried, and time-lag administration was performed. Combination therapy was effective and lengthened the therapeutic time window. Next, a completely new approach to improve cerebral ischemic damage, namely, H2 gas inhalation therapy, was tried. This therapy was also effective, even in the ischemic core. PMID:22687352

  8. Clinical study of interventional therapy for acute cerebral infarction

    Objective: To evaluate the clinical efficacy and safety of interventional therapy for acute cerebral infarction. Method: Using urokinase, 35 patients with acute cerebral infarction within 24 hours were treated by intra-artery thrombolytic therapy. Europe stroke scale (ESS), Barthel index (BI) were used to evaluate the recovery of neurological functions. Result: ESS score increase rapidly after thrombolytisis, and there were significant difference between the two teams. Thirteen of 13 cases treated within 6 hours from onset showed complete/partial recanalization in cerebral angiography and intraparenchymal hemorrhagic rate were 0%, twenty-six of 35 cases treated within 24 hours showed complete/partial recanalization and intraparenchymal hemorrhagic rate were 5.71%. Conclusion: Interventional therapy for acute cerebral infarction within 6h were safe and effective. (authors)

  9. Watershed Cerebral Infarction in a Patient with Acute Renal Failure

    Ruya Ozelsancak

    2016-02-01

    Full Text Available Acute renal failure can cause neurologic manifestations such as mood swings, impaired concentration, tremor, stupor, coma, asterixis, dysarthria. Those findings can also be a sign of cerebral infarct. Here, we report a case of watershed cerebral infarction in a 70-year-old female patient with acute renal failure secondary to contrast administration and use of angiotensin converting enzyme inhibitor. Patient was evaluated with magnetic resonance imaging because of dysarthria. Magnetic resonance imaging revealed milimmetric acute ischemic lesion in the frontal and parietal deep white matter region of both cerebral hemisphere which clearly demonstrated watershed cerebral infarction affecting internal border zone. Her renal function returned to normal levels on fifth day of admission (BUN 32 mg/dl, creatinine 1.36 mg/dl and she was discharged. Dysarthria continued for 20 days.

  10. Acute cerebral infarction: pathophysiology and modern treatment concepts

    This review focuses on the pathophysiological changes in acute cerebral ischemia, with special emphasis on disturbances of the cerebral blood flow (CBF) and the associated penumbra concept. Alternatively, the model of peri-infarct depolarization is demonstrated. Metabolic and molecular changes caused by cerebral ischemia and reperfusion are discussed, namely energy failure, release of glutamate with an excitatoric burst, calcium influx in neurons, generation of free radicals, activation of different proteases, disturbances of protein synthesis, induction of gene expression and apoptosis, loss of membrane integrity, edema formation and microvascular disturbances. In summary, the pathophysiological changes after focal cerebral ischemia and reperfusion are most adequately described by a network of interacting different mechanisms of tissue alterations. The simple concept of a cascade of ischemic effect which would be easy to block seems to be less applicable. A time window of approximately 6 h for the acute stroke therapy is postulated on the base of the above mentioned pathophysiological changes. (orig./AJ)

  11. Local intracranial intraarterial thrombolytic therapy in acute cerebral infarction

    To evaluate the efficacy of direct intracranial intraarterial thrombolytic therapy in patients with acute atherothrombotic and embolic stroke. Forth-one patients with cerebral thromboembolic disease, all in the area of the middle cerebral artery and including two cases of internal carotid artry occlusion, were treated with microcatheter-directed local intraarterial thrombolysis, using 180,000 to 1,000,000 unit urokinase and 15 to 50 mg of tissue plasminogen activator (tPA). The time elapsed before treatment ranged from 260 to 470 minute (mean : 380 minutes). The effect of treatment was assessed by cerebral angiography, by the clinical outcome. For 25 patients (61%), complete vessel recanalization was successful. In eight and three cases, respectively, the result was partial recanalization and residual stenosis. In 21 patients (51%), both acute neurologic and functional outcomes improved significantly within 24 hours and in 92% of patients, within one month. Hemorrhagic transformations occurred in five patients (12.2%), and in five others there were high density lesions around the basal ganglia and temporal lobe, which was cleared on CT within 24 hours. This suggested transient extrapolation of the contrast media rather than true hemorrhage. tPA showed better results than urokinase in terms of the rate of recanalization (68.7% vs 56.7%) and the occurrence of hemorrhagic infarction(6.3% vs 16.0%). Local intraarterial cerebral thrombolysis is thought be an effective method in the treatment of acute brain infarction, but in some patients may cause intracerebral hemorrhage in some patients

  12. Local intracranial intraarterial thrombolytic therapy in acute cerebral infarction

    Kim, Sun Yong; Suh, Jung Ho [Ajou Univ. College of Medicine, Suwon (Korea, Republic of)

    1996-06-01

    To evaluate the efficacy of direct intracranial intraarterial thrombolytic therapy in patients with acute atherothrombotic and embolic stroke. Forth-one patients with cerebral thromboembolic disease, all in the area of the middle cerebral artery and including two cases of internal carotid artry occlusion, were treated with microcatheter-directed local intraarterial thrombolysis, using 180,000 to 1,000,000 unit urokinase and 15 to 50 mg of tissue plasminogen activator (tPA). The time elapsed before treatment ranged from 260 to 470 minute (mean : 380 minutes). The effect of treatment was assessed by cerebral angiography, by the clinical outcome. For 25 patients (61%), complete vessel recanalization was successful. In eight and three cases, respectively, the result was partial recanalization and residual stenosis. In 21 patients (51%), both acute neurologic and functional outcomes improved significantly within 24 hours and in 92% of patients, within one month. Hemorrhagic transformations occurred in five patients (12.2%), and in five others there were high density lesions around the basal ganglia and temporal lobe, which was cleared on CT within 24 hours. This suggested transient extrapolation of the contrast media rather than true hemorrhage. tPA showed better results than urokinase in terms of the rate of recanalization (68.7% vs 56.7%) and the occurrence of hemorrhagic infarction(6.3% vs 16.0%). Local intraarterial cerebral thrombolysis is thought be an effective method in the treatment of acute brain infarction, but in some patients may cause intracerebral hemorrhage in some patients.

  13. Magnetic resonance imaging (MRI) in patients with acute cerebral infarction

    In order to evaluate that how early we can detect an ischemic lesion and how we can recognize the stages of evolution of ischemic infarcts, 10 patients with acute hemispheric cerebral infarction were studied by a high resolution MRI apparatus with 0.5 Tesla magnetic field and the following results were obtained: 1) In ischemic infarcts, the earliest change was detected 3 hours after the insult in one patient. In the other two patients, the change was seen 5 and 6 hours after the accidents respectively. So MRI can detect the earliest change within 24 hours after ischemic infarcts by T2 weighted image. 2) The stages of evolution of infarction involving the cerebral hemisphere was quite similar to those seen by CT. Selective gray matter high signal images were noted as the earliest changes by T2 weighted images within a few hours after the episode. During 24 hours to 1 week, the MRI abnormalities gradually extended to involve the underlying white matter with homogenously increased signal intensity on T2 weighted scans. In the subacute stage between 1 week to 3 weeks, the MRI had a rather mottled appearance with surrounding isodense areas, probably correlating to the fogging phenomenon seen by CT. In the chronic stage after 4 weeks, the lesion of the T2 image became smaller with the areas of mottled and decreased signal intensity. Some lesions were surrounded by areas of increased signal intensity. 3) T1 and T2 values of ischemic areas prolong significantly in comparison to the value in healthy white matter. But the change of T1, T2 values does not seem to be specific for the evolution of pathological changes. (author)

  14. Demonstration of focal hyperemia in acute cerebral infarction with iodine-123 iodoamphetamine

    Focal hyperemia is known to occur in regions of acute cerebral infarction. Presented here are two cases in which SPECT images with 123I-labeled iodoamphetamine demonstrated focal areas of increased tracer concentration associated with cerebral infarction. These results may have important implications regarding the physiology of iodoamphetamine in cerebral infarction and, in particular, whether the distribution of this tracer is related to regional blood flow in this setting. In addition, interpretation of iodoamphetamine images in cerebral infarction should include consideration of this finding

  15. The evaluation of diffusion weighted imaging in acute cerebral infarction with permanent type MR scanner

    Objective: To evaluate the value of diffusion weighted imaging (DWI) in acute cerebral infarction using permanent type MR scanner. Methods: DWI and conventional MRI sequences were done in 77 patients suspected with cerebral infarction. The sensitivity of DWI and conventional MRI was comparatively evaluated on lesion signal intensity and size. The characteristics and orderliness of lesions were studied. Results: (1) DWI has higher sensitivity than conventional MRI. (2) The higher b value was applied in the imaging, the higher signal intensity of acute cerebral infarction was revealed. The lesions were easier to identify on DWI images than on conventional MRI. Conclusion: DWI of permanent type MR imager is a feasible imaging modality, which is valuable in early diagnosis and management of acute cerebral infarction. (authors)

  16. Perfusion MRI in cerebral infarction

    Purpose: To investigate the hemodynamic changes in patients with acute cerebral stroke by perfusion MRI. Materials and methods: In 12 patients with acute stroke in the territory of the middle cerebral artery, perfusion MRI was performed. Peak time, mean transit time, regional cerebral blood volume and regional cerebral blood flow were calculated in the infarction, the peri-infarction area and the contralateral hemisphere. Results: In the infarction the mean blood flow was 29 ml/100 g/min, compared to about 40 ml/100 g/min in the peri-infarction area and the contralateral hemisphere. In two patients increased cortical blood flow was found in the infarction due to luxury perfusion. The cerebral blood volume was reduced in the infarction, but significantly increased, to 7.3 ml/100 g, in the peri-infarction tissue. Conclusion: Perfusion MRI allows one to differentiate various patterns of perfusion disorders in patients with acute cerebral stroke. (orig./AJ)

  17. Study on the diagnostic value of emergency-electroencephalogram and hypnogram to acute cerebral infarction

    Objective: To investigate the diagnostic value of emergency-EEG (EmEEG) and sleep electroencephalogram to acute cerebral infarction. Methods: Forty-two patients with acute cerebral infarction were collected. The first 30 minutes artifact-free segment of CEEG was selected as EmEEG, and its diagnostic value was compared with CT. Results: The EmEEG revealed that acute cerebral infarction abnormal accounted for 71.4%, while the number was 59.5% for the first CT scanning. Among those suffering from subcortical and cortical infarct, the EmEEG was more valuable in showing the ill lateral or site than those suffering from lacunar infarct. Along with the time elapsing, the positive rate of CT increased, while EmEEG's advantage of diagnostic value weakened. The abnormal rate of hypnogram was 79.31. Conclusion: The diagnostic value of EmEEG is higher in the patient who is excluded hemorrhage and found no ischemia focus by CT scanning in the earlier stage of acute cerebral infarction. (authors)

  18. Detection of acute cerebral infarction by dual echo subtraction technique in MR imaging

    Harada, Kengo; Nishimaru, Eiji; Yukutomo, Takeharu [Hiroshima City Hospital (Japan); Ishida, Takayuki [Hiroshima International Univ., Kurose (Japan). Faculty of Health Sciences

    2003-05-01

    The purpose of this study was to develop an image enhancement technique to detect acute cerebral infarct regions in brain MR images. Transverse relaxation times for abnormal changes tend to be longer than those for normal tissues. In order to obtain MR images with two different echo times, we employed the fast spin echo sequence. We then employed the image subtraction technique using two T{sub 2}-weighted images to enhance acute cerebral infarct regions. As a result, the areas of acute cerebral infarct regions were enhanced as regions of higher signal than normal regions of brain tissue. Further, high signal areas in dual echo subtraction images corresponded to cerebral infarct regions of high signal areas in diffusion weighted images (DWI). We found that the image subtraction technique is useful to enhance very subtle regions of acute cerebral infarction in MR images. Because we employ the difference between transverse relaxation times for normal and abnormal tissues, which does not depend on the strength of the magnetic field, the dual echo subtraction method can be used in many hospitals. (author)

  19. The usefulness of deconvolution perfusion CT in patients with acute cerebral infarction: comparison with diffusion MRI

    This study was performed to evaluate the usefulness of Deconvolution perfusion CT in patients with acute cerebral infarction. Nine patients with acute cerebral infarction underwent conventional CT and cerebral perfusion CT within 23 hours of the onset of symptoms. The perfusion CT scan for each patient was obtained at the levels of basal ganglia and 1 cm caudal to the basal ganglia. By special imaging software, perfusion images including cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps were created. The infarcted lesions were evaluated on each perfusion maps by 3 radiolocical technician. MTT delay time was measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size were measured on each perfusion map and compared with the value obtained by diffusion weighted MR imaging (DWMRI). All perfusion CT maps showed the perfusion defect lesion in all patients. There were remarkable MTT delay in perfusion defect lesion. In comparison of lesion size between each perfusion map and DWMRI, the lesion on CBF map was the most closely correlated with the lesion on DWMRI (7/9). The size of perfusion defect lesion on MTT map was larger than that of lesion on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Deconvolution Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra but also hemodynamic status in perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction

  20. The usefulness of deconvolution perfusion CT in patients with acute cerebral infarction: comparison with diffusion MRI

    Eun, Sung Jong [Chonnam National University Graduate School, Gwangju (Korea, Republic of); Kim, Young Keun [Kwangju Health College, Gwangju (Korea, Republic of)

    2003-06-15

    This study was performed to evaluate the usefulness of Deconvolution perfusion CT in patients with acute cerebral infarction. Nine patients with acute cerebral infarction underwent conventional CT and cerebral perfusion CT within 23 hours of the onset of symptoms. The perfusion CT scan for each patient was obtained at the levels of basal ganglia and 1 cm caudal to the basal ganglia. By special imaging software, perfusion images including cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) maps were created. The infarcted lesions were evaluated on each perfusion maps by 3 radiolocical technician. MTT delay time was measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion size were measured on each perfusion map and compared with the value obtained by diffusion weighted MR imaging (DWMRI). All perfusion CT maps showed the perfusion defect lesion in all patients. There were remarkable MTT delay in perfusion defect lesion. In comparison of lesion size between each perfusion map and DWMRI, the lesion on CBF map was the most closely correlated with the lesion on DWMRI (7/9). The size of perfusion defect lesion on MTT map was larger than that of lesion on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Deconvolution Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra but also hemodynamic status in perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

  1. Acute Cerebral Infarction after FK 506 Administration in a Kidney Transplantation Recipient: A Case Report

    Lim, Ji Kyung; Byun, Woo Mok; Kim, Jae Woon [Yeungnam University College of Medicine, Daegu (Korea, Republic of)

    2011-02-15

    FK506 is widely used as a potent immunosuppressive agent following organ transplantation. However, the use of FK506 is associated with a wide spectrum of neurotoxicity. FK506-induced cerebral infarctions have rarely been reported. We report here on a case of the acute cerebral infarction caused by vasospasm after FK506 administration in a kidney transplantation recipient. There were areas with increased signal intensity on the diffusion-weighted image. The areas showing increased signal intensity on the diffusion- and T2-weighted images demonstrated decreased signal intensity on the apparent diffusion coefficient mapping. MR angiography showed diffuse stenosis in both the anterior and middle cerebral arteries

  2. Comparative study of SPECT and X-CT in examining elderly patients with acute cerebral infarction

    Objective: To investigate the differences of brain 99Tcm-ECD SPECT and X-CT in examining elderly patients with acute cerebral infarction thus to guide clinical diagnosis and treatment. Methods: 100 elderly patients with acute cerebral infarction underwent 99Tcm-ECD SPECT and X-CT between 1996 and 1997. On each patient, the two procedures were performed sequentially within three days. Results: The positive rate of X-CT was 54%, while the positive rate of SPECT was 92%. The results of X-CT correlated with the results of SPECT (x2 = 0.953, P>0.1), and the positive rate of SPECT was higher (x2 = 30.422, P99Tcm-ECD SPECT is better at predictive diagnosis of elderly acute cerebral infarction and gain valuable time for in-time treating, and it is more sensitive for detecting and localizing the lesions and makes the interpretation of clinical symptoms and signs easier. X-CT is more sensitive to detect basal ganglionic lacunar infarction and to distinguish cerebral infarction from cerebral hemorrhage. SPECT and X-CT can not be used in place of each other

  3. Intra-Carotid Urokinase thrombolytic therapy in acute cerebral infarction: a preliminary study

    We conducted a pilot study to evaluate the possibility that the intraarterial thrombolytic therapy might lead to recanalization of the acutely occluded cerebral arteries and subsequent clinical improvement in patients with acute cerebral infarction. Mean time from the onset of symptoms to the start of treatment and mean dosage of thrombolytic agent, Urokinase, were 6.4 hours and 1,260,000 units, respectively. Seven of 12 cases (58%) with acute cerebral infarction demonstrated successful recanalization. Neurological evaluation at one week and three months after the onset of symptoms suggested better outcome in the cases with recanalization. Repeat CT scan at 24 hours and one week after the procedure demonstrated the evidence of hemorrhagic infarction in the infarcted territories in five cases (41%), but clinical deteriorations were observed in only 2 cases. Though statistical analysis could not be done because the limited number of cases, these results suggest that the intraarterial thrombolytic therapy had a role in the management of acute cerebral infarction

  4. Retrospective analyses of super acute cerebral infarction on plain CT scan

    Objective: To discuss the diagnostic value of plain CT scan on super acute cerebral infarction. Method 23 patients were retrospective studied, which were confirmed suffering from super acute cerebral infarction. CT scans were performed within 6 hours after onset. TCT-300SCT was used, with slice thickness and distance 10mm. Results 14 patients showed cerebral shape abnormal on CT imaging. Among them, 4 patients showed locally narrowed or disappeared sulci, 8 patients displayed cistern asymmetry of both sides, 2 patients showed lateral ventricle distortion, 5 patients showed slight lower density, 6 cases showed blurry basal nuclei structure. 7 patients showed normal on CT scans. Only 7 patients were diagnosed as super acute cerebral infarction, with the accurate ratio 30.43%. Conclusion: Brain edema and blurry basal nuclei structure are very important features for diagnosing super acute cerebral infarction on plain CT scan, but these features are easily ignored. So we should pay more attention to the CT exhibitions combined with clinical information in order to diagnose correctly and provide useful information for clinical treatment. (authors)

  5. Usefulness of proton MR spectroscopy in acute cerebral infarction: an experimental and clinical study

    To evaluate the usefulness of single-voxel localized proton MR spectroscopy (MRS) in monitoring changes in cerebral metabolites in cases of acute cerebral infarction. In 15 cats with common carotid artery occlusion and 21 patients with acute cerebral infarction T2-weighted (T2WI), diffusion-weighted (DWI), and MR spectroscopic images were obtained at various times after stroke onset. In the cat model, Lac and α-Glx levels increased as early as 30 minutes after vascular occlusion and continued to increase for a further 2.5 hours. The remaining metabolites, NAA, Cho, mI, and β,γ-Glx, showed no significant change. During clinical study, increases in Lac and β,γ-Glx, and decreases in NAA were detected three hours after stroke onset. These metabolites continued to change until 72 hours had elapsed. The remaining metabolites, Cho, mI, and α-Glx tended to be constant. MRS is capable of measuring and monitoring the metabolites involved in acute cerebral infarction. MRS may play an important role in the investigation of pathophysiology as well as in the early diagnosis of acute cerebral infarction

  6. Clinical significance of changes of plasma TNF-α and CRP levels in patients with acute cerebral infarction

    Objective: To investigate the clinical significance of the changes of serum TNF-α and CRP levels in patients with acute cerebral infarction. Methods: Serum TNF-α (with RIA) and CRP (with scatter velocity turbidimetry) levels were determined in 50 patients with acute cerebral infarction and 62 controls. Results: The serum levels of TNF-α and CRP in patients with acute cerebral infarction were significantly higher than those in controls (P <0.01). Moreover, the levels were positively correlated with the size of the infarction (P<0.05). Conclusion: Changes of serum TNF-α and CRP levels during acute stage of cerebral infarction were closely related the clinical progression of the disease process. (authors)

  7. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    Okuyama, Tohru; Sasamori, Yumiko; Takahashi, Hachisaburou; Mikami, Juniti; Ishii, Yuuko; Okada, Kinya; Shirafuji, Naoko; Kashiwakura, Takeshi [Takahashi Neurosurgical Hospital, Sapporo (Japan)

    2000-09-01

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  8. Diagnosis of acute cerebral infarction using diffusion-weighted imaging by low field (0.2 T) magnetic resonance image

    The purpose of this study is to confirm the diagnosis of acute cerebral infarction on diffusion-weighted imaging using low field (0.2 T) magnetic resonance image (MRI). Acute cerebral infarctions in 51 patients were examined on diffusion-weighted imaging using low field MRI within 48 hours after clinical symptoms. Diffusion-weighted imaging was examined using line scan method. Twenty-four cases were cortical infarction, and twenty-two cases were perforating infarction. In five cases out of 51 cases, ischemic regions were not detected as abnormal high signal intensity area on diffusion-weighted imaging. Four cases of no abnormal detection were transient ischemic attack, and the other one was a perforating infarction. The earliest detection time in cortical infarction cases was 1 hour and 20 minutes. On the other hand, the earliest detection time in perforating infarction cases was 3 hours. Detective ability for acute cerebral infarction on diffusion-weighted imaging by low field MRI was depending on both size and lesion of infarction. That is to say, either small size or brain stem infarction was hard to detect. Thin slice and vertical slice examination for the infarction may improve to diagnose in low field MRI. Our conclusion is acute cerebral infarction was able to be diagnosed on diffusion-weighted imaging by low field as well as high field MRI. (author)

  9. Determination of NSE and GST Levels Before and After Treatment in Patients with Acute Cerebral Infarction and Its Clinical Significance

    To explore the changes of NSE and GST levels before and after treatment in patient with acute cerebral infarction and its clinical significance, the plasma NSE levels and serum GST levels in 64 patients with acute cerebral infarction and in 44 health controls were determined by RIA and EIA respectively. The results showed that there was significantly difference in the levels of NSE and GST between two groups,as well as before and after treatment. The determination of NSE and GST levels might be helpful in the diagnosis of patient with acute cerebral infarction and to assess the therapeutic efficacy dynamically. (authors)

  10. Meta-analysis of defibrase in treatment of acute cerebral infarction

    2006-01-01

    Background Fibrinogen-depleting agents are promising in the treatment of cerebral ischemic disease. They were studied by many trials, and the outcomes were different because of different regimens and different doses. In this study, we assessed the efficacy and safety of defibrase on acute cerebral infarction in China.Methods A search using Chinese hospital knowledge database (CHKD) and MEDLINE database for randomized controlled trials was carried out. A CHKD (1994 June 2005) search was performed with the keyword "defibrase", then a second search for the keyword "acute cerebral infarction"; a MEDLINE search (1950 June 2005) was performed with the following keywords: [(cerebral ischemia), OR (acute cerebral infarction), OR (stroke)], AND [defibrase]. Meta-analysis was performed with RevMan software 4.2.Results Included were 14 studies comparing the efficiency and safety of defibrase with other drugs in the treatment of acute cerebral infarction. Patients' records were pooled (total 646 patients; defibrase, n=328, no defibrase n=318). Neurological deficit score (NDS) before treatment showed weighted mean differences (WMD)=0.95, 95% confidence interval (CI)= (-0.60, 2.50), P=0.23; NDS after treatment showed WMD=-2.20, 95% CI= (-4.21, -0.18), P=0.03; Barthel index at 3 months showed WMD=4.45, 95% CI= (-0.13, 9.03), P=0.06; the plasma fibrinogen level before treatment showed WMD=0.02, 95% CI= (-0.16, 0.19), P=0.86; plasma fibrinogen level after treatment showed WMD=-1.51, 95% CI= (-1.88, -1.15), P<0.00 001. Conclusions With the given dose and regimen of defibrase in China, defibrase may play a role of anticoagulation. It might inhibit the progression of stroke and prevent the recurrence of stroke.

  11. Efficacy and Safety Evaluation on Arterial Thrombolysis in Treating Acute Cerebral Infarction.

    Shen, Baozhong; Liu, Qingan; Gu, Yingli; Wang, Yan; Zhang, Zhuobo

    2015-11-01

    The objective of this study was to evaluate the efficacy and safety of intra-arterial thrombolysis in treating acute cerebral infarction and further discuss the indications of acute cerebral infarction treatment, in order to enhance the therapeutic effects of arterial thrombolysis. The data of 164 patients with acute cerebral infarction who accepted intra-arterial thrombolysis treatment by using rt-PA or reteplase between 2009 and 2014 at the Department of Neurology of our hospital, were collected, including patients' medical history, characteristics of the onset procedure, intervals between onset and intra-arterial thrombolysis, bleeding or death, and the changing process of patient's main neurologic function after the treatment. The neurological functions including muscle strength, speech, and level of consciousness were chosen for evaluation. Through a review of cerebral angiography, we collected the digital subtraction angiography (DSA) morphological changes of blood vessels before and after arterial thrombolysis to evaluate whether those blood vessels had been reperfused. Thereafter, we analyzed and statistically processed above-mentioned data. The mean time of arterial thrombolysis was 5.7 h. DSA results were as follows: 22 patients had complete internal carotid artery (ICA) occlusion; 49 patients middle cerebral artery's (MCA's) Ml or M2 segment occlusion; 6 patients anterior cerebral artery (ACA) occlusion; 58 patients reperfusion after thrombolysis, and the recanalization rate was 76 %. Based on vertebral-basilar artery (VBA) system, 18 patients had complete occlusion, 11 patients had reperfusion after thrombolysis, and the recanalization rate was 61 %. A total of 63 patients had severe stenosis, and they had significantly improved after thrombolysis. The clinical symptoms of patients were improved: 79 out of 164 patients with paralysis had partially recovered their limb muscle strength after operation, while 33 patients had completely recovered, and

  12. Use of rt-PA (Alteplase) for acute cerebral infarction

    Among those patients with cerebral infarction who were brought to our emergency department from December 2005 through June 2007, 28 satisfied the criteria for indication for alteplase, recombinant tissue plasminogen activator (rt-PA), and served as the subjects of this study. According to the treatment protocol that our group, led by neurologists, had prepared, 0.6 mg/kg of rt-PA was administered following a CT of the head region that negated the presence of a brain hemorrhage. The time that elapsed between onset and rt-PA administration was 41-167 minutes (median 95). For 24 hours after medication, the patients were placed under respiratory and circulatory care and their neurological performances were observed in an intensive care unit (ICU) or a neurological ward. On a modified ranking scale, which indicates the possibility for social rehabilitation, 9 patients (32%) were rated to be between 0 to 1. Four (14%) succumbed during this period. By formulating a treatment protocol, rapid administration of rt-PA and monitoring to prevent complications became possible. (author)

  13. MRI of acute cerebral infarcts: increased contrast enhancement with continuous infusion of gadolinium

    We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop. (orig.)

  14. Clinical significance of changes of serum Hcy and IGF-I levels after treatment in patients with acute cerebral infarction

    Objective: To investigate the clinical significance of serum Hcy and IGF-I levels in patients with acute cerebral infarction. Methods: Serum IGF-I (with RIA), Hcy (with ELISA)levels were measured in 32 patients with acute cerebral infarction both before and after treatment as well as in 35 normal controls. Results: Before treatment, the serum Hcy level was remarkably higher than that in controls (P0.05). Conclusion: The level of Hcy increased and IGF-I decreased in the patients with acute cerebral infarction which closely to the severity of acute cerebral infarction and may be taken as a sensitive biochemical indicator for predicting pathogenesis and progress of ACI. (authors)

  15. Study on the relationship between plasma ET, Hcy levels and lipid peroxidation in patients with acute cerebral infarction

    Objective: To explore the relationship between plasma ET, Hcy levels and lipid peroxidation in patients with acute cerebral infarction. Methods: Plasma ET and Hcy levels were measured with RIA in 36 patients with acute cerebral infarction and 35 controls while plasma SOD, MDA levels were measured with colorimetry. Results: Plasma ET, Hcy, MDA levels were significantly higher in patients with acute cerebral infarction than those in controls (P<0.01), while the serum levels of SOD were significantly lower (P<0.01). Plasma levels of ET and Hey were positively correlated with MDA levels (r=0.6018,0.6128,P<0.01) but SOD levels were negatively correlated with MDA levels (r=-0.4418, P<0.05). Conclusion: Lipid peroxidation was present in patients with acute cerebral infarction, with correlated changes of ET and Hcy levels. (authors)

  16. Plasma Homocysteine Levels Predict the Risk of Acute Cerebral Infarction in Patients with Carotid Artery Lesions.

    Wu, Wei; Guan, Yi; Xu, Kan; Fu, Xi-Jia; Lei, Xiao-Feng; Lei, Li-Jian; Zhang, Zhi-Qing; Cheng, Yan; Li, Yun-Qian

    2016-05-01

    This study examined the association between elevated plasma homocysteine (Hcy) levels and the risk of acute cerebral infarction in patients with carotid artery lesions. A total of 78 patients were divided into two groups, the high Hcy group (n = 38; Hcy levels >15 umol/L) and the low Hcy group (n = 40; Hcy levels ≤15 umol/L). High-resolution B-mode ultrasounds were performed to assess intima media thickness (IMT), infarcts, plaques, and stenosis in the extracranial carotid artery of these patients. All patients underwent 3 T MR scanners to evaluate cerebral artery stenosis in the intracranial cerebral artery. The plasma Hcy levels did not show any statistically significant differences when comparisons were based on gender, age, blood pressure, diabetes, hyperlipidemia, and systolic and diastolic pressures. Importantly, the incidence of carotid plaque and severe stenosis of intracranial and extracranial artery were significantly higher in the high Hcy group compared to the low Hcy group. Pearson's test indicated that plasma Hcy levels positively correlated with IMT, total number of plaques and unstable plaques. Overall, the elevated plasma Hcy levels correlated with increased frequency of carotid plaque formation, extra- and intracranial arterial stenosis, and the degree of stenosis. In conclusion, we find a significant correlation between elevated plasma Hcy levels and the increased incidence of acute cerebral infarction in patients with carotid artery lesions. PMID:26063590

  17. Development of acute stage cerebral infarction detection method in X-rays CT image using morphological filter

    Cerebrovascular disease is currently the third cause of death in Japan. Recent westernization of the diet and an increase in geriatric diseases has now made cerebral infarction the focus of much research. Prehospital thrombolysis with alteplase (rt-PA) is reported to be effective for cerebral infarction that is defined as 'ischemic stroke, the treatment for which can be started within 3 hours after the development.' However, X-ray CT imaging visualizes acute-stage cerebral infarction as a low attenuation area, making it difficult to detect. This study presents a method to detect acute-stage cerebral infarction that uses a morphological filter in the algorithm. Using an image in which the cerebral parenchyma was extracted, and assuming that chronic-stage and acute-stage infarction sites were similar regions, the threshold and the pixel number were calculated based on the tendency of the CT values. In the binary format image, candidate regions were narrowed down by repeatedly applying an open-closing filter four times, while changing the structural element to 5, 10, 20, and 40. Since the infarction region after labeling tended to exceed 200 pixels, regions below 200 pixels were removed to detect the final candidate region for acute-stage cerebral infarction. (author)

  18. Studies of cerebral blood flow, cerebral oxygen metabolism, cerebral glucose metabolism, and tissue pH in human acute cerebral infarction using positron emission tomography

    This preliminary PET study was designed to investigate physiological and biochemical changes in acute cerebral infarction by positron emission tomography (PET). PET studies were performed in six patients with acute cerebral infarction within 48 hours after onset of stroke using continuous inhalation of C15O2 for cerebral blood flow (CBF), 15O2 for cerebral metabolic rate for oxygen (CMRO2), 11CO for cerebral blood volume, the intravenous injection of 11C-dimethyloxazolidinedione for tissue pH and the intravenous injection of 18F-fluorodeoxyglucose for cerebral metabolic rate for glucose (CMRGlu). Metabolic coupling index (MCI) image was made from CBF image and CMRGlu image to investigate relation between CBF and CMRGlu. Aslo oxygen glucose index (OGI) image was made from CMRO2 image and CMRG lu image to investigate relation between CMRO2 and CMRGlu. Preliminary resul ts demonstrate that reduction of CBF, CMRO2, and CMRGlu in the affected co rtex except for reperfusion case. Increase of OER was recognized four of six cases. Patterns of MCI and OGI in the cortex which CMRO2 value is less than 65 μmol/100g/min were different from those in the cortex which CMRO2 value is more than 65. MCI of the affected cortex (CMRO22>=65). OGI of the affected cortex (CMRO22>=65). Two patients showed decrease of tissue pH and reperfusion case showed increase of tissue pH in infarcted area as compared to contralateral cortex. In addition it was suggested that threshold of CBF for tissue pH was approximately 14ml/100g/min. (J.P.N.)

  19. Adaptive partial median filter for early CT signs of acute cerebral infarction

    Purpose: Detection of early CT signs of infarct in non- enhanced CT image is mandatory in patients with acute ischemic stroke. Loss of the gray-white matter interface at the lentiform nucleus or the insular ribbon has been an important early CT sign of acute cerebral infarction, which affects decisions on thrombolytic therapy. However, its detection is difficult, since the principal early CT sign is subtle hypoattenuation. An image processing method to reduce local noise with edges preserved was developed to improve infarct detection. Rationale: An adaptive partial median filter (APMF) was selected for this application, since the APMF can markedly improve the visibility of the normal gray-white matter interface. APMF should enhance the conspicuity of gray-white matter interface changes due to hypoattenuation that accompanies cerebral infarction. Method: In a criterion referenced performance study using simulated CT images with gray-white matter interfaces, a total of 14 conventional smoothing filters were also used for comparison to validate the usefulness of the proposed APMF. The APMF indicated the highest performance among the compared methods. Then, observer performance study by receiver operator characteristic (ROC) analysis was performed with 4 radiologist observers using a database with 18 abnormal and 33 normal head CT images. The average Az values of ROC curves for all radiologists increased from 0.876 without the APMF images to 0.926 with the APMF images, and this difference was statistically significant (P = 0.04). The results from the two observer performance studies demonstrated that APMF has significant potential to improve the diagnosis of acute cerebral infarction using non-enhanced CT images. (orig.)

  20. Adaptive partial median filter for early CT signs of acute cerebral infarction

    Lee, Yongbum; Tsai, Du-Yih [Niigata University, Department of Radiological Technology, School of Health Sciences, Niigata (Japan); Takahashi, Noriyuki; Ishii, Kiyoshi [Sendai City Hospital, Department of Radiology, Sendai (Japan)

    2007-08-15

    Purpose: Detection of early CT signs of infarct in non- enhanced CT image is mandatory in patients with acute ischemic stroke. Loss of the gray-white matter interface at the lentiform nucleus or the insular ribbon has been an important early CT sign of acute cerebral infarction, which affects decisions on thrombolytic therapy. However, its detection is difficult, since the principal early CT sign is subtle hypoattenuation. An image processing method to reduce local noise with edges preserved was developed to improve infarct detection. Rationale: An adaptive partial median filter (APMF) was selected for this application, since the APMF can markedly improve the visibility of the normal gray-white matter interface. APMF should enhance the conspicuity of gray-white matter interface changes due to hypoattenuation that accompanies cerebral infarction. Method: In a criterion referenced performance study using simulated CT images with gray-white matter interfaces, a total of 14 conventional smoothing filters were also used for comparison to validate the usefulness of the proposed APMF. The APMF indicated the highest performance among the compared methods. Then, observer performance study by receiver operator characteristic (ROC) analysis was performed with 4 radiologist observers using a database with 18 abnormal and 33 normal head CT images. The average A{sub z} values of ROC curves for all radiologists increased from 0.876 without the APMF images to 0.926 with the APMF images, and this difference was statistically significant (P = 0.04). The results from the two observer performance studies demonstrated that APMF has significant potential to improve the diagnosis of acute cerebral infarction using non-enhanced CT images. (orig.)

  1. MR image features predicting hemorrhagic transformation in acute cerebral infarction: a multimodal study

    The aims of this study were to observe magnetic resonance imaging (MRI) features and the frequency of hemorrhagic transformation (HT) in patients with acute cerebral infarction and to identify the risk factors of HT. We first performed multimodal MRI (anatomical, diffusion weighted, and susceptibility weighted) scans on 87 patients with acute cerebral infarction within 24 hours after symptom onset and documented the image findings. We then performed follow-up examinations 3 days to 2 weeks after the onset or whenever the conditions of the patients worsened within 3 days. We utilized univariate statistics to identify the correlations between HT and image features and used multivariate logistical regression to correct for confounding factors to determine relevant independent image features of HT. HT was observed in 17 out of total 87 patients (19.5 %). The infarct size (p = 0.021), cerebral microbleeds (CMBs) (p = 0.004), relative apparent diffusion (rADC) (p = 0.023), and venous anomalies (p = 0.000) were significantly related with HT in the univariate statistics. Multivariate analysis demonstrated that CMBs (odd ratio (OR) = 0.082; 95 % confidence interval (CI) = 0.011-0.597; p = 0.014), rADC (OR = 0.000; 95 % CI = 0.000-0.692; p = 0.041), and venous anomalies (OR = 0.066; 95 % CI = 0.011-0.403; p = 0.003) were independent risk factors for HT. The frequency of HT is 19.5 % in this study. CMBs, rADC, and venous anomalies are independent risk factors for HT of acute cerebral infarction. (orig.)

  2. MR image features predicting hemorrhagic transformation in acute cerebral infarction: a multimodal study

    Liu, Chunming; Xu, Liang; Dong, Longchun; Liu, Zhenxing; Yang, Jun; Liu, Jun [Tianjin Union Medicine Centre, Department of Radiology, Tianjin (China); Dong, Zhengchao [Columbia University, Translational Imaging and MRI Unit, Department of Psychiatry, New York, NY (United States); New York State Psychiatric Institute, New York, NY (United States); Khursheed, Aiman [Tianjin Medical University, International Medical School, Tianjin (China)

    2015-11-15

    The aims of this study were to observe magnetic resonance imaging (MRI) features and the frequency of hemorrhagic transformation (HT) in patients with acute cerebral infarction and to identify the risk factors of HT. We first performed multimodal MRI (anatomical, diffusion weighted, and susceptibility weighted) scans on 87 patients with acute cerebral infarction within 24 hours after symptom onset and documented the image findings. We then performed follow-up examinations 3 days to 2 weeks after the onset or whenever the conditions of the patients worsened within 3 days. We utilized univariate statistics to identify the correlations between HT and image features and used multivariate logistical regression to correct for confounding factors to determine relevant independent image features of HT. HT was observed in 17 out of total 87 patients (19.5 %). The infarct size (p = 0.021), cerebral microbleeds (CMBs) (p = 0.004), relative apparent diffusion (rADC) (p = 0.023), and venous anomalies (p = 0.000) were significantly related with HT in the univariate statistics. Multivariate analysis demonstrated that CMBs (odd ratio (OR) = 0.082; 95 % confidence interval (CI) = 0.011-0.597; p = 0.014), rADC (OR = 0.000; 95 % CI = 0.000-0.692; p = 0.041), and venous anomalies (OR = 0.066; 95 % CI = 0.011-0.403; p = 0.003) were independent risk factors for HT. The frequency of HT is 19.5 % in this study. CMBs, rADC, and venous anomalies are independent risk factors for HT of acute cerebral infarction. (orig.)

  3. Study on the phenomenon of insulin resistance (IR) in patients with acute cerebral infarction

    Objective: To investigate the presence of insulin resistance (IR) in patients with cerebral infarction and the indication for insulin therapy. Methods: Fasting blood glucose (FPG) (with biochemistry), fasting serum insulin (FINS) and cortisol (with RIA) levels were measured in 50 patients with cerebral infarction and 80 controls. Insulin sensitivity index (ISI) was calculated and correlation with the score of neurologic impairment as well as the size of lesion was studied. Results: FPG, FINS and cortisol levels in the patients were significantly higher than those in the controls (P<0.001 ) while the ISI was significantly lower (P <0.001 ) than that in the controls. Levels of there parameters were significantly higher in patients with moderate-severe lesions than those in patients with only mild lesion (P<0.001, P<0.01, P<0.05 respectively). ISI was negatively correlated to the size of infarction (r=-0.313, P<0.05) and also to the score of neurologic impairment (r=-0.317, P<0.05). The mortality and morbidity in the moderate severe group were naturally higher than those in the mild group. Conclusion: Insulin resistance does exist during the acute stage of cerebral infarction. Degree of hyperinsulinaemia and severity of the resistance are related to the course and prognosis of the disease process. Insulin therapy should be considered in those patients with hyperglycemia. (authors)

  4. Analysis on risk factors of short-term poor outcome among different subtypes of acute cerebral infarction

    Objective: to investigate the risk factors of short-term poor outcome among patients suffering from acute cerebral infarction who had different subtypes of cerebral infarction. Methods: A total of 3231 acute cerebral infarction patients were included in the present study. Data on demographic characteristics, life style, risk factors, history of cardiovascular disease, admission blood pressure, and clinical outcome at discharge were collected for all participants. Poor outcome was defined as NIHSS ≥10 at discharge or death occurring during hospitalization. The association between poor outcome of cerebral infarction and risk factors was analyzed by using multiple logistic models. Results: Incidence rate of poor outcome is the highest in the patients with cerebral embolism, next in patients with cerebral thrombosis and the lowest in patients with lacunar infarction. Cerebral thrombosis was positively associated with smoking (OR: 1.228; 95% CI: 1.013∼1.637), dyslipidemia (OR: 1.264; 95% CI: 1.081∼1.478), and a history of diabetes mellitus (OR: 1.371; 95% CI: 1.075∼1.747); cerebral embolism was positively associated with a history of atrial fibrillation (OR: 3.131; 95% CI: 1.206∼8.128) and a history of rheumatic heart disease (OR: 5.601; 95% CI: 1.561∼20.091); lacunar infarction is positively associated with alcohol consumption, (OR: 1.428; 95% CI: 1.063∼1.919). Conclusion: The incidence rate of poor outcome is the highest in the patients with cerebral embolism among three subtypes of cerebral infarction, there are different risk factors of poor outcome for three subtypes of cerebral infarction. (authors)

  5. A clinical study of acute cerebral infarction with a midline shift on the CT scan

    Twenty-one cases of acute cerebral infarction with a midline shift on the CT scan were studied with respect to the development of the midline shift, the angiographic findings, the clinical pictures and the outcome of these patients. The CT findings of hemorrhagic infarction were also studied. No cases showed a midline shift on a CT scan taken within 6 hours after the onset. A midline shift was, however, noted as early as 9 hours after the onset, and it reached its peak between the 2nd and 7th day of the onset. It gradually disappeared by the end of the third week. Hemorrhagic infarction was diagnosed in 6 patients by either spinal tap or autopsy. The CT findings of these hemorrhagic infarction were divided into two types, solid hemorrhages with an unequivocal high density within the low-density area, and small, scattered hemorrhagic of almost the same density as normal brain tissue within the low-density area. In 19 of 21 patients, an round-edged occlusion and/or embolus were observed on the initial angiograms. The recanalization of the occluded vessels was proved in 10 of 14 patients by subsequent angiographic studies. Twenty of 21 patients showed a sudden development of neurological symptoms, and 15 patients had a history of various kinds of heart disease, such as atrial fibrillation, valvular heart disease and myocardial infarction. The patients had atrial fibrillation on EKG on admission. These angiographic findings and clinical pictures strongly suggest that the infarction with a midline shift on the CT scan may be caused by a cerebral embolism of cardiac origin. Eight patients died of cerebral herniation between the 2nd and 6th day of the onset. Taking these poor outcomes into consideration, surgical as well as medical decompression of the brain would seem to be most important when the CT scan shows a midline shift. (author)

  6. Semiquantitative dynamic computed tomography to predict response to anti-platelet therapy in acute cerebral infarction

    Chokyu, K.; Shimizu, K. [Department of Neurosurgery, Kochi Medical School, Kohasu (Japan); Fukumoto, M. [Department of Radiology, Kochi Medical School (Japan); Mori, T. [Department of Stroke Treatment, Shonan Kamakura General Hospital, Kanagawa (Japan); Mokudai, T.; Mori, K. [Mominoki Hospital, Kochi (Japan)

    2002-04-01

    We investigated whether dynamic computed tomography (CT) in patients with acute cerebral infarction could identify patients likely to respond to anti-platelet therapy. Seventy patients underwent semiquantitative dynamic CT within 6 h as well as cerebral angiography. All then received anti-platelet therapy with a thromboxane A2 synthetase inhibitor. Peak value (pv) and time-to-peak (tp) (time-density curves) for the Sylvian fissure were extracted from dynamic CT data and standardizing interpatient data, two indices, PV/TP index and TP index, were prepared following a standard semiquantitative manner. Both PV/TP index and TP index were effective in discriminating between 48 responders (modified Rankin scale (mRS): 0 to 2) and 22 non-responders (mRS: 3 to 5, or death: 6; both P<0.0001). High PV/TP index ({>=}0.8) was a strong indicator of favorable response. Most of these patients maintained regional cerebral blood flow (rCBF) via anterograde flow or collaterals, with a TP index {<=}1.1. Low PV/TP index ({<=}0.4) predicted non-response associated with increased TP index (>1.1) and non-compensated rCBF. Intermediate PV/TP values could not predict outcome. Dynamic CT prior to therapy can identify patients with acute cerebral infarction who are treatable with anti-platelet therapy alone. (orig.)

  7. Hyperbaric oxygen combined with drug therapy in the treatment of acute cerebral infarction clinical analysis

    Wen-Cui Lin; Kang Lin; Jing Wang; Shuai Li

    2015-01-01

    Objective:To explore the effects of hyperbaric oxygen combined with edaravone, salviae miltiorrhizae and ligustrazine and sodium ozagrel in the treatment of acute cerebral infarction clinical analysis.Methods: A total of 200 cases of acute cerebral infraction patients were randomly divided into observation group and control group. The control group was treated with edaravone, salvia miltiorrhizae and ligustrazine and sodium ozagrel; on the basis of treatment in control group, the observation group was combined with hyperbaric oxygen therapy. The neurological deficit scores were observed before and after treatment in patients of two groups, meanwhile the activities of daily living (ADL) and clinical effects were compared.Results: The total effective rate in observation group (92%) was significantly higher than control group (79%), the differences were statistically significant; the score of ADL in observation group after treatment was obviously higher than control group [(79.91±5.16)vs (61.62±5.60)], and the differences were statistically significant. The neurological deficit scores after treatment were obviously lower than the control group [(9.55±4.13)vs (15.46±4.92)], the differences were statistically significant.Conclusion: Hyperbaric oxygen combined with edaravone, salvia miltiorrhizae and ligustrazine and sodium ozagrel in the treatment of acute cerebral infarction can improve the symptoms of microcirculation and neurologic impairment, and improve the patient s quality of life.

  8. Clinical significance of the changes of serum leptin levels in patients with acute cerebral infarction

    Objective: To study the relationship between cerebral infarction and changes of serum leptin and to explore the occurrence mechanism of cerebral infarction. Methods: Serum leptin (with RIA) levels were measured in 79 patients with CT proved cerebral infarction and 56 controls. Results: The serum leptin levels in patients with cerebral infarction were significantly higher than those in the controls (t=3.99, P<0.01), with no difference between the levels in mild and severe patients. Conclusion: There are hyperleptinemia and leptin resistance in cerebral infarction patients. Leptin takes part in regulation of energy equilibrium. Increase of leptin level is a risk marker for cerebral infarction and further study on the mechanism is needed. (authors)

  9. A comparative study on administration routes of recombinant staphylokinase in canine model with acute cerebral infarction

    Objective: To evaluate the efficacy and complications in the treatment of dogs with acute cerebral infarction using recombinant staphylokinase (r-Sak) via different administration routes. Methods: The model of left internal cerebral embolism was established with interventional technique in 24 beagle adult dogs which were randomly divided into control group, intraarterial group and intravenous group. Postembolization 5 hours (or 3 hrs in intravenous group), a cerebral angiography was performed, a dosage of 10 000 u/kg r-sak was infused through left internal carotid artery or left femoral vein within 30 mins, and only 10 ml of saline was infused in control group. Angiography was repeated to observe the effects on recanalization and blood samples were collected to determine activated partial thromboplastin time, etc. at 30, 60 and 120 mins respectively after thrombolysis. The behavior of these canines was observed and all of the dogs were sacrificed after 24 hours for pathologic study. Results: 2 hour's after thrombolysis, recanalization rates of embolized cerebral vessels were 0%, 93.3% and 37.5% in control group, intraarterial group and intravenous group respectively, and the complete recanalization rates were 0%, 60% and 6.7%, respectively. There were significant differences between the two r-Sak groups and the control group (P<0.05), and the complete recanalization rate of intraarterial group was obviously higher than that of intravenous group (P<0.05). Influence on blood coagulation and fibrillolysis in two r-Sak groups showed no significant difference, and no serious complication occurred in 24 hours. Conclusion: Thrombolysis using r-Sak is an effective treatment for canine models with acute cerebral infarction, and the thrombolysis effect of intraarterial method is much more than that of intravenous method. (authors)

  10. Clinical significant of measurement of plasma Hcy and serum adiponectin levels after treatment in patients with acute cerebral infarction

    Objective: To explore the clinical significance of changes of plasma Hcy and serum adiponectin levels after treatment in patients with acute cerebral infarction. Methods: Plasma Hcy (with RIA) and serum adiponectin (with ELISA) levels were determined in 36 patients with acute cerebral infarction both before and after treatment as well as in 35 controls. Results: Before treatment, the plasma Hcy levels were significantly higher than those in controls (P<0.01), while serum adiponectin levels were significantly lower than those in controls (P<0.01), After treatment for three months, the levels, though corrected markedly, remained significantly different from those in controls (P<0.05). Plasma Hcy levels were negatively correlated with serum adiponectin levels (r =-0.4021, P<0.05). Conclusion: Plasma Hcy and serum adiponectin levels were closely related to the diseases process of acute cerebral infarction and determination of which were of great clinical importance. (authors)

  11. The study on the relationship between the level of serum CysC and atrial fibrillation in patients with acute cerebral infarction

    刘萍

    2013-01-01

    Objective To investigate the relationship between the level of serum cystatin C(CysC) and atrial fibrillation(AF) in patients with acute cerebral infarction(ACI).Methods Two hundred fifty-three patients with acute cerebral infarction were divided into ACI with AF group

  12. Correlating cognitive impairment with carotid atherosclerosis and carotid artery stenosis in patients with acute cerebral infarction

    Yamei Cai; Xiaoming Wang; Xin Liu; Liting Cao

    2008-01-01

    BACKGROUND: Studies have demonstrated that carotid atherosclerosis and carotid artery stenosis are closely associated with cognitive impairment in patients with and without clinically evident cerebrovascular disease.OBJECTIVE: To investigate the correlation between the degree of pathological changes in carotid atherosclerosis, carotid artery stenosis, and cognitive impairment in patients with acute cerebral infarction through the use of color Doppler imaging.DESIGN, TIME AND SETTING: The present concurrent, non-randomized, controlled experiment was performed at the Departments of Neurology and Ultrasound, Affiliated Hospital of North Sichuan Medical College between November 2006 and August 2007.PARTICIPANTS: Fifty-five patients with cerebral infarction, consisting of 35 males and 20 females, aged 50-82 years, were admitted to the hospital between November 2006 and August 2007 and recruited for this study, An additional 30 subjects consisting of 18 males and 12 females, aged 47-78 years, that concurrently received a health examination at the same hospital, were also included as normal controls.METHODS: Intima-media thickness (IMT), plaque shape, size, and echo intensity of all subjects were detected by color Doppler flow imaging. Assessment criteria: IMT > 1.0 mm was considered to be intimal thickening, and IMT > 1.2 mm was determined to be formed atherosclerotic plaques. In the position of the largest plaque, the degree of carotid artery stenosis was determined by the following formula:(1-cross-sectional area of residual vascular luminal area/vascular cross-sectional area) x 100%. Less than 30% exhibited mild stenosis, 30%-40% moderate stenosis, and > 50% severe stenosis.MAIN OUTCOME MEASURES: IMT and the degree of carotid artery stenosis were evaluated by color Doppler flow imaging. The Mini-Mental State Examination (MMSE), as well as the clinical memory scale,was compared between patients with cerebral infarction and normal controls.RESULTS: In the cerebral

  13. Study on the changes of plasma neuropeptides levels in patients with acute cerebral infarction and the treatment efficacy of naloxone

    Objective: To investigate the changes of plasma neuropeptides (β-EP.NT.NPY) levels in patients with acute cerebral infarction and the clinical efficacy of Naloxone. Methods: (1) The concentration of these neuropeptides were measured on the 1st, 3rd, 7th, 14th day after the onset of disease with RIA in 38 patients with acute cerebral infarction and 66 controls. (2) 38 cases of acute cerebral infarction were randomly divided into treatment groups: Naloxone and Xue shuan tong. The concentration of these neuropeptides in the two groups were compared with each other and clinical efficacy of Naloxone was observed. Results: (1) Plasma β-EP. NT and NPY levels in the patients with acute cerebral infarction were significantly higher than those in control (F=46.66, p=0.00<0.01; F=6.031, p=0.000<0.01; F=29.675, p<0.01). The levels were highest at the onset and approaching normal on the 14th day. (2) The plasma β-EP levels at 3rd and 7th days in the Naloxone group were significantly higher than those in the Xue shuan tong group (p<0.05, p<0.01 respectively). For NT and NPY levels, there were no significant differences. Clinical result of treatment was much better with Naloxone than Xue shuan tong group. Conclusion: The plasma neuropeptide levels (β-EP.NT.NPY) were closely related to the pathogenesis of acute cerebral infarction and might be very useful in the clinical treatment of the diseases. Naloxone could effectively resist β-EP and reduce hydrocephalus and improve the convalescence of acute cerebral infarction

  14. INFLUENCE OF ACUPUNCTURE ON BRAIN-TAXIS OF TETRAMETHYLPYRAZINE IN ACUTE CEREBRAL INFARCTION RATS

    崔荣秀; 陈以国; 谷雨

    2003-01-01

    Purpose: To observe the effect of acupuncture on the brain-taxis of tetrarmethylpyrazine (TMP) and toexplore into the underlying mechanisms of combined action of acupuncture and medicine in the treatment of acute cere-bral ischemia. Methods: 37 male Wistar rats were randomly divided into normal control group (n= 10), sham-operationgroup (n= 10), acute cerebral ischemia (ACI) + drug group (model group, n=8)and ACl+drug+acupuncture group(acupuncture group, n=9). Rat ACl model was established by using photochemical method. "Neiguan"(PC 6) and"Shuigou"(GV 26) were punctured and stimulated with both hand manipulation and electroacupuncture, 30 min and16hrs after ACI. TMP was given to the rats of the later 2 groups using gastric perfusion method. High pressure chro-matography (HPLC) was used to detect the target absorption level of TMP in the brain. Results: The content of TMP inthe brain in acupuncture group was significantly higher than that in model group (P<0.01), suggesting that acupunc-ture can strengthen the brain-taxis of TMP in ACl rats, and combined administration of acupuncture and Chinese drugmaybe work better for treatment of acute cerebral infarction. Conclusion: Acupuncture can strengthen the chano-taxisof TMP to the brain in ACl rats.

  15. Effect of Acupuncture on Plasmic Levels of Insulin, Glucagon and Hypercoagulability in NIDDM Complicated by Acute Cerebral Infarction

    谌剑飞; 李创鹏; 丁萍; 马雅玲

    2001-01-01

    Twenty-one cases of acute cerebral infarction secondary to NIDDM were treated with acupuncture and conventional therapy, and compared with 16 cases treated with conventional therapy alone. The results showed that acupuncture was more effective in reducing insulin and glucagon levels (P<0.001) and improving hypercoagulability (P<0.05) of blood.

  16. Combined intra-arterial thrombolysis and neuprotectant agents reduce cerebral infarction in rabbits with experimental acute cerebral ischemia

    Pei Shi

    2006-01-01

    BACKGROUND:The intra-arterial thrombolytic therapy is one of main methods for more patients to obtain bene-fits.The percentage of arterial recanalization treated with intre-arterial therapy is higher than with intra-venous therapy.next,the dose of thrombolytic medicines is lower and the therapeutic time window may be possibly longer.Related researches are focus on intra-artedal thrombolysis combining with neuprotectant agents to treat acute ischemic stroke.The results show that combination of them can further prolong the therapeutic time window.improve the percentage of arterial recanalization and reduce cerebral infarction volume.OBJECTIVE:To observe the effect of single thmmbolitic therapy combined with neuroprotectant agents in the treatment of acute ischemic stroke.DESIGN:Randomized block design.SETTING:Xinhua Hospital of Xixiang City.Henan Province.MATERIALS:Thirty-six adult male white rabbits.weighing 1.5-2.0 kg.dean grade.were provided by Expedmental Animal Center of Xinxiang Medical College.All rabbits were randomly divided into three groups:intra-arterial thrombolysis control group.corenalin control group and combination group with 12 in each group.Urekinase was provided by Beijing Saisheng Pharmaceutical Co.,Ltd.(batch number:020923);corenalin by Sanjing Pharmaceutical Co.,Ltd.of Harbin Pharmacautical Group(batch number:021106):nimodipine by Shandong Xihua Pharmaceutical Co.,Ltd.(batch number:020611):contrast medium IOPAMlR0300 by Bracco s.P.a.Milano italian (batch number:0584);2,3,5-triphenyltetrazolium chloride(TTC)by Beijing Mashi Fine ChemicaL Product Co.,Ltd.(batch number:020926).METHODS: The experiment was camed out in the Department of Intervention. Second People's Hospital of Xinxiang from September 2002 to May 2003.①According to techniques of Benes et al and Zhu et al,animal models with acute ischemia were established.Two hours later.the therapy began.Intra-artedal thrombolysis control group:5 000 U/kg urokinase was dripped in Ieft common

  17. Early magnetic resonance detection of cortical necrosis and acute network injury associated with neonatal and infantile cerebral infarction

    Okabe, Tetsuhiko; Aida, Noriko; Nozawa, Kumiko [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Niwa, Tetsu [Kanagawa Children' s Medical Center, Department of Radiology, Yokohama (Japan); Tokai University School of Medicine, Department of Radiology, Isehara (Japan); Shibasaki, Jun [Kanagawa Children' s Medical Center, Department of Neonatology, Yokohama (Japan); Osaka, Hitoshi [Kanagawa Children' s Medical Center, Department of Neurology, Yokohama (Japan)

    2014-05-15

    Knowledge of MRI findings in pediatric cerebral infarction is limited. To determine whether cortical necrosis and network injury appear in the acute phase in post-stroke children and to identify anatomical location of acute network injury and the ages at which these phenomena are seen. Images from 12 children (age range: 0-9 years; neonates [<1 month], n=5; infants [1 month-12 months], n=3; others [≥1 year], n=4) with acute middle cerebral artery (MCA) cortical infarction were retrospectively analyzed. Cortical necrosis was defined as hyperintense cortical lesions on T1-weighted imaging that lacked evidence of hemorrhage. Acute network injury was defined as hyperintense lesions on diffusion-weighted imaging that were not in the MCA territory and had fiber connections with the affected cerebral cortex. MRI was performed within the first week after disease onset. Cortical necrosis was only found in three neonates. Acute network injury was seen in the corticospinal tract (CST), thalamus and corpus callosum. Acute network injury along the CST was found in five neonates and one 7-month-old infant. Acute network injury was evident in the thalamus of four neonates and two infants (ages 4 and 7 months) and in the corpus callosum of five neonates and two infants (ages 4 and 7 months). The entire thalamus was involved in three children when infarction of MCA was complete. In acute MCA cortical infarction, MRI findings indicating cortical necrosis or acute network injury was frequently found in neonates and early infants. Response to injury in a developing brain may be faster than that in a mature one. (orig.)

  18. Interventional model establishment and computed tomography perfusion imaging for early diagnosis of acute cerebral infarction in dogs

    Objective: To establish interventionally a new canine model of focal cerebral infarction suitable to the study of imaging diagnosis and thrombolytic therapy, and to evaluate the application of computed tomography perfusion (CTP) in super acute ischemic cerebrovascular disease. Methods: Ten beagle adult dogs with self white thrombi of venous blood, injected into the left internal carotid arteries through 4F headhunter catheter selectively were created under fluoroscopic guidance. The cerebral angiography was performed before and after the embolization and the patency of the occluded cerebral arteries was observed with angiography at 1, 2 and 5 hours after the procedure. The CTP was performed at 2 hours after embolization. These dogs were sacrificed and their cerebra were taken out for pathologic study at 24th hour. Results: The occlusions of middle cerebral artery were shown angiographically in all 10 dogs with additional other cerebral arteries occlusion in 4. All occluded arteries were not recanalized at 2 hours after embolization, but the occluded arteries of 2 canines were partly recanalized at 5 hours. The regional cerebral blood flow (rCBF) was decreased to 48.3% ± 13.2% (33.7%-69.2%) in CTP of 9 canines showing no significant difference between digital subtraction angiography (DSA) and CTP (P>0.05). All dogs were survived at 24 hours without any severe complications. The cerebral infarction was found in deep part of cerebrum of all dogs. Conclusions: The establishment of acute cerebral infarction model in dogs with interventional technique is simple, micro invasive and reliable, for investigating CTP as a fast, accurate and no invasive method in evaluating the canine super acute ischemic cerebrovascular disease. (authors)

  19. Mobilization of CD133+ progenitor cells in patients with acute cerebral infarction.

    Dominik Sepp

    Full Text Available Progenitor cells (PCs contribute to the endogenous repair mechanism after ischemic events. Interleukin-8 (IL-8 as part of the acute inflammatory reaction may enhance PC mobilization. Also, statins are supposed to alter number and function of circulating PCs. We aimed to investigate PC mobilization after acute ischemic stroke as well as its association with inflammatory markers and statin therapy. Sixty-five patients with ischemic stroke were enrolled in the study. The number of CD133+ PCs was analyzed by flow cytometry. Blood samples were drawn within 24 hours after symptom onset and after 5 days. The number of CD133+ PCs increased significantly within 5 days (p<0.001. We found no correlation between CD133+ PCs and the serum levels of IL-8, IL-6, or C-reactive protein (CRP. Multivariate analysis revealed that preexisting statin therapy correlated independently with the increase of CD133+ PCs (p=0.001. This study showed a mobilization of CD133+ PCs in patients with acute cerebral infarction within 5 days after symptom onset. The early systemic inflammatory response did not seem to be a decisive factor in the mobilization of PCs. Preexisting statin therapy was associated with the increase in CD133+ PCs, suggesting a potentially beneficial effect of statin therapy in patients with stroke.

  20. Evaluation of corticospinal tract injury with three-dimensional diffusion tensor tract in patients with acute cerebral infarction

    Hui Xiao; Ziqian Chen; Biyun Zhang; Ping Ni

    2006-01-01

    BACKGROUND: Three-dimensional diffusion tensor tract (DTT) is the newest imaging to describe the structure of white matter fiber in three-dimensions, it has great significance in dividing the concrete anatomic site of gray and white matter lesions, displaying the correlation with fibrous band and judging clinical prognosis, which is incomparable by other imagings.OBJECTTVE: To observe the conditions of corticospinal tract (CST) in acute cerebral ischemic stroke patients,and analyze the relationship between motor function and the severity of CST injury.DESIGN: A case-control observation.SETTTNG: Department of Medical Imaging, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA.PARTTCTPANTS: Fifteen patients with acute cerebral infarction were selected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from February to December in 2005. They all suffered from acute attack and motor disorder of hemiplegic limbs to different extent, and were conformed by CT or MRI.There were 9 males and 6 females, aging 16-87 years old, the median age was 51.7 years, and all were right handed. Fifteen right-handed normal subjects, who were matched by age and sex with the patients in the cerebral infarction group, were selected from the relatives of patients and physicians of the Imaging Department as the control group. All the subjects were informed and agreed with the study.METHODS: The patients with acute cerebral infarction and subjects in the control group received MR diffusion tensor imaging (DTI) with GE 1.5 T nuclear magnetic resonance system, fiber tracking with the software of dTV- Ⅱ. Fractional anisotropy (FA) maps and three-dimensional tractography of bilateral CST of all patients were created. Displacement, continuity and destroy of fibrous bands were observed. At the same time, muscle strength of ipsilateral hand of patients with cerebral infarction was measured with Brunnstrom standard. The correlation between the severity

  1. Changes of biochemical indexes in patients with acute cerebral infarction after treatment with simvastatin

    Cheng Yang

    2006-01-01

    BACKGROUND: At present, it is believed that the important causes of cerebral infarction are the disorders of lipid metabolism and endothelial function, and the outcomes of clinical treatment can be improved by regulating serum lipids and antiinflammation, etc.OBJECTIVE: To observe the effect of simvastatin, inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase, on the levels of serum lipids, serum enzymic indexes and inflammatory metabolic indexes in patients with cerebral infarction.DESIGN : A comparative observation.SETTING: Department of Geriatrics, Longquanshan Hospital of Liuzhou City.PARTICIPANTS: Forty-eight patients with acute cerebral infarction wera selected from the Department of Geriatrics of Longquanshan Hospital of Liuzhou from March 2004 to February 2006, including 24 males and 24females, the mean age was (54±12) years, average disease course was (10.0±4.5) days. They were all accorded with the diagnostic standard for cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1999, and cerebral hemorrhage was excluded by cranial CT scanning. The 48patients were randomly divided into control group (n =24) and traatment group (n =24). Informed consents were obtained from all the participants.METHODS: ① All the patients wera treated according to the symptoms, besides those in the traatment group were given simvastatin (Harbin Pharm. Group Sanjing Pharmaceutical Shareholding, Co.,Ltd., No. H20010454;Batch number: 20040218; 5 mg/tablet). The initial dosage was 10 mg per day for 4 weeks, and then increased to 30 mg per day for another 4 weeks. ② Before treatment and within 1 week after treatment, the total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), craatine kinase and C raactive protein in serum were determined with Beckman-cx7 automatic biochemical analytical apparatus in both groups. ③ The

  2. Combined intra-arterial thrombolysis and neuprotectant agents reduce cerebral infarction in rabbits with experimental acute cerebral ischemia

    Pei Shi

    2006-01-01

    BACKGROUND:The intra-arterial thrombolytic therapy is one of main methods for more patients to obtain bene-fits.The percentage of arterial recanalization treated with intre-arterial therapy is higher than with intra-venous therapy.next,the dose of thrombolytic medicines is lower and the therapeutic time window may be possibly longer.Related researches are focus on intra-artedal thrombolysis combining with neuprotectant agents to treat acute ischemic stroke.The results show that combination of them can further prolong the therapeutic time window.improve the percentage of arterial recanalization and reduce cerebral infarction volume.OBJECTIVE:To observe the effect of single thmmbolitic therapy combined with neuroprotectant agents in the treatment of acute ischemic stroke.DESIGN:Randomized block design.SETTING:Xinhua Hospital of Xixiang City.Henan Province.MATERIALS:Thirty-six adult male white rabbits.weighing 1.5-2.0 kg.dean grade.were provided by Expedmental Animal Center of Xinxiang Medical College.All rabbits were randomly divided into three groups:intra-arterial thrombolysis control group.corenalin control group and combination group with 12 in each group.Urekinase was provided by Beijing Saisheng Pharmaceutical Co.,Ltd.(batch number:020923);corenalin by Sanjing Pharmaceutical Co.,Ltd.of Harbin Pharmacautical Group(batch number:021106):nimodipine by Shandong Xihua Pharmaceutical Co.,Ltd.(batch number:020611):contrast medium IOPAMlR0300 by Bracco s.P.a.Milano italian (batch number:0584);2,3,5-triphenyltetrazolium chloride(TTC)by Beijing Mashi Fine ChemicaL Product Co.,Ltd.(batch number:020926).METHODS: The experiment was camed out in the Department of Intervention. Second People's Hospital of Xinxiang from September 2002 to May 2003.①According to techniques of Benes et al and Zhu et al,animal models with acute ischemia were established.Two hours later.the therapy began.Intra-artedal thrombolysis control group:5 000 U/kg urokinase was dripped in Ieft common

  3. Effect of long-term low dose of aspirin on severity of disease following onset of acute cerebral infarction

    Jun Xu; Lili Cao; Xiaomei Deng; Enji Han

    2006-01-01

    BACKGROUND: Aspirin can decrease the incidence risk of high-risk crowdgroup of cerebral infarction, but there are still controversy if it might decrease the degree of disease in degree of patients with acute cerebral infarction.OBJECTIVE: To observe the effect of lower dose of aspirin during taking for a long time on disease degree of disease following onset of acute cerebral infarction.DESIGN: Grouping according to the admission time and 1:1 paired observation.SETTING: Department of Neurology, Qilu Hospital of Shandong University.PARTICIPANTS: The participants in present study were 321 patients with acute cerebral infarction who received treatments in the Department of Neurology, Qilu Hospital of Shandong University from January 1999 to June 2000. There were 190 male and 131 female ,with mean (65±11 )years of age. Inclusive criteria: ① A focal neurological disturbance occurred suddenly and had lasted for more than 24 hours, patients were admitted within 3 days after onset of disease; ② A computed tomography of the brain was performed and excluded hemorrhage in all patients; ③ The patients were proved internal carotid occlusions by clinical features and image findings; ④ The functions of limbs were normal (before the first stroke) or almost normal (before the second stroke). Exclusive criteria: ①The patients who had have cardiogenic cerebral embolism; ②The patients who had taken warfarin orally and other platelet agglutination drugs.METHODS: ①All the patients were divided into 2 groups according to whether they had taken aspirin before: aspirin-treated group (n=110) and blank control group (n=211). There were 70 male and 40 female in aspirin-treated group, with average(65±10) years of age.All patients had taken 50-100 mg/d aspirin for 6 months to 10 years before onset. There were 120 male and 91 female in blank control group, with average (65±13)years of age. Patients received a clinical scoring within 3 days and similar therapeutic measures (such

  4. The therapeutic effect and prognosis of acute cerebral infarction patients with atrial fibrillation treated by intravenous thrombolysis with recombinant tissue plasminogen activator

    尤寿江

    2013-01-01

    Objective To investigate the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in acute cerebral infarct patients with atrial fibrillation (AF) and the predicting factors of poor prognosis.Methods Totally 162 patients with acute cerebral infarct were treated with rt-PA within 4.5hours from the onset.According to past history and the electrocardiogram,the patients was classified into AF

  5. Hyperbaric oxygen therapy for cerebral blood flow and electroencephalogram in patients with acute cerebral infarction Choice for therapeutic occasion

    Lei Chen; Fei Li; Dexiang Gu

    2007-01-01

    BACKGROUND: Hyperbaric oxygen (HBO) therapy increases blood oxygen content, changes cerebral blood flow (CBF) and cerebral metabolism. Its therapeutic effects on cerebrovascular disease have been fully confirmed, but the occasion for HBO therapy is still unclear.OBJECTIVE: To observe the therapeutic effects of HBO therapy at different time on CBF and electroencephalogram (EEG) in patients with acute cerebral infarction (CI).DESIGN: Randomized controlled trial.SETTING: Department of Neurology, Shidong Hospital, Yangpu District of Shanghai.PARTICIPANTS: Ninety-six inpatients with acute CI, admitted to Department of Neurology, Shidong Hospital, Yangpu District of Shanghai from January 2001 to December 2006, were involved in this experiment. The involved participants met the diagnosis criteria of acute CI and confirmed by skull CT or MRI. They all were patients with moderate CI (16- 30 points) according to neurologic deficit score formulated by Chinese Medical Association. Informed consents of detected items and therapeutic regimen were obtained from all the involved participants. They were randomized into two groups with 48 in each:early-stage treatment group and advanced-stage treatment group. Among the 48 patients in the early-stage treatment group, 21 male and 27 female, aged 53 -68 years, 22 patients were found with basal ganglia infarction, 10 with brain lobe infarction, 16 with multiple infarction, 27 accompanied with hypertension and 2 accompanied with diabetes mellitus. Among the 48 patients in the advanced-stage treatment group, 23 male and 25 female, aged 52 - 71 years, 25 patients were found with basal ganglia infarction, 10 with brain lobe infarction, 12 with multiple infarction, 1 with brain stem infarction, 28 accompanied with hypertension and 1 accompanied with diabetes mellitus.METHODS: After admission, patients of two groups received routine drug treatment. ① Patients in the early-stage treatment group and advanced-stage treatment group began to

  6. Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis

    Lian Zuo; Ting Wan; Xiahong Xu; Feifeng Liu; Changsong Li; Ying Li; Yue Zhang; Jing Zhang; Huan Bao; Gang Li

    2016-01-01

    We examined the relationship between an early spontaneous type V blood pressure fluctuation and the post-thrombolysis prognosis of patients with acute cerebral infarction. Patients were admitted consecutively. All patients were categorized into the type V blood pressure fluctuation group or non-type V blood pressure group. Their blood pressure was monitored before thrombolysis and until 6 h after thrombolysis. Baseline data and clinical outcomes were compared. Of 170 patients, 43 (25.2%) had ...

