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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. 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

  3. 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.)

  4. Cerebral hemorrhage associated with sildenafil (Revatio) in an infant.

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    Samada, Kazunori; Shiraishi, Hirohiko; Aoyagi, Jun; Momoi, Mariko Y

    2009-10-01

    A case of cerebral hemorrhage associated with sildenafil (Revatio) use in an infant is presented. Sildenafil is increasingly used in the treatment of primary and secondary pulmonary arterial hypertension and pulmonary arteriovenous fistula. In the reported case, sildenafil used to treat pulmonary arteriovenous fistula improved right-to-left shunting across the pulmonary fistula but resulted in cerebral hemorrhage. Cerebral hemorrhage, a previously reported complication of sildenafil, developed in an infant after a rapid increase in dose, to 4.7 mg/kg/day. Therefore, sildenafil doses must be increased only with care, and cerebral hemorrhage must be considered a potential complication.

  5. 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.

  6. Recurrent craniospinal subarachnoid hemorrhage in cerebral amyloid angiopathy

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    Mathew Alexander

    2013-01-01

    Full Text Available Cerebral amyloid angiopathy (CAA usually manifests as cerebral hemorrhage, especially as nontraumatic hemorrhages in normotensive elderly patients. Other manifestations are subarachnoid (SAH, subdural, intraventricular hemorrhage (IVH and superficial hemosiderosis. A 52-year-old hypertensive woman presented with recurrent neurological deficits over a period of 2 years. Her serial brain magnetic resonance imaging and computed tomography scans showed recurrent SAH hemorrhage, and also intracerebral, IVH and spinal hemorrhage, with superficial siderosis. Cerebral angiograms were normal. Right frontal lobe biopsy showed features of CAA. CAA can present with unexplained recurrent SAH hemorrhage, and may be the initial and prominent finding in the course of disease in addition to superficial cortical siderosis and intracerebal and spinal hemorrhages.

  7. 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

  8. Cerebral Edema and Cerebral Hemorrhages in Interleukin-10-Deficient Mice Infected with Plasmodium chabaudi

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    Sanni, Latifu A; Jarra, William; Li, Ching; Langhorne, Jean

    2004-01-01

    During a Plasmodium chabaudi infection in interleukin-10 (IL-10) knockout mice, there is greater parasite sequestration, more severe cerebral edema, and a high frequency of cerebral hemorrhage compared with infection of C57BL/6 mice. Anti-tumor necrosis factor alpha treatment ameliorated both cerebral edema and hemorrhages, suggesting that proinflammatory responses contributed to cerebral complications in infected IL-10−/− mice.

  9. 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.

  10. 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

  11. 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.

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

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

    2009-10-15

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

  13. 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.

  14. 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

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

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    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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. Cerebral salt-wasting syndrome due to hemorrhagic brain infarction: a case report

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    Tanaka, Tomotaka; Uno, Hisakazu; Miyashita, Kotaro; Nagatsuka, Kazuyuki

    2014-01-01

    Introduction Cerebral salt-wasting syndrome is a condition featuring hyponatremia and dehydration caused by head injury, operation on the brain, subarachnoid hemorrhage, brain tumor and so on. However, there are a few reports of cerebral salt-wasting syndrome caused by cerebral infarction. We describe a patient with cerebral infarction who developed cerebral salt-wasting syndrome in the course of hemorrhagic transformation. Case presentation A 79-year-old Japanese woman with hypertension and ...

  1. [Histostructural changes of rat cerebral cortex during hemorrhagic stroke modeling].

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    Savos'ko, S I; Chaĭkovs'kyĭ, Iu B; Pogoriela, N Kh; Makarenko, O M

    2012-01-01

    Pathological changes during modeling of primary and secondary acute hemorrhagic stroke were studied in rats. We revealed differences in the activity of pharmacological action of medications under condition of acute stroke. The action of medications increased viability of neurons in both hemispheres of rat cerebrum at a right-side primary and secondary hemorrhagic stroke. Following secondary stroke, the amount of degenerative neurons amounted 25.5 +/- 0.8 cells/mm2, following the action ofcerebrolysin this value was 17.6 +/- 1.7 cells/ mm2 and after the action of cortexine and cerebral this value amounted 18.0 +/- 0.9 cells/mm2 and 10.7 +/- 0.4 cells/ mm2, respectively. In control animals the number of degenerative neurons did not exceed 2% and averaged 1.5 +/- 0.1 cells/mm2. Analysis of the morphological and statistical data showed that the most effective remedies under the primary and secondary hemorrhagic insult are cortexine and cerebral. Cerebral was found to be more effective.

  2. 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...

  3. 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.

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

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    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.

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

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    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

  6. Chronic cerebral paragonimiasis combined with aneurysmal subarachnoid hemorrhage.

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    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.

  7. Study on Compound Salvia Pellet in Treating Hypertensive Cerebral Hemorrhage

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    徐雄鹰; 陈霄峰

    2004-01-01

    Objective: To assess the efficacy and safety of compound Salvia pellet (CSP) in treating hypertensive cerebral hemorrhage (HCH). Methods: Control group (n= 116) was given HCH conventional therapy, and the treated group (n=118) given the same conventional therapy plus CSP 10 pills through sublingual sucking/6 hrs, the efficacy was compared. Results= (1) The 3rd day after admission CT monitoring showed both the volume of hematoma and hematoma plus edema in the treated group were smaller than those in the control group, the difference was significant (P<0.05); comparison between 14th day and 28th day after admission showed that the difference was significant (P<0.01). (2) The 14th day, 28th day and 3months after admission, regarding the Chinese stroke scale (CSS), activity of daily living (ADL) andmodified Barthol index (BI), the treated group was better than that of control group, the difference was significant (P<0.01). (3) The incidence of brain-heart syndrome reduced as time went by in both groups, but that of the treated group lowered more than that of control group, the difference being.significant (P<0.05, or P<0.01). Conclusion= CSP in treating HCH patients could cease the expansion of cerebral hematoma in the early phase, and accelerate the absorption of cerebral hematoma, improve the cerebral blood flow, alleviate cerebral edema, lower the disability, and elevate the quality of life. Besides, CSP also could prevent and treat brain-heart syndrome. CSP is cheap, convenient in administration, effective and safe.

  8. 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

  9. Detection of cerebral hemorrhage in rabbits by time-difference magnetic inductive phase shift spectroscopy.

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    Wencai Pan

    Full Text Available Cerebral hemorrhage, a difficult issue in clinical practice, is often detected and studied with computed tomography (CT, magnetic resonance imaging (MRI, and positron emission tomography (PET. However, these expensive devices are not readily available in economically underdeveloped regions, and hence are unable to provide bedside and emergency on-site monitoring. The magnetic inductive phase shift (MIPS is an emerging technology that may become a new tool to detect cerebral hemorrhage and to serve as an inexpensive partial substitute to medical imaging. In order to study a wider band of cerebral hemorrhage MIPS and to provide more useful information for measuring cerebral hemorrhage, we established a cerebral hemorrhage magnetic induction phase shift spectroscopy (MIPSS detection system. Thirteen rabbits with five cerebral hemorrhage states were studied using a single coil-coil within a 1 MHz-200 MHz frequency range in linear sweep. A feature band (FB with the highest detection sensitivity and the greatest stability was selected for further analysis and processing. In addition, a maximum conductivity cerebrospinal fluid (CSF MRI was performed to verify and interpret the MIPSS result. The average phase shift change induced by a 3 ml injection of autologous blood under FB was -7.7503° ± 1.4204°, which was considerably larger than our previous work. Data analysis with a non-parametric statistical Friedman M test showed that in the FB, MIPSS could distinguish the five states of cerebral hemorrhage in rabbits, with a statistical significance of p<0.05. A B-F distribution profile was designed according to the MIPSS under FB that can provide instantaneous diagnostic information about the cerebral hemorrhage severity from a single set of measurements. The results illustrate that the MIPSS detection method is able to provide a new possibility for real-time monitoring and diagnosis of the severity of cerebral hemorrhage.

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

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    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

  11. Cerebral venous thrombosis presenting with intracerebral hemorrhage in a patient with paroxysmal nocturnal hemoglobinuria

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    Gentle Sunder Shrestha

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke. Paroxysmal nocturnal hemoglobinuria (PNH is a rare type of hemolytic anemia, frequently associated with thrombophilia. PNH may rarely present with CVT. Approximately, one-third of the patients with CVT develop cerebral hemorrhage. Here, we present a rare combination of CVT presenting with intracerebral hemorrhage in a patient with PNH. High index of suspicion is needed to avoid misdiagnosis. Patient was successfully managed with anticoagulation therapy.

  12. 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

  13. Cerebral hemodynamics and metabolism in patients with moyamoya disease not demonstrating either cerebral infarct or hemorrhage on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Sasaki, Masayuki; Akashi, Yuko; Yoshida, Tsuyoshi; Fukumura, Toshimitsu; Masuda, Kouji; Matsushima, Toshio; Fukui, Masashi [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine

    1995-12-01

    We evaluated the cerebral hemodynamics and metabolism in moyamoya patients who did not demonstrate either cerebral infarct or hemorrhage on MRI. The subjects consisted of 5 patients with moyamoya disease (4 females and one male, aged from 15 to 40 ears). The CBF, OEF and CMRO{sub 2} of the moyamoya patients did not differ from those of the normal control subjects. The CBV did increase significantly in the cerebral cortices and striatum, but not in the cerebellum. The TT was also significantly prolonged in the frontal and parietal regions. The cerebrovascular CO{sub 2} response was markedly impaired in the frontal, temporal and parietal cortices. However, it was relatively preserved in the occipital cortex, thalamus and cerebellum. Thus, the cerebral hemodynamic reserve capacity decreased even in the moyamoya patients not demonstrating either cerebral infarct or hemorrhage on MRI, and it should be considered in the management of these patients. (author).

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. Delayed cerebral ischemia associated with reversible cerebral vasoconstriction in a patient with Moyamoya disease with intraventricular hemorrhage: Case report.

    Science.gov (United States)

    Matsuoka, Go; Kubota, Yuichi; Okada, Yoshikazu

    2015-06-01

    We describe a case of cerebral infarctions caused by transient vasoconstrictions in the posterior circulation 2 weeks after intraventricular hemorrhage without subarachnoid hemorrhage in a 35-year-old patient with Moyamoya disease. To our knowledge, this is the first case report where diffuse segmental vasoconstrictions of the basilar and posterior cerebral arteries were recognized after intraventricular hemorrhage in Moyamoya disease. The patient complained of severe and acute-onset headache 14 days after the intraventricular hemorrhage, which had a different character and severity from the one she complained of at the onset of intraventricular hemorrhage. Finally, headache disappeared within 1 month and vasoconstriction resolved in 2 months. Reversible cerebral vasoconstriction syndrome was under consideration for the etiology of her condition because of the "thunderclap" characteristics of the headache and the delayed timing of occurrence of the vasoconstriction. This case report informs and alerts neurologists, neurosurgeons and neuroradiologists who observe and treat patients with Moyamoya disease that vasoconstriction in the posterior circulation may occur after intraventricular hemorrhage in these patients.

  19. 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

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

    Directory of Open Access Journals (Sweden)

    J. Sun

    2014-02-01

    Full Text Available 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.

  1. Early events triggering delayed vasoconstrictor receptor upregulation and cerebral ischemia after subarachnoid hemorrhage

    DEFF Research Database (Denmark)

    Povlsen, Gro Klitgaard; Johansson, Sara Ellinor; Larsen, Carl Christian

    2013-01-01

    that the drop in cerebral blood flow (CBF) and wall tension experienced by cerebral arteries in acute SAH is a key triggering event. We here investigate the importance of the duration of this acute CBF drop in a rat SAH model in which a fixed amount of blood is injected into the prechiasmatic cistern either......Upregulation of vasoconstrictor receptors in cerebral arteries, including endothelin B (ETB) and 5-hydroxytryptamine 1B (5-HT(1B)) receptors, has been suggested to contribute to delayed cerebral ischemia, a feared complication after subarachnoid hemorrhage (SAH). This receptor upregulation has been...

  2. 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.

  3. 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.

  4. Effect of Maixuekang enteric coated tablets on absorption of hematoma and treatment of acute cerebral hemorrhage patients with cerebral edema

    Institute of Scientific and Technical Information of China (English)

    Bing-Ding Lu; Chuan Wang

    2016-01-01

    Objective:To study the clinical efficacy of Maixuekang in treating acute cerebral hemorrhage hematomas and promoting brain hemorrhage.Methods: A total of 192 patients with acute intracerebral hemorrhage treated within 3 hours in our hospital during April 2013 to February 2015 were selected. After admission immediately apply brain CT, blood, coagulation function tests were carried out. They were randomly divided into 2 groups. Both groups had anti-infective, mannitol and other conventional treatment. Observation group were treated with enteric-coated tablets Maixuekang on this basis. Clinical efficacy, various stages of treatment of cerebral hematoma volume, brain edema volume, NIHSS score were compared.Results: Before treatment, difference in edema volume and HIHSS scores were not statistically significant (P>0.05). After14 d and 28 d treatment, edema volume of observation group were significantly smaller than those of control group (P<0.01); NIHSS score of observation group were significantly lower than those of control group (P<0.01); 28 d after treatment total effective rate of observation group was significantly higher than that of the control group (P<0.01).Conclusions:Maixuekang enteric-coated tablets as a thrombin inhibitor, can effectively reduce a series of pathological changes after acute cerebral hemorrhage caused by partial thrombin content, promote absorption of hematoma and neurological recovery. The side effects is small, safe and worthy of promotion.

  5. 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.

  6. Anticoagulation Therapy and Imaging in Neonates With a Unilateral Thalamic Hemorrhage Due to Cerebral Sinovenous Thrombosis

    NARCIS (Netherlands)

    Kersbergen, Karina J.; de Vries, Linda S.; van Straaten, H. L. M. (Irma); Benders, Manon J. N. L.; Nievelstein, Ruter A. J.; Groenendaal, Floris

    2009-01-01

    Background and Purpose-Cerebral sinovenous thrombosis is a rare disorder with a high risk of an adverse neurodevelopmental outcome. Until now, anticoagulation therapy has been restricted to neonates without an associated parenchymal hemorrhage. In this study, we describe sequential neuroimaging find

  7. Construction of a Cerebral Hemorrhage Test System Operated in Real-time

    Science.gov (United States)

    Li, Gen; Sun, Jian; Ma, Ke; Yan, Qingguang; Zheng, Xiaolin; Qin, Mingxin; Jin, Gui; Ning, Xu; Zhuang, Wei; Feng, Hua; Huang, Shiyuwei

    2017-02-01

    The real-time monitoring and evaluation of the severity and progression of cerebral hemorrhage is essential to its intensive care and its successful emergency treatment. Based on magnetic induction phase shift technology combined with a PCI data acquisition system and LabVIEW software, this study established a real-time monitoring system for cerebral hemorrhage. To test and evaluate the performance of the system, the authors performed resolution conductivity experiments, salted water simulation experiments and cerebral hemorrhage experiments in rabbits and found that when the conductivity difference was 0.73 S/m, the phase difference was 13.196°. The phase difference change value was positively proportional to the volume of saline water, and the conductivity value was positively related to the phase difference of liquid under the same volume conditions. After injecting 3 mL blood into six rabbits, the average change in the blood phase difference was ‑2.03783 ± 0.22505°, and it was positively proportional to the volume of blood, which was consistent with the theoretical results. The results show that the system can monitor the progressive development of cerebral hemorrhage in real-time and has the advantages of low cost, small size, high phase accuracy, and good clinical application potentiality.

  8. Construction of a Cerebral Hemorrhage Test System Operated in Real-time

    Science.gov (United States)

    Li, Gen; Sun, Jian; Ma, Ke; Yan, Qingguang; Zheng, Xiaolin; Qin, Mingxin; Jin, Gui; Ning, Xu; Zhuang, Wei; Feng, Hua; Huang, Shiyuwei

    2017-01-01

    The real-time monitoring and evaluation of the severity and progression of cerebral hemorrhage is essential to its intensive care and its successful emergency treatment. Based on magnetic induction phase shift technology combined with a PCI data acquisition system and LabVIEW software, this study established a real-time monitoring system for cerebral hemorrhage. To test and evaluate the performance of the system, the authors performed resolution conductivity experiments, salted water simulation experiments and cerebral hemorrhage experiments in rabbits and found that when the conductivity difference was 0.73 S/m, the phase difference was 13.196°. The phase difference change value was positively proportional to the volume of saline water, and the conductivity value was positively related to the phase difference of liquid under the same volume conditions. After injecting 3 mL blood into six rabbits, the average change in the blood phase difference was −2.03783 ± 0.22505°, and it was positively proportional to the volume of blood, which was consistent with the theoretical results. The results show that the system can monitor the progressive development of cerebral hemorrhage in real-time and has the advantages of low cost, small size, high phase accuracy, and good clinical application potentiality. PMID:28205627

  9. 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...

  10. 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

    The pathological constriction of cerebral arteries known as cerebral vasospasm (CVS) is with a delay of 4 to 10 days linked to subarachnoid hemorrhage. Several agents have been suggested as being responsible; amongst these perhaps 5-hydroxytryptamine (5-HT) and endothelin-1 (ET-1) are the most...... 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...

  11. Cortical subarachnoid hemorrhage associated with reversible cerebral vasoconstriction syndrome after elective triplet cesarean delivery.

    Science.gov (United States)

    Albano, Beatrice; Del Sette, Massimo; Roccatagliata, Luca; Gandolfo, Carlo; Primavera, Alberto

    2011-06-01

    Reversible cerebral vasoconstriction syndromes (RCVS) comprise a group of disorders characterized by prolonged, but reversible vasoconstriction of the cerebral arteries, usually associated with acute-onset, severe, recurrent headaches, with or without additional neurological signs and symptoms. Various complications of this condition have been observed, such as cortical subarachnoid hemorrhages (cSAH), intracerebral hemorrhages, reversible posterior leukoencephalopathy, ischaemic strokes and transient ischaemic attacks. It is important to include RCVS in thunderclap headache differential diagnosis and among non-aneurismatic subarachnoid hemorrhage causes. In the past years, thanks to the major diffusion of new diagnostic tools such as magnetic resonance, computed tomography and digital subtraction angiography, RCVS have been demonstrated to be more frequent than previously thought. We report an illustrative case of a woman affected by a small cSAH, associated to RCVS, after elective triplet cesarean delivery. To our knowledge, this is the first case of cSAH associated to RCVS after a triplet pregnancy.

  12. 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.

  13. 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

    After subarachnoid hemorrhage (SAH), pathologic changes in cerebral arteries contribute to delayed cerebral ischemia and poor outcome. We hypothesize such changes are triggered by early intracellular signals, targeting of which may prevent SAH-induced vasculopathy. We performed an unbiased quanti......-induced signaling components downstream and upstream of ERK1/2.Journal of Cerebral Blood Flow & Metabolism advance online publication, 29 May 2013; doi:10.1038/jcbfm.2013.78....... quantitative analysis of early SAH-induced phosphorylations in cerebral arteries and evaluated identified signaling components as targets for prevention of delayed vasculopathy and ischemia. Labeled phosphopeptides from rat cerebral arteries were quantified by high-resolution tandem mass spectrometry. Selected...

  14. 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 .

  15. [Experience gained with Solcoseryl as treatment of patients with cerebral hemorrhage].

    Science.gov (United States)

    Dziak, L A; Golik, V A

    2001-01-01

    It is constrictive-stenotic arteriopathy developing in the remote period together with delayed ischemic affliction of the brain resulting in formation of persistent neurological deficit, disability of the patient or fatality that is regarded as the most important pathogenetic mechanism of unfavourable functional and vital prognosis of cerebral hemorrhage. Examined in the trial were 350 patients presenting with cerebral hemorrhage induced by rupture of the brain arterial aneurysms. 300 patients were treated with the drug preparation solcoseryl, 50 patients were the control group. A clinical and paraclinical monitoring of the state of the patients was conducted with the aid of an X-ray computerized tomography, ultrasound dopplerography of the extra- and intracranial arteries. A positive effect is shown of the drug on the risk of development of a clinically manifested neurological deficit that does not undergo regression against the background of paraclinically recordable objective signs of constrictive-stenotic arteriopathy and formation of unfavourable (gross disability, vegetative state, fatality) outcome as per the Glasgow Scale of Outcomes and a low level of the functional activity according to the Barttel's index at day 30 following the development of hemorrhage. The drug is well-tolerated and can be recommended in the treatment of aneurysmatic cerebral hemorrhages.

  16. 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

  17. 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.

  18. Hereditary cerebral hemorrhage with amyloidosis in patients of Dutch origin is related to Alzheimer disease

    Energy Technology Data Exchange (ETDEWEB)

    van Duinen, S.G.; Castano, E.M.; Prelli, F.; Bots, G.T.A.B.; Luyendijk, W.; Frangione, B.

    1987-08-01

    Hereditary cerebral hemorrhage with amyloidosis in Dutch patients is an autosomal dominant form of vascular amyloidosis restricted to the leptomeninges and cerebral cortex. Clinically the disease is characterized by cerebral hemorrhages leading to an early death. Immunohistochemical studies of five patients revealed that the vascular amyloid deposits reacted intensely with an antiserum raised against a synthetic peptide homologous to the Alzheimer disease-related ..beta..-protein. Silver stain-positive, senile plaque-like structures were also labeled by the antiserum, yet these lesions lacked the dense amyloid cores present in typical plaques of Alzheimer disease. No neurofibrillary tangles were present. Amyloid fibrils were purified from the leptomeningeal vessels of one patient who clinically had no signs of dementia. The protein had a molecular weight of approx. 4000 and its partial amino acid sequence to position 21 showed homology to the ..beta..-protein of Alzheimer disease and Down syndrome. These results suggest that hereditary cerebral hemorrhage with amyloidosis of Dutch origin is pathogenetically related to Alzheimer disease and support the concept that the initial amyloid deposition in this disorder occurs in the vessel walls before damaging the brain parenchyma. Thus, deposition of ..beta..-protein in brain tissue seems to be related to a spectrum of diseases involving vascular syndromes, progressive dementia, or both.

  19. Hemorrhagic transformation after cerebral infarction: current concepts and challenges

    OpenAIRE

    Zhang, Jie; Yang, Yi; Sun, Huijie; Xing, Yingqi

    2014-01-01

    Hemorrhagic transformation (HT) is a frequent complication of acute ischemic stroke that is especially common after thrombolytic therapy. The risk of HT limits the applicability of tissue plasminogen activator (tPA). Here, we sought to review the rate, classification, predictors, possible mechanism, and clinical outcomes of HT, as well as existing therapeutic approaches, in order to call attention to the current challenges in the treatment of this complication.

  20. 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

  1. 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 melatonin were less than those without melatonin treatment (p melatonin could mitigate CV after experimental SAH.

  2. 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.

  3. Cerebral venous dynamics in newborn mice with intracranial hemorrhage studied using wavelets

    Science.gov (United States)

    Pavlov, A. N.; Semyachkina-Glushkovskaya, O. V.; Sindeeva, O. A.; Pavlova, O. N.; Shuvalova, E. P.; Huang, Q.; Zhu, D.; Li, P.; Tuchin, V. V.; Luo, Q.

    2015-03-01

    We investigate the stress-induced development of the intracranial hemorrhage in newborn mice with the main attention to its latent stage. Our study is based on the laser speckle contrast imaging of the cerebral venous blood flow and the wavelet-based analysis of experimental data. We study responses of the sagittal sinus in different frequency ranges associated with distinct regulatory mechanisms and discuss significant changes of the spectral power in the frequency area associated with the NO-related endothelial function.

  4. Detrended fluctuation analysis of cerebral venous dynamics in newborn mice with intracranial hemorrhage

    Science.gov (United States)

    Pavlov, A. N.; Semyachkina-Glushkovskaya, O. V.; Bibikova, O. A.; Pavlova, O. N.; Mohammad, Y. K.; Huang, Q.; Zhu, D.; Li, P.; Tuchin, V. V.; Luo, Q.

    2015-03-01

    We study pathological changes in cerebral venous dynamics in newborn mice using the laser speckle contrast imaging and the detrended fluctuation analysis with a special attention to the latent stage of the development of the intracranial hemorrhage. We show that this stage is characterized by a high responsiveness of the sagittal sinus to pharmacological stimulations of adrenorelated dilation. We conclude that this effect can be considered as an important mechanism underlying the development of ICH in newborns.

  5. Poxue Huayu and Tianjing Busui Decoction for cerebral hemorrhage Upregulation of neurotrophic factor expression**

    Institute of Scientific and Technical Information of China (English)

    Jixiang Ren; Xiangyu Zhou; Jian Wang; Jianjun Zhao; Pengguo Zhang

    2013-01-01

    This study established a rat model of cerebral hemorrhage by injecting autologous anticoagulated blood. Rat models were intragastrical y administered 5, 10, 20 g/kg Poxue Huayu and Tianjing Bu-sui Decoction, supplemented with Hirudo, raw rhubarb, raw Pol en Typhae, gadfly, Fructrs Tricho-santhis, Radix Notoginseng, Rhizoma Acori Talarinowi , and glue of tortoise plastron, once a day, for 14 consecutive days. Results demonstrated that brain water content significantly reduced in rats with cerebral hemorrhage, and intracerebral hematoma volume markedly reduced after treatment. Immunohistochemical staining revealed that brain-derived neurotrophic factor, tyrosine kinase B and vascular endothelial growth factor expression noticeably increased around the surrounding hematoma. Reverse transcription-PCR revealed that brain-derived neurotrophic factor and tyrosine kinase B mRNA expression significantly increased around the surrounding hematoma. Neurologic impairment obviously reduced. These results indicated that Poxue Huayu and Tianjing Busui De-coction exert therapeutic effects on cerebral hemorrhage by upregulating the expression of brain-derived neurotrophic factor.

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

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    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

  7. 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.

  8. 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.)

  9. 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

  10. 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

  11. Pseudo subarachnoid Hemorrhage: A Finding of Diffuse Cerebral Edema Leading to Misdiagnosis

    Directory of Open Access Journals (Sweden)

    Eda Kılıç Çoban

    2015-12-01

    Full Text Available Increased attenuation of the basal cisterns and subarachnoid spaces on CT scans is a characteristic finding of acute subarachnoid hemorrhage. CT mimics of SAH have been called pseudo-SAH. Our case is presented to underline the differentiation of two diagnosis. A 63-year-old man was admitted to the emergency room with right-sided hemiparesis and aphasia. He had middle cerebral artery enfarct on his CT. A week after his hospitalisation his neurological examination was deteriorated. A plain CT-scan of brain was consistent with sub-arachnoid hemorrhage. His antiagregant therapy was ended and anti edema therapy started. Urgent neurosurgical consultation was sought & surgery was not planned. Brain death was the finding in his CT angiography. So the CT-scan findings turned out to be `pseudo sub-arachnoid haemorrhage’.Pseudo sub-arachnoid haemorrhage is a rare CT scan finding that has been reported in different cerebral disease with cerebral edema. MR imaging studies, CSF examination by lumbar puncture and the criterias proposed by Yazawa can be useful to make the diagnosis. The aim is the unnecessary termination of antiagregant and anticoagulant therapy.

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

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    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.

  13. Cerebral Salt-wasting Syndrome and Inappropriate Antidiuretic Hormone Syndrome after Subarachnoid Hemorrhaging.

    Science.gov (United States)

    Nakajima, Hanako; Okada, Hiroshi; Hirose, Kazuki; Murakami, Toru; Shiotsu, Yayoi; Kadono, Mayuko; Inoue, Mamoru; Hasegawa, Goji

    2017-01-01

    Hyponatremia is a common finding after subarachnoid hemorrhaging (SAH) and can be caused by either cerebral salt-wasting syndrome (CSWS) or syndrome of inappropriate antidiuretic hormone (SIADH). Distinguishing between these two entities can be difficult because they have similar manifestations, including hyponatremia, serum hypo-osmolality, and high urine osmolality. We herein report the case of a 60-year-old man who suffered from SAH complicated by hyponatremia. During his initial hospitalization, he was diagnosed with CSWS. He was readmitted one week later with hyponatremia and was diagnosed with SIADH. This is the first report of SAH causing CSWS followed by SIADH. These two different sources of hyponatremia require different treatments.

  14. 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.

  15. Inter ventional therapy of diabetes mellitus type 2 complicated with acute cerebral hemorrhage by using dexmedetomidine

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    Shan-Shan Zheng

    2016-09-01

    Full Text Available Objective: To study the effects of dexmedetomidine on cerebral injury, inflammation, oxidative stress and renal function of patients with diabetes mellitus type 2 complicated with acute cerebral hemorrhage. Methods: A total of 98 cases who had been diagnosed with diabetes mellitus type 2 complicated with acute cerebral hemorrhage and treated with interventional therapy in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2014 January 2016 were chosen to be our study subjects. Among them, 50 cases given dexmedetomidine treatment in the process of anesthesia were included in the dexmedetomidine group (Group A, while the other 48 cases treated with equal amount of normal saline were considered as the negative control group. The postoperative cerebral injury indexes and the serum biochemical indexes were detected after 24 h. Results: The contents of serum S100b [(2.1 ± 0.2 mg/L] and neuron-specific enolase (NSE [(14.2 ± 1.3 mg/mL] in Group A were all significantly lower than serum S100b [(2.9 ± 0.3 mg/L] and NSE [(16.6 ± 1.7 mg/mL] of patients in negative control group. The contents of cerebrospinal fluid S100b [(0.9 ± 0.1 mg/L] and NSE [(10.7 ± 1.3 mg/ mL] in Group A were all significantly lower than cerebrospinal fluid S100b [(1.3 ± 0.2 mg/L] and NSE [(15.3 ± 1.7 mg/mL] of patients in negative control group. The contents of erythrocyte sedimentation rate [(11.7 ± 2.5 mm/h], c-reactive protein [(2.3 ± 0.4 mg/L], urea nitrogen [(10.7 ± 1.2 mmol/L] and serum creatinine [(151.6 ± 14.9] mmol/L in Group A were all significantly lower than erythrocyte sedimentation rate [(23.6 ± 3.8 mm/h], c-reactive protein [(6.9 ± 1.1 mg/L], urea nitrogen [(16.7 ± 1.7 mmol/L] and serum creatinine [(192.5 ± 18.3] mmol/L of patients in negative control group. Conclusions: The application of dexmedetomidine in the interventional therapy of diabetes mellitus type 2 complicated with acute cerebral hemorrhage could

  16. Interventional therapy of diabetes mellitus type 2 complicated with acute cerebral hemorrhage by using dexmedetomidine

    Institute of Scientific and Technical Information of China (English)

    Shan-Shan Zheng; Xin-Ye Qian; Si-Yuan Li; Xuan Zhao

    2016-01-01

    Objective: To study the effects of dexmedetomidine on cerebral injury, inflammation, oxidative stress and renal function of patients with diabetes mellitus type 2 complicated with acute cerebral hemorrhage. Methods: A total of 98 cases who had been diagnosed with diabetes mellitus type 2 complicated with acute cerebral hemorrhage and treated with interventional therapy in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2014 January 2016 were chosen to be our study subjects. Among them, 50 cases given dexmedetomidine treatment in the process of anesthesia were included in the dexmedetomidine group (Group A), while the other 48 cases treated with equal amount of normal saline were considered as the negative control group. The postoperative cerebral injury indexes and the serum biochemical indexes were detected after 24 h. Results: The contents of serum S100b [(2.1 ± 0.2) mg/L] and neuron-specific enolase (NSE) [(14.2 ± 1.3) mg/mL] in Group A were all significantly lower than serum S100b [(2.9 ± 0.3) mg/L] and NSE [(16.6 ± 1.7) mg/mL] of patients in negative control group. The contents of cerebrospinal fluid S100b [(0.9 ± 0.1) mg/L] and NSE [(10.7 ± 1.3) mg/mL] in Group A were all significantly lower than cerebrospinal fluid S100b [(1.3 ± 0.2) mg/L] and NSE [(15.3 ± 1.7) mg/mL] of patients in negative control group. The contents of erythrocyte sedimentation rate [(11.7 ± 2.5) mm/h], c-reactive protein [(2.3 ± 0.4) mg/L], urea nitrogen [(10.7 ± 1.2) mmol/L] and serum creatinine [(151.6 ± 14.9)] mmol/L in Group A were all significantly lower than erythrocyte sedi-mentation rate [(23.6 ± 3.8) mm/h], c-reactive protein [(6.9 ± 1.1) mg/L], urea nitrogen [(16.7 ± 1.7) mmol/L] and serum creatinine [(192.5 ± 18.3)] mmol/L of patients in negative control group. Conclusions: The application of dexmedetomidine in the interventional therapy of diabetes mellitus type 2 complicated with acute cerebral hemorrhage could

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

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    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.

  18. 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.

