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Sample records for cerebral hemorrhage

  1. Phenylpropanolamine and cerebral hemorrhage

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    McDowell, J.R.; LeBlanc, H.J.

    1985-05-01

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures.

  2. Phenylpropanolamine and cerebral hemorrhage

    International Nuclear Information System (INIS)

    Computerized tomography, carotid angiograms, and arteriography were used to diagnose several cases of cerebral hemorrhage following the use of phenylpropanolamine. The angiographic picture in one of the three cases was similar to that previously described in association with amphetamine abuse and pseudoephedrine overdose, both substances being chemically and pharmacologically similar to phenylpropanolamine. The study suggests that the arterial change responsible for symptoms may be due to spasm rather than arteriopathy. 14 references, 5 figures

  3. Cerebral Hemorrhage and APOE genotype

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    Sun xiaojiang; Wu ping; Zhang jing; Lu shanqing; Li bing

    2000-01-01

    Background and Purpose: Current evidence Suggests that the apolipoprotein E (APOE)ε 4 allele predisposes to cerebral amyloid angiopathy (CAA) whereas ε 2 is associated with CAA-zelated hemorrhage. In this study we examined potential clinical risk factors inpatients with cerebral hemorrhage and assessed these with respect to APOE genotype. Methoeds: 146 patinas with cerebral hemorrhage and 70 normal controls were investigated. APOE genotypes were determined with use of polymerase Chain reaction techniques.Results: The frequency of allele gene ( 0.180 ) and the percentage of the APOE ε 4 genotype in the cerebral hemorrhage group were Significantly higher as compared with the e 4 prequency ( O.O72 ) in the control group respectively ( p=O.O389 ) .Conelusious: APOE ε 4 :allele is a risk gene for cerebral hemorrhage.

  4. Asymptomatic cerebral hemorrhage detected by MRI

    International Nuclear Information System (INIS)

    Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author)

  5. Asymptomatic cerebral hemorrhage detected by MRI

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    Nakajima, Yumi; Ohsuga, Hitoshi; Yamamoto, Masahiro; Shinohara, Yukito (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1991-03-01

    Detection of previous cerebral infarction on CT films of patients with no history of stroke is a common occurrence. The incidence of silent cerebral infarction was reported to be about 10 to 11 percent, but very few reports concerning asymptomatic cerebral hemorrhage available. However, recent clinical application of MRI has resulted in the detection of old asymptomatic hemorrhage in patients with no history known stroke-like episodes. The purpose of this study was to elucidate the incidence, the cause and the character of the asymptomatic cerebral hemorrhage among patients who had undergone MRI examinations. From September 1987 through June 1990, 2757 patients have undergone 3474 MR scans of the brain with 1.0 Tesla Siemens Magneton unit in our hospital. Seventeen patients showed no clinical signs or symptoms suggesting a stroke episode corresponding to the detected hemorrhagic lesion. The 17 patients corresponded to 0.6% of the patients who underwent MRI, 1.5% of the patients with cerebrovascular disease and 9.5% of the patients with intracerebral hemorrhage(ICH), which was rather higher than expected. Among the 17 patients, 12 were diagnosed as primary ICH and 5 as secondary ICH. Most of the primary asymptomatic hemorrhage were hypertensive ones and slit-like curvilinear lesions between the putamen and claustrum or external capsule. The secondary asymptomatic hemorrhage were due to AVM and angiomas in the frontal cortex, thalamus and pons. (author).

  6. Cerebral Cavernous Malformation and Hemorrhage

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    ... patients and this could contribute to predisposition to hemorrhagic stroke. Extreme stimulants such as cocaine and other illicit drugs have been shown to cause brain hemorrhages among patients without prior ... even after a hemorrhagic event. Should symptoms suddenly appear, don't delay ...

  7. SURGICAL TACTICS REGARDING CEREBRAL METASTASES WITH HEMORRHAGES

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    E. V. Prozorenko

    2015-01-01

    Full Text Available Cerebral metastases occur with 10 to 30 % of all oncological patients. Hemorrhages into cerebral metastases are one of the most dangerous complications of the metastatic process. With that, cerebral metastases of such widespread solid malignant tumors as melanoma, kidney cancer, germ cell tumors, less frequently, lung cancer and breast cancer are prone to hemorrhages. The purpose of the work is to improve the results of surgical treatment of patients with brain metastases complicated with hemorrhages.Materials  and  methods. Surgical  treatment  of  69  patients  with  brain  metastases complicated  with  hemorrhages was  performed in N.N. Blokhin Russian Cancer Research Center. Hemorrhage on the macroscopic level was confirmed intraoperatively and in accordance with the results of the morphological study of surgical drugs. Total microsurgical resection of one or several cerebral metastases with hemor rhages was performed regarding all patients studied. The time interval of observation of patients after the surgical treatment comprises 1 to 72 months. There were 27 women and 42 men. The age range was from 18 to 74 y.o. Besides, the state of veins of lower extremities and the state of the coagulation blood system in accordance with the data of coagulograms was studies. The analysis of the macrostructure and the microstructure of metastases with hemorrhages as well as the morphological study of the brain tissue adjacent to hematomas was performed with a morphological study and histological techniques. The patients were distributed in accordance with the RPA (recursive partitioning analysis classes: I class (n = 7, II class (n = 39, III class (n = 23; in accordance with the hemorrhage type: intratumoral type (26 metastases, perifocal type (20, mixed type (32; in accordance with the histological principle: melanoma (n = 25, lung cancer (n = 13, kidney cancer (n = 17, breast cancer (n = 4, colorectal cancer (n = 1, soft tissue sarcoma (n

  8. [Cerebral vasospasm after subarachnoid hemorrhage].

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    Milojević, T M; Baljozović, B V; Rakić, M Lj; Nestorović, B D; Dostanić, M M; Milaković, B D; Kojić, Z Z; Repac, N R; Cvrkota, I S

    2008-01-01

    Cerebral vasospasm causes permanent neurolological deficit or death occurance in 13% of clinical cases. Peak frequency is from 8-10th day after SAH. The purpose of this study is factor analysis that may have influence on vasospasm development , as well as predictor determination. The study is prospective and analysis 192 patients treated in Institute of Neurosurgery, Clinical Centre of Serbia, Belgrade. The majority of patients were admitted in hospital in first four days after SAH, and 184 had GCS over 7. Univariate methods of factor analysis were used, and for significance of predictors influence testing multivariante regression analysis was used. Vasospasm occurred in 22,40% of all cases. No relationships have been found between sex, age, previous hypertension, timing of surgery, appearance of hydrocephalus and intracerebral hematoma, hypertermia or mean arterial blood pressure, with occurrence of cerebral vasospasm. Factors with significantly associated with the occurance of vasospasm were: hearth disease, hypernatriemia, Hct, clinical grade on admission as well as preoperative clinical grade and Fisher CT scan grade. In the first four days after SAH, Fisher scan grade, preoperative clinical grade and Hct, appeared as predictors. After four days, clinical grade on admission and hypernatiemia, showed as poredictors. PMID:18792575

  9. Arterial spin-labeling MR imaging of cerebral hemorrhages

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    Noguchi, Tomoyuki [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki [Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Yakushiji, Yusuke [Saga University, Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Kawashima, Masatou [Saga University, Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga (Japan)

    2015-11-15

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  10. Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage.

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    Chen, Zhi; Chen, Jingyu; Miao, Hongpin; Li, Fei; Feng, Hua; Zhu, Gang

    2013-05-01

    Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.

  11. Clinical Features of Liver Cancer with Cerebral Hemorrhage.

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    Lu, Qiuhong; Chen, Li; Zeng, Jinsheng; Huang, Gelun; Qin, Chao; Cheng, Daobin; Yu, Lixia; Liang, Zhijian

    2016-01-01

    BACKGROUND Cerebral hemorrhage is common in patients with cancer, but the clinical features and pathogenesis of liver cancer patients with cerebral hemorrhage are not well known. MATERIAL AND METHODS Liver cancer patients who developed cerebral hemorrhage were recruited from the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014. We retrospectively analyzed clinical presentations, results of laboratory tests, and imaging examinations. The clinical features and pathogenesis were summarized. RESULTS Among 11133 patients with liver cancer, 9 patients (0.08%), including 3 females and 6 males met the inclusion criteria. The age range was 48-73 years and the average age was 61.67±8.97 years. Five patients did not have traditional hemorrhage risk factors and 4s had the risk factors; however, all had developed hepatocellular carcinoma, and 3 had developed metastasis. All 9 patients showed elevated tumor markers: an increased AFP level was detected in 6 patients, coagulation dysfunctions in 8 patients, and abnormal liver functions in 6 patients. Five patients had developed cerebral hemorrhagic lesions in the lobes of their brains, while hemorrhagic lesions in the basal ganglia occurred in 3 patients and in the brainstem in only 1 patient. Four patients had clear consciousness, while 5 patients were in coma and showed poor prognosis. CONCLUSIONS Patients who have liver cancer complicated with cerebral hemorrhage usually lack traditional risk factors of cerebral hemorrhage. The site of cerebral hemorrhage is often detected in the lobes of the brain. Coagulation dysfunctions might be the main pathogenesis of liver cancer complicated with cerebral hemorrhage. PMID:27209058

  12. Clinical Features of Liver Cancer with Cerebral Hemorrhage

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    Lu, Qiuhong; Chen, Li; Zeng, Jinsheng; Huang, Gelun; Qin, Chao; Cheng, Daobin; Yu, Lixia; Liang, Zhijian

    2016-01-01

    Background Cerebral hemorrhage is common in patients with cancer, but the clinical features and pathogenesis of liver cancer patients with cerebral hemorrhage are not well known. Material/Methods Liver cancer patients who developed cerebral hemorrhage were recruited from the First Affiliated Hospital of Guangxi Medical University between January 2003 and December 2014. We retrospectively analyzed clinical presentations, results of laboratory tests, and imaging examinations. The clinical features and pathogenesis were summarized. Results Among 11133 patients with liver cancer, 9 patients (0.08%), including 3 females and 6 males met the inclusion criteria. The age range was 48–73 years and the average age was 61.67±8.97 years. Five patients did not have traditional hemorrhage risk factors and 4s had the risk factors; however, all had developed hepatocellular carcinoma, and 3 had developed metastasis. All 9 patients showed elevated tumor markers: an increased AFP level was detected in 6 patients, coagulation dysfunctions in 8 patients, and abnormal liver functions in 6 patients. Five patients had developed cerebral hemorrhagic lesions in the lobes of their brains, while hemorrhagic lesions in the basal ganglia occurred in 3 patients and in the brainstem in only 1 patient. Four patients had clear consciousness, while 5 patients were in coma and showed poor prognosis. Conclusions Patients who have liver cancer complicated with cerebral hemorrhage usually lack traditional risk factors of cerebral hemorrhage. The site of cerebral hemorrhage is often detected in the lobes of the brain. Coagulation dysfunctions might be the main pathogenesis of liver cancer complicated with cerebral hemorrhage. PMID:27209058

  13. Acute cerebral paragonimiasis presenting as hemorrhagic stroke in a child.

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    Chen, Zhi; Zhu, Gang; Lin, Jiangkai; Wu, Nan; Feng, Hua

    2008-08-01

    A hemorrhagic stroke in children is rarely secondary to cerebral paragonimiasis. We describe a 9-year-old boy in whom an intracerebral hemorrhage was the leading clinical indication of acute cerebral paragonimiasis. He was hospitalized because of a sudden onset of headache, right hemiparesis, and dysarthria. A computed tomography scan revealed an intracerebral hemorrhage in the left parietal lobe. Magnetic resonance angiography did not confirm any vascular abnormalities at the location of the hematoma. Four weeks later, he presented with right hemiparesis again, and fever. A diagnosis of cerebral paragonimiasis was based on repeated magnetic resonance imaging of the brain and an enzyme-linked immunosorbent assay for paragonimiasis. The patient gradually recovered with praziquantel treatment. Cerebral paragonimiasis should be considered in the differential diagnosis of hemorrhagic strokes in children in areas where paragonimiasis is epidemic.

  14. Treatment of acute hydrocephalus and cerebral ischemia after subarachnoid hemorrhage

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    D. Hasan (Djo)

    1990-01-01

    textabstractOnly recently has acute hydrocephalus after subarachnoid hemorrhage been recognized as a clinical important problem. The mortality rate in patients with acute hydrocephalus after subarachnoid hemorrhage is higher than in those without, which is mainly caused by cerebral ischemia. An expl

  15. A schizophrenic patient with cerebral infarctions after hemorrhagic shock

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    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.

  16. Cerebral hemorrhage without manifest motor paralysis

    International Nuclear Information System (INIS)

    Before the introduction of computerized tomography (CT) there were some cases of intracerebral bleeding who were wrongly diagnosed as hypertensive encephalopathy or senile psychosis. We here report 5 cases who did not show any sign of motor paralysis. The clinical aspects of these cases were nausea and vomiting with dizziness (case 1), nausea and vomiting with slight headache (case 2), agnosia of left side with several kinds of disorientation (case 3), nausea and vomiting (case 4), and visual disturbance of right, lower quadrant (case 5). All of these cases showed no motor paralysis or abnormal reflex activities. By examination with CT each of them exhibited a high density area in the subcortical area of the right parietal lobe, the subcortical area of the right occipital lobe, the right temporal and parietal lobe, rather small portion of the left putamen and external capsule, and the subcortical area of left occipital lobe, respectively. Patients of cerebral hemorrhage without motor or sensory disturbances might often be taken for some psychic abnormality. We here have emphasized the importance of CT in such a group of patients. But for this technique, most of them would not be given adequate treatment and might be exposed to lifethreatening situations. (author)

  17. Contrast study on CT and BA in cerebral hemorrhage due to hypertension%CONTRAST STUDY ON CT AND BA IN CEREBRAL HEMORRHAGE DUE TO HYPERTENSION

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    Mingshun Liu; Guoqiu Wang; Po Ma

    2007-01-01

    Objectives:To explore contrast application on CT and BA in cerebral hemorrhage due to hypertension. Methods: CT and BA were examined in 106 patients with cerebral hemorrhage due to hypertension. Results:The different changes of CT and BA were showed in 106 patients with cerebral hemorrhage due to hypertension. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of cerebral hemorrhage due to hypertension. The value of clinical application of BA was important in cerebral hemorrhage due to hypertension.

  18. Clinical and pathological study on 10 cases of cerebral lobe hemorrhage related with cerebral amyloid angiopathy

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    Xiao-qi LI

    2015-07-01

    Full Text Available Objective To summarize the clinical data and pathological features of 10 cases of cerebral lobar hemorrhage related with cerebral amyloid angiopathy (CAA diagnosed pathologically, thereby to improve the knowledge and diagnosis of the disease. Methods The clinical data of 10 cases of cerebral lobar hemorrhage related with CAA, collected in the General Hospital of Shenyang Command from 1983 up to now, were retrospectively analyzed, and the clinical and neuropathological features of these cases were summarized. Results Of the 10 patients, 2 suffered from single lobar hemorrhage and 8 multiple lobar hemorrhage, all of them were confirmed pathologically to have ruptured into the subarachnoid space. Pathological examination revealed microaneurysm in 2 cases, "double barrel" change in 4 cases, multiple arteriolar clusters in 5 cases, obliterative onion-liked intima change in 4 cases, and fibrinoid necrosis of vessel wall in 7 cases. In addition, neurofibrillary tangles were found in 8 cases, and senile plaque was observed in 5 cases. Conclusions Cerebral lobar hemorrhage related with CAA is mainly located in the parietal, temporal and occipital lobes, readily breaking into the subarachnoid space, and it is often multiple and recurrent. The CAA associated microvasculopathy was found frequently in the autopsy sample of CAA related cerebral lobar hemorrhage, and it may contribute to the pathogenesis of cerebral hemorrhage. DOI: 10.11855/j.issn.0577-7402.2015.07.04

  19. Action of Schwann Cells Implanted in Cerebral Hemorrhage Lesion

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    HONG WAN; SHAO-DONG ZHANG; JUN-HUA LI

    2007-01-01

    Objective To investigate whether there is neogenesis of myelin sheath and neuron after transplantation of Schwann cells into cerebral hemorrhage lesion. Methods Schwann cells were expanded, labeled with BrdU in vitro and transplanted into rat cerebral hemorrhage with blood extracted from femoral artery and then injected into the basal nuclei. Double immunohistochemistry staining and electron microscopy were used to detect the expression of BrdU/MBP and BrdU/GAP-43 and remyelination. Results BrdU/MBP double positive cells could be seen at 1 week up to 16 weeks after transplantation of Schwann cells. Thin remyelination was observed under electron microscope. GAP-43 positive cells appeared after 12 weeks and were found more in Hippocamp. Conclusions Grafted Schwann cells participate in remyelination and promoter nerve restore in rat cerebral hemorrhage.

  20. Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration

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    Mocharla, R. [Department of Radiology, Slot 105, Arkansas Children`s Hospital, 800 Marshall Street, Litte Rock, AR 72202-3591 (United States); Schexnayder, S.M. [Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR (United States)]|[Department of Critical Care Medicine, University of Arkansas for Medical Sciences and Arkansas Children`s Hospital, Little Rock, AR (United States); Glasier, C.M. [Department of Radiology, Slot 105, Arkansas Children`s Hospital, 800 Marshall Street, Litte Rock, AR 72202-3591 (United States)]|[Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR (United States)

    1997-10-01

    We report neuroimaging findings of intracranial hemorrhage and cerebral edema in an infant with obtundation and seizures, initially suspected to be secondary to non-accidental trauma but finally attributed to hypernatremic dehydration. Neuroimaging findings due to hypernatremic dehydration have not been previously described in the radiologic literature. Hypernatremia should be included in the differential diagnosis of intracranial hemorrhage in the infant without evidence of nonaccidental trauma. (orig.). With 1 fig.

  1. Fatal cerebral edema and intracranial hemorrhage associated with hypernatremic dehydration

    International Nuclear Information System (INIS)

    We report neuroimaging findings of intracranial hemorrhage and cerebral edema in an infant with obtundation and seizures, initially suspected to be secondary to non-accidental trauma but finally attributed to hypernatremic dehydration. Neuroimaging findings due to hypernatremic dehydration have not been previously described in the radiologic literature. Hypernatremia should be included in the differential diagnosis of intracranial hemorrhage in the infant without evidence of nonaccidental trauma. (orig.). With 1 fig

  2. Matrix Metalloproteinases in Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage

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    Vivek Mehta

    2013-01-01

    Full Text Available Delayed cerebral vasospasm is a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH. While the cellular mechanisms underlying vasospasm remain unclear, it is believed that inflammation may play a critical role in vasospasm. Matrix metalloproteinasees (MMPs are a family of extracellular and membrane-bound proteases capable of degrading the blood-rain barrier (BBB. As such, MMP upregulation following SAH may result in a proinflammatory extravascular environment capable of inciting delayed cerebral vasospasm. This paper presents an overview of MMPs and describes existing data pertinent to delayed cerebral vasospasm.

  3. Changes in Cerebral Perfusion around the Time of Delayed Cerebral Ischemia in Subarachnoid Hemorrhage Patients

    NARCIS (Netherlands)

    Dankbaar, J. W.; de Rooij, N. K.; Smit, E. J.; Velthuis, B. K.; Frijns, C. J. M.; Rinkel, G. J. E.; van der Schaaf, I. C.

    2011-01-01

    Background: Because the pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear, we studied cerebral perfusion at different time points around the occurrence of DCI. Methods: We prospectively enrolled 53 patients admitted to the University Medical Center Utrech

  4. Relationship between vasospasm, cerebral perfusion, and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

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    Dankbaar, Jan W.; Rijsdijk, Mienke; van der Schaaf, Irene C.; Velthuis, Birgitta K.; Wermer, Marieke J. H.; Rinkel, Gabriel J. E.

    2009-01-01

    Vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is thought to cause ischemia. To evaluate the contribution of vasospasm to delayed cerebral ischemia (DCI), we investigated the effect of vasospasm on cerebral perfusion and the relationship of vasospasm with DCI. We studied 37 consecutive SAH

  5. RECENT PROGRESSES OF ACUPUNCTURE TREATMENT OF CEREBRAL HEMORRHAGE

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    赵耀东; 郑俊江; 郑魁山

    2003-01-01

    In the present paper, the authors review recent progresses of acupuncture treatment of cerebral hem-orrhage and theoretical research. Regarding the clinical application of acupuncture therapy, in the acute stage of thedisease, many doctors adopt body acupuncture and scalp-acupuncture, fewer doctors applied eye acupuncture; whilein the chronic stage of the disease, many medical workers employ body acupuncture, sc alp-acupuncture, combinedtherapies of acupuncture, functional exercise, massage, acupoint injection, etc.. Concerning studies on the mecha-nisms of acupuncture in the treatment of cerebral hemorrhage, abundant experience evidence show that acupuncturecan raise the activity of the plasma fibrinolytic system to promote the absorption of blood clots of the foci; improve mi-crocirculation; reduce cerebral tissue edema; regulate some chemical substances' levels to lessen harmful effects ofoxygen free radicals; and enhance the patient' s immune function. However, some problems still exist in clinical re-searches at present and affect the reasonable evaluation on the clinical therapeutic effect of acupuncture.

  6. Youth hypertension cerebral hemorrhage in basal ganglia surgery operation analysis

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    Qi-Hua Wang; Da-Shuang Lu; Jie Cui; Bo-Lin Qiao; Jing-Chun Wang

    2016-01-01

    Objective:Discuss surgical treatment of youth hypertension cerebral hemorrhage in basal ganglia.Methods:Retrospective analysis from January 2012 to April 2015 were adopted to bone flap craniotomy decompression for removal of hematoma and drainage drilling two kinds of surgical treatment of 46 cases of young patients with hypertension cerebral hemorrhage in basal ganglia.Results:Surgical operation, 28 patients postoperative review head CT, no further hemorrhage cases, residual hematoma volume 2-6 mL. Drilling drainage in the treatment of 18 patients, 1 case was bleeding again given surgical operation to remove the hematoma and the rest of the 17 cases without bleeding again, after 3 d, 17 cases of patients of postoperative hematoma drainage thoroughly. After 6 months, 46 cases of patients with postoperative review, GOS score light disability 9 cases, moderate disability 33 cases, 4 cases were severely disabled, curative effect is satisfied.Conclusions:Two kinds of operative methods each have advantages and disadvantages, young patients with hypertension cerebral hemorrhage in basal ganglia should according to patients' disease progression after speed, on admission patient's state of consciousness and head CT measured on admission hematoma volume, respectively.

  7. CT guided interventional therapy for hypertensive cerebral hemorrhage

    International Nuclear Information System (INIS)

    Objective: To discuss the curative effect of CT-guided puncture and drainage in treating hypertensive cerebral hemorrhage. Methods: Adjusting the suitable point and direction of puncture according to the form and size of the haematoma and patient's status, the haematoma was eliminated by minimally invasive puncture and drainage guided under CT layer image in 40 cases of hypertensive cerebral hemorrhage. Results: Modality rate of treatment group was 12.5% (5/40), and is much lower than control group, which was 45% (13/30) (P<0.01). When asscess the Activities of Daily Living (ADL) after 6 months follow-up, the ADL1-ADL3 scale in treatment group was 27 cases (70%), and was much higher than that in control group, which was 29.4% (5/17), (P < 0.05). Conclusion: Minimal invasive therapy of cerebral hemorrhage has great superiority in elimination most part of the hematoma such as simple, accurate location, low cost, safe and effective, and is worthy of recommendation clinically. (authors)

  8. Role of unphosphorylated transcription factor STAT3 in late cerebral ischemia after subarachnoid hemorrhage

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    Samraj, Ajoy K; Müller, Anne H; Grell, Anne-Sofie;

    2014-01-01

    Molecular mechanisms behind increased cerebral vasospasm and local inflammation in late cerebral ischemia after subarachnoid hemorrhage (SAH) are poorly elucidated. Using system biology tools and experimental SAH models, we have identified signal transducer and activator of transcription 3 (STAT3...

  9. Cerebral computed tomographic angiography scan delay in subarachnoid hemorrhage

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    Lukosevicius Saulius

    2005-01-01

    Full Text Available CONTEXT: Computed tomographic angiography (CTA is widely applied in the evaluation of cerebral vessels. Contrast enhancement in cerebral CTA without care or test bolus is not always sufficient for high-quality images. AIMS: Evaluation of the possibilities of calculation of scan delay for cerebral CTA in case of subarachnoid hemorrhage (SAH, based on clinical data of a patient and to find out prognostic error of the model. SETTINGS AND DESIGN: Prospective study in Neurosurgery and Radiology departments. MATERIALS AND METHODS: Scan delay in 53 patients suffering an acute SAH was measured employing test bolus technique. Cerebral CTA was performed afterwards. STATISTICAL ANALYSIS USED: SPSS for Windows v.10.1 software package was applied for dispersion analysis, including one-sample Kolmogorov-Smirnov′s test and Levene′s Test of Equality of Error Variances. RESULTS: A statistical model for the prediction of scan delay in SAH was developed. Cerebral CTA scan delay was dependent upon age, neurological status and impact of the latter factors together (P<0.05. The determined mean square error of prognosis of scan delay of the developed model equals 3.3 sec. CONCLUSION: Using our proposed model it is possible to estimate an optimal delay time for CTA in most patients with SAH with a determined error.

  10. Categorical course in neuroradiology cerebral ischemia, hemorrhage, and vascular lesions

    International Nuclear Information System (INIS)

    The diagnostic imaging of acute stroke is primarily directed toward identifying the lesion, characterizing it as either intracranial hemorrhage or ischemia, and assessing the anatomic extent of the lesion. The acute medical or surgical management decisions are best aided by a combination of CT and cerebral angiography, the latter used acutely mostly for intracranial hemorrhage, especially subarachnoid hemorrhage. More complex presentations benefit from MR imaging evaluation as well. After the acute phase, the main goal of treatment, especially for patients who have had reasonable recovery from the acute stroke, is the prevention of recurrent, and perhaps more severe, stroke. Treatments such as aneurysm clipping or arteriovenous malformation removal for hemorrhagic lesions, or anticoagulation or carotid endarterectomy for ischemic lesions, require brain and vascular imaging studies for appropriate treatment planning. Angiography to show the anatomic vascular cause for the bleed or ischemia is therefore usually a requirement. The enlarging experience with MR imaging has contributed greatly to the identification of occult vascular lesions of the brain that may be prone to bleeding and to recognizing blood in the brain accurately. For this purpose MR imaging is sometimes more specific than CT

  11. Drug treatment of cerebral vasospasm after subarachnoid hemorrhage following aneurysms

    Institute of Scientific and Technical Information of China (English)

    Yongfei Liu; HanCheng Qiu; Juan Su; WeiJian Jiang

    2016-01-01

    Cerebral vasospasm (CVS) is a common and severe complication of aneurysmal subarachnoid hemorrhage (aSAH). Despite the improvement in treatment of aSAH, CVS complicating aSAH has remained the main cause of death. CVS begins most often on the third day after the ictal event and reaches the maximum on the 5th–7th postictal days. Several therapeutic modalities have been employed to prevent or reverse CVS. The aim of this review is to summate all the available drug treatment modalities for vasospasm.

  12. Value of serum OPN levels in patients with acute cerebral hemorrhage for assessment of nerve function impairment

    Directory of Open Access Journals (Sweden)

    Jian-Ming Li

    2016-05-01

    Conclusions: The level of serum OPN in patients with acute cerebral hemorrhage increased significantly. The level of serum OPN could estimate the bleeding volume and the severity of nerve function impairment for patients with acute cerebral hemorrhage.

  13. A study on correlation of obstructive sleep apnea-hypopnea syndrome and perihematoma edema of hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    高晓刚

    2013-01-01

    Objective To analyse the correlation of obstructive sleep apnea-hypopnea syndrome (OSAHS) and perihematoma edema of hypertensive cerebral hemorrhage.Methods One hundred and forty-four patients with hypertensive cerebral hemorrhage were collected and 78 of

  14. Chronic cerebral paragonimiasis combined with aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Choo, Juk-Dong; Suh, Bumn-Suk; Lee, Hyun-Sung; Lee, Jong-Soo; Song, Chang-June; Shin, Dae-Whan; Lee, Young-Ha

    2003-11-01

    A 67-year-old Korean woman attended our hospital complaining of a severe headache. A brain computed tomography scan showed conglomerated, high-density, calcified nodules in the left temporo-occipito-parietal area and high-density subarachnoid hemorrhage in the basal cisterns. Magnetic resonance imaging of the brain shows multiple conglomerated iso- or low-signal intensity round nodules with peripheral rim enhancement. She underwent craniotomies to clip the aneurysm and remove the calcified masses. Paragonimus westermani eggs were identified in the calcified necrotic lesions. Results of parasitic examinations on the sputum and an enzyme-linked immunosorbent assay for P. westermani were all negative. The patient presented with headache and dizziness that had occurred for more than 30 years. She had not eaten freshwater crayfish or crabs. However, she had sometimes prepared raw crabs for several decades. Overall, this case was diagnosed as chronic cerebral paragonimiasis, in which she may have been infected through the contamination of utensils during the preparation of the second intermediate hosts, combined with a cerebral hemorrhage.

  15. Application values of clinical nursing pathway in patients with acute cerebral hemorrhage

    OpenAIRE

    Li, WeiHua; GAO, JIANMEI; WEI, SHUFANG; Wang, Donghai

    2015-01-01

    Acute cerebral hemorrhage accounts for approximately 25% of strokes for elderly patients. Consequently, treatments to improve prognosis should be identified. The aim of the present study was to examine the clinical values of the application of clinical nursing pathway for patients with acute cerebral hemorrhage. Between January 2013 and January 2015, 92 patients diagnosed with acute intracerebral hemorrhage were enrolled in the study based on the guidelines recommended for providing appropria...

  16. Surgical strategy for cerebral arteriovenous malformation with acute hemorrhage

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Presently, there have been craniocerebral operation, interventional embolization,stereotactic radiotherapy and other methods in treating cerebral arteriovenous malformation (AVM).However, the standard of different therapeutic regimens of cerebral AVM at the acute stage of hemorrhage has not been completely identified.OBJECTIVE: To observe the clinical characteristics and therapeutic effects of AVM at the acute stage of hemorrhage in patients, and to analyze corresponding therapeutic strategies.DESIGN: Non-randomized clinical observation.SETTING: Department of Neurosurgery, Foshan First People's Hospital, Sun Yat-sen University.PARTICIPANTS: Forty-six patients with cerebral AVM complicated by hemorrhage admitted to Department of Neurosurgery, Foshan First People's Hospital between January 1999 and December 2006,were involved in this study. All the patients were confirmed as cerebral AVM complicated by hemorrhage by brain angiography or/and postoperational pathology. The involved patients, 32 males and 14 females,averaged 25 years old, ranging from 6 to 62 years. Informed consents of therapeutic items were obtained from the relatives of all the patients.METHODS: ①On admission, skull CT and brain angiography were conducted in the involved subjects. ②The therapeutic method was confirmed according to the consciousness, hematoma region, hematoma volume,imageological results following comprehensive analysis: DSA examination was permitted to identify the size and position of abnormal vessel mass, and the distribution of feeding artery and draining vein. Craniocerebral operation was carried out as early as possible in patients with severe or progressive conscious disturbance, in which most of hematoma with obvious occupied effect or cerebral hernia was located in lobe of brain. The primary thing was to clean intracerebral hematoma for in time decompression. According to different situations, corresponding therapeutic measures were used for resecting abnormal

  17. New auto-segment method of cerebral hemorrhage

    Science.gov (United States)

    Wang, Weijiang; Shen, Tingzhi; Dang, Hua

    2007-12-01

    A novel method for Computerized tomography (CT) cerebral hemorrhage (CH) image automatic segmentation is presented in the paper, which uses expert system that models human knowledge about the CH automatic segmentation problem. The algorithm adopts a series of special steps and extracts some easy ignored CH features which can be found by statistic results of mass real CH images, such as region area, region CT number, region smoothness and some statistic CH region relationship. And a seven steps' extracting mechanism will ensure these CH features can be got correctly and efficiently. By using these CH features, a decision tree which models the human knowledge about the CH automatic segmentation problem has been built and it will ensure the rationality and accuracy of the algorithm. Finally some experiments has been taken to verify the correctness and reasonable of the automatic segmentation, and the good correct ratio and fast speed make it possible to be widely applied into practice.

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

    International Nuclear Information System (INIS)

    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)

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

    Energy Technology Data Exchange (ETDEWEB)

    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).

  20. Follow-up CT of hemorrhagic cerebral infarction

    International Nuclear Information System (INIS)

    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)

  1. Hemostasis and fibrinolysis in delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage : a systematic review

    NARCIS (Netherlands)

    Boluijt, Jacoline; Meijers, Joost C. M.; Rinkel, Gabriel J. E.; Vergouwen, Mervyn D. I.

    2015-01-01

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) has been associated with microthrombosis, which can result from activated hemostasis, inhibited fibrinolysis, or both. We systematically searched the PUBMED and EMBASE databases to identify hemostatic or fibrinolytic par

  2. Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage : the role of coagulation and fibrinolysis

    NARCIS (Netherlands)

    M.D.I. Vergouwen

    2009-01-01

    Patients with aneurysmal subarachnoid hemorrhage (SAH) are at risk to develop complications, especially within the first two weeks after the hemorrhage. Delayed cerebral ischemia (DCI) is a complication which occurs in about 30% of SAH patients, leading to symptoms such as aphasia, hemiparesis, or i

  3. Angiopoietin-1 is associated with cerebral vasospasm and delayed cerebral ischemia in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Pfausler Bettina

    2011-05-01

    Full Text Available Abstract Background Angiopoietin-1 (Ang-1 and -2 (Ang-2 are keyplayers in the regulation of endothelial homeostasis and vascular proliferation. Angiopoietins may play an important role in the pathophysiology of cerebral vasospasm (CVS. Ang-1 and Ang-2 have not been investigated in this regard so far. Methods 20 patients with subarachnoid hemorrhage (SAH and 20 healthy controls (HC were included in this prospective study. Blood samples were collected from days 1 to 7 and every other day thereafter. Ang-1 and Ang-2 were measured in serum samples using commercially available enzyme-linked immunosorbent assay. Transcranial Doppler sonography was performed to monitor the occurrence of cerebral vasospasm. Results SAH patients showed a significant drop of Ang-1 levels on day 2 and 3 post SAH compared to baseline and HC. Patients, who developed Doppler sonographic CVS, showed significantly lower levels of Ang-1 with a sustained decrease in contrast to patients without Doppler sonographic CVS, whose Ang-1 levels recovered in the later course of the disease. In patients developing cerebral ischemia attributable to vasospasm significantly lower Ang-1 levels have already been observed on the day of admission. Differences of Ang-2 between SAH patients and HC or patients with and without Doppler sonographic CVS were not statistically significant. Conclusions Ang-1, but not Ang-2, is significantly altered in patients suffering from SAH and especially in those experiencing CVS and cerebral ischemia. The loss of vascular integrity, regulated by Ang-1, might be in part responsible for the development of cerebral vasospasm and subsequent cerebral ischemia.

  4. Predicting hemorrhagic transformation by microvascular permeability using perfusion CT acute cerebral infarction in elderly patients

    Institute of Scientific and Technical Information of China (English)

    田超

    2014-01-01

    Objective To study the possibility of microvascular permeability(PS)value derived from perfusion CT(PCT)in predicting hemorrhagic transformation(HT)in acute cerebral infarction in elderly patients.Methods 52consecutive patients with middle cerebral artery acute ischemic stroke who received thrombolytic therapy were divided into HT group and control group,and patients in

  5. Detection of acute cerebral hemorrhage in rabbits by magnetic induction

    Energy Technology Data Exchange (ETDEWEB)

    Sun, J.; Jin, G.; Qin, M.X. [College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing (China); Wan, Z.B. [Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing (China); Wang, J.B.; Wang, C.; Guo, W.Y. [College of Electronic Engineering, Xidian University, Xi' an, China, College of Electronic Engineering, Xidian University, Xi' an (China); Xu, L.; Ning, X.; Xu, J.; Pu, X.J.; Chen, M.S. [College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing (China); Zhao, H.M. [Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing (China)

    2014-02-17

    Acute cerebral hemorrhage (ACH) is an important clinical problem that is often monitored and studied with expensive devices such as computed tomography, magnetic resonance imaging, and positron emission tomography. These devices are not readily available in economically underdeveloped regions of the world, emergency departments, and emergency zones. We have developed a less expensive tool for non-contact monitoring of ACH. The system measures the magnetic induction phase shift (MIPS) between the electromagnetic signals on two coils. ACH was induced in 6 experimental rabbits and edema was induced in 4 control rabbits by stereotactic methods, and their intracranial pressure and heart rate were monitored for 1 h. Signals were continuously monitored for up to 1 h at an exciting frequency of 10.7 MHz. Autologous blood was administered to the experimental group, and saline to the control group (1 to 3 mL) by injection of 1-mL every 5 min. The results showed a significant increase in MIPS as a function of the injection volume, but the heart rate was stable. In the experimental (ACH) group, there was a statistically significant positive correlation of the intracranial pressure and MIPS. The change of MIPS was greater in the ACH group than in the control group. This high-sensitivity system could detect a 1-mL change in blood volume. The MIPS was significantly related to the intracranial pressure. This observation suggests that the method could be valuable for detecting early warning signs in emergency medicine and critical care units.

  6. Detection of acute cerebral hemorrhage in rabbits by magnetic induction

    International Nuclear Information System (INIS)

    Acute cerebral hemorrhage (ACH) is an important clinical problem that is often monitored and studied with expensive devices such as computed tomography, magnetic resonance imaging, and positron emission tomography. These devices are not readily available in economically underdeveloped regions of the world, emergency departments, and emergency zones. We have developed a less expensive tool for non-contact monitoring of ACH. The system measures the magnetic induction phase shift (MIPS) between the electromagnetic signals on two coils. ACH was induced in 6 experimental rabbits and edema was induced in 4 control rabbits by stereotactic methods, and their intracranial pressure and heart rate were monitored for 1 h. Signals were continuously monitored for up to 1 h at an exciting frequency of 10.7 MHz. Autologous blood was administered to the experimental group, and saline to the control group (1 to 3 mL) by injection of 1-mL every 5 min. The results showed a significant increase in MIPS as a function of the injection volume, but the heart rate was stable. In the experimental (ACH) group, there was a statistically significant positive correlation of the intracranial pressure and MIPS. The change of MIPS was greater in the ACH group than in the control group. This high-sensitivity system could detect a 1-mL change in blood volume. The MIPS was significantly related to the intracranial pressure. This observation suggests that the method could be valuable for detecting early warning signs in emergency medicine and critical care units

  7. Cerebral hemorrhage without manifest motor paralysis. Reports of 5 cases

    Energy Technology Data Exchange (ETDEWEB)

    Taketani, T.; Dohi, I.; Miyazaki, T.; Handa, A. (Central Hospital of JNR, Tokyo (Japan))

    1982-01-01

    Before the introduction of computerized tomography (CT) there were some cases of intracerebral bleeding who were wrongly diagnosed as hypertensive encephalopathy or senile psychosis. We here report 5 cases who did not show any sign of motor paralysis. The clinical aspects of these cases were nausea and vomiting with dizziness (case 1), nausea and vomiting with slight headache (case 2), agnosia of left side with several kinds of disorientation (case 3), nausea and vomiting (case 4), and visual disturbance of right, lower quadrant (case 5). All of these cases showed no motor paralysis or abnormal reflex activities. By examination with CT each of them exhibited a high density area in the subcortical area of the right parietal lobe, the subcortical area of the right occipital lobe, the right temporal and parietal lobe, rather small portion of the left putamen and external capsule, and the subcortical area of left occipital lobe, respectively. Patients of cerebral hemorrhage without motor or sensory disturbances might often be taken for some psychic abnormality. We here have emphasized the importance of CT in such a group of patients. But for this technique, most of them would not be given adequate treatment and might be exposed to lifethreatening situations.

  8. Cllnical analysis on 80 cases with hypertensive cerebral hemorrhage compllcating upper digestive tract hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Yang Y1chao; Wang Jian; Ye Bin; Li Honghong

    2000-01-01

    Objective: To irrvestigate the treatment and prognosis of the hypertensive cerebral hemorrhage (HCH)With upper dgest tract hemorrhage (UDDIH). Scence:I a surey of 760 cases randomely with HCH in nerve department betweem Jaruarry 1995 and October 1999, including 80 cases wuth UDTH (9.5%). Of the 80 cases 55 were males and25 were fenales, mean age of 60.2 years andrange of 45 to 80 years. Methods:To analyze the clinical materials of 80 cases with HCH complicating UDTH and HCH without UDTH for the same time. Results: Of the 80 cases 52 were cled during the treatment, death rate was 65%, but the death rate of cases without UDTH was 30.2% at the sane time. The death rate of HCH complicating UDTH was significantly ligher than that without UDTH Discussion The nosogeny of HCH complicating UDTH was more likely related to thalanic and brain-stem Lew is thought that thalemric and brain-stem were stimulated to secret CRF and made pituitany gland release ACTH, futhet secret advencortirn These factors gave rise to UDTH by incriesed to secretion of gastic acid Therefore, original ciseases wre Primarily be predcted and treated Patients with intracranial lypenrtension should be inmediately treated by using manniol or glyceric co, and antiacid, anticholinergic drugs. If all kinds of methods shouldn′t control UDTH, thrombin and noradrenaline bitarlrate with cold Natrii Chlori de would be giwn by nostril There have bettertherapeutic efficiency. Conclusion: HCH with UDTH belongs to severe cases, death rates are higher, original diseases and complication should be actively treated

  9. Secondary decline of cerebral autoregulation is associated with worse outcome after intracerebral hemorrhage

    DEFF Research Database (Denmark)

    Reinhard, Matthias; Neunhoeffer, Florian; Gerds, Thomas A;

    2010-01-01

    and 5 after ictus. Autoregulation was noninvasively measured from spontaneous fluctuations of blood pressure and middle cerebral artery flow velocity (assessed by transcranial Doppler) using the correlation coefficient index Mx. From the same signals, non-invasive cerebral perfusion pressure was......PURPOSE: Blood pressure management in acute intracerebral hemorrhage (ICH) relies on functioning cerebral autoregulation. The time course of autoregulation in acute ICH and its relation with clinical outcome are not known. METHODS: Twenty-six patients with spontaneous ICH were studied on days 1, 3...... related with lower Glasgow coma score, ventricular hemorrhage (both sides) and lower noninvasive cerebral perfusion pressure (ipsilateral). Increasing ipsilateral Mx between days 3 and 5 was related with lower Glasgow coma score and ventricular hemorrhage. In a multivariate analysis controlling for other...

  10. Effect of intracranial hypertension on cerebral hemorrhage induced autonomic nerve imbalance

    Institute of Scientific and Technical Information of China (English)

    Xuelong Jin; Wenli Jing; Fengxia Yan; Zhaoqiang Zhang; Fengjun Lü; Shuiqing Jing; Na Sun; Kazushige Mizoguchi

    2007-01-01

    BACKGROUND: Cerebral hemorrhage can cause the imbalance of nerve function, whereas its mechanism and main impact factors are still not quite clear.OBJECTIVE: To explore the rules about the changes of intracranial pressure in brainstem hemorrhage and internal capsule hemorrhage, and analyze the role of intracranial hypertension in the changes of nerve function caused by cerebral hemorrhage.DESIGN: A self-controlled trial.SETTING: Department of Physiology, Tianjin Medical University.MATERIALS: Sixty-five healthy male Japanese white rabbits with long ears (1.5-1.8 kg) were supplied and fed by the Department of Animal Experiment of Tianjin Medical University. The RM6240B biological signal collecting and processing system was used.METHODS: The experiments were conducted in the Department of Physiology, Tianjin Medical University from August 2001 to May 2006. ① The rabbits were anesthetized, then fixed onto the brain stereotaxic apparatus, and afterwards fenestration on skull and intubation to lateral ventricle were performed. The dynamic changes of intracranial pressure were monitored continuously. Rabbits were infused with autologous arterial blood (0.3 mL) into midbrain corpora quadrigemina inferior colliculus to induce model of acute brainstem hemorrhage; models of internal capsule hemorrhage were established by infusing autologous arterial blood into internal capsule. ② The dynamic intracranial pressures under the above conditions were recorded continuously with the RM6240B biological signal collecting and processing system. ③ An animal model of persistent intracranial hypertension was established by infusion of physiologic saline into lateral ventricle. ④ The changes of the intensity of autonomic nerve discharge were analyzed, using the biological signal collecting and processing system before and after hemorrhage and under persistent intracranial hypertension. ⑤ Ten animal models of internal capsule hemorrhage and 10 of brainstem hemorrhage were selected

  11. Experimental animal models and inflammatory cellular changes in cerebral ischemic and hemorrhagic stroke

    OpenAIRE

    Yan, Tao; Chopp, Michael; Chen, Jieli

    2015-01-01

    Stroke, including cerebral ischemia, intracerebral hemorrhage, and subarachnoid hemorrhage, is the leading cause of long-term disability and death worldwide. Animal models have greatly contributed to our understanding of the risk factors and the pathophysiology of stroke, as well as the development of therapeutic strategies for its treatment. Further development and investigation of experimental models, however, are needed to elucidate the pathogenesis of stroke and to enhance and expand nove...

  12. Relationship of cerebral microbleeds with hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage

    OpenAIRE

    Shou-feng LIU; Yu-wang LI; Xin WANG; XU Xiao-lin

    2015-01-01

    Objective To investigate whether cerebral microbleeds (CMBs) can predict hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage.  Methods The clinical records of 98 elderly patients with acute hypertensive intracerebral hemorrhage who underwent initial CT within 6 h and repeated CT and susceptibility-weighted imaging (SWI) within 24 h of onset were analyzed. Based on the performance of SWI, patients were divided into microbleeds group and non-microbleeds gr...

  13. Multiple intracranial hemorrhages in a normotensive demented patient: A probable cerebral amyloid angiopathy.

    Science.gov (United States)

    Chitsaz, Ahmad; Norouzi, Rasul; Marashi, Seyed Mohammad Javad; Salimianfard, Marzieh; Fard, Salman Abbasi

    2012-01-01

    Cerebral amyloid angiopathy (CAA) is the most common cause of lobar intracerebral hemorrhage. Repeated bleeding may be presented with vascular dementia. We have reported a 68-year-old normotensive demented patient with probable CAA presented with hemiparesia, headache and vomiting. According to the experience of this case, it is recommended to consider CAA for normotensive elderly patients presented with multiple and superficial intracerebral hemorrhage.

  14. Numerous cerebral hemorrhages in a patient with influenza-associated encephalitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Ye; Seong, Su Ok; Park, Noh Hyuck; Park, Chan Sup [Dept. of Radiology, Myongji Hospital, Goyang (Korea, Republic of)

    2016-02-15

    Influenza-associated encephalitis (IAE) is a complication of a common disease that is rare even during an epidemic. Awareness of magnetic resonance imaging features of IAE is important in treatment planning and prognosis estimation. Several reports have described necrotizing encephalopathy in children with influenza. However, few reports have described multifocal hemorrhages in both cerebral hemispheres in adults with concomitant infection with influenza A and B. Here, we describe a case of influenza A- and B-associated encephalitis accompanied by numerous cerebral hemorrhages.

  15. Electroencephalographic response to sodium nitrite may predict delayed cerebral ischemia after severe subarachnoid hemorrhage

    OpenAIRE

    Garry, Payashi S.; Rowland, Matthew J.; Ezra, Martyn; Herigstad, Mari; Hayen, Anja; Sleigh, Jamie W.; Westbrook, Jon; Warnaby, Catherine E; Pattinson, Kyle T.

    2016-01-01

    OBJECTIVES: Aneurysmal subarachnoid hemorrhage often leads to death and poor clinical outcome. Injury occurring during the first 72 hours is termed "early brain injury," with disruption of the nitric oxide pathway playing an important pathophysiologic role in its development. Quantitative electroencephalographic variables, such as α/δ frequency ratio, are surrogate markers of cerebral ischemia. This study assessed the quantitative electroencephalographic response to a cerebral nitric oxide...

  16. Primary intraventricular hemorrhage: Clinical features, risk factors, etiology, and yield of diagnostic cerebral angiography

    OpenAIRE

    Trilochan Srivastava; Raghavendra Bakki Sannegowda; Vipin Satija; R. S Jain; Shankar Tejwani; Tarun Mathur

    2014-01-01

    Background: Primary intraventricular hemorrhage (PIVH) is a rare neurological disorder, with bleeding confined to the ventricles only, without recognizable parenchymal or subarachnoid component. Aim: The purpose of this retrospective study was to identify clinical features, predisposing risk factors, etiology, radiological features and yield of diagnostic cerebral angiography in identifying the etiological causes. Settings and Design: Records of patients admitted in neurology division were an...

  17. Mycotic brain aneurysm and cerebral hemorrhagic stroke: a pediatric case report.

    Science.gov (United States)

    Flor-de-Lima, Filipa; Lisboa, Lurdes; Sarmento, António; Almeida, Jorge; Mota, Teresa

    2013-09-01

    Endocarditis due to Abiotrophia spp. is rare and often associated with negative blood cultures, infection relapse, and high rates of treatment failure and mortality (Lainscak et al., J Heart Valve Dis 14(1):33-36, 2005). The authors describe a case of an adolescent with cerebral hemorrhagic stroke due to mycotic brain aneurysm rupture.

  18. The VASOGRADE: A Simple Grading Scale for Prediction of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

    NARCIS (Netherlands)

    Oliveira Manoel, A.L. de; Jaja, B.N.; Germans, M.R.; Yan, H.; Qian, W.; Kouzmina, E.; Marotta, T.R.; Turkel-Parrella, D.; Schweizer, T.A.; Macdonald, R.L.

    2015-01-01

    BACKGROUND AND PURPOSE: Patients are classically at risk of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage. We validated a grading scale-the VASOGRADE-for prediction of DCI. METHODS: We used data of 3 phase II randomized clinical trials and a single hospital series to asses

  19. Intraventricular hemorrhage in the preterm neonate: timing and cerebral blood flow changes

    Energy Technology Data Exchange (ETDEWEB)

    Ment, L.R.; Duncan, C.C.; Ehrenkranz, R.A.; Lange, R.C.; Taylor, K.J.; Kleinman, C.S.; Scott, D.T.; Sivo, J.; Gettner, P.

    1984-03-01

    Serial cranial ultrasound studies, 133xenon inhalation cerebral blood flow determinations, and risk factor analyses were performed in 31 preterm neonates. Contrast echocardiographic studies were additionally performed in 16 of these 31 infants. Sixty-one percent were found to have germinal matrix or intraventricular hemorrhage. Seventy-four percent of all hemorrhages were detected by the thirtieth postnatal hour. The patients were divided into three groups: early GMH/IVH by the sixth postnatal hour (eight infants) interval GMH/IVH from 6 hours through 5 days (10), and no GMH/IVH (12). Cerebral blood flow values at 6 postnatal hours were significantly lower for the early GMH/IVH group than for the no GMH/IVH group (P less than 0.01). Progression of GMH/IVH was observed only in those infants with early hemorrhage, and these infants had a significantly higher incidence of neonatal mortality. Ventriculomegaly as determined by ultrasound studies was noted equally in infants with and without GMH/IVH (50%) and was not found to correlate with low cerebral blood flow. The patients with early hemorrhage were distinguishable by their need for more vigorous resuscitation at the time of birth and significantly higher ventilator settings during the first 36 postnatal hours, during which time they also had higher values of PCO2. An equal incidence of patent ductus arteriosus was found across all of the groups. We propose that early GMH/IVH may be related to perinatal events and that the significant decrease in cerebral blood flow found in infants with early GMH/IVH is secondary to the presence of the hemorrhage itself. Progression of early GMH/IVH and new interval GMH/IVH may be related to later neonatal events known to alter cerebral blood flow.

  20. 小脑出血 32例致残性特点分析%Disabling character analysis of 32 cases of cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    苏赤; 侯廷平

    2001-01-01

    @@Background: The clinical manifestation of the cerebral hemorrhage is complex and the disabilities are different. According to the hemorrhage amount and the sites, the treating and rehabilitation methods are different also. So, to ensure amount and position and to master its disabling characters is important for the treatment and rehabilitation of patients with cerebral hemorrhage Objective:According to its amount and position, to analyse its disabling characters for the treatment and rehabilitation of patients with cerebral hemorrhage .

  1. Spreading Depolarizations: A Therapeutic Target Against Delayed Cerebral Ischemia After Subarachnoid Hemorrhage.

    Science.gov (United States)

    Chung, David Y; Oka, Fumiaki; Ayata, Cenk

    2016-06-01

    Delayed cerebral ischemia is the most feared cause of secondary injury progression after subarachnoid hemorrhage. Initially thought to be a direct consequence of large artery spasm and territorial ischemia, recent data suggests that delayed cerebral ischemia represents multiple concurrent and synergistic mechanisms, including microcirculatory dysfunction, inflammation, and microthrombosis. Among these mechanisms, spreading depolarizations (SDs) are arguably the most elusive and underappreciated in the clinical setting. Although SDs have been experimentally detected and examined since the late 1970s, their widespread occurrence in human brain was not unequivocally demonstrated until relatively recently. We now know that SDs occur with very high incidence in human brain after ischemic or hemorrhagic stroke and trauma, and worsen outcomes by increasing metabolic demand, decreasing blood supply, predisposing to seizure activity, and possibly worsening brain edema. In this review, we discuss the causes and consequences of SDs in injured brain. Although much of our mechanistic knowledge comes from experimental models of focal cerebral ischemia, clinical data suggest that the same principles apply regardless of the mode of injury (i.e., ischemia, hemorrhage, or trauma). The hope is that a better fundamental understanding of SDs will lead to novel therapeutic interventions to prevent SD occurrence and its adverse consequences contributing to injury progression in subarachnoid hemorrhage and other forms of acute brain injury. PMID:27258442

  2. Electroencephalographic Response to Sodium Nitrite May Predict Delayed Cerebral Ischemia After Severe Subarachnoid Hemorrhage

    Science.gov (United States)

    Rowland, Matthew J.; Ezra, Martyn; Herigstad, Mari; Hayen, Anja; Sleigh, Jamie W.; Westbrook, Jon; Warnaby, Catherine E.; Pattinson, Kyle T. S.

    2016-01-01

    Objectives: Aneurysmal subarachnoid hemorrhage often leads to death and poor clinical outcome. Injury occurring during the first 72 hours is termed “early brain injury,” with disruption of the nitric oxide pathway playing an important pathophysiologic role in its development. Quantitative electroencephalographic variables, such as α/δ frequency ratio, are surrogate markers of cerebral ischemia. This study assessed the quantitative electroencephalographic response to a cerebral nitric oxide donor (intravenous sodium nitrite) to explore whether this correlates with the eventual development of delayed cerebral ischemia. Design: Unblinded pilot study testing response to drug intervention. Setting: Neuroscience ICU, John Radcliffe Hospital, Oxford, United Kingdom. Patients: Fourteen World Federation of Neurosurgeons grades 3, 4, and 5 patients (mean age, 52.8 yr [range, 41–69 yr]; 11 women). Interventions: IV sodium nitrite (10 μg/kg/min) for 1 hour. Measurements and Main Results: Continuous electroencephalographic recording for 2 hours. The alpha/delta frequency ratio was measured before and during IV sodium nitrite infusion. Seven of 14 patients developed delayed cerebral ischemia. There was a +30% to +118% (range) increase in the alpha/delta frequency ratio in patients who did not develop delayed cerebral ischemia (p < 0.0001) but an overall decrease in the alpha/delta frequency ratio in those patients who did develop delayed cerebral ischemia (range, +11% to –31%) (p = 0.006, multivariate analysis accounting for major confounds). Conclusions: Administration of sodium nitrite after severe subarachnoid hemorrhage differentially influences quantitative electroencephalographic variables depending on the patient’s susceptibility to development of delayed cerebral ischemia. With further validation in a larger sample size, this response may be developed as a tool for risk stratification after aneurysmal subarachnoid hemorrhage. PMID:27441898

  3. Study on the relationship of cytochrome C expression and cerebral edema in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    CAI Heng; LIU Guixiang; XU Chunsheng; LIU Qingxin; XU Xiaobo

    2007-01-01

    Objective To investigate the expression of cytochrome C in perihematomal brain tissue and its relationship with the histopathological change and formation of cerebral edema in patients with hypertensive cerebral hemorrhage. Methods Thirty four patients (23 male, 11 female) of hypertensive cerebral hemorrhage in hospital from Sep. 2001 to Sep. 2002 were selected with a mean age 55.6± 10.2 years (from 35 to 75 years). The mean volume of hemorrhagic blood was 50.4±11.6 ml (from 25 to 85 ml). The perihematomal brain tissue was obtained from the minimally invasive surgery. Histopathological change and expressions of cytochrome C in perihematomal brain tissue was detected by histopathological and immunohistochemical techniques. The volume of perihematomal cerebral edema was determined by computed tomographic scan before operation. The results of staining and the volume of perihematomal cerebral edema were analyzed with double blind fashion. Results Perihematomal cerebral edema were found 12-72h after cerebral hemorrhage. Myelin sheath degeneration, condensation of nucleus and typical apopototic body were observed in perihematomal brain tissue. Expression of cytochrome C in perihematomal brain tissue was observed at 4 h and reached peak around 48-72 h after cerebral hemorrhage. Cytochrome C expressed higher positively in 16 patients and lower positively in 13 patients. Cytochrome C expression was not detected only in 5 patints. There were significant differences in volume of perihematomal cerebral edema with different expression of cytochrome C in perihematomal brain tissue (P<0.01). Conclusions Cytochrome C expression was upregulated in perihematomal brain tissue in patients with hypertensive cerebral hemorrhage. Cytochrome C might involve in the histopathological change and the formation of perihematomal cerebral edema.

  4. 分析脑出血继续出血的相关因素%Analysis of related factors of continuous hemorrhage of cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    邴启爱

    2015-01-01

    Objective To analyze the related factors affecting cerebral hemorrhage continued bleeding. Methods To choose his own 38 patients with cerebral hemorrhage continued bleeding as the ifrst division, choose 54 cases of cerebral hemorrhage patients did not continue to bleeding as group b, the clinical data of two groups of patients were analyzed retrospectively, in order to understand the influence factors of cerebral hemorrhage continued bleeding.Results In the ifrst division in patients with diabetes, continuous high blood pressure, alcohol consumption, thalamic hemorrhage and CT blood loss were higher than in patients with b, the difference was statistically significant (P<0.05).Conclusion Cerebral hemorrhage continued bleeding is influenced by many factors, should actively take effective measures to deal with, in order to reduce the incidence of cerebral hemorrhage continued bleeding.%目的 对影响脑出血继续出血的相关因素进行分析.方法 选择38例脑出血继续出血患者作为甲组,选54例脑出血未继续出血患者作为乙组,对两组患者的临床资料进行回顾性分析,以了解影响脑出血继续出血的影响因素.结果 甲组中患者的糖尿病、持续高血压、饮酒、丘脑出血以及CT出血量等均比乙组患者高,差异有统计学意义(P<0.05).结论 脑出血继续出血受诸多因素影响,应积极采取有效措施予以应对,以降低脑出血继续出血的发生率.

  5. Spontaneous Anterior Cerebral Artery Dissection Presenting with Simultaneous Subarachnoid Hemorrhage and Cerebral Infarction in a Patient with Multiple Extracranial Arterial Dissections

    OpenAIRE

    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...

  6. Impacts of acupuncture on blood pressure and hematoma in patients of cerebral hemorrhage at the early stage

    Institute of Scientific and Technical Information of China (English)

    陶文强

    2014-01-01

    Objective To explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.Methods Fifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group,27 cases in each.In the conventional treatment group,special care,oxygen therapy,nerve nutrition and symptomatic support were applied.If necessary,dehydrant and hypotensive drugs were prescribed for antihypertension,or surgery

  7. Melatonin mitigate cerebral vasospasm after experimental subarachnoid hemorrhage: a study of synchrotron radiation angiography

    Science.gov (United States)

    Cai, J.; He, C.; Chen, L.; Han, T.; Huang, S.; Huang, Y.; Bai, Y.; Bao, Y.; Zhang, H.; Ling, F.

    2013-06-01

    Cerebral vasospasm (CV) after subarachnoid hemorrhage (SAH) is a devastating and unsolved clinical issue. In this study, the rat models, which had been induced SAH by prechiasmatic cistern injection, were treated with melatonin. Synchrotron radiation angiography (SRA) was employed to detect and evaluate CV of animal models. Neurological scoring and histological examinations were used to assess the neurological deficits and CV as well. Using SRA techniques and histological analyses, the anterior cerebral artery diameters of SAH rats with melatonin administration were larger than those without melatonin treatment (p experimental SAH.

  8. The return of an old worm: cerebral paragonimiasis presenting with intracerebral hemorrhage.

    Science.gov (United States)

    Koh, Eun Jung; Kim, Seung-Ki; Wang, Kyu-Chang; Chai, Jong-Yil; Chong, Sangjoon; Park, Sung-Hye; Cheon, Jung-Eun; Phi, Ji Hoon

    2012-11-01

    Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.

  9. Subarachnoid Hemorrhage from Posterior Cerebral Artery Aneurysm during Puerperium – Case Report and Review of Literature

    OpenAIRE

    Schebesch, Karl-Michael; Schödel, Petra; Rennert, Janine; Mark, Karl-Heinz; Brawanski, Alexander

    2012-01-01

    Subarachnoid hemorrhages (SAH) due to true aneurysms of the Posterior Cerebral Artery (PCA) during puerperium in young and healthy females are extremely rare. We present the case of a 31-year old, healthy woman that experienced a spontaneous SAH due to a PCA aneurysm, arising from the P3 segment, 9 days post-delivery. The aneurysm was successfully treated via an endovascular approach and the patient recovered well. After 21 days she was discharged from hospital without neurological defici...

  10. Nursing Experience of Cerebral Hemorrhage%脑出血护理体会

    Institute of Scientific and Technical Information of China (English)

    钱婷

    2015-01-01

    Cerebral hemorrhage, commonly known as cerebral haemorrhage, primary brain parenchyma of non traumatic bleeding, often forming ranging from the size of the brain hematoma, sometimes worn out brain parenchyma secondary intraventricular or subarachnoid hemorrhage was formed. It is often found in the middle and old aged patients with hypertension, but in recent years, the incidence of cerebral hemorrhage has become younger, and the incidence of cerebral hemorrhage is very fast, which is mainly manifested in the nervous system of the disturbance of consciousness, limb paralysis and aphasia. The mortality and disability rate is gradually increased, so the prognosis depends on the location of bleeding, bleeding volume and complications. The following is my experience in the clinical work of nursing.%脑出血,俗称脑溢血,是原发于脑实质内的非外伤性的出血,常形成大小不等的脑内血肿,有时可穿破脑实质形成继发性的脑室内或蛛网膜下腔出血。常好发于中老年高血压患者,但近年来报道脑出血的发病年龄日趋年轻化,临床上脑出血发病十分迅速,主要表现为意识障碍、肢体偏瘫、失语等神经系统的损害。死亡率和致残率也在逐渐的提高,所以其预后取决于出血的部位、出血量以及有无并发症有关。本文将介绍笔者临床工作中所积累的护理经验。

  11. Curative effect of monosialotetrahexosylganglioside combined with Xingnaojing injection on acute cerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Rui-xing SUN

    2015-07-01

    Full Text Available This paper aims to observe the curative effect of monosialotetrahexosylganglioside combined with Xingnaojing injection on acute cerebral hemorrhage. A total of 120 cases with acute cerebral hemorrhage were treated with Xingnaojing injection monotherapy (control group, N = 60 or monosialotetrahexosylganglioside combined with Xingnaojing injection (combined treatment group, N = 60. Bleeding amount and National Institutes of Health Stroke Scale (NIHSS scores of 2 groups were both significantly reduced on the 21th day after treatment (P = 0.000, for all, but bleeding amount and NIHSS scores in combined treatment group were significantly lower than those in control group (P = 0.000, for all. After 21 d treatment, total effective rate of combined treatment group was 86.67% (52/60, which was significantly higher than that of control group [66.67% (40/60; χ2 = 1.493, P = 0.024]. For patients with acute cerebral hemorrhage, monosialotetrahexosylganglioside combined with Xingnaojing injection can significantly improve the neurological function. DOI: 10.3969/j.issn.1672-6731.2015.07.014

  12. EFFECT OF ACUPUNCTURE ON NEUROLOGICAL DEFECTS AND DAILY LIFE ABILITY IN PATIENTS WITH ACUTE CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    周爽; 方邦江; 孙国杰

    2003-01-01

    Objective: To observe the effect of acupuncture of Shuigou (GV 26), Neiguan (PC 6), Zusanli (ST36), etc. on neurological defects and daily life ability in patients with acute cerebral hemorrhage. Methods: Fifty-eight cases of acute cerebral hemorrhage patients were randomized into control group (n = 28) and treatment group (n =30). Patients of two groups were both treated with intravenous infusion of Mannitol and other expectant medicines. In addition, patients of treatment group were also treated with acupuncture therapy, once daily and continuously for one month. Before and after treatment, the scores of neurological defects and daily life ability (Barthel Index) were givenfor assessing the therapeutic effect. Results: Following treatment, both scores of neurological defects of two groups decreased significantly (P < 0.05), and the score of treatment group was strikingly lower than that of control group (P<0.05). After treatment, values of Barthel Index (BI) of two groups increased considerably in comparison with pretreatment (P< 0.01 ), and the value of BI of treatment group was bigger than that of control group (P< 0.05). Conclusion: Acupuncture can improve acute cerebral hemorrhage patients' nervous function and daily life ability.

  13. Inflammatory demyelinating pseudotumor with hemorrhage masquerading high grade cerebral neoplasm

    Directory of Open Access Journals (Sweden)

    Amit Agrawal

    2015-03-01

    Full Text Available Demyelinating pseudotumors are rare, benign, solitary intracranial space occupying lesions which masquerade cerebral neoplasms. Contrast MRI shows open ring enhancement which is fairly specific for this entity. Advanced MRI techniques like MR spectroscopy and magnetizing transfer techniques can help differentiating these lesions. NAA/Cr ratio is significantly elevated in central regions of demyelinating pseudotumors than in gliomas and other lesions. Presence of abundant foamy macrophages, lymphoid inflammatory infiltrates around blood vessels, sheets of gemistocytic astrocytes with well-developed processes, well defined border of the lesion absence of neovascularity and necrosis should help us diagnose demyelinating pseudotumor fairly confidently on histopathology.

  14. Subarachnoid hemorrhage enhances endothelin receptor expression and function in rat cerebral arteries

    DEFF Research Database (Denmark)

    Hansen-Schwartz, Jacob; Hoel, Natalie Løvland; Zhou, Mingfang;

    2003-01-01

    OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood into the prechiasm......OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood...... into the prechiasmatic cistern. After 2 days, the middle cerebral artery, basilar artery, and posterior communicating artery were harvested. Pharmacological studies were performed in vitro, and levels of messenger ribonucleic acid (mRNA) were quantified in real-time reverse transcriptase-polymerase chain reaction assays....... RESULTS: In the middle cerebral artery and basilar artery from rats with induced SAH, enhanced biphasic responses to ET-1 were observed. The -log(50% effective concentration) value for the high-affinity phase was approximately 12, compared with approximately 8.5 for sham-operated animals...

  15. A case of cerebral aneurysm rupture and subarachnoid hemorrhage associated with air travel

    Directory of Open Access Journals (Sweden)

    Cui V

    2014-04-01

    Full Text Available Victoria Cui,1,2 Timur Kouliev,1 Jason Wood1 1Beijing United Family Hospital, Beijing, People's Republic of China; 2Department of Biological Sciences, Columbia University, New York, NY, USA Abstract: During air travel, passengers are exposed to unique conditions such as rapid ascent and descent that can trigger significant physiological changes. In addition, the cabins of commercial aircraft are only partially pressured to 552–632 mmHg or the equivalent terrestrial altitudes of 1,500–2,500 m (5,000–8,000 feet above sea level. While studies in high-altitude medicine have shown that all individuals experience some degree of hypoxia, cerebral edema, and increased cerebral blood flow, the neurological effects that accompany these changes are otherwise poorly understood. In this study, we report a case of acute subarachnoid hemorrhage from a ruptured cerebral aneurysm associated with travel on commercial aircraft. We then review relevant cases of neurological incidents with possible air travel-related etiology and discuss the physiological factors that may have contributed to the patient's acute subarachnoid hemorrhage. In the future, this report may serve as reference for more detailed and conservative medical guidelines and recommendations regarding air travel. Keywords: high-altitude, cabin pressure, emergency, cerebral edema, triage, neurological

  16. Radiological findings in cerebral venous thrombosis presenting as subarachnoid hemorrhage: a series of 22 cases

    Energy Technology Data Exchange (ETDEWEB)

    Boukobza, Monique [APHP - Paris-Diderot University, Department of Neuroradiology and Therapeutic Angiography, Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, Paris (France); Crassard, Isabelle; Bousser, Marie-Germaine [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); Chabriat, Hugues [Assistance publique - University Hospitals Lariboisiere-St-Louis-Fernand-Widal, APHP - Paris-Diderot University Paris, France, Department of Neurology, Paris (France); INSERM UMR 1161 and DHU NeuroVasc, Paris (France)

    2016-01-15

    The main objectives of the present study are to assess the incidence of cerebral venous thrombosis (CVT) presenting as isolated subarachnoid hemorrhage (SAH) and to determine the occurrence of cortical venous thrombosis (CoVT). Among 332 patients with CVT, investigated with the same CT and MR standardized protocol, 33 (10 %) presented with SAH, associated in 11 cases with hemorrhagic infarct or intracerebral hemorrhage. This study is based on 22 cases of CVT presenting as SAH in the absence of hemorrhagic brain lesion. Diagnosis of sinus thrombosis was established on T2* and magnetic resonance venography and that of CoVT on T2* sequence. Diagnostic of SAH was based on fluid-attenuated inversion recovery (FLAIR) sequence. CVT involved lateral sinus in 18 patients, superior sagittal sinus in 16, and straight sinus in 1. Cortical veins were involved in all patients, in continuity with dural sinus thrombosis when present. SAH was circumscribed to few sulci in all cases and mainly localized at the convexity (21 cases). CoVT implied different areas on the same side in four patients and was bilateral in seven. There was no perimesencephalic or basal cisterns hemorrhage. Cortical swelling was present in 12 cases, associated with localized edema. All patients except one had a favorable outcome. This report shows that the incidence of CVT presenting as isolated SAH is evaluated to 6.4 % and that SAH is, in all cases, in the vicinity of CoVT and when dural thrombosis is present in continuity with it. (orig.)

  17. Predicting sites of new hemorrhage with amyloid imaging in cerebral amyloid angiopathy

    Science.gov (United States)

    Dierksen, Gregory; Betensky, Rebecca; Gidicsin, Christopher; Halpin, Amy; Becker, Alex; Carmasin, Jeremy; Ayres, Alison; Schwab, Kristin; Viswanathan, Anand; Salat, David; Rosand, Jonathan; Johnson, Keith A.; Greenberg, Steven M.

    2012-01-01

    Objective: We aimed to determine whether amyloid imaging can help predict the location and number of future hemorrhages in cerebral amyloid angiopathy (CAA). Methods: We performed a longitudinal cohort study of 11 patients with CAA without dementia who underwent serial brain MRIs after baseline amyloid imaging with Pittsburgh compound B (PiB). Mean distribution volume ratio (DVR) of PiB was determined at the sites of new micro/macrobleeds identified on follow-up MRI and compared with PiB retention at “simulated” hemorrhages, randomly placed in the same subjects using a probability distribution map of CAA-hemorrhage location. Mean PiB retention at the sites of observed new bleeds was also compared to that in shells concentrically surrounding the bleeds. Finally the association between number of incident bleeds and 3 regional amyloid measures were obtained. Results: Nine of 11 subjects had at least one new microbleed on follow-up MRI (median 4, interquartile range [IQR] 1–9) and 2 had 5 new intracerebral hemorrhages. Mean DVR was greater at the sites of incident bleeds (1.34, 95% confidence interval [CI] 1.23–1.46) than simulated lesions (1.14, 95% CI 1.07–1.22, p < 0.0001) in multivariable models. PiB retention decreased with increasing distance from sites of observed bleeds (p < 0.0001). Mean DVR in a superior frontal/parasagittal region of interest correlated independently with number of future hemorrhages after adjustment for relevant covariates (p = 0.003). Conclusions: Our results provide direct evidence that new CAA-related hemorrhages occur preferentially at sites of increased amyloid deposition and suggest that PiB-PET imaging may be a useful tool in prediction of incident hemorrhages in patients with CAA. PMID:22786597

  18. Primary intraventricular hemorrhage: Clinical features, risk factors, etiology, and yield of diagnostic cerebral angiography

    Directory of Open Access Journals (Sweden)

    Trilochan Srivastava

    2014-01-01

    Full Text Available Background: Primary intraventricular hemorrhage (PIVH is a rare neurological disorder, with bleeding confined to the ventricles only, without recognizable parenchymal or subarachnoid component. Aim: The purpose of this retrospective study was to identify clinical features, predisposing risk factors, etiology, radiological features and yield of diagnostic cerebral angiography in identifying the etiological causes. Settings and Design: Records of patients admitted in neurology division were analyzed in a tertiary care teaching hospital. Materials and Methods: We analyzed the records of 27 patients with PIVH evaluated and treated at our institute from August 2010 to April 2013. PIVH was diagnosed as hemorrhage in the ventricles only, detected by computed tomography scan without evidence of intraparenchymal, subarachnoid hemorrhage or intraventricular hemorrhage associated with trauma. CT angiography (CTA alone was done in 10 patients (37.03%, digital subtraction angiography (DSA in 2 patients (7.4% and both CTA as well as DSA was done in 15 patients (55.5%. Statistical Analysis Used: Categorical and continuous data were analyzed using SPSS version 17. Results: 17 (62.96% patients were females and 10 (37.03% were males with ratio of F:M= 1.7:1. Headache was the commonest mode of presentation (85.18%. Hypertension was most common predisposing factor (29.62% followed by arterio-venous malformations (AVMs (25.92%, moyamoya disease (MMD (11.11%, lenticuostriate artery aneurysm (LSA (11.11%, arterial dissections (7.4% and dural arteriovenous fistula (dAVF (3.7%. Conclusions: PIVH is rare and hypertension is important predisposing factor. Yield of cerebral angiography is high in diagnosing the etiology. AVMs and other rare etiological causes like MMD, LSA aneurysm, arterial dissection, and dAVF should be kept in mind with a high index of suspicion and warrants cerebral angiography in them, as some of the causes are potentially treatable.