  7. Clinical evaluation of the diagnosis of neuronal reversibility with acute cerebral infarction using ADC by diffusion weighted echo planar imaging

    Okada, Toshiko; Harada, Masafumi; Hisaoka, Sonoka; Nishitani, Hiromu; Uno, Masaaki [Tokushima Univ. (Japan). School of Medicine

    2000-06-01

    The possibility of diagnosing neuronal reversibility with acute cerebral infarction was studied using ADC measured by diffusion weighted imaging (DWI). The subjects were eleven patients who underwent DWI within 24 hours of onset. The area of abnormal signal on DWI during the acute stage was visually compared with that on T2-WI in the subacute phase. ADC was calculated in the two different abnormal areas on DWI, which were differentiated by the presence or absence of abnormality on T2-WI in the subacute phase. The abnormal signals of three cases showed an obviously narrowed area on DWI in the acute phase compared with the abnormality on T2-WI in the sub-acute phase. ADCs of the ischemic areas in DWI abnormalities that showed no abnormality on subacute T2-WI were slightly higher than those of the infarct areas with remaining abnormal signals on T2-WI. However, no statistically significant difference was found between these two regions, because there were large variations within each pixel. We considered that the diagnosis of neuronal reversibility in acute cerebral infarction was difficult using ADC values only and that other parameters such as perfusion or blood volume will be necessary to improve diagnostic quality prior to determining therapy. (author)

  8. Application of DWI and DTI in diagnosis of cerebral infarction

    Objective: To analyze and evaluate the applications of diffusion tensor imaging(DTI) and diffusion weighted imaging (DWI) in cerebral infarction. Methods: 84 cases with different phases cerebral infarction (6 cases in super-acute, 30 cases in acute, 26 cases in sub-acute and 22 cases in chronic phase) were performed by routine MRI, DWI and DTI scan, apparent diffusion coefficient (ADC), fractional anisotropy (FA) and the signal changes of DWI of the leision and the conlateral side were calculated and compared; The relationships among DWI, FA and ADC in different phases of cerebral infarction were analyzed. Results: The leisions of super-acute and acute cerebral infarction showed obviously high signal on DWI images, and low signal in chronic cerebral infarction. The mean relative ADC (rADC) values of sub-acute and chronic cerebral infarction were higher than those of super-acute and acute cerebral infarction (P<0.05). The FA values in 45 cases with different phases cerebral infarction (4 cases in super-acute, 16 cases in acute, 14 cases in sub-acute and 11 cases in chronic phase) were all lower than those in conlateral regions (P<0.05). Conclusion: DWI and DTI can detect superacute and acute lesions, the combination of DWI and conventional MRI can differentiate the phases of cerebral infarction. (authors)

  9. Clinical significance of measurement serum Hcy, ACA and APN levels after treatment in patients with acute cerebral infarction

    Objective: To explore the clinical significance of changes of serum Hcy, ACA and APN levels after treatment in patients with acute cerebral infarction. Methods: Serum Hcy (with RIA), serum ACA, APN (with ELISA) levels were determined in 32 patients with acute cerebral infarction both before and after treatment as well as in 35 normal controls. Result: Before treatment the serum Hcy, ACA levels were significantly higher than those in controls (P<0.01), while the serum APN levels were significantly lower than those in controls (P<0.01), after treatment for 3 months, the levels remained still different from those in controls (P<0.05). Serum Hcy levels were positively correlated with serum ACA levels (r=0.6138, P<0.01), while the serum Hcy levels were negatively correlated with serum APN levels (r=-0.4218, P<0.05). Conclusion: serum Hcy, ACA and APN levels were closely related to the diseases process of acute cerebral infarction and determination of which were of great clinical importance. (authors)

  10. Correlating plasma endothelin-1 and beta-endorphin levels to nine risk factors of acute cerebral infarction

    Daoyou Zhou; Jun Liu; Yingrong Lao; Yigang Xing; Yan Huang

    2008-01-01

    BACKGROUND:Several studies have confirmed that endothelin and endorphin are involved in the occurrence of cerebral vasospasm. However, the correlation of these factors to acute cerebral infarction-related risk factors needs to be confirmed.OBJECTIVE:To detect endothelin-1(ET-1)and beta-endorphin(β-EP)levels in plasma of patients with acute cerebral infarction,and to analyze the correlations of these factors to smoking,alcohol abuse, hypertension,diabetes mellitus,diseased region,diseased degree,gender,and other factors related to acute cerebral infarction. DESIGN:A case-control observation. SETTING:First Department of Neurology,Guangdong Hospital of Traditional Chinese Medicine; Department of Neurology,Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS:Sixty-nine inpatients with acute cerebral infarction were admitted to the Department of Neurology,Second Affiliated Hospital of Sun Yat-sen University(March 2003-January 2004)and First Department of Neurology,Guangdong Hospital of Traditional Chinese Medicine(March - July 2004)and recruited for this study.All 69 inpatients corresponded to the diagnosis criteria of acute cerebral infarction,formulated in the National Working Conference of Cerebrovascular Disease in 1998,and were confirmed as acute cerebral infarction by CT/MRI.The patient group consisted of 35 males [(64±12)years old] and 34 females[(67±13 )years old].Among them,9 patients were smokers,7 were alcohol users,48 had a history of hypertension,and 16 had a history of diabetes mellitus.CT/MRI examinations revealed that 35 patients presented with left focus sites,11 with right ones and 23 with bilateral ones.Following attack,24 patients had Barthel Index Scale grading<40 points,21 patients 40-60 points,and 24 patients>60 points.An additional 59 healthy individuals,who received health examinations simultaneously,were included as controls.Among the control subjects,there were 37 males [(62±10)years old] and 22 females [(65±11) years old

  11. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  12. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy

  13. Effect of Herbal Prescriptions in Accordance with Pattern Identification in Acute Cerebral Infarction Patients: Based on Fire-Heat Pattern

    Jung, WooSang; Park, JungMi; Moon, SangKwan; Hyun, Sangho

    2015-01-01

    Objectives. This study was conducted to verify the necessity of corresponding prescription to the diagnosed pattern in acute cerebral infarction patients. Methods. We studied cerebral infarction patients hospitalized within 30 days after the ictus. Forty-four clinical indicators, Motricity Index (MI) score, Scandinavian Stroke Scale (SSS) score, and herbal prescriptions were checked twice, two weeks apart. The probability of each pattern was calculated based on the clinical indicators. Changes in MI score, SSS score, and the probability of fire-heat pattern were compared between the pattern-prescription correspondence group and the noncorrespondence group. Results. Increments of MI score and SSS score in the correspondence group were significantly greater than those of the noncorrespondence group (p = 0.003, p = 0.001) while the baseline score of the two groups showed no significant difference. Probability of fire-heat pattern decreased significantly in the correspondence group (p = 0.013) while the noncorrespondence group showed no significant difference after the treatment. Conclusion. Acute cerebral infarction patients who are diagnosed as fire-heat pattern showed better improvement in dysfunctions caused by the disease when they took the pattern corresponding prescriptions. This study provides evidence for the necessity and usefulness of pattern identification in Traditional Korean Medicine. PMID:26523149

  14. EFFECT OF LEFT VENTRICULAR SYSTOLIC DYSFUNCTION ON CEREBRAL HEMODYNAMICS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION (THE RESULTS OF OBSERVATIONAL STUDIES

    V. E. Kulikov

    2015-12-01

    Full Text Available Aim. To study the effect of left ventricular (LV systolic dysfunction on cerebral hemodynamic in patients with ST segment elevation myocardial infarction (STEMI during acute period. Material and methods. Cerebral hemodynamics ultrasound assessment was performed in the extra-and intracranial vessels in 118 patients with STEMI. Results. Significant changes in cerebral hemodynamics were found in LV systolic dysfunction with ejection fraction (LVEF ≤40% due to hemispheric blood flow asymmetry in the middle cerebral artery (MCA as large as 45.1±6.7% with correlation coefficient r=-0.87. Compensation of cerebral blood flow was manifested in vasoconstriction or vasodilation (resistive index 0.63-0.76 and 0.49-0.43 c.u., respectively. Conclusion. A strong relationship between LV systolic dysfunction and cerebral hemodynamic was found in patients with STEMI. It was manifested in significant contralateral hemispheric blood flow asymmetry in MCA in patients with LVEF ≤40%. Reduction in cerebral blood flow velocity activated autoregulation mechanism in the form of vasoconstriction or vasodilation.

  15. Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage

    We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/μL and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia

  16. Hypereosinophilia with Multiple Thromboembolic Cerebral Infarcts and Focal Intracerebral Hemorrhage

    Lee, Eun Ju; Lee, Young Jun; Lee, Seung Ro; Park, Dong Woo; Kim, Hyun Young [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2009-10-15

    We report a case of hypereosinophilia causing multiple areas of cerebral infarcts. A 52-year-old Korean man presented with dysarthria and weakness in both arms. A brain MRI revealed multiple acute infarcts in the distal border zone with focal intracerebral hemorrhage, whereas a cerebral angiogram was not remarkable. The eosinophil count was 5,500/{mu}L and was accompanied by elevated cardiac enzyme levels. The pattern of cerebral infarcts and laboratory results suggest a thromboembolic infarction associated with hypereosinophilia.

  17. Dose-effective investigation of intraarterial r-Sak in canine model with acute cerebral infarctions

    Objective: To compare the effect and complications of intraarterial thrombolysis with different doses of recombinant-staphylokinase (r-Sak) in canine model with acute cerebral infarction, and then to find out the most properly appropriate effective dose. Methods: The model with left cerebral embolism was established with interventional technique in 24 beagle adult dogs. They were randomly divided into 4 groups including control group(saline, 10 ml), group of low dose(r-Sak, 5 000 u/kg), middle dose(r-Sak, 10 000 u/kg) and high dose(r-Sak, 20 000 u/kg). Angiography and intraarterial thrombolysis were performed within 30 minutes after the embolization. Microcatheter was superselectively inserted into left carotid artery. Five hour's later with a repeated angiography at half, 1 and 2 hours after thrombolysis to observe the recanalization. Blood samples were collected at a series of time pre-and post-thrombolysis to test the plasma levels of PT, APTT and D-dimer. These canines were sacrificed, and their cerebri were taken out for pathologic study by the end of 24 hours. Results: The rates of efficacy within 2 hours after thrombolysis were 10.0% (1/10) in control group, 40.0% (4/10) in low dose group, 90.9% (10/11) in middle dose group and 100% (9/9) in high dose group. The rates of complete recanalization were 0, 10% (1/10), 36.4% (4/11) and 66.7% (6/9), correspondingly and respectively. There were statistically obvious differences between the 3 groups (P0.05). Death occurred in 1 canine(high dose group) within 24 hours after thrombolysis with hemorrhagic lesion in parietal lobe of brain. No other severe complications ocurred. Conclusions: (1) Intraarterial thrombolysis with r-Sak within 5 hours after onset of thrombosis is effective and feasible. Intraarterial r-Sak shows strong thrombolytic effect for white thrombus including a few platelets. There is relative high rate of recanalization with no less than 10 000U/kg of r-Sak but accompanied with high risk of

  18. Clinical studies on cerebral infarction

    Hemorrhagic infarction (HI) is termed as the infarction in which a large part of the necrotic tissue is stippled with small hemorrhage. The pathogenetic mechanism of this disease still remains controversial. Cerebral infarction has long been divided into two subtypes-thrombosis and embolism-according to the pathogenetic mechanisms. Clinical studies were carried out in 31 cases of HI with cerebral thrombosis. CT findings of these cases were classified into five groups according to both size of low density area which indicates regions of infarction and distribution of arterial supply. The low density area of Type I-Type III were observed in the area of the middle cerebral artery. That of Type IV was observed in the area of the internal capsule and basal ganglia. That of Type V was observed in the area of the posterior cerebral artery. CT reveals two patterns of HI -pattern A and pattern B-. The CT finding of pattern A is appearance of high density area in the low density area. The CT finding of pattern B is appearance of iso density area in the low density area. rCBF was measured by 133Xe inhalation technique in 21 patients with CT type I, II and III. Thereafter, with regard to the various findings in CT, the clinical findings and CBF findings, a comparative study was carried out on these ten groups. From the results of present studies, it is concluded that sequential changes of CBF in cases with pattern A are different from those with pattern B, and that CBF measurement does not permit an estimation of a patient's chance for functionary recovery after a stroke in acute and subacute stage but permits estimation of functional outcome in chronic stage. (J.P.N.)

  19. The Incidence and Risk Factors of Associated Acute Myocardial Infarction (AMI) in Acute Cerebral Ischemic (ACI) Events in the United States

    Ali Seifi; Kevin Carr; Mitchell Maltenfort; Michael Moussouttas; Lee Birnbaum; Augusto Parra; Owoicho Adogwa; Rodney Bell; Fred Rincon

    2014-01-01

    OBJECTIVES: To determine the association between myocardial infarction (AMI) and clinical outcome in patients with primary admissions diagnosis of acute cerebral ischemia (ACI) in the US. METHODS: Data from Nationwide Inpatient Sample (NIS) was queried from 2002-2011 for inpatient admissions of patients with a primary diagnosis of ACI with and without AMI using International Classification of Diseases, Ninth Revision, Clinical Modification coding (ICD-9). A multivariate stepwise regression an...

  20. An evaluation of MR diffusion imaging in the diagnosis of cerebral infarction

    Objective: To evaluate MR diffusion-weighted imaging (DWI) in the diagnosis of cerebral infarction. Methods: Thirty patients with clinically-diagnosed acute (6 hyper-acute and 24 acute) cerebral infarction scanned with both conventional and DW MRI. Results: DWI had the 100% sensitivity for hyper-acute and acute cerebral infarction. Hyper-acute and acute cerebral infarctions all showed hyper intensity on DWI. All 6 hyper-acute cerebral infarctions were only revealed on DWI but silent on conventional MRI. Conclusion: DWI is a useful MR technique, which is superior to conventional MR sequences in revealing the hyper-acute, acute cerebral infarct. DWI has a higher sensitivity for acute, especially hyper-acute cerebral infarction than conventional MRI. (authors)

  1. The Application of Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging in the Diagnosis and Therapy of Acute Cerebral Infarction

    Jianping Dai

    2006-10-01

    Full Text Available Diffusion- and perfusion-weighted magnetic resonance imaging (DWI and PWI was applied for stroke diagnose in 120 acute (<48 h ischemic stroke patients. At hyperacute (<6 h stage, it is difficult to find out the infarction zone in conventional T1 or T2 image, but it is easy in DWI, apparent diffusion coefficient (ADC map; when at 3–6-hour stage it is also easy in PWI, cerebral blood flow (CBF map, cerebral blood volume (CBV map, and mean transit time (MTT map; at acute (6–48 h stage, DWI or PWI is more sensitive than conventional T1 or T2 image too. Combining DWI with ADC, acute and chronic infarction can be distinguished. Besides, penumbra which should be developed in meaning was used as an indication or to evaluate the therapeutic efficacy. There were two cases (<1.5 h that broke the model of penumbra because abnormity was found in DWI but not that in PWI, finally they recovered without any sequela.

  2. Automatic Detection and Quantification of Acute Cerebral Infarct by Fuzzy Clustering and Histographic Characterization on Diffusion Weighted MR Imaging and Apparent Diffusion Coefficient Map

    Jang-Zern Tsai

    2014-01-01

    Full Text Available Determination of the volumes of acute cerebral infarct in the magnetic resonance imaging harbors prognostic values. However, semiautomatic method of segmentation is time-consuming and with high interrater variability. Using diffusion weighted imaging and apparent diffusion coefficient map from patients with acute infarction in 10 days, we aimed to develop a fully automatic algorithm to measure infarct volume. It includes an unsupervised classification with fuzzy C-means clustering determination of the histographic distribution, defining self-adjusted intensity thresholds. The proposed method attained high agreement with the semiautomatic method, with similarity index 89.9 ± 6.5%, in detecting cerebral infarct lesions from 22 acute stroke patients. We demonstrated the accuracy of the proposed computer-assisted prompt segmentation method, which appeared promising to replace the laborious, time-consuming, and operator-dependent semiautomatic segmentation.

  3. 高压氧对急性脑梗死临床应用分析%CLINICAL APPLICATION OF HYPERBARIC OXYGENATION TO ACUTE CEREBRAL INFARCTION

    邵伟波

    2002-01-01

    Objective:To determine the effect of hyperbaric oxygenation(HBO) on treating acute cerebral infarction(ACI). Methods: We randomly divided 60 patients with acute cerebral infarction into the treatment group and the control group. Hyperbaric oxygenation treatment was applied in the treatment group as routine drug therapy was used. The neurological function, living ability, clinical therapeutic effectiveness and hemorrheology changes of pa tients in the two groups before and after treatment were observed and evaluated. Results: The indexes of treatment were obviously improved one month after treatment (P < 0.05 ). Clinical effective rate was 93.3 % in this group,which was obviously higher than that of the control group(P < 0.05). Conclusion: Hyperbaric oxygenation can accelerate the recovery of neurological function of patients with acute cerebral infarction.

  4. Clinical significance of measurement of changes of plasma NPY, CGRP and serum IGF-I levels in patients with acute cerebral infarction

    Objective: To investigate the clinical significance of changes of plasma NPY, CGRP and serum IGF-I levels in patients with acute cerebral infarction. Methods: Plasma NPY, CGRP and serum IGF-I levels were determined with RIA in 32 patients with acute cerebral infarction both before and after treatment and 30 controls. Results: Before treatment plasma NPY levels were significantly higher (P<0.01) than those in the controls, while plasma CGRP and serum IGF-I levels were lower than those in controls (P<0.01). After treatment, plasma NPY levels decreased significantly (vs before treatment P<0.05), and plasma CGRP and serum IGF-I levels increased (P<0.05). Conclusion: Changes of plasma NPY, CGRP and serum IGF-I levels were closely related to the disease process in patients with acute cerebral infarction, determination of which was of important clinical values. (authors)

  5. Clinical significance of changes of plasma ET-1 and serum NSE, NPY levels both before and after treatment in patients with acute cerebral infarction

    Objective: To explore the changes of plasma ET-1 and serum NSE, NPY levels both before and after treatment in patients with acute cerebral infarction and their significance. Methods: Plasma ET-1 and serum NSE, NPY levels were measured with RIA in 32 patients with acute cerebral infarction both before and after treatment as well as in 35 controls. Results: Before treatment plasma ET-1 and serum NSE, NPY levels were significantly higher than those in controls (P<0.01). After for 3 months of treatment,the levels dropped markedly, but still remained significant higher (P<0.05). Conclusion: Changes of plasma ET-1 and serum NSE, NPY contents both before and after treatment might be of prognostic importance in patients with acute cerebral infarction. (authors)

  6. Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis.

    Zuo, Lian; Wan, Ting; Xu, Xiahong; Liu, Feifeng; Li, Changsong; Li, Ying; Zhang, Yue; Zhang, Jing; Bao, Huan; Li, Gang

    2016-01-01

    We examined the relationship between an early spontaneous type V blood pressure fluctuation and the post-thrombolysis prognosis of patients with acute cerebral infarction. Patients were admitted consecutively. All patients were categorized into the type V blood pressure fluctuation group or non-type V blood pressure group. Their blood pressure was monitored before thrombolysis and until 6 h after thrombolysis. Baseline data and clinical outcomes were compared. Of 170 patients, 43 (25.2%) had an early type V blood pressure fluctuation. The National Institute of Health Stroke Scale (NIHSS) score before thrombolysis and 24 h after thrombolysis, and the modified Rankin scale score at 90 days differed significantly between the two groups (P V blood pressure fluctuation is common in patients with acute cerebral infarction who received venous thrombolysis, especially if they have a higher NIHSS score before thrombolysis. The type V blood pressure fluctuation may not influence patients' prognosis; however, this needs to be confirmed in future trials. PMID:27278121

  7. Impact of diffusion-weighted MRI-measured initial cerebral infarction volume on clinical outcome in acute stroke patients with middle cerebral artery occlusion treated by thrombolysis

    Sanak, Daniel; Bartkova, Andrea; Herzig, Roman; Skoloudik, David; Vlachova, Ivanka; Kanovsky, Petr [University Hospital, Stroke Center, Department of Neurology, Olomouc (Czech Republic); Nosal' , Vladimir; Kurca, Egon [University Hospital, Department of Neurology, Martin (Slovakia); Horak, David; Bucil, Jiri; Burval, Stanislav; Koecher, Martin [University Hospital, Stroke Center, Department of Radiology, Olomouc (Czech Republic); Zelenak, Kamil; Cisarikova, Viera [University Hospital, Department of Radiology, Martin (Slovakia); Zapletalova, Jana [Palacky University Medical School, Department of Biometry and Statistics, Olomouc (Czech Republic)

    2006-09-15

    Magnetic resonance imaging (MRI) may help identify acute stroke patients with a higher potential benefit from thrombolytic therapy. The aim of our study was to assess the correlation between initial cerebral infarct (CI) volume (quantified on diffusion-weighted MRI) and the resulting clinical outcome in acute stroke patients with middle cerebral artery (MCA) (M{sub 1-2} segment) occlusion detected on MRI angiography treated by intravenous/intraarterial thrombolysis. Initial infarct volume (V{sub DWI-I}) was retrospectively compared with neurological deficit evaluated using the NIH stroke scale on admission and 24 h later, and with the 90-day clinical outcome assessed using the modified Rankin scale in a series of 25 consecutive CI patients. The relationship between infarct volume and neurological deficit severity was assessed and, following the establishment of the maximum V{sub DWI-I} still associated with a good clinical outcome, the patients were divided into two groups (V{sub DWI-I} {<=}70 ml and >70 ml). V{sub DWI-I} ranged from 0.7 to 321 ml. The 24-h clinical outcome improved significantly (P=0.0001) in 87% of patients with a V{sub DWI-I} {<=}70 ml (group 1) and deteriorated significantly (P=0.0018) in all patients with a V{sub DWI-I} >70 ml (group 2). The 90-day mortality was 0% in group 1 and 71.5% in group 2. The 90-day clinical outcome was significantly better in group 1 than in group 2 (P=0.026). Clinical outcome could be predicted from initial infarct volume quantified by MRI-DWI in acute CI patients with MCA occlusion treated by intravenous/intraarterial thrombolysis. Patients with a V{sub DWI-I} {<=}70 ml had a significantly better outcome. (orig.)

  8. REASSESSMENT OF DEFIBRASE IN TREATMENT OF ACUTE CEREBRAL INFARCTION: A MULTICENTER, RANDOMIZED, DOUBLE-BLIND,PLACEBO-CONTROLLED TRIAL

    The Cooperative Group for Reassessment of Defibras

    2005-01-01

    Objective To evaluate the efficacy and safety of defibrase in patients with acute cerebral infarction by a large sample,multicenter, randomized, double-blind, placebo-controlled clinical trial.Methods Patients with acute cerebral infarction within 12 hours of stroke onset were randomly assigned to receive either an initial intravenous infusion of defibrase 15 U plus normal saline 250 Ml or 250 Ml of normal saline only.Subsequent infusions of defibrase 15 U or placebo (normal saline) were given on the 3rd, 5th, 7th, and 9th day, respectively.Both groups received standard care of acute cerebral infarction. The primary efficacy outcome was functional status(Barthel Index) at 3 months after treatment. Safety outcome were bleeding events and mortality rate. Secondary outcome included Chinese Stroke Scale (CSS) score at 14 days and recurrence rate of stroke at 1 year. Results A total of 1053 patients were enrolled at 46 centers from September 2001 to July 2003, and 527 patients were randomly assigned to receive defibrase and 526 to receive placebo. A similar proportion of patients in both groups completed a full course of treatment. There was a significantly greater proportion of favorable functional status (Barthel Index ≥95) in defibrase group than in placebo group at 3 months (52.2% vs. 42.8%, P < 0.01), and the proportion of dependent functional status (Barthel Index ≤60) was a little lower in defibrase group compared with placebo group(27.7%vs. 32.4%). These differences were more obvious among patients who were treated within 6 hours of stroke onset.Patients in defibrase group had better improvement with respect to CSS score than those in placebo group at 14 days (P <0.05). Recurrence rate of stroke at 1 year was lower in the defibrase group compared with placebo group (6.2% vs. 10.1%,P = 0.053). Patients in defibrase group had higher risk of extracranial bleeding events (4.7%vs. 1.5%, P< 0.01) and a tendency of higher risk of symptomatic intracranial hemorrhage

  9. A study of whole brain perfusion CT and CT angiography in hyperacute and acute cerebral infarction

    Objective: To evaluate the diagnostic value of whole-brain perfusion blood volume-weighted CT imaging (PWCT) and simultaneous CT angiography (CTA) on early stage of cerebral ischemic infarction. Methods: Non-contrast CT (NCCT), CT perfusion-weighted imaging (PWCT) and delayed CT (DCT) were conducted on 20 cases of early ischemic infarction of whose onset time ranged from 2 to 24 hours. All cases were reexamined with CT or MRI one week to one month later. CT values and perfusion blood volume (PBV) of central and peripheral low perfusion areas as well as those of collateral side were measured. CTA was reconstructed with PWCT as source images to evaluate occlusion or stenosis of blood vessel, and DCT was used to detect the collateral circulation. Results: Of the 20 cases, NCCT, PWCT and CTA were negative in 10 cases in which 6 were confirmed as Transient Ischemic Attack (TIA) on reexamined CT and clinical features, and the other 4 were confirmed as lacunar infarction. For the remaining 10 cases, a comparison was made with ANOVA between low perfusion area (central, peripheral inside and outside) and collateral side. The difference was significant (P<0.01). However, no significant difference was revealed in the central, peripheral inside and outside areas. PBV values were significant in low perfusion area and collateral side (P<0.05). The area of the final infarction was larger than that of the low perfusion area, and the percentage of enlargement exhibited medium negative correlation to the time of ischemia. CTA indicated that 2 cases suffered from left middle cerebral artery occlusion, meanwhile anterior and middle branches of MCA in the other 3 cases were not identified. The sensitivity of NCCT, PWCT and CTA were 28.5%, 71.4% and 35.7% respectively. DCT indicated that 5 cases had asymmetrical blood vessels. Conclusion: The whole-brain perfusion-weighted CT imaging and simultaneous CT angiography (CTA) is p roved to be a simple, timesaving and effective method for the

  10. Relationship between glucose fluctuation and the degree of nervous dysfunction of the acute cerebral infarction in patients with type 2 diabetes mellitus

    张名扬

    2014-01-01

    Objective To investigate the relationship between glucose fluctuation and the degree of nervous dysfunction of the acute cerebral infarction in patients with type 2 diabetes mellitus.Methods 30 patients with ACI and T2DM were chosen as observation group and 30 patients with T2DM without ACI as the control group.Glucose

  11. 血清铁蛋白与急性脑梗死的关系研究进展%Research Progress of Serum Ferritin and Acute Cerebral Infarction

    李鑫(综述); 丰宏林(审校)

    2015-01-01

    铁是人体必需的微量元素,而血清铁蛋白是机体内重要的铁贮存蛋白,其是检测体内铁的可靠指标。血清铁蛋白通过自由基、纤维蛋白酶原、血脂、血小板等参与了急性脑梗死的发生、发展。该文就血清铁蛋白在急性脑梗死中的作用机制、急性脑梗死与血清铁蛋白关系和治疗现状予以综述,以期为急性脑梗死的治疗提供新的作用靶点。%Iron is an essential trace element,while serum ferritin is not only a significant kind of protein that reserves iron in vivo,but also a reliable indicator for detecting body iron .Serum ferritin is involved in the occurrence and progression of acute cerebral infarction through free radicals,fibrinogen,lipids and platelet, etc.In order to provide new targets for treatment of acute cerebral infarction,here reviews the pathogenesis of serum ferritin in acute cerebral infarction,relationship between acute cerebral infarction and serum ferritin, and the present status of the treatment.

  12. Perfusion MR imaging in patients with acute cerebral infarction: comparison with T2-weighted and diffusion-weighted MR imaging

    Jae, Hwan Jun; Chang, Kee Hyun; Song, In Chan; Park, Sun Won; Kim, Yoon Hee; Choi, Joon Il; Han, Moon Hee [College of Medicine, Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Kim, Hong Dae [Kang Nam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Hyung Seok [Cheju Medical Center, Cheju (Korea, Republic of)

    2000-07-01

    To evaluate the clinical usefulness of perfusion MR imaging by comparing with T2-weighted and diffusion weighted MR imaging in patients with acute cerebral ischemic infarction. Conventional, diffusion weighted, and perfusion MR images were obtained within one week of clinical onset in 14 cases of acute ischemic infarction. For perfusion MRI, the gradient-echo EPI technique after IV bolus injection of 15 cc of contrast media was used. Four kinds of perfusion MR images (rCBV, rCBF, mean transit time (MTT), time to peak concentration (TTP)) were generated by home-made software from the raw data. T2-weighted, diffusion-weighted, and perfusion images of each patient were retrospectively analyzed, with attention to the number, signal intensity, and size of lesions. T2-weighted and diffusion-weighted images demonstrated 21 acute ischemic lesions in 14 patients. Six lesions had a long diameter of more than 3 cm, while the other 15 were smaller than 3 cm. On T2-weighted images, 17 lesions showed high signal intensity and four showed subtle high signal intensity. On diffusion-weighted images, all lesions showed bright high signal intensity. The six lesions larger than 3 cm were all delineated by all four kinds of perfusion MR imaging, but among the 15 smaller than 3 cm, only four (26.7%), five (33.3%) and six (40%) were delineated on rCBV and r CBF maps, the MTT map, and the TTP map, respectively. As compared with T2-weighted and diffusion-weighted imaging, the rCBV and rCBF maps showed that four lesions were smaller and six were the same size. On the MTT map, three lesions were seen to be larger, four were smaller, and the other four were the same size as they appeared on diffusion-weighted images, while on the TTP map, seven were larger and five were smaller than they appeared on these images. In all cases, diffusion-weighted images most clearly delineated acute ischemic lesions, regardless of lesion size. Many such lesions smaller than 3 cm were not apparent on perfusion

  13. Optic atrophy and cerebral infarcts caused by methanol intoxication: MRI

    We present the MRI findings of cerebral and optic pathway damage in the acute and subacute stages of methanol intoxication. In the acute stage, CT and MRI showed bilateral haemorrhagic necrosis of the corpus striatum and infarcts in the anterior and middle cerebral arterial territories. MRI in the subacute stage demonstrated atrophy of the optic chiasm and prechiasmatic optic nerves in addition to the cerebral infarcts. The patient survived, with total blindness. (orig.)

  14. Dynamic CT scan in cerebral infarction

    Forty-two dynamic CT studies were performed on 27 patients with cerebral infarction (11 to 75 years of age), and perfusion patterns of low density areas on plain CT were evaluated. The initial studies were performed 1.5 hours to 60 days after acute onset. The following results were obtained. 1) The perfusion pattern in the low density area on plain CT varies among patients at any periods after onset, ranging from absent perfusion pattern to hyperfusion pattern. No consisitent perfusion pattern was obtained at any given time after onset. 2) Repeat dynamic CT revealed that the perfusion pattern in the low density area changed with time variously. 3) The perfusion pattern or change of perfusion pattern did not correlate with outcome of the patient. 4) At an acute stage, when no abnormal findings were obtained on plain CT, dynamic CT revealed abnormal perfusion pattern, enabling early diagnosis of cerebral infarction and estimation of blood perfusion in the infarcted area. In determining the treatment for the cerebral infarction at an acute stage, it is important to know the condition of the blood perfusion in the infarcted area. For the patients in whom recanalization has already taken place, mannitol or steroid might be effective, providing protection against severe brain edema and hemorrhagic infarction. On the other hand, if recanalization has not taken place, revascularization therapy might be worth trying within 6 hours since the onset. It has been said that ischemic brain damage may not be reversed by the revascularization after 6 hours. Dynamic CT is safe, less invasive, convenient and very useful for early diagnosis of the cerebral infarction and determination of the treatment at the acute stage. (J.P.N.)

  15. Acute myocardial infarct imaging

    A brief review is presented of radiopharmaceuticals used for imaging acute myocardial infarction and instrumentation using the rectilinear scanner and the scintillation camera. Clinical experience indicates that myocardial imaging with /sup 99 m/Tc pyrophosphate is a useful adjunct to the electrocardiogram and serum enzyme activity in managing patients with myocardial infarction. The technique allows rapid diagnosis, accurate localization, and an estimate of the size of acute infarcts. It can also be used to document infarct extension and in association with myocardial perfusion imaging can help differentiate fresh from old myocardial infarction

  16. Bilateral posterior cerebral artery infarction.

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  17. The diagnostic and prognostic significance of changes of serum CRP and Hcy levels in patients with acute cerebral ischemia and infarction

    Objective: To study the changes of serum levels of C reactive protein (CRP) and homocystine in patients with acute cerebral infarction and their correlationship with clinical function impairment(NIHSS). Methods: 112 patients with acute cerebral infarction (79 male and 33 female, age, 62.8±10.5 years old) and 53 healthy controls were included in this study. Serum levels of CRP were measured with radioimmunoassay, serum levels of Hcy was analyzed with fluorescence polarization time chemiluminescence analysis. The significance of data and correlationship with NIHSS were stadied with t-test and spearman analysis respectively. Results: The serum levels of CRP and Hcy were significantly higher in patients with acute cerebral than those controls (P<0.01). Furthermore, the levels of CRP and Hcy were positively correlated with clinical functional disorder score (P<0.05). Conclusion: CRP and Hcy may play important pathophysiologic roles in acute cerebral ischemia and infarction and it may also be an independent predictor for clinical outcome. (authors)

  18. Dynamic CT scan in cerebral infarction

    62 Dynamic CT studies were performed on 40 patients with cerebral infarction (11 to 75 years of age), and the perfusion patterns of low-density areas on plain CT were evaluated. The examinations were performed 1.5 hours to 60 days after acute onset. The procedures were as follows: 65 % amidotrizomeglumin (1 ml/kg) was injected upon the initiation of the second scanning over 5 seconds through an 18 G needle placed in the antecubital vein. A total of 8 and 10 serial high-speed scans were performed with the SOMATOM 2 and CT/T 8800 apparatuses respectively. The perfusion pattern was evaluated by comparing the two time-density curves obtained from the infarcted area and the same region on the contralateral side. The following results were obtained: 1) The perfusion patterns of the infarcted area may be classified into 5 groups: ''absent,'' ''hypo,'' ''normal,'' ''hyper,'' and ''absent + late'' perfusion patterns. 2) In most cases, a dynamic CT reveals absent perfusion pattern at the acute stage in the infarcted area when no abnormal findings are obtained on plain CT. 3) Repeat dynamic CT revealed that the perfusion pattern varied with the time, and in some cases we could know the development of the hemorrhagic infarction in advance. 4) The perfusion pattern or change in the perfusion pattern did not correlate with the outcome of the patient. For the patients in whom recanalization has already taken place, the main point of treatment is to protect the brain against severe brain edema and hemorrhagic infarction. On the other hand, if recanalization has not yet taken place, revascularization therapy might be worth trying unless 6 hours or more have passed since onset. While it is safe, less invasive, and convenient, dynamic CT is also very useful for the early diagnosis of cerebral infarction, for the determination of the treatment at the acute stage and for the forecasting of hemorrhagic infarction. (J.P.N.)

  19. Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction.

    Saito, Tsukasa; Hayashi, Keisuke; Nakazawa, Hajime; Ota, Tetsuo

    2016-08-01

    Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P Swallowing hesitation caused by acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition. PMID:27277890

  20. Magnetic resonance imaging (MRI) of cerebral infarction

    Fifty-five patients with cerebral infarction were studied with magnetic resonance imaging (MRI) and correlative CT scans. MRI was more sensitive than CT for detecting cerebral infarction, and T2-weighted spin-echo (SE) pulse sequence was most sensitive for detecting cerebral infarction except for some subcortical infarction. The size of infarcted areas on MRI was larger than that on CT in 29 of 51 infarcted areas, equal in 22. The pulse sequence using long repetition time (TR) and double echo delay time (TE), such as SE (2000/30, 90), improved the detectability of cerebral infarction. (author)

  1. Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.

    Okamoto, Kensho; Hamada, Eri; Okuda, Bungo

    2004-01-01

    We describe a patient with ascending tetraparesis following stroke. The patient presented initially with spastic paraparesis which acutely evolved to tetraparesis with abulia. Magnetic resonance imaging revealed acute infarctions in the bilateral medial frontal regions but not in the brainstem or spinal cord. Multiple infarctions in the anterior cerebral artery territory appeared to originate from artery to artery embolism. The present case provides distinct clinical features of anterior cerebral artery syndrome which mimic myelopathy or brainstem lesions. PMID:17903956

  2. Clinical significance of determination of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction

    Objective: To study the clinical significance of changes of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction. Methods: Plasma NPY levels (with RIA) and serum lipid profile (with biochemistry) were determined in (1) 48 patients with acute cerebral hemorrhage (2) 46 patients with acute cerebral infarction and (3) controls.Results Plasma NPY levels in both patients with cerebral hemorrhage and patients with cerebral infarction were significantly higher than those in controls (P0.05). Conclusion: NPY played important roles in the development and pathogenesis of cerebral vascular accidents. Lipid profile changes was the basic etiological factor. (authors)

  3. Differential expression of 114 oxidative stressrelated genes in peripheral blood mononuclear cells of acute cerebral infarction patients A gene microarray experiment

    Jing Yang; Fei Zhong; Mingshan Ren; Jiangming Zhao

    2010-01-01

    Previous studies have focused on the analysis of single or several function-related genes in oxidative stress;however,little information is available regarding altered expression of oxidative stress-related genes in the process of ischemia-reperfusion injury from microarray experiments.The aim of the present study was to investigate the changes in cell oxidative stress-and toxicity-related gene expression utilizing microarray screening in patients with acute cerebral infarction during cerebral ischemia-reperfusion injury.Of the included 114 genes,expression was significantly upregulated in eight genes,including three heat shock protein-related genes,one oxidative and metabolic stress-related gene,one cell growth arrest/senescence related gene,two apoptosis signal-related genes,and one DNA damage and repair related gene.Expression was significantly downregulated in four genes,including one cell proliferation/cancer related gene,two oxidative and metabolic stress-related genes and one DNA damage and repair related gene.The results demonstrated that cerebral ischemia-reperfusion injury in patients with acute cerebral infarction was affected by many genes including oxidative stress-,heat shock-,DNA damage and repair-,and apoptosis signal-related genes.Therefore,it could be suggested that cerebral ischemia-reperfusion injury may be subjected to complex genetic regulation mechanisms.

  4. Bilateral posterior cerebral artery infarction

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA

  5. Classification of Oxfordshire community stroke project assisted by transcranial Doppler ultrasound examination for treating acute cerebral infarction

    Xiaohua Xiao; Jie Situ; Tinghui Li; Shaohong Qiu

    2006-01-01

    BACKGROUND: The early correct diagnosis of acute cerebral infarction (ACI) is very important for choosing therapeutic regimen. The classification of Oxfordshire community stroke project (OCSP) provides guide for easy and rapid diagnosis and choosing therapeutic regimen in clinical practice. But current operation is not satisfied. Only depending on clinical symptoms and body signs do objective evidences lack. Transcranial Doppler ultrasound (TCD) examination may provide hemodynamical evidences for the correct classification of OCSP to some extent. OBJECTIVE: To compare the results of OCSP classification and TCD examination for treating ACI in patients, and analyze the relationship between them as well as the effect of TCD on the correct classification of OCSP. DESIGN: Controlled observation.SETTING: Department of Internal Medicine, Shenzhen Hospital of Prevention and Treatment for Occupational Disease. PARTICIPANTS: Thirty-eight inpatients with ACI including 21 males and 17 females, aged 50 to 81 years, who received treatment in the Department of Internal Medicine, Shenzhen Hospital of Prevention and Treatment for Occupational Disease within 24 hours after onset from October 2002 to October 2005 were involved. The involved inpatients all confirmed to the diagnostic criteria of ACI formulated in the 4th National Cerebrovas- cular Diseases Conference. All the cases received skull computer tomography (CT) or magnetic resonance imaging (MRI) examinations at 24 hours after onset. Those patients who had no obvious infarct focus in skull CT examination within 24 hours after onset were performed re-examination to verify ACI within 72 hours after onset. Informed consents of examination method were obtained from all the patients. METHODS: According to the classification of OCSP, the patients were assigned into 4 subtypes: lacunar infarction (LACI), total anterior circulation infarction (TACI), part anterior circulation infarction (PACI) and posterior circulation infarction

  6. Correlations between MRI and Cognitive Changes during Acute to Rehabilitation Phase of Cerebral Infarction%脑梗死患者急性期-康复期认知变化与脑MRI分析

    徐晓云; 高伟明; 朱雯霞; 沈伟文

    2002-01-01

    Objective: To examine correlations between MRI and cognitive changes associated with cerebral infarction. Methods: Using HDS-R and Senior Cognitive Scale, we assessed 101 patients with cerebral infarction during acute to rehabilitation phase. The results were compared with their MRI. Results: At 3 weeks after onset, cognitive impairment was found in 70.3% of the patients. At 6 months after onset, 10% recovered to normal, 35.6% improved, 22.8% worsened, and 42.5% met the criteria of dementia. During acute phase, infarction focus and leukoaraiosis (LA) were related to cognitive impairment P<0.05). During rehabilitation phase, cognitive impairment was related to LA.Conclusion:Cerebral infarcti on results in significant cognitive impairment. LA is the major cause of cognitive impairment associated with cerebral infarction in rehabilitation.

  7. Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis

    Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Fifty seven 99mTc-Ethylene Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=56±17 years) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age =36±10 years) in a voxel-by-voxel manner (two sample t-test, p99mTc-ECD SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated

  8. Magnetic Resonance Imaging Criteria for Thrombolysis in Hyperacute Cerebral Infarction

    AHMETGJEKAJ, ILIR; KABASHI-MUÇAJ, SERBEZE; LASCU, LUANA CORINA; KABASHI, ANTIGONA; BONDARI, A.; Bondari, Simona; DEDUSHI-HOTI, KRESHNIKE; BIÇAKU, ARDIAN; SHATRI, JETON

    2014-01-01

    Purpose: Selection of patients with cerebral infarction for MRI that is suitable for thrombolytic therapy as an emerging application. Although the efficiency of the therapy with i.v. tissue plasminogen activator (tPA) within 3 hours after onset of symptoms has been proven in selected patients with CT, now these criteria are determined by MRI, as the data we gather are fast and accurate in the first hours. Material and methods: MRI screening in patients with acute cerebral infarction before ap...

  9. Onset risk factor analysis of acute cerebral infarction of middle age and young people%中青年急性脑梗死发病危险因素分析

    彭连栋; 马英文

    2002-01-01

    Background: People paid more attention to the search of onset risk factors of cerebral apoplexy of middle and young people because of its severe harmfulness. We analyzed clinical data of 57 patients with acute cerebral infarction of middle age and young people from 1997~ 2000.

  10. Carotid color doppler flow imaging of cerebral infarction in Korea

    Until now, there have been no reported document concerning the incidence of atheroma of the carotid artery associated with occlusive cerebrovascular disease in Korea. We tried to identify atheroma of the carotid artery in acute cerebral infarction patients using duplex sonography and color flow imaging. Recent reports state that duplex sonography and color flow imaging were reported to be more accurate and safer non-invasive method of detecting carotid atheroma than carotid angiography. Atheromas were detected in 41(56%) out of total of 73 acute cerebral infarction patients. However, other conditions such as hypertension (37/73), cardiac problems(22/73), diabetes mellitus(10/73), and conditions of unknown etiologiest (13/73) were also observed in association with acute cerebral infarction. We conclude that carotid atheroma presents as the most important cause of cerebral infraction in Korea

  11. Carotid color doppler flow imaging of cerebral infarction in Korea

    Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Eun Joo; Yang, Hee Chul; Choi, Il Saing; Lee, Myung Sik; Lee, Byung In [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1990-10-15

    Until now, there have been no reported document concerning the incidence of atheroma of the carotid artery associated with occlusive cerebrovascular disease in Korea. We tried to identify atheroma of the carotid artery in acute cerebral infarction patients using duplex sonography and color flow imaging. Recent reports state that duplex sonography and color flow imaging were reported to be more accurate and safer non-invasive method of detecting carotid atheroma than carotid angiography. Atheromas were detected in 41(56%) out of total of 73 acute cerebral infarction patients. However, other conditions such as hypertension (37/73), cardiac problems(22/73), diabetes mellitus(10/73), and conditions of unknown etiologiest (13/73) were also observed in association with acute cerebral infarction. We conclude that carotid atheroma presents as the most important cause of cerebral infraction in Korea.

  12. Detection of hemorrhagic transformation in patients with acute cerebral infarction: comparison of CT with T1W1, FLAIR, and gradient-echo MR imaging

    Chung, Seok Kyun; Seo, Jeong Jin; Yoon, Woong; Jeong, Yong Yeon; Chung, Tae Woong; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National University Hospital School of Medicine, Gwangju (Korea, Republic of)

    2003-07-01

    To determine the diagnostic accuracy of T1-weighted, FLAIR, and GRE MR imagings in the detection of hemorrhagic transformation in patients with acute cerebral infarction and to compare it with CT. Fifty-three patients with acute territorial cerebral infraction were studied prospectively. All patients underwent nonenhanced CT and MRI including the T1-weighted, FLAIR, and GRE. Lesion conspicuity of hemorrhage was scored as follows: 0-none; 1-suspicious; 2-sure. CT and MR imagings were reviewed two radiologists respectively. The mean value of the lesion conspicuity in each CT and MR sequences was compared by means of a Wilcoxon signed ranks test. The time intervals between CT and MR imagings ranged from 3 to 14 hours (mean; 7.6 hours). Hemorrhagic transformation was detected on nonenhanced CT in 26 of 53 patients. In the detection of hemorrhage in patients with acute cerebral infraction, T1-weighted and FLAIR MR imagings were inferior to NECT (p<0.05). By contrast, lesion conspicuity of GRE MR imaging was not different from that of CT (p=0.5). In addition, lesion conspicuity of GRE MR imaging was greater than that of CT in five patients on reader A and two patients on reader B. GRE MR imaging was superior to T1-weighted and FLARI MR imagings, equal to nonenhanced CT in the detection of hemorrhagic transformation in patients with acute cerebral infraction.

  13. No effect of ablation of surfactant protein-D on acute cerebral infarction in mice

    Lambertsen, Kate Lykke; Østergaard, Kamilla; Clausen, Bettina Hjelm; Hansen, Søren; Stenvang, Jan; Thorsen, Stine Buch; Meldgaard, Michael; Kristensen, Bjarne Winther; Hansen, Pernille B. Lærkegaard; Sørensen, Grith Lykke; Finsen, Bente

    2014-01-01

    -induced increase in TNF mRNA production one day after induction of ischemia; however the TNF response to the ischemic insult was affected at five days. SP-D mRNA was not detected in parenchymal brain cells in either naïve mice or in mice subjected to focal cerebral ischemia. However, SP-D mRNA was detected in...... middle cerebral artery cells in WT mice and SP-D protein in vascular cells both in normal appearing and ischemic human brain tissue. Measurements of the levels of SP-D and TNF in plasma in mice suggested that levels were unaffected by the ischemic insult. Microglial-leukocyte and astroglial responses...

  14. Clinical analysis of sleep disorders in patients with acute cerebral infarction%急性脑梗死患者睡眠障碍的临床分析

    陈美琳; 陈娟; 王晓利

    2015-01-01

    目的:探讨急性脑梗死患者睡眠障碍的临床特点。方法对72例脑梗死患者,根据病史并采用匹兹堡睡眠指数问卷(PSQI),神经功能缺损程度评分(NDS),及多导睡眠图(PSG)进行研究。结果急性脑梗死患者睡眠障碍的临床表现形式主要以失眠为主,检出率为44.4%,女性大于男性。脑梗死神经缺损越严重,睡眠障碍的发生率就越高。脑梗死患者皮质下梗死较皮质梗死、小脑梗死睡眠障碍的发生率高。急性脑梗死睡眠障碍的患者PSG改变为:总睡眠时间减少,入睡潜伏期延长,睡眠效率明显降低。NREMⅠ期睡眠明显增多,Ⅱ期和Ⅲ期睡眠减少。结论急性脑梗死睡眠障碍的发生率较高,发病与多种因素有关,通过了解脑梗死睡眠障碍患者的睡眠情况有助于指导治疗。%Objective To explore the characteristics of sleep disorders in patients with acute cere‐bral infarction .Methods Adopting medical history and Pittsburgh Sleep QuestionnaireIndex(PSQI) ,de‐gree of Nerve Function Defect Score (NDS)and Polysomnography (PSG) methods to study 72 patients with cerebral infarction .Results Clinical manifestation of sleep disorders in patients with acute cerebral infarction was mainly suffering from insomnia ,the detection rate was 44 .4% ,and the rate of women washigher than men .The more serious Cerebral infarction nerve defect ,the higher the incidence rate of sleep disorders .Patients with subcortical infarction were more likely to have sleep prbolems .PSG chan‐ges for patients with acute cerebral infarction of sleep disorders:total sleep time reduced ,sleep latency extended ,sleep efficiency decreased .NREM sleepⅠstage significantly increased and stage Ⅱand Ⅲ de‐creased .Conclusions The sleep disorder incidence rate of patients with acute cerebral infarction is high‐er ,which is associated with a variety of factors ,by understandingthe sleep state of

  15. Relationship Between Serum Homocysteine Levels with Acute Cerebral Infarction%急性脑梗死与血清同型半胱氨酸的关系探讨

    李艳平; 张元元

    2014-01-01

    Objective:To evaluate the relationship between Acute Cerebral Infarction and Serum homocysteine level. Methods:170 patients were divided intotw groups.85cases group as Acute Cerebral Infarction,while the control group was 85 cases of medical center volunteers.Results:Acute Cerebral Infarction group, Serum homocysteine (16.2±6.2), Serum homocysteinecontrol group (12.2±3.5), P<0.001.Conclusion:Acute Cerebral Infarction group than in the control group, Serum homocysteine levels, Serum homocysteinelevels may be associated with the occurrence of Acute Cerebral Infarction.%目的:探讨了解急性脑梗死与Hcys水平的关系。方法:急性脑梗死患者85例作为病例组,对照组为85例。结果:急性脑梗死Hcys值为(16.2±6.2),对照组Hcys值(12.2±3.5),急性脑梗死组Hcys水平高于对照组,差异有统计学意义(P<0.01)。结论:急性脑梗死组比对照组Hcys升高,Hcys升高可能与急性脑梗死的发生有关。

  16. Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis

    Hong, Sun Pyo; Yoon, Joon Kee; Choi, Bong Hoi; Joo, In Soo; Yoon, Seok Nam [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2008-10-15

    Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Fifty seven {sup 99m}Tc-Ethylene Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=56{+-}17 years) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age =36{+-}10 years) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Using {sup 99m}Tc-ECD SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

  17. P-31 MR spectroscopy of cerebral infarction in rats

    Sequential P-31 magnetic resonance (MR) spectroscopy was performed in an experimental rat model of cerebral infarction from the acute to the chronic stage. In the acute stage, acidosis, an increase in inorganic phosphate, and depletion of high-energy phosphates were observed. This acute pattern gradually evolved into a chronic pattern that was similar to that of normal brain, with certain quantitative differences, namely, an increase in the relative levels of phosphomonoester and phosphodiester. Histopathologic studies of the chronic lesions revealed gliosis. The MR spectroscopic findings in the chronic stage are similar to those found in clinical cerebral infarction and appear to reflect the bioenergetics of gliosis

  18. EFFECT OF ACUPUNCTURE ON PLASMA STRESS HORMONE LEVELS OF HYPOTHALAMUS-PITUITARY-ADRENAL AXIS IN TYPE II DIABETES WITH CONCURRENT ACUTE CEREBRAL INFARCTION PATIENTS

    谌剑飞; 梁浩荣; 关少侠; 马雅玲

    2001-01-01

    Objective: To observe the effect of acupuncture on the contents of stress hormones of the hypothala-mus-pituitary-adrenal axis (HPA) in treatment of type Ⅱ diabetes with concurrent acute cerebral infarction patients. Methods: 60 cases of inpatients were randomly and evenly divided into treatment group (conventional medication plus acupuncture) and control (conventional mediation) group. Plasma corticotropin releasing hormone (CRH), adrenocorticotropin hormone (ACTH) and corticosteroid (CS) contents before and after treatment were measured using radioimmunoassay (RIA) and compared with these of healthy subject group (n = 30). Results: Plasma CRH, ACTH and CS levels in patients of both treatment group and control group at admission were significant higher than those of normal subject group (P<0.05). After treatment for 15~30 days, results shewed that plasma CRH, ACTH and CS levels in both treatment and control groups lowered significantly in comparison with those of pre-treatment (P < 0.05 or 0.01 );while those of treatment group were even more lower (being closer to the normal values) than those of control group (P < 0.05 or 0.01 ). Conclusion: Acupuncture therapy can reduce the stress state of HPA in type Ⅱ diabetes with concurrent acute cerebral infarction patients, i.e. regulate the neuroendocrine immunological net, which may be one of the mechanisms for acupuncture treatment of cerebral stroke.

  19. 液体高压氧对急性脑卒中患者神经功能缺损恢复的作用%Observation on the effect of liquid hyperbaric oxygen therapy for acute cerebral infarction

    杨金升; 王燕; 于伟玲; 罗晓红; 石莉

    2002-01-01

    @@ Background:Liquid hyperbaric oxygen therapy is a quickly developed therapy for acute cerebral infarction in recent years.It has characteristics of high safety,low toxicity,easy manipulation,especially good recovering effect on neurological deficit in acute stroke patients.We observed this effect in this paper.

  20. Effects of Repetitive Hyperbaric Oxygen Treatment in Patients with Acute Cerebral Infarction: A Pilot Study

    Cheng-Hsin Chen

    2012-01-01

    Full Text Available The role of hyperbaric oxygen therapy (HBOT in the treatment of acute ischemic stroke is controversial. This prospective study assessed the efficacy and safety of HBOT as adjuvant treatment on 46 acute ischemic stroke in patients who did not receive thrombolytic therapy. The HBOT group (n=16 received conventional medical treatment with 10 sessions of adjunctive HBOT within 3–5 days after stroke onset, while the control group (n=30 received the same treatment but without HBOT. Early (around two weeks after onset and late (one month after onset outcomes (National Institutes of Health Stroke Scale, NIHSS scores and efficacy (changes of NIHSS scores of HBOT were evaluated. The baseline clinical characteristics were similar in both groups. Both early and late outcomes of the HBOT group showed significant difference (P≤0.001. In the control group, there was only significant difference in early outcome (P=0.004. For early efficacy, there was no difference when comparing changes of NIHSS scores between the two groups (P=0.140 but there was statistically significant difference when comparing changes of NIHSS scores at one month (P≤0.001. The HBOT used in this study may be effective for patients with acute ischemic stroke and is a safe and harmless adjunctive treatment.

  1. A dynamic concept of middle cerebral artery occlusion and cerebral infarction in the acute state based on interpreting severe hyperemia as a sign of embolic migration

    Olsen, T S; Lassen, N A

    1984-01-01

    The present study investigates the pathogenesis of focal cerebral hyperemia, its effect on brain tissue and discusses its pathophysiological and therapeutic importance in the light of interpreting severe hyperemia as a sign of arterial reopening probably due to embolic migration. Cerebral...... well as in non-infarcted tissue. Apparently, it is the severity of the initial ischemic episode and not the hyperemia that determines whether or not tissue necrosis develops. Interpreting severe hyperemia as a sign of arterial reopening and embolic migration (evidenced by partial reopening affecting...

  2. Ischaemic cerebral infarction combined determination of regional cerebral blood flow and volume via SPECT

    A combined measurement of regional cerebral blood flow (r CBF) and volume (r CBV) by SPECT was performed in 15 patients with ischaemic cerebral infarction. For measurement of r CBF 99mTc-HMPAO was used, and for r CBV 99mTc-labelled red blood cells. Patients with acute or subacute cerebral infarction (n=10) showed elevation of r CBV whereas r CBF was either reduced or elevated. Patients with chronic cerebral infarction (n=5) showed reduction of both r CBF and R CBV. The combined measurement of both r CBF and r CBV by SPECT allows imaging and semiquantitative evaluation of haemodynamic changes in ischaemic cerebral infarction at various stages. The resulting data may be helpful in describing the pathophysiologic compensatory mechanisms. (orig.)

  3. Acute Myocardial Infarction 19922001

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  4. Monitoring the changes in plasm C-reactive protein,fibrinogen and blood white cell in patients with primary hypertension combined with acute cerebral infarction

    Yuanfei Deng; Juan Hang; Yane Chen

    2006-01-01

    BACKGROUND: Inflammatow reaction and the increased level of its accompanying active protein play an important role in the occurrence and development of cerebral infarction. C-reactive protein, fibrinogen and white blood cell, as the monitoring index of inflammatory reaction, are very important in the occurrence and development of acute cerebral infarction.OBJECTIVE: To make a comparison between patients with primary hypertension accompanied with acute cerebral infarction and with simple primary hypertension by observing the changes in plasma C-reactive protein and fibrinogen levels as well as white blood cell and differential counts and analyzing their significances.DESIGN : Controlled observation.SETTTNG: Ward Building for VIP, Shenzhen Hospital, Peking University.PARTICIPANTS: Totally 133 patients with primary hypertension were selected from Ward Building for VIP,Shenzhen Hospital, Peking University during September 2003 to September 2005. The diagnostic criteda were based on the hypertension diagnosis criteria formulated by the 7th World Health Organization-lnternational Society of Hypertension Guidelines (WHO-ISH) in 1998. The informed consents were obtained from all the participants. The involved patients were assigned into two groups: primary hypertension group, in which, there were 65 patients with primary hypertension ( degree 2), including 42 males and 23 females,with mean age of (61 ±14)years and mean blood pressure of (162.7±6.8)/(94.2±8.4) mm Hg(1 mm Hg =0.133 kPa), and primary hypertension combined with cerebral infarction group, in which, there were 68 patients with primary hypertension combined with cerebral infarction ( meeting the diagnostic criteria formulated in the 4th National Cerebrovascular Diseases Meeting in 1995 and diagnosed by skull CT or MRI to exclude the patients with lacunar infarction), including 42 males and 26 females, with mean age of (56±15)years and mean blood pressure of (176.4±9.2)/(96.3±9.7) mm Hg.METHODS: Plasm C

  5. Locations of cerebral infarctions in tuberculous meningitis

    The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the 'TB zone' supplied by medial striate and thalamoperforating arteries; only 11% occurred in the 'IS zone' supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%). (orig.)

  6. Effects of tanshinone Ⅱ sodium sulfonate plus cinepazide maleate on the hemorrheologic indexes and blood lipids in patients with acute cerebral infarction

    Chunliang Li; Mingzhu Zhang; Haijun Zheng; Fengzhi Xue

    2007-01-01

    BACKGROUND: The severity of cerebral infarction is associated with the increase of blood viscosity caused by hyperfibrinogenemia and hyperlipidemia, etc. Thus it has become one of the target for treating cerebral infarction to decrease blood viscosity by integrated Chinese and western medicine.OBJECTIVE: To investigate the influence and clinical therapeutic effects of cinepazide maleate combined with tanshinone Ⅱ A sodium sulfonate on the hemorrheologic indexes and blood lipids of patients with acute cerebral infarction, and compare the results with those of simple cinepazide maleate treatment.DESIGN: A non-randomized case-controlled observation.SETTINGS: Hebei North University; the Second Affiliated Hospitals of Hebei North University; the Third Affiliated Hospitals of Hebei North University.PARTICIPANTS: Eighty-six inpatients with cerebral infarction were selected from the infirmary, the Second and Third Affiliated Hospitals of Hebei North University from September 2004 to October 2006.They were all diagnosed to have acute cerebral infarction by CT or MRI, and accorded with the diagnostic standards for acute cerebral infarction set by the Fourth National Academic Meeting for Cerebrovascular Disease in 1995. Meanwhile, 40 teachers and medical staff of voluntary physical examinees were selected as the control group. Informed contents were obtained from all the patients and their relatives.METHODS: The patients were divided into combined treatment group (n=43) and simple treatment group (n=43). In the combined treatment group, the patients were administrated with 160 mg cinepazide maleate injection (Beijing Four-ring Pharmaceutical, Co.,Ltd, No. H200220125; 80 mg/2 mL) added in 5% glucose,and 40 mg tanshinone Ⅱ sodium sulfonate (Shanghai No.1 Biochemical & Pharmaceutical Co.,Ltd., No.H31022558, 10 mg/2 mL) added in 250 mL normal saline. In the simple treatment group, the patients were only administrated with cinepazide maleate 320 mg added in 5% glucose or

  7. The incidence and risk factors of associated acute myocardial infarction (AMI in acute cerebral ischemic (ACI events in the United States.

    Ali Seifi

    Full Text Available OBJECTIVES: To determine the association between myocardial infarction (AMI and clinical outcome in patients with primary admissions diagnosis of acute cerebral ischemia (ACI in the US. METHODS: Data from Nationwide Inpatient Sample (NIS was queried from 2002-2011 for inpatient admissions of patients with a primary diagnosis of ACI with and without AMI using International Classification of Diseases, Ninth Revision, Clinical Modification coding (ICD-9. A multivariate stepwise regression analysis was performed to assess the correlation between identifiable risk factors and clinical outcomes. RESULTS: During 10 years the NIS recorded 886,094 ACI admissions with 17,526 diagnoses of AMI (1.98%. The overall cumulative mortality of cohort was 5.65%. In-hospital mortality was associated with AMI (aOR 3.68; 95% CI 3.49-3.88, p≤0.0001, rTPA administration (aOR 2.39 CI, 2.11-2.71, p<0.0001, older age (aOR 1.03, 95% CI, 1.03-1.03, P<0.0001 and women (aOR 1.06, 95% CI 1.03-1.08, P<0.0001. Overall, mortality risk declined over the course of study; from 20.46% in 2002 to 11.8% in 2011 (OR 0.96, 95% CI 0.95-0.96, P<0.0001. Survival analysis demonstrated divergence between the AMI and non-AMI sub-groups over the course of study (log-rank p<0.0001. CONCLUSION: Our study demonstrates that although the prevalence of AMI in patients hospitalized with primary diagnosis of ACI is low, it negatively impacts survival. Considering the high clinical burden of AMI on mortality of ACI patients, a high quality monitoring in the event of cardiac events should be maintained in this patient cohort. Whether prompt diagnosis and treatment of associated cardiovascular diseases may improve outcome, deserves further study.