  19. Severe pathological manifestation of cerebral amyloid angiopathy correlates with poor outcome from cerebral amyloid angiopathy related intracranial hemorrhage

    Institute of Scientific and Technical Information of China (English)

    TANG Ya-juan; WANG Shuo; ZHU Ming-wei; SUN Yi-lin; ZHAO Ji-zong

    2013-01-01

    Background Cerebral amyloid angiopathy (CAA) is one of the main causes of spontaneous intracranial hemorrhage (ICH).No established link is available between pathological scores of CAA and its outcome.This study aimed to identify the correlations between pathological severity and poor postoperative outcome in the Chinese population.Methods Between May 2006 and April 2011,367 consecutive patients who underwent surgery for CAA-related ICH in 71 hospitals throughout the mainland of China were enrolled in this study.Twelve months after surgery,we evaluated these patients' outcomes according to the modified Rankin Scale (mRS) and statistically correlated risk factors (demographics,medical history,pathological results,and surgical details) that are associated with a favorable (mRS <3)and poor (mRS >3) outcome groups.Results Risk factors for poor postoperative outcome in 367 patients with CAA-related ICH included advanced age (OR 1.034,95% Cl 1.001-1.067,P=-0.042),CAA pathology severity (OR 2.074,95% CI 7.140-16.25,P <0.001),lobar hematoma (OR 0.225,95% Cl 0.104-0.486,P <0.001),presence of intraventricular hemorrhage (OR 0.478,95% CI 0.229-1.001,P=-0.050),and/or subarachnoid hemorrhage (OR 2.629,95% CI,1.051-6.577,P=-0.039).Conclusions Poor postoperative outcome of patients with CAA-related ICH was more related to the severe pathological manifestation instead of other factors.Prior ischemia may present an early stage of CAA.

  20. 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

  1. Effects of angiopoietin-1 on hemorrhagic transformation and cerebral edema after tissue plasminogen activator treatment for ischemic stroke in rats.

    Science.gov (United States)

    Kawamura, Kunio; Takahashi, Tetsuya; Kanazawa, Masato; Igarashi, Hironaka; Nakada, Tsutomu; Nishizawa, Masatoyo; Shimohata, Takayoshi

    2014-01-01

    An angiogenesis factor, angiopoietin-1 (Ang1), is associated with the blood-brain barrier (BBB) disruption after focal cerebral ischemia. However, whether hemorrhagic transformation and cerebral edema after tissue plasminogen activator (tPA) treatment are related to the decrease in Ang1 expression in the BBB remains unknown. We hypothesized that administering Ang1 might attenuate hemorrhagic transformation and cerebral edema after tPA treatment by stabilizing blood vessels and inhibiting hyperpermeability. Sprague-Dawley rats subjected to thromboembolic focal cerebral ischemia were assigned to a permanent ischemia group (permanent middle cerebral artery occlusion; PMCAO) and groups treated with tPA at 1 h or 4 h after ischemia. Endogenous Ang1 expression was observed in pericytes, astrocytes, and neuronal cells. Western blot analyses revealed that Ang1 expression levels on the ischemic side of the cerebral cortex were decreased in the tPA-1h, tPA-4h, and PMCAO groups as compared to those in the control group (P = 0.014, 0.003, and 0.014, respectively). Ang1-positive vessel densities in the tPA-4h and PMCAO groups were less than that in the control group (p = 0.002 and cerebral homogenate (p = 0.007) and cerebral edema due to BBB damage (p = 0.038), as compared to administering COMP protein alone. In conclusion, Ang1 might be a promising target molecule for developing vasoprotective therapies for controlling hemorrhagic transformation and cerebral edema after tPA treatment.

  2. Possible overlap between reversible cerebral vasoconstriction syndrome and symptomatic vasospasm after aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Forget, Patrice; Goffette, Pierre; van de Wyngaert, Françoise; Raftopoulos, Christian; Hantson, Philippe

    2009-08-01

    A 34-year-old woman with a previous history of severe headache ("thunderclap") was admitted with a diagnosis of aneurysmal subarachnoid hemorrhage (SAH). The patient developed symptomatic vasospasm on day 5 that resolved rapidly after having increased arterial blood pressure. She experienced also short-lasting excruciating headache. On day 12, while velocities had normalised, as revealed by transcranial Doppler (TCD), for more than 48 h, she developed aphasia and right hemiplegia associated with diffuse segmental vasospasm on the left middle cerebral artery. Intra-arterial infusion of vasodilatory agents was required. Recurrence of symptomatic vasospasm was noted on day 25, with a great number of territories involved as shown in the cerebral angiogram. A second intra-arterial treatment was needed. The patient complained of multiple episodes of extremely severe headache ("thunderclap"), with also transient dysarthria and hemiparesia on day 30. She was discharged on day 38 after full recovery. The clinical and TCD/radiological findings were consistent with a reversible cerebral vasoconstriction syndrome overlapping SAH related symptomatic vasospasm.

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

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    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.

  4. 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.

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

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    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.)

  6. 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.

  7. Cerebral microdialysis in traumatic brain injury and subarachnoid hemorrhage: state of the art.

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    de Lima Oliveira, Marcelo; Kairalla, Ana Carolina; Fonoff, Erich Talamoni; Martinez, Raquel Chacon Ruiz; Teixeira, Manoel Jacobsen; Bor-Seng-Shu, Edson

    2014-08-01

    Cerebral microdialysis (CMD) is a laboratory tool that provides on-line analysis of brain biochemistry via a thin, fenestrated, double-lumen dialysis catheter that is inserted into the interstitium of the brain. A solute is slowly infused into the catheter at a constant velocity. The fenestrated membranes at the tip of the catheter permit free diffusion of molecules between the brain interstitium and the perfusate, which is subsequently collected for laboratory analysis. The major molecules studied using this method are glucose, lactate, pyruvate, glutamate, and glycerol. The collected substances provide insight into the neurochemical features of secondary injury following traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) and valuable information about changes in brain metabolism within a short time frame. In this review, the authors detail the CMD technique and its associated markers and then describe pertinent findings from the literature about the clinical application of CMD in TBI and SAH.

  8. [Two children with cerebral and retinal hemorrhages: do not diagnose shaken baby syndrome too rapidly].

    Science.gov (United States)

    Botte, A; Mars, A; Wibaut, B; De Foort-Dhellemmes, S; Vinchon, M; Leclerc, F

    2012-01-01

    We report on 2 cases associating retinal (RH) and cerebral hemorrhages (CH), which first suggested the diagnosis of shaken baby syndrome (SBS). After an etiologic search, the diagnosis was corrected: the first case was a late hemorrhagic disease of the newborn and the second case hemophilia A. RH is a major feature of SBS, although not pathognomonic. There is no specific RH of SBS but they usually affect the posterior retinal pole. Typically, RHs of SBS are present in both eyes, although unilateral RHs do not exclude the diagnosis of SBS. The relationship between RH and CH has been reported in SBS but also in other diseases. Thus, one must search for hemostasis abnormalities, even though the clinical presentation suggests SBS. Ignoring SBS as well as coming to the conclusion of SBS too quickly should be avoided. Diagnostic difficulties may be related to the number of physicians involved and their interpretation of the facts. These 2 cases underline the need for working as a team that includes hematologists able to interpret coagulation parameters.

  9. 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

    2015-12-29

    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.

  10. T cell mediated cerebral hemorrhages and microhemorrhages during passive Aβ immunization in APPPS1 transgenic mice

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    de Calignon Alix

    2011-03-01

    Full Text Available Abstract Background Immunization against amyloid-β (Aβ, the peptide that accumulates in the form of senile plaques and in the cerebrovasculature in Alzheimer's disease (AD, causes a dramatic immune response that prevents plaque formation and clears accumulated Aβ in transgenic mice. In a clinical trial of Aβ immunization, some patients developed meningoencephalitis and hemorrhages. Neuropathological investigations of patients who died after the trial showed clearance of amyloid pathology, but also a powerful immune response involving activated T cells probably underlying the negative effects of the immunization. Results To define the impact of T cells on this inflammatory response we used passive immunization and adoptive transfer to separate the effect of IgG and T cell mediated effects on microhemorrhage in APPPS1 transgenic mice. Neither anti Aβ IgG nor adoptively transferred T cells, alone, led to increased cerebrovascular damage. However, the combination of adoptively transferred T cells and passive immunization led to massive cerebrovascular bleeding that ranged from multiple microhemorrhages in the parenchyma to large hematomas. Conclusions Our results indicate that vaccination can lead to Aβ and T cell induced cerebral micro-hemorrhages and acute hematomas, which are greatly exacerbated by T cell mediated activity.

  11. Effect of subarachnoid hemorrhage on contractile responses and noradrenaline release evoked in cat cerebral arteries by histamine

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    Lobato, R.D.; Marin, J.; Salaices, M.; Rico, M.L.; Sanchez, C.F.

    1981-10-01

    This study analyzes the changes induced by subarachnoid hemorrhage (SAH) on the contractile responses and the noradrenaline release evoked in cat cerebral arteries by histamine. The dose-dependent vasoconstriction induced by histamine on the cerebral arteries of normal cats was significantly reduced by diphenhydramine and phentolamine. When SAH was produced 3 and 7 days before the experiment, the histamine-induced vasoconstriction also decreased. Thereafter, a tendency to normalization in the contractile vascular responses was observed such that in 15 days after the hemorrhage it was not significantly different from that found in controls animals. The decrease in the contractile responses to histamine provoked by SAH was similar to that seen after pretreatment with intracisternal injections of 6-hydroxydopamine. The amount of radioactivity released by histamine following preincubation with /sup 3/H-noradrenaline from the cerebral arteries of cats exposed to SAH 3, 7, and 15 days before the experiment was significantly reduced when compared with controls. Moreover, the basal level of tritium release and the radioactivity retained at the end of the experiment were also decreased after SAH. Results indicate histamine releases noradrenaline from cat cerebral arteries, and SAH produce a transient denervation of the perivascular adrenergic nerve endings, which explained by the impairment of the indirect adrenergic mechanism involved in the overall contractile response elicited by this amine in cerebral arteries. Histamine does not seem to play a significant role in the production of the cerebral vasospasm occurring after SAH.

  12. 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.

  13. Application of frameless stereotactic aspiration in the treatment of hypertension cerebral hemorrhage

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    You-san ZHANG

    2016-09-01

    Full Text Available Objective  To investigate the technical points and clinical outcomes of frameless stereotactic aspiration in treatment of patients with hypertension cerebral hemorrhage (HPCH. Methods  The clinical data of 68 consecutive patients with HPCH, treated with frameless stereotactic aspiration from Jan. 2012 to Jun. 2014, were retrospectively analyzed, and compared to that of 45 patients treated in the meantime by frame-based stereotactic aspiration. The surgical results, procedure-related complications and clinical prognosis were evaluated. Results  For the patients treated with frameless stereotactic aspiration, the median age was 53.3 years (range 36-80, the mean initial Glasgow coma scale score was over 5. Among them seven patients died within a month after operation: 3 died of respiratory failure, 2 of cerebral edema and 2 of rehemorrhage. At the six-months follow-up, the good recovery rate (gradeⅠ-Ⅲof ADL was 77.9%(53/68, better than that of patients treated with frame-based stereotactic aspiration (60.0%, P<0.05. Conclusion  Frameless stereotactic aspiration for HPCH is easy to operate, minimal invasion and safe procedure with low mortality and rehemorrhage rate. DOI: 10.11855/j.issn.0577-7402.2016.08.12

  14. 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.

  15. Effect of autologous bone mesenchymal stem cell transplantation on neurological function in rehabilitation period of multifocal cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Rui Zhang

    2016-01-01

    Objective:To study the effect of autologous bone mesenchymal stem cell transplantation on neurological function in rehabilitation period of multifocal cerebral hemorrhage.Methods:A total of 48 patients with multifocal cerebral hemorrhage who were treated in our hospital from April 2012 to December 2014 were selected as the research subjects, the therapy was made according to the illness and the patients’ will, combined treatment group received minimally invasive evacuation of hematoma combined with autologous bone mesenchymal stem cell transplantation therapy, surgical treatment group received regular minimally invasive evacuation of hematoma, and then imaging features, endothelial progenitor cell activation in peripheral blood as well as the content of nerve injury molecules and neurotrophic factors in serum of two groups were compared.Results:According to the result of head CT scan, the degree of brain edema of both groups was reduced 14 days after treatment, and the reducing degree of brain edema of combined treatment group was more significant than that of surgical treatment group; the 7th day, 14th day, 21st day and 28th day after treatment, CD34+CD133+endothelial progenitor cell levels in peripheral blood of combined treatment group were higher than those of surgical treatment group; 7th day and 14th day after treatment, serum S100β and NSE levels of combined treatment group were significantly lower than those of surgical treatment group; 21st day and 28th day after treatment, serum BDNF and NGF levels of combined treatment group were significantly higher than those of surgical treatment group. Conclusions:Autologous bone mesenchymal stem cell transplantation can relieve cerebral edema, increase the content of endothelial progenitor cells and neurotrophic factors and decrease neurological function injury in patients with multifocal cerebral hemorrhage, and it is conducive to the recovery of neurological function in patients with cerebral hemorrhage.

  16. 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

  17. Continuous Selective Intra-Arterial Application of Nimodipine in Refractory Cerebral Vasospasm due to Aneurysmal Subarachnoid Hemorrhage

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    Stephanie Ott

    2014-01-01

    Full Text Available Background. Cerebral vasospasm is one of the leading courses for disability in aneurysmal subarachnoid hemorrhage. Effective treatment of vasospasm is therefore one of the main priorities for these patients. We report about a case series of continuous intra-arterial infusion of the calcium channel antagonist nimodipine for 1–5 days on the intensive care unit. Methods. In thirty patients with aneurysmal subarachnoid hemorrhage and refractory vasospasm continuous infusion of nimodipine was started on the neurosurgical intensive care unit. The effect of nimodipine on brain perfusion, cerebral blood flow, brain tissue oxygenation, and blood flow velocity in cerebral arteries was monitored. Results. Based on Hunt & Hess grades on admission, 83% survived in a good clinical condition and 23% recovered without an apparent neurological deficit. Persistent ischemic areas were seen in 100% of patients with GOS 1–3 and in 69% of GOS 4-5 patients. Regional cerebral blood flow and computed tomography perfusion scanning showed adequate correlation with nimodipine application and angiographic vasospasm. Transcranial Doppler turned out to be unreliable with interexaminer variance and failure of detecting vasospasm or missing the improvement. Conclusion. Local continuous intra-arterial nimodipine treatment for refractory cerebral vasospasm after aSAH can be recommended as a low-risk treatment in addition to established endovascular therapies.

  18. Cerebral infarction following intracranial hemorrhage in pediatric Moyamoya disease - A case report and brief review of literature

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    Soumya Patra

    2012-01-01

    Full Text Available Moyamoya disease is a clinical entity characterized by progressive cerebrovascular occlusion with spontaneous development of a collateral vascular network called Moyamoya vessels. This disease mainly manifests as cerebral ischemia. Intracranial bleeding is another major presentation of patients with Moyamoya disease. We report here a 12-year-old male child who presented with severe headache, vomiting and meningismus. Initial neuroimaging study with noncontrast computed tomography scan revealed fresh intraventricular hemorrhage in right-sided lateral ventricle. Magnetic resonance imaging with angiography of brain was done 5 days later when the child developed right-sided hemiparesis, and the diagnosis of Moyamoya disease was confirmed along with lacunar infarction of right posterior peri and paraventricular area and in the left paraventricular area and centrum semiovale. Simultaneous presence of cerebral infarction along with intraventricular hemorrhage in adult with bleeding-type Moyamoya disease is reported in literature, but it is a rare entity in a child.

  19. Unusual Initial Manifestation of Acquired Hemophilia A: A Normal Activated Partial Thromboplastin Time, Intramuscular Hematoma and Cerebral Hemorrhage

    Science.gov (United States)

    Tsuyama, Nobuaki; Ichiba, Toshihisa; Naito, Hiroshi

    2016-01-01

    We herein present a case of acquired hemophilia A with a normal activated partial thromboplastin (aPTT), intramuscular hematoma and cerebral hemorrhage occurring in a 73-year-old man. The patient visited our emergency department with gait disturbance, pain and swelling in his right leg. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed intramuscular hematoma and intracranial hemorrhage. The results of initial coagulation studies were normal, but repeated coagulation studies revealed an isolated prolongation of the aPTT. Additional laboratory tests confirmed the diagnosis of acquired hemophilia A. If the initial aPTT is normal, we should therefore repeat the aPTT and also perform other coagulation studies including a mixing study, factor VIII level and inhibitor, to investigate the underlying diseases in elderly patients with spontaneous hemorrhaging of unknown etiology. PMID:27853081

  20. 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.

  1. 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

  2. Prevalence and clinical demographics of cerebral salt wasting in patients with aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Kao, Lily; Al-Lawati, Zahraa; Vavao, Joli; Steinberg, Gary K; Katznelson, Laurence

    2009-01-01

    Hyponatremia is a frequent complication following subarachnoid hemorrhage (SAH), and is commonly attributed either to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) or cerebral salt wasting syndrome (CSW). The object of this study is to elucidate the clinical demographics and sequelae of hyponatremia due to CSW in subjects with aneurysmal SAH. Retrospective chart review of patients >18 years with aneurysmal SAH admitted between January 2004 and July 2007 was performed. Subjects with moderate to severe hyponatremia (serum sodium <130 mmol l(-1)) were divided into groups consistent with CSW and SIADH based on urine output, fluid balance, natriuresis, and response to saline infusion. Clinical demographics were compared. Of 316 subjects identified, hyponatremia (serum sodium <135 mmol l(-1)) was detected in 187 (59.2%) subjects and moderate to severe hyponatremia in 48 (15.2%). Of the latter group, 35.4% were categorized with SIADH and 22.9% with CSW. Compared to eunatremic subjects, hyponatremia was associated with significantly longer hospital stay (15.7 +/- 1.9 vs. 9.6 +/- 1.1 days, p < 0.001). Subjects with CSW had similar mortality and duration of hospital stay vs. those with SIADH. Though less common than SIADH, CSW was detected in approximately 23% of patients with history of aneurysmal SAH and was not clearly associated with enhanced morbidity and mortality compared to subjects with SIADH. Further studies regarding the pathogenesis and management, along with the medical consequences, of CSW are important.

  3. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

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    Eric A. Schmidt

    2012-09-01

    Full Text Available Background: Patients with good-grade subarachnoid hemorrhage (SAH are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP is sometimes performed in an attempt to reduce intracranial pressure (ICP and release headaches. We hypothesize that in good-grade SAH patients, a 20-ml LP releases headaches, reduces ICP and improves cerebral blood flow (CBF as measured with O15 PET scan. Methods: Six good-grade (WFNS grade 1or 2 SAH patients (mean age 48 years, 2 women, 4 men were prospectively included. All aneurysms (4 anterior communicating artery and 2 right middle cerebral artery were coiled at day 1. Patients were managed according to our local protocol. LP was performed for severe headache (VAS >7 despite maximal painkiller treatment. Patients were included when the LP was clinically needed. The 20-ml LP was done in the PET scan (mean delay between SAH and LP: 3.5 days. LP allows hydrostatic measurement of ICP. Arterial blood pressure (ABP was noninvasively gauged with photoplethysmography. Every signal was monitored and analyzed off-line. Regional CBF (rCBF was measured semiquantitatively with O15 PET before and after LP. Then we calculated the difference between baseline and post-LP condition for each area: positive value means augmentation of rCBF after the LP, negative value means reduction of rCBF. Individual descriptive analysis of CBF was first performed for each patient; then a statistical group analysis was done with SPM for all voxels using t statistics converted to Z scores (p 3.2. Results: A 20-ml LP yielded a reduction in pain (–4, a drop in ICP (24.3 ± 12.5 to 6.9 ± 4.7 mm Hg, but no change in ABP. Descriptive and statistical image analysis showed a heterogeneous and biphasic change in

  4. 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.

  5. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage.

    Science.gov (United States)

    Qureshi, Adnan I; Palesch, Yuko Y; Barsan, William G; Hanley, Daniel F; Hsu, Chung Y; Martin, Renee L; Moy, Claudia S; Silbergleit, Robert; Steiner, Thorsten; Suarez, Jose I; Toyoda, Kazunori; Wang, Yongjun; Yamamoto, Haruko; Yoon, Byung-Woo

    2016-09-15

    within 7 days after randomization was significantly higher in the intensive-treatment group than in the standard-treatment group (9.0% vs. 4.0%, P=0.002). Conclusions The treatment of participants with intracerebral hemorrhage to achieve a target systolic blood pressure of 110 to 139 mm Hg did not result in a lower rate of death or disability than standard reduction to a target of 140 to 179 mm Hg. (Funded by the National Institute of Neurological Disorders and Stroke and the National Cerebral and Cardiovascular Center; ATACH-2 ClinicalTrials.gov number, NCT01176565 .).

  6. 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.)

  7. Nao-Xue-Shu Oral Liquid Protects and Improves Secondary Brain Insults of Hypertensive Cerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Hongning Jiang

    2016-01-01

    Full Text Available Aim. To determine one traditional Chinese medicine (TCM Nao-Xue-Shu oral liquid which protects and improves secondary brain insults (SBI in hypertensive cerebral hemorrhage (HCH. Methods. 158 patients with HCH were divided into routine clinical medicine plus Nao-Xue-Shu oral liquid (n=78 as treatment group, and routine clinical medicine (n=80 only served as the control group. The incidence of SBI and the classification of a favorable prognosis and a bad prognosis using the Glasgow outcome scale (GOS were assessed to evaluate the clinical effects. The changes of IL-6 and TNF-α levels were determined to study the mechanism of the effects for the TCM. Results. The incidence of SBI at the end of week 2 was 8.97% in the treatment group and 23.75% in the control group, and the difference was significant (P<0.001. The incidence of a favorable prognosis was 48.72% in the treatment group and 32.72% in the control group, and the difference was significant (P<0.01 at the end of week 2. These findings indicate clear differences for IL-6 and TNF-α at the end of week 1 and week 2 compared with before treatment for the treatment group and a marked difference at the end of week 2 between the two groups. It also shows a significant difference between the end of week 2 and before treatment for IL-6 and TNF-α for the control group, although the difference was much smaller than the treatment group. Conclusion. Nao-Xue-Shu oral liquid could protect against the occurrence of SBI and improve HCH and SBI patients. It may also decrease the damage and the mass effects of the hematoma by reducing IL-6 and TNF-α to obtain the effects, and thus it is a potentially suitable drug for HCH and SBI.

  8. 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

  9. 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.)

  10. 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

  11. 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).

  12. [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.

  13. 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.

  14. 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.

  15. Cerebral Blood Flow Changes after Shunt in Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage: Analysis by statistical Parametric Mapping

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, I. Y.; Choi, W. S.; Pak, H. S. [College of Medicine, Univ. of Inhwa, Incheon (Korea, Republic of)

    2003-07-01

    The purpose of this study was to evaluate the changes of regional cerebral blood flow (rCBF) after shunt operation in patients with hydrocephalus after aneurysmal subarachnoid hemorrhage ba statistical parametric mapping (SPM). Seven patients (4 male, mean age 54 years) with hydrocephalus after aneurysmal subarachnoid hemorrhage underwent a shunt operation. Tc-99m HMPAO SPECT was performed within I week before, and 2 weeks after the shunt operation. All of the SPECT images were spatially transformed to standard space, smoothed, and globally normalized. After spatial and count normalization, rCBF of pre- and post- shunting Tc- 99m HMPAO SPECT was estimated at every voxel using t statistics. The voxels with a P value of less than 0.001 were considered to be significantly different. The shunt operation was effective in all patients. Pre-shunting Tc-99m HMPAO SPECT showed hypoperfusion, predominantly in the periventricular area. After shunt operation, periventricular low perfusion was disappeared. The results of this study show that periventricular CBF is impaired in hydrocephalus after aneurysmal subarachnoid hemorrhage. Significant increase of periventricular CBF after shunt operation suggests the evaluation of periventricular CBF by SPM might be of value for the prediction of shunt effectiveness in hydrocephalus.

  16. 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

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

    OpenAIRE

    1998-01-01

    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...

  18. Convulsion during intra-arterial infusion of fasudil hydrochloride for the treatment of cerebral vasospasm following subarachnoid hemorrhage.

    Science.gov (United States)

    Enomoto, Yukiko; Yoshimura, Shinichi; Yamada, Kiyofumi; Iwama, Toru

    2010-01-01

    The incidence of convulsion and associated factors were retrospectively analyzed in 23 patients with symptomatic cerebral vasospasm following subarachnoid hemorrhage (SAH) who underwent a total of 31 intra-arterial infusion of fasudil hydrochloride (IAFH) procedures in 49 vessels. Fasudil hydrochloride was administered by superselective infusion via a microcatheter positioned at the proximal portion of the affected artery. Thirteen procedures were performed by manually controlled infusion of 30-75 mg fasudil hydrochloride (1.2-3.75 mg/ml) for approximately 10 minutes. Eighteen procedures were performed by continuous infusion of 60 mg fasudil hydrochloride (1.2 mg/ml) by infusion pump at a constant rate of 3 mg/min. Neurological improvement was observed after 18 of 22 procedures in patients with neurological deterioration due to vasospasm. Convulsion during IAFH developed in 4 patients, all treated by manual infusion (p convulsion during IAFH. IAFH was effective for treating cerebral vasospasm following aneurysmal SAH. IAFH at a constant rate of 3 mg/min delivered by infusion pump improved the symptoms of cerebral vasospasm and prevented convulsions during IAFH.

  19. 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。

  20. 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...

  1. Cerebral cortical tissue damage after hemorrhagic hypotension in near-term born lambs.

    NARCIS (Netherlands)

    Os, S.H.G. van; Tweel, E. van den; Egberts, H.; Hopman, J.; Ruitenbeek, W.; Bel, F. van; Groenendaal, F.; Bor, M. van de

    2006-01-01

    Hypotension reduces cerebral O(2) supply, which may result in brain cell damage and loss of brain cell function in the near-term neonate. The aim is to elucidate 1) to what extent the functional disturbance of the cerebral cortex, as measured with electrocortical brain activity (ECBA), is related to

  2. 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

    after SAH in cerebral arteries. SAH was induced in rats by injecting 250 microl of blood into the prechiasmatic cistern. Two days after the SAH, cerebral arteries were harvested and contractile responses to the TP receptor agonist U46619 were investigated with myographs. In addition, the contractile...

  3. 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.

  4. 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.)

  5. 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.

  6. 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...

  7. The Physiopathologic Mechanism of Cerebral Edema with Intracerebral Hemorrhage%脑出血后脑水肿形成的病理生理机制

    Institute of Scientific and Technical Information of China (English)

    屈洪党; 殷亮; 陈齐鸣

    2011-01-01

    Objective: To investigate the physiopathologic mechanism of cerebral edema after intracere-bral hemorrhage. Methods: To analyze the physiopathologic mechanism of cerebral edema after intracerebral hemorrhage by summarizing pertinent literatures. Results:The cerebral edema generated after intracerebral hemorrhage in the ultra - early onset. The significant factors which aggravated cerebral edema included compression of hematoma, ischemia, thrombase, hemoglobin and plasma protein, leucocytes and inflammatory cell factor. Conclusions:The physiopathologic mechanism of cerebral edema with intracerebral hemorrhage is complicated, which can provide ways and methods to treat the edema in the surrounding tissues of cerebral hematom.%目的:探讨脑出血后脑水肿形成的病理生理机制.方法:总结相关文献,分析脑出血后脑水肿形成的病理生理机制.结果:脑水肿多在脑出血后超早期发生.血肿占位效应、缺血因素、凝血酶、血红蛋白和血浆蛋白、白细胞和炎性细胞因子等在脑水肿形成的过程中具有重要作用.结论:脑出血后脑水肿形成的病理机制十分复杂,研究脑水肿的形成机制,可以为临床医师治疗血肿周围脑组织水肿提供新的途径和方法.

  8. 脑出血与脑梗死并发腹泻发生率的临床研究%Clinical Comparison of Incidence of Diarrhea between Cerebral Hemorrhage and Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    黄微; 李劲涛; 戴萍

    2014-01-01

    目的:分析比较脑出血与脑梗死患者并发腹泻的发生率.方法对云南省第三人民医院住院期间的147例脑出血患者与142例脑梗死患者发生腹泻者进行发生率的统计,并观察腹泻发生的时间.结果脑出血患者发生腹泻率为36.05%,脑梗死患者发生腹泻率16.91%,脑出血并发腹泻率高于脑梗死患者.结论脑出血并发腹泻率高于脑梗死患者,可能是脑出血患者颅高压的因素较脑梗死更显著,引起应急状态下免疫功能下降,再加上卧床易并发感染等并发症,进食障碍致低蛋白血症加重肠粘膜水肿,长期用抗生素导致肠道菌群失调等因素较脑梗死更显著,故而腹泻的发生率较高.%Objective To analyze and compare the incidence of diarrhea between cerebral hemorrhage and infarction. Method We observed and compared the time when diarrhea occurred in both 147 cases of cerebral hemorrhage patients and 142 cases of cerebral infarction patients by using statistical methods. Result The incidence of diarrhea in former group was 36.05%, and that of latter was 16.91%. Conclusions The incidence in patients with diarrhea of cerebral hemorrhage was markedly higher than that of patients with cerebral infarction. This may attribute to the higher intracranial pressure in cerebral hemorrhage patients than that of cerebral infarction ones. The complications of reduction of immune function,intestinal infection and hypoproteinemia may be the other factors resulting in the higher incidence of diarrhea in cerebral hemorrhage patients than that of cerebral infarction ones.

  9. [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.

  10. 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

  11. Effects of Minimally Invasive Puncture and Drainage of Intracranial Hematoma on the Blood-brain Barrier in Patients with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    HUANG Xiaojiang; GUO Shougang; WANG Wei

    2007-01-01

    The effects of minimally invasive surgery on the blood-brain barrier (BBB) of 30 patients with cerebral hemorrhage were investigated. Difference of the BBB index and serum MBP concentration were assessed in 15 cases of conservative treatment group and 15 cases of minimally invasive surgery group. The BBB index in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and the BBB index in the two treatment groups was significantly higher than in control group (P<0.01). Serum MBP concentration in minimally invasive surgery group was significantly lower than in conservative treatment group (P<0.05), and that in the two treatment groups was significantly higher than in control group (P<0.01). It was suggested the permeability of BBB in patients with cerebral hemorrhage was increased, and BBB index and serum MBP concentration in patients with cerebral hemorrhage were increased. Minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

  12. Identification of specific age groups with a high risk for developing cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Malinova, Vesna; Schatlo, Bawarjan; Voit, Martin; Suntheim, Patricia; Rohde, Veit; Mielke, Dorothee

    2016-07-01

    The impact of age on the incidence of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) is a matter of ongoing discussion. The aim of this study was to identify age groups with a higher risk for developing vasospasm, delayed ischemic neurological deficit (DIND), or delayed infarction (DI) and to identify a cut-off age for a better risk stratification. We defined six age groups (70 years). ROC analysis was performed to determine a cutoff age with the highest positive predictive value (PPV) for developing vasospasm, defined as a blood-flow-velocity-increase >120 cm/s in transcranial-Doppler-sonography (TCD). Multivariate binary-logistic-regression-analysis was then performed to evaluate differences in the incidence of cerebral vasospasm, DIND, and DI among the different age groups. A total of 753 patients were included in the study. The highest incidence (70 %) of TCD-vasospasm was found in patients between 30 and 39 years of age. The cutoff age with the highest PPV (65 %) for developing TCD-vasospasm was 38 years. Multivariate analysis revealed that age <38 years (OR 3.6; CI 95 % 2.1-6.1; p < 0.001) best predicted vasospasm, followed by the need for cerebrospinal fluid drainage (OR 1.5; CI 95 % 1.0-2.3; p = 0.04). However, lower age did not correlate with higher rates of DIND or infarcts. The overall vasospasm-incidence after aSAH is age-dependent and highest in the age group <38 years. Surprisingly, the higher incidence in the younger age group does not translate into a higher rate of DIND/DI. This finding may hint towards age-related biological factors influencing the association between arterial narrowing and cerebral ischemia.

  13. Cerebral Hemodynamic Changes Induced by a Lumbar Puncture in Good-Grade Subarachnoid Hemorrhage

    OpenAIRE

    Schmidt, Eric A.; Stein Silva; Jean François Albucher; Aymeric Luzi; Isabelle Loubinoux; Anne Christine Januel; Christophe Cognard; Pierre Payoux; François Chollet

    2012-01-01

    Background Patients with good-grade subarachnoid hemorrhage (SAH) are those without initial neurological deficit. However, they can die or present severe deficit due to secondary insult leading to brain ischemia. After SAH, in a known context of energy crisis, vasospasm, hydrocephalus and intracranial hypertension contribute to unfavorable outcome. Lumbar puncture (LP) is sometimes performed in an attempt to reduce intracranial pressure (ICP) and release headaches. We hypothesize that in good...

  14. 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.

  15. 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...

  16. 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 late cerebral ischemia and the upregulation of receptors or the cerebral vasoconstriction observed following SAH. METHODS: Rats were allocated to 1 of 3 experimental conditions: 1) cisternal injection of 250 microl blood (SAH Group), 2) cisternal injection of 250 microl NaCl (Saline Group), or 3......) 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...

  17. 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.

  18. 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...... than arterial narrowing such as early brain injury and cortical spreading depression and of their contribution to overall mortality and morbidity....

  19. 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

    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...

  20. 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

    hemodynamic factors, higher ipsilateral Mx on day 5 (p = 0.013) was a significant predictor for poor 90-day outcome. CONCLUSIONS: Cerebral autoregulation is primarily preserved in acute ICH, but a secondary decline mainly ipsilateral to the ICH can occur. This is associated with poor clinical status...

  1. [Systemic complications of subarachnoid hemorrhage from spontaneous rupture of a cerebral aneurysm].