  19. Safety Assessment of Anticoagulation therapy in Patients with Hemorrhagic Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2013-07-01

    Full Text Available Background: Anticoagulation therapy is a routine treatment in patients with hemorrhagic cerebral venous thrombosis (CVT. However, fear of hemorrhagic complications and deterioration course following anticoagulation often disturbs the responsible physician.Methods: This was a Prospective observational study on consecutive CVT patients with hemorrhagic venous infarction or subarachnoid hemorrhage (SAH admitted in Ghaem Hospital, Mashhad, Iran, during 2006-2012. The diagnosis of CVT in suspected cases was confirmed by magnetic resonance imaging/magnetic resonance venography (MRI/MRV, and computerized tomography (CT angiography following established diagnostic criteria. Demographic data, clinical manifestations from onset to end of the observation period, location of thrombus, location and size of infarction and hemorrhage, and clinical course during treatment were recorded. Choice of the treatment was left to the opinion of the treating physician. Clinical course during 1 week of treatment was assessed based on the baseline modified National Institute of Health Stroke Scale (NIHSS score. Three or more points decrease or increase of modified NIHSS after 1 week of treatment was considered as improvement or deterioration courses, respectively. Other clinical courses were categorized as stabilization course.Results: 102 hemorrhagic CVT patients (80 females,22 males with mean age of 38.6 ± 8 years were prospectively investigated. Of the 102 hemorrhagic CVT patients in the acute phase, 52 patients (50.9% were anticoagulated with adjusted dose intravenous heparin infusion and 50 cases (49.1% received subcutaneous enoxaparin 1mg/Kg twice daily. Decreased consciousness had a significant effect on the clinical course of the patients (X2 = 9.493, df = 2, P = 0.009. Presence of SAH had no significant effect on the clinical course of our anticoagulated hemorrhagic CVT cases (X2 = 0.304, df = 2,P = 0.914. Extension of Infarction in more than two thirds of a

  20. CCM3 Mutations Are Associated with Early-Onset Cerebral Hemorrhage and Multiple Meningiomas

    Science.gov (United States)

    Riant, F.; Bergametti, F.; Fournier, H.-D.; Chapon, F.; Michalak-Provost, S.; Cecillon, M.; Lejeune, P.; Hosseini, H.; Choe, C.; Orth, M.; Bernreuther, C.; Boulday, G.; Denier, C.; Labauge, P.; Tournier-Lasserve, E.

    2013-01-01

    Mutations of CCM3/PDCD10 cause 10-15% of hereditary cerebral cavernous malformations. The phenotypic characterization of CCM3-mutated patients has been hampered by the limited number of patients harboring a mutation in this gene. This is the first report on molecular and clinical features of a large cohort of CCM3 patients. Molecular screening for point mutations and deletions was used to identify 54 CCM3-mutated index patients. Age at referral and clinical onset, type of inaugural events and presence of extra-axial lesions were investigated in these 54 index patients and 22 of their mutated relatives. Mean age at clinical onset was 23.0 ± 16 years. Clinical onset occurred before 10 years in 26% of the patients, and cerebral hemorrhage was the initial presentation in 72% of these patients. Multiple extra-axial, dural-based lesions were detected in 7 unrelated patients. These lesions proved to be meningiomas in 3 patients who underwent neurosurgery and pathological examination. This ‘multiple meningiomas’ phenotype is not associated with a specific CCM3 mutation. Hence, CCM3 mutations are associated with a high risk of early-onset cerebral hemorrhage and with the presence of multiple meningiomas. PMID:23801932

  1. Acupuncture inhibits Notch1 and Hes1 protein expression in the basal ganglia of rats with cerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Wei Zou

    2015-01-01

    Full Text Available Notch pathway activation maintains neural stem cells in a proliferating state and increases nerve repair capacity. To date, studies have rarely focused on changes or damage to signal transduction pathways during cerebral hemorrhage. Here, we examined the effect of acupuncture in a rat model of cerebral hemorrhage. We examined four groups: in the control group, rats received no treatment. In the model group, cerebral hemorrhage models were established by infusing non-heparinized blood into the brain. In the acupuncture group, modeled rats had Baihui (DU20 and Qubin (GB7 acupoints treated once a day for 30 minutes. In the DAPT group, modeled rats had 0.15 μg/mL DAPT solution (10 mL infused into the brain. Immunohistochemistry and western blot results showed that acupuncture effectively inhibits Notch1 and Hes1 protein expression in rat basal ganglia. These inhibitory effects were identical to DAPT, a Notch signaling pathway inhibitor. Our results suggest that acupuncture has a neuroprotective effect on cerebral hemorrhage by inhibiting Notch-Hes signaling pathway transduction in rat basal ganglia after cerebral hemorrhage.

  2. Role of nitric oxide and mechanisms involved in cerebral injury after subarachnoid hemorrhage: is nitric oxide a possible answer to cerebral vasospasm?

    Science.gov (United States)

    Crobeddu, Emanuela; Pilloni, Giulia; Tardivo, Valentina; Fontanella, Marco M; Panciani, Pier P; Spena, Giannantonio; Fornaro, Riccardo; Altieri, Roberto; Agnoletti, Alessandro; Ajello, Marco; Zenga, Francesco; Ducati, Alessandro; Garbossa, Diego

    2016-09-01

    Cerebral vasospasm represents the most critical event that could occur after subarachnoid hemorrhage (SAH). Therapy is only partially effective because cerebral arterial constriction is not fully understood yet. One of the most important biological messenger associated to SAH is nitric oxide (NO), that is considered local regulator of cerebral blood flow. Different nitric oxide synthase (NOS) forms play a role in different biological processes, one of which is to link neuronal activity to blood flow in cerebral cortex. We performed a reassessment of the literature to summarize the role of NO as the main inflammatory pathway activated after SAH to clarify its importance for treatment of vasospasm.

  3. Intra-arterial colforsin daropate for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Cerebral vasospasm (CV) remains a major cause of mortality and morbidity in patients with subarachnoid hemorrhage (SAH). Here, we examined the effectiveness and safety of intra-arterial injection of colforsin daropate hydrochloride (CDH). A consecutive series of 29 patients with angiographically confirmed CV received intra-arterial CDH (IAC) therapy. Angiographic changes in spastic vessels and the cerebral circulation time (CCT) were assessed before and after IAC treatment, together with the change in clinical status. IAC treatment was performed in 53 procedures in 29 patients. Angiographic improvement was observed following all procedures (100%), and clinical improvement was observed following 36 of 42 procedures (86%) in symptomatic cases. CCT improved significantly. At the 3-month follow-up, 19 patients (66%) showed good recovery or moderate disability on the Glasgow Outcome Scale. Major adverse effects were headache and increased heart rate. IAC treatment was effective and safe for the treatment of CV after SAH. (orig.)

  4. Acute-phase proteins in stroke: influences of its cause (cerebral hemorrhage or infarction), of the cerebral site of infarction, and of the sex of patients.

    Science.gov (United States)

    Ionescu, D A; Haţegan, D; Jipescu, I; Steinbruch, L; Scu, M G

    1991-01-01

    In most of the 129 patients with a recent stroke by cerebral hemorrhage or infarction a note-worthy acute-phase response was found, as demonstrated by important quantitative alterations of blood levels of several acute-phase proteins (APP). These alterations were different in patients with cerebral hemorrhage as compared to those with cerebral infarction. The alterations due to cerebral infarction were not different according to the site of the infarction in brain, i.e. in the brain territories irrigated by the carotid artery system or by the basilar artery system. The APP alterations do not depend on the sex of patients or on the time elapsed from stroke-onset to blood collection.

  5. Cerebral Blood Flow Dynamics and Head-of-Bed Changes in the Setting of Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    David K. Kung

    2013-01-01

    Full Text Available Head-of-bed (HOB elevation is usually restricted in patients with aneurysmal subarachnoid hemorrhage (SAH. The goal of this study is to correlate HOB changes ( and with cerebral blood flow using transcranial Doppler (TCD and thermal diffusion probe in SAH patients. Thirteen patients with SAH were prospectively enrolled in the study. Eight patients underwent placement of a thermal diffusion probe for regional CBF measurement. CBF values were measured with the patients in flat ( and upright sitting positions ( at days 3, 7, and 10. The average increase in blood flow velocity when changing HOB from to was 7.8% on day 3, 0.1% on day 7, and 13.1% on day 10. The middle cerebral artery had the least changes in velocity. The average regional CBF measurement was 22.7 ± 0.3 mL/100 g/min in the supine position and 23.6 ± 9.1 mg/100 g/min in the sitting position. The changes were not statistically significant. None of the patients developed clinical cerebral vasospasm. Changing HOB position in the setting of SAH did not significantly affect cerebral or regional blood flow. These data suggest that early mobilization should be considered given the detrimental effects of prolonged bed rest.

  6. Cerebral venous circulatory disturbance as an informative prognostic marker for neonatal hemorrhagic stroke

    Science.gov (United States)

    Semyachkina-Glushkovskaya, Oxana; Pavlov, Alexey; Navolokin, Nikita; Lychagov, Vladislav; Abdurashitov, Arkady; Zinchenko, Ekaterina; Gekaluk, Artemiy; Zhu, Dan; Shi, Rui; Luo, Qingming; Tuchin, Valery

    2016-04-01

    Neonatal hemorrhagic stroke (NHS) is a major problem of future generation's health due to the high rate of death and cognitive disability of newborns after NHS. The incidence of NHS in neonates cannot be predicted by standard diagnostic methods. Therefore, the identification of prognostic markers of NHS is crucial. There is evidence that stress-related alterations of cerebral blood flow (CBF) may contribute to NHS. Here, we assessed the stroke-associated CBF abnormalities for high prognosis of NHS using a new model of NHS induced by sound stress in the pre- and post-stroke state. With this aim, we used interdisciplinary methods such as a histological assay of brain tissues, laser speckle contrast imaging and Doppler coherent tomography to monitor cerebral circulation. Our results suggest that the venous stasis with such symptoms as progressive relaxation of cerebral veins, decrease the velocity of blood flow in them are prognostic markers for a risk of NHS and are an informative platform for a future study of corrections of cerebral venous circulatory disturbance related to NHS.

  7. 脑出血76例临床分析%Clinical analysis of 76 patients with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    敖小明; 敖思纯; 孙瑞珍

    2014-01-01

    目的:分析探讨内科脑出血的诱因、出血部位、年龄特点及预后。方法回顾性分析2010年1月至2013年3月在佛山市南海区第九人民医院住院的76例脑出血患者的临床资料(排除外伤所致)。结果由高血压诱发的脑出血68例(89.47%),其中27例为中青年患者,入院时确诊。由血管瘤及血管畸形诱发脑出血6例,鼻咽癌脑转移诱发1例,酒精性肝硬化诱发1例。基底节区出血33例(43.42%),丘脑出血22例(28.95%),脑叶出血13例,小脑出血6例,脑干出血1例,脑室出血1例。发病年龄20~50岁20例(26.31%),50~70岁29例(38.16%),70~95岁27例(35.53%)。治愈24例(31.58%),好转30例(39.47%),放弃11例(14.47%),死亡5例(6.58%),转院6例(7.89%)。结论高血压是诱发脑出血的首要因素,高血压病的年轻化、且未及早诊治是导致脑出血的危险因素,只要及早合理治疗脑出血就能减少病死率。%Objective To analyze the causes of internal hemorrhage,position of bleeding,the age characteristics and progno-sis. Methods The clinical data of 76 patients with cerebral hemorrhage from January 2010 to March 2013 in the ninth people’s hospital of Nanhai district of Foshan were retrospectively analyzed(rule out caused by trauma). Results Hypertensive cerebral hemorrhage occared in 68 cases(89. 47% ),27 cases were young adults,diagnosed on admission. Six patients with cerebral hemorrhage induced by hemangioma and vascular malformation,brain metastaszs from nasopharyngeal carcinoma induced cerebral hemorrhage occured in 1 case,alcoholic liver cirrhosis induced cerebral hemorrhage occured in 1 case. Basal ganglia hemorrhage occured in 33 cases(43. 42% ),thalamus hemorrhage occured in 22 cases(28. 95% ),cerebral lobe hemorrhage occured in 13 cases,cerebellar hemorrhage occured in 6 cases,the brain stem hemorrhage occured in 1 case,ventricular hemorrhage occured in 1

  8. Clinical analysis of 76 patients with cerebral hemorrhage%脑出血76例临床分析

    Institute of Scientific and Technical Information of China (English)

    敖小明; 敖思纯; 孙瑞珍

    2014-01-01

    Objective To analyze the causes of internal hemorrhage,position of bleeding,the age characteristics and progno-sis. Methods The clinical data of 76 patients with cerebral hemorrhage from January 2010 to March 2013 in the ninth people’s hospital of Nanhai district of Foshan were retrospectively analyzed(rule out caused by trauma). Results Hypertensive cerebral hemorrhage occared in 68 cases(89. 47% ),27 cases were young adults,diagnosed on admission. Six patients with cerebral hemorrhage induced by hemangioma and vascular malformation,brain metastaszs from nasopharyngeal carcinoma induced cerebral hemorrhage occured in 1 case,alcoholic liver cirrhosis induced cerebral hemorrhage occured in 1 case. Basal ganglia hemorrhage occured in 33 cases(43. 42% ),thalamus hemorrhage occured in 22 cases(28. 95% ),cerebral lobe hemorrhage occured in 13 cases,cerebellar hemorrhage occured in 6 cases,the brain stem hemorrhage occured in 1 case,ventricular hemorrhage occured in 1 case. Onset age:20 cases were 20 to 50 years old(26. 31% ),29 cases were 50 - 70 years old(38. 16% ),27 cases were 70 - 95 years old(35. 53% ). Cured in 24 cases(31. 58% ),improvement in 30 cases(39. 47% ),11 cases gave up treatment, 5 cases died(6. 58% ),transferred in 6 cases. Conclusion Hypertension is the main factor of cerebral hemorrhage,hyperten-sion of the younger,and delayed diagnosis and treatment are the risk factors of cerebral hemorrhage. Early and reasonable treat-ment of can reduce the mortality.%目的:分析探讨内科脑出血的诱因、出血部位、年龄特点及预后。方法回顾性分析2010年1月至2013年3月在佛山市南海区第九人民医院住院的76例脑出血患者的临床资料(排除外伤所致)。结果由高血压诱发的脑出血68例(89.47%),其中27例为中青年患者,入院时确诊。由血管瘤及血管畸形诱发脑出血6例,鼻咽癌脑转移诱发1例,酒精性肝硬化诱发1例。基底节区出血33例(43.42%),丘

  9. Relationship between brain interstitial fluid tumor necrosis factor-α and cerebral vasospasm after aneurysmal subarachnoid hemorrhage

    OpenAIRE

    Hanafy, Khalid A.; Stuart, R Morgan; Khandji, Alexander G.; Connolly, E. Sander; Badjatia, Neeraj; Mayer, Stephan A; Schindler, Christian

    2010-01-01

    Tumor necrosis factor-α (TNF-α) has a crucial role in the onset of hemolysis-induced vascular injury and cerebral vasoconstriction. We hypothesized that TNF-α measured from brain interstitial fluid would correlate with the severity of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH). Methods and results: From a consecutive series of 10 aSAH patients who underwent cerebral microdialysis (MD) and evaluation of vasospasm by CT angiogram (CTA) or digital subtraction angiography (DSA)...

  10. MRI of acute post-ischemic cerebral hemorrhage in stroke patients: diagnosis with T2*-weighted gradient-echo sequences

    International Nuclear Information System (INIS)

    The use of T2*-weighted sequences has been advocated for early differentiation between hematoma and ischemia in patients with acute stroke. Early hemorrhagic transformation of ischemic stroke is an adverse event which may occur under treatment and may impair the prognosis: our aim is to evaluate the ability of T2*-weighted gradient-echo sequence (T2* GRE) to detect post-ischemic cerebral hemorrhage. The imaging procedure included: (1) baseline CT scan at admission. (2) MRI performed within 24 h of therapy onset including: (a) dual fast spin echo T2 sequence, (b) axial isotropic echoplanar diffusion-weighted imaging sequence, (c) conventional T2* GRE, and (d) 3D TOF turbo MRA. Post-ischemic cerebral hemorrhage was diagnosed if T2* GRE detected a focal intraparenchymal area of signal loss. The diameter of this lesion had to be more than 5 mm in order to eliminate past microbleeds. (3) Patients who showed an early suspicion of bleeding on MRI promptly had a second CT scan, and, if this one was negative for bleeding, another CT scan was performed 1 day later. All the other patients had a control CT scan during the first week. Forty-five consecutive patients have been included. T2* GRE showed intracranial bleeding in seven. The diagnosis of post-ischemic cerebral bleeding was confirmed by CT in all patients. Control CT scans did not reveal any post-ischemic cerebral hemorrhage in patients with negative MRI. In one case, hemorrhage was seen earlier on MRI than on CT scan. In conclusion, T2* GRE appeared to be at least as efficient as CT scan in the detection of early post-ischemic cerebral hemorrhage. (orig.)

  11. Clinical analysis of recurrent cerebral hemorrhage in patients with cerebral infarction complicated with cerebral hemorrhage%合并脑微出血的脑梗死患者再发脑出血临床分析

    Institute of Scientific and Technical Information of China (English)

    魏瑞花

    2016-01-01

    目的:探讨合并脑微出血(CMB)的脑梗死患者再发脑出血的相关因素及预防措施。方法选取急性脑梗死患者124例为研究对象,根据磁共振梯度回波 T2加权成像(GRE-T2*W1)结果分为两组,合并CMB 者42例为研究组,无 CMB 者82例为对照组,比较两组再发脑出血情况及相关因素。结果研究组CMB 在颅内的分布情况为:分布于基底节/丘脑区23个,占54.7%;皮质-皮质下区12个,占28.5%;幕下区7个,占16.7%。再出血发生情况为:基底节/丘脑区11.3%,发生于皮质-皮质下区7.3%,发生于幕下区位0.8%。研究组再出血发生率40.4%,明显高于对照组的10.9%,差异有统计学意义(χ2=11.263,P <0.05)。结论合并 CMB 的脑梗死患者,为再发脑出血的高危人群。通过 GRE-T2*W1及时发现 CMB,可有效指导临床医生合理选择治疗方案,降低脑出血的发生率,改善患者预后。%Objective To investigate the related factors and prevention measures of recurrent intracerebral hemorrhage in cerebral infarction patients with cerebral microbleeds.Methods 124 patients with acute cerebral infarction were divided into two groups according to the GRE -T2 * W1 examination,cerebral microbleeds as control group(n =42),non cerebral microbleeds as observation group(n =82);The recurrence of cerebrahemorrhage and related factors of the two groups were compared.Results In the control group,the distribution of the CMB in intracranial:thalamus -basal ganglia area was 23,accounting for 54.7%;cortical -subcortical area was 12,accounting for 28.5%,under the curtain area was 7,accounting for 16.7%.The incidence of recurrent intracerebral hemorrhage was 1 1 .3 % ,7.3% and 0.8% respectively .The incidence of recurrent intracerebral hemorrhage in the group with CMB(40.4%)was obviously higher than that of without the CMB group(10.9%),the difference was statistically

  12. CSF and Serum Biomarkers Focusing on Cerebral Vasospasm and Ischemia after Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Carla S. Jung

    2013-01-01

    Full Text Available Delayed cerebral vasospasm (CVS and delayed cerebral ischemia (DCI remain severe complications after subarachnoid hemorrhage (SAH. Although focal changes in cerebral metabolism indicating ischemia are detectable by microdialysis, routinely used biomarkers are missing. We therefore sought to evaluate a panel of possible global markers in serum and cerebrospinal fluid (CSF of patients after SAH. CSF and serum of SAH patients were analyzed retrospectively. In CSF, levels of inhibitory, excitatory, and structural amino acids were detected by high-performance liquid chromatography (HPLC. In serum, neuron-specific enolase (NSE and S100B level were measured and examined in conjunction with CVS and DCI. CVS was detected by arteriography, and ischemic lesions were assessed by computed tomography (CT scans. All CSF amino acids were altered after SAH. CSF glutamate, glutamine, glycine, and histidine were significantly correlated with arteriographic CVS. CSF glutamate and serum S100B were significantly correlated with ischemic events after SAH; however, NSE did not correlate neither with ischemia nor with vasospasm. Glutamate, glutamine, glycine, and histidine might be used in CSF as markers for CVS. Glutamate also indicates ischemia. Serum S100B, but not NSE, is a suitable marker for ischemia. These results need to be validated in larger prospective cohorts.

  13. CSF and Serum Biomarkers Focusing on Cerebral Vasospasm and Ischemia after Subarachnoid Hemorrhage

    Science.gov (United States)

    Jung, Carla S.; Lange, Bettina; Zimmermann, Michael; Seifert, Volker

    2013-01-01

    Delayed cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) remain severe complications after subarachnoid hemorrhage (SAH). Although focal changes in cerebral metabolism indicating ischemia are detectable by microdialysis, routinely used biomarkers are missing. We therefore sought to evaluate a panel of possible global markers in serum and cerebrospinal fluid (CSF) of patients after SAH. CSF and serum of SAH patients were analyzed retrospectively. In CSF, levels of inhibitory, excitatory, and structural amino acids were detected by high-performance liquid chromatography (HPLC). In serum, neuron-specific enolase (NSE) and S100B level were measured and examined in conjunction with CVS and DCI. CVS was detected by arteriography, and ischemic lesions were assessed by computed tomography (CT) scans. All CSF amino acids were altered after SAH. CSF glutamate, glutamine, glycine, and histidine were significantly correlated with arteriographic CVS. CSF glutamate and serum S100B were significantly correlated with ischemic events after SAH; however, NSE did not correlate neither with ischemia nor with vasospasm. Glutamate, glutamine, glycine, and histidine might be used in CSF as markers for CVS. Glutamate also indicates ischemia. Serum S100B, but not NSE, is a suitable marker for ischemia. These results need to be validated in larger prospective cohorts. PMID:23509668

  14. Subarachnoid hemorrhage with transient ischemic attack: Another masquerader in cerebral venous thrombosis

    Directory of Open Access Journals (Sweden)

    Bhawna Sharma

    2010-01-01

    Full Text Available Cerebral venous thrombosis has a wide spectrum of clinical manifestations that may mimic many other neurological disorders and lead to frequent misdiagnoses or delay in diagnosis. The most frequent symptoms and signs are headache, seizures, focal deficits, and papilledema. A number of rare atypical manifestations have been described. Cerebral venous thrombosis may present with an isolated intracranial hypertension type picture, thunderclap headache, attacks of migraine with aura, isolated psychiatric disturbances, pulsatile tinnitus, isolated or multiple cranial nerve involvement, and occasionally as subarachnoid hemorrhage (SAH or transient ischemic attack. Our patient presented with thunderclap headache and transient ischemic attack like episode with obvious SAH on CT scan. Acute SAH suggests the presence of a vascular lesion, such as ruptured aneurysm, and CVT is not generally considered in the diagnostic workup of SAH. The case emphasizes the importance of cerebral venous study in nonaneurysmal cases of SAH. It is important to have a high index of suspicion in such atypical cases to avoid delay in diagnosis.

  15. Clinical utility of multislice computed tomographic angiography for detection of cerebral vasospasm in acute subarachnoid hemorrhage.

    Science.gov (United States)

    Joo, S P; Kim, T S; Kim, Y S; Moon, K S; Lee, J K; Kim, J H; Kim, S H

    2006-10-01

    Digital subtraction angiography (DSA) has been used as the standard method for detecting cerebral vasospasm after subarachnoid hemorrhage (SAH). Multislice computed tomographic angiography (CTA) is a relatively recent method used for evaluating the vasculature of the intracranial arteries. The purpose of this study was to compare multislice CTA and DSA for the detection and quantification of cerebral vasospasm after SAH, and to analyze the usefulness of multislice CTA. Eight patients with SAH underwent initial CTA with DSA within 72 hours after the onset of symptoms and follow-up multislice CTA and DSA 8 to 48 days after SAH. Five arterial locations were established in the A1 and A2 segments of the anterior cerebral artery, the M1 and M2 segments of the middle cerebral artery and the posterior cerebral artery (PCA) on both multislice CTA and DSA images. Vasospasm was classified as none, mild (up to 30% reduction in luminal diameter), moderate (31-60% reduction), and marked (at least 60% reduction) using the scale of Schneck and Kricheff. The multislice CT system used the following parameters: 1.25 mm collimation and 3.75 pitch with a 4-channel system. The degree of vasospasm revealed by the multislice CTA was significantly correlated with the degree of vasospasm revealed by DSA. In general, most discrepancies between CTA and DSA were in the detection of mild and moderate vasospasm. We found that the consistency between multislice CTA and DSA was greater for mild (100%, n=3) or moderate (100%, n=3) vasospasm than none (n=1) or marked vasospasm (n=1). However, it was unclear whether multislice CTA was more specific for a proximal location (A1, M1, PCA) or distal location (A2, M2) for evaluation of cerebral arteries. Multislice CTA can detect angiographic vasospasm after SAH with an accuracy similar to that of DSA. Multislice CTA is highly sensitive, specific and accurate in detecting mild and moderate cerebral vasospasm. It is less accurate for detecting no vasospasm

  16. EFFECT OF ELECTROACUPUNCTURE OF SCALP-POINTS ON ABNORMAL DISCHARGES OF NEURONS AROUND THE CEREBRAL HEMORRHAGE FOCUS IN THE RAT

    Institute of Scientific and Technical Information of China (English)

    东红升; 东贵荣; 白妍

    2004-01-01

    Objective: To study the mechanism of electroacupuncture (EA) of scalp-points for regulating abnormal discharges of neurons in different regions around the cerebral hemorrhage focus by using neuro-electrophysiological methods. Methods: 80 Wistar rats (anesthetized with 20% urethane 1 g/kg, I.p.) were randomly divided into normal, saline, model and EA groups, with 20 cases in each group. Cerebral hemorrhage model was established by intracerebral injection of the rat's own arterial blood sample (40 uL). In rats of saline group, the same volume of saline was given for intracerebral injection. Extracellular electrical activity of neurons of the caudate nucleus and parafascicular nucleus and Tail filiform needles and stimulated electrically with stimulating parameters of strength of 1 V, frequency of 15 Hz and duration of 15 min. Results: Compared with normal group, TFL values of model group and EA group increased significantly (P<0.01); and compared with model group, those of EA group decreased significantly (P<0.01), suggesting that the pain threshold increased significantly in cerebral hemorrhage rats while after acupuncture stimulation, it lowered strikingly. Compared with normal and saline groups, the latency values of the pain excitement and inhibitory responses of the cellular discharges of the caudate and parafascicular nuclei in model and EA groups increased significantly (P<0.05~0.01), while after EA, it recovered apparently (P<0.01), showing an apparent regulative effect of EA on the abnormal changes of discharges of neurons around the cerebral hemorrhage focus. Conclusion: Scalp-acupuncture possesses an apparent regulatory effect on the abnormal electrical activity of neurons around the cerebral hemorrhage focus which may favor the early recovery of functional activity of neurons near the focus tissues.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    International Nuclear Information System (INIS)

    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.)

  19. Primary report of noninvasive impedance monitoring of cerebral hematoma and edema in patients with intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xia Yi Lu; Dong Wei-Wei; Yang Hao; Long Men; Yang Hua

    2000-01-01

    Background and Objective Brain edema is one of the most important clinical process in many diseases. Tissue impedance monitoring offers a non-invasive, bedside, rapid, and reliable technique for the monitoring of the brain edema. Methods We use a bioelectrical impedance(BEI) monitoring unit to record the brain impedance in the healthy volunteer and the patients with intracerebral hemorrhage. Percent of BEI variations were calculation. Results and Conclusions Brain BEI haven f any difference between both hemispheres in normal ones. In 48hrs, BEI value at hematoma-side was obviously decreased; after 48hrs, BEI value was obviously increased and continue to tenth day. Brain bioelectrical impedance monitoring, particularly noninvasively, is a first time in this field. The primary results show brain BEI could reflect the evolution of cerebral hematoma and edema.

  20. Gene expression and molecular changes in cerebral arteries following subarachnoid hemorrhage in the rat

    DEFF Research Database (Denmark)

    Vikman, Petter; Beg, Saema; Khurana, Tejvir S;

    2006-01-01

    OBJECT: The authors investigated early changes in the cerebral arteries of rats that occur after subarachnoid hemorrhage (SAH). METHODS: Messenger RNA was investigated by performing microarray and quantitative real-time polymerase chain reaction (PCR) analyses, and protein expression was shown...... by performing immunohistochemical studies. The array data indicated that the initial processes that occur after SAH involve activation of genes involved in angiogenesis, inflammation, and extracellular matrix (ECM) remodeling. The real-time PCR investigation confirmed upregulation of genes that were observed...... using the microarray to be regulated, including iNOS, MMP13, and cxcl2. The authors also verified the upregulation of previously implicated genes for G-protein-coupled receptors (endothelin B [ETB], angiotensin 1 [AT1], and AT2) and metalloproteinase 9. The results of an immunohistochemical study...

  1. Cellular processing of the amyloidogenic cystatin C variant of hereditary cerebral hemorrhage with amyloidosis, Icelandic type

    DEFF Research Database (Denmark)

    Benedikz, Eirikur; Merz, G S; Schwenk, V;

    1999-01-01

    of an amyloidogenic mutation on the intracellular processing of its protein product. The protein, a mutant of the cysteine protease inhibitor cystatin C, is the amyloid precursor protein in Hereditary Cerebral Hemorrhage with Amyloidosis--Icelandic type (HCHWA-I). The amyloid fibers are composed of mutant cystatin C...... (L68Q) that lacks the first 10 amino acids. We have previously shown that processing of wild-type cystatin C entails formation of a transient intracellular dimer that dissociates prior to secretion, such that extracellular cystatin C is monomeric. We report here that the cystatin C mutation engenders...... several alterations in its intracellular trafficking. It forms a stable intracellular dimer that is partially retained in the endoplasmic reticulum and degraded. The bulk of mutant cystatin C that is secreted does not dissociate and is secreted as an inactive dimer. Thus, formation of the stable mutant...

  2. Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review

    Science.gov (United States)

    Zou, Hai; Pan, Ke-Hua; Pan, Hong-Ying; Huang, Dong-Sheng; Zheng, Ming-Hua

    2015-01-01

    Tuberculosis (TB) is a common disease to threaten human health. TB of the central nervous system (CNS) is rare but the most serious type of systemic TB because of its high mortality rate, serious neurological complications and sequelae. In this case report, we describe a woman who presented with walking instability, intracerebral hemorrhage and leptomeningeal enhancement due to tuberculosis meningitis. The patient had no significant medical history and the initial clinical symptoms were walking instability. On analysis, the cerebrospinal fluid was colorless and transparent, the pressure was more than 400 mm H2O, there was lymphocytic pleocytosis, increased protein, and decreased glucose levels present. No tuberculosis or other bacteria were detected. The patient's brain computed tomography image showed intra-cerebral hemorrhage (ICH) and contrast magnetic resonance imaging showed ICH in the right frontal lob, and leptomeningeal enhancement. CNS TB is rare but has a high mortality rate. As this disease has no unique characteristics at first presentation such as epidemiology and obvious clinical manifestation, a diagnosis of CNS TB remains difficult. PMID:26675758

  3. ADVANCES IN CLINICAL AND EXPERIMENTAL STUDIES ON ACUPUNCTURE TREATMENT OF ACUTE CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    DING Jing; SHI Xue-min

    2005-01-01

    In the present paper, the authors review recent advances in clinical and experimental studies on acupuncture treatment of cerebral hemorrhage(CH). Regarding clinical studies, the resuscitation-inducing needling maneuver, and main points of Shuigou(水沟GV 26),Baihui(百会 GV 20) and scalp-points Motor Area(MS 6), Sensory Area(MS 7), etc. are often involved. Concerning experimental studies, the underlying mechanisms of acupuncture of GV-26+"Neiguan"(内关 PC 6), GV-20,GV-26+GV-20, etc. in improving acute CH are introduced. In a word, acupuncture therapy works well in improving clinical symptoms and signs of CH patients, and acupuncture stimulation induced ameilioration of cerebral blood flow, favorable modulation of some bioactive substances as excitatory and inhibitory amino acids, endothelin, CGRP, heat shock protein 70, etc. and neuro-endocrine-immune network may contribute to the effect of acupuncture on CH. In addition, acupuncture combined with medicine and earlier application of acupuncture therapy in the acute stage of CH are recommended in clinical practice.

  4. Reduced cerebral blood flow and oxygen metabolism in extremely preterm neonates with low-grade germinal matrix- intraventricular hemorrhage

    Science.gov (United States)

    Lin, Pei-Yi; Hagan, Katherine; Fenoglio, Angela; Grant, P. Ellen; Franceschini, Maria Angela

    2016-05-01

    Low-grade germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common complication in extremely premature neonates. The occurrence of GM-IVH is highly associated with hemodynamic instability in the premature brain, yet the long-term impact of low-grade GM-IVH on cerebral blood flow and neuronal health have not been fully investigated. We used an innovative combination of frequency-domain near infrared spectroscopy and diffuse correlation spectroscopy (FDNIRS-DCS) to measure cerebral oxygen saturation (SO2) and an index of cerebral blood flow (CBFi) at the infant’s bedside and compute an index of cerebral oxygen metabolism (CMRO2i). We enrolled twenty extremely low gestational age (ELGA) neonates (seven with low-grade GM-IVH) and monitored them weekly until they reached full-term equivalent age. During their hospital stay, we observed consistently lower CBFi and CMRO2i in ELGA neonates with low-grade GM-IVH compared to neonates without hemorrhages. Furthermore, lower CBFi and CMRO2i in the former group persists even after the resolution of the hemorrhage. In contrast, SO2 does not differ between groups. Thus, CBFi and CMRO2i may have better sensitivity than SO2 in detecting GM-IVH-related effects on infant brain development. FDNIRS-DCS methods may have clinical benefit for monitoring the evolution of GM-IVH, evaluating treatment response, and potentially predicting neurodevelopmental outcome.

  5. Nimodipine for treatment of perifocal edema following aspiration and drainage in patients with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xianzhong Ning; Qiang Liu; Hua Zhao

    2007-01-01

    BACKGROUND: After cephalophyma removal, perifocal edema does not disappear subsequently, but progresses occasionally. Nimodipine can improve cerebral blood flow, so it maybe reduce cerebral edema area, and speed up the absorption of edematous fluid. OBJECTIVE: To observe the effect of nimodipine on perifocal edema area and neurologic function in patients with hypertensive intracerebral hemorrhage (HIGH) following stereotaxic aspiration. DESIGN: Clinical controlled observation. SETTING: Department of Neurology, Third Hospital Affiliated to Liaoning Medical University. PARTICIPANTS: Totally 116 HIGH inpatients admitted to the Department of Neurology, Third Hospital Affiliated to Liaoning Medical University from January 2003 to January 2005 were involved in this experiment. They all met the classification and diagnosis of cerebrovascular disease proposed in 1995 4th National Conference on Cerebrovascular Disease. The bleeding volume≥35 Ml was confirmed by skull CT. The involved patients, 64 male and 52 femlae, averaged 63 years old, ranging from 40 to 70 years. All the patients suffered from unilateral cerebral hemisphere hemorrhage, and muscle strength of paralyzed limb was less than degree Ⅲ. Informed consents of therapeutic items were obtained from all the patients and relatives. METHODS: ①According to different wills, the patients were assigned into treatment group (n =60) and control group (n =56). In the treatment group, the involved patients, 32 male, 28 female, averaged 63 years. They underwent operation and administration of nimodipine. In the control group, the involved patients, 30 male and 26 female, averaged 62 years old. They all underwent operation simply. Patients in the two groups all received stereotaxic aspiration, drainage, dehydration, haemostasis, antiinflammation, blood pressure controlling and other treatments. Patients in the treatment group were also intravenously injected with 0.2 g/L nimodipine(Bayer Medicine Health Care Co., Ltd

  6. Decreased expression of transient receptor potential channels in cerebral vascular tissue from patients after hypertensive intracerebral hemorrhage

    DEFF Research Database (Denmark)

    Thilo, Florian; Suess, Olaf; Liu, Ying;

    2011-01-01

    the expression of TRP expression and hypoxic conditions caused by the intracerebral bleeding, we examined the expression of hypoxia inducible factor 1a (HIF1a). Transcripts of TRPC3, TRPC5, TRPM6, and HIF1a were significantly reduced in cerebral vascular tissue from patients after hypertensive intracerebral...... hemorrhage compared to controls. TRPC3 mRNA correlated well with the expression of HIF1a mRNA (r(2) = 0.59; p = 0.01). TRPC3 expression is associated with hypertension and hypoxic conditions in human cerebral vascular tissue....

  7. Regional cerebral blood flow after hemorrhagic hypotension in the preterm, near-term, and newborn lamb.

    Science.gov (United States)

    Szymonowicz, W; Walker, A M; Yu, V Y; Stewart, M L; Cannata, J; Cussen, L

    1990-10-01

    Developmental changes in regional cerebral blood flow (CBF) responses to hemorrhagic hypotension during normoxia and normocapnia were determined using radioactively labeled microspheres to measure flow to the cortex, brainstem, cerebellum, white matter, caudate nucleus, and choroid plexus in three groups of chronically catheterized lambs: 90- to 100-d preterm fetal lambs (n = 9); 125- to 136-d near-term fetal lambs (n = 9); and newborn lambs 5- to 35-d-old (n = 8). Heart rate, central venous pressure, and arterial blood pressure were monitored continuously and arterial blood gas tensions, pH, Hb, and oxygen saturation together with regional CBF were measured periodically. Hemorrhagic hypotension produced a mean decrease in arterial blood pressure of 27 +/- 4, 23 +/- 2, and 41 +/- 4% in the three groups, respectively, whereas reinfusion of the lamb's blood resulted in a return to control blood pressure within 3% in all three groups. In the pre-term fetal lamb, CBF decreased significantly in all regions during hypotension. In the near-term fetal lamb, only blood flow to the cortex decreased significantly during hypotension. In the newborn lamb, only the choroid plexus demonstrated a significant decrease in blood flow during hypotension. The lower limit of regional CBF autoregulation was identical to the resting mean arterial pressure in fetal life but significantly lower in newborn lambs. These experiments demonstrate for the first time that vulnerability to hypotension decreases with increasing maturity and that the brainstem, the phylogenetically oldest region of the brain, is the least vulnerable to the effects of hypotension at any age in the lamb model. PMID:2235134

  8. Long-Term Functional Consequences and Ongoing Cerebral Inflammation after Subarachnoid Hemorrhage in the Rat

    Science.gov (United States)

    Kooijman, Elke; Nijboer, Cora H.; van Velthoven, Cindy T. J.; Mol, Wouter; Dijkhuizen, Rick M.; Kesecioglu, Jozef; Heijnen, Cobi J.

    2014-01-01

    Subarachnoid hemorrhage (SAH) represents a considerable health problem with an incidence of 6–7 per 100.000 individuals per year in Western society. We investigated the long-term consequences of SAH on behavior, neuroinflammation and gray- and white-matter damage using an endovascular puncture model in Wistar rats. Rats were divided into a mild or severe SAH group based on their acute neurological score at 24 h post-SAH. The degree of hemorrhage determined in post-mortem brains at 48 h strongly correlated with the acute neurological score. Severe SAH induced increased TNF-α, IL-1β, IL-10, MCP-1, MIP2, CINC-1 mRNA expression and cortical neutrophil influx at 48 h post-insult. Neuroinflammation after SAH was very long-lasting and still present at day 21 as determined by Iba-1 staining (microglia/macrophages) and GFAP (astrocytes). Long-term neuroinflammation was strongly associated with the degree of severity of SAH. Cerebral damage to gray- and white-matter was visualized by immunohistochemistry for MAP2 and MBP at 21 days after SAH. Severe SAH induced significant gray- and white-matter damage. MAP2 loss at day 21 correlated significantly with the acute neurological score determined at 24 h post-SAH. Sensorimotor behavior, determined by the adhesive removal task and von Frey test, was affected after severe SAH at day 21. In conclusion, we are the first to show that SAH induces ongoing cortical inflammation. Moreover, SAH induces mainly cortical long-term brain damage, which is associated with long-term sensorimotor damage. PMID:24603553

  9. MMP-2/MMP-9 plasma level and brain expression in cerebral amyloid angiopathy-associated hemorrhagic stroke.

    Science.gov (United States)

    Hernandez-Guillamon, Mar; Martinez-Saez, Elena; Delgado, Pilar; Domingues-Montanari, Sophie; Boada, Cristina; Penalba, Anna; Boada, Mercè; Pagola, Jorge; Maisterra, Olga; Rodriguez-Luna, David; Molina, Carlos A; Rovira, Alex; Alvarez-Sabin, José; Ortega-Aznar, Arantxa; Montaner, Joan

    2012-03-01

    Cerebral amyloid angiopathy (CAA) is one of the main causes of intracerebral hemorrhage (ICH) in the elderly. Matrix metalloproteinases (MMPs) have been implicated in blood-brain barrier disruption and ICH pathogenesis. In this study, we determined the levels MMP-2 and MMP-9 in plasma and their brain expression in CAA-associated hemorrhagic stroke. Although MMP-2 and MMP-9 plasma levels did not differ among patients and controls, their brain expression was increased in perihematoma areas of CAA-related hemorrhagic strokes compared with contralateral areas and nonhemorrhagic brains. In addition, MMP-2 reactivity was found in β-amyloid (Aβ)-damaged vessels located far from the acute ICH and in chronic microbleeds. MMP-2 expression was associated to endothelial cells, histiocytes and reactive astrocytes, whereas MMP-9 expression was restricted to inflammatory cells. In summary, MMP-2 expression within and around Aβ-compromised vessels might contribute to the vasculature fatal fate, triggering an eventual bleeding. PMID:21707819

  10. EXPRESSION OF IL-2 AND SIL-2R AND ALTERATION OF CELL IMMUNITY IN PATIENTS WITH HYPERTENSIVE CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    Zhang Yuelin; Qiu Shudong; Shi Wei; Dang Xiaojun

    2006-01-01

    Objective To study the expression of interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R),determine the alteration of erythrocytic immunity and T cell subgroup in the blood of outer circulation in patients with hypertensive cerebral hemorrhage so and to probe into the relationship between them, and to explore the clinical significance. Methods Enzyme linked immnunosorbent assay (ELISA) was used to determine the content of IL-2 and sIL-2R. The immunoadsorption was employed to examine the erythrocytic immune activity and its regulating function.Streptavidin-peroxidase(S-P) was used to determine the cell number of CD3 (cluster of differentiation3), CD4 and CD8. Results The content of IL-2 in the group with hypertensive cerebral hemorrhage was significantly lower than that in the control group (P<0.01), and the content of sIL-2R increased. Red blood cell C3b receptor (RBC. C3b R)and RBC immune adherence enhancing factor (RFEB) dropped greatly (P<0.01), while RBC immune complex rosette (RBC. ICR) and RBC immune adherence inhibiting factor (RFIR) increased greatly. The cell number of CD3 and CD4decreased (P<0.01) and there was no obvious change in CD8 (P<0.05). Conclusion The decrease of immune function was observed in patients with hypertensive cerebral hemorrhage. The determination of the content of IL-2, sIL-2R, erythrocytic immunity and the activity of T subgroup has an important clinical significance in the occurrence,development, treatment, and prognosis of hypertensive cerebral hemorrhage.

  11. Early cerebral circulatory disturbance in patients suffering subarachnoid hemorrhage prior to the delayed cerebral vasospasm stage. Xenon computed tomography and perfusion computed tomography study

    International Nuclear Information System (INIS)

    Subarachnoid hemorrhage (SAH) causes dynamic changes in cerebral blood flow (CBF), and results in delayed ischemia due to vasospasm, and early perfusion deficits before delayed cerebral vasospasm (CVS). The present study examined the severity of cerebral circulatory disturbance during the early phase before delayed CVS and whether it can be used to predict patient outcome. A total of 94 patients with SAH underwent simultaneous xenon computed tomography (CT) and perfusion CT to evaluate cerebral circulation on Days 1-3. Cerebral blood flow (CBF) was measured using xenon CT and the mean transit time (MTT) using perfusion CT and calculated cerebral blood volume (CBV). Outcome was evaluated with the Glasgow Outcome Scale (good recovery [GR], moderate disability [MD], severe disability [SD], vegetative state [VS], or death [D]). Hunt and Hess (HH) grade II patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. HH grade III patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. Patients with favorable outcome (GR or MD) had significantly higher CBF and lower MTT than those with unfavorable outcome (SD, VS, or D). Discriminant analysis of these parameters could predict patient outcome with a probability of 74.5%. Higher HH grade on admission was associated with decreased CBF and CBV and prolonged MTT. CBF reduction and MTT prolongation before the onset of delayed CVS might influence the clinical outcome of SAH. These parameters are helpful for evaluating the severity of SAH and predicting the outcomes of SAH patients. (author)

  12. Sequential changes in cerebral blood flow and outcome in patients with subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    The sequential cerebral blood flow (CBF) and the CBF response to acetazolamide (AZ; 1 g I.V.; cerebrovascular reserve capacity rate (CRCR)) were studied within four days after the initial subarachnoid hemorrhage (SAH) in 42 patients. Stable xenon-enhanced computed tomography (xenon-CT) was used. The mean global CBF of the patients was reduced in accordance with the severity of the neurological grade (Hunt and Kosnik (H-K) grading). In the subacute stage of SAH, the CBF had the tendency to decline in patients with H-K grades I and II. By comparison, in the chronic stage there was an increase in the CBF in all patients. On the other hand, the CBF response to AZ declined in accordance with the severity of neurological grading. The CRCR at the acute phase of SAH was significantly diminished in patients who had a poor outcome as compared to that of individuals who had a good outcome. Questions pertaining to the usefulness of the CBF response to AZ in the acute phase of SAH are being addressed in the present report. (author)

  13. Subarachnuid cerebral hemorrhage treated with unequal volume of cerebrospinal fluid replacement

    Institute of Scientific and Technical Information of China (English)

    Chen Min; Zhejiang; Tongxiang; Shen jinsong; Lu jianhong; Xu Yusi; Cai Aiying; Qiu Jiannin

    2000-01-01

    Objective To asscss the effcct and safely of treatment with unequal volume replacement of cerebrospinal fluid(CSF) in cases of subarachnosd hemorrhage(SAH). Background 48 cases of SAH were seleeted which comply to the diagnostic standard set bh the 2nd National meeting of cerebro-vascular diseases and confirmed by CT and CSF examination. Randomly 24 cases were treated as above called treated cases and the other 24 cases as control. Method Treated Treated cases, after successful spinal puncture, 5to 10 ml of CSF were withdrawn. Normal saline were replaced but the volume were 2ml less than the amount withdraw. This is repeated until 6-10ml were withdrawn. The last injeetion of normal saline was aeeompanied with 5mg of dexamethasonum. Cases treated replacement were between 1 to 4times. Result After replacement intracranial pressure (ICP) were generally lowered and headache immediately lcssened or relieved. No further bleeding or herniation of brain occurred. Discussion At present the replaccment of CSF are generally of equal volame. This may cause recurrent bleeding or herniation of brain. After unequal volume replacement, great fluctuation of ICP bu comparison may be lowered. In treated cases duration of headache cerebral vasospasm(CVS), ocurance of hydrocephlus were generally less than the control cases(p<0.05). No intracranial infection in treated casea. Conelusion Unequal volume replacement of CSF in treatment of SAH is effeetive. It is safer than equal volume replacement

  14. The detection of chronic cerebral hemorrhage in rabbits with magnetic induction

    Science.gov (United States)

    Sun, Jian; Jin, Gui; Qin, Mingxin; Wan, Zibing; Wang, Jinbao; ChaoWang; Guo, Wanyou; Xu, Lin; Ning, Xu; Xu, Jia; Pu, Xianjie; Chen, Mingsheng; Zhao, Hongmei

    2012-12-01

    Chronic cerebral hemorrhage (CCH) in the brain is an important clinical problem that is often monitored and studied with expensive devices such as MRI and PET, which are not readily available in low economical resource parts of the world. We have developed a less expensive tool for non-contact monitoring of CCH in the brain. The system measures the phase shift between the electromagnetic signals on the two coils. CCH was induced in the brain of rabbits by stereotactic method. Intracranial pressure (ICP) and Electrocardiograph (ECG) of subjects were monitored for 1.5h. Signals were continuously monitored up to t=1.5h at exciting frequency 10.7MHz. From 0.8 to 2.4 ml of autologous blood was injected (each injection quantity of 0.8 ml, the interval time for 30 minutes). The results show significant phase shifts increase as a function of injection volume. ICP and phase shift were directly proportional to the related, while HRV were stable around 200beats*min-1. Our system has high sensitivity that even 0.8 ml can also be detected. In this study, the curves of inductive phase shift are significantly related to ICP. This observation suggests that the method could be valuable, in addition to continuous monitoring, also for early warning in emergency medicine and critical care units.

  15. Functional response of cerebral blood flow induced by somatosensory stimulation in rats with subarachnoid hemorrhage

    Science.gov (United States)

    Li, Zhiguo; Huang, Qin; Liu, Peng; Li, Pengcheng; Ma, Lianting; Lu, Jinling

    2015-09-01

    Subarachnoid hemorrhage (SAH) is often accompanied by cerebral vasospasm (CVS), which is the phenomenon of narrowing of large cerebral arteries, and then can produce delayed ischemic neurological deficit (DIND) such as lateralized sensory dysfunction. CVS was regarded as a major contributor to DIND in patients with SAH. However, therapy for preventing vasospasm after SAH to improve the outcomes may not work all the time. It is important to find answers to the relationship between CVS and DIND after SAH. How local cerebral blood flow (CBF) is regulated during functional activation after SAH still remains poorly understood, whereas, the regulation of CBF may play an important role in weakening the impact of CVS on cortex function. Therefore, it is worthwhile to evaluate the functional response of CBF in the activated cortex in an SAH animal model. Most evaluation of the effect of SAH is presently carried out by neurological behavioral scales. The functional imaging of cortical activation during sensory stimulation may help to reflect the function of the somatosensory cortex more locally than the behavioral scales do. We investigated the functional response of CBF in the somatosensory cortex induced by an electrical stimulation to contralateral forepaw via laser speckle imaging in a rat SAH model. Nineteen Sprague-Dawley rats from two groups (control group, n=10 and SAH group, n=9) were studied. SAH was induced in rats by double injection of autologous blood into the cisterna magna after CSF aspiration. The same surgical procedure was applied in the control group without CSF aspiration or blood injection. Significant CVS was found in the SAH group. Meanwhile, we observed a delayed peak of CBF response in rats with SAH compared with those in the control group, whereas no significant difference was found in magnitude, duration, and areas under curve of relative CBF changes between the two groups. The results suggest that the regulation function of local CBF during

  16. Imaging manifestations and diagnosis of a case of adult cerebral paragonimiasis with the initial symptom of hemorrhagic stroke.

    Science.gov (United States)

    Wang, Hong; Shao, Bei

    2015-01-01

    This study is to investigate the clinical features, neuroimaging and diagnosis of adult cerebral paragonimiasis. One case of patient with cerebral paragonimiasis as retrospectively analyzed in this study. Analysis included medical history, clinical manifestations and neuroimaging. Blood test, body fluid examination, immunological test, stool examination and imaging examination were performed. Many symptoms such as headache, hemiplegia, chest pain, cough, and pleural effusion were detected in the patient. The features of "tunnel-like shape" and "ring-like shape", the intracranial hemorrhage and edema were shown by CT and MRI imaging. Chest CT examination revealed pleural effusion. Eosinophil count of peripheral blood and pleural effusion increased. Lung fluke ELISA test was positive and anti-parasitic treatment was effective. The typical clinical manifestations of MRI of cerebral paragonimiasis, such as the "tunnel-like shape" and "ring-like shape", were of high diagnostic value. And, blood eosinophil count examination and paragonimiasis antibody test could also help the diagnosis value.

  17. Different CT perfusion algorithms in the detection of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Tracer delay-sensitive perfusion algorithms in CT perfusion (CTP) result in an overestimation of the extent of ischemia in thromboembolic stroke. In diagnosing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), delayed arrival of contrast due to vasospasm may also overestimate the extent of ischemia. We investigated the diagnostic accuracy of tracer delay-sensitive and tracer delay-insensitive algorithms for detecting DCI. From a prospectively collected series of aSAH patients admitted between 2007-2011, we included patients with any clinical deterioration other than rebleeding within 21 days after SAH who underwent NCCT/CTP/CTA imaging. Causes of clinical deterioration were categorized into DCI and no DCI. CTP maps were calculated with tracer delay-sensitive and tracer delay-insensitive algorithms and were visually assessed for the presence of perfusion deficits by two independent observers with different levels of experience. The diagnostic value of both algorithms was calculated for both observers. Seventy-one patients were included. For the experienced observer, the positive predictive values (PPVs) were 0.67 for the delay-sensitive and 0.66 for the delay-insensitive algorithm, and the negative predictive values (NPVs) were 0.73 and 0.74. For the less experienced observer, PPVs were 0.60 for both algorithms, and NPVs were 0.66 for the delay-sensitive and 0.63 for the delay-insensitive algorithm. Test characteristics are comparable for tracer delay-sensitive and tracer delay-insensitive algorithms for the visual assessment of CTP in diagnosing DCI. This indicates that both algorithms can be used for this purpose. (orig.)

  18. Different CT perfusion algorithms in the detection of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Room G03.232, Brain Center Rudolf Magnus Department of Neurology and Neurosurgery, PO Box 85500, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Dankbaar, Jan Willem; Bennink, Edwin; Velthuis, Birgitta K.; Schaaf, Irene C. van der [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Room G03.232, Brain Center Rudolf Magnus Department of Neurology and Neurosurgery, PO Box 85500, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2015-05-01

    Tracer delay-sensitive perfusion algorithms in CT perfusion (CTP) result in an overestimation of the extent of ischemia in thromboembolic stroke. In diagnosing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), delayed arrival of contrast due to vasospasm may also overestimate the extent of ischemia. We investigated the diagnostic accuracy of tracer delay-sensitive and tracer delay-insensitive algorithms for detecting DCI. From a prospectively collected series of aSAH patients admitted between 2007-2011, we included patients with any clinical deterioration other than rebleeding within 21 days after SAH who underwent NCCT/CTP/CTA imaging. Causes of clinical deterioration were categorized into DCI and no DCI. CTP maps were calculated with tracer delay-sensitive and tracer delay-insensitive algorithms and were visually assessed for the presence of perfusion deficits by two independent observers with different levels of experience. The diagnostic value of both algorithms was calculated for both observers. Seventy-one patients were included. For the experienced observer, the positive predictive values (PPVs) were 0.67 for the delay-sensitive and 0.66 for the delay-insensitive algorithm, and the negative predictive values (NPVs) were 0.73 and 0.74. For the less experienced observer, PPVs were 0.60 for both algorithms, and NPVs were 0.66 for the delay-sensitive and 0.63 for the delay-insensitive algorithm. Test characteristics are comparable for tracer delay-sensitive and tracer delay-insensitive algorithms for the visual assessment of CTP in diagnosing DCI. This indicates that both algorithms can be used for this purpose. (orig.)

  19. 脑出血患者早期进食防治上消化道出血%Effect of Early Food-taking Preventing the Upper Digestive Tract Hemorrhage in the Patients with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孔令瑜

    2001-01-01

    为探讨脑出血患者早期(72 h内)进食防治上消化道出血的作用,随机将78例脑出血患者分为两组,观察组发病72 h内进流质饮食;对照组常规禁食。结果观察组发生上消化道出血4例(10.5%),对照组13例(32.5%),两组比较,差异有显著性(P<0.05)。提示脑出血患者早期进流质饮食可防治上消化道出血。%In order to investigate the effect of early food-taking preventing the upper digestive tract hemorrhage in the patients with cerebral hemorrhage within 72 h of onset, 78 cases of cerebral hemorrhage were randomly divided into two groups: observation group taking liquid diet within 72 h of onset and control group with fasting. The results showed that there was significant difference in the occurrence of upper digestive tract hemorrhage between the two groups (P<0.05). It was suggested that the early food-taking of the liquid diet for the patients with cerebral hemorrhage could prevent the occurrence of hemorrhage of upper digestive tract.

  20. Inhibition of cerebrovascular raf activation attenuates cerebral blood flow and prevents upregulation of contractile receptors after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Maddahi Aida

    2011-10-01

    Full Text Available Abstract Background Late cerebral ischemia carries high morbidity and mortality after subarachnoid hemorrhage (SAH due to reduced cerebral blood flow (CBF and the subsequent cerebral ischemia which is associated with upregulation of contractile receptors in the vascular smooth muscle cells (SMC via activation of mitogen-activated protein kinase (MAPK of the extracellular signal-regulated kinase (ERK1/2 signal pathway. We hypothesize that SAH initiates cerebrovascular ERK1/2 activation, resulting in receptor upregulation. The raf inhibitor will inhibit the molecular events upstream ERK1/2 and may provide a therapeutic window for treatment of cerebral ischemia after SAH. Results Here we demonstrate that SAH increases the phosphorylation level of ERK1/2 in cerebral vessels and reduces the neurology score in rats in additional with the CBF measured by an autoradiographic method. The intracisternal administration of SB-386023-b, a specific inhibitor of raf, given 6 h after SAH, aborts the receptor changes and protects the brain from the development of late cerebral ischemia at 48 h. This is accompanied by reduced phosphorylation of ERK1/2 in cerebrovascular SMC. SAH per se enhances contractile responses to endothelin-1 (ET-1, 5-carboxamidotryptamine (5-CT and angiotensin II (Ang II, upregulates ETB, 5-HT1B and AT1 receptor mRNA and protein levels. Treatment with SB-386023-b given as late as at 6 h but not at 12 h after the SAH significantly decreased the receptor upregulation, the reduction in CBF and the neurology score. Conclusion These results provide evidence for a role of the ERK1/2 pathway in regulation of expression of cerebrovascular SMC receptors. It is suggested that raf inhibition may reduce late cerebral ischemia after SAH and provides a realistic time window for therapy.

  1. Quantification of structural cerebral abnormalities on MRI 18 months after aneurysmal subarachnoid hemorrhage in patients who received endovascular treatment

    Energy Technology Data Exchange (ETDEWEB)

    Bresser, Jeroen de [University Medical Center Utrecht, Department of Radiology, P.O. Box 85500, Utrecht (Netherlands); Schaafsma, Joanna D.; Luitse, Merel J.A.; Rinkel, Gabriel J.E.; Biessels, Geert Jan [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Viergever, Max A. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2015-03-01

    Volume measurements performed on brain MRI after aneurysmal subarachnoid hemorrhage (aSAH) may provide insight into the structural abnormalities that underlie the commonly occurring and persistent long-term functional deficits after aSAH. We examined the pattern of long-term cerebral structural changes on MRI in relation to known risk factors for poor functional outcome. We studied MRI scans from 38 patients who received endovascular treatment and were not dependent for activities of daily life at 18 months after aSAH. Risk factors for poor functional outcome (clinical condition, Hijdra score, and bicaudate index on admission; occurrence of hydrocephalus or delayed cerebral infarction during hospitalization) were related to supratentorial cerebral parenchymal and lateral ventricular volumes on MRI with linear regression analyses adjusted for age, sex, and intracranial volume. Clinical condition, Hijdra score, and bicaudate index on admission were not related to cerebral parenchymal volume at 18 months. A higher bicaudate index on admission was related to lateral ventricular enlargement at 18 months after aSAH (Beta; 95%CI: 0.51; 0.14<->0.88). Delayed cerebral infarction was related to smaller cerebral parenchymal volumes (-0.14; -0.25<->-0.04) and to lateral ventricular enlargement (0.49; 0.16<->0.83) at 18 months. Volume measurements of the brain are able to quantify patterns of long-term cerebral damage in relation to different risk factors after aSAH. Application of volumetric techniques may provide more insight into the heterogeneous underlying pathophysiological processes. After confirmation of these results in larger studies, volumetric measures might even be used as outcome measures in future treatment studies. (orig.)

  2. Atypical radiological and intraoperative findings of acute cerebral hemorrhage caused by ruptured cerebral aneurysm in a patient with severe chronic anemia.

    Science.gov (United States)

    Matano, Fumihiro; Murai, Yasuo; Nakagawa, Shunsuke; Kato, Taisei; Kitamura, Takayuki; Sekine, Tetsuro; Takagi, Ryo; Teramoto, Akira

    2014-01-01

    Acute intracerebral hemorrhage (ICH) associated with mild anemia is commonly observed on radiological examination, and there are several reports of ruptured aneurysms occurring with ICH but without accompanying subarachnoid hemorrhage. However, the relationship among computed tomography (CT), magnetic resonance imaging (MRI), and intraoperative findings of ICH caused by ruptured cerebral aneurysm in patients with severe chronic anemia has been rarely reported and is poorly understood. Here, we report atypical radiological and intraoperative findings of acute ICH caused by ruptured cerebral aneurysm in a patient with severe chronic anemia. A 64-year-old man with anemia was admitted to our hospital after he experienced left hemiparesis and a disturbance of consciousness. At a referring institution, he showed evidence of macrocytic anemia (white blood cell count, 9,000/μL; red blood cell count, 104×10(4)/μL; hemoglobin, 4.0 g/dL; hematocrit, 12.2%; and platelet count, 26.6×10(4)/μL). Both CT and MRI showed a right frontal ICH. The outer ring of the hematoma appeared as low-density area on CT, a low-intensity area on T1-weighted MRI, and a high-intensity area on T2-weighted MRI with a serous component. The patient received a blood transfusion and underwent surgical removal of the hematoma the following day. The white serous effusion visualized with CT and MRI was identified as a blood clot in the hematoma cavity. The blood that leaks from blood vessels appears as a high-intensity area on CT because it undergoes plasma absorption in a solidification shrinkage process, and is, therefore, concentrated. Although we did not examine the white effusion to determine if serous components were present, we speculated that the effusion may have contained serous components. Therefore, we removed the part of the effusion that appeared as a low-density area on CT. The presence of ICH without subarachnoid hemorrhage suggested the possible adhesion and rupture of a previous

  3. Conditional deletion of Ccm2 causes hemorrhage in the adult brain: a mouse model of human cerebral cavernous malformations

    OpenAIRE

    Cunningham, Kirk; Uchida, Yutaka; O'Donnell, Erin; Claudio, Estefania; Li, Wenling; Soneji, Kosha; Wang, Hongshan; Mukouyama, Yoh-suke; Siebenlist, Ulrich

    2011-01-01

    Cerebral cavernous malformations (CCM) are irregularly shaped and enlarged capillaries in the brain that are prone to hemorrhage, resulting in headaches, seizures, strokes and even death in patients. The disease affects up to 0.5% of the population and the inherited form has been linked to mutations in one of three genetic loci, CCM1, CCM2 and CCM3. To understand the pathophysiology underlying the vascular lesions in CCM, it is critical to develop a reproducible mouse genetic model of this di...

  4. Modulation of cerebral blood flow with transcutaneous electrical neurostimulation (TENS) in patients with cerebral vasospasm after subarachnoid hemorrhage

    NARCIS (Netherlands)

    ter Laan, Mark; van Dijk, J.M.C.; Stewart, Roy; Staal, Michiel J; Elting, Jan-Willem J

    2014-01-01

    ObjectivesTranscutaneous electrical neurostimulation (TENS) and spinal cord stimulation have been shown to increase peripheral and cerebral blood flow. We postulate that certain pathological conditions attenuate cerebral autoregulation, which may result in a relative increase of the importance of ne

  5. Semiquantitative regional cerebral blood flow evaluation using sup 123 I-IMP SPECT in a case showing transient ischemic attack caused by putaminal hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Y.; Ayada, Y.; Takahashi, T.; Toyama, Y.; Matsuo, H. (Second Department of Internal Medicine, Kagawa Medical School (Japan)); Katsuragawa, M.; Tanabe, M. (Department of Radiology, Kagawa Medical School (Japan))

    1991-01-01

    A 69-year-old woman presented a transient cerebral ischemic attack, showing left arm weakness and slurred speech which recovered within 4 h of onset, while computed tomography indicated a putaminal hemorrhage. The regional cerebral blood flow distribution, measured semiquantitatively by use of {sup 123}I amphetamine emission tomography, was disturbed, which persisted more than one month up to a maximum of 4.5 months from the onset of symptoms. the case illustrates a variety of putaminal hemorrhage of good functional and vital prognosis, and provides and example in which the regional cerebral blood flow disturbances might persist for more than one month up to 4.5 months after the occurrence of a transient ischemic attack caused by a putaminal hemorrhage. (author).

  6. [A Case of Aplastic or Twig-Like Middle Cerebral Artery Presenting with an Intracranial Hemorrhage Two Years after a Transient Ischemic Attack].

    Science.gov (United States)

    Uchiyama, Taku; Okamoto, Hiroaki; Koguchi, Motofumi; Tajima, Yutaka; Suzuyama, Kenji

    2016-02-01

    Aplastic or twig-like middle cerebral artery (Ap/T-MCA) is a rare anatomical anomaly, which can be associated with intracranial hemorrhage and cerebral ischemia. A 52-year-old woman who presented with sudden headache was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging showed no abnormality; however, magnetic resonance angiogram revealed an occlusion or severe stenosis in the left middle cerebral artery. Three-dimensional CT angiography demonstrated severe stenosis in the left middle cerebral artery. The patient was discharged without any neurological deficit; however, she subsequently complained of temporary weakness in the right hand. It was possibly due to a transient ischemic attack; therefore, cilostazol 200 mg/day was administered for prevention of cerebral ischemia. Single photon emission computed tomography(with or without administration of acetazolamide)showed neither significant decrease in the cerebral blood flow nor cerebrovascular reactivity; hence, surgical revascularization was not performed. However, two years after the initial admission, she was urgently admitted to our hospital with sudden headache and nausea followed by aphasia and weakness of the right extremities. CT images showed diffuse subarachnoid hemorrhage and intracerebral hemorrhage in the left temporo-parietal lobe. Cerebral angiography revealed that the left middle cerebral artery was Ap/T-MCA without cerebral aneurysms. The patient was treated conservatively, and she eventually recovered without any neurological deficit except mild aphasia. Since Ap/T-MCA is associated with both hemorrhagic and ischemic stroke, antiplatelet therapy should be administered carefully. Moreover, it is necessary to consider extracranial-intracranial bypass to reduce hemodynamic stress on the abnormal vessels.

  7. Medical Management of Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage: A Review of Current and Emerging Therapeutic Interventions.

    Science.gov (United States)

    Adamczyk, Peter; He, Shuhan; Amar, Arun Paul; Mack, William J

    2013-01-01

    Cerebral vasospasm is a major source of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH). Evidence suggests a multifactorial etiology and this concept remains supported by the assortment of therapeutic modalities under investigation. The authors provide an updated review of the literature for previous and recent clinical trials evaluating medical treatments in patients with cerebral vasospasm secondary to aSAH. Currently, the strongest evidence supports use of prophylactic oral nimodipine and initiation of triple-H therapy for patients in cerebral vasospasm. Other agents presented in this report include magnesium, statins, endothelin receptor antagonists, nitric oxide promoters, free radical scavengers, thromboxane inhibitors, thrombolysis, anti-inflammatory agents and neuroprotectants. Although promising data is beginning to emerge for several treatments, few prospective randomized clinical trials are presently available. Additionally, future investigational efforts will need to resolve discrepant definitions and outcome measures for cerebral vasospasm in order to permit adequate study comparisons. Until then, definitive recommendations cannot be made regarding the safety and efficacy for each of these therapeutic strategies and medical management practices will continue to be implemented in a wide-ranging manner.

  8. Medical Management of Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage: A Review of Current and Emerging Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Peter Adamczyk

    2013-01-01

    Full Text Available Cerebral vasospasm is a major source of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH. Evidence suggests a multifactorial etiology and this concept remains supported by the assortment of therapeutic modalities under investigation. The authors provide an updated review of the literature for previous and recent clinical trials evaluating medical treatments in patients with cerebral vasospasm secondary to aSAH. Currently, the strongest evidence supports use of prophylactic oral nimodipine and initiation of triple-H therapy for patients in cerebral vasospasm. Other agents presented in this report include magnesium, statins, endothelin receptor antagonists, nitric oxide promoters, free radical scavengers, thromboxane inhibitors, thrombolysis, anti-inflammatory agents and neuroprotectants. Although promising data is beginning to emerge for several treatments, few prospective randomized clinical trials are presently available. Additionally, future investigational efforts will need to resolve discrepant definitions and outcome measures for cerebral vasospasm in order to permit adequate study comparisons. Until then, definitive recommendations cannot be made regarding the safety and efficacy for each of these therapeutic strategies and medical management practices will continue to be implemented in a wide-ranging manner.

  9. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Young; Shin, Hwa Seon; Choi, Hye Young; Chung, Sung Hoon; You, Jin Jong; Choi, Dae Seob; Son, Seung Nam [Gyeongsang National Univ. Hospital/Gyeongsang National Univ. School of Medicine, Jinju (Korea, Republic of); Ryu, Jae Wook [Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed.

  10. Changes in the cerebral blood flow in newborn rats assessed by LSCI and DOCT before and after the hemorrhagic stroke

    Science.gov (United States)

    Semyachkina-Glushkovskaya, O. V.; Lychagov, V. V.; Abdurashitov, A. S.; Sindeeva, O. V.; Sindeev, S. S.; Zinchenko, E. M.; Kajbeleva, E. I.; Pavlov, A. N.; Kassim, M.; Tuchin, V. V.

    2015-03-01

    The incidence of perinatal hemorrhagic stroke (HS) is very similar to that in the elderly and produces a significant morbidity and long-term neurologic and cognitive deficits. There is strong evidence that cerebral blood flow (CBF) abnormalities make considerable contribution to HS development. However, the mechanisms responsible for pathological changes in CBF in infants with HS are not established. Therefore, quantitative assessment of CBF may significantly advance the understanding of the nature of neonatal stroke. The aim of this investigation was to determine the particularities of alterations in macro- microcirculation in the brain of newborn rats in the different stages of stress-related development of HS using three-dimensional Doppler optical coherence tomography (DOCT) and laser speckle contrast imaging (LSCI).Our results show that cerebral veins are more sensitive to harmful effect of stress compared with microcirculatory vessels. Stress-induced progressive dilation of cerebral veins with the fall of blood flow velocity precedes HS while pathological changes in microcirculatory vessels are accompanied by development of HS. The further detailed study of cerebral venous and microcirculatory circulation would be a significant advance in development of prognostic criteria for a HS risk during the first days after birthday.

  11. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed

  12. MRI of acute post-ischemic cerebral hemorrhage in stroke patients: diagnosis with T2{sup *}-weighted gradient-echo sequences

    Energy Technology Data Exchange (ETDEWEB)

    Hermier, M. [Dept. of Radiology, Univ. Claude-Bernard Lyon-I (France); Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France); Service de Radiologie, Hopital Neurologique, Lyon (France); Nighoghossian, N. [Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France); Cerebrovascular Disease and Ataxia Research Center, Univ. Claude-Bernard Lyon-I, Lyon (France); Derex, L.; Blanc-Lasserre, K.; Trouillas, P. [Cerebrovascular Disease and Ataxia Research Center, Univ. Claude-Bernard Lyon-I, Lyon (France); Berthezene, Y. [Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France); Dept. of Radiology, Univ. Claude-Bernard Lyon-I, Lyon (France); Froment, J.C. [Dept. of Radiology, Univ. Claude-Bernard Lyon-I (France); Centre de Recherche et d' Application en Traitement de l' Image et du Signal (CREATIS), UMR CNRS Lyon (France)

    2001-10-01

    The use of T2{sup *}-weighted sequences has been advocated for early differentiation between hematoma and ischemia in patients with acute stroke. Early hemorrhagic transformation of ischemic stroke is an adverse event which may occur under treatment and may impair the prognosis: our aim is to evaluate the ability of T2*-weighted gradient-echo sequence (T2{sup *} GRE) to detect post-ischemic cerebral hemorrhage. The imaging procedure included: (1) baseline CT scan at admission. (2) MRI performed within 24 h of therapy onset including: (a) dual fast spin echo T2 sequence, (b) axial isotropic echoplanar diffusion-weighted imaging sequence, (c) conventional T2* GRE, and (d) 3D TOF turbo MRA. Post-ischemic cerebral hemorrhage was diagnosed if T2{sup *} GRE detected a focal intraparenchymal area of signal loss. The diameter of this lesion had to be more than 5 mm in order to eliminate past microbleeds. (3) Patients who showed an early suspicion of bleeding on MRI promptly had a second CT scan, and, if this one was negative for bleeding, another CT scan was performed 1 day later. All the other patients had a control CT scan during the first week. Forty-five consecutive patients have been included. T2* GRE showed intracranial bleeding in seven. The diagnosis of post-ischemic cerebral bleeding was confirmed by CT in all patients. Control CT scans did not reveal any post-ischemic cerebral hemorrhage in patients with negative MRI. In one case, hemorrhage was seen earlier on MRI than on CT scan. In conclusion, T2{sup *} GRE appeared to be at least as efficient as CT scan in the detection of early post-ischemic cerebral hemorrhage. (orig.)