  8. Digital subtraction angiography in cerebral infarction

    The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the angiographic causes, findings, and the usefulness of DSA in cerebral infarction. The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional angiogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. Among the 51 patients of cerebral infarction 43 patients (84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in angiogram. DSA findings of cerebral atherosclerosis were multiple narrowing in 42 patients (97.7%), tortuosity in 22 (51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients (86.0%), middle cerebral artery in 29 (67.4%) posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement (16.2%). In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered

  9. Clinical Characteristics of Restless Legs Syndrome after Acute Cerebral Infarction%急性脑梗死后不宁腿综合征的临床特征

    丁晓; 邓丽影

    2015-01-01

    Objective To investigate the clinical characteristics and inlfuences of restless legs syndrome (RLS) after acute cerebral infarction. Methods All acute cerebral infarction patients admitted were screened in accordance with the deifnition criteria of International Restless Legs Syndrome Study Group (IRLSSG). The patients without RLS were matched with a group in similar with age, gender, location of lesion to RLS group. The clinical characteristics of the patients with and without RLS were analyzed. Results Two hundred and seventy-five patients with acute cerebral infarction were studied. Nineteen cases met the diagnostic criteria for RLS. The morbidity rate is 6.91%. The age of RLS group and non-RLS group were (62.89±10.26)vs (62.63±9.96) respectively. The Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) of RLS group were higher than non-RLS group. Barthel Index (BI) of RLS group was lower than that in non-RLS group (all P10分的比例更高(57.9%vs 21.1%,P=0.020),匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)>15分的比例也更高(47.4%vs 15.8%,P=0.040)。脑梗死后90 d和180 d,RLS组Barthel指数(Barthel Index,BI)低于非RLS组(P值分别是<0.001和<0.001),改良Rankin量表(modified Rankin Scale,mRS)评分高于非RLS组(P值分别是0.64和0.04)。RLS组14例(73.68%)患者合并周期性腿动,15例(78.9%)患者合并阻塞性睡眠呼吸障碍。结论急性脑梗死后RLS患者较无RLS患者睡眠质量及预后更差。

  10. Scorpion bite and multiple cerebral infarcts.

    Thacker A; Lal R; Misra M

    2002-01-01

    Multiple cerebral infarcts, bilateral optic neuropathy with limb ischemia, following scorpion bite is documented. Vasospasm and autonomic storm due to envenomation is a plausible explanation for this symptom complex.

  11. 血清同型半胱氨酸检测对急性脑梗死患者的临床价值%Clinical Value of Serum Homocysteine in Patients With Acute Cerebral Infarction

    崔佳音

    2016-01-01

    目的:探讨血清同型半胱氨酸检测对急性脑梗死患者的临床价值。方法选取110例脑梗死患者作为观察组,100例体检健康者为对照组,检测两组血清同型半胱氨酸,分析其与急性脑梗死的关系。结果观察组入院时血清同型半胱氨酸浓度高于对照组,治疗后血清同型半胱氨酸浓度下降,差异具有统计学意义(P<0.05)。结论急性脑梗死患者的血清同型半胱氨酸水平检测,能够为其诊断与疗效观察提供有效的临床依据,是重要的观察指标。%Objective To explore the clinical value of serum homocysteine in patients with acute cerebral infarction.Methods110 patients with cerebral infarction were selected as the observation group, 100 cases of healthy persons as the control group, the serum homocysteine was detected in the two groups, and the relationship between them and the acute cerebral infarction was analyzed.ResultsThe serum homocysteine concentrations in patients on admission were signiifcantly higher than those in the control group, and the serum homocysteine concentrations were significantly decreased after treatment, the difference was significant (P<0.05). Conclusion Detection of serum homocysteine level in patients with acute cerebral infarction can provide effective clinical basis for the diagnosis and treatment of acute cerebral infarction, and it is an important observation index.

  12. MRI of sickle cell cerebral infarction

    Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

  13. Clinical Analysis of Acute Cerebral Infarction with High Homocysteine%急性脑梗死与高同型半胱氨酸的临床分析

    刘建英

    2015-01-01

    目的:探讨急性脑梗死与高同型半胱氨酸的相关性。方法选取本院自2012年1月~2013年1月收治的86例脑梗死患者作为观察组,同时选取86例健康体检者作为对照组,对两组患者的血浆同型半胱氨酸水平进行检测,并进行对比。结果观察组患者的平均血浆同型半胱氨酸水平为(17.1±3.3)μmol/L,对照组患者的平均血浆同型半胱氨酸水平为(9.8±1.8)μmol/L,观察组患者的血浆同型半胱氨酸水平明显高于对照组(<0.05),且观察组患者中男性患者的血浆同型半胱氨酸水平明显高于女性患者,<0.05。结论脑梗死患者的血浆同型半胱氨酸水平明显高于正常人,且男性患者的血浆同型半胱氨酸水平明显高于女性患者。%Objective To investigate the relationship between acute cerebral infarction and homocysteine. Methods In our hospital from January 2013 2012 to January 2010, 86 cases of cerebral infarction patients as the observation group, and selected 86 cases of healthy persons as control group, the two groups of patients with plasma homocysteine levels were detected, and compared. Results In the observation group, the mean plasma homocysteine levels for (17.1±3.3) mol/L, control group, the mean plasma homocysteine levels for (9.8±1.8) mol/L were observed in group of patients with plasma homocysteine level was significantly higher than that of the control group ( < 0.05) and observation group in male patients with plasma homocysteine level was significantly higher in female patients, <0.05. Conclusion The plasma homocysteine level in cerebral infarction patients is significantly higher than that in normal subjects, and the plasma homocysteine level of male patients is significantly higher than that of female patients.

  14. Cerebral infarction showed hyperperfusion pattern on radionuclide cerebral angiography

    Four patients of middle cerebral infarctin showed hyperperfusion on radionuclide cerebral angiography and fan-shape accumulation at the area of middle cerebral artery on early and delayed brain scan. In these patients, bone scanning agents such as sup(99m)Tc-EHDP or sup(99m)Tc-MDP also prominently accumulated at the area of infarction. These findings were observed on the study when it was performed within seventeen days after attack, but reexamination tended to show normal or decreased perfusion on radionuclide cerebral angiography and improve abnormal accumulation on brain scans. The clinical diagnosis of these three patients were cerebral embolism with heart disease, but one patient was internal carotid artery occlusion. The prognosis of all patients were very good. The hyperperfusion on radionuclide cerebral angiography of these patients represents the luxury perfusion in the lesion and these infarction has been called hot stroke by Yarnell et al. (author)

  15. 脑梗死发病前使用抗栓药物治疗对急性脑梗死后出血转化的影响分析%Analysis of the effects of anti thrombotic drugs before cerebral infarction in patients with acute cerebral infarction

    刘思维; 周立春; 贾伟华

    2016-01-01

    目的:探讨脑梗死发病前使用抗栓药物治疗对急性脑梗死后出血转化的影响分析。方法回顾性分析神经内科2012年1月至2015年1月间住院的5967例急性脑梗死患者。收集所有患者入院时的基础资料、抗栓药物(溶栓、抗凝或抗血小板聚集药物)的使用情况以及 CT/ MRI 等影像学资料。按照入院后72 h 复查的影像学结果,将脑梗死发病出血转化的患者入组出血转化组,非出血转化的患者入组非出血转化组是按1:1入组,且患者的年龄、性别构成比均与出血转化组患者相匹配。比较两组患者发病前用药情况,比较两组患者入院前后美国国立卫生研究院卒中量表(NIHSS)评分、影像学监测到的脑梗死面积、糖尿病史、入院24 h 内的血压、心房颤动;采用多因素 Logistic 回归方法对差异有统计学意义的指标进行分析,确定脑梗死后出血转化的危险因素,并对比抗栓药物治疗对急性脑梗死后出血转化发生率的影响。结果本次研究选取5967例病例,符合标准共纳入728例。统计学分析显示两组患者脑梗死面积、NIHSS 评分、心房颤动、发病前抗栓药物治疗的差异有统计学意义,出血转化组患者发病前进行溶栓治疗以及使用抗凝药物的比率显明显高于非出血转化组( P <0.07)。结论脑梗死面积、NIHSS 评分、心房颤动比率、发病前抗栓药物治疗为急性脑梗死后出血转化的危险因素,其中发病前进行溶栓治疗、使用抗凝药物与急性脑梗死后出血转化密切相关,但与预后的远期影响关系有待进一步研究。%Objective To investigate the effect of anti - thrombotic drugs(anti - coagulation or anti - platelet aggregation drugs)on the bleeding and transformation of patients with acute cerebral infarction before the onset of cerebral infarction. Methods Retrospective analysis was performed in 5 967 patients

  16. ‘A lipaemic mystery’: a patient with hypertriglyceridaemic pancreatitis and cerebral infarction

    King, Patricia; Smith, Philip Joseph; Betteridge, John; Brown, Mike

    2011-01-01

    Hypertriglyceridaemia (HTG) causes up to 10% of all cases of acute pancreatitis (AP). It is the third most common cause after gallstones and alcohol. Despite this frequency, there are no clear guidelines for its specific management, mainly due to the paucity of evidence. The authors present a case and discussion of hypertriglyceridaemic pancreatitis (HTGP) complicated by an acute cerebral infarct. The patient’s subsequent death secondary to cerebral infarction opens the discussion as to wheth...

  17. Effect of ultraviolet blood irradiation and oxygenation on nerve function and function of the red blood cell membrane pump in patients with acute cerebral infarction

    Jiaquan Wang; Chun Mao; Kaifu Ma; Shiqing Wang

    2006-01-01

    BACKGROUND: Ultraviolet blood irradiation and oxygenation (UBIO) has obtained better clinical effect in treating acute cerebral infarction, but the mechanism underlying this effect remains unclear.OBJECTIVE: To observe the effect of UBIO on the nerve function and activities of K+-Na+-ATPase and Ca2+-Mg2+-ATPase activities on the red blood cell (RBC) membrane of patients with acute cerebral infarction.DESIGN: A randomized and controlled study.SETTING: Department of Neurology, Xiangfan Central Hospital.PARTICIPANTS: From January 2000 to December 2001, excluding those above 70 years old, 58 cases of 700 patients with acute cerebral infarction admitted in the Department of Neurology, Xiangfan Central Hospital, were recruited and divided into two groups according to the random number table: UBIO treated group (n=28), including 17 males and 11 females, aged 40-68 years; and control group (n=30), including 20males and 10 females, aged 44-69 years. All the patients agreed to participate in the therapeutic program and detected items. The general informations were comparable without obvious differences between the two groups (P > 0.05).METHODS: ① The patients in both groups received routine treatments, besides, those in the UBIO treated group were given UBIO treatment by using the XL-200 type therapeutic apparatus produced in Shijiazhuang, whose ultraviolet wave was set at 253.7 nm with the energy density of 0.568 J/m2 per second, UBIO treatment started from the second day after admission, once every other day, with a single course consisting of 5-7 treatments. ② In the UBIO treated group, the venous blood was sampled before and after the first, third and the completion of the treatment course respectively, the venous blood was taken at each corresponding time point in the control group. After centrifugation of the blood at 10 000 rounds per minute,the RBC membrane was separated and then the activities of K+-Na+-ATPase and Ca2+-Mg2+-ATPase were detected by means of

  18. MR imaging of acute hemorrhagic brain infarction

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author)

  19. MR imaging of acute hemorrhagic brain infarction

    Uchino, Akira; Ohnari, Norihiro; Ohno, Masato (Kyushu Rosai Hospital, Fukuoka (Japan))

    1989-11-01

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author).

  20. Clinical significance of urine ferritin in patients with cerebral infarction

    周慧

    2013-01-01

    Objective To find an indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction (CI) ,with ratio ofmales to females

  1. Acute ischemic cerebral attack

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  2. Complete middle cerebral artery block without brain infarction

    Sunil Pradhan

    2016-01-01

    Full Text Available We report a patient with progressive supranuclear palsy and incidentally detected the absence of right middle cerebral artery (MCA without any old or acute infarct in its territory. The magnetic resonance angiography and computed tomography angiography failed to detect any significant collateral circulation. We discuss the embryogenesis of brain circulation and offer a possible explanation for the nonvisualization of the right MCA in our patient.

  3. Care of Hyperbaric Oxygen in the Treatment of Patients with Acute Cerebral Infarction%急性脑梗死高压氧治疗的护理

    刘艳洁; 李雪莲; 任秀国; 王静; 李超; 王丽茹

    2012-01-01

    本文总结了30 例高压氧治疗急性脑梗死患者过程中的护理要点.护理要点主要包括高压氧入舱前的护理、舱内的护理、出舱后的护理等.入舱前的护理主要包括对患者的常规护理及对病人的安全告知,并对患者进行心理护理及健康教育,使患者充分了解高压氧治疗前的一些注意事项.舱内的护理主要是定时与患者沟通,了解治疗过程中患者的感受与需求,以保证治疗的顺利进行.出舱后的护理包括协助患者出舱,告知患者出舱后的一些注意事项,如休息及饮食等,告知下次治疗的时间,并将患者安全送回病房.良好的护理能够提高高压氧治疗急性脑梗死的疗效.%This paper summarizes the nursing points of 30 cases of hyperbaric oxygen therapy of acute cerebral infarction . Nursing points include care before entering hyperbaric chamber, care in the hyperbaric chamber and care after hyperbaric oxygen therapy . Care before entering hyperbaric chamber includes the routine care safety inform to patients , psychological care and health education to patients , making the patients fully know about the notes before hyperbaric oxygen treatment. Care in the hyperbaric chamber is to communicate with patients , knowing about the feelings and needs of the patients during treatment for making sure the smooth progress of treatment . Care after hyperbaric oxygen therapy is to help patients* spacewalk . Informing some notes of the patients extravehicular , such as rest and diet , informing them the time of next treatment and safely transporting patients return to the wards . Therefore, the author thinks that good care can improve the efficacy of the patients with acute cerebral infarction which is worth to the application for the nurses .

  4. 急性脑梗死与血浆同型半胱氨酸的相关性分析%Analysis of relationship between acute cerebral infarction and plasma homocysteine

    胡林强; 曹亦宾

    2012-01-01

    Objective To observe the relationship between acute cerebral infarction and plasma homocysteine(Hcy).Methods Serum bomocysteien levels were tested in patients with cerebral infarction and the normal to analyze the relationship between hyperhomocysteincmia and cerebral infarction.Results The average level of serum homocysteine in patients with the cerebral infarction was (16.4 ±3.1)μmol/L,and the average level of serum homocysteine in the normals was (10.0 ± 1.8) μmol/L.There was a significant difference between two groups (P <0.01).Conclusions Patients with cerebral infarction have a higher level of serum homocysteine than normal,so hyperhomocysteincmia may be one of the dangerous factors of cerebral infarction.It is possible to reduce and delay the development of cerebral infarction by decreasing the level of serum homocysteine.%目的 观察急性脑梗死与血浆同型半胱氨酸(Hcy)的关系.方法 对102例脑梗死患者(脑梗死组)及113例体检健康者(对照组)进行血浆Hcy检测,比较2组血浆Hcy水平的差异,并分析其与脑梗死的关系.结果 脑梗死组患者中高Hcy血症45例(42.9%),血浆Hcy水平平均为(16.4±3.1) μmol/L,对照组高Hcy血症12例(9.8%),血浆Hcy水平平均为(10.0±1.8) μmol/L,2组比较差异有统计学意义(P<0.01).结论 脑梗死患者血浆Hcy水平明显高于正常人,高Hcy血症可能是脑梗死的危险因素.

  5. SPECT analysis of recent cerebral infarction

    Raynaud, C; Rancurel, G; Tzourio, N; Soucy, J P; Baron, J C; Pappata, S; Cambon, H; Mazoyer, B; Lassen, N A; Cabanis, E

    1989-01-01

    We measured regional cerebral blood flow and [123I]iodoamphetamine (IMP) uptake in 16 patients with unilateral brain infarcts during the subacute period (Day 3 to Day 50) and again after 3 months. Our results show that the central and peripheral areas described earlier in the chronic period were ...

  6. Clinical application of MR imaging in the acute stage of brain infarction

    The purpose of this study was to assess the clinical usefulness of diffusion weighted image (DWI) and perfusion image (PI) using echo planar imaging in the acute stage of cerebral infarction. Eighteen patients with cerebral infarction were imaged with magnetic resonance angiography, fast fluid attenuated inversion recovery (FLAIR), DWI, and PI. With PI, time-Δ R2 curve can calculate hemodynamics of relative regional cerebral blood volume (rCBV) and mean transit time (MTT). All regions of acute stage of brain infarction in 18 patients were demonstrated with DWI clearly. The lesion, in one case, was visible only 1.5 hour after the onset. The infarct lesions, which included lacunas, infarct, cortical infarct, and cardioembolic infarct, were distinguished from old infarct or leukoariosis. Time intensity curves, regional CBV maps, and relative MTT maps of perfusion study revealed low cerebral perfusion in the area of the infarct. The rMTT map demonstrated a perfusion abnormality much larger than the rCBV map abnormality. According to PI studies, one case had collateral flow in ischemic area, while five other cases had cardioembolic infarctions and received thrombolytic therapy. In conclusion, diffusion weighted image was useful for diagnosis of cytotoxic edema in cerebral infarction during the hyperacute stage. Perfusion image was useful as a simple modality of cerebral hemodynamics in cerebral infarction. These neuroimaging of magnetic resonance can help in deciding thrombolytic and neuroprotective therapies for brain ischemia. (author)

  7. Effect of the Principle of Activating Blood Circulation to Break Stasis on GMP-140 and D2 Dimer in Patients with Acute Cerebral Infarction

    WANG Ning

    2005-01-01

    Objective:To explore the clinical efficacy of the principle of activating blood circulation to break stasis (ABCBS) and its influence on platelet membranous protein particle (GMP-140) and D2 dimer (Ddimer) before and after treatment. Methods: Eighty-eight patients with blood stasis syndrome (BSS) of acute cerebral infarction (ACI) were randomly divided into two groups, both of which were treated with conventional treatment, i.e. with western medicine (WM), with Salvia injection added through intravenously dripping.One of the two groups was used as the control and the other group as the treated group who had ABCBS herbs orally taken in addition. The duration of treatment course for both groups was 3 weeks. Results: There were changes in both groups over clinical symptoms, nerve function deficit scoring and GMP-140, D-dimer, but the treated group showed significantly better than that of the control group, (P<0.05). Conclusion: ABCBS principle could serve as an important auxiliary treating method for BSS of ACI, as it can effectively alter the blood of ACI patients which was viscous, condense, coagulant and aggregating.

  8. Clinical analysis of serum H-FABP level in the patients of acute cerebral infarction%急性脑梗死患者H-FABP检测结果的临床分析

    何永利; 黄廷富; 潘小平

    2013-01-01

    ObjectiveTo observe the relationship between the risk factors of acute cerebral infarction and serum H-FABP level and to evaluate the value of H-FABP measurement in the early diagnosis, treatment and prognosis of acute cerebral infarction.MethodsTodetect serum levels of H-FABP in the patients of acute cerebral infarction, and to analysis serum H-FABP level in the 126 cases of acute cerebral infarction by age, infarction area, hypertension, diabetes, hyperlipidemia, level of consciousness, stress hyperglycemia.ResultsClinical data analysis suggests that maximum area of cerebral ischemia and diabetic complications was statistically significant with serum H-FABP level in the patients of acute cerebral infarction H-FABP. Age, hypertension, hyperlipidemia, level of consciousness and stress hyperglycemia were not statistically significant with serum H-FABP level. Serum H-FABP level increased with infarct area at 1 hour and 3 hours after the onset of acute cerebral infarction(P<0.05). Diabetic patients with acute cerebral infarction were higher than non-diabetic patients with acute cerebral infarction in H-FABP level (P<0.05)[30 min: (8.03±0.41)μg/L in diabetes higher than(4.65±0.32)μg/L in non-diabetic patients; 1 h:(11.48±0.52)μg/L in diabetes higher than (6.74±0.38)μg/L; 3 h:(18.67±0.48)μg/L in diabetes higher than (8.89±0.53)μg/L;6 h:(12.59±0.55]μg/L in diabetes higher than (8.81±0.37)μg/L]. Conclusion The increase of serum H-FABP level after acute cerebral infarction is multifactorial. The serum H-FABP level may be the clinical assessment indicators as acute cerebral infarction diagnosis, treatment and prognosis.%目的:探讨急性脑梗死的危险因素与心肌型脂肪酸结合蛋白(H-FABP)血清水平的关系,评价检测 H-FABP在急性脑梗死的早期诊断、评定临床治疗和预后中的价值。方法对126例急性脑梗死的患者,检测H-FABP 在急性脑梗死的早期血清水平值,分析年龄、最大梗死面

  9. Acute myopericarditis masquerading as acute myocardial infarction

    Wen Tian; Zixin Zhang; Xiaojuan Bai; Dingyin Zeng; Guoxian Qi

    2008-01-01

    Patients with abrupt onset of chest pain, ischemic ECG abnormalities and elevated levels of cardiac markers could be given a diagnosis of acute myocardial infarction. However, some other diseases should be taken into consideration in this clinical setting when coronary arteries are proven to be normal. Here we report a case of acute myopericarditis with clinical presentation of myocardial infarction and normal coronary anatomy. The Herpes Simplex Virus Ⅱ was considered as the organism causing myopericarditis and the patient was recovered by the treatment with valacicloavir. A precise diagnosis is a prerequisite of successful treatment and favorable prognosis.

  10. Enteroviruses in Acute Myocardial Infarction

    A Gholoobi; MS Nabavinia; T Mohamadpoor; MS Alavi; Z Meshkat

    2012-01-01

    Background: Human enteroviruses (EVs) may have a role as a possible risk factor in the pathogenesis of MI. The aim of this study was to evaluate the presence of enterovirus genomic RNA in peripheral blood samples of patients with acute myocardial infarction (MI). Methods: We investigated the presence of enterovirus genomic RNA in the peripheral blood of 115 patients with acute MI hospitalized in the Coronary Care Unit of Imam Reza and Ghaem University Hospitals (Mashhad, Iran) by RT-PCR using...

  11. Painless acute myocardial infarction on Mount Kilimanjaro.

    Jamal, Nasiruddin; Rajhy, Mubina; Bapumia, Mustaafa

    2016-01-01

    An individual experiencing dyspnoea or syncope at high altitude is commonly diagnosed to have high-altitude pulmonary edema or cerebral edema. Acute myocardial infarction (AMI) is generally not considered in the differential diagnosis. There have been very rare cases of AMI reported only from Mount Everest. We report a case of painless ST segment elevation myocardial infarction (STEMI) that occurred while climbing Mount Kilimanjaro. A 51-year-old man suffered dyspnoea and loss of consciousness near the mountain peak, at about 5600 m. At a nearby hospital, he was treated as a case of high-altitude pulmonary edema. ECG was not obtained. Two days after the incident, he presented to our institution with continued symptoms of dyspnoea, light-headedness and weakness, but no pain. He was found to have inferior wall and right ventricular STEMI complicated by complete heart block. He was successfully managed with coronary angioplasty, with good recovery. PMID:26989121

  12. Determination of serum neuron specific enolase and glutathion S transferases levels in patients with acute cerebral infarction and its clinical significance

    Objective: To evaluate the variation of serum neuron specific enolase (NSE) and glutathion S transferases (GST) levels in patients with cerebral infarction and its clinical significance. Methods: The serum levels of NSE in cerebral infarction patients were determined with immunoradiometric assay (IRMA), and the serum level of GST were determined by enzyme immuno sandwich assay (ELISA). Results: Serum NSE levels linked in patients were significantly higher (p<0.01) and GST serum levels were significantly lower (p < 0.01) within 3 days after onset of disease than those at two weeks and those in the controls. There was a positive correlation between serum NSE levels and neurological deficit scores (p < 0.001) and a negative correlation with serum GST levels (p < 0.05). There was also a close relationship between the serum NSE levels and the volume of infarction (p < 0.001). Conclusion: There was a close relationship between the Serum levels of NSE, GST and clinical features of Patients in the early stage of cerebral infarction

  13. Acute myocardial infarction.

    Rischpler, Christoph

    2016-09-01

    Inflammatory processes after myocardial infarction have gained major interest in recent cardiovascular research. It is believed that not only the degree of cell recruitment to the heart plays a pivotal role in the quality of wound healing after myocardial infarction, but also the balance between different types or even subtypes of cells. It is also this balance which is thought to control key processes in tissue repair, such as apoptosis and neoangiogenesis. In this paper, we aim to review imaging strategies (with a special focus on nuclear molecular imaging strategies) that target cells and processes involved in postischemic inflammation and that have a high potential to be translated into clinic or that are already being used and evaluated in humans. PMID:27225319

  14. Acute myocardial infarction

    De la Vega-Vélez Henrique

    2012-01-01

    The prevalence of the myocardial infarction (MI) was increasing according to the decadesof the 20th century. In the second decade, the electrocardiogram was introduced, animportant diagnostic tool which still has full validity. The professor of the Facultadde Medicina of the Universidad de Cartagena, Colombia, Henrique de la Vega Vélezpublished in 1942 a thematic review that includes three clinical cases of MI. The textallows observing the conceptualization that was managed seventy years ago ...

  15. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

    Dastidar Prasun; Marchesotti Silvia; Jason Eeva; Rossi Maija E; Ollikainen Jyrki; Soimakallio Seppo

    2010-01-01

    Abstract Background Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. Methods The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acut...

  16. Recirculation usually precedes malignant edema in middle cerebral artery infarcts

    Nielsen, T H; Ståhl, N; Schalén, W;

    2012-01-01

    In patients with large middle cerebral artery (MCA) infarcts, maximum brain swelling leading to cerebral herniation and death usually occurs 2-5 days after onset of stroke. The study aimed at exploring the pattern of compounds related to cerebral energy metabolism in infarcted brain tissue....

  17. [Fibrinolysis in acute myocardial infarct].

    Bleifeld, W

    1987-10-24

    Fibrinolysis has opened up a new avenue in the treatment of acute myocardial infarction (AMI). In principle, the rate of reperfusion depends on the type of compound used, the mode of administration and the time between onset of symptoms and the beginning of treatment. With intracoronary streptokinase the reperfusion rate is of the order of 85%. Intravenous urokinase administered as a bolus results in a reopening rate of 50-60%; a similar rate of reperfusion is achieved with rt-PA as infusion, while i.v. streptokinase produces about 50% reopened coronary vessels. The final infarct size is decreased in 70% of patients if fibrinolysis is initiated within 2.5 hours after the onset of symptoms and followed by reopening of the occluded vessel. This results in a lowering of in-hospital mortality, which in various studies is of the order of 45-60%.- Bearing in mind the contraindications, fibrinolysis should be initiated within 3 hours. Hemodynamic improvement by a decrease of infarct size may also be achieved beyond 3 hours in large anterior myocardial infarctions and in posterior infarctions with cardiogenic shock. Early initiation of thrombolysis is of major importance in improving left ventricular function and lowering mortality following acute myocardial infarction. Therefore, prehospital thrombolytic therapy should be considered. - In the postinfarction phase coronary angiography is indicated in patients with angina at rest, stable angina of ECG signs of ischemia. In this situation transfer to a specialized cardiology division for possible percutaneous transluminal angioplasty is indicated. - Reocclusion after successful thrombolysis occurs in 20-30%, and it is therefore important to avoid reinfarction to improve the long term prognosis after AMI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3321420

  18. Pure dysarthria due to cerebral infarction

    No large case series of pure dysarthria due to stroke has been reported. We investigated the anatomical lesions in patients with pure dysarthria by examining findings on brain magnetic resonance imaging (MRI), including diffusion-weighted imaging. We reviewed the admission records of 835 consecutive patients who presented for treatment between April 2003 and March 2008. We selected the patients with pure dysarthria and investigated findings from magnetic resonance imaging (MRI), 3-dimensional magnetic resonance angiography (3-D MRA), single photon emission computed tomography (SPECT), and carotid artery echography, as well as the prothrombin time-international ratio (PT-INR) and D-dimer measurement. A total of 20 patients had pure dysarthria (17 men, 3 women; frequency, 2.4%). Facial nerve paresis was noted in 8 patients and poor tongue movement in 7. Seven patients had more than 2 cerebrovascular risk factors for stroke. Twelve patients initially visited other departments; 6 initially presented to the otorhinolaryngology department. Brain MRI revealed that in 15 patients, left-side lesions had caused the pure dysarthria. The corresponding lesions were located in the internal capsule in 8 patients, in the cerebral cortex in 4, in the corona radiata in 4, in the putamen in 2, in the cerebral peduncle in 1, and in the pons in 1. Three-dimensional MRA showed marked stenosis of the middle cerebral artery in 1 patient. Sixteen patients had lacunar infarction, and cerebral emboli were implicated in the pathogenesis of infarction in 4 patients. Brain SPECT data showed significant hypoperfusion in the central and pre-central regions on the side of the infarct. Carotid artery echograms and MR imaging of lesions were not correlated. PT-INR and D-dimer were not associated with the clinical type of cerebral infarction. Although pure dysarthria is likely a rare condition, it should be considered in patients with cerebral infarction. Brain MRI revealed that the topographically

  19. 急性脑梗死早期溶栓的观察与护理%Early Thrombolysis in Acute Cerebral Infarction and Nursing

    杨境云

    2015-01-01

    目的:探讨和评价对急性脑梗死患者早期溶栓治疗的观察体会和临床护理效果。方法选择2012年1月~2014年7月在我院接受治疗的168例急性脑梗死患者为研究对象,对这168例入院患者采用静脉滴注溶栓剂进行治疗,并进行优质护理,观察溶栓前与溶栓后的机体各项指标情况,结果所有患者在溶栓后2 h有效率为70.24%,溶栓后2~12 h为79.76%,溶栓后12~24 h为91.07%,溶栓后24~48 h为97.62%不同时间段比较具有统计学意义(P<0.05);并发胃肠道出血和头痛呕吐患者各2例,占总人数的2.38%。结论急性脑梗死患者行早期溶栓处理,并采取优质护理,可提高血管通畅性,对减小患者死亡率、提高治愈率具有非常重要的临床意义,值得进一步推广。%Objective January 2012~July 2014 in our hospital treated 168 cases of acute cerebral infarction patients for the study,these 168 cases of hospitalized patients with intravenous thrombolytic agent for treatment,and quality care,observation before thrombolysis with various indicators of the body after thrombolysis,Results Al patients in the two hours after thrombolysis effective rate of 70.24%,2~12 h after thrombolysis was 79.76%,12 ~ 24h after thrombolysis was 91.07%,Compare with a 24~48 h to 97.62% in different time periods after thrombolysis significantly (P<0.05);2.38% concurrent gastrointestinal bleeding and headaches and vomiting in patients with various two cases,the total number.ConclusionPatients with acute cerebral infarction thrombolytic treatment,and take high-quality care,can improve blood vessel patency,in reducing mortality,improve the cure rate has very important clinical significance,worthy of further promotion.

  20. Myocardial infarction and cerebral infarction in a Danish suburban community

    Lyngborg, K; Marquardsen, J; Trautner, F;

    1985-01-01

    females; the rates for CI were 2.4 and 2.5, respectively. The age-incidence curves, particularly those for AMI, were significantly steeper in the females than in the males. Correspondingly, the male predominance in the AMI-group subsided with age. Age-specific incidence-rates rose exponentially with...... advancing age; for each sex and diagnosis the relationship can thus be expressed as a simple mathematical formula, which may facilitate comparisons of incidence patterns in different communities. Theories explaining the similarities and differences of the age-incidence curves for AMI and CI are discussed.......A comparison was made of 485 cases of cerebral infarction (CI), registered prospectively in Frederiksberg, Copenhagen, with 495 cases of myocardial infarction (AMI), recorded retrospectively in the same population. The overall annual incidence of AMI was 6.5 per 1,000 population for males, 3.8 for...

  1. The combined analysis of biological markers for the prognosis of acute cerebral infarction%影响急性脑梗死预后的各生物学标志物联合分析

    李东杰; 杜宗孝; 张亚梅; 朴文花

    2012-01-01

    Objective To evaluate the prognosis effects of biological markers on acute cerebral infarction .Methods 111 patients with acute cerebral infarction and 104 normal controls were randomly recruited .S100B protein,myelin basic protein(MBP),glial fi-brillary acidic protein(GFAP),interleukin-6(IL-6) were determined within 24 h and 3 d alter acute cerebral infarction .All biological markers concentration in normal controls were determined immediately alter medical check-up .All biological markers and risk factors were evaluated by logistic regression .Results The logistic regression analysis results showed that serum IL-6,S100B protein, smoking,GFAP,hs-CRP,MBP,D-Dimer,body mass index,alcohol drunken were associated with poor outcomes of acute cerebral infarction,odds ratio (OR ) values were 3 .21,2 .70,2 .53,2 .11,1 .91,1.57,1.50,1 .13 and 1.11 .Conclusion IL-6,S100B protein, smoking,glial fibrillary acidic protein, hs-CRP, myelin basic protein,D-Dimer,body mass index, alcohol drunken were associated with poor outcomes of acute cerebral infarction .It has great significance to monitor the changing of those markers for prognosis e-valuation of acute cerebral infarction .%目的 探讨各生物学标志物对急性脑梗死预后的影响.方法 选取急性脑梗死病例111例,健康对照组104例,在发病24 h内、发病后3 d检测病例组血清S100B蛋白、髓鞘碱性蛋白(MBP)、胶质纤维酸性蛋白(GFAP)、白细胞介素-6 (IL-6)浓度,在发病24 h内检测血清超敏C-反应蛋白(hs-CRP)、血浆D-二聚体(DD)浓度,并于体检当天检测对照组相应标志物浓度.对各标志物浓度及风险因素进行Logistic回归分析.结果 血清IL-6、S100B、吸烟、GFAP、hs-CRP、MBP、血浆DD、体质量指数、饮酒与急性脑梗死的不良结局相关,其OR值分别为3.21、2.70、2.53、2.11、1.91、1.57、1.50、1.13、1.11.结论 血清IL-6、S100B、吸烟、GFAP、hs-CRP、MBP、血浆DD、体质量指数、饮酒与急性脑梗

  2. Application of MR diffusion-weighted imaging in the diagnosis of hyperacute cerebral infarction

    Objective: To evaluate the accuracy of MR diffusion-weighted imaging (DWI) in the diagnosis of hyperacute cerebral infarction. Methods: Twenty-one patients with onset of stroke like symptoms underwent conventional MRI and DWI within 6 hours. Results: DWI indicated cerebral infarction in 16 patients, all of whom had a final diagnosis of acute stroke. DWI was negative in 5 patients, all of whom had a final diagnosis of TIA. The abnormality seen at DWI was confirmed with follow-up study. DWI had a sensitivity of 100% and a specificity of 100% in the diagnosis of hyperacute cerebral infarction, and conventional MRI interpretation yielded a sensitivity and specificity of 25% and 100%, respectively. Conclusion: DWI is highly accurate in diagnosing hyperacute cerebral infarction and is superior to conventional MRI

  3. DI-3-butylphthalide-enhanced hematopoietic stem cell transplantation and endogenous stem cell mobilization for the treatment of cerebral infarcts

    Baoquan Lu; Xiaoming Shang; Yongqiu Li; Hongying Ma; Chunqin Liu; Jianmin Li; Yingqi Zhang; Shaoxin Yao

    2011-01-01

    Exogenous stem cell transplantation and endogenous stem cell mobilization are both effective for the treatment of acute cerebral infarction. The compound dl-3-butylphthalide is known to improve microcirculation and help brain cells at the infarct loci. This experiment aimed to investigate the effects of dl-3-butylphthalide intervention based on the transplantation of hematopoietic stem cells and mobilization of endogenous stem cells in a rat model of cerebral infarction, following middle cerebral artery occlusion. Results showed that neurological function was greatly improved and infarct volume was reduced in rats with cerebral infarction. Data also showed that dl-3-butylphthalide can promote hematopoietic stem cells to transform into vascular endothelial cells and neuronal-like cells, and also enhance the therapeutic effect on cerebral infarction by hematopoietic stem cell transplantation and endogenous stem cell mobilization.

  4. 2型糖尿病合并急性脑梗死的临床研究%Clinical study of type-2 diabetes mellitus complicated with acute cerebral infarction

    关颖; 张茁

    2011-01-01

    Objective To investigate the clinical characteristics of type-2 diabetes mellitus complicated with acute cerebral infarction. Methods 150 patients with type-2 diabetes mellitus complicated with acute cerebral infarction in Anzhen Hospital from 2008 to 2009 were investigated as the diabetes group. 150 cases with acute cerebral infarction without type-2 diabetes mellitus were enrolled as the control group. Age, sex, fasting blood glucose ( FBG), glycosylated hemoglobin (HbAlc) ,TG,TC, HDL-C,LDL-C, clinical manifestation, position of cerebral infarction, complications, efficacy of treatment and prognosis were compared between the two groups. Results Compared with the control group,age and proportion of male patients were significantly lower, hemianopia,vertigo,diplopia,ataxia,FBG,HbAlc,TG,TC,LDL-C were significantly higher in diabetes group (P ll. 1 mmol/L were 5. 12±1. 21,7. 94±2. 13 and 11. 90±2. 35 (P < 0. 01). Conclusion Diabetes mellitus and stroke were correlated with age and sex. Severity of clinical symptoms was correlated with the blood glucose level on admission in type-2 diabetes mellitus complicated with acute cerebral infarction. Main type of cerebral infarction was posterior circulation infarction in diabetes group. Incidence of complications in the diabetes group was significantly higher than that in the control group. Therapeutic efficacy and prognosis were worse in diabetes group.%摘要:目的 探讨2型糖尿病合并急性脑梗死的临床特点.方法 选择住院的糖尿病合并急性脑梗死患者(糖尿病组)150例,另随机选择同期的非糖尿病合并急性脑梗死患者(对照组)150例.对2组患者年龄、性别、空腹血糖、糖化血红蛋白、血脂、临床表现、脑梗死部位、病情轻重程度、并发症、临床疗效及预后进行比较.结果 与对照组比较,糖尿病组患者年龄、男性比例明显降低,空腹血糖、糖化血红蛋白、TC、TG、LDL-C、偏盲、眩晕、复视

  5. A rat model of reproducible cerebral infarction using thrombotic blood clot emboli

    Overgaard, K.; Sereghy, T.; Boysen, G.; Pedersen, H.; Høyer, S.; Diemer, Nils Henrik

    Neuropathology, experimental thromboembolism, stroke, blood flow, in vitro thrombotic clotting, cerebral infarction, rat......Neuropathology, experimental thromboembolism, stroke, blood flow, in vitro thrombotic clotting, cerebral infarction, rat...

  6. Study on the Relationship of Carotid Atherosclerosis and Acute Cerebral Infarction%颈动脉粥样硬化程度与急性脑梗死相关性探讨研究

    沈雪莉; 张斯萌; 隹梦遥; 戚其学

    2011-01-01

    Objective To investigate carotid atherosclerosis risk factors and sclerosis hardenability in patients with acute cerebral infarction. Methods 60 cases of acute cerebral infarction patients,the normal physical exam compares 40 cases,two groups of patients on blood glucose,blood lipids,fibrinogen,blood pressure,carotid atherosclerosis were compared,while carotid atherosclerosis the degree of clinical manifestations of patients with cerebral infarction were compared to explore the correlation between them Results The acute cerebral infarction group and the normal control group,blood glucose,cholesterol,low density lipoprotein,fibrinogen levels and high blood pressure,smoking,drinking rates were significantly higher(P<0.05),carotid artery intimal thickness of atherosclerotic plaque formation and stenosis rate,there were significant differences between the two groups(P<0.05),carotid atherosclerotic plaque,stenosis <50% and≥50% of the clinical symptoms of cerebral infarction patients with different neurological deficit score(NIHSS score) compared with significant difference(P<0.05).Conclusion The blood glucose,blood lipids,fibrinogen level increased and carotid atherosclerosis,hypertension,smoking,alcohol risk factors of acute cerebral infarction,carotid artery atherosclerotic plaque and the degree of stenosis are closely related to the severity of patients.%目的 探讨颈动脉粥样硬化的危险因素及硬化程度与急性脑梗死的相关性.方法 选择急性脑梗死病例60例,正常健康体检对照40名,对其血糖、血脂、纤维蛋白原、血压、颈动脉粥样硬化程度等进行对照分析,同时将颈动脉粥样硬化的程度与脑梗死病人临床表现进行对照分析,探讨它们之间的相关性.结果 急性脑梗死组与正常对照组相比,血糖、胆固醇(TC)、低密度脂蛋白(LDH-C)、纤维蛋白原(FIB)含量以及高血压、吸烟、饮酒者比率均明显增高(P<0.05),颈动脉粥样硬化内膜

  7. CORRELATION BETWEEN FIBRINOGEN LEVEL AND CEREBRAL INFARCTION

    Yi-cheng Zhu; Li-ying Cui; Bao-lai Hua; Jia-qi Pan

    2006-01-01

    Objective To investigate the correlation between plasma fibrinogen level and cerebral infarction (CI) as well as the difference of fibrinogen among subtypes of CI.Methods A case-controlled study was conducted with 131 cases of CI and 148 controls. Plasma fibrinogen levels were detected by the Clauss method.Results High fibrinogen level (3.09±0.94 g/L) was correlated with CI (OR=2.47, 95% CI:1.51-4.04,P<0.005) at the onset stage of the disease. Persistent high fibrinogen level (3.14±0.81 g/L) at 6-month after stroke onset was detected and correlated with CI (OR=4.34, 95% CI: 1.80-10. 51,P=0.001). Higher fibrinogen level was correlated with total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), and posterior circulation infarction (POCI) (OR = 4.008, P<0.001). Higher fibrinogen level was correlated with extracranial atherosclerosis (OR=3.220, P<0.05), but not with intracranial atherosclerosis.Conclusion Fibrinogen level may be a risk factor of CI and probably correlates with subtypes of CI and distributions of atherosclerosis.

  8. Massive cerebral infarction as a feature of pituitary apoplexy.

    Lath R

    2001-04-01

    Full Text Available A patient with pituitary apoplexy is reported who, in addition to the clinical features of apoplexy, developed a cerebral infarct secondary to compression of the internal carotid artery. The mechanisms of a cerebral infarct associated with pituitary apoplexy are discussed.

  9. Delayed Ventricular Septal Rupture after Percutaneous Coronary Intervention in Acute Myocardial Infarction

    Park, Ji Young; Park, Seong Hoon; Oh, Ji Young; Kim, In Je; Lee, Yu Hyun; Park, Si Hoon; Kwon, Ki Hwan

    2005-01-01

    In the era before reperfusion therapy, ventricular septal rupture complicated 1~3% of acute myocardial infarctions (AMI) usually 3-5 days after onset. Studies have reported a positive correlation between the incidence of septal perforation and total occlusion of the coronary arteries. A 70-year old female patient was referred to the emergency room with the diagnosis of acute anterior myocardial infarction (MI) and recent cerebral infarction. The coronary angiogram showed a 90% stenosis at the...

  10. SERUM MAGNESIUM IN ACUTE MYOCARDIAL INFARCTION

    Nambakam Tanuja; Girish P

    2015-01-01

    BACKGROUND: In myocardial infarction, there occurs functional deficit of available magnesium due to trapping of free magnesium in adipocytes. Magnesium has been implicated in the pathogenesis of acute myocardial infarction and its complications. Magnesium ions are considered essential for the maintenance of functional integrity of myocardium. The serum magnesium concentration was found to have g reat significance in acute myocardial infarction. The present study was un...

  11. 持续性健康教育对急性脑梗死患者复发率的影响%Influence of Relapse rate in patients with persistent health education on acute cerebral infarction

    张红

    2014-01-01

    目的:探讨持续性健康教育对急性脑梗死患者复发率的影响。方法:选取急性脑梗死患者168例,随机分为对照组和观察组,每组84例。对照组在住院期间给予常规的治疗和的护理模式,出院后不给予主动的健康教育干预措施。观察组从患者入院开始到出院后6个月给予持续系统化的健康教育。结果:观察组在随访6个月后的脑梗死的复发率明显低于对照组,差异有统计学意义( P<0.01)。结论:持续性健康教育能明显降低脑梗死的复发率,从而进一步提高患者的生活质量。%Objective To study the sustainable health education effect on recurrence in patients with acute cerebral infarction. Method 168 cases of patients with acute cerebral infarction who were selected,were randomly divided into control group and observation group,84 cases in each group. Control group was given conventional treatment and nursing care during hospitalization model,after discharge was not to take the initiative to health education intervention measures. Observation group from the patientˊs admission to the hospital after 6 months was given continuous systematic health education. Results The observation group in the follow-up of 6 months after cerebral infarction re-currence rate significantly was lower than the control group,The difference was statistically significant( P<0. 01 ). Conclusion persistent health education can significantly reduce the recurrence rate of cerebral infarction,further improve the patientˊs quality of life.

  12. Diffusion-weighted MRI in acute cerebral stroke

    Takayama, Hideichi; Kobayashi, Masahito; Suga, Sadao; Kawase, Takeshi; Nagasawa, Masakazu; Sadanaga, Humiko; Okamura, Miyuki; Kanai, Yoshihiro; Mihara, Ban [Mihara Memorial Hospital, Isezaki, Gunma (Japan)

    1999-03-01

    Diffusion-weighted MRI has been demonstrated to be valuable in the assessment of cerebral stroke. Recent advance in MR systems of hardware with larger maximum gradient amplitude and faster imaging strategies, such as EPI, has made it possible to acquire whole brain diffusion-weighted imaging (DWI) in less that one minute. The purposes of this study are to evaluate clinical usefulness of DWI and to clarify pitfalls in the diagnosis of acute cerebral stroke. Seventeen patients with 18 ischemic lesions were studied. DWI were taken with 1.5 Tesla MRI (Magnetom Vision, Siemens, Germany) using EPI sequence. Fifteen lesions out of them (3 in cerebral cortex, 9 in basal ganglia/deep white matter and 3 in cerebellum) were studied serially at various times up to 147 days. Acute cerebral infarction was seen clearly as an area of hyperintensity with DWI and as hypointensity in apparent diffusion coefficient (ADC) maps which are indicative of decreased diffusion. DWI detected areas of hyperintense acute infarcts, as early as 2.5 hours after onset, which were not visualized on T{sub 2}-weighted image (T2WI). The lesion of cerebral infarction became isointense in ADC maps at 14-28 days after onset, whereas with DWI it became isointense at about 2 months. Because ADC changed earlier than DWI, ADC maps were useful for differentiate acute from nonacute lesion in cases of recurrent stroke within a short period. In a patient with transient global amnesia for 7 hours, DWI did not show any lesion at 8 hours. In terms of cerebral hemorrhage, lesions were seen as area of hyperintensity in DWI at 3 days and were not distinguishable from that of infarct. Despite limitations in the diagnosis of transient ischemia and cerebral hemorrhage, DWI is a useful technique for early detection of cerebral infarction, especially within the first 6 hours after stroke onset. (author)

  13. Diffusion-weighted MRI in acute cerebral stroke

    Diffusion-weighted MRI has been demonstrated to be valuable in the assessment of cerebral stroke. Recent advance in MR systems of hardware with larger maximum gradient amplitude and faster imaging strategies, such as EPI, has made it possible to acquire whole brain diffusion-weighted imaging (DWI) in less that one minute. The purposes of this study are to evaluate clinical usefulness of DWI and to clarify pitfalls in the diagnosis of acute cerebral stroke. Seventeen patients with 18 ischemic lesions were studied. DWI were taken with 1.5 Tesla MRI (Magnetom Vision, Siemens, Germany) using EPI sequence. Fifteen lesions out of them (3 in cerebral cortex, 9 in basal ganglia/deep white matter and 3 in cerebellum) were studied serially at various times up to 147 days. Acute cerebral infarction was seen clearly as an area of hyperintensity with DWI and as hypointensity in apparent diffusion coefficient (ADC) maps which are indicative of decreased diffusion. DWI detected areas of hyperintense acute infarcts, as early as 2.5 hours after onset, which were not visualized on T2-weighted image (T2WI). The lesion of cerebral infarction became isointense in ADC maps at 14-28 days after onset, whereas with DWI it became isointense at about 2 months. Because ADC changed earlier than DWI, ADC maps were useful for differentiate acute from nonacute lesion in cases of recurrent stroke within a short period. In a patient with transient global amnesia for 7 hours, DWI did not show any lesion at 8 hours. In terms of cerebral hemorrhage, lesions were seen as area of hyperintensity in DWI at 3 days and were not distinguishable from that of infarct. Despite limitations in the diagnosis of transient ischemia and cerebral hemorrhage, DWI is a useful technique for early detection of cerebral infarction, especially within the first 6 hours after stroke onset. (author)

  14. Contralateral Cerebral Infarction after Stent Placement in Carotid Artery: An Unexpected Complication

    Park, Seong-Ho; Lee, Chang Young

    2008-01-01

    Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondar...

  15. Effect of prostaglandin E1 on cerebral blood flow in patients with chronic cerebral infarction

    The effect of prostaglandin E1 (PGE1) on cerebral blood flow (CBF) was studied in 10 patients with chronic cerebral infarction. Regional cerebral blood flow (rCBF) was measured by single photon emission computed tomography before and after they received PGE1 120 μg daily for 2 weeks. The rCBF of the brainstem, cerebellum, and frontal, temporal, and parietal lobes increased significantly after PGE1 administration. PGE1 also significantly increased the rCBF of the non-infarcted area adjacent to infarction. The results indicate that PGE1 increases the CBF of patients with chronic cerebral infarction without causing the intracerebral steal phenomenon. (author)

  16. Acute ischemic cerebral attack

    Franco-Garcia Samir

    2010-12-01

    Full Text Available The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violent death in the world and the first of disability. Many risk factors favor the presentation of these events and some of them are susceptible of modification and therfore are objetives of primary prevention just as the control of diabetes, hypertension and the practice of healthy habits of life. The advances in the knowledge of the physiopatology, had taken to sustantial change in the nomenclature and management of ischemic ACS. Within these changes it was substituted the term cerebrovascular accident fo acute stroke, making emphasis in the key rol of a timely management with goals of time similiar to the acute coronary syndrome. It was redefined the time of acute ischemic attack to a one hour. Once stablished the cerebrovascular attack the semiology of symtoms with frecuency will led us make a topographic diagnosis of the in injury that joined to the cerebral TAC will allow us to exclude an hemorragic event and to start the treatment. In the management of these patients its essential the coordination of the differents teams of work, from the early recognition of symtoms on the part of patients andthe family, the rapid activation and response of emergency systems and the gearing of health care institutions. Are pillars of treatment: the abcde of reanimatiion, to avoid the hiperpirexis, the seizures, the hipoglicemy, the hiperglicemy, to achieve the thrombolysis in the first three hours of the begining of symtoms, to use antiplatelets, antithrombotic profilaxis

  17. Acute myocardial infarction following a hornet sting

    Cvetković-Matić Danica; Ašanin Milika; Matić Dragan; Ivanović Branislava; Simić Dragan; Kalezić Nevena; Stojanov Vesna

    2009-01-01

    Background. The occurrence of an acute myocardial infarction following a hornet sting has been very rarely reported in the previous literature. Pathogenetic mechanisms include direct action of the venom components on the coronary endothelium and allergic reaction with mediators released from mast cells. The anaphylactic reaction and venom components can produce acute coronary artery thrombosis. Case report. We reported a 45-year-old man with acute myocardial infarction after a hornet sting in...

  18. Analysis on risk factors of short-term poor outcome among different subtypes of acute cerebral infarction%不同亚型急性脑梗死短期不良结局危险因素分析

    张晓龙; 张金涛; 鞠忠; 彭颖; 许锬; 张永红

    2012-01-01

    Objective To investigate the risk factors of short-term poor outcome among patients suffering from acute cerebral infarction who had different subtypes of cerebral infarction. Methods A total of 3 231 acute cerebral infarction patients were included in the present study. Data on demographic characteristics , life style, risk factors, history of cardiovascular disease, admission blood pressure, and clinical outcome at discharge were collected for all participants. Poor outcome was defined as NIHSS ^ 10 at discharge or death occuring during hospitalization. The association between poor outcome of cerebral infarction and risk factors was analyzed by using multiple logistic models. Results Incidence rate of poor outcome is the highest in the patients with cerebral embolism, next in patients with cerebral thrombosis and the lowest in patients with lacunar infarction, cerebral thrombosis was positively associated with smok-ing(OR: 1.228; 95% CI: 1.013-1.637), dyslipidemia (OR; 1.264; 95% CI: 1.081 -1.478), and a history of diabetes mellitus(OR: 1.371; 95% 01: 1.075 -1.747); cerebral embolism was posi-tively associated with a history of atrial fibrillation (OR; 3.131; 95% CI: 1.206 ~8.128)and a history of rheumatic heart disease (OR: 5.601; 95% CI; 1.561 ~20.091); lacunar infarction is positively associated with alcohol consumption, (OR; 1.428; 95% CI: 1.063-1.919). Conclusion The incidence rate of poor outcome is the highest in the patients with cerebral embolism among three subtypes of cerebral infarction, there are different risk factors of poor outcome for three subtypes of cerebral infarction.%目的 探讨不同亚型急性脑梗死短期不良结局的危险因素.方法 以3 231例急性脑梗死住院患者为研究对象,收集人口统计学、生活方式、疾病史、心血管病家族史、入院血压、实验室检测结果及出院结局等临床资料.将出院时美国国立卫生研究脑率中量表(NIHSS)≥10或住院期间死亡定义为不良结

  19. Analysis of clinical manifestations and prognosis of acute cerebral infarction with diabetes mellitus%糖尿病并发急性脑梗死临床表现及预后分析

    王大力; 王艳东

    2016-01-01

    Objective To investigate the clinical manifestations of acute cerebral infarction with diabetes and its relationship with prognosis .Methods Retrospective analysis of 120 cases of acute cere‐bral infarction in our hospital ,61 cases of diabetic group(DM group) ,59 cases of non diabetes group (NDM group) ,2 groups of patients with imaging performance ,clinical symptoms and clinical efficacy were compared .Results The cerebral infarction in DM group was higher than that in NDM group( P <0 .05) ;the incidence of coronary heart disease in DM group was higher than that in NDM group( P < 0 . 05) ;The incidence of DM was higher than that of NDM group( P < 0 .05) ;the clinical outcome of NDM group was significantly higher than that in DM group ,the difference was statistically significant( P < 0 . 05) .Conclusion Clinical manifestation and prognosis of type 2 diabetes mellitus patients with cerebral infarction .%①目的探讨糖尿病并发急性脑梗死的临床表现及其与预后的关系。②方法回顾性分析我院收治的120例急性脑梗死患者,根据其是否患有糖尿病分为糖尿病组(DM 组)61例,非糖尿病组(NDM 组)59例,比较两组患者影像学表现、临床症状及临床疗效。③结果 DM 组基底节区脑梗死率、冠心病发生率、意识障碍发生率均高于 NDM 组,差异均有统计学意义( P <0.05);NDM 组临床预后明显优于 DM 组,差异有统计学意义( P <0.05)。④结论糖尿病影响脑梗死患者临床表现及预后。

  20. Cerebral infarctions due to CNS infection with Enterobacter sakazakii

    Recent reports have implicated Enterobacter sakazakii, a gram-negative enteric bacillus, in neonatal sepsis and meningitis. Cases of severe central nervous system involvement, including ventriculitis, brain abscess, infarction, and cyst formation, have been described. We present serial head CT findings in a case of neonatal E. sakazakii meningitis complicated by a ring enhancing cerebral infarction which mimicked abscess formation. In meningitis secondary to this agent, a recognized pattern of cerebral hypodensity with or without cystic degeneration late in the course of the infection is likely to represent cerebral infarction rather than an abscess especially if there is a lack of culture evidence of a bacterial infection. (orig.)

  1. Neuroprotective effect of high-dose hyperbaric oxygenation on rats with acute cerebral infarction in super-early stage Curative comparison between 9-hour and 18-hour therapeutic protocols

    2007-01-01

    Experimental evaluation: Neurologic functions of rat models in the 9-hour and 18-hour HBO groups as well as control group were scored by Bederson and Garica two neurological grading systems at hours 14 and 28 and on day 5; Infarct volume of rat models in the two HBO groups and control group was measured at hour 24 and on day 5 with NIH image processing software Image J; The pathological changes of brain tissue in the brain infarct region and its opposite region of rat models in the two HBO groups and 3-hour ultrastructure control group were observed with a Philips EM 208S transmission electron microscope.MAIN OUTCOME MEASURES: ① Neurobehavioral outcome. ② Rat brain infarct volume. ③Ultrastructure of brain tissue in the ischemic penumbra of infarct models at the different time points RESULTS: ① Neurobehavioral outcome: After treatment, Garica score in the 9-hour and 18-hour HBO groups was significantly higher than that in the control group (P < 0.01). Bederson score on day 5 after modeling in the 9-hour and 18-hour HBO groups was significantly lower than that in thecontrol group (P <0.01). ② Cerebral infarct volume: Cerebral infarct volume in the 9-hour and 18-hour HBO groups was significantly smaller than that in the control group at hour 24 and on day 5 after modeling (P < 0.01). In the 18-hour HBO group, infarct volume on day 5 after modeling was significantly larger than that at hour 24 after modeling (P < 0.05). ③In the 3-hour ultrastructure control group, astrocyte edema and neuron damage around the capillary in the infarct cerebral tissue significantly relieved in the rats which were subjected to HBO.CONCLUSION: High dose of HBO is highly efficient in reducing infarct volume and improving neurobehavioral outcome of rats with acute cerebral infarction, and also has an important role in inhibiting the pathological progression of ischemic brain tissue after cerebral infarction.

  2. An evaluation of MRI-DWI and FLAIR on staging the cerebral infarction

    Objective: It's an evaluation of MRI-DWI and FLAIR on staging the cerebral infarction. Methods: Serial MRI-DWI and FLAIR scan were performed in 65 patients with cerebral infarction. The appearing time, extent and FLAIR scan were performed, signals were analyzed. Results: In super-acute stage apparent hyper-intense lesions were revealed on DWI, while no abnormality was found on FLAIR in demonstrating the hyperintensity of lesions. In the later sub-acute stage the lesion signal began to decline. In the early chronic stage the lesions presented iso-intensity on DWI, when the lesion signal started to decline on FLAIR. After 30 day of episode, the lesions were iso-intense in most of the cases except hypo-intense lesions revealed in several cases. Conclusion: DWI is a routine study in super-acute stag of cerebral infarction because of the good demonstration of the lesion extent, FLAIR is superior to DWI in investigation of the lesion in sub-acute and chronic stage, and FLAIR is also helpful in staging lesions in a case with multiple cerebral infarctions

  3. Cerebral infarct eight months after primary Varicella-zoster virus infection

    Bjerrum, Maja Carsting; Nielsen, Jens Erik Klint; Nordling, Mette Maria

    Ischemic stroke is a recognised complication of Varicella-zoster virus (VZV) infections. We report on an otherwise healthy four-year-old boy who presented with acute neurological symptoms due to cerebral infarction eight months after primary VZV infection. Magnetic resonance imaging showed an...

  4. 不同时间窗及疗程的高压氧治疗对急性脑梗死的影响%Influence of Acute Cerebral Infarction and Treatment of Different Time Windows Hyperbaric Oxygen Therapy

    潘红伟

    2016-01-01

    Objective To investigate the effect of hyperbaric oxygen on acute cerebral infarction in different time windows and treatment. Methods 112 patients with acute cerebral infarction were divided into four groups according to the time window and the course of treatment, 28 cases in each group. After hyperbaric oxygen therapy, the daily activity of daily living (ADL) score and EEG were examined and compared between groups. Result The same line course of hyperbaric oxygen therapy, hyperbaric oxygen therapy sooner, the patient's activities of daily living (ADL) score and EEG better result, the difference was statistically significant (P<0.05). Conclusion Hyperbaric oxygen therapy time window has an important influence on the treatment of first onset of acute cerebral infarction patients, the early treatment time is better, with the incidence of 24 h after treatment with hyperbaric oxygen therapy, 24-72 h within the efficacy of intervention, more than 72 h.%目的:探讨不同时间窗及疗程的高压氧对急性脑梗死疗效的影响。方法对我院2013年7月至2015年1月间接治的112例急性脑梗死患者按从发病到高压氧治疗的时间窗及疗程分为四组,每组28例。对各组患者在高压氧治疗后分别进行日常生活活动能力(ADL)评分及脑电图检查,并进行各组之间的比较。结果在行同样疗程的高压氧治疗中,越早进行高压氧治疗,患者的日常生活活动能力(ADL)评分及脑电图结果越好,差异有统计学意义(P<0.05)。结论高压氧治疗时间窗对首次发病的急性脑梗死患者疗效具有重要影响,开始治疗时间越早则疗效越佳,以发病后24 h 内行高压氧治疗疗效最佳,24~72 h 内干预则疗效次之,超过72 h 则疗效大幅降低。

  5. Clinical study on local brain mild hypothermia in the treatment of acute cerebral infarctions%脑局部亚低温治疗急性脑梗塞的临床研究

    胡以慧; 朱双成; 岑跃南

    2013-01-01

    目的 观察脑局部亚低温治疗在脑梗死急性期的疗效,并评估其应用的安全性.方法 40例急性脑梗死患者随机分为A、B两组,A组在常规治疗的基础上给予脑局部亚低温治疗72小时,疗程为14天.两组在治疗开始、结束时分别行临床神经功能缺损(NIHSS)评分和日常生活活动能力量表(BI)评分,同时观察生命体征、内环境各项指标变化及并发症的发生情况.结果 治疗结束时A组NIHSS、BI评分明显优于B组(P<0.05),各项指标及并发症无统计学差异.结论 脑局部亚低温治疗对改善急性期脑梗死患者的神经功能缺损具有积极意义,疗效确切,不良反应较少,可作为目前基层医院的治疗选择.%Objective To evaluate the clinical efficacy of brain mild hypothermia treatment in the patients with acute cerebral infarctions,and evaluate the safety of its application.Methods 40 cases of acute cerebral infarction were randomly divided into group A and B,on the basis of routine treatment,group A was treated with local mild hypothermia treatment in 72 hours,14 days for a course.At the beginning and the end of treatment two groups were all evaluted respectively with clinical neurological function deficit scale (NIHSS) and activities of daily living scale (BI) score,simultaneous observation of vital signs,environmental indicators change and complications were also observed.Results At the end of treatment,NIHSS and the BI score in group A were significantly lower than those in group B (P<0.05),no significant difference of each index and complications was found.Conclusion Local brain mild hypothermia treatment has positive curative effect in improving neurological function in acute cerebral infarction patients,with less adverse reaction,which can be used as the treatment of choice for primary hospitals.

  6. 音乐疗法对急性脑梗死的治疗和观察%The observation and curative effect of music therapy on the acute cerebral infarction patients

    钟艳梅

    2012-01-01

    Objective To observe the effect of music therapy on the acute cerebral infarction patients. Methods 120 cases of acute cerebral infarction patients in internal medicine-neurology of our hospital were randomly divided into the treatment group which was given conventional therapy combined with music therapy and control group which was given conventional therapy combined with hyperbaric oxygen, each group had 60 cases. The total effective rate of two groups were observed and compared. Results The effectiveness of treatment group and control group was respectively 100.0% and 81.7%, it had significant differences (P < 0.05). Conclusion Music combined with conventional treatment is a conservative therapy for the acute cerebral infarction patients, which not only can relieve pain but also promote patients'recovery and create favorable conditions for the comprehensive rehabilitation.%目的 观察音乐疗法治疗急性脑梗死的临床疗效.方法 回顾性分析在我院神经内科住院的120例急性脑梗死患者,随机分为治疗、对照两组,每组60例,两组患者均采用常规治疗,治疗组采用常规治疗的同时加音乐治疗,对照组采用常规治疗的同时加高压氧治疗.观察两组的总有效率.结果 两组总有效率分别为100.0%和81.7%,治疗组与对照组比较差异有统计学意义(P < 0.05).结论 音乐联合常规治疗是对急性脑梗死患者的保守治疗,不仅能缓解病痛,而且可更好地促进患者健康恢复,为急性脑梗死患者全面康复创造有利条件.

  7. Cerebral circulation and metabolism in cerebral infarction of middle cerebral artery territory

    Regional cerebral blood flow (rCBF), oxygen metabolism (rCMRO2), oxygen extraction fraction (rOEF) and blood volume (rCBV) were measured with a high performance positron CT (HEADTOME-III) and the 15O labeled gas steady-state method. Seven normal volunteers and 13 patients with ischemic infarction located in the territory of unilateral middle cerebral artery (MCA) were subjected to the positron CT measurement. In the present study, over estimation of rOEF and rCMRO2 were corrected by rCBV using the principle described by Lammertsma and Jones. From these paremeters we also calculated an rCBV/rCBF which meant regional blood transient time of cerebral vessels (rTT). Early ischemic lesions showed two types of uncoupling between rCBF and rCMRO2. Patients studied within the 5th day of the onset showed high rOEF with low rCBF in the infarcted forcus (misery perfusion). About a week after onset rOEF was changed into low level with decreased rCMRO2 and recovered rCBF, and the change lasted to a month after onset recovered rCBF, and the change lasted to a month after onset (luxury perfusion). Then, about two months later, the lesions gradually went to matched change of rCBF and rCMRO2 (coupled perfusion). These changes of rCBF and rCMRO2 described above will reveal the natural course of ischemic brain tissue with acute onset. It was also proved that there was positive correlation between rTT and rOEF. A parameter of rTT will be important to presume rOEF from a single photon emission CT measurement, which has not been able to study oxygen metabolism but could measure rCBF and rCBV. The threshold levels of rCBF and rCMRO2 for morphological tissue damages assessed as a low density area on a X-ray CT were clinically estimated from the present study. The thresholds evaluated in patients within a day of onset, were 12 ml/100 ml/min, and 1.5 ml/ 100 ml/min for rCBF and rCMRO2, respectively. (J.P.N.)

  8. Diffusion and Perfusion MRI in Acute Cerebral Ischemia

    Tchoyoson CC Lim; Chong-Tin Tan

    2001-01-01

    Reeent advances in magnetic resonance imaging (MRI), in particular diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI), have allowed clinicians to have the ability to differentiate between irreversible cerebral infarction and the potentially reversible ischemic penumbra. This article examines the principles and practice of DWI and PWI. With continued advances in thrombolysis and other therapy for acute cerebral ischemia, neuroimaging is poised to play an increasingly important role in decisionmaking in aeute stroke.

  9. Alternation of plasma c-type natriuretic peptide in cerebral infarction%脑梗死患者血浆c-型利钠肽变化

    赵文凤; 宋利春

    2003-01-01

    AIM:To investigate the effects of c type natriuretic peptide (CNP) on cerebral infarction.METHODS:Plasma levels of CNP were concomitantly measured by radioimmunoassay in 30 patients with cerebral infarction and in 30 normal controls.RESULTS:Plasma levels of CNP were increased significantly in the acute stage of cerebral infarction than those in the normal controls(P< 0.01) and levels in the moderate and serious cases were lower than those in the slight cases(P< 0.01).CONCLUSION:In cerebral infarction the increase of plasma CNP was in accordance with the severity of the disease .CNP in the pathophysiology of acute cerebral ischemia had a deleterious effect on the evolution of cerebral infarction.

  10. Primary coronary angioplasty in acute myocardial infarction.

    Grech, E. D.; Ramsdale, D. R.

    1996-01-01

    It is well established that recanalisation of the infarct-related artery is of great benefit in the early hours after acute myocardial infarction. This can be achieved by the use of thrombolytic agents and/or by percutaneous transluminal coronary angioplasty (PTCA). This article reviews data on the role of primary PTCA and summarises current opinion on its use.