    Science.gov (United States)

    Rama-Maceiras, P; Fàbregas Julià, N; Ingelmo Ingelmo, I; Hernández-Palazón, J

    2010-12-01

    Systemic complications secondary to subarachnoid hemorrhage from an aneurysm are common (40%) and the mortality attributable to them (23%) is comparable to mortality from the primary lesion, rebleeding, or vasospasm. Although nonneurologic medical complications are avoidable, they worsen the prognosis, lengthen the hospital stay, and generate additional costs. The prevention, early detection, and appropriate treatment of systemic complications will be essential for managing the individual patient's case. Treatment should cover major symptoms (headache, nausea, and dizziness) and ambient noise should be reduced, all with the aim of achieving excellence and improving the patient's perception of quality of care.

  2. [Cerebral hemorrhage induced by low-dose streptokinase: a pharmacologic paradox? Report of a clinical case].

    Science.gov (United States)

    Fedeli, F; Skouse, D; Messina, A

    1997-01-01

    A case of an important intracranial hemorrhage after a low dose (approx. 500,000 UI) of streptokinase in a 60 year-old woman suffering from myocardial infarction is presented. Clinical, electrocardiographic, echocardiographic, lab and tomographic findings are described. The authors suggest a pharmacokinetic mechanism which could be responsible of a "paradox effect" (a powerful and dangerous effect of the drug when given in low dose) and they wonder whether in case of allergic reactions should it be better not to stop the infusion of the thrombolytic drug and be more liberal with the "symptomatic" drugs. Tha patient is still alive and the clinical conditions slowly progressing.

  3. 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

  4. Clinical nursing of geriatric hypertension cerebral hemorrhage.%老年高血压脑出血患者的临床护理

    Institute of Scientific and Technical Information of China (English)

    范少华; 宋明浩

    2012-01-01

    Objective: To analyze the clinical symptoms of geriatric hypertension cerebral hemorrhage and summarize nursing highlights. Methods: Retrospectively analyzed in February 2006 - August 2010 were treated geriatric hypertension cerebral hemorrhage with clinical data of 53 cases. Results: The major clinical symptom of geriatric hypertension cerebral hemorrhage is confusion of consciousness while the symptom of intracranial hypertension is not significant , the occurrence of complications is easy. The nursing points includes attention to awareness and vital signs detected, prevention the occurrence of complications. Conclusions: The symptom of geriatric cerebral hemorrhage is not obvious in the early stage, and thus medical treatment may be delayed. Elderly patients are more prone to complications and of a heavy task of nursing.%目的:分析老年高血压脑出血患者的临床表现,总结其临床护理要点.方法:对我院2006年2月~2010年8月所收治的53例老年高血压脑出血患者的临床资料进行回顾性分析.结果:老年高血压脑出血组患者临床表现以意识障碍为主,颅内高压症不明显,易出现并发症.护理要点是注意意识及生命体征的监测,防止并发症的发生.结论:老年高血压脑出血患者早期临床表现不明显,易延误就医,并发症多,护理任务重.

  5. Effects of Acupuncture on mRNA Levels of Apoptotic Factors in Perihematomal Brain Tissue During the Acute Phase of Cerebral Hemorrhage.

    Science.gov (United States)

    Li, Zuowei; Zheng, Xiaonan; Li, Ping; Itoua, Eudes Saturnin Régis; Moukassa, Donatien; Ndinga Andely, Françoise

    2017-03-30

    BACKGROUND To explore the time-dependent effects of acupuncture on mRNA levels of the apoptotic factors BCL-2 and BAX in a rat cerebral hemorrhage model, slow injection of autologous blood to the caudate nucleus was used to generate the cerebral hemorrhage model. MATERIAL AND METHODS A sham surgery control group, groups with acupuncture applied 3, 9, 24, and 48 hours after model induction, and time-matched model-only control groups were used. In situ hybridization was used to detect BCL-2 and BAX mRNA expression, and semi-quantitative RT-PCR was used to measure the expression. RESULTS The number of BCL-2 and BAX mRNA-positive cells significantly increased during the acute phase of cerebral hemorrhage. BCL-2 mRNA was significantly upregulated in acupuncture groups compared to other groups, whereas BAX mRNA levels in the acupuncture groups were lower in the other groups, except for the sham surgery group. Additionally, earlier acupuncture intervention was associated with a lower ratio of expression between the two genes. Changes in BCL-2 and BAX mRNA expression were consistent with changes in the number of cells positive for BCL-2 and BAX mRNA; however, the change in the expression ratio was consistent with the change in the number of cells positive for BCL-2 mRNA, but opposite to the change in the number of cells positive for BAX mRNA. CONCLUSIONS Acupuncture ameliorated changes in expression of apoptotic factors in the brain induced by acute cerebral hemorrhage and may thus protect the brain, with greater efficacy when the delay before acupuncture was minimized.

  6. Effects of Acupuncture on mRNA Levels of Apoptotic Factors in Perihematomal Brain Tissue During the Acute Phase of Cerebral Hemorrhage

    Science.gov (United States)

    Li, Zuowei; Zheng, Xiaonan; Li, Ping; Itoua, Eudes Saturnin Régis; Moukassa, Donatien; Andely, Françoise Ndinga

    2017-01-01

    Background To explore the time-dependent effects of acupuncture on mRNA levels of the apoptotic factors BCL-2 and BAX in a rat cerebral hemorrhage model, slow injection of autologous blood to the caudate nucleus was used to generate the cerebral hemorrhage model. Material/Methods A sham surgery control group, groups with acupuncture applied 3, 9, 24, and 48 hours after model induction, and time-matched model-only control groups were used. In situ hybridization was used to detect BCL-2 and BAX mRNA expression, and semi-quantitative RT-PCR was used to measure the expression. Results The number of BCL-2 and BAX mRNA-positive cells significantly increased during the acute phase of cerebral hemorrhage. BCL-2 mRNA was significantly upregulated in acupuncture groups compared to other groups, whereas BAX mRNA levels in the acupuncture groups were lower in the other groups, except for the sham surgery group. Additionally, earlier acupuncture intervention was associated with a lower ratio of expression between the two genes. Changes in BCL-2 and BAX mRNA expression were consistent with changes in the number of cells positive for BCL-2 and BAX mRNA; however, the change in the expression ratio was consistent with the change in the number of cells positive for BCL-2 mRNA, but opposite to the change in the number of cells positive for BAX mRNA. Conclusions Acupuncture ameliorated changes in expression of apoptotic factors in the brain induced by acute cerebral hemorrhage and may thus protect the brain, with greater efficacy when the delay before acupuncture was minimized. PMID:28357997

  7. [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.

  8. Characterization of neonatal patients with intraventricular hemorrhage using 3D ultrasound cerebral ventricle volumes

    Science.gov (United States)

    Kishimoto, Jessica; Fenster, Aaron; Lee, David S. C.; de Ribaupierre, Sandrine

    2015-03-01

    One of the major non-congenital cause of neurological impairment among neonates born very preterm is intraventricular hemorrhage (IVH) - bleeding within the lateral ventricles. Most IVH patients will have a transient period of ventricle dilation that resolves spontaneously. However, those patients most at risk of long-term impairment are those who have progressive ventricle dilation as this causes macrocephaly, an abnormally enlarged head, then later causes increases intracranial pressure (ICP). 2D ultrasound (US) images through the fontanelles of the patients are serially acquired to monitor the progression of the ventricle dilation. These images are used to determine when interventional therapies such as needle aspiration of the built up CSF might be indicated for a patient. Initial therapies usually begin during the third week of life. Such interventions have been shown to decrease morbidity and mortality in IVH patients; however, this comes with risks of further hemorrhage or infection; therefore only patients requiring it should be treated. Previously we have developed and validated a 3D US system to monitor the progression of ventricle volumes (VV) in IVH patients. This system has been validated using phantoms and a small set of patient images. The aim of this work is to determine the ability of 3D US generated VV to categorize patients into those who will require interventional therapies, and those who will have spontaneous resolution. Patients with higher risks could therefore be monitored better, by re-allocating some of the resources as the low risks infants would need less monitoring.

  9. Metabolic pattern of the acute phase of subarachnoid hemorrhage in a novel porcine model: studies with cerebral microdialysis with high temporal resolution.

    Directory of Open Access Journals (Sweden)

    Christoffer Nyberg

    Full Text Available BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH may produce cerebral ischemia and systemic responses including stress. To study immediate cerebral and systemic changes in response to aneurysm rupture, animal models are needed. OBJECTIVE: To study early cerebral energy changes in an animal model. METHODS: Experimental SAH was induced in 11 pigs by autologous blood injection to the anterior skull base, with simultaneous control of intracranial and cerebral perfusion pressures. Intracerebral microdialysis was used to monitor concentrations of glucose, pyruvate and lactate. RESULTS: In nine of the pigs, a pattern of transient ischemia was produced, with a dramatic reduction of cerebral perfusion pressure soon after blood injection, associated with a quick glucose and pyruvate decrease. This was followed by a lactate increase and a delayed pyruvate increase, producing a marked but short elevation of the lactate/pyruvate ratio. Glucose, pyruvate, lactate and lactate/pyruvate ratio thereafter returned toward baseline. The two remaining pigs had a more severe metabolic reaction with glucose and pyruvate rapidly decreasing to undetectable levels while lactate increased and remained elevated, suggesting persisting ischemia. CONCLUSION: The animal model simulates the conditions of SAH not only by deposition of blood in the basal cisterns, but also creating the transient global ischemic impact of aneurysmal SAH. The metabolic cerebral changes suggest immediate transient substrate failure followed by hypermetabolism of glucose upon reperfusion. The model has features that resemble spontaneous bleeding, and is suitable for future research of the early cerebral and systemic responses to SAH that are difficult to study in humans.

  10. 小剂量糖皮质激素治疗脑出血迟发性脑水肿临床分析%Clinical analysis of low dose glucocorticoidin treatment of delayed cerebral edema after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    林茵

    2014-01-01

    ObjectiveTo observe the clinical efifcacy of low dose glucocorticoidin treatment of delayed cerebral edema after cerebral hemorrhage.MethodsRetrospective analysis was performed on the clinical data of 13 patients, who were of delayed cerebral edema after cerebral hemorrhage and treated with small-dosed glucocorticoid. The efficacy of glucocorticoid treatment on these patients was probed.ResultsAfter treatment, the condition of patients was improved in various degrees; the activities of daily living were signiifcantly improved. Ultimately, all the 13 patientswere discharged with better health condition while three of them were improved dramatically. ConclusionsLow dose glucocorticoid is effective in treating delayed cerebral edema after cerebral hemorrhage with no serious side effects.%目的:观察糖皮质激素对脑出血迟发性脑水肿的治疗效果。方法回顾分析13例经小剂量糖皮质激素治疗的脑出血后迟发性脑水肿患者的临床资料,探讨糖皮质激素治疗对迟发性脑水肿的效用。结果治疗后脑出血迟发性脑水肿患者病情不同程度好转,生活能力明显改善,最终13例均好转出院,其中3例症状明显改善。结论小剂量糖皮质激素对于脑出血迟发性脑水肿有明显的治疗作用,无严重不良反应。

  11. 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。

  12. Nontraumatic intracranial hemorrhage.

    Science.gov (United States)

    Fischbein, Nancy J; Wijman, Christine A C

    2010-11-01

    Nontraumatic (or spontaneous) intracranial hemorrhage most commonly involves the brain parenchyma and subarachnoid space. This entity accounts for at least 10% of strokes and is a leading cause of death and disability in adults. Important causes of spontaneous intracranial hemorrhage include hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformations, and hemorrhagic infarcts (both venous and arterial). Imaging findings in common and less common causes of spontaneous intracranial hemorrhage are reviewed.

  13. 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.

  14. 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.

  15. Clinical study of diabetic cerebral hemorrhagic infarction and cerebral hemorrhagic infarction without diabetic%2型糖尿病合并出血性脑梗死的相关性研究

    Institute of Scientific and Technical Information of China (English)

    饶琦; 桂绍高; 朱晓钢

    2016-01-01

    Objective To study clinical characteristics on diabetic cerebral hemorrhagic infarction and cerebral hemorrhagic infarction without diabetic. Methods The changes of blood glucose,total cholesterol (TC),triglyceride (TG),high-density lipopro-tein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),uric acid(UA) in 55 patients with diabetes complicated with HI and 60 patients without diabetes complicated with HI were analyzed retrospective. The relationship between the degree of neu-rological deficit,the size of infarction and the size of bleeding area between the two groups were compared. Results Blood glu-cose,TC,TG,LDL-C,UA in the diabetes complicated with the non-diabetes complicated with HI group (P<0.05),while the HDL-C decreased significantly (P<0.05),The degree of neurological deficit,the size of infarction and the size of bleeding area complica-tions and mortality in the diabetes complicated with HI group were significantly higher than those in the non-diabetes complicated with HI group. Conclusion The patients with diabetes complicated with HI often has abnormal fat metabolism because of Glucose metabolism disorders. When HI occurred,the size of infarction might increase,and the symptom and glucose metabolism disorder may be aggravated. So The prognosis in patients with diabetics complicated with HI is poor.%目的:探讨糖尿病出血性脑梗死与非糖尿病出血性脑梗死患者的临床特点。方法回顾性分析115例出血性脑梗死患者,分为糖尿病HI组55例及非糖尿病HI组60例,对比两组空腹血糖(GLU)、血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C),低密度脂蛋白(LDL-C),血清尿酸(UA),以及两组梗死灶及出血灶稳定后神经功能损害、梗死面积及出血面积进行对比研究。结果糖尿病HI组患者TC、TG、LDL-C、UA均显著高于非糖尿病HI组患者(P<0.5),糖尿病HI组患者HDL-C低于非糖尿病出血性脑梗死组患者(P<0.5),

  16. 血压与出血性脑梗死预后的关系探讨%Relationships between blood pressure and hemorrhagic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    邱金华; 刘红英; 蔡春生

    2011-01-01

    Objective To explore the relationship between blood pressure and hemorrhagic cerebral infarction. Methods Retrospectively reviewed clinical data of 242 patients with acute cerebral infarction, then all patients with hemorrhagic cerebral infarction were selected. The distributions of different level of blood pressure (>180/110mm Hg;90/70~180/110mm Hg;<90/70mm Hg) were compared between the patients with or without hemorrhagic cerebral infarction, as the same, different prognosis were compared among the patients with hemorrhagic cerebral infarction based on the different level of blood pressure. Results Of the total patients with acute cerebral infarction,4. 1%(10) presented with blood pressure<90/70mm Hg,88. 0%(213) with blood pressure 90/70~180/110mm Hg and 7.9%(19) with blood pressure>180/110mm Hg. In all the patients,20 cases(8. 3%) with hemorrhagic cerebral infarction,among which,60.0%(12) patients with blood pressure>180/110mm Hg and with 7 cases died, 10.0%(2) patients with blood pressure<90/70mm Hg and with 1 case died,30.0%(6) patients with blood pressure 90/70~180/110mm Hg and with 2 cases died. The distribution of patients with blood pressure>180/110mm Hg in those two type of cerebral infraction were statistically significant (P=0. 000) ,the ratio seemed higher in patients with hemorrhagic cerebral infarction, and among the patients with hemorrhagic cerebral infarction, the distribution of prognosis were the same statistically significant based on the diffetent level of blood pressure, among which, patients with blood pressure>180/110mm Hg(P =0.041) or<90/70mm Hg(P =0.037) seemed like to have a higher mortality. Conclusion Severe high blood pressure(>180/110mm Hg) should be one of the high risk factors for patients with hemorrhagic cerebral infarction,when blood pressure>180/110 mm Hg or <90/70mm Hg happened in the pathogenesis, patients always be with poor outcome. So, making proper control strategy of blood pressure for

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

    Directory of Open Access Journals (Sweden)

    Sergio Vargas

    1998-04-01

    Full Text Available 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. 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.

  18. Nerve growth factor affects focal cerebral cortical neuronal Bcl-2 and Bax expression in a mouse model of oxyhemoglobin-induced subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Xianfeng Jiang; Wei Shi; Jin Liang

    2008-01-01

    BACKGROUND: Studies have demonstrated that oxyhemoglobin (OxyHb) can induce brain cell apoptosis in vivo.OBJECTIVE: To observe the effects of exogenous nerve growth factor (NGF) on cerebral cortical neuronal Bcl-2 and Bax expression in mice with OxyHb-induced subarachnoid hemorrhage.DESIGN, TIME AND SETTING: A completely randomized grouping, controlled animal experiment was performed at the Experimental Center for Biomedicine, College of Medicine, Xi'an Jiaotong University between February and April 2005.MATERIALS: Fifty-four healthy, male, adult, ICR mice were included in this study. Subarachnoid hemorrhage was induced by a subarachnoid injection of OxyHb in 48 mice. Mouse NGF was obtained from Xiamcn Beidazhilu Bioengineering Co., Ltd., China.METHODS: All 54 mice were randomly divided into three groups: control (n = 6), injury (n = 24), and NGF (n = 24). The NGF group received a subarachnoidal administration of OxyHb, immediately followed by a caudal vein injection of NGF (1 μg). The injury group was injected with OxyHb, and subsequently with physiological saline. Thc control group only received intravenous physiological saline.MAIN OUTCOME MEASURES: At 1, 6, 24, and 48 hours following subarachnoid hemorrhage induction,expression levels of Bcl-2 and Bax were detected by immunohistochemistry in the cerebral cortex 3 mm anterior and posterior to the injection site.RESULTS: At all time points following OxyHb injection, cerebral cortical Bax levels were significantly higher in the injured group than in the control and NGF groups (P < 0.01). During the first 24 hours following OxyHb injection, cerebral cortical Bcl-2 levels were significantly lower in the injury group compared to the control group (P < 0.05 0.01). Between 1 and 48 hours, Bcl-2 levels were significantly higher in the NGF group than in the injury group (P < 0.01).CONCLUSION: Exogenous NGF can inhibit increased neuronal Bax expression and decreased Bcl-2expression in the cerebral cortex of mice with Oxy

  19. 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.

  20. 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.

  1. Analysis of Fibrinogen relevant factors in delayed cerebral edema of cerebral hemorrhage%脑出血后迟发性脑水肿与纤维蛋白原等相关因素的分析

    Institute of Scientific and Technical Information of China (English)

    黄园园; 陈吉相; 王芳; 肖海兵

    2011-01-01

    目的 研究脑出血迟发性脑水肿与纤维蛋白原(FIB)等因素的相互联系,并探讨对脑出血预后的影响.方法 回顾性分析本院2008年1月~2011年2月接受内科保守治疗的非外伤性急性脑出血60例,其中并发迟发性脑水肿29例,未发生迟发性脑水肿31例.于发病后连续3周监测FIB值等指标,并同时期行头颅CT检查,动态观察血肿及其周围水肿的变化.行χ2检验比较迟发性脑水肿组与未发生组间FIB的升高率; logistic回归分析迟发性脑水肿与各指标的相关性,并采用多元逐步COX模型分析脑出血预后的相关影响因素.结果 迟发性脑水肿组较未发生组FIB值明显升高(P<0.005); FIB升高、脑出血量大、吸烟、高血压病史与迟发性脑水肿相关(P<0.05);迟发性脑水肿、持续升高的FIB和高血压病影响脑出血的预后,其P值均<0.05,有统计学意义.结论 脑出血者FIB持续升高、脑出血量大、吸烟、高血压与迟发性脑水肿的发生密切相关,迟发性脑水肿、FIB升高和高血压病影响预后,对疾病恢复有不良影响.%Objective To observe Pibrinogen and other related factors on delayed cerebral edema in cerebral hemorrhage, and to explore related factor impact on prognosis in cerebral hemorrhage. Methods Analyzed retrospectively the 60 cases of acute non-traumatic and conservative treated cerebral hemorrhage in January 2008- February 2011, which 29 cases complicated with delayed cerebral edema and 31 cases not complicated . Monitored FIB values and other indicators for three weeks ,and observed hematoma and the surrounding low-density changes by head CT during the same period; x2 test to compare the increase rate of FIB in two groups; Analyze related factors on delayed cerebral edema and their relationship with prognosis. Results FIB significantly increased in delayed brain edema group(P<0. 005). Elevated FIB, hematoma volume, smoking, and hypertension associated with delayed

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. Vasospasm on transcranial Doppler is predictive of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

    Science.gov (United States)

    Kumar, Gyanendra; Shahripour, Reza Bavarsad; Harrigan, Mark R

    2016-05-01

    OBJECT The impact of transcranial Doppler (TCD) ultrasonography evidence of vasospasm on patient-centered clinical outcomes following aneurysmal subarachnoid hemorrhage (aSAH) is unknown. Vasospasm is known to lead to delayed cerebral ischemia (DCI) and poor outcomes. This systematic review and meta-analysis evaluates the predictive value of vasospasm on DCI, as diagnosed on TCD. METHODS MEDLINE, Scopus, the Cochrane trial register, and clinicaltrials.gov were searched through September 2014 using key words and the terms "subarachnoid hemorrhage," "aneurysm," "aneurysmal," "cerebral vasospasm," "vasospasm," "transcranial Doppler," and "TCD." Sensitivities, specificities, and positive and negative predictive values were pooled by a DerSimonian and Laird random-effects model. RESULTS Seventeen studies (n = 2870 patients) met inclusion criteria. The amount of variance attributable to heterogeneity was significant (I(2) > 50%) for all syntheses. No studies reported the impact of TCD evidence of vasospasm on functional outcome or mortality. TCD evidence of vasospasm was found to be highly predictive of DCI. Pooled estimates for TCD diagnosis of vasospasm (for DCI) were sensitivity 90% (95% confidence interval [CI] 77%-96%), specificity 71% (95% CI 51%-84%), positive predictive value 57% (95% CI 38%-71%), and negative predictive value 92% (95% CI 83%-96%). CONCLUSIONS TCD evidence of vasospasm is predictive of DCI with high accuracy. Although high sensitivity and negative predictive value make TCD an ideal monitoring device, it is not a mandated standard of care in aSAH due to the paucity of evidence on clinically relevant outcomes, despite recommendation by national guidelines. High-quality randomized trials evaluating the impact of TCD monitoring on patient-centered and physician-relevant outcomes are needed.

  8. 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.

  9. 某三级医院1194例脑出血病例统计分析%Statistical Analysis of 1 194 Cases of Patients with Cerebral Hemorrhage in Some AAA Hospital

    Institute of Scientific and Technical Information of China (English)

    孙义峰

    2016-01-01

    Objective To know the incidence of patients with cerebral hemorrhage and provide scientific reference for the further prevention and treatment of cerebral hemorrhage. Methods 1 194 cases of patients with cerebral hemorrhage diag-nosed in our hospital were counted and analyzed by the case management system according to the national disease classifi-cation code ICD-10. Results The proportion of cerebral hemorrhage in the cerebrovascular disease in our hospital took on an increasing trend from 2010 to 2015, and the number of patients with cerebral hemorrhage obviously increased, and the proportion increased from 16.6% in 2010 to 24.3% in 2015, and the growth rate per annum of patients with cerebral hem-orrhage was 14.5%, and the proportion of male and female was 1.20:1, and the male patients were more than the female pa-tients, and the patients were mainly more than 60 years old, 787 cases in total (65.91%), and the onset time of the disease was mostly from September to February of next year, accounting for 58.3%. Conclusion The patients with cerebral hemor-rhage takes on an increasing trend in our hospital, in addition to treatment for patients with cerebral hemorrhage, various forms of health education should be adopted to popularize the preventive common knowledge of cerebral hemorrhage, advo-cate the healthy lifestyle and good dieting habits, and we should focus on the initial prevention and first-class prevention, and the elderly population (older than 50 years) is the key objects.%目的:了解脑出血患者的发病情况,为进一步预防和治疗脑出血发病提供科学参考。方法以国际疾病分类编码ICD-10为标准,采用病案管理系统对该院2010-2015年出院病案主要诊断为脑出血的1194例进行统计分析。结果2010-2015年该院脑出血在脑血管病中所占比例呈上升趋势,脑出血患者数量明显增加,构成比由2010年的16.6%增至2015年的24.3%,脑出血病人的年平均增长速度是14.5%

  10. 两种不同方法治疗高血压脑出血疗效比较%Two Different Treatment of Hypertensive Cerebral Hemorrhage Curative Effect

    Institute of Scientific and Technical Information of China (English)

    赵庆; 单桂梅; 刘建春

    2015-01-01

    Objective To explore the curative effect of different methods on hypertensive intracerebral hemorrhage in the elderly patients. Methods We analyse retrospectively hypertensive intracerebral hemorrhage patients, respectively 40 cases with minimally invasive hematoma aspiration biopsy and removal of small bone window craniotomy hematoma, by comparing the hematoma clearance rate, postoperative complications, mortality and postoperative ADL grading, we can evaluate the curative effect of two methods objectively. Results Through compring the two methods, small bone window craniotomy surgery for removal of hematoma and minimally invasive hematoma aspiration biopsy, has the same therapeu-tic effect, for larger hematoma, surgical indications, and did not happen cerebral hernia, in the treatment of hypertensive ce-rebral hemorrhage, but it is worthy of appling widely in aspect of comparing the two surgical trauma to the patients and saving medical resources. Conclusion Minimally invasive hematoma aspiration biopsy is a kind of safe and effective treatment, which especially suits for the basic-level hospitals, it can effectively save the patients'life, because of shorter operation time, small surgical injury, simple operation, also obvious curative effect and low cost etc.%目的 探讨不同方法在老年人高血压脑出血的治疗效果.方法 回顾性分析高血压脑出血病人80例,随机分为两组,分别采用微创血肿碎吸术和小骨窗开颅血肿清除术,术后并发症,死亡率和术后ADL分级进行比较,所获数据采用2检验.结果 两组血肿清除率与再出血率比较,P>0.05,无显著性差异.两组术后并发症比较,P>0.05,无显著性差异.两组术后功能恢复比较,P>0.05,无显著性差异.结论 微创血肿碎吸术具有手术时间短,创伤小,操作简单,效果确切,能明显降低患者医疗费用等特点,特别适合在基层医院开展.

  11. Stereotactic therapy for elderly patients with hypertensive cerebral hemorrhage%老年高血压脑出血患者的立体定向治疗

    Institute of Scientific and Technical Information of China (English)

    马长城; 王振宇; 谢京城; 刘彬; 陈晓东

    2012-01-01

    Objective To find the safe and appropriate therapies for elderly patients with hypertensive cerebral hemorrhage. Methods Twenty-one patients with hypertensive cerebral hemorrhage aged over 75 years(with a hematoma volume of 20 ?30 ml in 5 and 30 ?60 ml in 16) were treated with stereotactic puncture and drainage. Results Hematomas were completely removed from all patients. Their Glasgow score (GCS) increased significantly on days 1 and 3 after operation. No severe complication occurred except for recurrent hemorrhage in 1 patient, pneumonia in 2 patients, and transient renal dysfunction in 1 patient after operation. The average hospital stay time of the patients was 13. 2 days. The patients were followed up for 6 months during which 7 patients were well recovered,12 had moderate disability,2 had severe disability,and no patient died. Conclusion Stereotactic puncture and drainage are a minimally invasive,safe and effective procedure for hematoma, which can effectively reduce complications and shorten hospital stay time of patients.%目的 研究老年高血压脑出血患者的治疗方法,为老年高血压脑出血患者寻找合适、安全的治疗途径.方法 利用立体定向穿刺引流治疗年龄>75岁的高血压脑出血患者21例,其中血肿量20~30 ml 5例,30~60 ml 16例.结果 所有患者血肿均得到了有效清除,术后第1、3天格拉斯哥昏迷评分(GCS)明显升高.术后除1例少量再出血,2例肺炎、1例一过性肾功能障碍外,无其他严重并发症出现.所有患者平均住院时间为13.2d.术后随访6个月,恢复良好者7例,中度残疾12例,量度残疾2例,无死亡.结论 立体定向血肿穿刺抽吸引流微创、安全、有效,能有效减少并发症,并缩短住院时间.

  12. 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.

  13. 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。

  14. Plasma level of sFas and sFasL in acute cerebral hemorrhage with delayed cerebral edema%脑出血后迟发性脑水肿血浆sFas和sFasL水平分析

    Institute of Scientific and Technical Information of China (English)

    王兆平; 王文静; 王前友; 潘健; 孙一兵

    2011-01-01

    目的:探讨可溶性Fas (sFas)和可溶性Fas配体(sFasL)的变化与急性脑出血(ACH)后迟发性脑水肿的关系.方法:ACH后迟发性脑水肿患者12例,其中男性9例;随机选取同期ACH无迟发性脑水肿组12例,其中男性8例;同期年龄和性别相匹配的12例健康体检合格者作为对照组,其中男性8例.采用酶联免疫吸附法( ELISA)法测定血浆sFas和sFasL浓度,比较各组之间sFas和sFasL浓度差异.结果:ACH后迟发性脑水肿组14d血浆sFas和sFasL水平明显高于ACH无迟发性脑水肿组和对照组(P<0.01),ACH后迟发性脑水肿组较ACH无迟发性脑水肿组于发病7d后血浆sFas和sFasL水平下降速度缓慢,血浆sFasL水平稍有上升.结论:sFas和sFasL可能参与脑出血后迟发性脑水肿的形成,动态性检测血浆sFas和sFasL水平,可对于发现潜在的ACH后迟发性脑水肿具有一定的意义.%Objective To investigate the relationship between the changes of the plasma levels of soluble Fas (sFas) , soluble Fas-ligand(sFasL) and delayed cerebral edema following acute cerebral hemorrhage ( ACH). Methods Our study included 12 cases of ACH with delayed cerebral edema patients (male 9) and 12 cases of ACH without delayed cerebral edema (male 8) and 12 cases of the age and sex matched healthy subjects( male 8). The plasma levels of sFas and sFasL were measured by enzyme-linked immunosorbent assay ( ELISA) method in these groups and the difference in the levels of sFas and sFasL were compared among each groups. Results The levels of serum sFas and sFasL at 14d after onset in ACH with delayed cerebral edema group were significantly higher than that of the ACH without delayed cerebral e-dema and control groups(P <0.01) and that in ACH with delayed cerebral edema group was slow rate of decline at 7d after onset. The levels of serum sFasL in ACH with delayed cerebral edema group were increased slightly 7d after onset. Conclusion The sFas and sFasL probably take roles in the

  15. 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.

  16. 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

  17. Analysis of CT Features and Prognosis Related Factors of Hypertensive Cerebral Hemorrhage%高血压脑出血CT特征与预后的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    李娟

    2015-01-01

    目的:分析高血压脑出血CT特征与其与预后的相关性。方法回顾性分析我院2013年1月-2014年12月收治的75例高血压脑出血患者CT影像资料及其他资料,观察高血压脑出血CT特征(包括出血部位、血肿形态、出血量、是否破入脑室等),根据mRS评分将患者分为预后良好组与预后不良组,对CT特征与预后相关性行单因素及多因素Logistic分析。结果高血压脑出血CT特征:基底节区出血占57.3%,血肿形态规则占81.3%;出血量30ml以下占46.7%,出血量60ml以上占18.7%;出血破入脑室占30.7%。30ml以下出血量患者发病3个月mRs评分明显低于30-60ml、60ml以上(P<0.05)。单因素及多因素Logistic分析患者年龄、脑出血量、出血破入脑室是高血压脑出血患者预后不良独立危险因素。结论 CT影像特征可作为高血压脑出血预后评估的重要依据。%Objective To analyze the CT features and their correlation with prognosis of hypertensive cerebral hemorrhage.Methods CT imaging data and other data of 75 patients with hypertensive cerebral hemorrhage who were treated in our hospital during January 2013 to December 2014 were retrospectively analyzed. The CT features (including bleeding site, hematoma shape, bleeding volume and whether breaking into ventricle or not) of hypertensive cerebral hemorrhage were observed. According to mRS score, the patients were divided into the favorable prognosis group and the poor prognosis group. For CT features and their correlation with prognosis, univariate and multiple Logistic analysis were performed.Results CT features of hypertensive cerebral hemorrhage: basal ganglia hemorrhage accounted for 57.3%, regular hematoma shape for 81.3%, bleeding volume less than 30ml for 46.7%, bleeding volume more than 60ml for 18.7% and hemorrhage breaking into ventricle for 30.7%. The mRs score of patients with bleeding volume less than 30ml and 3 months after onset was

  18. 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

  19. 亚低温治疗高血压脑出血患者改善功能预后及相关因素分析%Function prognosis promotion and relative factor analysis of subhypothermia therapy to hypertension cerebral hemorrhage patients

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To study the effect of sub hypothermia on hypertension cerebral hemorrhage and content of serum endothelin(ET). Method 87 hypertension cerebral hemorrhage cases were divided into subhypothermia group and control group randomly,patients in subhypothermia group received subhypothermia therapy in NICU-6 hours after operation or hospitalization.We tested serum ET content with specific radioimmunoassay method 24 hours,72 hours and 3 weeks after therapy,and compared them with control group.Result ET content of two groups increased apparently after 24 hours,ET of subhypothermia group was lower than that of control group(P< 0.01);it recovered 3 weeks after therapy.Conclusion Subhypothermia techniques can apparently improve prognosis of hypertension cerebral hemorrhage patients,serum ET level may be one important index to evaluate severity of hypertension cerebral hemorrhage.