  13. Hemorrhage in cerebral metastasis from angiosarcoma of the heart: case report Hemorragia em metástase cerebral de angiossarcoma cardíaco: relato de caso

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    2001-09-01

    Full Text Available The purpose of this article is to describe the clinical and pathological features of metastatic angiosarcoma in the central nervous system. Only a few cases of cerebral metastasis from angiosarcoma of the heart have been recorded in the literature; particulary related to intracerebral hemorrhage. A case of secondary cerebral angiosarcoma of the heart in a 33 years old man is presented. The initial symptoms were headache, vomiting, lethargy and aphasia. There was a mass in the left temporal lobe with hemorrhage and edema on the computerized tomography (CT. After 24 hours the neurological status worsened and another CT scan showed rebleeding on the tumor area. He underwent an emergency craniotomy but died two days after. Considering the longer survival of sarcoma patients with new modalities of treatment, the incidence of brain metastasis may increase, demanding a bether preventive and more aggressive approach. Besides, due to the hemorrhagic nature of such lesions, we suggest the imediate surgery to prevent a fast and lethal evolution because rebleeding.O propósito deste artigo é descrever os achados clínicos e patológicos das metástases de angiossarcoma no sistema nervoso central. Apenas poucos casos de metástases cerebrais de angiossarcoma cardíaco foram relatados na literatura, menos ainda relacionados a hemorragia intracerebral. Relatamos o caso de um tumor cerebral secundário a angiossarcoma cardíaco em um paciente masculino de 33 anos. Os sintomas iniciais foram: cefaléia, vômitos, letargia e afasia. A tomografia computadorizada mostrou massa no lobo temporal esquerdo associada a hemorragia e edema. Após 24 horas houve piora do estado neurológico e nova tomografia demonstrou ressangramento no leito tumoral. Foi submetido a uma craniotomia de urgência mas faleceu dois dias após. Considerando a longa sobrevida dos pacientes com sarcoma devido às novas modalidades terapêuticas, poderá aumentar a incidência de met

  14. Application of clinical pathway in patients with cerebral hemorrhage%临床路径在脑出血患者中的应用

    Institute of Scientific and Technical Information of China (English)

    陈建国; 石振东

    2015-01-01

    Objective:To investigate application effects of clinical pathway in patients with cerebral hemorrhage. Methods:By using a historical control study method, the average hospitalization days and costs of the patients with cerebral hemorrhage before and after the application of clinical pathway were analyzed. Results:After the application of clinical pathway, the average hospitaliza-tion days and costs of the patients with cerebral hemorrhage were reduced, and the differences were statistically significant (P<0. 05). Conclusions:The implementation of clinical pathways can reduce hospitalization costs, and shorten hospitalization days in the patients with cerebral hemorrhage.%目的::探讨临床路径在脑出血患者中的应用效果。方法:采用历史对照研究方法,主要将应用临床路径前后的脑出血患者的平均住院天数、住院费用情况进行分析。结果:应用临床路径后脑出血患者的平均住院天数、住院费用均有所下降,差异有统计学意义( P<0.05)。结论:实施临床路径能减少脑出血患者住院费用,缩短住院天数。

  15. Equal contribution of increased intracranial pressure and subarachnoid blood to cerebral blood flow reduction and receptor upregulation after subarachnoid hemorrhage. Laboratory investigation

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2009-01-01

    OBJECT: Cerebral ischemia remains the key cause of disability and death in the late phase after subarachnoid hemorrhage (SAH), and its pathogenesis is still poorly understood. The purpose of this study was to examine whether the change in intracranial pressure or the extravasated blood causes the...

  16. Hyperbaric oxygen in the treatment of hypertension- induced cerebral hemorrhage on 34 cases%高血压脑出血术后高压氧治疗34例

    Institute of Scientific and Technical Information of China (English)

    程晋成; 沈月萍; 王水平; 吴杨

    2003-01-01

    @@ INTRODUCTION In this study,we investigated effect of hyperbaric oxygen(HBO) on the hypertension- induced basio- cerebral hemorrhage.The affected patients often showed signs of cerebral circulation disorder,spasm of vessels,insufficiency of cerebral blood supply and intracranial hypertension.

  17. Accuracy of computed tomography perfusion in detecting delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Haogeng Sun

    2013-01-01

    Full Text Available Background and Purpose: In recent years, significant literature shows that computed tomography perfusion (CTP can provide sufficient information on cerebral hemodynamics and effectively indicate delayed cerebral ischemia (DCI before the development of infarction. We aimed at performing a meta-analysis to provide a more full and accurate evaluation of CTP and CTP parameters in detecting DCI in patients with aneurysmal subarachnoid hemorrhage. Materials and Methods: We searched the PubMed, MedLine, Embase and Cochrane databases for analysis published from February 2005 to February 2013. We extracted CTP parameters, including cerebral blood volume (CBV, cerebral blood flow (CBF, mean transit time (MTT, time to peak (TTP, interhemispheric ratios for CBV and CBF and interhemispheric differences for MTT and TTP. Pooled estimates of sensitivity, specificity, positive likelihood ratio (PLR, negative likelihood ratio (NLR, diagnostic odds ratio (DOR and the summary receiver-operating characteristic curve were determined. Results: Four research studies are met the inclusion criteria for the analysis. The pooled sensitivity, specificity, PLR, NLR and DOR of CTP for detecting the DCI were 82%, 82%, 4.56, 0.22 and 20.96, respectively. Through the evaluation of absolute CTP parameters, CBF and MTT showed diagnostic value for DCI, but CBF and TTP did not. Moreover, CBF ratio, MTT difference and TTP difference showed more diagnostic value than CBV ratio in DCI detection by the assessment of relative CTP parameters. Conclusions: As a non-invasive and short time consuming screening method, CTP own a high diagnostic value for the detection of DCI after aneurysm rupture.

  18. Multiresolution analysis of pathological changes in cerebral venous dynamics in newborn mice with intracranial hemorrhage: adrenorelated vasorelaxation

    International Nuclear Information System (INIS)

    Intracranial hemorrhage (ICH) is the major problem of modern neonatal intensive care. Abnormalities of cerebral venous blood flow (CVBF) can play a crucial role in the development of ICH in infants. The mechanisms underlying these pathological processes remain unclear; however it has been established that the activation of the adrenorelated vasorelaxation can be an important reason. Aiming to reach a better understanding of how the adrenodependent relaxation of cerebral veins contributes to the development of ICH in newborns, we study here the effects of pharmacological stimulation of adrenorelated dilation of the sagittal sinus by isoproterenol on the cerebral venous hemodynamics. Our study is performed in newborn mice at different stages of ICH using the laser speckle contrast imaging and wavelet analysis of the vascular dynamics of CVBF. We show that the dilation of the sagittal sinus with the decreased velocity of blood flow presides to the stress-induced ICH in newborn mice. These morphofunctional vascular changes are accompanied by an increased variance of the wavelet-coefficients in the areas of endothelial and non-endothelial (KATP-channels activity of vascular muscle) sympathetic components of the CVBF variability. Changes in the cerebral venous hemodynamics at the latent stage of ICH are associated with a high responsiveness of the sagittal sinus to isoproterenol quantifying by wavelet-coefficients related to a very slow region of the frequency domain. The obtained results certify that a high activation of the adrenergic-related vasodilatory responses to severe stress in newborn mice can be one of the important mechanisms underlying the development of ICH. Thus, the venous insufficiency with the decreased blood outflow from the brain associated with changes in the endothelial and the sympathetic components of CVBF-variability can be treated as prognostic criteria for the risk of ICH during the first days after birth. (paper)

  19. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Schaaf, Irene C. van der; Velthuis, Birgitta K.; Dankbaar, Jan Willem [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands)

    2015-09-15

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  20. Hemorrhagic shock-induced cerebral bioenergetic imbalance is corrected by pharmacologic treatment with EF24 in a rat model.

    Science.gov (United States)

    Rao, Geeta; Xie, Jun; Hedrick, Andria; Awasthi, Vibhudutta

    2015-12-01

    Maintenance of cerebral viability and function is an important goal of critical care in victims of injury due to ischemia and hypovolemia. As part of the multiple organ dysfunction syndrome, the brain function after trauma is influenced by the systemic inflammatory response. We investigated the effect of EF24, an anti-inflammatory bis-chalcone, on cerebral bioenergetics in a rat model of 45% hemorrhagic shock. The rats were treated with EF24 (0.4 mg/kg) or EF24 with an artificial oxygen carrier liposome-encapsulated hemoglobin (LEH). The volume of LEH administered was equal to the shed blood. The brain was collected after 6 h of shock for biochemical assays. EF24 treatment showed significant recovery of ATP, phosphocreatine, and NAD/NADH ratio. It also increased citrate synthase activity and cytochrome c oxidase subunit IV expression which were reduced in shock brain. Furthermore, it reduced the shock-induced accumulation of pyruvate and pyruvate dehydrogenase kinase-1 expression, suggesting that EF24 treatment improves cerebral energetics by restoring perturbed pyruvate metabolism in the mitochondria. These effects of EF24 were associated with reduced poly(ADP-ribose) polymerase cleavage and a significant improvement in the levels of nerve growth factor and brain-derived neurotrophic factor in shock brain. Co-administration of LEH with EF24 was only marginally more effective as compared to the treatment with EF24 alone. These results show that EF24 treatment sets up a pro-survival phenotype in shock by resurrecting cerebral bioenergetics. Since EF24 was effective in the absence of accompanying fluid resuscitation, it has potential utility as a pre-hospital pharmacotherapy in shock due to accidental blood loss. PMID:26232641

  1. High Plasma Levels of Neuropeptide Y Correlate With Good Clinical Outcome But are not Correlated to Cerebral Blood Flow or Vasospasm After Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Stavngaard, Trine; Jessing, Iben R;

    2016-01-01

    BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a serious and frequent complication following subarachnoid hemorrhage. Treatments with convincing effect are lacking and the pathophysiology behind DCI remains poorly understood. Neuropeptide Y (NPY) is a potent endogenous vasoconstrictor...... and a role of NPY in the development of DCI has been proposed. This study investigated the relationship between plasma-NPY and cerebral blood flow (CBF), cerebral vasospasm, DCI, and clinical outcome. METHODS: In 90 patients with subarachnoid hemorrhage, NPY was measured in peripheral blood days 2 to 11. Any...... occurrence of DCI was recorded and CBF was quantified day 3 and day 8 using computed tomography (CT) perfusion. CT angiography was performed day 8. Clinical outcome was assessed after 3 months. RESULTS: No correlation was found between plasma-NPY and CBF or angiographic vasospasm. The correlation between...

  2. Predicting cerebral amyloid angiopathy-realated intracerebral hemorrhages and other cerebrovascular disorders in Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Masahito eYamada

    2012-04-01

    Full Text Available Cerebral amyloid angiopathy (CAA of amyloid β-protein (Aβ type is common in Alzheimer’s disease (AD. Aβ immunotherapies have been reported to induce CAA-related intracerebral hemorrhages (ICH or vasogenic edema. For the purpose of developing a method to predict CAA-related ICH and other cerebrovascular disorders in AD, the biomarkers and risk factors are reviewed. The biomarkers include (1 greater occipital uptake on amyloid PET imaging and a decrease of cerebrospinal fluid Aβ40 levels as markers suggestive of CAA, and (2 symptomatic lobar ICH, lobar microhemorrhages, focal subrachnoidal hemorrhages/superficial siderosis, cortical microinfarcts, and subacute encephalopathy (caused by CAA-related inflammation or angiitis as imaging findings of CAA-related ICH and other disorders. The risk factors include (1 old age and AD, (2 CAA-related gene mutations and apolipoprotein E genotype as genetic factors, (3 thrombolytic, anti-coagulation, and anti-platelet therapies, hyertension, and minor head trauma as hemorrhage-inducing factors, and (4 anti-amyloid therapies. Positive findings for one or more biomarkers plus one or more risk factors would be associated with a significant risk of CAA-related ICH and other cerebrovascular disorders. To establish a method to predict future occurrence of CAA-related ICH and other cerebrovascular disorders in AD, prospective studies with a large number of AD patients are necessary, which will allow us to statistically evaluate to what extent each biomarker or risk factor would increase the risk. In addition, further studies with progress of technologies are necessary to more precisely detect CAA and CAA-related cerebrovascular disorders.

  3. 脑动脉粥样硬化出血斑块与急性脑梗死的相关性分析%The association between intraplaque hemorrhage of cerebral arteries and acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    陈军; 孟琳; 孙胜军

    2015-01-01

    Objective To evaluate the relationship between intraplaque hemorrhage of cerebral arteries and acute cerebral infarcts. Methods 35 patients with severe stenosis in M1 segment of middle cerebral arteries (MCA)were included in this study.Intracranial TOF MRA (time of flight MR angiography)was performed to detect the stenosis in MCA,and DWI (diffusion weighted imaging) was performed to detect cerebral acute infarcts.T1 MPRAGE sequence was positioned on the stenosis in M1 segment of MCA,and intraplaque hemorrhage was determined according to high signal on T1 MRRAGE images.35 patients were divided into two groups:one group with intraplaque hemorrhage and the other group without intraplaque hemorrhage.Whether there was significant differ-ence in the incidences of acute cerebral infarcts between the two groups were determined byχ2 test.Results Intraplaque hemorrhage was detected in 1 5 patients,in which 12 patients had acute cerebral infarcts.There were no intraplaque hemorrhage in 20 patients,in which 9 patients had acute cerebral infarcts.There was significant difference in the incidences of acute cerebral infarcts between the two groups (P =0.046 <0.05).Conclusion There is a higher incidence of acute cerebral infarcts in patients with intraplaque hem-orrhage than those without intraplaque hemorrhage.Intraplaque hemorrhage in severe stenosis of cerebral arteries is a high-risk indi-cation for acute cerebral infarction.%目的:探讨脑动脉粥样硬化出血斑块与急性脑梗死的关系。方法选择大脑中动脉 M1段重度狭窄患者35例,所有患者均行颅脑时间飞跃法 MR 血管成像(TOF MRA)和扩散加权成像(DWI),TOF MRA 确定大脑中动脉狭窄的部位,DWI 检测脑内急性梗死灶。对粥样硬化斑块部位行 T1 MRRAGE 序列成像,斑块内高信号判定为斑块内出血。35例患者分为出血斑块组和无出血斑块组,采用χ2检验统计分析2组患者中急性脑梗死的发生率有无统计学差异。结果35

  4. [Increased urinary sodium excretion in the early phase of aneurysmal subarachnoid hemorrhage as a predictor of cerebral salt wasting syndrome].

    Science.gov (United States)

    Nakagawa, Ichiro; Kurokawa, Shinichiro; Takayama, Katsutoshi; Wada, Takeshi; Nakase, Hiroyuki

    2009-12-01

    Cerebral salt wasting syndrome (CSWS) in patients with aneurysmal subarachnoid hemorrhage (SAH) is considered to correlate with delayed ischemic neurological deficits (DIND) induced by cerebral vasospasm; however, its exact mechanism is still not well-known. The purpose of the present study is to evaluate the relationship between hyponatremia caused by CSWS and the increase of the urinary sodium excretion in early phase following SAH. Fifty-four patients with SAH were divided into 2 groups, normonatremia group and hyponatremia group which suffered hyponatremia after SAH. The hyponatremia group comprise 14 patients (26%) in whom the hyponatremia developed of the SAH. In this group, the serum level of sodium significantly decreased 7 days after SAH and then gradually normalised. Further, excretion of sodium in the urine tended to increase 3 days after SAH and significantly increased 7 days after SAH. In conclusion, the increased urinary sodium excretion in the early phase of SAH would serve as a predictive factor for CSWS after SAH. We consider that it is important to start sodium and fluid supplementation and inhibit natriuresis by fludrocortisone acetate administration before hyponatremia occurs in order to prevention delayed ischemic neurological deficits in SAH patients.

  5. 出血性脑梗死诊疗方式分析%Hemorrhagic Cerebral Infarction Diagnosis Analysis Approach

    Institute of Scientific and Technical Information of China (English)

    李浩涛

    2014-01-01

    Objective To study the analysis of cause of hemorrhagic cerebral infarction and the related factors influencing the prognosis of disease treatment,summarizes the effective way of diagnosis and treatment. Methods Our hospital were retrospectively analyzed clinical data of 90 cases of hemorrhagic cerebral infarction patients,and analyze the related factors to induce hemorrhagic cerebral infarction,the clinical curative effect and bleeding time,bleeding in patients with type relationship with the prognosis of diseases,and so on and so forth. Results The patients' blood sugar levels,whether to impose thrombolysis therapy and infarction in patients with type is an important risk factor of induced hemorrhagic cerebral infarction,this group of al of the patients after targeted individualized treatment,71 cases(78.9%),the person that the il ness get better treatment is invalid in 16 cases(17.8%),the remaining three patients died due to multiple organ failure,and mortality rate of 3.3%;Infarction occurred after 7 d hemorrhage patients and non hematoma in patients with clinical total effective rate(89.5%),(90%) was significantly higher infarction occurred hemorrhage patients(73.1%)and 7 d type hematoma patients(68.3%),contrast differences were statistically significant(P< 0.05). Conclusion Clinical work should be paid attention to during the process of high blood sugar,large area cerebral infarction and thrombolysis treatment of patients with bleeding risk factors of diagnosis and treatment,as far as possible do early diagnosis,early take effective individualized treatment,is helpful for improving the prognosis of patients,reduce mortality.%目的:探讨分析诱发出血性脑梗死以及影响疾病治疗预后的相关因素,总结有效的诊疗方式。方法回顾性分析我院收治的出血性脑梗死90例患者临床资料,分析诱发出血性脑梗死的相关因素、临床治疗疗效以及患者出血时间、出血类型与疾病预后的关系等情

  6. Cerebral vasoconstriction after subarachnoid hemorrhage--role of changes in vascular receptor phenotype

    DEFF Research Database (Denmark)

    Hansen-Schwartz, Jacob; Ansar, Saema; Edvinsson, Lars

    2008-01-01

    prominent given their ability to elicit powerful constriction of cerebral arteries. Investigating both 5-HT and ET receptors we have observed that there are distinct changes in receptor phenotype after experimental SAH, namely upregulation of the ETB and 5-HT1B receptors, and that this upregulation is...... linked to a higher sensitivity to the endogenous agonists. It has also been shown that reduction in regional cerebral blood flow (CBF) is associated with receptor upregulation and interventional animal experiments have shown a benefit from inhibiting the PKC and MAP kinase pathways on receptor...

  7. Subarachnoid hemorrhage induces enhanced expression of thromboxane A2 receptors in rat cerebral arteries

    DEFF Research Database (Denmark)

    Ansar, Saema; Larsen, Carl; Maddahi, Aida;

    2010-01-01

    on the smooth muscle cells (SMCs) was increased in SAH compared to sham. Global and regional CBFs were reduced in SAH as compared to sham. The results demonstrate that SAH results in CBF reduction and this is associated with the enhanced expression of TP receptors in the SMC of cerebral arteries...

  8. Cerebral vasoconstriction after subarachnoid hemorrhage--role of changes in vascular receptor phenotype

    DEFF Research Database (Denmark)

    Hansen-Schwartz, J.; Ansar, S.; Edvinsson, L.

    2008-01-01

    linked to a higher sensitivity to the endogenous agonists. It has also been shown that reduction in regional cerebral blood flow (CBF) is associated with receptor upregulation and interventional animal experiments have shown a benefit from inhibiting the PKC and MAP kinase pathways on receptor...

  9. Cerebral vasospasm following subarachnoid hemorrhage: time for a new world of thought

    DEFF Research Database (Denmark)

    Pluta, Ryszard M; Hansen-Schwartz, Jacob; Dreier, Jens;

    2009-01-01

    OBJECTIVE: Delayed cerebral vasospasm has long been recognized as an important cause of poor outcome after an otherwise successful treatment of a ruptured intracranial aneurysm, but it remains a pathophysiological enigma despite intensive research for more than half a century. METHOD: Summarized ...

  10. Subarachnoid hemorrhage in the rat: cerebral blood flow and glucose metabolism during the late phase of cerebral vasospasm

    International Nuclear Information System (INIS)

    A double-isotope technique for the simultaneous measurement of CBF and CMRglu was applied to a subarachnoid hemorrhage (SAH) model in the rat. Cisternal injection of 0.07 ml blood caused a rather uniform 20% reduction in CBF together with an increase in glucose utilization of 30% during the late phase of vasospasm. In one-third of the SAH animals, there were focal areas where the flow was lowered to 30% of the control values and the glucose uptake increased to approximately 250% of control. We suggest that blood in the subarachnoid space via a neural mechanism induces the global flow and metabolic changes, and that the foci are caused by vasospasm superimposed on the global flow and metabolic changes. In the double-isotope autoradiographic technique, [14C]iodoantipyrine and [3H]deoxyglucose were used for CBF and CMRglu measurements, respectively, in the same animal. In half of the sections, the [14C]iodoantipyrine was extracted using 2,2-dimethoxypropane before the section was placed on a 3H- and 14C-sensitive film. The other sections were placed on x-ray film with an emulsion insensitive to 3H. The validity of the double-isotope method was tested by comparing the data with those obtained in animals receiving a single isotope. The CBF and metabolic values obtained in the two groups were similar

  11. Linguistic rehabilitation nursing of pregnancy induced hypertension syndrome associated with cerebral hemorrhage%妊娠高血压综合征并发脑出血的语言康复护理

    Institute of Scientific and Technical Information of China (English)

    刘焕美; 石文利

    2003-01-01

    @@ BACKGROUND:Pregnancy induced hypertension syndrome associated with cerebral hemorrhage is the common cause of obstetric death and even emergency treatment succeeds,living quality is affected because of lalopathy.

  12. Subtype activation and interaction of protein kinase C and mitogen-activated protein kinase controlling receptor expression in cerebral arteries and microvessels after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2008-01-01

    BACKGROUND AND PURPOSE: The pathogenesis of cerebral ischemia associated with subarachnoid hemorrhage (SAH) still remains elusive. The aim of this study was to examine the involvement of mitogen-activated protein kinase (MAPK) and protein kinase C (PKC) subtypes in the pathophysiology of cerebral...... enhanced phosphorylation only at 48 hours after SAH. The pattern was identical in large cerebral arteries and in intracerebral microvessels. Treatment with either the PKC (RO-31-7549) or the raf (SB386023-b) inhibitor prevented the kinase activation. CONCLUSIONS: The results show that specific subtypes...... ischemia after SAH in cerebral arteries and microvessels and to examine temporal activation of the kinases. We hypothesize that treatment with a MAPK or PKC inhibitor will prevent the SAH-induced kinase activation in brain vessels. METHODS: SAH was induced by injecting 250 microL blood...

  13. Postpartum cerebral angiopathy presenting with non-aneurysmal subarachnoid hemorrhage and interval development of neurological deficits: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Li Yang

    2013-01-01

    Full Text Available Postpartum cerebral angiopathy (PCA is a cerebrovascular disease that occurs during the postpartum period. It is characterized by reversible multifocal vasoconstriction of the cerebral arteries. We report a patient with PCA proven by cerebral angiography that revealed multifocal, segmental narrowing of the cerebral arteries and non-aneurysmal subarachnoid hemorrhage. The patient suddenly deteriorated with focal neurological deficits on the 5 th day of hospitalization. She was treated with calcium-channel blockers and monitored with daily transcranial Doppler ultrasound. Her symptoms gradually improved and she was discharged on the 11 th day of hospitalization. At 1-month follow-up, patient was completely symptom-free with no neurological deficits.

  14. EFFECT OF ELECTROACUPUNCTURE ON DISCHARGES OF PAINREACTION NEURONS IN CAUDATE NUCLEUS AND PARAFACICULAR NUCLEUS IN RATS WITH CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    DONG Gui-rong; BAI Yan; JIN Chun-yu; DONG Hong-sheng; LI Li-qiu

    2005-01-01

    Objective:To study the bidirectional adjustment effect of electroacupuncture (EA) on the electrical activities of neurons in caudate nucleus (CN) and parafascicular nucleus (PFN) in rats with acute cerebral hemorrhage (ACH). Methods: ① 32 male Wistar rats were evenly randomized into normal, EA+normal, model and model+EA groups for observing the effect of EA on pain reaction; ② another 40 male Wistar rats were equally randomized into control, saline, model and EA groups for comparing the effects of EA on discharges of pain-reaction neurons in CN and PFN. ACH model was established by intracerebral injection of the rat's own arterial blood sample (30μL) into CN and PFN. Pain reaction was tested by using tail-flicking (TF) reflex induced by radiation-heat irradiation. Extra-cellular discharges of neurons of CN and PFN were recorded by using glass micropipettes. EA (1 V, 15 Hz and duration of 10 min) was applied to"Baihui"(百会 GV 20) and "Taiyang"(太阳 EX-HN 5). Frequency of discharges of CN and PFN neurons was calculated before and after intracerebral injection of blood sample, heat nociceptive stimulation and EA respectively. Results: Compared with control group and pre-EA in the same group, TF latency (TFL) values of normal rats increased significantly; compared with pre-injection of blood, TFL of model group also increased pronouncedly (P<0.01). In comparison with model group, TFL values of EA group decreased significantly (P<0.01), indicating that EA of GV 20 and EX-HN 5 could suppress ACH induced increase of TFL. In ACH rats, the latency of pain-excitement response of discharges of CN and PFN neurons increased significantly, while the net increase values of pain-excitement response decreased significantly in model group (P<0.05~0.01), the duration of pain-inhibitory response and the net decrease values of discharges of CN and PFN neurons increased clearly. Comparison between model and EA groups showed that the latency values of the pain

  15. [Massive natriuresis and polyuria after triple craniocervical subarachnoid hemorrhage: cerebral salt wasting syndrome?].

    Science.gov (United States)

    Berendes, E; Scherer, R; Schuricht, G; Rol, R; Hengst, K

    1992-11-01

    A thirty-year-old male patient suffered subarachnoidal haemorrhage from an angioma positioned in the cranio-cervical transition. After rebleeding twice the patient developed a hydrocephalus internus malresorptivus and excessive natriuresis and polyuria, accompanied by depressed renin activity and extremely low aldosterone plasma levels. Neither fluid restriction and sodium substitution, nor administration of hydro-chlorothiazide/indomethacin affected natriuresis and polyuria. It was only after treatment with fludrocortisone-acetate/hydrocortisone that hyponatraemia and polyuria were resolved. At the same time a ventriculo-peritoneal shunt was applied. Differential diagnosis excluded the syndromes of inadequate antidiuretic hormone secretion, renal and cerebral diabetes insipidus, osmotic receptor hypofunction, chronic renal dysfunction and tubular necrosis. Natriuresis and polyuria developed under dexamethasone therapy. Since patient history, physical examination and laboratory criteria could not explain the electrolyte and fluid imbalance, this might be attributed to the hydrocephalus. Similar disturbances have been reported from other patients with intracranial disorders. Mechanical pressure exercised on the hypothalamus might cause the disturbance of fluid and sodium balance. Assuming a cerebral salt wasting syndrome, a putative natriuretic factor coming from the brain or an imbalance in the cerebral renin-angiotensin-system, as described in rats and dogs, must be discussed.

  16. Subarachnoid Hemorrhage from a Dissecting Aneurysm of the Posterior Cerebral Artery in a Child : Rebleeding after Stent-Assisted Coiling Followed by Stent-Within-Stent Technique

    OpenAIRE

    Lee, Ji Yeoun; Kwon, Bae Ju; Kang, Hyun-Seung; Wang, Kyu-Chang

    2011-01-01

    Pediatric patients with dissecting aneurysms usually present with ischemia rather than bleeding. We report a case of a 15-year-old boy with a dissecting aneurysm of the posterior cerebral artery (PCA) presenting with hemorrhage. He was first treated with stent-assisted coil embolization, in an attempt to avoid trapping of the PCA and preserve the perforators. After the procedure, he recovered well from general anesthesia, but rebleeding occurred from the same lesion 6 hours after the procedur...

  17. 脑出血动物模型研究进展%The research progress of animal model of cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    段晓春; 王中; 陈罡

    2015-01-01

    For the reason to study the procedure of pathophysiology of cerebral hemorrhage, this review has summarized the models currently used in cerebral hemorrhage scientific research including cerebral hemorrhage model by injection of collagenase, by injection of autologous blood, by filling microsphere and by hypertensive. In this paper, the author will discuss in detail the making method of different animal model such as dog, rabbit, pig, etc. and pathophysiological mechanism and advantages and disadvantages in the research work.%本综述为了深入研究脑出血的病理生理过程,对目前用来开展科学研究的常用脑出血模型,包括胶原酶注射脑出血模型,自体血注入脑出血模型,微球囊充盈脑出血模型,高血压性脑出血模型进行了总结。在本文中笔者将详细探讨狗、兔子、猪等不同动物模型制作方法、病理生理机制以及在研究中的优点和缺点。

  18. Factors associated with delayed intracerebral hemorrhage after superficial temporal artery-middle cerebral artery bypass in stenoocclusive cerebrovascular diseases

    Institute of Scientific and Technical Information of China (English)

    Mao Zhiqi; Li Meng; William A.Li; Yu Xinguang

    2014-01-01

    Background Intra-cerebral hemorrhage (ICH) is a devastating complication that can result from superficial temporal artery-middle cerebral artery (STA-MCA) bypass in patients undergoing treatment for steno-occlusive cerebrovascular disease (CVD).There is a clinical need to find the possible risk factors to prevent ICH,as it is a significant cause of mortality and morbidity.The aim of the study was to investigate the factors associated with delayed ICH after STA-MCA bypass in patients with steno-occlusive CVDs.Methods We retrospectively analyzed the records of 163 patients seen from 2002 to 2011 with STA-MCA bypass for steno-occlusive cerebrovascular diseases at the Department of Neurosurgery,Xuan Wu Hospital,Beijing.Demographic and clinical data,including age,gender,vascular risk factors,preoperative syndrome,preoperative National Institutes of Health Stroke Scale (NIHSS),ipsilateral ischemic lesions,classification of steno-occlusive CVDs,donor branches of STA,graft patency,postoperative hypertension,and postoperative-increased MCA velocity were recorded and analyzed.Binary Logistic regression served to identify factors associated with delayed ICH after STA-MCA bypass.Results We identified 8 (4.9%) patients with delayed ICH after STA-MCA bypass.Patients with hypertension,preoperative stroke,ipsilateral ischemic lesions,postoperative hypertension and postoperative-increased MCA velocity were significantly more prone to experiencing delayed ICH after STA-MCA bypass.Logistic regression analysis shows ipsilateral ischemic lesions,postoperative hypertension,and postoperative-increased MCA velocity remained independent predictors for delayed ICH after STA-MCA bypass.Conclusion Despite the varied associated factors in patients with steno-occlusive CVDs,ipsilateral ischemic lesions,postoperative hypertension,and postoperative-increased MCA velocity could be associated with delayed ICH after STAMCA bypass.

  19. Signal transduction in cerebral arteries after subarachnoid hemorrhage-a phosphoproteomic approach

    DEFF Research Database (Denmark)

    Parker, Benjamin; Larsen, Martin Røssel; Povlsen, Gro Klitgaard;

    2013-01-01

    SAH-induced phosphorylations were validated by immunoblotting and monitored over a 24-hour time course post SAH. Moreover, inhibition of key phosphoproteins was performed. Major SAH-induced phosphorylations were observed on focal adhesion complexes, extracellular regulated kinase 1/2 (ERK1/2), calcium...... calmodulin-dependent kinase II, signal transducer and activator of transcription (STAT3) and c-Jun, the latter two downstream of ERK1/2. Inhibition of ERK1/2 6-hour post SAH prevented increases in cerebrovascular constrictor receptors, matrix metalloprotease-9, wall thickness, and improved neurologic outcome....... STAT3 inhibition partially mimicked these effects. The study shows that quantitative mass spectrometry is a strong approach to study in vivo vascular signaling. Moreover, it shows that targeting of ERK1/2 prevents delayed pathologic changes in cerebral arteries and improves outcome, and identifies SAH...

  20. Patient-tailored multimodal neuroimaging, visualization and quantification of human intra-cerebral hemorrhage

    Science.gov (United States)

    Goh, Sheng-Yang M.; Irimia, Andrei; Vespa, Paul M.; Van Horn, John D.

    2016-03-01

    In traumatic brain injury (TBI) and intracerebral hemorrhage (ICH), the heterogeneity of lesion sizes and types necessitates a variety of imaging modalities to acquire a comprehensive perspective on injury extent. Although it is advantageous to combine imaging modalities and to leverage their complementary benefits, there are difficulties in integrating information across imaging types. Thus, it is important that efforts be dedicated to the creation and sustained refinement of resources for multimodal data integration. Here, we propose a novel approach to the integration of neuroimaging data acquired from human patients with TBI/ICH using various modalities; we also demonstrate the integrated use of multimodal magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) data for TBI analysis based on both visual observations and quantitative metrics. 3D models of healthy-appearing tissues and TBIrelated pathology are generated, both of which are derived from multimodal imaging data. MRI volumes acquired using FLAIR, SWI, and T2 GRE are used to segment pathology. Healthy tissues are segmented using user-supervised tools, and results are visualized using a novel graphical approach called a `connectogram', where brain connectivity information is depicted within a circle of radially aligned elements. Inter-region connectivity and its strength are represented by links of variable opacities drawn between regions, where opacity reflects the percentage longitudinal change in brain connectivity density. Our method for integrating, analyzing and visualizing structural brain changes due to TBI and ICH can promote knowledge extraction and enhance the understanding of mechanisms underlying recovery.

  1. Low Cholesterol in Erythrocyte Membranes and High Lipoperoxides in Erythrocytes Are the Potential Risk Factors for Cerebral Hemorrhagic Stroke in Human

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective To explore the association of risk for human cerebral hemorrhage with blood cholesterol, free radicals, oxidatation and lipoperoxidation. Methods 351 cerebral hemorrhage patients (CHP) in the acute phase and 100 healthy adult volunteers (HAV) were investigated by testing the contents of cholesterol (CH), lipoperoxides (LPO), nitric oxide (NO), vitamin C (VC) and vitamin E (VE) and activities of superoxide dismutase (SOD) in plasma and erythrocytes (RBC), and by assessing the contents of CH and LPO in RBC with spectrophotometric assays. Results Compared with the average values (AV) of the above biochemical parameters (BP) in the HAV group, the AV of CH in plasma and RBC, VC and VE in plasma as well as SOD in plasma and RBC in the CHP group were significantly decreased (P=0.0000), while the AV of the LPO in plasma and RBC as well as NO in plasma in the CHP group were significantly increased (P=0.0000). The findings of linear correlation analysis for the CHP group showed that the above biochemical parameters were significantly correlated with both intracranial hemorrhagic sizes (IHS) and neurotic functional defective scales (NDS). The findings of stepwise correlation analysis for the CHA group suggested that HIS was closely correlated with the values of CH and LPO in RBC as well as NO and VE in plasma, and that NDS was closely correlated with the values of CH and LPO in RBC as well as NO and VC in plasma. Conclusions The findings of the present study suggest that marked low RBC cholesterol and marked high RBC lipoperoxides may constitute the potential main risk factors for human cerebral hemorrhage, and that the oxidative and lipoperoxidative stress in the CHP bodies is pathologically aggravated, leaeing to the oxidative and lipoperoxidative damages in the CHP.

  2. Low Cholesterol in Erythrocyte Membranes and High Lipoperoxides in Erythrocytes Are the Potential Risk Factors for Cerebral Hemorrhagic Stroke in Human

    Institute of Scientific and Technical Information of China (English)

    CHENHUAI-HONG; ZHOUJNU-FU; 等

    2001-01-01

    Objective:To explore the association of risk for human cerebral hemorrhage with blood cholesterol,free radicals,oxidatation and lipoperoxidation,Methods:351 cerebral hemorrhage patients(CHP) in the acute phase and 100 healthy adult volunteers(HVA) were investigated by testing the contents of cholesterol(CH),lipoperoxides(LPO),nitric oxide(NO),vitamin C(VC)and vitamin E(VE) and activities of superoxide dismutase(SOD) in plasma and erythrocytes (RBC),and by assessing the contents of CH and LPO in RBC with spectrophotometric assays.Results:Compared with the average vlaues(AV) of the above biochemical parameters(BP)in the HAV group,the AV of CH in plasma and RBC,VC and VE in plasma as well as SOD in plasma and RBC in the CHP group were significantly decreased(P=0.000),while the AV of the LPO in plasma and RBC as well as NO in plasma in the CHP group were significantly increased(P=0,0000),The findings of linear correlation analysis for the CHP group showed that the above biochemical parameters were significantly correlated with both intracraial hemorrhagic sized(IHS) and neurotic functional defective scales(NDS).The findings of stepwise correlation analysis for the CHA group suggested that HIS was closely correlated with the values of CH and LPO in RBC as well as NO and VE in plasma,and that NDS was closely correlated with the values of CH and LPO in RBC as well as NO and VC in plasma.Conclusions:The findings of the present study suggest that marked low RBC cholesterol and marked high RBC lipoperoxides may constitute the potential main risk factors for human cerebral hemorrhage,and that the oxidative and lipoperoxidative stress in the CHP bodies is pathologically aggravated.leading to the oxidative and lipoperoxidative damages in the CHP.

  3. Rehabilitation of motor function following hematoma removal in profuse cerebral hemorrhage%大量脑出血锥颅血肿清除术与运动功能康复

    Institute of Scientific and Technical Information of China (English)

    李康增; 郑建明; 郑志雄; 彭友敬; 张秀英; 潘彬政

    2003-01-01

    @@ INTRODUCTION Mortality of profuse cerebral hemorrhage is high.Objective of therapy is to reduce injury of edema and recover brain function,improve successive rate of salvage,and decrease disability incidence.Puncture and removal of cerebral hematoma and drain with urokinase under CT dirction(0.3 cm of vertebral cerebral aperture) is safe and simple,impact of which on muscle fore and movement function is investaged in this study.

  4. La trapia endovascular: una nueva alternativa en el tratamiento del vasoespasmo cerebral asociado a la hemorragia subaracnoidea espontánea Endovascular therapy: new alternative for treatment of cerebral vasospasm associated with spontaneous subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Sergio Vargas

    1998-04-01

    Full Text Available EI vaso espasmo cerebral es la principal causa tratable de muerte e incapacidad por hemorragia subaracnoidea espontánea secundaria a la ruptura de un aneurisma cerebral. Sin embargo, su tratamiento ha sido tradicionalmente frustrante, con resultados desalentadores. A pesar de que aún no se han aclarado del todo los mecanismos fisiopatológicos a través de los cuales ocurre este intrigante fenómeno, en los últimos 9 años, paralelamente al desarrollo de las técnicas endovasculares para el tratamiento de las enferm~dades cerebrovasculares, han surgido nuevas alternativas en el manejo del vasoespasmo cerebral. Entre ellas se destacan el uso intraarterial de papaverina y la angioplastia con balón de los vasos cerebrales. Se presenta una revisión del estado actual de estos novedosos instrumentos terapéuticos, así como el reporte de un caso en el cual usamos la papaverina intraarterial en el tratamiento del vasoespasmo quese presentó durante un procedimiento endovascular para excluir un aneurisma de la arteria cerebral media. Cerebral vasospasm is the first treatable cause of death and disability secondary to spontaneous subarachnoid hemorrhage due to ruptured cerebral aneurysms. However, its treatment has been disapointing with poor results. Despite the fact that the physiopathologic mechanisms governing this phenomenon are largely unknown, during the last nine years, simultaneously with the development of endovascular therapy techniques for treatment of cerebrovascular diseases, two new alternatives have emerged in order to alleviate cerebral vasospasm: intraarterial papaverine and cerebral balloon angioplasty. We report the use of intraarterial papaverine in one case to treat cerebral vasospasm presented during the endovascular therapy procedure; a review of literature is included.

  5. 807C/T polymorphism of platelet glycoprotein Ia gene is associated with cerebral hemorrhage in a Chinese population.

    Science.gov (United States)

    Zeng, Yi; Zhang, Le; Hu, Zhiping; Yang, Qidong; Ma, Mingming; Liu, Baoqiong; Xia, Jian; Xu, Hongwei; Liu, Yunhai; Du, Xiaoping

    2016-08-01

    Platelet glycoprotein (GP) mediated the role of platelet in coagulation. Platelet GP Ia 807C/T is the only GP polymorphism associated with the expression levels of GP Ia/IIa (the platelet collagen receptor). Recently, the GP Ia 807C/T polymorphism has been reported to have no association with cerebral hemorrhage (CH) in two studies pertained to Caucasian populations. The purpose of this study is to evaluate the association between platelet GP Ia 807C/T polymorphism and CH in a Han Chinese population. We performed genotype analysis for platelet GP Ia 807C/T polymorphism in a case-control study involving 195 patients with CH and 116 age- and sex-matched controls. In contrast to previous reports, we found that the frequencies of GP Ia 807C/T T allele, CT and TT genotype were much higher in CH patients than in controls (33.9% vs. 22.8%, p = 0.004; 45.5% and 11.1% vs. 40.4% and 2.6%, p = 0.022). Logistic regression analysis revealed that the presence of GP Ia 807C/T C allele and CC genotype were both associated with a decreased risk of CH compared with T allele, CT and TT genotypes, respectively (adjusted odds ratio [OR] = 0.565, 95% CI: 0.384-0.887, p = 0.005; adjusted OR = 0.172, 95% CI: 0.043-0.639, p = 0.009; adjusted OR = 0.254, 95% CI: 0.085-0.961, p = 0.041, respectively). These findings indicated that platelet GP Ia 807C/T polymorphism could be a protective factor of CH in the Chinese population.

  6. Early whole-brain CT perfusion for detection of patients at risk for delayed cerebral ischemia after subarachnoid hemorrhage.

    Science.gov (United States)

    Malinova, Vesna; Dolatowski, Karoline; Schramm, Peter; Moerer, Onnen; Rohde, Veit; Mielke, Dorothee

    2016-07-01

    OBJECT This prospective study investigated the role of whole-brain CT perfusion (CTP) studies in the identification of patients at risk for delayed ischemic neurological deficits (DIND) and of tissue at risk for delayed cerebral infarction (DCI). METHODS Forty-three patients with aneurysmal subarachnoid hemorrhage (aSAH) were included in this study. A CTP study was routinely performed in the early phase (Day 3). The CTP study was repeated in cases of transcranial Doppler sonography (TCD)-measured blood flow velocity (BFV) increase of > 50 cm/sec within 24 hours and/or on Day 7 in patients who were intubated/sedated. RESULTS Early CTP studies revealed perfusion deficits in 14 patients, of whom 10 patients (72%) developed DIND, and 6 of these 10 patients (60%) had DCI. Three of the 14 patients (21%) with early perfusion deficits developed DCI without having had DIND, and the remaining patient (7%) had neither DIND nor DCI. There was a statistically significant correlation between early perfusion deficits and occurrence of DIND and DCI (p 50 cm/sec within 24 hours, revealing a perfusion deficit in 3 of them (38%). Two of the 3 patients (67%) developed DCI without preceding DIND and 1 patient (33%) had DIND without DCI. In 4 of the 7 patients (57%) who were sedated and/or comatose, additional CTP studies on Day 7 showed perfusion deficits. All 4 patients developed DCI. CONCLUSIONS Whole-brain CTP on Day 3 after aSAH allows early and reliable identification of patients at risk for DIND and tissue at risk for DCI. Additional CTP investigations, guided by TCD-measured BFV increase or persisting coma, do not contribute to information gain.

  7. 807C/T polymorphism of platelet glycoprotein Ia gene is associated with cerebral hemorrhage in a Chinese population.

    Science.gov (United States)

    Zeng, Yi; Zhang, Le; Hu, Zhiping; Yang, Qidong; Ma, Mingming; Liu, Baoqiong; Xia, Jian; Xu, Hongwei; Liu, Yunhai; Du, Xiaoping

    2016-08-01

    Platelet glycoprotein (GP) mediated the role of platelet in coagulation. Platelet GP Ia 807C/T is the only GP polymorphism associated with the expression levels of GP Ia/IIa (the platelet collagen receptor). Recently, the GP Ia 807C/T polymorphism has been reported to have no association with cerebral hemorrhage (CH) in two studies pertained to Caucasian populations. The purpose of this study is to evaluate the association between platelet GP Ia 807C/T polymorphism and CH in a Han Chinese population. We performed genotype analysis for platelet GP Ia 807C/T polymorphism in a case-control study involving 195 patients with CH and 116 age- and sex-matched controls. In contrast to previous reports, we found that the frequencies of GP Ia 807C/T T allele, CT and TT genotype were much higher in CH patients than in controls (33.9% vs. 22.8%, p = 0.004; 45.5% and 11.1% vs. 40.4% and 2.6%, p = 0.022). Logistic regression analysis revealed that the presence of GP Ia 807C/T C allele and CC genotype were both associated with a decreased risk of CH compared with T allele, CT and TT genotypes, respectively (adjusted odds ratio [OR] = 0.565, 95% CI: 0.384-0.887, p = 0.005; adjusted OR = 0.172, 95% CI: 0.043-0.639, p = 0.009; adjusted OR = 0.254, 95% CI: 0.085-0.961, p = 0.041, respectively). These findings indicated that platelet GP Ia 807C/T polymorphism could be a protective factor of CH in the Chinese population. PMID:26134877

  8. 急性脑出血大鼠肠屏障功能的变化%Changes of Intestinal Barrier Function of Rats with Acute Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张继龙; 武国艳; 汪连珍; 李立为; 王智超

    2014-01-01

    目的:研究急性脑出血对肠粘膜屏障功能的影响。方法:成年雄性Wistar大鼠60只,随机分为脑出血组和对照组各30只。脑出血组采用立体定向技术将大鼠自体尾动脉不抗凝动脉血液50μL缓慢注入尾状核制备脑出血模型,对照组注射等量生理盐水。2组分别于造模前和造模后0.5、3、6、12、24 h检测血浆二胺氧化酶(DAO)活性和D-乳酸(D-Lac)浓度,于造模前和造模后12、24 h检测血浆内毒素(LPS)浓度;造模后24 h取空肠l cm,光镜下观察肠粘膜。结果:与对照组比较,脑出血组造模后12、24 h DAO活性和造模后6、12、24 h D-Lac浓度及造模后12、24 h LPS浓度明显增高,差异有统计学意义(<0.05或<0.01)。光镜下观察,脑出血组小肠存在病理性损伤,对照组小肠结构正常。结论:急性脑出血早期即发生肠屏障功能障碍。%ObjectiveTo observe the changes of intestinal barrier function of rats with acute cerebral hemorrhage. Methods:Sixty Wistar rats were randomly divided into cerebral hemorrhage group and control group with 30 rats in each group. The cerebral hemorrhage model was established by stereotactic infusing 50 μL autologous caudate artery blood. The control group were only infused with equal normal saline. The concentra-tion of plasma diamine oxidase (DAO) and activity of D-lactate (D-lac) in plasma were measured before operation and 0.5, 3, 6, 12, 24 h after operation. The concentration of plasma Lipopolysaccharide (LPS) was measured before operation and 12, 24 h after operation. The jejunums (1 cm) of the both groups were taken at 24 h after operation, and light microscopic examination was performed for morphological measurement of intestinal epithelial cells. Results:Compared with those in the control group, the DAO and LPS concentrations at 12, 24 h and the D-lac levels at 6,12, 24 h after operation were significantly increased in the cerebral

  9. Compliance behavior survey in patients with epilepsy after cerebral hemorrhage operation%脑出血术后癫痫患者的遵医行为调查

    Institute of Scientific and Technical Information of China (English)

    田果桃

    2013-01-01

    Objective To analyze the influence factors of compliance behavior in patients with epilepsy after cerebral hemorrhage operation,discuss countermeasures for strengthening compliance behavior. Methods 56 cases of patients with epilepsy after cerebral hemorrhage operation were selected. The form of questionnaire survey was adopted,and 5 compliance behavior dimensions of periodic inspection,quitting drinking and smoking,prescribed medication,diet control,moderate social activities were investigated. Then the effects of age,culture level,course of disease,medical payment,family per capita income on compliance behavior were compared. Results The sequence of 5 dimensional compliance behaviors in patients with epilepsy after cerebral hemorrhage operation were periodic inspection (55.36%) > quitting drinking and smoking (53.57%) > prescribed medication (50.00%) > diet control (44.64%) > moderate social activities (42.86%). Patients with higher education level,younger,shorter course of disease,higher incomes had greater fully compliance behavior; the compliance behavior of patients participated in medical insurance was significantly higher than that of patients with their own expenses (P 戒除烟酒(53.57%)>遵医嘱用药(50%)>饮食控制(44.64%)>适度社会活动(42.86%);文化程度越高、年龄越轻、病程越短、收入越高,完全遵医行为的依从性越高,参加医疗保险患者遵医行为明显高于自费患者(P < 0.05).结论 脑出血术后癫痫患者总体遵医行为较差,应建立完善的社会支持系统,加强患者的心理疏导和健康教育,强化患者的遵医行为.

  10. Imaging diagnosis of hemorrhagic cerebral infarction%出血性脑梗死的影像学诊断

    Institute of Scientific and Technical Information of China (English)

    康志毅

    2015-01-01

    目的:探讨出血性脑梗死患者的CT影像学特点及其在诊断中的价值。方法回顾性分析2014年1月~12月我院收治的出血性脑梗死患者42例的临床特点和CT检查资料,进行图像分析,总结出血性脑梗死CT影像学特点。结果 CT能够清晰成像出血性脑梗死的出血病灶分布,并可根据其出血情况CT表现作出HI分型。结论出血性脑梗死的CT影像学具有特征性,CT影像对出血性脑梗死具有很好的诊断价值。%ObjectiveTo analyze hemorrhagic infarction CT imaging features and significance. MethodsAretrospective analysis of 42 cases of investigation hemorrhagic infarction CT imaging data and clinical features, summarize imaging features of hemorrhagic infarction.ResultsCT can give hemorrhage of hemorrhagic infarction a clear image. We can make classification according to CT imaging of the conditions of bleeding by hemorrhagic infarction patients.ConclusionHemorrhagic infarction has characteristic CT features,CT images with better diagnostic value of hemorrhagic infarction.

  11. Clinical Study on Zhuyu Tongfu(逐瘀通腑) Serial Recipe Combined with Acupuncture and Massotherapy in Treating Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To observe the clinical efficacy and mechanism of Zhuyu Tongfu (逐瘀通腑,ZYTF) Serial Recipe combined with acupuncture and massotherapy in treating hypertensive cerebral hemorrhage (HCH). Methods: One hundred and eighteen patients with hypertensive cerebral hemorrhage, on the basis of conventional Western medicine treatment, were randomly divided into ZYTF combined with acupuncture and massotherapy group (treated group) and simple Western medicine group (control group); the clinical efficacy, neurofunction deficit scoring (NDS) alterations and hematoma absorption rate of both groups were observed, and also the plasma superoxide dismutase (SOD) activity, plasma lipid peroxidase (LPO)content, erythrocyte glutathion peroxidase (GSH-Px) activity, hematocrit (Ht) and the whole blood viscosity(Va) change were also observed. Results: In the treated group, the clinical efficacy, NDS improvement and hematoma absorption rate were superior to that of the control group; comparison between the two groups after treatment showed that plasma SOD activity and GSH-Px activity got more elevated and plasma LPO content, Ht and Va more lowered in the the treated group than those in the control group. Conclusion: ZYTF combined with acupuncture and massotherapy has better effect, its therapeutic mechanism was possibly correlated to the elevation of plasma SOD activity, GSH-Px activity and lowering of plasma LPO content, Ht and Va.

  12. 脑出血术后并发肺部感染的治疗%Treatment of pneumonia in cerebral hemorrhage of postoperation

    Institute of Scientific and Technical Information of China (English)

    高永峰; 张世奇; 侯凤琴

    2012-01-01

    Objective To investigate the treatment of pneumonia in cerebral hemorrhage of postoperation.Methods To studv the clinical data,risk factors and treatment measures of 89 patients with pneumonia in cerebral hemorrhage of postoperation from January 2008 to March 2010 in the people' s hospital of Xiangcheng.Results There were 36 cases of pneumonia in cerebral hemorrhage of postoperation.The rate of infection was 40.45%.There were 20 elderly patients,24 patients in continuing coma,26 patients after incision of tracheal,11 patients sucted the stomach contents,19 patients were used the glucocorticoids.The total 36 cases were cured after disinfection and insulation,posture convertion,aspiration of sputum,airway humidification,antibiotics and ambroxol used,using the tracheal casing with saccuspipe.Conclusions Elderly,continuing coma,incision of tracheal,suction of the stomach contents,using glucocorticoids are danger factors of the patients with pneumonia in cerebral hemorrhage of postoperation.Strick performance of sterilization and isolation,Changing posture timing,timely and effective sputum aspiration and airway humidification,selecting antibiotics according to the results of sputum culture and drug sensitivity test,intravenous administration of ambroxol,using the tracheal casing with saccuspipe can effectively control the pneumonia in cerebral hemorrhage of postoperation.%目的 探讨脑出血术后并发肺部感染的危险因素及治疗措施.方法 对襄城县人民医院2008年1月至2010年3月收治的89例脑出血术后患者并发院内肺部感染及其危险因素、治疗措施进行回顾性分析.结果 脑出血术后并发肺部感染患者36例,感染发生率为40.45%.高龄20例,长期昏迷24例,气管切开26例,胃内容物反流误吸11例,应用激素19例.经严格消毒隔离、定时更换体位、及时有效吸痰、气道湿化、根据痰培养+药敏选用有效抗生素、静脉应用“氨溴索针”、

  13. 无蛛网膜下腔出血的破裂脑动脉瘤%Ruptured cerebral aneurysms without subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    梁玉敏; 江基尧; 潘耀华; 万杰清; 殷玉华; 包映晖; 高国一; 熊文浩; 徐纪文; 罗其中

    2009-01-01

    Objective To summarize the experiences of diagnosis and treatment of ruptured cerebral aneurysm without subarachnoid hemorrhage(SAH). Methods The clinical manifestations, neuroradiological results, methods of treatment and outcome of 15 cases of ruptured cerebral anenrysm which presented with intracerebral hemorrhage (ICH), and/or intraventricular hemorrhage (IVH), subdural hematoma (SDH) or intramural hemorrhage(IMH) without SAH on initial CT or MRI were reviewed retrospectively. Results The initial CT or MRI in 15 cases was obtained within 2 days after onset. Of these cases, three patients presented with ICH, six with ICH and IVH, one with IVH, one with SDH, three with IMH and 1 with mixed density. There are six middle cerebral artery, four anterior communicating artery, three posterior communicating artery, one anterior cerebral artery and one posterior inferior cerebellar artery aneurysms. Thirteen patients underwent a craniotomy for clipping and two patients endovascular coiling. According Glasgow Outcome Scale (GOS),8 patients recovered well, 3 became moderately disabled, 3 were severely disabled and 1 was in vegetative state on discharge. The incidence of aneurysm rupture with ICH and/or IVH, SDH, IMH without SAH is 3.8% in this report. Conclusions Initial CT or MRI of ruptured cerebral aneurysms may presented with ICH, and/or IVH, SDH and IMH without SAH, which may have a muhifactorial cause attributable to the timing of CT or MRI, location of the aneurysm and direction of its dome, and the amount of hemorrhage. The key points to improve the outcome of such cases are to control increased intracranial pressure earlier, diagnose and manage ruptured aneurysms promptly.%目的 总结无蛛网膜下腔出血(SAH)的破裂脑动脉瘤的诊治经验.方法 对15例在起病后2 d内首次CT或MRI上表现为脑内出血(ICH),和(或)脑室内出血(IVH)、硬脑膜下血肿(SDH)和壁间出血(IMH)而无SAH的破裂脑动脉瘤患者的临床

  14. 急性脑卒中合并上消化道出血危险因素分析%Analysis of risk factors of acute cerebral stroke combined with upper gastrointestinal hemorrhage

    Institute of Scientific and Technical Information of China (English)

    罗珲

    2014-01-01

    目的:探讨急性脑卒中并发上消化道出血的相关危险因素。方法收集49例急性脑卒中并上消化道出血患者(观察组)及90例未合并上消化道出血急性脑卒中患者(对照组)的临床资料,分析2组饮酒、消化道疾病史、脑卒中类型、病变部位、病情程度等。结果观察组饮酒、消化道疾病史、出血性脑卒中、丘脑出血、脑出血破入脑室、大面积脑梗死及严重的脑卒中发生率明显高于对照组,差异有统计学意义( P<0.05)。结论急性脑卒中并发上消化道出血与消化道疾病史、脑卒中类型、病变部位、病情危重程度等危险因素相关。%Objective To explore the related dangerous factors of acute cerebral stroke combined with upper gastrointesti-nal hemorrhage.Methods By investigated the clinical data of 49 cases of acute cerebral stroke combined with upper gastrointes-tinal hemorrhage(Observation group)and 90 cases of acute cerebral stroke with no upper gastrointestinal hemorrhage in hospital (Control group) ,we retrospectively analyzed such aspects as drinking ,history of digestive tract diseases ,the type of cerebral apoplexy ,the position of pathological changes and the degree of the illness.Results The rates of alcohol consumption ,history of gastrointestinal disease ,hemorrhagic stroke ,thalamic hemorrhage ,cerebral hemorrhage broken into ventricles ,massive cer-ebral infarction and severe stroke incidence in the observation group was significantly higher than that of the control group ,the difference was statistically significant (P<0.05).Conclusion Acute cerebral stroke combined with upper gastrointestinal hem-orrhage was correlated with history of digestive tract diseases ,the type of cerebral stroke ,the position of pathological changes and the degree of the illness.

  15. Subarachnoid Hemorrhage: An Update.

    Science.gov (United States)

    Dority, Jeremy S; Oldham, Jeffrey S

    2016-09-01

    Subarachnoid hemorrhage (SAH) is a debilitating, although uncommon, type of stroke with high morbidity, mortality, and economic impact. Modern 30-day mortality is as high as 40%, and about 50% of survivors have permanent disability. Care at high-volume centers with dedicated neurointensive care units is recommended. Euvolemia, not hypervolemia, should be targeted, and the aneurysm should be secured early. Neither statin therapy nor magnesium infusions should be initiated for delayed cerebral ischemia. Cerebral vasospasm is just one component of delayed cerebral edema. Hyponatremia is common in subarachnoid hemorrhage and is associated with longer length of stay, but not increased mortality. PMID:27521199

  16. Spontaneous disappearance and reappearance of a ruptured cerebral aneurysm: one case found in a group of 33 consecutive patients with subarachnoid hemorrhage who underwent repeat angiography.

    Science.gov (United States)

    Nakajima, Y; Yoshimine, T; Mori, H; Nakamuta, K; Fujimura, I; Sakashita, K; Kohmura, E; Hayakawa, T; Yokota, J

    2000-09-01

    The spontaneous disappearance and reappearance of a ruptured cerebral aneurysm is generally assumed to be a rare phenomenon although the actual incidence is unknown. Among 39 consecutive cases of acute subarachnoid hemorrhage (SAH), 33 were studied by three-dimensional computed tomographic angiography (CTA) within 6 h after the onset of SAH, followed by digital subtraction angiography (DSA) within 24 h after the ictus. Of those patients, one, a 58-year-old woman, had a saccular aneurysm at the distal anterior cerebral artery; the aneurysm was clearly demonstrated by CTA 2.5 h after the SAH onset, but was not shown by a subsequent DSA performed 8.5 h after the ictus. A follow-up DSA detected the neck of aneurysm on day 11, and the whole aneurysm was visualized on day 19. The observations in this particular case suggest that the spontaneous disappearance of a ruptured cerebral aneurysm may occur during the ultra-early stage of SAH and that reappearance may follow during the next few weeks. The patient did not suffer complications such as vasospasm or systemic hypotension nor was she treated with antifibrinolytic agents. The aneurysmal shape and the surrounding clot are considered as putative factors possibly related to the intermittent appearance of the aneurysm. PMID:11045020

  17. Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; You, Jin Jong; Choi, Ho Cheol; Kim, Ji Eun [Dept. of Radiology, Gyeongsang National University Hospital, Jinju (Korea, Republic of); Choi, Dae Seob [Gyeongsang Institue of Health Science, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of); Ryoo, Jae Wook [Dept. of Radiology, Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2011-10-15

    To evaluate the usefulness of multidetector-row CT angiography (MDCTA) for the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) by comparison of digital subtraction angiography (DSA) and to compare the bone subtraction CT angiography (BS-CTA) and standard CT angiography (S-CTA). Thirty-three patients who were treated with intraarterial nimodipine infusion for the cerebral vasospasm after aneurysmal SAH were evaluated with MDCTA and DSA. BS-CTA images were reconstructed from the S-CTA and unenhanced CT source images. A total of 207 vascular segments were evaluated. A four-step scale for the degree of stenosis was applied for each segment. With DSA as the standard images, BS-CTA and S-CTA images were comparied. On DSA, 56 segments (27%) presented vasospasm. Concordance between the DSA and S-CTA and between DSA and BS-CTA were 94.7% and 82.1%, respectively. Overestimation for the degree of stenosis was shown in 37 segments on BS-CTA and in 8 segments on S-CTA, but underestimated segments were only shown on S-CTA (n = 4). MDCTA with standard technique seems to be a useful imaging tool for the evaluation of the cerebral vasospasm after aneurysmal SAH. However, BS-CTA is not needed because of additional radiation and overestimation of the degree of stenosis.

  18. Effect of early rehabilitation intervention on nerve function rehabilitation of cerebral hemorrhage patients in recovery stage%脑出血患者早期康复介入对恢复期神经功能的影响

    Institute of Scientific and Technical Information of China (English)

    纪兴海; 李大军; 王军

    2002-01-01

    @@ Background: Incidence, mortality and handicapping rate are very high. Early, proper and active rehabilitation therapy can decrease handicapping rate, improve function recovery and living quality. We study and analyze rehabilitation methods and curative effects of 84 cerebral hemorrhage cases, results as follow.

  19. 丙型肝炎病毒感染与脑出血的关系研究%Relationship between HCV Infection and Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    袁磊

    2016-01-01

    目的:探讨丙型肝炎病毒(HCV)感染与脑出血的关系。方法选取2010—2015年在河南省南阳市第二人民医院神经内科住院治疗的患者342例,根据脑出血发生情况分为脑出血组64例与非脑出血组278例。根据既往文献报道及临床经验筛选脑出血的相关因素,并分析 HCV 感染与脑出血的关系。结果两组患者性别、年龄、吸烟率、饮酒率及冠心病、心房颤动、颅内动脉狭窄发生率比较,差异均无统计学意义( P >0.05);脑出血组患者高血压、糖尿病、高脂血症、高同型半胱氨酸血症及 HCV 感染发生率高于非脑出血组(P 0. 05),while incidence of hypertension,diabetes,hyperlipidaemia,hyperhomocysteinemia and HCV infection of A group was statistically significantly higher than that of B group,respectively(P < 0. 05). Multivariate logistic regression analysis showed that,hypertension〔OR= 4. 163,95% CI(1. 174,15. 870),P = 0. 023〕,diabetes〔 OR = 4. 578,95% CI(1. 366,15. 482),P = 0. 012〕, hyperhomocysteinemia〔OR = 4. 382,95% CI(1. 325,16. 738),P = 0. 018〕 and HCV infection〔 OR = 3. 306,95% CI (1. 028,10. 605),P = 0. 015〕were risk factors of cerebral hemorrhage. Conclusion HCV infection is one of risk factors of cerebral hemorrhage,which may play an important role in the genesis and development of cerebral hemorrhage.

  20. The significance of changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage caused by acute hypertension%急性高血压脑出血患者脑糖氧代谢变化及意义

    Institute of Scientific and Technical Information of China (English)

    马骏; 陈锷峰; 屠传建; 钱辉; 骆明; 顾志伟; 张建民

    2014-01-01

    Objective To study the clinical significance of early changes in cerebral oxygen and glucose metabolism in patients with cerebral hemorrhage and with Glasgow coma score (GCS) of 5-8 caused by acute hypertension in order to find relationship between those changes and prognosis.Methods From January 1,2011 to June 30,2012,a cohort of 43 patients with cerebral hemorrhage caused by acute hypertension were enrolled for retrospective study.Radial artery and internal jugular vein were separately cannulated retrogradely for collecting blood for blood gas analysis and blood glucose tests carried out 24 hours after the onset of the cerebral hemorrhage and then every 6-8 hours and as any major changes in physical signs of patients occurred.And this monitoring kept for consecutive 3 days.The data of these laboratory findings were analyzed and calculated to determine internal jugular vein oxygen saturation (SjVO2),cerebral oxygen utilization rate (CEO2),cerebral arterio-venous oxygen difference (AVDO2),arterio-venous blood glucose difference (V-Aglu),arterio-venous lactic acid difference (V-Alac) and absolute value of carbon dioxide pressure difference between jugular vein and artery (V-APCO2).All patients met the diagnostic criteria of hypertensive cerebral hemorrhage revised by the 4th National Academic Conference on cerebrovascular disease in 1995 requiring diagnosis confirmed by brain CT,admitted within 24 hours of onset,Glasgow coma score (GCS) 5-8 and a history of hypertension.Exclusion criteria were:cerebral hemorrhage caused by traumatic intracranial hematoma,spontaneous subarachnoid hemorrhage,arteriovenous malformation and Moyamoya disease,intracranial tumor apoplexy,cerebral bleeding derived from the disturbance of blood coagulation system,and cerebral hemorrhagic infarction.According to the short-term prognosis,the patients were divided into the death group and the survival group.Then the differences in biomarkers mentioned above between two groups were compared to

  1. 血尿酸水平与急性脑出血的关系研究%A Study on the Relation of blood uric acid content and acute cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张怀东

    2014-01-01

    Objective:Approach the relation of blood uric acid content and acute cerebral hemorrhage .Methods:A metered analysis was made of blood uric acid content among 178 cases of acute cerebral hemorrhage and 100 healthy controls ,and the relation between the blood uric acid content with acute cerebral hemorrhage was clarified as wel 1.Results:Blood uric acid content in the massive hemorrhage group was higher than the healthy controls and the small amounts hemorrhage group ( P<0.05).Blood uric acid content in the severe in-jury group was higher than the healthy controls and the minor injury group ( P<0.05) .Conclusion:Blood uric acid contentshould be the significant index to judge the pathogenetic conditions in acute cerebral hemorrhage .%目的:探讨血尿酸水平与急性脑出血之间的关系。方法:通过测定178例急性脑出血患者和100例正常对照人群的血尿酸水平的变化,分析血尿酸水平与急性脑出血的关系。结果:出血量多组血尿酸水平高于正常对照组、出血量少组( P<0.05);重型组血尿酸水平高于正常对照组、轻型组( P<0.05)。结论:血尿酸的测定可作为急性脑出血患者判断病情严重程度的重要指标。

  2. Correlation between plasma total nitric oxide levels and cerebral vasospasm and clinical outcome in patients with aneurysmal subarachnoid hemorrhage in Indian population

    Directory of Open Access Journals (Sweden)

    Shruthi Shimoga Ramesh

    2014-01-01

    Full Text Available Context: Cerebral vasospasm remains a major cause of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH. Reduced bioavailability of nitric oxide has been associated with the development of cerebral vasospasm after aSAH. Such data is not available in Indian population. Aims: The objective of the study was to measure the plasma total nitric oxide (nitrite and nitrate-NOx level in aSAH patients and healthy controls treated at a tertiary hospital in India and to investigate a possible association between plasma total nitric oxide level and cerebral vasospasm and clinical outcome following treatment in patients with aSAH. Settings and Design: A case-control study of aSAH patients was conducted. Plasma total NOx levels were estimated in aSAH patients with and without vasospasm and compared the results with NOx levels in healthy individuals. Materials and Methods: aSAH in patients was diagnosed on the basis of clinical and neuro-imaging findings. Plasma total NOx levels in different subject groups were determined by Griess assay. Results: Plasma total NOx level was found to be significantly decreased in patients with aSAH when compared to controls. Plasma total NOx level in the poor-grade SAH group was lower than that in the good-grade SAH group. Plasma total NOx level further reduced in patients with angiographic (P < 0.05 and clinical vasospasm. Conclusions: Reduced plasma NOx level is seen in aSAH patients as compared to normal individuals. In aSAH patients reduced levels are associated with increased incidence of cerebral vasospasm and poor outcome. Plasma total NOx level could be used as a candidate biomarker for predicting vasospasm and outcome for this pathology.

  3. Transcriptional regulation of inflammatory and extracellular matrix-regulating genes in cerebral arteries following experimental subarachnoid hemorrhage in rats. Laboratory investigation

    DEFF Research Database (Denmark)

    Vikman, Petter; Ansar, Saema; Edvinsson, Lars

    2007-01-01

    , and gene regulation in the cerebral arteries was examined at various points in time following SAH by using quantitative polymerase chain reaction (PCR) and immunohistochemistry. RESULTS: Immunohistochemical findings demonstrated that SAH phosphorylates and activates p38 and ERK1/2 as well as the downstream......, IL1beta, CXCL1, CXCL2, CCL20, MMP8, MMP9, MMP13, and iNOS), as demonstrated using real-time PCR. For MMP13 and iNOS, the changes in transcription were translated into functional proteins, as revealed on immunohistochemistry. CONCLUSIONS: Activation of the p38 and ERK1/2 signaling pathways......OBJECT: Subarachnoid hemorrhage (SAH) results in the expression of inflammatory and extracellular matrix (ECM)-related genes and various G protein-coupled receptors. In the present study, the authors evaluated the time course and sequence of the transduction pathways, p38 mitogen-activated protein...

  4. The Relationship of Hematoma Size and Mortality in Non-Traumatic Intra-Cerebral Hemorrhages in Basal Ganglia

    Directory of Open Access Journals (Sweden)

    P. Ahmadi

    2006-04-01

    Full Text Available Introduction & Objective: Among all of the neurologic diseases in adult life, the cerebrovascular disease (CVD is the most common and important ones. Intracerebral hemorrhage (ICH in basal ganglia (BG is one of the common and major types of CVD. The relations between clot size and mortality rate, in different parts of the brain, has been addressed by several researchers. It is unclear whether such a relationship is in BG. Therefore this study was designed to find a formula that predicts outcome of hemorrhage based on clot size in BG.Materials & Methods: This descriptive-comparative study that was carried out prospectively, conducted on all 63 patients who admitted to the hospital during one year, with definite diagnosis of ICH in BG. After urgent CT scanning, the size of hematoma was determined by scan images. Routine treatment was uniform for all patients. Focal signs and consciousness state were assessed in the first and last days of admission. The data were analyzed using descriptive statistics, frequency tables and chi-square and T- test. Results: 33% of patients died. Hematoma size in 70% of them was larger than 5cm and in other 30% smaller. None of the hematoma with less than 4cm size was fatal. In patients with clots of 5cm or larger, the mortality was 100%. Conclusion: The results indicated that, there was meaningful relationship between hematoma size and mortality, in BG hemorrhages. So the clot size can be used as a factor in predicting hemorrhage outcome in BG.

  5. Lethal hypoplasia and developmental anomalies of the lungs in a newborn with intrauterine adrenal hemorrhage and cerebral infarcts: a proposed pulmonary disruption sequence.

    Science.gov (United States)

    Lertsburapa, Terakeith; Vargas, Diana; Lambert-Messerlian, Geralyn; Tantravahi, Umadevi; Gündoğan, Füsun; DeLaMonte, Suzanne; Coyle, Mara G; De Paepe, Monique E

    2014-01-01

    We report a case of a 31-week-gestation male newborn who died soon after birth from intractable respiratory failure and persistent pulmonary hypertension. The pregnancy had been complicated by intermittent bleeding between 13 and 20 weeks' gestation, attributed to peripheral placental separation, as well as bilateral fetal adrenal hemorrhage, first detected at 17 weeks' gestation. Postmortem examination revealed small, calcified adrenal glands as well as several remote cerebral and cerebellar infarcts. The lungs were hypoplastic (lung weight/body weight ratio: 1.64%; 10th percentile for 28-36 weeks' gestation: 2.27%) and distorted by exaggerated lobulation. Microscopically, the lungs exhibited several developmental anomalies, including focal acinar dysgenesis suggestive of arrested development in the pseudoglandular stage of development (8-16 weeks' gestation) (mainly in the upper lobes), and features of bronchial obstruction, including focal lobular hyperplasia and microcystic maldevelopment (mainly in the lower lobes). The adrenal and cerebral findings were consistent with a severe early-gestation hypoxic-ischemic insult, likely related to peripheral placental separation and chronic abruption. The co-occurrence and timing of these well-recognized hypoxic lesions provide further evidence that certain developmental lung anomalies, such as focal acinar dysplasia, focal lobular hyperplasia, and microcystic maldevelopment, may, at least in some cases, have a hypoxic/ischemic etiology.

  6. The Clinical Diagnosis of the Hemorrhagic Cerebral Infarction of the Nuclear Magnetic Resonance Imaging%分析出血性脑梗死患者核磁共振成像的临床诊断

    Institute of Scientific and Technical Information of China (English)

    王思坚

    2014-01-01

    Objective To observe and analysis research of hemorrhagic cerebral infarction of the clinical data of nuclear magnetic resonance imaging. Methods From May 2013 to May 2013 of our hospital, 30 cases of hemorrhagic cerebral infarction mri imaging data were retrospectively analyzed. Results The MRI performance for a total of 30 cases of hemorrhagic cerebral infarction, 16 cases which occur in the temporal lobe, temporal top 6 patients with occipital lobe, temporal and occipital lobe in 5 cases, temporal and parietal in 2 cases, front temporal and parietal in 1 case. Conclusion MRI of hemorrhagic cerebral infarction through information cognition and has great clinical value of diagnosis and treatment.%目的:观察和分析研究出出血性脑梗死(hemorrhagic infarction)患者核磁共振成像(MRI)的临床资料。方法选取2013年5月~2014年5月我院收治的30例出血性脑梗死的核磁共振成像的影像学资料进行回顾性分析。结果 MRI表现为出血性脑梗死共30例,其中发生在颞叶16例,发生在颞顶枕叶6例,发生在颞枕叶5例,发生在颞顶叶2例,发生在额颞顶叶1例。结论通过资料得出MRI对出血性脑梗死的认知与诊治都有很大的临床价值。

  7. Infarto cerebral hemorrágico por embolización de un trombo mural cardíaco Hemorrhagic cerebral infarction due to embolization of a mural thrombus within the right ventricle

    Directory of Open Access Journals (Sweden)

    R. Marín

    2008-04-01

    neurological impairment of unknown aetiology appeared during her hospitalization, and she died 9 days after her admission. Forensic autopsy found a hemorrhagic cerebral infarction in the territory of the left middle cerebral artery. As the arteries of the polygon of Willis were patent and there were vital thrombi adhered to the free wall of the right ventricle, thromboembolism was considered the most probable cause of the cerebrovascular event.