  11. Effects of Sophora japonica flowers (Huaihua on cerebral infarction

    Hsieh Ching-Liang

    2010-09-01

    Full Text Available Abstract The dried flowers and buds of Sophora japonica are used as a medicinal herb in China, Japan and Korea to treat bleeding hemorrhoids and hematemesis. This article presents an overview of the effects of Sophora japonica on cerebral infarction based on literature searched from Medline, PubMed, Cochrane Library and the China National Knowledge Infrastructure (CNKI. Sophora japonica contains both anti-hemorrhagic and anti-hemostatic substances. Sophora japonica reduces cerebral infarction partly as a result of its anti-oxidative and anti-inflammatory activities. Previous studies found that Sophora japonica reduced the size of cerebral infarction and neurological deficits and reduced microglial activation, interleukin-1β release and number of apoptotic cells in ischemia-reperfusion injured Sprague-Dawley rats. Further study is required to determine the relationship between Sophora japonica-mediated reduction in cerebral infarction size and the effects of Sophora japonica on platelet aggregation and cardiovascular function.

  12. Magnetic resonance imaging of cerebral infarction: Time course of Gd-DTPA enhancement and CT comparison

    Thirty-five patients (7 females and 28 males) with cerebral infarction and suspicion of cerebral infarction of 4 h to 27 months duration were studied 45 times with magnetic resonance (MR) imaging using Gd-DTPA. Spin echo (SE) images were obtained before and after the administration of Gd-DTPA (0.1 or 0.15 mmol/kg) and compared with the enhanced CT. MR imaging using Gd-DTPA was more sensitive than enhanced CT and very useful for detecting a new focus of cerebral infarction, especially in the cases with multiple infarcted areas and for showing the extent of cortical and subcortical infarction. In most cases the MR enhancement was obvious in the subacute stage, especially after cerebral embolism, and the signal intensity of the lesion tended to show a gradual increase. The diagnosis of embolism was accepted on the basis of acute onset without prior TIA, coupled with angiography showing the embolus itself and/or a capillary blush and a wide area of infarction. (orig.)

  13. Pleuropulmonary blastoma with a large embolic cerebral infarct

    Tan Kendrick, Anne P.A.; Krishnamurthy, Ganesh [Department of Diagnostic Imaging, Kandang Kerbau Women' s and Children' s Hospital (Singapore); Joseph, V.T. [Department of Paediatric Surgery, Kandang Kerbau Women' s and Children' s Hospital (Singapore)

    2003-07-01

    We report on a 3-year-old girl who developed a large embolic cerebral infarct 1 day after an uneventful thoracotomy to remove a large pleuropulmonary blastoma. The tumour had encased the heart and great vessels and ruptured into the left hemithorax. Pleuropulmonary blastoma is a rare, but unique, primary thoracic neoplasm in young children and, to our knowledge, the development of a secondary large embolic cerebral infarct is also uncommon and has not been reported in this tumour. (orig.)

  14. Prognostic significance of MR angiography in patients with cerebral infarction

    This study was designed to evaluate the prognostic significance of Magnetic resonance angiography(MRA) in patients with cerebral infarction. Magnetic Resonance Imaging(MRI) and 2 dimensional or 3 dimensional Time-of-Flight MRA were performed subsequently in 83 patients with cerebral infarction proven by brain CT and clinical manifestations, using GE Signa Advantage 1.5 T. We classified the size of infarction on MRI as Extent I( 6 cm) and classified the intracranial vascular occlusion according to visualizations of intracranial vascular branches on MRA as Grade 0, Grade I, Grade II, Grade III. And we evaluated clinical outcomes of these patients according to Rankin's disability scale, compared with MRI and MRA. In 72 cases(86.8%), the larger the size of infarction on MRI, the more severe vascular occlusion on MRA, the worse the clinical outcomes were noted(p < 0.01). However, in 7 cases(8.4%) who showed huge cerebral infarction on MRI with low grade intracranial vascular occlusion on MRA, the clinical outcomes were improved. In 4 cases(4.8%) who noted small sized cerebral infarction on MRI with high grade vascular occlusion on MRA, the clinical outcomes were worsened. MRA provides additional useful information to that provided by MRI in predicting the prognosis of patients with cerebral infarction

  15. CT classification and clinical prognosis of cerebral infarction in the area of middle cerebral artery

    Computerized tomographies (CT) were repeatedly scanned on 70 patients with cerebral infarction in the middle cerebral artery. Low density area (LDA) was measured with HounFsfield's Unit (HU) and studied on the progressive changes. Classification of LDA was attempted and studied on correlation with mass effect, contrast enhancement, angiographical findings, clinical symptoms and prognosis. It was considered that important points of diagnosis of cerebral infarction were timing of examination of CT and determination of LDA with HUF. It was also thought that CT classification of LDA was usefull to estimate prognosis of the patients with cerebral infarction. (author)

  16. A schizophrenic patient with cerebral infarctions after hemorrhagic shock

    Youichi Yanagawa

    2013-01-01

    Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

  17. A case of cerebral infarction showing interesting SPECT images

    A case of cerebral infarction showing interesting SPECT images was reported. One month after stroke, 81mKr and 99mTc-HMPAO-SPECT were showed post ischemic high flow area as hot lesion, but 123I-IMP-SPECT was showed as cold lesion in early scan. Two months after stroke, all SPECT images showed infarction as cold area. (author)

  18. Drug Therapy and Combined with Hyperbaric Oxygen in the Treatment of Acute Cerebral Infarction Clinical Analysis%单纯药物治疗与联合高压氧治疗急性脑梗死临床分析

    杨淑琴; 张泽萍

    2013-01-01

      Objective:To study the effects of hyperbaric oxygen in the treatment of cerebral infarction and clinical analysis. Method:A retrospective study of our hospital from 2010 July to 2012 March,80 patients with acute cerebral infarction. Patients were randomly divided into 2 groups, 40 cases in the control group only received drug therapy,The treatment group of 40 cases in addition to drug treatment,also given the hyperbaric oxygen therapy. According to the“European Stroke Scale”(ESS)in the treatment group and the control group before and after treatment,and observe the clinical curative effect,score. Result:Drug and hyperbaric oxygen in the treatment of acute cerebral infarction clinical curative effect is better than simple drug use. Conclusion:Early hyperbaric oxygen treatment,In many ways to better improve brain ischemia,hypoxia,so as to achieve the purpose of treatment.%  目的:探讨高压氧治疗脑梗死的效果并进行临床分析。方法:回顾性研究笔者所在医院2010年4月-2012年11月急性脑梗死住院病例80例。随机分为两组,对照组40例,仅单纯药物治疗。治疗组40例,单纯药物治疗+高压氧治疗。根据“欧洲卒中量表”(ESS)对治疗组和对照组于治疗前、后,进行评分并观察疗效。结果:药物联合高压氧治疗急性脑梗死临床疗效优于单纯使用药物。结论:及早进行高压氧的治疗,并配合康复锻炼对减少梗死后的残疾、提高生活质量有极大的帮助。

  19. Acute/subacute cerebral infarction (ASCI in HIV-negative adults with cryptococcal meningoencephalitis (CM: a MRI-based follow-up study and a clinical comparison to HIV-negative CM adults without ASCI

    Chang Chiung-Chih

    2011-01-01

    Full Text Available Abstract Background Acute/subacute cerebral infarction (ASCI in HIV-negative cryptococcal meningoencephalitis (CM adults has rarely been examined by a series of MRI-based follow-up study. We studied a series of MRI follow-up study of CM adults and compared the clinical characters of those with ASCI and those without ASCI. Methods The clinical characteristics and a series of brain MRI findings of seven CM adults with ASCI were enrolled for analysis. The clinical characteristics of another 30 HIV-negative CM adults who did not have ASCI were also included for a comparative analysis. Results The seven HIV-negative CM adults with ASCI were four men and three women, aged 46-78 years. Lacunar infarction was the type of ASCI, and 86% (6/7 of the ACSI were multiple infarctions distributed in both the anterior and posterior cerebrovascular territories. The seven CM patients with ASCI were significantly older and had a higher rate of DM and previous stroke than the other 30 CM adults without ASCI. They also had a higher incidence of consciousness disturbance at presentation and had a poor prognosis. Conclusion ASCI was found in 18.9% (7/37 of HIV-negative CM adults. Serial MRI follow-up studies may allow a better delineation of ASCI in this specific group of infectious disease and multiple lacunar infarctions was the most common type. Older in age and presence of DM and previous stroke were the significant underlying conditions. CM patients with ASCI also had a poor therapeutic outcome.

  20. Asymptomatic cerebral infarction examined by magnetic resonance imaging (MRI)

    To find the real incidence and risk factors in asymptomatic cerebral infarction, a retrospective review was made on magnetic resonance (MR) images, which were obtained from 713 outpatients seen at the Geriatrics Research Institute Hospital between March and November of 1990. The criteria for asymptomatic cerebral infarction are: high signal intensity areas larger than 3 mm in diameter on T2-weighted image; no history of stroke; no neurological and psychological signs or symptoms with or without subjective symptoms. Symptomatic cerebral stroke was defined as stroke episodes associated with neurological signs and infarction lesions on CT or MR imaging. Of a total of 713 patients, 215 (30.2%) had symtomatic cerebral infarction and 384 (53.9%) had no cerebral lesions. The incidence of asymptomatic cerebral infarction increased with aging. Cerebral risk factors, i.e. hypertension, atrial fibrillation, and diabetes mellitus, were more significantly common in both symptomatic and asymptomatic groups than the normal control group. In the group of asymptomatic patients, T2-weighted images showed hyperintensity in the corona radiata in 60.9%, in the frontal lobe in 32.1%, in the semioval center in 28.8%, and in the basal ganglia in 23.7%. Periventricular hyperintensity was present in 124 of all 713 patients (17.4%). Common complaints in asymptomatic patients were headache (40.0%), dizziness (14.4%), and neck muscle contraction (9.8%). In conclusion, MR imaging may contribute to manage asymptomatic patients. (N.K.)

  1. 46例急性脑梗死患者血清同型半胱氨酸与血清胱抑素C检测结果分析%Analysis of Test Results of 46 Cases of Serum Homocysteine in Patients with Acute Cerebral Infarction and Serum Cystatin C

    张伟

    2015-01-01

    Objective To investigate serum homocysteine in patients with acute cerebral infarction (homocysteine, Hey), changes in cystatin C (cystatin C, Cys-C) levels and clinical significance. Methods A retrospective analysis of 46 patients with acute cerebral infarction serum homocysteine, Cystatin C test results in January 2013 ~2014 in September in our hospital, and for comparative analysis with the same period 50 cases of normal healthy people. Results Acute cerebral infarction and serum cystatin C Hcy levels were significantly higher ( cerebral infarction, serum homocysteine and serum cystatin C detection in the diagnosis of acute cerebral infarction and have a bet er prognosis The clinical value.%目的探讨急性脑梗死患者血清同型半胱氨酸(homocysteine,Hey)、胱抑素C(cystatin C,Cys-C)水平的变化及临床意义。方法回顾性分析2013年01月~2014年09月我院收治的46例急性脑梗死患者血清同型半胱氨酸、胱抑素C检测结果,并与同期50例正常健康人作对比分析。结果急性脑梗死组血清Hcy与胱抑素C水平均显著高于对照组(<0.05)。结论血清同型半胱氨酸、胱抑素C与脑梗死的发生及发展密切相关,血清同型半胱氨酸与血清胱抑素C检测在急性脑梗死的诊断及预后判断中有较好的临床价值。

  2. Cerebral infarction presenting pure motor mono-paresis. Diagnosis by diffusion-weighted MR imaging

    Oda, Masaya; Udaka, Fukashi; Nishinaka, Kazuto; Kubori, Tamotsu; Kameyama, Masakuni [Sumitomo Hospital, Osaka (Japan)

    2001-02-01

    We studied 10 patients with acute ischemic cerebrovascular disorders presenting paralysis confined to one limb, unaccompanied by sensory signs (pure motor monoparesis, PMM) on diffusion-weighted MR imaging (DWI). DWI revealed fresh ischemic lesions in all patients, except for 2 cases of transient ischemic attack. On DWI, acute infarction in multiple lesions was identified, and small superficial lesions were clearly described. Superficial lesions were seen in 4 patients, and deep lesions were also seen in 4 patients. DWI is useful for lesion analysis in cerebral infarction with PMM. (author)

  3. Cerebral infarction presenting pure motor mono-paresis. Diagnosis by diffusion-weighted MR imaging

    We studied 10 patients with acute ischemic cerebrovascular disorders presenting paralysis confined to one limb, unaccompanied by sensory signs (pure motor monoparesis, PMM) on diffusion-weighted MR imaging (DWI). DWI revealed fresh ischemic lesions in all patients, except for 2 cases of transient ischemic attack. On DWI, acute infarction in multiple lesions was identified, and small superficial lesions were clearly described. Superficial lesions were seen in 4 patients, and deep lesions were also seen in 4 patients. DWI is useful for lesion analysis in cerebral infarction with PMM. (author)

  4. Whether chronic bronchitis is an independent risk factor for cerebral infarction in the elderly 1:1 case paired study

    2007-01-01

    BACKGROUND: The inflammatory reaction already becomes an important risk factor of causing acute cerebral infarction; however, the correlation between chronic bronchitis and senile cerebral infarction is still unclear.OBJECTIVE: To study whether the chronic bronchitis is the risk factor for senile cerebral infarction.DESIGN: 1:1 pair, case contrast, and risk factor study.SETTINGS: Department of Respiratory Medicine, Third Hospital of Tangshan; Department of Neurology,Affiliated Hospital of North China Coal Medical College.PARTICIPANTS: A total of 147 patients with acute cerebral infarction who were regarded as case group were selected from Department of Neurology, the Third Hospital of Tangshan from January 2004 to December 2006. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Diseases Meeting. There were 87 males and 60 females, and their ages ranged from 65 to 83 years. Based on 1∶1 pair study, another 147 subjects without cerebrovascular disease were regarded as control group. Except the diseases about infection, there were 73 males and 74 females, and their ages ranged from 62 to 81 years. All subjects provided the confirm consent and agreed with the coordinate experiment.METHODS: ① Questionnaire of risk factor of cerebral infarction was designed to measure the following items: chronic bronchitis, hypertension, diabetes mellitus, hyperlipemia, coronary heart disease, primary cerebral infarction/transient ischemic attack and history of smoking. ② Cerebral infarction was regarded as the dependent variance, while chronic bronchitis, hypertension, diabetes mellitus, hyperiipemia, primary cerebral infarction/transient ischemic attack, coronary heart disease and smoking were regarded as the independent variance for multiple regression analysis.MAIN OUTCOME MEASURES: Risk factors of senile cerebral infarction.RESULTS: All 147 patients with acute cerebral infarction and 147 subjects without cerebrovascular diseases were involved in

  5. 同型半胱氨酸水平与急性脑梗死患者梗死面积及病情进展的关系%The correlation between homocysteine and infarct size and disease progress of patients with acute cerebral in-farction

    张永祥; 王霆; 江宏杰

    2014-01-01

    目的:探讨同型半胱氨酸水平与急性脑梗死患者梗死面积及病情进展的关系。方法选择我院神经内科收治的105例急性脑梗死患者,检测患者同型半胱氨酸水平并分析其与临床症状的关系。结果不同脑梗死面积患者之间的同型半胱氨酸水平比较差异有统计学意义( P<0.05);不同程度神经功能障碍患者之间的同型半胱氨酸水平比较差异有统计学意义( P<0.05);高同型半胱氨酸组患者中出现轻度神经功能障碍和重度神经功能障碍的比例与正常同型半胱氨酸组差异有统计学意义(P<0.05);高同型半胱氨酸组出现病情进展的比例与正常同型半胱氨酸组比较差异有统计学意义(P<0.05)。结论同型半胱氨酸水平可反映急性脑梗死患者梗死面积,有助于了解病情进展情况。%Objective To investigate the correlation between homocysteine and infarct size and disease progress of patients with acute cerebral infarction .Methods 105 patients with acute cerebral infarction in the department of neurology of our hospi-tal were selected as the subjects ,homocysteine level was detected and its correlation with clinical symptoms was analyzed .Re-sults Homocysteine levels in different infarct size of patients were significant difference (P<0 .05);Homocysteine levels in patients with different degrees of neurological dysfunction were significant difference (P< 0 .05);The proportion of patients with Mild and severe neurological dysfunction in high homocysteine groups was significant difference from that of normal homo-cysteine groups(P< 0 .05);The proportion of patients with disease progression in high homocysteine group was significant difference from that of normal homocysteine group (P<0 .05) .Conclusion Homocysteine level can reflect the infarct size of pa-tients with acute cerebral infarction .It is instrumental to understand the progress of acute cerebral infarction .

  6. Acute arterial infarcts in patients with severe head injuries

    Deepak Agrawal

    2012-01-01

    Full Text Available Aims and Objectives: To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods: Patients with severe head injury (Glasgow coma score (GCS ≤8 presenting within 8 h of injury in the Department of Neurosurgery over a period of 5 months were enrolled in the study. Patients with penetrating head injury, infarct due to herniation and iatrogenic arterial injuries were excluded from the study. Only arterial infarcts developing within 8 h of injury were included in the study. A computed tomography (CT head was done on all patients within 8 h of injury and repeated if necessary. Arterial infarct was defined as well-demarcated wedge-shaped hypodensity corresponding to an arterial territory on plain CT of the head. Outcome was assessed using Glasgow outcome score (GOS at 1 month post-injury or at death (whichever came earlier. Results: Forty-four patients of severe head injury were included in the study during the above period. Of these, four patients (9.1% had arterial infarcts on the initial CT scan. The male:female ratio was 1:3. The mean age was 54 years (range 3-85 years. Two patients had infarcts in the middle cerebral artery distribution and two in the superior cerebellar artery distribution. Poor outcome (GOS 1-3 was seen in 100% of the patients with arterial infarct compared to 52.5% (n=21 in patients with severe head injury without arterial infarct. Conclusions: A significant percentage of patients with severe head injury have arterial infarcts on admission, which may imply arterial injury. Our study shows that these patients have a poorer prognosis vis-a-vis patient without these findings.

  7. Early detection of cerebral infarction by 31P spectroscopic imaging

    Recent advances in magnetic resonance spectroscopy permit noninvasive study of brain metabolism in vivo, 31P spectroscopic imaging being the method for evaluation of localized phosphorous metabolism. Experimentally, an ischemic-hypoxic brain insult is characterized by depletion of high energy metabolites. These changes are seen immediately after an ischemic insult. We had the opportunity of carrying out 31P spectroscopic imaging of hyperacute cerebral infarction, while MRI and CT were negative. Cerebral infarction of the middle cerebral artery territory was suggested by 31P spectroscopic imaging, which was closely consistent with a later-developing region of low density on CT. In cerebral infarction, early detection of the lesion is a useful pointer to the patient's prognosis, making 31P spectroscopic imaging a potential tool. (orig.)

  8. 早期r-tpA溶栓治疗急性脑梗死的护理%Nursing of r-tpA thrombolytic treatment acute cerebral infarction in early stage.

    王宏梅

    2011-01-01

    Objective: To investigate the recombinant tissue - type plasminogen activator ( r - tpA ) intravenous thrombolytic therapy acute cerebral infarction and its related nursing methods. Methods:48 patients with cerebral infarction were given intravenous therapy with r - tpA. To observation the treatment effect. Results:There were 42 cases cured,2 cases has remarkable improvement,2 cases has improvement, 1 case was no change. There were 2 cases occurred mucous hemorrhage, 1 case occurred hematuria and 1 case melena. Conclusion: In the process of observing closely thrombolysis, especially in the thrombolys-is and 24 hours of observation with bleeding tendency, blood pressure, level of consciousness, muscle strength, observation, prevention and treatment of complications, to better recovery for patients to play an important role.%目的:探讨重组组织型纤溶酶原激活物静脉溶栓治疗急性脑梗死的疗效与护理方法.方法:对符合适应证的48例脑梗死患者给予重组组织型纤溶酶原激活物静脉溶栓治疗.观察患者疗效.结果:基本治愈42例,显著进步3例,进步2例,无效1例.出现皮肤黏膜出血2例,血尿1例,黑便1例.结论:在溶栓过程中严密观察病情,特别是在溶栓中及溶栓后24 h内对出血倾向、血压、意识水平、肌力的观察,预防及处理并发症,能够为患者更好的恢复起重要的作用.

  9. Perfusion scintigraphy in acute myocardial infarction

    The Tc-99m sestamibi perfusion SPECT scintigraphy in acute myocardial infarction is a feasible method to assess the size of area at risk and the residual blood flow to this area as the most important determinants of final infarct size without any delay in treatment. In combination with a follow-up study final infarct size as well as myocardial salvage can be quantified. Clinical indications for the use of Tc-99m sestamibi scintigraphy are the noninvasive identification of arterial occlusion in patients suspected to acute myocardial infarction without electrocardiographic ST-elevation and the assessment of reperfusion success. In clinical trials Tc-99m sestamibi scintigraphy has proven to be a useful method to assess the impact of varying reperfusion therapies. The present review article discusses the indication, the study protocol, the interpretation of results and the clinical and scientifically importance of this method. (orig.)

  10. Secondary Prevention in Acute Myocardial Infarction

    IRMAK, Yrd.Doç.Dr. Zöhre; FESCİ, Doç.Dr. Hatice

    2005-01-01

    Recent studies on patients who had an acute myocardial infarction have shown that risk factors are decreased, atherosclerosis regressed, and re-infarction and mortality rates are reduced as a result of drug therapy in combination with the changes in the lifestyle. This treatment called as secondary prevention, requires a behavioral change in the lifestyle that includes stopping smoking, making healthy food choices, and increasing physical activity. Risk factors related with lifestyle, wh...

  11. Clinical outcome of cerebral infarction in the treatment of Kudiezi Injection Combined with low molecular weight heparin

    Yu-hong ZHANG

    2013-11-01

    Full Text Available Objective:  to evaluate combinative effect of Kudiezi Injection and low molecular weight heparin calcium in the treatment of acute cerebral infarction. Methods:  72 cases of acute cerebral infarction were randomly divided into two groups, the treatment group of 36 cases were treated with the combination of Kudiezi Injection and low molecular heparin calcium; the other 36 cases in the control group were treated with the combination of Xuesaitong injection and low molecular weight heparin calcium. The degree of neurological deficit score and clinical outcome were respectively evaluated before and after treatment. Results:  There are significant differences between the treatment group and the control group in results efficiency. Conclusion:  It can improve the curative effect and the prognosis of the patients in the acute stage of cerebral infarction in the combinative treatment of Kudiezi Injection and low molecular weight heparin.

  12. Study on the correlation of plasma fibrinogen levels and Fg Bβ-455A gene polymorphisms to the acute cerebral infarction%急性脑梗死与血浆Fg水平以及FgBβ-455G/A多态性的相关性研究

    张海霞; 杨美荣; 张江; 陈乃耀; 王大力

    2011-01-01

    Objective To investigate the correlation of plasma fibrinogen level and Fg Bβ-455 A gene polymorphisms with the acute cerebral infarction. Methods A total of 90 patients with acute cerebral infarction and 102 healthy subjects as case-control group were selected. The plasma fibrinogen levels in the two groups were compared, and the relationship analysis was performed among the plasma fibrinogen levels, the Fg Bβ-455A gene polymorphisms and the acute cerebral infarction. Results The plasma fibrinogen level in the acute cerebral infarction group was higher than that in control group (P < 0.05 ). The plasma fibrinogen level in gene-455A carrier, gene-455AA especially, was significantly higher than that in gene-455G carrier. Through Logisitic analysis, the increasing of fibrinogen concentrations and Fg Bβ-455G/A were independent risk factors in the acute cerebral infarction. Conclusion The alleles of Fg Bβ-455A are associated with fibrinogen concentrations. The increasing of fibrinogen concentrations and Fg Bβ-455G/A are independent risk factors of cerebral infarction.%目的 探讨急性脑梗死与血浆纤维蛋白原(Fg)水平及Fg Bβ-455G/A多态性的相关性.方法 选择急性脑梗死患者90例及同期门诊体检的健康者102例,比较两组间血浆Fg水平,对血浆Fg、Fg Bβ-455G/A基因多态性与急性脑梗死做相关性分析.结果 病例组血浆Fg水平高于对照组;突变基因-455A(AA、GA基因型)携带者的血浆Fg水平均高于非-455A携带者(GG型);以脑梗死为因变量经过多因素非条件的Logistic回归分析显示,血浆Fg水平、-455GA+AA进入回归方程.结论 Fg Bβ-455G/A多态性与血浆Fg水平具有相关性,血浆Fg浓度、FgBβ-455G/A是急性脑梗死发生的独立危险因素.

  13. Effects of hypertension on stroke-associated pneumonia after acute cerebral infarction%急性脑梗死患者血压对卒中相关性肺炎的影响

    陈武松

    2014-01-01

    目的:研究急性脑梗死患者的血压与卒中相关性肺炎(SAP)的相关性。方法选取2010-03-2013-03在我院诊治的急性脑梗死患者174例,根据患者的血压状况分为血压正常组(31例)、轻度高血压组(27例)、中度高血压组(63例)和重度高血压组(53例);根据患者有无并发卒中相关性肺炎分为卒中相关性肺炎组(46例)和无卒中相关性肺炎组(128例)。比较各组患者的外周血白细胞计数(WBC)、血清C反应蛋白(CRP)、白蛋白、吞咽障碍发生率、收缩压(SBP)、Glasgow昏迷量表(GCS),记录所有患者既往病史,包括吸烟史、饮酒史、既往脑梗死病史、高血压史、糖尿病史、缺血性心脏病史及充血性心力衰竭病史等。结果血压正常组、轻度组、中度组和重度组患者WBC、CRP、GCS评分、吞咽障碍及SAP发生率比较,差异有统计学意义(P<0.05)。SAP与无SAP组SBP、WBC、CRP水平、吸烟史、GCS评分、意识障碍和吞咽障碍发生率比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析发现CRP、WBC以及高血压状况、吸烟史、GCS评分和吞咽障碍是SAP的危险因素,与血压正常组患者相比较,重度高血压组患者发生SAP的风险明显增高(P<0.05)。结论重度高血压是急性脑梗死患者发生卒中相关性肺炎的独立危险因素,为急性脑梗死患者防治SAP发生提供依据。%Objective To investigate the relationship between the blood pressure (BP) and stroke-associated pneumonia (SAP) in patients with acute cerebral infarction.Methods A total of 174 patients with acute cerebral infarction admitted to our hospital from March 2010 to March 2013 were divided ,according to acute blood pressure values ,into normal BP group (with normal BP ,n=31) ,mild group (with mild hypertension ,n=27) ,moderate group (with moderate hypertension ,n=63) ,se-vere group (with

  14. The application of diffusion weighted imaging and apparent diffusion coefficients mapping in monitoring the development of cerebral infarction

    Objective: To study the roles of isotropic diffusion weighted imaging and apparent diffusion coefficients (ADC) mapping in diagnosing cerebral infarction, monitoring the development of cerebral infarction and defining the infarction stages. Methods: 86 work-ups in 70 patients with cerebral infarction (8 hyperacute, 13 acute, 32 subacute, 11 steady, and 22 chronic) were imaged with both conventional MRI and single-shot echo-planar isotropic diffusion weighted imaging. The change of the infarct lesion in DWI and T2WI was also analyzed. The average ADC, relative ADC (rADC), and the ADC from center to periphery of the lesion were calculated. Results: 8 hyperacute cerebral ischemic regions were revealed at DWI and ADC mapping. Hyperacute and acute infarcts appeared as areas of hyperintensity on DWI, and their average ADC was significantly depressed compared with that of homologous contralateral tissue [(0.698±0.104) x 10-3 mm2/s versus (0.990±0.161) x 10-3 mm2/s; t=-14.372, P2WI, ADC values can differentiate different stages of infarction and may portend the time when stroke may be treated more effectively and with individually tailored therapy, and may be used to define the core and penumbra of ischemic lesions, and to evaluate the efficacy of treatments by dynamic observation

  15. Long-term follow-up of cerebral infarction patients with proton magnetic resonance spectroscopy

    Gideon, P; Sperling, B; Arlien-Søborg, P;

    1994-01-01

    serially from the acute stage to the chronic stage of infarction. Regional cerebral blood flow was also measured within the affected areas. These factors were compared with the clinical outcome. METHODS: Six patients with ischemic stroke were examined serially from the acute stage (< or = 2 days) to the...... chronic stage (> 6 months) with proton magnetic resonance spectroscopy. Cerebral blood flow was measured with single-photon emission-computed tomography with 99mTc-labeled d,l-hexamethylenepropyleneamine oxime as flow tracer. RESULTS: Lactate was found in all patients in the acute stage of stroke. Lactate...... in the acute and chronic stage, whereas hyperemia was found in 4 patients in the subacute stage. CONCLUSIONS: In this preliminary study no clear correlation was found between the level of N-acetylaspartate or lactate in the acute stage of stroke and the clinical outcome; however, there does appear to...

  16. Personal peculiarities in patients with middle cerebral artery infarction

    Antonova N.A.

    2013-12-01

    Full Text Available The purpose of the work is to reveal personal peculiarities in patients who have suffered middle cerebral artery infarction. Material and Methods. 39 patients with middle cerebral artery infarction have been under the study. All patients have received clinical instrumental inspection (neurologic survey, duplex ultrasound investigation of vessels of neck, head and brain, the research CT or MRT. Personal peculiarities have been studied by "The standard multiple-factor method of research of the personality" (PITCHES. Results. Psychological reactions for the disease have been determined. They include hypochondria, depression, psychasthenia and anxiety. Conclusion. Personal peculiarities in patients suffered from middle cerebral artery infarction may be characterized by the appearance of psychological response to the psychotraumatic situation. Therefore it is necessary to give psychotherapeutic aid.

  17. Determination of the Role of Oxygen in Suspected Acute Myocardial Infarction by Biomarkers

    2016-01-25

    Acute Myocardial Infarction (AMI); Acute Coronary Syndrome (ACS); ST Elevation (STEMI) Myocardial Infarction; Ischemic Reperfusion Injury; Non-ST Elevation (NSTEMI) Myocardial Infarction; Angina, Unstable

  18. Radiologic findings of neonatal cerebral infarction related with portal vein thrombosis: case report

    Lim, Yeon Soo [Holy Family Hospital, College of Medicine, the Catholic University of Korea, Bucheon (Korea, Republic of)

    2007-03-15

    A cerebral infarction in a newborn infant is not uncommon and is major cause of neonatal seizure. The author encountered one case of cerebral infarction that was assumed to be related to a portal vein thrombosis, and reports the radiology findings of a neonatal cerebral infarction and portal vein thrombosis.

  19. Radiologic findings of neonatal cerebral infarction related with portal vein thrombosis: case report

    A cerebral infarction in a newborn infant is not uncommon and is major cause of neonatal seizure. The author encountered one case of cerebral infarction that was assumed to be related to a portal vein thrombosis, and reports the radiology findings of a neonatal cerebral infarction and portal vein thrombosis

  20. Concealment of neonatal cerebral infarction on MRI by normal brain water

    Magnetic resonance imaging (MRI) is highly sensitive in detecting cerebral infarction in adults, both in the acute and chronic stages. Cytotoxic and vasogenic edema produce an increase in the water content of acutely ischemic brain, resulting in good tissue contrast from adjacent normal brain on spin density, T1 and T2 weighted MR images. Gliosis and other chronic brain changes are well seen in later stages. We recently encountered a case of remote cerebral infarction in an infant, however, which was not evident on the initial MR examination at 7 weeks of age but which was clearly seen on a follow-up scan at 9 1/2 months. Our contention is that the infarct was masked by the known increased water content of the neonatal brain, which results in lengthened spin density and relaxation times; edema and gliosis may thus be obscured. This age-related concealment of ischemic brain changes on MR has not to our knowledge been reported, and we present this case as a caveat in the detection of cerebral infarction in neonates. (orig.)

  1. Low frequency electric stimulation combined with the early rehabilitation training for treatment of the patients with acute cerebral infarction%低频电刺激联合早期康复训练治疗急性脑梗死

    金志萍; 刘学源

    2012-01-01

      Objective: To explore the effect of the early rehabilitation training and low frequency electric stimulation on the neurological dysfunction (ND) scores and ADL scores in the patients with acute cerebral infarction. Method: Ninety cases of acute cerebral infarction were randomly divided into the low frequency electric stimulation with the early rehabilitation training group (A group), low frequency electric stimulation group (B group) and control group (C group)(n=30). The patients of A and B groups were treated with the routine drugs and low frequency electric stimulation treatment, in addition to the patients in the A group were treated with the early rehabilitation training within 48h occurrence. Then the changes of the ND scores at 21d and ADL scores were observed. Result: Here was no significant difference among those three groups before the treatment in ND scores and ADL scores (P>0.05). Compared with B and C groups, the ND scores and ADL scores in A group were remarkably turned for the better at 21d after treatment (P<0.01). Conclusion: Here was a significant clinical treatment effect of the early rehabilitation training and the low frequency electric stimulation on the patients with the acute cerebral infarction.%  目的:探讨双乳突法头部低频电刺激及早期康复训练对急性脑梗死患者神经功能缺损程度及日常生活能力(ADL)恢复的影响.方法:90例急性脑梗死患者,随机分为低频电刺激及早期康复训练组(A 组)、低频电刺激组(B 组)和对照组(C 组),每组30例.A、B 两组均采用低频电刺激、常规药物治疗,A 组在发病48 h 内立即进行早期康复训练,分别观察治疗前后神经功能缺损评分及 ADL 的变化.结果:三组在治疗前神经功能缺损评分、ADL 评分差异均无统计学意义(P<0.05),A 组治疗后神经功能缺损评分、ADL 评分明显好于 B 组及对照组,差异有统计学意义(P<0.01).结论:低频电刺激及早期康复

  2. MR-Angiography in young adults with cerebral infarction

    Out of 111 patient with cerebral infarction of uncertain etiology, who underwent a magnetic resonance angiography (MRA) study, a group of seven patents younger than 40 years is described. In four patients MRA showed patterns typical for cerebral artery with concomitant infarction. Only in one patient MRA was inconspicuous. Especially in young stroke patients, where magnetic resonance tomography (MRT) is indicated, MRT should be completed with a MRA of the circle of Willis. Depending on negative or questionable MRA findings and clinical considerations an additional angio-graphical investigation is required. (authors)

  3. [Family experiences post-acute myocardial infarction].

    Garcia, Raquel Pötter; Budó, Maria de Lourdes Denardin; Simon, Bruna Sodré; Wünsch, Simone; Oliveira, Stefanie Griebeler; Barbosa, Mariane da Silva

    2013-09-01

    This study aimed to describe the family experiences post-infarction. Qualitative, descriptive and exploratory research, carried out with six families of post-infarction patients. Data collection was conducted in families' homes, in the period of February to May of 2012, through observation and interviews with the family. The software Atlas Ti 6.2 was used to code the interviews and the data were explored with thematic analysis. Two categories emerged "Difficult times": immediate consequence of acute myocardial infarction for the families; and "We reeducate ourselves--we can adapt ourselves": current experience of families. The immediate post-infarction experience is permeated by several feelings, with the need for families to adapt to fit into the needs. The current experience shows changes in families due to the disease. The family is the main responsible for the care giving, although Nursing should exchange and share knowledge. PMID:24344600

  4. The Clinical analyse of 206 patients of cerebral infarction (Abstract)

    Mai Mai; Ti Yi Ming; Ghen Bo

    2000-01-01

    This thesis make a summary and analyse to 206 patients of cerebral infarction. The morbidity of the age from 51 to 70 is thehighist in 206 patients. It is 75.3 % a mong the patient that hypertension is original. The frequently-occurring cerebral in farction patient are 36.8 % and it is the highist. Because our hospital have purchased CT machinery, we can early diagnose cerebral infarction and do dissolving thrombus in early time, controlling blood pressure, clearing away free radical, dehydrating, di lating cerebral blood vessel, recovering treat early and so on. It reduced the appear ing of conplication and the death rate and viability by oneselfare improved obvious lv.

  5. 急性脑梗死早期行微导管动脉溶栓治疗的护理%The nursing coordination of acute cerebral infarction patients undergoing early arterial thrombolysis

    陈叶香; 易萍; 吕美云

    2011-01-01

    目的 探讨急性脑梗死早期动脉溶栓治疗护理配合的重要性.方法 对37例急性脑梗死早期选择性行微导管动脉溶栓治疗的患者,进行规范的术前准备、术中护理配合、术后的病情观察与护理.结果 37例患者治疗3个月后随访,21例发病6 h内行动脉溶栓治疗预后好的患者占80.95%,16例发病6~24 h行动脉溶栓治疗预后好的患者占68.75%,提高了患者的生存质量.结论 急性脑梗死早期选择性行微导管动脉溶栓治疗疗效良好,行微导管动脉溶栓治疗中规范的术前准备、术中护理配合、术后的病情观察与护理至关重要.%Objective To approach the importance of nursing coordination of early arterial thrombolysis in acute cerebral infarction (ACI). Methods 37 cases of ACI early selective micro-catheter arterial thrombolytic therapy were observed and nursed after the standard preoperative preparation, intraoperative nursing coordination, postoperative condition observation and nursing care. Results 80.95% of 21cases had much improvement of symptoms after arterial thrombolytic therapy and care within 6h;68.75% within 6 ~ 24 h. The rate of disability in patients with ACI were significantly reduced and the quality of life of patients were improved.Conclusions Early selective micro-catheter arterial thrombolytic therapy is of benefit for the acute cerebral infarction patient. The standard preoperative preparation, intraoperative nursing coordination, postoperative condition observation and nursing care are essential.

  6. Therapeutic Hypothermia for Cardioprotection in Acute Myocardial Infarction

    Kang, In Sook; Fumiaki, Ikeno; Pyun, Wook Bum

    2016-01-01

    Mild therapeutic hypothermia of 32–35℃ improved neurologic outcomes in outside hospital cardiac arrest survivor. Furthermore, in experimental studies on infarcted model and pilot studies on conscious patients with acute myocardial infarction, therapeutic hypothermia successfully reduced infarct size and microvascular resistance. Therefore, mild therapeutic hypothermia has received an attention as a promising solution for reduction of infarction size after acute myocardial infarction which are...

  7. Ozone Autohemotherapy in the treatment of 120 cases of acute cerebral infarction clinical operation and nursing experience%臭氧自血疗法治疗急性脑梗塞120例临床疗效观察与护理体会

    高丽丽; 赵龙辉; 张红叶

    2015-01-01

    Objective: Review and summarize the clinical experience of the operation and nursing of ozone Autohemotherapy in the treatment of acute cerebral infarction. Methods:Retrospective analysis of application of ozone Autohemotherapy in the treatment of 120 cases of acute cerebral infarction in patients with clinical data.Results: Ozone therapy and autologous blood reinfusion therapy patients timely given combination, clinical nurse, obtain satisfactory curative effect.Conclusion:Ozone Autohemotherapy therapy combined with clinical nursing is a new effective method for the treatment of acute cerebral infarction.%目的:回顾并总结臭氧自血疗法治疗急性脑梗塞的临床操作与护理体会。方法回顾性分析应用臭氧自血疗法治疗120例急性脑梗塞患者临床资料。结果患者及时给予臭氧自体血回输疗法治疗,结合临床护理,均获得满意疗效。结论臭氧自体血回输疗法结合临床护理是治疗急性脑梗塞的一个有效新方法。

  8. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    D. P. Sementsov

    2015-01-01

    Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  9. THROMBOLYTIC THERAPY OF ACUTE MYOCARDIAL INFARCTION

    D. P. Sementsov

    2015-12-01

    Full Text Available Importance of thrombolytic therapy for restoration of coronary blood flow in acute myocardial infarction is emphasized. Indications and contraindications, advantages and disadvantages for thrombolysis therapy are discussed. The ways of different thrombolytics implementation, efficacy criteria and possible side effects are also presented.

  10. Affect of mood and cognitive function on motor function in patients with acute cerebral infarction%情绪和认知功能对早期脑梗死患者运动功能影响的研究

    朱菊清; 冯子平; 杨旭东; 伯丹花; 陈世兵

    2015-01-01

    Objective:To analyze the relationship between motor dysfunction with cognitive function and mood among patients with a-cute cerebral infarction. Methods:Collected 78 cases patients with cerebral infarction, use upper limb function assessment table (DASH), 10m walking speed, Cognitive Assessment (MoCA), Self -Rating Anxiety Scale (SAS), Self -Rating Depression Scale ( SDS) to assess;comparison of patients with diffusion tensor imaging ( DTI) parameters:fractional anisotropy ( FA) values, and the ap-parent diffusion coefficient ( ADC) and FA index, ADC index, then correlation analysis and assessment of cognitive and emotional.Re-sults:DASH score and 10m walking speed had no correlation with MoCA, SAS, SDS scores (P>0.05);FA values in the ipsilateral and contralateral handers were negatively correlated (P<0.05) with SDS sorce.Conclusion:Cerebral infarction movement disorders might have no correlation with mood and cognitive function, while the infarct-induced defects in patients with neural networks should be associ-ated with emotions.%目的:研究脑梗死患者早期运动功能障碍与认知功能和情绪之间的关系。方法:收集自2011年5月~2014年5月于我院就诊的脑梗死患者78例,用上肢功能评定表( DASH)、10m步行速度、认知评估量表( MoCA)、焦虑自评量表( SAS)、抑郁自评量表( SDS)进行评定;比较患者弥散张量成像( DTI)相关参数:各向异性分数( FA)值、表观扩散系数( ADC)和FA指数、ADC指数,并与认知和情绪评估结果进行相关性分析。结果:DASH评分和10m步行速度与MoCA、SAS、SDS评分无相关性( P>0.05);患侧和健侧内囊后肢的FA值均与SDS评分呈负相关(P<0.05)。结论:脑梗死患者早期运动障碍与情绪和认知功能无相关性,而梗死灶所致的神经网络缺损则与情绪相关。

  11. Thrombolytic therapy in acute myocardial infarction.

    Woo, K S; White, H D

    1994-07-01

    Thrombolytic therapy has revolutionized the treatment of acute myocardial infarction by reducing mortality and preserving left ventricular function. It is relatively safe and cost-effective. However, it is currently underused in most countries. Patients in whom thrombolysis is indicated include those with ST elevation on the electrocardiogram or bundle branch block pattern who present within 12 hours of myocardial infarction; the indications should be widened to include the elderly, patients who have undergone nontraumatic cardiopulmonary resuscitation, and women during menstruation. The risk-benefit ratio should be assessed for the individual patient. Prehospital thrombolytic treatment has been shown to be feasible with the support of well-trained staff and resuscitation equipment, and may be cost-effective in communities with time delays before hospitalization greater than 1 hour. The most important strategy is to shorten the "door to needle" time in hospital. The importance of full infarct-related artery flow (Thrombolysis in Myocardial Infarction [TIMI] grade 3 flow) for preservation of ventricular function and survival has been documented in the second Thrombolysis Trial of Eminase in Acute Myocardial Infarction (TEAM 2) and the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) studies. Aspirin and heparin are beneficial adjunctive regimens to thrombolytic therapy but optimal epicardial reperfusion is achieved in only about half of patients. Improved thrombolytic, adjunctive antiplatelet, and antithrombotic regimens are required to achieve early full reperfusion, which is crucial to improve survival and quality of life. PMID:7919592

  12. Acute Myopericarditis Mimicking Acute Myocardial Infarction

    Seval İzdeş; Neriman Defne Altıntaş; Gülin Karaaslan; Recep Uygun; Abdulkadir But

    2011-01-01

    Acute coronary syndromes among young adults are relatively low when compared with older population in the intensive care unit. Electrocardiographic abnormalities mimicking acute coronary syndromes may be caused by non-coronary syndromes and the differential diagnosis requires a detailed evaluation. We are reporting a case of myopericarditis presenting with acute ST elevation and elevated cardiac enzymes simulating acute coronary syndrome. In this case report, the literature is reviewed to dis...

  13. Intrauterine extremity gangrene and cerebral infarction at term

    Tanvig, M; Jørgensen, J S; Nybo, M;

    2011-01-01

    Intrauterine extremity gangrene in combination with cerebral infarction is a serious and rare event. We present a case with a healthy mother who gave birth to a child with this condition. At term, the mother presented at the antenatal clinic with decreased fetal movements. Cardiotocography (CTG...

  14. Time course of the apparent diffusion coefficient after cerebral infarction

    Ahlhelm, F.; Backens, M.; Reith, W.; Hagen, T. [Department of Neuroradiology, University of Saarland, 66424 Homburg/Saar (Germany); Schneider, G. [Department of Radiology, University of Saarland, 66424 Homburg/Saar (Germany)

    2002-09-01

    The purpose of this study was to evaluate quantitative apparent diffusion changes in the center of infarction by measurement of the apparent diffusion coefficient (ADC), and to investigate the influence of ischemia on the contralateral hemisphere. By diffusion echo-planar imaging (EPI) 52 patients showing cerebral infarction were studied within 5 h to >12 months after onset of clinical symptoms. Using three diffusion gradient strengths (b1=30 s/mm{sup 2}; b2=300 s/mm{sup 2}, b3=1100 s/mm{sup 2}) ADC maps were generated. After onset of ischemia, ADC in the center of infarction was lower than in the contralateral regions of human brain. At first ADC declined for approximately 28 h to a minimum of approximately 150 x 10{sup -8} cm{sup 2}/s. Then the ADC reincreased and reached a ''pseudonormalization'' after approximately 5 days. Chronic infarctions did show much higher ADC values (2000 x 10{sup -8} cm{sup 2}/s) than unaffected areas. Neither localization nor size of infarctions showed a significant influence on this time course. In the center of infarction diffusion is isotropic. Even brain regions of the contralateral hemisphere are influenced by cerebral ischemia. In these regions ADC is higher than for physiological conditions. The ADC also declines especially for the first 2-3 days after onset of symptoms, also followed by reincrease. The ADC calculation enables determination of the onset of infarction more exactly than is possible using only diffusion-weighted imaging. Diffusion in the center of infarction is isotropic; hence, orientation of the diffusion gradients has no significant influence on sensitivity of measurements. The calculation of the ADC ratio based on data derived from the center of infarction and the contralateral hemisphere seems to be critical because the ADC in the unaffected contralateral hemisphere also changes. (orig.)

  15. Time course of the apparent diffusion coefficient after cerebral infarction

    The purpose of this study was to evaluate quantitative apparent diffusion changes in the center of infarction by measurement of the apparent diffusion coefficient (ADC), and to investigate the influence of ischemia on the contralateral hemisphere. By diffusion echo-planar imaging (EPI) 52 patients showing cerebral infarction were studied within 5 h to >12 months after onset of clinical symptoms. Using three diffusion gradient strengths (b1=30 s/mm2; b2=300 s/mm2, b3=1100 s/mm2) ADC maps were generated. After onset of ischemia, ADC in the center of infarction was lower than in the contralateral regions of human brain. At first ADC declined for approximately 28 h to a minimum of approximately 150 x 10-8 cm2/s. Then the ADC reincreased and reached a ''pseudonormalization'' after approximately 5 days. Chronic infarctions did show much higher ADC values (2000 x 10-8 cm2/s) than unaffected areas. Neither localization nor size of infarctions showed a significant influence on this time course. In the center of infarction diffusion is isotropic. Even brain regions of the contralateral hemisphere are influenced by cerebral ischemia. In these regions ADC is higher than for physiological conditions. The ADC also declines especially for the first 2-3 days after onset of symptoms, also followed by reincrease. The ADC calculation enables determination of the onset of infarction more exactly than is possible using only diffusion-weighted imaging. Diffusion in the center of infarction is isotropic; hence, orientation of the diffusion gradients has no significant influence on sensitivity of measurements. The calculation of the ADC ratio based on data derived from the center of infarction and the contralateral hemisphere seems to be critical because the ADC in the unaffected contralateral hemisphere also changes. (orig.)

  16. MR diffusion weighted imaging detecting cerebral infarction: a meta-analysis

    Objective: To determine the diagnostic value of diffusion-weighted imaging(DWI) in hyperacute and acute cerebral infarction by using Meta-analysis. Methods: Based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic, studies in English and Chinese from 1997 to 2007 were selected from Medline, Cochrane, Springer, Ovid, Elsevier, LWW and CNKI( China National Knowledge Infrastructure). The characteristics of the included articles were appraised and extracted. Statistical analysis was performed with the software Meta-test 0.6 and Comprehensive meta-analysis 2.0. Heterogeneity of the included articles was tested, which was used to select proper effect model to calculate pooled weighted values of sensitivity and specificity and the corresponding 95% CI. Summary receiver operating characteristic (SROC) curve was performed and the area under the curve (Az) was calculated. Publication bias was analyzed by Funnel Plot in Comprehensive Meta- analysis 2.0. A sensitivity analysis was performed. Results: Twelve articles meeting inclusion criteria were analyzed for the value of DWI in hyperacute cerebral infarction. The pooled sensitivity, specificity and diagnostic odds ratio was 92%, 87%, 180.37 respectively, Az=0.9717. Novice is a main factor for total diagnostic effect (Q=4.34, P>0.05). Non-asymmetric funnel plot suggested the publication bias. Fifteen articles meeting inclusion criteria were analyzed for the value of DWI in both hyperacute and acute cerebral infarction (≤ 24 h). The pooled sensitivity, specificity diagnostic odds ratio was 92%, 91%, 623.62 respectively, Az=0.9659. Fixed effects model used in Meta-analysis for database suggested homogeneity (Q=2.70,P>0.05). Nonasymmetric funnel plot suggested the publication bias. Conclusions As a noninvasive method, diffusion-weighted imaging is valuable in detecting hyperacute and acute cerebral infarction. More support from multi-center prospective researches is

  17. Cerebral infarction secondary to temporal lobe herniation in head trauma: a CT study

    Cerebral infarction is a known complication of temporal lobe herniation caused by a traumatic intracranial lesion. To ascertain the frequency, time of recognition, and influence on mortality of posttraumatic cerebral infarction secondary to temporal lobe herniation, we retrospectively reviewed brain CT scans and clinical records of 55 patients who had CT and clinical signs of temporal lobe herniation on admission date. Cerebral infarctions were recognized in seven (12.7%) patients on CT scans taken within two days after admission (mean: 1.3 days). Cerebral infarctions were in the terrtiories of the posterior cerebral artery in all seven patients, two of whom had infarctions of the anterior choroidal artery as well. Mortality (71.4%) for these seven patients was not statistically significant from that (50%) of patients without cerebral infarction admitted with the same range of Glasgow Coma Scale score. The result suggests that such cerebral infarction dose not greatly influence patient's mortality

  18. PREVALENCE AND RISK FACTORS OF ASYMPTOMATIC CEREBRAL INFARCTION

    R. R. Zhetishev

    2015-05-01

    Full Text Available Acute stroke manifesting as focal neurological deficit is a leading cause of death and disability. Of interest is the problem of asymptomatic cerebral infarctions (AСI, in which there is focal medullary involvement unaccompanied by the development of focal symptoms. The role of AСI as a marker for the progression of vascular dementia and for the further development of symptomatic stroke has not been adequately explored. There are current instrumental (neuroimaging criteria for diagnosing AСI. An update on the risk factors of AСI and their association with the further course of cerebrovascular involvement is analyzed. The results of a number of prospective studies conducted in the countries of Asia and Europe to investigate risk factors for AСI and their prognostic value are considered in detail. There is a relationship between hypertension, blood pressure instability, type 2 diabetes mellitus, some other factors, and a significantly increased risk for AСI. Based on the results of analyzing the data available in the literature, the authors demonstrate the association of prior AСI with the higher rates of progressive vascular cognitive impairments. A correlation is shown between prior AСI and an increased risk for further development of ischemic stroke accompanied by its clinical symptoms, which leads to disability. It is suggested that it is advisable to implement measures for secondary cardiovascular disease prevention, including the administration of antiaggregatory and antihypertensive agents, in patients with AСI. 

  19. Case of cerebral venous thrombosis with unusual venous infarcts.

    Narra, Ramakrishna; Kamaraju, Susheel Kumar; Pasupaleti, Bhimeswarao; Juluri, Naganarasimharaju

    2015-04-01

    Cerebral venous thrombosis is a relatively rare condition when compared with vascular accidents of arterial origin representing 0.5-1% of all strokes. Unlike arterial infarcts parenchymal changes are seldom present and when present most of the times are reversible. We present a case report of 28-year-old female with thrombosis of internal cerebral veins and straight sinus and hemorrhagic infarcts in bilateral basal ganglia and bilateral thalami .The findings of bilateral symmetrical hyper intensities in basal ganglia and thalami on MRI may be due to various causes of diverse etiology and cerebral venous thrombosis remains an important cause. Early recognition and prompt anticoagulation therapy helps to reduce the mortality to a great extent. The MRI imaging features of straight sinus thrombosis and other imaging differentials are discussed. PMID:26023623

  20. Clinical Studies of Cerebral Edema Recanalization After Thrombolysis in Acute Cerebral Infarction%急性脑梗死动脉溶栓血管再通后的脑水肿临床研究

    王喜春; 马冲; 张健莉; 于杰

    2015-01-01

    目的:探讨急性缺血性脑卒中动脉溶栓血管再通后脑水肿的临床研究,旨在为此类疾病患者的下一步临床工作提供借鉴。方法选择通过动脉溶栓血管再通的患者40例。将患者分为1~3 h组(A组)、>3~6h组(B组)。头颅CT监测、随访脑水肿情况。记录溶栓前、术后1周及1年NIHSS评分、MRS评分及BI指数。结果动脉溶栓血管再通后脑水肿发生率为100%,随访发现脑水肿局部有明显软化灶。两组患者脑水肿及临床结局比较差异无统计学意义(P>0.05)。结论动脉溶栓血管再通后脑水肿的及其脑组织缺失发生率极高,脑水肿局部有明显软化灶,良好的脑内局部循环和全身状况是改善此类脑水肿的重要因素。%Objective To investigate the acute arterial ischemic stroke thrombolytic recanalization clinical studies of cerebral edema, designed to provide a reference for the next clinical disease in these patients.Methods arterial thrombolysis recanalization by 40 patients. Patients were divided into 1 ~ 3h group (A),> 3 ~ 6h group (group B). Cranial CT monitoring, follow-up of brain edema. Recorded before thrombolysis, after 1 week and 1 year NIHSS score, MRS score and BI index.Results arterial thrombolysis recanalization rate was 97.5% of cerebral edema, cerebral edema partial follow-up found a significant malacia. Two groups of patients and clinical outcomes of cerebral edema was no significant difference (P> 0.05).Conclusion The arterial thrombolysis recanalization of cerebral edema and high incidence of brain tissue loss, good local circulation in the brain and body condition is such an important factor in improving brain edema.

  1. Early CT findings in acute middle cerebral artery ischemia

    Stroke is characterized by a sudden onset of focal central neurological deficit, with symptoms lasting more than 24 hours, that can be fatal. The introduction of anti-coagulation treatments, together with continuous advances inneuroimaging techniques, have a positive impact, both on morbidity and mortality in stroke patients. It must be stressed, that 'therapeutic window' for fibrolytic treatment is up to 3 hours. The group consisted of 50 patients with clinical diagnosis of stroke, who met the following criteria: first ever, non-hemorrhagic stroke, middle cerebral artery territory involvement, first CT performed within 12 hours from the onset of symptoms, control CT, performed within 7 days, confirming signs of infarction in the distribution of middle cerebral artery. All CT were performed without contrast administration. First CT examinations were retrospectively studied for early evidence of ischemic changes, subsequently depicted as infarction in the control CT. Hyperdencemiddle cerebral artery sign (HMCAS), hypoattenuation of lentiform nucleus (ALN), loss of insular ribbon (LIR), hemispheric sulcus effacement (HES) were found as early abnormalities CT examinations continue to play a dominant role in the initial diagnosis of acute cerebral ischemia. Signs of early ischemia can be often detected within the first three hours from the onset, in the hyper acute phase. CT is used in evaluation of recent symptoms in acute phase and proper selection of patients for thrombolysis with significant therapeutic results. [author

  2. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures

    Yoon, Sang-Youl; Hwang, Jeong-Hyun; Hwang, Sung-Kyoo

    2016-01-01

    We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit in the acute stage to prevent extent of stroke. Aspirin was started for antiplatelet therapy in the chronic stage. The possibility of symptomatic cerebral infarctions due to traumatic VAD following cervical fracture should be considered.

  3. Diagnosis and treatment of patients with acute cerebral ischemia using stroke MRI

    Between November 1999 and September 2002, 175 patients with acute cerebral infarction were admitted to our Stroke Care Unit. Stroke MRI (diffusion-, perfusion- and T2-weighted imaging and MR angiography) was performed for these patients, and we used diffusion/perfusion mismatch for indication of cardiovascular reconstruction. Of 175 patients, 44 were diagnosed as atherothrombotic infarction, 70 as cardioembolic infarction and 57 as lacunar infarction. In 19 patients (27.1%) of cardioembolic infarction and 17 (38.6%) of atherothrombotic infarction, cerebrovascular reconstructions were performed. Although outcome after treatment was good in only 3 of these 19 patients (15.8%) with cardioembolism, outcome was good in 13 of 17 (76.5%) with atherothrombotic infarction. Outcomes of patients with cardioembolic internal carotid occlusion were very poor even if stroke MRI indicated acute thrombolysis, because almost all thrombolysis were failed. In conclusion, stroke MRI accurately diagnosed acute cerebral infarction, and acute and subacute cerebrovascular reconstruction induced good outcome in patients with atherothrombotic infarction. (author)

  4. Analysis of Serum NSE Levels in Hemorrhagic Transformation of Acute Cerebral Infarction Without Thrombolysis%非溶栓性急性脑梗死后出血性转化患者血清NSE相关性分析

    程鹤云; 赵幸娟

    2015-01-01

    Objective Discuss the correlationg between the levels of serum neuron-specific enolase ( NSE) and the risk of hemorrhagic transformation( HT) of acute cerebral without thrombolysis. Method 96 cases whose admission time <72 hours was selected in accordance with the WHO criteria for the di-agnosis of cerebral infarction, and head CT ruled out bleeding in patients with acute infarction. After 7 to 10 days after the review of magnetic resonance imaging ( MRI) gradient echo sequence showed low signal for hemorrhagic transformation. The level of NSE was detectioned by Elisa, and we also stuied the corre-lation between NSE and HT. Results 36 of 96 pations come to hemorrhagic transformation, other 60 pa-tions were no transformaion group. The NSE levels was higher in hemorrhagic transformation group than no transformation group, and the differences were significant (P<0. 05). Factors affecting the hemor-rhagic transformation included by history of atrial fibrillation, hypertension, low density lipoprotein cho-lesterol ( hdl-c ) and NSE level ( P<0 . 05 ) . Logistic stepwise polynomial regression analisis indicated that serum NSE level and atrial fibrillation were risk factors for hemorrhage transformation. Conclusion Testing the level of NSE was relationship with the risk of HT in actue cerebral infavction patients in the early stage, and this could be the independent risk factor of HT.%目的:探讨未进行溶栓的急性脑梗死患者血浆神经烯醇化酶( NSE)水平与出血性转化的相关性。方法选择96例入院时间<72 h,符合WHO脑梗死诊断标准,且头部CT排除出血的急性脑梗死患者,发病7~10 d后复查MRI梯度回波序列显示低信号为出血性转化;Elisa法定量检测血浆NSE水平;并探讨其与出血性转化的相关性。结果96例患者中36例出现出血性转化(转化组),其余60例为非转化组,出血性转化脑梗死组神经烯醇化酶水平高于非出血性转化组,差异有统计学意义(P<0.05),

  5. [Five elderly patients with cerebral infarction seen during a heat wave].

    Iwamoto, T; Akazawa, M; Ami, M; Shimizu, T; Umahara, T; Takasaki, M

    1999-08-01

    Five elderly patients (> or = 65 y) with cerebral infarction induced by dehydration during a heat wave were described to clarify the relationship between dehydration and stroke in the aged. When the daily maximum temperature exceeded 30 degrees C every day for two weeks, 6 patients with acute stroke came to our hospital. Five of them were patients with cerebral infarction aged 73-89 (the elderly group) and one was a 52-year-old woman with putaminal hemorrhage. As control groups, patients with ischemic stroke during the period 4 weeks before and after, but excluding the heat wave period, which consisted of an elderly control group (n = 7) and a young control group (n = 5), were also studied retrospectively with regard to clinical findings and neuroimaging. The incidence of cerebral infarction in the elderly group was higher in the heat wave period among all three groups. Atherothrombotic, lacunar, and cardioembolic infarctions were seen in 1, 2 and 2 cases, respectively. The onset in the elderly group was characteristic as all occurred before noon and were related to exercise. Physical examination at arrival revealed decreased skin turgor and dry tongue. A high BUN/creatinine ratio (> or = 25) and elevated fibrinogen (> 400 mg/dl) was frequently noted, although high hematocrit (> or = 45) was not seen. According to clinical findings, dehydration was diagnosed and they were infused with fluid, resulting in the improvement of skin turgor and tongue moisture. These findings indicated that dehydration due to excess perspiration due to the heat wave induced cerebral infarction in the elderly. It suggests that water intake on awakening in summer is important to prevent dehydration and ischemic stroke because elderly people are especially susceptible to those conditions in the morning. PMID:10554565

  6. Contralateral diaphragmatic palsy after subcortical middle cerebral artery infarction without capsular involvement.

    Wu, Meng-Ni; Chen, Po-Nien; Lai, Chiou-Lian; Liou, Li-Min

    2011-06-01

    Diaphragmatic palsy after acute stroke is a novel clinical entity and may result in a high incidence of respiratory dysfunction and pneumonia, which especially cause greater morbidity and mortality. Generally, internal capsule and complete middle cerebral artery (MCA) infarctions are major risk-factors for developing diaphragmatic palsy. Herein, we present a case with contralateral diaphragmatic palsy after a subcortical MCA infarction without capsular involvement. Dyspnea occurred after stroke, while a chest X-ray and CT study disclosed an elevated right hemidiaphragm without significant infiltration or patch of pneumonia. A phrenic nerve conduction study showed bilateral mild prolonged onset-latency without any significant right-left difference. This suggested a lesion causing diaphragmatic palsy was not in the phrenic nerve itself, but could possibly originate from an above central location (subcortical MCA infarction). We also discussed the role of transcranial magnetic stimulation study in the survey of central pathway and demonstrated diaphragmatic palsy-related orthopnea. PMID:21365293

  7. Acute Myocardial Infarction, 1992-2001.

    Robert Schmitz

    2005-01-01

    Heart disease is the leading cause of hospitalization and death in the United States among persons age 65 and older. Acute myocardial infarction (AMI), more commonly known as heart attack, accounted for more than 321,000 hospitalizations among Medicare beneficiaries in 2001. This report presents trends in AMI hospitalization, readmission, and mortality rates from 1992 through 2001 among Medicare fee-for-service beneficiaries across various demographic groups.

  8. Clinical Practice Guidelines for Acute Myocardial Infarction.

    Francisco de Jesús Valladares Carvajal; Arelys Falcón Hernández; Félix Rolando Jorrín Román; Juan Emilio García Rivas

    2009-01-01

    Clinical Practice Guidelines for Acute Myocardial Infarction. It has been defined as the clinical condition caused by the ischemic myocardial necrosis, usually caused by abrupt reduction of coronary blood irrigation affecting one or more myocardial areas. The document includes a review and update of the concept, classification, diagnosis and therapy. Risk stratification and main aspects of rehabilitation are also stressed. It includes assessment guidelines focused on the most important aspect...

  9. Acute myocardial infarction after mediastinal radiotherapy

    Mediastinal radiotherapy can affect the heart and great vessels to different degrees. It may turn up as coronary heart disease and less frequently as acute myocardial infarction. We report the case of a patient without coronary risk factors and an antecedent of mediastinal radiotherapy for Hodgkin's lymphoma. Considerations about mediastinal radiation as a risk factor for early development of coronary heart diseases are exposed. (author)

  10. Clinical Practice Guidelines for Acute Myocardial Infarction.

    Francisco De Jesús Valladares Carvajal

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Acute Myocardial Infarction. It has been defined as the clinical condition caused by the ischemic myocardial necrosis, usually caused by abrupt reduction of coronary blood irrigation affecting one or more myocardial areas. The document includes a review and update of the concept, classification, diagnosis and therapy. Risk stratification and main aspects of rehabilitation are also stressed. It includes assessment guidelines focused on the most important aspects to be accomplished.

  11. The electrocardiogram in acute myocardial infarction

    In 2006, 94 years after Eindhoven W. performed the first electrocardiogram (ECG) three derivations, J. Willis Hurst said: The treatment of acute coronary syndrome is based entirely on electrocardiogram a normalities. Therefore, the correct interpretation of the electrocardiogram is needed now more than ever in the history of medicine.This article will address those aspects of the subject that we consider most useful for clinical cardiologists should assist patients with acute myocardial infarction (AMI) in the crucial first minutes or hours of their evolution

  12. Clinical significance of measurement of plasma Hcy and serum GST levels after treatment in patients with cerebral infarction

    Objective: To exeplore the clinical significance of changes of plasma Hey and serum GST levels after treatment in patients with cerebral infarction. Methods: Plasma Hey (with RIA) and serum GST (with ELISA) levels were determined in 32 patients with cerebral infarction both before and after treatment as well as in 35 controls. Results: Before treatment, the plasma Hey levels were significantly higher than those in controls (P<0.01), while serum GST levels were significantly lower than those in controls (P<0.01). After treatment for three months the levels, though corrected markedly, remained significantly different from those in controls (P<0.05). Plasma Hey levels were negatively correlated with serum GST levels (r=-0.4125, P<0.05). Conclusion: The plasma Hcy and serum GST levels were closely related to the diseases process of acute cerebral infarction and were of great clinical importance. (authors)

  13. Regional cerebral blood flow and periventricular hyperintensity in silent cerebral infarction. Comparison with multi-infarct dementia

    In order to investigate relationship between regional cerebral blood flow (rCBF) and the white matter lesions on MRI in silent cerebral infarction, we quantitatively measured rCBF by 123I-IMP autoradiography method (IMP ARG method) and single photon emission tomography (SPECT) in 36 patients with silent cerebral infarction (SCI group), 22 patients with multi-infarct dementia (MID group), and 16 control subjects without periventricular hyperintensity (PVH) and lacunar infarction on MRI (CL group). Regions of interest (ROIs) on rCBF images were set in the frontal (F), temporal (T), parietal (P), occipital (O) cortex, and the cerebral white matter (W). The severity of PVH on MRI T2-weighted image was divided into four grades (grade 0-3). Though the frequency of hypertension was significantly higher in SCI group and MID group compared with CL group, no significant difference was seen in the mean age among these three groups. rCBF in the white matter and cerebral cortices except the occipital cortex in SCI group was significantly low compared with CL group (rCBFSCI/rCBFCL: W 0.87, F 0.87, T 0.87, P 0.88, O 0.92). rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex, in MID group was significantly low compared with SCI group (rCBFMID/rCBFCL: W 0.69, F 0.71, T 0.74, P 0.75, O 0.81). The mean grade of PVH in MID group was significantly higher than that in SCI group (SCI 1.1 vs MID 2.5). The severity of PVH was significantly correlated with each rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex. Our findings suggest that the quantitative measurement of rCBF by IMP ARG method is useful for the follow-up study in the patients with silent cerebral infarction as well as the evaluation of the severity of PVH on MRI. (author)

  14. Cerebral edema associated with acute hepatic failure.

    Fujiwara,Masachika

    1985-02-01

    Full Text Available The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64% of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more frequently in patients later found to have cerebral edema. Moreover, the length of time from deep coma to death was much shorter in the brain edema cases with cerebral herniation than without herniation.

  15. Cerebral edema associated with acute hepatic failure.

    Fujiwara, Masachika; Watanabe,Akiharu; Yamauchi,Yasuhiko; Hashimoto, Makoto; Nakatsukasa, Harushige; Kobayashi, Michio; Higashi,Toshihiro; Nagashima,Hideo

    1985-01-01

    The clinicopathological findings of cerebral edema were investigated in patients with acute hepatic failure autopsied at Okayama University Hospital between 1970 and 1980 retrospectively. Nine (64%) of 14 hepatic failure cases were found to have cerebral edema during a post-mortem examination of the brain. Clinical features of the patients with cerebral edema were not significantly different from those of the patients without cerebral edema. However, general convulsions were observed more fre...