  20. Pharmacologic modulation of cerebral metabolic derangement and excitotoxicity in a porcine model of traumatic brain injury and hemorrhagic shock

    DEFF Research Database (Denmark)

    Hwabejire, John O; Jin, Guang; Imam, Ayesha M;

    2013-01-01

    Cerebral metabolic derangement and excitotoxicity play critical roles in the evolution of traumatic brain injury (TBI). We have shown previously that treatment with large doses of valproic acid (VPA) decreases the size of brain lesion. The goal of this experiment was to determine whether this eff...

  1. 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. ``

  2. 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

  3. 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)

  4. 脑出血急性期血肿扩大的临床分析%Clinical Analysis of the enlargement of the lntracerebral hematomas in the acute stage of cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王岭; 李海燕

    2001-01-01

    Objective:To explore the incidence,causes,clinical,manifestation of the enlargement of hematomas in the acute stage of cerebral hemorrhage and the measures to it .Methods:The clinical course and their CT of 867 cases with cerebral hemorrhage occuning during 1994~2000 were analyses.Results:The incidence of the enlargement of the intracerebral hematomas in the acute stage of cerebral hemorrhage was 20.1% ,which was related to the degree of hypertension,coagulation statement,bleeding site,morphologic charge of hematomas and extreme dehydration in early stage.The enlargement of the hematomas would make higher incident of the cerebral hemorrhage .Conclusions:The progress was affected by the enlargement hematomas,so we should diagnose it as possibly earlier and take effective measures to improve prognosis of patients.%目的:探讨脑出血急性期血肿扩大的发生率、原因、临床表现、预后及采取的相应措施。方法:回顾性分析1994~2000年间诊治的867例脑出血病人的临床和CT资料。结果:脑出血急性期血肿扩大的发生率为20.1%,其主要与血压增高的程度、凝血功能、出血部位、血肿形态及早期过度脱水有关,血肿扩大增加了病人的死亡率。结论:血肿扩大的发生影响病人预后,应尽早确诊,采取积极防治措施,改善病人预后。

  5. Effect Observation on Prehospital Emergency Measures for the Prognosis of Patients With Cerebral Hemorrhage%院前急救措施对脑出血患者预后的影响观察

    Institute of Scientific and Technical Information of China (English)

    郑嘉

    2015-01-01

    Objective To observe the effect of prehospital emergency treatment on the prognosis of patients with cerebral hemorrhage.Methods 44 patients with cerebral hemorrhage which used prehospital emergency treatment were selected as the observation group,44 cases of cerebral hemorrhage patients treated by the patients' family members were selected as the control group. The neurological function defect score, complication rate and mortality rate were compared between the two groups. Results The neurological function defect score, the incidence of complications and mortality of the the observation group were significantly lower than that of the control group(P<0.05).Conclusion Emergency treatment for patients with cerebral hemorrhage can significantly improve the prognosis of patients,reduce the mortality and the incidence of complications.%目的 观察院前急救措施对脑出血患者预后的影响.方法 选择我院收治的采取院前急救措施的44例脑出血患者为观察组,同期由患者家属自行送院的脑出血患者44例作为对照组,对所有患者随访20 d,比较两组患者出院时的神经功能缺损评分、并发症发生率以及病死率.结果 观察组出院时神经功能缺损评分、并发症发生率以及病死率均低于对照组,差异有统计学意义(P<0.05).结论 对脑出血患者实施院前急救措施可以改善患者的预后,降低病死率和并发症发生率.

  6. Alteration of Basilar Artery Rho-Kinase and Soluble Guanylyl Cyclase Protein Expression in a Rat Model of Cerebral Vasospasm following Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Chih-Jen Wang

    2014-01-01

    Full Text Available Background and Purpose. The vasoconstrictor endothelin-1 (ET-1 has been implicated in the pathogenesis of cerebral vasospasm following subarachnoid hemorrhage (SAH. Previous results showed that CGS 26303, an endothelin converting enzyme (ECE inhibitor, effectively prevented and reversed arterial narrowing in animal models of SAH. In the present study, we assessed the effect of CGS 26303 on neurological deficits in SAH rats. The involvement of vasoactive pathways downstream of ET-1 signaling in SAH was also investigated. Methods. Sprague-Dawley rats were divided into five groups (n=6/group: (1 normal control, (2 SAH, (3 SAH+vehicle, (4 SAH+CGS 26303 (prevention, and (5 SAH+CGS 26303 (reversal. SAH was induced by injecting autologous blood into cisterna magna. CGS 26303 (10 mg/kg was injected intravenously at 1 and 24 hr after the initiation of SAH in the prevention and reversal protocols, respectively. Behavioral changes were assessed at 48 hr after SAH. Protein expression was analyzed by Western blots. Results. Deficits in motor function were obvious in the SAH rats, and CGS 26303 significantly improved the rate of paraplegia. Expressions of rho-kinase-II and membrane-bound protein kinase C-δ and rhoA were significantly increased, while those of soluble guanylyl cyclase α1 and β1 as well as protein kinase G were significantly decreased in the basilar artery of SAH rats. Treatment with CGS 26303 nearly normalized these effects. Conclusions. These results demonstrate that the rhoA/rho-kinase and sGC/cGMP/PKG pathways play pivotal roles in cerebral vasospasm after SAH. It also shows that ECE inhibition is an effective strategy for the treatment of this disease.

  7. 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.

  8. 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

  9. The Research of Acupuncture Combing with Ditan Decoction to Neuroethology and Cerebral Edema of Rat on the Acute Cerebral Hemorrhage%针刺结合涤痰汤对急性脑出血大鼠神经行为学指标及脑水肿影响的研究

    Institute of Scientific and Technical Information of China (English)

    王桂芳; 杨超; 崔海

    2012-01-01

    目的 探讨针刺结合涤痰汤对急性脑出血大鼠神经行为学指标和脑水肿功能的影响.方法 在SD大鼠身上复制急性脑出血模型,以针刺结合涤痰汤为治疗手段,观察脑出血急性期神经行为学评分和脑组织含水量状况,并与对照组进行比较.结果 针刺结合涤痰汤治疗组72 h后脑组织含水量均低于对照组.结论 针刺结合涤痰汤组对SD大鼠急性脑出血后神经行为学指标有改善作用,能够有效降低脑水肿的发生.%Objective: To explore the effect of acupuncture combing with Ditan Decoction for neuroethology and cerebral edema of rat on the acute cerebral hemorrhage. Methods: The SD rat models of acute cerebral hemorrhage were made and were treated by acupuncture combing with Ditan Decoction.Neuroethology and cerebral edema of them on the acute stage were observed and were compered to control group. Results: The water contents in cerebral tissues in the therapy group of acupuncture combing with Ditan Decoction after 72h was lower than the control group. Conclusion: The therapy of acupuncture combing with Ditant Decoction has the significant effect to improve neuroethology of SD rats on the acute cerebral hemorrhage, and effectively decrease the occurrences of cerebral edema.

  10. 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.

  11. Cannabinoid type 2 receptor stimulation attenuates brain edema by reducing cerebral leukocyte infiltration following subarachnoid hemorrhage in rats.

    Science.gov (United States)

    Fujii, Mutsumi; Sherchan, Prativa; Krafft, Paul R; Rolland, William B; Soejima, Yoshiteru; Zhang, John H

    2014-07-15

    Early brain injury (EBI), following subarachnoid hemorrhage (SAH), comprises blood-brain barrier (BBB) disruption and consequent edema formation. Peripheral leukocytes can infiltrate the injured brain, thereby aggravating BBB leakage and neuroinflammation. Thus, anti-inflammatory pharmacotherapies may ameliorate EBI and provide neuroprotection after SAH. Cannabinoid type 2 receptor (CB2R) agonism has been shown to reduce neuroinflammation; however, the precise protective mechanisms remain to be elucidated. This study aimed to evaluate whether the selective CB2R agonist, JWH133 can ameliorate EBI by reducing brain-infiltrated leukocytes after SAH. Adult male Sprague-Dawley rats were randomly assigned to the following groups: sham-operated, SAH with vehicle, SAH with JWH133 (1.0mg/kg), or SAH with a co-administration of JWH133 and selective CB2R antagonist SR144528 (3.0mg/kg). SAH was induced by endovascular perforation, and JWH133 was administered 1h after surgery. Neurological deficits, brain water content, Evans blue dye extravasation, and Western blot assays were evaluated at 24h after surgery. JWH133 improved neurological scores and reduced brain water content; however, SR144528 reversed these treatment effects. JWH133 reduced Evans blue dye extravasation after SAH. Furthermore, JWH133 treatment significantly increased TGF-β1 expression and prevented an SAH-induced increase in E-selectin and myeloperoxidase. Lastly, SAH resulted in a decreased expression of the tight junction protein zonula occludens-1 (ZO-1); however, JWH133 treatment increased the ZO-1 expression. We suggest that CB2R stimulation attenuates neurological outcome and brain edema, by suppressing leukocyte infiltration into the brain through TGF-β1 up-regulation and E-selectin reduction, resulting in protection of the BBB after SAH.

  12. Differential Diagnosis of normal cerebral falx and Hemorrhage of the interhemispheric Fissure cistern with CT%正常大脑镰与纵裂池出血的CT诊断及鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    付建斌; 路洪春

    2013-01-01

    Objective To recognize correcting Ctappeurances of the normal cerebral falx(CF) and the hemorrhage of the interhemispheric Fissure cistern (IHFC).so as to improve accuracy of interhermipheric ifssure hemorrhage CT diagnosis, reduce misdiagnose.Methods 35 cases of hemorrhage of IHFC had been collectell,which were delimiting diagnosable by CT in addiction 80 cases of normal.skull.All travel axle’s CT scanning, The cerebral falx and the interhemispheric ifssure cistern were divied into superior ,anterior and posterior segment by the corpus cellosum.Results the normal falx cerebral presented as a thinning hyper-dense line, hemorrhage in the interhemispheric ifssure cistern presented as a widening hyper-dense line;edge obscured, a few presented zigzag hyper-dense.naomal interval disappear, thickening of the tent rid incisures margin, Conclusion CT scan is of important value in differential diagnosing normal falx cerebral and hemorrhage of the interhmispheric ifssures cistern.%目的:正确认识正常大脑镰与纵裂池出血的CT表现特点,以提高纵裂池出血CT诊断的准确性,减少漏疹或误诊。方法回顾性收集经CT检查确诊为纵裂池出血35例。另收集我科正常颅脑CT80例。均行轴位CT扫描,将大脑镰与纵裂池以及胼胝体和侧脑室为界分为上、前、后三部分[1]进行对比分析。结果正常大脑镰表现为细现状高密度影,纵裂池出血则表现为呈一较正常大脑镰粗的高密度影,边缘模糊,少数呈密度“之”字征。正常镰旁脑脊液间隙消失。天幕切迹缘增宽。结论 CT鉴别诊断正常大脑镰与纵裂池出血有重要价值。

  13. 蛛网膜下腔出血后游离脂肪酸与迟发性脑缺血的关系%Relation between free fatty aid and delayed cerebral ischemia after subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    崔晓梅; 韩冰; 张玉镇; 尹红蕾; 李金凤; 乔娜娜; 王运良

    2014-01-01

    目的:探讨蛛网膜下腔出血后血清游离脂肪酸浓度变化与迟发性脑缺血的关系。方法选取75例蛛网膜下腔出血患者,发病14 d内进行间接热量测定法检查全身耗氧量和液相色谱法测定游离脂肪酸浓度;应用多变量广义估计方程模型验证游离脂肪酸浓度与蛛网膜下腔出血的关系,Cox风险比例模型证实迟发性脑缺血的时间关系。结果75例蛛网膜下腔出血患者进行249项检查,发现n-6FFA和n-3FFA浓度与全身耗氧和改良的Fisher评分有关;21例(28%)患者出血后平均7 d发生迟发性脑缺血,迟发性脑缺血病人改良的Fisher评分,平均n-6FFA :n-3FFA比例和平均耗氧量较高;在Cox风险比例模型中,平均n-6FFA :n-3FFA比例、年轻和改良的Fisher评分与迟发性脑缺血的时间有关。结论蛛网膜下腔出血后脑损伤的严重性和耗氧代谢亢进与n-FFA浓度增高有关,n-6FFA :n-3FFA比例增加与迟发性脑缺血有关,提示调节氧耗和FFA浓度能减少DCI发生。%Objective To explore the relation between in serum free fatty acid levels changes and delayed cerebral ischemia after subarachnoid hemorrhage.Methods In 75patients with subarachnoid hemorrhage ,we performed measurement of system oxygen consumption by indirect calorimetry and free fatty acid levels by liquid chromatography in the first 14days after ic-tus.Multivariable generalized estimating equation models identified associations with free fatty acid levels and subarachnoid hemorrhage.Cox proportional hazards model was used to identify associations with time to delayed cerebral ischemia.Results There were 249 measurements in 75 patients with subarachnoid hemorrhage ,and n-6FFAand n-3FFA levels were found to be associated with oxygen consumption and the modified Fisher score.Twenty one (28% ) patients developed delayed cerebral is-chemia on median 7days after subarachnoid hemorrhage.In patients who developed delayed

  14. Early-Phase 11C-PiB PET in Amyloid Angiopathy-Related Symptomatic Cerebral Hemorrhage: Potential Diagnostic Value?

    Science.gov (United States)

    Farid, Karim; Hong, Young T; Aigbirhio, Franklin I; Fryer, Tim D; Menon, David K; Warburton, Elizabeth A; Baron, Jean-Claude

    2015-01-01

    Although late-phase (>35min post-administration) 11C-PiB-PET has good sensitivity in cerebral amyloid angiopathy (CAA), its specificity is poor due to frequently high uptake in healthy aged subjects. By detecting perfusion-like abnormalities, early-phase 11C-PiB-PET might add diagnostic value. Early-frame (1-6min) 11C-PiB-PET was obtained in 11 non-demented patients with probable CAA-related symptomatic lobar intracerebral haemorrhage (70±7yrs), 9 age-matched healthy controls (HCs) and 10 HCs PiB data did not change the sensitivity and specificity of late-phase PiB, but combined early- and late-phase positivity entails a very high suspicion of underlying Aβ-related clinical disorder, i.e., CAA or Alzheimer disease (AD). In order to clarify this ambiguity, we then show that the occipital/posterior cingulate ratio is markedly lower in CAA than in AD (N = 7). These pilot data suggest that early-phase 11C-PiB-PET may not only add to late-phase PiB-PET with respect to the unclear situation of late-phase positivity, but also help differentiate CAA from AD.

  15. 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.

  16. [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.

  17. 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

  18. 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.

  19. Analysis of 65 cases of emergency internal medicine therapeutic effect in the treatment of sudden cerebral hemorrhage%急诊内科治疗65例突发性脑出血的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈杰

    2014-01-01

    ObjectiveTo investigate the clinical efifcacy of the treatment and analysis emergency internal medicine sudden cerebral hemorrhage.Methods 65 cases of sudden cerebral hemorrhage patients were selected and retrospectively analyzed in our hospital from 2012 december to 2013 december. they were treated with the emergency internal medicine.Results after the emergency internal medicine treatment, 33 cases of 65 patients with sudden cerebral hemorrhage were cured (50.77%), effective in 19 cases (29.23%), the total effective rate was 80%; 5 cases (7.69%) with sequelae of different degree of limb movement disorder and epilepsy. Because the special bleeding position 8 cases (12.31%) showed re-bleeding, following by the complications such as oppression and life central cerebral edema, pulmonary infection, alimentary tract hemorrhage and even death.Conclusioncorrect understanding and mastering the clinical manifestations in patients with symptoms in sudden cerebral hemorrhage and given treatment measures of the emergency internal medicine can reduce the morbidity and mortality of patients with sudden cerebral hemorrhage and improve the survival rate and the quality of life in cured patients.%目的:探讨和分析急诊内科治疗突发性脑出血的临床疗效。方法随机抽取我院2012年12月至2013年12月急诊内科收治的65例突发性脑出血患者的资料,进行回顾性分析。结果通过急诊内科的治疗,65例突发性脑出血患者,治愈33例(50.77%),有效19例(29.23%),总有效率为80%;5例(7.69%)患者留下肢体运动障碍、癫痫等不同程度的后遗症;8例(12.31%)患者因出血位置比较特殊,再次出血压迫生命中枢并出现脑水肿、肺部感染、消化道出血等并发症而死亡。结论正确的了解和掌握突发性脑出血患者的症状、临床表现以及急诊内科的诊疗措施,才能降低突发性脑出血患者的致残率和致死率,提高治愈率及患者的生存质量。

  20. 口服避孕药及妊娠情况与女性脑出血的关系%Correlations between cerebral hemorrhage in women and oral contraceptives and pregnant status

    Institute of Scientific and Technical Information of China (English)

    徐卫历; 汪培山

    2001-01-01

    Objective: To investigate the correlations between cerebral hemorrhage in women and oral contrceptives and pregnant status. Methods:A1:1 pair matched case control study was conducted on145 women with cerebral hemorrhage diagnosed by CT scan of the head and the same number of hospital controls, using conditional logistic regression analysis. Results: Odds ratio(OR) for OC was 3.50(95% CI:1.49~8.20), after adjusting by the history of hypertension the OR was 3.56 (95% CI:1.04~17.82). Single factor analysis revealed history of pregnant hypertension increased the risk of cerebral hemorrhage the OR were 3.15(95%CI:1.75~5.65) , after adjusting by the history of hypertension the effects of pregnant hypertension became non-significant. Conclusion: Use of OC were independent risk factor of cerebral hemorrhage in women, it was infered history of pregnant hypertension probably increased the risk of cerebral hemorrhage by influencing blood pressure. No correlations between cerebral hemorrhage in women and history of menstruation and child bearing were found.%目的:探讨口服避孕药及妊娠情况与脑出血的关系。方法:采用配比病例对照研究方法,对145例经颅脑[摘要]目的:探讨口服避孕药及妊娠情况与脑出血的关系。方法:采用配比病例对照研究方法,对145例经颅脑CT确诊的女性脑出血病例均配以医院对照,应用条件Logistic回归分析。结果:口服避孕药对女性脑出血的OR为:2.50(95%CI:1.49~8.20),按高血压病史调整后为3.56(95%CI:1.04~17.82)。单因素分析时,妊娠高血压史可增加患脑出血的危险性,OR为3.15(95%CI:1.75~5.65),按高血压病史调整后其作用失去显著意义。结论:口服避孕药很可能是女性脑出血的独立的危险因素,提示妊娠高血压可能是借助于影响血压间接地增加了患脑出血的危险性。未发现妊娠次数、初末产年龄及月经初潮年龄与女性脑出血有关。

  1. Dysphagia screening and rehabilitation nursing of cerebral hemorrhage patients in postoperative early stage%脑出血患者术后早期吞咽障碍筛查及康复护理

    Institute of Scientific and Technical Information of China (English)

    柏慧华; 姚秋近; 祝晓娟; 王卉; 张峰极; 张一

    2013-01-01

    Objective To evaluate the effect of dysphagia screening and rehabilitation nursing of cerebral hemorrhage patients in postoperative early stage. Methods Forty cerebral hemorrhage patients in postoperative early stage were assessed with the Gugging Swallowing Screen (GUSS), and patients with dysphagia received diet guidance and rehabilitation nursing. Results Twenty-four patients suffered dysphagia and 13 patients recovered after rehabilitation nursing. According to the score of Glasgow Coma Scale, 13 patients were discharged with good recovery, 19 patients with mild disability and 8 patients with severe disability. No patient died of complications such as pneumonia or malnutrition. Conclusion Early dysphagia screening and rehabilitation nursing can effectively improve the outcomes of patients with cerebral hemorrhage.%目的 探讨早期吞咽障碍筛查及康复护理对高血压脑出血患者的影响.方法 对40例脑出血并行手术治疗的患者采用Gugging吞咽功能评估表(Gugging Swallowing Screen,GUSS)进行评估,并对存在吞咽障碍的患者进行相应的饮食指导及康复训练.结果 24例存在吞咽障碍,经过康复训练,出院时存在吞咽障碍的患者为11例.出院时按格拉斯哥预后评分,5级恢复良好者13例,4级轻度残疾19例,3级重度残疾8例.未因肺炎、营养不良等并发症导致死亡.结论 术后早期进行GUSS吞咽障碍筛查及康复护理,可有效改善脑出血患者的预后.

  2. 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。

  3. Evaluate the effect to omeprazole in preventing treatment of hypertensive cerebral hemorrhage with stress ulcer bleeding%奥美拉唑对脑出血应激性溃疡的预防效果

    Institute of Scientific and Technical Information of China (English)

    丁凤英; 罗伟良

    2008-01-01

    Objective To evaluate the effect of omeprazole in preventing treatment of hypertensive cerebral hemorrhage with stress ulcer bleeding. Methods A total of 100 patients with hypertensive cerebral hemorrhage were treated with conventional therapy including dehydration, antihypertensive and supporting treatment. The patients were randomly divided into omeprazole group(n=50) and control group( n = 50). The control group received conventional therapyonly, while the omeprazole group received additional omeprazole 40mg, iv, qd, for 14d. Results Omeprazole group stress ulcer 6 eaess(12.0% ) was significantly lower than the control group 12 cases(24.0% );two groups stress ulcer incidence of severity are increasing with the increase of the disease; the mortalities of cerbral hemorrhage were 6.0 % in the omeprazole group and 16.0 % in the control group and the difference had significant meaning(P>0.05). Conclusion Omeprazole has significant beneficial effect in preventing upper gastrointestinal hemorrhage after hypertensive cerebral hemorrhage.%目的 观察奥美拉唑治疗高血压性脑出血并发应激性溃疡出血的疗效.方法 将100例高血压性脑出血患者分为奥美拉唑组(50例)和对照组(50例),均予常规脱水、降颅压及对症支持治疗,奥美拉唑组加用奥美拉唑40 mg,静脉注射,1次/d,共14 d.结果 奥美拉唑组应激性溃疡6例(12.0%),明显低于对照组12例(24.0%);两组应激性溃疡发生率均随病情程度加重而增加;奥美拉唑组死亡3例(6.0%),明显低于对照组8例(16.0%)(P<0.05).结论 奥美拉唑静脉注射预防高血压性脑出血并发应激性溃疡出血疗效确切,且未见不良反应发生.

  4. 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。

  5. Minimally invasive intracranial hematoma in patients with hypertensive cerebral hemorrhage%高血压脑出血微创颅内血肿清除术

    Institute of Scientific and Technical Information of China (English)

    赵勇

    2015-01-01

    Objective To observe the clinical effect of minimally invasive intracranial hematoma in treatment of hypertensive in-tracerebral hemorrhage patients. Methods 100 cases of hypertensive cerebral hemorrhage patients were selected as the research object in our hospital from January, 2010 to January, 2014. All the cases are in line with the Chinese Medical Association related diagnostic standard setting the fourth national academic meeting for cerebrovascular disease, 100 patients were randomly divided into observation group and control group with 50 cases in each group, the control group was given the conservative drug treatment, the observation group was given minimally invasive intracranial hematoma. The clinical curative effect and complications incidence and follow-up of quality of life of 6 months were compared between the two groups. Results The clinical efficacy of two groups were compared, the effect of observation group was significantly better than the control group (P<0.05). The observation group there were three cases of digestive tracThemorrhage, pulmonary infection in six cases, cardiac changes in three cases, two cases of cen-tral high fever, the complication rate was 28%; the control group occurred in 7 cases of digestive tracThemorrhage, pulmonary in-fection in 12 cases, cardiac changes in 5 cases, 4 cases of central high fever, the incidence of complications was 56%, group com-parison between observation group than in the control group, with significant difference (P<0.05). The observation group in physio-logical function(RP), social function(SF), the physiological function of overall health (PF), self rating (GH) four aspects of the scores were significantly higher than control group (P<0.05). Conclusion Compared with conservative treatment clinical department of in-ternal medicine, invasive intracranial hematoma is better, which is conducive to the quality of life in patients with recovery, and it has higher security. Therefore, hypertensive

  6. 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.

  7. 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.

  8. 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.

  9. 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。

  10. 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.

  11. Correlative study of the relationship between hemorrhagic transformation and premorbid antithrombotic therapy after acute cerebral infarction%急性脑梗死后出血转化与病前抗栓治疗的相关性研究

    Institute of Scientific and Technical Information of China (English)

    陈艳超; 雷春艳; 刘鸣

    2015-01-01

    死后出血转化独立相关,其与急性脑梗死远期预后的关系有待进一步研究。%Objective To investigate the impact of using antithrombotic drugs (anticoagulants or antiplatelet aggregation drugs)before the onset of cerebral infarction on hemorrhagic transformation after acute cerebral infarction. Methods The consecutive patients with acute cerebral infarction from Chengdu Stroke Registry Project admitted to the Department of Neurology,West China Hospital,Sichuan University from January 1,2004 to January 1,2014 were enrolled. The baseline data on admission,previous usage of anticoagulants and anti-platelet aggregation drugs,as well as CT/ MRI and other imaging data of all patients were collected. According to the results of CT/ MRI reexamined at 72 h after admission,the patients with hemorrhagic transformation were enrolled into a hemorrhagic transformation group;the patients with non-hemorrhagic transformation were enrolled into a non-hemorrhagic transformation group according to the ratio of 1 ∶ 1. Their gender and age were matched with the hemorrhagic transformation group. The baseline data and drug used of the patients in both groups were compared. The differences of risk factors between the two groups were analyzed with multivariate Logistic regression analysis. The relationship between hemorrhagic transformation and premorbid use of antithrombotic drugs were observed. Results A total of 6 916 patients with acute cerebral infarction were enrolled,including 433 (6. 3%)hemorrhagic transformation (hemorrhagic transformation group)and 433 non-hemorrhagic transformation. (1)There were significant differences between the patients of the two groups on admission in the National Institutes of Health Stroke Scale (NIHSS)score,atrial fibrillation,previous cerebral infarction,and blood glucose levels on admission (all P < 0. 05). (2)The proportions of using anticoagulants and antiplatelet aggregation agents in the hemorrhagic transformation group were

  12. 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.

  13. 前瞻性护理干预对脑出血术后患者便秘的影响%Efficacy of Prospective Nursing Intervention in Constipation Patients With Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    崔玉梅

    2015-01-01

    Objective To observe the cerebral hemorrhage patients with constipation affecting forward-looking nursing intervention. Methods 62 patients admitted to our hospital with cerebral hemorrhage surgery patients in this study were randomly divided into two groups(prospective nursing intervention)and control group(usual care),the two groups were analyzed after the occurrence rate and constipation constipation degree. Results The patients with severe constipation not much happened with the control group,and the overweight of constipation were significantly lower than the control group,the difference was statistical y significant data comparison(P< 0.05). Conclusion Brain hemorrhage patients prospective nursing intervention can significantly reduce the incidence of constipation and reduce the degree of constipation.%目的:观察前瞻性护理干预对脑出血术后患者便秘的影响。方法选取我院收治的62例脑出血手术患者为研究对象,将其随机分为观察组(前瞻性护理干预)与对照组(常规护理),对比分析两组患者术后便秘发生情况及便秘程度。结果观察组未发生便秘患者多于对照组,且重度、超重度便秘发生率低于对照组,数据对比差异有统计学意义(P<0.05)。结论脑出血术后患者采用前瞻性护理干预可降低便秘发生率,并可减轻便秘程度。

  14. 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。

  15. Analysis of Different Surgical Treatment of Hypertensive Intracerebral Hemorrhage after Cerebral Edema%不同术式治疗高血压脑出血对术后脑水肿的影响分析

    Institute of Scientific and Technical Information of China (English)

    朱冠军

    2015-01-01

    ObjectiveTo investigate the effect on braln edema of different surgical methods for the treatment of hypertensive cerebral hemorrhage.Method For the patients with in our hospital from December 2011 to December 2013 were selected for hypertensive cerebral hemorrhage, 67 patients were randomly divided into two groups were observed and compared, including the control group using the traditional craniotomy operation, experimental group received minimally invasive evacuation of intracranial hematoma for treatment.Results After operation, the volume of edema, cerebral edema duration and idiotic left blood volume, the experimental group was statistically signiifcant difference compared with the control group(P<0.05).Conclusion In the treatment of hypertensive cerebral hemorrhage, intracranial hematoma can signiifcantly shorten the duration of postoperative braln edema, reduce the volume of edema, is worth the clinical promotion.%目的:了解不同术式治疗高血压脑出血对术后脑水肿的影响。方法对我院2011年12月至2013年12月收治的高血压脑出血患者进行抽样,选取67例患者随机分成两组进行对比观察,其中对照组采用传统开颅手术,实验组予以微创颅内血肿清除术进行治疗。结果术后在水肿体积、脑水肿持续时间以及脑残留血液量上,实验组较对照组差异具有显著统计学意义(P<0.05)。结论针对高血压脑出血治疗,微创颅内血肿清除术能显著缩短水肿持续时间,降低术后脑水肿体积,值得临床推广。

  16. 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, ...

  17. Glibenclamide for the prevention of cerebral edema and hemorrhagic transformation in ischemic stroke%格列本脲预防缺血性卒中患者脑水肿和出血性转化

    Institute of Scientific and Technical Information of China (English)

    陈红艳; 王红军

    2015-01-01

    Cerebral edema and hemorrhagic transformation(HT) are the common complications of ischemic stroke. Ischemic cerebral edema is the primary cause of death in patients w ith large infarction. The sulfonylurea receptor 1 (Sur1) transient receptor potential M4 (Trpm4) channel plays an important role in focal cerebral ischemia. Both animal experiment and clinical studies have show n that the Sur1 selective inhibitor glibenclamide provides neuroprotection for ischemic stroke, including infarct volume reduction and improvement of neurological function, especial y in attenuating cerebral edema and reducing the incidence of HT. This article review s the advances in research on glibenclamide for the prevention of cerebral edema and HT in patients w ith ischemic stroke.%脑水肿和出血性转化(hemorrhagictransformation,HT)是缺血性卒中的常见并发症。缺血性脑水肿是大面积脑梗死患者死亡的主要原因。磺脲类受体1(sulfonylurea receptor 1, Sur1)-瞬时受体电位通道M4型(transient receptor potential melastatin 4, Trpm4)通道在局灶性脑缺血中起着重要作用。动物实验和临床研究均显示,Sur1选择性抑制剂格列本脲可为缺血性卒中提供神经保护,包括缩小梗死体积和改善神经功能,特别是减轻脑水肿和降低HT 发生率。文章对格列本脲预防缺血性卒中患者脑水肿和HT的研究进展进行了综述。

  18. 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

  19. 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.

  20. The protective effect of Nimodipine treatment of brain damage in patients with cerebral hemorrhage%尼莫地平对脑出血后脑损害的保护作用研究

    Institute of Scientific and Technical Information of China (English)

    江明庆

    2011-01-01

    Objective To study the protective effect of Nimodipine treatment of brain damage in patients with cerebral hemorrhage.Methods 62 cases of brain damage in patients with cerebral hemorrhage were divided into treatment group and control group,each for 31 cases.The control group were given conventional treatment,and the treatment group were given Nimodipine on the basis of the control group,treatment for 10d.NIHSS,hematoma volume and clinical effective rate were compared.Results After treatment,the NIHSS was lower between two groups,the treatment group decline was more obvious(P < 0.05).The hematoma volume was decreased,the treatment group decrease was more obvious(P <0.05).The total effective rate was 51.6% in the control group,and the total effective rate was 77.4%.There were significantly statistical differences between two groups(P < 0.05).Conclusion Nimodipine had a protective effect for brain damage in patients with cerebral hemorrhage,and could improve the nervous function and decrease hematoma volume,and it was a reliable drug.%目的 研究尼莫地平对脑出血后脑损害的保护作用.方法 62例脑出血后脑损伤患者随机分成两组,每组31例,对照组采用常规方法治疗,治疗组在对照组基础上采用尼莫地平治疗,疗程为l0 d.比较治疗前后两组患者的神经功能缺损评分、血肿体积、临床有效率.结果 治疗后,两组患者神经缺损评分均显著降低,治疗组下降更明显(P<0.05);两组患者血肿体积明显缩小,治疗组更明显(P<0.05);对照组总有效率为51.6%,治疗组总有效率为77.4%,两组差异有统计学意义(P<0.05).结论 尼莫地平对脑出血后脑损伤具有明显的保护作用,可改善神经功能,缩小血肿体积.

  1. 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.

  2. 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.

  3. 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.