  8. Acromegaly With Cardiomyopathy, Cardiac Thrombus and Hemorrhagic Cerebral Infarct: A Case Report of Therapeutic Dilemma With Review of Literature

    Science.gov (United States)

    Mendoza, Erick; Malong, Chandy Lou; Tanchee-Ngo, Mary Jane; Mercado-Asis, Leilani

    2015-01-01

    Introduction: Cardiomyopathy with congestive heart failure (CHF) is a rare complication of growth hormone (GH)-secreting pituitary adenoma occurring in 3% of cases. We report a case of acromegaly complicated not only by CHF but also by the presence of intracardiac thrombus and cardioembolic stroke with hemorrhagic formation. Case Presentation: A 46-year-old Filipino female presented with amenorrhea, progressive coarsening of facial features, deepening of voice and enlargement of digits. She experienced easy fatigability, orthopnea and bipedal edema. The cardiac apex beat was sustained and displaced. Growth hormone was nonsuppressible. Cranial magnetic resonance imaging showed pituitary macroadenoma with hemorrhage. Incidentally, there was a left frontal lobe cortical infarct with hemorrhagic component. The echocardiogram demonstrated cardiomyopathic changes with a left ventricular thrombus. Conclusions: The primary treatment for GH-producing adenoma is surgery; however, this patient has high surgical risk from her severe cardiomyopathy. Radiotherapy poses a greater risk because of increased cerebrovascular mortality. Somatostatin receptor ligands are significantly associated with improvement of cardiovascular and hemodynamic parameters. Dopamine agonists must be considered regardless of prolactin level and immunostaining. The risks and benefits of any treatment must be emphasized in the presence of conflicting clinical features such as in the case reported. PMID:25926851

  9. 兔脑急性出血对脑阻抗影响初步实验研究%Preliminary experimental study on effects of cerebral impedance with acute cerebral hemorrhage in rabbits

    Institute of Scientific and Technical Information of China (English)

    吴剑威; 张鲁闽; 史学涛; 董秀珍

    2011-01-01

    目的:研究家兔脑急性出血时脑阻抗的定性变化及频率特性.方法:采用第四军医大学医学电子工程教研室研制的阻抗监护系统,用自体血注入法建立兔脑实质出血模型后对7只家兔进行脑阻抗监测.结果:出血初期,阻抗实部明显下降,虚部变化不明显,但随时间推移,脑阻抗实部、虚部绝对值均明显升高.对兔脑阻抗出血前后数据进行配对t检验,具有显著性差异(P<0.001),有统计学意义.在150 s时阻抗实部、虚部、模变化率绝对值随频率升高而升高;900 s时,在20kHz频率点,阻抗模变化率绝对值最大(|-3.12%|).结论:采用电阻抗技术对脑急性出血进行监测是可行的,采用不同的测量频率会得到不同的脑部电阻抗变化量,阻抗最大变化率频率点随时间推移向低频转移.随着时间推移,脑急性出血后阻抗实部、虚部和模变化率的频谱特性在变化中,这意味着以往单一频率的监测并不能全面反映脑急性出血后的阻抗变化信息.%Objective: To study the effects of cerebral impedance and the impedance frequency characteristic with acute cerebral hemorrhage in rabbits. Methods After establishing the rabbit model of cerebral hemorrhage with autologous blood injection in 7 rabbits, with four-electrode method, the cerebral impedance was measured by electrical impedance monitor which made by Faculty of Medical Electronic Engineering, Department of Biomedical Engineering, Fourth Military Medical University. The prompting current was set to 1mA at the frequency of 100Hz, 200Hz, 400Hz, 600Hz, 800Hz, 1KHz, 2KHz, 4KHz, 6KHz, 8KHz, 10KHz, 20KHz, 40KHz, 60KHz, 80KHz, 100KHz, 180KHz. Results:The monitoring results showed that the real part of impedance decreased and the imaginary pert did not change significantly at the initial time and two real means are significantly different at the 0.001 level with paired t test. The real and absolute imaginary part of impedance rose over

  10. Effects of electroacupuncture treatment on cerebral hematoma after intracerebral hemorrhage in rats%电针对大鼠脑出血后脑血肿的影响

    Institute of Scientific and Technical Information of China (English)

    曹健; 吴生兵; 周美启; 高纺; 杨影

    2012-01-01

    Objective To investigate the therapeutic effect of electroacupuncture treatment on the early stage of cerebral hematoma formation following after intracerebral hemorrhage(ICH)in rats. Methods Ten animals were randomly selected as sham operation group(SOG)from 60 Wistar rats and the remaining rats were used to prepare the model of cerebral hematoma after ICH. Then, 30 modeled rats were randomly divided into 3 groups, I.e. Model group(MG), extra-meridiansacupoints group(EMG)and electro-acupoint group(EAG), 10 rats per group. Acupoints Renzhong(DU26)and Fengfu(DU26)were used in EAG and the extra-point in hips of rats in EMG; elctro-puncturing 20 mins, once 24 hours, and lasting 3 days; and the electro-puncturing were used not in SOG and MG. Results Except for SOG, the various size of bleeding spots and hematomas were within cerebral issue; under the microscopic observation, the different degrees of cerebral edema around the hematoma, swelling nerve cells, nucleus fragmentation dissolve or disappear, red blood cells visible within the organization were seen in rat brain tissue within the injection area and there existed different degrees of inflammatory cell infiltration; compared with EMG and MG, hematoma diameter were significantly reduced in EAG(P<0.05). Conclusion Early acupuncture intervention can significantly reduce the size of hematoma and effectively control the occurrence and development of cerebral hematoma following ICH.%目的 观察早期电针治疗对大鼠脑出血(intracerebral hemorrhage,ICH)后脑血肿的影响.方法 从60只Wistar大鼠中随机选择10只作为假手术对照组,其余50只用于大鼠ICH模型的复制,然后根据模型成功的评判标准随机选取模型复制成功大鼠30只,再分为模型组、非经非穴组和电针组,每组各10只.电针组选取“人中”、“(风)府”,非经非穴组选取大鼠臀部非经非穴点.电针每次20min,每隔24h1次,连续3d.假手术对照组、

  11. 一种新的兔株网膜下腔出血后症状性脑血管痉挛模型的建立%Establishment of a new symptomatic cerebral vasospasm model following subarachnoid hemorrhage in rabbit

    Institute of Scientific and Technical Information of China (English)

    施国君; 刘俊雄; 王敏

    2002-01-01

    Objective To establish an experimental model of symptomatic cerebral vasospasm(CVS) after subarachnoid hemorrhage( SAH) in rabbits. Method 2 weeks after the ligation of bilateral common carotid arteries, We induced CVS by injecting arterial blood twice via a cranial hole 2 mm× 2 mm and then neurological symptoms ,cerebral blood flow(rCBF) and food intake were evaluated. Results Food intake and rCBF decreased and neurological disorders were observed. Conclusion An experimental rabbit model of symptomatic CVS can be established by injecting blood via a cranial hole after bilateral common carotid arteries ligation. ``

  12. MEK1/2 Inhibitor U0126 but Not Endothelin Receptor Antagonist Clazosentan Reduces Upregulation of Cerebrovascular Contractile Receptors and Delayed Cerebral Ischemia, and Improves Outcome after Subarachnoid Hemorrhage in Rats

    DEFF Research Database (Denmark)

    Povlsen, Gro K; Edvinsson, Lars

    2015-01-01

    Cerebral vasospasm and late cerebral ischemia (LCI) remain leading causes of mortality in patients experiencing a subarachnoid hemorrhage (SAH). This occurs typically 3 to 4 days after the initial bleeding and peaks at 5 to 7 days. The underlying pathophysiology is still poorly understood. Because...... SAH is associated with elevated levels of endothelin-1 (ET-1), focus has been on counteracting endothelin receptor activation with receptor antagonists like clazosentan, however, with poor outcome in clinical trials. We hypothesize that inhibition of intracellular transcription signaling...

  13. 儿童脑动静脉畸形出血危险因素分析%Rick Factors for Cerebral Arteriovenous Malformation Hemorrhage in Pediatric Patients

    Institute of Scientific and Technical Information of China (English)

    陈晓霖; 马力; 王书磊; 赵元立

    2015-01-01

    Objective To investigate the clinical and morphological features of cerebral arteriovenous malformation (CAVM) in children and to assess its risk factors of hemorrhage in pediatric patients. Methods The clinical data of pediatric patients admitted to Beijing Tiantan Hospital for CAVMs between 2012 and 2014 were retrospectively analyzed. All patients were diagnosed using digital subtraction angiography. The effects of demographic characteristics and CAVM morphological characteristics on hemorrhage presentation were studied using univariate and multivariate Logistic regression analysis. The characteristics including the gender, age, deep location, malformation diameter, AVM side, venous drainage, associated aneurysms. Results Seventy-three pediatric CAVM cases were identified, 49 (67.1%) cases presented with hemorrhage. The malformation diameter had signiifcant difference on the malformation, (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93~0.99,P<0.05). The gender, age, AVM side, deep location, deep venous drainage, associated aneurysms, venous drainage did not have significant difference on the malformation. Conclusion Hemorrhagic brain arteriovenous malformations relate with the malformation diameter, and the malformations with small AVM diameter should be treated early to reduce morbidity and mortality.%目的:研究儿童脑动静脉畸形(cerebral arteriovenous malformation,CAVM)临床特点及形态特点,评估其破裂出血的相关因素。方法回顾性分析2012年1月~2014年12月首都医科大学附属北京天坛医院收治年龄小于14岁CAVM患者73例,均经数字减影血管造影(digital subtraction angiography,DSA)检查明确诊断。采用单变量及多变量Logistic回归分析儿童入院时CAVM破裂出血与患者性别、年龄、CAVM侧别、DSA最大径、是否合并动脉瘤、病变是否位于深部、是否纯深静脉引流及静脉引流类型(浅静脉、深静脉及浅静脉合并深静脉)

  14. Rick Factors for Cerebral Arteriovenous Malformation Hemorrhage in Pediatric Patients%儿童脑动静脉畸形出血危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈晓霖; 马力; 王书磊; 赵元立

    2015-01-01

    目的:研究儿童脑动静脉畸形(cerebral arteriovenous malformation,CAVM)临床特点及形态特点,评估其破裂出血的相关因素。方法回顾性分析2012年1月~2014年12月首都医科大学附属北京天坛医院收治年龄小于14岁CAVM患者73例,均经数字减影血管造影(digital subtraction angiography,DSA)检查明确诊断。采用单变量及多变量Logistic回归分析儿童入院时CAVM破裂出血与患者性别、年龄、CAVM侧别、DSA最大径、是否合并动脉瘤、病变是否位于深部、是否纯深静脉引流及静脉引流类型(浅静脉、深静脉及浅静脉合并深静脉)等因素的关系。结果共73例儿童CAVM患者纳入研究,其中49例入院时合并出血,出血率为67.1%。CAVM直径小是儿童CAVM出血的独立危险因素[比值比(odds ratio,OR)0.96,95%可信区间(confidence interval,CI)0.93~099,P<0.05]。结论儿童CAVM破裂出血与动静脉畸形大小有关。%Objective To investigate the clinical and morphological features of cerebral arteriovenous malformation (CAVM) in children and to assess its risk factors of hemorrhage in pediatric patients. Methods The clinical data of pediatric patients admitted to Beijing Tiantan Hospital for CAVMs between 2012 and 2014 were retrospectively analyzed. All patients were diagnosed using digital subtraction angiography. The effects of demographic characteristics and CAVM morphological characteristics on hemorrhage presentation were studied using univariate and multivariate Logistic regression analysis. The characteristics including the gender, age, deep location, malformation diameter, AVM side, venous drainage, associated aneurysms. Results Seventy-three pediatric CAVM cases were identified, 49 (67.1%) cases presented with hemorrhage. The malformation diameter had signiifcant difference on the malformation, (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93~0.99,P<0.05). The gender, age

  15. A Preliminary Study the Correlation of Blood Uric Acid and Hypertension Cerebral Hemorrhage%初探血尿酸与高血压脑出血的相关性

    Institute of Scientific and Technical Information of China (English)

    沈钦龙; 张延军; 夏海艳

    2016-01-01

    Objective To investigate the relationship between cerebral hemorrhage in the peripheral blood plasma uric acid and hypertension. Methods Group selection into the group of 241 cases of patients with essential hypertension, to head CT imaging diagnosis for cerebral hemorrhage, divided the patients into cerebral hemorrhage group (147 cases) and hyperten-sion group (94 cases). By immune method in the detection of peripheral blood uric acid, uric acid 430 umol/L as the stan-dard of diagnosis of high uric acid hematic disease, hypertension patients with high uric acid hematic disease (156 cases), not in hypertensive patients with high uric acid hematic disease (85 cases). Results Peripheral blood uric acid level is higher than the high blood pressure in patients with hypertensive cerebral hemorrhage group (503.4 ±40.2) than (447.3 ± 38.8), P < 0.05. With high uric acid levels, a higher proportion of hypertensive cerebral hemorrhage in patients with high blood pressure patients (64.7%:9.6%, P< 0.05). Multiariable Logistic regression showed that the risk factors affecting hy-pertensive cerebral hemorrhage with hyperlipidemia (OR =1.08), high uric acid hematic disease (OR =1.04), alcohol (OR =2.30), systolic blood pressure(OR = 1.10), and homocysteine(OR = 1.02), P< 0.01. Conclusion Patients with high uric acid hematic disease high blood pressure are more likely to cerebral hemorrhage, namely high uric acid hematic disease risk of hypertension cerebral hemorrhage is higher.%目的:探讨外周血浆中尿酸与高血压脑出血的关系。方法整群选取2014年1月—2015年12月就诊于郑州市第六人民医院神经内科原发性高血压患者241例,以头颅CT影像学确诊有无脑出血,将患者分为脑出血组(147例)和高血压组(94例)。采用免疫法检测外周血中尿酸,以尿酸≥430 umol/L作为诊断高尿酸血症的标准。结果高血压性脑出血患者外周血中尿酸水平高于高血压组(503.4±40.2)比(447.3

  16. CT Angiography May Be a More Useful Modality Than Digital Subtractional Angiography in the Diagnosis of Patients with Subarachnoid Hemorrhage Due to Cerebral Aneurysms

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-05-01

    Full Text Available Background/Objective: The preoperative diagnostic"nvalidity of two radiological modalities (computed"ntomographic angiography and digital subtractional"nangiography in the diagnosis of brain aneurysms were"ncompared."nPatients and Methods: During 2 years of study,"nreferred patients with signs of SAH to the emergency"nward underwent routine CT scan and after SAH was"nfirmly diagnosed, CTA and DSA methods were done"nand patients with correct indications were operated."nAfter surgery and detecting the existence of aneurysms"nand their location, the data were recorded in a"nchecklist. Sensitivity, specificity, positive and negative"npredictive values were calculated and compared in"nboth methods."nResults: The mean age of the 30 patients were"n49.5±9.13 years. 57.9 % of the subjects were female"nand the others were male. On CTA reports 100% true"npositive, 0% false positive, 85% true negative, and 15%"nfalse negative were calculated. DSA reports were true"npositive, false positive, true negative and false negative"nin 100%, 0%, 69% and 31%, respectively. CTA showed"n89% of sensitivity, and 100% of specificity in contrast"nto 74% sensitivity and 100% specificity of DSA."nPositive predictive values of both methods were 100%,"nbut negative predictive values of CTA and DSA were"n85% and 69%, respectively."nConclusion: Based on our data, CTA is more preferable"ndiagnostic modality for the brain aneurysm's site and"nanatomy in patients with subarachnoid hemorrhage"nthan DSA."nKeywords: CT Scan Angiography, Digital Subtraction"nAngiography, Cerebral Aneurysm, Subarachnoid"nHemorrhage

  17. 牛磺酸对脑出血大鼠神经细胞的保护作用研究%The protective effects of taurine on nerve cells of SD rats suffered from cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈世伟; 张黎明; 张蜂

    2011-01-01

    Objective : To study the effects of taurine on nerve cell of SD rats. Methods : SpragueDawley rat were randomly divided in to groups named cerebral hemorrhage group and taurine group, and determined the level of nerve cells apoptosis at different time by using immunohistochemistry technique.Results : There was significant difference between taurine group and cerebral hemorrhage group (P<0. 05).Conclusion: Taurine can protect nerve cells of SD rats againse cerebral hemorrhage by means of certain ways.%目的:探讨牛磺酸对脑出血大鼠的神经细胞的作用.方法:将SD大鼠随机分为脑出血模型组、牛磺酸剂量治疗组,应用免疫组化技术分别在不同时间点测定神经细胞凋亡程度,研究牛磺酸对脑出血后神经细胞的作用,及其影响程度.结果:与模型组相比,牛磺酸治疗组细胞凋亡细胞明显减少(P<0.05).结论:牛磺酸可能通过多种途径来对大鼠脑出血起到一定的保护作用.

  18. The comparative study on diagnostic validity of cerebral aneurysm by computed tomography angiography versus digital subtraction angiography after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Masih Saboori

    2011-01-01

    Full Text Available Background: In order to declare the preoperative diagnostic value of brain aneurysms, two radiological modalities, computed tomographic angiography and digital subtraction angiography were compared. Methods: In this descriptive analytic study, diagnostic value of computed tomographic angiography (CTA was com-pared with digital subtraction angiography (DSA. Sensitivity, specificity, positive and negative predictive values were calculated and compared between the two modalities. All data were analyzed with SPSS software, version 16. Results: Mean age of patients was 49.5 ± 9.13 years. 57.9 % of subjects were female. CTA showed 89% sensitivity and 100% specificity whereas DSA demonstrated 74% sensitivity and 100% specificity. Positive predictive value of both methods was 100%, but negative predictive value of CTA and DSA was 85% and 69%, respectively. Conclusions: Based on our data, CTA is a valuable diagnostic modality for detection of brain aneurysm and su-barachnoid hemorrhage.

  19. HIMALAIA (Hypertension Induction in the Management of AneurysmaL subArachnoid haemorrhage with secondary IschaemiA) : a randomized single- blind controlled trial of induced hypertension vs. no induced hypertension in the treatment of delayed cerebral ischemia after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Gathier, C. S.; van den Bergh, W. M.; Slooter, A. J. C.

    2014-01-01

    RationaleDelayed cerebral ischemia (DCI) is a major complication after aneurysmal subarachnoid hemorrhage (SAH). One option to treat delayed cerebral ischemia is to use induced hypertension, but its efficacy on the eventual outcome has not been proven in a randomized clinical trial. This article des

  20. 高血压性脑出血患者术后抑郁危险因素的Logistic回归分析%Logistic regression analysis of risk factors of depression in patients with hypertensive cerebral hemorrhage after opera- tion

    Institute of Scientific and Technical Information of China (English)

    陈莉; 吕建国; 陈仕芬; 徐文斌

    2015-01-01

    目的:探讨高血压性脑出血患者术后抑郁的危险因素,为其早期预防提供依据。方法对266例高血压性脑出血患者进行了系统性的调查分析,对可能是导致其抑郁的危险因素进行了 Logistic 回归分析。结果266例患者中有91例出现了抑郁,发病率为34.2%。通过 Logistic 回归分析发现:性格、脑出血程度、家庭经济情况和文化程度等是高血压性脑出血患者术后抑郁的独立危险因素。结论高血压性脑出血患者术后抑郁症的发病率较高,早期干预可降低抑郁症的发病率。%Objective To explore the risk factors related to depression in patients with hypertensive cerebral hemorrhage after operation,and to provide the basis for the prevention.Methods For 266 cases of hypertensive cerebral hemorrhage patients,a systematic investigation and analysis,in view of depression as a risk factor,were analyzed by logistic regression analysis.Results In 266 cases,91 cases appeared depression,and the incidence rate was 34.2%.Through Logistic regression analysis,we found that:character,the degree of cerebral hemorrhage, family economic conditions and cultural level are risk factors for depression of hypertensive cerebral hemorrhage patients after operation.Conclusion Patients with hypertensive cerebral hemorrhage surgery have a higher inci-dence of depression,which affects the prognosis and outcome of the disease.We should actively intervene earlier.

  1. 脑出血手术患者预后的CT影像学评估分析%Analysis of CT Imaging Evaluation of Prognosis in Patients Undergoing Cerebral Hemorrhage Operation

    Institute of Scientific and Technical Information of China (English)

    高永开

    2016-01-01

    Objective To analyze the application value of CT imaging examination in evaluating the prognosis of patients undergoing cerebral hemorrhage operation. Methods The clinical data of 76 patients with cerebral hemorrhage who underwent surgical treatment in our hospital from February 2011 to December 2014 were analyzed retrospectively. All patients underwent CT examination before operation. After operation, all patients were followed up for 6 months and data were complete. The correlation between CT imaging findings and prognosis of patients with cerebral hemorrhage was analyzed.Results There were 47 cases with good prognosis and 29 cases with poor prognosis in the study; Multivariate analysis confirmed that bleeding volume ≥30ml, hematoma broken into ventricle, midline shift > 10mm, operative mode, operative timing, state of consciousness and postoperative rebleeding were independent risk factors affecting the prognosis of patients with cerebral hemorrhage.Conclusion To perform CT screening in patients with cerebral hemorrhage before operation to make clear imaging findings is conductive to early intervention for patients with risk factors and control of risk factors. It can improve the prognosis.%目的 分析CT影像学检查评估脑出血手术患者预后的应用价值.方法 回顾性分析2011年2月-2014年12月于我院接受手术治疗的76例脑出血患者的临床资料,术前所有患者均接受CT检查,所有患者术后均接受6个月随访调查,且资料完整,分析CT影像学特点与脑出血手术患者预后相关性.结果 本组预后良好47例,预后不良29例;多因素分析证实:出血量≥30ml、血肿破入脑室、中线移位>10mm、手术方式、手术时机、意识状态、术后再出血均为影响脑出血患者手术预后的独立危险因素.结论 脑出血患者术前作CT筛查,明确影像学特点,对合并危险因素者早期作手术干预,控制危险因素,可改善其预后.

  2. Effects of Freezing Disaster and Other Psychological Factors on Cerebral Hemorrhage%冰冻灾害及其他心理因素对脑出血发病的影响

    Institute of Scientific and Technical Information of China (English)

    钞雪林; 郭明; 黄佳; 胡勃; 袁也丰; 黄永红

    2011-01-01

    目的 探讨冰冻灾害及其他社会心理因素对脑出血患者发病的影响.方法 应用自制一般情况量表、生活事件量表、社会支持量表、特质应对方式问卷、A型行为类型评定量表对60例脑出血患者及60例健康体检者进行病例对照研究.结果 冰冻灾害、文化、职业、高血压病史、糖尿病病史、卒中家族史、正性事件刺激量、负性事件刺激量、事件刺激总量、主观支持、对支持的利用度、消极应对、积极应对,脑出血患者与健康体检者比较差异有统计学意义(P<0.05或P<0.01).多元逐步Logistic回归分析发现:冰冻灾害、高血压病史、负性事件刺激量与脑出血呈正相关(P<0.05或P<0.01),主观支持与脑出血呈负相关(P<0.05).结论 冰冻灾害作为社会环境因素对脑出血患者发病有明显影响.%Objective To investigate the effects of freezing disaster and other psychological factors on cerebral hemorrhage. Methods Sixty patients with cerebral hemorrhage and 60 healthy subjects were assessed by Life Event Scale (LES), Type A Behavior Pattern (TABP), Social Support Rating Scale (SSRS) and Trait Coping Style Questionnaire (TCSQ). Results There were significant differences (P<0.05 or P<0.01 )in correlative factors of cerebral hemorrhage,including freezing disaster, culture, occupation, hypertension history, diabetes history, family history of stroke,amount of positive life events,amount of negative life events,total amount of life events,subjective support,utilization of support, negative coping and positive coping, between patients with cerebral hemorrhage and healthy subjects. Multiple logistic analysis showed that freezing disaster,hypertension history, and amount of negative life events were positively correlated with cerebral hemorrhage(P<0.05 or P<0.01). Subjective support was negatively correlated with cerebral hemorrhage(P<0.05). Conclusion Freezing disaster as a social

  3. Effect of graded hyperventilation on cerebral metabolism in a cisterna magna blood injection model of subarachnoid hemorrhage in rats

    DEFF Research Database (Denmark)

    Ma, Xiaodong; Bay-Hansen, Rikke; Hauerberg, John;

    2006-01-01

    after experimental SAH in rats (injection of 0.07 mL of autologous blood into the cisterna magna). Four groups of Sprague-Dawley male rats were studied at predetermined PaCO2 levels: group A: normocapnia (5.01-5.66 kPa [38.0-42.0 mm Hg]); group B: slight hyperventilation (4.34-5.00 kPa [32.5-37.5 mm Hg......]); group C: moderate hyperventilation (3.67-4.33 kPa [27.5-32.4 mm Hg]); group D: profound hyperventilation (3.00-3.66 kPa [22.5-27.4 mm Hg]). Each of the four groups included eight rats with SAH and eight sham-operated controls. CBF was determined by the intracarotid Xe method; CMRo2, CMRglc, and CMRlac...... were obtained by cerebral arteriovenous differences. In both SAH rats and controls, hyperventilation decreased CBF in proportion to the decrement in PaCO2 without affecting either CMRO2, CMRglc, or CMRlac. In groups C and D, CBF decreased by 20%-35%, but CMRs were maintained by a compensatory increase...

  4. Clinical analysis of hematoma enlargement in patients with hypertensive cerebral hemorrhage cerebral vascular CTA prediction%脑血管CTA预测高血压脑出血患者血肿扩大的临床探析

    Institute of Scientific and Technical Information of China (English)

    王建; 刘世芳; 曾征; 涂桂英

    2013-01-01

    objective:to study the cerebral CTA predict hematoma enlargement of hypertensive cerebral hemorrhage patients clinical value. Methods:60 cases of high blood pressure in patients with acute cerebral hemorrhage as the research object, CT scan and CTA enhanced spiral scanning, was in hospital (within 6 h), 24 h after onset appointment, statistical check twice the hematoma volume, key points of positive cases and visit the hematoma expansion of positive cases. Results:both the points patients positive for hematoma volume is significantly higher than patients negative (t =6.819,P <0.01), new point) positive patients, visit the hematoma expansion patients negative, positive rate was significantly higher than point visit hematoma expansion of positive rate (χ2=8.458, P <0.01), and the hematoma volume was also significantly higher than the latter (t =2.341,P <0.05). Conclusion:for patients hospitalized time earlier, CTA for evaluating hematoma expansion aspect, has the high reference value, worthy of clinical thinking.%目的探讨脑血管CTA预测高血压脑出血患者血肿扩大的临床价值。方法60例高血压急性脑出血患者作为研究对象,进行CT平扫和CTA增强螺旋扫描,于入院时(发病6h内)初诊一次,发病24h后复诊1次,统计两次检查的血肿量,初诊时的点征阳性例数和复诊时的血肿扩大阳性例数。结果初诊点征阳性患者血肿量显著高于点征阴性患者(t=6.819,P<0.01),初诊点征阳性患者,复诊血肿扩大阳性率显著高于初诊点征阴性患者,复诊血肿扩大阳性率(χ2=8.458, P<0.01),且血肿量也显著高于后者(t=2.341,P<0.05)。结论对于入院时间较早的患者来说,CTA对于评估血肿扩大可能性方面,具有较高的参考价值,值得临床考虑。

  5. Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic

    Energy Technology Data Exchange (ETDEWEB)

    Fainardi, E. [Arcispedale S. Anna, Neuroradiology Unit, Department of Neurosciences, Ferrara (Italy); Tagliaferri, M.F.; Compagnone, C.; Tanfani, A.; Cocciolo, F.; Targa, L.; Chieregato, A. [Ospedale M. Bufalini, Neurocritical Care Unit, Cesena (Italy); Battaglia, R.; Frattarelli, M. [Ospedale M. Bufalini, Neurosurgery Unit, Cesena (Italy); Pascarella, R. [Ospedale M. Bufalini, Neuroradiology Unit, Cesena (Italy)

    2006-09-15

    The aim of this study was to assess regional cerebral blood flow (rCBV) in areas of CT hypoattenuation appearing in the postoperative period in patients treated for aneurysmal subarachnoid hemorrhage (SAH) using xenon-enhanced CT scanning (Xe-CT). We analyzed 15 patients (5 male and 10 female; mean age 49.7{+-}12.1 years) with SAH on CT performed on admission to hospital and who showed a low-density area within a well-defined vascular territory on CT scans after clipping or coiling of a saccular aneurysm. All zones of hypoattenuation were larger than 1 cm{sup 2} and showed signs of a mass effect suggesting a subacute phase of evolution. Two aneurysms were detected in two patients. Aneurysms were located in the middle cerebral artery (n=7), in the anterior communicating artery (n=6), in the internal carotid artery (n=3), and in the posterior communicating artery (n=1). Treatments were surgical (n=8), endovascular (n=2) or both (n=1). A total of 36 Xe-CT studies were performed and rCBF values were measured in two different regions of interest (ROI): the low-density area, and an area of normal-appearing brain tissue located symmetrically in the contralateral hemisphere. rCBF levels were significantly lower in the low-density area than in the contralateral normal-appearing area (P<0.01). In the low-density areas, irreversible ischemia (CBF <10 ml/100 g per minute) was present in 11/36 lesions (30.6%), ischemic penumbra (CBF 10-20 ml/100 g per minute) and oligemia (CBF 20-34 ml/100 g per minute) in 8/36 lesions (22.2%), relative hyperemia (CBF 34-55 ml/100 g per minute) in 7/36 lesions (19.4%), and absolute hyperemia (CBF >55 ml/100 g per minute) in 2/36 lesions (5.6%). Our study confirmed that rCBF is reduced in new low-density lesions related to specific vascular territories. However, only about one-third of the lesions showed rCBF levels consistent with irreversible ischemia and in a relatively high proportion of lesions, rCBF levels indicated penumbral, oligemic and

  6. [The relationship between placental lesions and early hemorrhagic-ischemic cerebral injury in very low birth weight infants].

    Science.gov (United States)

    Vaihinger, Mara; Mazzitelli, Nancy; Balanian, Nora; Grandi, Carlos

    2013-01-01

    Introducción: El examen histopatológico de la placenta es trascendente para evidenciar desordenes relacionados con el embarazo que se asocian a lesiones isquémico hemorrágicas cerebrales (LIHC) en recién nacidos prematuros (RNPT). Objetivo: Estudiar la asociación entre lesiones placentarias y LIHC precoces detectadas con ecografía en RNPT ≤ 1500 g y 32 semanas. Material y Métodos: diseño caso – control. Criterios de inclusión: RNPT ≥ 24 y ≤ 32 semanas, ≥ 500 y ≤ 1500 g, nacidos en la Maternidad Sardá entre años 2006 y 2012. Criterios de exclusión: RNPT gemelares, con malformaciones o infecciones intrauterinas específicas y los fallecidos antes de las 24 horas de vida. Resultados: fueron incluidos 198 RNPT, 49 con LIHC (casos) y 149 sin LIHC (controles). No se encontraron diferencias en las lesiones histopatológicas placentarias entre los dos grupos, aunque se apreció una clara tendencia de lesiones inflamatorias en los casos (67.3%) en comparación con los controles (48 %, p = 0.018). La ruptura prematura de las membranas (p = 0.027) y la corioamnionitis clínica fueron más frecuentes en los casos. Complicaciones fuertemente asociadas a prematurez fueron estadísticamente más evidentes entre los casos. La hemorragia intraventricular fue la lesión cerebral más hallada. El 50% de los casos persistieron con LIHC a las 36-40 semanas, mientras que a mayor edad gestacional el riesgo de LIHC fue menor . Conclusiones: las lesiones histopatológicas placentarias no estuvieron asociadas independientemente a mayor riesgo de LIHC, aunque se observó un predominio de lesiones inflamatorias en los casos.

  7. Pituitary dysfunction in survivors of spontaneous subarachnoid hemorrhage of anterior communicating artery and middle cerebral artery aneurysms: A comparative study

    Directory of Open Access Journals (Sweden)

    Pinaki Dutta

    2012-01-01

    Full Text Available Background: The data on incidence of hypopituitarism after SAH are conflicting. Furthermore, it is still not known whether there is any difference in hormonal deficiencies between SAH due to anterior communicating artery (A-com and middle cerebral artery (MCA aneurysms. Materials and Methods: This study includes both retrospective and prospective arms. The data collected included baseline demographic profile, clinical severity on admission to the hospital by the Hunt and Hess grading system and World Federation of Neurological Surgeons (WFNS grading, radiological severity of bleed by the Fisher′s classification, and treatment details. All the patients underwent detailed hormonal evaluation at baseline and 6 months in prospective group while at the end of 1 year in the retrospective group. Hormonal deficiencies between patients with A-com and MCA aneurysmal SAH were compared using appropriate statistical tests. Results: Of 60 patients studied, 47 patients (A-com: 28 and MCA: 19 were in the retrospective group, while 13 patients (A-com-9, MCA-4 were in the prospective group. The baseline data were comparable between the two groups. At or after 6 months follow-up, 19 (31.6% patients, 10 patients with A-com and 9 patients with MCA aneurysmal SAH, had some form of hormone deficiency. Furthermore, there was no difference in endocrine dysfunctions between the two groups. There was no correlation between the severity of hormonal deficiency and the clinical severity of SAH grade by Hunt and Hess and radiological grade of SAH by Fisher′s grade. Conclusion: Hormonal deficiencies are not uncommon in patients with SAH. There is no difference in hormonal deficiencies and severity of hypopituitarism in patients with SAH due to A-com and MCA bleed.

  8. Analysis on Surgery for Hypertensive Cerebral Hemorrhage in Basal Ganglia Regions%基底节区高血压脑出血手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    汤秉洪; 覃宗明; 杨明彬; 陈建刚

    2012-01-01

    Objective To study the surgical timing, method and curative effect of surgery on hypertensive cerebral hemorrhage in basal ganglia regions. Methods We reviewed the clinical data of 168 patients undergoing operation cures for hypertensive cerebral hemorrhage in basal ganglia regions from January 2006 to January 2011. There were 98 males and 70 females with their age ranging from 35 to 84 years old averaging at 65.2 years. The time between onset of the disease and admission to hospital ranged from 0.5 to 48 hours averaging 7.1 hours. At admission, the conscious status was classified as class I in 32 patients, II in 46, III in 41, IV in 28, and V in 21. Head CT examination at admission showed the lateral type in 51 patients, medial type in 71, and mixed type in 46. The volume of hematoma was 25 to 50 mL in 76 patients, 50 to 80 mL in 53, and larger than 80 mL in 39. The small window craniotomy was performed in 127 cases, and lines of bone flap craniotomy was performed in 41 cases. Results Among the 168 patients, 16 died (9.52%). Re-hemorrhage occurred in 8 patients 4 to 28 hours after operation, among whom immediate operation was performed to remove the hematoma in 6 patients, non operation treatment in 2 cases, and 4 patients died. Six patients died of large volume of hematoma or hemiation. Pulmonary or urinary tract infection occurred in 3 patients, and multiple organ failure in 3 patients. According to Glasgow outcome scale (GOS) score at discharge, the outcome was good in 82 patients, moderate disability in 46, severe disability in 16, persistent vegetative in 8, and 16 died. Patients were followed up for 3 to 6 months, and according to the daily work capacity (ADL) classification, there were 33 cases of class I , 49 of class Ⅱ , 54 of class Ⅲ , 8 of class Ⅳ , and 8 of class Ⅴ . Conclusion Ultra early or early operation done under direct vision, clearing hematoma completely, and reliable coagulation of the bleeding arteries responsible for the hematoma

  9. Cerebral Arteriosclerosis

    Science.gov (United States)

    ... the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in ...

  10. Analysis of 8 cases of the performance of pseudo subarachnoid hemorrhage of acute cerebral infarction%表现为假性蛛网膜下腔出血的急性脑梗死8例分析

    Institute of Scientific and Technical Information of China (English)

    张梅芳; 易婷玉; 吴燕敏; 陈文伙

    2015-01-01

    目的:探讨表现为假性蛛网膜下腔出血的急性脑梗死的原因.方法:收治急性脑梗死患者8例,分析临床表现及影像学表现.结果:右侧偏瘫及失语3例,左侧偏瘫3例,视野异常2例.头颅MRI显示急性脑梗死8例,左侧额叶3例,其中2例合并皮层下分水岭梗死,右侧额叶3例,均合并皮层下分水岭梗死,右侧枕叶2例, MRA提示脑血管狭窄、闭塞5例,左侧大脑中动脉重度狭窄2例,右侧大脑中动脉闭塞2例,右侧大脑中动脉重度狭窄1例.结论:急性大脑皮层梗死早期因代偿脑膜支血流缓慢,易在CT表现为假性蛛网膜下腔出血.%Objective:To explore the manifestations of acute cerebral pseudo subarachnoid hemorrhage causes.Methods:8 patients with acute cerebral infarction were selected,analysis of clinical manifestation and imaging performance.Results:On the right side of 3 cases of hemiplegia and aphasia,3 cases of left hemiplegia,2 cases of abnormal visual field.Brain MRI showed acute cerebral infarction in 8 cases,left frontal lobe in 3 cases,2 cases with cerebral watershed infarction,right frontal lobe in 3 cases,2 cases of right occipital lobe,5 cases of cerebral artery stenosis,2 cases of left middle cerebral artery stenosis,2 cases of right middle cerebral artery occlusion,right middle cerebral artery stenosis in 1 cases.Conclusion:Acute cortical infarction due to compensatory meningeal branch blood flow is slow,easy to show in CT as a pseudo subarachnoid hemorrhage.

  11. 促红细胞生成素对脑出血神经再生影响的临床研究%CLINICAL STUDY OF EFFECT OF ERYTHROPOIETIN ON NERVE REGENERATION AFTER CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    肖峰; 胡涛

    2011-01-01

    [目的]探讨重组人促红细胞生成素对脑出血患者神经再生的影响.[方法]应用腰穿注射重组人促红细胞生成素,观察脑出血患者血清VEGF、bFGF的变化以及欧洲卒中量表.[结果]治疗组d7、d 10、d 14、d 17、d21血清VEGF和血清bFGF高于对照组,治疗组欧洲卒中量表d I0、d 14、d 17、d 21高于对照组,差异均有统计学意义(P<0.05).[结论]通过腰穿注入重组人促红细胞生成素能促进脑出血患者的神经再生.%[Objective] To study the effect of erythropoietin on nerve regeneration after cerebral hemorrhage. [Methods] We observed VEGF and bFGF in serum and Europe Stroke Scale (ESS) of cerebral hemorrhage patients after recombi-nant human erythropoietin with lumbar infusion. [Results] The VEGF and bFGF in serum were higher in treatment group than in the control group after 7, 10, 14, 17, 21 days. The difference between the two groups was significant (P<0.05). [Con-ClUSion ] Recombinant human erythropoietin with lumbar infusion can promote nerve regeneration of cerebral hemorrhage.

  12. Clinical Experience of Stroke Unit Care for Hemiplegia Patients With Cerebral Hemorrhage%脑出血偏瘫患者行卒中单元护理的临床体会

    Institute of Scientific and Technical Information of China (English)

    钱堂美

    2014-01-01

    Objective Discuss the effect of stroke unit care in hemiplegic cerebral hemorrhage patients. Methods 46 cases patients with hemiplegia due to cerebral hemorrhage were randomly divided into observation group and control group. The patients in the control group received routine care, observation group received stroke unit care. Results FMA (motor function points) scored signiifcantly in observation group was higher after treatment, P<0.05. Conclusion Stroke unit care can signiifcantly improve motor function in patients with hemiplegic cerebral hemorrhage.%目的:探讨卒中单元护理在脑出血偏瘫患者护理中的应用临床效果,总结护理体会。方法选取我院在2011年9月~2013年9月收治的因脑出血致偏瘫患者46例,随机分为观察组和对照组各23例,对照组给予常规护理,观察组应用卒中单元护理模式给予护理,比较两组治疗护理后的运动功能恢复情况。结果观察组在护理后的FMA(运动功能积分)得分明显大于对照组,且P<0.05。结论卒中单元护理模式在脑出血致偏瘫患者中的应用效果显著,可明显改善患者运动功能。

  13. 高血压脑溢血偏瘫患者焦虑状态及影响因素的调查与分析%Investigation and analysis of anxiety status among paralytic patients suffered from hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    侯学莲

    2011-01-01

    目的 了解高血压脑溢血偏瘫患者焦虑状态及影响因素,更好地实施整体护理.方法 采用一般资料调查表,焦虑自评量表对70例高血压脑溢血患者进行问卷调查.结果 本组3例患者无焦虑,中、重度焦虑占52.9%,自费患者得分高于公费患者,文化程度和社会地位越高得分越高,差异均有统计学意义(P<0.01).结论 高血压脑溢血偏瘫患者焦虑的发生率高,应给予患者正确的心理护理,促使患者早日康复.%Objective To investigate anxiety status as well as corresponding influencing factors among paralytic patients suffered from hypertensive cerebral hemorrhage, so as to carry out better holistic nursing. Methods General data questionnaire and SAS were used to investigate 70 patients suffered with hypertensive cerebral hemorrhage. Results 3 patients have no anxiety,while 52. 9% patients were with medium or severe anxiety. Patients who payed their own expenses have higher levels of anxiety when compared with those at public expenses. Those patients have higher edcation and higher social status have higher anxiety scores. Conclusion Paralytic patients suffered from hypertensive cerebral hemorrhage have higher incidence of anxiety. They should be nursed with more attention on their psychological care to promote their recovery.

  14. 糖尿病合并脑出血的治疗与护理配合疗效分析%Treatment and Nursing of Diabetic Cerebral Hemorrhage Curative Effect Analysis

    Institute of Scientific and Technical Information of China (English)

    范景杰

    2016-01-01

    Objective To analysis of surgical treatment for patients with diabetic cerebral hemorrhage during nursing meth-ods. Methods In December 2012 to December 2015, our hospital diabetic cerebral hemorrhage and to give a total of 30 pa-tients with surgical treatment as the research object, computer methods patients were randomly divided into two groups at random. Control group for routine care, experimental group gives comprehensive perioperative care, contrast effect. Results The nursing after fasting glucose was (6.96±1.02) tendency for l, complications for 1 case, lower than the control group, P<0.05). Conclusion The diabetic patients with cerebral hemorrhage giving comprehensive surgical perioperative care effect is better.%目的:分析糖尿病合并脑出血患者的外科治疗期间的护理方法。方法以2012年12月-2015年12月该院收治糖尿病合并脑出血并给予外科治疗患者共30例为研究对象,计算机随机方法将患者随机分为两组。对照组为常规护理,实验组给予围手术期综合护理,对比效果。结果实验组护理后空腹血糖为(6.96±1.02) mmol/L,并发症为1例,低于对照组,P<0.05。结论糖尿病合并脑出血患者给予外科围手术期综合护理效果较好。

  15. Intracranial hemorrhage of the mature newborn infant

    International Nuclear Information System (INIS)

    Concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT, the labour course, treatment, and prognoses were discussed. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by severeness of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal. (Ueda, J.)

  16. Analysis of Related Factors of Depression in Patients with Hypertensive Cerebral Hemorrhage after Operation%高血压性脑出血患者术后抑郁的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    叶顶英

    2014-01-01

    Objective:To explore the factors related to depression in patients with hypertensive cerebral hemorrhage after operation,provide the basis for the prevention.Methods:Were investigated and analyzed for the occurrence of depression in 86 patients with hypertensive cerebral hemorrhage patients after surgery,in may and correlated with depression factor was analyzed.Results:In 86 cases,36 cases appeared depression,the incidence rate was 41.86%.Statistical analysis showed that patients' cultural degree,family relations,the character and degree of cerebral hemorrhage,bleeding and depression have certain relevance.Conclusion:Patients with hypertensive cerebral hemorrhage surgery have a higher incidence of depression,affects the prognosis and outcome of the disease,should actively intervene.%目的:探讨高血压性脑出血患者术后抑郁的相关因素,为其预防提供依据。方法:对86例高血压性脑出血患者手术后抑郁的发生情况进行了调查,并对可能与发生抑郁有相关性的因素进行了分析。结果:86例患者中有36例出现了抑郁,发生率为41.86%。统计学分析显示,患者的文化程度、家庭关系、性格、脑出血程度、出血部位等与抑郁的发生有一定的相关性。结论:高血压性脑出血患者术后有较高的抑郁发生率,在一定程度上影响着疾病的预后及转归,对那些有与抑郁密切相关因素的患者应积极进行干预。

  17. CT findings in hemorrhagic infarction

    International Nuclear Information System (INIS)

    7 cases of hemorrhagic infarction in which a high-density area in a low-density area were revealed on follow-up CT scan are reported. Symptomatically, 4 cases were completed strokes, while 3 cases were RIND. Recanalization of the occluded vessel was seen in all 5 cases on which follow-up angiography was performed. Hemorrhagic infarction was recognized between the 6th and 21st day after onset. CT scan revealed various patterns of hemorrhagic infarction - massive hematoma, watershed hemorrhage, diffuse petechial hemorrhage, etc. Clinical prognoses of these cases were provided in two groups. 3 cases whose clinical symptoms deteriorated at the time of hemorrhage died. On the other hand, 4 cases whose clinical symptoms were stationary, but who nevertheless had hemorrhagic infarction, had good or excellent prognoses. Hemorrhagic infarction of the former group took place during the acute stage of cerebral ischemia(6-8th day after onset), but that of the latter group took place during the subacute stage of cerebral ischemia (12-21st day after onset). Contrast enhancement was seen in all the cases except for one case of the acute stage. Contrast enhancement in the acute stage was recognized in 2 cases on the 4th day after onset. (author)

  18. Hemorrhagic brain metastases

    International Nuclear Information System (INIS)

    Tumor hemorrhage on computed tomography (CT) was found in 14 patients with brain metastases (7 % of two hundred patients with brain metastases), from April 1979 to July 1983. Primary foci of these lesions were the lung (6 patients), breast (2), kidney (2), uterus (2), colon (1) and adrenal gland (1). ''Stroke'' syndrome was the initial presenting symptom in 3 patients; neurological focal sign or symptoms of increased intracranial pressure in the remaining patients. CT demonstrated peritumoral hemorrhage in all patients with solid mass, intratumoral hemorrhage in a few patients and also cerebral or ventricular hemorrhage, which was fatal complication, in 2 patients (colon and breast cancers). A cystic mass with fluid-blood level was noted in a patient with breast cancer. Several predisposing factors including chemotherapy, thrombocytopenia, radiotherapy or combination of these were recognized in 8 patients. Of these, chemotherapy was the most causative factor of tumor hemorrhage. Brain irradiation for hemorrhagic brain metastases was effective for prolongation of mean survival time of these patients as follows; 10 months in irradiated group, whereas 1.5 months in non-irradiated group. (author)

  19. Recurrent intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Shen jinsong; Lu jianhong

    2000-01-01

    Objective: In order to study the clinical manifestation and risk factor of recurrent intracerebral hemorrhage(ICH).Methods:The 256 patients were analysed who admitted to our hospital for intracerebral hemorrhage between 1995 and 1997.The 15(5 .86%)patients had a recurrent ICH.There were 9 men and 6 women and the mean age of the patients was 63.5 ± 6.4years at the first bleeding episode and 67.8± 8. 5 years at the second. The mean interval between the two bleeding episodes was 44.6 ± 12.5 months. The 73.3%patients were hypertensive .′The site of the first hemorrhage was ganglionic in 8 patients , ]ohar in six paients and brainstem in one .The recurrent hemorrhage occurred at a different location from the previous ICH.The most common pattern of recurrence was “ganglionic -ganglionic” (7 patients), lobar - ganglionic (3 patients), lobar-lobar(three patients), which was always observed in hypertensive patients. The outcome after the recurrent hemorrhage was usually poor. By comparison with 24 patients followed up to average 47.5± 18.7 months with isolated ICH without recurrence .Only lobar hematoma and a younger age were risk factors for recurrences whereas sex and previous hypertension were not. The mechanism of recurrence of ICH were multiple(hypertension, cerebral amyloid angiopathy).Contral of blood pressure and good living habit after the first hemorrhage may prevent ICH recurrences.

  20. Study on prevention of concurrent cerebral infarction after hypertensive intracerebral hemorrhage surgery%高血压脑出血术后并发脑梗死的防治研究

    Institute of Scientific and Technical Information of China (English)

    张晓阳; 刘霄

    2011-01-01

    目的 探讨高血压脑出血术后脑梗死发生的原因及预防和治疗的措施.方法 回顾性分析周口市中心医院收治的90例高血压脑出血术后脑梗死的临床资料.52例术后3d、8例术后6d复查CT见脑梗死征象,其中70例为同侧顶枕叶凸面,14例为同侧额叶,6例为对侧大脑基底节区.并发脑梗死后停用止血药、加强脱水、充分补液、应用血管解痉及改善微循环药物.结果 生存85例,死亡5例.生存者按ADL标准,Ⅰ级+Ⅱ级42例,Ⅲ级+Ⅳ级38例,V级5例.结论 高血压脑出血术后脑梗死是多因素共同作用的结果.术中、术后采取正确的预防和治疗措施,可提高临床疗效.%Objective To explore the causes and prevention of cerebral infarction after hypertensive intracerebral hemorrhage surgery. Methods Retrospectively analyze the data of 90 patients with cerebral infarction after hypertensive intracerebral hemorrhage in our hospital. 52 cases 3 days after surgery and 8 cases 6 days after surgery were reviewed by CT and were found cerebral infarction. 70 of them were hotnolateral parieto - occipital lobe convexity ,14 cases were homolateral frontal lobe,6 cases were contralateral brain basal ganglia. After complication of cerebral infarction stop the hemostatic medicine , strengthen the dehydration, fully rehydration, application of vascular spasmolysis and improving circulation drugs. Results Survival 85 cases,5 cases died. According to the ADL standards,stage Ⅰ and stage Ⅱ 38 cases, stage and stage IV 38 cases, stage V 5 cases. Conclusions Cerebral infarction after hypertensive intracerebral hemorrhage surgery is the consequence of the interaction between multiple factors. Using the correct preventive measures in intraoperation and postoperation can improve the clinical effect.

  1. 出血脑梗死老年患者66例临床疗效分析%Clinical Analysis of 66 Elderly Patients with Hemorrhagic Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    王遂山

    2013-01-01

      目的分析出血脑梗死老年患者临床疗效。方法通过观察我院66例出血脑梗死老年患者的临床治疗效果,分析其疗效。结果66例出血脑梗死老年患者中,有45名治疗痊愈已出院,11名留院观察,虽有轻微的口眼歪斜和语言障碍,但生活基本上可以自理,5名有半身不遂和偏瘫后遗症患者已出院,与入院时比较,有了很大好转,另有5名患者因肺部感染严重和大量出血,没有及时治疗导致死亡。结论出血脑梗死老年患者发病的时间短,其症状就会很严重,所以,对患者及时的进行诊断治疗是减少出血脑梗死老年患者病死率的关键。%  Objective To analysis the clinical efficacy in elderly patients with hemorrhagic cerebral infarction. Methods The clinical curative effect observation of 66 cases in our hospital bleeding in patients with cerebral infarction in elderly, analyze the effect of. Results 66 cases of hemorrhagic cerebral infarction in elderly patients, 45 were treated and discharged, 11 patients admitted to hospital for observation, although a slight deviation of the eyes and mouth and language barriers, but life basically can take care of themselves, 5 had hemiplegia and hemiparesis after-effects patients who had been discharged, compared with admission, has been greatly improved, another 5 patients because of the lung infection and bleeding, no timely treatment leads to death. Conclusion The incidence of infarction in elderly patients with cerebral hemorrhage in a short time, the symptoms will be very serious, so, for patients with timely diagnosis and treatment is to reduce the mortality rate of bleeding in critical elderly patients with cerebral infarction.

  2. Tratamiento del vasoespasmo cerebral asociado a hemorragia subaracnoidea espontánea mediante angioplastia percutánea con balón: reporte de tres casos Treatment of cerebral vasospasm associated with subarachnoid hemorrhage by means of percutaneous balloon agioplasty: report of three cases

    Directory of Open Access Journals (Sweden)

    Carlos Mario Jiménez Yepes

    2002-03-01

    Full Text Available Reportamos el uso de la angioplastia percutánea con balón en tres pacientes con diagnóstico de vasoespasmo cerebral secundario a hemorragia subaracnoidea espontánea. Todos los pacientes estaban en mala condición clínica neurológica pero dentro de la ventana terapéutica para isquemia cerebral. El tratamiento fue considerado exitoso tanto en términos angiográficos como clínicos. La terapia endovascular mediante la angioplastia cerebral percutánea con balón es una herramienta útil en el vasoespasmo cerebral, en pacientes debidamente seleccionados y que estén dentro de la ventana terapéutica, que parece ser de doce horas luego de instalados los signos y síntomas. Succesful treatment of cerebral vasospasm by using percutaneous balloon angioplasty is reported in three cases. All patients were in bad condition with a short therapeutic window. All of them had a good recovery, both in terms of angiographic and clinical criteria. Use of endovascular therapy of spastic vessels by means of balloon percutaneous angioplasty in selected patients, is a good choice for treatment of cerebral vasospasm associated with spontaneous subarachnoid hemorrhage.

  3. 出血性脑梗死的临床治疗分析%Clinical Analysis on the Treatment of Hemorrhagic Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    徐忠海; 张建平

    2015-01-01

    Objective To observe the therapeutic effect and clinical analysis of hemorrhagic cerebral infarction patients. Methods Retrospective analysis of 2010 January to 2013 December in our hospital treated 47 cases of clinical data of patients with hemorrhagic cerebral infarction. Results In this group, 47 cases of hemorrhagic cerebral infarction patients after active treatment, 11 cases were basically cured (23.40%), signiifcant effective in 22 cases (46.81%), effective 6 cases (12.77%), invalid 6 cases (12.77%), 2 cases of death (4.26%); efifciency is 87.23%, of which 1 cases of formation cerebral hernia, 1 cases with renal failure and death. Conclusion The pathogenesis of hemorrhagic cerebral infarction is complex, the main reason for infarction after vascular injury and reperfusion; infarct size, location, complications and bleeding, bleeding and sooner or later type is closely related to the prognosis, timely diagnosis and treatment for measures, to improve prognosis, it has important clinical signiifcance improve the quality of life.%目的:观察并分析临床对出血性脑梗死患者的治疗效果。方法回顾性分析2010年1月至2013年12月本院收治的47例出血性脑梗死患者的临床资料。结果本组47例出血性脑梗死患者经积极治疗,基本痊愈11例(占23.40%)、显著有效22例(占46.81%)、有效6例(占12.77%)、无效6例(占12.77%)、死亡2例(占4.26%);有效率为87.23%,其中1例形成脑疝、1例合并肾功能衰竭死亡。结论出血性脑梗死发病机制复杂,其主要原因为梗死后血管损伤和血流再灌注;梗死灶大小、部位、合并症以及出血发生早晚、出血类型等与其预后密切相关,及时明确诊断及针对性的治疗措施,对于改善患者的预后,提高其生活质量具有重要的临床意义。

  4. Hemorrhagic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  5. Glycemia in Spontaneous Intracerebral Hemorrhage: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Alvis-Miranda Hernando

    2014-10-01

    Full Text Available Spontaneous cerebral hemorrhage or intracranial hemorrhage accounts for 10-15% of all strokes. Intracranial hemorrhage is much less common than ischemic stroke, but has higher mortality and morbidity, one of the leading causes of severe disability. Various alterations, among these the endocrine were identified when an intracerebral hemorrhage, these stress-mediated mechanisms exacerbate secondary injury. Deep knowledge of the injuries which are directly involved alterations of glucose, offers insight as cytotoxicity, neuronal death and metabolic dysregulations alter the prognosis of patients with spontaneous intracerebral hemorrhage.

  6. The ward of ultraviolet germicidal irradiation to reduce cerebral hemorrhage patients with postoperative infection%病房紫外线照射消毒对降低脑出血患者术后感染的影响

    Institute of Scientific and Technical Information of China (English)

    王作珍

    2012-01-01

    目的:探讨病房紫外线照射消毒对降低脑出血患者术后感染的影响,为临床实践提供参考.方法:对60例脑出血患者术后未行病房紫外线照射消毒和行病房紫外线照射进行对比研究,以评价2种不同方法的临床效果.结果:病房紫外线照射消毒(2次/天)与未行病房紫外线照射消毒患者感染率的比较(P<0.05),有统计学意义.%Objective Investigate the influence of ward ultraviolet irradiation sterilization to reducing postoperative infection in patients with cerebral hemorrhage, provide a reference for clinical practice. Method Comparative study of 60 cases of cerebral hemorrhage patients whether use UV disinfection unit or not, to evaluating Two different methods of clinical results. Results Ultraviolet radiation disinfection unit (2 times / day) with no line UV disinfection unit comparison of patients with infection (P<0.05), was statistically significant.

  7. 青年脑出血128例的病因、危险因素及预后分析%Analysis of the etiology,risk factors and prognosis of youth cerebral hemorrhage in 128 cases

    Institute of Scientific and Technical Information of China (English)

    徐新良

    2015-01-01

    Objective:To explore the etiology,risk factors and prognosis of youth cerebral hemorrhage.Methods:The clinical data of 128 patients with youth cerebral hemorrhage were retrospectively analyzed.Results:99 cases(77.34% ) had definite etiology, including 43 cases(33.59% ) of hypertension,36 cases(28.13% ) of arteriovenous malformation,12 cases(9.38% ) of internal medicine diseases,6 cases(4.69%) of hematological system diseases,2 cases(1.56%) of pregnancy status.29 cases(22.67%) were unknown cause.The main risk factors were smoking,drinking.32 cases(25% ) were cured,50 cases(39.06% ) were improved,22 cases(17.19%) were unrecovered,24 cases(18.75%) were death.Conclusion:Hypertension,cerebral vascular malformation are the main causes of youth cerebral hemorrhage,its clinical symptoms are heavier,most patients have good prognosis.%目的:探讨青年脑出血的病因、危险因素及预后。方法:对128例青年脑出血患者的临床资料进行回顾性分析。结果:有明确病因99例(77.34%),其中高血压43例(33.59%),动静脉畸形36例(28.13%),内科疾病12例(9.38%),血液系统疾病6例(4.69%),妊娠状态2例(1.56%);原因不明29例(22.67%)。主要危险因素有吸烟、饮酒。痊愈32例(25%),好转50例(39.06%),未愈22例(17.19%),死亡24例(18.75%)。结论:高血压病、脑血管畸形是青年脑出血的主要病因,临床症状表现较重,大多数患者预后良好。

  8. Dengue hemorrhagic fever

    Science.gov (United States)

    Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever ... Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person is bitten by ...

  9. The value of spiral CT in diagnose and curativ e effect of cerebral infarction following surgery for hypertensive cerebral hemorrhage%螺旋CT在高血压脑出血术后继发性脑梗死诊断及疗效观察中的价值

    Institute of Scientific and Technical Information of China (English)

    祝华强; 罗东梅; 邱其良; 刘奕仕; 陈建乐; 周才金

    2015-01-01

    目的:探讨螺旋CT在高血压脑出血术后早期脑缺血/脑梗死诊断及疗效观察中的价值。方法回顾分析我院2008—2014年间收治的25例高血压脑出血术后脑梗死病例影像资料。结果25例脑出血中基底节区15例,皮层区9例,脑室内1例,血肿破入脑室5例。术后出现脑梗死共72处(按脑叶统计),其中额叶12处(17%)、颞叶12处(17%)、顶叶11处(15%)、枕叶21处(29%)、小脑3处(4%)、脑干5处(7%)、基底节区8处(11%)。随诊观察治疗效果,经治疗除了6例病例死亡,其余病例经8~40 d随诊复查,10例脑梗死区密度恢复正常,4例病情好转转院治疗,5例脑梗死区出现脑软化灶。25例患者进行随访,按照目前常用的日常生活能力分级(GOS评分):GOS评分Ⅰ级3例(12%);GOS评分Ⅱ级8例(32%);GOS评分Ⅲ级5(20%),GOS评分Ⅳ级2例(8%),GOS评分Ⅴ级1例(4%);死亡6例(24%)。结论螺旋CT扫描速度快,检查时间短,对早期发现高血压脑出血术后继发脑梗死病变、及时治疗以提高患者的生存率,降低病残率以及估计其预后有重要的意义。%Objective To study the value of spiral CT in diagnose and curative effect of cerebral ischemia/infarction following surgery for hypertensive cerebral hemorrhage (HCH). Methods Retrospective analysis the CT image data 25 cases with cerebral infarction following the surgery for HCH, who were treated in our department from, 2008 to 2014. Results In 25 cases of cerebral infarction following surgery for hypertensive cerebral Hemorrhage. There were 15 cases of basis festival area cerebral hemorrhage, 9 cases of cortical hemorrhage, 1 cases of in-traventricular hemorrhage, 5 cases of hematoma broken into ventricles. Postoperative cerebral infarction were 72 points (according to the statistics), the frontal lobe were 12 points(17%), temporal lobe were 12 points(17%), parietal

  10. 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

    Institute of Scientific and Technical Information of China (English)

    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),

  11. Comparison of magnetic resonance imaging and CT in the identification of cerebral hemorrhage%磁共振成像与CT对脑出血的鉴别对比分析

    Institute of Scientific and Technical Information of China (English)

    李占吉

    2016-01-01

    Objective To investigate the clinical value of CT and magnetic resonance imaging (MRI) in the diagnosis of cerebral hemorrhage.Methods Preoperative CT and MRI data of 101 patients with cerebral hemorrhage from March 2010 to March 2014 were analyzed retrospectively,and the results were compared with postoperative pathological results,and calculated the diagnostic value of two imaging examinations.Results There were no statistically significant differences in the coincidence rates of the diagnosis of basal ganglia hemorrhage,lobar intracerebral hemorrhage by CT,MRI and postoperative pathological results (P>0.05).The coincidence rates of the diagnosis of putamen hemorrhage,thalamic hemorrhage by CT and postoperative pathological results were 59.09%,47.37%,significantly lower than those by MRI (P<0.05).The sensitivity,specificity of MRI in the diagnosis of cerebral hemorrhage were 94.74%,96.04%,higher than 47.37%,85.37% of CT (P<0.05).The misdiagnosis rate,the rate of missed diagnosis,Kappa value of MRI in the diagnosis of cerebral hemorrhage were 3.66%,5.26%,0.875,all lower than 14.85%,52.47%,0.315 of CT.Conclusion The diagnostic value of MRI is better than CT,which can be used as an effective method for the diagnosis of cerebral hemorrhage.%目的 探讨CT和磁共振(MRI)检查诊断脑出血的临床价值.方法 对本院2010年3月至2014年3月手术后病理确诊的101例脑出血患者的术前CT、MRI检查资料进行回顾性分析,比较CT和MRI检查判定结果与手术后病理检查结果的一致性,并计算两种影像学检查的诊断学评价指标.结果 CT与MRI对基底节出血、脑叶出血的诊断结果与病理检查结果的符合率比较差异无统计学意义(P>0.05),CT检查壳核出血、丘脑出血与术后病理检查结果的符合率分别为59.09%、47.37%,显著低于MRI检查与术后病理检查结果的符合率(86.36%、94.74%) (P<0.05).MRI检查术前诊

  12. Glibenclamide for the Treatment of Ischemic and Hemorrhagic Stroke

    OpenAIRE

    Nicholas Caffes; Kurland, David B.; Volodymyr Gerzanich; J. Marc Simard

    2015-01-01

    Ischemic and hemorrhagic strokes are associated with severe functional disability and high mortality. Except for recombinant tissue plasminogen activator, therapies targeting the underlying pathophysiology of central nervous system (CNS) ischemia and hemorrhage are strikingly lacking. Sur1-regulated channels play essential roles in necrotic cell death and cerebral edema following ischemic insults, and in neuroinflammation after hemorrhagic injuries. Inhibiting endothelial, neuronal, astrocyti...

  13. Experiment on prevention of cerebral vasospasm after subarachnoid hemorrhage and progress of Clinical research%蛛网膜下腔出血并发脑血管痉挛预防的实验与临床研究进展

    Institute of Scientific and Technical Information of China (English)

    梁柯

    2007-01-01

    @@ Cerebral vasospasm(CVS),a common complication of subarachnoid hemorrhage(SAH),is caused by many factors and associated with poor prognosis of SAH.CVS generally occurs 3-4 days after the initial SAH and peaks at 5-7 days.

  14. 凉血通瘀中药治疗脑出血急性期168例疗效观察%Liangxue Tongyu Fang for treating acuter-phase cerebral hemorrhage in 168 cases

    Institute of Scientific and Technical Information of China (English)

    过伟峰; 王敬卿; 赵扬; 邵凤扬; 陈隐漪; 顾锡镇; 王永生; 路楷; 张兰坤; 吴勉华; 李国春; 周学平; 叶放; 袁园; 全亚萍; 陈顺中

    2012-01-01

    目的 评价凉血通瘀中药治疗脑出血急性期的临床疗效.方法 将337例患者随机分为治疗组168例和对照组169例,2组均采用西医内科常规治疗,治疗组同时服用凉血通瘀中药,疗程均为21 d.疗程结束后分别统计并比较2组综合疗效、中风病类诊断评分、脑出血吸收情况、脑水肿分级及格拉斯哥预后结果( GOS)评分.结果 治疗组总有效率88.0%,高于对照组的77.5%(P<0.05).2组治疗后中风病类诊断评分及GOS评分均较治疗前显著下降(P<0.01),且治疗组优于对照组(P <0.05或P<0.01).结论 结合凉血通瘀中药治疗脑出血急性期能显著提高临床疗效,改善预后.%Objective To review the curative effect of Liangxue Tongyu Fang on acute-phase cerebral hemorrhage. Methods All patients (n =337) were randomly divided into treatment group (n - 168) and control group (n = 169). The two groups were given routine therapies of Western internal medicine, and treatment group was given Liangxue Tongyu Fang at the same time. A therapeutic course was 21 days. The comprehensive curative effect, diagnostic scores of stroke, absorption of cerebral hemorrhage, haematoma grading and scores of Glasgow outcome score (GOS) were counted and compared in two groups. Results The total effective rate was 88. 0% in treatment group, which was higher than that (77. 5% ) in control group (P <0. 05) . The diagnostic scores of stroke and GOS decreased significantly in two groups after the treatment than before (P <0. 01) , which was more significant in treatment group than that in control group ( P < 0. 05 or P < 0. 01 ). Conclusion Liangxue Tongyu Fang can significantly improve the curative effect and outcomes in the treatment of acute cerebral hemorrhage.

  15. 右美托咪定在高血压脑出血开颅术中的应用意义研究%Dexmedetomidine in the Application Significance of Craniotomy in Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    曹鸣洋

    2016-01-01

    目的:研究右美托咪定在高血压脑出血开颅术中的应用意义。方法选取2013年10月~2015年8月我院收治的86例高血压脑出血开颅术患者进行分组研究,按照抽签法分为对照组(n=43,应用生理盐水)和试验组(n=43,应用右美托咪定),比较两组临床效果。结果 T0点两组患者的 DBP、SBP、MAP、HR 比较,差异不明显(P >0.05);T1、T2、T3、T4时两组上述指标比较,对照组大于试验组(P <0.05),且自主呼吸恢复时对照组 PaO2低于试验组(P <0.05)。结论在高血压脑出血开颅术中的应用右美托咪定,可有效改善血压、心率,安全可靠。%Objective To study the right supporting the mi in the application of hypertension cerebral hemorrhage open-brain surgery. Methods 86 cases of patients with hypertension cerebral hemorrhage open-brain surgery were chosen as group study from October 2013 to August 2015 in our hospital, according to the draw method is divided into control group (n=43, application of physiological saline) and experimental group (n=43, application dexmedetomidine), compare the clinical effect of two groups. Results The T0 DBP and SBP points two groups of patients, MAP, HR, no significant difference (P>0.05). T1, T2, T3, T4 above index comparison of two groups, control group is greater than the experimental group (P<0.05), and spontaneous breathing recovery control group PaO2 is lower than the experimental group (P<0.05). Conclusion The application in hypertension cerebral hemorrhage open-brain surgery right beautiful mi set, which can effectively improve the blood pressure, heart rate, safe and reliable, has a positive value of clinical use and promotion.

  16. 早期肠内营养对老年脑出血患者预后的影响%Effects of Early Enteral Nutrition on Prognosis in Elderly Patients with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    申林; 张春晖; 孙兰心

    2014-01-01

    目的:探讨早期肠内营养对老年脑出血患者预后的影响。方法将我院住院治疗的90例老年脑出血患者随机分为两组,观察组45例,对照组45例。观察组给予早期肠内营养,对照组给予肠外营养。比较不同营养方式支持前后,患者血糖(GLU)、电解质、血清白蛋白(ALb)、肝肾功能等血清生化指标的变化,进行疗效判定。结果观察组 ALb 明显升高,血糖、电解质、肝肾功能指标均优于对照组,两组差异有统计学意义(P <0.05)。结论早期肠内营养可有效改善老年脑出血患者营养不足的状况,防止电解质紊乱、免疫功能降低等不良预后。%Objective To investigate the effects of early enteral nutrition on Prognosis in elderly Patients with cerebral hemorrhage. Methods 90 elderly Patients with cerebral hemorrhage were randomly divided into observation grouP(n = 45)and control grouP(n = 45). Enteral nutrition was given to Patients in observation grouP,and Parenteral nutrition was given to Patients in control grouP. Serum biochemical indexes such as blood glucose(GLU),electrolytes, serum albumin(ALb),liver and renal function were comPared before and after nutritional suPPort. Results ALb sig-nificantly increased. GLU,electrolytes,liver and renal function indexes in observation grouP were better than those in control grouP. There were significant differences between the two grouPs(P < 0. 05). Conclusion Early enteral nutri-tion can imProve the status of undernutrition in elderly Patients with cerebral hemorrhage,which can Prevent Poor Prog-nosis such as electrolyte imbalance and decrease in immune function.

  17. The effect of pre hospital emergency care on prognosis of patients with cerebral hemorrhage%院前急救护理对脑出血患者预后的影响

    Institute of Scientific and Technical Information of China (English)

    焦国英

    2014-01-01

    目的:探讨院前急救护理对脑出血患者预后的影响。方法:整理分析80例脑出血患者的临床资料,入院前经过院前急救护理的40例患者为观察组,没有经过院前急救护理的40例为对照组,比较两组治疗效果、临床死亡率及并发症发生情况。结果:观察组临床治疗效果明显高于对照组,观察组死亡率和并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论:脑出血患者的临床风险较高,实施院前急救和护理可以有效降低患者的死亡率和并发症发生率,对患者的治疗效果具有明显的提高。%Objective:To investigate the effect of pre hospital emergency care on prognosis of patients with cerebral hemorrhage. Methods:We analyzed the clinical datas of 80 cases with cerebral hemorrhage.40 cases who had the pre hospital emergency care before went into the hospital after of patients as the observation group, without pre hospital emergency care as the control group. We compared the therapeutic effect,clinical mortality and complications incidence of the two groups.Results:The clinical therapeutic effect of the observation group was obvious higher than that of the control group.The mortality and complications incidence of patients of the observation group were lower than those of the control group.The differences were all statistically significant.Conclusion:The patients with cerebral hemorrhage were higher risk in clinical.The implementation of pre hospital first aid and nursing can effectively reduce the mortality and the complications incidence.It can improved the patients outcomes significantly.

  18. MRI磁敏感加权成像(SWI)在脑出血中的应用价值分析%MRI Magnetic Sensitive Weighted Imaging (SWI) in Cerebral Hemorrhage, the Application of Value Analysis

    Institute of Scientific and Technical Information of China (English)

    刘春岭

    2015-01-01

    Objective To approach the applicate value of MRI susceptibility weighted imaging(SWI) on intracerebral hemorrhage(ICH). Methods Thirty-two ICH patients diagnosed by CT were examined by conventional MRI sequence and SWI scan. The display rate of lesion, distribution of cerebral microbleeds and volume of hemorrhage were evaluated according to those examinations. Results Seventy-five hemorrhagic focus were found out in 32 ICH patients. The positive rate of patients by MRI(TlWI and T2WI), Flair, SWI was 28.13%、65.63%、100%, respectively. And the relevance rate of ICH was 30.67%、45.33%and 100%.The positive rate and relevance rate by SWI was significantly higher than the other MR sequences(all P<0.05). The cerebral micmbleed lesions were found in 13 eases by SWI, and there were 25 cerebral micmbleeds in basal ganglia area, 5 in cerebella, 5 in brain stem, 3 in thalamus, 3 in cerebral codex. Conclusion SWI sequence is more sensitive than conventional MRI sequences to show intracerebral hemorrhage(ICH).There is great value for SWI in clinical application, and it is also a very important guide for clinical treatment.%目的:探讨MRI磁敏感加权成像(SWI)在脑出血中的应用价值。方法对32例经CT确诊的脑出血患者分别进行MRI常规序列及SWI扫描,并对各序列的出血灶显示率、微出血灶的检出率和分布进行评估。结果在32例脑出血患者中,共发现75处出血灶。常规MRI(T1WI和T2WI)、Flair和SWI序列对脑出血患者检出的阳性率分别为28.13%、65.63%和100%,而对出血灶的检出率分别为30.67%、45.33%和100%。SWI序列的阳性率和检出率均显著高于MRI其他常规序列(均P<0.05)。13例患者在SWI序列上发现微出血灶,其中基底节25处,小脑5处,脑干5处,丘脑3处,大脑皮质下3处。结论 SWI序列比常规MRI序列对显示脑出血更敏感,有很好的临床应用价值,且对临床治疗有重要指导意义。

  19. Acidente vascular cerebral hemorrágico associado à acidente ofídico por serpente do gênero bothrops: relato de caso Hemorrhagic stroke related to snakebite by bothrops genus: a case report

    Directory of Open Access Journals (Sweden)

    Amanda Silva Machado

    2010-10-01

    Full Text Available Este trabalho tem como objetivo relatar um caso de acidente vascular cerebral hemorrágico, associado à acidente ofídico por serpente do gênero bothrops e hipertensão arterial sistêmica grave. Apesar do ofidismo botrópico ser frequente no Estado do Pará, tais associações são incomuns, necessitando de uma abordagem especializada e precoce, visando menores complicações.This research reports a clinical case of hemorrhagic stroke due to envenomation by bothrops snakebite associated with severe hypertension. Although bothrops snakebites are frequent in the State of Pará, such associations are uncommon, requiring specialized and early management to avoid severe complications.