  16. Study on plasma homocysteine (HCY) levels in patients with cerebral infarction and cerebral hemorrhage

    Objective: To investigate the relationship between the plasma levels of HCY, folate and vitamin B12 and the development of cerebrovascular accidents (infarction and hemorrhage). Methods: Plasma HCY concentrations (with fluorescence polarization immunoassay FPIA) and folate, VitB12 contents (with immunofluorescence technique) were measured in 150 patients with cerebral infarction, 171 patients with cerebral hemorrhage (all patients confirmed with CT/MRI) and 96 controls. Results: Plasma HCY concentrations were significantly higher (P12 contents were significantly lower (P12 concentrations were critically involved in the development and pathogenesis of cerebrovascular accidents. (authors)

  17. Cerebral infarction: an unusual manifestation of viper snake bite

    Jyotirmoy Pal

    2014-06-01

    Full Text Available Snake envenomation causes significant mortality and morbidity. Viper bite usually present with local cellulites, renal failure and bleeding disorders. Thrombotic manifestation of snake bite is rarely reported and early administration of Anti-Snake Venom Serum (ASV also reduces the risk of thrombotic complications. Cerebral infarction in case of viper bite may be due to hypotension, hypercoagulability or direct action of venom on vessel wall. We report a rare case of viper bite, presented with renal failure and cerebral infarction in spite of early ASV institution. The thrombotic manifestation in this case was possibly due to disseminated intravascular coagulation. [Int J Res Med Sci 2014; 2(3.000: 1180-1183

  18. [Prehospital thrombolytic therapy in acute myocardial infarction].

    Carlsson, J; Schuster, H P; Tebbe, U

    1997-10-01

    The extent of myocardial damage occurring during acute myocardial infarction is time dependent, and there is abundant evidence from most clinical trials that mortality reduction is greatest in patients treated early with thrombolytic agents, although beneficial effects have been shown with treatment initiated up to 12 h after onset of symptoms. All studies on prehospital thrombolysis have conclusively shown the practicability and safety of patient selection and administration of the thrombolytic agent. The accuracy of diagnosis in the prehospital setting was comparable to trials of in-hospital thrombolysis, e.g., in the Myocardial Infarction Triage and Intervention Project (MITI) 98% of the patients enrolled had subsequent evidence of acute myocardial infarction. With regard to time savings, all randomized studies showed positive results. The smallest time gain was observed in the MITI trial: prehospital-treated patients received thrombolytic therapy an average of 33 min earlier than those treated in hospital. In the European Myocardial Infarction Project (EMIP) the difference in time between prehospital and hospital treatment was a median of 55 min. However, none of these trials was able to show a significant short-term mortality difference between the two groups. Only a meta analysis of five randomized studies with a combined median time gain of about 60 min showed a significant 17% reduction in short-term mortality for patients who received thrombolytic therapy in the prehospital phase. In the Grampian Region Early Anistreplase Trial (GREAT), a study performed in a more rural area than other studies, the time gain by prehospital initiation of thrombolysis was a median of 130 min. GREAT was the only study to date reporting a significant mortality benefit for prehospital-treated patients after 3 months and 1 year. In conclusion, prehospital thrombolysis is feasible and safe. Patients with acute myocardial infarction can be correctly identified and treated with

  19. Immunocompetent young man with cerebral abscess and cortical venous infarction mimicking cerebritis caused by Gemella morbillorum

    Milnik, Annette; Gazis, Angelos; Tammer, Ina; Bartels, Claudius

    2013-01-01

    Gemella morbillorum is an anaerobic gram-positive diplococcus and in most cases a harmless commensal, which occasionally causes infections in the central nervous system. We report on an immunocompetent young man with focal neurological symptoms and cephalgia caused by a cerebral abscess. Although successful treatment was done with neurosurgical intervention and antibiotic therapy, he suffered from a venous infarction 5 weeks after first diagnosis, which mimicked cerebritis as an early stage o...

  20. The use of magnetic resonance and MR angiography in the detection of cerebral infarction: A complication of pediatric bacterial meningitis

    Stošić-Opinćal Tatjana

    2005-01-01

    Full Text Available Bacground. Association of both cerebral infarction and acute bacterial meningitis is more common in younger patients than in the elderly. The rate of mortality and the frequency of sequel are very high inspite of the use of modern antibiotic therapy. In more than 30% of the cases of childhood bacterial meningitis, both arterial and venous infarctions can occur. The aim of this study was to present the role of the use of magnetic resonance (MRI, and MR angiography (MRA in the detection of bacterial meningitis in children complicated with cerebral infarctions. Method. In the Centre for MR, the Clinical Centre of Serbia, 25 patients with the diagnosis of bacterial meningitis, of which 9 children with cerebral infarction whose clinical conditon deteriorated acutely, despite the antibiotic therapy, underwent MRI and MR angiography examination on a 1T scanner. Examination included the conventional spin-echo techniques with T1-weighted saggital and coronal, and T2- weighted axial and coronal images. Coronal fluid attenuated inversion recovery (FLAIR and the postcontrast T1-weighted images in three orthogonal planes were also used. The use MR angiography was accomplished by the three-dimensional time-of-flight (3D TOF technique. Results. The findings included: multiple hemorrhagic infarction in 4 patients, multiple infarctions in 3 patients, focal infarction in 1 patient and diffuse infarction (1 patient. Common sites of involvement were: the frontal lobes, temporal lobes and basal ganglia. The majority of infarctions were bilateral. In 3 of the patients empyema was found, and in 1 patient bitemporal abscess was detected. In 8 of the patients MR angiography confirmed inflammatory vasculitis. Conclusion. Infarction is the most common sequel of severe meningitis in children. Since the complication of cerebral infarction influences the prognosis of meningitis, repetitive MRI examinations are very significant for the evaluation of the time course of

  1. Cerebral Infarction Presenting with Unilateral Isolated Foot Drop

    Kim, Ki-Wan; Park, Jung-Soo; Koh, Eun-Jeong; Lee, Jong-Myong

    2014-01-01

    Weakness of the dorsiflexor muscles of the ankle or toe, referred to as foot drop, is a relatively common presentation. In most cases, foot drop is caused by a lower motor neuron disease such as peroneal peripheral neuropathy, L4-5 radiculopathic sciatic neuropathy, or polyneuropathy. Although upper motor neuron lesions can present as foot drop, the incidence is very rare. Here, we report an extremely rare case in which foot drop was the only presenting symptom of cerebral infarction.

  2. Correlated study of cerebral infarcts by CAT and autopsy

    The author aims to demonstrate the increased information which can be acquired from a correlated study of the computed tomogram and the pathomorphological patterns of the most common infarctions seen at autopsy. The discussion is divided into two sections: 1. A short bird's-eye view on the laws of distribution of flow in cases of cerebrovascular insufficiency, particularly all the deviations from simple hemodynamics in the process of infarction. 2. A systematic demonstration of the most frequent CT-patterns correlated with the corresponding pathomorphological specimens. This report is based on 6500 cerebral CTs, from which 590, i.e. 9%, showed infarcts. These include mainly cases seen in the neurological ward of the Merheim City Hospital. (Auth.)

  3. Systemic inflammatory response following acute myocardial infarction

    Lu FANG; Xiao-Lei Moore; Anthony M Dart; Le-Min WANG

    2015-01-01

    Acute cardiomyocyte necrosis in the infarcted heart generates damage-associated molecular patterns, activating complement and toll-like receptor/interleukin-1 signaling, and triggering an intense inflammatory response. Inflammasomes also recognize danger signals and mediate sterile inflammatory response following acute myocardial infarction (AMI). Inflammatory response serves to repair the heart, but excessive inflammation leads to adverse left ventricular remodeling and heart failure. In addition to local inflammation, profound systemic inflammation response has been documented in patients with AMI, which includes elevation of circulating inflammatory cytokines, chemokines and cell adhesion molecules, and activation of peripheral leukocytes and platelets. The excessive inflammatory response could be caused by a deregulated immune system. AMI is also associated with bone marrow activation and spleen monocytopoiesis, which sustains a continuous supply of monocytes at the site of inflammation. Accumulating evidence has shown that systemic inflammation aggravates atherosclerosis and markers for systemic inflammation are predictors of adverse clinical outcomes (such as death, recurrent myocardial in-farction, and heart failure) in patients with AMI.

  4. Correlation between plasma fibrinogen content and prognosis in patients with acute cerebral infarction%脑梗死急性期血浆纤维蛋白原水平与预后的关系

    田栓让; 屈秋民

    2013-01-01

    Objective To explore the correlation between plasma fibrinogen content and prognosis in patients with acute cerebral in -farction.Methods A total of 106 patients with non-cardiogenic cerebral infarction were enrolled .Fibrinogen in plasma from elbow vein was measured in 72 h after the disease attack.Neurological impairment was assessed using the national institutes of health stroke scale ( NIHSS) , the level of consciousness was evaluated by Glasgow coma scale ( GCS) , and the disability of living was estimated by Barthel index (BI) at 3 month after the disease attack.Results Plasma fibrinogen of 106 patients was 2.36-6.42 g/L [ (3.58 ± 0.76 ) g / L ] , with an increase in 6 8 cases (64.2 % ) .The single and multiple factor analysis showed that age (OR = 1 .026, P = 0.011),GCS (OR = 1.546,P=0.006),NIHSS (OR=1.358,P =0.042) and infarct size (OR = 1.256,P =0.024) were related to plasmatic fibrinogen content.The risk factors related to disability in living at 3 month after the disease attack included age ( OR = 3.598,P = 0.006),NIHSS (OR= 5.110,P =0.001),infarct size (OR= 2.286,P =0.026) and fasting blood glucose (OR = 1.024, P=0.021) ,while plasmatic fibrinogen content was excluded (OR=2.783,P = 0.259).Conclusion Increased plasma fibrinogen is a common performance in non-eardiogenic cerebral infarction.Plasma fibrinogen content is closely related to the severity of cerebral in -farction and disability at 3 month after the disease attack.%目的 研究脑梗死急性期血浆纤维蛋白原(fibrinogen,FIB)水平与患者预后的关系.方法 106名非心源性栓塞性脑梗死患者,发病后72 h内采集肘静脉血测定血浆FIB浓度,应用美国国立卫生院卒中量表(NIHSS)评价神经功能缺损,Glasgow昏迷量表(GCS)评价意识水平,Barthel指数(BI)评估发病后3月的生活能力.结果 106例急性脑梗死患者入院时FIB为2.36-6.42 g/L(3.58±0.76 g/L),其中FIB增高(>4 g/L )68例(64.2%).单因素及多因素分析显示,影响入院

  5. Study on the change and relationship between plasma D-dimer and homocysteine levels in patients with acute cerebral vascular accident

    Objective: To study the clinical significance of the changes and the relationships between plasma D-dimer (D-D) and Homocysteine (Hcy) expression in patients with acute cerebral infarction and acute cerebral hemorrhage. Methods: Plasma D-D (with ELISA) and Hcy (with CLIA) levels were measured in 397 patients with cerebral infarction, 122 patients with cerebral hemorrhage and 30 controls.Results 1) The mean level of the plasma D-D and Hcy in patients with acute cerebral infarction was 5.20±0.92μg/L and 21.23±13.54 μmol/L respectively, which was significant higher than that in controls and patients with acute cerebral hemorrhage. 2) Higher expressing of D-D and Hcy was found in 101 (25.4%) and 140 (35.3%) cases of acute cerebral infarction patients. The data in acute cerebral hemorrhage group was 17 (13.9%) and 27 (22.1%) respectively. There was significant difference between two groups, P<0.01. 3) There was not correlations with the expression level of D-D and Hcy in patients with acute cerebral infarction and patients with acute cerebral hemorrhage. 4) The expressing level of the Plasma D-D in acute cerebral infarction patients was not significant difference in both age and sex. The expressing level of Hcy in male was higher than that in female. There was not significant difference in the expressing level of Hcy in different age. Conclusion: The levels of plasma D-D and Hcy in patients with acute cerebral infarction significantly in creased, but there were not correlations between the levels of the two parameters. (authors)

  6. Acute myocarditis triggering coronary spasm and mimicking acute myocardial infarction

    Andreas; Kumar; Rodrigo; Bagur; Patrick; Béliveau; Jean-Michel; Potvin; Pierre; Levesque; Nancy; Fillion; Benoit; Tremblay; éric; Larose; Valérie; Gaudreault

    2014-01-01

    A 24-year-old healthy man consulted to our center because of typical on-and-off chest-pain and an electrocardiogram showing ST-segment elevation in inferior leads. An urgent coronary angiography showed angiographically normal coronary arteries. Cardiovascular magnetic resonance imaging confirmed acute myocarditis. Although acute myocarditis triggering coronary spasm is an uncommon association, it is important to recognize it, particularly for the management for those patients presenting with ST-segment elevation and suspect myocardial infarction and angiographically normal coronary arteries. The present report highlights the role of cardiovascular magnetic resonance imaging to identify acute myocarditis as the underlying cause.

  7. T2-enhanced tensor diffusion trace-weighted image in the detection of hyper-acute cerebral infarction: Comparison with isotropic diffusion-weighted image

    Chou, M.-C. [Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan (China); Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China); Tzeng, W.-S. [Department of Radiology, Chi-Mei Medical Center, Tainan, Taiwan (China); Chung, H.-W.; Wang, C.-Y.; Liu, H.-S.; Juan, C.-J. [Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan, ROC (China); Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China); Lo, C.-P. [Department of Radiology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (China); Hsueh, C.-J. [Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan (China); Chen, C.-Y., E-mail: sandy0928@seed.net.t [Department of Radiology, Tri-Service General Hospital, Taipei, Taiwan (China)

    2010-06-15

    Background and purpose: Although isotropic diffusion-weighted imaging (isoDWI) is very sensitive to the detection of acute ischemic stroke, it may occasionally show diffusion negative result in hyper-acute stroke. We hypothesize that high diffusion contrast diffusion trace-weighted image with enhanced T2 may improve stroke lesion conspicuity. Methods: Five hyper acute stroke patients (M:F = 0:5, average age = 61.8 {+-} 20.5 y/o) and 16 acute stroke patients (M:F = 11:5, average age = 67.7 {+-} 12 y/o) were examined six-direction tensor DWIs at b = 707 s/mm{sup 2}. Three different diffusion-weighted images, including isotropic (isoDWI), diffusion trace-weighted image (trDWI) and T2-enhanced diffusion trace-weighted image (T2E{sub t}rDWI), were generated. Normalized lesion-to-normal ratio (nLNR) and contrast-to-noise ratio (CNR) of three diffusion images were calculated from each patient and statistically compared. Results: The trDWI shows better nLNR than isoDWI on both hyper-acute and acute stroke lesions, whereas no significant improvement in CNR. Nevertheless, the T2E{sub t}rDWI has statistically superior CNR and nLNR than those of isoDWI and trDWI in both hyper-acute and acute stroke. Conclusions: We concluded that tensor diffusion trace-weighted image with T2 enhancement is more sensitive to stroke lesion detection, and can provide higher lesion conspicuity than the conventional isotropic DWI for early stroke lesion delineation without the need of high-b-value technique.

  8. Periventricular hyperintensity lesions and dementia in multiple cerebral infarction

    To examine the relationship between the presence of periventricular hyperintensity (PVH), as shown on MR-T2 weighted images, and both ischemia and dementia, regional cerebral blood flow (rCBF), oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen (CMRO2), and cerebral blood volume (CBV) were determined by positron emission computed tomography using the 15O and 11CO inhalation technique. Thirty-three patients with subcortical cerebral infarction were classified according to the presence of PVH: the PVH (+) group with severe PVH (n=17) and the PVH (-) group without PVH (n=16). In the PVH (+) group of patients with no association of dementia and the PVH (-) group, both decreased rCBF and increased OEF were significantly observed in the frontal cingulate gyrus and PVH area, when compared with the normal controls. In the PVH (+) group of dementia patients, on the other hand, rCBF was significantly decreased in the PVH lesion and each cortical region; and CMRO2 was significantly decreased and OEF was increased in the PVH lesion and all cortical regions, especially the frontal cingulate gyrus. Moreover, the PVH(+) group had a significantly decreased rCBF and rCBF/CBV ratio in PVH lesion. These results showed that 'compensated hypoperfusion' existed in PVH lesion and cortical regions, especially the frontal cingulate gyrus, in multiple infarction patients without dementia and that 'ischemic hypoperfusion' was observed when associated with dementia. These changes, which seemed to be caused by cerebroarteriosclerosis, not only preceded the occurrence of mental deterioration, but also still persisted after dementia had occurred. PVH also reflected severe ischemic changes of the brain in multiple cerebral infarction, irrespective of the association of dementia. (N.K.)

  9. MR imaging of acute myocardial infarction

    This paper reports on superparamagnetic iron oxide particles (AMI-25) evaluated in comparison with paramagnetic Gd-DOTA for the MR evaluation of acute myocardial infarct size. Twelve openchest dogs underwent 2 hours of LAD occlusion followed by 6 hours of reperfusion. AMI-25 and Gd-DOTA were intravenously injected 1 hour and 10 minutes before euthanasia, respectively, in two groups of six dogs. Gradient-echo and T1- and T2-weighted spin-echo images were obtained in six AMI-25-injected excised hearts, and T1- and T2-weighted images in six Gd-DOTA injected excised hearts. Infarct size was evaluated by planimetry of each 8-mm-thick transverse slice after ex vivo double staining and correlated with the planimetry of each 8-mm-thick transverse MR section

  10. Value of ASTRAL Scale in Predicting the Prognosis of Posterior Circulation Acute Cerebral Infarction%ASTRAL量表评分对后循环急性脑梗死患者预后的评估价值

    王大力; 彭延波; 范海燕; 张江

    2016-01-01

    目的:探讨ASTRAL量表评分对后循环急性脑梗死( ACI)患者预后的评估价值。方法选择2011年6月—2014年6月于华北理工大学附属医院神经内科住院的经颅脑MRI明确诊断的后循环ACI患者211例为研究对象。患者在入院24 h内采用ASTRAL量表进行评分,发病30 d时采用改良Rankin量表( mRS )评分进行预后评估。按照mRS评分将患者分为预后良好组和预后不良组。描绘ASTRAL量表评分评估后循环ACI患者预后的受试者工作特征曲线(ROC曲线),计算ROC曲线下面积(AUC)、最大Youden指数,找出理想界值;以预后为因变量, ASTRAL量表评分为自变量,进行Fisher法线性判别分析。结果预后良好组167例,预后不良组44例。预后良好组患者ASTRAL量表评分低于预后不良组(t=-7.66, P<0.05)。预后不良率随ASTRAL量表评分增加而升高(P<0.05)。ASTRAL量表评分评估后循环ACI患者预后的AUC为0.788,95%CI (0.712,0.864),理想界值为19分,灵敏度为72.7%,特异度为68.9%,正确率为69.7%。按照理想界值将患者分为高分组(≥19分,84例)和低分组(<19分,127例)。高分组患者预后不良率高于低分组(χ2=25.14, P<0.01)。 Fisher法线性判别分析得到判别方程式:Y0=-6.807+0.709X , Y1=-12.191+0.972X ,其中Y0为预后良好, Y1为预后不良。用该判别方程式对患者预后进行判别,正确率为71.8%,进一步行Bayes交互验证,计算准确度为71.7%,提示该判别方程式有较好的稳定性。结论ASTRAL 量表评分对后循环ACI 患者预后有一定的评估价值。%Objective To investigate the value of ASTRAL scale in predicting the prognosis of posterior circulation acute cerebral infarction.Methods Enrolled 211 patients with posterior circulation acute cerebral infarction who were hospitalized in the Department of Neurology of

  11. The value of transcranial doppler on therapeutic effects of intravenous thrombolysis for patients with acute cerebral infarction%经颅多普勒在急性脑梗死静脉溶栓治疗中的应用

    邓宇平; 罗伟良

    2010-01-01

    Objective To explore the role of transcranial doppler(TCD) on therapeutic effects of intravenous thrombolysis for patients with acute cerebral infarction by using transcranial doppler to make dynamic detection pre and pro-intravenous thrombolysis. Methods 60 patients with the final diagnosis of acute cerebral infarction were selected according to the inclusion criteria and exclusion criteria standard promissory. Recombinant tissue type plasminogen activator as the intravenous thrombolysis agent was used 4.5h later onset of the disease in all these cases, and TCD monitoring was preformed to understand the sitiations of the target blood vessels pre and pro-thrombloysis treatment on the 6,12 hours and 24 hours,the 2st day and the 7th day,all the data offered by which was used to adjust the treatment protocois of antiplatelet and anticoagulant therapy after 24 hours. All patients were followed up for 3 months,among whom prognostic evaluation, situations of revascularization was carried out as well as the complications of secondary intracranial hemorrhages and reocclusion basing on the neurologic impairment Score and the Thrombolysis in Brain lschemia(TIBI) respectively. Results No patient was dead after following-up for 3 months and 17 cases with basi- healing(28.3%) ,20 cases with excellence(33.3%), 16 cases got better(26.7%) ,3 cases with inefficiency (5.0%), and 4 cases became deterioration (6.7%). According to the Thrombolysis in Brain lschemia( TIBI), 22 cases got 4-5 level( 36.7 %), 31 cases with 2-3 level ( 51.7% ), and 7 cases got 0-1 level ( 11.6 % ). Among all these cases ,4 cases were found with secondary intracranial hemorrhages (6. 7% ) and 5 cases with reocclusion ( 8.3% ) Conclusion Dynamic detection with transcranial doppler pre and pro-intravenous thrombolysis could improve the therapeutic effect on patients with acute cerebral infarction, and reduce its complication, which is important for the clinical wrok and deserving consulting.%目的 利用经

  12. Observation and nursing of early thrombolysis treatment of acute cerebral infarction%超早期溶栓治疗急性脑梗塞的观察与护理

    朱银花; 阚鲁; 孙敏; 石爱梅; 吴小新

    2012-01-01

      目的观察超早期溶栓治疗急性脑梗塞的疗效与护理方法.方法将80例急性脑梗塞患者随机分为两组,对照组50例患者予以扩容,改善脑部循环,营养神经等对症支持治疗;溶栓组30例在对症治疗基础上予以超早期溶栓治疗.结果溶栓组神经功能缺损程度评分较对照组改善,两组比较有极显著性差异(P0.05).结论超早期溶栓治疗急性脑梗塞效果显著,能明显降低致残率,提高患者的生活质量.在溶栓过程中严密观察病情,预防和及时处理并发症,是顺利完成溶栓治疗的保证.%  Objective: To observe the effectiveness of the reorganization type tissue plasminogen activator(rt-PA) treatment of acute cerebral infarction(ACI) and nursing. Methods:80 patients were randomly divided into two groups, fluid expansion, improving cerebral circulation and nourishing brain cel treatment were applied in the controlgroup(n=50) and on the basis of it, rt-PAwas used in the thrombolysis group (n=30). Results: The neurologic impairment score was improved in the thrombolysis group than that in the control group (P0.05). Conclusion: Thrombolysis of ACI is satisfied and can clearly shorten the course of disease and reduce disability and improve the quality of life of patients. It is very important in the process of thrombolysis that observing closely to provent the complications.

  13. Significance of non-specific complaints in asymptomatic cerebral infarction. Approach based on the cerebral circulation

    Seventy-three cases with asymptomatic cerebral infarction detected by MR scanning and 80 cases of past stroke patients were evaluated. The regional cerebral blood flow (CBF) using the SPECT, idoine-123-IMP autoradiography (ARG) method was measured. Twenty-two patients with non-specific complaints (dizziness, numbness of the extremities, headache, etc.) without cerebrovascular risk factors were also examined as controls. Fifty-two percent of the asymptomatic infarction cases had non-specific complaints. The regional CBF in all cerebral non-specific complaints showed significantly lower values as compared to the controls. There was no difference in CBF values between the asymptomatic infarction cases with non-specific complaints and the past stroke patients. Among the asymptomatic infarction patients, cases with both non-specific complaints and hypertension displayed significantly lower CBF values, especially in the frontal and temporal cortical regions, than did cases without non-specific complaints or hypertension. These findings suggest that the patient''s complaints should be taken into consideration when determining the clinical treatment of asymptomatic infarction. (author)

  14. 急性脑梗死后非溶栓患者出血转化的影响因素分析%Influencing factors analysis of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction

    谭戈; 刘鸣; 雷春燕; 陈艳超; 郝子龙

    2015-01-01

    化呈独立正相关(OR=2.823,95%CI:1.946~4.095,P<0.001)。结论高脂血症、心房颤动、血糖、NIHSS评分及TOAST分型与急性脑梗死后非溶栓患者出血转化具有独立相关性。%Objective To investigate the influencing factors of hemorrhagic transformation in non-thrombolysis patients after acute cerebral infarction. Methods According to Chengdu Stroke Registry Project,2598 consecutive patients with acute cerebral infarction admitted to the Department of Neurology,West China Hospital within 1 week of attack from January 2010 to December 2013 were enrolled prospectively. The patients were divided into a hemorrhagic transformation group and a non-hemorrhagic transformation group according to whether they had hemorrhagic transformation or not. As for patients with hemorrhagic transformation,they were divided into a symptomatic hemorrhagic transformation (SHT)group and an asymptomatic hemorrhagic transformation (ASHT)group according to whether they had aggravation of symptom and sign. The baseline data of all patients were collected and compared between the groups. The P0. 05). The results of multivariate logistic regression analysis showed that dyslipidemia (OR,0. 588, 95%CI 0. 374-0. 924,P=0. 021)was negatively correlated with hemorrhagic transformation. Atrial fibrillation (OR,3. 188,95%CI 2. 159-4. 707,P<0. 001),blood glucose (OR,1. 081,95%CI 1. 044-1. 119,P<0.001),and NHISS score (OR,1. 305,95%CI 1. 170-1. 455,P<0. 001)were positively correlated with hemorrhagic transformation. In TOAST classification,relative to the large atherosclerotic stroke,the small artery occlusive cerebral infarction was negatively correlated with hemorrhagic transformation (OR,0. 315, 95%CI 0. 167-0. 596,P<0. 001). After removing the influencing factor of atrial fibrillation,compared with the large artery atherosclerotic stroke,cardioembolism stroke was positively correlated with hemorrhagic transformation (OR,2. 823,95%CI 1. 946-4. 095,P<0. 001). Conclusion

  15. Study of cerebral blood flow in patients with cerebral infarction by 133Xe inhalation method

    Cerebral blood flow in both hemispheres was studied by the Xe-133 inhalation method in 49 patients with cerebral infarction in the unilateral hemisphere. They were classified into three groups by computed tomographic findings as follows: relatively large low density lesion including the cerebral cortex and subcortex (group I), relatively large low density lesion including the subcortical white matter and basal ganglia (group II), and small low density lesion including the subcortical white matter (group III). Mean cerebral blood flow (mCBF) in the affected hemisphere was markedly low in group I, moderately low in group II, and slightly low in group III. Several cases in groups I and II revealed remarkable changes of mCBF within one month after the onset. The mCBF in both hemispheres was lower in group I than in groups II and III within one week after the onset. Seven to 12 weeks later, mCBF was lower in the affected hemisphere than in the unaffected one in groups I and II: This was lower when compared with that in group III. There was almost no difference in mCBF between the affected and unaffected hemispheres in group III. Sequential changes of mCBF in both hemispheres were divided into 7 types in reevaluable 27 patients. Sequential changes of mCBF in both hemispheres of the patients with cerebral infarction were considered to be caused mainly by recanalization and hemorrhagic infarction. (J.P.N.)

  16. Systemic Atherosclerotic Inflammation Following Acute Myocardial Infarction: Myocardial Infarction Begets Myocardial Infarction

    Joshi, Nikhil V; Toor, Iqbal; Shah, Anoop S V; Carruthers, Kathryn; Alex T. Vesey; Alam, Shirjel R; Sills, Andrew; Hoo, Teng Y; Melville, Adam J; Langlands, Sarah P; Jenkins, William S A; Uren, Neal G; Mills, Nicholas L.; Fletcher, Alison M; van Beek, Edwin J.R.

    2015-01-01

    BACKGROUND: Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans.METHODS AND RESULTS: Overall, 40 patients with MI and 40 with stable angina underwent thoracic 18F-fluorodeoxyglucose combined positron emission and computed tomography scan. Radiotracer uptake was measured in aortic atheroma and nonv...

  17. The prognostic importance of creatinine clearance after acute myocardial infarction

    Sørensen, C R; Brendorp, B; Rask-Madsen, C;

    2002-01-01

    AIMS: The purpose of this study was to assess renal dysfunction as an independent predictor of mortality after acute myocardial infarction. METHODS: The study population was 6252 patients with a myocardial infarction admitted alive from 1990 to 1992. The mortality status was obtained after at least.......9-1.3) respectively. CONCLUSION: Renal dysfunction is an important risk factor after acute myocardial infarction. When the risk is adjusted for available competing risk factors only severely reduced renal function is associated with an important and independent risk of mortality after acute myocardial infarction. The...

  18. The Influence of Ginkgo-dipyidamolum Injection for Lipid And CRP On Acute Cerebral Infarction Patients%银杏达莫注射液对急性脑梗死患者血脂和C-反应蛋白的影响

    吴国龙

    2013-01-01

      目的:探讨银杏达莫注射对急性脑梗死患者血脂和C-反应蛋白(CRP)的影响。方法:采用银杏达莫注射治疗急性脑梗死患者,检测治疗前后血清血脂和CRP的浓度变化,并进行对比分析。结果:银杏达莫注射能有效的降低血清总胆醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和CRP水平(P<0.05);高密度脂蛋白胆固醇(HDL-C)则较治疗前有显著上升(P<0.05)。结论:银杏达莫注射有效消除急性脑梗易患病因素,对急性脑梗死患者疗效显著,能有效的改善动脉粥样硬化。%Objective:To discuss the influence of Ginkgo-dipyidamolum injection on acute cerebral infarction patients lipid and C-reactive protein (CRP). Methods:The acute cerebral infarction patients treated with Ginkgo-dipyidamolum injection and tested blood lipid before and after treatment and the serum CRP concentration change,and then compared and analyzed.Results:Ginkgo-dipyidamolum injection was effective in reducing serum total bile alcohol(TC),serum triglycerides (TG),low density lipoprotein cholesterol(LDL-D) and CRP level,comparison before treatment were significantly(P<0.05);high density lipoprotein cholesterol (HDL-C) was a significant rise before treatment(P<0.05).Conclusion:Ginkgo-dipyidamolum injection effectively eliminate acute cerebral infarction easy sick factors,on acute cerebral infarction patients curative effect is distinct,can effectively improve the atherosclerosis.

  19. Acute myocardial infarction related to smoke inhalation and myocardial bridging.

    McCabe, M J; Weston, C. F.; Fraser, A G

    1992-01-01

    A previously healthy 26 year old woman who was exposed to smoke during a house fire developed acute anterior myocardial infarction complicated by ventricular fibrillation. Subsequent left ventriculography confirmed anterior infarction, but coronary arteriography was normal apart from myocardial bridging over a segment of the left anterior descending artery. The development of acute myocardial infarction in this patient suggests that, in the presence of bridging, carbon monoxide inhalation may...

  20. 脑微出血对急性脑梗死患者认知功能的影响:前瞻性病例系列研究%Effect of cerebral microbleeds on cognitive function in patients with acute cerebral infarction: a retrospective case series study

    王国珍; 汪国宏; 王小强; 张持; 岳宏; 吴君仓

    2013-01-01

    目的 探讨急性脑梗死患者认知功能与脑微出血(cerebral microbleed,CMB)的相关性.方法 前瞻性分析急性脑梗死患者的临床和影像学资料,根据MRI结果对CMB进行计数,详细记录患者的一般情况、CMB部位和脑白质疏松严重程度,在入院次日应用蒙特利尔评估量表(Montreal Assessment Scale,MoCA)对患者进行认知功能评估,在3、6和9个月时进行MoCA评估随访.分析急性脑梗死患者的认知功能变化及其与CMB的关系.结果 共纳入82例缺血性卒中患者,其中33例伴有CBM,49例无CBM.CMB组收缩压[(155.03±19.68)mm Hg对(142.20±21.22)mm Hg(1 mm Hg=0.133 kPa);t=2.762,P=0.007]和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分[(6.21±4.57)分对(4.00±3.98)分;t=2.322,P=0.023]均显著性高于非CMB组.多变量logistic回归分析显示,收缩压水平[优势比(odds ratio,OR)1.032,95%可信区间(confidence interval,CI)1.008~1.057;P=0.009]和NIHSS评分(OR 1.163,95% CI l.013~1.311;P=0.014)是急性脑梗死患者存在CMB的独立预测因素.CMB与MoCA量表评分密切相关,且随访时间越长,相关性越强.在CMB患者中,执行功能(rs=-0.318,P=0.004)、视空间功能(rs=-0.403,P=0.000)和计算功能(rs=-0.362,P=0.001)均显著受损,CMB越严重,这3个认知域评分越低,损害也越严重.结论 CMB与急性脑梗死患者认知功能损害密切相关,CMB越严重,认知功能损害越明显,且CMB患者的认知功能损害随着时间的推移而加重.%Objective To investigate the correlation between cognitive function and cerebral microbleeds (CMBs) in patients with acute cerebral infarction.Methods The clinical and imaging findings in patients with acute stroke were analyzed retrospective.CMBs were counted according to the findings of MRI.The general conditions,CMB site and leukoaraiosis severity of the patients were recorded in detail.The cognitive function of the patients was assessed

  1. Immunoscintigraphy for detecting acute myocardial infarction without electrocardiographic changes.

    Jain, D; Lahiri, A; Raftery, E B

    1990-01-01

    OBJECTIVE--To establish whether immunoscintigraphy with antibody to myosin may detect acute myocardial infarction without electrocardiographic changes. DESIGN--Prospective study of patients with suspected acute myocardial infarction or unstable angina with cardiac imaging with 111indium myosin antibody, estimation of cardiac enzyme concentrations, electrocardiography, 201thallium imaging, and radionuclide ventriculography. SETTING--Coronary care unit in a district general hospital. PATIENTS--...

  2. Prognostic importance of complete atrioventricular block complicating acute myocardial infarction

    Aplin, Mark; Engstrøm, Thomas; Vejlstrup, Niels G;

    2003-01-01

    Third-degree atrioventricular block after acute myocardial infarction is considered to have prognostic importance. However, its importance in conjunction with thrombolytic therapy and its relation to left ventricular function remains uncertain. This report also outlines an important distinction...... between atrioventricular block in the setting of anterior and inferior wall acute myocardial infarction, with profound clinical and prognostic implications....

  3. Twenty cases of acute cerebral infarction complicated with deep venous thrombosis in lower limb%急性脑梗死并发下肢深静脉血栓形成20例

    麦卫华; 王俊峰; 刘汉伟; 韩蓉蓉

    2011-01-01

    目的 探讨急性脑梗死患者并发下肢深静脉血栓形成(LDVT)的发病原因、临床特点及诊治方法.方法 对我科收治的20例急性脑梗死并发LDVT患者的病例资料进行回顾性分析.结果 20例脑梗死并发LDVT患者中,65岁以上占55%,血清纤维蛋白原增高者占65%,红细胞压积升高者占45%.瘫痪侧肢体LDVT发生率为75%,健侧肢体为10%.左侧LDVT占60%,右侧LDVT占25%.脑梗死后1周内LDVT发生率最高(55%).LDVT发病3 d内的4例患者行尿激酶溶栓治疗,LDVT发病3-14 d的14例患者行低分子肝素抗凝治疗,两组治愈显效率比较差异无统计学意义(75%V8 57%,P>0.05).结论 高龄、血液粘滞度增高、长期卧床及解剖因素等均是急性脑梗死患者发生LDVT的重要原因.溶栓与抗凝治疗疗效类似,均为治疗LDVT的有效手段.急性脑梗死患者早期防治LDVT具有重要意义.%Objective To investigate the etiological factors, clinical characteristics, diagnosis and treatment of deep venous thrombosis in lower limb ( LDVT) in patients with acute cerebral infarction (CI).Methods Clinical datas of twenty cases of acute CI complicated with LDVT who were hospitalized in our department were analyzed retrospectively. Results Among these 20 cases, the percentage of patients over 65 years old was fifty - five. The percentages of patients with increased serum fibrinogen and hematocrit were sixty - five and forty - five respectively. The incidence rates of LDVT happened in palsy and normal limbs were 75% and 10% , respectively. The percentage of DVT in left lower limb was sixty, while that in right lower limb was twenty - five. The incidence rate of LDVT within one week after acute CI was the highest (55% ). Four cases with LDVT happened within three days received thrombolysis therapy by urokinase. Fourteen cases with LDVT happened in three to fourteen days received anticoagulant therapy by low molecular heparin. Healing rates between the two groups were

  4. Efficiency and safety evaluation of Baimaiointment for alleviating hypermyotonia following cerebral infarction

    2007-01-01

    BACKGROUND: Baimai ointment has Shujin and Huoluo efficiency. It has been confirmed by basic pharmacodynamic experiments that Baimai ointment has some therapeutic effects on stroke. However, the detailed evaluations of Baimai ointment on clinically treating stroke patients for function recovery are still insufficient with little reports.OBJECTIVE: To observe the efficiency and safety of Baimai ointment on alleviating hyperrnyotonia following cerebral infarction DESIGN: A randomized, parallel and controlled experiment.SETTING: Department of Neurology, Beijing Aerospace General Hospital.PARTICIPANTS: A total of 120 patients with acute front-cycle cerebral infarction were selected from Department of Neurology, Beijing Aerospace General Hospital from July to December 2006 and met the diagnosis criteria modified by Forth National Seminar on Cerebrovascular Disease. The experiment had got confirmed consent from local ethic committee. All 120 patients with cerebral infarction were randomly divided into experimental group (n =80; 32 in the acute phase, 32 in the recovery phase and 16 in the sequela phase) and control group (n =40; 16 in the acute phase, 16 in the recovery phase and 8 in the sequela phase).METHODS: Within 4 weeks after the patients were enrolled in this study, no other traditional Chinese medicines containing similar components were adopted besides routine supporting therapy. The Baimai ointment being consisted of Jianghuang, Roudoukou, Gansong, Yangqishi, Gancao, She, shannai,Zanghuixiang, Zangchangpu, Huajiao and Jianhua was used by trial group (20 g/ampoule, Tibet Lingzhiqizheng Tibetan Drug Factory; batch number: 050403), 2 3 times per day, the ointment was moderately coated traveling parts of Baimai.MAIN OUTCOME MEASURES: The evaluation of National Institutes of Health Stroke Scale (NIHSS),Modified Rankin Scale and Modified Ashworth Scale were performed before administration, 2 and 4 weeks after administration.RESULTS: All 120 patients with acute front

  5. Evaluation of ocular acupuncture on cerebral infarction with cerebral blood flow perfusion imaging

    To evaluate the immediate effect of ocular acupuncture on patients, an method of SPECT image of cerebral blood flow daily stress test was established. 10 patients diagnosed as cerebral infarction by CT or MRI were tested. They all received 99Tcm-ECD SPECT imaging at twice before and after ocular acupuncture. By means of image subtraction technique and semi-quantitative method of regional interesting area, the change of regional cerebral blood flow was observed between the two images. Under restful state perfusion of cerebral blood flow in 18 foci was low at the frontal lobe, the cerebellum, the basal ganglia and temporal lobe. After ocular acupuncture, the perfusions were obviously increased in 16 foci among them and the reactivity of the frontal lobe and the cerebellum to ocular acupuncture was higher, the average improvement rate of which was 55.15% and 53.06% respectively, lower in the basal ganglia and temporal lobe, the average improvement rate was 31.79% and 36.67% respectively. 99Tcm-ECD SPECT cerebral perfusion image has some significant clinic value for evaluating the effect of ocular acupuncture to treating cerebral infarction. (authors)

  6. Effects of human urinary kallidinogenase in the treatment of acute cere-bral infarction%人尿激肽原酶治疗急性缺血性脑卒中的效果

    赵志斌

    2014-01-01

    Objective To evaluate the effects of human urinary kallidinogenase in the treatment of acute cerebral in-farction, in order to provide a better way for acute cerebral infarction treatment. Methods 120 patients with acute cere-bral infarction from December 2011 to December 2013 in the Central Hospital of Panjin City were selected and divided into two groups, each group had 60 cases. Patients in the control group were given treatment including reasonable se-lection of mannitol for reducing intracranial pressure, Aspirin for anti-platelet aggregation, prevention of complications, necessary nutritional support, rehabilitation therapy and other conventional treatment. Patients in the treatment group were given urinary kallidinogenase 0.15 PNAu joined in 250 mL of normal saline intravenously once a day for 14 d, on the basis of the control group. The treatment efficacy, neurological deficit score (NIHSS) before and after treatment, live ability after treatment, the recurrence and adverse reactions after treatment were observed in the two groups. Results In the treatment group 17 cases had cured, 31 cases had significant progress, 10 cases had progress, 2 cases had invalid, no one had deteriorate, the total effective rate was 96.67%; while in the control group, there were 12, 21, 8, 16 and 3 cases retrospectively, the total effective rate was 68.33%; the difference between the two groups in the total effective rate was statistically significant (P<0.05). After 14 days of treatment, NIHSS score [(7.06±3.64) scores] in the treat-ment group was significantly lower than that of before treatment [(15.03±5.77) scores] and the control group after treat-ment [(9.85±4.35) scores], the differences were statistically significant (P<0.05). After treatment activities of daily liv-ing score in the treatment group [(58.4±5.6) scores] was significantly higher than that of before treatment [(38.7±6.3) scores] and the control group after treatment [(43.3±5.4) scores], the differences

  7. Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

    Kosuke Matsuzono

    2014-04-01

    Full Text Available We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

  8. The Effect of Combined Therapy of Exercise and Nootropic Agent on Cognitive Function in Focal Cerebral Infarction Rat Model

    Song, Min-Keun; Seon, Hyo-Jeong; Kim, In-Gyu; Han, Jae-Young; Choi, In-Sung; Lee, Sam-Gyu

    2012-01-01

    Objective To investigate the effect of combined therapy of exercise and nootropic agent on cognitive function in a focal cerebral infarction rat model. Method Forty 10-week old male Sprague-Dawley rats were subjected to photothrombotic cerebral infarction of the left parietal lobe. All rats were randomly divided into 4 groups: group A was photothrombotic cerebral infarction rats without any treatment (n=10); group B was photothrombotic cerebral infarction rats with swimming exercise (n=10); g...

  9. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

    Dastidar Prasun

    2010-09-01

    Full Text Available Abstract Background Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. Methods The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females were imaged using computed tomography (CT in the acute phase (within 3-4 hours and magnetic resonance imaging (MRI in the chronic phase (follow-up at 12 months, with a range of 8-27 months. The chronic-phase fractional anisotropy (FA and mean diffusivity (MD values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10 were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Results Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. Conclusions A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations.

  10. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

    Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acute phase (within 3-4 hours) and magnetic resonance imaging (MRI) in the chronic phase (follow-up at 12 months, with a range of 8-27 months). The chronic-phase fractional anisotropy (FA) and mean diffusivity (MD) values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10) were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations

  11. The relationship between lipoprotein lipase-447C/G genepolymorphism and cerebral infarction in the elderly

    胡晓雁

    2013-01-01

    Objective To explore the relationship between the lipoprotein lipase(LPL)-447C/G gene polymorphism and cerebral infarction in the elderly. Methods This was a case-control study,which enrolled 206 cases with cerebral infarction in the elderly and 203 elderly

  12. Expression of Sema4D in patients with cerebral infarction and its clinical significance

    朱琳

    2012-01-01

    Objective To explore the expression and clinical significance of Semaphorin4D (Sema4D) mRNA in peripheral blood lymphocyte,Sema4D on platelet surface, soluble Sema4D (sSema4D) in plasma in patients with cerebral infarction. Methods Taking 299 patients with cerebral infarction

  13. Acute cerebral vascular accident associated with hyperperfusion

    Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

  14. Clinical study of correlation of pre-senile and senile depressive stage with silent cerebral infarction

    The relationship between the pre-senile/senile depressive state and silent cerebral infarction was examined by MRI. Consecutive 56 depressive patients aged 50 years or older underwnt MRI. MRI revealed silent cerebral infarction in 60.3% of patients in whom depression occurred at the age of less than 65 years. The complication rate was significantly higher in these patients than the younger patients (60.9% vs 20%). Complications of silent cerebral infarction were found in 53.6% for patients in whom depression occurred at the age of less than 65 years and symptoms were deteriorated at the age of 65 years or older and in 100% for patients in whom it occurred at the age of 65 years or older and hospitalization was simultaneously required. These figures were remarkably higher than the age-related complication rate of silent cerebral infarction in non-depressive normal persons. This suggested that approximately half of depressive patients of pre-senile onset and majority of depressive patients of senile onset might have parenchymal involvement due to silent cerebral infarction. Both perforating-type and cortical-type infarcts were found. This has a implication for the involvement of multiple infarct-related foci in depressive state. For cortical-type infarcts, partial lesions were predominant, followed by frontal and temporal lesions. The incidence of left frontal infarcts was significanly higher than that of right frontal infarcts. Infarcts in both the parietal and left frontal lobes may be responsible for depressive state. (N.K.)

  15. Review of the Current Status of Intra-Arterial Thrombolysis for Treating Acute Cerebral Infarction: a Retrospective Analysis of the Data from Multiple Centers in Korea

    Lee, Deok Hee [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Na, Dong Gyu [Seoul National University College of Medicine, Seoul (Korea, Republic of); Ihn, Yon Kwon [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)] (and others)

    2007-04-15

    The purpose of the study was to review the current status of intraarterial (IA) thrombolysis in Korea by conducting a retrospective analysis of the data from multiple domestic centers. The radiologists at each participating institution were asked to fill out case report forms on all patients who had undergone IA recanalization due to acute anterior circulation ischemia. These forms included clinical, imaging and procedure-related information. A central reader analyzed the CT/MR and angiographic results. The rates of successful recanalization, hemorrhagic transformation and functional outcome were obtained. The univariate analyses were performed together with the multivariate analysis. We analyzed the data from 163 patients, and they had been treated at seven institutes. The initial imaging modalities were CT for 46 patients (28%), MR for 63 (39%), and both for 54 (33%). Various mechanical treatment methods were applied together in 50% of the patients. Radiologically significant hemorrhage was noted in 20/155 patients (13%). We found various factors that influenced the recanalization rate and the occurrence of significant hemorrhagic transformations. The favorable outcome rate, reported as modified Rankin Scale {<=}2, was 40%, and the mortality rate was 11%. The factors that predicted a poor functional outcome were old age (p = 0.01), initially severe neurological symptoms (p < 0.0001), MR findings of a wide distribution of lesions (p = 0.001), involvement of the basal ganglia (p = 0.01), performance of procedures after working hours (p 0.01), failure of recanalization (p 0.003), contrast extravasation after the procedure (p = 0.007) and significant hemorrhagic transformation (p = 0.002). The subsequent multivariate analysis failed to show any statistically significant variable. There was a trend toward increased dependency on MR imaging during the initial evaluation and increased usage of combined pharmacologic/mechanical thrombolysis. The imaging and clinical

  16. Cerebral blood flow in acute and chronic ischemic stroke using xenon-133 inhalation tomography

    Vorstrup, S; Paulson, O B; Lassen, N A

    1986-01-01

    Serial measurements of cerebral blood flow (CBF) were performed in 12 patients with acute symptoms of ischemic cerebrovascular disease. CBF was measured by xenon-133 inhalation and single photon emission computer tomography. Six patients had severe strokes and large infarcts on the CT scan. They...

  17. The importance of early patency after acute myocardial infarction.

    Grover, A; Rihal, C S

    1995-07-01

    The importance of achieving rapid patency of the infarct-related artery during acute myocardial infarction has become well recognized. Early, sustained patency of the infarct-related vessel correlates with improved left ventricular function, better in-hospital outcomes, and lower mortality. Various strategies designed to improve early patency, including "prehospital" thrombolysis, use of an accelerated recombinant tissue plasminogen activator regimen, and immediate angioplasty have been studied. This paper reviews the importance of achieving early patency, the various strategies employed, and the evidence for their efficacy. Future directions in treatment of acute myocardial infarction are touched upon briefly. PMID:7549077

  18. Cerebral blood flow and metabolism in multi-infarct dementia

    Cerebral blood flow and oxygen metabolism were studied in three aged normal volunteers and 10 patients with multi-infarct dementia (MID) by Positron Emission Tomography using O-15. The diagnosis of MID was done according to the Loeb's modified ischemic score and X-ray CT findings. The MID patients, whose X-ray CT showed localized low density areas in the subcortical white matter and basal ganglia and thalamus, were studied. No occulusion was observed at anterior cerebral artery and/or middle cerebral artery on cerebral angiography. All cases of MID were mild dementias. Regional CBF, rOEF and rCMRO2 were measured by the steady state technique described by Terry Jones et al. The values of rCBF in MID patients were significantly low compared with those of aged normal subjects in frontal, temporal, occipital, parietal cortices and thalamus. The values of CMRO2 in MID were significantly low in frontal, temporal, occipital cortices and thalamus compared with normal subjects'. The OEF was 0.46 in aged normal subjects, and 0.52 in MID patients. The MID patients in the early stage of dementia showed the increased oxygen extraction fraction, and this fact suggests that ischemia is a significant pathogenic mechanism in the production and progression of multi-infarct dementia. The decrease of CBF and CMRO2 in MID compared from normal subjects' were most remarkable in frontal cortex. The impairment of mental functions in MID should be caused by the decreased neuronal activities in frontal association cortex. (author)

  19. Correlation between carotid atherosclerosis and serum high-sensitivity C-reactive protein in patients with cerebral infarction

    Yan Du; Yan Ren; Bo Chen; Chun Li

    2007-01-01

    BACKROUND: Some researches demonstrate that high-sensitivity C-reactive protein may be a risk factor to cause carotid atherosclerosis in patients with cerebral infarction. Inflammatory reaction may participate in formation of carotid atherosclerosis in patients with acute cerebral infarction.OBJECTIVE: To investigate the correlation between levels of serum high-sensitivity C-reactive protein and carotid atherosclerosis in patients with acute cerebral infarction accompanied with carotid atherosclerosis.DESIGN: Contrast observation between two groups.SETTING: Department of Neurology, Zhenzhou Hospital, Shenyang Medical College.PARTICIPANTS: A total of 102 patients with acute cerebral infarction regarded as cerebral infarction group were selected from Department of Neurology, Shenzhou Hospital Affiliated to Shenyang Medical College from February 2005 to September 2006. There were 55 males and 47 females and their ages ranged from 55 to 86 years. All patients met the variously diagnostic points of cerebral infarction established by the Fourth National Cerebrovascular Disease Academic Meeting and were finally diagnosed with CT or MRI examination. Illness course was in an acute phase. A total of 96 healthy subjects were regarded as control group, including 51 males and 45 females aged from 48 to 78 years. All accepted subjects provided the confirmed consent.METHODS: ① Patients in the cerebral infarction group received carotid ultrasound Doppler examination and serum high-sensitivity C-reactive protein detection within 72 hours after onset. IMMAGE immune biochemical system and latex reinforcement particle-enhanced nephelometric immunoassay (PENIA) were used for quantitative detection of serum high-sensitivity C-reactive protein. ② Healthy subjects in the control group received the same detection. SEQUOIA512 color Doppler ultrasound (Siemens Company,USA) was used to detect carotid artery of all subjects so as to observe intima media thickness of artery and formation of

  20. Effect of combined Antioxidants on Acute Myocardial infarction size

    B.Farahani; K.Hadiyan; A.Mohseni

    2001-01-01

    SummaryBackground and purpose : The role of oxygen-derived free radicals in destruction of myocardial cells during acute ischemia or reperfusion has been proved. This phenomenon made the workers to study and find the inhibitory therapeutic methods in order to reduce the myocardial cell destruction during acute myocardial infarction. This study evaluates the role of combined antioxidants on acute myocardial infarction sige in patients referring to vali asr hospital of Arak.Materials and Method...

  1. Acute myocardial infarction in infectious endocarditis. Report of one case

    The acute myocardial infarction is a rare complication in the course of an acute endocarditis. It takes place in the first weeks infection. Although is not associated with any particular microorganism it has been associated with virulent microorganism and is common in aortic valve endocarditis insufficiency. This report is a case of a patient who suffered a myocardial infarction during a acute endocarditis of native valve

  2. Exercise test in acute myocardial infarction.

    Hsi, W L; Lai, J S

    1996-01-01

    Although maximal oxygen consumption (VO2max) and oxygen consumption at anaerobic threshold (VO2AT) were used to measure cardiac function, the clinical significance in acute myocardial infarction (MI) has not been reported. The purpose of this study was to compare VO2max and VO2AT between post-MI patients and healthy men and to correlate the parameters to other clinical measures. Forty-three active healthy men, 44 sedentary healthy men, and 43 post-MI patients were studied using incremental cycle exercise test. Their work rates, oxygen consumption, heart rates, oxygen pulses, ventilation, and other parameters at VO2max and VO2AT were determined with spirometer, gas concentration analyzer, and electrocardiograph. Anaerobic threshold was determined by analyzing the ventilatory parameters. Most of the exercise test parameters at VO2max were greatest in the active men, intermediate in the sedentary men, and least in the post-MI patients (P pressure products of the active men and sedentary men were not significantly different from each other and were greater than those of the post-MI patients (P < 0.01). In the post-MI patients, VO2max was inversely correlated to the peak serum level of creatine phosphokinase MB isoenzyme (P < 0.01) and associated with extensive infarction (P < 0.05). Most of the parameters at VO2AT were greater in the active men than in the sedentary men (P < 0.01) but not significantly different between the sedentary men and post-MI patients. In the post-MI patients, VO2AT was significantly correlated to left ventricular ejection fraction (P < 0.01) and associated with heart failure (P < 0.05). The results revealed that VO2max and VO2AT had different clinical significance in post-MI patients; VO2max was related to the infarct size, and VO2AT was related to the pumping function of heart. PMID:8777021

  3. Thrombolysis for acute myocardial infarction: drug review.

    Cundiff, David K

    2002-01-01

    The proof of efficacy of thrombolysis for acute myocardial infarction (AMI) depends on 9 randomized placebo-controlled trials totaling 58,511 patients. The meta-analysis of these trials showed an overall survival advantage of about 2% (11.5% vs 9.6%) in favor of thrombolysis. Iatrogenic deaths from thrombolysis complications occur in about 1% of AMI patients. Timely opening of the infarct-related artery (IRA) allowing myocardial reperfusion has been proposed to explain any survival advantage seen with thrombolysis ("open-artery hypothesis"). Angiographic data does not support the open-artery hypothesis as the mechanism of any benefit of thrombolysis. The "early hazard" (ie, increased mortality in the first 12 hours after thrombolysis) also suggests that the supposed survival benefit is due to something other than early reperfusion. The variable use of aspirin in the meta-analysis trials may have confounded the results and conclusions. In the 4 studies of the meta-analysis in which aspirin was used routinely (n = 21,144), the survival benefit was not statistically significant (P =.14). Lack of blinding in some studies and other methodologic problems may also call the conclusions of the meta-analysis into question. AMI registry reports comparing patients with and without thrombolysis have not borne out a significant survival advantage with thrombolysis. The National Registry of Myocardial Infarction (NRMI) registry data suggest that a significant number of AMI patients may be inappropriately receiving thrombolytics. An independent analysis of the NRMI mortality data adjusted for age and other risk factors would help determine whether thrombolysis for AMI improves survival. PMID:11965203

  4. A new non-human primate model of photochemically induced cerebral infarction.

    Satoshi Ikeda

    Full Text Available BACKGROUND AND PURPOSE: Rat models of photochemically induced cerebral infarction have been readily studied, but to date there are no reports of transcranial photochemically induced infarctions in the marmoset. In this report, we used this non-human primate as a model of cerebral thrombosis and observed the recovery process. METHODS: Five common marmosets were used. Cerebral ischemia was produced via intravascular thrombosis induced by an intravenous injection of Rose Bengal and irradiation with green light. After inducing cerebral infarction, we observed the behavior of marmosets via a continuous video recording. We evaluated maximum speed, mean speed, and distance traveled in 1 min. In addition, we evaluated scores for feeding behavior, upper limb grip, and lower limb grip. We confirmed the infarct area after cerebral infarction using 2,3,5-triphenyltetrazolium chloride staining in a separate marmoset. RESULTS: We found functional decreases 2 days after creating the cerebral infarction in all measurements. Total distance traveled, average speed, upper limb score, and feeding behavior score did not recover to pre-infarction levels within 28 days. Maximum speed in 1 min and lower limb score recovered 28 days after infarction as compared to pre-infarction levels. We confirmed the infarct area of 11.4 mm × 6.8 mm as stained with 2,3,5-triphenyltetrazolium chloride. CONCLUSION: We were able to create a primate photothrombosis-induced cerebral infarction model using marmosets and observe functional recovery. We suggest that this is a useful model for basic research of cerebral infarction.

  5. Effects of Xingnaojing Injection on the Expression of Vascular endothelial Growth Factor in Patients with Acute Cerebral Infarction%醒脑静注射液对急性脑梗死患者血清VEGF表达的影响

    张晓玲; 翟丽萍; 官俏兵; 杜瑛媛; 钱淑霞

    2012-01-01

      目的:观察醒脑静注射液对急性脑梗死患者血清血管内皮生长因子(VEGF)表达的影响.方法:65例急性脑梗死患者随机分为醒脑静注射液治疗组33例和对照组32例,另设立正常对照组60例.两组急性脑梗死患者均给予常规抗血小板、他汀类药物治疗,治疗组在此基础上加用醒脑静注射液20mL加入生理盐水250mL中静滴,1天1次,14天为1个疗程.采用双抗体夹心酶联免疫吸附法(ELISA)动态测定两组患者发病第1、3、7、14天时血清VEGF浓度.同时记录入院时和治疗14天的脑梗死灶体积,并进行神经功能缺损评分(NIHSS).结果:与正常对照组比较,65例患者中风后1、3、7、14天各时间点的血清VEGF浓度均明显增高,差异有统计学意义(P0.05).结论:醒脑静注射液能促进急性脑梗死后血清VEGF的表达,参与新生血管形成,提高临床疗效.%  Objective: To explore the effects of Xingnaojing injection on the expression of vascular endothelial growth factor (VEGF) in patients with acute cerebral infarction (ACI). Methods: Sixty-five patients with ACI were randomly divided into Xingnaojing treatment group (experimental group, n=33) and routine treatment group(n=32). Both groups were treated with anti-platelet aggregation and stating, and patients in the experimental group were given additional Xingnaojing injection (20mL/250mL saline, vd, qd) for 14 days. Serum concentrations of VEGF were measured by double antibody sandwich ELISA on day 1,3,7 and 14 after the onset of stroke. Vol⁃umes of infarction and scores of national institutes of health stroke scale(NIHSS)were recorded on admission and on day 14. Other 60 healthy individuals served as blank controls. Results: Compared with the blank control group, the serum concentrations of VEGF in patients with ACI on day 1,3,7 and 14 were obviously increased (P0.05). Conclusion: Xingnaojing injection can promote the production of VEGF and participate in

  6. Immunocompetent young man with cerebral abscess and cortical venous infarction mimicking cerebritis caused by Gemella morbillorum.

    Milnik, Annette; Gazis, Angelos; Tammer, Ina; Bartels, Claudius

    2013-01-01

    Gemella morbillorum is an anaerobic gram-positive diplococcus and in most cases a harmless commensal, which occasionally causes infections in the central nervous system. We report on an immunocompetent young man with focal neurological symptoms and cephalgia caused by a cerebral abscess. Although successful treatment was done with neurosurgical intervention and antibiotic therapy, he suffered from a venous infarction 5 weeks after first diagnosis, which mimicked cerebritis as an early stage of relapsing abscess. Imaging and investigation of cerebrospinal fluid was necessary for sufficient differential diagnosis and antibiotic therapy could be stopped after altogether 8 weeks of treatment. In summary, G morbillorum causes not only biphasic infections, but also can be accompanied by infarction in the central nervous system despite sufficient antibiotic therapy. PMID:23355562

  7. Eigenimage filter application to MR imaging in patients with cerebral infarction

    The authors investigate the MR appearance of cerebral infarction using Eigenimage filtering. Eigenimage filtering is a postprocessing technique that enhances desired features while suppressing those that are interfering on MR sequences in the same anatomic region. The authors have used this technique on spin-echo images of infarct sites and used signature vectors and vector analysis technique to separate various zones within the infarct region. Volumes for the differing zones are determined. Five patients with CT and clinical evidence for infarcts ranging from 48 hours to 6 months in age were analyzed by means of the Eigenimage filter technique. An outer transitional zone and an inner persistent zone were discerned in acute and subacute cases. The outer zone returned to normal signal in a patient reimaged 2 months later. Eigenimage filter application to MR imaging in stroke patients allows two distinct zones to be discussed. The outer zone may represent a penumbra of astrocyte proliferation or a region of reversible ischemia. The inner zone likely represents tissue undergoing irreversible ischemic damage

  8. Multivariate Analysis of Risk Factors of Cerebral Infarction in 439 Patients Undergoing Thoracic Endovascular Aneurysm Repair

    Kanaoka, Yuji; Ohki, Takao; Maeda, Koji; Baba, Takeshi; Fujita, Tetsuji

    2016-01-01

    Abstract The aim of the study is to identify the potential risk factors of cerebral infarction associated with thoracic endovascular aneurysm repair (TEVAR). TEVAR was developed as a less invasive surgical alternative to conventional open repair for thoracic aortic aneurysm treatment. However, outcomes following TEVAR of aortic and distal arch aneurysms remain suboptimal. Cerebral infarction is a major concern during the perioperative period. We included 439 patients who underwent TEVAR of aortic aneurysms at a high-volume teaching hospital between July 2006 and June 2013. Univariate and multivariate logistic regression analyses were performed to identify perioperative cerebral infarction risk factors. Four patients (0.9%) died within 30 days of TEVAR; 17 (3.9%) developed cerebral infarction. In univariate analysis, history of ischemic heart disease and cerebral infarction and concomitant cerebrovascular disease were significantly associated with cerebral infarction. “Shaggy aorta” presence, left subclavian artery coverage, carotid artery debranching, and pull-through wire use were identified as independent risk factors of cerebral infarction. In multivariate analysis, history of ischemic heart disease (odds ratio [OR] 6.49, P = 0.046) and cerebral infarction (OR 43.74, P = 0.031), “shaggy aorta” (OR 30.32, P < 0.001), pull-through wire use during surgery (OR 7.196, P = 0.014), and intraoperative blood loss ≥800 mL (OR 24.31, P = 0.017) were found to be independent risk factors of cerebral infarction. This study identified patient- and procedure-related risk factors of cerebral infarction following TEVAR. These results indicate that patient outcomes could be improved through the identification and management of procedure-related risk factors. PMID:27082585

  9. Diffusion- and T2-weighted MR imagings of cerebral infarction in rabbit: time course of imaging findings and histologic correlation

    To correlate the serial findings obtained by diffusion-and T2-weighted imaging with histologic findings obtained from 30 minutes to 31 days after the development of cerebral infarction in rabbits. Nineteen male New Zealand white rabbits were subjected to intracerebral embolic infarction. Diffusion- and T2-weighted imagings were performed at 30 min, 2, 4 and 6 hours, and 1, 3, 5, 7, 11, 21 and 31 days. Apparent diffusion coefficient (ADC) ratios and T2 signal intensity ratios of infarcted and normal brain were calculated. Microphotographic or electron microscopic (EM) examinations were performed during hyperacute, acute and chronic infarctions. During hyperacute infarction, diffusion-weighted images showed high signal intensity in the infarcted area, and ADC ratios ranged from 0.81 to 0.56. High signal intensity on diffusion-weighted images continued until day 3, decreasing thereafter. The ADC ratio increased continuously after day 1. High signal intensity on T2-weighted images was noted from 6 hours and continued until day 7, decreasing thereafter. Microphotographic findings at 6 hours were normal, but EM examination revealed cellular swelling with intact basement membrane, suggesting cytotoxic edema. During acute infarction, abnormal dilatation of the perineural space, cell destruction, and loosening of the neuropil matrix were revealed by microphotography. During chronic infarction, microphotographic and EM findings revealed liquefaction necrosis. These data indicated that in cases of hyperacute infarction, diffusion-weighted images reflect cytotoxic edema more accurately than do T2-weighted images. A gradually increasing ADC ratio during the course of infarction may be associated with vasogenic edema and cell lysis

  10. Patent Foramen Ovale in Patients with Cerebral Infarction: A Transesophageal Echocradigraphy Study

    Petty, George W.; Khandheria, Bijoy K.; Chu, Chu-Pin; Sicks, JoRean D.; Whisnant, Jack P.

    1997-01-01

    Patent foramen ovale was detected in 37 patients (32%). Mean age was similar in those with (60 years) and those without (64 years) PFO. Patent foramen ovale was more frequent among men (39%) than women (20%, P=.03). Patients with PFO had a lower frequency of atrial fibrillation, diabetes me!litus, hypertension, and peripheral vascular disease compared with those without PFO. There was no difference in frequency of the following characteristics in patients with PFO compared with those without PFO: pulmonary embolus, chronic obstructive pulmonary disease, pulmonary hypertension, peripheral embolism, prior cerebral infarction, nosocomial cerebral infarction, Valsalva maneuver at the time of cerebral infarction, recent surgery, or hemorrhagic transformation of cerebral infarction. Patent foramen ovale was found in 22 (40%) of 55 patients with infarcts of uncertain cause and in 15 (25%) of 61 with infarcts of known cause (cardioembolic, 21%; large vessel atherostenosis, 25%; lacune, 40%) (P=.08). When the analysis was restricted to patients who underwent Valsalva maneuver, PFO with right to left or bidirectional shunt was found in 19 (50%) of 38 patients with infarcts of uncertain cause and in 6 (20%) of 30 with infarcts of known cause (P=.Ol). Conclusion: Although PFO was over-represented in patients with infarcts of uncertain cause in our and other studies, it has a high frequency among patients with cerebral infarction of all types. The relation between PFO and stroke requires further study.

  11. Acute myocardial infarction. Clinical application of technetium 99m stannous pyrophosphates infarct scintigraphy

    Acute myocardial infarction is being recognized as a spectrum of clinical subsets. This appreciation has been brought about to a large degree by the development of several new tools that can be applied clinically to aid in evaluation of patients with acute infarction, and in some cases to provide short- and long-term prognostic information. In the realm of noninvasive methods, several tests utilizing radiopharmaceuticals and scintillation cameras have emerged and are rapidly becoming reliable diagnostic parameters in patients with coronary disease and infarction. Technetium-99m (stannous) pyrophosphate (TcPYP) scintigraphy, one of the first of these techniques to find clinical use, has been shown to be an accurate indicator of acute transmural myocardial infarction and provides added sensitivity and specificity to the diagnosis. Increased diagnostic accuracy, the dimension of visible localization, and the potential for infarct sizing promise physicians better understanding of a patient's clinical presentation and a more rational approach to management

  12. Aquaporin-4 gene silencing protects injured neurons after early cerebral infarction

    Zhan-ping He

    2015-01-01

    Full Text Available Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffusion-weighted imaging (DWI. We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and siRNA-aquaporin-4 was immediately injected via the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefficient value on T2-weighted imaging (T2WI and DWI gradually increased within 0.5-6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2WI and DWI reduced, relative apparent diffusion coefficient value was increased, and cellular edema was obviously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefficient value was similar between treatment and model groups, but angioedema was still obvious in the treatment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefficient value and the area of high signal intensity on T2WI and DWI can reflect therapeutic effects of aquaporin-4 gene silencing on cellular edema.