  4. 脑出血患者偏瘫急性期体位护理观察%Posture nursing observation for patients with hemiplegia caused by cerebral hemorrhage in acute stage

    Institute of Scientific and Technical Information of China (English)

    阮选; 纪光州

    2016-01-01

    Objective:To investigate the effect of different body positions on the rehabilitation of patients with hemiplegia caused by cerebral hemorrhage in acute stage.Methods:60 cases of patients with hemiplegia caused by cerebral hemorrhage were divided into two groups randomly.The control group was given routine nursing.The observation group was given posture nursing on the basis of the control group.The muscle strength,incidence of adverse reactions in the two groups were compared.Results:The total effective rate of the observation group was significantly higher than that of the control group (P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion:Proper posture could improve the muscle strength of patients with hemiplegia caused by cerebral hemorrhage significantly and improve the quality of life,which was safe and effective.%目的:探讨脑出血导致偏瘫的患者在急性期采取不同体位对康复的影响。方法:收治脑出血导致偏瘫的患者60例,随机分为两组。对照组给予常规护理,观察组在对照组基础上给予体位护理,比较两组肌力、不良反应发生情况。结果:观察组的治疗总有效率明显高于对照组(P<0.05)。观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:合适的体位能显著提高脑出血导致偏瘫的患者的肌力,改善生活质量,且安全、有效。

  5. Application and Experience of Clinical Nursing Path in Nursing Care of Cerebral Hemorrhage%临床护理路径在脑出血护理中的应用体会

    Institute of Scientific and Technical Information of China (English)

    黄云廷

    2014-01-01

    目的:探讨临床护理路径在脑出血中的护理效果及体会。方法选择我院2010年8月至2013年11月收治的68例脑出血患者为研究对象,随机分为对照组34例,观察组34例,对照组行常规护理,观察组行临床护理路径护理,对两组患者的护理效果进行对比分析。结果观察组患者的住院费用与患者护理质量评分、住院时间、健康知识知晓评分明显优于对照组,差异有统计学意义(P<0.05)。结论对脑出血患者实施临床护理路径护理,是一种安全性高,可促进患者恢复的护理措施,值得临床进一步推广使用。%Objective To study the nursing effect and experience of clinical nursing pathway in cerebral hemorrhage. Methods From August 2010 to November 2013 were analyzed in 68 cases of cerebral hemorrhage patients as the research object,34 cases were randomly divided into control group and observation group, 34 cases in the control group routine nursing,the observation group lines of clinical nursing path care,nursing effect of two groups of patients were analyzed. Results The hospitalization expenses of patients with observation group, patients nursing quality grade, length of hospital stay, the health knowledge level was better than control group,the difference was statistically significant (P< 0.05). Conclusion The implementation of clinical nursing path in patients with cerebral hemorrhage,is a kind of high safety,can promote the nursing measures of patients recovery, is worth further clinical use.

  6. Analysis of the correlation between obstructive sleep apnea hypopnea syn-drome and cerebral infarction combined with cerebral hemorrhage%阻塞性睡眠呼吸暂停低通气综合征与脑梗死并发脑出血的相关性分析

    Institute of Scientific and Technical Information of China (English)

    黄春

    2014-01-01

    目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与脑梗死并发脑出血的相关性。方法选取本院2012年1月~2014年1月收治的合并OSAHS的脑梗死并发脑出血患者40例为观察组,另选取本院同一时间收治的未合并OSAHS的脑梗死并发脑出血患者40例为对照组,对两组患者发病后的相关临床指标以及昏迷程度和预后等情况进行比较。结果观察组发病后的MAP、SaO2、LDL-C、HCT和Fg指标均差于对照组,昏迷状况严重于对照组,预后情况差于对照组,差异有统计学意义(P<0.05);两组患者发病后的MAP、SaO2、LDL-C、HCT和Fg存在明显相关性,且均呈正相关。结论合并OSAHS的脑梗死患者更易并发脑出血,且一旦发生脑出血昏迷状况严重,预后较差。%Objective To explore the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and cerebral infarction complicated with cerebral hemorrhage. Methods 40 patients with cerebral infarction conbined with cerebral hemorrhage and OSAHS in our hospital from January 2012 to January 2014 were selected as observation group.Another 40 patients with cerebral infarction combined and cerebral hemorrhage yet without OSAHS in our hospi-tal during the same period of time were selected as control group.Related clinical indices from the onset of the disease, degree of coma and prognosis between the two groups was compared respectively. Results MAP,SaO2,LDL-C,HCT and Fg in the observation group was worse than that in the control group respectively,the degree of coma was more severe than that in the control group,and the prognosis was worse than that in the control group,with statistical difference (P<0.05).Correlation of MAP,SaO2,LDL-C,HCT and Fg in the two groups were significant,and the correlations were positive. Conclusion Patients with cerebral infarction complicated with OSAHS tend to have cerebral hemorrhage easily,once it occurs,may lead to severe coma and

  7. Research Progress in Association of Matrix Metalloproteinases with Cerebral Edema after Hypertensive Intracerebral Hemorrhage%基质金属蛋白酶与高血压脑出血后脑水肿相关性的研究进展

    Institute of Scientific and Technical Information of China (English)

    周德生; 李煦昀; 王仙伟

    2012-01-01

    Hypertensive intracerebral hemorrhage is one of the critical diseases in neurological system. In addition to the mass effect of hematoma,the blood brain barrier damage and cerebral edema caused by hema-toma components and the secondary nerve damage caused by cerebral edema are the main causes of deterioration and death the cerebral hemorrhage patients. Recent studies suggested that matrix metalloproteinases increased expression after hypertensive intracerebral hemorrhage, which participated in and mediated cerebral edema, and the expression and adjustment of which has become the new target for the treatment of cerebral e-dema.%高血压脑出血是神经系统的危重病之一.除了血肿本身的占位效应外,血肿成分引发的血脑屏障的破坏和脑水肿反应,以及脑水肿导致的继发性神经损害,是脑出血患者病情恶化和引起死亡的主要原因.基质金属蛋白酶在高血压脑出血后表达增高,参与和介导了脑水肿的发生、发展,其表达和调控成为研究脑水肿的治疗靶点.

  8. 醒脑静联合纳络酮治疗对脑出血后水肿的影响%The Influence of Xingnaojing Combined with Naloxone for Edema after Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    戴启荷

    2013-01-01

    Objective:To investigate the influence of xingnaojing combined with naloxone for edema after cerebral hemorrhage. Methods:70 patients with cerebral hemorrhage were randomly divided into two groups.The treatment group (n=35) were treated by xingnaojing combined with naloxone,while the control group (n=35) were only treated with naloxone.The treatment duration lasted 14 days for both the groups.The total effective rates and the size of cerebral edema before and after treatment were compared.Results:The total effective rate of treatment group (88.6%) was significantly better than that of control group (71.4%)(P<0.05);The size of cerebral edema in treatment group was significantly smaller than that of control group after treatment(P<0.05).Conclusion:The treatment of xingnaojing combined with naloxone can significantly reduce brain edema and improve the clinical efficacy.It be worthy of clinical application.%  目的:观察醒脑静联合纳络酮治疗对脑出血后水肿的影响.方法:70例脑出血患者随机分为两组,治疗组(n=35)采用醒脑静联合纳络酮治疗,对照组(n=35)采用纳络酮治疗,两组疗程均为14天,比较两组治疗前后脑水肿大小及临床疗效.结果:治疗组总有效率88.6%,对照组总有效率71.4%,两组比较差异有显著性意义(P<0.05);治疗组治疗后的脑水肿体积明显小于对照组(P<0.05).结论:醒脑静联合纳络酮治疗脑出血可明显减轻脑水肿,提高临床疗效,值得临床推广应用.

  9. 脑出血后抑郁症状与甲状腺功能相关研究%Investigation of the relationship between thyroid function and depression occurred with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    何银华; 李飞; 金立钢; 颜宇飞

    2011-01-01

    Objective To investigate the relationship between depression and thyroid function in patients with acute cerebral hemorrhage.Methods 100 patients with primary cerebral hemorrhage were enrolled and classified into 2 groups (depression group and non-depression group) according to depression self rating scales (SDS) and Hamilton depression rating scale ( HAMD ).Triothyrone ( T3 ), thyroxine ( T4 ), free triothyrone ( FT3 ), free thyroxine ( FT4 ),thyrotropic-stimulating hormone ( TSH), anti thyroid peroxidase antibody (TPO-Ab) and anti thyroglobulin antibody ( TGAb) in serum were determined respectively.Results The levels of serum FT3 and TSH were lower, and FT4 was higher in depression group than in non-depression group ( P < 0.01 ).There was no significant difference between depression group and non-depression group in the levels of T3, T4, TPO-Ab and TG-Ab ( P > 0.05 ).Conclusions Depression symptoms occurred in the patients with acute cerebral hemorrhage are related with the changes of thyroid function.The levels of FT3, FT4 and TSH in serum may be the markers of depression in patients with acute cerebral hemorrhage.%目的 研究脑出血患者急性期抑郁症状与甲状腺功能的关系.方法 选择首次发病的急性脑出血患者100例,根据抑郁自评量表(SDS)和汉密尔顿抑郁量表(HAMD)评分结果 分为伴抑郁组和无抑郁组,分析2组患者血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPO-Ab)和抗甲状腺球蛋白抗体(TG-Ab)水平.结果 伴抑郁组患者血清FT3和TSH水平显著低于无抑郁组,FT4显著高于无抑郁组(P0.05).结论 急性脑出血患者抑郁症状可能与甲状腺功能变化有关,血清FT3、FT4和TSH可作为评价急性脑出血患者抑郁症状的客观指标.

  10. 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.

  11. 盐酸替扎尼定促进脑出血术后语言障碍康复2例%Tizanidine Hydrochloride Promoting the Rehabilitation of Language Disorder of Cerebral Hemorrhage after Operation in 2 Cases

    Institute of Scientific and Technical Information of China (English)

    郭耀良; 许仕海; 刘莉莉

    2014-01-01

    语障碍是脑出血病症所引发的常见并发症,对患者的日常正常生活会造成很严重的干扰,十分影响患者的生存质量,该症状的矫治恢复对患者社会生活有着重要的意义。盐酸替扎尼定是一种咪唑啉间二氮杂环戊烯衍生物,作为一种辅助用药,安全性较好,应用前景较广,对脑出血术后语言障碍的恢复有着明显的效果。本文通过2例康复实例简单分析下笔者的意见观点。%The language barrier is a common complicationof cerebral hemorrhage caused by disease, may cause interference is very serious to the daily normal life of the patient, very influence the life quality of the patients, thesymptoms of patients recovery treatment plays an important role in social life. Tizanidine hydrochloride is a kind of imidazoline between two nitrogen heterocyclicpentadiene derivative, as an adjunct to medication, good safety, wide application of cerebral hemorrhage,postoperative recovery of language barriers has obvious ef ect. This paper makes a simple analysis of the author'sopinions through 2 cases of rehabilitation case.

  12. 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.

  13. A comparative analysis 43 cases of intraoperative ultrasound as an auxiliary therapy for hypertensive cerebral hemorrhage%手术治疗高血压脑出血43例B超辅助与否对比分析

    Institute of Scientific and Technical Information of China (English)

    王小龙; 庞永斌; 衣志刚; 张国来; 白茫茫; 周志武

    2011-01-01

    目的:探讨术中B超辅助治疗高血压性脑出血的方法与疗效.方法:将43例需开颅清除血肿的中、重度高血压脑基底节区出血患者随机分为两组,治疗组:22例,术中在B超辅助下清除血肿;对照组:21例,行常规开颅清除血肿,术中不使用B超.并分析、比较两组患者的血肿清除率和临床疗效.结果:术中B超辅助下清除血肿组临床疗效良好率、血肿清除率均优于对照组(P<0.05).结论:术中B超辅助治疗高血压脑出血可显著提高血肿清除率及临床疗效.%Objective: This paper summarizes and explores the therapy and effect of intraoperative ultrasound as an auxiliary therapy for hypertensive cerebral hemorrhage. Methods; 43 cases of medium and severe hypertensive intracerebral ganglionic hematomas, which need clearance of hematoma. Were divided into two groups at random. Group A (experimental group): 22 cases of clearance of hematoma with the assistance of intraoperative ultrasound; Group B (control group): 21 cases of routine craniotomy, without intraoperative ultrasound. A contrast was made between the two experimental groups in clearance rates and curative effects.Results: Group A (experimental group) was superior to Group B( control group) in curative effect and clearance rate and the difference was of statistical significance (p<0. 05). Conclusion: Clearance rates and curative effects of treatment for hypertensive cerebral hemorrhage are remarkably increased with intraoperative ultrasound aa an auxiliary therapy.

  14. Observation Efficacy on Cerebral Hemorrhage Piracetam Sodium Chloride Injection Therapy%吡拉西坦氯化钠注射液治疗脑出血的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王明达

    2016-01-01

    Objective Piracetam sodium chloride injection to be applied to the efficacy of the treatment of cerebral hemorrhage were observed and analyzed. Methods From March 2014 to September 2015 in our hospital, 238 cases of cerebral hemorrhage patients were divided into 2 groups and test groups of 119 cases of patients were to be mannitol treatment, and topiramate levetiracetam sodium chloride treatment. For the treatment groups were observed. Results Observed after treatment, the experimental group of patients with total efficiency than the conventional group, in addition to intracranial pressure and neuropeptide Y levels lower than conventional group. Conclusion Observed after treatment, the experimental group of patients with total efficiency than the conventional group, in addition to intracranial pressure and neuropeptide Y levels lower than conventional group.%目的:对吡拉西坦氯化钠注射液应用于治疗脑出血患者的疗效进行观察和分析。方法选取2014年3月~2015年9月来我院就诊并接受治疗的238例脑出血患者,分为常规组和试验组,每组119例,分别予以甘露醇治疗和吡拉西坦氯化钠进行治疗,对两组患者治疗效果进行观察。结果经治疗后观察比较,试验组患者的总有效率优于常规组,此外颅压和神经肽 Y 水平低于常规组。结论吡拉西坦氯化钠注射液治疗脑出血能够获得较好效果。

  15. 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.

  16. Safety of anticoagulation after hemorrhagic infarction.

    Science.gov (United States)

    Pessin, M S; Estol, C J; Lafranchise, F; Caplan, L R

    1993-07-01

    Cerebral hemorrhagic infarction visualized on CT, secondary to embolic stroke in an anticoagulated individual, is usually associated with clinically stable or improving neurologic signs; fear of transforming the hemorrhagic infarction into a hematoma, however, usually prompts cessation of anticoagulation until the blood has cleared on CT, despite the recognized risk of recurrent embolism during this non-anticoagulated period. We now report our experience with 12 patients with hemorrhagic infarction who remained anticoagulated. Eleven men and one woman, ages 33 to 77, developed hemorrhagic infarction while on heparin, warfarin, or both, for prevention of recurrent embolism. Patients were either continued on uninterrupted anticoagulation from stroke onset (n = 6), or anticoagulation was withheld for several days and then resumed (n = 4), or it was withheld for 5 and 14 days (n = 2) after stroke onset and then continued uninterrupted despite the CT appearance of hemorrhagic infarction. Eleven patients had a definite cardioembolic source for stroke (atrial fibrillation, seven; ventricular thrombus, two; and ventricular dyskinesia, two). One patient had carotid occlusion with local intra-arterial embolism. Hemorrhagic infarcts varied in size and were located in the middle cerebral artery territory in 11 patients and posterior cerebral artery territory in one. All patients remained clinically stable or improved on anticoagulation. Serial CTs showed fading hemorrhagic areas. When the risk of recurrent embolism is high, anticoagulation may be safely used in some patients with hemorrhagic infarction.

  17. Logistic regression analysis on risk factors of cerebral hemorrhage complicated with stress ulcer%脑出血并发应激性溃疡危险因素的logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    薛翔; 刘红梅; 邵旦兵; 张炜; 任艺; 孙兆瑞; 林金锋; 聂时南

    2014-01-01

    cerebral hemorrhage complicated with stress ulcer (SU). Methods The clinical data of 1 185 patients with cerebral hemorrhage admitted to Department of Emergency Medicine of Nanjing General Hospital from March 2006 to March 2014 were retrospectively analyzed. Patients were divided into two groups according to whether patients complicated with SU or not. Data was collected within 8 hours after admission in two groups including gender,age,amount of bleeding,the bleeding site (basal ganglia,thalamus, brainstem,brain lobe,ventricle,subarachnoid,and cerebellum),disturbance of consciousness,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,systolic blood pressure(SBP),history of hypertension,and history of cerebral hemorrhage. The statistically significant risk factors found using univariate analysis was selected and was analyzed to find independent risk factors with multivariate logistic regression analysis. The receiver operating characteristic curve (ROC curve)was plotted to analyze the independent risk factors and evaluate their power of test. Results 1 185 patients with cerebral hemorrhage were enrolled in the study,293 cases occurred SU,accounting for 24.7%,and 892 cases without SU,which accounted for 75.3%. As shown by univariate analysis,risk factors for cerebral hemorrhage complicated with SU included age,amount of bleeding,the bleeding site,disturbance of consciousness,APACHEⅡscore,SBP. As to the site of bleeding,brain,thalamus,brainstem hemorrhage complicated with SU were higher proportion,45.3%(43/95),39.1%(63/161),36.9%(48/130),which were significantly higher than those of the lobes of the brain 〔26.2% (33/126)〕,cerebellum 〔18.8% (15/80)〕,basal ganglia〔16.1%(78/485)〕,arachnoid the inferior vena cava 〔12.0% (13/108)〕. Multivariate logistic regression analysis showed that amount of bleeding 〔odds ratio (OR)=3.305,P=0.001,95%confidence interval (95%CI)2.213-48.634〕,the bleeding site (OR=1.762,P=0.008,95%CI 0.123-2.743),SBP (OR=1

  18. 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.

  19. 脑出血大鼠血清白蛋白水平与肠黏膜变化的关系%Correlation between serum albumin level and intestinal mucosa change in rats with cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    王建林; 张苏明; 杨志秀; 张晓敏; 范云虎; 王静梅

    2010-01-01

    目的 探讨脑出血大鼠血清白蛋白水平与空肠黏膜形态学之间的关系.寻找导致低蛋白血症的机制.方法 制作脑出血大鼠模型.检测正常对照组、假手术组及脑出血组术后1、7、14 d(每组8只)血清白蛋白水平与空肠黏膜形态学的参数.进行血清白蛋白水平与空肠黏膜形态学的参数值之间的相关分析.结果 血清白蛋白与小肠绒毛高度(r=0.869,P<0.01)、绒毛面积(r=0.659,P<0.01)、黏膜厚度(r=0.915,P<0.01)、肠腺深度(r=0.545,P<0.05)及肠腺密度(r=0.475,P<0.05)呈正相关.结论 血清白蛋白水平与空肠黏膜形态学变化的关系密切.%Objective To explore the correlation between the serum albumin level and the jejunal mucosal morphology in rats with cerebral hemorrhage and to find out the mechanism of the resulting hypoproteinemia.Methods A rat model of cerebral hemorrhage was used to detect the serum albumin level and the morphologic parameters of jejunal mucosa on day 1,7 and 14 after the hemorrhage.The results were compared to the normal control group and the sham-operated group. The correlation between the serum albumin level and the parameters of the jejunal mucosal morphology was explored.Results The serum albumin level was positively correlated with the small intestinal villous height(r =0.869,P<0.01),villous area(r=0.659,P<0.01),mucosal thickness (r=0.915,P<0.01),depth of intestinal glands(r=0.545,P<0.05)and density of intestinal glands(r=0.475,P<0.05).Conclusion The serum albumin level is closely related to the morphologic changes of the jejunal mucosa.

  20. The influence of early rehabilitation on motor disorder after cerebral hemorrhage%早期康复训练对急性脑出血患者功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    张玉玲; 史莉瑾; 陈志军; 毛兴爱; 赵清英

    2008-01-01

    目的 探讨早期康复对急性脑出血患者运动功能障碍及生活能力的影响.方法 对60例急性脑出血患者分别进行基础治疗和基础治疗加早期运动康复与生活能力训练,于入院时和4 w时进行神经功能缺损程度测评以及日常生活能力的评定,组内及组间对比.结果 两组患者在生活能力和运动功能方面均有显著差异(P<0.01),康复组改善明显.结论 早期康复训练在促进患者肢体运动功能恢复及提高日常生活能力方面显著优于单纯药物治疗.%Objective To Busses8 the influence of early rehabilitation on motor disorder after cerebral hemorhage.Methods 60 case8 of cerebral hemorrhage were divided into two groups.One group received basic therapy.Except for basic therapy,early motor rehabilitation and education of life ability were used in the other group.The damnification of nerval function and life ability were estimated when patients entered the hospital and after4 weeks.Data were contrasted in group and between groups.Results The two groups had remarkable differences in life ability and motor function(P<0.01).The improve of the rehabilitation group Was very evidonee.Conclusion Early rehabilitation Was much better than single medicine therapy in the improvement of motor function and life ability.Rehabilitation in the 24 hours after cerebral hemorrhage Wma feasible and resultful.Methods in our hospital were very simple and effective.

  1. Comparative study on different minimally invasive surgery ofr hypertensive cerebral hemorrhage%不同微创钻孔手术治疗高血压性脑出血的疗效对比

    Institute of Scientific and Technical Information of China (English)

    崔杰; 李树祥; 乔柏林; 崔福义; 黄春刚; 徐常亮

    2014-01-01

    Objective To compare the efficacy of different minimally invasive operation on hypertensive cerebral hemor-rhage.Methods One hundred patients with hypertensive cerebral hemorrhage were chosen.Case-control retrospective study was used.Treatment group (n= 50) was treated by the minimally invasive puncture hematoma suction ,urokinase was used af-ter operation. The control group(n= 50) was treated by small bone window craniotomy for removal of hematoma. NIHSS score ,GOS scores ,and the differences of overall curative effect of two groups were compared. Results The length of stay in hospital ,and NIHSS score of the treatment group were lower than those of the control group (P< 0.05).At the 1 stday thechange of postoperative hematoma of the treatment group ,was more obvious than that of the control group ,but at the 7th day after surgery ,the changes of postoperative hematoma between the two groups had a statistical significance (P<0.05). The volume of finally residual hematoma of the treatment group was less than that of the control group.Conclusion The minimally invasive puncture hematoma suction combined with urokinase is an effective intervention and treatment of hypertensive cerebral hemorrhage ,and is worth of clinical popularization.%目的:比较不同微创钻孔手术治疗高血压性脑出血的临床疗效。方法纳入合格的高血压性脑出血患者100例。试验组(n=50)采用微创穿刺血肿抽吸术,术后用尿激酶。对照组(n=50)行小骨窗开颅血肿清除术。比较2组NIHSS评分、GOS评分以及疗效。结果试验组住院时间、NIHSS评分低于对照组(P<0.05)。术后1 d血肿变化,试验组明显多于对照组,但术后7 d时,2组比较差异有统计学意义(P<0.05)。试验组最终残留血肿量低于对照组。结论微创穿刺血肿抽吸术联合尿激酶是有效干预和治疗高血压性脑出血的手术方案,值得在临床中推广。

  2. 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...

  3. 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...... in conjunction with and after the induced SAH in rats. At 2 days after the SAH, cerebral arteries were harvested for quantitative real-time polymerase chain reaction, immunohistochemistry and analysis of contractile responses to endothelin-1 (ET-1; ET(A) and ET(B) receptor agonist) and 5-carboxamidotryptamine (5...

  4. 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

  5. Survey and analysis of patient's grasp of the disease-related knowledge and the lifestyle in 169 patients with cerebral hemorrhage%脑出血169例疾病知识与生活方式调查分析

    Institute of Scientific and Technical Information of China (English)

    张瑞敏; 米凯

    2012-01-01

    Objective: To explore the relationship between grasping of the disease - related knowledge and the lifestyle of patients with cerebral hemorrhage so as to implement nursing interventions to reduce the incidence of cerebral hemorrhage. Methods: 169 cerebral hemorrhage patients who were treated from January 2003 to December 2010 were selected and investigated by using the self - designed questionnaire on cerebral hemorrhage knowledge and questionnaire on lifestyle of patients with cerebral hemorrhage. Results: The patients grasp of disease - related knowledge was poor and they had obviously unhealthy lifestyle, the relationship between them was moderately and positively correlated (P<0. 05,P<0.01 );the lifestyle of female patients was better compared with that of male patients ( P < 0. 01 ). Conclusion : Propaganda and health education at all levels should be further strengthened to enable masses grasp the knowledge of disease widely, correct the unhealthy lifestyle and reduce the incidence of cerebral hemorrhage.%目的:探讨脑出血患者疾病知识掌握情况及与生活方式的关系,为减少脑出血发生率采取护理干预措施.方法:选择2003年1月~2010年12月收治的169例脑出血患者,采用自行设计的"脑出血相关疾病知识调查问卷"、"脑出血患者生活方式调查问卷"进行调查.结果:脑出血患者疾病知识掌握较差,存在明显不良生活方式,两者间呈中度正相关(P<0.05,P<0.01);且相对于男性,女性有较好的生活方式(P<0.01).结论:加强各级宣教,使广大群众掌握疾病知识,调整不良生活方式,降低脑出血的发病率.

  6. Initial diagnosis of the congenital disorder of glycosylation PMM2-CDG (CDG1a) in a 4-year-old girl after neurosurgical intervention for cerebral hemorrhage.

    Science.gov (United States)

    Stefanits, Harald; Konstantopoulou, Vassiliki; Kuess, Magnus; Milenkovic, Ivan; Matula, Christian

    2014-11-01

    The congenital disorder of glycosylation characterized by a deficiency of phosphomannomutase 2 (PMM2-CDG) is the most common variant of congenital disorders of glycosylation. Besides typical clinical features, such as dysmorphism and abnormal body fat distribution, coagulation abnormities often lead to thromboembolic and hemorrhagic events in these patients. However, only 2 cases of intracerebral bleeding in patients with PMM2-CDG have been described so far. A 4-year-old girl who initially presented with symptoms resulting from raised intracranial pressure underwent acute neurosurgical intervention for intracranial hemorrhage. The differential diagnoses after MRI included arteriovenous malformation and intraparenchymal brain tumor. However, clinical investigations promoted the diagnosis of PMM2-CDG, which was supported further by neuropathological findings and finally confirmed by isoelectric focusing and mutational analysis. No major complications or neurological deficits were evident after surgery, and the patient was able to attend an integrated kindergarten. Unexplained intracranial hemorrhage should raise suspicion of a metabolic disorder and should be discussed with specialists to rule out an orphan disease such as PMM2-CDG.

  7. 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

    into the prechiasmatic cistern in the rat. The activation of different MAPK and PKC isotypes in large circle of Willis cerebral arteries and intracerebral microvessels was examined at 0, 1, 3, 6, 12, 24, and 48 hours after SAH and after intrathecal treatment with PKC or MAPK inhibitor by use of Western blot. RESULTS...

  8. 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.

  9. 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

    OpenAIRE

    1998-01-01

    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 tratam...

  10. 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.

  11. Effects of nimodiping on delayed cerebral vasospasm after traumatic subarachnoid hemorrhage%尼莫地平治疗外伤性蛛网膜下腔出血后脑血管痉挛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    曹永胜; 程宏伟; 冯春国

    2011-01-01

    Objective: To investigate the clinical efficacy and safety of nimodiping on delayed cerebral vasospasm after traumatic subarachnoid hemorrhage ( tSAH) . Methods: Eighty patients with tSAH were randomly divided into nimodiping treatment group and control group. While the routine treatments of decreasing intracranial pressure, stopping bleeding, nutrition for nerve and so on, were used in two groups, the nimodiping was added through intravenous administration ( 1 mg/h) in treatment group. Two weeks later, nimodiping were continuously used through oral administration ( 30 mg tid) for 12 - 24 weeks. And then, the examination of color doppler were performed to observe hemodynamic changes of the middle cerebral artery at 24 hours, 72 hours, the seventh, fourteenth day. Glasgow outcome scale after three months of the treatments was observed and analysed. Results: The levels of cerebral vasospasm and prognosis were significant difference between nimodiping treatment group and control group (P < 0. 05). Conclusions: Nimodiping can obviously prevent cerebral vasospasm and improve outcome of patient's after tSAH.%目的:观察尼莫地平对治疗外伤性蛛网膜下腔出血(tSAH)后脑血管痉挛的疗效.方法:80例tSAH患者随机分为对照组和尼莫地平组各40例.均进行常规降颅压、止血、营养神经等治疗,尼莫地平组在常规治疗基础上加用尼莫地平1 mg/h微量泵入,2周后改为尼莫地平片剂30 mg,每天3次持续使用12~24周.并于治疗后24 h和72 h、7 d和14 d应用经颅多普勒观察伤后大脑中动脉血流动力学变化及3个月后哥拉斯哥昏迷预后评分.结果:尼莫地平组脑血管痉挛程度及预后与对照组差异有统计学意义(P<0.05).结论:尼莫地平对tSAH后脑血管痉挛的防治效果明显,并改善患者预后.

  12. [Alveolar hemorrhage].

    Science.gov (United States)

    Parrot, A; Fartoukh, M; Cadranel, J

    2015-04-01

    Alveolar hemorrhage occurs relatively rarely and is a therapeutic emergency because it can quickly lead to acute respiratory failure, which can be fatal. Hemoptysis associated with anemia and pulmonary infiltrates suggest the diagnosis of alveolar hemorrhage, but may be absent in one third of cases including patients in respiratory distress. The diagnosis of alveolar hemorrhage is based on the findings of a bronchoalveolar lavage. The causes are numerous. It is important to identify alveolar hemorrhage due to sepsis, then separate an autoimmune cause (vasculitis associated with antineutrophil cytoplasmic antibody, connective tissue disease and Goodpasture's syndrome) with the search for autoantibodies and biopsies from readily accessible organs, from a non-immune cause, performing echocardiography. Lung biopsy should be necessary only in exceptional cases. If the hemorrhage has an immune cause, treatment with steroids and cyclophosphamide may be started. The indications for treatment with rituximab are beginning to be established (forms that are not severe and refractory forms). The benefit of plasma exchange is unquestionable in Goodpasture's syndrome. In patients with an immune disease that can lead to an alveolar hemorrhage, removing any source of infection is the first priority.

  13. 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 .

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 基底节区脑出血患者急诊的CT表现及手术选择分析%Analysis of CT Findings and Surgical Selection of Emergency Patients with Cerebral Hemorrhage in Basal Ganglia

    Institute of Scientific and Technical Information of China (English)

    刘明蓉; 李立为; 张东友

    2016-01-01

    Objective To explore the CT findings of emergency patients with cerebral hemorrhage in basal ganglia and the reference value of CT in surgical selection of patients.Methods 75 patients with cerebral hemorrhage in the basal ganglia treated in the neurosurgery department of our hospital from August 2011 to August 2014 were treated as the research objects. All patients underwent double-slice spiral CT to make clear CT typing of patients and the prognosis was evaluated with ADL.Results Among the 19 patients undergoing traditional craniotomy, the percentage of grade (Ⅰ+Ⅱ) patients was 84.2%. In 31 cases of patients undergoing small bone window minimally invasive craniotomy, grade (I+II) patients accounted for 80.6%.The difference was not statistically significant (P<0.05). In 50 patients, 41 patients had better prognosis which was grade I or II and CT typing results of the patients mainly were type I, II and Ⅲ of which the number of cases was 1, 7 and 16. The rate of good prognosis was 92.3%. The rate of good prognosis in 24 cases of type IV and type V patients was 70.8%. The difference was statistically significant (P<0.05), which indicated that the lower CT type was, the better prognosis was.Conclusion The application of CT in diagnosis of cerebral hemorrhage in basal ganglia is of significant features and it can provide reference for early diagnosis and surgical selection and can predict prognosis. It is worthy of promotion and application.%目的:探析基底节区脑出血患者急诊CT表现及对手术选择的参考价值。方法选择我院神经外科2011年8月-2014年8月收治75例基底节区脑出血患者为例,均行双层螺旋CT检查,明确患者CT分型并应用ADL量表评估预后。结果19例传统开颅手术患者中,(Ⅰ+Ⅱ)级患者所占百分率为84.2%,31例小骨窗微创开颅患者的(Ⅰ+Ⅱ)级患者所占百分率为80.6%,差异无统计学意义(P<0.05)。50例患者中,共41例患者预后较佳,为Ⅰ

  20. Green Channel in the Emergency Rescue Hypertension Cerebral Hemorrhage Patients to Explore the Value%急诊绿色通道在抢救高血压脑出血患者中的价值探讨

    Institute of Scientific and Technical Information of China (English)

    曾贵成

    2013-01-01

    Objective to study retrospectively the green channel in the rescue hypertension cerebral hemorrhage patients in clinical application value.Methods a retrospective analysis in our hospital rescue hypertension cerebral hemorrhage patients 126 cases material, according to whether to of prehospital emergency treatment group: of prehospital emergency treatment group 66 examples, not of prehospital emergency treatment group of 60 cases first aid after statistical patients mortality, final y statistical methods to test the dif erences have statistical significance.Results the death of prehospital emergency treatment group 7 cases (10.6%), not of prehospital emergency treatment group of death 23 cases (38.3%), statistical methods to test showed that with statistical dif erence (P<0.05). 1 hours emergency person 2 cases died (5.6%), 1~5 hours the first aid death 10 cases (20%).Conclusion emergency green channel in the rescue hypertension cerebral hemorrhage patients play an important role, is to reduce the mortality of patients with first aid ef ective means.%目的探讨急诊绿色通道在抢救高血压脑出血患者中的临床应用价值。方法回顾性分析在我院抢救高血压脑出血患者126例病例资料,按照是否进行院前急救分组:院前急救组66例,非院前急救组60例,急救后统计患者死亡率情况,再按急救时间分组:1h内急救者36例,1~5h内急救者50例,5h以上者40例,急救后统计患者死亡率,最后统计学方法检验各组间的差异是否具有统计学意义。结果院前急救组死亡7例(10.6%),非院前急救组死亡23例(38.3%),统计学方法检验表明具有统计学差异(P<0.05)。1h内急救者死亡2例(5.6%),1~5h内急救者死亡10例(20%),5h以上者死亡19例(47.5%)。结论急诊绿色通道在抢救高血压脑出血患者中发挥重要作用,是降低患者急救死亡率的有效手段。

  1. 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

  2. 中枢性低钠血症与非创伤性脑出血的相关研究%Research of central hypornatremia and spontaneous cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    刘晓燕; 刘国荣; 樊恩雷

    2012-01-01

    目的 研究中枢性低钠血症与非创伤性脑出血患者的预后及出血部位的关系.方法 分析397例脑出血患者,分为低钠血症及正常血钠两组,研究其死亡率差异以及低钠血症与出血部位的关系.结论 397例患者中58例患者发生低钠血症,1例诊断抗利尿激素分泌异常综合征(SIADH),57例为脑耗盐综合征(CSWS),死亡10例,采用χ2检验,低钠血症死亡率高于正常血钠组(P=0.014,P<0.05),低钠血症与死亡率呈正相关(Pearson相关系数r =0.123);两组脑出血部位分布不同,低钠血症患者中蛛网膜下腔出血多于基底节区出血,频数差异有显著性(P=0.01,P<0.0125).结果 中枢性低钠血症发生与脑出血部位相关,中枢性低钠血症中CSWS较SIADH更易发生.低钠组患者死亡率明显增高,血钠水平可预测疾病危险程度.%Objective Studying the relationship of motality and bleeding part in cerebral hemorrhage patients obtained hyponatremia. Methods Reviewed 397 patients of spontaneous cerebral hemorrhage in two years , 58 cases obtained hyponatremia among them. Analysed the motality and parts distribution in two gropes. Results 58 cases obtained hyponatremia among 397cases, one of them diagnosed SIADH,the other 57 cases were CSWS. Using x2-test, mortility of patinat obtiained hyponatremia is higher than those in normal blood sodiumin ( P = 0. 014, P < 0.05; Pearson 's R = 0. 123 ). Parts distribution of hyponatremia was different in two groups ( P = 0. 01, P < 0.0125 ). Conclusions CSWS is more common than SIADH in hyponatremia. Morbility of hyponatremia is related to bleeding parts.