  20. Study on Correlation Between Interleukin - 6 Gene Polymorphism and Cerebral Hemorrhage%IL-6基因多态性与脑出血的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李拥军; 谷文萍; 陈瑞利; 聂晶晶; 曾学辉

    2012-01-01

    目的 分析IL-6基因- 634位点C/G替换单核苷酸多态性与脑出血的关系.方法 采用PCR和RFLP方法检测596例脑出血及335例正常对照者IL-6基因- 634位点多态性.结果 湖南汉族人群中,IL-6基因- 634位点存在GG、GC、CC基因型,其不同基因型频率及等位基因频率在脑出血组和对照组间差异无统计学意义(P>0.05).结论 中国湖南汉族人群中,IL-6 - 634C/G基因多态性可能与脑出血的发病无关.%Objective To analyze the correlation between IL - 6 - 634C/G gene polymorphism and cerebral hemorrhage (CH). Methods PCR and RFLP were used to detect IL - 6 - 634C/G polymorphism in 596 CH patients and 335 healthy controls. Results IL - 6 - 634C/G had GG, GC and CC genotypes in Hunan Hans. There was no statistically significant difference in the genotypes and alleles frequencies between CH patients and the controls (P > 0.05). Conclusions There may be no relationship between the IL- 6 - 634C/G gene polymorphism and cerebral hemorrhage in the Hunan Hans population.

  1. The Analysis of the Effect of Rehabilitation Strengthen Care to Cerebral Hemorrhage Patients with Hemiplegia%脑出血偏瘫患者加强康复护理的效果分析

    Institute of Scientific and Technical Information of China (English)

    曹丽; 杨巧巧

    2013-01-01

      目的:探讨在脑出血偏瘫患者住院期间加强康复护理的效果。方法:以我院2009年12月~2011年10月收治的84例脑出血偏瘫患者作为研究对象。随机将患者分为两组,对照组给予一般护理,实验组加强康复护理,观察比较两组患者的护理效果。结果:实验组患者生活质量明显优于对照组患者,P<0.05;实验组肌力明显优于对照组,P<0.05。结论:脑出血偏瘫患者加强康复护理有助于提高生活质量,改善肌力。%Objective:To investigate the effect of enhance rehabilitation care to cerebral hemorrhage hemiplegic patients during hospitalization. Methods:84 hemiplegic patients of cerebral hemorrhage admitted to hospital from December 2009 to October 2011 as research subjects. Patients were randomly divided into two groups, control group received general care, the experimental group gived enhance rehabilitation care,then compared the effect of the two groups. Results:The quality of life of experimental group patients was significantly better than control group patients, p<0.05;muscle strength of the experimental group better than the control group (p<0.05). Conclusion:The strengthen rehabilitation care to patients with hemiplegia.

  2. Assessment of Prealbumin on the Prognosis of Patients with Acute Cerebral Hemorrhage%前清蛋白对急性脑出血患者预后的评估

    Institute of Scientific and Technical Information of China (English)

    李基克; 李军; 郭志强; 徐朝; 蒋芬

    2011-01-01

    Objective To investigate the serum of patients with acute cerebral hemorrhage prealbumin (pre-albumin, PA) trends and the severity and prognosis. Methods Measurement of brain surgery from 2010 March to 2010 in Second Hospital of Armed Police Beijing Office in November among 122 patients with acute cerebral hemorrhage on admission and after first, 3,5,7 days PA level. According to the condition of patients with developmental outcomes and more after the differences,patients would be divided into death group (29 cases) ,and severe sequelae group (42 cases) ,mild sequelae group (51 cases), and for each PA value change tendency and the same time the various PA values were statistically analysed. Results With the extended hospital stay, the death group PA was statistically significant,and decreasing trend; severe sequelae of group PA was statistically significant,and showing the first fall after rise;mild sequelae of group PA was statistically significant, and presents the trend of escalation. The group PA value using paired t test was used to compare first days (P>0. 05) ,not statistically significant,3 ,5 and 7 days of mild sequelae of group PA>severe sequelae of group PA death group PA (P0.05,差异无统计学意义,第3,5,7天表现为轻度后遗症组PA值>重症后遗症组PA值>死亡组PA值,P<0.05差异有统计学意义.结论 PA水平在各组间的差异有统计学意义,急性脑出血患者PA值水平越低,预后越差.

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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

  4. Impact of internal and surgical therapy in rehabilitation ofhypertensive cerebral hemorrhage on the drape in middle-age and elderly population%内、外科治疗对中、老年幕上高血压脑出血患者康复效果的影响

    Institute of Scientific and Technical Information of China (English)

    刘宏利; 佟加恩; 关小宏; 张中东

    2002-01-01

    Objective To observe the impact of internal and surgical therapy in prognosis of hypertensive cerebral hemorrhage on the drape in the middle-age and elders.Method According to amount of hemorrhage,740 patients with hypertensive cerebral hemorrhage on the drape were divided into 3 groups .Then,according to age and therapeutic methods,each group was divided into 4 groups. The mortality and clinical neurologic impairment socre after 3-month follow up were compared between groups.Result Mortality of internal middle-age and mild group were lower as compared with that of old-age group .Mortality and neurological impairment score of surgical middle-age group and moderate group were lower than those of internal middle-age and surgical old-age group.There was no significant difference in mortality between internal old-age and surgical groups.Neurological impairment scores of medicine groups were lower than those of surgey groups.Mortality and neurological impairment score of severe group,middle-age medicine and surgery groups were lower than those of old-age groups.Mortality and neurological impairment score of middl and old-age surgery groups were lower than those of internal groups.Conclusion Internal therapy is effective in treating mild to moderate hypertensive cerebral hemorrhage on the drape in elders.For other patients,surgical treatment is suggested.

  5. 人工鼻在脑出血气管切开患者气道湿化中的应用%Application of airway humidification of artificial nose on tracheal incision after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    刘慧

    2012-01-01

    目的 探讨人工鼻在脑出血气管切开患者气道湿化中的应用效果.方法 选择脑出血行气管切开患者126例,随机分为对照组和观察组,每组各63例.对照组采取常规气道湿化护理,观察组采用人工鼻进行气道湿化.观察两组患者的每天吸痰次数、排痰量及肺部感染和痰痂发生情况.结果 观察组患者每天排痰量、吸痰次数及肺部感染及痰痂发生率均较对照组低,治疗效果优子对照组,两组比较,均P<0.05,差异具有统计学意义.结论 采用人工鼻对脑出血气管切开患者的气道进行湿化,对减少并发症的发生,提高治疗效果具有积极意义.%Objective To investigate the clinical efficacy of airway humidification of artificial nasal tracheal in patients with cerebral hemorrhage. Methods 126 cases of tracheotomy patients after cerebral hemorrhage were randomly divided into the control and treatment group equally. Control group took regular treatment of continued humidification while treatment group were treated with artificial nasal airway humidification. After treatment, the number of daily suction in the two groups, daily sputum volume, occurrence of pulmonary infection and sputum were recorded. Results There were significant differences between the two groups (all P < 0.05). Using artificial nasal airway humidification can reduce sputum volume, suction times, pulmonary infection and incidence of sputum formation. The treatment group had higher efficiency than the control group (P < 0.05). Conclusion Artificial nose can be an effective treatment for intracerebral hemorrhage patients with tracheotomy on airway humidification and also can reduce the incidence of complications.

  6. 脑梗死后自发性出血转化及其影像学评价%Spontaneous Hemorrhagic Transformation After Cerebral Infarction and Its Imaging Assessment

    Institute of Scientific and Technical Information of China (English)

    杨飞; 刘怀军; 杨冀萍

    2008-01-01

    The research of hemorrhagic transformation (HT) after cerebral infarction is now focus on HT after thrombolytic therapy. However, attention should also be aroused to the occurrence of spontaneous HT in most patients who cannot receive thrombolysis promptly because of various reasons, for it has important influence on the treatment of cerebral infarction and prognosis. This article reviews the concept, typing, pathogenesis, correlation factors, imaging diagnosis and prediction of HT, as well as the effects of non-thrombolytic therapies on HT, such as antiplatelet, defibrase, anticoagulant, anti-free radical, and the relations between HT typing and prognosis.%脑梗死后出血性转化(HT)的研究目前多关注于溶栓治疗后HT.但是,对大多数因各种原因未能及时行溶栓治疗而发生的自发性HT亦应引起关注,因其对脑梗死的治疗和预后具有重要影响.文章对HT的概念、分型、发病机制、相关因素、影像学诊断和预测,以及抗血小板、降纤、抗凝、抗自由基等非溶栓疗法对HT的影响,HT分型与预后的关系等进行了综述.

  7. Imaging the future of stroke: II. Hemorrhage.

    Science.gov (United States)

    Liebeskind, David S

    2010-11-01

    Bleeding into the brain or adjacent structures is one of the most devastating neurological conditions, incurring tremendous emotional, financial, and societal costs. Imaging is essential to differentiate variants of hemorrhage, as the clinical features may be insufficient. A comprehensive approach to hemorrhage therefore relies on imaging to disclose pathophysiology, elucidate mechanisms, and thereby open further avenues to effective treatment. Hemorrhage patterns from superficial to deep locations in the brain are surveyed in this work, noting myriad potential causes and the influential pathophysiology of arterial ischemia, venous hypertension, and microvascular dysfunction. Recent progress of imaging studies and novel techniques to evaluate hemorrhage are explored. For decades, only computed tomography was available to define a hematoma without corroborating evidence of other pathology whereas multimodal computed tomography and magnetic resonance imaging, including noninvasive imaging of brain tissue, vessels, and perfusion, have now radically altered clinical practice. Imaging of the blood-brain barrier, cerebral microbleeds, coexistent ischemia, associated vascular lesions, and markers of hemorrhage expansion is possible with routine protocols akin to diagnostic strategies for ischemic stroke. Imaging applications for hemorrhagic transformation, venous thrombosis, and microvascular disorders are considered with a perspective that balances concern for hemorrhage with prevention of ischemia as these processes are often intertwined and clinical conundrums arise. Imminent imaging advances are anticipated with increased use of detailed imaging for hemorrhage and overlap with cerebral ischemia. Numerous questions abound regarding optimal management of hemorrhage and definitive treatments are lacking, yet imaging of pivotal pathophysiology offers tremendous opportunity for future progress in combating this debilitating condition.

  8. Regulation of microRNAs miR-30a and miR-143 in cerebral vasculature after experimental subarachnoid hemorrhage in rats

    DEFF Research Database (Denmark)

    Müller, Anne Holt; Povlsen, Gro Klitgaard; Edvinsson, Lars;

    2015-01-01

    in cerebral arteries post-SAH. Two miRNAs, miR-30a and miR-143, were significantly upregulated in cerebral arteries after SAH when compared to sham-operated animals. However, none of these exhibited significantly altered serum levels after SAH versus post-sham surgery. The most robust upregulation was seen...... for miR-143, which has several predicted targets and is a strong regulator of vascular morphology. We hypothesize that miR-30a and miR-143 may play a role in the vascular wall changes seen after SAH. CONCLUSIONS: We report that miR-30a and miR-143 in the cerebral arteries show significant changes over...

  9. Equal contribution of increased intracranial pressure and subarachnoid blood to cerebral blood flow reduction and receptor upregulation after subarachnoid hemorrhage. Laboratory investigation

    DEFF Research Database (Denmark)

    Ansar, Saema; Edvinsson, Lars

    2009-01-01

    ) the same procedure but without fluid injection (Sham Group). Two days after the procedure, the basilar and middle cerebral arteries were harvested, and contractile responses to endothelin (ET)-1 and 5-carboxamidotryptamine (5-CT) were investigated by means of myography. In addition, real-time polymerase...... chain reaction was used to determine the mRNA levels for ET(A), ET(B), and 5-HT(1) receptors. Regional and global cerebral blood flow (CBF) were quantified by means of an autoradiographic technique. RESULTS: Compared with the sham condition, both SAH and saline injection resulted in significantly...

  10. Biological markers of cerebral vasospasm after subarachnoid hemorrhage%蛛网膜下腔出血后脑血管痉挛的生物学标记物

    Institute of Scientific and Technical Information of China (English)

    吕涛; 张晓华

    2015-01-01

    Cerebralvasospasmisthemostcommonandmostdangerouscomplicationofsubarachnoid hemorrhage (SAH). If it can not be diagnosed and treated early, it w il result in delayed cerebral ischemia and delayed ischemic neurological deficits, and seriously affect the outcomes of patients. SAH can cause oxidative stress and inflammation, causing vasospasm, and leading to brain tissue damage. Numerous studies have show n that the concentrations and activities of numerous metabolites w il change in these pathological physiological processes. Identification of the changes of location, time and trend of these markers has important clinical significance for investigating the mechanism of cerebral vasospasm after SAH and seeking better therapeutic targets. This article review s the molecular markers of cerebral vasospasm after SAH.%脑血管痉挛是蛛网膜下腔出血(subarachnoidhemorrhage,SAH)最常见和最凶险的并发症,如果不能早期诊断和治疗,将会造成迟发性脑缺血和迟发性缺血性神经功能缺损,严重影响患者的转归。 S AH会造成氧化应激和炎症反应,引发血管痉挛,进而导致脑组织损伤。很多研究显示,这些病理生理学过程中多种代谢产物浓度或活性会发生改变,明确这些标记物发生变化的部位、时间和趋势,对于探讨S AH后脑血管痉挛的发生机制和寻找更佳的治疗靶点具有重要临床意义。文章对S AH后脑血管痉挛的生物学标记物进行了综述。

  11. The relation between long-term alcohol and hypertensive cerebral hemorrhage surgical prognosis%长期饮酒与高血压脑出血手术预后相关性分析

    Institute of Scientific and Technical Information of China (English)

    贾浩; 黄纯海; 朱英杰; 向昌华; 周桂林; 向顺明; 田志

    2012-01-01

    Objective To investigate the relation between long -term alcohol and hypertensive cerebral hemorrhage surgical prognosis. Methods 120 patients with hypertensive intracerebral hemorrhage were divided into treatment group of 40 cases and control group of 80 cases accorded to alcohol consumption,, the treatment group were had a long history of drinking alcohol, and the control group were never drink alcohol or even a little alcohol, two groups were treated by surgery. Results After the observation, the effectiveness of the treatment group were lower than the control group, the mortality was higher than that in the control group (P< 0.05). after 3 days, 14 days and 28 days, the cerebral edema volume of the treatment group were significantly more than control group (P<0.05). The postoperative bleeding, pneumonia and renal failure of the treatment were significantly higher than the control group (P<0.05). Conclusion Long-term alcohol consumption can reduce the effectiveness of surgical treatment of hypertensive cerebral hemorrhage, and increase postoperative complications, relieve cerebral edema narrow changes, we should take early measures to adopt comprehensive measures to promote patients to limit alcohol abstinence, and improve patients' quality of life.%目的:探讨高血压脑出血手术预后与长期饮酒相关性.方法:120例高血压脑出血病人根据饮酒情况分为治疗组40例与对照组80例,治疗组有长期饮酒史,对照组从不饮酒或偶少许饮酒,两组所有患者都采用手术治疗.结果:经过观察,治疗组的有效率显著低于对照组,病死率显著高于对照组义(P<0.05).治疗组在术后3天、14天与28天脑水肿体积明显多于对照组(P<0.05).治疗组术后再出血、肺炎与肾功能衰竭发生率明显高于对照组(P<0.05).结论:长期饮酒能够降低高血压脑出血手术疗效,提高术后并发症,缓解脑水肿缩小变化.故应尽早采取措施,采取综合措施促使患者限

  12. Clinical Research of Reoperation Reasons for Hypertension Cerebral Hemorrhage%高血压性脑出血术后再手术原因的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋明浩; 李志祥; 马文斌

    2012-01-01

    目的 对高血压性脑出血术后再手术的原因进行临床研究,为以后的临床工作提供理论及实践依据. 方法 回顾性分析我院自2002年2月~2011年6月所有因高血压性脑出血行手术治疗213例,其中因各种原因再次手术治疗36例的临床资料. 结果 因颅内再出血再次行手术治疗29例,因大面积脑梗塞再次行手术治疗7例.再出血再手术组患者的GOS结果提示,Ⅰ~Ⅲ级者明显多于再出血未再手术组,差异有显著统计学意义(P<0.01);GOSⅣ者差异无统计学意义(P>0.05);GOSV级者明显少于未再手术组,差异有显著统计学意义(P<0.01).脑梗塞再手术组患者的GOS结果提示,Ⅰ~Ⅲ级明显多于脑梗塞未再手术组,差异有统计学意义(P<0.05);GOSⅣ级者,差异无统计学意义(P>0.05);GOSⅤ级者明显少于未再手术组,差异有显著统计学意义(P<0.05). 结论 术前认真评估患者的整体状况,手术切口的选择,手术的规范化操作,术中及术后规范化治疗以及避免医源性损伤都是防止因再出血和脑梗塞而再手术的关键.%Objective To explore the reoperation causes for hypertensive cerebral hemorrhage, so as to provide theoretical and practical basis for the future clinical work. Method The clinical data of 36 patients with reoperation out of 213 patients who received surgical operation for hypertension cerebral hemorrhage in our hospital from February 2002 to June 2011 were reviewed and analyzed. Results There were 29 cases of rebleeding and 7 cases with a large area of cerebral infarct received reoperation. In the reoperation group of rebleeding patients, the rate of I ~ III GOS stage was obviously higher than the non-reoperation group ( P 0. 05 ). And the rate of V stage was much lower ( P 0. 05). And the rate of V stage was much lower( P < 0. 05). Conclusion Careful evaluation of the overall condition, suitable surgical incision, standardized operation and

  13. 水分离技术在治疗高血压脑出血中的应用%Application of water jet dissection technique in the treatment of hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王宏; 汪平; 闫锐; 王安生; 张世荣; 张胡金; 杨彦平; 王波; 章翔

    2013-01-01

    目的 探讨水分离技术在经侧裂-岛叶手术治疗基底节区高血压脑出血中的应用及效果.方法 对42例应用水分离技术经侧裂-岛叶入路显微手术治疗的基底节区高血压脑出血患者的临床资料进行回顾性分析.结果 42例患者均术后24h内行CT扫描,38例血肿清除完全,4例血肿少量残留,术后存活40例,死亡2例.存活40例患者均随访3月以上,ADL评分为Ⅰ级13例,Ⅱ级15例,Ⅲ级9例,Ⅳ级2例,Ⅴ级1例.结论 水分离技术是一种安全简便的分离技术,在经侧裂-岛叶清除基底节区高血压脑出血中能很好帮助解剖侧裂和清除血肿,且对脑组织损伤小、血肿清除彻底、神经功能恢复好.%Objective To study the application and effect of water jet dissection technique in microsurgical treatment of hypertensive cerebral hemorrhage via transsylvian transinsular approach.Methods The clinical data of 42 patients with hypertensive cerebral hemorrhage in the basal ganglia who accepted microsurgical treatment via transsylvian transinsular approach by water jet dissection technique were analyzed retrospectively.Results Postoperative CT within 24 h was performed in 42 cases,which showed that the hematomas were evacuated totally in 38 cases and a small amount of residual in 4 cases.Forty cases survived and 2 cases died after operation.All 40 survived cases were followed up for more than 3 months.According to the activity of daily living,there were 13 cases ofgradeⅠ,15 cases of grade Ⅱ,9 cases of grade Ⅲ,2 cases of grade Ⅳ,and 1 case of grade Ⅴ.Conclusion The water jet dissection technique can be applied very simply and safely,which is effective for opening the sylvian fissure and removing hematoma on hypertensive cerebral hemorrhage in the basal ganglia via transsylvian transinsular approach,which it is characterized by minimal cerebral injury,high removal rate and good function recovery.

  14. MR imaging of acute hemorrhagic brain infarction

    International Nuclear Information System (INIS)

    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)

  15. MR imaging of acute hemorrhagic brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    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).

  16. Hemorrhagic Chickenpox

    Directory of Open Access Journals (Sweden)

    sengupta B

    1995-01-01

    Full Text Available A case of chickenpox in a boy of 16 years is described for its uncommon presentation with hemorrhagic vesicles, gum-bleeding without being preceded by any prodromal symptom and unassociated with any immunosuppressive disorder.

  17. Subtype activation and interaction of protein kinase C and mitogen-activated protein kinase controlling receptor expression in cerebral arteries and microvessels after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, S.; Edvinsson, L.

    2008-01-01

    ischemia after SAH in cerebral arteries and microvessels and to examine temporal activation of the kinases. We hypothesize that treatment with a MAPK or PKC inhibitor will prevent the SAH-induced kinase activation in brain vessels. METHODS: SAH was induced by injecting 250 microL blood...

  18. Statins and cerebral hemodynamics

    Science.gov (United States)

    Giannopoulos, Sotirios; Katsanos, Aristeidis H; Tsivgoulis, Georgios; Marshall, Randolph S

    2012-01-01

    HMG-CoA reductase inhibitors (statins) are associated with improved stroke outcome. This observation has been attributed in part to the palliative effect of statins on cerebral hemodynamics and cerebral autoregulation (CA), which are mediated mainly through the upregulation of endothelium nitric oxide synthase (eNOS). Several animal studies indicate that statin pretreatment enhances cerebral blood flow after ischemic stroke, although this finding is not further supported in clinical settings. Cerebral vasomotor reactivity, however, is significantly improved after long-term statin administration in most patients with severe small vessel disease, aneurysmal subarachnoid hemorrhage, or impaired baseline CA. PMID:22929438

  19. Remote multiple intracranial hemorrhage in multiple metastatic lung adenocarcinoma following decompression of posterior fossa lesion: Unknown cause

    Directory of Open Access Journals (Sweden)

    Subhas Konar

    2015-01-01

    Full Text Available Cerebral metastasis can present with hemorrhage. However, multiple hemorrhages in metastatic lesions following surgical decompression of a single lesion are never reported. We report a case of cerebral metastasis from lung cancer that developed multiple hemorrhages in supratentorial metastatic lesions following surgical resection of an infratentorial lesion.

  20. Supernova hemorrhage: obliterative hemorrhage of brain arteriovenous malformations following γ knife radiosurgery.

    Science.gov (United States)

    Alexander, Matthew D; Hetts, Steven W; Young, William L; Halbach, Van V; Dowd, Christopher F; Higashida, Randall T; English, Joey D

    2012-09-01

    Hemorrhage represents the most feared complication of cerebral arteriovenous malformations (AVMs) in both untreated patients and those treated with gamma knife radiosurgery. Radiosurgery does not immediately lead to obliteration of the malformation, which often does not occur until years following treatment. Post-obliteration hemorrhage is rare, occurring months to years after radiosurgery, and has been associated with residual or recurrent AVM despite prior apparent nidus elimination. Three cases are reported of delayed intracranial hemorrhage in patients with cerebral AVMs treated with radiosurgery in which no residual AVM was found on catheter angiography at the time of delayed post-treatment hemorrhage. That the pathophysiology of these hemorrhages involves progressive venous outflow occlusion is speculated and the possible mechanistic link to subsequent vascular rupture is discussed. PMID:21990534

  1. Infarto cerebral hemorrágico por embolización de un trombo mural cardíaco Hemorrhagic cerebral infarction due to embolization of a mural thrombus within the right ventricle

    OpenAIRE

    Marín, R; Rico, A.; Blanco, M.; E. Barrero; I. Manresa; Santos, M.; J. Lucena

    2008-01-01

    Las enfermedades cerebrovasculares son consecuencia de una alteración en la circulación cerebral. Su forma más distintiva de presentación es el ictus, entendido como un déficit neurológico focal de instauración brusca y evolución rápida. Un infarto cerebral de origen oclusivo puede deberse bien a una trombosis in situ o bien a una embolia procedente de un foco distante. En las embolias cerebrales la causa principal son los trombos murales cardiacos y el área encefálica afectada con mayor frec...

  2. 优质护理在高血压脑出血患者健康教育中的实施%The Effect of High Quality Nursing in Health Education for Patients with Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    汪文英; 王银娥; 徐云侠; 张晓珍

    2012-01-01

    Objective To investigate the effect of high quality nursing in health education for patients with hypertensive cerebral hemorrhage. Methods 50 patients with hypertensive cerebral hemorrhage were randomly divided into trial group and control group according to method of nursing care,general data of the patients were similar. All patients were treated with neurologic conservative treatment. Patients in the trial group received high quality nursing of " work contracted to households" nursing model while patients in the control group received traditional " Flow Shop" holistic Nursing. Results The clinic data of the patients in each group was collected and analyzez. Degree of satisfaction,taking medicine on time,understanding of the disease,compliance to recovery exercise etc in trial group were significantly better than those in control group( P <0.01) .there was significant difference between two groups. Conclusion The usage of high quality nursing in nursing work for patients with hypertensive cerebral hemorrhage can heighten patient's confidence to triumph over diseases,improve patient' s abilities of self management,compliance and degree of satisfaction,and promote patient's rehabilitation. This method had great value in clinical application.%目的 探讨优质护理在高血压脑出血患者健康教育中的效果.方法 将50例高血压脑出血患者按护理方法随机分为观察组和对照组,各组患者一般资料相似.所有患者均采用神经内科保守治疗,在高血压性脑出血患者的护理中,实验组采取包床到护理的优质护理;对照组采用传统的流程式整体护理.结果 对实验组和观察组两组各患者的临床数据进行收集、统计.实验组的患者对护士满意程度、按时服药情况、对病情的了解程度、对康复锻炼的依从性等各方面均优于对照组(P<0.01),差异有统计学意义.结论 优质护理应用于高血压性脑出血患者的护理工作中,增强了患者

  3. 醒脑静注射液治疗急性脑出血30例疗效观察%Observation of Xingnaojing injection for treatment of acute cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    林蓉芳

    2011-01-01

    Objective To report the effect of Xingnaojing injection for recovery of consciousness, neurological deficit scores in patients with acute cerebral hemorrhage. Methods 60 cases of acute cerebral hemorrhage were randomly divided into two groups. Patients in control group ( n =30) received conventional western medicine. Patients in treatment group ( n =30) received Xingnaojing injection. The course was 14 days in two groups. Recovery of consciousness before and a week after treatment was evaluated by Glasgow coma in two groups ( GCS). Neurologic impairment score was carried on by NIHSS for evaluation of clinical effect. Results GCS score a week after treatment were significantly increased in comparison with those before treatment in two groups ( P <,0. 05 ) , and that of the treatment group was higher than that in control group ( P < 0. 05 ) . NIHSS after treatment was significantly decreased in comparison with that before treatment in two groups ( P <0. 05) , and NIHSS in the treatment group was lower than that in the control group ( P <0. 05 ). Treatment group was 93. 3% , control group was 73. 3% , 2 group, the total effective rate in treatment group (93. 3%) was significantly higher than that in control group (73. 3% , P < 0. 05 ) . Conclusion Xingnaojing injection can significantly improve impairment of neurological function in patients with acute cerebral hemorrhage impairment, reduce duration of coma, promote restoring consciousness and has obvious effect, the method is worthy of clinical application.%目的 观察醒脑静注射液对急性脑出血患者意识障碍恢复情况、神经功能缺损情况的影响及临床疗效.方法 将60例急性脑出血患者随机分为2组,对照组30例予西医常规治疗,治疗组30例在对照组治疗基础上予醒脑静注射液静脉滴注,2组均连续用药14 d.采用格拉斯哥昏迷意识量表(glasgow coma,GCS)评定2组治疗前及治疗后1周意识障碍恢复情况.2组治疗前后神经功能缺损

  4. Effect of Microinvasive Aspiration and Drainage of Intracranial Hematoma in the Treatment of Cerebral Hemorrhage%脑出血应用微创颅内血肿抽吸引流术治疗的效果探讨

    Institute of Scientific and Technical Information of China (English)

    陈容

    2016-01-01

    Objective To explore the clinical effect of microinvasive aspiration and drainage of intracranial hematoma in the treatment of cerebral hemorrhage. Methods 80 cases with cerebral hemorrhage admitted in our hospital from January 2014 to June 2015 were selected as the subjects and randomly divided into two groups with 40 cases in each. Patients in the con-trol group were treated by medical conservative treatment, and those in the experimental group were treated by microinva-sive aspiration and drainage of intracranial hematoma. And the treatment effect was evaluated by comparing the values of indexes of the two groups. Results The treatment results showed that the total effective rate of the experimental group was significantly higher than that of the control group (P<0.05). The experimental group had significantly lower incidence of complications than the control group (P<0.05). The conscious disturbance scores and nerve function impairment scores were significantly better than those before treatment in both groups, and the conscious disturbance scores and nerve function im-pairment scores were significantly better in the experimental group than in the control group (P<0.05). Conclusion Microin-vasive aspiration and drainage of intracranial hematoma has good overall clinical effect on cerebral hemorrhage, which can significantly improve the symptoms of neurological deficit and the state of consciousness, so it is suitable for wide clinical application.%目的:对脑出血应用微创颅内血肿抽吸引流术治疗的临床效果进行探讨。方法整群选取该院于2014年1月—2015年6月接收的80例脑出血患者为研究对象,将所有患者随机将其分为两组,各40例。其中对照组患者采取内科保守进行干预,而实验组患者采取微创颅内血肿抽吸引流术治疗,在治疗结束后通过比较两组患者的各项指标,评价治疗效果。结果治疗结果表明,实验组患者的治疗总有效率明显高

  5. Clinical Analysis of the Blood Glucose level and Prognosis in Patients with Acute Cerebral Hemorrhage%脑出血急性患者血糖水平与预后临床分析

    Institute of Scientific and Technical Information of China (English)

    张新慧

    2014-01-01

    目的:探究急性脑出血患者的血糖水平与预后的关系。方法选取我院近三年收治的急性脑出血患者82例,根据患者入院时空腹血糖水平,将患者分为血糖正常组28例、高血糖组27例和重度高血糖组27例,采用美国国立卫生研究所卒中量表(niHss)和 BartHel(Bi)指数对患者入院时及入院三周后进行评价,并作数据分析。结果入院时三组脑出血急性患者的 niHss 评分与 Bi 指数均无明显差异,入院三周后血糖正常组和高血糖组的 niHss 评分明显低于重度高血糖组,Bi 指数明显高于重度血糖组,组间差异具有显著性(p<0.05);入院三周后,血糖正常组和高血糖组的 niHss 评分较入院时均明显降低,Bi 指数明显升高,组间差异具有统计学意义(p<0.05);而重度高血糖组的niHss 评分与 Bi 指数均较入院时无明显改变。结论急性脑出血患者的早期血糖水平越高,患者预后越差,故患者早期血糖水平对于估计预后具有一定参考价值。%Objective to investigate the relationship between blood glucose level and prognosis in patients with acute cerebral hemorrhage. Methods eighty-two patients with acute cerebral hemorrhage were chosen who were treated in our hospital in the last three years. all patients were divided into normal blood glucose group(n=28), high blood glucose group(n=27) and severe high blood glucose group(n=27) according to the fasting blood glucose concentration on admission. and the scores of national institute of Health stroke scale(niHss) and Barthel(Bi)index on admission and at three weeks were assessed and also were statistically analyzed. Results There were no significant differences in NIHSS scores and BI index among three groups on admission, but after three weeks, the NIHSS scores in the first two groups were significantly lower than the severe high blood glucose group and the BI index in these two groups were

  6. 艾司洛尔联合硝酸甘油在高血压脑出血术中的应用研究%CLINICAL STUDY ON NITROGLYCERIN COMBINED WITH ESMOLOL IN HYPERTENSIVE CEREBRAL HEMORRHAGE SURGERY

    Institute of Scientific and Technical Information of China (English)

    李艳丽; 何光范; 汪友平; 陈伟锋

    2014-01-01

    目的:探讨艾司洛尔联合硝酸甘油在高血压脑出血术中的应用。方法将72例急诊脑出血手术(入选标准为SBP≥200 mmHg)的患者随机分为A、B组,A组(n=36)为艾司洛尔联合硝酸甘油;B组(n=36)硝酸甘油组。观察分析A、B组患者血流动力学、术中出血及麻醉时间。结果两组MAP与同组T0相比较T1、T2、T3均明显降低(p<0.05),A组与B组MAP在各时点间比较无统计学差异。 B 组 HR 在 T1、T2、T3较 T0时点明显增快(p <0.05),A组T2、T3、T4心率较T0时点明显减低(p<0.05);A组T1、T2、T3、T4时点HR较B组同时点降低(p<0.01)。结论艾司洛尔联合硝酸甘油对高血压脑出血手术干预有一定优势。%Objective To explore the application of nitroglycerin combined with esmolol in hypertensive cerebral hemorrhage surgery.Methods 72 patients undergoing emergency surgery for cerebral hemorrhage ( inclusion criteria: SBP≥200 mmHg) were randomly divided into two groups (Group A and Group B).Nitroglycerin combined with esmolol was used in Group A (n=36); nitroglycerin was used in Group B (n=36).Hemodynamics, the intraoperative blood loss and the duration of anesthesia in patients in Group A and Group B were observed and statistically analyzed .Results Compared to T0, MAP in both two groups at T1, T2 and T3 were decreased significantly (p<0.05).There were no significant differences between Group A and Group B in MAP at any time points.Compared to T0 , HR at T1 , T2 and T3 in Group B were increased significantly (p<0.05), while HR at T2, T3 and T4 in Group A were decreased significantly (p<0.05).HR at T1,T2, T3 and T4 in Group A were lower than those in Group B (p<0.01).Conclusion Nitroglycerin combined with esmolol on inter-vention for hypertensive cerebral hemorrhage surgery has certain advantages.

  7. 老年脑出血患者早期康复治疗效果的系统评价%A systematic review of the effect of early rehabilitative therapy for patients with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    周婷; 张莉; 贺建湘; 李大芬; 肖燕; 冯翼

    2015-01-01

    目的:系统评价老年脑出血患者早期康复的效果。方法计算机检索中国期刊全文数据库(CNKI)、维普信息资源系统(VIP)、万方数据资源系统、中国生物医学文献数据库(CBM )(均从建库至2014年10月),并手工检索同期老年脑出血患者早期康复效果的相关灰色文献。按纳入与排除标准独立筛选文献、提取资料,采用 Rev‐M an 5.1软件进行 M eta分析。结果纳入7个研究共711例患者,其中早期康复组369例,传统组342例。M eta分析结果显示:早期康复能提高老年脑出血患者日常生活能力[MD=10.64,95% CI(10.10,11.17),Z=39.13,P<0.00001],肢体运动功能[MD=10.77,95% CI(7.39,14.15),Z=6.25,P<0.00001]。结论老年脑出血患者通过早期康复,能促进日常生活能力,改善肢体运动功能,提高生活质量。%Objective To systematically review the effect of early rehabilitative therapy for patients with cerebral hemorrhage .Method we electronically searched in China National Knowledge Infrastruct‐ure (CNKI) ,Chinese Sci‐ence Technology Periodical Databases(VIP) ,WanFang Database ,China Biology Medicine disc(CBM) for studies the effect of early rehabilitative therapy for patients with cerebral hemorrhage from inception to October 2014 .The Rev‐Man 5 .1 software was used for meta analysis .Result 711 patients with cerebral hemorrhage were investigated .Meta analysis showed that the scores of Fugl‐Meyer[MD=10 .77 ,95% CI(7 .39 ,14 .15) ,Z=6 .25 ,P<0 .00001]and Bar‐thel MD= 10 .64 ,95% CI(10 .10 ,11 .17) ,Z= 39 .13 ,P< 0 .00001〗were significantly higher in the rehabilitation group than in control group .Conclusion Early rehabilitative intervention therapy can be effective in improving life a‐bility and motor function so that it enhances quality of life .

  8. 院前急救护理对脑出血患者预后质量的临床影响分析%Clinical Influence of Prognosis of Pre-hospital Emergency Care on Patients with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    蒙敏华

    2015-01-01

    目的:探究院前急救护理对于脑出血患者预后质量的临床效果,并分析其作用价值。方法:选取2013年1月-2014年12月笔者所在医院收治的急救脑出血患者82例,按照随机数字表法将其分为对照组和观察组,每组41例。对照组患者未采取院前急救护理,而观察组患者采取院前急救护理,统计两组患者的治疗结果和并发症情况。结果:对照组患者治疗的总有效率为70.73%,12例患者出现并发症,观察组患者治疗的总有效率为92.68%,4例患者出现并发症,即观察组的总体有效率明显要高于对照组,并发症例数少于对照组,差异有统计学意义(P<0.05)。结论:院前急救护理对于脑出血患者预后质量影响显著,能够明显改善患者的治疗结果,降低并发症的发生率,适合在临床上推广使用,应引起广大医学卫生工作者的关注。%Objective:To explore the clinical influence on prognosis of pre-hospital emergency care of patients with cerebral hemorrhage,and analyze its function value.Method:82 patients with emergency cerebral hemorrhage from January 2013 to December 2014 in our hospital were selected, they were randomly divided into the control group and the observation group,41 cases in each group.Patients in the control group did not take pre-hospital emergency care,the observation group was given pre-hospital emergency care,counted treatment results and complications of two groups. Result:The treatment effective rate of the Control group was 70.73%,12 patients occurred complications,the total effective rate of the observation group was 92.68%,4 patients occurred complications,the total effective rate of the observation group was significantly higher than that of the control group, complications were less than that of the control group,the differences were statistically significant(P<0.05).Conclusion:Pre-hospital emergency care can significantly improvement prognosis

  9. Management Treatment of Naloxone in Treatment of 87 Patients with Cere-bral Hemorrhage Treatment%纳洛酮治疗管理脑出血87例分析

    Institute of Scientific and Technical Information of China (English)

    曹栋

    2015-01-01

    Objective To explore the clinical curative effect of naloxone on cerebral hemorrhage. Methods 87 cases pa-tients with cerebral hemorrhage patients in our hospital were selected as the research object, and all patients were randomly divided into treatment group (44 cases) and control group (43 cases), the 87 patients are discretionary given dehydration treatment, anti-infection, nutrition nerves and regulate blood pressure treatment. On the basis of the above treatment,the treatment group combined with 1.2 mg naloxone to treat, 2 times/d intravenous drip, a course of treatment was 14 d, in total 2 course. Compared nerve function defect grade and the change of the Glasgow coma scale of 87 patients before and after treatment, at the same time, regained consciousness between the two groups were compared. Results The neural function defect score of treatment group was obviously lower than the control group, and Glasgow coma scale of which was signifi-cantly higher than the control group, regain consciousness time shorter than the control group, the total effective rate of treatment group was 90.91%, which was significantly higher than the 72.09% in the control group, the difference was statis-tically significant (P< 0.05). Conclusion The clinical curative effect of Naloxone in treatment of cerebral hemorrhage was satisfied, which could improve the patient's nerve function defect degree, and promoting the recovery of patients with con-sciousness.%目的:探讨使用纳洛酮治疗脑出血的临床管理疗效。方法选取该院收治的87例脑出血患者作为研究对象,随机分为治疗组44例和对照组43例,所有的87例患者均酌情给予脱水治疗、抗感染、营养神经、调控血压等治疗,治疗组在以上治疗的基础上加用纳洛酮1.2 mg,2次/d静脉滴注,每治疗14 d作为1个疗程,一共观察2个疗程。对比87例患者治疗前后神经功能缺损评分、Glasgow昏迷评分的变化,同时比较两组患者的恢复意

  10. 亚低温治疗急性脑出血的临床疗效观察%Observation of the clinical effect of mild hypothermia on acute cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张鹏; 陈润青; 甄明清; 李梅

    2014-01-01

    Objective:To explore the clinical effect of mild hypothermia on acute cerebral hemorrhage.Methods:112 cases with acute cerebral hemorrhage were selected from February 2010 to February 2014.They were divided into the observation group and the control group with 56 cases in each group according to the order of admission.The two groups were given routine therapy,and the observation group were treated with mild hypothermia therapy on the basis of that.We compared the improvement of clinical symptoms,glass coma score(GCS),neural function defect score(ESS) after treatment of the two groups.Results:After treatment, symptoms of two groups were improved,but the observation group was better than the control group.The difference was statistically significant(P<0.05).Before treatment,there was no significant difference between two groups in GCS,ESS score.30 days after treatment,the observation group was superior to the control group,and the difference was statistically significant(P<0.05). Conclusion:Compared with conventional drug therapy,mild hypothermia therapy can effectively improve the clinical symptoms in patients with acute cerebral hemorrhage,relieve the coma and nerve function injury,reduce the duration of disturbance of consciousness,and improve the ability of life.%目的:探讨亚低温治疗急性脑出血的临床疗效。方法:2010年2月-2014年2月收治急性脑出血患者112例,按入院顺序分为观察组和对照组,各56例。两组均给予常规药物治疗,观察组在此基础上采用亚低温联合治疗。对比治疗后两组临床症状改善情况、格拉斯昏迷程度评分(GCS)、神经功能缺损程度评分(ESS)。结果:治疗后两组症状均有所改善,但观察组较对照组改善明显,差异有统计学意义(P<0.05);治疗前两组GCS、ESS评分无显著差异,治疗30 d后观察组评分均优于对照组,差异有统计学意义(P<0.05)。结论:亚低温治疗较常规药物治疗能有效

  11. Acupuncture combined with therapeutic equipment on dysphagic patients with cerebral hemorrhage%针刺结合吞咽障碍治疗仪治疗脑出血后吞咽障碍

    Institute of Scientific and Technical Information of China (English)

    马金娜; 秦晓勇; 王再岭; 王智达; 熊杰

    2015-01-01

    Objective The research aims to observe the clinical effect of acupuncture combined treatment with a therapeutic equipment on dysphagic patients after cerebral hemorrhage .Methods The 50 dysphagic patients with cerebral hemorrhage were selected and randomly divided into acupuncture group and acupuncture combined with therapeutic equipment group (combination group for short ) ,25 cases in each group .The patients in acupuncture group were given acupuncture treatment , and the patients in combination group were given acupuncture treatment in combination with therapeutic equipment .14 days after treatment ,watian drinking water experiment ,and the dysphagia scale were used to evaluate the therapeutic effect .Re-sults After the treatment ,swallowing function of the patients in two groups was significantly improved ( P<0 .01 ) ,the score difference among the two groups is statistical significance from the score of combination group ( P<0 .01 ) ,effective-ness of combination group (96 .0% )was higher than that of acupuncture group (88 .0% ) ( P<0 .05 ) .Conclusion Acupuncture combined with swallowing treatment apparatus can modify swallowing muscle movement disorders through irri-tating throat ,then realize the recovery and reconstruction of swallowing reflex ,obviously improve the swallowing function of patient after cerebral hemorrhage .%目的:观察运用针刺法结合吞咽障碍治疗仪治疗脑出血后吞咽障碍的临床疗效。方法选取脑出血后吞咽障碍的患者50例,随机分为针刺组、针刺结合吞咽障碍治疗仪组(简称“结合组”),每组各25例。针刺组给予针刺治疗,结合组给予针刺治疗加用吞咽障碍治疗仪治疗。治疗14 d后采用洼田饮水实验、脑卒中患者神经功能缺损程度评分标准中的吞咽困难亚量表进行评定。结果治疗后,2组吞咽功能较治疗前均有显著改善( P<0.01),2组间的评分差值,较结合组,均具有统计学意义( P

  12. Secondary cerebral hemorrhage patients in operation room of first aid measures of pregnancy induced hypertension syndrome%妊娠高血压综合征继发脑出血患者的手术室急救措施

    Institute of Scientific and Technical Information of China (English)

    周洁璐

    2014-01-01

    Objective To explore pregnancy induced hypertension syndrome secondary to cerebral hemorrhage patients in operation room of ifrst aid measures.Methods Selected in our hospital from February 2013 to February 2014 during the 34 pregnancy induced hypertension syndrome secondary to cerebral hemorrhage patients as research object, randomly divided into control group and observation group, each group 17 cases, control group received the routine operation of emergency nursing, the observation group in the control group based on the nursing intervention nursing effects between the two group.Results In the observation group, SDS score, SAS score and body health scores were higher than those in the control group, nursing effect of the difference between the two groups was signiifcant, with P<0.05 as the difference has statistical signiifcance; the observation group had 1 cases of venous thrombosis, 1 cases appeared hypostatic pneumonia, complication rate was 11.76%; the control group 3 cases appeared venous thrombosis, 2 cases appeared hypostatic pneumonia, complication rate was 29.41%, the rate of complications in two groups was significant compared toP<0.05, the difference was statistically significant.Conclusions In the implementation of nursing intervention in the surgical treatment of cerebral hemorrhage, alleviate the patients condition, shorten the operation time to prepare, improve the effect of clinical treatment, worthy of clinical application.%目的:分析探讨妊娠高血压综合征继发脑出血患者的手术室急救措施。方法选取我院于2013年2月至2014年2月期间收治的34例妊娠高血压综合征继发脑出血患者作为研究对象,随机分为对照组和观察组,各组17例,对照组实施常规手术急救护理,观察组在对照组基础上实施护理干预,比较两组护理效果。结果观察组的SDS评分、SAS评分及躯体健康评分均高于对照组,两组护理效果比较差异显著,以P<0.05为

  13. 急性外伤性颅内血肿患者术后发生迟发性脑出血的临床分析%Clinical analysis of acute traumatic intracranial hematoma with postoperative delayed cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    蔡亮

    2013-01-01

    目的:探讨急性外伤性颅内血肿患者的临床特征与术后迟发性脑出血发生的相关性,寻找防治措施。方法:回顾分析58例急性外伤性颅内血肿患者开颅血肿清除术后再出血的临床资料,其中23例患者术后发生迟发性脑出血( DTIH组),35例未发生( NDTIH)组。对2组患者的临床特征进行总结归纳,分析寻找再出血原因,对迟发性脑出血患者行再次手术治疗,并随访行GOS评分。结果:与NDTIH组比较DTIH组有如下特征:术前GCS评分<8分(p<0.05);术前头颅CT提示多有多发脑挫伤,对冲伤,合并颅骨骨折等,并予及时再次手术治疗,术后随访行GOS评估≥4分18例。结论:根据急性外伤性颅内血肿开颅术后患者的临床特征,及时发现迟发性脑出血,并清除迟发性颅内血肿,是提高疗效的关键。%Objective:To explore the corelation between the clinical features of patients with incidence of acute traumatic intracranial hematoma and late postoperative hemorrhage occurs and to make prevention and control measures .Methods:The clinical data of 58 cases divided two groups,postoperative delayed cerebral hemorrhage (DTIH,n=23) and did not occur (NDTIH,n=35),of acute traumatic in-tracranial hematoma in patients with invasive hematoma removal were retrospectively analyzed ,which to invastigate the reason of rehaemor-rhagia and did surgical treatment again ,to follow up through GOS score .Results:Compared with the NDTIH group ,the DTIH had the fol-lowing characteristics:preoperative GCS score <8 points ( p <0.05);Preoperative skull CT indicated that multiple cerebral contusion , hedge, skull fractures, etc,which to timely surgery again , there were18 cases those value of GOS evaluation were four points or more . Conclusion:According to the clinical features of patients with acute traumatic intracranial hematoma after craniotomy , timely detected the late-onset cerebral

  14. 院前急救护理在急性脑出血患者中的应用价值研究%Application Value Research of Pre-hospital Emergency Nursing Care on Patients with Acute Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王晓庆

    2014-01-01

    目的:探索院前急救护理在急性脑出血患者中的应用价值。方法将2012年5月_2014年4月该院收治的104例急性脑出血患者按不同护理方案和入院时间均分为观察组﹙实施院前急救护理﹚和对照组﹙未实施院前急救护理﹚,对两组患者住院期间死亡率﹑致残率以及接受正规治疗时间进行比较分析。结果观察组死亡率﹑致残率及接受正规治疗时间分别为13.5%﹑46.2%﹑﹙45.37±11.43﹚min,对照组为30.8%﹑65.4%﹑﹙76.51±17.38﹚min,观察组均显著优于对照组,差异有统计学意义﹙P<0.05﹚。结论院前急救护理干预对急性脑出血患者效果确切,能显著降低患者死亡率﹑致残率及治疗时间,值得临床推广。%Objective To explore the application value of pre-hospital emergency nursing care in patients with acute cerebral hemorrhage. Methods 104 patients with acute cerebral hemorrhage admitted in our hospital from May 2012 to April 2014 were di_vided into the observation group with pre-hospital emergency nursing care, and the control group without pre-hospital emergency nursing care according to different nursing measures and time of admission. The mortality, rate of disability and receiving regular treatment time during hospitalization were compared two groups of patients. Results The mortality, rate of disability and receiving regular treatment time of the observation group was 13.5%, 46.2%, (45.37 ±11.43)min, respectively, much better than 30.8%, 65.4%,(76.51±17.38)min of the control group, respectively (P<0.05). Conclusion The pre-hospital emergency nursing care has an exact effect on patients with acute cerebral hemorrhage, which can significantly decrease the mortality, disability rate and duration of treatment, so it deserves the clinical promotion.

  15. 浅析脑出血采用颅内血肿抽吸引流术手术室护理体会%Elementary analysis the operation room nursing experience of Cerebral hemorrhage by intracranial hematoma suction drainage

    Institute of Scientific and Technical Information of China (English)

    牛英华; 丁丽丽

    2015-01-01

    目的:探讨采用颅内血肿抽吸引流术治疗脑出血的手术室临床护理措施及效果。方法对48例高血压致脑淤血患者(对照组)行止血、控制血压和防止并发症等常规治疗护理,对50例疾病类型同上的患者(观察组)行内科保守治疗基础上采用颅内血肿抽吸引流术治疗,并实施全程手术室护理干预。结果术后对改善脑出血效果明显,但必须做好手术期护理,以减少再出血发生,进一步改善术后生存质量。结论微创颅内血肿抽吸引流术具有使用器械少,创面小,手术时间段,伤口愈合快,术后并发症少等优点,对老年和体弱患者可明显提高其生存期。%Objective To study the smoke attract streams of intracranial hematomas surgery clinical nursing measures and effect for the treatment of cerebral hemorrhage.Methods 48 cases of hypertension cerebral blood clot patients (control group) to stop bleeding, control of blood pressure and prevent complications such as routine care, 50 patients with disease type ditto (observation group) internal medicine conservative treatment on the basis for the treatment of intracranial hematoma suction attract flow, and implement the whole operating room nursing intervention. Observe therapeutic effect of two groups, sum up nursing experience.Results To improve the postoperative hemorrhage effect is obvious, but must be prepared to the preoperative nursing, to reduce the bleeding occurred again,further improve the quality of life after surgery.Conclusion Minimally invasive intracranial hematoma aspiration and drainage with little equipment, small wound, operation time, wound healing fast, less postoperative complications and other advantages, for elderly and frail patients can signiifcantly improve the survival.

  16. "Timing" of arrival and in-hospital mortality in a cohort of patients under anticoagulant therapy presenting to the emergency departments with cerebral hemorrhage: A multicenter chronobiological study in Italy.

    Science.gov (United States)

    Fabbian, Fabio; Manfredini, Roberto; De Giorgi, Alfredo; Gallerani, Massimo; Cavazza, Mario; Grifoni, Stefano; Fabbri, Andrea; Cervellin, Gianfranco; Ferrari, Anna Maria; Imberti, Davide

    2016-01-01

    Therapy with oral anticoagulants (OACs) is a risk factor for cerebral hemorrhage (CH). Although different studies have been undertaken to investigate the timing of the onset of major cardiovascular events, no data exist on temporal patterns of the onset of CH in subjects treated with OACs. The aim of this study is to evaluate the timing of CH in patients treated with OACs. All patients who developed CH under OACs therapy and admitted to 28 Italian Emergency Departments (EDs) between September 2011 and July 2013 were enrolled. Age, sex, time and location of the hemorrhagic lesion, type of the bleeding events (idiopathic or post-traumatic), anticoagulant therapy (warfarin or new oral anticoagulants - NOAs) and time of ED admission (i.e., hour, day, month and season) were recorded. Five hundred and seventeen patients (63.2% male aged 80 ± 7.9 yrs) with CH were involved. Warfarin was taken by 494 patients (95.6%), and NOAs by 23 (4.4%). In-hospital mortality (IHM) was recorded in 208 cases (40.2%). Cosinor analysis showed a peak of CH arrival between 12:00 and 14:00 h both in the whole population (PR 73.9%, p = 0.002) and the male subgroup (PR 65.2%, p = 0.009), whereas females showed an anticipated morning peak between 08:00 and 10:00 h (PR 65.7%, p = 0.008). A further analysis between idiopathic and post-traumatic CH confirmed the presence of a 24 h pattern with a peak between 12:00 and 14:00 h (PR 58.5%, p = 0.019) and between 08:00 and 10:00 h (PR80.1%, p < 0.001) for idiopathic events and post-traumatic hemorrhages, respectively. Moreover, a seasonal winter peak was identified for idiopathic forms (PR 74%, p = 0.035), and a summer peak for post-traumatic forms (PR 77%, p = 0.025). The present study suggests the presence of a temporal pattern of ED arrivals in CH patients treated with OACs. PMID:26852790

  17. 早期高压氧及针灸治疗高血压性脑出血术后脑及肢体功能障碍%The effect of early hyperbaric oxygen and acupuncture on hypertension patients with cerebral hemorrhage and limb dysfunction

    Institute of Scientific and Technical Information of China (English)

    林志忠; 李万川; 黄镔霖; 张和平; 余惠平

    2001-01-01

    Objective To evaluate the rehabilitation therapy for the patient with hypertensive cerebral hemorrhage after operation.Method All cases suffered from hyperensive cerebral hemorrhage are divided into two groups,the rehabiliatation therapy group(the one with both early hyperbaric oxygen and the early acupuncture ),the common therapy group(the one neither with hyperbaric oxygen nor with acupuncture).Result 93 cases in rehabilitation therapy group are favourable(ADL:1~3).14 cases in common therapy group are favourable.The outcome of the rehabilitation therapy group is better than that of the latter(P<0.05). Conclusion The early treatment by hyperbaric oxygen and acupuncturewill promoted the rehabilitation of the patient suffered from hypertensive cerebral hemorrhage after operation.%目的 讨高血压脑出血术后脑及肢体功能障碍的康复治疗。方法康复治疗组行早期高压氧及针灸等治疗,对照组单纯药物治疗。结果 DL1~3级康复治疗组93例,对照组14例,康复治疗组优于对照组,P<0.05。结论 期高压氧及针灸治疗,有利于高血压脑出血术后康复。

  18. 早期高压氧及针灸治疗高血压性脑出血术后脑及肢体功能障碍%The effect of early hyperbaric oxygen and acupuncture on hypertension patients with cerebral hemorrhage and limb dysfunction

    Institute of Scientific and Technical Information of China (English)

    林志忠; 李万川; 黄镔霖; 张和平; 余惠平

    2001-01-01

    Objective To evaluate the rehabilitation therapy for the patientwith hypertensive cerebral hemorrhage after operation.Method All cases suffered from hyperensive cerebral hemorrhage are divided into two groups,the rehabiliatation therapy group(the one with both early hyperbaric oxygen and the early acupuncture ),the common therapy group(the one neither with hyperbaric oxygen nor with acupuncture).Result 93 cases in rehabilitation therapy group are favourable(ADL:1~3).14 cases in common therapy group are favourable.The outcome of the rehabilitation therapy group is better than that of the latter(P<0.05). Conclusion The early treatment by hyperbaric oxygen and acupuncturewill promoted the rehabilitation of the patient suffered from hypertensive cerebral hemorrhage after operation.%目的 探讨高血压脑出血术后脑及肢体功能障碍的康复治疗。方法康复治疗组行早期高压氧及针灸等治疗,对照组单纯药物治疗。结果 DL1~3级康复治疗组93例,对照组14例,康复治疗组优于对照组,P<0.05。结论 期高压氧及针灸治疗,有利于高血压脑出血术后康复。

  19. ERK1/2 inhibition attenuates cerebral blood flow reduction and abolishes ET(B) and 5-HT(1B) receptor upregulation after subarachnoid hemorrhage in rat

    DEFF Research Database (Denmark)

    Beg, Saema A S; Hansen-Schwartz, Jacob A; Vikman, Petter J;

    2006-01-01

    -regulated kinase (ERK1/2). In the present study, we hypothesized that inhibition of ERK1/2 alters the ET(B) and 5-HT(1B) receptor upregulation and at the same time prevents the sustained cerebral blood flow (CBF) reduction associated with SAH. The ERK1/2 inhibitor SB386023-b was injected intracisternally......-CT; 5-HT1 receptor agonist) in a sensitive myograph. To investigate if ERK1/2 inhibition had an influence on the local and global CBF after SAH, an autoradiographic technique was used. At 48 h after induced SAH, global and regional CBF were reduced by 50%. This reduction was prevented by treatment...... with SB386023-b. The ERK1/2 inhibition also decreased the maximum contraction elicited by application of ET-1 and 5-CT in cerebral arteries compared with SAH. In parallel, ERK1/2 inhibition downregulated ET(B) and 5-HT(1B) receptor messenger ribonucleic acid and protein levels compared with the SAH...

  20. 蛛网膜下腔出血后脑痉挛的临床研究及CT征象分析%Clinical Study of Cerebral Vascular Spasm after Subarachnoid Hemorrhage and Analysis of CT Findings

    Institute of Scientific and Technical Information of China (English)

    李伟钦; 郑华英; 朱玉莉; 江晨辉

    2016-01-01

    Objective To analyze the clinical characteristics and CT findings of cerebral vascular spasm (CVS) after subarachnoid hemorrhage (SAH).Methods The clinical data of 54 patients with SAH who were treated in our hospital between February 2010 and May 2015 were collected. All patients were examined by CT and digital subtraction angiography (DSA) after admission, and the clinical data were complete. With DSA as the golden standard, the accuracy of CT in the diagnosis of CVS after SAH was statistically analyzed. The CT imaging findings were summarized.Results There was 1 cases with ACA, MCA distal segment CVS missed diagnosed by CTA, and the accuracy rate in the diagnosis of CVS was 88.24%, slightly lower than that of DSA (P>0.05); CBV and CBF in patients with SAH and CVS were lower than those in patients with SAH and without CVS (P0.05);SAH并CVS者CBV、CBF低于SAH无CVS者(P<0.05),其MTT、TTP明显长于SAH无CVS者,对比差异有统计学意义(P<0.05)。结论 SAH后CVS患者脑灌注降低,MTT、TTP延长,痉挛血管可见均匀性狭窄,采用CT、CTP诊断与DSA符合率高,可为临床诊治提供影像学依据。

  1. The Effect of Community Nursing on Constipation of Patients With Cerebral Hemorrhage During Convalescence%社区护理对脑出血康复期患者便秘的影响

    Institute of Scientific and Technical Information of China (English)

    马艳萍

    2015-01-01

    Objective To discuss the effect of community nursing on constipation of patients with cerebral hemorrhage during convalescence. Methods To take targeted nursing measures on 154 cases of patients, including sports, dietary and drug guidance. Results In 154 patients, the stool unobstructed in 78 cases, defecation smoothly in 59 cases, to dig out for 15 cases, due to defecation and forced bleeding in 2 cases. Conclusion The comprehensive application of various nursing measures can help patients establish normal defecation behavior and improve the quality of life.%目的:探讨社区护理对脑出血康复期患者便秘的影响。方法对154例患者采取包括运动指导,饮食指导和用药指导等有针对性的护理措施。结果154例患者中,大便通畅自行排便1次/d有78例,排便变顺利59例,需人工掏便15例,因排便用力引起再出血2例。结论各种护理措施的综合应用可以帮助患者建立正常的排便行为,提高生存质量。

  2. Different Effects of CRRT on Prognosis for Patients with Hypernatremia Secondary to Head Trauma and Cerebral Hemorrhage%CRRT治疗对颅脑创伤及脑出血继发严重高钠血症患者预后的差异性影响

    Institute of Scientific and Technical Information of China (English)

    卓建钦; 黄志勇

    2013-01-01

    Objective:To investigate the different effects of CRRT on prognosis for patients with hypernatremia secondary to head trauma and cerebral hemorrhage.Method:To retrospectively analyze the clinical data of patients with hypernatremia secondary to head trauma(n=36) and cerebral hemorrhage(n=17) in our hospital from January 2007 to August 2011. The prognosis of patients with the head trauma group and the cerebral hemorrhage group was compared according to the score of GOS.Result:GOS scores in the two groups had significantly difference(P<0.05).Conclusion:In our study,we found that patients with hypernatremia secondary to cerebral hemorrhage treated by CRRT seemed like to have better prognosis than the ones with head trauma,which tipped CRRT in the treatment of patients with cerebral hemorrhage secondary to severe hypernatremia may has a higher application value.%目的:探讨CRRT治疗对颅脑创伤及脑出血继发严重高钠血症患者预后的差异性影响。方法:回顾性分析笔者所在医院2007年1月-2011年8月因颅脑创伤(n=36)以及脑出血(n=17)继发严重高钠血症而行CRRT治疗患者的临床资料,以GOS作为预后评估指标,比较两组患者预后的差异。结果:两组患者GOS评分比较,差异有统计学意义(P<0.05)。结论:本组研究结果显示,对于病程中继发严重高钠血症的颅脑创伤以及脑出血患者,CRRT的治疗效果以脑出血患者为优,提示CRRT在脑出血继发严重高钠血症患者的治疗中可能具有更高的应用价值。

  3. Occult infarct with acute hemorrhagic stroke in juvenile diabetic ketoacidosis.

    Science.gov (United States)

    Lin, Jainn-Jim; Lin, Kuang-Lin; Wang, Huei-Shyong; Wong, Alex Mun-Ching; Hsia, Shao-Hsuan

    2008-01-01

    Diabetes ketoacidosis (DKA) is one of the common complications of type I insulin-dependent diabetes mellitus. Neurological deterioration during an episode of DKA is usually assumed to be caused by cerebral edema and cerebral vascular accidents. However, hemorrhagic stroke is a very rare complication of juvenile DKA. We describe a girl who had newly diagnosed insulin-dependent diabetes mellitus with juvenile DKA developed intracerebral hemorrhage. PMID:17629647

  4. 自发性脑出血后锥颅血肿吸吸引对远期神经功能的影响%Drainage of spine and brain hematoma following spontaneous cerebral hemorrhage and its effect on long-termed merve function

    Institute of Scientific and Technical Information of China (English)

    何明利; 李祖伦; 李国友

    2002-01-01

    @@ Background:Clear of hematoma and decrease of intracerebral pressure are necessary in the treatment of spontaneous cerebral hemorrhage.Conservative therapy is characterized by stable effect and less risks,which is effective in treating small hematoma with stable vital signs.Clinical practice indicated surgery had no define effect on hematoma.Neurological therapists concerned the way of clearing cerebral hematoma and decrease of cerebral pressure and reducing brain injury.Now drainage of spine and brain hematoma has been accepted,which treat hematoma according to rules of hematoma development.Directional CT,computer imitated orientation,hand pushed revolved drill skull and microcatheter drawing could effectively clear hematoma and long term effect is define.

  5. The study of prevention and treatment effects of Ligustrazine on experimental cerebral vasospasm following subarachnoid hemorrhage%川芎嗪对实验性SAH后CVS防治作用的研究

    Institute of Scientific and Technical Information of China (English)

    邵国富; 包仕尧; 楚冰; 张志琳

    2003-01-01

    目的研究兔症状性蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)与内皮素(ET)和一氧化氮(NO)的关系及川芎嗪的保护作用.方法采用双侧颈动脉结扎和枕大池二次注血制成兔SAH模型,观察SAH前后动物进食量和神经功能改变,用放射免疫方法和硝酸还原酶法分别测定血液和脑脊液中ET和NOx-含量,以氢清除法测定局部脑血流量(rCBF).结果SAH后大部分动物进食量有不同程度的下降,所有动物均有不同程度的神经功能障碍和rCBF下降.SAH后血液和脑脊液中ET含量增加,NOx-含量下降(P<0.01).上述变化随出血时间延长和出血量的增大而增加.川芎嗪治疗组上述变化均有不同程度的改善.结论双侧颈动脉结扎后枕大池二次注血可制成可靠的兔症状性SAH后CVS的动物模型.兔SAH后ET和NO含量的改变与CVS的发生密切相关,并进而导致临床症状的恶化.川芎嗪可通过抑制SAH后ET和NO的变化而对CVS的发生和发展起到防治作用.%Objective To investigate the relationship between endothelin(ET), nitric oxide(NO) and experimental cerebral vasospasm following subarachnoid hemorrhage, and the protective effect of Ligustrazine(LZ) on cerebral vasospasm. Methods The model of SAH was set up by injecting blood two times via cisternal after occlusion of bilateral carotid in rabbit. The food-intake and behavior of experimental animals were under observation at various stages of experiment. The content of ET in blood and CSF was tested by radioimmunoassay, and the NOx- by HNO3 redutase method. Regional cerebral blood flow(rCBF) was measured by hydrogen clearance method. Results It was observed that the food-intake decrease in most of animals with SAH in various degree, and the neurofunction disturbance appeared in all SAH-animals. rCBF decreases were also observed in all SAH-animals at various degree.The content of ET in blood and CSF increased but NOx- decreased (P < 0.01). All of above mentioned

  6. Therapeutic effect of autologous stem cell transplantation of patients with cerebral hemorrhage sequelae under the stereotactic%脑出血后遗症患者立体定向下自体干细胞移植的效果观察

    Institute of Scientific and Technical Information of China (English)

    任虹宇; 刘明亮; 李明轩; 马建功; 何承

    2015-01-01

    Objective To investigate the therapeutic effect of autologous stem cell transplantation research for patients with cerebral hemorrhage sequelae under the stereotactic.Methods One hundred patients with cerebral hemorrhage from Jan.2011 to Sep.2013 in our hospital were selected and randomly divided into the experimental group (n =50) and the control group (n =50).The patients of experimental group were given autologous stem cell transplantation under the stereotactic in 6 months after cerebral hemorrhage,while the patients in control group were just given traditional treatment.At 6,7 and 12 months after cerebral hemorrhage,rate with neural function defect scale and functional independence measure(FIM) scores of the two groups were compared.Results FIM scores in the experimental group was 102.08 ± 8.28,significant higher than that in control group(95.28±8.75,P<0.05).Functional independence measure scores in the experimental group at 7 months after cerebral hemorrhage was 13.12±4.00,significant lower than that in control group(20.40±4.33,P <0.05).While,there was no statistical difference at 6 months and 12 months after cerebral hemorrhage between the two groups(P>0.05).Conclusion The therapeutic of autologous stem cell transplantation on patients with cerebral hemorrhage sequelae under the stereotactic is benefit at short term,but the long term therapy effective still needs further study.%目的 探讨立体定向下自体干细胞移植治疗脑出血后遗症的临床效果.方法 将2011年1月至2013年9月在我院住院治疗的100例脑出血后遗症患者应用计算机随机分为实验组和对照组,每组50例.实验组患者脑出血后6个月在立体定向下行自体干细胞移植治疗,对照组患者仅行对症治疗.比较两组患者在脑出血7、12个月时神经功能缺损评分和功能独立性测量(FIM)评分.结果 实验组和对照组脑出血后7个月FIM评分分别为(102.08±8.28)分与(95.28±8.75)分,神经

  7. 比较青年与中老年发生急性脑出血的危险因素及其预后%Risk factors and prognosis of acute cerebral hemorrhage in young and middle aged and elderly patients

    Institute of Scientific and Technical Information of China (English)

    莎其尔; 乌达木

    2015-01-01

    Objective: To investigate the risk factors and prognosis of acute cerebral hemorrhage in young and middle aged and elderly patients.Methods: The clinical data of 393 patients with acute cerebral hemorrhage admitted to our hospital from January 2010 June to were retrospectively analyzed. The patients were divided into two groups: young group (aged 45 years old,n=155) and middle aged group (aged over 45 years,n=238). Risk factors and hospital mortality of the two groups were analyzed and compared. Results: Compared with the analysis, the risk factors of acute cerebral hemorrhage in the youth group had a large amount of alcohol consumption and smoking history. The risk factors of acute cerebral hemorrhage in the young group were hypertension, hyperlipidemia, and the difference was statistically significant (P<0.05). The mortality rate in the young group was 3.2%, significantly lower than that in the middle and old aged group 8.4%. The difference was statistically significant (P<0.05).Conclusion: Hypertension is a risk factor of cerebral hemorrhage in all ages, especially in the middle and old people. The risk factors of acute cerebral hemorrhage in young group were also a large number of drinking history, smoking history. The prognosis of patients with acute cerebral hemorrhage was significantly better than that in elderly patients.%目的:探讨分析青年与中老年发生急性脑出血的危险因素及其预后。方法对我院2010年1月—2015年6月期间收治的393例急性脑出血患者的临床资料予以回顾性分析,根据患者年龄分为两组:青年组(年龄不超过45岁,n=155)、中老年组(年龄超过45岁, n=238)。分析比较两组发病的危险因素及住院死亡率。结果经分析比较可知,青年组发生急性脑出血的危险因素有大量饮酒史、吸烟史,中老年组发生急性脑出血的危险因素是高血压、高脂血症,组间对比差异有统计学意义(P<0.05)。

  8. 不同术式治疗高血压脑出血对术后脑水肿的影响%Analysis of the influence of different types of operations on post-operative cerebral edema in the treatment of hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    李仕卓; 罗维平; 赵永耀; 郑仲贤; 詹传伟; 岑伟培

    2014-01-01

    Objective To explore the influence of different types of operations on cerebral edema in the treatment of hypertensive cerebral hemorrhage. Methods 180 patients with hypertensive cerebral hemorrhage who were admitted to our hospital from 2008 to 2012 and received operation were selected as research subjects. The patients were assigned into three groups A, B, and C according to different curative methods, with 60 patients in each group. Group A was received hematoma drainage by skull drilling and catheter, group B was received hematoma clearance by craniotomy of small bone flap, and group C was received regular decompressive craniotomy. The edema volume and duration of edema in 72h after operation and the residual blood volume in 48h after operation were compared between the three groups. Results The clinical indices of patients received hematoma clearance by craniotomy of small bone flap were better than those received hematoma drainage by skull drilling and catheter and regular decompressive craniotomy, and the differences were statistically significant (P<0.05). Conclusion The patients with hypertensive cerebral hemorrhage who are received hematoma clearance by craniotomy of small bone flap have less edema volume in 72h, less residual blood volume in 48h and shorter duration of edema. The operation has a significant clinical effect and is worthy of clinical promotion and application.%目的:探讨高血压脑出血患者并应用不同手术方法后对于脑水肿的影响。方法选取我院2008~2012年收治的180例高血压脑出血手术患者做为研究对象。按照不同的治疗方法分为A、B、C三组,每组60例。A组患者采用钻孔置管血肿引流治疗,B组患者应用小骨瓣开颅血肿清除治疗,C组患者应用常规开颅去骨瓣减压治疗。比较三组患者的术后72h水肿体积、水肿持续时间与术后48h残留血液量。结果患者应用小骨瓣开颅血肿清除术后各项临床指标优于钻孔置

  9. Hemorrhagic disorder

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930167 Relationship among changes of bloodpicture and hemorrhage to skin,fundus occuliand brain in 220 cases of hematologic disease.WU Bingquan(吴秉权),et al.Blood Dis Hosp,CMAS.Tianjin Med J 1992;20(9):515-517.Changes of blood picture related to bleedingof the skin,fundus occuli and brain were ana-lyzed in 220 cases of blood diseases.Resultsshowed,in iron deficient anemia with pro-

  10. [Hemorrhagic enteropathy].

    Science.gov (United States)

    Brobmann, G F; van Lessen, H; Springorum, H W; Thomas, C

    1976-10-21

    Intestinal infarction in the absence of organic vascular occlusion received increasing attention in recent years. The clinical picture is discussed based on results in 9 cases, an attempt to suggest a possible pathophysiological mechanism is made. Prophylactic digitalisation especially in the elderly patient in the absence of severe heart failure and in cases with already low mesenteric perfusion may lead to a further vasoconstriction and to hemorrhagic enteropathy. Therapeutic possibilities are discussed. PMID:1086816

  11. Blockade of the MEK/ERK pathway with a raf inhibitor prevents activation of pro-inflammatory mediators in cerebral arteries and reduction in cerebral blood flow after subarachnoid hemorrhage in a rat model

    DEFF Research Database (Denmark)

    Maddahi, Aida; Ansar, Saema; Chen, Qingwen;

    2011-01-01

    hours, cerebral arteries were harvested, and iNOS, interleukin (IL)-6, IL-1ß, matrix metalloproteinase (MMP)-9, tissue inhibitors of metalloproteinase (TIMP)-1, and phosphorylated ERK1/2 were investigated by immunofluorescence, real-time polymerase chain reaction (PCR), and Western blot analysis....... Cerebral blood flow (CBF) was measured using autoradiography. Protein levels of MMP-9, TIMP-1, iNOS, IL-6, and IL-1ß were increased after SAH, as were mRNA levels of IL-6, MMP-9, and TIMP-1. After SAH, pERK1/2 was increased, but CBF was reduced. Treatment with SB-386023-b at 0 or 6 hours after SAH...... normalized CBF and prevented SAH-induced upregulation of MMPs, pro-inflammatory cytokines, and pERK1/2 proteins. These results suggested that inhibition of MEK/ERK signal transduction by a specific raf inhibitor administered up to 6 hours after SAH normalized the expression of pro-inflammatory mediators...

  12. Blockade of the MEK/ERK pathway with a raf inhibitor prevents activation of pro-inflammatory mediators in cerebral arteries and reduction in cerebral blood flow after subarachnoid hemorrhage in a rat model

    DEFF Research Database (Denmark)

    Maddahi, Aida; Ansar, Saema; Chen, Qingwen;

    2011-01-01

    hours, cerebral arteries were harvested, and iNOS, interleukin (IL)-6, IL-1β, matrix metalloproteinase (MMP)-9, tissue inhibitors of metalloproteinase (TIMP)-1, and phosphorylated ERK1/2 were investigated by immunofluorescence, real-time polymerase chain reaction (PCR), and Western blot analysis....... Cerebral blood flow (CBF) was measured using autoradiography. Protein levels of MMP-9, TIMP-1, iNOS, IL-6, and IL-1β were increased after SAH, as were mRNA levels of IL-6, MMP-9, and TIMP-1. After SAH, pERK1/2 was increased, but CBF was reduced. Treatment with SB-386023-b at 0 or 6 hours after SAH...... normalized CBF and prevented SAH-induced upregulation of MMPs, pro-inflammatory cytokines, and pERK1/2 proteins. These results suggested that inhibition of MEK/ERK signal transduction by a specific raf inhibitor administered up to 6 hours after SAH normalized the expression of pro-inflammatory mediators...