  13. Holmium:YAG laser coronary angioplasty in acute myocardial infarction

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Patients who sustain complicated acute myocardial infarction in whom thrombolytic agents either fail or are contraindicated often need mechanical revascularization other than PTCA. In 24 patients with acute infarction complicated by continuous chest pain and ischemia who either received lytics or with contraindication to lytics, a holmium:YAG laser (Eclipse Surgical Technologies, Palo Alto, CA) was utilized for thrombolysis and plaque ablation. Clinical success was achieved in 23/24 patients, with 23 patients (94%) surviving the acute infarction. Holmium:YAG laser is very effective and safe in thrombolysis and revascularization in this complicated clinical setting.

  14. A study for the correlation of hemorrhagic cerebral infarction with the hemodynamics measured by dynamic CT

    In 15 cases of cerebral infarction (9 embolisms, 6 thromboses), dynamic CT scans were repeatedly undertaken during 4 week period of stroke. The ratio of peak height to mean transit time (PH/MTT), which was calculated from density time curve, was used as an index of cerebral blood flow. Hemorrhagic infarction was defined as a high density area with CT value over 50 within low density area. The PH/MTT was significantly increased after the appearance of hemorrhagic infarction. Nine of 10 areas, in which hemorrhagic infarctions were not recognized after recoverry of PH/MTT to over 0.5, did not show hemorrhagic infarctions during 4 week period of stroke. The areas in which hemorrhagic infarctions appeared during 4 week period of stroke had mdore prolonged period of low PH/MTT values than the areas in which hemorrhagic infarctions were not recognized. In conclusion dynamic CT is useful for predicting hemorrhagic infarction. (author)

  15. Study for the correlation of hemorrhagic cerebral infarction with the hemodynamics measured by dynamic CT

    Shibagaki, Yasuro (Tokyo Women' s Medical Coll. (Japan))

    1989-06-01

    In 15 cases of cerebral infarction (9 embolisms, 6 thromboses), dynamic CT scans were repeatedly undertaken during 4 week period of stroke. The ratio of peak height to mean transit time (PH/MTT), which was calculated from density time curve, was used as an index of cerebral blood flow. Hemorrhagic infarction was defined as a high density area with CT value over 50 within low density area. The PH/MTT was significantly increased after the appearance of hemorrhagic infarction. Nine of 10 areas, in which hemorrhagic infarctions were not recognized after recoverry of PH/MTT to over 0.5, did not show hemorrhagic infarctions during 4 week period of stroke. The areas in which hemorrhagic infarctions appeared during 4 week period of stroke had mdore prolonged period of low PH/MTT values than the areas in which hemorrhagic infarctions were not recognized. In conclusion dynamic CT is useful for predicting hemorrhagic infarction. (author).

  16. Application research of clinical nursing pathway in swallowing disorder patients with acute cerebral infarction%临床护理路径在急性脑梗死吞咽障碍中的应用研究

    顾志娥; 俞龙; 刘必琴; 秦长江

    2015-01-01

    ABSTRACT:Objective To study the application effect of clinical nursing pathway in swal-lowing disorder patients with acute cerebral infarction.Methods A total of 60 swallowing disorder patients with acute cerebral infarction hospitalized in our department the patients were divided into control group with 30 cases and the observation group with 30 cases according to admission time. The control group was given the routine nursing while the observation group was given clinical nurs-ing pathway on the basis of control group,including swallowing function assessment,health educa-tion,psychological nursing,feeding training,basic training and rehabilitation training,diet test, discharge guidance,and one-week telephone follow-up service.On the 15th day after admission, questionnaire and kubota drinking water test was used to evaluate the extent of the mastery of swal-lowing disorder knowledge and improvement of swallowing disorder,and the complications occur-rence (aspiration pneumonia and malnutrition)was recorded.Results The awareness of swallow-ing disorder knowledge in the observation group was higher than that in the control group,the dif-ference was statistically significant(P incidence of complications of swallowing disorder,so it is worthy of widely promotion in clinic.%目的:探讨临床护理路径在急性脑梗死吞咽障碍患者中的应用效果。方法选取急性脑梗死后吞咽障碍患者60例按入院时间段分为对照组和观察组各30例,对照组在药物治疗基础上采取常规护理方法,观察组在药物治疗基础上采取临床护理路径实施护理,内容包括吞咽功能评估、健康宣教、心理护理、摄食训练、基础训练、康复训练、试食、出院指导、电话跟踪随访服务1周。住院第15天采用自行设计的有关吞咽障碍的知识问卷、洼田饮水试验评估患者掌握吞咽障碍知识的程度和吞咽障碍程度改善的情况,并记录上述时间内患者并发症

  17. Anti-Cardiolipin Antibody in Acute Myocardial Infarction

    Abdolreza S. Jahromi; Mohammad Shojaie; Samira Dana; Abdoulhossain Madani

    2010-01-01

    Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Data concerning the relation between anti-Phospholipid (aPL) antibodies and myocardial infarction in subjects without evidence of overt autoimmune disease are conflicting. Anticardiolipin antibody is detected in various diseases like rheumatoid arthritis, systemic lupus erythematosus and anti-phospholipid antibody syndrome. The study of Anticardiolipin antibody in Acute Myocardial Infarction...

  18. Study on the Clinical Relationship between Blood Glucose, Glycated Hemoglobin Level and Acute Cerebral Infarction%血糖、糖化血红蛋白水平与急性脑梗死临床关系的探讨

    袁勇

    2012-01-01

      Objective To investigate acute patient of brain infarct blood sugar competence and clinical relation. Methods Empty stomach blood sugar level when admitting to hospital divide into normal blood sugar group,high blood sugar group, at random according to patient, Before treating, after treating,flawed or damaged to go on and give a mark to nervous system,Observe blood sugar, glycosylated hemoglobin have illness coming on the total mark and clinical relation. Results Acute brain infarct blood sugar level high,and have illness coming on and flawed or damaged to give a mark either high nervous system of patient,the worse its clinical curative effect is. Conclusion High bloods sugars accompany high glycosylated hemoglobin increase acute brain nervous system of infarct damage especially with have illness coming on. Lower candy treatment may improve acute brain clinical curative effect of infarct effectively,Prevent and treat high blood sugar to prevent brain infarct effective measure one of actively.%  目的探讨血糖、糖化血红蛋白水平与急性脑梗死患者的临床关系。方法对收治的78例急性脑梗死患者的临床资料进行回顾性分析,根据入院时空腹血糖水平分为正常血糖组、高血糖组,病情好转后对所有患者进行神经系统缺损评分,观察血糖、糖化血红蛋白和临床的关系。结果急性脑梗死患者高血糖组与正常血糖组相比,其神经系统缺损评分高,总有效率低。结论高血糖尤其伴高糖化血红蛋白会增加急性脑梗死神经系统损伤,预后差。故积极预防和治疗高血糖是预防脑梗死的有力措施之一。

  19. Decompressive craniectomy in malignant middle cerebral artery infarction: clinical evidence

    Alcalá-Cerra Gabriel

    2011-12-01

    Full Text Available Malignant middle cerebral artery infarction represents a 5 to 10% of patients withischemic stroke, leading to high mortality and disability. For its treatment, decompressivecraniectomy has been utilized in a selected group of patients.Decompressive craniectomy is a neurosurgical procedure that has been used in thetreatment of a select group of patients. In this paper we review the literature on theeffectiveness of this procedure. Additionally, evidence-based recommendations for thecareful and rational selection of potential candidates for this surgery are also exposed.RESUMEN:El infarto maligno de la arteria cerebral media representa entre 5 a 10% de lospacientes con enfermedad vascular cerebral isquémica, conllevando una alta mortalidady discapacidad funcional. Para su tratamiento ha sido utilizada la craniectomíadescompresiva en un grupo selecto de pacientes. En este escrito es revisada la literaturareferente a la efectividad de este procedimiento. Adicionalmente, son recopiladas lasrecomendaciones basadas en la evidencia para la elección meticulosa y racional delos potenciales candidatos a esta cirugía.

  20. Electrocardiographic localization of infarct related coronary artery in acute ST elevation myocardial infarction

    C.S. Thejanandan Reddy; D Rajasekhar; Vanajakshamma, V.

    2013-01-01

    The electrocardiogram (ECG) remains a crucial tool in the identification and management of acute myocardial infarction (MI). A detailed analysis of patterns of ST-segment elevation may influence decisions regarding the use of reperfusion therapy. The early and accurate identification of the infarct-related artery on the ECG can help predict the amount of myocardium at risk and guide decisions regarding the urgency of revascularization. The specificity of the ECG in acute MI is lim...

  1. Cancer risk of patients discharged with acute myocardial infarct

    Dreyer, L; Olsen, J H

    1998-01-01

    We studied whether common shared environmental or behavioral risk factors, other than tobacco smoking, underlie both atherosclerotic diseases and cancer. We identified a group of 96,891 one-year survivors of acute myocardial infarct through the Danish Hospital Discharge Register between 1977 and...... acute myocardial infarct patients were similar to those of the general population, as were the rates for hormone-related cancers, including endometrial and postmenopausal breast cancers. We found a moderate increase in the risk for tobacco-related cancers, which was strongest for patients with early...... onset of acute myocardial infarct and for female patients. Overall, there do not seem to be major shared environmental or behavioral risk factors for acute myocardial infarct and cancers, except for smoking, and there seems to be no common inherited susceptibility to the development of these diseases....

  2. Secondary prevention with calcium antagonists after acute myocardial infarction

    Hansen, J F

    1992-01-01

    Experimental studies have demonstrated that the 3 calcium antagonists nifedipine, diltiazem, and verapamil have a comparable effect in the prevention of myocardial damage during ischaemia. Secondary prevention trials after acute myocardial infarction, which aimed at improving survival and...

  3. Aneurysm of the left aortic sinus causing acute myocardial infarction

    Jan-Peter Smedema; Vernon Freeman; Johan Brink

    2011-01-01

    This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva.

  4. Aneurysm of the left aortic sinus causing acute myocardial infarction

    This report describes the findings and management of a young male who presented with an acute ST-segment elevation myocardial infarction due to compression of the circumflex coronary artery by a large aneurysm of left sinus of Valsalva

  5. Study on the relationship between serum interleukins, platelet activation indexes and cerebral infarction

    Bo Wu

    2015-01-01

    Objective:To study and investigate the relationship between serum interleukins, platelet activation indexes and cerebral infarction.Methods:58 patients with cerebral infarction in our hospital from March 2013 to September 2014 were selected as observation group; meanwhile, 58 healthy persons at the same period were selected as control group, then the serum interleukins and platelet activation indexes of two groups were detected and compared, then the detection results of observation group with different stages and severity of cerebral infarction were compared too, and the relationship between those blood detection indexes and cerebral infarction were analyzed by the Logistic analysis.Results:The serum interleukins and platelet activation indexes of observation group were obviously higher than those of control group, and the detection levels of observation group with cerebral infarction at early and severe stage were obviously higher than those of patients at other stages and light, moderate, and those blood indexes all had close relationship to the cerebral infarction by the Logistic analysis,P<0.05. Conclusion:The serum interleukins and platelet activation indexes all have close relationship to cerebral infarction, and they can be as the important monitoring indexes of the disease.

  6. Influence of rotating magnetic field on cerebral infarction volume, cerebral edema and free radicals metabolism after cerebral ischemia/reperfusion injury in rats

    Xiaohong Liu; Zhiqiang Zhang; Lixin Zhang

    2006-01-01

    .09) μmol/g, t =4.076, P < 0.05]. ④ General morphological observation:General morphology manifested that the edema was distinct in the right cerebral hemisphere in the control group, showing fat-like white, shallow anfractuosity, flat gyria, brittle tissue and easy to break up. The edema of right cerebral hemisphere was light and surface was hyperaemia in the treatment group.CONCLUSION: RMF may improve anti-oxidative ability of brain tissue of rats with acute focal cerebral ischemia/reperfusion injury and reduce volume of cerebral infarction and degrees of cerebral edema.

  7. Acute myocardial infarction in the puerperium. A case report

    Providência, R; Mota, P.; Rosa-Pais, J; Leitão-Marques, A

    2007-01-01

    Acute myocardial infarction is a rare event in the puerperium that can have life-threatening consequences if not diagnosed early. Spontaneous coronary artery dissection is the most frequent causative mechanism in the period immediately after labor. This article reports the case of a 38-year-old woman with acute myocardial infarction due to spontaneous coronary artery dissection on the 7th day after delivery. The authors review this entity and also discuss the prognosis and future management o...

  8. Study on the Value of Urine Ferritin Creatinine Ratio Detection in Patients with Acute Cerebral Infarction%急性脑梗死患者尿铁蛋白肌酐比检测价值探讨

    袁静宁

    2015-01-01

    目的 探讨尿铁蛋白/尿肌酐在脑梗死患者病情诊断中的检测价值. 方法 选取2012 年3月至2014年9 月开江县人民医院收治的52例脑梗死患者(观察组)以及同期本院进行体检60 例健康体检者(对照组)为研究对象,采用放射免疫法测定两组血清以及尿液中的铁蛋白水平. 结果观察组尿铁蛋白/尿肌酐及血清铁蛋白均高于对照组[(15.2 ±2.4) μg/g 比 (6.3 ±1.2) μg/g, (96.3 ±11.7) μg/L 比(46.6 ±12.2) μg/L,P<0.01]. 相关性分析显示,观察组尿铁蛋白/尿肌酐与血清铁蛋白间存在显著正相关(r=0.882,P<0.05). 观察组中随着梗死面积的增大,尿铁蛋白/尿肌酐越大,随着神经功能缺损评分的增多,尿铁蛋白/尿肌酐越大. 经 Pearson 相关分析,尿铁蛋白/尿肌酐水平与脑梗死面积及神经缺损评分间存在显著正相关(r=0.873,0.675,均P<0.05). 结论 早期检测尿铁蛋白/尿肌酐对于脑梗死的诊断具有一定的价值.%Objective To explore the detection value of urine ferritin/urine creatinine ratio in the diag-nosis of patients with cerebral infarction.Methods A total of 52 patients with cerebral infarction(the obser-vation group) admitted in Kaijiang County People's Hospital from Mar.2012 to Sep.2014 and 60 healthy patients underwent physical examination in the hospital during the same period(the control group) were cho-sen as the research objects,ferritin levels in serum and urine of the two groups were detected by radioimmu-noassay.Results Levels of urine ferritin/urine creatinine and serum ferritin of the observation group were higher than those of the control group,there were statistically significant differences[(15.2 ±2.4) μg/g vs (6.3 ±1.2) μg/g,(96.3 ±11.7) μg/L vs (46.6 ±12.2) μg/L,P<0.01].Results of correlation analy-sis showed that there was significant positive correlation between urine ferritin/urine creatinine and serum ferritin(r=0.882,P <0.05).With the increase of infarction area

  9. Significance in diagnosis of acute cerebral ischemia by diffusion-weighted and perfusion-weighted images

    Ikawa, Fusao; Kurisu, Kaoru; Arita, Kazunori; Migita, Keisuke; Akimitsu, Tomohide; Takeshita, Shinichiro; Chen, Shuda; Itoh, Katsuhide [Hiroshima Univ. (Japan). School of Medicine

    2000-07-01

    The purpose of this study was to diagnose acute stroke by diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) using echo planar imaging (EPI) with special reference to the corticospinal tract and hemodynamics. Six cases of acute stroke within 72 hours of onset were imaged with FLAIR, DWI and PWI. All studies were performed using a 1.5 T Signa Horizon MRI scanner (GE YMS). The imaging parameters of the DWI were employed in phase, frequency, and slice encode directions in four time frames; b=250, 500, 750, 1000 s/mm{sup 2}. DWI was imaged with single shot SE type EPI, TE=120 ms, matrix=100 x 100, 1 NEX, thickness 6 mm, FOV 40 cm. PWI was performed with single shot gradient echo type echo-planar technique during the injection of 0.2 mmol per kilogram of body weight of gadopentate dimeglumine, TE=42 ms, matrix=128 x 128, 1 NEX, thickness 6 mm, FOV 30 cm. Apparent diffusion coefficient (ADC) map, relative cerebral blood volume (rCBV) map, and relative mean transit time (rMTT) map were reconstructed by workstation. All six acute infarctions could be imaged by DWI. In phase directional DWI, the relationship between infarction and corticospinal tract was easily detected. A perfusion map could reveal a larger area with disturbance of hemodynamics around the acute infarction. In conclusion, diffusion-weighted imaging was useful for the diagnosis of acute stage cerebral infarction. Perfusion-weighted imaging was useful as a simple model of cerebral hemodynamics in cerebral infarction. (author)

  10. The tole of ischemic preconditioning in acute myocardial infarction

    Ristić Anđelka

    2005-01-01

    Full Text Available Introduction Ischemic preconditioning is a phenomenon in which brief episodes of ischemia and reperfusion increase myocardial tolerance and substantially reduce the infarction size. Case report Two patients with acute left anterior descending artery occlusion received fibrinolytic therapy within 6 hours of symptom onset, but nevertheless developed myocardial infarctions of different size. The first patient, without a history of preinfarction angina, developed a large anterior infarction, because there was no time for ischemic preconditioning or development of coronary collateral vessels. The second patient, with a 4-day history of preinfarction angina, had a more favorable outcome-he developed apical necrosis, with greater myocardial viability in the infarct-related area. Conclusion The beneficial effects of angina occurring 24-48h before infarction are resulting from ischemic preconditioning, which reduces cardiac mortality, infarct size and occurrence of life-threatening ventricular arrhythmias. .

  11. Combined analysis of the relative risk of risk factors for acute cerebral infarction%急性脑梗死风险指标相对危险度联合分析

    李东杰; 杜宗孝; 张亚梅; 朴文花

    2012-01-01

    目的 探讨不同风险指标对急性脑梗死(ACI)的影响程度.方法 选择ACI确诊患者111例(ACI组),在发病24 h内检测血小板参数、凝血指标及超敏C反应蛋白(hs-CRP)、尿酸(UA)、空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等参数,调查身体质量指数(BMI)、吸烟、饮酒等一般资料.以104例体检健康者作为对照组.采用Logistic回归分析各风险因素的相对危险度(OR值).结果 Logistic回归分析显示,吸烟、LDL-C、平均血小板体积(MPV)、TC、FBG、TG、BMI、饮酒、hs-CRP、血小板分布宽度(PDW)为ACI高危因素,其OR值分别为2.527、2.036、1.570、1.478、1.456、1.345、1.128、1.103、1.080、1.062.结论 吸烟、LDL-C、MPV、TC、FBG、TG、BMI、饮酒、hs-CRP、PDW均为ACI高危因素,监测其变化对预防ACI有重要意义.%Objective To evaluate the effects of different risk factors on acute cerebral infarction (ACI). Methods 111 cases of patients with ACI(ACI group) were enrolled, and platelet parameters, coagulation parameters, hypersensitivity C reactive protein (hs-CRP) ,urea acid(UA) ,fasting blood glucose(FBG) , triacylglyceroKTG) , total cholesterol(TC) ,high density lipoprotein choles-terol(HDL-C) ,low density lipoprotein cholesterol(LDL-C) were determined within 24 h after morbidity. Body mass index(BMI) , history of smoking and drinking alcohol were inquired. 104 cases of healthy controls were enrolled as control group. Relative risk, indicated as odd ratio(OR) ,of all risk factors were evaluated by logistic regression. Results Logistic regression analysis demonstrated that smoking, LDL-C, mean platelet volume ( MPV) , TC, FBG, TG, BMI, drinking alcohol, hs-CRP and platelet distribution width(PDW) were high risk factors of ACI,with OR values of 2. 527,2. 036,1. 570,1. 478,1. 456,1. 345,1. 128,1. 103,1. 080 and 1. 062 respectively. Conclusion Smoking, LDL-C, MPV

  12. Copeptin Testing in Acute Myocardial Infarction: Ready for Routine Use?

    Sebastian Johannes Reinstadler

    2015-01-01

    Full Text Available Suspected acute myocardial infarction is one of the leading causes of admission to emergency departments. In the last decade, biomarkers revolutionized the management of patients with suspected acute coronary syndromes. Besides their pivotal assistance in timely diagnosis, biomarkers provide additional information for risk stratification. Cardiac troponins I and T are the most sensitive and specific markers of acute myocardial injury. Nonetheless, in order to overcome the remaining limitations of these markers, novel candidate biomarkers sensitive to early stage of disease are being extensively investigated. Among them, copeptin, a stable peptide derived from the precursor of vasopressin, emerged as a promising biomarker for the evaluation of suspected acute myocardial infarction. In this review, we summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers.

  13. Follow-up CT of hemorrhagic cerebral infarction

    The computed tomography (CT) findings in cases of hemorrhagic cerebral infarction were divided into the following two different patterns: (1) The precontrast scan showed small high-density spots, mainly at the cortico-subcortical junctions. These appeared to represent a small amount of hemorrhage. The contrast enhancements were remarkable around these high-density areas as observed by the plain CT. (2) The precontrast scan showed only low-density areas, but the contrast scan showed an enhancement at the border zone of the gray and white junction, similar to those observed in Type 1 CT. Three (20%) of the 15 patients presented Type 1, and 12 patients (80%), Type 2. In the cases of Type 1, a positive CE was seen within a few days after the insult. This CE demonstrated the disturbance of the blood-brain barrier (B B B) during the stage of vasogenic edema. In the cases of Type 2, the positive CE was further divided into two subtypes: the early stage (2 to 3 weeks) and the late stage (4 weeks) after the stroke. The positive CE at the early stage, might be explainable to a significant extent by an extravasation of the contrast medium resulting from permeability changes in the vessels located in the boundary zones of the gray and white matter. On the contrary, the CE enhancement observed in the late stage might result chiefly from newly formed vessels with a defective BBB in and around the infarcted area. (author)

  14. Clinical efficacy of immune ozone blood auto-transfusion therapy in treatment of 170 patients with acute cerebral infarction%免疫三氧血回输疗法治疗170例急性脑梗死的临床疗效

    王生锋

    2014-01-01

    ObjectiveTo investigate the clinical efficacy of immune ozone blood auto-transfusion therapy for acute cerebral infarction.Methods340 patients with acute cerebral infarction admitted to our hospital from August 2012 to August 2013 were selected and randomly divided into two groups, namely the control group(ordinary treatment) and the treatment group(ordinary treatment+immune ozone blood auto-transfusion therapy), with 170 patients in each group. The efficacy of the two groups was analyzed comparatively. ResultsThe effective rate of the treatment group was 91.2% and that of the control group was 78.2%(x2=4.379,P=0.008), indicating that the treatment group had significantly higher effective rate than the control group. Conclusion Medical ozone blood auto-transfusion therapy is quite suitable for the treatment of neurological diseases,especially acute cerebral infarction,and shows remarkable efficacy.%目的:探讨免疫三氧血回输疗法治疗急性脑梗死的临床疗效。方法选取我院2012年8月~2013年8月期间收治的急性脑梗死患者340例,随机分成两组,对照组(一般治疗)及治疗组(一般治疗+免疫三氧血回输疗法)各170例,对比分析其疗效。结果治疗组有效率为91.2%,对照组有效率为78.2%, x2=4.379,P=0.008,表明治疗组基本治愈率及总有效率明显高于对照组,治疗组有效率明显高于对照组。结论医用臭氧自体血回输疗法非常适合神经系统疾病,特别是急性脑梗死等治疗,且疗效显著。

  15. Helicobacter pylori infection and acute myocardial infarction.

    Nakić, Dario; Vcev, Aleksandar; Jović, Albino; Patrk, Jogen; Zekanović, Drazen; Klarin, Ivo; Ivanac, Kresimir; Mrden, Anamarija; Balen, Sanja

    2011-09-01

    The aim of this investigation was to determine whether H. pylori infection is an independent risk factor for acute myocardial infarction (AMI), determine is there a link between H. pylori infection and severity of disease. In this prospective, single centre study, were enrolled 100 patients with AMI and control group was consisted 93 healthy individuals. The results of this study showed no difference between H. pylori seropositivity distribution in the investigate and control group (29 vs. 26 %) and there was no significant difference on the severity of the disease. There was significant association in the patients with three and more risk factors, where the patients with lower blood pressure (124.4/77.4 vs. 145.9/87.7 mmHg) and better controlled diabetes (HbA1c 6.1% vs. 6.9%) had greater risk for AMI if they are H. pylori seropositive. The large multicentric trials would be needed to define a precise role of H. pylori infection on the developement of AMI. PMID:22053556

  16. Alberta stroke program early CT score on diffusion -w eighted imaging predicts new cerebral microbleeds in patients w ith acute middle cerebral artery infarction%弥散加权成像阿尔伯塔卒中项目早期CT 评分预测急性期大脑中动脉供血区梗死患者的新发脑微出血

    刘艳; 丁云龙; 刘文鹏; 魏灿; 张艳荣; 刘丽; 陆云峰; 徐俊

    2015-01-01

    Objective To investigate the predictive value of Alberta stroke program early CT score on diffusion-w eighted imaging (DWI-ASPECTS) for predicting new cerebral microbleeds (CMBs) in patients w ith acute middle cerebral artery infarction. Methods The patients w ith acute middle cerebra artery infarction w ere enroled prospectively. MRI examinations w ere completed w ithin 48 h on admission and they w ere examined again at 10 to 14 d after onset. Susceptibility-w eighted imaging (SWI) w as use to detect CMBs. DWI-ASPECTS w as used to assess the infarction extent. Results A total of 82 patients w ith acute middle cerebra artery infarction w ere enroled, including 27 females and 55 females. Their ages w ere 71.7 ± 8.9 years. Eighteen patients (22.0%) had old CMBs, 25 (30.5%) had new CMBs, 57 (69.5%) did not have new CMBs. Compared w ith the non-new CMB group, DWI-SPECTS (3.20 ±1.73 vs.7.11 ±1.69;t = 9.573, P 5), the risk of new CMBs w ould decrease 86 % (odds ratio 0.14, 95%confidence interval 0.17 -0.48; P 5分时,新发 CMBs 风险下降86%(优势比0.14,95%可信区间0.17~0.48;P <0.001)。受试者工作特征曲线分析显示,ASPECTS 评分≤5分预测新发CMBs 的敏感性为87.7%,特异性为88.3%,曲线下面积为0.940。结论DWI-ASPECTS 可有效预测急性大脑中动脉供血区脑梗死患者新发 CMBs 风险。

  17. Application of 3DAC (3D anisotropy contrast) imaging to predict motor function outcome of patients with cerebral infarction

    ThreeDAC (3D anisotropy contrast) image can depict neuronal fibers in 3 dimensions and the way those anatomical structures exist. However, despite its sophistication, quantitative analysis of 3DAC image has been performed poorly, probably, due to difficulties collecting numerical factors, thus we have tried to evaluate a feasible quantitative 3DAC image technique to predict motor function outcome in patients with cerebral infarction. Twenty-five patients with a acute cerebral infarctions, who underwent 3DAC procedure with 3 tesla MRI within 1 week after the onset, were enrolled in this study. To assess motor function, we applied manual muscle testing (MMT) score, which was modified by designating from 1 to 13 points corresponding to MMT, during both the onset and 3 months later. 3DAC image was created through the procedure assigning each direction to red, green and blue (RGB) colors after obtaining rare 3DAC images. On the slice showing the maximally injured region, Injured Fiber Ratio (IFR), defined as the ratio of injured area on horizontal fibers shown as blue area to the area of whole horizontal fibers in a healthy side, was calculated and compared with MMT score. Although MMT score at the onset did not correlate significantly with IFR, each MMT score of the arm and leg 3 months later revealed a significant correlation with IFR(R2=0.47 and R2=0.67, respectively). Given these results, by exploiting the IFR obtained from 3DAC image a motor function outcome in patients with cerebral infarction might be predicted even in a very acute stage and 3DAC image could be a feasible modality for analyzing a neuronal injury in cerebral infarction patients. (author)

  18. Cerebral blood flow in acute mountain sickness

    Jensen, J B; Wright, Anne; Lassen, N A;

    1990-01-01

    Changes in cerebral blood flow (CBF) were measured using the radioactive xenon technique and were related to the development of acute mountain sickness (AMS). In 12 subjects, ascending from 150 to 3,475 m, CBF was 24% increased at 24 h [45.1 to 55.9 initial slope index (ISI) units] and 4% increased...

  19. Computational modeling of acute myocardial infarction.

    Sáez, P; Kuhl, E

    2016-01-01

    Myocardial infarction, commonly known as heart attack, is caused by reduced blood supply and damages the heart muscle because of a lack of oxygen. Myocardial infarction initiates a cascade of biochemical and mechanical events. In the early stages, cardiomyocytes death, wall thinning, collagen degradation, and ventricular dilation are the immediate consequences of myocardial infarction. In the later stages, collagenous scar formation in the infarcted zone and hypertrophy of the non-infarcted zone are auto-regulatory mechanisms to partly correct for these events. Here we propose a computational model for the short-term adaptation after myocardial infarction using the continuum theory of multiplicative growth. Our model captures the effects of cell death initiating wall thinning, and collagen degradation initiating ventricular dilation. Our simulations agree well with clinical observations in early myocardial infarction. They represent a first step toward simulating the progression of myocardial infarction with the ultimate goal to predict the propensity toward heart failure as a function of infarct intensity, location, and size. PMID:26583449

  20. Application of computed tomography,magnetic resonance imaging,magnetoencephalography in the diagnosis of acute cerebral infarction%X线计算机体层摄影术、磁共振成像和脑磁图描记术在急性脑梗死诊断中的应用

    孙占用; 荀丽颖; 吕佩源

    2014-01-01

    急性脑梗死是临床常见的缺血性脑血管疾病,具有高发病率、高死亡率及高致残率的特点,早诊断、早治疗是及早阻止疾病发展、改善预后的关键。笔者主要就急性脑梗死在X线计算机体层摄影术(CT)、磁共振成像(MRI)、脑磁图描记术(MEG)等神经影像中的早期表现及相关原理进行阐述。常规CT普及率高、经济、便捷,对脑出血敏感度高,是急性脑梗死与脑出血鉴别首选,缺点是成像对比度差,对脑梗死早期诊断精确性差。CT灌注成像对急性脑梗死的早期诊断和缺血半暗带定位具有更大的优势。MRI是具有多种扫描序列,可对不同状态下脑组织内水分子状态精确分辨,对脑梗死的诊断、分期具有极高的应用价值。临床常规的T1、T2、FLAIR加权像可在起病后数小时观测到异常信号,而DWI序列在局部脑组织缺血后5 min即可见信号增强。SWI序列可以检测CT、常规MRI无法显示的微出血灶。MRS成像可以检测多种细胞内化合物成分,这些化合物对急性脑梗死不同时期、不同程度的细胞损伤具有特定意义。MEG可以灵敏检测大脑神经元细胞的异常放电,并能对异常信号发生源精确定位,时间分辨率达ms级,空间分辨率达mm级。MEG通过监测不同功能区的诱发磁场,可以定位病灶,同时灵敏客观反映脑功能损伤情况。但其昂贵的价格、低普及率、对被检查者的配合要求都限制了MEG的应用。目前神经影像学技发展快,随着设备及软件的进一步开发,急性脑梗死诊治水平会有进一步的提高。%As a common type of cerebrovascular disease,acute cerebral infarction has higher incidence,mortality and morbidity.Earlier diagnosis and treatment is a key to prevent the development of diseases and improve prognosis.The author mainly focus on the different roles of CT,MRI and MEG in early stage of acute

  1. Can cerebral blood flow measurement predict clinical outcome in the acute phase in patients with artherosclerotic occlusive carotid artery disease?

    It has been thought that the clinical course of patients with acute carotid occlusive disease depends on their collateral cerebral blood flow (CBF) and duration of ischemia. However, there have been few clinical reports to prove this hypothesis. Therefore, we performed CBF study in patients with artherosclerotic carotid occlusive disease in the very acute phase, and precisely assessed the prognosis of those patients under intensive medical therapy. This prospective study included a total of 44 patients (72±13 years) who were admitted to our hospital between April, 2007 and December, 2008. To evaluate their initial CBF, single photon emission computed tomography (SPECT) studies were performed within 6 hours after the onset. All patients included in this study were medically treated and were periodically followed up by neurological and radiological examination. Moreover, in patients with reduced CBF (ipsilateral CBF/contralateral CBF x 100: %CBF <80%), dobutamine-induce hyperdynamic therapy was performed. Multivariate analysis was performed to detect significant predictors for the occurrence of further cerebral infarction. Multivariate analysis showed that the occurrence of further infarction was associated with older age and smaller %CBF. Of 44 patients, 21 experienced further cerebral infarction within 10 days after onset. Fourteen out of 15 patients with %CBF <60% developed cerebral infarction. This study showed that the prognosis of the patients with artherosclerotic carotid occlusive disease in the acute phase is associated with their initial residual CBFs. It may be difficult to stop the developed cerebral infarction in those patients with %CBF <60% despite intensive medical therapy. (author)

  2. Reassessment of Defibrase in the treatment of Acute Cerebral lnfarction

    Liu XQ; Guo YP; Wang WZ; Zhang CX; Yang JH; Qin Z

    2000-01-01

    Objective: to assess the safety and efficacy of defibrase in the treatment of acute cerebral iinfarction by a large sample, multicerter, randomized, double-blind, and placebo-controlled clinical trial Methods: 2244 cases with acute infarction in 41centers were randomly allocated to receive either an imitial intrdvcnons infusion of defibrase 10Bu or placebo in 250ml of normal saline within 24 hours of stroke onset Subsequent in fusions of defibrase 5Bu or placebo on the third and fifth days respectively. This treatment protocol was determined on the bases of the pretrial of 114 patientsin 8 centers The end points fincluded Climcally Neurological De ficits Scale of Stroke, Barthel Index, Mortality, adverse reaction and the level of plasma fibrinogen (FIB)Results: (1) the level of plasma FIB in defibrase group was reurarkably declied after treatment whereas the bleeding evcnts and other adverse reaction was not incteased in comparison with control group There was difference in the imtcnsity of degrading plasna FIB between defibrase from Agkistrodon halys and that frorn Agkistrodon acutns. (2) Theare were no statistically significant differences at Clinically Neurological Deficits Scale of Stroke at 2 weeks, Barthel Index sc ore and mortality at 3 months between two groups. Conclutions: This study showed that defibrase atppears safe and effective in degading plastua FIB.The dose of defibrase should regnlate propcrly according to preparations from diffcrent snake venom .This study did not show that clinical efficacy of defibrase was supetior to those present used medicines for acute cerebral infarction It is necessary to further study about the relations between its clinical efficacy and the dose,protocol of drug administration and indication.

  3. Relativity analysis of arterosclerotic cerebral infarction of senile patients and secondary epilepsy%老年动脉硬化性脑梗死与继发性癫痫相关性分析

    张英杰; 马艳

    2001-01-01

    @@Background: Acute cerebral vascular secondary epilepsy isn't uncommon in clinic.It can happen at any time of epilepsy,even as first- onset or main clinical manifestation.Main cause of stroke of senile patients is arteriosclerosis,which is main cause of old stage epilepsy. Objective:To analyze relativity of arterosclerotic cerebral infarction of senile patients and secondary epilepsy.

  4. Health service organization for patients with cerebral infarction: current status and specifics of outpatient medical care

    Parkhomenko A.A.

    2015-06-01

    Full Text Available Stroke and cerebral infarction in particularly are important medical and social problems. The article describes the historical changes of legal acts regulating medical care for patients with stroke and observes recent researches dealing with the law enforcement in this sphere. Content analysis revealed the lack of correspondence between the legal framework and clinical guidelines for cerebral infarction. Particular attention is paid to the low level of scientific research results concerned with the stroke outpatient medical care.

  5. Left ventricular global longitudinal strain in acute myocardial infarction

    Ersbøll, Mads

    Systolic dysfunction, clinical heart failure and elevated levels of neurohormonal peptides are major predictors of adverse outcome after acute myocardial infarction (MI). In the present thesis we evaluated global longitudinal strain (GLS) in patients with acute MI in relation to neurohormonal...

  6. Acute Myocardial Infarction Due To Electrical Injury

    Uzkeser M et al.

    2011-01-01

    Rhythm abnormalities (conduction defects, tachycardia, and arrhythmia)due to electric shock are common. Rarely, myocardial infarction may beseen in these patients. This situation is generally caused by coronaryartery vasospasm and direct myocardial damage. In this report, wepresent a rare case of myocardial infarction due to electric shock.

  7. The validity and reliability of signs of early infarction on CT in acute ischaemic stroke

    Dippel, D.W.J.; Du Ry van Beest Holle, M.; Kooten, F. van; Koudstaal, P.J. [Univ. Hospital Rotterdam (Netherlands). Dept. of Neurology

    2000-09-01

    It has been suggested that subtle signs of early cerebral infarction on CT are important indicators of outcome and of the effect of thrombolytic treatment in acute ischaemic stroke. We studied these signs prospectively, in 260 patients with an anterior circulation stroke from a European-Australian randomised trial of lubeluzole in acute ischaemic stroke. Interobserver reliability was assessed by means of the {chi} statistic. The validity of the early signs was assessed by comparing the assessments of the first CT with another CT at 1 week after the onset of stroke, and with stroke outcome at 12 weeks. Each initial CT study was assessed by two of a group of five reviewers, who were blinded to each other's assessments and to the findings on the follow-up CT. The images were assessed twice, once without clinical information and again after disclosure of the side (left or right hemisphere) of the lesion. All reviewers were experienced clinicians with a special interest and training in vascular neurology and CT. The median time between stroke onset and the first CT was 3.2 h; 59 % of the patients were imaged within 3 h and 77 % within 6 h. More than half of the patients (52 %) had a large middle cerebral artery territory (MCA) infarct on follow-up CT. Chance-adjusted interobserver agreement ({chi}) for any early infarct was 0.27 (95 % confidence interval (CI): 0.15 to 0.39). Agreement ({chi}) on the extent of a middle cerebral artery (MCA) infarct and on the indication for treatment with recombinant tissue plasminogen activator (rt-PA) was fair: 0.37 and 0.35, respectively. Patients with early signs of an infarct of more than 1/3 of the MCA territory were more likely to have a large MCA infarct on follow-up CT (odds ratio 5.7, 95 % confidence interval 2.8-11.5); the positive and negative predictive value of these signs was 81 % and 57 %, respectively. Chance-adjusted interobserver agreement on early, subtle signs of a large MCA territory infarct on CT by

  8. The validity and reliability of signs of early infarction on CT in acute ischaemic stroke

    It has been suggested that subtle signs of early cerebral infarction on CT are important indicators of outcome and of the effect of thrombolytic treatment in acute ischaemic stroke. We studied these signs prospectively, in 260 patients with an anterior circulation stroke from a European-Australian randomised trial of lubeluzole in acute ischaemic stroke. Interobserver reliability was assessed by means of the χ statistic. The validity of the early signs was assessed by comparing the assessments of the first CT with another CT at 1 week after the onset of stroke, and with stroke outcome at 12 weeks. Each initial CT study was assessed by two of a group of five reviewers, who were blinded to each other's assessments and to the findings on the follow-up CT. The images were assessed twice, once without clinical information and again after disclosure of the side (left or right hemisphere) of the lesion. All reviewers were experienced clinicians with a special interest and training in vascular neurology and CT. The median time between stroke onset and the first CT was 3.2 h; 59 % of the patients were imaged within 3 h and 77 % within 6 h. More than half of the patients (52 %) had a large middle cerebral artery territory (MCA) infarct on follow-up CT. Chance-adjusted interobserver agreement (χ) for any early infarct was 0.27 (95 % confidence interval (CI): 0.15 to 0.39). Agreement (χ) on the extent of a middle cerebral artery (MCA) infarct and on the indication for treatment with recombinant tissue plasminogen activator (rt-PA) was fair: 0.37 and 0.35, respectively. Patients with early signs of an infarct of more than 1/3 of the MCA territory were more likely to have a large MCA infarct on follow-up CT (odds ratio 5.7, 95 % confidence interval 2.8-11.5); the positive and negative predictive value of these signs was 81 % and 57 %, respectively. Chance-adjusted interobserver agreement on early, subtle signs of a large MCA territory infarct on CT by neurologists was thus no

  9. Transient global amnesia associated with an acute infarction at the cingulate gyrus.

    Gallardo-Tur, Alejandro; Romero-Godoy, Jorge; de la Cruz Cosme, Carlos; Arboix, Adriá

    2014-01-01

    Background. Transient global amnesia (TGA) is a syndrome of sudden, unexplained isolated short-term memory loss. In the majority of TGA cases, no causes can be identified and neuroimaging, CSF studies and EEG are usually normal. We present a patient with TGA associated with a small acute infarct at the cingulate gyrus. Case Report. The patient, a 62 year-old man, developed two episodes of TGA. He had hypertension and hypercholesterolemia. He was found to have an acute ischemic stroke of small size (15 mm of maximal diameter) at the right cerebral cingulate gyrus diagnosed on brain magnetic resonance imaging. No lesions involving other limbic system structures such as thalamus, fornix, corpus callosum, or hippocampal structures were seen. The remainder of the examination was normal. Conclusion. Unilateral ischemic lesions of limbic system structures may result in TGA. We must bear in mind that TGA can be an associated clinical disorder of cingulate gyrus infarct. PMID:25126430

  10. Reduction of infarct volume by thrombolysis with rt-PA in an embolic rat stroke model

    Overgaard, K.; Sereghy, T.; Boysen, G.; Pedersen, H.; Diemer, Nils Henrik

    Rat, thrombolytic therapy, recombinant tissue plasminogen activator, acute ischaemic stroke, cerebral infarction and embolism, experimental thromboembolism, in vitro thrombotic clotting, cerebral ......Rat, thrombolytic therapy, recombinant tissue plasminogen activator, acute ischaemic stroke, cerebral infarction and embolism, experimental thromboembolism, in vitro thrombotic clotting, cerebral ...

  11. Curvilinear T1 hyperintense lesions representing cortical necrosis after cerebral infarction

    Kinoshita, Toshibumi; Tamura, Hajime; Kado, Hirotsugu; Okudera, Toshio [Research Institute of Brain and Blood Vessels-Akita, Department of Radiology, Akita (Japan); Ogawa, Toshihide [Tottori University, Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Yonago, Tottori (Japan); Yoshida, Yasuji [Research Institute of Brain and Blood Vessels-Akita, Department of Pathology, Akita (Japan)

    2005-09-01

    Curvilinear T1 hyperintense lesions in the cerebral cortex in patients with subacute infarction were investigated for: (1) the presence or absence of T2* hypointensity and (2) correlations with neuropathologic findings. Thirty-six consecutive patients with subacute to chronic embolic infarction, in whom curvilinear hyperintense lesions in the infarcted cortex were seen on T1-weighted images, underwent echo-planar gradient-echo (GRE-EPI) T2*-weighted imaging. GRE-EPI T2*-weighted imaging revealed no evidence of hemorrhage within the curvilinear T1 hyperintense lesions of the cerebral cortex in all of the patients. In 11 of the 36 patients, focal hypointense lesions were seen in the depth of infarcted gyri on GRE-EPI T2*-weighted images. In the remaining 25 patients, no T2* hypointensities were seen in the infarct zone. Pathological correlation was performed in a patient with middle cerebral artery infarction and curvilinear hyperintense lesions on postmortem T1-weighted images. In the autopsied brain, curvilinear T1 hyperintense lesions corresponded to necrosis of all the cortical layers on histological examination. These data suggest that curvilinear hyperintense lesions in the cerebral cortex on T1-weighted images during the subacute to chronic period of cerebral infarction may not represent hemorrhage. (orig.)

  12. Successful repair of a syphilitic aortic arch aneurysm accompanied by serious cerebral infarction.

    Sato, Katsutoshi; Chiba, Kiyoshi; Koizumi, Nobusato; Ogino, Hitoshi

    2014-01-01

    We present a 52-year-old male with a syphilitic aortic arch aneurysm accompanied by relevant extensive cerebral infarction. He was admitted to a local hospital for sudden loss of consciousness, where he was diagnosed with serious cerebral infarction. During his treatment, a multilocular aortic arch aneurysm involving the arch vessels was found incidentally. He was transferred to our hospital for surgical treatment. A preoperative routine laboratory test for syphilis was highly positive, which suggested that the aneurysm was likely caused by syphilis and the cerebral infarction was also induced by the involvement of syphilitic aortitis or arteritis. After 2 weeks of antibiotic therapy for syphilis, total arch replacement was performed successfully using meticulous brain protection with antegrade selective cerebral perfusion and deep hypothermia. He recovered without any further cerebral deficits. The pathological examination of the surgical specimen showed some characteristic changes of syphilitic aortitis. PMID:24492165

  13. Mild focal cerebral ischemia in the rat. The effect of local temperature on infarct size

    Hildebrandt-Eriksen, Elisabeth S; Christensen, Thomas; Diemer, Nils Henrik

    2002-01-01

    We aimed at investigating a new model of mild focal cerebral ischemia in rats with repeated, noninvasive magnetic resonance scanning combined with histology. Magnetic resonance imaging yielded information about infarct development enabling us to test the putative growth of the infarct over time. ...

  14. Significance of decreased serum interleukin-10 levels in the progression of cerebral infarction.

    Diao, Zeng-Yan; Wang, Cui-Lan; Qi, Hong-Shun; Jia, Guo-Yong; Yan, Chuan-Zhu

    2016-05-01

    Anti-inflammatory cytokine and its serological detection may have an important role in the process of cardiovascular and cerebrovascular diseases. We investigated whether serum interleukin-10 (IL-10) is associated with cerebral infarction or not in the general population. Identified comprehensive searching was performed covering PubMed, EMBASE, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine, and China National Knowledge Infrastructure databases. Two reviewers extracted data and assessed studies independently. Information was extracted separately and classed into Asians and Caucasians. Summary standardized mean differences (SMDs) with 95 % confidence intervals (CI) were used with the utilization of Z test. Nine studies ranged from 2003 to 2014 were collected for meta-analysis. Results identified a negative association between serum IL-10 levels and cerebral infarction (SMD = 1.80, 95 % CI 0.79-2.81, P cerebral infarction in India (SMD = 1.44, 95 % CI 1.13-1.75, P cerebral infarction in Asians (SMD = 2.52, 95 % CI 0.47-4.57, P = 0.016), while not in Caucasians (P > 0.05). The lower serum IL-10 concentration was significantly associated with an increased likelihood of cerebral infarction in this meta-analysis. More prospective studies should be conducted to provide stronger evidence justifying the use of IL-10 as new biomarker to identify a predisposition toward cerebral infarction. PMID:25847570

  15. Weather fronts and acute myocardial infarction

    Kveton, Vit

    1991-03-01

    Some methodological aspects are discussed of the investigation of acute infarct myocarditis (AIM) in relation to weather fronts. Results of a new method of analysis are given. Data were analysed from about the hour of the onset of symptoms, and led to the diagnosis of AIM either immediately or within a few hours or days (3019 cases observed over 4.5 years during 1982 1986 in Plzen, Czechoslovakia). Weather classification was based on three factors (the type of the foregoing front, the type of the subsequent front, the time section of the time interval demarcated by the passage of the surfaces of the fronts). AIM occurrence increased in particular types of weather fronts: (i) by 30% during 7 12 h after a warm front, if the time span between fronts exceeded 24 h; (ii) by 10% in time at least 36 h distant from the foregoing cold or occlusion front and from the succeeding warm or occlusion front; (iii) by 20% during 0 2 h before the passage of the front, provided the foregoing front was not warm and the interval between fronts exceeded 5 h. AIM occurrence decreased by 15% 20% for time span between fronts > 24 h at times 6 11, 6 23 and 6 35 h before a coming warm or occlusion front (for interfrontal intervals 25 48, 49 72 and possibly > 72 h), and also at 12 23 and possibly 12 35 h before a cold front (for intervals 49 72 and possibly > 72 h), if the foregoing front was cold or an occlusion front.

  16. Clinical Manifestation of Acute Myocardial Infarction in the Elderly

    Miftah Suryadipradja

    2003-12-01

    Full Text Available A retrospective study were performed in patients with acute myocardial infarction (AMI that hospitalized in ICCU Cipto Mangunkusumo hospital, Jakarta during the period of January 1994 until Decmber 1999. There were 513 patients hospitalized with MCI, 227 patients (44.2% were classified as elderly, and 35.2% of them were female. Most of the elderly AMI patients reported typical chest pain just like their younger counterparts. Elderly AMI patients tend to come later to the hospital, and more Q-wave myocardial infarction were identified compared to non- Q-wave myocardial infarction. Risk factors of diabetes mellitus and hypertension were more common among the elderly. The prevalence of atrial fibrillation and the mortality rate were higher among elderly AMI patients. (Med J Indones 2003; 12: 229-35 Keywords: clinical manifestation, acute myocardial infarction, elderly

  17. IDIOPATHIC OMENTAL INFARCTION : A RARE CAUSE OF ACUTE PAIN ABDOMEN

    Narendra Nath

    2015-02-01

    Full Text Available Omental torsion leading on to omental infarction is an unusual cause of acute abdominal pain in adults. Often the condition mimics common causes of acute abdomen like acute cholecystitis, acute appendicitis or acute pancreatitis. A review of literature reveals that this enigmatic condition has been managed both non - operatively and by surgery in the past. We report the case of a 46 - year - old man who presented with a 4 - day history of severe right - sided abdominal pain mimicking acute cholecystitis. Abdominal CT scan revealed a right upper quadrant mass with a whirl - like appearance, suspicious for omental infarction. He was started on conservative management with analgesics and antibiotics. He improved symptomatically and was discharged

  18. {sup 1}H and {sup 31}P-magnetic resonance spectroscopy of cerebral infarction in rats

    Yamamuro, Manabu; Katayama, Yasuo; Igarashi, Hironaka; Terashi, Akiro [Nippon Medical School, Tokyo (Japan)

    1997-04-01

    Magnetic resonance spectroscopy (MRS) allows the noninvasive study of metabolism in vivo. In order to further understand the time course of biochemical changes during cerebral infarction, we performed the MRS study with pathological analysis. The left middle cerebral artery (MCA) was occluded in spontaneously hypertensive male rats (SHR) by the method of Tamura et al. The spectra were obtained from the infarcted hemisphere by placing the surface coils over the left side of the calvarium. {sup 31}P and {sup 1}H-MRS were performed at 3 hours, 24 hours and 7 days after MCA occlusion. Ischemic lesions caused by the left MCA occlusion extended into the parietal lobe and caudate putamen. After 3 hours of ischemia, vacuolated neurophils and shrunken neurons were observed. At 24 hours, these changes were severe. After 7 days, infiltration of monocytes and capillary hyperplasia were seen, and neurons had disappeared. At the acute stage of ischemia the phosphocreatine/inorganic phosphate (PCr/Pi) peak ratio decreased. After 7 days of ischemia, these changes became obscure. The intracellular pH (pHi) decreased after 3 hours of ischemia and recovered almost to the control level at 24 hours post ischemia. Alkalosis was apparent 7 days after ischemia. This alkalosis might be due to increased permeability of the deteriorated blood brain barrier. Although the lactate level was high 24 hours post ischemia, the pHi was almost normal. The N-acetyl-aspartate/creatine ratio decreased significantly from the acute stage of stroke. This decrease correlated with pathological changes. The correlation of the magnetic resonance spectra with the histological results may open aspects for monitoring stroke therapy and a new approach to tissue characterization. (author)

  19. Thrombin Receptor and Ventricular Arrhythmias after Acute Myocardial Infarction

    Tang, Lilong; Deng, Chunyu; Long, Ming; Tang, Anli; Wu, Shulin; Dong, Yugang; Saravolatz, Louis D.; Gardin, Julius M.

    2008-01-01

    The mechanism mediating the development of ventricular arrhythmia (VA) after acute myocardial infarction (AMI) is still uncertain. Thrombin receptor (TR) activation has been proven to be arrhythmogenic in many other situations, and we hypothesize that it may participate in the genesis of post-AMI VA. Using a left coronary artery ligation rat model of AMI, we found that a local injection of hirudin into the left ventricle (LV) significantly reduced the ratio of VA durations to infarction sizin...

  20. Why people experiencing acute myocardial infarction delay seeking medical assistance

    Carney, R.; Fitzsimons, D; Dempster, Martin

    2002-01-01

    Background: Delay time from onset of symptoms of myocardial infarction to seeking medical assistance can have life- 31 threatening consequences. A number of factors have been associated with delay, but there is little evidence regarding the predictive 32 value of these indices. Aim: To explore potential predictors of patient delay from onset of symptoms to time medical assistance 33 was sought in a consecutive sample of patients admitted to CCU with acute myocardial infarction. Methods: The C...

  1. Polycythemia vera presenting as acute myocardial infarction: An unusual presentation

    Bahbahani, Hussain; Aljenaee, Khaled; Bella, Abdelhaleem

    2014-01-01

    Acute myocardial infarction (AMI) is usually seen in the setting of atherosclerosis and its associated risk factors. Myocardial infarction in the young poses a particular challenge, as the disease is less likely, due to atherosclerosis. We report the case of a 37-year-old female patient who presented with ST segment elevation anterolateral AMI. The only abnormality on routine blood investigation was raised hemoglobin and hematocrit. After further testing, she was diagnosed according to the Wo...

  2. Lessons from the management of acute myocardial infarction

    Pearson, M.

    2005-01-01

    The National Service Framework for coronary heart disease set a number of challenging targets for the care of patients following an acute myocardial infarction. The Myocardial Infarction National Audit Project (MINAP) was devised to monitor progress and has been notably successful in winning professional support and participation and helping trusts to meet these targets. The new challenge is in translating this success to other areas of medicine. Heart failure is one such area, although it po...

  3. Double heart rupture after acute myocardial infarction: A case report

    Ivanov Igor; Lovrenski Aleksandra; Dejanović Jadranka; Petrović Milovan; Jung Robert; Raffay Violetta

    2014-01-01

    Introduction. Double heart rupture is a rare complication of acute myocardial infarction with high mortality. Case report. We presented a 67-year-old female patient with symptoms and signs of myocardial infarction, diagnosed with echocardiography, rupture of the septum, the presence of a thrombus and a small pericardial effusion. Soon after admission the patient died. Autopsy revealed tamponade and double myocardial rupture, free wall rupture and ventricula...

  4. Helicobacter pylori seropositivity in subjects with acute myocardial infarction.

    Rathbone, B; Martin, D.; Stephens, J.; Thompson, J. R.; Samani, N.J.

    1996-01-01

    OBJECTIVE: To determine whether Helicobacter pylori infection increases the risk of myocardial infarction. DESIGN: Case-control study. SETTING: University teaching hospital. METHODS: Serological evidence of H pylori infection was determined in 342 consecutive patients with acute myocardial infarction admitted into the coronary care unit and in 236 population-based controls recruited from visitors to patients on medical and surgical wards. RESULTS: 206/342 (60.2%) of cases were H pylori positi...

  5. Triggering of acute myocardial infarction by different means of transportation

    Peters, Annette; Klot, Stephanie von; Mittleman, Murray A.; Meisinger, Christine; Hoermann, Allmut; Kuch, Bernhard; Wichmann, Heinz-Erich

    2013-01-01

    Background: Prior studies have reported an association between traffic-related air pollution in urban areas and exacerbation of cardiovascular disease. We assess here whether time spent in different modes of transportation can trigger the onset of acute myocardial infarction (AMI). Design: We performed a case-crossover study. We interviewed consecutive cases of AMI in the KORA Myocardial Infarction Registry in Augsburg, Southern Germany between February 1999 and December 2003 eliciting data o...

  6. Acute Myocardial Infarction in Puerperium Stage. A Case Presentation

    Teresa Oliva Rivero; Israel Sotolongo Castro; Maria Victoria Jó Díaz

    2007-01-01

    A 38 year-old hypertensive, smoker female patient was presented. She suferred from an acute myocardial infarction in the mediate puerperium stage of an normal deliver. She was assisted in the Heart intensive care unit taking into consideration the basic care principles for this kind of patient. The infarct was diagnosed due to the clinical picture, and the electrographic alterations as well as the enzimatic alterations. The case is presented because it is a low frequency complication and it i...

  7. Acute renal infarction resulting from fibromuscular dysplasia: a case report

    Saarinen, Harri Juhani; Palomäki, Ari

    2016-01-01

    Background Acute abdominal pain is one of the most frequent complaints evaluated at emergency departments. Approximately 25 % of abdominal pain patients discharged from emergency departments are diagnosed with undifferentiated abdominal pain. One possible reason for acute abdominal pain is renal infarction. Diagnosis is difficult and often late. Case presentation A white, 33-year-old, previously healthy Finnish man came to our emergency department because of acute abdominal pain. After evalua...

  8. Cerebral atrophy and subdural haemorrhage after cerebellar and cerebral infarcts in an 8-month-old child after having been stung by a scorpion

    Sığırcı, Ahmet; Öztürk, Mehmet; Yakıncı, Cengiz

    2014-01-01

    A scorpion sting causing cerebellar and cerebral infarctions with corpus callosum involvement and bilateral cerebral atrophy with subdural haemorrhage in an 8-month-old girl, has not been previously described to the best of our knowledge. PMID:24962491

  9. Tocilizumab inhibits neuronal cell apoptosis and activates STAT3 in cerebral infarction rat model

    Wang, Shaojun; Zhou, Jun; Kang, Weijie; Dong, Zhaoni; Wang, Hezuo

    2016-01-01

    Cerebral infarction is a severe hypoxic ischemic necrosis with accelerated neuronal cell apoptosis in the brain. As a monoclonal antibody against interleukin 6, tocilizumab (TCZ) is widely used in immune diseases, whose function in cerebral infarction has not been studied. This study aims to reveal the role of TCZ in regulating neuronal cell apoptosis in cerebral infarction. The cerebral infarction rat model was constructed by middle cerebral artery occlusion and treated with TCZ. Cell apoptosis in hippocampus and cortex of the brain was examined with TUNEL method. Rat neuronal cells cultured in oxygen-glucose deprivation (OGD) conditions and treated with TCZ were used to compare cell viability and apoptosis. Apoptosis-related factors including B-cell lymphoma extra large (Bcl-xL) and Caspase 3, as well as the phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in brain cortex were analyzed from the protein level. Results indicated that TCZ treatment could significantly prevent the promoted cell apoptosis caused by cerebral infarction or OGD (P < 0.05 or P < 0.01). In brain cortex of the rat model, TCZ up-regulated Bcl-xL and down-regulated Caspase 3, consistent with the inhibited cell apoptosis. It also promoted tyrosine 705 phosphorylation of STAT3, which might be the potential regulatory mechanism of TCZ in neuronal cells. This study provided evidence for the protective role of TCZ against neuronal cell apoptosis in cerebral infarction. Based on these fundamental data, TCZ is a promising option for treating cerebral infarction, but further investigations on related mechanisms are still necessary. PMID:26773188

  10. Headache: A Symptom of Acute Myocardial Infarction

    Yasmine Elgharably; Cesar Iliescu; Stefano Sdringola; Syed Wamique Yusuf

    2013-01-01

    ABSTRACT:We present a case of 55 year old man, with myocardial infarction and coronary thrombosis, whose initial presentation was with severe headache and review the literature.INTRODUCTION:Coronary ischemia typically presents with retrosternal pain that radiates to left arm (1). present atypically in various forms like indigestion (2), otalgia (3), facial pain (4) and syncope (5). Headache as the sole presentation of myocardial infarction (MI) is rare; however it has been reported previously...

  11. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  12. Study on the relationship between serum Hcy and plasma thromboxane B2(TXB2) levels in patients with cerebral infarction

    Objective: To study the relationship between changes of serum Hcy and plasma thromboxane (TXB2) levels in patients with cerebral infarction. Methods: Serum Hcy (with ELISA) and plasma TXB2 (with RIA) levels were measured in 34 patients with cerebral infarction and 35 controls. Results: Levels of serum Hcy and plasma TXB2 were significantly higher in the patients than those in controls (P2 levels were highly correlated in patients with cerebral infarction. (authors)

  13. The Factors Influencing the Cognitive Disorder of the Patients with Cerebral Infarction%脑梗死病人认知障碍影响因素的探讨

    毛海燕; 孙雪梅

    2001-01-01

    为探讨脑梗死病人认知功能障碍的影响因素。选择100例急性脑梗死病人,对其认知能力采用四项智能量表测量,并进行分析。结果①急性脑梗死后认知障碍的发生率为52.0%,随年龄的增长呈正相关;②脑皮质梗死易导致认知障碍,与脑皮质下梗死比较,差异有极显著性意义(P<0.01);③急性脑梗死后认知障碍的发生与文化水平、脑梗死次数、语言障碍及运动功能障碍有密切关系。提示早期对脑梗死所引起的认知障碍作出判断,给予及时有效的治疗和训练,可减缓认知障碍的发展,对提高病人的生存质量具有重要意义。%In order to investigate the factors influencing the cognitive function dissonance of the patients with cerebral infarction, the cognitive ability in 100 cases of acute cerebral infarction was measured by using four list intelligent scales and the factors influencing cognitive dissonance analyzed. The results showed that: ①The incidence of the cognitive dissonance following acute cerebral infarction was 52.0 % and was positively correlated with age of the patients; ②The infarction of the cerebral cortex could easily induce cognitive dissonance with the difference as compared with subcortical infarction being very significant (P<0.01); ③The occurrence of cognitive dissonance following acute cerebral infarction was closely correlated with educational level, the times of cerebral infarction, language disturbance and movement function disturbance. It was suggested that early judgment of cognitive dissonance following cerebral infarction could effectively prevent the development of cognitive dissonance and might play an important role in raising the quality of living of the patients.

  14. Justification for intravenous magnesium therapy in acute myocardial infarction

    Rasmussen, H S

    1988-01-01

    Recent studies have shown that patients with acute myocardial infarction (AMI) are magnesium-deficient and develop an additional transient decrease in serum magnesium concentrations (S-Mg c) during the acute phase of the infarct. Animal experiments, as well as studies on humans, have indicated...... that the acute decrease in S-Mg c as well as a more chronic magnesium (Mg) deficiency state are harmful to the myocardium in the setting of acute ischaemia. This knowledge has led during the last couple of years to the performance of four double-blind placebo controlled studies in which the effect of i.......v. magnesium therapy on mortality and incidence of arrhythmias in patients with AMI has been evaluated. Magnesium treatment more than halved the acute mortality and incidence of arrhythmias requiring treatment in three of the four intervention studies. The mechanisms behind the beneficial effect of magnesium...

  15. Focal cerebral hyperemia in acute stroke. Incidence, pathophysiology and clinical significance

    Olsen, T S; Larsen, B; Skriver, E B; Herning, M; Enevoldsen, E; Lassen, N A

    1981-01-01

    method and a 254 multi-detector camera. CT scan was done 24 hours after the rCBF study. Focal cerebral hyperemia was found in 16 patients. The study revealed 3 different types of hyperemia: Border-zone hyperemia, surrounding ischemic areas, was seen in patients with occluded arteries on angiography......, presumably resulting from accumulation of acid metabolites in the border-zone of acute infarcts. Postischemic hyperemia was seen in patients without occlusion, presumably due to recanalization of a prior occluded artery. Remote hyperemia was found distant from the infarcted area, presumably due to local...

  16. Environmental temperature and mortality from acute myocardial infarction

    Mannino, Joseph A.; Washburn, Richard A.

    1989-03-01

    Mortality from acute myocardial infarction (MI) over the 5 year period 1982 1987 in Brown County, Wisconsin, was analyzed to assess the relationship with environmental temperature. Deaths occurrring on the day of and the day following a significant snowfall as well as deaths occuring in health care facilities were eliminated from consideration because the focus was upon temperature, not snowfall or events within a hospital. These criteria resulted in the inclusion of 1,802 days and 926 cases of acute MI. The mean temperature on the day of death was obtained from climatological data and were grouped into six categories covering a range of temperatures frommyocardial infarction.

  17. SIGNIFICANCE OF LIPID PROFILE ESTIMATION IN PATIENT WITH ACUTE MYOCARDIAL INFARCTION

    Santhosh Kumar N; Mohammad Anwar; Balu Mahendran.K; Kalaivanam. K N

    2013-01-01

    Acute myocardial infarction is one of the important reasons of death and unhealthiness in the world. The present study was undertaken to investigate the changes in serum lipids and lipoproteins in patients with acute myocardial infarction. The levels of lipid profile were significantly changed in the acute myocardial infarction patients. Acute myocardial infarction patients had significantly higher levels of total cholesterol, LDL-cholesterol, TG, Lipoprotein and lower level of HDL-cholestero...

  18. The CT manifestations and clinical analysis of traumatic cerebral infarction in children

    Objective: To evaluate pathogenesis, CT manifestations, diagnosis and treatment, and prognosis of traumatic cerebral infarction in children. Methods: Axial head CT scanning was performed in 35 cases, meanwhile the treatment included vessel dilatation, anti-spasm, nerve nourishment and anti-coagulation. Results: The traumatic cerebral infarction in children was commonly located in the basal ganglia. CT scan revealed low dense lesions in all cases. 33 patients out of 35 convalesced gradually, when no anomaly was shown on CT. The rest 2 patients improved, whose lesions decreased in size on CT images. Conclusion: The major pathophysiology of traumatic cerebral infarction in children is occlusion of cerebral microcirculation and convulsion of vein after trauma. CT scan and follow-up are of great value in monitoring the damages. Early diagnosis and treatment result in good prognosis

  19. Memory strategy training in children with cerebral infarcts related to sickle cell disease.

    Yerys, Benjamin E; White, Desirée A; Salorio, Cynthia F; McKinstry, Robert; Moinuddin, Asif; DeBaun, Michael

    2003-06-01

    Cerebral infarcts occur in approximately 30% of children with sickle cell disease (SCD), but little information exists regarding remediation of associated cognitive deficits. The authors examined the benefits of training children with infarcts to use memory strategies. Six children with SCD-related infarcts received academic tutoring; three of these children received additional training in memory strategies (silent rehearsal to facilitate short-term memory and semantic organization to facilitate long-term memory). The performance of children receiving strategy training appeared to improve more than that of children receiving only tutoring. Memory in children with SCD-related infarcts may be enhanced through strategy training. PMID:12794531

  20. 脑梗死合并糖尿病对患者神经功能的影响%Impact of cerebral infarction complicated by diabetes on neurological function

    江先娣; 冼明健

    2002-01-01

    Background:Diabetes is a factor resulting cerebral infarction.Neurological injury in patients suffered from cerebral infarction complicated with diabetes is more common and severe than that in patients with cerebral infarction alone.From December 1990 to Octomber 2001,144 patients with CT proved cerebral infarction were surveyed including 28 patients suffered from cerebral infarction complicated with diabetes and 116 patients with cerebral infarction alone.Here is the report.