  3. 微创穿刺引流术治疗高血压脑出血患者的护理体会%Nursing experience of patients with hypertensive cerebral hemorrhage treated by minimally invasive puncture drainage

    Institute of Scientific and Technical Information of China (English)

    王力伟; 李学良; 周晓满; 湛金梅; 郝晓; 付刚; 史琳

    2014-01-01

    目的:总结32例高血压脑出血患者行微创穿刺引流术的护理经验。方法应用微创颅内血肿粉碎穿刺针对32例高血压脑出血患者进行血肿抽吸、粉碎冲洗、液化及引流,并采取积极的术前及术后护理方法。结果本组治愈16例(50%),显著进步8例(25%),进步4例(12.5%),无变化2例(6.25%),死亡2例(6.25%),总有效率为87.5%。结论微创颅内血肿穿刺术治疗高血压脑出血疗效确切,加强基础护理、密切监测病情、预防和及时发现潜在并发症、及早进行康复锻炼、家庭访视,对患者预后起着积极作用,可提高患者生活质量。%Objective To summarize the experience of 32 patients with hypertensive cere-bral hemorrhage treated by minimally invasive puncture drainage.Methods Minimally invasive intracranial hematoma needle was used to pump,crush and flush,liquidate and drain hematoma. There were 16 cured cases (50%),8 improved cases (25%),4 progressive cases (12.5%),2 un-changed cases (6.25%)and 2 died patients (6.25%),the total effective rate was 87.5%.Con-clusion Minimally invasive treatment of intracranial hematoma puncture for hypertensive cerebral hemorrhage could strengthen basic nursing,closely monitor of the disease,prevent and timely de-tect potential complications,early do rehabilitation exercises,conduct home visits early.So it could promote the prognosis of patients and enhance the quality of life of patients.

  4. 浅谈冠心病合并高血压脑出血的护理方法%Nursing care of coronary heart disease complicated with hypertension cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙淑萍

    2014-01-01

    目的:探讨冠心病合并高血压脑出血的临床护理对策。方法选取我科室收治的68例冠心病合并高血压脑出血的患者进行治疗并进行分析讨论,随机将其分两组,对一组患者实施常规护理措施设为对照组,对另一组患者在实施常规护理基础上给予有效的护理措施为观察组,比较两组患者的神经功能、运动功能以及并发症的发生率。结果观察组患者经过有效的护理对策干预后,并发症的发生率、神经功能以及运动功能均明显优于对照组,经比较差异显著(P<0.05),有临床统计学意义。结论实施有效的护理对策干预于措施能够提高冠心病合并高血压脑出血患后患者的临床疗效,减少并发症的发生率,提高患者的满意度及术后生活质量。%Objective to explore the clinical nursing of coronary heart disease complicated with hypertension cerebral hemorrhage. Methods our department treated 68 cases ofcoronary heart disease complicated with hypertension cerebral hemorrhage were treated and analyzed, and randomly divided two groups, one group were given routine care measures set as control group, nursing measures. for the observation group to another group of patients treated in the implementation of the basis of conventional care, incidence rates were compared between the two groups of neurological function,motor function and complications. Results the observation group patients aftereffective nursing measures after the intervention, the incidence of neurologicalcomplications, and motor function were signiifcantly better than the control group, the difference was signiifcant (P<0.05), clinical signiifcance. Conclusion nursingcountermeasures of effective intervention measures to improve the clinical efifcacy inpatients with coronary heart disease complicated with hypertension cerebralhemorrhage patients, reduce the incidence of complications, improve patient satisfaction and

  5. Propofol and Midazolam in Acute Cerebral Hemorrhage Surgery%丙泊酚与咪达唑仑在急性脑出血手术中的应用效果对比

    Institute of Scientific and Technical Information of China (English)

    王晓军

    2015-01-01

    目的:探讨丙泊酚与咪达唑仑在急性脑出血手术中的应用效果。方法将86例急性脑出血患者分为为丙泊酚组和咪达唑仑组,各43例,分别给予丙泊酚和咪达唑仑静-吸麻醉,观察两组患者血压、心率、血氧饱和度等相关指标变化情况。结果丙泊酚组麻醉后MAP、HR均恢复至正常水平,且与术前比较差异有统计学意义( P0.05)。丙泊酚组麻醉后CaO 2、CE O 2等氧和情况与术前相比均有一定改善(P0.05)。结论丙泊酚麻醉效果优于咪达唑仑,且有降压、改善氧合、护脑等作用。%Objective Discuss the potency of propofol and midazolam in acute cerebral hemorrhage surgery. Methods The 86 acute cerebral hemorrhage sufferers were equally divided to groups of propofol and midazolam. They were anaesthetized by propofol and midazolam, resp. Measures of blood pressure, heart rate, and oxygen saturation were observed among two groups. Results MAP and HR returned to normal after the propofol group was anaesthetized, and it was statistically meaningful to compare that before the surgery(P0. 05). Enormous improvement in oxygen saturation, such as CaO2 and CE O2, was achieved in the propofol group after the surgery(P0. 05). Conclusion Anesthetic effect of propofol is better than that of midazolam. And the propofol is conducive to blood pressure reduction, oxygenation improvement, and brain care.

  6. The effect of prehospital emergency care in the treatment of patients with severe hypertensive cerebral hemorrhage%院前急救在重症高血压脑出血患者救治中的作用

    Institute of Scientific and Technical Information of China (English)

    毕学志; 王国兴; 黄富

    2015-01-01

    Objective To explore the effect of prehospital emergency care in the treatment of patients with severe hy-pertensive cerebral hemorrhage. Methods Retrospectively analyzed the clinical data and follow-up results of 143 patients , they were divided into two groups (study group and control group) according to whether received prehospital emergency care. Comparatively analyzed the preoperative time, aspiration and pulmonary infection rate, decompressive craniotomy rate, GOS score and mortality rate between the two groups. Results The preoperative time of study group that received prehospital e-mergency care was shorter than control group (P0.05), but the mortality rate of study group was lower than control group (P<0.05). Conclusion The prehospital emergency care has an important role in the treatment of patients with severe hypertensive cerebral hemorrhage , which can give appropriate treatment to patients earlier and reduce mortality effectively.%目的:探讨院前急救在重症高血压脑出血患者救治中的作用。方法回顾性分析143例重症高血压脑出血患者的临床资料及随访结果,根据患者是否进行院前急救分为研究组与对照组,比较分析两组患者的术前时间、误吸及肺部感染发生率、去骨瓣减压率、GOS评分及死亡率。结果行院前急救的研究组患者术前时间较短(P<0.05),误吸及术后肺部感染率、因脑肿胀而行去骨瓣减压率较低(P<0.05),两组患者GOS评分差异无统计学意义(P>0.05),但研究组患者的死亡率低于对照组(P<0.05)。结论院前急救在重症高血压脑出血患者的救治中有重要作用,可使患者更早地得到合适的治疗并降低死亡率。

  7. An Investigation on Severe Hypertensive Cerebral Hemorrhage of Prehospital Care in Primary Hospital%基层医院重症高血压性脑出血院前救护效果分析

    Institute of Scientific and Technical Information of China (English)

    覃华勤

    2013-01-01

    Objective:To analyze the successful rescue rate importance of the patients with fast and effective method on severe hypertension cerebral hemorrhage in Prehospital care. Methods:Totally 166 cases of the emergency department from 2008 January to 2011 December were divided into 2 groups. Prehospital first aid patients were in observation group, Families admitted were in the control group, Statistics the death toll within 24 hours after. Hospitalization . Results:In 106 cases, 18 cases of death in prehospital first aid, mortality is 17% . In 60 cases, 26 cases of death in families admitted, mortality is 43% .Conclusion:The mortality differences between prehospital emergency measures disposing and not disposing of the patients have significant differences(P<0.01). These Descriptors that Prehospital emergency and safety transfer is the key to reduce severe hypertensive cerebral hemorrhage prehospital patients' mortality, and improve the success rate.%  目的:探讨基层医院快速有效的对重症高血压性脑出血病人院前救护对提高病人抢救成功率的重要性.方法:对急诊科2008年1月~2011年12月收治的166例病人分成2组.院前急救病人为观察组,家属自行送入医院的为对照组,统计入院抢救后24小时内死亡人数.结果:经院前救护的106例中死亡18例,死亡率17%,未经院前救护家属自行送入的60例中死亡26例,死亡率43%.结论:经过院前急救措施处置的重症高血压性脑出血病人死亡率与未经院前处置的病人死亡率差异有统计学意义(P<0.01),说明院前急救、安全转送是降低重症高血压性脑出血院前死亡率,提高抢救成功率的关键.

  8. 综合护理对高血压脑出血患者肺部感染的预防效果观察%Observation of the Effect of Comprehensive Nursing on Pulmonary Infection in Patients With Hypertensive Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张萍萍

    2016-01-01

    Objective To observe the comprehensive nursing to prevent hypertension cerebral hemorrhage patients with pulmonary infection. Methods 102 patients with hypertensive cerebral hemorrhage were randomly divided into experimental group and control group, respectively adopt comprehensive care and routine nursing. Results experimental lung infection rate and quality of life scores were better than control group (P<0.05). Conclusion Comprehensive nursing in patients with hypertension cerebral hemorrhage, the effect is better.%目的:观察综合护理对预防高血压脑出血患者肺部感染的护理效果。方法102例高血压脑出血患者被随机分成实验组与对照组,分别采取综合护理和常规化护理。结果实验组肺部感染率与生活质量评分均优于对照组(P <0.05)。结论对高血压脑出血患者实施综合护理,效果较好。

  9. Computed tomography and intracranial hemorrhages in the neonate

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Iekado; Kushida, Yoshimasa; Shishido, Masaru; Nagasawa, Sadatsugu; Seiki, Yoshikatsu (Toho Univ., Tokyo (Japan). School of Medicine)

    1983-02-01

    Thirty-two of 290 neonates admitted to the Perinatal Intensive Care Unit, Toho University Medical School, were examined by CT scan because of tentative clinical diagnosis of intracranial hemorrhage. CT scanner employed in this study was TCT-60 A from the Toshiba The Electric Co., Ltd. Fourteen cases (44%) were confirmed by the CT scan to have intracranial hemorrhage. Four cases had hemorrhage in the ventricle, while the remaining ten cases had subarachnoid hemorrhage. Subdural hemorrhage was not revealed in our series. Three of the four cases with intraventricular hemorrhage showed a typical subependymal germinal matrix hemorrhage. The prognosis of intraventricular hemorrhage in neonates seemed to be poor; two of the four cases died within a week. Their body weight at birth was apparently under the standard, and their Apgar score was 3 points. The subarachnoid hemorrhage was the main type of intracranial neonatal hemorrhages. In our series, it was constituted approximately 70% of the intracranial hemorrhages. The CT images of the subarachnoid hemorrhage in neonate were greatly different from those in adults. An irregular, wide high-density area around the falxtentorial junction was characteristic of the CT in many neonatal subarachnoid hemorrhages. In severe subarachnoid hemorrhages, a characteristic Y-shaped, high-density figure was demonstrated. In cases of subarachnoid hemorrhage from the deep venous system, high-density spreading immediately ventral to the falx-tentrium junction was demonstrated. These high-density areas due to blood in the subarachnoid space rapidly disappeared with the lapse of time. On the other hand, high-density areas in cerebral cisterns and/or fissures were rarely demonstrated in neonatal subarachnoid hemorrhages. The prognosis of subarachnoid hemorrhage in neonates was fairly good in the sense of life and cerebral functions.

  10. 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...

  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-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...

  12. Influence of clinical nursing pathway on rehabilitation effect in patients with cerebral hemorrhage hemiparalysis%临床护理路径对脑出血偏瘫患者康复效果的影响

    Institute of Scientific and Technical Information of China (English)

    尚金红

    2016-01-01

    目的 探究与分析临床护理路径对脑出血偏瘫患者康复效果的影响.方法 选取本院自2013年7月至2015年7月收治的90例脑出血偏瘫患者,按照就诊时间顺序分为常规护理组与临床护理路径组,每组45例.常规护理组给予基础护理对策,包括入院时宣教、介绍病情、观察病情变化等;临床护理路径组指派至少由1名护士长及3名以上护理人员建立临床护理路径小组,由护士长组织组内人员系统性的学习并加强脑出血偏瘫后康复护理的相关知识,根据每位患者的个体情况给予评估,并对每个阶段后的康复护理效果给予评价.对比两组患者康复护理效果、活动能力、肢体功能及负面情绪评分.结果 临床护理路径组的护理效果总有效率明显高于常规护理组,差异具有统计学意义(P<0.05).两组患者治疗后较治疗前相比Barthel评分及Harris评分均明显升高,临床护理路径组较常规护理组相比Barthel评分及Harris评分升高更加明显,差异具有统计学意义(P<0.05).两组患者治疗后较治疗前相比HAMA评分及HAMD评分评分均明显降低,临床护理路径组较常规护理组相比HAMA评分及HAMD评分降低更加明显,差异具有统计学意义(P<0.05).结论 临床护理路径可有效提高脑出血偏瘫患者的护理效果,促进改善日常活动能力及肢体功能,降低负面情绪.%Objective To explore and analyze the influence of clinical nursing pathway on rehabilitation effect in patients with cerebral hemorrhage hemiplegia.Methods 90 cerebral hemorrhage patients with hemiplegia treated at our hospital from July,2013 to July,2015 were selected and divided into a routine nursing and a clinical nursing pathway group according to the hospitalization time sequence,45 cases for each group.The routine nursing group were given basic nursing countermeasures,including propaganda and education on admission,introducing disease conditions

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

    Institute of Scientific and Technical Information of China (English)

    马艳萍

    2015-01-01

    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。%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.

  14. 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。

  15. 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)。

  16. Hemorrhagic complications of thrombolytic therapy in experimental stroke.

    Science.gov (United States)

    Slivka, A; Pulsinelli, W

    1987-01-01

    Recent success with thrombolytic therapy for acute myocardial infarction has stimulated interest in its use for stroke. To determine the hemorrhagic potential of thrombolytic therapy in experimental cerebral infarction, we compared a group of tissue plasminogen activator-treated rabbits (n = 4) with 2 groups of streptokinase-treated rabbits (n = 6 in each), as well as with 3 groups of heparin-treated rabbits (n = 5 in each) and untreated controls (n = 12). Focal cerebral infarction was produced in rabbits by occlusion of the right common carotid and middle cerebral arteries coupled with 2 hours of halothane-induced hypotension. Treatment with heparin or thrombolytic agents began 24 hours after occlusion. One additional group was treated with streptokinase 1 hour after occlusion (n = 6) to determine the hemorrhagic potential of thrombolytic agents in evolving infarction. Rabbits were killed 29-33 hours after occlusion, and brain sections were examined using light microscopy. The results demonstrate that microscopic hemorrhage is frequently present in infarcted tissue irrespective of treatment. Gross cerebral hemorrhage did not occur in untreated rabbits or in rabbits treated with streptokinase 1 hour after occlusion. Only rabbits treated with streptokinase, tissue plasminogen activator, or excessive doses of heparin 24 hours after occlusion, at a time when cerebral infarction was well established, exhibited gross hemorrhage in the area of infarction. These data suggest that treatment of ischemic stroke with thrombolytic agents carries an increased risk of cerebral hemorrhage unless the agents are given early after the onset of symptoms.

  17. Influence of neuroplasticity of rat cerebral hemorrhage by bone marrow mesenchymal stem cells transplantation%骨髓间充质干细胞移植对大鼠脑出血后神经可塑性的影响

    Institute of Scientific and Technical Information of China (English)

    单泓; 李建斌; 刘敏; 戚正; 王姣杰; 韩小改; 梁会涛

    2013-01-01

    of rats. Results Much new neuron and neurogliocyte were observed around cerebral hemorrhage in BMSCs group by transmission electron microscope. The number of neurosynaptic increased obviously. The curvature of synaptic boundary magnified and dense area of postsynatic thicken. The gap of cynapse narrowed obviously. Compared with control group, it was statistically significant (P<0.01). The expression of Shank1 protein around cerebral hemorrhage increased in BMSCs group. Compared with control group, it was statistically significant. The expression of Nestin positive cells around cerebral hemorrhage were detected in BMSCs group. There is no Nestin positive cells in control group. The neurological scores of BMSCs group was significantly decreased. Compared with control group, it was statistically significant. Conclusion The BMSCs transplantation can repair the nervous tissue,strengthen the plasticity of nerve and promote the recovery of neural function.

  18. 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

  19. A preliminary study on the selection criteria of drainage and craniotomy for patients with supratentorial cerebral hemorrhage%幕上脑出血患者钻孔引流和开颅手术选择标准的初步探讨

    Institute of Scientific and Technical Information of China (English)

    乔建勇; 王昌盛; 武焕颖; 韩广明; 郭伟伦

    2012-01-01

    共288 例幕上脑出血患者分别接受钻孔引流术(140 例)和血肿清除术(148 例).通过分析术前意识状态分级和出血量与6 个月后患者病残率和病死率间的关系,获得钻孔引流术与神经外科手术之间的分界标准,并探讨幕上脑出血患者的合理手术方式.%The study involved a total of 288 patients with supratentorial cerebral hemorrhage who were surgically treated. Among them 140 patients underwent trepanation and drainage, and the other 148 patients underwent evacuation of hematoma. Through analyzing Glasgow Coma Scale (GCS) and the volume of hemorrhage before operation and after 6 months were related with the patients' disability rate and mortality rate. The delimitation standards of drainage and craniotomy were explored, and the reasonable techniques of supratentorial cerebral hemorrhage were investigated.

  20. 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-

  1. 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...

  2. 脑桥出血早期患者脑皮质结构变化的磁共振研究%Magnetic resonance imaging of structural change in the cerebral cortex for early pons hemorrhage patients

    Institute of Scientific and Technical Information of China (English)

    莫本成; 张自力; 敖锋; 刘振华; 杨凡; 李华菊

    2016-01-01

    目的:探讨脑桥出血早期患者脑皮质结构变化,并分析与感觉运动功能损伤的相关性。方法选择2014年5月至2015年3月本院接诊的16例脑桥出血患者进行研究将其作为观察组,选取同期16例健康者作为对照组。观察组患者入院后给予结构磁共振( MRI)检测,通过基于体素形态学方法对MRI的结构数据进行分析,比较两组患者大脑灰质体积区域的改变。并通过相关性分析患者脑皮质结构的改变与运动感觉功能的关系。结果两组患者在年龄与性别方面差异无统计学意义( P>0.05);观察组的轻触觉评分、针刺觉评分以及运动评分均低于对照组,两组比较差异具有统计学意义( P<0.001);基于体素形态学方法分析结果显示,观察组的双侧初级感觉中心、初级运动中心及其辅助运动区发生了灰质体积减小的现象( P<0.05);观察组结构异常区域萎缩发生程度经相关分析与轻触觉评分、针刺觉评分以及运动评分无相关性( P>0.05)。结论脑桥出血早期患者初级感觉中心、初级运动中心及其辅助运动区发生了灰质萎缩,但是萎缩程度与患者轻触觉评分、针刺觉评分以及运动评分无关。%Objective To evaluate the structural change in the cerebral cortex for early pons hemorrhage patientsandanalysissensorymotorfunctionimpairement.Methods 16patientswithpontinehemorrhagefromMay 2014 to March 2015 in our hospital were researched as observer group.Select the same period 16 cases of healthy people as a control group.After admission, observation group structure of magnetic resonance detection, analysis the method based voxel morphology structure of magnetic resonance data,compare two groups of patients with brain gray matter volume area change, And through the correlation analysis of structural changes in the patients with cerebral cortex and the relationship between the

  3. 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.

  4. Cerebral hemorrhage with central hyponatremia in 25 cases%脑出血并发中枢性低钠血症25例临床分析

    Institute of Scientific and Technical Information of China (English)

    张国华; 张艳华; 单若莹

    2009-01-01

    Objective To investigate the pathogenesis, diagnosis and treatment of central hy-ponatremia. Methods According to their clinical presentation and laboratory examination,25 cases who diagnosed as central hyponatremia were exerted different treatments;then observed their curative effect.Results The patients of syndrome of inappropriate antidiuretic hormone (SIADH) were limited liquid supplement, while the patients of cerebral salt wasting syndrome (CSWS) were supplied adequate liquid and salt. All patients' hyponatremia were corrected. Conclusions Central hyponatremia has two differ-ent clinical manifestation and treatments, accurate recognitionand treatment of central hyponatremia have significant clinical meanings.%目的 探讨中枢性低钠血症的发病机制、诊断和治疗方法.方法 在25例脑出血后中枢性低钠血症患者中,通过其临床表现及实验室检查明确诊断,并给予不同的治疗,观察其临床疗效.结果 抗利尿激素分泌不当综合征应限水治疗,脑性盐耗综合征应补水和补盐治疗,全部病例低钠血症均得到纠正.结论 中枢性低钠血症有两种不同表现形式,且治疗方法不同.正确认识和处理中枢性低钠血症有重要临床意义.

  5. 高血压脑出血患者护理的伦理困境和对策%Ethical Dilemmas and Countermeasures in Hypertensive Cerebral Hemorrhage Patient Nursing

    Institute of Scientific and Technical Information of China (English)

    俞素卿; 娄志玲; 季林玲; 邵吉红; 周莉丽

    2012-01-01

    高血压脑出血因其致死率和致残率高,导致预期治疗效果与患者实际状况之间、医院诊疗结果与传统死亡观之间、患者亲属之间产生一系列伦理冲突,也使密切和他们接触的护理人员不得不面对伦理困境.建议护理人员尊重生命,尊重患者和家属的价值观和信仰,加强护理管理,合理安排护理人员编制,加强伦理知识的学习和应用,促进护患和谐,提高患者和家属的生活质量.%Hypertension cerebral hemorrhage patients have high fatality rate and disability rate, which resulted in the ethical conflicts between treatment expection and the patients actual condition, hospital diagnosis results and the traditional view of life and death, and between the patients and their families, also bring some dilemmas for nursing staff who have close contact with them. This paper proposed that nursing staff should show respect for the values and believes of patients and their families'concept, enhancing care management, rationalizing the arrangements of nursing management and strengthening the learning and application of ethics knowledge so as to establish a harmonious relationship between the nursing staff and patients and thus improve the life quality of patients their families.

  6. 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.

  7. 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 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

    2016-06-01

    Protein Z (PZ) and factor (F) VII are two important factors in the clotting pathway which have similar structure, linked function and nearby gene sites. The aims of this study were to investigate whether the common variants of PZ and FVII genes are associated with the risk of cerebral hemorrhage (CH) and to explore the combined effects of PZ and FVII polymorphisms for CH risk. We performed genotyping analysis for two single-nucleotide polymorphisms (SNPs) of FVII (rs510317 and rs6046) and three SNPs of PZ (rs2273971, rs3024718 and rs3024731) both in a population-based case-control study and in a family-based association study. Case-control analysis found no evidence of significant association. But family-based association 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, and four haplotypes carrying or crossing the 'A' allele of PZ rs2273971: haplotypes CA, ACAA, ACAT and ACAAT of PZ and FVII 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 genetic evidences that PZ and FVII genes, especially PZ rs2273971 are involved in the development of CH in Han-Chinese families.

  8. 肝硬化患者并发上消化道出血和急性脑梗塞临床分析%Clinical characteristics of patients with liver cirrhosis complicated by upper gastrointestinal hemorrhage and acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    郭秀丽; 徐有青

    2011-01-01

    Objective To investigate the clinical characteristics of patients with liver cirrhosis complicated by upper gastrointestinal hemorrhage (UGH)and acute cerebral infarction (ACI).Methods The patients with UGH and ACI were compared with those without.Results The risk factors included the amount of gastrointestinal bleeding(x2=24.238, P<0.01), lienectomy(x2=37.10, P<0.01) , Child- Pugh scores and ascites (x2=29.002,P<0.01),arteriosclerosis and use of antifibrinolytic agent.Conclusions For the patients with liver cirrhosis, the risk factors for ACI should be taken into consideration to prevent its occurrence.%目的 探讨肝硬化并发上消化道出血和急性脑梗死的临床特点.方法 比较肝硬化上消化道出血并发急性脑梗死与同期肝硬化消化道出血未合并脑梗塞患者的临床特点.结果 消化道出血量(x2=24.238,P<0.01)、脾切除手术(x2=37.10,P<0.01)、Child-Pugh分级、腹水量(x2=29.002,P<0.01)、动脉硬化因素和应用强力抗纤溶药物在梗塞组与非梗塞组之间差别明显.结论 肝硬化患者在上消化道出血后,应尽早评估并发脑梗塞的危险因素,以预防急性脑梗塞的发生.

  9. Efficacy Observation of the Sequential Therapy of Traditional Chinese Medicine for Hypertensive Cerebral Hemorrhage%中药序贯治疗高血压性脑出血的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王中甫; 王静雅

    2011-01-01

    OBJECTIVE: To observe the clinical efficacy of traditional Chinese medicine for hypertensive cerebral hemorrhage. METHODS: 179 patients with hypertensive cerebral hemorrhage were randomly divided into study group (90 cases) and control group (89 cases). Two groups were treated by routine western medicine, such as to reduce blood pressure and keep the stability of the vital sign during acute phase, rehabilitative exercises during convalescence. Study group was additionally given sequential therapy of traditional Chinese medicine using Tongqiao huoxue decoction of acute phase and Buyang huanwu decoction of convalescence phase as routine therapy. We record the survival status for 90 days, changes of hematoma volume for 14 days, score of neurological impairment before treatment, 14 days, 30 days and 90 days after treatment, and evaluation of ability of daily living (ADL) for 90 days after treatment. RESULTS: (1) Survival rate of study group and control group were 83.3% and 79.8% (Kaplan Meier method), respectively, Log Rank (Mantel-Cox)x2=0.359,P=0.549. (2)Hematoma absorption, reduction, fixation or enlargement were 24 cases, 46 cases and 12 cases in study group at 14 days, and 10 cases, 56 cases and 14 cases in control group (Z=-2.092, P=0.036). (3)The score of neurological impairment of both groups were decreasing,F=503.114,P=0.000; The decrease of the score of neurological impairment in study group was more significant than control group, F= 178.481 ,P=0.000. The trend of the score of neurological impairment of both groups were not parallel,F=11.816,P=0.000. (4) Possibility of grade Ⅰ ADL in study group was 1.992 times as in control group (Wald x2=5.184,P=0.023). CONCLUSION: The sequential therapy of traditional Chinese medicine for hypertensive cerebral hemorrhage could accelerate hernatoma absorption, protect nerve cell, and improve ability of daily living.%目的:观察中药治疗高血压性脑出血的临床效果.方法:将179例高血压脑出

  10. 急性期脑出血病人早期综合康复治疗效果的临床观察%THE CLINICAL OBSERVATION OF EFFECT OF EARLY COMPREHENSIVE REHABILITATION IN HEMIPLEGIC PATIENTS WITH ACUTE CEREBRAL HEMORRHAGE

    Institute of Scientific and Technical Information of China (English)

    董欣敏; 齐晓飞; 毛永军

    2011-01-01

    目的:观察早期综合康复治疗对急性期脑出血偏瘫病人功能恢复的影响.方法:将90例急性期脑出血病人随机分为康复组和对照组,两组病人均同时接受常规药物治疗.其中康复组60例,病情稳定48h后(发病7d内)即依据病人不同情况分别进行生物反馈训练(电刺激)、肢体功能训练、语言训练等综合个体化的康复治疗.对照组病人30例,不接受康复治疗.治疗前及治疗开始后30、60、90d分别采用美国国立卫生院卒中量表(NIHSS)、改良量表(MRS)、卒中影响量表(SIS)对病人日常生活活动能力(ADL)、残疾程度、生活质量状况进行评定.结果:治疗前康复组和对照组在NIHSS、MRS、SIS评分均无差异(P>0.05);治疗30d后两组ADL、残疾程度、生活质量状况与治疗前比较有显著差异( P<0.01) ;康复组改善更明显,与对照组比较有显著性差异( P<0.01) ;治疗60、90d随访,两组仍有显著差异,康复组改善程度明显优于对照组,组间差异有统计学意义(P<0.01).结论:急性期脑出血病人进行早期综合康复治疗,能显著改善病人日常生活活动能力,降低致残率,提高病人生活质量.%Objective: To observe the effect of early comprehensive rehabilitation on recovery of hemiplegic patients with acute cerebral hemorrhage.Methods :90 patients with acute cerebral hemorrhage were randomly divided into rehabilitation group and control group.Patients were both received conventional drug treatment in two groups.Patients in rehabilitation group were evaluated on their conditions and treated with individualized comprehensive rehabilitation including electrical stimulation,physical functional training, language training, etc.The rehabilitation group (60 cases) shows stable vital signs, stable condition (seven days after onset within).The control patients (30 cases) did not receive rehabilitation treatment.Instead of evaluation by the U.S.National Institutes of Health Stroke

  11. 西藏地区脑出血危险因素及预后10年趋势分析%Trend analysis of risk factors and prognosis of cerebral hemorrhage in Tibet in 10 years

    Institute of Scientific and Technical Information of China (English)

    李泽文; 潘冬生; 邱克军; 秦妍; 贾红运

    2015-01-01

    Objective To analyze the basic characteristics , risk factors and prognosis of cerebral hemorrhage in high-altitude area of Tibet in the last 10 years, and to summarize the therapeutic experience .Methods The patients with cerebral hemorrhage to receive treatment in General Hospital of Tibet Military Command from 2002 to 2012 were selected as the research subjects and divided into two groups per five years;and then, the clinical data in the two groups were compared and analyzed .Results According to the comparison between the two groups , the annual average number of the hospitalized people was 61 from 2002 to 2007, but it increased to 143 from 2007 to 2012, and the males decreased from 75% to 66%, while the females increased from 25% to 34% in the same periods (P<0.01); the ratio of smoking patients decreased from 38% to 29% (P <0.01), and the ratio of application of antihypertensive drugs in patients increased from 13%to 27%(P<0.01);the hospitalization period was shortened from 21d to 16 d (P<0.05).Modified Rankin scale (mRS) was used to assess the recovery of neurological function , and the ratio of patients of mRS 0-3 increased from 43% to 58% (P <0.01), while that of mRS 4-5 decreased from 46% to 34% (P <0.01).Conclusion Although the number of patients with cerebral hemorrhage in Tibet has increased in recent years , the prognosis was improved overall;the reason maybe due to that the health consciousness of the residents , the medical equipment , and the methods of treatment have been improved.%目的:分析西藏高海拔地区过去10年脑出血的基本特征、危险因素及预后,并总结其治疗经验。方法以西藏军区总院2002~2012年收治的脑出血病例每5年分成一组,对前后二组临床资料进行对比分析。结果后5年组与前5年组对比,住院人数从2002~2007年的年均61例增加至2007~2012年的年均143例,男性比例从75%下降至66%,而女性比例从25%增加至34%(P<0.01

  12. 吡拉西坦氯化钠注射液治疗脑出血的临床疗效分析%Analysis of Clinical Efficacy of Piracetam Sodium Chloride Injection in the Treatment of Cerebral Hemor-rhage

    Institute of Scientific and Technical Information of China (English)

    程蓓

    2014-01-01

    [Objective] To explore the clinical efficacy of piracetam sodium chloride injection in the treatment of pa-tients with cerebral hemorrhage .[Methods] Totally 120 patients with cerebral hemorrhage in our hospital from Aug . 2010 to Aug .2012 were chosen and randomly divided into two groups .The experiment group( n=60) was treated with 20% piracetam sodium chloride injection 100ml by fast infusion every 6~8h for continuous 7d ,and then instilled by rou-tine velocity for 7d after 7d .The control group( n=60) was treated with intravenous injection of 20% mannitol 125ml every 6~8h for continuous 7d .All patients received consecutive monitoring of intracranial pressure .The changes of in-tracranial pressure ,plasma neuropeptide Y and neural function deficit score before ,7d and 14d after treatment were ob-served .[Results] There was no significant difference in intracranial pressure before treatment between experiment group and control group( P>0 .05) .Compared with before treatment ,intracranial pressure in two groups after drug therapy were obviously decreased ,and there was significant difference between before and after treatment ( P0 .05) .Compared with before treatment ,neural function deficit score and neuropeptide in two group were obviously decreased ,and there was significant difference between before and after treatment ( P<0 .05) .Neural function deficit score and neuropeptide in experiment group were decreased more obviously than that in control group ,and there was significant difference ( P<0 .05) .[Conclusion]Piracetam sodium chloride injection for the treatment of patients with cerebral hemorrhage can obviously reduce intracranial pressure ,improve the nerve function deficit score and markedly de-crease plasma level of neuropeptide .%【目的】探讨应用吡拉西坦氯化钠注射液治疗脑出血患者的临床效果。【方法】选择本院2010年8月至2012年8月间进行诊治的120例脑出血患者,将其随

  13. Relationship of matrix metallo proteinase-9 dynamic expression at different time points with brain edema after cerebral hemorrhage%脑出血后不同时间点基质金属蛋白酶-9的动态变化及其与脑水肿的关系

    Institute of Scientific and Technical Information of China (English)

    崔巍; 谈颂; 许晓辉; 宋波; 许予明

    2010-01-01

    目的 探讨血清基质金属蛋白酶-9(MMP-9)水平在脑出血后不同时间点的动态变化在脑水肿形成过程中的作用.方法 采用放射免疫法检测90例符合纳入标准的急性脑出血患者及80例正常对照者24 h、72 h、7 d 和14 d时血清MMP-9水平,分析其在脑水肿形成过程中的作用.结果 脑水肿在入院72 h时达高峰,之后缓慢下降.在发病24 h 内患者血清MMP-9含量已明显升高,发病后72 h达高峰,与脑水肿高峰一致;7 d下降明显,与对照组比较均明显升高(P<0.01),第14天接近正常水平.血清MMP-9水平在脑出血后24 h、72 h与水肿体积、水肿比值呈正相关(P<0.01).结论 脑出血后血清MMP-9随着时间动态变化,MMP-9与脑水肿体积相关,与相对水肿体积相关性更强.%Objective To study the effect of dynamic expression at different time points of metallo proteinase-9 on brain edema after cerebral hemorrhage. Methods Serum levels of MMP-9 in 90 patients with brain hemorrhage and 80 normal patients were detected by radioimmunoassay on 24 h、72 h、7 d and 14 d.The relationship between levels of MMP-9 and brain edema after cerebral hemorrhage.Results Brain edema went up to the peak at 72 h and slowly decline after it. At 24 h, the serum level of MMP-9 were significantly higher, and reached the peak at 72 h according to the peak of cerebral edema, and then decreased significantly after 7 d. Cerebral hemorrhage group compared with the control group were significantly higher(P<0.01). The level of MMP-9 close to normal levels on 14 d. MMP-9 was positive correlated with edema volume and edema ratioat 24 h and 72 h (P=0.01).Conclusions Serum MMP-9 dynamic changes over time after cerebral hemorrhage. The level of MMP-9 was correlated with the brain edema volume and had more stronger correlation with relative size of brain edema. MMP-9 was correlated with inflammation after cerebral hemorrhage.