  13. 七叶皂苷钠联合依达拉奉治疗脑出血的效果分析%Effect analysis on aescinate combined with edaravone in treatment of cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    唐云; 宴勇

    2014-01-01

    Objective To analyze the effect of sodium aescinate combined with edaravone in treating cerebral hemorrhage .Methods 120 cases of cerebral hemorrhage in the neurology department of the Liangping County People's Hospital from January 2009 to June 2013 were divided into the observation group and the control group according the therapeutic methods ,60 cases in each group .The control group used the conventional conservative treatment , while on this basis the observation group adopted the treatment of aescinate combined with edaravone .The changes of cerebral edema volume ,NIH stroke score and Barthel index (BI)score were compared between before treatment and after 14 d treatment .The differences of the serum NO ,TNF‐α,IL‐6 levels also were compared between before treat‐ment and after 7 d treatment .Results The differences of brain edema ,NIH stroke score ,BI index scoreand ,serum NO ,TNF‐αand IL‐6 levels between after treatment and before treatment in the observation group were(4 .75 ± 2 .21) mL ,(6 .25 ± 2 .21)score ,(35 .29 ± 21 .79)score ,(4 .33 ± 1 .15)pg/mL ,(4 .64 ± 1 .73)pg/mL and(8 .33 ± 4 .17)pg/mL respectively ;which in the control group were(7 .11 ± 3 .09)mL ,(7 .85 ± 2 .69)score ,(32 .87 ± 20 .34)score ,(8 .02 ± 4 .54)pg/mL ,(5 .76 ± 2 .78)pg/mL and(20 .11 ± 10 .29)pg/mL respectively ,the differences between the two groups had statistical significance(P<0 .05) .Conclusion Aescinate combined with edaravone has a significant effect in the treatment of cerebral hemorrhage and is worthy of clinical promotion and application .%目的:分析七叶皂苷钠联合依达拉奉治疗脑出血患者的效果。方法将梁平县人民医院2009年1月至2013年6月神经内科收治的120例脑出血患者按治疗方法不同分为观察组和对照组,每组各60例。对照组患者采用常规保守疗法,观察组在常规治疗的基础上采用七叶皂苷钠联合依达拉奉治疗,比较两组患者治疗14d后与治疗前

  14. The analysis of cerebral hemodynamics in patients with aneurysmal subarachnoid hemorrhage%动脉瘤性蛛网膜下腔出血患者的脑血流动力学分析

    Institute of Scientific and Technical Information of China (English)

    颜燕红; 惠品晶; 王中; 张世明; 郭亮

    2012-01-01

    Objective To study the clinical value of hemodynamic changes in cerebral circulation detected by transcranial Doppler (TCD) in the patients with aneurysm subarachnoid hemorrhage(SAH). Methods SAH in 35 patients was confirmed by CTA and/or DSA, who were operated for aneurysm clipping and underwent periodic TCD monitoring. The changes of mean flow velocities in the middle cerebral artery (MCA Vm) were record and Lindegaard index (LI) was calculated The hemodynamic changes of cerebral circulation were analyzed and the onset of cerebral vasospasm(CVS) detected by TCD with CTA during 7-10 days after aneurysm SAH was compared. Results MCA Vm and LI usually increased during 3-6 days,peaked in 7-9 days and lasted until 13-16 days after aneurysm SAH. Taking MCA Vm> 120 cm/s and Ll>3 as the criteria for CVS. the incidence rate of CVS was 51.4%. The results of TCD were well accordant to those of CTA (Kappa= 0. 727). Conclusion TCD is a noninvasive method for detecting CVS after aneurysm SAH with an advantage of simple and repeated examination.%目的 探讨经颅多普勒(TCD)检测动脉瘤性蛛网膜下腔出血(SAH)患者脑血流动力学改变的临床意义.方法 35例CT检查为SAH患者,均行CTA和(或)DSA检查证实为动脉瘤并行动脉瘤夹闭术.于SAH后备时间段行TCD检测,动态检测大脑中动脉平均血流速度(MCA Vm)、阻力指数(RI)等血流动力学参数,计算同侧大脑中动脉与颅外段颈内动脉之比(LI)指数,分析血流频谱形态等脑血流动力学改变,并且与SAH后7-10 d CTA检测结果进行对比分析.结果 TCD检测显示,MCA Vm、LI指数于动脉瘤性SAH后3-6 d开始升高,7-9d达高峰,持续至13-16 d;以MCA Vm高于120 cm/s及LI指数>3作为判断脑血管痉挛(CVS)的标准,CVS发生率51.4% (18/35),且TCD与CTA检测结果有良好的一致性(Kappa=0.727).结论 TCD是判断动脉瘤性SAH后CVS的一项无创的检查手段,具有操作简便、可重复检测等优势.

  15. Continuous EEG Monitoring in Aneurysmal Subarachnoid Hemorrhage

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Friberg, Christian Kærsmose; Wellwood, Ian;

    2015-01-01

    BACKGROUND: Continuous EEG (cEEG) may allow monitoring of patients with aneurysmal subarachnoid hemorrhage (SAH) for delayed cerebral ischemia (DCI) and seizures, including non-convulsive seizures (NCSz), and non-convulsive status epilepticus (NCSE). We aimed to evaluate: (a) the diagnostic...

  16. Effect of hyperbaric oxygenation on plasma endothelin and calcitonin gene related peptide in hypertensive cerebral hemorrhage patients%高压氧对高血压脑出血患者血浆ET、CGRP的影响

    Institute of Scientific and Technical Information of China (English)

    赵波; 吕云利; 姚向荣; 廖军

    2012-01-01

    目的 探讨高压氧对高血压脑出血患者血浆内皮素(ET)、降钙素基因相关肽(CGRP)的影响.方法 选择70例高血压脑出血患者,随机分为高压氧治疗组和常规治疗组,每组35例;2组均予常规治疗,高压氧治疗组在常规治疗的基础上于入院后第5天生命体征稳定后进行高压氧治疗,每天1次,共治疗14d.采用放射免疫法在治疗不同时间点(24h、5d、14d、21d)分别测血浆ET、CGRP值.另选择35例健康体检者作为正常对照组.结果 入院时24h高压氧治疗组及常规治疗组ET值高于正常对照组,CGRP值低于正常对照组.入院后(14d、21d)高压氧治疗组ET值低于常规治疗组,CGRP值高于常规治疗组.结论 高压氧治疗可以降低血浆ET水平,提高CGRP含量,从而改善高血压脑出血患者预后,并对继发性脑损伤有一定的治疗作用.%Objective It is to investigate the effect of hyperbaric oxygenation on plasma endothelin( ET ) and calcitonin gene-related peptide( CGRP ). Methods 70 hypertensive cerebral hemorrhage patients were randomly divided into hyperbaric oxygenation therapeutic group and conventional therapy group ( 35 cases in each group ). Beside the conventional therap,patients in hyperbaric oxygenation therapeutic group also received hyperbaric oxygenation in the fifth day after being in hospital if the body signs were stable,once a day and for 14 days. The developments of ET and CGRP levels in serum from both groups were monitored ( 24 h, 5 d, 14 d, 21 d ) with radioimmunoassay ,35 healthy people ( control group ) were enrolled in this stud-y. Results The level of ET was higher and the level of CGRP was lower in treatment group and conventional therapy group than that in normal control group in 24 h after being in hospital. The level of ET was lower and the level of CGRP was higher in hyperbaric oxygenation therapy group after therapy at 14 d and 21 d than that in conventional therapy( P <0. 05 ). Conclusion Hyperbaric

  17. Effects of AstragalosideⅣon delayed cerebral vasospasm after subarachnoid hemorrhage%黄芪甲苷对大鼠蛛网膜下腔出血后脑血管痉挛的影响

    Institute of Scientific and Technical Information of China (English)

    赵建伍; 于耀宇; 余天垒; 李延良; 唐铸; 桂铮; 周欣; 姬文婕

    2015-01-01

    Objective To explore the effect of Astragaloside Ⅳ(AS-Ⅳ) on delayed cerebral vasospasm after subarachnoid hemorrhage (SAH) and its mechanism. Methods Forty male SD rats were randomly were divided into 4 groups of 10 animals each, i.e. normal, SAH+AS-Ⅳ, SAH+dimothyl sulfoxide (DMSO) and SAH groups. The SAH model was made by endovascularly puncturing the internal carotid artery. The rats were given daily by intraperitoneal injection of AS-Ⅳsuspension in SAH+AS-Ⅳgroup 30 minutes after the establishment of the model, equal volume of 0.1%DMSO in SAH+DMSO group, and equal volume of saline in the normal and SAH groups. The morphological changes in the basilar arteries were observed by a microscope, the expressions of TLR4 and NF-κB p65 in the basilar arteries were determined by immunohistochemical technique, and the plasma levels of TNF-αand IL-6 were determined by enzyme-linked immunosorbent assay. Results The thickness of the basilar artery wall was significantly thinner in the normal group than that in SAH+AS-Ⅳgroup (P0.05)。黄芪甲苷组基底动脉管壁厚度较DMSO组明显变薄(P0.05)。黄芪甲苷组基底动脉TLR4、NF-κB阳性率较DMSO组明显下降(P<0.05)。结论黄芪甲苷可能通过干预TLR4、NF-κB介导的炎症信号通路来缓解大鼠SAH后CVS。

  18. Association of protein Z and factor VII gene polymorphisms with risk of cerebral hemorrhage: a case–control and a family-based association study in a Chinese Han pulation

    Indian Academy of Sciences (India)

    YI ZENG; LE ZHANG; ZHIPING HU; QIDONG YANG; MINGMING MA; BAOQIONG LIU; JIAN XIA; HONGWEI XU; YUNHA I LIU; XIAOPING DU

    2016-06-01

    Protein Z (PZ) and factor (F) VII are two important factors in the clotting pathway which have similar structure, linkedfunction and nearby gene sites. The aims of this study were to investigate whether the common variants of PZ and FVII genesare associated with the risk of cerebral hemorrhage (CH) and to explore the combined effects of PZ and FVII polymorphismsfor CH risk. We performed genotyping analysis for two single-nucleotide polymorphisms (SNPs) of FVII (rs510317 andrs6046) and three SNPs of PZ (rs2273971, rs3024718 and rs3024731) both in a population-based case–control study andin a family-based association study. Case–control analysis found no evidence of significant association. But family-basedassociation study revealed that the G allele of PZ rs2273971, and three haplotypes carrying the ‘G’ allele of PZ rs2273971:haplotype GA, CG and CGA of PZ and FVII genes, all had a significant effect on CH susceptibility (Z =1.882,P =0.049;Z =1.922,P =0.044; Z =1.826,P =0.047; Z =1.977,P =0.048, respectively). While, the A allele of PZ rs2273971, andfour haplotypes carrying or crossing the ‘A’ allele of PZ rs2273971: haplotypes CA, ACAA, ACAT and ACAAT of PZ andFVII genes, may confer protection against CH (Z =−1.882,P =0.049; Z =−2.000,P =0.045; Z =−2.319,P =0.020;Z =−2.002,P =0.045; Z =−2.015,P =0.043, respectively). This is a first family-based association study providing geneticevidences that PZ and FVII genes, especially PZ rs2273971 are involved in the development of CH in Han-Chinese families.

  19. Hemorragia de tronco cerebral após remoção cirúrgica de cisto aracnóide da fissura silviana: Relato de caso Brainstem hemorrhage after surgical removal of arachnoid cyst of the sylvian fissure: case report

    Directory of Open Access Journals (Sweden)

    Guilherme Borges

    1995-12-01

    Full Text Available Os autores relatam um caso de hemorragia de tronco cerebral após craniotomia para ressecção de grande cisto aracnóide de fissura silviana esquerda. A sintomatologia inicial pré-operatória incluía sinais de hipertensão intracraniana e a tomografia computadorizada mostrava desvio de linha média. Diversos fatores são discutidos para explicar o sangramento parenquimatoso pós-operatório: edema cerebral, diminuição do retorno venoso e de fluxo sanguíneo no lado comprimido. Entretanto a fisiopatologia da hemorragia parenquimatosa em casos como o relatado permanece obscura. Uma abordagem cirúrgica mais cautelosa é proposta nesses pacientes com de hipertensão intracraniana.The authors report a case of a hemorrhage of the brainstem after craniotomy for resection of a huge arachnoid cyst of the sylvian fissure on the left hemisphere. The previous simptomatology included clinical signs of increased intracranial pressure, and the computerized tomography showed midline shift. Some factors may contribute to brain hemorrhage post-operatively: cerebral edema, ipsilateral changes in the venous reflux and blood perfusion, although the physiopathology remains obscure. A more careful approach is suggested in such cases with intracranial hypertension.

  20. Viral Hemorrhagic Fevers

    Science.gov (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. How are hemorrhagic ... exist that can protect against these diseases. Therefore, prevention efforts must concentrate on avoiding contact with host ...

  1. Clinical analysis of lower respiratory tract infections in patients treated with cerebral hemorrhage surgery%脑出血术后患者下呼吸道感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    李明艳; 周定球; 刘全; 赖军华

    2014-01-01

    OBJECTIVE To learn about the characteristics of lower respiratory tract infections and pathogen distri-bution in patients treated with cerebral hemorrhage surgery so as to better instruct the use of drugs in clinical prac-tice and improve the cure rate .METHODS The clinical data of 98 cases of patients who suffered lower respiratory tract infections after receiving cerebral hemorrhage surgery from April 2012 to March 2013 were retrospectively analyzed ,the pathogen distribution and drug resistance were statistically analyzed ,and the anti-infection effect was summarized and analyzed .The pathogens were cultured for identification as per National Clinical Laboratory Procedures and Conventional Diagnostic Methods of Bacteriology , and the pathogens of positive culture were thrown into in vitro drug sensitivity test and the results were determined according to the standard issued by Clini-cal and Laboratory Standards Institute .RESULTS A total of 121 strains of pathogens were detected in 98 patients , including gram-negative bacteria (67 .77% ) ,gram-positive bacteria (18 .18% ) and fungi (14 .05% ) .The patho-gens with top 5 detection rates were Acinetobacter baumannii(A .baumannii) ,Staphylococcus aureus(S .aureus) , Pseudomonas aeruginosa(P .aeruginosa) ,Stenotrophomonas maltophilia(S .maltophilia) ,and Klebsiella pneu-moniae (K .pneumoniae) ,accounting for 19 .83% ,16 .53% ,14 .05% ,11 .57% and 10 .74% respectively .A . baumannii had the lowest drug resistance rate of 20 .83% to imipenem ;the ESBLs production rates of K .pneu-moniae and Escherichia coli(E .coli) were 81 .8% and 88 .9% respectively ,however ,the carbapenems-resistant strains were not detected out ;among the S .aureus ,the detection rate of methicillin-resistant S .aureus(MRSA) was 80 .00% ,and all the S .aureus were sensitive to vancomycin ;Candida albicans (C .albicans) and Candida tropicalis(C .tropicalis) were sensitive to antifungal agents like fluconazole and itraconazole .CONCLUSION The

  2. Effect of early enteral nutrition on prognosis of patients with cerebral hemorrhage%早期肠道内营养对脑出血预后的影响

    Institute of Scientific and Technical Information of China (English)

    张峰

    2013-01-01

    目的探讨脑出血早期肠道内营养的临床应用价值及可行性。方法抽取我院2011年1月~2012年1月收治的84例脑出血患者的临床资料进行回顾性分析,将本组患者分为两组,对照组和观察组,每组42例,一组采用常规静脉补液营养,一组采用早期肠道内营养,针对两组患者的营养效果进行评价分析。结果对照组完成静脉补液营养后,仍旧有3例并发症发生,而观察组完成肠道内营养,无一例手术并发症发生,且患者的能量和蛋白质摄入量明显高于对照组,差异有统计学意义(P<0.05);观察组术后肠道功能恢复时间、住院费用明显低于对照组,差异有统计学意义(P<0.05);另外,对照组满意度为71.4%,观察组治疗满意度为97.6%,差异有统计学意义(P<0.05)。结论脑出血患者早期例行肠道内营养是安全有效的,能够有效改善患者的营养状况,减少患者体内蛋白质分解,促进肠道功能恢复,缩短患者住院时间,降低住院费用效果明显,值得临床推广与应用。%Objective To study the clinical application value and feasibility of early enteral nutrition on prognosis of cerebral hemorrhage. Methods The clinical data of prognosis of 84 patients with cerebral hemorrhage in our hospital during January 2011 to January 2012 were retrospectively analyzed and the patients were divided into two groups, namely the control group and the observation group, each group had 42 cases. One group was given conventional intravenous fluids nutrition, the other group was given early enteral nutrition,the nutrition effect of patients in two groups were evaluated and analyzed. Results Three cases in the control group occurred complications after intravenous fluids nutrition, while no one case in the observation group happened surgery complications after enteral nutrition, and the energy and protein intake of patients in the observation

  3. The Study of Relationship Between Acute Cerebral Hemorrhage and Electrocardiographic Changes%急性脑出血与心电图改变的关系研究

    Institute of Scientific and Technical Information of China (English)

    杨法; 苏明兰; 李小珠; 张斌

    2014-01-01

    , there were significant differences with other ECG, P<0.05, there was statistically significant; Among lobe, putamen, thalamus, arachnoid lower chamber, cerebellar hemorrhage of ECG changes were high speciifcity. Conclusion The bleeding site and the actual disease in patients with acute cerebral hemorrhage is the main reason impacting of the patient's electrocardiogram changes, mainly in moderate to severe acute cerebral hemorrhage patients.

  4. Multivariate Logistic Regression Analysis of the Risk Factors of Old People′s Subsequent Multiple Organ Dysfunction Syndrome after Cerebral Hemorrhage%老年脑出血继发多器官功能障碍综合征的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    鲍治诚; 夏雪龙; 王万华; 吴亚平

    2014-01-01

    目的:探讨老年人脑出血并发多器官功能障碍综合征( MODS)的危险因素。方法回顾性分析2012年2月至2014年2月昆山市第一人民医院神经内科收治的80例(其中并发 MODS 54例)老年脑出血患者的临床资料。对脑出血并发 MODS的危险因素进行单因素和多因素 Logistic回归分析。结果单因素分析结果显示,患者年龄、原有基础疾病、脏器衰竭数目、营养状态、机体免疫功能和感染与脑出血并发MODS有关(P<0.05);多因素Logistic回归分析结果显示,原有基础疾病、脏器衰竭数目和感染是脑出血并发MODS的独立危险因素(P<0.05)。结论老年人脑出血继发MODS的主要危险因素是原有基础疾病、脏器衰竭数目和感染,在临床工作中应积极重视这些危险因素并给予有效治疗,从而有效预防MODS的发生。%Objective To investigate the risk factors of cerebral hemorrhage with multiple organ dys-function syndrome(MODS) in the elderly.Methods Total of 80 cases of cerebral hemorrhage (54 cases with MODS) of the elderly in Neurological department of the First People′s Hospital of Kunshan from Feb. 2012 to Feb.2014 were selected,and their clinical information were retrospectively analyzed.The risk factors of the cerebral hemorrhage with MODS were analyzed by single factors and multivariate Logistic regression a-nalysis.Results Single factor analysis showed that age of patients,primary disease,the number of organ fail-ure,nutritional status,immune function,and infection were associated with cerebral hemorrhage with MODS (P<0.05).Multivariate Logistic regression analysis showed that primary disease,the number of organ fail-ure,infection were the independent risk factors of cerebral hemorrhage with MODS(P<0.05).Conclusion The risk factors of cerebral hemorrhage with MODS in the elderly include primary disease ,the number of organ failure and infection.More attention should be given

  5. Acute Transverse Myelitis Complicated in Korean Hemorrhagic Fever: A Case Report and Review of the Literature

    OpenAIRE

    Kim, Min Ja; Choi, Jong Soo; Lee, Hyun Koo; Hyun, Jin Hai

    1986-01-01

    Involvement of the central nervous system in Korean hemorrhagic fever is expected. When such involvement does occur, it is usually in the form of cerebral hemorrhage or pituitary necrosis. Paralytic disease due to Korean hemorrhagic fever is exceptional. A case of transverse myelitis in an adult female, in which a serologic test of immunofluorescent antibodies to Hantaan virus was positive with clinical pictures of Korean hemorrhagic fever, is reported here.

  6. Spontaneous Partial Regression of Cerebral Arteriovenous Malformation

    OpenAIRE

    Choi, Jae Ho; Shin, Ji Hoon; Cho, Seong Shik; Choi, Deuk Lin; Byun, Bark Jang; Kim, Dong Won

    2002-01-01

    Arteriovenous malformation (AVM) of the brain is one of the important pathologic conditions which cause intracerebral or subarachnoid hemorrhage, epilepsy, or chronic cerebral ischemia. The spontaneous regression of cerebral AVM is reported to be very rare and more likely to occur when the AVM is small, is accompanied by hemorrhage, and has fewer arterial feeders. We report a case of right occipital AVM which at follow-up angiography performed four years later showed near-complete spontaneous...

  7. Spontaneous partial regression of cerebral arteriovenous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jae Ho; Shin, Ji Hoon; Cho, Seong Shik; Choi, Deuk Lin; Byun, Bark Jang; Kim, Dong Won [Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

    2002-01-01

    Arteriovenous malformation (AVM) of the brain is one of the important pathologic conditions which cause intracerebral or subarachnoid hemorrhage, epilepsy, or chronic cerebral ischemia. The spontaneous regression of cerebral AVM is reported to be very rare and more likely to occur when the AVM is small, is accompanied by hemorrhage, and has fewer arterial feeders. We report a case of right occipital AVM which at follow-up angiography performed four years later showed near-complete spontaneous regression.

  8. 早期康复护理对脑出血偏瘫患者肢体运动功能的影响分析%Analysis the Effects of Limb Motor Function on Hemiplegic Patients With Cerebral Hemorrhage by Early Rehabilitation Nursing

    Institute of Scientific and Technical Information of China (English)

    姜影

    2016-01-01

    Objective To investigate the effect of early rehabilitation nursing on extremity motor function in hemiplegic cerebral hemorrhage patients. Methods82 patients with hemiplegic cerebral hemorrhage were randomly divided into two groups, each group had 41 cases. the observation group with early rehabilitation nursing, control group underwent routine care, compared nursing effect of two groups.Results Observation group cure rate was 90.2% higher than the control group 63.4%, FMA score (53.1±4.7) was higher than the control group (32.0±5.3) (P<0.05).Conclusion Hemiplegia cerebral hemorrhage patients with early rehabilitation nursing exact effect.%目的:探讨早期康复护理对脑出血偏瘫患者肢体运动功能的影响。方法将82例脑出血偏瘫患者随机分成两组,各41例,观察组应用早期康复护理,对照组行常规护理,对比两组的护理效果。结果观察组痊愈率90.2%,高于对照组的63.4%,观察组FMA评分(53.1±4.7)分,高于对照组的(32.0±5.3)分(P<0.05)。结论脑出血偏瘫患者行早期康复护理效果确切。

  9. 脑出血患者心肌酶谱与纤维蛋白原联合检测的临床价值%The clinical significance of combined detection of myocardial enzymes and fibrinogen in patients with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王喜栋; 张琳; 李伟; 张瑞

    2012-01-01

    目的 探讨急性脑出血后患者心肌酶谱及纤维蛋白原的早期预警作用.方法 收集我院住院就诊的47例脑出血患者为病例组,另选50例健康体检者为对照组.用Roche-P800生化分析仪检测心肌酶谱,用ACL-TOP全自动凝血分析仪检测纤维蛋白原.观察病例组与对照组的心肌酶谱及纤维蛋白原的水平,并进行比较分析两者联合检测的临床意义.结果 与对照组比较,病例组的心肌酶谱及纤维蛋白原明显升高(P<0.05).结论 急性脑出血患者的心肌酶谱和纤维蛋白原的异常升高对合并心肌受损有早期预测价值,联合监测心肌酶谱和纤维蛋白原可为临床早期采取治疗措施提供实验依据.%Objective To investigate the early warning role of myocardial zymogram and fibrinogen in patients after acute cerebral hemorrhage . Methods Fourty-seven cases with acute cerebral hemorrhage were collected and , other 50 healthy volunteers as control group. Myocardial enzymes were determined by Roche-P800 biochemical analyzer and fibrinogen was detected by ACL-TOP automatic coagulation analyzer. To observe the level of myocardial enzyme and fibrinogen in both case and control groups and analyse the clinical significance of combined detection of myocardial enzymes and fibrinogen. Results Compared with control group, the level of myocardial enzymes and fibrinogen in cerebral hemorrhage group was increased significantly( P < 0. 05 ). Conclusion The abnormal elevation of myocardial enzymes and fibrinogen in patients with cerebral hemorrhage has predictive value of early myocardial damage. Combined detection of myocardial enzymes and fibrinogen may provide the theoretical basis for the clinical early treatment.

  10. 大鼠脑出血后同侧海马区Slit2、 Nogo-A表达的相关研究%Relationship study of the expressions of Slit2 and Nogo-A in rats with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王风波; 王琼芬; 张弘; 李飞; 唐明薇

    2015-01-01

    目的 观察大鼠脑出血后同侧海马区Slit2、Nogo-A的表达情况.方法 将64只成年SD大鼠按随机数字表法分为对照组(n=32)、模型组(n=32).模型组采用Ⅶ型胶原酶制备诱导尾状核出血模型;对照组手术操作方法同模型组,注射同等剂量生理盐水.2组大鼠分别于术后24h、7、14及21 d时相点行出血侧海马区免疫组化Slit2、Nogo-A检测.结果 与对照组相比,模型组Slit2、Nogo-A阳性反应均明显增强(P<0.01),以7d最为显著.结论 脑出血可引起Slit2、Nogo-A的表达显著增强,两者呈正相关,可能对脑损伤后的修复有着重要的影响作用.%Objective To investigate the expressions of Slit2 and Nogo-A in the ipsilateral hippocampus after cerebral hemorrhage in rats.Methods A total of 64 adult Sprague-Dawley (SD) rats was randomly divided into control and model groups.Collagenase Ⅶ was used to induce cerebral hemorrhage model.Immunohistochemistry was used to detect the expressions of Slit2 and Nogo-A in hippocampus at the cerebral hemorrhage side at the time points (24 h,7 d,14 d,and 21 d).Results Compared to the control group,the expressions of Slit2 and Nogo-A were significantly enhanced in model group (P <0.01),with the highest level at the 7 d.Conclutions Cerebral hemorrhage can significantly enhance expressions of Slit2 and Nogo-A with a positive correlation of Slit2 and Nogo-A,which might have an important effect on the recovery of brain injury.

  11. 预见性干预对高血压脑出血患者去骨瓣减压联合血肿引流术后便秘与上消化道出血的预防效果%Effect of predictive intervention in preventing constipation and upper digestive tract hemorrhage after decompressive craniectomy and drainage hematoma operation in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    马晓红; 张爱华; 彭玉洁; 陈香林

    2016-01-01

    Objective To explore the effect of predictive nursing intervention in preventing constipation and upper digestive tract hemorrhage after decompressive craniectomy and drainage hematoma operation in patients with hypertensive cerebral hemorrhage.Methods Fifty patients with hypertensive cerebral hemorrhage from June 2014 to June 2015 were enrolled as observation group,and were given predictive nursing;50 patients with hypertensive cerebral hemorrhage from May 2013 to May 2014 were enrolled as control group,and were given conventional nursing.The volume and position of hemorrhage,incidences of postoperative constipation and upper gastrointestinal bleeding were observed and recorded.Results The volume and position of hemorrhage were not significantly different between groups (P > 0.05).The incidences of difficult defecation,scleroma defecation,abdominal pain,abdominal distension,anorexia,anxiety and upper digestive tract hemorrhage in observation group were significantly lower than those in control group [16.0% (8/50) vs 42.0% (21/50),4.0% (2/50) vs26.0% (13/50),10.0% (5/50) vs 32.0% (16/50),24.0% (12/50) vs 46.0% (23/50),30.0%(15/50) vs54.0% (27/50),14.0% (7/50) vs 36.0% (18/50),2.0% (1/50) vs 20.0% (10/50)](P <0.05).Conclusion Predictive nursing intervention can effectively reduce the incidence of upper gastrointestinal hemorrhage and improve the constipation in patients with hypertensive cerebral hemorrhage after operation.%目的 探讨预见性干预对高血压脑出血患者去骨瓣减压联合血肿引流术后便秘与上消化道出血的预防效果.方法 回顾性分析2014年6月至2015年6月解放军第四二二医院收治的50例高血压脑出血患者(观察组)和2013年5月至2014年5月收治的50例高血压脑出血患者(对照组)的临床资料.观察组采用预见性干预措施;对照组采用常规护理模式.观察并比较2组患者脑出血部位、出血量、术后便秘以及上消化

  12. Periventricular hemorrhagic leukomalacia

    Energy Technology Data Exchange (ETDEWEB)

    Kaude, J.V.; Nanni, G.S.

    1984-11-01

    Periventricular white matter hemorrhages were diagnosed by ultrasound in 9/376 (2.4%) of premature infants. The most frequent site of such a hemorrhagic event is the area immediately posterolateral to the trigone of the lateral ventricle. These bleedings probably represent hemorrhagic infarcts into areas of periventricular leukomalacia. Porencephalic cysts developed at 12/14 hemorrhagic sites. In 2 infants follow-up studies showed progressive brain necrosis exceeding the area of initial hemorrhage.

  13. 1例多囊肝多囊肾合并脑出血患者的药学监护%Pharmaceutical care on a patient with cerebral hemorrhage with polycystic liver and polycystic kidney disease

    Institute of Scientific and Technical Information of China (English)

    石秀锦; 魏国义

    2012-01-01

    One 76-year-old male patient with cerebral hemorrhage, polycystic liver and polycystic kidney, pulmonary infection and hypertension was hospitalized. The patient was given empirical anti-infection treatment with cefepime for pulmonary infection. Considering the renal insufficiency and susceptibility culture results of the patient, clinical pharmacists proposed to treat with fusidic sodium, vancomycin and cefoperazone/sulbactam. Fat overload syndrome induced by intralipid was analyzed, and clinical pharmacist recommended to withdraw the intralipid intravenous infusion and switch to glucose injection to supply of energy. In addition, the elderly patient with renal hypertension, the selection of antihypertensive drugs was discussed, and captopril, telmisartan and sodium nitroprusside should be changed to fosinopril sodium, amlodipine besylate and furosemide. After the rational optimization of the treatment, the pulmonary infection was controlled timely and effectively and the blood pressure was controlled stably. The symptoms of this patient improved markedly.%1例76岁男性患者,因多囊肝多囊肾合并脑出血、肺部感染及高血压入院.针对患者肺部感染,医生经验性给予头孢吡肟,结合患者肾功能不全及药敏培养结果,临床药师建议采用夫西地酸钠、万古霉素及头孢哌酮钠/舒巴坦钠联合抗感染;同时,对脂肪乳引起的脂肪超载综合征进行分析,建议停用脂肪乳静脉滴注,改用葡萄糖注射液供给能量;并对患者降压药物的选择进行讨论,建议将卡托普利、替米沙坦、硝普钠改为福辛普利钠、苯磺酸氨氯地平、呋塞米.经合理优化治疗方案后,患者感染得到及时、有效的治疗,血压控制较平稳,病情明显好转.

  14. 芬太尼对蛛网膜下腔出血后脑血管痉挛的影响%Effect of Fentanyl on cerebral vasospasm after subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    刘玉明; 马建荣

    2012-01-01

    Objective To study the effect of Fentanyl on cerebral vasospasm after subarachnoid hemorrhage and its mechanism. Methods Seventy-two healthy adult rabbits were randomly divided into four groups: the control group (group A), SAH group (group B), SAH with fentanyl intravenous (group C) and SAH with fentanyl intramuscular (group D). The rabbits underwent neurobiology score every day. The basar artery was stained by HE, and hippocampus undrewent HE staining and Bcl~2\\Bax immunohistochemical staining, then the neuron density as well as the expression of Bax and Bcl-2 were detected. Results After SAH, the expression of Bcl-2 and Bax increased. After intervention with fentanyl, the expression Bcl-2 was increased, while the expression of Bax decreased., The neurological function score, neuron density and Bax and Bcl-2 expression in group B showed statistically significant differences with those in group C and group D (P<0.05). Conclusion Fentanyl can inhibit neuron apoptosis possibly through enhancing Bcl-2 expression and inhibiting Bax expression.%目的 研究芬太尼(Fentanyl)对蛛网膜下腔出血后脑血管痉挛的影响及其作用机制.方法 选用健康成年家兔72只,随机分成假手术对照组(A组)、SAH组(B组)、芬太尼静脉干预组(C组)、芬太尼肌注干预组(D组).每天进行神经生物学评分,并在实验24h、72h、7d后处死,取基底动脉进行H-E染色,观察管壁情况,同时取左侧海马分别行HE染色及免疫组化染色,观测神经元密度、Bcl-2及Bax的表达.结果 SAH后Bcl-2、Bax表达均增加,芬太尼干预后Bcl-2表达升高,Bax表达下降.B组的神经生物学评分、神经元密度、Bcl-2及Bax的表达与C、D组差异有统计学意义(P<0.05).结论 芬太尼可抑制CVS后细胞凋亡,可能通过促进SAH家兔Bcl-2的表达而抑制Bax表达.

  15. Vascular CTA Imaging in the Early Diagnosis and Determine the Cause of the Value of Clinical Application of Cerebral Hemorrhage%血管CTA成像技术在脑出血早期诊断及其病因判断中的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    廖文彬

    2015-01-01

    Objective To investigate the multi slice spiral CT angiography (MSCTA) in the application value in the early diagnosis of cerebral hemorrhage. Methods Through spiral CT plain scan in 45 cases of patients, cerebral hemorrhage patients for clinical diagnosis, the results of whole brain angiography diagnosis result is compared with the DSA method. Results In 45 cases of cerebral hemorrhage patients, were examined by MSCTA on it, found that 29 patients with cerebral aneurysm, 9 patients with arteriovenous malformation, 2 cases of patients with moyamoya disease, 3 patients with venous vascular malformation, 2 cases of patients with unexplained. Pathological detection of cerebral aneurysm in 30 cases, SCTA showed aneurysm in 29, the detection rate was 96.67%, 4 cases of patients with tumors located in the intracranial segment of internal carotid artery in 9 patients, the tumors located in the anterior communicating artery, 4 cases of patients with tumors located in the anterior cerebral artery, 3 cases of patients with tumor in the vertebral basilar artery, 9 patients with tumor in the brain artery. Conclusion Vascular CTA imaging technique is a safe, no brain vascular imaging invasive, reliable and can be used as the preferred method for early diagnosis of cerebral hemorrhage.%目的:探讨多层螺旋CT血管成像技术(MSCTA)在脑出血早期诊断的应用价值。方法通过对患者进行螺旋CT平扫,对45例脑出血患者进行临床诊断,将诊断的结果与DSA全脑动脉造影检查结果进行比较。结果在45例脑出血患者中,通过对其进行MSCTA检查,结果发现29例患者为脑动脉瘤,9例患者为动静脉畸型,2例患者为烟雾病,3例患者为静脉性血管畸型,2例患者原因不明。病理检出脑动脉瘤30例,SCTA显示动脉瘤29,检出率为96.67%,4例患者肿瘤位于颈内动脉颅内段、9例患者肿瘤位于前交通动脉、4例患者肿瘤位于大脑前动脉、3例患

  16. Intracranial hemorrhage of the mature newborn infant. Centering around the CT picture

    Energy Technology Data Exchange (ETDEWEB)

    Takemine, Hisao

    1983-08-01

    The labour course, treatment, and prognoses were discussed concerning four mature newborn infants with intracranial hemorrhage diagnosed by CT. Of intracranial hemorrhage, 70.7% was small hemorrhage along the cerebellar tentorium and the falx cerebri, 12.2% subdural hemorrhage in the posterior cranial fossa, and 9.8% subdural hemorrhage in the fornex. Intraventricular or extradural hemorrhage was rarely found. The prognosis is determined by the severity of neurotic symptoms due to cerebral hypoxia. Subdural hemorrhage of the posterior cranial fossa resulted in cerebral palsy in one fifth of the cases, and in slight enlargement of the ventricle in three fifths. Subdural hematoma left porencephaly in one fourth of the patients, but the remaining recovered to normal.

  17. 脑出血患者气管切开术后焦虑障碍发病情况与抗焦虑治疗%The Incidence of Anxiety Disorder and Anti-anxiety Treatment in Patients with Cerebral Hemorrhage after Tracheotomy

    Institute of Scientific and Technical Information of China (English)

    唐月岭; 赵立波

    2013-01-01

    Objective:To study the incidence of anxiety disorder in patients with cerebral hemorrhage after tracheotomy, and explore the prognosis of anti-anxiety treatment. Methods:The incidence of anxiety disorder was studied by self-rating anxiety scale in 62 pa-tients with cerebral hemorrhage after tracheotomy, and patients with anxiety disorder were randomly divided into treatment group and control group, treatment group was treated with flupenthixol and melitracen oral tablets until tube drawing after 7 days, control group received conventional therapy, to observe the incidence of common complications between two groups and calculate the time of tube. Results:32 patients suffered from anxiety disorders, including 18 mild cases, 10 moderate cases, 4 severe cases;there was the same incidence of complications between treatment group and control group (P>0.05);average time of tube in treatment group was shorter than that in control group (P0.05);治疗组平均带管时间短于对照组(P<0.05)。结论:脑出血患者气管切开术后焦虑障碍发病率较高,应给予重视;抗焦虑治疗并发症率减少,但无统计学意义;抗焦虑治疗可减少带管时间。

  18. 脑出血患者术后早期活动对预防下肢深静脉血栓形成的影响%The effect of the postoperative patients' early activities with cerebral hemorrhage to prevent deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    李爱文; 谢春雷; 李春霞; 黄维明; 钟丽丽

    2010-01-01

    Objective To explore the clinical results that the postoperative patients' early activities with cerebral hemorrhage to prevent deep venous thrombosis. Methods A total of 84 cases of the postoperative patients with cerebral hemorrhage were randomly divided into experimental group and control group, the experimental group was implemented the early activities' program; the control group was implemented the current clinical to prevent the conventional care of deep venous thrombosis; the two groups' patients were recorded the change of the blood pressure and heart rate after they were operated in 6 hours; the two groups' patients during hospitalization were observed if the complication with deep venous thrombosis or not Results The comparison of the change in blood prssure and heart rate after they were operated in 6 hours had no significance different (P > 0. 05) , the comparison in the prevention of occuring the deep venous thrombosis (P 0.05);术后发生下肢深静脉血栓的防治上比较,差异有统计学意义(P<0.05).结论 脑出血术后早期活动可促进患者术后早期康复,预防下肢深静脉血栓的发生.

  19. MRI findings and differential diagnosis in children with cerebral paragonimiasis

    Directory of Open Access Journals (Sweden)

    Zhen Zeng

    2016-06-01

    Conclusions: The clinical manifestations of cerebral paragonimiasis are nonspecific in children while the MRI findings of cerebral paragonimiasis are characteristic, including irregular hemorrhage, ring-like enhancement and disproportionately large areas of surrounding edema. Brain MRI plays an important role in the diagnosis of cerebral paragonimiasis in children.

  20. 微创穿刺引流术治疗基底节区高血压脑出血对水肿带变化的影响%Effect of minimally invasive puncture and drainage on the changes of edema belt of cerebral hemorrhage in basal ganglion

    Institute of Scientific and Technical Information of China (English)

    曹栓柱; 王艳州; 李金泉; 田勇; 牛海涛; 邢晓峰

    2015-01-01

    Objective To observe the effect of minimally invasive puncture and drainage on the changes of edema belt of cerebral hemorrhage in basal ganglion region.Methods 97 cases with cerebral hemorrhage in basal ganglion from March 2011 to August 2014 in our hospital were selected and randomly divided into group A and group B.51 cases in group A were treated by minimally invasive puncture and drainage based on conventional therapy and 46 cases in group B received conventional thera‐py.The changes of edema belt of cerebral hemorrhage ,clearance rate of hematoma ,the condition of neurological function recov‐ery ,mRS scores and mortality were compared between the two groups .Results Compared with pre‐operation ,the edema belt of cerebral hemorrhage in group A decreased obviously ,which in group B increased remarkably and peaked on the 5th day after operation ,which on 1st ,3rd ,5th and 7th day in group A reminded lower levels compared with group B (P0.05).Conclusion The treatment of mini‐mally invasive puncture and drainage has higher clearance rate of hematoma and less surgical trauma in cerebral hemorrhage pa‐tients in basal ganglion ,which can promote the recovery of neurological function and improve the quality of life.%目的探讨微创穿刺引流术用于基底节区高血压脑出血患者对水肿带变化的影响。方法我院2011‐03-2014‐08收治的97例高血压基底节区脑出血患者,随机分为A、B 2组,其中A组51例,在内科保守治疗的基础上行微创穿刺引流术;B组46例,仅采用内科保守治疗。比较2组水肿带、血肿清除率、神经功能恢复情况、m RS评分及病死率。结果与术前比较,术后A 组水肿带明显减小,B组水肿带逐渐变大,第5天达到峰值;与B组相比,A 组在第1、3、5、7天均较低(P<0.01)。治疗3周后,与B组比较,A组血肿清除率较高且神经功能缺损评分较低。治疗3个月后,与B组比较,A

  1. 氯碘羟喹对实验性脑出血大鼠铜蓝蛋白表达的影响%Influence of clioquinol on experimental cerebral hemorrhage in rats with ceruloplasmin expression

    Institute of Scientific and Technical Information of China (English)

    陈艳丽; 王改青; 尹永峰; 赵瑞

    2014-01-01

    Objective To study the effect of clioquinol on the expression of ceruloplasmin in experimental cerebral hemorrhage ( ICH) rats.Methods 48 Wistar rats were randomly divided into 2 groups: control group and the intervention group with each group of 24 rats, using stereotactic injection of collagenase preparation ICH model to the caudate nucleus of rats, after molding success the intervention group were given clioquinol 50 mg /kg orally every 12 h;intragastric saline control group.From each of 2 groups, six rats decapitated at different time points after 1, 3,7,14 d, using immunohistochemical stai-ning and real-time PCR detection of Cp .Results ICH model after preparation , two groups with time Cp positive expression was significantly increased in the first seven days of the peak;compared with the control group , the intervention group within the brain tissue of rats in the first Cp day showed no significant difference ( P >0.05), the expression at 3-14 d were higher ( P <0.05).2 groups'Cp mRNA expression levels peaked at 7 days, and the first 3,7,14 d were higher than the first day expression level ( P <0.05).Compared with the control group , the intervention group 3,7,14 day Cp mRNA expression lev-els were higher ( P <0.05).Conclusion CQ adjust cerebral hemorrhage by regulating the expression of ceruloplasmin in brain tissue, brain tissue may accelerate the removal of iron ions and thus play a protective role in the brain .%目的:研究金属螯合剂氯碘羟喹(CQ)干预大鼠脑出血(ICH)后铁超载状态下铜蓝蛋白(Cp)的表达。方法将48只Wistar大鼠随机分为2组:对照组、干预组各24只,均采用立体定向技术向大鼠尾状核区注射胶原酶制备ICH模型,制模成功后干预组给予氯碘羟喹50 mg/kg灌胃,1次/12 h;对照组用等量生理盐水灌胃。2组在术后1、3、7、14 d不同时间点各取6只大鼠断头取脑,采用免疫组化染色和实时荧光定量PCR检测Cp的表达。结

  2. Yl-1型粉碎穿刺针在服用阿司匹林患者脑出血中的应用%The Application of Yl-1 Type Smash Puncture in Treatment of Cerebral Hemorrhage in Patients Taking Aspirin

    Institute of Scientific and Technical Information of China (English)

    万意; 费喜峰; 周强; 王之敏; 蒋栋毅

    2015-01-01

    目的:探讨采用YL-I型粉碎穿刺针对应用阿司匹林高血压脑出血患者进行治疗的临床效果。方法回顾性分析35例口服阿司匹林患者高血压脑出血患者采用YL-I型粉碎穿刺针进行血肿引流治疗,围手术期配合血小板血浆输注维生素K肌注等综合治疗。结果27例患者血肿明显减少,3例患者再次出血,2例开颅手术,5例脑水肿加重患者,1例开颅手术治疗。结论对于口服阿司匹林脑出血患者的治疗尚无统一标准,选择YL-1型粉碎穿刺针起到了治疗的效果。对于情况严重的患者只能起到临时缓解症状的作用。%Objective To analyze the effect of YL-I type smash puncture in treatment of cerebral hemorrhage in patients taking aspirin. Methods Hematoma drainage was performed in 35patients with hypertensive cerebral hemorrhage who were taking aspirin by YL-I type smash puncture A ,and intramuscular injection of vitamin K coordinated with blood platelet and plasma input was conducted during peri operation period .The whole process was retrospectively analyzed. Results 27 cases of hematoma in patients decreased significantly, 3 patients bleeding again, 2 cases received operation, 5 cases of cerebral edema aggravated, surgical oper-ation treatment of 1 cases. Conclusion For the treatment of patients with oral aspirin cerebral hemorrhage there are no uniform standards, choose YL-1 type smash puncture the treatment effect. To the relief of the symptoms of patients with more serious con-ditions can only play.

  3. 基因芯片技术检测脑出血大鼠血肿周围组织早期基因表达%Detection on early gene expression of tissues around hematom in rats with cerebral hemorrhage with the technique of DNA microarray

    Institute of Scientific and Technical Information of China (English)

    吴碧华; 胡常林

    2006-01-01

    BACKGROUND: Changes of physiological structure, changes of phenotype and first basic excision are all the changes of gene expression. The technique of DNA microarray is a new method to filtrate target genes fleetly and largely by using the theory of base-partnershin, which can holistically and magnificently study the expression and function of organics genes. OBJECTIVE: To study early differential expression genes of rats with cerebral hemorrhage with DNA microarray and establish academic foundation for exploring mechanism of cerebral hemorrhage.DESIGN: Randomized controlled research.SETTING: Department of Neurology, Affiliated Hospital of North Sichuan Medical College. MATERIALS: The experiment was conducted at the Affiliated Hospital of North Sichuan Medical College from October 2002 to December 2003. Twenty Wistar rats, of either gender, with body mass of 220-260 g, without special pathogen, provided by Experimental Animal Center of Chongqing University of Medical Sciences, were selected and randomly divided into control group and cerebral hemorrhage group, with 10 in each group. METHODS: Animal models with cute cerebral hemorrhage of rats were established with type Ⅶ collagenase tridimensional localization method,and 4 hours later tissues around hematom and normal cerebral tissue at the same part were detected with gene chip. Fluorescent signal was scanned with scanning apparatus and analyzed with computer. Result of genic expressive pattern was researched with reverse transcriptase-polymerase chain reaction (RT-PCR). MAIN OUTCOME MEASURES: Result of gene chip in cerebral tissue of rats and result of RT-PCR.RESULTS: Four hours after acute cerebral hemorrhage, 129 differential expression genes were screened out, in which there were 114 up-regnlation genes and 15 down-regulation genes. Those genes were mostly related to the following aspects: stress, immunological response, apoptosis, energy metabolism and signal transmitting. Genes related with inflammatory

  4. Anaplastic Medullary Ependymoma Presenting as Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Nicolas Nicastro

    2013-01-01

    Full Text Available A-41-year old man presented with violent thunderclap headache and a bilateral proprioceptive sensibility deficit of the upper limbs. Cerebral CT scan and MRI were negative. Lumbar puncture confirmed subarachnoid hemorrhage (SAH, but cerebral angiography was negative. Three months later, the patient presented with paraparesis, and a thorough work-up revealed a diffuse, anaplastic extramedullary C7-D10 ependymoma with meningeal carcinomatosis considered the source of hemorrhage. The patient went through a D5-D8 laminectomy, temozolomide chemotherapy, and radiotherapy. The situation remained stable for a few months. In this paper, we would like to emphasize that spinal masses should be considered in cases of SAH with negative diagnostic findings for aneurysms or arteriovenous malformation.

  5. Angiographically occult arteriovenous malformations causing intracerebral hemorrhage

    International Nuclear Information System (INIS)

    We had experienced 5 cases of angiographically occult AVMs led to intracerebral hemorrhage and progressive neurologic deficit and seizure. Cerebral angiography in each case failed to demonstrate the vascular nature of the lesion and conventional skull radiography was no use. Computed tomography (CT), in 4 cases out of 5, showed well demarcated, slightly hyperdense and ovoid masses which turned out resolving hematomas. These lesions had also contained focal areas of high densities. In one case we observed definitively enhanced area in the resolving hematoma and it was corresponded to histopathologically proved AVM. CT appearance of acute hemorrhage at the subcortical region of cerebral hemisphere was showed in another case. We believe that CT can afford important supplementary information regarding an associated hematoma for angiographically occult AVM. Caution is advised in assuming that angiographically avascular lesion demonstrable by CT is not vascular malformation.

  6. A model of subarachnoid hemorrhage in rats

    Institute of Scientific and Technical Information of China (English)

    Liao-liaoLI; Xiao-liangWANG

    2004-01-01

    AIM: To build a simple and repeatable animal model of subarachnoid hemorrhage (SAH). METHODS: SAH was introduced by passing a nylon thread up through the right internal carotid artery and piercing a hone in the right anterior cerebral artery. At 12 and 24 h, the rats were evaluated with rotarod test and the behavior scale (5-point scale). RESULTS: The ratswere trained through rotarod test and then randomly divided into

  7. Hemorrhage Following Tonsillectomy

    OpenAIRE

    Yorgancılar, Ediz; Yıldırım, Müzeyyen; Meriç, Faruk Meriç Faruk

    2008-01-01

    Hemorrhage is one of the most important and serious complications which follows tonsillectomy. In this retrospective study, 14 male, 9 female, total of 23 patients who were treated at Ear Nose Throat Department at Dicle University Faculty of Medicine for posttonsillectomy hemorrhage were presented. The average age was 15,5 ± 10,6. There were 4 primary (%17,3), 19 secondary (%82,7) hemorrhage cases. The times of presentation of patients with secondary hemorrhage following tonsillect...

  8. Risk analysis for aspirin and postoperative intracranial hemorrhage - report of 3 cases

    Institute of Scientific and Technical Information of China (English)

    YU Shu-qing; WANG Ji-sheng; JI Nan; LIU Wei; QIAN Ke

    2009-01-01

    @@ Aspirin has been widely used clinically since 1899.For patients with cerebral ischemia and implanted intravascular stents, aspirin has been used routinely for prevention of intracranial hemorrhage and for anticoagulation treatment. However, many multi-center,large sample, controlled studies have shown that aspirin may actually increase the risk of spontaneous cerebral hemorrhage, and that aspirin was an independent predictor of death shortly after cerebral hemorrhage. Here we report a case series, between July 1 2006 and January 1 2008, of 3 patients who experienced postoperative intracranial hemorrhage after receiving regular aspirin treatment before surgery in the Center of Neurosurgery,Beijing Tiantan Hospital, Capital Medical University.Two of them died. There were 86 patients in all receiving regular aspirin treatment before surgery in the same period. The incidence of intracranial hemorrhage in this group is 3.49%.

  9. The value of hyperbaric oxygen therapy in postoperative care of subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Griessenauer Christoph J

    2012-12-01

    Full Text Available Abstract In this editorial, the issues related to the hyperbaric oxygen therapy and its utility in managing cerebral vasospasm in patients with subarachnoid hemorrhage is discussed.

  10. A segmentation algorithm of intracranial hemorrhage CT image

    Science.gov (United States)

    Wang, Haibo; Chen, Zhiguo; Wang, Jianzhi

    2011-10-01

    To develop a computer aided detection (CAD) system that improves diagnostic accuracy of intracranial hemorrhage on cerebral CT. A method for CT image segmentation of brain is proposed, with which, several regions that are suspicious of hemorrhage can be segmented rapidly and effectively. Extracting intracranial area algorithm is introduced firstly to extract intracranial area. Secondly, FCM is employed twice, we named it with TFCM. FCM is first employed to identify areas of intracranial hemorrhage. Finally, FCM is employed to segment the lesions. Experimental results on real medical images demonstrate the efficiency and effectiveness.

  11. 早期持续腰大池引流对于脑外伤合并蛛网膜下腔出血的疗效观察%Effect observation of early continuous lumbar drainage on treatment of cerebral traumatic subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈贵平

    2012-01-01

    目的 观察脑外伤合并蛛网膜下腔出血患者行早期持续腰大池引流的临床疗效.方法 将183例脑外伤合并蛛网膜下腔出血患者随机分为2组,A组(n=92)接受早期持续腰大池引流术治疗,B组(n=91)接受每日腰穿术放脑脊液治疗.比较2组患者疗效及预后.结果 A组每日脑脊液引流量显著多于B组,而脑脊液压力复常时间、转清时间以及临床症状持续时间显著短于B组.A组总并发症发生率、脑积水及癫痫发生率均显著低于B组.2组患者无植物状态和死亡病例,A组预后良好率显著高于B组,而预后不良率显著低于B组.结论 早期持续腰大池引流治疗脑外伤合并蛛网膜下腔出血患者可以有效缓解临床症状,改善预后.%Objective To observe the clinical effect of early continuous lumbar drainage in treatment of cerebral traumatic subarachnoid hemorrhage. Methods 183 patients with cerebral traumatic subarachnoid hemorrhage were randomly divided into 2 groups. Group A (n = 92) received early continuous lumbar drainage, while group B (n = 91) received daily lumbar puncture cerebrospinal fluid drainage. Efficacy and prognosis were compared between 2 groups. Results The drainage amount of cerebrospinal fluid in group A was obviously larger than group B, and normalization time of cerebrospinal fluid pressure, clearness time and duration of clinical symptoms in group A were obviously shorter than group B. Incidence of total complication, hydrocephalus and epilepsia in group A were obviously lower than group B. There was no case of vegetative state or death. The well prognosis rate in group A was obviously higher than group B, while unhealthy prognosis rate was obviously lower. Conclusion Early continuous lumbar drainage for treating cerebral traumatic subarachnoid hemorrhage can effectively alleviate the clinical symptoms and improve prognosis.

  12. 康复训练加心理干预在脑出血患者术后恢复期的效果应用评价%Evaluation of application rehabilitation training and psychological intervention for cerebral hemorrhage in recovery period

    Institute of Scientific and Technical Information of China (English)

    钟华

    2012-01-01

      Objective: To discuss the clincal effect of application rehabilitation training and psychological intervention for cerebral hemorrhage in recovery period. Methods: Choosed 110 cases of cerebral hemorrhage in recovery period to divide into study group and controled group. Controled group were treated with rutine treatment and commom nursing, while study group were treated added rehabilitation training and psychological intervention. Compared the clinicla effect. Results: The scores of Fugl-Meyer, index of Barthel in these two groups were higher than treating before, bur results in study group was better than controled group. The SAS and SDS score in study group decreased more definitely than controled group (p<0.05). Conclusion: Application rehabilitation training and psychological intervention for cerebral hemorrhage in recovery period could improve limbs athletic ability and patients' mood to extend in clinical.%  目的:探讨康复训练加心理干预在脑出血患者术后恢复期的应用效果.方法:将110例脑出血术后恢复期的患者随机分为对照组与实验组,对照组常用常规治疗与护理措施,实验组在此基础上给予康复训练与心理干预,对比两组病例的临床效果.结果:康复训练后,两组病例的 Fugl-Meyer 评分、Barthel指数评分结果均明显升高(P < O.05).实验组经康复训练后的评分结果明显优于对照组(P <0.05),差异具有统计学意义.心理干预4周后,实验组的 SAS评分、SDS 评分结果显著下降,明显优于对照组,两组比较差异具有统计学意义(P < O.O5).结论:在脑出血患者术后恢复期,早期康复训练与心理干预措施相结合,有利于提高患者的肢体运动能力,并且改善不良心理情绪,应进一步推广和应用.

  13. Analysis of curative effect of edaravone combined with seven Ye Zao glycosides sodium on treating patients with cerebral hemorrhage%依达拉奉联合七叶皂苷钠治疗脑出血的疗效观察

    Institute of Scientific and Technical Information of China (English)

    韩桐师; 王丹辉; 孙岩; 谢满红; 周平

    2014-01-01

    Objective To investigate the clinical curative effect of edaravone combined with seven Ye Zao glycosides sodi-um on treating patients with cerebral hemorrhage. Methods 60 patients with cerebral hemorrhage from February 2012 to De-cember 2012 in our hospital were randomly divided into the observation group (n=30 ,treated with the conventional treatment ) and the control group (n=30 ,treated with the edaravone combined with seven Ye Zao glycosides sodium ). The curative effect of two groups were compared. Results The total effective rate was 93.3% (in the observation group) and 76.7% (in the con-trol group);The NIHSS score ,edema area and hematoma volume of observation group were lower than these of control group , which had a significantly statistical difference (P<0.05). Conclusion The edaravone combined with seven Ye Zao glycosides sodium has a better curative effect on treating patients with cerebral hemorrhage ,which is worthy of clinical application.%目的:探讨依达拉奉联合七叶皂苷钠治疗脑出血的临床疗效。方法60例脑出血患者采用随机对照方法分为观察组和对照组各30例。对照组给予常规对症支持治疗,观察组在此基础上应用依达拉奉联合七叶皂苷钠治疗,比较2组临床疗效。结果观察组总有效率93.3%,对照组76.7%,观察组显著高于对照组,差异有统计学意义( P<0.05);观察组NIHSS评分、水肿面积及血肿体积均显著少于对照组,差异有统计学意义(P<0.05)。结论依达拉奉联合七叶皂苷钠治疗脑出血疗效显著,可有效改善患者临床症状,促进神经功能恢复,值得临床应用和推广。

  14. Superficial siderosis is a warning sign for future intracranial hemorrhage.

    Science.gov (United States)

    Linn, Jennifer; Wollenweber, Frank A; Lummel, Nina; Bochmann, Katja; Pfefferkorn, Thomas; Gschwendtner, Andreas; Bruckmann, Hartmut; Dichgans, Martin; Opherk, Christian

    2013-01-01

    Supratentorial superficial siderosis (SS) is a frequent imaging marker of cerebral amyloid angiopathy (CAA). It is most probably caused by focal subarachnoid hemorrhages (fSAHs). Based on single-case observations, it has been proposed that such fSAHs might be a predisposing factor for future intracranial hemorrhage. Here we tested the hypothesis if a SS as a residue of fSAHs must be regarded as a warning sign for future intracranial hemorrhage. Fifty-one consecutive patients with SS and no apparent cause other than possible or probable CAA were identified through a database search and followed-up for a median interval of 35.3 months (range 6-120 months). Main outcome measures were rate and location of new intracranial hemorrhages. Twenty-four patients (47.1 %) had experienced any new intracranial hemorrhage, 18 patients (35.3 %) had an intracerebral hemorrhage (ICH), and in 13 of them (25.5 %), the hemorrhage was located at the site of pre-existing siderosis. Six patients (11.7 %) had developed a new subarachnoid hemorrhage (SAH), four of them at the site of siderosis. Patients with SS are at substantial risk for subsequent intracranial hemorrhage. SS can be considered a warning sign of future ICH or SAH, which frequently occur adjacent to pre-existing SS. Prospective studies are needed to confirm these findings.

  15. Maternal mortality from hemorrhage.

    Science.gov (United States)

    Haeri, Sina; Dildy, Gary A

    2012-02-01

    Hemorrhage remains as one of the top 3 obstetrics related causes of maternal mortality, with most deaths occurring within 24-48 hours of delivery. Although hemorrhage related maternal mortality has declined globally, it continues to be a vexing problem. More specifically, the developing world continue to shoulder a disproportionate share of hemorrhage related deaths (99%) compared with industrialized nations (1%). Given the often preventable nature of death from hemorrhage, the cornerstone of effective mortality reduction involves risk factor identification, quick diagnosis, and timely management. In this monograph we will review the epidemiology, etiology, and preventative measures related to maternal mortality from hemorrhage.

  16. Plasticity of cerebrovascular smooth muscle cells after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Edvinsson, Lars; Larsen, Stine Schmidt; Maddahi, Aida;

    2014-01-01

    Subarachnoid hemorrhage (SAH) is most often followed by a delayed phase of cerebral ischemia which is associated with high morbidity and mortality rates. The causes underlying this delayed phase are still unsettled, but are believed to include cerebral vasospasm, cortical spreading depression, in...... signaling involved in the vascular plasticity is discussed with a focus on the Raf-MEK1/2-ERK1/2 pathway which seems to play a crucial role in SAH pathology....

  17. CT findings and pathogenetic mechanisms of hemorrhagic infarction

    International Nuclear Information System (INIS)

    Twenty-five patients were diagnosed as having hemorrhagic infarction by autopsy (4 cases), by an operation (3 cases), or by the combination of CT and a spinal tap (18 cases). Angiography was repeated to identify the recanalization as far as possible. The progression or resolution of the mass sign (brain edema) and the contrast enhancement were observed by CT, which was performed at intervals of from one to seven days in almost all cases. The CT findings of hemorrhagic infarction were as follows: 1) Appearance of the foci of an increased density in the low-density area; Generally the foci were indicated as a high-density area, but sometimes they were presented as isodensity in the acute stage of a stroke. Adjacent severe brain edema in the acute stage was supposed to be the main cause of the reduction in the CT number. 2) Ring-formed contrast enhancement in the subacute stage; a ring-formed contrast enhancement was seen on post-contrast scans after the resorption of the hemorrhage. According to our data, hemorrhagic infarction was found not only in the acute stage (within 4 days of the stroke, 9 cases) but also in the subacute stage (over 7 days after the stroke, 19 cases). The acute type of hemorrhage was usually associated with marked cerebral edema. On the other hand, the subacute type of hemorrhage usually appeared when enhancement after contrast infusion was observed and the cerebral edema was being resolved. On angiograms, a recanalization of the occlusion was frequently observed (18 cases, 68%). A comparative study of angiography and CT revealed the difference in the timing of the hemorrhage between the acute and subacute types of hemorrhages. The acute type of hemorrhage usually appeared in response to the angiographical recanalization, but the subacute type of hemorrhage sometimes occurred unrelated to that of angiographical recanalization. (author)

  18. Recurrent delayed brain hemorrhage over years after irradiation and chemotherapy for astrocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Hillemanns, Andreas; Skalej, Martin; Krapf, Hilmar [Department of Neuroradiology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Kortmann, Rolf-Dieter [Department of Radiooncology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Herrlinger, Ulrich [Department of Neurology, Eberhard Karls University, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)

    2003-08-01

    We report on an adult patient with a right frontal astrocytoma, classification WHO II, who suffered from radionecrosis 3.5 years after surgery and combined radio- and chemotherapy. Beginning 8 years after initial diagnosis, repeated episodes of bilateral cerebral hemorrhage and cavitation occurred. This case description emphasizes the possibility of repeated hemorrhage as a delayed reaction to brain irradiation and chemotherapy. (orig.)

  19. Studies of cerebrovascular lesion by computer tomography, cerebral scintigrapy and EEG in longitudinal section

    International Nuclear Information System (INIS)

    A long-term follow-up of an intracerebral hemorrhage by computer tomography, cerebral scintigraphy and EEG is reported. In the acute phase of the cerebral hemorrhage, EEG, computer tomography and scintigraphy are equally useful diagnostic techniques. In the recovery phase of the hemorrhage only the results of computer tomography fitted with the clinical status of the patients. In this phase of hemorrhage, scintigraphy was less sensitive in the following of the regeneration of cerebral circulation than in the previous phases. (L.G.)

  20. 98例急性多灶性脑出血经软通道多点穿刺的临床治疗体会分析%98 cases of acute multifocal cerebral hemorrhage by soft channel multi-point puncture Clinical treatment analysis

    Institute of Scientific and Technical Information of China (English)

    来怡农; 庞建军

    2013-01-01

      目的分析急性多灶性脑出血经软通道多点穿刺的临床治疗体会。方法98例急性脑出血患者应用CT定位经皮肤微创多点穿刺,局部麻醉下,YL-1型粉碎穿刺抽吸颅内血肿并(尿激酶溶解血凝块)冲洗引流。结果施穿刺术后因颅内高压行开颅清除血肿、减压11例。血肿变化不大10例,血肿增大7例,血肿明显减少者53例,血肿基本消失28例,其中再出血8例。98例患者治疗结果按GOS分级:中残40例、重残16例、植物态7例、死亡3例、良好32例。结论采用微创经软通道多点穿刺技术治疗急性脑出血,优点是安全、简便、快速、微创、疗效显著及并发症少等,且要高度重视手术时机、术后再出血处理、前后的血压控制等方面。%Objective To study the experience of clinical treatment of soft channel multi-point puncture of acute multifocal cerebral hemorrhage.Methods 98 cases of acute cerebral hemorrhage patients using CT percutaneous minimally invasive multiple puncture,local anesthesia,YL 1 type of intracranial hematoma smash puncture aspiration and(urokinase to dissolve blood clots)irrigation and drainage.Results the puncture after intracranial hypertension underwent craniotomy evacuation of hematoma,decompression in 11 cases.10 cases of hematoma changed little,hematoma enlargement in 7 cases,hematoma was significantly reduced in 53 cases,hematoma disappeared in 28 cases,including 8 cases of hemorrhage.98 patients were treated according to the GOS classification:Disabled in 40 cases,severe disability in 16 cases,7 cases of plant state,died in 3 cases,good in 32 cases.Conclusions:minimally invasive puncture technique by soft passageway in treatment of acute cerebral hemorrhage,has the advantages of safety,simple,rapid,minimally invasive,significant and has less complications,and attach great importance to the operation time,postoperative hemorrhage of blood pressure control before and

  1. Intrathecal treatment of cerebral vasospasm.

    Science.gov (United States)

    Zhang, Yi Ping; Shields, Lisa B E; Yao, Tom L; Dashti, Shervin R; Shields, Christopher B

    2013-11-01

    Treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) remains a major therapeutic challenge. Systemic drug administration is the current treatment of choice, but patients often do not respond beneficially to this approach. Intrathecal (IT) drug administration has several anatomic and pharmacodynamic advantages over conventional systemic treatment of cerebral vasospasm. We reviewed the most recent literature describing IT administration of several drugs to treat aneurysm-induced SAH and cerebral vasospasm, including 16 clinical trials using IT fibrinolytic agents and 10 trials using several IT vasodilators. We evaluated the safety and effectiveness of these trials but made no attempt to perform a meta-analysis using these data. IT drug administration of fibrinolytic agents and vasodilators caused lysis of the subarachnoid clot burden and diminished cerebral vasospasm, respectively. The studies reviewed reported a wide range of drug doses, intervals between aneurysm hemorrhage and initiation of treatment, success of clot dissolution, and degree of vasodilation of vessels in vasospasm. Treatment of vasospasm by IT drug administration is safe and largely effective after the aneurysm has been secured. Our findings indicate that IT treatment effectively delivers a higher drug concentration to vessels in vasospasm with minimal systemic effects. Drugs administered by this route are reported to lyse subarachnoid clots, attenuate cerebral vasospasm, improve clinical outcomes, and decrease the incidence of hydrocephalus. With greater understanding of drug pharmacodynamics, the IT route of drug administration may provide a rational, alternative approach to treating aneurysm-induced cerebral vasospasm. PMID:22651990

  2. THE EXPERIMENTAL STUDY ON THE CELL APOPTOSIS AND EXPRESSION OF BCL-2 PROTEIN IN INTRACEREBRAL HEMORRHAGE IN MODEL OF RATS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Intra-cerebral hemorrhage is a common clinicaldisease,with a high mortality and morbidity.So itis one of the clinical hot topics.It has been foundinrecent years that there is a close relationship bet weenthe cell apoptosis and the course or prognosis of in-tra-cerebral hemorrhage.Bcl-2,as the apoptosis-adjusted gene,plays ani mportant role in the courseof cell apoptosis,but the mechanis min the cell ap-optosis in intra-cerebral hemorrhage remains un-clear.In this experi ment,with the model buildingof the in...

  3. Cerebral Hypoxia

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Hypoxia Information Page Synonym(s): Hypoxia, Anoxia Table of Contents ( ... Trials Organizations Publicaciones en Español What is Cerebral Hypoxia? Cerebral hypoxia refers to a condition in which ...

  4. Troponin elevation in subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Ioannis N Mavridis; Maria Meliou; Efstratios-Stylianos Pyrgelis

    2015-01-01

    Troponin (tr) elevation in aneurysmal subarachnoid hemorrhage (SAH) patients is often difficult to be appropriately assessed by clinicians, causing even disagreements regarding its management between neurosurgeons and cardiologists. The purpose of this article was to review the literature regarding the clinical interpretation of tr elevation in SAH. We searched for articles in PubMed using the key words:“troponin elevation”and“subarachnoid hemorrhage”. All of them, as well as relative neurosurgical books, were used for this review. Some type of cardiovascular abnormality develops in most SAH patients. Neurogenic stunned myocardium is a frequent SAH complication, due to catecholamine surge which induces cardiac injury, as evidenced by increased serum tr levels, electrocardiographic (ECG) changes and cardiac wall motion abnormalities. Tr elevation, usually modest, is an early and specific marker for cardiac involvement after SAH and its levels peak about two days after SAH. Cardiac tr elevation predictors include poor clinical grade, intraventricular hemorrhage, loss of consciousness at ictus, global cerebral edema, female sex, large body surface area, lower systolic blood pressure, higher heart rate and prolonged Q-Tc interval. Elevated tr levels are associated with disability and death (especially tr>1μg/L), worse neurological grade, systolic and diastolic cardiac dysfunction, pulmonary congestion, longer intensive care unit stay and incidence of vasospasm. Tr elevation is a common finding in SAH patients and constitutes a rightful cause of worry about the patients’ cardiac function and prognosis. It should be therefore early detected, carefully monitored and appropriately managed by clinicians.

  5. An ultrasound protocol in premature infants with intracranial hemorrhage

    Directory of Open Access Journals (Sweden)

    Velisavljev-Filipović Gordana

    2005-01-01

    Full Text Available Introduction. Prematurity is a great health problem in our country and in the world. There are more than 11% of premature births in America annually, and in Europe this rate is between 5-10%. In Vojvodina, 9% of babies are born prematurely. Intracranial hemorrhage takes a significant place in the morbidity of prematurely born children. Intracranial hemorrhage in premature newborn infants Incomplete CNS development of premature infants causes numerous complications, but it is also the factor which enables survival of extremely immature infants without sequelae. The management protocol depends on the level of hemorrhage. Early diagnosis of intracranial hemorrhage and determination of the level of hemorrhage are of utmost importance for disability prevention. Ultrasound in monitoring intracranial hemorrhage Brain monitoring of prematurely born babies is performed by ultrasound. This type of visualization has several advantages over other techniques: it is mobile, so called "bedside technique", it is relatively cheap, it may be repeated several times, it is possible to define the exact time of hemorrhage and monitor its absorption from day to day. Ultrasound is safe, and there is no ionized radiation. No sedation is required for ultrasound examination. The examination is not painful. Conclusion The frequency of ultrasound depends on the level of hemorrhage, presence or absence of ventriculomegally/ hydrocephalus, as well as on the surrounding cerebral parenchyma. .

  6. Glibenclamide for the Treatment of Ischemic and Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    Nicholas Caffes

    2015-03-01

    Full Text Available Ischemic and hemorrhagic strokes are associated with severe functional disability and high mortality. Except for recombinant tissue plasminogen activator, therapies targeting the underlying pathophysiology of central nervous system (CNS ischemia and hemorrhage are strikingly lacking. Sur1-regulated channels play essential roles in necrotic cell death and cerebral edema following ischemic insults, and in neuroinflammation after hemorrhagic injuries. Inhibiting endothelial, neuronal, astrocytic and oligodendroglial sulfonylurea receptor 1–transient receptor potential melastatin 4 (Sur1–Trpm4 channels and, in some cases, microglial KATP (Sur1–Kir6.2 channels, with glibenclamide is protective in a variety of contexts. Robust preclinical studies have shown that glibenclamide and other sulfonylurea agents reduce infarct volumes, edema and hemorrhagic conversion, and improve outcomes in rodent models of ischemic stroke. Retrospective studies suggest that diabetic patients on sulfonylurea drugs at stroke presentation fare better if they continue on drug. Additional laboratory investigations have implicated Sur1 in the pathophysiology of hemorrhagic CNS insults. In clinically relevant models of subarachnoid hemorrhage, glibenclamide reduces adverse neuroinflammatory and behavioral outcomes. Here, we provide an overview of the preclinical studies of glibenclamide therapy for CNS ischemia and hemorrhage, discuss the available data from clinical investigations, and conclude with promising preclinical results that suggest glibenclamide may be an effective therapeutic option for ischemic and hemorrhagic stroke.

  7. Complications of hemorrhagic and ischemic stroke : a CT perfusion evaluation

    NARCIS (Netherlands)

    Dankbaar, J.W.

    2010-01-01

    In this thesis the use of CT-perfusion (CTP) imaging in the evaluation of the most severe complications of subarachnoid hemorrhage (SAH)) and ischemic stroke was explored. These complications are delayed cerebral ischemia (DCI) after SAH and damage to the blood-brain barrier (BBB) after ischemic str

  8. Calcium homeostasis during magnesium treatment in aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    van den Bergh, Walter M.; van de Water, Jolanda M. W.; Hoff, Reinier G.; Algra, Ale; Rinkel, Gabriel J. E.

    2008-01-01

    Objective Magnesium treatment in patients with subarachnoid hemorrhage (SAH) can result in hypocalcemia; this hypocalcemia increases the risk of delayed cerebral ischemia (DCI) and poor outcome. We assessed whether low serum levels of total calcium in patients with SAH treated with magnesium is medi

  9. Cardiac dysfunction after aneurysmal subarachnoid hemorrhage : Relationship with outcome

    NARCIS (Netherlands)

    van der Bilt, Ivo; Hasan, Djo; van den Brink, Renee; Cramer, Maarten-Jan; van der Jagt, Mathieu; van Kooten, Fop; Meertens, John; van den Berg, Maarten; Groen, Rob; ten Cate, Folkert; Kamp, Otto; Goette, Marco; Horn, Janneke; Groeneveld, Johan; Vandertop, Peter; Algra, Ale; Visser, Frans; Wilde, Arthur; Rinkel, Gabriel

    2014-01-01

    OBJECTIVE: To assess whether cardiac abnormalities after aneurysmal subarachnoid hemorrhage (aSAH) are associated with delayed cerebral ischemia (DCI) and clinical outcome, independent from known clinical risk factors for these outcomes. METHODS: In a prospective, multicenter cohort study, we perfor

  10. Hemorrhagic Stroke in Children

    OpenAIRE

    Jordan M.D., Lori C.; Hillis M.D., Argye E.