  1. Acute myocardial infarction in a young patient

    Myocardial infarction (MI) is considered to be the disease of the fifth and sixth decade as seen in the West but an earlier age incidence is not infrequently encountered in the South Asian population. However, occurrence of MI in the teen-age still remains a rare happening. We are reporting a case of a teenager, who suffered a myocardial infarction with cardiogenic shock and pulmonary edema on two separate occasions with ECG and biochemical evidence of myocardial infarction. An exercise stress test done in between the two episodes was negative at a workload of 13.5 METs. A coronary angiogram done after the second event revealed normal coronary arteries and a preserved left ventricular systolic and segmental function. Except for low HDL (high density lipoprotein) and mildly raised homocysteine levels, the patient did not have other conventional or novel risk factors for coronary artery disease. (author)

  2. 糖尿病合并脑梗死患者急性期血糖控制水平与神经功能缺损评分的相关分析%The clinical analysis of blood sugar control and NIHSS in acute stage of cerebral infarction with diabetes

    姚汉玲; 李竞

    2011-01-01

    Objective To investigate the relationship between the level of blood sugar and NIHSS in acute stage of cerebral infarction with diabetes.Methods Retrospective analysis 97 cases with cerebral infarction combined with diabetes.According to the situation of blood sugar control from 1 to 7 days after cerebral infarction attack, the cases were divided into normal group, high blood sugar group 1 and high blood sugar group 2.The NIHSS scoring were defined at the time points of attack and 2 weeks, and compared the prognosis among groups.Results The NIHSS scoring was not shown difference among 3 groups at the time point of attack( P > 0.05 ).There was no significant difference of NIHSS scoring between the level of blood sugar was less than 6.1 mmol/L and 6.1 ~ 8.4 mmol/L( P > 0.05 ), and the therapeutic effect was better in former group than latter group.There were significant difference between normal, high blood sugar group 1 and high blood sugar group 2( P < 0.01 ).Conclusion It suggested that the blood sugar should be controlled within 8.4 mmol/L in acute stage of cerebral infarction with diabetes, the prognosis would be worse once the blood sugar over 8.4 mmol/L.%目的 探讨糖尿病合并脑梗死患者急性期血糖控制水平与神经功能缺损评分的关系.方法 对97例糖尿病脑梗死患者资料进行回顾性分析,根据发病后1~7 d空腹血糖控制情况将患者分成3组:血糖控制正常组(I组),高血糖1组(II组),高血糖2组(III组),入院时及治疗2周后均行NIHSS评分,观察了解患者预后.结果 3组患者入院时NIHSS评分无差异(P>0.05),治疗后当急性期空腹血糖水平在6.1 mmol/L以内时,其NIHSS评分与空腹血糖水平在6.1~8.4 mmol/L时,无显著性差异(P>0.05),治疗有效率前者较后者高,二者均与空腹血糖平均水平控制8.4 mmol/L以上组有显著性差异(P<0.01).结论 糖尿病脑梗死患者急性期应积极将血糖控制在8.4 mmol/L以内,预后尚可,大于8

  3. Electrocardiographic localization of infarct related coronary artery in acute ST elevation myocardial infarction

    C.S. Thejanandan Reddy

    2013-07-01

    Full Text Available The electrocardiogram (ECG remains a crucial tool in the identification and management of acute myocardial infarction (MI. A detailed analysis of patterns of ST-segment elevation may influence decisions regarding the use of reperfusion therapy. The early and accurate identification of the infarct-related artery on the ECG can help predict the amount of myocardium at risk and guide decisions regarding the urgency of revascularization. The specificity of the ECG in acute MI is limited by individual variations in coronary anatomy as well as by the presence of preexisting coronary artery disease, particularly in patients with a previous MI, collateral circulation, or previous coronary-artery bypass surgery. The ECG is also limited by its inadequate representation of the posterior, lateral, and apical walls of the left ventricle. Despite these limitations, the electrocardiogram can help in identifying proximal occlusion of the coronary arteries, which results in the most extensive and most severe myocardial infarctions.

  4. New role of MR imaging in the acute stage of brain infarction

    Okumura, Ayumi; Nakagawa, Masanori; Furuichi, Masahiro; Nishimura, Yasuaki; Sakai, Noboru [Gifu Univ. (Japan). School of Medicine; Araki, Yuzo

    2000-12-01

    The purpose of this study was to evaluate the clinical utility of 3D-Contrast MR Angiography (MRA) with an automated bolus-detection algorithm (SmartPrep) in combination with diffusion-weighted imaging (DWI) and perfusion imaging (PI) of acute cerebral infarctions. Thirty-nine patients with brain attack were imaged with 3D-Contrast MRA, DWI and PI in the acute stage. For 3D-Contrast MRA, tracker volume was placed in the upper aorta. After bolus injection of gadolinium, an increase in signal that corresponded to the arrival of gadolinium was used to trigger centric reordered spoiled gradient echo arterial selective MRA. This technique provided images of craniocervical arteries from the aortic arch to the circle of Willis, similar to those obtained with conventional angiography. Furthermore, with this technique, it was possible to evaluate briefly the collateral pathway in a large field of view. This technique, in combination with DWI and PI, was useful in evaluating hemodynamics of acute cerebral infarction and in classifying the subtype of brain attack in relation to the treatment. (author)

  5. The TRIF-dependent signaling pathway is not required for acute cerebral ischemia/reperfusion injury in mice

    TIR domain-containing adaptor protein (TRIF) is an adaptor protein in Toll-like receptor (TLR) signaling pathways. Activation of TRIF leads to the activation of interferon regulatory factor 3 (IRF3) and nuclear factor kappa B (NF-κB). While studies have shown that TLRs are implicated in cerebral ischemia/reperfusion (I/R) injury and in neuroprotection against ischemia afforded by preconditioning, little is known about TRIF's role in the pathological process following cerebral I/R. The present study investigated the role that TRIF may play in acute cerebral I/R injury. In a mouse model of cerebral I/R induced by transient middle cerebral artery occlusion, we examined the activation of NF-κB and IRF3 signaling in ischemic cerebral tissue using ELISA and Western blots. Neurological function and cerebral infarct size were also evaluated 24 h after cerebral I/R. NF-κB activity and phosphorylation of the inhibitor of kappa B (IκBα) increased in ischemic brains, but IRF3, inhibitor of κB kinase complex-ε (IKKε), and TANK-binding kinase1 (TBK1) were not activated after cerebral I/R in wild-type (WT) mice. Interestingly, TRIF deficit did not inhibit NF-κB activity or p-IκBα induced by cerebral I/R. Moreover, although cerebral I/R induced neurological and functional impairments and brain infarction in WT mice, the deficits were not improved and brain infarct size was not reduced in TRIF knockout mice compared to WT mice. Our results demonstrate that the TRIF-dependent signaling pathway is not required for the activation of NF-κB signaling and brain injury after acute cerebral I/R.

  6. The TRIF-dependent signaling pathway is not required for acute cerebral ischemia/reperfusion injury in mice

    Hua, Fang, E-mail: fhua2@emory.edu [Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, 1365B Clifton Road, Suite 5100, Atlanta, GA 30322 (United States); Wang, Jun; Sayeed, Iqbal; Ishrat, Tauheed; Atif, Fahim; Stein, Donald G. [Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, 1365B Clifton Road, Suite 5100, Atlanta, GA 30322 (United States)

    2009-12-18

    TIR domain-containing adaptor protein (TRIF) is an adaptor protein in Toll-like receptor (TLR) signaling pathways. Activation of TRIF leads to the activation of interferon regulatory factor 3 (IRF3) and nuclear factor kappa B (NF-{kappa}B). While studies have shown that TLRs are implicated in cerebral ischemia/reperfusion (I/R) injury and in neuroprotection against ischemia afforded by preconditioning, little is known about TRIF's role in the pathological process following cerebral I/R. The present study investigated the role that TRIF may play in acute cerebral I/R injury. In a mouse model of cerebral I/R induced by transient middle cerebral artery occlusion, we examined the activation of NF-{kappa}B and IRF3 signaling in ischemic cerebral tissue using ELISA and Western blots. Neurological function and cerebral infarct size were also evaluated 24 h after cerebral I/R. NF-{kappa}B activity and phosphorylation of the inhibitor of kappa B (I{kappa}B{alpha}) increased in ischemic brains, but IRF3, inhibitor of {kappa}B kinase complex-{epsilon} (IKK{epsilon}), and TANK-binding kinase1 (TBK1) were not activated after cerebral I/R in wild-type (WT) mice. Interestingly, TRIF deficit did not inhibit NF-{kappa}B activity or p-I{kappa}B{alpha} induced by cerebral I/R. Moreover, although cerebral I/R induced neurological and functional impairments and brain infarction in WT mice, the deficits were not improved and brain infarct size was not reduced in TRIF knockout mice compared to WT mice. Our results demonstrate that the TRIF-dependent signaling pathway is not required for the activation of NF-{kappa}B signaling and brain injury after acute cerebral I/R.

  7. Effect of intravascular irradiation of He-Ne laser on cerebral infarction: Hemorrheology and apoptosis

    Zhu, Jian; Liang, Min-yi; Cao, Hao-cai; Li, Xiao-Yuan; Li, Shao-ming; Li, Shun-hao; Li, Wen-qi; Zhang, Jin-hong; Liu, Lei; Lai, Jian-hong

    2005-07-01

    Objective: To explore the efficacy of He-Ne laser intravascular irradiation on infarction and hemorrheology. To observe the effects of intravascular low level He-Ne laser irradiation (ILLLI) of blood on cell proliferation, apoptosis and chromosome in lymphocyte from cerebral infarction Methods: Seventy cases with cerebral infarction were randomly divided into groups control group (35 cases) treated only with common drugs and therapeutic group (35 cases) treated besides common drugs also by He-Ne laser intravascular irradiation. Their hemorrheology index and treatment results were observed and compared. The blood lymphocytes of cerebral infarction were cultured before and after treatment. After that, the mitosis index (MI), cell kinetics index (CKI), sister-chromatid exchanges (SCE) frequencies and apoptosis were determined. Results The therapeutic group was better than the control one. The effective rate in the therapeutic group was 88.6%, in the control one was 65.7%. The viscosity and fibrinogen, etc were better than that in the control group with significant difference (P0.05) in cerebral infarction patients after treatment; The CKI of lymphocytes had no obvious difference among groups (P>0.05) SCE frequencies of lymphocytes had no statistic significance between control group and ILLLI on (P>0.05). It showed the apoptosis rate of lymphocytes in cerebral infarction patients after ILLLI treatment increased significantly compared with the control group, (Pcerebral infarction patients than the control (Pcerebral infarction, the low level He-Ne by ILLLI can increase the proliferation of lymphocytes, and can induce lymphocytes to apoptosis, but has no mutagenicity of cells.

  8. Effective strategy for improving health care outcomes: Multidisciplinary care in cerebral infarction patients.

    Han, Kyu-Tae; Park, Eun-Cheol; Kim, Sun Jung; Kim, Woorim; Hahm, Myung-Il; Jang, Sung-In; Lee, Sang Gyu

    2015-08-01

    Multidisciplinary teams provide effective patient treatment strategies. South Korea expanded its health program recently to include multidisciplinary treatment. This study characterized the relationship between multidisciplinary care and mortality within 30 days after hospitalization in cerebral infarction patients. We used the National Health Insurance claim data (n = 63,895) from 120 hospitals during 2010-2013 to analyze readmission within 30 days after hospitalization for cerebral infarction. We performed χ(2) tests, analysis of variance and multilevel modeling to investigate the associations between multidisciplinary care and death within 30 days after hospitalization for stroke. Deaths within 30 days of hospitalization due to cerebral infarction was 3.0% (n = 1898/63,895). Multidisciplinary care was associated with lower risk of death within 30 days in inpatients with cerebral infarction (odds ratio: 0.84, 95% confidence interval: 0.72-0.99). Patients treated by a greater number of specialists had lower risk of death within 30 days of hospitalization. Additional analyses showed that such associations varied by the combination of specialists (i.e., neurologist and neurosurgeon). In conclusion, death rates within 30 days of hospitalization for cerebral infarction were lower in hospitals with multidisciplinary care. Our findings certainly suggest that a high number of both neurosurgeon and neurologist is not always an effective alternative in managing stroke inpatients, and emphasize the importance of an optimal combination in the same number of hospital staffing. PMID:26169372

  9. CLINICAL PROFILE OF ACUTE MYOCARDIAL INFARCTION YOUNG ADULTS

    Patel G. N; Khandeparkar; Kotha; Cacodcar

    2015-01-01

    BACKGROUND : Although acute myocardial infarction was believed to be an uncommon entity in the young, of late there has been a rising incidence in this group of population. The analysis of its clinical profile, including the etiologic and the risk factors gains much importance, for the preventive purpose. AIMS AND OBJECTIVES: To study the clinical profile of acute MI, including the evaluation of the cardiac enzyme markers, the risk factors, the management and ...

  10. The Probable Role of Cytomegalovirus in Acute Myocardial Infarction

    Morteza Izadi; Mohammad Mahdi Zamani; Nastaran Sabetkish; Hassan Abolhassani; Seyed Hassan Saadat; Saeed Taheri; Hossein Dabiri

    2014-01-01

    Background: Coronary artery disease (CAD) is the most common cause of death worldwide and many studies have been performed on reduction of its prevalence. Objectives: This case control study was designed to investigate the presence of Cytomegaloviruses, Chlamydia pneumoniae and Helicobacter pylori in atherosclerotic plaques of cadaveric coronary endothelium of patients with and without acute myocardial infarction. Patients and Methods: Sixty cadavers in two equal groups were analyzed. Acute m...

  11. 急性脑梗死患者血清 PD-ECGF和 VEGF 的动态变化%Dynamic changes of platelet derived endothelial cell growth factor and vascular endothelial growth factor in the serum of patients with acute cerebral infarction

    张晓玲; 钱淑霞; 官俏兵; 杜瑛媛; 翟丽萍; 王琰萍; 俞晓翔

    2013-01-01

    Objective To investigate the dynamic changes of platelet derived endothelial cel growth factor (PD-ECGF) and vascular endothelial growth factor (VEGF) in the serum of patients with acute cerebral infarction (ACI). Methods Thirty four patients with acute cerebral infarction and 30 healthy subjects (control group)were enrol ed in the study. The PD-ECGF and VEGF levels were detected by ELISA in patients on d1, d3, d7 and d14 after infarction as wel as in healthy controls. According to the size of lesions the patients were classified as large lesion group (n=10), middle lesion group (n=13) and smal lesion group (n=11); according to the etiology patients were classified as large-artery atherosclerosis group (LAA, n=15), smal -artery occlu-sion (SAO, n=10) group and cardioembolism (CE, n=9) group. Then the correlation between serum PD-ECGF,VEGF levels and infarct size, etiology were analyzed. Results Serum PD-ECGF and VEGF levels were significantly increased in patients with ACI at al time points compared with healthy controls (P<0.05). The levels of PD-ECGF in serum reached peak value after 3d, and VEGF reached peak value after 7d, and they remained high levels at d14 after stroke. PD-ECGF and VEGF showed dramatic in-crease in serum of large lesion group and LAA group (P<0.05). Conclusion The contents of serum PD-ECGF and VEGF in-crease dramatically in patients with acute cerebral infarction, and have correlation with infarct volume and etiology. The results in-dicate that PD-ECGF and VEGF may be involved in the pathophysiology of acute cerebral infarction.%  目的探讨急性脑梗死患者血清血小板衍生内皮细胞生长因子(PD-ECGF)和血管内皮细胞生长因子(VEGF)的动态变化并分析与梗死灶大小、梗死病因类型的相关性.方法采用双抗体夹心酶联免疫吸附法(ELISA)动态测定34例急性脑梗死患者在发病后第1、3、7、14天时血清 PD-ECGF 和 VEGF 的浓度,对照组为30例本院健康体检者.

  12. Thrombolytic therapy preserves vagal activity early after acute myocardial infarction

    Lind, P; Hintze, U; Møller, M;

    2001-01-01

    OBJECTIVE: The purpose of this study was to evaluate the effects of thrombolytic therapy on vagal tone after acute myocardial infarction (AMI). DESIGN: Holter monitoring for 24 h was performed at hospital discharge and 6 weeks after AMI in 74 consecutive male survivors of a first AMI, who fulfilled...

  13. Depressed natural killer cell activity in acute myocardial infarction

    Klarlund, K; Pedersen, B K; Theander, T G;

    1987-01-01

    Natural killer (NK) cell activity against K562 target cells was measured in patients within 24 h of acute myocardial infarction (AMI) and regularly thereafter for 6 weeks. NK cell activity was suppressed on days 1, 3, and 7 (P less than 0.01), day 14 (P less than 0.05) and at 6 weeks (P = 0...

  14. Surgical outcome after decompressive craniectomy in patients with extensive cerebral infarction

    Extensive cerebral hemispheric infarction is a devastating condition leading to early death in nearly 80% of cases due to the rapid rise of intracranial pressure in spite of maximum medical treatment for brain edema and swelling. Recently, decompressive craniectomy has been reevaluated to prevent the brain herniation caused by extensive hemispheric cerebral infarction. We studied the surgical results after decompressive craniectomy for extensive cerebral infarction. Between December 1997 and August 2006, 13 consecutive patients (7 males and 6 females aged from 39 to 73 with a mean age of 59 years) with massive cerebral infarction of internal carotid (IC) (11 patients) and middle cerebral artery (MCA) (2 patients) territory were treated with decompressive craniectomy and dural plasty. Five patients had a left-sided stroke with severe aphasia. The cardioembolic source of stroke was seen in 5 patients. Surgery was performed at the point of neurological deterioration, anisocoria, and effacement of perimesencephalic cistern on CT findings. The mean time between stroke onset and surgery was 39.8 hr and ranged from 13 to 102 hr. Glasgow outcome scale (GOS) on discharge was moderately disabled (MD) 1, severe disabled (SD) 5, vegetative state (VS) 1, and dead (D) 3 (mortality rate 30.8%). Severe pneumoniae were the causes of death. All survivors underwent cranioplasty and were transferred with the aim of rehabilitation. In this study, we showed that the decompressive craniectomy reduced mortality after extensive cerebral infarction. However, the functional outcome and level of independence are poor. It seems that the early decompressive craniectomy should be aggressively performed for extensive cerebral infarction before neurological deterioration such as worsening of consciousness disturbance or pupil abnormalities. Further investigations will be needed to clarify the surgical indications, timing, and functional outcomes. (author)

  15. Acute myocardial infarction mortality in Cuba, 1999-2008

    Nurys B. Armas

    2012-10-01

    Full Text Available INTRODUCTION: Acute myocardial infarction is one of the leading causes of death in the world. This is also true in Cuba, where no national-level epidemiologic studies of related mortality have been published in recent years. OBJECTIVE Describe acute myocardial infarction mortality in Cuba from 1999 through 2008. METHODS A descriptive study was conducted of persons aged >25 years with a diagnosis of acute myocardial infarction from 1999 through 2008. Data were obtained from the Ministry of Public Health's National Statistics Division database for variables: age; sex; site (out of hospital, in hospital or in hospital emergency room and location (jurisdiction of death. Proportions, age- and sex-specific rates and age-standardized overall rates per 100,000 population were calculated and compared over time, using the two five-year time frames within the study period. RESULTS A total of 145,808 persons who had suffered acute myocardial infarction were recorded, 75,512 of whom died, for a case-fatality rate of 51.8% (55.1% in 1999-2003 and 49.7% in 2004-2008. In the first five-year period, mortality was 98.9 per 100,000 population, falling to 81.8 per 100,000 in the second; most affected were people aged >75 years and men. Of Cuba's 14 provinces and special municipality, Havana, Havana City and Camagüey provinces, and the Isle of Youth Special Municipality showed the highest mortality; Holguín, Ciego de Ávila and Granma provinces the lowest. Out-of-hospital deaths accounted for the greatest proportion of deaths in both five-year periods (54.8% and 59.2% in 1999-2003 and 2004-2008, respectively. CONCLUSIONS Although risk of death from acute myocardial infarction decreased through the study period, it remains a major health problem in Cuba. A national acute myocardial infarction case registry is needed. Also required is further research to help elucidate possible causes of Cuba's high acute myocardial infarction mortality: cardiovascular risk studies

  16. [Real world study of Dengzhan xixin injection in treatment of cerebral infarction with medication].

    Li, Yuan-Yuan; Cheng, Hao; Xie, Yan-Ming

    2014-09-01

    To analysis of Dengzhan Xixin injection (DZI) in treatment of cerebral infarction (EBHM) in the real world population characteristics and concomitant medication. By selecting the 20 hospital information system (HIS) used in the database of DZI and primary diagnosis of 2 484 cases of cerebral infarction patients information, use the Apriori algorithm to construct the model, using Clementine 12.0 analysis, cerebral infarction complicating diseases, commonly used drug combination analysis of DZI. The results showed that patients with more males than females (1.63: 1); age > 46 in older persons, treatment 7-14 days accounted for the majority of patients with hypertension, cerebral infarction, diabetes, coronary heart disease and other diseases; common drug combination can be divided into seven categories: medicine of antiplatelet therapy (aspirin, clopidogrel hydrogen), hypolipidemic drugs (atorvastatin, probucol), calcium channel blockers (cinepazide), cerebral protection drugs (laci staw), to improve cerebral circulation drugs (alprostadil), other traditional Chinese medicine injection (Shuxuetong injection, Xueshuantong), treatment with underlying disease: nifedipine, metoprolol, isosorbide dinitrate etc. The clinical cure rate and improvement rate of 97.60%. The next step needs to be combined with clinical practice, carry out analysis of effectiveness and safety of the combination scheme, and provide reference for clinical rational drug use. PMID:25532393

  17. Risk factors and biochemical indicators of cerebral infarction%脑梗死危险因素及生化特征分析

    吴金飞; 陈传琳; 曾素琴; 熊宁

    2014-01-01

    Objective To explore risk factors ,biochemical indicators of cerebral infarction .Methods A retrospective analy-sis including 165 patients with cerebral infarction divided into acute group and non-acute group and 66 control subjects were carried out.The descriptive statistics,t test were used in the study of biochemical indicators of cerebral infarction ,logistic regression analysis were used in the study for comparing the risk factors .Results According to the results of single-factor logistic regression analysis ,sex, age,smoking history,hypertension history,diabetes were closely correlated with the occurrence of cerebral infarction (P<0.05).Ac-cording to the results of t test ,the WBC of patients with cerebral infarction in acute group was significant higher than WBC of patients in non-acute group and control group (P<0.05).The percentage of GRAN,and levels of CRP,LPA,TC,LDL-C and GLU of patients with cerebral infarction were significant higher than that of patients in the control group (P<0.05).Conclusion Abnormal blood lipids, increased blood glucose level ,increased blood pressure and the smoking were confirmed risk factors of cerebral infarction ,the inflamma-tory reaction during initial stage of cerebral infarction ,reasonable diet ,healthy life style as well as the good management of the underly-ing disease were significant measures for prevention of cerebral infarction .On the early stage of cerebral infarction should inhibit the in-flammatory reaction .%目的:探讨脑梗死发病的危险因素及生化指标特征。方法采用回顾性调查方法,将调查对象分为脑梗死组(165例)与对照组(66例),通过Logistic回归分析、t检验方法对数据进行处理。结果单因素Logistic回归分析中,年龄、吸烟史、高血压史、糖尿病史与脑梗死发病密切相关(P<0.05);组间比较t检验分析中,急性期脑梗死组白细胞计数高于非急性期组对照组(P<0.05

  18. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy resulting in stroke in an 11-year-old male

    Granild-Jensen, Jakob; Jensen, Uffe Birk; Schwartz, Marianne;

    2009-01-01

    . The patient suffered from common migraine with five to six attacks per month for 3 years 6 months before the stroke. Attacks occurred early in the morning with severe one-sided headache, photophobia, nausea, and vomiting. Antimigraine medications had no effect. The family history revealed more cases......Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is caused by mutations in the Notch3 gene on chromosome 19. The condition manifests itself clinically typically in the third to fifth decade with migraine and recurrent episodes of stroke or...... transient ischaemic attacks. We report the case of an 11-year-old male with CADASIL resulting in stroke with right hemiparesis and dysphasia. Acute magnetic resonance imaging suggested infarction in the left hemisphere; magnetic resonance angiography revealed calibre variation of the intracerebral arteries...

  19. Acute myocardial infarction: Can it be a complication of acute organophosphorus compound poisoning?

    Joshi, P.; P Manoria; Joseph, D., T.; Z Gandhi

    2013-01-01

    Organophosphorus compounds are used as pesticides and represent a common cause of poisoning in developing countries including India due to their widespread availability and use. Toxicity due to these agents can affect many organs including heart. Here, we report a case of acute organophosphorus poisoning (parathion), followed by acute myocardial infarction; documented by clinical features, electrocardiographic changes, and elevated cardiac enzymes. Myocardial infarction has been rarely report...

  20. Acute subdural hematoma secondary to cerebral venous sinus thrombosis: Case report and review of literature

    Bansal, Hanish; Chaudhary, Ashwani; Mahajan, Anuj; Paul, Birinder

    2016-01-01

    Cerebral venous sinus thrombosis is a rare type of stroke primarily affecting young women. Diagnosis is generally delayed or overlooked due to a wide spectrum of clinical symptoms. Subdural hematoma secondary to cerebral venous sinus thrombosis is very rare. We report a case of 40-year-old female with cerebral venous sinus thrombosis who presented to us with an acute subdural hematoma and subarachnoid hemorrhage besides venous infarct. Management of such patients is complicated due to the rarity of the condition and contraindication for the use of anticoagulation. We conducted a thorough literature search through PubMed and could find only nine cases of spontaneous subdural hematoma secondary to cerebral venous sinus thrombosis. PMID:27057237

  1. CT evaluation of late cerebral infarction after operation for ruptured cerebral aneurysm

    The cause of cerebral vasospasm after aneurysmal SAH is multifactorial and remains still unresolved. We clarified delayed low density areas (LDA) on CT after aneurysmal SAH surgery and analyzed different patterns of delayed LDA on CT. We studied 177 out of 251 consecutive patients with aneurysmal SAH and analyzed different patterns of late LDA after surgery on CT. Late LDAs were demonstrated in 28 patients (28/177 = 15.8 %). The types of late LDAs on CT after SAH were divided into five patterns. Single lesions (18/28 = 64.3 %) were significantly frequently observed: single cortical, 11/28 = 39.3 % single deep, 7/28 = 25.0 %; multiple cortical, 4/28= 14.3 %; multiple deep, 2/28 = 7.1 %; and multiple combined (cortical + deep), 4/28 = 14.3 %. According to Fisher's CT classification, group 2 was observed in 6 patients (6/28 = 21.4 % and group 3 in 22 (22/28 = 78.6 %). Delayed LDA on CT images, suggesting late vasospasm showed various patterns of cerebral infarction. Therefore, there may be several pathways for the development of vasospasm. (author)

  2. Correlations of cerebral blood flow with language function in aphasic patients following cerebral infarction

    To elucidate the participation of the brain regions in language function, cerebral blood flow (CBF) which were measured with positron emission tomography (PET) were compared with the language scores based on the standard language test for aphasics in 97 right-handed patients with aphasia due to cerebral infarction. PET studies were performed on 71.4±107.3 days after onset. By the linear regression analysis, the aphasic scores were correlated with the regional CBF from 55 brain regions. CBF from the left frontal, left temporal, and left parietal lobes significantly correlated with language scores of auditory comprehension, speaking, reading, writing, calculation, and repetition. Highly significant correlation was obtained from the left posterior inferior frontal, superior temporal, supramarginal and angular gyri. CBF from the right inferior frontal, right superior temporal, right parahippocampal and right anterior cingulate gyri also correlated with the auditory comprehension, speaking and reading. Accordingly, in addition to the classical language areas which play an essential roles in language function, the extensive areas in the left hemisphere and some part of the right hemisphere may be related to the language processing and recovery from aphasia. (author)

  3. Dissecting Aneurysms of Bilateral Anterior Cerebral Artery Complicated by Subarachnoid Hemorrhage After Cerebral Infarction: A Case Report

    Akihiro Kurosu

    2008-01-01

    Full Text Available Introduction: Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result.Case presentation: A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient’s postoperative course was uneventful.Conclusion: A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient’s functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty.

  4. Effects of Electroacupuncture plus Intra-carotid Drug Injection on Rheoencephalogram in Patients with Cerebral Infarction

    李江明; 胡永均; 童利民; 王大军; 张道敬

    2004-01-01

    Purpose: To investigate the mechanism of electroacupuncture (EA) plus intra-carotid drug injection for treating cerebral infarction. Methods: Rheoencephalogram was recorded with a RG-2B type of bridge rheoencephalograph and findings were compared before and after the treatment. Results: After the treatment, the prolonged rising time was shortened, and the decreased amplitude obviously elevated. Conclusion: The therapy can dilate cerebral blood vessels, increase the cerebral blood flow, and improve the elasticity of cerebral blood vessels, leading to sufficient blood and oxygen supply in the ischemic brain tissues and to restoration of their functions.

  5. Helicobacter Pylori Infection and Acute Myocardial Infarction

    Nakić, Dario; Včev, Aleksandar; Jović, Albino; Patrka, Jogen; Zekanović, Dražen; Klarin, Ivo; Ivanac, Krešimir; Mrđen, Anamarija; Balen, Sanja

    2011-01-01

    The aim of this investigation was to determine whether H. pylori infection is an independent risk factor for acutemyocardial infarction (AMI), determine is there a link between H. pylori infection and severity of disease. In this prospective, single centre study, were enrolled 100 patients with AMI and control group was consisted 93 healthy individuals. The results of this study showed no difference between H. pylori seropositivity distribution in the investigate and control group ...

  6. Effect of glycerol on cerebral blood flow in the cases of cerebral infarction in the chronic phase

    This report concerns the evaluation of the effects of glycerol for the treatment of cerebral infarction in the chronic phase. For this purpose, cerebral blood flow (CBF) was determined after glycerol loading in 19 patients, including 24 affected hemispheres. The mean global increase in CBF after glycerol infusion was 11.1%. The cases were classified into two groups: main trunk disease (Group A; occlusion or stenosis), and non-main trunk disease (Group B). Group A had a 6.4% decrease in CBF in the affected hemisphere and a 6.5% increase in the contralateral hemisphere. By contrast, the CBF of Group B increased by 20.2% and 14.8% in the affected and contralateral hemisphere, respectively. In the cases of cerebral infarction associated with main trunk disease, the functional reserve capacity of cerebral vessels may decrease significantly. Moreover, the steal phenomenon of CBF may occur in these cases after glycerol loading. Hence, glycerol infusion for the treatment of cerebral infarction in the chronic phase should be used with care, preferably after CBF measurements. (author)

  7. Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI.

    Liu, Y; Karonen, J O; Vanninen, R L; Nuutinen, J; Perkiö, J; Vainio, P A; Soimakallio, S; Aronen, H J

    2003-06-01

    Diffusion and perfusion weighted MRI have been widely used in ischaemic stroke. We studied 17 patients in whom ischaemic areas showed an ischaemic core, an area of infarct growth and hypoperfused but ultimately surviving tissue. Apparent diffusion coefficients (ADC) were measured on days 1, 2, and 8 in the three subregions and in contralateral control areas. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were measured in these regions on day 1 perfusion maps. On day 1, the ischaemic core had very low ADC and CBF and increased MTT. The ADC in the ischaemic core gradually increased during the week. The area of infarct growth on day 1 had slightly but significantly decreased ADC (96% of control, P=0.028), moderately decreased CBF and increased MTT. On day 1 the hypoperfused but surviving tissue had slightly but significantly increased ADC (103% of control, P=0.001), mildly decreased CBF and increased CBV and MTT. The ADC of the area of infarct growth decreased to the same level as in the ischaemic core on days 2 and 8. That of surviving tissue was still above normal on day 2 (103% of control), but had returned to the normal level by day 8. Measurement of ADC combined with perfusion MRI may help distinguish different subregions in acutely hypoperfused brain. PMID:12750863

  8. Detecting the subregion proceeding to infarction in hypoperfused cerebral tissue: a study with diffusion and perfusion weighted MRI

    Liu, Y.; Vanninen, R.L.; Vainio, P.A.; Soimakallio, S. [Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio (Finland); Karonen, J.O. [Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio (Finland); Department of Radiology, Mikkeli Central Hospital, Mikkeli (Finland); Nuutinen, J. [Department of Neurology, Kuopio University Hospital, Kuopio (Finland); Perkioe, J. [Department of Radiology, Helsinki University Central Hospital (Finland); Department of Physical Sciences, University of Helsinki (Finland); Functional Brain Imaging Unit, Helsinki Brain Research Centre (Finland); Aronen, H.J. [Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio (Finland); Department of Radiology, Helsinki University Central Hospital (Finland)

    2003-06-01

    Diffusion and perfusion weighted MRI have been widely used in ischaemic stroke. We studied 17 patients in whom ischaemic areas showed an ischaemic core, an area of infarct growth and hypoperfused but ultimately surviving tissue. Apparent diffusion coefficients (ADC) were measured on days 1, 2, and 8 in the three subregions and in contralateral control areas. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were measured in these regions on day 1 perfusion maps. On day 1, the ischaemic core had very low ADC and CBF and increased MTT. The ADC in the ischaemic core gradually increased during the week. The area of infarct growth on day 1 had slightly but significantly decreased ADC (96% of control, P=0.028), moderately decreased CBF and increased MTT. On day 1 the hypoperfused but surviving tissue had slightly but significantly increased ADC (103% of control, P=0.001), mildly decreased CBF and increased CBV and MTT. The ADC of the area of infarct growth decreased to the same level as in the ischaemic core on days 2 and 8. That of surviving tissue was still above normal on day 2 (103% of control), but had returned to the normal level by day 8. Measurement of ADC combined with perfusion MRI may help distinguish different subregions in acutely hypoperfused brain. (orig.)

  9. Clinical significance of measurement of plasma thromboxane B2 and 6-keto-prostaglandin F1α in patients with acute cerebral vascular accident

    Objective: To explore the clinical significance of the variations of plasma concentration of thromboxane B2(TXB2) and 6-keto-prostaglandin F1α (6-K-PGF1α) in patients with acute cerebral vascular accident. Methods: The plasma concentrations of TXB2 and 6-K-PGF1α in patients with acute cerebral infarction (n = 45) and patients with acute cerebral hemorrhage (n = 28) as wall as 40 controls were determined with radioimmunoassay (RIA). Results: Plasma concentration of TXB2 in patients with cerebral infarction were significantly higher than those in controls (p 1α levels were not much changed and T/P ratios (TXB2/6-K-PGF1α) were significantly increased (p 2 and 6-K-PGF1α levels were significantly increased (vs controls: p < 0.05), but T/P ratio remained unchanged. Conclusion: T/P increased obviously in patients with acute cerebral infarction, which suggested that anti-platelet aggregators might have remarkable effect on the treatment of acute cerebral infarction

  10. The follow-up research on the relationship between hyperhomocysteinemia and the recurrence rate of cerebral infarction after previous stroke

    谈晓牧

    2006-01-01

    Objective To explore the possible effect of the plasma homocysteine level on the risk of recurrent cerebral infarction patients by follow-up research in hope for finding a new theoretical evidence for the therapy and the prophylaxis of cerebral infarction. Methods We determined the free plasma total homocysteine (tHcy) of 151

  11. A Multidisciplinary Health Care Team's Efforts to Improve Educational Attainment in Children with Sickle-Cell Anemia and Cerebral Infarcts

    King, Allison; Herron, Sonya; McKinstry, Robert; Bacak, Stephen; Armstrong, Melissa; White, Desiree; DeBaun, Michael

    2006-01-01

    The primary objective of this study was to improve the educational success of children with sickle-cell disease (SCD) and cerebral infarcts. A prospective intervention trial was conducted; a multidisciplinary team was created to maximize educational resources for children with SCD and cerebral infarcts. Students were evaluated systematically…

  12. Study on the clinical usefulness of magnetic resonance imaging in cases of multiple cerebral infarction

    The clinical significance of MRI in thrombotic multiple cerebral infarction was examined in 9 patients having recent lacunar stroke. Recent infarct was identified on Gd-enhanced MRI in 4 patients. For patients multiple small infarction, Gd-enhanced MRI made it possible to differentiate recent from other lesions. To clarify the significance of periventricular high intensity lesion (PVH) on T2-weighted MRI, hemodynamic and neuropsychologic examinations were carried out in 41 patients with multiple cerebral infarction. All the patients had PVH, which was classified into three grades as follows: grade I (n=16) showing only a thin high intensity band along the body of lateral ventricles; grade 2 (n=15) showing a definite high intensity area around the lateral ventricles; grade 3 (n=10) showing diffuse thick and irregular foci around the whole ventricle. In these patients, rCBF was measured by 133Xe inhalation methods. Initial slope index was significantly higher in patients with grade 3 than those with grade I. Mini-mental state test score was significantly higher in patients with grade l than those with grade 2 and 3. Progression of PVH may be related with the reduction of the cerebral circulation and mental function in cases of multiple cerebral infarction. Ischemic and hemorrhagic lesions can be distinguished by MRI, because old intracerebral hemorrhage appear as hypointensity areas with or without hyperintensity area on T2w images. In 92 patients with multiple infarction, MRI was used to evaluate the incidence and distribution of coexisting old intracerebral hemorrhage. Old hemorrhage were found in 15 patients (16.3%). locating the site where hypertensive hemorrhage commonly occurred. High-field MRI is useful for assessing the coexistence of hemorrhage in hypertensive patients with multiple cerebral infarction. (N.K.)

  13. Study on the clinical usefulness of magnetic resonance imaging in cases of multiple cerebral infarction

    Miyashita, Kotaro (Niigata Univ. (Japan). Brain Research Inst.)

    1991-09-01

    The clinical significance of MRI in thrombotic multiple cerebral infarction was examined in 9 patients having recent lacunar stroke. Recent infarct was identified on Gd-enhanced MRI in 4 patients. For patients multiple small infarction, Gd-enhanced MRI made it possible to differentiate recent from other lesions. To clarify the significance of periventricular high intensity lesion (PVH) on T2-weighted MRI, hemodynamic and neuropsychologic examinations were carried out in 41 patients with multiple cerebral infarction. All the patients had PVH, which was classified into three grades as follows: grade I (n=16) showing only a thin high intensity band along the body of lateral ventricles; grade 2 (n=15) showing a definite high intensity area around the lateral ventricles; grade 3 (n=10) showing diffuse thick and irregular foci around the whole ventricle. In these patients, rCBF was measured by {sup 133}Xe inhalation methods. Initial slope index was significantly higher in patients with grade 3 than those with grade I. Mini-mental state test score was significantly higher in patients with grade l than those with grade 2 and 3. Progression of PVH may be related with the reduction of the cerebral circulation and mental function in cases of multiple cerebral infarction. Ischemic and hemorrhagic lesions can be distinguished by MRI, because old intracerebral hemorrhage appear as hypointensity areas with or without hyperintensity area on T2w images. In 92 patients with multiple infarction, MRI was used to evaluate the incidence and distribution of coexisting old intracerebral hemorrhage. Old hemorrhage were found in 15 patients (16.3%). locating the site where hypertensive hemorrhage commonly occurred. High-field MRI is useful for assessing the coexistence of hemorrhage in hypertensive patients with multiple cerebral infarction. (N.K.).

  14. Effects of exercise after focal cerebral cortex infarction on basal ganglion.

    Mizutani, Kenmei; Sonoda, Shigeru; Karasawa, Nobuyuki; Yamada, Keiki; Shimpo, Kan; Chihara, Takeshi; Takeuchi, Terumi; Hasegawa, Yoko; Kubo, Kin-Ya

    2013-06-01

    Identification of functional molecules in the brain related to improvement of motor dysfunction after stroke will contribute to establish a new treatment strategy for stroke rehabilitation. Hence, monoamine changes in basal ganglion related to motor control were examined in groups with/without voluntary exercise after cerebral infarction. Cerebral infarction was produced by photothrombosis in rats. Voluntary exercise using a running wheel was initiated from 2 days after surgery. Motor performance was measured by the accelerated rotarod test. Monoamine concentrations in striatum were analyzed using HPLC and immunohistochemical staining performed with anti-tyrosine hydroxylase antibody. In behavioral evaluation, the mean latency until falling from the rotating rod in the group with exercise (infarction-EX group) was significantly longer than that in the group without exercise (infarction-CNT group). When concerning the alteration of monoamine concentration between before and 2 days after infarction, dopamine level showed a significant increase 2 days after infarction. Subsequently, dopamine level was significantly decreased in the infarction-EX group at 10 days after infarction; in contrast, both norepinephrine and 5-HT concentrations were significantly higher in the infarction-EX group than in the infarction-CNT group. Furthermore, duration of rotarod test showed a significant inverse correlation with dopamine levels and a significant positive correlation with 5-HT levels. In immunohistochemical analysis, tyrosine hydroxylase immunoreactivity in substantia nigra pars compacta was shown to increase in the infarction-CNT group. In the present study, at least some of the alterations of monoamines associated with the improvement of paralysis in the basal ganglion related to motor control might have been detected. PMID:22718437

  15. Risk assessment in patients with acute myocardial infarction treated with thrombolysis

    Samad, Bassem Abdel

    1999-01-01

    Risk stratification in patients with acute myocardial infarction is essential for guiding the clinical decision concerning management. Thrombolytic therapy and other new management policies have led to a significant reduction in mortality from myocardial infarction. Several clinical variables and non-invasive methods have been shown in post-infarction studies to provide independent prognostic information. However, risk stratification of patients with myocardial infarction ...

  16. Acute Myocardial Infarction in Puerperium Stage. A Case Presentation

    Teresa Oliva Rivero

    2007-12-01

    Full Text Available A 38 year-old hypertensive, smoker female patient was presented. She suferred from an acute myocardial infarction in the mediate puerperium stage of an normal deliver. She was assisted in the Heart intensive care unit taking into consideration the basic care principles for this kind of patient. The infarct was diagnosed due to the clinical picture, and the electrographic alterations as well as the enzimatic alterations. The case is presented because it is a low frequency complication and it is not too much registered in the the medical literature revised.

  17. Radiologic manifestations of focal cerebral hyperemia in acute stroke

    Olsen, T S; Skriver, E B; Herning, M

    1991-01-01

    In 16 acute stroke patients with focal cerebral hyperemia angiography and regional cerebral blood flow (rCBF) were studied 1 to 4 days post stroke. CT was performed twice with and without contrast enhancement 3 +/- 1 days and 16 +/- 4 days post stroke. Angiographic evidence of focal cerebral hype...

  18. 赛百纤溶酶联合高压氧治疗对脑梗死急性期凝血功能及预后的影响%Influence of plasminogen combined hyperbaric oxygen therapy on prognosis and coagulation in patients with acute cerebral infarction

    姚汉玲; 杨珺

    2011-01-01

    Objective To investigate the influence of plasminogen combined hyperbaric oxygen therapy on prognosis and coagulation in patients with acute cerebral infarction.Methods 86 patients with acute cerebral infarction were randomly divided into two groups, hyperbaric oxygen combined fibrinolytic therapy( HBD group, n= 40 cases ) and hyperbaric oxygen therapy ( non-HBO group, n =46 cases ) were given respectively.Indexes of two groups of patients with coagulation, neurological deficit score and overall efficacy were recorded and analyzed.Results After treatment, the total efficacy in hyperbaric oxygen group( 92.5% )was significantly higher than non-HBO group ( 73.9% ), the difference was statistically significant ( P < 0.05 ).compared with before treatment, PT, APTT prolonged, and TT shortened in the 2 groups after treatment.Fib levels decreased and neurological deficit scores were significantly lower, the differences between them were statistically significant( P < 0.05 ), the hyperbaric oxygen group were superior to the non-HBO group( P < 0.05 ).Conclusion Plasmin combined hyperbaric oxygen therapy is a effective and safe method on the coagulation of acute cerebral infarction, the neurological deficit score and overall effect were improved obviously.%目的 探讨纤溶酶联合高压氧治疗对脑梗死急性期凝血功能及预后的影响.方法 86例急性脑梗死患者随机分为2组,分别给予纤溶酶联合高压氧治疗(高压氧组,n=40)和非高压氧治疗(非高压氧组,n=46),分析2组患者的凝血功能、神经功能缺损评分及总体疗效.结果 治疗后高压氧组总有效率(92.5%)显著高于非高压氧组(73.9%),差异有统计学意义(P<0.05).2组治疗后与治疗前比较,PT、APTT延长,TT缩短,Fib含量下降,神经功能缺损评分降低,差异均有统计学意义(P<0.05),且高压氧组优于非高压氧组(P<0.05).结论 纤溶酶联合高压氧治疗对脑梗死急性期的凝血功能、神经功能缺损评

  19. 急性脑梗死患者血浆同型半胱氨酸水平与颈动脉粥样硬化关系的临床研究%Relationship between carotid atherosclerosis and plasma homocysteine level in patients with acute cerebral infarction

    王志晔; 张作念; 潘振华; 张进秋; 顾伟; 章慧; 孙轶; 潘锡近

    2013-01-01

    Objective To investigate the relation between the serum homocysteine level in patients with acute cerebral infarction and carotid artery atherosclerosis.Methods In 103 patients with initial acute cerebral infarction and 46 healthy persons,carotid intima-medial wall thickness(IMT) was determined with colored doppler ultrasound; serum homocysteine level was determined with immunoturbidimetry.Results The serum homocysteine level in the patient group was significantly higher than that in control group[(18.21 ±0.51) μmol/L vs (12.32 ±0.16) μmol/L,P < 0.01].The serum homocysteine level in the patients with carotid artery intima media thickness oratheromatous plaque was significantly higher than that in the patients without atheromatous plaque [(18.37 ±0.24),(20.16 ±0.58) μmol/L vs (13.25 ±0.13) μmol/L,P<0.05].The serum homocysteine level of patients with atheromatous plaque was significantly higher than that of patients with carotid artery intima media thickness(P <0.05) ; the serum homocysteine level was positively correlated with intimal-medial wall thickness (r =0.68,P <0.01).Conclusion The serum homocysteine level is significantly correlated with the degree of atherosclerosis of patients with acute cerebral infarction.%目的 研究急性脑梗死患者血浆同型半胱氨酸(Hcy)水平与颈动脉粥样硬化的关系,对其发病机制进行初步探讨.方法 入选103例首次发病的急性脑梗死患者和46例健康体检者,应用颈动脉多普勒彩色超声检测颈动脉内膜中层厚度(IMT).用免疫比浊法测定血浆Hcy,并对检测结果进行统计学分析.结果 急性脑梗死组血浆Hcy水平明显高于对照组[(18.21±0.51) μmol/L比(12.32±0.16) μmol/L,P<0.01];脑梗死内膜增厚组、斑块组血浆Hcy明显高于无斑块组[(18.37 ±0.24)、(20.16±0.58) μmol/L比(13.25±0.13) μmol/L,P<0.05];斑块组血浆Hcy水平明显高于内膜增厚组(P<0.05).直线相关分析显示

  20. Clinical significance on changes of platelet aggregation test, von Willebrand factor,antithrombin and D-dimer assayin acute cerebral infarction patients%急性脑梗死患者血小板聚集功能、血管性血友病因子、抗凝血酶及 D-二聚体测定的临床意义

    叶青跃; 程鹏飞; 周有利; 饶汉武; 黄承芳; 周立

    2015-01-01

    目的:探讨急性脑梗死患者血小板聚集功能( PAgT)、血管性血友病因子( vWF)、抗凝血酶( AT)和D-二聚体( D-dimer)水平变化及临床意义。方法选用相应的方法和仪器测定112例脑梗死及80例健康对照者血(浆) PAgT、vWF、AT和D-dimer水平变化,同时对部分患者进行治疗前、后的对比分析。结果脑梗死患者血中PAgT、vWF、D-dimer等指标均明显高于健康对照组,AT活性较对照组显著降低,差异有统计学意义(P<0.05或P<0.01)。选取经治疗效果明显好转的78例脑梗死患者,出院前取空腹静脉血测定PAgT、vWF、AT、D-dimer等指标,并与治疗前对照,结果治疗后PAgT、vWF、D-dimer降低,AT活性升高,差异有统计学意义(P<0.05或P<0.01)。结论脑梗死患者体内存在明显的凝血及纤溶功能异常,与血管内皮损伤、血小板聚集功能增强、凝血及纤溶功能亢进、抗凝功能降低等多因素有关。 PAgT、vWF、AT、D-dimer可以作为脑梗死患者诊断、治疗监测和预后判断的参考指标。%Objective To evaluate the clinical signification of coagulation ,anti-coagulation and fibrinolysis indexes i.e.platelet aggrega-tion test(PAgT),von Willebrand factor(vWF),antithrombin(AT),D-dimer in acute cerebral infarction patients.Methods vWF was as-sayed using ELISA method,AT was determined by chromogenic substances assay,and Latex enhanced immune turbidimetry for D-dimer. vWF,AT and D-dimer all the parameters were finished by SysmexCA-7000 automated blood coagulation analyzer.PAgT was measured sim-ultaneously using a whole-blood Lumi-Aggregometer by CHRMNO-LOG platelet aggregation apparatus.Results PAgT, vWF, D-dimer were significantly higher in acute cerebral infarction patients group,compared with those in the control group(P<0.05 or P<0.01). while AT was significantly lower(P<0.05).After effective treatment,PAgT,vWF,AT,D-dimer Indicators are all

  1. 尤瑞克林联合依达拉奉治疗中重度急性脑梗死的随机临床研究%Randomized clinical study of urinary kallidinogenase combined with edaravone treating moderate and severe acute cerebral infarction

    王展航

    2012-01-01

    Objective To explore the effect and safety of urinary kallidinogenase combined with edaravone in treating moderate and severe acute cerebral infarction.Methods 84 patients who had acute cerebral infarction were randomly divided into 2 groups,control group was given edaravone,treatment group was added urinary kallidinogenase based on control group,other conventional medical treatments were same.Results After 14 days treatment,the change of National Institute of Health stroke scale(NIHSS)and Activities of Daily Living(ADL)before and after the 14 days were compared.After the treatment,NIHSS of urinary kallidinogenase group and control group both improved (P < 0.01),urinary kallidinogenase group improved more significantly,and had significant difference compared with control group(P < 0.01).ADL level of the two groups both went up(P < 0.01),urinary kallidinogenase group went up more significantly,and had the significant difference compared with controlled group(P < 0.01).Conclusion Uri nary kallidinogenase could selectively expand ischemic vessel,open collateral circulation,and promote the formation of new vessels,if combined with edaravone treating moderate and severe acute cerebral infarction,it could significantly improve the neurological deficit,reduce disability rate and increase the safety.%目的 观察尤瑞克林联合依达拉奉治疗中重度急性脑梗死的有效性和安全性.方法 对84例急性脑梗死患者随机分为两组:对照组给予依达拉奉治疗,治疗组在对照组基础上再加尤瑞克林,其它内科常规治疗相同.结果 比较两组治疗14 d前后美国国立卫生院神经功能缺损评分(NIHSS)和日常生活能力(ADL)的变化.治疗后治疗组和对照组NIHSS评分均有改善(P<0.01),但治疗组改善更明显(P<0.01);两组ADL水平均较治疗前上升(P<0.01),但治疗组上升更明显(P<0.01).结论 尤瑞克林可选择性扩张缺血区血管,开放侧枝循环,促进新生血管形成,

  2. Effect of low-power He-Ne ILIB on rheology in patients with cerebral infarction

    Lu, Zheng-Guo

    1998-11-01

    We determined rheology in patients with cerebral infarction, before and after low-power He-Ne ILIB. The test covered whole blood viscosity red blood cell distortion index, platelet aggregation and D-dimer. The results shoed that low-power He-Ne ILIB results in non-significant decrease in whole blood viscosity, significant decrease in plasma viscosity, platelet aggregation and D-dimer and significant increase in RBC rheology index. This study suggests that He- He ILIB which may improve rheology and clinical symptoms of cerebral infarction patients is a simple, safe and effective therapy.

  3. A Case Associated with Comorbidities Among Cerebral Infarction, Idiopathic Thrombocytopenic Purpura, and Triple X Syndrome

    Hanjun Kim

    2014-06-01

    Full Text Available A 46-year-old female presented to the emergency room due to the chief complaint of left-sided weakness. By imaging study, she was diagnosed with cerebral infarction. Thrombolytic and antiplatelet agents were not considered due to the “golden hour” for treatment having passed and a low platelet count. The peripheral blood smear, bone marrow biopsy, and aspirate findings were consistent with immune thrombocytopenic purpura. The chromosome analysis revealed the 47,XXX karyotype. To the best of our knowledge, this is the first case report associated with the comorbidities of cerebral infarction, idiopathic thrombocytopenic purpura, and triple X syndrome.

  4. Frequency of cerebral infarction and haemorrhage in the patients of stroke

    Stroke is rapidly developing phenomena of symptoms and signs of focal, and at times global, loss of cerebral function with no apparent cause other than that of vascular origin. The Objective was to know the frequency of cerebral infarction and haemorrhage in one hundred patients of stroke in a period of one year. Data was collected by consecutive sampling technique. Total one hundred patients of stroke were collected for the study. They were assessed through a detailed history of hypertension, diabetes mellitus, smoking, previous stroke, transient ischemic attack (TIA), previous myocardial infarction, angina, atrial fibrillation, alcohol intake, drugs used for hypertension/diabetes mellitus. Blood pressure was recorded at arrival and 24 hours after admission. There were 70% males and 30% females. Twenty percent of the patients were in the age range of 51-60 years, 26% of the patients were in the age range of 61-70 years and 18% were in the age range of 71-80 years. Cerebral infarction was present in 72% patients while cerebral haemorrhage was present in 28% patients. Hypertension was the most common risk factor among these stroke patients. Average blood pressure was 180/100 mmHg. Cerebral infarction is the commonest form of stroke. Hypertension is the leading risk factor in stroke patients. (author)

  5. 同型半胱氨酸、叶酸、维生素 B12水平与急性脑梗死的关系分析%Analysis of the relationship between homocysteine,folate,vitamin B12 levels and acute cerebral infarction

    区腾飞; 赵旭; 李荣; 李永鸿; 王鹏; 张俊

    2015-01-01

    Objective To study the relationship between homocysteine,folate,vitamin B12 levels and acute cerebral infarction. Meth-ods 50 cases of mild infarction,moderate infarction and severe infarction in our hospital from 2011 August to 2013 December were enrolled in ob-servation group and 50 cases of healthy persons underwent physical examination in our hospital were enrolled in control group. Then serum homo-cysteine,folate,vitamin B12 content were detected,nerve function,cognitive function and life ability were evaluated by NIHSS scale,MMSE scale and ADL scale. Results Patients with cerebral infarction Homocysteine levels was significantly higher than that of the control group,folic acid,vitamin B12 levels was lower than control group. There were statistically significant between mild,moderate and severe. The patients with cerebral infarction NIHSS,MMSE,Barthel was significantly lower than control group,there were statistically significant between mild,moderate and severe. The serum Hcy levels were positively correlated with NIHSS score and negatively correlated with MMSE score,Barthel index. The fo-late,vitamin B12 levels were negatively correlated with NIHSS score and positively correlated with MMSE score,Barthel index. Conclusion Ser-um homocysteine,folate,vitamin B12 content change in patients with acute cerebral infarction and are ideal index to evaluate prognosis for their levels,which have good correlation with nerve function,cognitive function and life ability.%目的:研究同型半胱氨酸、叶酸、维生素 B12水平与急性脑梗死的关系。方法参照 Pullicinp 法将2011年8月至2013年12月期间接受治疗的急性脑梗死轻度、中度和重度患者各50例纳入研究的观察组,同期体检健康者50例纳入研究的对照组。检测血清中同型半胱氨酸、叶酸、维生素 B12水平,并采用美国国立卫生研究院卒中量表(NIHSS 量表)、简易精神状态评价量表(MMSE 量表)和日常生活活动

  6. Circulatory and metabolic effects of glycerol infusion in patients with recent cerebral infarction.

    Meyer, J S; Itoh, Y; Okamoto, S; Welch, K M; Mathew, N T; Ott, E O; Sakaki, S; Miyakawa, Y; Chabi, E; Ericsson, A D

    1975-04-01

    The effect of intravenous infusion of 10 per cent glycerol on regional cerebral blood flow (using hydrogen bolus and Xenon-133 (133Xe) clearance methods) and metabolism was investigated in 57 patients with recent cerebral infarction. Hemispheric blood flow (HBF) increased, together with increase in regional cerebral blood flow (rCBF) and cerebral blood volume (rCBV), in foci of brain ischemia. Hemispheric oxygen consumption (HMIO2) decreased together with hemispheric respiratory quotient. Systemic blood levels of glucose, lactate, pyruvate, and triglycerides also increased after glycerol while free fatty acids (FFA) and inorganic phosphate (Pi) decreased. Hemispheric glucose consumption was unaltered after glycerol so that hemispheric glucose to oxygen ratio tended to rise. Pyruvate and lactate production by brain was unchanged. Glycerol moved across the blood brain barrier into brain and cerebrospinal fluid (CSF). Release of FFA and Pi from infarcted brain was reversed by glycerol. Total phosphate balance was maintained actoss brain both before and after glycerol infusion. Triglycerides increased in CSF after glycerol, originating either from cerebral blood or as a result of lipogenesis in cerebral tissue. The EEG Recording and neurological status of the patients improved despite decreased brain oxygen consumption. Results of this study suggest that after intravenous infusion of 10 per cent glycerol in patients with recent cerebral infarction, glycerol rapidly enters the CSF and brain compartments and favorably affects the stroke process in two ways: first, by redistribution of cerebral blood flow with increase in rCBF and rCBV in ischemic brain secondary to reduction in focal cerebral edema; and second glycerol may become an alternative source of energy either by being directly metabolized by the brain, or indirectly, by enhancing lipogenesis, or by both processes. Involvement of glycerol in lipogenesis with esterification to accumulated FFA might lead to

  7. Thromboxane B2 formation in patients with acute myocardial infarction

    Thromboxane A2 is a stable metabolite of thromboxane B2 which production and release were reported with many of the risk factors related to coronary-artery disease. In 18 patients with acute transmural myocardial infarction serial determinations of thromboxane B2 were performed in the blood having clotted at 370C for 30 min. Significantly less (p < 0.05) of thromboxane B2 was formed in the first week after infarction compared to the control group. Thromboxane B 2 formed in the blood of these patients increased slightly in the recovery period but was still lower than in healthy population. Since thromboxane A2 exerts deleterious effects upon myocardial performance an adaptive protective effect of the decreased thromboxane synthesis in patients with myocardial infarction was suggested. (orig.)

  8. Hepatic infarction complicating acute pancreatitis: a case report

    Kim, Hyun Suk; Hong, Sung Hwan; Park, Hong Suk; Lee, Eil Seong; Kang, Ik Won [College of Medicine, Hallym University, Seoul (Korea, Republic of)

    2000-07-01

    Hepatic infarction is relatively uncommon and is usually related to surgery or interventional procedures. Pancreatitis-associated hepatic infarction has not been reported in the literature, and we now describe a case of hepatic infarction in a 31-year-old man with acute pancreatitis. Initial CT scanning demonstrated an enlarged pancreas with multifocal fluid collection, and a large wedge-shaped low attenuation lesion was seen in the right lobe of the liver along with thrombi in the posteroinferior branch of the right portal vein. Hepatic arteriography and SMA portography revealed a pseudoaneurysm in the right hepatic artery, thrombi in the main portal vein and its posteroinferior branch, and perfusion defects confined to S6 of the liver. (author)

  9. The immune system in atherosclerosis and in acute myocardial infarction

    Antonio Barsotti

    2009-08-01

    Full Text Available Acute myocardial infarction (AMI occurs when the atheromatous process prevents total blood flow through the coronary artery. It was previously thought that progressive luminal narrowing from the continued growth of smooth muscle cells (SMCs in the plaque was the main cause of infarction, however, angiographic studies, have identified culprit lesions that do not cause marked stenosis. Is now evident that plaque activation, rather than stenosis, precipitates ischemia and infarction. Coronary spasm could be involved to some extent, but most cases of AMI are due to the formation of an occluding thrombus on the surface of the plaque; the two major causes of coronary thrombosis are plaque rupture and endothelial erosion. Plaque rupture is detectable in 60- 70% of cases and preferentially occurs when the fibrous cap is thin and partly destroyed. One of the major challenges in modern cardiology is the knowledge of the factors that induce a silent atherosclerotic plaque shifting from a stable to a vulnerable form.

  10. Protective Effects of Overexpression of bcl-xl Gene on Local Cerebral Infarction in Transgenic Mice Undergoing Permanent Occlusion of Middle Cerebral Artery

    Furong WANG; Yongsheng JIANG; Suming ZHANG; Wenwu XIAO; Suiqiang ZHU

    2008-01-01

    In order to investigate the protective effects of the overexpression of bcl-xl gene on local cerebral infarction in the transgenic mice subject to permanent occlusion of middle cerebral artery, the models of bcl-xl transgenic mice were established and subjected to cerebral infarction by intralu- minal occlusion of the middle cerebral artery. The infarct volume and the neurological scores were observed and comparison between the wild type mice and the transgenic mice was made. It was found that the infarct volume and the neurological scores in the transgenic mice were significantly decreased as compared with those in the wild type mice. It was suggested that the overexpression of bcl-xl gene in transgenic mice could reduce the infarct volume and improve the neurological function of the mice.

  11. Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

    Chen, Po-Chuan; Tsai, Shih-Hung; Chen, Yu-Long; Liao, Wen-I

    2014-01-01

    Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompress...

  12. Susceptibility gene for stroke or cerebral infarction in the Han population in Hunan Province of China★

    Mo, Danheng; Xu, Hongwei; Zhou, Wensheng; Yang, Qiming; Yang, Jianwen; Xiao, Bo; Yang, Qidong

    2013-01-01

    The scavenger receptor class B type I gene can protect against atherosclerosis; a mononucleotide polymorphism is associated with differences in blood lipid metabolism, postprandial serum lipid levels, insulin resistance, coronary artery disease and familial hyperlipidemia. In this study, the scavenger receptor class B type I gene exon 1 G4A gene polymorphism in atherosclerotic cerebral infarction patients, cerebral hemorrhage patients and normal controls was detected using the polymerase chai...

  13. System delay and timing of intervention in acute myocardial infarction (from the Danish Acute Myocardial Infarction-2 [DANAMI-2] trial)

    Nielsen, Peter Haubjerg; Terkelsen, Christian Juhl; Nielsen, Torsten Toftegård;

    2011-01-01

    The interval from the first alert of the healthcare system to the initiation of reperfusion therapy (system delay) is associated with mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention (pPCI). The importance of system delay...... in patients treated with fibrinolysis versus pPCI has not been assessed. We obtained data on system delay from the Danish Acute Myocardial Infarction-2 study, which randomized 1,572 patients to fibrinolysis or pPCI. The study end points were 30-day and 8-year mortality. The short system delays were...

  14. Clinical significance of the detection of serum B-FABP in patients with acute cerebral infarction%脑型脂肪酸结合蛋白在急性脑梗死检测方面的临床意义

    张黎军; 邱晨红; 王锋; 孙沁怡; 周华; 沈蓉; 赵中

    2011-01-01

    Objective To explore clinical significance of brain-type fatty acid binding protein(B-FABP)in early diagnosis of patients with acute cerebral infarction. Methods Serum concentrations of B-FABP were detected by using enzyme-linked immunosorbent assay(ELISA)in 100 patients admitted within 24 hours, 7 days and 14 days after cerebral infarction, while the relationships between serum concentrations of B-FABP and size,location and neurologic impairment of cerebral infarction were analyzed. 50 healthy subjects were selected as control groups. Results We took venous blood samples of 100 patients admitted within 24 hours,7 days and 14 days after stroke onset. Serum concentrations of B-FABP were higher significantly than those of control groups (P<0. 01). The sensitivity of serum B FABP in patients within 24 hours was 68%. Serum concentrations of B-FABP in patients with LACI was highest among four groups(P<0. 01). Serum concentrations of B-FABP in patients with TACI was higher than those of other two groups(P<0. 05). Serum concentrations of B-FABP in patients with POCI was higher than that in patients with PACI (P<0. 05); Serum concentrations of B-FABP in patients with small infarction volume was higher than those of other two groups (P<0. 01); Serum concen trations of B-FABP in patients with large infarction volume was higher than that in patients with median infarc tion volume (P<0. 05); According to NIHSS, serum concentrations of B-FABP in mild group was higher than those of other two groups(P<0. 01); Serum concentrations of B-FABP in severe group was higher than that in moderate group (P<0. 05); The comparisons among groups mentioned above have statistical significance.Conclusions B FABP may be related to size and location of infarction lesion and the severity of the neurological deficit early to some extent. Higher serum concentration of B-FABP within 24 hours after ischemic infarction may support the early diagnosis of cerebral infarction.%目的 探

  15. MRI findings of acute cerebral swelling and brain edema in the acute stage

    We report two cases, one of acute cerebral swelling and the other with a major stroke, whose MRI has shown very interesting findings. Case 1, a 32-year-old male, was admitted to our service because of a lowering of his consciousness immediately after a head injury. On admission, the patient was semicomatous (E1M2V1, with anisocoria (R > L). His plain skull X-ray was normal. A CT scan, however, demonstrated right isodensity hemispheric swelling associated with a subarachnoid hemorrhage in the right Sylvian fissure. A right carotid angiogram showed no vascular disorders. MR imaging of the spin density demonstrated a hyperintensitive thickening of the gray matter in the whole right hemisphere. Case 2, a 58-year-old female, was admitted because of a sudden onset of loss of consciousness, with right hemiparesis and dysarthria. On admission, her consciousness was semicomatous (E1M3V1), and it deteriorated to a deep coma 1 hour later. A CT scan demonstrated a diffuse left hemispheric low density, with a finding of hemorrhagic infarction in the basal ganglia. MR imaging of the spin density showed a hyperintensitive thickening of the gray matter resembling that of Case 1. The findings of the spin-echo images of our two cases showed a hyperintensitive thickening of the gray matter in both. The hyperintensity and thickening of the gray matter apparently indicated a sort of hyperemia and brain edema. These findings led us to suspect that the hyperemia associated with acute cerebral swelling and ischemic brain edema of our two cases originated in the gray matter, although it has been considered that the pathogenesis of acute cerebral swelling is not known and that brain edema, especially vasogenic edema, will mostly develop in the white matter rather than in the gray matter. (author)

  16. [Trials with ACE-inhibitors in acute myocardial infarction].

    Dalla Volta, S

    1994-12-01

    In acute myocardial infarction, the results of the trials with ACE-inhibitors have not been always good, in contrast with what has been observed in chronic heart failure. The comparison of these compounds with the placebo has demonstrated lack of reduction of mortality in the study CONSENSUS II, favorable results on the survival as first endpoint and on the secondary endpoints, as reinfarction, heart failure and stroke in the studies SOLVD, AIRE, GISSI 3, ISIS 4, and uncertain (interim report) results in the Chinese study. Nevertheless, the analysis of the recruitment of the patients with acute infarction and the way these patients have been treated seem to be the most important cause of the conflicting results. ACE-inhibitors have proved no efficacy in acute myocardial infarction without signs of left ventricular failure (CONSENSUS II), have worsened the clinical picture and the mortality in patients in shock or with severe heart failure in the acute phase. On the reverse, in presence of mild to moderate left ventricular dysfunction and failure, the use of ACE-inhibitors has been followed by reduction of mortality in the early (AIRE, GISSI 3, ISIS 4), medium term (GISSI 3) and long-term follow-up (up to 4 years in the AIRE study). In parallel with the reduction of the primary endpoint, also secondary endpoints have been favorably influenced by the different ACE-inhibitors. No differences have been observed among the different class of compounds. ACE-inhibitors seem, therefore, to have a clear indication in acute myocardial infarction with mild or moderate signs and symptoms of heart failure. PMID:7634258

  17. Microbiological tests to identify a link between periodontitis and acute myocardial infarction-an original research

    Mohan Kumar Pasupuleti; Ravindra Reddy Nagireddy; Roopa Dinahalli; Deepa Anumala; Avula Kishore Kumar; Vinay Chavan

    2013-01-01

    Background and Objectives Gingival and periodontal diseases are associated with specific bacterial infections. The main aim of the study was to know whether the periodontitis is associated with an increased risk for acute myocardial infarction (AMI) and to know the distribution of Porphyromonas gingivalis in patients with acute myocardial infarction associated with chronic periodontitis and acute myocardial infarction Groups. Materials and Methods Out of 50 patients, 20 were diagnosed as acut...

  18. Concurrent Ruptured Pseudoaneurysm of the Internal Carotid Artery and Cerebral Infarction as an Initial Manifestation of Polycythemia Vera

    Choi, Kyu-Sun; Kim, Jae-Min; Ryu, Je-il; Oh, Young-Ha

    2015-01-01

    The most common neurologic manifestations of polycythemia vera (PV) are cerebral infarction and transient ischemic attacks, while cerebral hemorrhage or intracranial dissection has been rarely associated with PV. Here we report the first case of a 59-year-old patient with intracranial supraclinoid internal carotid artery (ICA) dissection causing cerebral infarction and concomitant subarachnoid hemorrhage due to pseudoaneurysm rupture as clinical onset of PV. This case report discusses the pos...