  14. 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.

  15. 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。

  16. 高血压脑出血偏瘫患者早期肢体康复训练及护理效果观察%The clinical therapeutic effect of early limb rehabilitation training on hypertensive cerebral hemorrhage hemiplegia patients

    Institute of Scientific and Technical Information of China (English)

    万宝珍; 徐雪梅

    2015-01-01

    Objective: To explore the clinical therapeutic effect of early limb rehabilitation training on hypertensive cerebral hemorrhage hemiplegia patients. Methods: 100 patients of hypertensive cerebral hemorrhage hemiplegia, admitted to our hospital from April 2013 to June 2015, were randomized into the observation group and the control group evenly. The control group received routine treatment while the observation group received an early limb rehabilitation training, the therapeutic effects were compared. Results: The total efficiency of the observation group(96.0%) was significantly better than that of the control group(80.0%), the difference was statistically significant (P<0.05). Conclusion:The early limb rehabilitation training had a remarkable effect in treating hypertensive cerebral hemorrhage hemiplegia patients and it was worth clinical application.%目的:分析临床高血压脑出血偏瘫患者行早期肢体康复训练的临床效果.方法:选取我院2013年4月—2015年6月接收高血压脑出血偏瘫100例患者作为调查对象,分成两组,对照组行基础疗法,研究组行早期肢体康复训练疗法,于临床预后评定疾病效果.结果:研究组患者预后疾病缓解率96.0%高于对照组80.0%,存在临床差异(P<0.05).结论:临床针对高血压脑出血偏瘫患者行早期肢体康复疗法作用显著,可加快康复进度,改善神经缺损度,值得借鉴.

  17. 糖尿病对脑梗死出血转化及不同分型发生率的影响%The effect of diabetes on the incidence of hemorrhagic transformation of cerebral infarction and different types

    Institute of Scientific and Technical Information of China (English)

    张跃武

    2016-01-01

    目的:探讨糖尿病对脑梗死出血转化及各分型发生率的影响,为临床制定诊疗方案及预后评估提供有价值的资料。方法回顾性分析运城市中心医院及平陆县人民医院神经内科2011年1月—2015年6月间收治的495例临床资料完整的脑梗死住院患者,根据是否有糖尿病将所入选患者分为糖尿病组及非糖尿病组,通过查阅患者影像及临床资料,观察2组住院期间脑梗死出血转化发生率及不同分型出血转化发生率情况。结果糖尿病组153例中发生出血转化76例(49.7%),其中脑实质血肿型21例(13.8%);非糖尿病组342例中发生出血转化113例(33.0%),其中脑实质血肿型17例(5.0%),2组比较差异具有统计学意义(P<0.01)。结论糖尿病能增加脑梗死出血转化的发生,并能增加更具临床意义的脑实质血肿型出血转化的发生。%ObjectiveTo investigate the effect of diabetes on the incidence of Hemorrhagic transformation(HT)of cerebral infarction and different types,and to improve the understanding of the effect of diabetes on HT of cerebral infarction,in order to provide valuable data for making diagnosis and treatment plan and prognosis evaluation.Methods Retrospective analysis of 495 cases of clinical patients in neurological department of Central Hospital of Yuncheng city and People's Hospital of Pinglu County from January,2011 to Jun 2015,clinical data were complete in inpatients with cerebral infarction. The patients were divided into diabetes group and non-diabetes group. Observe incidence of HT in two groups, at the same time observe the different classification of HT in two groups.ResultsIn 495 cases,76 (49.7%)cases in 153 cases of diabetes group occur HT,Among them 21(13.8%)cases occur PH;113(33.0%)cases in 342 cases of non-diabetes group occur HT,Among them 17(5.0%)cases occur PH,both chi-square test,P<0.01,the difference is statistically significant

  18. 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.

  19. 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.

  20. 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

  1. 吡拉西坦联合甘露醇治疗脑出血后脑水肿的效果观察%Observation of the effect of piracetam combined with mannitol in the treatment of patients with brain edema after cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    赵宝顺

    2015-01-01

    目的:观察吡拉西坦联合甘露醇治疗脑出血后脑水肿的效果。方法:收治脑出血后脑水肿患者84例,随机平分为两组,对照组予以甘露醇治疗,观察组联合吡拉西坦治疗,观察并比较两组临床疗效及脑水肿体积情况。结果:观察组治疗总有效率80.95%高于对照组的59.52%,且治疗后脑水肿体积低于对照组(P<0.05)。结论:吡拉西坦联合甘露醇治疗脑出血后脑水肿效果显著,可有效减小脑水肿体积,降低颅内压,从而促进患者的神经功能恢复。%Objective:To observe the effect of piracetam combined with mannitol in the treatment of patients with brain edema after cerebral hemorrhage.Methods:84 patients with brain edema after cerebral hemorrhage were selected.They were randomly divided into the two groups with 42 patients in each group.Patients of the control group received mannitol treatment,and the observation group combined with piracetam for treatment.The clinical curative effect and cerebral edema volume of the two groups were observed and compared.Results:The total effective rate of the observation group of 80.95% was higher than the control group of 59.52% ,and the cerebral edema volume after treatment was lower than the control group(P<0.05).Conclusion:Piracetam combined with mannitol in the treatment of patients with brain edema after cerebral hemorrhage has significant effect can effectively reduce the volume of brain edema,and reduce intracranial pressure,in order to promote the recovery of neurological function.

  2. Efficacy of Piracetam Injection Combined With Mannitol in the Treatment of Cerebral Edema After Intracerebral Hemorrhage%吡拉西坦注射液联合甘露醇治疗脑出血后脑水肿的疗效观察

    Institute of Scientific and Technical Information of China (English)

    师卫中

    2015-01-01

    目的:探讨吡拉西坦注射液联合甘露醇治疗脑出血后脑水肿的疗效。方法选自本院2013年7月~2014年7月收治64例脑出血后脑水肿患者,采用随机抽样法分为两组,予对照组32例甘露醇治疗,予观察组32例吡拉西坦注射液联合甘露醇治疗,比较两组疗效。结果两组治疗8d、20d后脑水肿体积均缩小,但观察组脑水肿体积在8d、20 d时均小于对照组,比较差异具有统计学意义(P<0.05);且两组均未发生严重不良反应(P>0.05)。结论吡拉西坦注射联合甘露醇能够有效治疗脑出血后脑水肿。%Objective To discuss the effect of piracetam injection combined with mannitol in the treatment of cerebral edema after intracerebral hemorrhage. Methods 64 cases of cerebral edema after intracerebral hemorrhage patients in July 2013~2014 July in our hospital were divided into two groups by random sampling, 32 cases in the control group were treated with mannitol, 32 cases in observation group were treated with piracetam injection combined with mannitol therapy, compared the effect between two groups. Results After treatment for 8 d, 20 d, cerebral edema volume were reduced, but the cerebral edema volume in 8 d and 20 d in observation group were less than the control group, the difference had statistically signiifcant (P0.05) . Conclusion Piracetam injection combined with mannitol are effective treatment for cerebral edema after intracerebral hemorrhage.

  3. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    Science.gov (United States)

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

  4. [Infratentorial hemorrhage following supratentorial surgery].

    Science.gov (United States)

    Tomii, M; Nakajima, M; Ikeuchi, S; Ogawa, T; Abe, T

    1999-10-01

    Hemorrhage in regions remote from the site of initial intracranial operations is rare, but does occur. We report three cases of cerebellar hemorrhage that developed after supratentorial surgery, all of which had similar clinical findings and CT images. The first case was a 37-year-old man with a craniopharyngioma in the suprasellar lesion. Partial removal of the tumor was performed through frontal craniotomy and the translaminaterminals approach. A large quantity of cerebospinal fluid (CSF) was suctioned from the third ventricle during the operation, resulting in marked brain shrinkage. The second and third cases were 34- and 51-year-old women with unruptured right middle cerebral aneurysms. Clipping of the aneurysms through the pterional approach was performed in both cases. In the second case, CSF was suctioned in large quantity from the carotid and prechiasmal cistern at the operation, resulting in marked brain shrinkage. In the third case, however, only a small volume of CSF was suctioned from the carotid and prechiasmal cistern during the operation, and no marked brain shrinkage was observed. CT scan showed that the hematomas were located mainly in the subdural or the subarachnoid spaces over the cerebellar hemisphere and partially extending into the cerebellar cortex. The mechanism of cerebellar hemorrhage in these series of patients was thought to be multifactorial. The possible etiology for cerebellar hemorrhage in the three cases presented was examined, including the role of CSF suction during surgery and disturbance of venous circulation in the posterior fossa. Suction of the CSF may cause intracranial hypotension. Further reduction of intracranial pressure leads to an increased transluminal venous pressure. There was no episode of hypertension or disturbed blood coagulation during or after the operation. The preoperative angiogram also revealed no abnormality at the region of the posterior fossa. Neuroimaging of infratentorial hemorrhage after

  5. [Intracranial hemorrhage during hemorrhagic disease of the newborn infant at term].

    Science.gov (United States)

    Moyoukolo, J; Retbi, J M; Allemon, M C; Semaan, N; J'Mii, B

    1990-01-01

    The authors report a case of intra-cerebral hematoma in a patient with hemorrhagic disease of the newborn. This hematoma had to be taped, and after that, an hydrocephalus shunted. The state of deficiency of vitamin K in the newborn should be treated systematically. The oral route is as good as the intra-muscular route for the baby.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Cerebral Vasospasm Pharmacological Treatment: An Update

    OpenAIRE

    Ioannis Siasios; Kapsalaki, Eftychia Z; Fountas, Kostas N

    2013-01-01

    Aneurysmal subarachnoid hemorrhage- (aSAH-) associated vasospasm constitutes a clinicopathological entity, in which reversible vasculopathy, impaired autoregulatory function, and hypovolemia take place, and lead to the reduction of cerebral perfusion and finally ischemia. Cerebral vasospasm 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 for preventing or reversing cerebral vasosp...

  11. 微创碎吸术手术时机对高血压脑出血患者血清 IL-6、TNF-α水平的影响%The influence of minimally invasive aspiration operation time on the clinical effect,serum IL-6,TNF-αlevel in pa-tients with hypertensive cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    房晓勇; 郭春光; 李志涛; 房巧英; 王金丽; 张秋菊; 李桂文

    2015-01-01

    Objective To explore the influence of minimally invasive aspiration operation time on the clinical effect , serum IL-6,TNF-αlevel in patients with hypertensive cerebral hemorrhage .Methods 220 patients with hypertensive cerebral hemorrhage were randomly divided into observation group and control group ,110 cases of each .All patients were treated by diu-resis dehydration ,blood sugar and blood pressure control ,neurotrophic therapy and other symptomatic treatment .The observa-tion group was received minimally invasive aspiration operation in 6 hours after hypertensive cerebral hemorrhage , while the control group was treated after hypertensive cerebral hemorrhage 6 hours but in 24 hours.The serum level of IL-6 and TNF-α, therapy effect of two groups were tested and compared the differences .Results Total effective rate of observation group (91.82%) was higher than that of the control group (74.55%),the difference was statistically significant (P0.05). After treatment ,the serum levels of two groups were significantly lower than that before treatment , and with the extension of treatment time,serum IL-6 and TNF-αlevels decreased gradually .The serum IL-6 and TNF-αlevels in treatment of 2, 3, 5,7d were lower than the control group ,the differences were statistically significant (P<0.05).Conclusion Taking the minimally invasive aspiration operation within 6 hours after hypertensive cerebral hemorrhage can improve the effectiveness .%目的:探讨微创碎吸术手术时机对高血压脑出血患者血清IL-6、TNF-α水平的影响。方法将220例高血压脑出血患者随机分为观察组及对照组各110例。2组患者均常规给予脱水降颅内压、控制血糖和血压及神经营养支持等治疗。观察组患者脑出血6h内进行微创碎吸术手术,对照组患者脑出血6~24h内进行微创碎吸术手术。检测2组患者手术前后血清IL-6及TNF-α的含量水平,并比较2组的临床疗效。结果观察组总有效率为91

  12. 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

  13. 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

  14. 高血压脑出血无创颅内压及脑灌注压监测临床研究%Monitoring noninvasive intracranial pressure and cerebral perfusion pressure in treatment of patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张文德; 张湘; 邹志浩; 吴勤奋; 殷捷; 王建江; 郑玺; 莫拉丁

    2012-01-01

    Objective To evaluate clinical significance of monitoring noninvasive intracranial pressure (NICP) and cerebral perfusion pressure (CPP) in treatment of patients with hypertensive intracerebral hemorrhage. Methods This clinical randomized controlled trial enrolled 120 patients with hypertensive intracerebral hemorrhage who had sought medical treatment in our department from June 2008 through May 2010. They were randomized equally into a monitoring group where NICP and CPP were continuously monitored before and after operation and a non-monitoring group where no monitoring of NICP and CPP was performed. Results In the monitoring group,increased NICP and decreased CPP were shown in 50 patients and only 10 patients were shown with normal NICP (<26.6mmHg) and CPP (> 124.3 mm Hg). The abnormal NICP and CPP continuously monitored were treated with specific interventions like further operation or medication. In the non-monitoring group,patients received only conventional treatments.According to the Glasgow Outcome Scale (GOS), 31 patients (51.7%) had good recovery,20 (33.3%) were moderately disabled,5 (8.3%) severely disabled and 4 (6.7%) dead in the monitoring group while 23 (38.3%) patients had good recovery,18 (30.0%)were moderately disabled,10 (16.7%) severely disabled and 9 (15.0%) dead in the non-monitoring group.The outcomes of the monitoring group were significantly better than those of the non-monitoring group (P<0.05). Conclusion Continuous monitoring of NICP and CPP before and after operation should be performed in the treatment of patients with hypertensive intracerebral hemorrhage because it is helpful for clinical medication and reducing complications and mortality as well.%目的 探讨高血压脑出血手术前后监测无创颅内压(NICP)、脑灌注压(CPP)变化的临床意义. 方法 收集解放军第474医院神经外科自2008年6月至2010年5月收治的120例高血压脑出血手术患者,按照随机数字表法分为

  15. 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

  16. 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.

  17. 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

  18. 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%.

  19. Rodent neonatal germinal matrix hemorrhage mimics the human brain injury, neurological consequences, and post-hemorrhagic hydrocephalus

    OpenAIRE

    2012-01-01

    Germinal matrix hemorrhage (GMH) is the most common neurological disease of premature newborns. GMH causes neurological sequelae such as cerebral palsy, post-hemorrhagic hydrocephalus, and mental retardation. Despite this, there is no standardized animal model of spontaneous GMH using newborn rats to depict the condition. We asked whether stereotactic injection of collagenase type VII (0.3 U) into the ganglionic eminence of neonatal rats would reproduce the acute brain injury, gliosis, hydroc...

  20. Therapeutic implications of melatonin in cerebral edema.

    Science.gov (United States)

    Rathnasamy, Gurugirijha; Ling, Eng-Ang; Kaur, Charanjit

    2014-12-01

    Cerebral edema/brain edema refers to the accumulation of fluid in the brain and is one of the fatal conditions that require immediate medical attention. Cerebral edema develops as a consequence of cerebral trauma, cerebral infarction, hemorrhages, abscess, tumor, hypoxia, and other toxic or metabolic factors. Based on the causative factors cerebral edema is differentiated into cytotoxic cerebral edema, vasogenic cerebral edema, osmotic and interstitial cerebral edema. Treatment of cerebral edema depends on timely diagnosis and medical assistance. Pragmatic treatment strategies such as antihypertensive medications, nonsteroidal anti-inflammatory drugs, barbiturates, steroids, glutamate and N-methyl-D-aspartate receptor antagonists and trometamol are used in clinical practice. Although the above mentioned treatment approaches are being used, owing to the complexity of the mechanisms involved in cerebral edema, a single therapeutic strategy which could ameliorate cerebral edema is yet to be identified. However, recent experimental studies have suggested that melatonin, a neurohormone produced by the pineal gland, could be an effective alternative for treating cerebral edema. In animal models of stroke, melatonin was not only shown to reduce cerebral edema but also preserved the blood brain barrier. Melatonin's beneficial effects were attributed to its properties, such as being a potent anti-oxidant, and its ability to cross the blood brain barrier within minutes after its administration. This review summarizes the beneficial effects of melatonin when used for treating cerebral edema.

  1. Relationship between alexithymia and depression in patients with cerebral hemorrhage%述情障碍与脑出血患者抑郁的相关性分析

    Institute of Scientific and Technical Information of China (English)

    颜敏素; 毛小丹

    2014-01-01

    Objective :To explore the relationship between alexithymia and depression in patients with cerebral hemorrhage (CH) .Methods:All 206 patients with CH were subjected to a questionnaire survey by Toronto alexi-thymia scale (TAS) and Hamilton depression scale (HAMD) one week after operation ,and divided into the depres-sion group and non-depression group according to the HAMD .Firstly ,the general information was compared be-tween the two groups ,and then the Pearson correlation analysis and multivariate linear regression analysis were used to explore the effect of alexithymia on depression .Results :57 .28% (118/206) and 41 .26% (85/206) patients with CH suffered depression and alexithymia ,respectively .The affective disorder of recognition ,affective disorder of de-scription ,extroverted thinking and the total score of TAS in the depression group were significantly higher than those in the non-depression group (P<0 .05) .Pearson correlation analysis revealed that the HAMD was positively correlated with TAS score ,the affective disorder of recognition ,affective disorder of description ,extroverted think-ing (r=0 .389 ,0 .374 ,0 .281 and 0 .456 respectively ,P<0 .05) .Multivariate linear regression analysis showed that affective disorder of recognition and extroverted thinking were the influencing factors of depression in patients with CH (P<0 .05) .Conclusions:Alexithymia was an influencing factor of depression in patients with CH .%目的:探讨述情障碍与脑出血患者抑郁的相关性。方法:采用多伦多述情障碍量表(TAS)和汉密尔顿抑郁量表(HAMD)对206例脑出血患者进行问卷调查,据此分为抑郁组和非抑郁组。首先,单因素分析比较2组基本资料的差别,然后采用多层回归分析法,探讨述情障碍对脑出血患者抑郁的影响。结果:脑出血患者抑郁和述情障碍发生率分别为57.28%(118/206)和41.26%(85/206)。抑郁组TAS识别情感障碍、描述

  2. Viral Hemorrhagic Fevers

    Science.gov (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. Virus Families Information ... 2014 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases ( ...

  3. Application of timing nursing care in the treatment of patients with hypertensive cerebral hemorrhage and observation on its efficacy%时间护理在高血压脑出血患者中的应用及效果观察

    Institute of Scientific and Technical Information of China (English)

    江淑萍

    2012-01-01

    目的:探讨时间护理在高血压脑出血患者中的应用方法及临床效果.方法:将86例高血压脑出血患者按照随机数字表法分为干预组和对照组各43例,对照组给予常规护理,干预组在常规护理基础上实施时间护理.对比分析两组临床疗效、护理前后肢体运动、生活自理能力情况及护理满意度.结果:干预组临床疗效、肢体运动功能、日常生活自理能力及护理满意度均优于对照组(P<0.05).结论:时间护理可提高高血压脑出血患者的治疗效果及护理满意度,值得临床推广使用.%Objective: To explore the approaches and clinical effect of timing nursing care in the treatment of patients with hypertensive cerebral hemorrhage. Methods: 86 patients with hypertensive cerebral hemorrhage were divided into an intervention group and a control group ( 43 cases in each group ) according to random number table. The routine nursing care was taken in the control group and the timing nursing care was additionally implemented in the intervention group. The clinical efficacy,limb movements before and after nursing care, activities of daily living and patients satisfaction with nursing care were analyzed and compared between the two groups. Results:The clinical efficacy,limb motor function,activities of daily living and patients satisfaction were better in the intervention group than those in the control group ( P <0. 05 ). Conclusion:The timing nursing care can improve the curative effect and patients satisfaction in the treatment of hypertensive cerebral hemorrhage.

  4. Prognostic impact and cleaning effectiveness of inflammatory factors with blood purification in patients with cerebral hemorrhage%血液净化对脑出血患者炎症因子的清除作用和预后的影响

    Institute of Scientific and Technical Information of China (English)

    付志新; 张津华; 赵燕; 何蕴

    2012-01-01

    目的 观察血液净化对于脑出血患者血中炎症因子的清除作用以及对于预后的影响.方法 112例脑出血患者按照是否进行血液净化分为两组:血液净化组(A组)50例,住院期间进行血液净化治疗;常规治疗组(B组)62例,住院期间未进行血液净化治疗.比较未进行血液净化和血液净化后3、7、14 d的SIRS情况以及CRP 、IL-6和TNF-α的差异,并比较两组患者病死率.结果 A组患者经血液净化治疗3、7、14 d后SIRS好转率高于B组,CRP、IL-6和TNF-α水平低于B组,病死率低于B组,两组比较差异均有统计学意义.结论 血液净化可以清除脑出血患者的炎症因子,改善预后.%Objective To invesligale the prognostic impact and inflammatory factors cleaning effectiveness of blood purification in palienls with cerebral hemorrhage. Methods 112 cerebral hemorrhage palienls were divided into 2 groups; group A (n =50) were given blood purification therapy, and group B ( n = 62) were not given blood purification therapy. Syslemic inflammatory response syndrome (SIRS) , blood serum level of C - reactive prolein(CRP) , inlerleukin - 6(IL - 6) and tumor necrosis faclor - α(TNF - α) were compared belween two groups on the 3,7, 14 d After the beginning of blood purification therapy. And the mortality of two groups was also compared. Results SIRS amelioration rale were super in the group A than in the group B, while the blood serum level of CRP, IL - 6 and TNF - α. Were lower in the group A than in the group B on the 3,7, 14 d after the beginning of blood purification therapy. The mortalily of the group A were lower than that of the group B. Conclusion Blood purification can scavenge the inflammatory factors and improve the prognosis in patienls with cerebral hemorrhage.

  5. 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.

  6. 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。

  7. A Comparison of Curative Effect of Ganglioside and Piracetam in treatment of Patients with Hypertensive Cerebral Hemorrhage%神经节苷酯与吡拉西坦治疗高血压性脑出血的疗效比较

    Institute of Scientific and Technical Information of China (English)

    李学良; 郝晓

    2011-01-01

    目的 对比研究单唾液酸神经节苷酯与吡拉西坦治疗高血压性脑出血的效果.方法 将96例急性高血压性脑出血的患者分为神经节苷酯组和吡拉西坦组,每组48例.神经节苷酯组给于神经节苷酯40 mg/d静脉滴注;吡拉西坦组给予吡拉西坦20 g/d静脉滴注,3周为1个疗程.两组患者均给于脱水降颅压、维持电介质平衡、调控血压及防治并发症等治疗.比较两组治疗后神经功能缺损及日常生活活动能力的改善情况.结果 3周后两组临床疗效比较差异有统计学意义(P<0.05).结论 神经节苷酯治疗高血压性脑出血有良好的疗效,能促进脑出血患者的神经功能恢复,提高生活质量.%Objective To observe the effects of ganglioside and piracetam in improving the neurological function in patients with hypertensive cerebral hemorrhage.Methods Ninety-six patients with hypertensive cerebral hemorrhage Were randomly divided into 2 groups,ganglioside group(48 patients)and piracetam group(48 patients).Ganglioside group used the amount 40mg ganglioside mixed with sodium chloride injection(100ml,concentration 0.9%),and the piracetam group uesd piracetam(20g)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 3 weeks,the general information and the improvement of nerve were observed.Results The effective rate and excellent rate of ganglioside group were remarkably higher than piracetam group,there was significant difference between the two groups(P<0.05).Conclusion Ganglioside was better than pimcetam in improving clinical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage.

  8. 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.

  9. Term neonate with intracranial hemorrhage and hereditary hemorrhagic telangiectasia: a case report and review of the literature.

    Science.gov (United States)

    Delaney, H M; Rooks, V J; Wolfe, S Q; Sawyer, T L

    2012-08-01

    Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by mucocutaneous telangiectases and arteriovenous malformations (AVMs). The disease rarely presents in the neonatal period, primarily manifesting with epistaxis and gastrointestinal bleeding in adulthood. Occasionally, HHT can also present with symptoms related to AVMs in the cerebral, pulmonary or gastrointestinal vasculature. In prior reports, intracranial hemorrhage (ICH) secondary to cerebral AVM in neonates with HHT has been catastrophic and uniformly fatal. Here we report a case of a newborn with HHT and ICH from a suspected AVM who survived with aggressive medical management and surgical intervention, and provide a comprehensive review of the literature on ICH in neonates with HHT.

  10. Did Robert Louis Stevenson have hereditary hemorrhagic telangiectasia?

    Science.gov (United States)

    Guttmacher, A E; Callahan, J R

    2000-03-06

    Chronic illness played a major role in the life and literary success of Robert Louis Stevenson. However, the exact nature of his chronic illness remains unclear. It is possible that Stevenson had hereditary hemorrhagic telangiectasia (Osler-Rendu-Weber Syndrome). This would explain his chronic respiratory complaints, recurrent episodes of pulmonary hemorrhage, and his death, at age 44 years, of probable cerebral hemorrhage. It would also explain his mother's hitherto unreported but apparent stroke, at age 38 years. Further support for this hypothesis might come from new details about the health of Stevenson and his relatives or from molecular analysis of tissue specimens remaining from him.

  11. 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.

  12. Risk stratification for prognosis in intracerebral hemorrhage: A decision tree model and logistic regression

    Directory of Open Access Journals (Sweden)

    Gang WU

    2016-01-01

    Full Text Available Objective  To analyze the risk factors for prognosis in intracerebral hemorrhage using decision tree (classification and regression tree, CART model and logistic regression model. Methods  CART model and logistic regression model were established according to the risk factors for prognosis of patients with cerebral hemorrhage. The differences in the results were compared between the two methods. Results  Logistic regression analyses showed that hematoma volume (OR-value 0.953, initial Glasgow Coma Scale (GCS score (OR-value 1.210, pulmonary infection (OR-value 0.295, and basal ganglia hemorrhage (OR-value 0.336 were the risk factors for the prognosis of cerebral hemorrhage. The results of CART analysis showed that volume of hematoma and initial GCS score were the main factors affecting the prognosis of cerebral hemorrhage. The effects of two models on the prognosis of cerebral hemorrhage were similar (Z-value 0.402, P=0.688. Conclusions  CART model has a similar value to that of logistic model in judging the prognosis of cerebral hemorrhage, and it is characterized by using transactional analysis between the risk factors, and it is more intuitive. DOI: 10.11855/j.issn.0577-7402.2015.12.13

  13. Angiographic warning of hemorrhagic transformation after stent retriever thrombectomy procedure

    OpenAIRE

    Vollman, Andrew T; Bruno, Charles A; Dumeer, Shifali; Malone, Hani; Meyers, Philip M

    2013-01-01

    This study reports cerebral angiographic findings observed after stent retriever thrombectomy that is suggestive of a higher risk of hemorrhagic transformation (HT). A woman aged 65–75 presented with a right middle cerebral artery syndrome confirmed by non-contrast CT brain scan. Endovascular revascularization using the Solitaire device was placed across the thromboembolic occlusion and thromboembolectomy was performed. Angiography showed complete recanalization of the left internal carotid a...

  14. 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

  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. Effect of holistic nursing intervention on negative emotion and quality of life of patients with hypertensive cerebral hemorrhage%整体护理干预对高血压脑出血患者负性情绪和生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    韩红梅

    2009-01-01

    Objective To investigate the effect of hotistic nursing intervention on negative emotion and quality of life of patients with hypertensive cerebral hemorrhage. Methods One hundred and twelve hypertensive cerebral hemorrhage inpatients with negative emotion disorder from 2006 June to 2008 December were randomly divided into the routine nursing group and the holistie nursing intervention group with 56 patients in each group. The routine nursing group were given the normal nursing care of hypertensive cerebral hemorrhage,the holistic nursing group received psychological nursing, health education and rehabilitative intervention on the basis of normal nursing care for 4 weeks. All patients were evaluated with self rating depression scale (SDS), self rating anxiety scale (SAS) and GQOIL before and after investigation. Results There was no difference in GQOIL, SDS and SAS between the two groups before nursing intervention. After the holistie nursing intervention, the scores of SDS and SAS of the holistic nursing intervention group were significantly lower than that of the routine nursing group, the score of GQOIL was better than that of the routine nursing group. Conclusions The holistie nursing intervention obtains a better effect on managing the hypertensive cerebral hemorrhage patients with negative emotion disorder, it is effective in alleviating negative emotion and raising their quality of life.%目的 观察整体护理干预对高血压脑出血患者的负性情绪和生活质量的影响.方法 收集2006年6月-2008年12月住院的高血压脑出血伴负性情绪障碍患者112例,随机分为常规组和整体组各56例.常规组行高血压脑出血常规护理,整体组在常规护理基础上增加心理护理、健康教育和康复干预等措施,疗程4周.比较2组患者干预前后抑郁自评量表(SDS)、焦虑自评量表(SAS)以及生活质量综合评定问卷(GQOIL)评定的差异.结果 整体护理前2组的GQOIL、SDS

  17. Transient Oliguria during Anesthesia in Cerebral Salt Wasting Syndrome

    OpenAIRE

    Lee, Kwang Ho; Park, Jong Taek; Cho, Dong Woo; Song, Seung Woo; Lim, Hyun Kyo

    2016-01-01

    Cerebral salt wasting syndrome is a hyponatremic and hypovolemic condition caused by intracranial disorders, such as head injury, subarachnoid hemorrhage, brain tumor, and brain operations. We report a case of a 5-year-old girl that had cerebral salt wasting syndrome with marked polyuria who showed transient oliguria during general anesthesia. The patient had undergone an operation for traumatic intracranial hemorrhage three months prior and has had marked polyuria and hyponatremia since then...