    2007-01-01

    Hemorrhagic stroke accounts for approximately half of stroke in childhood. Unlike arterial ischemic stroke, there are no consensus guidelines to assist in the evaluation and treatment of these children. We review the literature on the evaluation, treatment, etiology and neurologic outcome of hemorrhagic stroke in children. Important differences between pediatric and adult hemorrhage are highlighted, as treatment guidelines for adults may not be applicable in all cases. Needed future research ...

  11. The influences of ulinastatin on serum levels of IL-Iβ and sICAM- 1 in acute cerebral hemorrhage patients%乌司他丁对脑出血患者急性期血清IL-1β和sICAM-1的影响

    Institute of Scientific and Technical Information of China (English)

    李改丽; 汪丙昂; 王晓湘; 胡健; 王建; 张汝

    2011-01-01

    Objective To investigate the influences of ulinastatin on serum levels of IL??(inter-leukin條? and sICAM?(soluble intercellular adhesion molecule?). Methods 140 cerebral hemor-rhage patients were collected in 4 years (July in 2006 to July in 2010) from neurology and neurosurgery departments in the General Hospital of Chengdu Military Region were randomly divided into two groups : control group and treatment group. The treatment group was treated with ulinastatin 14 days i. v.. Blood samples were collected at three time points:day 2,day 7 and day 14 after admission to hospital. Se-rum levels of IL - 1?and sICAM - 1 were determined with double antibody ABC - ELISA. Results Compared with controls, the levels of two inflammatory mediators of cerebral hemorrhage pa-tients in acute stage were significantly reduced by ulinastatin. All patients showed no obvious side effects. Conclusions The ulinastatin may be one of alternative medicines inhibiting the inflammatory re-sponse after intracerebral hemorrhage.%目的 观察鸟司他丁对脑出血患者血清IL-1β和可溶性细胞间黏附分子水平的影响.方法 对我院2006年7月~2010年7月神经内、外科的脑出血患者140例进行研究,随机分为对照组和治疗组两组,治疗组静滴鸟司他丁14 d,分别在入院第2,7,14天采用双抗体夹心ABC- ELISA法观察患者血清IL-1β和sICAM-1的水平.结果 和对照组相比,乌司他丁可以降低脑出血患者急性期这两种交性介质的水平,全部病例未出现明显副作用.结论 乌司他丁可能可以作为抑制脑出血后炎性反应的备选药物之一.

  12. Hereditary Hemorrhagic Telangiectasia - HHT

    Science.gov (United States)

    ... access catheters Vertebroplasty Women and vascular disease Women's health Social Media Facebook Twitter ... Hereditary Hemorrhagic Telangiectasia - HHT Interventional Radiologists Offer Non-surgical Treatment for Underdiagnosed Genetic Disorder ...

  13. Relevant factors of recurrent bleeding in hypertensive cerebral hemorrhage after treated by microinvasive drain and aspiration%早期微创治疗高血压脑出血术后继续出血的因素分析

    Institute of Scientific and Technical Information of China (English)

    薛山; 张贤鹏

    2012-01-01

    Objective To explore the relevant factors of recurrent bleeding in hypertensive cerebral hemorrhage (HCH) after treated by microinvasive drain and aspiration, and prevent postoperative recurrent bleeding. Methods A total of 230 patients with HCH were received microinvasive drain and aspiration with YL- I transfixion pin, 68 patients among them occurred recurrent bleeding (recurrent bleeding group) and 162 did not have recurrent bleeding (non-recurrent bleeding group), the onset time, blood pressure, amount of first time haematoma aspiration, bleeding part and shape and restlessness before and after surgery were compared to analyze the factors of recurrent bleeding. Results The onset time of most patients in recurrent bleeding group was within 6 hours (61.76%), and less occurred after 24 hours (8.82%), there was a statistical difference compared with non-recurrent bleeding group (x2 = 3.78,P < 0.05); both preoperative systolic pressure and dias-tolic pressure were significantly higher than those of non-recurrent bleeding group (t = 2.73 、3.20, P < 0.05); the amount of first time haematoma aspiration was more than that of non-recurrent bleeding group (t = 2.91 ,P < 0.05); the bleeding parts were mostly in basal ganglia (42.65%), colliculus nervi optici (29.41%) and dorsal caudate putamen (27.94%); irregular haematoma was more prone to recurrent bleeding (x2 = 11.83, P < 0.01); restlessness of patients was more prone to recurrent bleeding (x2 = 24.37, P < 0.01). Conclusion Recurrent bleeding after microinvasive drain and aspiration is relevant to onset within 6 hours, hypertension, large amount of first time haematoma aspiration, basal ganglia, colliculus nervi optici and dorsal caudate putamen bleeding, irregular haematoma and restlessness, and corresponding measures should be applied to decrease the incidence of recurrent bleeding and improve the prognosis of patients.%目的 探讨影响高血压脑出血早期微创治疗后继续出血的相关因素,

  14. ECG changes during cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, K.; Nishimura, Y.; Yoshida, M.; Itoh, K.; Hayashi, N.; Aoki, J.; Nakamura, K.; Imai, M.; Ono, T.; Morikawa, S.

    1984-09-01

    We have analyzed HR changes greater than 20% among 334 patients and 942 cerebral angiographies. A tachycardial effect was seen in 14.9% of patients, while a bradycardial effect was seen in 7.1% including two patients having cardiac standstill (0.5%). These two patients were examined without atropine premedication after subarachnoid hemorrhage. Patients under 19 years of age, unpremedicated with atropine sulfate and suffering from subarachnoid hemorrhage secondary to ruptured aneurysm or arteriovenous malformation showed a significantly high incidence of bradycardia. On the other hand, patients with the neoplastic disease and having an initial sinus bradycardia showed a significantly high incidence of a tachycardial effect.

  15. Rehabilitation Outcomes: Ischemic versus Hemorrhagic Strokes

    Directory of Open Access Journals (Sweden)

    Robert Perna

    2015-01-01

    Full Text Available Background. Ischemic and hemorrhagic strokes have different pathophysiologies and possibly different long-term cerebral and functional implications. Hemorrhagic strokes expose the brain to irritating effects of blood and ischemic strokes reflect localized or diffuse cerebral vascular pathology. Methods. Participants were individuals who suffered either an ischemic (n=172 or hemorrhagic stroke (n=112 within the past six months and were involved in a postacute neurorehabilitation program. Participants completed three months of postacute neurorehabilitation and the Mayo Portland Adaptability Inventory-4 (MPAI-4 at admission and discharge. Admission MPAI-4 scores and level of functioning were comparable. Results. Group ANOVA comparisons show no significant group differences at admission or discharge or difference in change scores. Both groups showed considerably reduced levels of productivity/employment after discharge as compared to preinjury levels. Conclusions. Though the pathophysiology of these types of strokes is different, both ultimately result in ischemic injuries, possibly accounting for lack of findings of differences between groups. In the present study, participants in both groups experienced similar functional levels across all three MPAI-4 domains both at admission and discharge. Limitations of this study include a highly educated sample and few outcome measures.

  16. 微创联合依达拉奉对高血压脑出血患者 MMP-9的影响及疗效观察%Influence of minimally invasive combined edaravone on MMP-9 of hypertensive patients with cerebral hemor-rhage and its curative effect

    Institute of Scientific and Technical Information of China (English)

    苏彦果; 袁发东; 李建明; 贾婕; 高钟生

    2014-01-01

    Objective To observe the minimally invasive combined edaravone on the serum of patients with hypertensive cerebral hemorrhage matrix metalloproteinase-9 (MMP-9) impact.Methods A retrospective analysis of 80 cases of cerebral hemorrhage patients in our hospital from January 2011-2013 in December ,who were randomly divided into observation group and control group ,40 cases in each group ,the control group was given conventional treatment ,the observation group was ob-served in the conventional treatment group based on the use of edaravone ,continued drug were used for about 2 weeks ,the ser-um levels of MMP-9 ,and recorded the NIHSS score and BI index were detected.Results Serum MMP-9 levels before treat-ment showed no significant difference (P> 0.05) ,and significant differences after treatment (t= 11.2636 , P0.05) ,and BI con-tent MESSS significant difference after treatment in both groups (respective t=3.1762 ,3.9890 ,all P<0.01).Conclusion Min-imally invasive and edaravone on MMP-9 in patients with hypertensive intracerebral hemorrhage are mainly for inhibition , which can effectively reduce the patients 'inflammatory response after cerebral hemorrhage ,protect brain cells function ,it is worthy of promotion and application.%目的:观察微创联合依达拉奉对高血压脑出血患者血清基质金属蛋白酶-9(MMP-9)的影响。方法回顾性分析我院2011-01-2013-12收治的80例脑出血患者,随机分为观察组和对照组各40例,对照组给予常规治疗,观察组在常规治疗的基础上加用依达拉奉治疗,持续用药2周,检测2组血清 MMP-9水平,并记录NIHSS评分和BI指数。结果血清MMP-9含量治疗前差异无统计学意义(P>0.05),治疗后差异有统计学意义(t=11.2636,P<0.01);治疗前2组MESSS和BI差异无统计学意义(P均>0.05),治疗后2组中MESSS和BI含量差异有统计学意义(t=3.1762、3.9890,P均<0.01)。结论微创联合依达拉奉对高

  17. Let's Talk about Hemorrhagic Stroke

    Science.gov (United States)

    ... Pressure Tools & Resources Stroke More Let's Talk About Hemorrhagic Stroke Updated:Dec 9,2015 About 13 percent of ... or near the brain. This is called a hemorrhagic stroke. When a hemorrhagic stroke happens, blood collects in ...

  18. Hemorrhagic prepatellar bursitis

    Energy Technology Data Exchange (ETDEWEB)

    Donahue, F. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Turkel, D. [Dept. of Radiology, Musculoskeletal Section, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Mnaymneh, W. [Dept. of Orthopedics, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States); Ghandur-Mnaymneh, L. [Dept. of Pathology, Univ. of Miami/Jackson Memorial Hospital, Miami, FL (United States)

    1996-04-01

    Simple prepatellar bursitis is easily diagnosed both clinically and by MRI. MRI shows the typical T1 and T2 lengthening of fluid within the bursa. However, because of complex MRI appearance of hemorrhage, chronic hemorrhagic bursitis and the size of the prepatellar mass the clinical and MRI appearance can be very different. (orig.)

  19. Effect of magnesium treatment and glucose levels on delayed cerebral ischemia in patients with subarachnoid hemorrhage : a substudy of the Magnesium in Aneurysmal Subarachnoid Haemorrhage trial (MASH-II)

    NARCIS (Netherlands)

    Leijenaar, Jolien F.; Mees, Sanne M. Dorhout; Algra, Ale; van den Bergh, Walter M.; Rinkel, Gabriel J. E.

    2015-01-01

    BackgroundMagnesium treatment did not improve outcome in patients with aneurysmal subarachnoid haemorrhage in the Magnesium in Aneurysmal Subarachnoid Haemorrhage II trial. We hypothesized that high glucose levels may have offset a potential beneficial effect to prevent delayed cerebral ischemia. We

  20. Comprehensive Overview of Contemporary Management Strategies for Cerebral Aneurysms.

    Science.gov (United States)

    Manhas, Amitoz; Nimjee, Shahid M; Agrawal, Abhishek; Zhang, Jonathan; Diaz, Orlando; Zomorodi, Ali R; Smith, Tony; Powers, Ciarán J; Sauvageau, Eric; Klucznik, Richard P; Ferrell, Andrew; Golshani, Kiarash; Stieg, Philip E; Britz, Gavin W

    2015-10-01

    Aneurysmal subarachnoid hemorrhage (SAH) remains an important health issue in the United States. Despite recent improvements in the diagnosis and treatment of cerebral aneurysms, the mortality rate following aneurysm rupture. In those patients who survive, up to 50% are left severely disabled. The goal of preventing the hemorrhage or re-hemorrhage can only be achieved by successfully excluding the aneurysm from the circulation. This article is a comprehensive review by contemporary vascular neurosurgeons and interventional neuroradiolgists on the modern management of cerebral aneurysms. PMID:26072457

  1. Comprehensive Overview of Contemporary Management Strategies for Cerebral Aneurysms.

    Science.gov (United States)

    Manhas, Amitoz; Nimjee, Shahid M; Agrawal, Abhishek; Zhang, Jonathan; Diaz, Orlando; Zomorodi, Ali R; Smith, Tony; Powers, Ciarán J; Sauvageau, Eric; Klucznik, Richard P; Ferrell, Andrew; Golshani, Kiarash; Stieg, Philip E; Britz, Gavin W

    2015-10-01

    Aneurysmal subarachnoid hemorrhage (SAH) remains an important health issue in the United States. Despite recent improvements in the diagnosis and treatment of cerebral aneurysms, the mortality rate following aneurysm rupture. In those patients who survive, up to 50% are left severely disabled. The goal of preventing the hemorrhage or re-hemorrhage can only be achieved by successfully excluding the aneurysm from the circulation. This article is a comprehensive review by contemporary vascular neurosurgeons and interventional neuroradiolgists on the modern management of cerebral aneurysms.

  2. Tuberculoma cerebral Cerebral tuberculoma

    OpenAIRE

    ELIZABETH CLARA BARROSO; TÂNIA REGINA BRÍGIDO DE OLIVEIRA; ANA MARIA DANTAS DO AMARAL; VALÉRIA GÓES FERREIRA PINHEIRO; ANA LÚCIA DE OLIVEIRA SOUSA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  3. POSTPARTUM HEMORRHAGE - A REVIEW

    Directory of Open Access Journals (Sweden)

    I. Marcovici

    2005-10-01

    Full Text Available Postpartum hemorrhage has been defined as either a 10% change in hematocrit between admission and postpartum period or a need of erythrocyte transfusion. The incidence of postpartum hemorrhage is 3.9% for vaginal deliveries and 6.4% for cesarean delivery. Clinically the blood loss is often underestimated by as much as 30% - 50% resulting in a delay in addressing the problem. Postpartum hemorrhage can become rapidly catastrophic. The ACOG ranks postpartum hemorrhage as the third cause of maternal mortality after embolism and hypertensive disease. Predisposing factors for postpartum hemorrhage are: uterine atony (50%, lower genital tract lacerations (20%, uterine abnormalities (20% etc. Management of the postpartum hemorrhage includes a rapid but thorough physical examination, specifically of the abdominal and pelvic regions, concurrent with laboratory evaluation and volume replacement therapy. Coagulation studies are also necessary. If no genital tract lacerations are found, some maneuvers must be done: uterine exploration followed by uterine massage and blunt curettage, if the products of conception are found in the uterine cavity. If postpartum hemorrhage is due to uterine atony then, uterotonic regimens should be used (methyl-ergonovine, 15-methyl prostaglandin F2 (alpha, prostaglandin E2 or misoprostol. When all other conservative methods of treatment of postpartum hemorrhage failed, before going for invasive procedures as uterine embolization and laparotomy, I strongly suggest the use of Intrauterine Balloon Tamponade. Invasive procedures comprise embolization and laparotomy with conservative techniques (ligation of the uterine blood supply and uterine compression sutures or hysterectomy or/and Transvaginal Pressure Pelvic Pack. In conclusion, post-partum hemorrhage can become rapidly catastrophic. Once the diagnosis is made, a quick and methodic approach to the problem, following the algorithm bellow, can be very helpful. Also, remember the

  4. Clinical Research of the Protective Effect of Nifedipine on Brain Injury in Patients with Cere-bral Hemorrhage%硝苯地平对脑出血患者脑损伤保护作用的临床观察

    Institute of Scientific and Technical Information of China (English)

    余海亚; 刘展

    2014-01-01

    Objective To explore the protective effect of nifedipine on brain injury in patients with cere-bral hemorrhage .[Methods] A total of 58 patients with cerebral hemorrhage were randomly divided into rou-tine treatment group and nifedipine treatment group .Clinical neurologic impairment score ,Barthel index (BI) score ,hematoma volume and edema area volume of patients before and after treatment were observed .[Re-sults] Total effective rate of nifedipine group was 75% ,which was markedly higher than that of routine treat-ment group(60% ) .Compared with routine treatment group ,the decline value of clinical neurological impair-ment score and BI score were elevated and the dependency level of daily living activity was markedly reduced in nifedipine group after treatment .Hematoma volume in two groups after treatment was obviously decreased , but there was no significant difference in the decline value of hematoma volume between two groups after treat-ment .Edema area of two groups after treatment was also decreased ,but the decline value of edema area vol-ume in nifedipine group was obviously elevated .[Conclusion] Nifedipine can obviously alleviate brain edema , protect nerve cells ,decrease neurologic impairment level and improve quality of life of patients with cerebral hemorrhage .%【目的】探讨硝苯地平对脑出血患者脑损伤的保护作用。【方法】将58例脑出血患者随机分为常规治疗组(对照组)与硝苯地平治疗组(观察组),患者均分别在治疗前后观察临床神经功能缺损评分(MESS)、Barthel指数评分(BI)、血肿体积、水肿带体积。【结果】针对治疗的总有效率,观察组总有效率为75%,显著高于对照组(60%)。此外,与对照组比较,硝苯地平治疗后明显提高了临床神经功能缺损评分减少值、BI评分增加值以及显著降低了治疗后日常生活活动的依赖程度。观察组和对照组经治疗后血肿体积均明显缩小

  5. Study on early application of the somatosensory evoked potential in the judgement of limb movement disorder and its prognosis in the patients with cerebral hemorrhage%早期体感诱发电位检测对脑出血患者肢体运动障碍程度及预后判断的研究

    Institute of Scientific and Technical Information of China (English)

    侯群; 陈眉; 孙岩; 黄晓明

    2001-01-01

    目的 探讨早期检测脑出血患者短潜伏期体感诱发电位(short-latency somatosensory evoked potential,SLSEP)在判断肢体瘫痪程度及预后中的意义。方法 对62例天幕上脑出血患者在发病10 d内检测SLSEP,根据SLSEP异常程度不同将患者分成轻度、中度及重度异常3组。在发病初期及发病后3个月,按改良爱丁堡-斯堪的那维亚脑卒中量表中肢体运动功能部分(partial revised Edinburgh-Scandinavia Stroke Scale,PRESSS)对每位患者计算积分,并根据积分的多少将患者分为轻度、中度及重度瘫痪。结果 在发病初期及3个月后,不同程度SLSEP异常患者组间的PRESSS积分差异有显著性意义(P<0.05),SLSEP异常程度越严重,PRESSS积分越高,肢体瘫痪越严重;按二种方法分组的实际一致率分别为74.19%及66.13%。结论 对脑出血患者早期检测SLSEP有助于判断瘫痪肢体运动障碍的严重程度及预后。%Objective To explore the significance of early application of short-latency somatosensory evoked potential(SLSEP) recording in judging the extent of limb paralysis and its prognosis in the patients with cerebral hemorrhage. Methods Sixty-two patients were submitted to SLSEP recording within 10 days after attack of supratentorial cerebral hemorrhage, and consequently divided into three groups based on SLSEP abnormality: slight, moderate and severe. These patients were assessed using partial revised Edinburgh-Scandinavia Stroke Scale(PRESSS) at onset and at post-stroke 3 months, respectively, and further classified as slight, moderate and heavy palsy according to PRESSS score. Results PRESSS score was statistically significant among three groups with different levels of SLSEP abnormality both at onset and in 3 months(P<0.05). And the SLSEP abnormality was in direct proportion to the PRESSS score, as well as the severity of paralysis. Actual agreements of dividing groups through

  6. Compare the influence on postoperative quality of life and neurologic function of patients after using two kinds of surgical methods for the treatment of cerebral hemorrhage patients%两种手术方式对脑出血患者术后生活质量和神经功能恢复效果的影响∗

    Institute of Scientific and Technical Information of China (English)

    惠军; 张彬; 左毅; 李宝明; 陈尚军; 郭娟

    2015-01-01

    目的::探讨疼痛脑出血患者应用两种手术方式治疗后对患者的术后生活质量以及神经功能恢复情况的影响。方法:选取我院收治的180例脑出血患者,根据其手术方式的不同将其分为开颅手术组以及微创手术组,术后两组患者均给予常规的药物治疗,采用卒中量表(NIHSS)比较两组术后3个月的神经功能评分并应用生活质量问卷调查比较两组患者治疗后生活质量。结果:治疗后两组患者的 NIHSS 评分均较治疗前明显改善,微创手术组改善程度更明显,组间比较差异有统计学意义(P <0.05)。微创手术组患者治疗后的生理功能、躯体疼痛、活力、社会功能、情感、精神健康方面的评分相比于开颅手术组明显改善,组间比较有统计学差异(P <0.05)。结论:对于脑出血患者应用微创血肿钻孔减压术更有利于患者神经功能恢复,提高生活质量,值得推广应用。%Objective:Compare the influence on postoperative quality of life and neurologic function of pa-tients after using two kinds of surgical methods for the treatment of traumatic cerebral hemorrhage patients.Meth-ods:Select 90 cases of cerebral hemorrhage patients in our hospital ,according to the different operation methods di-vided them into the surgical craniotomy and minimally invasive surgery group,two groups of postoperative patients were given conventional drug treatment,the stroke scale (NIHSS)scores was used to compare nerve function score 3 months after surgery in two groups and health-related quality of life questionnaire was used to compared the quality of life of patients after treatment in two groups.Results:After treatment NIHSS score of patients in two groups both improved obviously,and the minimally invasive surgery group was more obvious,the difference between groups was statistically significant(P <0.05).Physiological function,body pain,vitality,social function

  7. 16层螺旋CT平扫和增强扫描对急性脑出血临床结局预测价值的比较%Comparision of predictive value of 16 slice spiral CT plain scan and en-hanced scan for clinical outcome of acute cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈弼政; 吴欣洪

    2015-01-01

    Objective To compare predictive value of 16 slice spiral CT plain scan and enhanced scan for clinical out-come of acute cerebral hemorrhage. Methods 200 patients with acute cerebral hemorrhage treated in our hospital from January 2010 to January 2014 were selected as research objects,and they were divided into the two groups,and there were 100 cases in each group.Observation group was conducted with CT enhanced scan,while control group was given CT plain scan.Imaging characteristics of two groups was observed,and diagnosed value between two groups was com-pared. Results The sensitivity of was 47.62%,the specificity was 84.81%,the negative predictive value was 85.90%,the positive predictive value was 45.45% in control group while the sensitivity was 66.67%,the specificity was 92.41%,the negative predictive value was 91.25%,the positive predictive value was 70.0% in observation group,and sensitivity and specificity in observation group was obviously higher than that of control group,and there was a statistical difference (P<0.05). Conclusion Predictive value of clinical outcome of acute cerebral hemorrhage of 16 slice spiral CT enhanced scan is higher than that of CT plain scan.%目的:比较16层螺旋CT平扫和增强扫描对急性脑出血临床结局的预测价值。方法选取本院2010年1月~2014年1月收治的急性脑出血患者200例为研究对象,根据影像学诊断方法不同分为两组,每组100例。观察组进行CT增强扫描,对照组行常规CT平扫,观察两组的影像学特征,比较两组的诊断价值。结果对照组预测脑出血增长的灵敏度为47.62%,特异度为84.81%,阴性预测值为85.90%,阳性预测值为45.45%,观察组的灵敏度为66.67%,特异度为92.41%,阴性预测值为91.25%,阳性预测值为70.0%,观察组的灵敏度、特异度均明显高于对照组,差异有统计学意义(P<0.05)。结论16层螺旋CT增强扫描对急性脑出血临床结局的预测价值高于常规平扫。

  8. 院前急救护理在急性脑出血患者中的应用及其对预后的影响%Application of pre-hospital emergency care in acute cerebral hemorrhage and its influence to prognosis

    Institute of Scientific and Technical Information of China (English)

    程丽梅; 胡子春; 刘贤玲

    2011-01-01

    Objective: To explore the application of pre-hospital emergency care in acute cerebral hemorrhage and its influence to prognosis. Methods: 120 cases with acute cerebral hemorrhage were randomly divided into control group and observation group. 68 patients of observation group were received pre-hospital emergency care, and 52 cases of control group were not received pre-hospital emergency care. The time of the patients treated after first onset and the mortality during in-hospital period were compared between two groups. MBI and FMA were used to evaluate ADL and extremity motor function before and after treatment. Results: The time of the patients treated after first onset in observation group was significantly shorter than that in control group [(46.28 ±10.35)min vs (71.92±19.27)min, P<0.01); The mortality during in-hospital period were 10.3% and 19.2% respectively in observation group and control group, and there was a significant difference between them (P<0.01); MBI and FMA in observation group were superior to control group (P<0.01). Conclusion: Application of pre-hospital emergency care in acute cerebral hemorrhage can decrease the mortality during in-hospital pe -riod and improve the prognosis of patients.%目的:探讨院前急救护理在急性脑出血患者的应用及对预后的影响.方法:选择120例急性脑出血患者进行研究,其中实施院前急救护理程序的68例患者为观察组,未进行院前急救护理的52例为对照组.比较两组患者接受正规治疗时间、住院期间病死率的差异.并于治疗前及治疗后3个月采用改良Barthel指数评估患者日常生活能力(ADL),采用FMA运动功能评定肢体运动功能.结果:观察组患者接受正规治疗时间为(46.28±10.35)min,短于对照组[(71.92±19.27)min],差异有高度统计学意义(P<0.01);观察组与对照组住院期间病死率分别为10.3%和19.2%,观察组低于对照组,差异有高度统计学意义(P<0.01);治疗后3个月观察组

  9. Microwave hemorrhagic stroke detector

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA)

    2007-06-05

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stoke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  10. Microwave hemorrhagic stroke detector

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, Waleed S. (Dublin, CA); Trebes, James E. (Livermore, CA)

    2002-01-01

    The microwave hemorrhagic stroke detector includes a low power pulsed microwave transmitter with a broad-band antenna for producing a directional beam of microwaves, an index of refraction matching cap placed over the patients head, and an array of broad-band microwave receivers with collection antennae. The system of microwave transmitter and receivers are scanned around, and can also be positioned up and down the axis of the patients head. The microwave hemorrhagic stroke detector is a completely non-invasive device designed to detect and localize blood pooling and clots or to measure blood flow within the head or body. The device is based on low power pulsed microwave technology combined with specialized antennas and tomographic methods. The system can be used for rapid, non-invasive detection of blood pooling such as occurs with hemorrhagic stroke in human or animal patients as well as for the detection of hemorrhage within a patient's body.

  11. Ebola hemorrhagic Fever.

    Science.gov (United States)

    Burnett, Mark W

    2014-01-01

    Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers.

  12. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  13. Concurrent Ruptured Pseudoaneurysm of the Internal Carotid Artery and Cerebral Infarction as an Initial Manifestation of Polycythemia Vera

    OpenAIRE

    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...

  14. Contribution of reactive oxygen species to cerebral amyloid angiopathy, vasomotor dysfunction, and microhemorrhage in aged Tg2576 mice

    OpenAIRE

    Han, Byung Hee; Zhou, Meng-liang; Johnson, Andrew W; Singh, Itender; Liao, Fan; Vellimana, Ananth K.; Nelson, James W.; Milner, Eric; Cirrito, John R.; Basak, Jacob; Yoo, Min; Dietrich, Hans H.; Holtzman, David M.; Zipfel, Gregory Joseph

    2015-01-01

    One of the hallmarks of Alzheimer’s disease (AD) is cerebral amyloid angiopathy (CAA), which is a strong and independent risk factor for cerebral hemorrhage, ischemic stroke, and dementia. However, the mechanisms by which CAA contributes to these conditions are poorly understood. Results from the present study provide strong evidence that vascular oxidative stress plays a causal role in CAA-induced cerebrovascular dysfunction, CAA-induced cerebral hemorrhage, and CAA formation, itself. They a...

  15. Differentiating between Hemorrhagic Infarct and Parenchymal Intracerebral Hemorrhage

    International Nuclear Information System (INIS)

    Differentiating hemorrhagic infarct from parenchymal intracerebral hemorrhage can be difficult. The immediate and long-term management of the two conditions are different and hence the importance of accurate diagnosis. Using a series of intracerebral hemorrhage cases presented to our stroke unit, we aim to highlight the clues that may be helpful in distinguishing the two entities. The main clue to the presence of hemorrhagic infarct on computed tomography scan is the topographic distribution of the stroke. Additional imaging modalities such as computed tomography angiogram, perfusion, and magnetic resonance imaging may provide additional information in differentiating hemorrhagic infarct from primary hemorrhages.

  16. Effect of dexmedetomidine on postoperative renal function in elderly patients with hypertensive cerebral hemorrhage undergoing removal of hematoma craniotomy%右美托咪定对高血压脑出血开颅血肿清除术的老年患者术后肾功能的影响

    Institute of Scientific and Technical Information of China (English)

    谢凡; 梁荣耀; 陈玲玲; 杨明明; 聂颖; 李韧韧

    2015-01-01

    Objective To evaluate the effect of dexmedetomidine on postoperative renal function in elderly patients with hypertensive cerebral hemorrhage undergoing removal of hematoma craniotomy.Methods 60 elderly patients with hypertensive cerebral hemorrhage scheduled for removal of hematoma craniotomy were randomly divided into control group (group C) and dexmedetomidine group (group D) with 30 cases in each group.Anesthesia was induced with target-controlled infusion of remifentanyl and propofol and injection of midazolam,sufentanyl and cisatracurium, endotracheal intubation before mechanical ventilation.Anesthesia was maintained with target-controlled infusion of remifentanyl and propofol and intravenous injection of cisatracurium.In group D,dexmedetomidine 0.2μg/(kg·h) was infused during operation, while the equal volume of normal saline was given instead in group C.The levels of blood urea nitrogen, serum creatinine, urine kidney injury molecule-l (KIM-1) were detected 5 minutes before anesthesia, at the beginning of operation, at the end of operation, postoperative 1 hour, 4 hours, 12 hours and 24 hours (T0-6).Recorded the amount of blood loss, blood transfusion, infusion and urine output.Results BUN and Cr significantly increased at T4, T5, T6 compared with T0 (P<0.05), KIM-1 significantly increased at T5 and T6 (P<0.05).BUN, Cr and KIM-1 significantly decreased at T6 compared with T5 (P<0.05).Compared with group C, BUN and Cr significantly decreased in group D at T4, T5 and T6 (P<0.05), KIM-1 significantly decreased at T5 and T6.Conclusion Postoperative renal function decreased in elderly patients with hypertensive cerebral hemorrhage undergoing removal ofhematoma craniotomy.Dexmedetomidine play a protective role in renal function of elderly patients with hypertensive cerebral hemorrhage undergoing removal of hematoma craniotomy.%目的 观察右美托咪定对高血压脑出血(HICH)行开颅血肿清除术的老年患者肾功能的影响.方法 因HICH

  17. Malaria cerebral Cerebral malaria

    Directory of Open Access Journals (Sweden)

    Carlos Hugo Zapata Zapata

    2003-03-01

    Full Text Available La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC. Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia.

  18. Impact of autologous bone marrow mesenchymal stem cell mobilization on neurological function recovery after minimally invasive surgery with cerebral hemorrhage%脑出血微创术后自体骨髓间充质干细胞动员对神经功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    胡炜; 胡维; 杨枫

    2014-01-01

    目的:观察脑出血大鼠微创术后骨髓间充质干细胞(BMSCs)动员对神经功能的影响。方法将45只大鼠建立脑出血模型后,随机分为两组,对照组(n=20,行微创引流手术)和治疗组(n=25,微创引流手术后3~5 d开始BMSCs动员)。术前当天及术后2、4、8周行Garcia神经功能量表评分,术前当天、术后2周测定外周血CD133+、CD34+细胞数,术前及术后2、4、8周行肝肾功能检查。结果两组术后Garcia量表分值均显著高于术前(P<0.05),治疗组术后各时间点Garcia神经功能量表分值显著高于对照组(P<0.05)。术后2周,治疗组外周血CD133+、CD34+细胞在单核细胞(MNCs)中的比例明显高于对照组(P<0.05)。BMSCs 动员后肝肾功能检查指标均正常。结论大鼠脑出血微创术后早期进行 BMSCs 动员,没有肝肾功能损伤,并可促进神经功能恢复。%Objective To observe the impact of autologous bone marrow mesenchymal stem cells (BMSCs) mobilization on neurological function recovery after cerebral hemorrhage minimally invasive surgery in rats.Methods After experimental intracerebral hemorrhage models was established, 45 SD rats were divided into two groups randomly, control group rats (20 rats, minimal invasive hematoma aspiration after modeling) and treated group (25 rats, begin BMSCs mobilization after aspiration 3-5 days). Garcia scales were performed at pre-modeling and 1, 4, 8 weeks post aspiration, CD133+, CD34+cell counts were measured in peripheral blood at pre-modeling and 2 weeks post aspiration, liver and renal function were performed in each group at 1, 3 months post BMSCs mobilization.Results Postoperative Garcia scores were significantly higher than those preoperative (P<0.05) in two groups, postoperative Garcia scores in treated group were significantly higher (P<0.05) than those in control group. Two weeks postoperation, the proportion of CD133+, CD34+ cells in

  19. 脑出血大鼠肠黏膜组织形态学变化与血浆儿茶酚胺水平的关系%Correlation between intestinal mucosa tissue morphologic parameters and plasma catecholamines level in rats with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    邱月; 宁显忠

    2012-01-01

    目的 探讨脑出血大鼠肠黏膜组织形态学变化与血浆儿茶酚胺(肾上腺素、去甲肾上腺素)水平之间的关系.方法 制作脑出血大鼠模型,检测正常组、假手术组及脑出血后24h、48h、72h(每组8只)肠黏膜组织形态学参数及血浆肾上腺素、去甲肾上腺素水平.进行空肠黏膜组织形态学参数值与血浆肾上腺素、去甲肾上腺素水平之间的相关分析.结果 小肠绒毛高度与血浆肾上腺素(r=-0.566,P<0.01)、血浆去甲肾上腺索(r=-0.545,P<0.01);绒毛面积与血浆肾上腺素(r=-0.755,P<0.01)、血浆去甲肾上腺素(r=-0.702,P <0.01);黏膜厚度与血浆肾上腺素(r=-0.478,P<0.01)、血浆去甲肾上腺素(r=-0.405,P<0.01);肠壁厚度与与血浆肾上腺素(r=-0.536,P<0.01)、血浆去甲肾上腺素肠(r=-0.489,P<0.01)均成显著的负相关.结论 脑出血时肠黏膜组织形态学变化与血浆儿茶酚胺水平呈负相关.%Objective To explore the correlation between intestinal mucosa tissue morphologic changes and plasma catecholamines(adrenaline and nurepinephrine) level in rats with cerebral hemorrhage. Methods A rat model of hemorrhage was used to detect the intestinal mucosa tissue morphologic parameters changes and the plasma catecholamines (adrenaline and norepinephrine) level at 24h,48h and 72h after the hemorrhage. The results were compared to normal control group and the sham-operated group. The correlation between the jejunal mucosa tissue morphologic parameters changes and plasma adrenaline and plasma norepinephrine were also explored. Results Small intestinal villous height was negatively correlated with the level of plasma adrenaline (r = - 0. 566, P < 0. 01) and plasma norepinephrine (r = - 0. 545, P < 0.01) . Small intestinal villous area was negatively correlated with the level of plasma adrenaline ( r = - 0. 755, P < 0. 01 ) and plasma norepinephrine( r = - 0. 702, P < 0. 01). Mucosal thickness was negatively

  20. Pial arteriovenous fistulas associated with multiple aneurysms presenting as intracerebral hemorrhage: a case report.

    Science.gov (United States)

    Cai, Wu; Gong, Jianping; Cheng, Bochao; Qiao, Fang; Zhang, Wei; Zhu, Qing; Lan, Qing

    2014-01-01

    Intracranial pial arteriovenous fistulas (AVFs) associated with multiple aneurysms of the main feeding arteries are very rare cerebrovascular lesions. We report a unique case of pial AVFs associated with four aneurysms of the feeding anterior cerebral artery (ACA) which presented as intracerebral hemorrhage (ICH), intraventricular hemorrhage (IVH) and spontaneous subarachnoid hemorrhage (SAH). CT angiography (CTA) and digital subtraction angiography (DSA) images demonstrated clearly the direct connection without nidus between the first and second segment of right ACA accompanied by four irregular aneurysms and an abnormally dilated draining vein into the superior sagittal sinus (SSS). Owing to the superficial-seated fistulas, the morphology of feeding arteries and associated four aneurysms and intracranial hemorrhage, the lesions were surgically treated. Postoperative cerebral angiography certified closure of the fistulas and exclusion of the four aneurysms as well as disappearance of early venous drainage. However, subsequent precontrast brain CT showed hydrocephalus underwent left ventriculoperitoneal shunt placement. PMID:25269054

  1. Risk Factors for Early Intracranial Hemorrhage after Intravenous rt-PA Thrombolysis in Patients with Cerebral Infarction%脑梗死患者溶栓后出现早期颅内出血的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    王娟

    2013-01-01

    目的 探讨脑梗死患者溶栓后出现早期颅内出血(ICH)的影响因素,为临床溶栓治疗提供支持.方法 回顾性分析2010年1月-2012年12月我院收治的于发病6 h内给予重组人组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗的急性脑梗死患者239例,依据患者是否发生ICH分为ICH组和未发生ICH组.分析其相关影响因素,对溶栓后患者进行随访并采用改良Rankin(mRS)进行预后评分.结果239例患者rt-PA静脉溶栓后发生ICH 56例(23.4%),其中出血性梗死(HI)和脑实质血肿(PH)分别为38例(15.9%)和18例(7.5%).HI的发生率高于PH,差异有统计学意义(χ2=13.710,P=0.001).ICH组与未发生ICH组性别构成比较,差异无统计学意义(P>0.05).ICH组患者年龄≥80岁、吸烟、高血压、冠心病、糖尿病、脑梗死面积≥5 cm、美国国立卫生院神经功能缺损评分(NIHSS评分)≥15分、溶栓时间≥3 h、溶栓药物剂量≥0.85 mg/kg、脑白质疏松化的发生率及抗血小板聚集药物使用率较未发生ICH组均升高,差异有统计学意义(P<0.05).术后随访90 d,未发生 ICH组患者基本痊愈63例,轻中度残疾79例,重度残疾27例,死亡14例;ICH组患者基本痊愈9例,轻中度残疾20例,重度残疾17例,死亡10例,两组预后比较差异有统计学意义(Z=3.767,P=0.000).结论 脑梗死患者溶栓后出现早期ICH与患有其他疾病、脑梗死病情严重程度和溶栓药物的应用等因素有关,发生ICH患者预后较差,应积极有效地控制这些影响因素.%Objective To study the related risk factors for early intraeranial hemorrhage ( ICH ) after intravenous re-combinant tissue - type plasminogen activator ( rt - PA ) thrombolysis in patients with cerebral infarction, in order to provide reference for clinical thrombolytic therapy. Methods A total of 239 cases of acute cerebral infarction who received intravenous rt -PA within 6 hours after onset from January 2010 to December 2012 in our

  2. Evaluation of regional cerebral perfusion after subarachnoid hemorrhage by multi spiral CT perfusion%多层螺旋CT灌注成像评价蛛网膜下腔出血后区域脑灌注不足的实验研究

    Institute of Scientific and Technical Information of China (English)

    王宏清; 杨运俊; 陈伟建; 梁盼; 吴楠; 林伯法

    2012-01-01

    目的 探讨蛛网膜下腔出血(SAH)后多层螺旋CT灌注成像(MS-CTP)评价区域脑灌注减低的应用价值.方法 将32只清洁级雄性日本大耳白兔随机分成两组,其中A组(正常组)8只,B组(SAH组)24只.采用枕大池二次注血法构建兔SAH模型,在造模后第7天行MS-CTP扫描.原始数据通过灌注分析软件获得两侧额顶及基底节的平均脑血流量(CBF)灌注参数图.并于MS-CTP扫描结束后立即处死、取脑,观察SAH情况.结果 两组实验动物额部(t=1.740,P=0.092)、顶部(t=1.868,P=0.072)平均CBF值差异无统计学意义,基底节区差异有统计学意义(t=2.481,P=0.O19).B组实验动物兔基底池可见血凝块分布,而额、顶部未见血凝块存在.结论MS-CTP能够监测SAH后兔脑微循环灌注的变化,并得出区域脑灌注减低与血凝块的分布有关,从而指导SAH后脑灌注减低的早期诊断,有利于临床进行早期的干预治疗.%Objective To explore the chiaical value of cerebral perfusion reduction after subarachnoid hemorrhage(SAH)by multi spiral CT perfusion in rabbits.Methods 32 male Japanese big-ear rabbits of clean level were randomly divided into 2 groups:Group A(n =8),the normal group,were to obtain normal MS-CTP values of rabbit cerebrums;Group B(n =24),the SAH group was made into two-hemorrhage animal models,checked on seven day by multi spiral CT perfusion.The source data was transmitted to the post-processing workstation ADW 4.2.Perfusion parameters maps(CBF)of both sides of frontal,parietal and basal ganglia were got by computing.Each rabbit was killed immediately after scanning,and the spider blood was observed.Results The average CBF value of the two groups:The difference was not statistically significant at the frontal(t =1.740,P =0.092)and parietal(t =1.868,P =0.072); The average values of CBF were significantly decreased at the basal ganglia(t =2.481,P =0.019).Group B showed the distribution of blood clot in the basal cistern,but there was

  3. Observation on the curative effect of the stroke unit combined with hyperbaric oxygen in the treatment of conscious disorder associated with acute cerebral hemorrhage%卒中单元联合高压氧治疗急性脑出血意识障碍的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王轶群; 夏添; 杨世泉; 余本松; 程晋成

    2015-01-01

    Objective To observe the clinical effect of the stroke unit combined with hyperbaric oxygen (HBO) in the treatment of patients with conscious disorder associated with acute cerebral hemorrhage . Methods The patients were divided into the stroke unit group (or the SU group) and the control group.Thepatients of the 2 groups all received routine mini-traumatic trepanation and drug treatment.In addition, thecontrol group received routine medical treatment , HBO therapy and rehabilitation treatment, while the SU groupreceived comprehensive rehabilitation treatment and HBO therapy in accordance with standard operatingprocedures.Clinical therapeutic effects both before and after treatment were compared between the 2 groups,evaluated with Glasgow coma scale (GCS) scores and neurologic impairment scores, and changes in cerebralvascular function were detected as well.Results After treatment, neurological impairment of the SU group(6.57 ±2.24)was improved more significantly than that of the control group (8.93 ±3.41).GCS scores of theSU group(14.56 ±2.71) were significantly increased than those of the control group (10.25 ±2.32).Inaddition, the indexes of cerebral vascular function were greatly improved , with that of the SU group beingobviously better than that of the control group .Conclusions Stroke unit treatment combined with HBO couldsignificantly improve conscious disorder of the patients associated with acute cerebral hemorrhage , and thetherapeutic efficacy was significantly superior to that of ordinary hospitalization mode .%目的:观察卒中单元联合高压氧治疗急性脑出血伴发意识障碍患者的临床疗效。方法将500例研究对象分为卒中单元组(stroke unit,SU组,280例)和对照组(220例),均常规采用颅内血肿微创清除术及药物治疗,对照组采用常规内科及高压氧和康复治疗,卒中单元组按标准化操作程序,给予综合康复及高压氧治疗。在治疗前后通过Glasgow评

  4. 动脉瘤性蛛网膜下腔出血致迟发性脑血管痉挛危险因素的Meta分析%A Meta-analysis of risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    吴政俊; 蒋永祥; 程远; 马颖

    2014-01-01

    Objective To systematically analyze the risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage in order to provide evidence for prevention and treatment of the disease .Methods Articles of risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage from VIP ,CBM ,CNKI ,Wangfang and pubmed ,springlink ,highwire database ,and correlated indexes were extracted for Meta‐analysis by using RevMan 5 .1 .Results Thirteen articles were selected . The heterogeneity of all data was equilibrium ,and used fixed effects model .The difference showed statistical significance in the his‐tory of hypertension ,Fisher > Ⅱ ,age>50 years and the posterior circulation aneurysm (P0 .05) .The symmetry of funnel plots prompted no publication bias .Conclusion Patients with history of hypertension ,Fisher > Ⅱ ,age< 50 years and the posterior circulation aneurysm are at higher risk of de1ayed cerebral vasospasm ,strengthen close monitoring and management are crucial in these patients .%目的:运用Meta分析方法综合分析动脉瘤性蛛网膜下腔出血致迟发性脑血管痉挛(DCVS)的相关危险因素,为疾病的预防、治疗决策提供依据。方法用关键词途径从维普中文科技期刊、中国知网和万方以及Pubmed、Springlink和 Highwire等外文数据库收录有关动脉瘤性蛛网膜下腔出血致DCVS相关危险因素的文献进行检索,经严格筛选后对最后纳入的文献用RevMan5.1软件进行Meta分析。结果共纳入13篇文献,经检验所有数据均均衡,采用固定效应模式进行Meta分析。高血压病史、Fisher分级(>2级)、年龄(>50岁)、动脉瘤位置(后循环)差异有统计学意义( P<0.05),性别(男性)、吸烟史、手术方式(夹闭)差异无统计学意义(P>0.05)。数据漏斗图分析对称,提示文献无发表偏倚。结论有高血压病史、Fisher分级(>2级)、年龄(<50

  5. 1例脑出血患者合并肠梗阻的护理体会%Nursing Experience of 1 Cases of Cerebral Hemorrhage Complicated with Intestinal Obstruction

    Institute of Scientific and Technical Information of China (English)

    程秀凤

    2015-01-01

    The nursing experience of a patient with cerebral hemor hage and ileus was summarized,including psychological nursing,symptoms nursing,gastrointestinal decompression nursing,enema nursing,diet nursing,etc.Through Careful observation,Active treatment,good nursing,Patient with ileus relieved,bet er discharged.%总结了1例脑出血患者合并肠梗阻的护理体会,包括心理护理、症状护理、胃肠减压的护理、灌肠的护理、饮食护理等。通过细致的观察、积极的救治、精心的护理,患者肠梗阻解除,病情好转出院。

  6. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  7. Differentiating between Hemorrhagic Infarct and Parenchymal Intracerebral Hemorrhage

    OpenAIRE

    Phan, T. G.; Holt, M; Chong, W; Ma, H.; Srikanth, V.; Ly, J. V.; Choi, P. M. C.

    2012-01-01

    Differentiating hemorrhagic infarct from parenchymal intracerebral hemorrhage can be difficult. The immediate and long-term management of the two conditions are different and hence the importance of accurate diagnosis. Using a series of intracerebral hemorrhage cases presented to our stroke unit, we aim to highlight the clues that may be helpful in distinguishing the two entities. The main clue to the presence of hemorrhagic infarct on computed tomography scan is the topographic distribution ...

  8. The Stress and Vascular Catastrophes in Newborn Rats: Mechanisms Preceding and Accompanying the Brain Hemorrhages

    Science.gov (United States)

    Semyachkina-Glushkovskaya, Oxana; Borisova, Ekaterina; Abakumov, Maxim; Gorin, Dmitry; Avramov, Latchezar; Fedosov, Ivan; Namykin, Anton; Abdurashitov, Arkady; Serov, Alexander; Pavlov, Alexey; Zinchenko, Ekaterina; Lychagov, Vlad; Navolokin, Nikita; Shirokov, Alexander; Maslyakova, Galina; Zhu, Dan; Luo, Qingming; Chekhonin, Vladimir; Tuchin, Valery; Kurths, Jürgen

    2016-01-01

    In this study, we analyzed the time-depended scenario of stress response cascade preceding and accompanying brain hemorrhages in newborn rats using an interdisciplinary approach based on: a morphological analysis of brain tissues, coherent-domain optical technologies for visualization of the cerebral blood flow, monitoring of the cerebral oxygenation and the deformability of red blood cells (RBCs). Using a model of stress-induced brain hemorrhages (sound stress, 120 dB, 370 Hz), we studied changes in neonatal brain 2, 4, 6, 8 h after stress (the pre-hemorrhage, latent period) and 24 h after stress (the post-hemorrhage period). We found that latent period of brain hemorrhages is accompanied by gradual pathological changes in systemic, metabolic, and cellular levels of stress. The incidence of brain hemorrhages is characterized by a progression of these changes and the irreversible cell death in the brain areas involved in higher mental functions. These processes are realized via a time-depended reduction of cerebral venous blood flow and oxygenation that was accompanied by an increase in RBCs deformability. The significant depletion of the molecular layer of the prefrontal cortex and the pyramidal neurons, which are crucial for associative learning and attention, is developed as a consequence of homeostasis imbalance. Thus, stress-induced processes preceding and accompanying brain hemorrhages in neonatal period contribute to serious injuries of the brain blood circulation, cerebral metabolic activity and structural elements of cognitive function. These results are an informative platform for further studies of mechanisms underlying stress-induced brain hemorrhages during the first days of life that will improve the future generation's health. PMID:27378933

  9. Research of CT Angiography Combined with CT Perfusion on Prognosis of Delayed Cerebral Ischemia After Onset of Subarachnoid Hemorrhage%CT血管造影联合CT灌注成像对蛛网膜下腔出血与迟发性脑缺血的相关性探讨

    Institute of Scientific and Technical Information of China (English)

    赵一平; 李松柏; 张贺; 徐克

    2013-01-01

    Objective To investigate the clinical value of CT angiography (CTA) combined with CT perfusion (CTP) on prognosis with delayed cerebral ischemia after onset of subarachnoid hemorrhage ( SAH). Methods CTP and CTA were performed in 71 patients with SAH. CTP data were analyzed using Philips Extended Brilliance Workspace Postprocessing workstation and the volume rendering (VR) images of cerebral arteries were reconstructed using advanced vessel analysis (AVA) software. Whole brain CTP maps were created using Brain Perfusion Software. CTP measurements were made on the CTP maps. CTA and CTP images were reconstructed to detect aneurysm and vasospasm. The change of CTP values on vasospasm and the relationship between perfusion characteristics and the prognosis of patients were evaluated. Results Among 71 patients, 67 cases had aneurysms which included 12 cases of two or more aneurysms; 33 cases showed severe vasospasm in CTA performance in which 14 cases occurred in the anterior cerebral artery and 19 cases occurred in the middle cerebral artery; 25 patients with the emergence of delayed cerebral ischemia (DCI) which were located in the anterior cerebral artery dominated area, accounting for 35.2% of the total number of patients with SAH. The CTP Rainbow Color Scheme had high sensitivity and specificity (78. 6% , 78% ) on diagnosis of DCI; patients with DCI whose anterior circulation cerebral blood flow in the brain had obvious hypoperfusion; these changes of cerebral blood flow and circulation time were relatively less in posterior cerebral artery circulation; the CBF which in four parameters of CTP had the highest sensi-tivity and specificity on diagnosis of DCI (72. 4% , 85. 7% ). The bad prognosis of patients had relationship with vaso-spasm, degree of vasospasm and CBF value. Conclusion CTA combined with CTP can detect the cause and vasospasm of the SAH, it can also judge the prognosis of patients on SAH.%目的 探讨CT血管造影(CTA)联合CT脑血流灌注(CTP)

  10. Upregulation of Relaxin after Experimental Subarachnoid Hemorrhage in Rabbits

    OpenAIRE

    Yuichiro Kikkawa; Satoshi Matsuo; Ryota Kurogi; Akira Nakamizo; Masahiro Mizoguchi; Tomio Sasaki

    2014-01-01

    Background. Although relaxin causes vasodilatation in systemic arteries, little is known about its role in cerebral arteries. We investigated the expression and role of relaxin in basilar arteries after subarachnoid hemorrhage (SAH) in rabbits. Methods. Microarray analysis with rabbit basilar artery RNA was performed. Messenger RNA expression of relaxin-1 and relaxin/insulin-like family peptide receptor 1 (RXFP1) was investigated with quantitative RT-PCR. RXFP1 expression in the basilar arter...

  11. Hereditary Hemorrhagic Telangiectasia.

    Science.gov (United States)

    Parambil, Joseph G

    2016-09-01

    Hereditary hemorrhagic telangiectasia (HHT) is an underrecognized and underdiagnosed autosomal-dominant angiodysplasia that has an estimated prevalence of 1 in 5000 individuals, with variable clinical presentations even within family members with identical mutations. The most common manifestations are telangiectasias of the skin and nasal mucosa. However, HHT can often be complicated by the presence of arteriovenous malformations and telangiectasias in the lungs, brain, gastrointestinal tract, and liver that are often silent and can lead to life-threatening complications of stroke and hemorrhage. This article reviews HHT for the pulmonologist, who is not uncommonly the first practitioner to encounter these patients. PMID:27514597

  12. 老年脑出血患者合并院内肺部感染的病原菌分布及耐药性监测%The surveillance of drugs resistance and distribution of pathogenic bacteria in elderly patients with cerebral hemorrhage complicated with nosocomial pulmonary infection

    Institute of Scientific and Technical Information of China (English)

    付钟

    2015-01-01

    Objective To investigate the surveillance of drugs resistance and distribution of pathogenic bacteria in elderly patients with cerebral hemorrhage complicated with nosocomial pulmonary infection. Methods We selected 130 elderly cases with cerebral hemorrhage from May 2010 to July 2014 in our hospital as research objects ,among who 80 cases complicated with nosocomial pulmonary infection (infection group) and 50 cases had no pulmonary infection (control group). The clinical charac‐teristics of pulmonary infection in two groups were comparatively conformed ,and we estimated the pathogenic bacteria and composition ratio through the cultivation and identification of bacterial strain in infection group. Meanwhile ,we monitored the drugs resistance by the application of multiple antibiotics. Results The clinical characteristics of two groups revealed that the body temperature and the ratio of pulmonary interstitial fibrosis in infection group were significantly higher than those in control group (P<0.05) ,while the positive rate of muscle biopsy was significantly lower than that in the control group (P<0.05). In distribution of pathogenic bacteria of infection group ,Gram‐negative bacteria accounted for 66.67% (52/78) which mainly in‐cluded Klebsiella pneumoniae , Pseudomonas aeruginosa , Acinetobacter baumannii , Gram‐positive bacteria accounted for 12.82% (10/78) and fungi for 20.51% (16/78) which primarily contained Candida albicans. Gram‐negative bacteria had rela‐tively lower drugs resistance on the third or fourth generation cephalosporins ,quinolones ,aminoglycoside antibiotic and aztreo‐nam of monoamide ,imipenen of carbapenems ,cotrimoxazole. While Gram‐positive bacteria almost had no resistance on vanco‐mycin. Conclusion The mainly bacteria of nosocomial pulmonary infection may be Gram‐negative bacteria and fungus in cere‐bral hemorrhage patients. We should pay close attention to cerebral hemorrhage patients to prevent nosocomial pulmonary

  13. Acute brain hemorrhage in dengue

    Institute of Scientific and Technical Information of China (English)

    Somsri Wiwanitkit; Viroj Wiwanitkit

    2014-01-01

    Dengue is a tropical arboviral infection that can have severe hemorrhagic complication.Acute brain hemorrhage in dengue is rare and is a big challenge in neurosurgery.To perform surgery for management of acute brain hemorrhage in dengue is a controversial issue.Here, the authors try to summarize the previous reports on this topic and compare neurosurgery versus conservative management.

  14. Validation of hyperintense middle cerebral artery sign in acute ischemic stroke

    OpenAIRE

    Guo, Gang; Yang, Yonggui; Yang, Weiqun

    2012-01-01

    We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on ...

  15. Clinical discriminators between acute brain hemorrhage and infarction: a practical score for early patient identification Características clínicas diferenciais entre hemorragia e infarto cerebral: uma escala prática para identificação precoce do paciente

    Directory of Open Access Journals (Sweden)

    Ayrton R. Massaro

    2002-06-01

    Full Text Available New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF and 237 had parenchymatous hemorrhage (HEM verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score Novas perspectivas no tratamento do acidente vascular cerebral (AVC requerem um método de triagem rápido para seleção dos pacientes. Nosso objetivo foi criar uma escala com informações clínicas simples para diferenciar hematoma intra-parenquimatoso (HEM entre os pacientes com AVC. Estudamos 1.273 pacientes com AVC isquêmico (INF e 237 com HEM do Stroke Data Bank. Variáveis independentes para o diagnóstico de INF e HEM foram determinadas pela análise de regressão logística e utilizadas para criar uma escala. Através da curva ROC foi escolhido o nível de corte para discriminar HEM (<= 2 , com sensibilidade de 76%, especificidade de 83%. Foi realizada validação externa utilizando os pacientes do estudo NOMASS. Embora o uso de uma escala de fácil aplicação pelas equipes de emergência não possa substituir os métodos de imagem na diferenciação entre INF e HEM para a indicação de trombolítico, a escala proposta pode ser útil para selecionar pacientes para estudos clínicos e tratamento pré-hospitalar, alertar técnicos de tomografia e as equipes médicas sobre a chegada de pacientes, contribuindo para reduzir atrasos cruciais no tratamento.

  16. Epidemiological and clinical characteristics of 266 cases of intracerebral hemorrhage in Hangzhou, China

    Institute of Scientific and Technical Information of China (English)

    Yun-zhen HU; Jian-wen WANG; Ben-yan LUO

    2013-01-01

    Ethnicity and socioeconomic factors can influence disease susceptibility,clinical presentation,and outcome.We investigated the clinical characteristics (age,sex,seasonal variation,lesion site,symptoms,complications,prognosis,and sequelae) and risk factors for intracerebral hemorrhage (ICH) in 266 cases treated at our hospital in Hangzhou City,China,from January 2011 to December 2011.Risk of ICH increased dramatically with age; only 4.3%of cases were <30 years old,while 44.4% were >60 years of age.Men outnumbered women by 2:1 (67.3% vs.32.7%).Single hemorrhage was most often located in the cerebral lobes (37.2% of cases),basal ganglia (34.2%),thalamus (8.3%),cerebellum (6.8%),ventricle (1.5%),and brainstem (1.1%),while 10.9% of cases exhibited hemorrhages at multiple sites.Hypertension was also a major risk factor for ICH,as 47% of all patients were hypertensive and the percentage increased with age.In hypertensive patients,the most common hemorrhage site was the basal ganglia and ICH was often associated with thrombopenia.In patients with leukemia (all forms),most hemorrhages were lobar.Warfarin-and encephalic operation-associated ICHs were all lobar.Headache was the major symptom of occipital,temporal,and frontal lobe hemorrhage.Dizziness,nausea,and vomiting were the major symptoms of cerebellum hemorrhage.Limb dysfunction was the major symptom of thalamic and basal ganglia hemorrhage.Disturbed level of consciousness was the major symptom in multisite,ventricular,parietal lobe,and brainstem hemorrhage.Hyperspasmia occurred most often in lobar hemorrhage and blurred vision in occipital lobe hemorrhage.Hospital mortality was 24.4% (n=65) with a mean delay from presentation to death of (10.5±18.5) d.The majority of fatalities were cerebral hernia cases (58.5%) and these patients also had the shortest time to death [(2.9±3.5) d].Mortality was 100%in brainstem ICH and hemorrhagic conversion of cerebral infarct

  17. [Subarachnoid hemorrhage without aneurysm].

    Science.gov (United States)

    Müller-Forell, W; Welschehold, S; Köhler, J; Schicketanz, K H

    2002-11-01

    The rupture and bleeding of intracranial aneurysms is the most common cause of a spontaneous, non-traumatic subarachnoid hemorrhage (SAH). In up to 20% of these patients, no aneurysm is found, but the prognosis of these patients is known to be better than in those with aneurysms. The retrospective evaluation of the initial CT- and angiographic findings of 773 patients with spontaneous SAH, who underwent (up to three) 4-vessel DSA, brought a percentage of 12.4% with negative angiography. We found the favourable prognosis of these patients with negative angiography not only to be dependent from the distribution of the hemorrhage, with preference to perimesencephalic pattern, but the initial clinical state. 85% of our patients, who presented with perimesencephalic blood pattern and even 80% of those patients with additional intraventricular hemorrhage but the good clinical condition of Hunt-Hess I/II were discharged without neurological deficits. We recommend the obligatory 4-vessel catheter-angiography (DSA) in all patients with spontaneous SAH, independent of the blood pattern on initial CT, and one control in the presence of other than perimesencephalic subarachnoid hemorrhage, CTA might be reserved for additional controls. PMID:12458439

  18. Post-thyroidectomy hemorrhage

    DEFF Research Database (Denmark)

    Godballe, Christian; Madsen, Anders Rørbaek; Pedersen, Henrik Baymler;

    2009-01-01

    ) was established in January 2001. This nationwide cohort study represents 5,490 patients included until December 2007. Overall hemorrhage frequency was 4.2% with a wide variation among departments. Multiple regression analysis identified age, male gender, malignant histology and extent of surgery as independent...

  19. MRI features of pediatric cerebral paragonimiasis in the active stage.

    Science.gov (United States)

    Zhang, Jin Song; Huan, Yi; Sun, Li Jun; Zhang, Guang Yun; Ge, Ya Li; Zhao, Hai Tao

    2006-04-01

    We retrospectively reviewed the MR images of the brains of six children (age = 5-13 years) who had cerebral paragonimiasis in the early active stage. Diagnosis was based on a positive antibody test enzyme-linked immunosorbent assay (ELISA) for paragonimiasis in serum. The most common finding (in five patients) was irregular hemorrhage of various degrees. Moreover, in three cases some multiple irregular lesions with surrounding edema appeared to be conglomerated and aggregated. The rare appearance (in one patient) was a "tunnel sign," which showed the migrating track of the adult worm. In one patient with abscess and minimal hemorrhage, diffusion-weighted imaging (DWI) showed a heterogeneous high signal of lesions. Other findings included slight (one patient) or marked (one patient) irregular contrast enhancement, and large edematous areas surrounding small centers of hemorrhage (two patients). MR findings of conglomerated lesions with hemorrhage or tunnel sign may help to establish the diagnosis of active-stage cerebral paragonimiasis.

  20. A technique for continuous bedside monitoring of global cerebral energy state

    DEFF Research Database (Denmark)

    Jakobsen, Rasmus; Halfeld Nielsen, Troels; Granfeldt, Asger;

    2016-01-01

    BACKGROUND: Cerebral cytoplasmatic redox state is a sensitive indicator of cerebral oxidative metabolism and is conventionally evaluated from the extracellular lactate/pyruvate (LP) ratio. In the present experimental study of global cerebral ischemia induced by hemorrhagic shock, we investigate...... whether the LP ratio obtained from microdialysis of cerebral venous blood may be used as a surrogate marker of global cerebral energy state. METHODS: Six female pigs were anesthetized and vital parameters were recorded. Microdialysis catheters were placed in the left parietal lobe, the superior sagittal...... by severe hemorrhagic shock, intravascular microdialysis of the draining venous blood will exhibit changes of the LP ratio revealing the deterioration of global cerebral oxidative energy metabolism. In neurocritical care, this technique might be used to give information regarding global cerebral energy...

  1. Postpartum cerebral angiopathy: atypical features and treatment with intracranial balloon angioplasty

    International Nuclear Information System (INIS)

    Postpartum cerebral angiopathy (PCA) is an uncommon cause of ischemic and hemorrhagic stroke in young women. It is usually clinically benign and not relapsing. We describe a patient with non-hemorrhagic PCA who had an atypical progressive neurological deficit from bilateral hemisphere watershed ischemia despite treatment with aggressive medical therapy and intracranial balloon angioplasty. (orig.)

  2. Postpartum cerebral angiopathy: atypical features and treatment with intracranial balloon angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Song, J.K. [Center for Endovascular Surgery, Hyman-Newman Inst. for Neurology and Neurosurgery, New York, NY (United States); Cacayorin, E.D. [Interventional Neuroradiology, Dept. of Radiology, Univ. of Texas Medical School, Houston, TX (United States); Fisher, S.; Seifert, T.D.; Alexandrov, A.V.; Malkoff, M.D.; Grotta, J.C.; Campbell, M.S. [Div. of Stroke Neurology, Dept. of Neurology, Univ. of Texas Medical School, Houston, TX (United States)

    2004-12-01

    Postpartum cerebral angiopathy (PCA) is an uncommon cause of ischemic and hemorrhagic stroke in young women. It is usually clinically benign and not relapsing. We describe a patient with non-hemorrhagic PCA who had an atypical progressive neurological deficit from bilateral hemisphere watershed ischemia despite treatment with aggressive medical therapy and intracranial balloon angioplasty. (orig.)

  3. Tuberculoma cerebral Cerebral tuberculoma

    Directory of Open Access Journals (Sweden)

    ELIZABETH CLARA BARROSO

    2002-01-01

    Full Text Available Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa 5-15% das formas extrapulmonares e é reconhecida como de alta letalidade. Apresentação tumoral como a relatada é rara, particularmente em imunocompetentes. Quando tratada, pode ter bom prognóstico e deve entrar sempre no diagnóstico diferencial de massas cerebrais.It is reported a case of a previously healthy man with seizures of sudden onset. A contrast head computerized tomogram (CT showed a right frontoparietal expanding lesion suggesting to be metastatic. No prior disease was found on investigation. The histologic exam of the brain revealed tuberculoma. The seizures were controlled with Hidantoin 300 mg/day and antituberculosis chemotherapy for 18 months. Central nervous system tuberculosis (5-15% of the extrapulmonary forms is highly lethal. The case reported herein is specially rare in immunocompetent patients. It may have good prognosis and should be considered in the differential diagnosis of brain tumours.

  4. Validation of hyperintense middle cerebral artery sign in acute ischemic stroke

    Institute of Scientific and Technical Information of China (English)

    Gang Guo; Yonggui Yang; Weiqun Yang

    2012-01-01

    We performed a retrospective analysis of non-contrast computed tomography (CT) scans, immediately subsequent magnetic resonance imaging (MRI), and cerebral angiography data from 30 consecutive patients with acute ischemic stroke within 6 hours after symptom onset. Results showed that eleven patients developed subsequent hemorrhagic transformation at follow-up. A hyperintense middle cerebral artery sign on MRI was found in six hemorrhagic patients, all of who had acute thrombosis formation on magnetic resonance angiography and digital subtraction angiography. No patients in the non-hemorrhagic group had hyperintense middle cerebral artery sign on MRI. The sensitivity, specificity, and positive predictive values of the hyperintense middle cerebral artery sign on MRI T1-weighted image for subsequent hemorrhagic transformation were 54.5%, 100%, and 100% respectively. Hyperdense middle cerebral artery sign on non-contrast CT was observed in nine patients, five of who developed hemorrhagic transformation. These data suggest that hyperintense middle cerebral artery sign on MRI T1-weighted image is a highly specific and moderately sensitive indicator of subsequent hemorrhagic transformation in patients after acute ischemic stroke, and its specificity is superior to CT.

  5. 神经调节素对脑出血大鼠血肿周围损伤的治疗作用和机制%Therapeutic effect and mechanism of NRG-1β on cerebral edema extent and Complement component 3 level in aintracerebral hemorrhage rat model

    Institute of Scientific and Technical Information of China (English)

    方和; 王海萍

    2016-01-01

    目的:研究神经调节素-1β(NRG-1β)对大鼠脑出血后C3表达及脑水肿的影响和机制。方法:随机选取SD大鼠分为假手术组、对照组、NRG-1β低剂量组(1μg/kg)、NRG-1β高剂量组(4μg/kg)随机各取10只每组。应用VII型胶原酶于右侧脑纹状体区注射法建立脑出血模型。采用干湿重法和免疫组化检测脑出血72小时各组大鼠血肿区域含水量占比及血肿周围组织C3的表达情况。结果:脑出血大鼠脑组织含水量及C3表达水平在对照组及治疗组明显高于假手术组(P<0.05),而NRG-1β治疗较对照组能够减少受损组织含水量及抑制C3升高(P<0.05),并与治疗剂量呈正比(P<0.05)。结论:N R G-1β可能通过下调脑出血诱导的C3表达和减轻脑水肿程度,改善脑内微环境,提示NRG-1β具有对脑出血后继发脑损伤有积极的保护作用。%Objective To explore the therapeutic effct and mechanism of NRG-1β on cerebral edema extent and Complement component 3 level in a intracerebral hemorrhage rat model in rats.Method 40 male SD rats were randomly allocated into sham-operation(n=10),Control group(n=10), low-dose NRG-1β group(1μg/kg, n=10) and the high-dose NRG-1β group (4μg/kg, n=10). ICH model was induced by collagenaseVII in the control group and treatment group. Cerebral edema was assessed at 72 hours using dry and wet right hemisphere weighing, and C3 levels around the hematoma were determined by immunohistochemical assay.Results Compared with the sham-operated group, the expression of C3 and the brain water content in the control group and treatment groups were obviously higher(P<0.05), the treatment groups is superior to the control group with a dose-dependent manner (P<0.05).Conclusion NRG-1βcan reduce the expression of C3 and the brain water content in rats after intracerebral hemorrhage On Day 3, thus improves the brain microenvironment and protect against secondary brain injury.

  6. Prohemostatic interventions in obstetric hemorrhage.

    Science.gov (United States)

    Bonnet, Marie-Pierre; Basso, Olga

    2012-04-01

    Obstetric hemorrhage is a major cause of maternal morbidity and mortality. Pregnancy is associated with substantial hemostatic changes, resulting in a relatively hypercoagulable state. Acquired coagulopathy can, however, develop rapidly in severe obstetric hemorrhage. Therefore, prohemostatic treatments based on high fresh frozen plasma and red blood cell (FFP:RBC) ratio transfusion and procoagulant agents (fibrinogen concentrates, recombinant activated factor VII, and tranexamic acid) are crucial aspects of management. Often, evidence from trauma patients is applied to obstetric hemorrhage management, although distinct differences exist between the two situations. Therefore, until efficacy and safety are demonstrated in obstetric hemorrhage, clinicians should be cautious about wholesale adoption of high FFP:RBC ratio products. Applications of transfusion protocols, dedicated to massive obstetric hemorrhage and multidisciplinarily developed, currently remain the best available option. Similarly, while procoagulant agents appear promising in treatment of obstetric hemorrhage, caution is nonetheless warranted as long as clear evidence in the context of obstetric hemorrhage is lacking. PMID:22510859

  7. 影响脑出血患者出院时日常生活活动能力的相关因素分析%Factors influencing the recovery of ability in the activities of daily living after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王瑜元; 古丽娜孜·那比尔; 何嫱; 张备; 白玉龙; 吴毅; 胡永善

    2012-01-01

    assessed at admission and before discharge.Linear regression analysis was used to relate the variables. Results After rehabilitation,the MBI scores and Brunnstrom stages had improved relative to the scores at admission.Factors influencing the MBI improvements included the intervention timing of rehabilitation and the course of therapy employed. Conclusions It is very important to comprehend the factors influencing the recovery of ADL ability after cerebral hemorrhage in order to design effective rehabilitation strategies,better predict functional outcomes and improve patients' ADL ability effectively.

  8. Apresentações de localização atípica de hemorragia no cérebro de recém-nascidos: considerações acerca de dois casos Atypical locations of cerebral hemorrhage in newborns: considerations about two cases

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Vieira Monteiro

    2009-12-01

    Full Text Available Estudo retrospectivo de dois casos de hemorragia craniana de localização atípica em 777 recém-natos internados na unidade de terapia intensiva neonatal da Casa de Saúde São José, Rio de Janeiro, RJ. Foram avaliados os aspectos clínicos e o diagnóstico por métodos de imagem. Verificamos que a ultrassonografia foi diagnóstica nos dois casos quando comparada com a ressonância magnética. Em relação à etiologia, esta foi multifatorial, e a manifestação clínica silenciosa independente da localização. Até o presente momento, a avaliação neurológica tem tido curso satisfatório, embora os pacientes ainda tenham baixa idade para a avaliação neurológica definitiva.Retrospective study of two cases of atypically localized cerebral hemorrhage among 777 newborns admitted to the neonatal intensive care unit at Casa de Saúde São José, Rio de Janeiro, RJ, Brazil. Clinical findings and imaging diagnoses were evaluated. The diagnostic effectiveness of ultrasonography was established by correlation with magnetic resonance imaging findings. Multifactorial etiology was observed, besides silent clinical presentation independently from localization. So far the neurological evaluation has satisfactorily progressed although the patients are still too young to allow a definite neurological evaluation.

  9. Cerebral Palsy

    Science.gov (United States)

    ... 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Cerebral Palsy: Keith's Story Physical Therapy I Have Cerebral Palsy. Can I Babysit? Body Image and Self-Esteem Contact Us Print Resources Send to a friend ...