  19. A Case of Apoplexy of Rathke’s Cleft Cyst Followed by Cerebral Infarction

    Yu-ichiro Ohnishi

    2015-01-01

    Full Text Available Rathke’s cleft cyst (RCC apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On referral to our hospital she gradually regained consciousness and presented with no neurological deficits. CT showed a round and slightly hyperdense area in the suprasellar region. However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day. Thirteen days after the first emergency visit she developed left hemiparesis and dysarthria. CT showed a round hypodense area in the suprasellar region. The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. CT also showed a low density area in the territory of the right middle cerebral artery, which indicated the cerebral infarction. MR angiography revealed poor visibility and stenotic changes of right middle cerebral arteries. Transsphenoidal surgery was performed. Histopathological findings confirmed a hemorrhagic RCC. Postoperative MR angiography showed that the visibility and stenosis of right middle cerebral arteries were recovered. This is the rare case of apoplexy of an RCC followed by cerebral infarction.

  20. Radioimmunoassay of human cardiac tropomyosin in acute myocardial infarction

    Tropomyosin was prepared from fresh human myocardium and antisera raised in rabbits. A sensitive radioimmunoassay was developed for the detection of human cardiac 125I-labelled tropomyosin in human sera down to levels of 1 ng/ml. Values for human cardiac tropomyosin in normal patients ranged from less than 1 to 3 ng/ml. In 18 patients with acute myocardial infarction all had elevated tropomyosin levels ranging from 41 to above 200 ng/ml with a mean peak level of 101 ng/ml. In this study there were no false positive or false negative results. In the initial stages of infarction the time course of appearance and peak levels of cardiac tropomyosin, total creatine kinase and creatine kinase MB isoenzyme were similar. Although total creatine kinase and creatine kinase MB isoenzyme levels were normal after 72 h in patients with single, uncomplicated infarction, cardiac tropomyosin levels were still significantly elevated above normal after this time, being 30-60% of peak values. Radioimmunoassay of human cardiac tropomyosin may prove useful in the diagnosis and in the management of patients with acute myocardial infarction, particularly in the long-term postinfarction period. (author)

  1. Clinical study of cerebral infarction in hemodialysis patients

    Stroke is one of the leading causes of death in patients undergoing chronic dialysis. However, few clinical studies have so far examined stroke, especially brain infarction, under such conditions. We retrospectively evaluated the clinical features and risk factors for brain infarction in 33 patients undergoing hemodialysis (hemodialysis, 29 patients; continuous ambulatory peritoneal dialysis, 4 patients; male:female ratio, 25:8) between May 2003 and August 2006. The mean age was 68.5±10.9 (mean±standard deviation (SD)) years. The basal renal diseases were chronic glomerulonephritis (n=16), diabetes mellitus (n=10) and other diseases (n=7). The mean duration of maintenance dialysis before the onset of stroke was 5.6±5.2 years. All 33 patients developed brain infarction, including the atherothrombotic (n=13), lacunar (n=9) and cardioembolic (n=11) types. The complications included a high frequency of hypertension (79%) in all groups, diabetes mellitus (36%) and atrial fibrillation (21%). Four of the patients, 2 with lacunar and 2 with atherothrombotic infarction, developed brain infarction within 3 hours after hemodialysis. Hemodynamic changes might have caused the infarction in these patients. The proportion of patients with a modified Rankin Scale grade of 4-6 at discharge was 42%, and the mortality rate was high (15%). The prognosis of brain infarction was poorer in patients with hemodialysis than in those without. (author)

  2. Role of cardiac MRI in acute myocardial infarction

    Erwin Mulia

    2013-02-01

    Full Text Available Mortality in patients with acute myocardial infarction (AMI has decreased significantly and appears to be the result of current reperfusion therapeutic strategies. Reperfusion itself may develop into reperfusion injury. Therefore, management of these patients poses several challenges, such as diagnosing and managing heart failure, identifying persistent or inducible ischaemia, estimating the need for anticoagulation, and assessing overall cardiovascular risk. This case presentation will demonstrate the impact of cardiac magnetic resonance imaging (MRI in the assessment of the pathophysiology of AMI in the current reperfusion era. Cardiac MRI can provide a wide range of clinically useful information which will help clinicians to manage and choose specific therapeutic strategies for AMI patients. (Med J Indones. 2013;22:46-53Keywords: Acute myocardial infarction, cardiac magnetic resonance imaging, reperfusion injury

  3. "DETERMINANTS OF PREHOSPITAL DELAY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION"

    Alidoosti, M

    2004-01-01

    Determination of pre-hospital delay time of patients with acute myocardial infarction and seeking ways of speeding up the time for reperfusion is an important factor to lower mortality in these patients. This is a cross-sectional study to determine pre-hospital delay time, its components, and related causes and conditions, obtained in 375 patients with prolonged chest pain referred to four hospitals of Tehran University of Medical Sciences. Means of transport to hospital, reasons of ambulance...

  4. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Bita Dadpour; Zohre Oghabian

    2013-01-01

    Aluminum phosphide (AlP) is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  5. ANTI-PHOSPHATIDYLSERINE ANTIBODIES IN ACUTE MYOCARDIAL INFARCTION

    Abdolreza Sotoodeh Jahromi; Mohammad Shojaei; Mohammad Reza Farjam; Abdolhossien Madani

    2013-01-01

    Acute Myocardial Infarction (AMI) is the combined result of environmental factors and personal predispositions. Many factors play a role in AMI including anti-Phospholipid (aPL) antibodies, that may act in the induction of immunological response leading to the development of AMI. Anti-Phosphatidylserine (PS) antibody is detected in various diseases like rheumatoid arthritis, systemic lupus erythematosus and anti-phospholipid antibody syndrome. The study of anti-PS antibody in AMI might shed l...

  6. IS OPIUM ADDICTION A RISK FACTOR FOR ACUTE MYOCARDIAL INFARCTION?

    "S. M. Sadr Bafghi; M Rafiei; L Bahadorzadeh; S. M. Namayeh; Soltani, M. H.; M. Motafaker A. Andishmand

    2005-01-01

    There is a misconception among our people that opioids may prevent or have ameliorating effects in the occurrence of cardiovascular diseases. In this study we evaluated 556 consecutive male patients hospitalized due to acute myocardial infarction (MI) in city of Yazd, from May 2000 to October 2001 and compared the characteristics of opium addicts to non opium users. Prevalence of opium addiction in MI patients was 19% in comparison with 2-2.8% in general population. There were not any differe...

  7. Acute Anterolateral Myocardial Infarction Due to Aluminum Phosphide Poisoning

    Bita Dadpour

    2013-08-01

    Full Text Available Aluminum phosphide (AlP is a highly effective rodenticide which is used as a suicide poison. Herein, a 24 year-old man who’d intentionally ingested about 1liter of alcohol and one tablet of AlP is reported. Acute myocardial infarction due to AlP poisoning has been occurred secondary to AIP poisoning. Cardiovascular complications are poor prognostic factors in AlP poisoning

  8. Proteinase 3 and prognosis of patients with acute myocardial infarction

    Ng, Leong L.; Khan, Sohail Q; Narayan, Hafid; Quinn, Paulene; Squire, Iain B; Davies, Joan E.

    2010-01-01

    Abstract Background A multimarker approach may be useful for risk stratification in AMI patients, particularly utilising pathways that are pathophysiologically distinct. Aim Our aim was to assess the prognostic value of Proteinase 3 in patients post acute myocardial infarction (AMI). We compared the prognostic value of Proteinase 3, an inflammatory marker to an established marker N-terminal pro-B-type natriuretic peptide (NT-proBNP) post-AMI. Method We recruited 9...

  9. The inflammatory response in myocarditis and acute myocardial infarction

    Emmens, R.W.

    2016-01-01

    This thesis is about myocarditis and acute myocardial infarction (AMI). These are two cardiac diseases in which inflammation of the cardiac muscle occurs. In myocarditis, inflammation results in the elimination of a viral infection of the heart. During AMI, one of the coronary arteries is occluded, causing ischemia and damaged cardiac muscle cells. Here, inflammation removes these damaged cells, so that scar formation can occur. However, for both diseases, inflammation also results in additio...

  10. Acute Myocardial Infarction after Switching from Warfarin to Dabigatran

    Wael Abuzeid; Hatim Al-Lawati; Neil Fam

    2015-01-01

    Dabigatran etexilate is a recently approved direct thrombin inhibitor (DTI), which is superior to warfarin in the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). However, dabigatran use is associated with an increased risk of myocardial infarction (MI) compared to warfarin. The mechanisms for this association effect remain speculative. We present a case of an acute MI and cardiac arrest in a patient with chronic AF who had been recently switched from warf...

  11. Acute Anteroseptal Myocardial Infarction after a Negative Exercise Stress Test

    Abdullah M. Al-Alawi; Jyotsna Janardan; Peck, Kah Y.; Alan Soward

    2016-01-01

    A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST...

  12. Acute Myocardial Infarction. An Update of the Clinical Practice Guideline

    Yanier Coll Muñoz; Francisco de Jesús Valladares Carvajal; Claudio González Rodríguez

    2016-01-01

    Clinical practice guidelines present all relevant evidence on a particular issue in order to help physicians select the best treatment strategies. This guideline aims to optimize the diagnostic process and treatment of acute myocardial infarction, to assess adherence to issued guidelines and to propose changes based on the results obtained. It refers to patients with ischemic symptoms or their equivalents, persistent ST-segment elevation or ST-segment and T-wave changes consistent with the di...

  13. Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

    Seyed Ahmad Hassantash; Hossein Vakili; Mohammad Hassan Namazi; Habibollah Saadat; Roxana Sadeghi; Hassan Rajabi Moghadam; Morteza Safi; Mohammad Reza Motamedi

    2009-01-01

    Background: Primary percutaneous coronary intervention (primary PCI) is the method of choice in establishing reperfusion in acute myocardial infarction (AMI) patients. The aim of this study was to determine the success rate of primary PCI in a university medical center in Iran with a view to promoting it as a first-line therapy in patients with AMI, especially in centers with established catheterization labs across the country. Methods: All cases of AMI admitted between September 2001 and Sep...

  14. Risk factors and outcomes of acute renal infarction

    Yang, Jihyun; Lee, Jun Yong; Na, Young Ju; Lim, Sung Yoon; Kim, Myung-Gyu; Jo, Sang-Kyung; Cho, Wonyong

    2016-01-01

    Background Renal infarction (RI) is an uncommon disease that is difficult to diagnose. As little is known about clinical characteristics of this disease, we investigated its underlying risk factors and outcomes. Methods We performed a retrospective single-center study of 89 patients newly diagnosed with acute RI between January 2002 and March 2015 using imaging modalities. Clinical features, possible etiologies, and long-term renal outcome data were reviewed. Results The patients' mean age wa...

  15. Study on CT perfusion-based intravenous thrombolysis with rt-PA in acute cerebral infarction%CT灌注成像指导重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死临床观察

    赵惠荣; 元小冬; 郭晶; 郭庆乐; 王燕玲

    2015-01-01

    Objective To evaluate efficiency and safety of CT perfusion-based intravenous thrombolysis with recombinant tissue plasminogen activator( rt-PA) in acute cerebral infarction.Methods 29 patients within 9 hours after symptom onset for a-cute cerebral infarction were enrolled in the study.After patients or relatives signed informed consent, they were scanned by CTP and CTA.10 patients with penumbra who agreed to accept rt-PA thrombolytic therapy were administrated with rt-PA 40mg.The NIH-SS was used to evaluate the recovery of neurological functions before, and 2 hours, 24 hours, 10 days and 30 days after thrombolytic therapy.A comparison of the Barthel Index ( BI) was made 30 day after treatment.CT was also re-examined.The adverse effect and complication were monitored.Results 10 patients who met the CTP thrombolytic criterion and accepted rt-PA thrombolytic therapy were evaluated.The NIHSS score before, and 2 hours, 24 hours ,10 days and 30 days after rt-PA treatment was (10.90 ± 4.04), (6.90 ±3.60), (6.70 ±4.11), (4.10 ±3.60), (3.20 ±3.19), The improvement of NIHSS was significantly difference between before and after thrombolytic therapy.BI score before treatment was (38.50 ±22.24), and increased to (78.53 ±30.00) at 30d after treatment, and statistical differences were also found .Re-infarction and cerebral hemorrhagic were not seen and no death occurred.Among the 10 patients undergone CT reexamined, 8 patients'infarction areas were diminution obviously and 2 pa-tients'were remained.Conclusion CTP-based intravenous thrombolysis with rt-PA is safe and effective for patients with acute cerebral infarction, CTP is helpful to assess the patients who may obtain benefit from intravenous thrombolytic therapy and may ex-pand the time window.%①目的探讨CT灌注成像(CTP)检查指导的重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死的有效性和安全性。②方法选取发病9h内急性脑梗死患者29例,

  16. Study on CT perfusion-based intravenous thrombolysis with rt-PA in acute cerebral infarction%CT灌注成像指导重组组织型纤溶酶原激活剂静脉溶栓治疗急性脑梗死临床观察

    赵惠荣; 元小冬; 郭晶; 郭庆乐; 王燕玲

    2014-01-01

    ①目的探讨CT灌注成像(CTP)检查指导的重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗急性脑梗死的有效性和安全性。②方法选取发病9h内急性脑梗死患者29例,经患者或家属签署知情同意书后行CTP、CTA检查,对存在缺血半暗带且同意rt-PA静脉溶栓治疗的10例患者给予rt-PA 40mg静脉溶栓治疗。记录溶栓前、溶栓后2h、24h、10d、30d NIHSS评分及溶栓前、溶栓后30dBarthel指数评分,并进行比较,复查头颅CT,监测并发症。③结果纳入的10例患者治疗前 NIHSS 评分为(10.90±4.04),溶栓治疗后2、24h、10、30d NIHSS评分分别降至(6.90±3.60)、(6.70±4.11)、(4.10±3.60)、(3.20±3.19),不同时间点NIHSS评分差异有统计学意义。溶栓前Barthel指数评分为(38.50±22.24),溶栓后30dBarthel指数评分为(78.53±30.00),两者比较差异有统计学意义。发生牙龈出血1例,无颅内出血、再闭塞及死亡病例,CT复查8例患者显示病灶较CTP低灌注区明显缩小,2例无明显变化。④结论 CTP指导的 rt-PA静脉溶栓治疗安全有效,有助于筛选适合溶栓的患者,并能扩大治疗的时间窗。%Objective To evaluate efficiency and safety of CT perfusion -based intravenous thrombolysis with recombinant tissue plasminogen activator ( rt-PA) in acute cerebral infarction .Methods 29 patients within 9 hours after symptom onset for a-cute cerebral infarction were enrolled in the study .After patients or relatives signed informed consent , they were scanned by CTP and CTA.10 patients with penumbra who agreed to accept rt -PA thrombolytic therapy were administrated with rt -PA 40mg.The NIH-SS was used to evaluate the recovery of neurological functions before , and 2 hours, 24 hours, 10 days and 30 days after thrombolytic therapy.A comparison of the Barthel Index (BI) was made 30 day after treatment.CT was also re

  17. Cerebral infarction versus solar and geomagnetic activity: a cross-regression study

    Mikulecký, M.; Střeštík, Jaroslav

    2007-01-01

    Roč. 9, č. 12 (2007), s. 835-838. ISSN 1565-1088 Institutional research plan: CEZ:AV0Z30120515 Keywords : cerebral infarction * solar activity * geomagnetic activity * cross-regression Subject RIV: DE - Earth Magnetism, Geodesy, Geography Impact factor: 0.577, year: 2007

  18. Fast FLAIR MR imaging finidngs of cerebral infarction : comparison with T2-weighted spin echo imaging

    To evaluate the utility of FLAIR(Fluid Attenuated Inversion Recovery) MR imaging in cerebral infarction by comparing its results with those of T2-weighted spin-echo imaging. We retrospectively evaluated fast FLAIR images and conventional spin echo images of 82 patients (47 men and 20 women ; median age 60.9 years) with cerebral infarction. MR imaging used a 1.5T MR unit with conventional T2(TR 3900, TE 90) and fast FLAIR sequence (TR 8000, TE 105, TI 2400). We analysed the size of the main lesion and number of lesions, and discrimination between old and new lesions and between small infarction and perivascular space. When T2-weighted and FLAIR imaging were compared, the latter showed that the main lesion was larger in 38 cases (46%), similar in 38 (46%), and smaller in six (7%). The number of lesions was greater in 23 cases(28%), similar in 52 (63%), and fewer in seven (9%). FLAIR images discriminated between old and new lesions in 31 cases ; perivascular space and small infarotion were differentiated in eight cases, and CSF inflowing artifact was observed in 66 (80%). In the diagnosis of cerebral infaretion, fast FLAIR provides images that are equal or superior to T2-weighted images. The fast FLAIR sequence may therefore be used as a part of routine MR brain study in the diagnosis of cerebral infarction

  19. Relationship between Helicobacterpylori bearing the cytotoxin associated gene-A and cerebral infarction

    Li Yajun; An Eenglian; Zhu Yongqing; MaoXiaolin; Wang Yumei

    2000-01-01

    Objective To explore the relationship between virulent Helicobacter pylori strains infection and cerebral infarction. Method We assessed the prevalence of infection by strains bearing the cytotoxin -associated gene-A(Cag-A),a strong virulence factor ,in 83 patients with cerebral infarction and in 71 age- and sex-matched controls with similar social background. Result Prevalence of Helicobacter pylori infection was significantly higher in patients than in controls(78.3% versus 56.3%,p<0.05),with an odds ratio of 2.8(95%CI,1.46 to 5.36) adjusted for age, sex, main stroke factors. Patients with cerebral infarction also had a higher prevalence of Cag-A-positive strains(45.8% versus 19.7%, P<0.01),with an adjusted odds ratio of 3.43(95%CI 1.5 to 7.24).Conclusion It was suggested that chronic Helicobacter pylori infection, especially Cag-A-positive strains infection is an independent risk factor for cerebral infarction.

  20. Acute Myocardial Infarction Quality of Care: The Strong Heart Study

    Best, Lyle G.; Butt, Amir; Conroy, Britt; Devereux, Richard B.; Galloway, James M.; Jolly, Stacey; Lee, Elisa T.; Silverman, Angela; Yeh, Jeun-Liang; Welty, Thomas K.; Kedan, Ilan

    2014-01-01

    Objectives Evaluate the quality of care provided patients with acute myocardial infarction and compare with similar national and regional data. Design Case series. Setting The Strong Heart Study has extensive population-based data related to cardiovascular events among American Indians living in three rural regions of the United States. Participants Acute myocardial infarction cases (72) occurring between 1/1/2001 and 12/31/2006 were identified from a cohort of 4549 participants. Outcome measures The proportion of cases that were provided standard quality of care therapy, as defined by the Healthcare Financing Administration and other national organizations. Results The provision of quality services, such as administration of aspirin on admission and at discharge, reperfusion therapy within 24 hours, prescription of beta blocker medication at discharge, and smoking cessation counseling were found to be 94%, 91%, 92%, 86% and 71%, respectively. The unadjusted, 30 day mortality rate was 17%. Conclusion Despite considerable challenges posed by geographic isolation and small facilities, process measures of the quality of acute myocardial infarction care for participants in this American Indian cohort were comparable to that reported for Medicare beneficiaries nationally and within the resident states of this cohort. PMID:21942161

  1. Holmium:YAG laser angioplasty: treatment of acute myocardial infarction

    Topaz, On

    1993-06-01

    We report our clinical experience with a group of 14 patients who presented with acute myocardial infarction. A holmium:YAG laser was applied to the infarct-related artery. This laser emits 250 - 600 mJ per pulse, with a pulse length of 250 microseconds and repetition rate of 5 Hz. Potential benefits of acute thrombolysis by lasers include the absence of systemic lytic state; a shortened thrombus clearing time relative to using thrombolytics; safe removal of the intracoronary thrombus and facilitation of adjunct balloon angioplasty. Potential clinical difficulties include targeting the obstructive clot and plaque, creation of debris and distal emboli and laser-tissue damage. It is conceivable that holmium:YAG laser can be a successful thrombolytic device as its wave length (2.1 microns) coincides with strong water absorption peaks. Since it is common to find an atherosclerotic plaque located under or distal to the thrombotic occlusion, this laser can also be applied for plaque ablation, and the patient presenting with acute myocardial infarction can clearly benefit from the combined function of this laser system.

  2. Acute myocardial infarction and infarct size: do circadian variations play a role?

    Ibáñez B

    2012-08-01

    Full Text Available Aída Suárez-Barrientos,1 Borja Ibáñez1,21Cardiovascular Institute, Hospital Clínico San Carlos, 2Centro Nacional de Investigaciones Cardiovasculares, Madrid, SpainAbstract: The circadian rhythm influences cardiovascular system physiology, inducing diurnal variations in blood pressure, heart rate, cardiac output, endothelial functions, platelet aggregation, and coronary arterial flow, among other physiological parameters. Indeed, an internal circadian network modulates cardiovascular physiology by regulating heart rate, metabolism, and even myocyte growth and repair ability. Consequently, cardiovascular pathology is also controlled by circadian oscillations, with increased morning incidence of cardiovascular events. The potential circadian influence on the human tolerance to ischemia/reperfusion has not been systematically scrutinized until recently. It has since been proven, in both animals and humans, that infarct size varies during the day depending on the symptom onset time, while circadian fluctuations in spontaneous cardioprotection in humans with ST-segment elevation myocardial infarction (STEMI have also been demonstrated. Furthermore, several studies have proposed that the time of day at which revascularization occurs in patients with STEMI may also influence infarct size and reperfusion outcomes. The potential association of the circadian clock with infarct size advocates the acknowledgment of time of day as a new prognostic factor in patients suffering acute myocardial infarction, which would open up a new field for chronotherapeutic targets and lead to the inclusion of time of day as a variable in clinical trials that test novel cardioprotective strategies.Keywords: cardioprotection, circadian rhythm, reperfusion injury, ST-segment elevation myocardial infarction

  3. Frequency of risk factors of cerebral infarction in stroke patients. a study of 100 cases in naseer teaching hospital, peshawar

    To study the risk factors of cerebral infarction in stroke patients. It is a descriptive hospital based study conducted at the Department of Medicine, Naseer Teaching Hospital, Peshawar from January 2005 to December 2005. One hundred patients of stroke with cerebral infarction confirmed on C.T. scan brain and more than twenty years of age were included. Risk factors for cerebral infarction were defined in terms of hypertension, diabetes mellitus, ischemic heart disease, smoking, dyslipidaemia, TIAs (transient ischemic attacks), carotid artery stenosis and family history of stroke. Data of 100 cases with cerebral infarction was recorded. Most of the patients had more than one risk factors for cerebral infarction. hypertension was commonest risk factor (55%), smoking (30%), ischemic heart disease (34%), diabetes mellitus) (26%), hyperlipedaemia (30%), atrial fibrillation (25%), carotid artery stenosis (27%), obesity (15%) and family history of stroke (12%). 39% of patients had physical inactivity. Males were slightly predominant than females (51% vs 49%) and mean age was 50 years. females were rather older with mean age of 53 years. Cerebral infarction accounts for 80% to 85% of cases of stroke, which is a common neurological disorder. It increases a burden of disability and misery for patients and their families. Most of the risk factors of cerebral infarction are modifiable, its prevention should be the main cause of concern for the community. (author)

  4. Sonothrombolysis in acute middle cerebral artery stroke

    Amira Zaki Dwedar

    2014-01-01

    Full Text Available Objectives: The objective of the following study is to determine the effect of continuous insonation using 2-MHz transcranial Doppler-ultrasound (TCD-US on the recanalization rate and the short-term outcome in subjects with acute ischemic stroke due to middle cerebral artery (MCA occlusion. Materials and Methods: A total of 42 patients with acute ischemic stroke due to MCA occlusion within 24 h were recruited and randomly allotted to two groups (21 patients in each group. Group 1 included patients who received 1 h continuous TCD-US for MCA and Group 2 included patients who did not receive 1 h continuous TCD-US. Patients in both groups were received MCA insonation and TCD study to measure mean flow velocity (MFV in MCA one after the initial study at 20 and 60 min. All patients received aspirin (150-325 mg. The clinical course during hospital stay was assessed before and after 1 h of US insonation, at 24 h after symptom onset using the National Institutes of Health Stroke Scale. Results: Change in MFV after insonation for Group 1 in comparison to Group 2 at 3 time points was significantly high (P < 0.001. Conclusion: Sonothrombolysis is a therapeutic option to improve the outcomes in patients with acute ischemic stroke due to MCA occlusion.

  5. Comparative analysis between MRI and MRA findings in patients with cerebral infarction

    The Purpose of this study was to evaluate the possibility of utilizing magnetic resonance angiography(MRA) in patients with cerebral infarction by comparative analysis of magnetic resonance imaging (MRI). MRI and MRA using 3D time-of-flight(TOF) technique with magnetization transfer and ramp(MTR) of 3D TOF with multiple overlapping thin slab acquisition(MOTSA) were performed in 39 patients with cerebral infarction. Vascular lesions detected on MRA were classified as normal,stenosis: and occlusion, and the different infarction sites were named according to their vascular territory. Correlation between MRI and MRA findings was evaluated. In 24(62%) of 39 cases, MRA showed stenosis or occlusion and 19(86%) of those corresponded to their vascular territory of infarction, as visualized on MRI. In 15(62.5%) of the 24 cases, MRA revealed additional diagnostic information such as visualization of unpredicted vascular lesions or the presence of collateral circulations. Of the 15 cases diagnosed as normal according to MRA, most of them actually and small infarctions of less than 2 cm in maximal dimension in the area of the perforating arteries. There was a strong correlation between the vascular lesion observed by MRA and the distribution of the infarct areas on MRI. Additional information was provided by MRA obtained together with conventional MRI

  6. Thrombus aspiration in acute myocardial infarction.

    Mahmoud, Karim D; Zijlstra, Felix

    2016-07-01

    The success of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) is often hampered by incomplete microvascular myocardial reperfusion owing to distal embolization of thrombus resulting in microvascular obstruction. To address this problem, thrombus aspiration devices have been developed that can be used to evacuate coronary thrombus either manually or mechanically. Thrombus aspiration has the potential to reduce the local thrombus load, minimize the need for balloon predilatation, facilitate direct stenting, prevent distal embolization, and ultimately improve myocardial reperfusion. Furthermore, thrombus aspiration has enabled us to study coronary thrombus in vivo, and has facilitated recognition of distinct mechanisms of coronary thrombosis. Clinical trials focusing on manual thrombus aspiration in primary PCI have generally shown improved myocardial reperfusion. However, in two large trials powered for clinical end points, no reduction in 1-year mortality or other adverse clinical events was observed with the use of this strategy. Moreover, one of these trials showed a marginally increased risk of stroke. Consequently, current guidelines do not recommend routine use of thrombus aspiration. Future studies should focus on the identification of subgroups of patients with STEMI who might derive benefit from manual thrombus aspiration, and establish the effect of operator performance on the efficacy and safety of the procedure. PMID:26961064

  7. The Effect of Acupuncture on Plasma Endothelin Content in Cerebral Infarction Patients——A Clinical Study

    2007-01-01

    Objective: To observe the effect of acupuncture on content of plasma endothelin in cerebral infarction patients. Methods: The plasma endothelin content in cerebral infarction patients was observed before and after acupuncture, which was compared with that of the medication group and the healthy subjects. Results: Before treatment, the content of plasma endothelin in cerebral infarction patients was significantly higher than that of the healthy subjects (P<0.01); after acupuncture treatment, the content greatly decreased (P<0.01), and there was a statistically significant difference between the acupuncture group and the medication group (P<0.05). Conclusion: Acupuncture may decrease the content of plasma endothelin in the cerebral infarction patients, improve the vascular elasticity, and improve the cerebral circulation of blood.

  8. Moringa Oleifera Lam Mitigates Oxidative Damage and Brain Infarct Volume in Focal Cerebral Ischemia

    Woranan Kirisattayakul

    2012-01-01

    Full Text Available Problem statement: At present, the therapeutic outcome of cerebral ischemia is still not in the satisfaction level. Therefore, the preventive strategy is considered. Based on the protective effect against oxidative damage of Moringa oleifera Lam. Leaves extract, we hypothesized that this plant extract might protect against cerebral ischemia, one of the challenge problems nowadays. In order to test this hypothesis, we aimed to determine the protective effect of M.oleifera leaves extract in animal model of focal cerebral ischemia induced by permanent occlusion of right middle cerebral artery. Approach: Male Wistar rats, weighing 300-350 g, were orally given the extract once daily at doses of 100, 200 and 400 mg kg-1 BW at a period of 2 weeks, then, they were permanently occluded the right Middle Cerebral Artery (MCAO. The animals were assessed the cerebral infarction volume and oxidative damage markers including MDA level and the activities of SOD, CAT and GSHPx enzymes at 24 h after occlusion. Results: Rats subjected to M.oleifera extract at all doses used in this study significantly decreased brain infarct volume both at cortical and subcortical structures in accompany with the elevation of SOD activity in both hippocampus and striatum while only the rats exposed to the extract at doses of 100 and 400 mg kg-1 BW showed the increased GSHPx activity in hippocampus. No the changes were observed. Therefore, our results demonstrates the potential benefit of M.oleifera leaves to decrease oxidative stress damage and brain infarct volume. Conclusion: This study is the first study to demonstrate the neuroprotective effect against focal cerebral ischemia of M.oleifera leaves. It suggests that M.oleifera may be served as natural resource for developing neuroprotectant against focal cerebral ischemia. However, the precise underlying mechanism and possible active ingredient are still required further study.

  9. Cerebral blood flow determination within the first 8 hours of cerebral infarction using stable xenon-enhanced computed tomography

    Cerebral blood flow mapping with stable xenon-enhanced computed tomography (Xe/CT) was performed in conjunction with conventional computed tomography (CT) within the first 8 hours after the onset of symptoms in seven patients with cerebral infarction. Six patients had hemispheric infarctions, and one had a progressive brainstem infarction. Three patients with very low (less than 10 ml/100 g/min) blood flow in an anatomic area appropriate for the neurologic deficit had no clinical improvement by the time of discharge from the hospital; follow-up CT scans of these three patients confirmed infarction in the area of very low blood flow. Three patients with moderate blood flow reductions (15-45 ml/100 g/min) in the appropriate anatomic area had significant clinical improvement from their initial deficits and had normal follow-up CT scans. One patient studied 8 hours after stroke had increased blood flow (hyperemia) in the appropriate anatomic area and made no clinical recovery

  10. CLINICAL PROFILE OF ACUTE MYOCARDIAL INFARCTION YOUNG ADULTS

    Patel G. N

    2015-08-01

    Full Text Available BACKGROUND : Although acute myocardial infarction was believed to be an uncommon entity in the young, of late there has been a rising incidence in this group of population. The analysis of its clinical profile, including the etiologic and the risk factors gains much importance, for the preventive purpose. AIMS AND OBJECTIVES: To study the clinical profile of acute MI, including the evaluation of the cardiac enzyme markers, the risk factors, the management and the complications and outcome of this g roup of patients aged 40 years or younger. RESULTS: Majority of patients belonged to the age group of 36 - 40years. 31 patients were overweight and 16 patients were obese. 46 patients (67.64% had anterior wall myocardial infarction, 22 patients had inferior wall myocardial infarction (32.35% and ST - elevation myocardial infarction was found in 69.2% of patients. Smoking/tobacco use was the most common risk factor (64.70% followed by dyslipidemia (60.29%, metabolic syndrome (52.94% diabetes mellitus (52.94 %, hyperhomocysteinemia (52.94%, alcohol consumption (48.52%, hypertension (34%, family history (26.47%, obesity (23.52%. Other than these, two patients had chronic kidney disease stage 3, two female patients were irregular oral contraceptive pill us ers, one was diagnosed as systemic lupus erythematosus and another patient had antiphospholipid antibody syndrome. Conclusions: Apart from early diagnosis and adequate treatment of acute MI in young patients, it is also essential to identify and prevent or control the risk factors at primary and secondary level.

  11. Cerebral hemodynamics in human acute ischemic stroke: a study with diffusion- and perfusion-weighted magnetic resonance imaging and SPECT.

    Liu, Y; Karonen, J O; Vanninen, R L; Ostergaard, L; Roivainen, R; Nuutinen, J; Perkiö, J; Könönen, M; Hämäläinen, A; Vanninen, E J; Soimakallio, S; Kuikka, J T; Aronen, H J

    2000-06-01

    Nineteen patients with acute ischemic stroke (<24 hours) underwent diffusion-weighted and perfusion-weighted (PWI) magnetic resonance imaging at the acute stage and 1 week later. Eleven patients also underwent technetium-99m ethyl cysteinate dimer single-photon emission computed tomography (SPECT) at the acute stage. Relative (ischemic vs. contralateral control) cerebral blood flow (relCBF), relative cerebral blood volume, and relative mean transit time were measured in the ischemic core, in the area of infarct growth, and in the eventually viable ischemic tissue on PWI maps. The relCBF was also measured from SPECT. There was a curvilinear relationship between the relCBF measured from PWI and SPECT (r = 0.854; P < 0.001). The tissue proceeding to infarction during the follow-up had significantly lower initial CBF and cerebral blood volume values on PWI maps (P < 0.001) than the eventually viable ischemic tissue had. The best value for discriminating the area of infarct growth from the eventually viable ischemic tissue was 48% for PWI relCBF and 87% for PWI relative cerebral blood volume. Combined diffusion and perfusion-weighted imaging enables one to detect hemodynamically different subregions inside the initial perfusion abnormality. Tissue survival may be different in these subregions and may be predicted. PMID:10894174

  12. Clinical significance of changes of plasma Hcy, ET and NPY levels after treatment in patients with cerebral infarction

    Objective: To investigate the changes of plasma Hcy, ET and NPY levels in patients with cerebral infarction. Methods: Plasma Hey (with ELISA) were determined ET and NPY (with RIA) levels in 39 patients with cerebral infarction both at admission and 35 controls. Results: Before treatment, the plasma Hcy, ET and NPY levels were significantly higher in the patients than those in controls (P<0.01). After treatment, the plasma Hcy, ET and NPY levels remained significantly higher (P < 0.05 ). Conclusion: Changes of plasma Hcy ET and NPY contents after treatment might be of prognostic importance in patients with cerebral infarction. (authors)

  13. Clinical significance of changes of plasma Hcy, CGRP and ET-1 levels after treatment in patients with cerebral infarction

    Objective: To study the clinical significance of changes of plasma Hcy, CGRP and ET-1 levels after treatment in patients with cerebral infarction. Methods: Plasma CGRP, ET-1(with RIA) and plasma Hcy(with ELISA) levels were determined in 33 patients with cerebral infarction both before and after treatment as well as in 35 controls. Results: Before treatment,in the patients the plasma Hcy, ET-1 levels were significantly higher than those in controls (P0.05). Conclusion: Plasma Hcy, CGRP and ET-1 levels changes could reflect the disease status as well as the progress of disease in patients with cerebral infarction. (authors)

  14. Risk Stratification and Management of Patients with Acute Myocardial Infarction (AMI)

    Peleška, Jan; Grünfeldová, H.; Faltus, Václav; Monhart, Z.; Ryšavá, D.; Velimský, T.; Ballek, L.; Hubač, J.; Tomečková, Marie; Janský, P.

    Timisoara: Cardiology Clinic of the Emergency County Hospital, 2007. s. 28-29. [International Workshop on the Risk Stratification in Patients with Ischemic Heart Disease. 12.04.2007-13.04.2007, Timisoara] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : pilot registry of acute myocardial infarction * risk stratification in acute myocardial infarction * effects of pharmacotherapy in acute myocardial infarction Subject RIV: BB - Applied Statistics, Operational Research

  15. [Reperfusion therapy for acute myocardial infarction in elderly patients].

    Takata, Jun; Nishinaga, Masanori; Doi, Yoshinori

    2006-11-01

    Although there has been great progress in reperfusion therapy, the role of coronary reperfusion for elderly patients with acute myocardial infarction has not been fully investigated. In general, mean age of the subjects in major trials was about 60 years old and approximately only 10 to 15% of patients were over age 75. On the other hand, large-scale registries such as the US national registry of myocardial infarction (NRMI) showed a higher prevalence of elderly (especially women) in the clinical setting. This discrepancy may be due to the fact that elderly patients with myocardial infarction have some difficulties in the treatment such as severe multi-vessel coronary lesions, non-cardiac complications and relatively high prevalence of adverse reactions to reperfusion therapy. Here we focus on the situation of elderly patients (especially those 75 years or older) with myocardial infarction in the "real world" clinical setting, showing the clinical changes and outcome of our registry in rural Japan: the Kochi AMI (KAMI) registry. PMID:17233445

  16. 血清血管生长因子浓度变化与急性脑梗死后神经功能康复的关系%Relationship between serum concentration of vascular growth factor and neurological recovery in patients with acute cerebral infarction

    官俏兵; 张晓玲; 王琰萍; 余波; 杜瑛媛; 万里红

    2013-01-01

    目的:研究血清血管生长因子浓度变化与急性脑梗死后神经功能康复的关系.方法:测定60例急性脑梗死患者发病后不同时间点的血清血小板衍生内皮细胞生长因子(PD-ECGF)与血管内皮生长因子(VEGF)浓度,同步评估美国国立卫生研究院脑卒中量表(NIHSS)评分,并记录脑梗死的体积.另选取同期健康体检人员(否认有高血压病、糖尿病、心、脑血管病等病史)30例作为对照组.结果:脑梗死患者发病后24 h内和第3、7、14天的平均血清PD-ECGF及VEGF浓度均高于相应对照组,并以发病后第7天最高,第14天最低.相应时间点的NIHSS评分差异无统计学意义(F = 1.925,P = 0.126).不同时间点的血清PD-ECGF及VEGF浓度与NIHSS评分无相关性,与脑梗死体积也无相关性.结论:血清PD-ECGF、VEGF浓度在脑梗死后即有升高,参与新生血管形成及脑神经功能恢复,但血清浓度高低并非短期神经功能康复程度和预后的决定因素.%Objective To explore the relationship between serum concentration of vascular growth factor and neurological recovery in patients with acute cerebral infarction (ACI). Methods Serum concentrations of platelet-derived endothelial cell growth factor (PD-ECGF) and vascular endothelial growth factor (VEGF) in 60 patients with ACI were measured, and the scores of national institutes of health stroke scale (NIHSS) were measured at different time points after stroke. Moreover, volumes of infarction at admission were recorded. Results Serum concentrations of PD-ECGF and VEGF in 24 hours and on day 3, 7, 14 in ACI group were significantly higher than those in control group, and reached the peak on day 7 and the trough on day 14. The differences of NIHSS scores at corresponding time points were statistically insignificant (F = 1.925, P = 0.126). The serum concentrations of PD-ECGF and VEGF were irrelevant to NIHSS scores or cerebral infarction volumes at any time point. Conclusions

  17. Short-term pretreatment with atorvastatin attenuates left ventricular dysfunction, reduces infarct size and apoptosis in acute myocardial infarction rats

    Chen, Tie-Long; Zhu, Guang-Li; He, Xiao-Long; Wang, Jian-an; Yu WANG; Qi, Guo-An

    2014-01-01

    Background: Atorvastatin showed a number of cardiovascular benefits, however, the role and underlying molecular mechanisms of short-term atorvastatin-mediated protection remain unclear. Methods: 30 rats were randomly divided into 3 groups: sham group, acute myocardial infarction model group and atorvastatin group. The rats of acute myocardial infarction model were established by ligation of the left anterior descending of coronary arteries. Before surgery, rats in the atorvastatin group recei...

  18. Estimation of Subjective Stress in Acute Myocardial Infarction

    Chockalingam A

    2003-01-01

    Full Text Available BACKGROUND and AIMS: Mental stress is considered to be a precipitating factor in acute coronary events. We aimed to assess the association of subjective or 'perceived' mental stress with the occurrence of acute coronary events. SETTINGS AND DESIGN: Prospective case-control survey was carried out in a referral teaching hospital. subjects & METHODS: Consecutive patients with acute myocardial infarction and ST elevation on electrocardiogram who were admitted to the Coronary Care Unit of a referral teaching hospital were enrolled in the study as cases. Controls were unmatched and were enrolled from amongst patients with coronary artery disease who did not have recent acute coronary events. Subjective Stress Functional Classification (SS-FC for the preceding 2-4 weeks was assessed and assigned four grades from I to IV as follows: I - baseline, II - more than usual but not affecting daily routine, III - significantly high stress affecting daily routine and IV - worst stress in life. STATISTICAL ANALYSIS: Proportions of different characteristics were compared using chi-square test with Yates continuity correction. Student's unpaired t test was applied for mean age. 'p' value of < 0.05 was considered statistically significant. RESULTS: SS-FC could be reliably (99% and easily assessed. Eighty (53% of the total 150 patients with acute MI reported 'high' levels of stress (stress class III and IV. This is in contrast to only 30 (20% of 150 healthy controls reporting high stress for the same period (p value < 0.001. CONCLUSION: Patients with acute myocardial infarction report a higher subjective mental stress during 2 to 4 weeks preceding the acute coronary event.

  19. Correspondence of CT perfusion imaging to pathological manifestations in rabbit models of hyperacute cerebral infarction

    Mingwu Lou; Yi Fan; Lizhong Jia; Weidong Hu; Yan Teng; Guangfu Yang

    2007-01-01

    BACKGROUND: Could the infarction be diagnosed quickly and accurately at the acute stage by CT perfusion imaging (CTPI) technology? Whether the images of CTPI will correspond with the pathological changes or not? All the questions need to be solved by experimental and clinical studies.OBJECTIVE: To reveal the rules of perfusion map changes and guide the early diagnosis of hyperacute cerebral infarction by analyzing the correlation of CTPI with pathological manifestations for hyperacute cerebral infarction.DESIGN: A randomized controlled animal experiment.SETTING: Experimental Center of Medical Radiology, Longgang Central Hospital of Shenzhen City.MATERIALS: Forty-two adult New Zealand rabbits of (2.6±0.5) kg, either male or female, were randomly divided into experimental group (n =36) and control group (n =6). Six rabbits in the experimental group were observed after ischemia for 0.5, 1, 2, 3, 4 and 6 hours respectively, and 1 rabbit in the control group was observed at each corresponding time point.METHODS: The experiments were carded out in the Experimental Center of Medical Radiology,Longgang Central Hospital of Shenzhen City from March 2003 to July 2004, Rabbit models of cerebral scanned at 0.5, 1, 2, 3, 4 and 6 hours after ischemia respectively. The dynamic CT scan slice was 13 mm from the anterior edge of the frontal cortex, and six fake color functional images were obtained, including cerebral blood flow map (CBF map), cerebral blood volume map (CBV map), peak to enhancement map (PE map),flow without vessels map, time to peak map (TP map), time to start map (TS map). The manifestations and (ROI) were drawn separately on the CBF map, CBV map, TP map and TS map. The blood flow parameters of focal and contralateral cerebral tissues could be obtained to calculate relative cerebral blood flow (rCBF,rCBF=focal CBF/contralateral CBF), relative cerebral blood volume (rCBV, rCBV= focal CBV/contralateral CBV), a relative time to peak (rTP, rTP= focal TP

  20. Cardiotrophin-1 in Patients with Acute Myocardial Infarction

    Abdolreza S. Jahromi

    2010-01-01

    Full Text Available Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Prothrombotic factors might play an important role in this phenomenon. Inflammation plays a pivotal role in atherosclerosis and coronary heart disease. Cardiotrophin-1 (CT-1, a member of the IL-6 family of cytokines, was identified as a growth factor for cardiac myocytes that induces cardiomyocyte hypertrophy and stimulates cardiac fibroblasts, protects myocytes from cell death. This study was designed to investigate whether plasma concentration of Cardiotrophin-1 (CT-1, in patients who had the first acute myocardial infarction and to analyze their relationship with traditional cardiovascular risk factors. Approach: This study was carried out on 45 patients with Acute Myocardial Infarction (AMI in their first 24 h of admission as case group and 36 healthy matched individuals were studied as the control. Plasma level of cardiotrophin-1 was determined by enzyme-linked immunosorbent assay and the results were compared. Results: Plasma CT-1 levels in the patients with AMI on admission 615.279±5.109 pmol L-1 were significantly higher than those in the control group 534.767±6.750 pmol L-1 (p = 0.001. Plasma CT-1 level was not correlated with diabetes mellitus, hyperlipidemia, sex, age and smoking. Conclusion: Our findings suggested that high plasma CT-1 level in patients with AMI is indicative of hypercoagulable state that is not related to the traditional cardiovascular risk factors.

  1. Anti-Cardiolipin Antibody in Acute Myocardial Infarction

    Abdolreza S. Jahromi

    2010-01-01

    Full Text Available Problem statement: Myocardial infarction is the combined result of environmental and personal factors. Data concerning the relation between anti-Phospholipid (aPL antibodies and myocardial infarction in subjects without evidence of overt autoimmune disease are conflicting. Anticardiolipin antibody is detected in various diseases like rheumatoid arthritis, systemic lupus erythematosus and anti-phospholipid antibody syndrome. The study of Anticardiolipin antibody in Acute Myocardial Infarction (AMI might shed light on etiologic mechanisms in the pathogenesis of acute coronary syndromes. The purpose of the present study was to determine association of plasma aPL antibodies, namely, anti-Cardiolipin (aCL antibodies, with AMI. Approach: This study recruited 45 patients with the diagnosis of AMI according to WHO criteria in their first 24 h of admission. Thirty six matched individuals were studied as the control group with normal coronary artery angiography. Samples were tested for IgG-class antibodies to cardiolipin by an ELISA and the results were compared. Results: There were not significant differences between plasma level of aCLAs IgG in the patients with AMI on admission ant the control group. Also aCLAs IgG was not correlated with hypertension, diabetes mellitus, hyperlipidemia, sex, age and smoking. Conclusion: Our findings suggest that aCLAs IgG are not indicative of hypercoagulable state in patients with AMI.

  2. The effects of different remedies on acute myocardial infarction

    Objective: To investigate the different treatment effects of intravenous thrombolysis vs primary coronary angioplasty and interhospital transfer for primary coronary angioplasty in acute myocardial infarction within 12 hours after onset. Methods: During January 2004 to December 2005, 63 consecutive patients with acute myocardial infarction admitted directly for primary PCI and 25 patients transferred from other hospitals for primary. PCI were compared with 32 patients treated with intravenous thrombolysis. Each patients arrived at hospital within 12 h from chest pain onset. T-test and Chi-square test were used to analyze the rate of mortality, re-infarction, heart failure in-hospital and 1-year latter. Results: Among the 3 groups, for group of intravenous thrombolysis, time interval from arriving to having reflow was the shortest (1.1 ± 0.2 h vs 2.3 ± 1.0 h vs 2.1 ± 1.1 h, P < 0.01), the mortalities in hospital (6.3% vs 3.2% vs 4.0%) and 1-year follow up (12.5% vs 4.8% vs 8.0%)were highest in spite of no statistic difference. After 1 year, the rate of reinfarction in intravenous thrombolysis group is higher than that in PCI group (18.8% vs 4.5%, P < 0.05). Conclusions: The key point of AMI remedy is to open the criminal vessel as fast as possible. Interhospital transfer for PCI is feasible and safe. (authors)

  3. Electroacupuncture acutely improves cerebral blood flow and attenuates moderate ischemic injury via an endothelial mechanism in mice.

    Ji Hyun Kim

    Full Text Available Electroacupuncture (EA is a novel therapy based on traditional acupuncture combined with modern eletrotherapy that is currently being investigated as a treatment for acute ischemic stroke. Here, we studied whether acute EA stimulation improves tissue and functional outcome following experimentally induced cerebral ischemia in mice. We hypothesized that endothelial nitric oxide synthase (eNOS-mediated perfusion augmentation was related to the beneficial effects of EA by interventions in acute ischemic injury. EA stimulation at Baihui (GV20 and Dazhui (GV14 increased cerebral perfusion in the cerebral cortex, which was suppressed in eNOS KO, but there was no mean arterial blood pressure (MABP response. The increased perfusion elicited by EA were completely abolished by a muscarinic acetylcholine receptor (mAChR blocker (atropine, but not a β-adrenergic receptor blocker (propranolol, an α-adrenergic receptor blocker (phentolamine, or a nicotinic acetylcholine receptor (nAChR blocker (mecamylamine. In addition, EA increased acetylcholine (ACh release and mAChR M3 expression in the cerebral cortex. Acute EA stimulation after occlusion significantly reduced infarct volume by 34.5% when compared to a control group of mice at 24 h after 60 min-middle cerebral artery occlusion (MCAO (moderate ischemic injury, but not 90-min MCAO (severe ischemic injury. Furthermore, the impact of EA on moderate ischemic injury was totally abolished in eNOS KO. Consistent with a smaller infarct size, acute EA stimulation led to prominent improvement of neurological function and vestibule-motor function. Our results suggest that acute EA stimulation after moderate focal cerebral ischemia, but not severe ischemia improves tissue and functional recovery and ACh/eNOS-mediated perfusion augmentation might be related to these beneficial effects of EA by interventions in acute ischemic injury.

  4. PSYCHOLOGICAL REACTIONS AND HEALTH BEHAVIOR FOLLOWING ACUTE MYOCARDIAL INFARCTION

    Tatjana Milenković

    2011-06-01

    Full Text Available Psychological reactions, risk health behavior and cardiac parameters can influence rehospitalization after acute myocardial infarction.The aim of the paper was to determine the presence of psychological reactions and risk health behavior in patients with acute myocardial infarction on admission as well as the differences after six months.The research included thirty-trhee patients of both sexes, who were consecutively hospitalized due to acute myocardial infarction. A prospective clinical investigation involved the following: semi-structured interview, Mini International Neuropsychiatric Interview (M.I.N.I for pcychiatric disorders, Beck Anxiety Inventory (BAI for measuring the severity of anxiety, Beck Depression Inventory (BDI for measuring the severity of depression, KON-6 sigma test for aggression, Holms-Rahe Scale (H-R for exposure to stressful events, and Health Behavior Questionnaire: alcohol consumption, cigarette smoking, lack of physical activity. Measurement of the same parameters was done on admission and after six months. The differences were assessed using the t-test and chi-square test for p<0.05.On admission, anxiety (BAI=8.15±4.37 and depression (BDI=8.67±3.94 were mild without significant difference after six months in the group of examinees. Aggression was elevated and significantly lowered after six monts (KON-6 sigma =53,26±9, 58:41,42±7.67, t=2,13 for p<0.05. Exposure to stressful events in this period decreased (H-R=113.19±67.37:91,65±63,81, t=3,14 for p<0.05; distribution of physical activity was significantly higher compared to admission values (54.83%: 84.84%. χ2=5.07 for p<0.01.In the group of examinees with acute myocardial infarction in the period of six months, anxiety and depression remained mildly icreased, while the levels of aggression and exposure to stressful events were lowered. Risk health behavior was maintained, except for the improvement in physical activity. In the integrative therapy and

  5. MTHFR homozygous mutation and additional risk factors for cerebral infarction in a large Italian family.

    Del Balzo, Francesca; Spalice, Alberto; Perla, Massimo; Properzi, Enrico; Iannetti, Paola

    2009-01-01

    Several cases with cerebral infarctions associated with the C677T mutation in the methylenetetrahydrofolate reductase gene (MTHFR) have been reported. Given the large number of asymptomatic individuals with the MTHFR mutation, additional risk factors for cerebral infarction should be considered. This study describes a large family with the MTHFR mutation and a combination of heterozygous factor V Leiden mutations and different additional exogenous and endogenous thrombogenic risk factors. Psychomotor retardation and a left fronto-insular infarct associated with the MTHFR mutation together with diminished factor VII and low level of protein C was documented in the first patient. In the second patient, generalized epilepsy and a malacic area in the right nucleus lenticularis was associated with the MTHFR mutation and a low level of protein C. In the third patient, right hemiparesis and a left fronto-temporal porencephalic cyst were documented, together with the MTHFR mutation and hyperhomocysteinemia. An extensive search of additional circumstantial and genetic thrombogenic risk factors should be useful for prophylaxis and prognosis of infants with cerebral infarctions associated with the MTHFR mutation and of their related family members. PMID:19068258

  6. Cerebral infarction mimicking brain tumor on Tc-99m tetrofosmin brain SPECT imaging

    Kim, Soon [College of Medicine, Dongguk Univ., Gyeongju (Korea, Republic of); Zeon, Seok Kil; Won, Kyoung Sook [School of Medicine, Keimyung Univ., Daegu (Korea, Republic of)

    2004-06-01

    A 43-year-old man was presented with persistent headache for two weeks. T2 weighted MR imaging showed high signal intensity with surrounding edema in the left frontal lobe. These findings were considered with intracranial tumor such as glioma or metastasis. Tc-99m tetrofosmin SPECT showed focal radiotracer accumulation in the left frontal lobe. The operative specimen contained cerebral infarction with organizing leptomeningeal hematoma by pathologist. Another 73-year-old man was hospitalized for chronic headache. Initial CT showed ill-defined hypodensity with mass effect in the right parietal lobe. Tc-99m tetrofosmin SPECT showed focal radiotracer uptake in the right parietal lobe. These findings were considered with low-grade glioma or infarction. Follow-up CT after 5 months showed slightly decreased in size of low density in the right parietal lobe, and cerebral infarction is more likely than others. Tc-99m tetrofosmin has been proposed as a cardiotracer of myocardial perfusion imaging and an oncotropic radiotracer. Tc-99 tetrofosmin SPECT image provides a better attractive alternative agent than TI-201 as a tumor-imaging agent, with characteristics such as high-energy flux, short half-life, favorable biodistribution, dosimetry and lower background radioactivity. We have keep in mind on the analysis of Tc-99m tetrofosmin imaging when cerebral infarction is being differentiated from brain tumor.

  7. Coronary Emboli in a Young Patient with Mechanical Aortic Valve: A Rare Cause of Acute Myocardial Infarction

    Arash Gholoobi

    2016-03-01

    Full Text Available Coronary artery embolism is an uncommon cause of Acute Myocardial Infarction (AMI. Herein, we reported a 24-year-old male who was admitted with acute infero-posterior myocardial infarction and cerebral Transient Ischemic Attack (TIA. He had undergone mechanical Aortic Valve Replacement (AVR surgery 6 years ago. Surprisingly, the patient had decided to stop taking his medication (warfarin 20 days earlier without any medical advice. Coronary angiography revealed a thrombus located at the distal part of the left circumflex artery. Discontinuation of anticoagulant therapy in the presence of mechanical valve prosthesis, clinical evidence of coincidental TIA, and lack of atherosclerotic risk factors were highly suggestive of coronary thromboembolism as the cause of AMI. Overall, this case report emphasized the necessity of continuous education in patients with mechanical heart valves to prevent such undesired events.

  8. Spontaneous Anterior Cerebral Artery Dissection Presenting with Simultaneous Subarachnoid Hemorrhage and Cerebral Infarction in a Patient with Multiple Extracranial Arterial Dissections

    Park, Yung Ki; Yi, Hyeong-Joong; Lee, Young Jun; Kim, Young-Seo

    2013-01-01

    Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subseque...

  9. Diabetes mellitus and cardiogenic shock in acute myocardial infarction

    Lindholm, M G; Boesgaard, S; Torp-Pedersen, C;

    2005-01-01

    AIMS: Cardiogenic shock is the leading cause of in-hospital mortality after acute myocardial infarction (MI). This study investigates the importance of age and preexisting diabetes mellitus on the incidence and prognosis of cardiogenic shock in a large group of consecutive patients with MI. METHODS...... AND RESULTS: Baseline characteristics and in-hospital complications to the infarction were prospectively recorded in 6676 patients with MI. Ten-year mortality was collected. Diabetes was present in 10.8% of the total population. A total of 443 developed cardiogenic shock with an incidence of 6.......2% among nondiabetics and 10.6% among diabetics. Age, wall motion index, reinfarction, and the absence of thrombolytic treatment were significant independent predictors of mortality in patients with cardiogenic shock. Intriguingly, diabetes was not a significant predictor for short- and long-term mortality...

  10. Evaluation of transplantation of mesenchymal cells in acute myocardial infarction

    Aliya Dzholdasbekova

    2012-12-01

    Full Text Available It has been studied in the pilot clinical research the effect of systemic (intravenous transplantation of mesenchymal stem cells (MSC of a bone marrow to 20 patients with an acute myocardial infarction with lifting segment of ST (STEMI carried out in the first 2 hours by percutaneous coronary intervention (PCI with stenting infarct related artery and the common course of drug therapy. It has been shown that the transplantation of MSCs had not caused any complications (allergic reactions, hazardous to health arrhythmias, embolism and heavy frustration of hemodynamic and had not lead to condition deterioration afterwards. In the first 3-6 months after systemic transplantation of MSCs to the patients’ heart contractive activity has been advanced which was clinically proved in the reduction of the heart failure level degree of expressiveness of warm insufficiency.

  11. Intracoronary and systemic melatonin to patients with acute myocardial infarction

    Halladin, Natalie L; Busch, Sarah Ekeløf; Jensen, Svend Eggert;

    2014-01-01

    INTRODUCTION: Ischaemia-reperfusion injury following acute myocardial infarctions (AMI) is an unavoidable consequence of the primary percutaneous coronary intervention (pPCI) procedure. A pivotal mechanism in ischaemia-reperfusion injury is the production of reactive oxygen species following...... following pPCI in patients with AMI. MATERIAL AND METHODS: The IMPACT trial is a multicentre, randomised, double-blinded, placebo-controlled study. We wish to include 2 × 20 patients with ST-elevation myocardial infarctions undergoing pPCI within six hours from symptom onset. The primary end-point is the...... Myocardial Salvage Index assessed by cardiovascular magnetic resonance imaging on day 4 (± 1) after pPCI. The secondary end-points are high-sensitivity troponin, creatinekinase myocardial band and clinical events. CONCLUSION: The aim of the IMPACT trial is to evaluate the effect of melatonin on reperfusion...

  12. Acute Anteroseptal Myocardial Infarction after a Negative Exercise Stress Test

    Al-Alawi, Abdullah M.; Janardan, Jyotsna; Peck, Kah Y.; Soward, Alan

    2016-01-01

    A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST segment elevation myocardial infarction was observed on electrocardiography. After thrombolysis, he was transferred to a tertiary hospital where coronary angiography subsequently revealed significant left anterior descending coronary artery stenosis. Thrombus aspiration and a balloon angioplasty were performed. The patient was discharged three days after the surgical procedure in good health.

  13. Prediction of language and neurologic recovery after cerebral infarction with SPECT imaging using N-isopropyl-p-(I-123) iodoamphetamine

    Fourteen patients (10 with left-sided and 4 with right-sided cerebral infarction) were prospectively studied with single-photon emission computed tomography (SPECT) using N-isopropyl-p-(I-123) iodoamphetamine (IMP, SPECTamine) to determine its usefulness in predicting neurologic/language recovery after cerebral infarction. All neuro-SPECT imaging was performed within 30 days after infarction. Detailed assessment of neurologic and/or language recovery (after 3 months) was carried out prospectively in each patient. Patients with smaller volume IMP defects in the region of infarction demonstrated significantly better neurologic and language recovery than patients with large IMP defects. Analysis of the IMP ''redistribution'' phenomenon failed to demonstrate definitively a relationship with clinical recovery. It was concluded that the volume of the IMP defect can aid in predicting recovery potential after cerebral infarction

  14. Middle cerebral artery occlusion in presence of low perfusion pressure increases infarct size in rats

    Sillesen, H; Nedergaard, Majken; Schroeder, T;

    1988-01-01

    A model was set up in order to evaluate the importance of hemispheric perfusion pressure when the middle cerebral artery (MCA) is occluded in anaesthetized rats. In 6 animals the internal carotid artery (ICA) was occluded prior to ipsilateral MCA occlusion; in 17 animals the MCA only was occluded......; 6 animals underwent the same preparation, but the vessels were left unoccluded. Four days after surgery the infarct volume was measured with a computerized image analyser. The infarcted areas were significantly larger in the ICA + MCA occluded group compared with the MCA occluded group (p less than...... occurs, as compared to patients with no, or only minor, reduction in hemispheric perfusion pressure....

  15. Acute Chagas Disease Induces Cerebral Microvasculopathy in Mice

    Nisimura, Lindice Mitie; Estato, Vanessa; de Souza, Elen Mello; Reis, Patricia A.; Lessa, Marcos Adriano; de Castro-Faria-Neto, Hugo Caire; Pereira, Mirian Claudia de Souza; Tibiriçá, Eduardo; Garzoni, Luciana Ribeiro

    2014-01-01

    Cardiomyopathy is the main clinical form of Chagas disease (CD); however, cerebral manifestations, such as meningoencephalitis, ischemic stroke and cognitive impairment, can also occur. The aim of the present study was to investigate functional microvascular alterations and oxidative stress in the brain of mice in acute CD. Acute CD was induced in Swiss Webster mice (SWM) with the Y strain of Trypanosoma cruzi (T. cruzi). Cerebral functional capillary density (the number of spontaneously perf...

  16. Clinical study of the relationship between arteriosclerosis obliterans (ASO) and cerebral infarction

    To clarify the relationship between arteriosclerosis obliterans (ASO) and cerebral infarction (CI), brain CT was performed and the risk factors for atherosclerosis were assessed. Thirty-five male and 5 female patients with intermittent claudication and/or leg ulceration were angiographically diagnosed as having ASO. According to CT findings, these patients were divided into three groups [no low-density areas (NLDA), hemorrhage, and infarction (CI)]. CI was subdivided as lacunar, cortical, and watershed infarction. Thirteen patients were in the NLDA group and 26 in the CI group (17 lacunar, 3 cortical and 6 mixed infarcts), indicating a CI incidence of 65%. Comparing the risk factors of the CI group with those of the NLDA group, hypertension (53.8%), diabetes (34.6%), and cigarette smoking (69.2%) was often seen in the CI group, although hypercholesterolemia (53.8%) and ischemic heart disease (42.3%) was the same in both groups. Multivariate analysis revealed that smoking had the strongest effect on the occurrence of CI in ASO patients. Furthermore, the number of combined risk factors (hypertension, diabetes, smoking, hypercholesterolemia) had a significant positive correlation with cortical infarction. As to the chronological relationship between the onset of ASO and CI, CI was present in 14 of 27 ASO patients on CT when the ischemic leg symptoms appeared, while symptomatic cortical infarction preceded ASO in 5 patients. CI patients increased gradually over a decade to 26 out of 40, among whom 16 patients with lacunae had silent infarcts. These findings suggested that ASO is frequently associated with CI, not only due to atherosclerosis of the main trunks of the cerebral vessels, but also due to arteriolosclerosis of the perforating arteries. (author)

  17. Correlation between synaptic plasticity, associated proteins, and rehabilitation training in a rat model of cerebral infarction

    Dan Yang; Qian Yu

    2008-01-01

    All motions provide sensory, motoric, and reflexive input to the central nervous system, as well as playing an important role in cerebral functional plasticity and compensation. Cerebral plasticity has become the theoretical basis of neurorehabilitation. Studies of cerebrovascular disease, in particular, demonstrate that regeneration is accompanied by multiple forms of plasticity, such as functional and structural, in different phases of stroke rehabilitation. This study was designed to measure synaptic plasticity and expression of associated proteins to analyze the effect of rehabilitation training on learning and memory in a rat model of cerebral infarction. Results suggest that rehabilitation training increases expression of nerve growth factor associated protein 43, brain-derived neurotrophic factor, and neural cell adhesion molecules, and also promotes cerebral functional plasticity.

  18. "DETERMINANTS OF PREHOSPITAL DELAY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION"

    M. Alidoosti

    2004-05-01

    Full Text Available Determination of pre-hospital delay time of patients with acute myocardial infarction and seeking ways of speeding up the time for reperfusion is an important factor to lower mortality in these patients. This is a cross-sectional study to determine pre-hospital delay time, its components, and related causes and conditions, obtained in 375 patients with prolonged chest pain referred to four hospitals of Tehran University of Medical Sciences. Means of transport to hospital, reasons of ambulance disuse, decision time by the patient and finally the entire time of pre-hospital delay were specified. Suspected factors related to delays of more than 2 and 6 h were scrutinized with chi-square test. Rate of ambulance utility (18.9% directly correlated with age of patients (P<0.05. Principal motives to disuse ambulance insuccession were unrememberance (33.7%, access to private vehicle (32.8% and supposition of sufficient speed of personal reference (18.9%. Pre-hospital delay time was 8.1 ± 9.1 h (mean ± SD in whole patients and 7.6 ± 9.1 h in those with acute myocardial infarction. Delays of more than 2 and 6 hoccurred in 67.5% and 33.6% of patients, respectively. Decision time constitute three fourth of whole pre-hospital delay and was correlated with female gender, older age, history of diabetes, lower level of literacy and nocturnal onset of symptoms. In conclusion, a significant number of patients with acute myocardial infarction have pre-hospital delay of more than 2 and even 6 h, when golden time for thrombolytic therapy has already been elapsed.

  19. The role of diffusion tensor imaging in motor outcome prediction in subcortical cerebral infarction in the acute period%弥散张量成像对急性期皮质下脑梗死肢体运动功能恢复的预测

    周克贵; 柯开富

    2010-01-01

    目的 对急性期内的运动功能残疾的皮质下脑梗死患者进行观察,探讨弥散张量纤维素成像(DTT)显示的锥体束累及程度等多个预测因素对运动功能改变的影响,以期发现最可靠和最密切的预测因素.方法 对82例急性脑梗死残疾患者(mRS评分≥3分),结合其基线临床特征、实验室与影像学等辅助检查及治疗方法 ,选取性别、年龄、高血压、糖尿病、高胆固醇血症、心房颤动或心绞痛史、吸烟史、酗酒史、初始残疾程度、同型半胱氨酸、C反应蛋白、治疗方式、梗死灶体积大小及锥体束累及程度作为观测指标,对患者发病后第90天的情况进行随访分析.结果 单因素差异检验采用x2检验,发现年龄(χ2=47.492,P<0.01)、糖尿病(χ2=5.126,P=0.024)、高胆固醇血症(χ2=6.242,P=0.012)、初始残疾程度(χ2=45.359,P<0.01)、锥体束累及程度(χ2=51.467,P<0.01)均可影响残疾患者的康复.采用多因素Logistic回归分析对其进行多因素回归分析,结果提示年龄(OR=0.068,P=0.042)、锥体束累及程度(OR=0.026,P=0.002)是患者运动功能康复的独立预测因素,而糖尿病、高胆固醇血症、初始残疾程度无明显相关性.结论 通过DTT反映出的锥体束累及程度为对在急性期内的运动功能残疾的皮质下脑梗死患者的康复最有价值的预测因素.%Objective To observe the patients with subcortical cerebral infarction in the acute period, disabled in the motor function, and explore the extent of impact of several predictive factors to the recovery of motor function, including diffusion tensor imaging (DTF) displaying the involving extent of pyramidal tract, in order to find the most reliable and closely predictors. Methods 82 patients with acute cerebral infarction and disability (mRS score ≥ 3 points) were followed up on the 90 d after the symptom onset, respectively. Combining the baseline clinical characteristics, the laboratory

  20. Mortality and morbidity remain high despite captopril and/or valsartan therapy in elderly patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction - Results from the Valsartan in Acute Myocardial Infarction Trial (VALIANT)

    White, HD; Aylward, PEG; Huang, Z; Dalby, AJ; Weaver, WD; Barvik, S; Marin-Neto, JA; Murin, J; Nordlander, RO; van Gilst, WH; Zannad, F; McMurray, JJV; Califf, RM; Pfeffer, MA

    2005-01-01

    Background - The elderly constitute an increasing proportion of acute myocardial infarction patients and have disproportionately high mortality and morbidity. Those with heart failure or impaired left ventricular left ventricular function after acute myocardial infarction have high complication and