  10. 醒脑静对脑出血患者 S100B、神经肽 Y和脑水肿的影响%Impact of Xingnaojing on the S100B,neuropeptide Y and brain edema of patients with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    刘颖

    2015-01-01

    Objective To investigate the impact of Xingnaojing on the S100B,neuropeptide Y and brain edema of patients with cerebral hemorrhage. Methods A total of 72 patients with cerebral hemorrhage were selected in the People's Hos-pital of Yichun in 2014,they were randomly divided into control group and observation group,36 cases in each group. Control group were given edaravone treatment,observation group were given Xingnaojing on the basis of control group. Before treatment and after treatment of 1,2 weeks S100B,neuropeptide Y levels,brain edema volume and incidence of adverse reactions be-tween the two groups were compared. Results There was interaction between time and method(P 0. 05),after treatment of 1 week,S100B levels,brain edema volume showed no significant differences between the two groups(P > 0. 05),after treatment of 1 week,neuropeptide Y levels of ob-servation group was lower than that of control group(P < 0. 05),after treatment of 2 week,S100B,neuropeptide Y levels of observation group were lower than those of control group,brain edema volume of observation group was less than that of control group(P < 0. 05);no one of the two groups occurred serious adverse reactions. Conclusion Xingnaojing can decrease S100B,neuropeptide Y levels of patients with cerebral hemorrhage,improve patients' brain edema.%目的:探讨醒脑静对脑出血患者 S100B、神经肽 Y 和脑水肿的影响。方法选取2014年宜春市人民医院收治的脑出血患者72例,随机分为对照组与观察组,各36例。对照组患者予以依达拉奉治疗,观察组患者在对照组基础上加用醒脑静治疗。观察两组患者治疗前及治疗1、2周 S100B、神经肽 Y 水平、脑水肿体积及不良反应发生情况。结果时间与方法有交互作用(P <0.05),组间比较,差异均有统计学意义( P <0.05),时间间比较,差异均有统计学意义(P <0.05),治疗前两组患者 S100B、神经肽 Y 水平、脑水肿体

  11. 补阳还五汤对脑出血大鼠脑组织水通道蛋白4表达及血-脑脊液屏障通透性的影响研究%Effects of Buyanghuanwu Decoction on Aquaporin 4 Expression and the Permeability of the Blood Brain Barrier in Cerebral Hemorrhage Rats

    Institute of Scientific and Technical Information of China (English)

    刘绍晨; 吴晓光; 杨岚; 李义学; 仇志富

    2016-01-01

    Objective To explore the effects of Buyanghuanwu decoction on aquaporin 4(AQP4)expression and the permeability of the blood brain barrier in cerebral hemorrhage rats. Methods From March 2014 to November 2015,SPF level adult male SD rats were randomly divided into sham operation group,model group,Buyanghuanwu decoction low,medium and high dose groups, 24 in each group. Model group and Buyanghuanwu decoction groups prepared models of cerebral hemorrhage. Since two days after modeling, Buyanghuanwu decoction low, medium, and high dose groups were given Buyanghuanwu decoction by gastric perfusion,the dose was 13. 2 g·kg - 1 ·d - 1 ,26. 5 g·kg - 1 ·d - 1 and 53. 0 g·kg - 1 ·d - 1 respectively,continuously for 14 days,and sham operation group and model group were given the equal volume of the corresponding 0. 9% sodium chloride solution. The expression of phosphatidylinositol 3 kinase( PI3K) and protein kinase B (AKT ) was detected by immunohistochemistry. The expression of AQP4 was detected by immunofluorescence labeling method. Content of water in brain was detected by wet and dry weight method,and formamide method was used to detect the blood- brain barrier permeability. Results Sham operation group,model group,Buyanghuanwu decoction low,medium and high dose groups were significantly different in the expression of PI3K and AKT(P ﹤ 0. 05);Buyanghuanwu decoction low,medium and high dose groups were higher than model group in the expression of PI3K;Buyanghuanwu decoction medium and high dose groups were higher than model group in the expression of AKT( P ﹤ 0. 05). The 5 groups were significantly different in the expression of AQP4(F = 95. 79,P ﹤ 0. 001);Buyanghuanwu decoction low,medium and high dose groups were higher than model group in the expression of AQP4 ( P ﹤ 0. 05) . The 5 groups were significantly different in brain water content( F= 16. 21,P ﹤ 0. 001);Buyanghuanwu decoction high dose group was lower than model group in brain water content( P

  12. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann;

    2013-01-01

    OBJECTIVE: To investigate short-term case fatality and long-term mortality after intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) using data from The Health Improvement Network database. METHODS: Thirty-day case fatality was stratified by age, sex, and calendar year after ICH...... and SAH using logistic regression. Cox proportional hazards regression analyses were used to estimate the risk of death during the first year of follow-up and survivors at 1 year. RESULTS: Case fatality after ICH was 42.0%, compared with 28.7% after SAH. It increased with age (ICH: 29.7% for 20-49 years......, 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients...

  13. Massive antenatal fetomaternal hemorrhage

    DEFF Research Database (Denmark)

    Dziegiel, Morten Hanefeld; Koldkjaer, Ole; Berkowicz, Adela

    2005-01-01

    Massive fetomaternal hemorrhage (FMH) can lead to life-threatening anemia. Quantification based on flow cytometry with anti-hemoglobin F (HbF) is applicable in all cases but underestimation of large fetal bleeds has been reported. A large FMH from an ABO-compatible fetus allows an estimation of t...... of the life span of fetal red blood cells (RBCs) in the maternal circulation.......Massive fetomaternal hemorrhage (FMH) can lead to life-threatening anemia. Quantification based on flow cytometry with anti-hemoglobin F (HbF) is applicable in all cases but underestimation of large fetal bleeds has been reported. A large FMH from an ABO-compatible fetus allows an estimation...

  14. Pulmonary Hemorrhage in Cryoglobulinemia

    OpenAIRE

    Kirkpatrick, G; Winstone, T.; Wilcox, P; Van Eeden, S

    2015-01-01

    Cryoglobulins are derived from one or more classes of immunoglobulin that reversibly precipitate at decreased temperatures. Although respiratory manifestations of cryoglobulinemia are rare, they can include mild dyspnea to life-threatening conditions such as alveolar hemorrhage. This article describes the diagnostic work-up and treatment course of a 56-year-old woman with a history of hypertension and congestive heart failure who presented to her general practitioner with gradual-onset dyspne...

  15. Clinical study of interventional therapy for acute cerebral infarction

    International Nuclear Information System (INIS)

    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)

  16. 上消化道出血高危的急性脑梗死患者应用西洛他唑治疗有效性和安全性的研究%Cilostazol for patients with acute cerebral infarction combined with upper digestive tract hemorrhage

    Institute of Scientific and Technical Information of China (English)

    潘锦权; 练培兴; 麦超君; 林美庆

    2014-01-01

    目的 观察合并上消化道出血(UGH)高危因素的急性脑梗死患者应用西洛他唑片治疗的有效性和安全性.方法 将120例合并UGH高危因素的急性脑梗死患者随机分为两组,阿司匹林组(A组,n=60):口服拜阿司匹林片100 mg,1次/天.西洛他唑组(B组,n=60):口服西洛他唑片100 mg,2次/天.观察随访疗程为6个月,监测治疗前后的血脂指标,记录治疗过程中消化道事件,评估临床疗效.结果 A组与B组临床治疗总有效率比较,差异无统计学意义(88.33%vs.86.67%),P>0.05;治疗后,B组HDL-C水平显著升高(1.02±0.19vs.1.20±0.18),P<0.05;B组消化道事件显著低于A组(1例vs.9例),P<0.01.结论 合并UGH高危因素的急性脑梗死患者应用西洛他唑抗血小板治疗是有效和安全的.%Objective To observe the effect and safety of cilostazol for patients with cerebral infarction combined with upper digestive tract hemorrhage risk factors.Methods 120 patients with acute cerebral infarction and UGH risk factors were randomly divided into an aspirin group (group A,n=60,orally taking aspirin once a day,100 mg once) and a cilostazol group (group B,n=60,orally taking cilostazol twice a day,100 mg once).All patients were observed and followed up for 6 months.The lipid indexes were monitored before and after the treatment,gastrointestinal events during the treatment recorded,and clinical curative effect evaluated.Results There were no statistical difference in clinical efficacy between the two groups (88.33% vs.86.67%,P > 0.05).After the treatment,the HDL-C level increased more significantly in group B than in group A [(1.02 ± 0.19) vs.(1.20 ± 0.18),P < 0.05].Fewer patients occurred gastrointestinal events in group B than in group A (1 case vs.9 cases,P < 0.05).Conclusions Cilostazol for patients with acute cerebral infarction associated and UGH risk factors is effective and safe.

  17. Cerebral aterial spasm. I. Adrenergic mechanism in experimental cerebral vasospasm.

    Directory of Open Access Journals (Sweden)

    Morooka,Hiroshi

    1978-04-01

    Full Text Available This study demonstrates that an adrenergic mechanism plays an important role in producing the delayed cerebral vasospasm which follows subarachnoid hemorrhage. Results were as follows: 1. Experimental subarachnoid hemorrhage (SAH was produced by injection of fresh arterial blood into the cisterna magna in cats. The cerebral vasospasm was shown angiographically to be biphasic in nature: immediate constriction lasting 1 h and marked prolonged spasm occurring between the 3rd and 5th day after SAH. The amount of noradrenaline (NA and dopamine-beta-hydroxylase (DBH activity decreased over a period of 24 h both within the wall of the basilar artery and in the locus ceruleus and then gradually increased, reaching a maximum on the 3rd day after SAH. 2. Topical application of spasmogenic substances (NA and blood produced a marked constriction of the hypersensitive basilar artery on the 3rd day after SAH. 3. 6-Hydroxydopamine (6-OHDA injection into the cisterna magna produced prolonged vasocilatation. The dilated vessel responded with mild transient constriction after the topical application of NA or fresh blood. DBH activity and NA concentration in the vessels, locus ceruleus and medial hypothalamus decreased markedly on the 3rd day after the cisternal injection of 6-OHDA. 4. Various spasmogenic substances (i.e. serotonin, NA, prostaglandins and methemoglobin were measured in a mixture of equal volume of CSF and blood in cats. ONly the serotonin in the mixed fluid produced vasoconstriction. Spasmogenic substances decreased markedly in the mixed fluid incubated for 3 days at 37 degrees C, and none of these substances apart from methemoglobin was present in a concentration sufficient to produce constriction of vessels. 5. These results suggest that early spasm is induced by serotonin around the arteries of the cranial base, and delayed spasm might be caused by hyperreaction of cerebral vessels to spasmogenic substances such as methemoglobin, during the

  18. Cerebral palsy.

    Science.gov (United States)

    Graham, H Kerr; Rosenbaum, Peter; Paneth, Nigel; Dan, Bernard; Lin, Jean-Pierre; Damiano, Diane L; Becher, Jules G; Gaebler-Spira, Deborah; Colver, Allan; Reddihough, Dinah S; Crompton, Kylie E; Lieber, Richard L

    2016-01-01

    Cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. Cerebral palsy is not a disease entity in the traditional sense but a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. There is currently no cure, but progress is being made in both the prevention and the amelioration of the brain injury. For example, administration of magnesium sulfate during premature labour and cooling of high-risk infants can reduce the rate and severity of cerebral palsy. Although the disorder affects individuals throughout their lifetime, most cerebral palsy research efforts and management strategies currently focus on the needs of children. Clinical management of children with cerebral palsy is directed towards maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation and scoliosis. These management strategies include enhancing neurological function during early development; managing medical co-morbidities, weakness and hypertonia; using rehabilitation technologies to enhance motor function; and preventing secondary musculoskeletal problems. Meeting the needs of people with cerebral palsy in resource-poor settings is particularly challenging. PMID:27188686

  19. [Cerebral salt wasting syndrome in bacterial meningitis].

    Science.gov (United States)

    Attout, H; Guez, S; Seriès, C

    2007-10-01

    Subarachnoid hemorrhage is the most common cause of cerebral salt wasting syndrome. There are few reports of this condition in infectious meningitis. We describe a patient with hyponatremia and bacterial meningitis. Hyponatremia rapidly improved after administration of sodium chloride. The purpose of this report is to alert clinicians to the fact that hyponatremic patients with central nervous system disease do not necessarily have a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), but may have cerebral salt wasting syndrome. By contrast with SIADH, the treatment requires saline administration.

  20. Advanced Imaging Modalities in the Detection of Cerebral Vasospasm

    OpenAIRE

    Mills, Jena N.; Vivek Mehta; Jonathan Russin; Amar, Arun P.; Anandh Rajamohan; William J. Mack

    2013-01-01

    The pathophysiology of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is complex and is not entirely understood. Mechanistic insights have been gained through advances in the capabilities of diagnostic imaging. Core techniques have focused on the assessment of vessel caliber, tissue metabolism, and/or regional perfusion parameters. Advances in imaging have provided clinicians with a multifaceted approach to assist in the detection of cerebral vasospasm and the diagnosis...

  1. Clinical manifestations and cerebral angiographic findings of moyamoya disease

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To study the clinical features and angiographic findings of moyamoya disease (MMD) as well as their relationship. Methods A total of 22 MMD patients received routine digital substraction angiography (DSA). The clinical manifestations and angiographic findings were analyzed. Results Clinical manifestations varied and each patient often had multiple symptoms,including cerebral infarction in 9 patients with an average age of 23.6 (13-39 years) and cerebral hemorrhage in 7 patients with an average age...

  2. A study on regional cerebral circulation in stroke patients with aphasia

    International Nuclear Information System (INIS)

    To study the pathophysiology of aphasia due to cerebral stroke, regional cerebral blood flow (rCBF) was measured by the 133Xe clearance method and the volume of low density area (LDA) was estimated on the basis of computerized tomography in 43 thrombotic (24 aphasia and 19 non-aphasia), 30 hemorrhagic (16 aphasia and 14 non-aphasia) and 6 non-stroke cases. 1) In the healthy hemisphere, rCBF showed no significant difference between aphasia and non-aphasia in both thrombotic and hemorrhagic cases. In the affected hemisphere, thrombotic cases showed significantly decreased rCBF in aphasic cases as compared to non-aphasic, however, hemorrhagic cases revealed no difference. 2) LDA volume showed no significant difference between aphasia and non-aphasia in cerebral thrombosis, however, LDA volume in non-aphasia was smaller than that in aphasia in cerebral hemorrage. 3) Significant differences in the pathophysiology of aphasia due to cerebral stroke were recognized between cerebral thrombosis and cerebral hemorrhage. Such differences should be taken into consideration in the management and treatment of aphasia caused by cerebral stroke. (author)

  3. Spontaneous subarachnoid hemorrhage in the emergency department

    Directory of Open Access Journals (Sweden)

    Diego Garbossa

    2012-07-01

    Full Text Available Subarachnoid hemorrhage (SAH is one of the major cause of mortality for stroke. The leading cause is the rupture of an intracrnial aneurym. Acute aneurysmal subarachnoid hemorrhage (SAH is a complex multifaceted disorder that plays out over days to weeks. The development of aneurysms is mainly due to a hemodynamic stress. Considerableadvances have been made in endovascular techniques, diagnostic methods, and surgical and perioperative management guidelines. Rebleeding remains the most imminent danger until the aneurysm is excluded from cerebral circulation. The only effective prevention of rebleeding is repair the aneurysm; choosing the right way with surgical or an endovascular approach. Outcome for patients with SAH remains poor, with population-based mortality rates as high as 45% and significant morbidity among survivors. In this work we analyzed the diagnostic-therapeutic course of patients presenting SAH. We analyzed the types and the occurrence of complications. We present two cases report to better demonstrate that treatments for specific patients need to be individualized.

  4. Hypercoagulability in hereditary hemorrhagic telangiectasia with epilepsy

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-01-01

    Full Text Available Recent data indicate that in patients with hereditary hemorrhagic teleangiectasia (HHT, low iron levels due to inadequate replacement after hemorrhagic iron losses are associated with elevated factor-VIII plasma levels and consecutively increased risk of venous thrombo-embolism. Here, we report a patient with HHT, low iron levels, elevated factor-VIII, and recurrent venous thrombo-embolism. A 64-year-old multimorbid Serbian gipsy was diagnosed with HHT at age 62 years. He had a history of recurrent epistaxis, teleangiectasias on the lips, renal and pulmonary arterio-venous malformations, and a family history positive for HHT. He had experienced recurrent venous thrombosis (mesenteric vein thrombosis, portal venous thrombosis, deep venous thrombosis, insufficiently treated with phenprocoumon during 16 months and gastro-intestinal bleeding. Blood tests revealed sideropenia and elevated plasma levels of coagulation factor-VIII. His history was positive for diabetes, arterial hypertension, hyperlipidemia, smoking, cerebral abscess, recurrent ischemic stroke, recurrent ileus, peripheral arterial occluding disease, polyneuropathy, mild renal insufficiency, and epilepsy. Following recent findings, hypercoagulability was attributed to the sideropenia-induced elevation of coagulation factor-VIII. In conclusion, HHT may be associated with hypercoagulability due to elevated factor-VIII associated with low serum iron levels from recurrent bleeding. Iron substitution may prevent HHT patients from hypercoagulability.

  5. Neurological involvement in hereditary hemorrhagic telangiectasia.

    Science.gov (United States)

    Labeyrie, Paul-Emile; Courthéoux, Patrick; Babin, Emmanuel; Bergot, Emmanuel; Touzé, Emmanuel; Pelage, Jean-Pierre

    2016-07-01

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by epistaxis, telangiectases, and multi-organ vascular dysplasia. Head and neck localizations of HHT are recurrent, frequent associated with serious complications. The aim of this study was to describe the clinical and imaging patterns of neurological involvement in HHT and to discuss the role of interventional radiology in the management of HHT patients. Based on a multidisciplinary experience of twenty years at our center, we report here the different aspects of neurological involvement of HHT. Depending on the genetic type of the disease, vascular abnormalities may affect different organs. The knowledge of neurological involvement according to specific localization of HHT makes detection easier. As cerebral or spinal arteriovenous fistula may be present in patients with epistaxis or pulmonary arteriovenous malformations (PAVMs), radiologists should be able to detect high-risk lesions and prevent related complications. Finally, we review indications and techniques of embolization for hemorrhagic lesions and emphasize that endovascular therapies are very effective and safe in experienced hands. Head and neck imaging is commonly used for the diagnosis of HHT. Imaging plays also a key role for patient evaluation before treatment as pluridisciplinary management is needed. PMID:27059009

  6. Magnetic resonance susceptibility weighted imaging in detecting intracranial calcification and hemorrhage

    Institute of Scientific and Technical Information of China (English)

    ZHU Wen-zhen; QI Jian-pin; ZHAN Chuan-jia; SHU Hong-ge; ZHANG Lin; WANG Cheng-yuan; XIA Li-ming; HU Jun-wu; FENG Ding-yi

    2008-01-01

    Background Computed tomography (CT) is better than routine magnetic resonance imaging (MRI) in detecting intracranial calcification. This study aimed to assess the value of MR susceptibility weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage.Methods Enrolled in this study were 35 patients including 13 cases of calcification demonstrated by CT and 22 cases of intracerebral hemorrhage. MR sequences used in all the subjects included axial T1WI, T2WI and SWI. The phase shift (PS) of calcification and hemorrhage on SWI was calculated and their signal features on corrected phase images were compared. The sensitivity of T1WI, T2WI and SWI in detecting intracranial calcification and hemorrhage was analyzed statistically.Results The detection rate of SWI for cranial calcification was 98.2%, significantly higher than that of T1 Wl and T2WI. It was not significantly different from that of CT (P >0.05). There were 49 hemorrhagic lesions at different stages detected n SWI, 30 on T2WI and 18 on T1WI. The average PS of calcification and hemorrhage was +0.734han routine MRI in detecting micro-hemorrhage, SWI may play an important role in differentiating cerebral diseases associated with calcification or hemorrhage.

  7. Hyperglycemia in aneurysmal subarachnoid hemorrhage : a potentially modifiable risk factor for poor outcome

    NARCIS (Netherlands)

    Kruyt, Nyika D.; Biessels, Geert Jan; DeVries, J. Hans; Luitse, Merel J. A.; Vermeulen, Marinus; Rinkel, Gabriel J. E.; Vandertop, W. Peter; Roos, Yvo B.

    2010-01-01

    Hyperglycemia after aneurysmal subarachnoid hemorrhage (aSAH) occurs frequently and is associated with delayed cerebral ischemia (DCI) and poor clinical outcome. In this review, we highlight the mechanisms that cause hyperglycemia after aSAH, and we discuss how hyperglycemia may contribute to poor c

  8. Role of magnesium in the reduction of ischemic depolarization and lesion volume after experimental subarachnoid hemorrhage

    NARCIS (Netherlands)

    van den Bergh, Walter M; Zuur, J Karel; Kamerling, Niels A; van Asseldonk, Jan Thies H; Rinkel, Gabriël J E; Tulleken, Cornelis A F; Nicolay, Klaas

    2002-01-01

    OBJECT: Ischemia-induced tissue depolarizations probably play an important role in the pathophysiology of cerebral ischemia caused by parent vessel occlusion. Their role in ischemia caused by subarachnoid hemorrhage (SAH) remains to be investigated. The authors determined whether ischemic depolariza

  9. Functional Outcome at School Age of Preterm Infants With Periventricular Hemorrhagic Infarction

    NARCIS (Netherlands)

    Roze, Elise; Van Braeckel, Koenraad N. J. A.; van der Veere, Christa N.; Maathuis, Carel G. B.; Martijn, Albert; Bos, Arend F.

    2009-01-01

    OBJECTIVES. Our objective was to determine motor, cognitive, and behavioral outcome at school age in preterm children with periventricular hemorrhagic infarction and to identify cerebral risk factors for adverse outcome. METHODS. This was a prospective cohort study of all preterm infants who were <3

  10. Clinical characteristics and risk factors of Intracranial hemorrhage in patients following allogeneic hematopoietic stem cell transplantation.

    Science.gov (United States)

    Zhang, Xiao-Hui; Wang, Qian-Ming; Chen, Huan; Chen, Yu-Hong; Han, Wei; Wang, Feng-Rong; Wang, Jing-Zhi; Zhang, Yuan-Yuan; Mo, Xiao-Dong; Chen, Yao; Wang, Yu; Chang, Ying-Jun; Xu, Lan-Ping; Liu, Kai-Yan; Huang, Xiao-Jun

    2016-10-01

    Intracranial hemorrhage (ICH) is one of the most life-threatening neurological complications after allogeneic hematopoietic stem cell transplantation. Although cerebral complications and its causes after allo-HSCT are well documented, assessment of the incidence and risk factors of intracranial hemorrhage following allo-HSCT are less discussed. A nested case-control study was conducted involving 160 subjects drawn from 2169 subjects who underwent HSCT at Peking University People's Hospital between 2004 and 2014. Thirty-two patients (1.5 %) with ICH were identified, and 128 controls were matched for age, gender, transplantation type, and time of transplantation. Intracranial hemorrhage was identified by CT scan and/or MRI by searching hospital records. Among the 32 ICH patients, 27 (82.9 %) developed intraparenchymal hemorrhages (IPH), 2 cases (5.7 %) suffered subdural hematomas (SDH), and 3 cases (8.6 %) had multiple hemorrhage lesions in the brain parenchyma. The median time of appearance for cerebral hemorrhages was 147.5 days. Multivariate analysis showed that systemic infections (hazard ratio 2.882, 95 % confidence interval 1.231-6.746), platelet count (5.894, 1.145-30.339), and fibrinogen levels (3.611, 1.528-8.532) were independent risk factors for intracranial hemorrhage among HSCT patients. The cumulative survival rate in the intracranial hemorrhage and control groups were 43.3 and 74.7 % (P = .001), respectively. Intracranial hemorrhage is associated with high mortality and a decreased overall survival rate. Systemic infections, platelet count, and fibrinogen levels were individual independent risk factors. PMID:27485455

  11. Rare anatomical variations of persistent trigeminal artery in two patients with non-aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Samaniego, Edgar A; Dabus, Guilherme; Andreone, Vincenzo; Linfante, Italo

    2011-09-01

    Carotid-basilar anastomoses are remnants of the fetal circulation and although rare, they may become symptomatic and should be recognized during cerebral angiography. Two patients are described with non-aneurysmal subarachnoid hemorrhage and persistent trigeminal arteries (PTA) found on cerebral angiography. In the first patient, the PTA ended in the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery. The second patient had a PTA terminating in the AICA and superior cerebellar artery. These rare anatomical PTA variants should be recognized on cerebral angiography. PMID:21990842

  12. Clinical studies on cerebral infarction

    International Nuclear Information System (INIS)

    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.)

  13. Cerebral hypoxia

    Science.gov (United States)

    ... the veins ( deep vein thrombosis ) Lung infections (pneumonia) Malnutrition When to Contact a Medical Professional Cerebral hypoxia ... References Bernat JL. Coma, vegetative state, and brain death. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  14. Protection of Momordica charantia polysaccharide against intracerebral hemorrhage-induced brain injury through JNK3 signaling pathway.

    Science.gov (United States)

    Duan, Zhen-Zhen; Zhou, Xiao-Ling; Li, Yi-Hang; Zhang, Feng; Li, Feng-Ying; Su-Hua, Qi

    2015-01-01

    It has been well documented that Momordica charantia polysaccharide (MCP) has multiple biological effects such as immune enhancement, anti-oxidation and anti-cancer. However, the potential protective effects of MCP on stroke damage and its relative mechanisms remain unclear. Our present study demonstrated that MCP could scavenge reactive oxygen species (ROS) in intra-cerebral hemorrhage damage, significantly attenuating the neuronal death induced by thrombin in primary hippocampal neurons. Furthermore, we found that MCP prevented the activation of the c-Jun N-terminal protein kinase (JNK3), c-Jun and caspase-3, which was caused by the intra-cerebral hemorrhage injury. Taken together, our study demonstrated that MCP had a neuroprotective effect in response to intra-cerebral hemorrhage and its mechanisms involved the inhibition of JNK3 signaling pathway. PMID:25264226

  15. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  16. Post-tonsillectomy hemorrhage

    DEFF Research Database (Denmark)

    Heidemann, Christian; Wallén, Mia; Aakesson, Marie;

    2008-01-01

    of PTH when coblation procedures are performed by non-experienced surgeons. We advise that implementation of coblation tonsillectomy is thoroughly planned with sufficient training of surgeons and continuous surveillance of results. If PTH rates comparable to "cold dissections tonsillectomy" cannot...... be reached intervention (learning or closing down of coblation tonsillectomy) has to be done.......Post-tonsillectomy hemorrhage (PTH) is a relatively common and potentially life-threatening complication. The objective of this study was to examine the rate of PTH and identify risk factors. A retrospective cohort study was carried out including all tonsillectomies (430 patients) performed...

  17. Near-infrared spectroscopy monitoring of cerebral oxygen during assisted ventilation

    OpenAIRE

    Booth, Erin A.; Dukatz, Christopher; Sood, Beena G.; Wider, Michael

    2011-01-01

    Background: Changes in the arterial partial pressure of CO2 (PaCO2) has a direct though transient effect on the cerebral vasculature and cerebral circulation. Decreased PaCO2 levels lead to vasoconstriction and can result in dangerously low levels of cerebral perfusion that resolve in 4–6 h. It is currently believed that perfusion abnormalities contribute to intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL) in the neonate. PaCO2-induced vasoconstriction may contribute t...

  18. Curative effect and surgical techniques of microsurgery for cerebral arteriovenous malformation: a report of 65 cases

    OpenAIRE

    Sheng-bao WANG; Sun, Zheng-Hui; Wu, Chen; Xu-jun SHU; Wen-xin WANG; Xue, Zhe

    2015-01-01

    Objective To assess the safety and efficacy of microsurgical resection of cerebral arteriovenous malformation (AVM).  Methods A total of 65 patients with cerebral AVMs were treated with microsurgical resections from April to August 2010 in our hospital. Of the 65 patients, 26 were male and 39 were female with age ranging from 4 to 72 years (average 42 years). Initial symptoms included cerebral hemorrhage in 32 cases, seizures in 10 cases, headache in 6 cases, neurological dysfunction ...

  19. CT examination, clinical situation and experimental characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency

    Institute of Scientific and Technical Information of China (English)

    Zhiqing Lin; Feng Fang; Min Chen; Guoxiang Cai

    2006-01-01

    BACKGROUND: Delayed vitamin K deficiency is characterized by acute onset, severe illness and high fatality rate. 33%-50% survivors accompany with other various nervous system sequelas. Therefore, diagnosis and treatment of intracranial hemorrhage in time become a key factor for improving healing rate and reducing fatality rate and incidence of sequela.OBJECTTVE: To investigate the clinical situation, experimental characteristics, CT examination and terminative characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency.DESIGN: Case analysis.SETTING: Department of Pediatrics, Zhongshan Hospital Affiliated to Xiamen University.PARTICIPANTS: A total of 17 infants with intracranial hemorrhage induced by delayed vitamin K deficiency aged 1-3 months including 11 boys and 6 girls were selected from Department of Pediatrics, Zhongshan Hospital Affiliated to Xiamen University from January 1994 to December 2005. All infants had drowsiness,rejective milk, spiting milk, gaze of both eyes, tic, coma, full anterior fontanelle, high muscular tension and cerebral hernia, etc. Experimental examination demonstrated that infants had anemia at various degrees;prothrombin time and partial thromboplastin time were prolonged; platelet count was normal. CT examination indicated that screenages of subarachnoid hemorrhage, subdural hematoma, cerebral parenchyma hemorrhage and intraventricular hemorrage were changed. Hemorrhage was stopped by the application of vitamin K. All patients provided informed consent.METHODS: ① Clinical situation and physical sign of infants were observed after hospitalization and scanned with rapid spiral CT scanning system. The thickness and average space of layers were 8-10 mm and the scanning time was 5 s with window width of 30-80 Hu and window position of 28-35 Hu. ② After hospitalization, four items of blood coagulation was measured with Futura meter and biochemical indexes of blood, such as serum calcium, serum

  20. The morphological peculiarities of the cerebrum arteries under the hemorrhagic and ischemic stroke in the patients with the metabolic syndrome

    OpenAIRE

    Natalia Chuiko

    2014-01-01

    In this article, the results of the morphological study of the cerebral arteries in the patients with the hemorrhagic ischemic stroke on the background of metabolic syndrome were submitted. We established that under hemorrhagic stroke on the background of metabolic syndrome one could observe the atherosclerotic damages in the form of plaques, hyalinosis of vessels walls, destructive and necrotic changes of the middle coat of vessel wall, which are, in our opinion, the main reason in morphogen...

  1. Cerebral palsy - resources

    Science.gov (United States)

    Resources - cerebral palsy ... The following organizations are good resources for information on cerebral palsy : National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy. ...

  2. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Cerebral Palsy KidsHealth > For Parents > Cerebral Palsy Print A A ... kids who are living with the condition. About Cerebral Palsy Cerebral palsy is one of the most common ...

  3. Progress in AQP Research and New Developments in Therapeutic Approaches to Ischemic and Hemorrhagic Stroke

    Directory of Open Access Journals (Sweden)

    Lauren E. Previch

    2016-07-01

    Full Text Available Cerebral edema often manifests after the development of cerebrovascular disease, particularly in the case of stroke, both ischemic and hemorrhagic. Without clinical intervention, the influx of water into brain tissues leads to increased intracranial pressure, cerebral herniation, and ultimately death. Strategies to manage the development of edema constitute a major unmet therapeutic need. However, despite its major clinical significance, the mechanisms underlying cerebral water transport and edema formation remain elusive. Aquaporins (AQPs are a class of water channel proteins which have been implicated in the regulation of water homeostasis and cerebral edema formation, and thus represent a promising target for alleviating stroke-induced cerebral edema. This review examines the significance of relevant AQPs in stroke injury and subsequently explores neuroprotective strategies aimed at modulating AQP expression, with a particular focus on AQP4, the most abundant AQP in the central nervous system.

  4. Subarachnoid Hemorrhage, Spreading Depolarizations and Impaired Neurovascular Coupling

    Directory of Open Access Journals (Sweden)

    Masayo Koide

    2013-01-01

    Full Text Available Aneurysmal subarachnoid hemorrhage (SAH has devastating consequences on brain function including profound effects on communication between neurons and the vasculature leading to cerebral ischemia. Physiologically, neurovascular coupling represents a focal increase in cerebral blood flow to meet increased metabolic demand of neurons within active regions of the brain. Neurovascular coupling is an ongoing process involving coordinated activity of the neurovascular unit—neurons, astrocytes, and parenchymal arterioles. Neuronal activity can also influence cerebral blood flow on a larger scale. Spreading depolarizations (SD are self-propagating waves of neuronal depolarization and are observed during migraine, traumatic brain injury, and stroke. Typically, SD is associated with increased cerebral blood flow. Emerging evidence indicates that SAH causes inversion of neurovascular communication on both the local and global level. In contrast to other events causing SD, SAH-induced SD decreases rather than increases cerebral blood flow. Further, at the level of the neurovascular unit, SAH causes an inversion of neurovascular coupling from vasodilation to vasoconstriction. Global ischemia can also adversely affect the neurovascular response. Here, we summarize current knowledge regarding the impact of SAH and global ischemia on neurovascular communication. A mechanistic understanding of these events should provide novel strategies to treat these neurovascular disorders.

  5. 高血压脑出血患者应激性高血糖与微创碎吸术后血清炎性细胞因子水平的相关性研究%Investigation of stress hyperglycemia and inflammatory cytokines in hypertensive cerebral hemorrhage after micro-injury operations

    Institute of Scientific and Technical Information of China (English)

    湛小波; 周勇; 史忠

    2013-01-01

    目的 观察高血压脑出血患者应激性高血糖对微创碎吸术后血清细胞因子水平的影响.方法 80例高血压脑出血患者按入院24小时内血糖分为正常血糖组(56例)和高血糖组(24例),同时选10例健康人血清做对照,连续监测血清中肿瘤坏死因子α(TNFα)、白细胞介素6(IL-6)的动态变化.结果 两组患者的TNFα、IL-6含量均高于健康对照组.正常血糖组患者其TNFα、IL-6含量达峰时间早.高血糖组患者TNFα、IL-6含量达峰时间较晚,且TNFα、IL-6水平较高.结论 脑出血患者血浆炎性细胞因子水平水平升高与应激反应有关,且对预后产生不利影响.%Objective To investigate the effect of stress hyperglycemia on inflammatory cytokines in serum of hypertensive cerebral hemorrhage after micro-injury operations. Methods 80 patients accepted micro-injury operation according their blood glucose with 24 hours after their enrollment were divided two groups: hyperglycemia group (n = 24) and normoglycemia group (n=56). 10 serum samples of healthy persons were tested as control. The changes of TNFα, IL-6 were observed continuously. Results The levels of TNFo.IL-6 of patients are higher than that of healthy control. That of group hyperglycemia was higher than normoglycemia group. Patients' peak levels of TNFa,IL-6 of appeared earlier in hyperglycemia group than normoglycemia group. Conclusion There is a relationship between the high level of inflammatory cytokines in serum and stress hyperglycemia and stress hyperglycemia makes the curative effect worse.

  6. Clinical Feature And Pathogeny Analysis Of Brain Hemorrhage In Young Adult Group

    Institute of Scientific and Technical Information of China (English)

    Wang Jianming; Zeng Xiaoyun

    2000-01-01

    Objection: The trend of brain hemorrhage cases of young adults have increased recently. In this article, We studied brain hemorrhage clinical feature and pathogenic causes of 72 young adults, Whose ages are all beneath 45Y. We found That the major pathogen reasons of young adult brain hemorrhage are blood system diseases、 arteriovenous malformation of cerebral blood vessel、 hypertension arteriosclerosis、 arteritis and rheumatic heart disease et. We also found that the trend can be related to hard work、 tense life、 drinking too much alcohol and eating high lipid food, and cercbral vascular disease family history. So in order to reduce the incidence of young adult brain hemorrhage, Young adults should not drink and smoke heavily, should not eat too much high lipid food. Young adults who have hypertension and brain vessel disease family history should be regularly measured blood pressure and blood lipid. If they had hypertension, should be treated regularly.

  7. MRI in predication of early hemorrhagic transformation after acute stroke

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship among early parenchymal enhancement, post- gadolinium (Gd) hyperintense middle cerebral artery (HMCA), and subsequent hemorrhagic transformation (HT) in patients with hyperacute ischemic stroke. Methods: Twenty-four consecutive patients with ischemic stroke who underwent MRI within 6 h [(4.3±1.4) h] of symptom onset were retrospectively reviewed. All of these patients underwent at least one follow-up MRI or non-enhanced CT study at 2 to 7 days. Post-Gd T1WI were analyzed for parenchymal enhancement and hyperintense MCA. Gradient echo MRI and CT were used for assessment of HT. Results: Ten patients developed HT on follow-up imaging (hemorrhagic group). Early parenchymal enhancement was found in 6 patients with HT (P1WI after Gd-DTPA administration are independent predictors of subsequent HT. (authors)

  8. Clinical observations on treating thalamic hemorrhage into ventricle

    Institute of Scientific and Technical Information of China (English)

    Dong Aiqin; Lv Xiudong; Wang Huagang

    2000-01-01

    Objective To investigate the treatment of severe patients with thalamic hemorrhage into ventricles. Method 12 cases with thalamic hemorrhage into ventricular system were studied, 9 male, 3 femaie, with a mean age of 64 years. All patients were unconscious. The average size of hematoma was 65 ml. Besides general comprehensive care, they received ventricular puncture for ingertion of drainage tape into the cerebral ventricle, infusion with urokinase for clotlysis, lumbar puncture for letting out some cerebrospinal fluid and injection of dexemethasone. Result The patients' clinical symptoms and signs were obviously improved.. The CT scan also demonstrated that hematomas were removed faster. The effective rate was 83.3 per cent, with a murtality of 16.7 per cent. Cohclusion This kind of therapy can increase the clinical cure rate. decrease the disability rate and death rete.

  9. The phosphodiesterase 3 inhibitor cilostazol dilates large cerebral arteries in humans without affecting regional cerebral blood flow

    DEFF Research Database (Denmark)

    Birk, Steffen; Kruuse, Christina Rostrup; Petersen, Kenneth A;

    2004-01-01

    Cilostazol, an inhibitor of phosphodiesterase (PDE) type 3, is used clinically in peripheral artery disease. PDE3 inhibitors may be clinically useful in the treatment of delayed cerebral vasospasm after subarachnoid hemorrhage. The authors present the first results on the effect of cilostazol on ...

  10. The utility of perfusion CT and CT angiography on early diagnosis and the management of vasospasm after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Samira Zabihyan

    2015-01-01

    Full Text Available Subarachnoid hemorrhage is one of the most important and dangerous neurologic emergencies worldwide. It is characterized by a sudden and severe headache caused most commonly by the rupture of intracranial aneurysm. Cerebral vasospasm is the most important cause of disability and death in whom survived from the first event. Early diagnosis and management of cerebral vasospasm could prevent and reduce its morbidity and mortality. Thus, an ideal technique must be able to detect the vasospasm before the occurrence of neurological deficits. Perfusion computed tomography could assess vascularity of brain including cerebral blood flow, cerebral blood volume, time to peak and mean transit time. For this application, perfusion computed tomography and computed tomography angiography techniques offer significant advantages and can result in early diagnosis of vasospasm. In this review, we discuss the utility of these two techniques and their safety in the diagnosis and the management of vasospasm following subarachnoid hemorrhage.

  11. Tuberculoma cerebral

    OpenAIRE

    BARROSO ELIZABETH CLARA; OLIVEIRA TÂNIA REGINA BRÍGIDO DE; AMARAL ANA MARIA DANTAS DO; PINHEIRO VALÉRIA GÓES FERREIRA; SOUSA ANA LÚCIA DE OLIVEIRA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  12. Massive fetomaternal hemorrhage

    DEFF Research Database (Denmark)

    Larsen, Rune; Berkowicz, Adela; Lousen, Thea;

    2008-01-01

    BACKGROUND: The clearance of D+ red blood cells (RBCs) from the circulation in D- individuals mediated by passively administered anti-D occurs by opsonization with the antibody and subsequent removal in the spleen. Few data exist on the kinetics of clearance of large volumes of D+ RBCs from the...... maternal circulation by anti-D in clinical cases of massive fetomaternal hemorrhage (FMH). CASE REPORT: A 33-year-old D- woman delivered a D+ female infant by emergency cesarean section for suspected fetal anemia. A massive FMH, initially estimated to be approximately 142 mL of RBCs, was found. In addition...... to the standard dose of intramuscular (IM) anti-D (300 microg) given immediately after delivery, 2700 microg of anti-D was administered intravenously (IV). The clearance of D+ fetal cells from the maternal circulation was monitored by flow cytometry in samples obtained on a daily basis using anti-D...

  13. Diffuse alveolar hemorrhages

    International Nuclear Information System (INIS)

    The Diffuse Alveolar Hemorrhage (DAH) it is a clinical syndrome that generally manifests with hemoptysis, anemia and infiltrated in the thorax x-ray. From the anatomical point of view, the DAH is defined as the presence of blood in the distal alveolar spaces without it can identify any endobronchial abnormality. The radiological presentation of the DAH is characterized by the presence of having infiltrated of alveolar occupation in the Rx of thorax of prevalence perihiliar and bilateral that goes converging to configure an image of complete consolidation of the air space, the apexes and the periphery of the lungs are generally respected. These infiltrated are solved in one to two weeks, but with the repeated episodes of having bled it can develop interstitial fibrosis

  14. Embolization for gastrointestinal hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, S.C.; Goerich, J.; Rilinger, N.; Aschoff, A.J.; Vogel, J.; Brambs, H.J. [Dept. of Diagnostic Radiology, University of Ulm (Germany); Siech, M. [Dept. of Abdominal Surgery, University of Ulm (Germany)

    2000-05-01

    Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications. (orig.)

  15. Angiographic Findings In Patients With Cerebral Aneurysm

    Directory of Open Access Journals (Sweden)

    Miri S M

    2004-09-01

    Full Text Available Background: This investigation was conducted in order to study angiographic findings in patients with cerebral aneurysm. Materials and Methods: The study conducted on 136 cases of ruptured cerebral aneurysms between 1995-2000 confirmed by means of 4-vessel cerebral angiography to get an insight to racial, geographic and environmental factors predisposing to the occurrence of subarachnoid hemorrhage and aneurysm formation. Results: The data analysis revealed the following results: 58% of the population comprised of male and 42% female with a mean age of 46 years. 89% of the aneurysms were found in the anterior circulation and 11% occurred in the posterior cerebral circulation. The most common site in both the sexes was the anterior communicating artery. 9.6% of the patients displayed two separate aneurysms. 5.2% of the aneurysms were found to be giant aneurysms and 3% of the patients had fusiform aneurysms. Conclusion: The low average age, a predilection in male population and the prevalence of aneurysms at carotid and middle cerebral artery bifurcation and the distal branches of anterior cerebral artery and a higher incidence of anterior communicating artery in women were the findings observed in this study.

  16. [Platelets, atherothrombosis, antiplatelet drugs and cerebral ischemia].

    Science.gov (United States)

    Bousser, Marie-Germaine

    2013-02-01

    Platelets play a much more important role in myocardial ischemia than in cerebral ischemia, because atherothrombosis - the underlying cause of the vast majority of myocardial infarcts - is responsible for only 25-30% of cerebral infarcts. Aspirin is the only effective antiplatelet drug for primary prevention of ischemic events, especially those affecting the heart. For secondary prevention of cerebral infarction, clopidogrel and the combination of aspirin with extended-release dipyridamole are both marginally better than aspirin alone, but aspirin remains the gold standard worldwide because of its remarkable cost/benefit/tolerability ratio. The clopidogrel-aspirin combination is to be avoided because of the risk of hemorrhage, particularly in the brain and gastrointestinal tract. Revascularization strategies and the choice of antiplatelet drugs for the acute phase of myocardial and cerebral ischemia are very different, consisting of endovascular treatment and aggressive platelet inhibition for coronary infarcts, versus intravenous thrombolysis and / or aspirin for cerebral infarcts. None of the new antiplatelet drugs used in acute coronary syndromes has so far been studied in acute cerebral ischemia. PMID:24919368

  17. 结合需要层次理论的护理干预在高血压脑出血患者中的应用价值%Value of nursing intervention based on Maslow's Hierarchy of Needs in patients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    崔翱; 林容旭; 张宝月; 罗针

    2016-01-01

    Objective To analyze the value of nursing intervention based on Maslow's Hierarchy of Needs in pa-tients with hypertensive cerebral hemorrhage. Methods A total of 118 patients of hypertensive cerebral hemorrhage treat-ed in West China Hospital, Sichuan University from December 2011 to December 2014 were chosen as study subjects, which were divided into observation group and control group according to random number table, each with 59 patients. Af-ter admission, the patients in the control group received routine nursing care, while those in the observation group received nursing intervention based on Maslow's Hierarchy of Needs. The recovery-related indicators, nerve function and activities of daily living, mental status and quality of life were compared between the two groups. Results (1) The score of basic nursing care quality in the observation group was (96.17 ± 3.28), significantly higher than (78.55 ± 5.82) in the control group. The time for consciousness recovery, limb function recovery, hospital stay in the observation group were shorter than those in the control group [(5.62 ± 0.92) d vs (9.81 ± 2.16) d, (8.72 ± 2.83) d vs (14.68 ± 3.07) d, (13.27 ± 3.78) d vs (25.16 ± 5.73) d], with statistically significant difference (P<0.05). (2) After nursing treatment, the National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI) score in the observation group were higher than those in the con-trol group [(59.72 ± 7.11) vs (42.38 ± 5.67), (63.29 ± 7.93) vs (41.26 ± 5.45)], with statistically significant difference (P<0.05). (3) After nursing treatment, the Self-Rating Anxiety Scale (SAS) score, Hamilton Depression Scale (HAMD) score in the observation group were significantly lower than those in the control group [(17.39 ± 3.11) vs (28.54 ± 4.57), (19.53 ± 3.26) vs (31.42 ± 4.78)], and the Short Form 36 health survey questionnaire (SF-36) score in the observation group was significantly higher than that in the control group [(83.11

  18. The Role of Prematurity in Patients With Hemiplegic Cerebral Palsy.

    Science.gov (United States)

    Zelnik, Nathanel; Lahat, Eli; Heyman, Eli; Livne, Amir; Schertz, Mitchell; Sagie, Liora; Fattal-Valevski, Aviva

    2016-05-01

    A multicenter retrospective study was conducted to investigate the perinatal factors, imaging findings and clinical characteristics of hemiplegic cerebral palsy with a particular focus on children born prematurely. Our cohort included 135 patients of whom 42% were born prematurely; 16% were extreme premature infants who were born at 30 weeks or earlier. Nineteen (14%) were twins. Right hemiplegia was slightly more common and accounted for 59% of the patients. Imaging findings of intraventricular hemorrhage and periventricular leukomalacia were more prevalent in premature children whereas stroke, porencephaly, cerebral hemorrhage and cerebral atrophy were more evenly distributed in both term-born and prematurely-born children (p< 0.01). The overall prevalence of epilepsy in the cohort was 26% with no differences in full-term compared to prematurely-born children. Regardless of the gestational birth age, intellectual deficits were more common in the presence of comorbidity of both hemiplegia and epilepsy (p< 0.05). PMID:26500242

  19. Clinical Outcome Prediction in Aneurysmal Subarachnoid Hemorrhage Using Bayesian Neural Networks with Fuzzy Logic Inferences

    Directory of Open Access Journals (Sweden)

    Benjamin W. Y. Lo

    2013-01-01

    Full Text Available Objective. The novel clinical prediction approach of Bayesian neural networks with fuzzy logic inferences is created and applied to derive prognostic decision rules in cerebral aneurysmal subarachnoid hemorrhage (aSAH. Methods. The approach of Bayesian neural networks with fuzzy logic inferences was applied to data from five trials of Tirilazad for aneurysmal subarachnoid hemorrhage (3551 patients. Results. Bayesian meta-analyses of observational studies on aSAH prognostic factors gave generalizable posterior distributions of population mean log odd ratios (ORs. Similar trends were noted in Bayesian and linear regression ORs. Significant outcome predictors include normal motor response, cerebral infarction, history of myocardial infarction, cerebral edema, history of diabetes mellitus, fever on day 8, prior subarachnoid hemorrhage, admission angiographic vasospasm, neurological grade, intraventricular hemorrhage, ruptured aneurysm size, history of hypertension, vasospasm day, age and mean arterial pressure. Heteroscedasticity was present in the nontransformed dataset. Artificial neural networks found nonlinear relationships with 11 hidden variables in 1 layer, using the multilayer perceptron model. Fuzzy logic decision rules (centroid defuzzification technique denoted cut-off points for poor prognosis at greater than 2.5 clusters. Discussion. This aSAH prognostic system makes use of existing knowledge, recognizes unknown areas, incorporates one's clinical reasoning, and compensates for uncertainty in prognostication.

  20. Determinants of cerebral infarction and intracerebral hemorrhage: the Rotterdam Study

    NARCIS (Netherlands)

    R.G. Wieberdink (Renske)

    2012-01-01

    textabstractStroke is a frequent disorder in elderly people. Despite improvements in primary prevention, the burden of stroke remains high and is predicted to even increase in the near future due to aging of the population. Therefore, additional targets for primary prevention are urgently needed. Mo

  1. The Spectrum of Pituitary Adenoma Hemorrhage

    OpenAIRE

    Hickstein, Dennis D.; Marshall, John C.; Chandler, William F.

    1986-01-01

    In 34 cases of pituitary adenoma hemorrhage at one institution, the clinical manifestations of adenoma hemorrhage depended upon the size of the adenoma, the presence of suprasellar extension, the amount of hemorrhage and the extent of pituitary glandular destruction. Recognition of the spectrum of acute, subacute and chronic pituitary adenoma hemorrhage should expedite diagnosis and treatment.

  2. HEMORRHAGIC STROKE AS POST-INTRACEREBRAL HEMORRHAGE INFLAMMATION

    OpenAIRE

    Yabluchanskiy, A.

    2011-01-01

    Intracerebral hemorrhage remains one of the less studied problems in modern neurology. Later publications suggest that inflammatory processes play a significant role in hemorrhagic stroke; however, most of these reports represent fragmentary information on the local and less system levels of inflammation, and do not show the correlation between these levels. In this review the attention is focused on the compensatory, adaptive and restorative nature of the inflammation in the post-intracerebr...

  3. Rehabilitation for a Patient with Hemiplegia, Ataxia, and Cognitive Dysfunction Caused by Pontine Hemorrhage

    Directory of Open Access Journals (Sweden)

    Tetsuya Tsunoda

    2015-10-01

    Full Text Available Patients with pontine hemorrhage usually experience severe disturbances of consciousness, pupillary abnormalities, quadriparesis, and respiratory failure. However, little is known regarding cognitive dysfunction in patients with pontine hemorrhage. We report the case of a rehabilitation patient presenting with hemiplegia, ataxia, and cognitive dysfunction caused by a pontine hemorrhage. A 55-year-old, right-handed male suffered sudden onset of vertigo, dysarthria, and hemiplegia on the right side. He was diagnosed with brain stem hemorrhage, and conservative treatment was administered. The vertigo improved, but dysarthria, ataxia, hemiplegia, and gait disorder persisted. He was disoriented with respect to time and place and showed a poor attention span, impaired executive function, and reduced volition. A computed tomography revealed hematomas across the pons on both sides, but no lesions were obvious in the cerebellum and cerebrum. Single-photon emission tomography showed decreased perfusion in the brain stem, bilateral basal ganglia, and frontal and parietal lobes in the left hemisphere. The patient received exercise therapy and cognitive rehabilitation, and home modifications were performed to allow him to continue living at home under the supervision of his family. His symptoms improved, along with enhanced regional cerebral blood flow to the frontal and temporal lobes. These findings suggest that the pontine hemorrhage caused diaschisis resulting in secondary reduction of activity in the cerebral hemisphere and the occurrence of cortical symptoms. Therefore, rehabilitation is necessary, along with active instructions for the family members of patients with severe neurological deficits.

  4. Refractory High Intracranial Pressure following Intraventricular Hemorrhage due to Moyamoya Disease in a Pregnant Caucasian Woman

    Directory of Open Access Journals (Sweden)

    Virginie Montiel

    2009-02-01

    Full Text Available Intraventricular hemorrhage during pregnancy is usually followed by a poor recovery. When caused by moyamoya disease, ischemic or hemorrhagic episodes may complicate the management of high intracranial pressure. A 26-year-old Caucasian woman presented with generalized seizures and a Glasgow Coma Score (GCS of 3 during the 36th week of pregnancy. The fetus was delivered by caesarean section. The brain CT in the mother revealed bilateral intraventricular hemorrhage, a callosal hematoma, hydrocephalus and right frontal ischemia. Refractory high intracranial pressure developed and required bilateral ventricular drainage and intensive care treatment with barbiturates and hypothermia. Magnetic resonance imaging and cerebral angiography revealed a moyamoya syndrome with rupture of the abnormal collateral vascular network as the cause of the hemorrhage. Intracranial pressure could only be controlled after the surgical removal of the clots after a large opening of the right ventricle. Despite an initially low GCS, this patient made a good functional recovery at one year follow-up. Management of refractory high intracranial pressure following moyamoya related intraventricular bleeding should require optimal removal of ventricular clots and appropriate control of cerebral hemodynamics to avoid ischemic or hemorrhagic complications.

  5. Refractory High Intracranial Pressure following Intraventricular Hemorrhage due to Moyamoya Disease in a Pregnant Caucasian Woman

    Science.gov (United States)

    Montiel, Virginie; Grandin, Cécile; Goffette, Pierre; Fomekong, Edward; Hantson, Philippe

    2009-01-01

    Intraventricular hemorrhage during pregnancy is usually followed by a poor recovery. When caused by moyamoya disease, ischemic or hemorrhagic episodes may complicate the management of high intracranial pressure. A 26-year-old Caucasian woman presented with generalized seizures and a Glasgow Coma Score (GCS) of 3 during the 36th week of pregnancy. The fetus was delivered by caesarean section. The brain CT in the mother revealed bilateral intraventricular hemorrhage, a callosal hematoma, hydrocephalus and right frontal ischemia. Refractory high intracranial pressure developed and required bilateral ventricular drainage and intensive care treatment with barbiturates and hypothermia. Magnetic resonance imaging and cerebral angiography revealed a moyamoya syndrome with rupture of the abnormal collateral vascular network as the cause of the hemorrhage. Intracranial pressure could only be controlled after the surgical removal of the clots after a large opening of the right ventricle. Despite an initially low GCS, this patient made a good functional recovery at one year follow-up. Management of refractory high intracranial pressure following moyamoya related intraventricular bleeding should require optimal removal of ventricular clots and appropriate control of cerebral hemodynamics to avoid ischemic or hemorrhagic complications. PMID:20508823

  6. Radiologic findings of cerebral septic embolism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jee Young; Kim, Sang Joon; Kim Tae Hoon; Kim, Seung Chul; Kim, Jae Seung; Pai, Hyun Joo [Dankook Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Dong Ik [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Chang, Kee Hyun [Seoul National Univ. (Korea, Republic of). Coll. of Medicine; Choi, Woo Suk [Kyung Hee Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1998-01-01

    To determine the MR and CT findings which differentiate cerebral septic embolism from thrombotic infarction. Cerebral septic embolism was confirmed by blood culture in six patients and autopsy in two. The number, size, distribution, contrast enhancement, and hemorrhage of the lesions, as seen on MR and CT, were retrospectively analyzed, and four patients were followed up for between one week and seven months. In a total of eight patients, infective endocarditis (n=5) and sepsis (n=3) caused cerebral septic embolism. The number, of lesions was 3 {approx} 7 in six patients, over 10 in one, and innumerable in one: these varied in size from punctate to 6 cm and were distributed in various areas of the brain. Gyral infarction was noted in five patients: non-enhancing patchy lesions involving the basal ganglia or white matter were found in five, tiny isolated nodular or ring-enhancing small lesions involving the cortex and white matter in three, peripheral rim-enhancing large lesions in one, and numerous enhancing nodules disseminated in the cortex in one. Hemorrhage had occurred in six. follow-up studies in four patients showed that initial lesions had enlarged in two and regressed in two: new lesions had appeared in two. Multiple lesions of different sizes and various patterns which include gyral infarction, patchy or nodular lesion in the cortex, white mater of basal ganglia, and isolated small ring-like or nodular enhancement or frequent hemorrhage are findings which could be helpful in the radiologic diagnosis of cerebral septic embolism. (author). 8 refs., 5 figs.

  7. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... host of Marburg virus is the African fruit bat, Rousettus aegyptiacus . Fruit bats infected with Marburg virus do not to show ... Information for Specific Groups, References... Marburg HF Outbreak Distribution Map Factsheet: Marburg Hemorrhagic Fever [PDF - 3 pages] ...

  8. Intracranial Hemorrhage Annotation for CT Brain Images

    OpenAIRE

    Tong Hau Lee; Mohammad Faizal Ahmad Fauzi; Su-Cheng Haw

    2011-01-01

    In this paper, we created a decision-making model to detect intracranial hemorrhage and adopted Expectation Maximization(EM) segmentation to segment the Computed Tomography (CT) images. In this work, basically intracranial hemorrhage is classified into two main types which are intra-axial hemorrhage and extra-axial hemorrhage. In order to ease classification, contrast enhancement is adopted to finetune the contrast of the hemorrhage. After that, k-means is applied to group the potential and s...

  9. Intracranial hemorrhage from undetected aneurysmal rupture complicating transphenoidal pituitary adenoma resection.

    Science.gov (United States)

    Rustagi, Tarun; Uy, Edilfavia Mae; Rai, Mridula; Kannan, Subramanian; Senatus, Patrick

    2011-08-01

    We report a case of a 39-year-old man who presented with a nonfunctioning pituitary macroadenoma which extended into the suprasellar region. He underwent a transcranial resection of the tumor followed eight months later by transsphenoidal surgery for the residual tumor. Postoperatively he developed massive subarachnoid and intraventricular hemorrhage. A cerebral angiogram revealed a leaking anterior communicating artery aneurysm which was not seen on the computed tomography angiography and magnetic resonance angiography before the surgery. Complications of transsphenoidal surgery, particularly vascular hemorrhagic complications, and risk of rupture of undetected aneurysms are discussed.

  10. Noninvasive Intracranial Pressure Determination in Patients with Subarachnoid Hemorrhage.

    Science.gov (United States)

    Noraky, James; Verghese, George C; Searls, David E; Lioutas, Vasileios A; Sonni, Shruti; Thomas, Ajith; Heldt, Thomas

    2016-01-01

    Intracranial pressure (ICP) should ideally be measured in many conditions affecting the brain. The invasiveness and associated risks of the measurement modalities in current clinical practice restrict ICP monitoring to a small subset of patients whose diagnosis and treatment could benefit from ICP measurement. To expand validation of a previously proposed model-based approach to continuous, noninvasive, calibration-free, and patient-specific estimation of ICP to patients with subarachnoid hemorrhage (SAH), we made waveform recordings of cerebral blood flow velocity in several major cerebral arteries during routine, clinically indicated transcranial Doppler examinations for vasospasm, along with time-locked waveform recordings of radial artery blood pressure (APB), and ICP was measured via an intraventricular drain catheter. We also recorded the locations to which ICP and ABP were calibrated, to account for a possible hydrostatic pressure difference between measured ABP and the ABP value at a major cerebral vessel. We analyzed 21 data records from five patients and were able to identify 28 data windows from the middle cerebral artery that were of sufficient data quality for the ICP estimation approach. Across these windows, we obtained a mean estimation error of -0.7 mmHg and a standard deviation of the error of 4.0 mmHg. Our estimates show a low bias and reduced variability compared with those we have reported before. PMID:27165879

  11. Statins and intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Zheng Haiping; Hu Zhiping; Lu Wei

    2014-01-01

    Objective To briefly review the literature regarding the impact of statins on the prevention and treatment of stroke,especially on intracerebral hemorrhage (ICH).We described statins' effects,mechanism of ICH,serum total cholesterol and ICH,and the relationship between statins and ICH.Data sources All articles used in this review were mainly searched from the PubMed database with no limitations of language and year of publication.Study selection Randomized controlled studies,prospective cohort studies,animal experiments,and meta-analysis articles related to this topic in the past decade were selected.Results Statins play an important role in the primary and secondary prevention of cardiovascular diseases and also have an impact on the treatment of vascular diseases.There still exist controversies about the relationship between statins and ICH.More clinical and experimental trials indicate that statins do not increase the risk of ICH.Conclusion A low or a regular dose of statins would not increase the risk of ICH.

  12. Neurokinin-1 receptor antagonism in a rat model of subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Svendgaard, Niels-Aage; Edvinsson, Lars

    2007-01-01

    ) were investigated using sensitive myographs. To determine whether NKIR inhibition had an influence on local CBF after post-SAH, a quantitative autoradiographic technique was used. After SAH, the vascular receptor phenotype was changed in cerebral arteries through upregulation of contractile ET, and 5......OBJECT: Cerebral vasospasm following subarachnoid hemorrhage (SAH) leads to reduced cerebral blood flow (CBF) and to cerebral ischemia, in some cases even producing infarction and long-term disability. The goal of the present study was to investigate the hypothesis that inhibition of neurokinin-1......-HT1B receptors, while regional and total CBF were markedly reduced. Treatment with the selective NK1R inhibitor L-822429 prevented both the receptor upregulation and the reduction in regional and global CBF. CONCLUSIONS: The data reveal the coregulation of vascular receptor changes and blood flow...

  13. The effects of exercises on the expression of matrix metalloproteinase-9 in perihematomal brain tissue after intra cerebral hemorrhage in rats%运动训练对大鼠脑出血后血肿周围基质金属蛋白酶-9表达的影响

    Institute of Scientific and Technical Information of China (English)

    王多姿; 郭富强; 张红艳; 孙皓; 孙祥荣; 曾宪容; 汪瑾宇; 吴文斌; 潘福琼

    2009-01-01

    Objective To study the effects of exercises training on the recovery of neurological function and the expression of matrix metalloproteinase-9 (MMP-9) in perihematomal brain tissue after intra cerebral hemorrhage (ICH) in rats. Methods Sixty-four male adult Sprague-Dawley rats were randomly divided into exercises group and control group. ICH model was induced by autobiood injection. The rats in exercises group were given balance, grasping and walking exercises every day. The rats in control group exercised freely in standard cages. Neurological function in both groups was measured at the 3rd, 7th, 14th and 21st d. All the rats were sacrificed and the concentration of MMP-9 was measured with immunohistochemical method and in situhybridization. Results In both groups neurological function scores was lowest at the 3rd d, were highest at the 21st d. There was no significant difference between two groups at the 3rd d, but at the 7th, 14th and 21st d the differences between two groups were significant ( P 0.05 ). Conclusions Early exercises can inhibit the expression of MMP-9 that could play a role in protecting neurons. Daily exercises can stimulates the expression of MMP-9 so as to have a positive role in midstage of disease. MMP-9 may be involved in tissue remodelling and vascular repairing, which prompt neu-rofunction recovery.%目的 探讨运动训练对大鼠脑出血后神经功能恢复和脑组织中基质金属蛋白酶-9(MMP-9)表达的影响.方法 将64只Sprague-Dawley大鼠随机分为运动组及对照组,采用自体血注入法制作脑出血模型.运动组每天给予平衡、抓握、行走等运动训练,对照组置于普通笼内自由活动.在术后第3、7、14和21天进行神经功能评估,并断头取脑组织制成标本,采用免疫组织化学法和原位杂交技术测定脑组织中MMP-9的水平.结果 运动组与对照组神经功能评分在第3天最低,第21天评分最高;2组比较,除第3天外,其余各时间点

  14. Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

    Directory of Open Access Journals (Sweden)

    Almeida Leila Azevedo de

    2006-01-01

    Full Text Available Cerebral infarctions of cardiac etiology are observed in around 20% of patients with ischemic stroke. Cerebral ischemia is the first clinical manifestation in 1/3 of cases of atrial myxomas. Although almost half of patients with atrial myxoma show changes at neurological exam, non-hemorrhagic cerebral infarction is seen in computed tomography in practically all cases. We present the case of a 40 year-old woman whose first clinical manifestation of atrial myxoma was an ischemic stroke. We point out to the possibility of silent cerebral infarction in atrial myxoma patients.

  15. A case of thalamic hemorrhage-induced diaschisis

    Institute of Scientific and Technical Information of China (English)

    Gang Yao; Yuhong Man; Xijing Mao; Tingmin Yu

    2011-01-01

    Diaschisis refers to a disturbance (inhibition or facilitation) of function in an area remote from the site of a primary brain lesion. Previous studies have confirmed that regional cerebral blood flow and metabolism are noticeably decreased in an infarct region. Transient excessive perfusion appears in the ischemic penumbra, and diaschisis occurs in an area remote from the lesion site, showing decreased regional cerebral blood flow and metabolism. Mirror diaschisis refers to a decrease in oxygen metabolism and blood flow in the "mirror image area" to the infarct regions in the contralateral hemisphere. In this study, a patient with right thalamic hemorrhage was affected with right arm and leg numbness. At 4 months before onset, magnetic resonance imaging of the head demonstrated lacunar infarcts in the left thalamus; therefore the right arm and leg numbness was not associated with lacunar infarcts in the left thalamus. At 8 days following onset, magnetic resonance imaging reexamination did not reveal the focus that could induce right arm and leg numbness and weakness. Thus, it is suggested in this study that the onset of this disease can be explained by mirror diaschisis. That is, right thalamic hemorrhage leads to decreased blood flow and metabolic disturbance in the contralateral thalamus, resulting in right arm and leg numbness.

  16. Cerebrovascular ETB, 5-HT1B, and AT1 receptor upregulation correlates with reduction in regional CBF after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Ansar, Saema; Vikman, Petter; Nielsen, Marianne;

    2007-01-01

    We hypothesize that cerebral ischemia leads to enhanced expression of endothelin (ET), 5-hydroxytryptamine (5-HT), and angiotensin II (ANG II) receptors in the vascular smooth muscle cells. Our aim is to correlate the upregulation of cerebrovascular receptors and the underlying molecular mechanisms...... with the reduction in regional and global cerebral blood flow (CBF) after subarachnoid hemorrhage (SAH). SAH was induced by injecting 250 microl blood into the prechiasmatic cistern in rats. The cerebral arteries were removed 0, 1, 3, 6, 12, 24, and 48 h after the SAH for functional and molecular studies...

  17. 急性多灶性脑出血5例报告及32篇相关文献复习(急性多灶性脑出血786例临床分析)%Acute multiple cerebral hemorrhage: report of 5 cases and literature review of 32 reference papers-Clinical analysis of 786 cases

    Institute of Scientific and Technical Information of China (English)

    黄明; 李宗海

    2013-01-01

    Objective To investigate the pathophysiology, clinical characteristics, diagnosis and outcome of acute multiple cerebral hemorrhage (AMCH). Methods We reported 5 cases with AMCH and reviewed 32 reference papers regarding AMCH in China. The relevant clinical data were summarized. Results A total of 786 cases of AMCH were found. The male to female ratio was 1. 97:1. There were 1469 hematomas reported in 700 cases among 29 references. Among them,678 hematomas were located in basal ganglion (46. 15% ) , 461 in cortical area (31. 38% ) , 150 in thalamus (10. 21% ) ,108 in brainstem(7. 35% ) ,70 in cerebellum (4. 77% ) ,and 2 in other Iocation(0. 14% ). In 469 cases, the distribution of hematoma was reported with 328 cases (69. 94 % ) in supratentorium, 29 ( 6. 18 % ) in infratentorium, and 112 (23. 88% ) in both supra-and infratentorium. In 661 cases among 29 references,there were 586 cases(88. 65% ) with 2 hematomas,61 (9. 23% ) with 3 hematomas,and 14(2. 12% ) with more than 4 hematomas. In 786 cases among 33 references, the causes of bleeding were hypertension in 591 cases(75. 19% ) , amyloid angiopathy in 54 cases(6. 87% ) , hematologic disease in 17 cases(2. 16% ) ,anticoagulation or thrombolysis in 15 cases(1.91% ) ,brain vascular malformation in 14 cases ( 1. 79% ) , tumor bleeding in 10 cases( 1. 27% ) ,dural sinus thrombosis in 2 cases(0. 25% ), moyamoya disease in 2 cases(0. 25% ) and unknown in 80 cases( 10. 18% ). The overall mortality rate was 39. 31% . Mortality rate was highest in patients with only infratentorial hematoma (76. 47% ). and lowest in patients with only supratentorial hematoma (33. 13% ). Conclusion The causes of AMCH are diverse and most frequently related to hypertensive hemorrhage. Although AMCH is not frequently seen,higher mortality rate is noted especially related to infratentorial hematoma. DSA has an irreplaceable diagnostic value.%目的 探讨急性多灶性脑出血(AMCH)的病因、临床特点及诊断.方法 通过5

  18. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  19. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  20. Cerebral arterial angioplasty in a patient with Loeys–Dietz syndrome

    OpenAIRE

    Kellner, Christopher P.; Sussman, Eric S; Donaldson, Christopher; Connolly, E. Sander; Meyers, Philip M.

    2014-01-01

    A 14-year-old boy with Loeys–Dietz syndrome (LDS) had an acute neurologic decline 6 days after a subarachnoid hemorrhage. Cerebral angiography at presentation did not show an aneurysmal source of the hemorrhage. However, on post-bleed day 6 the patient experienced an acutely worsening headache and subsequently lost consciousness. Head CT showed new subarachnoid blood and repeat angiography demonstrated a basilar tip aneurysm. Endovascular coil embolization was performed and his neurologic sta...

  1. The clinical relevance of cerebral microbleeds in patients with cerebral ischemia and atrial fibrillation.

    Science.gov (United States)

    Haji, Shamir; Planchard, Ryan; Zubair, Adeel; Graff-Radford, Jonathan; Rydberg, Charlotte; Brown, Robert D; Flemming, Kelly D

    2016-02-01

    The clinical significance of cerebral microbleeds (CMB) in patients hospitalized with atrial fibrillation (AF) and cerebral ischemia is unclear. We aimed to determine the prevalence of CMB in this population and determine the future risk of intracerebral hemorrhage (ICH) and cerebral infarction (CI). The medical records and brain imaging of patients hospitalized with cerebral ischemia due to AF between 2008 and 2011 were reviewed. Followup was obtained through medical record review, mailed survey, and acquisition of death certificates. Prevalence was calculated from those patients with a hemosiderin-sensitive MRI sequence. Recurrent CI and ICH were calculated using Kaplan-Meier curves censored at 3 years. Among 426 patients hospitalized with cerebral ischemia due to AF, 134 had an MRI with hemosiderin-sensitive sequences. The prevalence of CMB was 27.6%. At 3 years, 90.6% of CMB-negative patients were overall stroke free (ICH and CI) compared to 78.6% CMB-positive patients (p = 0.0591). Only one patient in the CMB-positive group had an ICH distant to the CMB. There was a nonsignificant trend toward higher recurrent CI, recurrent overall stroke rate, and mortality in patients with 5 or more CMB compared to 0-4 CMB. The rate of prospective CI in patients with prior cerebral ischemia due to AF is higher than the rate of ICH in patients with CMB. Further study is warranted to assess larger numbers of patients to determine appropriate antithrombotic use in this high-risk population.

  2. 平肝熄风汤对脑出血大鼠海马细胞色素C氧化酶活性和细胞凋亡影响的同步研究%Effects of pinggan xifeng decoction on activity of cytochrome C oxidase and cellular apoptosis in hippocampi of rats with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    梁清华; 陈疆; 蔡颖; 谭勇; 唐涛; 包太成; 李春燕

    2005-01-01

    BACKGROUND: Cytochrome C oxidase(CCO) is the terminal enzyme in respiration chain of mitochondrion, and it plays a key role in aerobic metabolism and energy production during the process of oxidative phosphorylation. Recently, it is found that energy production of mitochondrion is closely related to the cellular apoptosis, and the changes of CCO activity is closely related to the neuronal impairment after cerebral ischemia and anoxia.OBJECTIVE: To investigate the protective mechanisn of compound pinggan xifeng decoction on the neuronal impairment in cerebral hemorrhage (CH) according to the mitochondrial energy metabolism and cellular apoptosis in neurons.DESIGN: A randomized and controlled trial based on experimental animals.SETTING: Institute of Integrated Traditional Chinese Medicine and Western Medicine, Xiangya Hospital, and Center of Telemedicine.MATERIALS: The experiment was completed in the animal laboratory(key laboratory of province) of Institute of Combination of Traditional Chinese Medicine and Western Medicine from November 2 to 9 in 2003. A total of 80 healthy male SD rats were selected from Experimental Animal Center of Xiangya School of Medicine, Public Health Ministry.METHODS: CH rat models were induced with collagenase Ⅶ, CCO activity was assayed with histochemistry combined with semi-quantification of gray scale, and the cellular apoptosis was evaluated with Tunel method.MAIN OUTCOME MEASURES: CCO activity of CH rats in lateral hippocampal CA1;lateral cellular apoptosis of CH rats.RESULTS: After 12-hour model establishment, CCO activity in CH group was decreased dramatically compared with that in sham operation group (P< 0.01), which was 52.12 ±3.75 and 26.98 ±6.32 respectively in lateral hippocampal CA1. And the cellular apoptosis in CH group was increased notably compared with that in sham operation group(P < 0.01),which was(13.56 ± 1.72)/sight and(4. 32 ± 1.04)/sight respectively.Then the two had deteriorated afterwards. After the

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

    International Nuclear Information System (INIS)

    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)

  4. Increased hemorrhagic transformation and altered infarct size and localization after experimental stroke in a rat model type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Switzer Jeffrey A

    2007-10-01

    Full Text Available Abstract Background Interruption of flow through of cerebral blood vessels results in acute ischemic stroke. Subsequent breakdown of the blood brain barrier increases cerebral injury by the development of vasogenic edema and secondary hemorrhage known as hemorrhagic transformation (HT. Diabetes is a risk factor for stroke as well as poor outcome of stroke. The current study tested the hypothesis that diabetes-induced changes in the cerebral vasculature increase the risk of HT and augment ischemic injury. Methods Diabetic Goto-Kakizaki (GK or control rats underwent 3 hours of middle cerebral artery occlusion and 21 h reperfusion followed by evaluation of infarct size, hemorrhage and neurological outcome. Results Infarct size was significantly smaller in GK rats (10 ± 2 vs 30 ± 4%, p Conclusion These findings provide evidence that there is cerebrovascular remodeling in diabetes. While diabetes-induced remodeling appears to prevent infarct expansion, these changes in blood vessels increase the risk for HT possibly exacerbating neurovascular damage due to cerebral ischemia/reperfusion in diabetes.

  5. Intracerebral hemorrhage and cognitive impairment.

    Science.gov (United States)

    Xiong, Li; Reijmer, Yael D; Charidimou, Andreas; Cordonnier, Charlotte; Viswanathan, Anand

    2016-05-01

    Vascular cognitive impairment and vascular dementia are composed of cognitive deficits resulted from a range of vascular lesions and pathologies, including both ischemic and hemorrhagic. However the contribution of spontaneous intracerebral hemorrhage presumed due to small vessel diseases on cognitive impairment is underestimated, in contrast to the numerous studies about the role of ischemic vascular disorders on cognition. In this review we summarize recent findings from clinical studies and appropriate basic science research to better elucidate the role and possible mechanisms of intracerebral hemorrhage in cognitive impairment and dementia. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.

  6. Changes in signal intensity of cerebral hematoma in magnetic resonance. Claves en la semiologia del hematoma cerebral en resonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    Galant, J.; Poyatos, C.; Marti-Bonmarti, L.; Martinez, J.; Ferrer, D.; Dualde, D.; Talens, A. (Universidad de Valencia (Spain). Facultad de Ciencias Quimicas)

    1992-01-01

    Magnetic resonance is highly sensitive for the detection of intraparenchymatous hemorrhage. The evolution of hematoma over time translates into changes in signal intensity. This means that we can determine when the hematoma presented and, in addition. follow its course. On the other hand, many intracranial processes developing association with hemorrhage, the recognition of which is, in some cases, of importance. We have studied 60 cerebral hematomas and have described the changes that will take place in their signal and the reasons for them. (author)

  7. Cerebral palsy

    International Nuclear Information System (INIS)

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  8. Clinical presentation of cerebral aneurysms

    International Nuclear Information System (INIS)

    Presentation of