  18. Nimodipine treatment hepertensive cerebral hemorrhage to reduce cerebral vascular resistance and improve the effect of recent this paper probes into the signiifcance%尼莫地平治疗高血压性脑出血对降低脑血管阻力及提高近期疗效的意义

    Institute of Scientific and Technical Information of China (English)

    刘洪英; 刘希华; 潘双双; 何旦旦; 李梦瑶

    2014-01-01

    目的:探讨尼莫地平治疗高血压性脑出血过程中,对降低外周脑血管阻力(R)及提高近期治疗效果的意义与价值。方法选择20011年1月至2014年1月滨州市中心医院收治的高血压性脑出血患者208例,随机将其分成试验组与对照组,各104例,对照组行常规治疗,试验组在对照组治疗的基础上加用尼莫地平,采用静脉滴注方式,缓慢静滴,尼莫地平使用剂量为10 mg/d,滴注速度为1~3 mg/h。随后对两组患者的脑循环动力学参数(CVHI)进行检测,比较两组治疗前后平均血流速度(Vmean)、平均血流量(Qmean)、水肿面积与血肿体积、外周脑血管阻力(R)、临界压力值(CP)、神经功能缺损评分(NIHSS评分)、日常生活活动能力评分(BI评分),并对比两组治疗效果。结果治疗前与治疗后相比,两组患者的Qmean值均有所提高,但试验组较对照组升高明显(P0.05);两组患者R及CP值均有所降低,但试验组较对照组降低明显(P0.05),试验组NIHSS评分降低明显(P0.05);Two groups of patients R and CP values are reduced, but the lower than the control group obvious (P0.05), and the lower NIHSS scores significantly (P<0.05), BI score increase obviously (P<0.05), and the treatment were 85.58%and significant efficiency, and the 59.03%significant efficiency increased significantly (P<0.05). Conclusion Hepertensive cerebral hemorrhage application nimodipine treatment, small side effects, and the results were reliable, and can reduce cerebral vascular resistance, increase blood flow to the brain, to improve the short-term curative effect has a very important significance and value, popularization.

  19. 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...

  20. 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.

  1. Comparative analysis of minimally invasive hematoma puncture drainage and small bone window craniotomy for treating hypertensive cerebral hemorrhage%微创血肿穿刺引流术与小骨窗开颅术治疗高血压脑出血疗效的对比分析

    Institute of Scientific and Technical Information of China (English)

    黄春明; 张宏祥; 朱亚平

    2012-01-01

    Objective To investigate the efficacy of minimally invasive hematoma puncture drainage and small bone window craniotomy for treating hypertensive cerebral hemorrhage to provide a reference for a reasonable choice of surgical ways. Methods 120 cases hypertensive intracerebral hemorrhage patients were equally randomly divided into treatment group and control group of 60 cases, the control group were given with small bone window craniotomy, the treatment group were treated with CT-guided minimally invasive hematoma puncture drainage. Results No patients were died after surgery and follow-up, the re-bleeding, lung infection, gastrointestinal bleeding rate, the excellent rates of short-term efficacy and follow-up efficacy were better than the control group (P<0.05). Conclusion Hypertensive cerebral hemorrhage patients should as soon as possible to imply CT-guided minimally invasive hematoma puncture drainage for reducing patient morbidity and improving the prognosis of efficacy.%目的:探讨微创血肿穿刺引流术与小骨窗开颅术治疗高血压脑出血疗效对比情况,为合理选择手术方法提供参考.方法:高血压脑出血患者120例,根据随机原则分为治疗组与对照组各60例,对照组采用小骨窗开颅术,治疗组采用CT引导下微创血肿穿刺引流术.结果:两组术后都无死亡患者,两组的再次出血率、肺部感染率、消化道出血率均无显著性差异(P>0.05).随访中也无死亡病例,治疗组的近期疗效优良率好于对照组(P<0.05),治疗组的远期疗效也明显好与对照组(P<0.05).结论:高血压脑出血患者应尽早实施CT引导下微创血肿穿刺引流术与,降低患者的致残率,提高预后疗效.

  2. 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.

  3. 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

  4. 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

  5. Cerebral Tissue Oxygenation during Immediate Neonatal Transition and Resuscitation

    Science.gov (United States)

    Pichler, Gerhard; Schmölzer, Georg M.; Urlesberger, Berndt

    2017-01-01

    This article provides a review of cerebral tissue oxygenation during immediate transition after birth in human neonates. Recommended routine monitoring, especially if resuscitation is needed, during this period includes arterial oxygen saturation and heart rate measured by pulse oximetry and electrocardiogram. However, there is increasing interest to monitor in addition with near-infrared spectroscopy (NIRS) the oxygenation of the brain. There is a different pattern of increase between cerebral tissue oxygenation and arterial oxygen saturation during the immediate transition, with cerebral tissue oxygenation reaching a plateau faster than arterial oxygen saturation. Differences can be explained, since cerebral tissue oxygenation is not only affected by arterial oxygen saturation but also by cerebral blood flow, hemoglobin content, and cerebral oxygen consumption. Normal values have already been established for different devices, gestational ages, and modes of delivery in neonates without any medical support. Cerebral hypoxia during immediate transition might cause brain damage. In preterm neonates with cerebral hemorrhage evolving in the first week after birth, the cerebral tissue oxygenation is already lower in the first minutes after birth compared to preterm neonates without cerebral hemorrhage. Using cerebral NIRS in combination with intervention guidelines has been shown to reduce the burden of cerebral hypoxia in preterm neonates. Cerebral tissue oxygenation during immediate transition seems to have an impact on outcome, whereby NIRS monitoring is feasible and has the advantage of continuous, non-invasive recording. The impact of NIRS monitoring and interventions on short- and long-term outcomes still need to be evaluated. PMID:28280719

  6. 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.

  7. The role of lumbar drainage in symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage%腰大池置管术在动脉瘤性蛛网膜下腔出血后血管痉挛中的作用

    Institute of Scientific and Technical Information of China (English)

    李立; 周峰; 赵学群; 方兵; 陈贤宜

    2015-01-01

    目的 探讨动脉瘤性蛛网膜下腔出血后症状性血管痉挛及其预后的影响因素,评估腰大池置管引流术的治疗效果.方法 回顾性分析浙江大学附属第二医院神经外科自2012年1月至2013年12月175例动脉瘤性蛛网膜下腔出血患者的临床资料,采用多因素回归分析,通过性别、年龄、Hunt-Hess评分、改良Fisher分级和腰大池置管引流5个影响因素来评估蛛网膜下腔出血后症状性血管痉挛、痉挛相关性脑梗死、平均住院时间和出院1个月后Glasgow预后评分等预后指标.结果 诸多因素影响蛛网膜下腔出血患者的预后,其中腰大池置管是症状性血管痉挛(OR =0.243, 95% CI:0.119~0.497)和痉挛相关性脑梗死(OR=0.305,95% CI:0.154~0.604)的独立保护性因素.腰大池置管的患者Glasgow预后评分高于不置管的患者(P<0.05),但是腰大池置管引流延长了平均住院时间(P<0.05).结论 在动脉瘤性蛛网膜下腔出血的患者中,腰大池置管引流能有效缓解症状性脑血管痉挛,改善患者的预后.%Objective To investigate the risk factors of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and evaluate the effect of lumbar drainage of cerebrospinal fluid on vasospasm.Methods In this retrospective controlled-cohort study, 175 patients with aneurysmal subarachnoid hemorrhage met our study criteria between January 2012 and December 2013.By multi-factor regression analysis, gender, age, Hunt-Hess grade, modified Fisher grade and lumbar drainage were analyzed.The outcomes were assessed by the presence or absence of symptomatic cerebral vasospasm and vasospasm-related infarction, and the mean days of hospital stay and score of Glasgow Outcome Scale at 1-month follow-up.Results Several factors affected the prognosis of subarachnoid hemorrhage.Lumbar drainage was a protective factor of symptomatic cerebral vasospasm (OR =0.243, 95% CI: 0.119-0.497) and vasospasm

  8. 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

  9. Post-thyroidectomy hemorrhage

    DEFF Research Database (Denmark)

    Godballe, Christian; Madsen, Anders Rørbaek; Pedersen, Henrik Baymler;

    2009-01-01

    risk factors for hemorrhage. Increased hospital stay and infection rates were found in patients treated with drainage. The median time for onset of postoperative hemorrhage was 3 h (range 0-105). Compared with international literature our incidence of post-thyroidectomy hemorrhage is relatively high....... Improvement might be reached by the exchange of experience between departments with focus on adequate surgical technique and careful hemostasis....

  10. 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.

  11. 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.

  12. Hemorragia cerebral causada por enfermedad de la membrana hialina

    OpenAIRE

    Iglesias Rozas, José Rafael, 1942-

    1982-01-01

    Seis imágenes de una hemorragia cerebral en un neonato causada por la enfermedad de la membrana hialina (también conocida como síndrome de dificultad respiratoria neonatal). Six pictures of a cerebral hemorrhage in a neonate caused by the hyaline membrane disease (also known as neonatal respiratory distress syndrome).

  13. Intraventricular hemorrhage of the newborn

    Science.gov (United States)

    ... bleeding. Grade 1 is also referred to as germinal matrix hemorrhage (GMH). Grades 3 and 4 involve ... Saunders; 2015:chap 60. Volpe JJ. Intracranial hemorrhage: germinal matrix-intraventricular hemorrhage. In Volpe JJ, ed. Neurology ...

  14. [Neurologic complications of subarachnoid hemorrhage due to intracranial aneurysm rupture].

    Science.gov (United States)

    Rama-Maceiras, P; Fàbregas Julià, N; Ingelmo Ingelmo, I; Hernández-Palazón, J

    2010-12-01

    The high rates of morbidity and mortality after subarachnoid hemorrhage due to spontaneous rupture of an intracranial aneurysm are mainly the result of neurologic complications. Sixty years after cerebral vasospasm was first described, this problem remains unsolved in spite of its highly adverse effect on prognosis after aneurysmatic rupture. Treatment is somewhat empirical, given that uncertainties remain in our understanding of the pathophysiology of this vascular complication, which involves structural and biochemical changes in the endothelium and smooth muscle of vessels. Vasospasm that is refractory to treatment leads to cerebral infarction. Prophylaxis, early diagnosis, and adequate treatment of neurologic complications are key elements in the management of vasospasm if neurologic damage, lengthy hospital stays, and increased use of health care resources are to be avoided. New approaches to early treatment of cerebral lesions and cortical ischemia in cases of subarachnoid hemorrhage due to aneurysm rupture should lead to more effective, specific management.

  15. Angiographic warning of hemorrhagic transformation after stent retriever thrombectomy procedure.

    Science.gov (United States)

    Vollman, Andrew T; Bruno, Charles A; Dumeer, Shifali; Malone, Hani; Meyers, Philip M

    2014-01-01

    This study reports cerebral angiographic findings observed after stent retriever thrombectomy that is suggestive of a higher risk of hemorrhagic transformation (HT). A woman aged 65-75 presented with a right middle cerebral artery syndrome confirmed by non-contrast CT brain scan. Endovascular revascularization using the Solitaire device was placed across the thromboembolic occlusion and thromboembolectomy was performed. Angiography showed complete recanalization of the left internal carotid artery, anterior and middle cerebral artery branches. Twelve hours following the procedure the patient had a hemorrhagic conversion of the ischemic infarct with significant mass effect causing herniation. Despite surgical intervention (hemicraniectomy) the patient died. The angiographic features following revascularization of the vessels distal to the occlusion showed subtle dilations which were visualized at the branch points of the vessels. This may be a warning sign of increased risk of HT.

  16. Cerebral hyperperfusion following carotid endarterectomy

    DEFF Research Database (Denmark)

    Schroeder, T; Sillesen, H; Sørensen, O;

    1987-01-01

    , occurred in the low pressure ratio group, while the hemispheric asymmetry on average was unchanged in the high pressure ratio group. This relative hyperemia was most pronounced 2 to 4 days following reconstruction. The marked hyperemia, absolute as well as relative, in patients with a low ICA/CCA pressure...... ratio suggests a temporary impairment of autoregulation. Special care should be taken to avoid postoperative hypertension in such patients, who typically have preoperative hypoperfusion, to avoid the occurrence of cerebral edema or hemorrhage....

  17. Association of plasma levels of homocysteine,endothelin-1 and nitric oxide and hypertension with cerebral hemorrhage%高血压性脑出血与血浆同型半胱氨酸、内皮素1和一氧化氮的关系

    Institute of Scientific and Technical Information of China (English)

    王军; 张均

    2011-01-01

    Objective To investigate the relationship of plasma levels of homocysteine(Hcy), endothelin-1 (ET-1) and nitric oxide (NO) and hypertension with cerebral hemorrhage. Methods Plasma levels of Hcy, ET-1 and NO were examined in 62 patients with hypertension (group A), 45 patients with cerebral hemorrhage without hypertension(group B),60 hypertensive patients with cerebral hemorrhage(group C) and 40 healthy volunteers (group D). Results For groups of A,B,C and D,plasma levels of Hcy were (17. 6±6. 6) μmol/L, (18. 2±7. 2) μmol/L, (21. 9±6. 7) μmol/L and (10. 8±4. 6) μmol/L,those of ET-1 were (100. 7±11. 8) μg/L,(101. 2±12.1) μg/L,(120. 8+ 15. 9) μg/L and (44. 7±10. 6) μg/L,and those of NO were (57. 2±11. 7) mg/L,(58. 6±11. 2) mg/L, (41. 8±13. 2) mg/L and (120. 8±12. 6) mg/L,respectively. Compared with group D, plasma levels of Hcy and ET-1 were higher,but NO was lower in groups of A,B and C(P<0. 05). Plasma levels of Hcy and ET-1 were higher, but NO was lower in group C than those in groups of A and B(P<0. 05). The amount of cerebral hemorrhage was positively correlated to Hcy and ET-1, but negatively correlated with NO(P<0. 05). Conclusion The damage and dysfunction of the endothelial cells exist in the patients with hypertensive cerebral hemorrhage.%目的 探讨血浆同型半胱氨酸(Hcy)、内皮素1(ET-1)和一氧化氮(NO)水平与高血压及其合并脑出血的关系.方法 检测62例单纯高血压患者(A组)、45例单纯脑出血患者(B组)、60例高血压性脑出血患者(C组)和40名健康体检者(D组)血浆Hcy、ET-1和NO的水平.结果 A、B、C和D组的血浆Hcy分别为(17.6±6.6) μmol/L、(18.2±7.2)μmol/L、(21.9±6.7)μmol/L和(10.8±4.6)μmol/L;ET-1分别为(100.7±11.8)μg/L、(101.2±12.1)μg/L、(120.8±15.9)μg/L和(44.7±10.6)μg/L;NO分别为(57.2±11.7) mg/L、(58.6±11.2)m g/L、(41.8±13.2) mg/L和(120.8±12.6)mg/L.与D组比较,A、B和C组Hcy和ET-1水平升高,NO水平降低(P<0.05);C组Hcy和ET-1

  18. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  19. 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.)

  20. Clinical observation of treatment of hypertensive cerebral hemorrhage with minimally invasive surgery combined with mild hypothermia therapy%微创血肿清除术联合亚低温治疗高血压脑出血临床观察

    Institute of Scientific and Technical Information of China (English)

    张卫华; 韩增灿; 张玉清

    2010-01-01

    目的 研究微创血肿清除术联合亚低温治疗高血压脑出血的临床疗效.方法 将128例高血压脑出血患者分为3组:常规治疗组行内科保守治疗;微创治疗组在常规治疗的同时行微创血肿清除术;联合治疗组行常规治疗+微创血肿清除术+亚低温治疗.比较3组治疗前后神经功能缺损评分(NIHSS)和治疗后随访90 d时的日常生活能力Barthel指数.结果 治疗30、90 d后NIHSS评分联合治疗组[(6.4±4.2)分、(1.9±1.2)分]低于微创治疗组[(8.1±2.7)分、(3.2±2.4)分],微创治疗组低于常规治疗组[(9.9±3.2)分、(5.4±1.7)分](均P<0.05);治疗90 d后Barthel指数微创治疗组为(56.4±36.2)分,大于常规治疗组的(40.6±21.2)分,联合治疗组为(78.7±51.9)分,大于微创治疗组,差异均有统计学意义(P<0.05).结论 微创血肿清除术和亚低温联合治疗高血压脑出血可明显降低病死率和致残率,有利于神经功能恢复.%Objective To explore the clinical effect of minimally invasive surgery combined with mild hypothermia in treatment of hypertensive cerebral hemorrhage. Methods One hundred and twenty-eight cases with hypertensive cerebral hemorrhage were divided into three groups randomly: standard therapy group with medical conservative treatment; minimally invasive surgery group with cleaning intracranial hemorrhage at the time of medical therapy; combined therapy group with medical therapy and cleaning intracranial hemorrhage at the time of mild hypothermia therapy. Three groups with the National institute of Health Stroke scale (NIHSS) score was compared. The clinical therapeutic effects and Barthel index which was accessed in both groups before treatment and ninety days later. Results The total clinical NIHSS was lower than minimally invasive surgery group,the NIHSS in minimally invasive surgery group was lower than the medical therapy group ( P < 0.05 ); after 90 days, the barthel index ( 56.36 ±36.16) in the minimally

  1. 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

  2. Effect of Early Enteral Nutrition on Upper Gastrointestinal Bleeding in Patients with Minimal Invasive Therapy for Cerebral Hemorrhage%早期胃肠内营养对脑出血颅内血肿微创清除术后并发上消化道出血的影响

    Institute of Scientific and Technical Information of China (English)

    张秀云

    2014-01-01

    Objective:To study the effect of early enteral nutrition on upper gastrointestinal bleeding in patients with minimal invasive therapy for cerebral hemorrhage. Method:80 patients with minimal invasive therapy for cerebral hemorrhage were randomly divided into two groups,the experimental group 40 cases were given a gastric tube feeding within 24-48 hour after surgery,the control group 40 cases were given a gastric tube feeding after 72 hour after surgery. To compare the incidence rate of upper gastrointestinal bleeding and the rate of death because of upper gastrointestinal bleeding and the hospitalization days. Result:The incidence rate of upper gastrointestinal bleeding and the rate of death because of upper gastrointestinal bleeding in the experimental group was significantly lower than that of the control group,the difference was statistical significant(P<0.05). The hospitalization days was also less than the control group, the difference was statistical significant(P<0.05). Conclusion:Patients with minimal invasive therapy for cerebral hemorrhage should be given early enteral nutrition,it could reduce the occurrence of upper gastrointestinal bleeding, reduce the death rate and the hospitalization days,and promote a speedy recovery.%目的:探讨早期胃肠内营养对脑出血颅内血肿微创清除术患者并发上消化道出血的影响。方法:选择脑出血行颅内血肿微创清除术患者80例,随机分为两组,每组各40例。试验组40例在术后24~48 h内插管鼻饲进食,对照组40例在术后72 h以后插管鼻饲进食。比较两组患者发生上消化道出血及因上消化道出血死亡情况,两组患者住院天数。结果:试验组上消化道出血发生率及因出血死亡率明显低于对照组,比较差异有统计学意义(P<0.05);试验组患者住院天数少于对照组,比较差异具有统计学意义(P<0.05)。结论:脑出血颅内血肿微创清除术患者尽早实施胃肠内营

  3. 护理干预对尼莫地平治疗老年高血压脑出血患者依从性及满意度的影响%Influence of Nursing InterVention on the Compliance and Nursing Satisfaction Degree for Elderly Patients with HypertensiVe Cerebral Hemorrhage Treated by Nimodipine

    Institute of Scientific and Technical Information of China (English)

    万丽萍

    2015-01-01

    目的 探讨护理干预对尼莫地平治疗老年高血压脑出血患者依从性、护理满意度的影响.方法 将80例接受尼莫地平治疗的老年高血压脑出血患者随机分为对照组(常规护理)和观察组(护理干预),各40例,比较两组日常生活活动能力评定量表(Barthel指数)、功能独立性评定量表(FIM),以及患者对治疗的依从性和护理满意度.结果 与对照组相比,观察组Barthel评分(79. 6 ± 7. 2比64. 1 ± 8. 3)分和 FIM 评分(92. 3 ± 9. 1 比 81. 4 ± 8. 6)分均明显升高( P<0. 05);与对照组相比,观察组患者对治疗依从性(95. 00% 比75. 00%)明显提高( P<0. 05 );与对照组相比,观察组患者对护理服务的满意度(95. 00% 比77. 50%)明显提升( P<0. 05).结论 尼莫地平治疗老年高血压脑出血期间,有效的护理干预能明显提高患者对治疗的依从性,提升患者预后质量及护理满意度.%Objective To study the effect of nursing intervention on the compliance and nursing satisfaction degree for elderly patients with hypertensive cerebral hemorrhage treated by nimodipine. Methods 80 elderly patients with hypertensive cerebral hemorrhage treated by nimodipine in the hospital during the period were randomly divided into the control group ( routine nursing ) and the observation group ( nursing intervention ) , 40 cases in each group. The quality of life scores ( Barthel ) , the ability scores of daily living activity ( FIM ) , the patients' adherence to treatment and nursing satisfaction degree in the two groups were compared. Results Compared with the control group, the scores of Barthel(79. 6 ± 7. 2 vs 64. 1 ± 8. 3)and FIM(92. 3 ± 9. 1 vs 81. 4 ± 8. 6)were significantly increased in the observation group ( P < 0. 05 );compared with the control group, the patients' adherence to treatment (95. 00% vs 75. 00%)was obviously increased in the observation group ( P < 0. 05 );compared with the control group, the patients' satisfaction degree

  4. Clinical Observation of Comprehensive Care in the Improvement of the Quality of Life of Elderly Patients with Cerebral Hemorrhage%全面护理对老年脑出血患者生活质量改善的临床观察

    Institute of Scientific and Technical Information of China (English)

    史小琴; 童希; 丁玲

    2015-01-01

    目的:探讨全面护理对老年脑出血患者生活质量改善效果。方法:选取笔者所在医院2013年3月-2014年9月收治的78例脑出血老年患者为研究对象,将其随机分为干预组和常规组,分别采用全面护理和常规方法护理,比较两组患者运动功能、日常生活能力、生活质量及满意度。结果:干预组患者运动功能、日常生活能力及生活质量中生理功能、生理职能、健康状况、社会职能、情感职能评分均高于常规组,两组间各值比较差异均有统计学意义(P<0.05)。干预组患者满意度为94.87%,高于常规组的71.79%,差异有统计学意义(P<0.05)。结论:老年脑出血患者应用全面护理可提高患者运动功能、日常生活能力、生活质量及患者满意度,具有显著应用效果。%Objective:To investigate the clinical observation of comprehensive care in the improvement of the quality of life of elderly patients with cerebral hemorrhage.Method:78 cases of elderly patients with cerebral hemorrhage were selected from March 2013 to September 2014 in our hospital, randomly divided into intervention group and conventional group,respectively comprehensive nursing care and conventional methods,compared the patients in motor function,activities of daily living,quality of life and satisfaction of the two groups.Result:Motor function,activities of daily living, and quality of life in physical function,physical role,health status,social function,emotional function scores of the patients in the intervention group were higher than the conventional group,and the differences between the two groups were statistically significant values(P<0.05).Satisfaction rate for the intervention group was 94.87%,higher than the conventional group’s satisfaction rate(71.79%),and the difference was statistically significant(P<0.05). Conclusion:The application of the comprehensive care in elderly patients with cerebral hemorrhage can

  5. Relationship of prognosis and body temperature and white blood cell count in peripheral blood in early stage of patients of cerebral hemorrhage%急性脑出血患者早期体温变化及外周血白细胞计数与预后的关系

    Institute of Scientific and Technical Information of China (English)

    杨春永; 孙京莉

    2011-01-01

    目的 探讨急性脑出血患者早期体温变化及外周血白细胞计数与预后的关系.方法 将77例脑出血患者按体温与外周血白细胞计数分别分成发热组与不发热组;白细胞数正常组与白细胞数增高组;白细胞数轻度增高组与显著增高组,观察各组死亡率并进行统计学分析.结果 发热组死亡率(67.3%)高于不发热组的死亡率(20.0%)(P<0.01);白细胞数正常组死亡率(32.4%)低于白细胞数增高组的死亡率(67.4%)(P<0.01);白细胞数轻度增高组死亡率(43.5%)低于显著白细胞数增高组的死亡率(95.0%)(P<0.01).结论 根据急性脑出血患者早期体温变化及外周血白细胞计数可对预后做出较为准确的判断,且方法简单、易行,有很高的临床应用价值.%Objective To investigate the relationship of prognosis and body temperature and white blood cell count in peripheral blood in early stage of patients of cerebral hemorrhage. Methods Seventy-seven patients of cerebral hemorrhage were divided into fever group and normal temperature group, white blood cell count increasing group and normal white blood cell count group, white blood cell minimal increasing group and white blood cell increasing significantly group. Mortality of each group were calculated and compared. Results The mortality of fever group and normal temperature group was 67. 3% and 20.0% . There was significant difference between two groups ( P < 0. 01). The mortality of white blood cell count increasing group and normal white blood cell count group was 32.4% and 67.4%. There was significantly difference between two group ( P < 0.01). The mortality of white blood cell minimal increasing group and white blood cell increasing significantly group was 43. 5% and 95.0%. There was significantly difference in two group (P <0.01). Conclusion It would determine the prognosis by study body temperature and white blood cell count in peripheral blood in early stage of

  6. 颅内血肿钻孔引流术后早期应用补阳还五汤治疗高血压脑出血的效果观察%Effect observation of early application of Buyang Huanwu decoction in the treatment of hypertensive cerebral hemorrhage after the operation of drilling drainage

    Institute of Scientific and Technical Information of China (English)

    景志军; 杨建青; 刘亚宁; 李永利; 杨维艳; 周瑞涛; 毕艳平

    2015-01-01

    Objective To explore the effect of early application of Buyang Huanwu decoction in the treatment of hyper-tensive cerebral hemorrhage after the operation of drilling drainage. Methods 150 patients with hypertensive cerebral hemorrhage from March 2013 to February 2015 in our hospital were selected and randomly divided into the treatment group and the control group,75 cases in each group.The control group was treated with drilling drainage and taken care of in routine treatment of western medicine,the treatment group was treated with Buyang Huanwu decoction by orally or nasal feeding on the basis of the control group.The effect in two groups was compared. Results The proportion of con-scious awareness in the treatment group was higher than that in the control group,the recovery time of the conscious-ness in the treatment group was shorter than that in the control group,with significant difference (P<0.05).The recovery condition of limb muscle strength in the treatment group was better than that in the control group,with significant differ-ence (P<0.05). The proportion of language clarity in the treatment group was higher than that in the control group,with significant difference (P<0.05).The cure rate,the healing rate and the total effective rate in the treatment group was higher than that in the control group,with significant difference (P<0.05). Conclusion The curative effect of early appli-cation of Buyang Huanwu decoction in the treatment of hypertensive cerebral hemorrhage after the operation of drilling drainage is significant better than that in simple surgical treatment.%目的:探讨高血压脑出血患者行钻孔引流术后早期应用补阳还五汤的效果。方法选取本院2013年3月~2015年2月收治的150例高血压脑出血患者作为研究对象,随机分为治疗组和对照组,各75例。对照组采用颅内血肿钻孔引流术,并给予西医常规治疗,治疗组在对照组的基础上给予补阳还五汤加减鼻饲或口

  7. 早期肠内营养支持治疗对重症脑出血病人预后和营养指标的影响%Effect of early nutrition emulsion therapy on the prognosis and nutritional indicators of patients with severe cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    林兴建; 龚大伟; 陈道文; 孙丰

    2012-01-01

    Objective: To investigate the early enteral nutritional emulsion (TPF) on the prog nosis and nutrition indicators of patients with acute severe brain hemorrhage. Methods: 68 patients of . Acute severe cerebral hemorrhage accompanied with dysphagia were randomly divided into treatment group (n=33) and control group (n =35). On 24 ~ 72 h after admission, patients in treatment group were given nasogastric enteral nutrition support with TPF while the patients in control group were treated with general nasal feeding diet. Neurological scores of patients were tested by National Institutes of Health Stroke Scale (NIH Stroke Scale, NIHSS) at 2 d and 14 d after admission respectively, and the changes of nutritional indicators and the complication of pulmonary infection were observed simultaneously. Re sults : At 14 d, the NIHSS and incidence of lung infection in treatment group were significantly lower than those of the control group (P <0. 05) , and the nutrition indicators in treatment group were also signifi cantly improved than those of the control group. Conclusion: Early enteral nutritional support can improve the acute neurological function and nutrition indicator in patients with severe cerebral hemor rhage, and reduce the incidence of infectious complication as well. Therefore, it could be a safe and feasible way to treat the patients with severe cerebral hemorrhage.%目的:探讨早期肠内营养(EEN)支持治疗对急性重症脑出血病人预后和营养指标的影响. 方法:将急性重症脑出血伴吞咽障碍的病人68例随机分为治疗组(n=33)和对照组(n=35),于入院后24~72 h内分别给予鼻饲EN(瑞先)支持和普通鼻饲饮食.两组病人分别于人院第2和第14天采用美国国立卫生研究院卒中量表(NIH Stroke Scale,NIHSS)进行神经功能评分,并观察营养指标的变化以及肺部感染并发症的发生率. 结果:入院后第14天,治疗组病人NIHSS评分和肺部感染发生率均显著低于对照组(P<0

  8. 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

  9. 奥拉西坦对急性脑出血患者Hcy、hs-CRP、尿酸、半胱氨酸蛋白酶抑制剂及血脂指标水平的影响%Effect of oxiracetam on Hcy, hs-CRP, uric acid, cysteine protease inhibitors and blood lipid levels in patients with acute cerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    高艳秋

    2016-01-01

    Objective To investigate the effect of oxiracetam on (Hcy), high sensitive C-reactive protein (hs-CRP), uric acid (UA) and cysteine protease inhibitor (Cys C) and blood lipid index level in patients with acute cerebral hemorrhage.Methods 98 patients with acute cerebral hemorrhage were randomly divided into observation group ( n =49 ) and control group ( n =49 ) .The control group was given routine treatment, the observation group was given oxiracetam treatment on the basis of control group.Two groups were treated for 2 weeks.Results The observation group after treatment NIHSS score lower than control group(P<0.05), GCS score and ADL score higher than control group (P<0.05);The serum levels of Hcy, hs-CRP, Cys, C levels lower than control group post-treatment, while the level of UA was higher than that of control group (P<0.05);The observation group TG, TC, LDL-C levels were lower than control group post-treatment ( P <0.05 ); Two groups had no severe adverse reactions. Conclusion Oxiracetam by reducing and Hcy in patients with acute cerebral hemorrhage hs-CRP, Cys C level, increased UA level, and improve blood lipid function, and thus improve symptoms.%目的:探讨奥拉西坦对急性脑出血患者同型半胱氨酸( Hcy)、超敏C-反应蛋白( hs-CRP)、尿酸( UA)、半胱氨酸蛋白酶抑制剂( Cys C)及血脂指标水平的影响。方法急性脑出血患者98例依据随机数字表法随机分为观察组49例与对照组49例。对照组采用常规治疗,观察组在对照组基础上结合奥拉西坦治疗。2组疗程均为2周。结果观察组治疗后NIHSS评分低于对照组, GCS评分和ADL评分高于对照组(P<0.05);观察组血清Hcy、hs-CRP、Cys C水平治疗后低于对照组,而UA水平高于对照组(P<0.05);观察组TG、TC、LDL-C水平治疗后低于对照组(P<0.05);2组均未见严重不良反应。结论奥拉西坦可通过降低

  10. 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。

  11. 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

    OpenAIRE

    2002-01-01

    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 vasoespa...

  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. Blood and cerebrospinal fluid levels of brain-derived neurotrophic factor in patients with hypertensive cerebral hemorrhage and their correlation with recovery of neurological functions%高血压脑出血患者脑源性神经营养因子水平变化及其与神经功能的相关性研究

    Institute of Scientific and Technical Information of China (English)

    陈胜利; 龚涛; 李长清; 张书琼; 李莉

    2011-01-01

    Brain-derived neurotropic factor (BDNF) contents in blood and cerebrospinal fluid (CSF) were detected by ELISA method in 30 cases of hypertensive cerebral hemorrhage (HCH group) and 30 healthy subjects (control group).The performance and neurological functions of patients were evaluated by National Institutes of Health Stroke Scale( NIHSS),Hamilton Depression Scale ( HAMD),Barthel Index of Daily Living Skills.The result showed that the contents of BDNF in blood and CSF of HCH patients in recovery stage were significantly higher than those in acute stage and those of control group ( P < 0.05 ) ; the contents of BDNF in blood and CSF were negatively correlated with neurological impairment degree ( P <0.05).The results suggest that BDNF in the blood or the CSF may promote the recovery of neurological function in patients with hypertensive cerebral hemorrhage.%采用ELISA法检测30例高血压脑出血患者(观察组,因检测时间点不同而分为M1、M2亚组),30名正常人(对照组)血液和脑脊液中脑源性神经营养因子(BDNF)的含量;用美国国立卫生院神经功能评分量表(NIHSS)、汉密顿抑郁量表(HAMD)、日常生活能力Barthel指数对观察组患者按不同的时间点(发病后≤7 d,发病后≥21 d)进行评分.结果显示高血压脑出血患者恢复期血液和脑脊液BDNF显著高于急性期患者和对照组(P<0.05);血液和脑脊液BDNF含量与出院时神经功能缺损程度呈显著负相关(P<0.05).脑脊液或血液中的BDNF对高血压脑出血患者神经功能的恢复具有促进作用.

  14. Cerebral Arterial Fenestrations

    Science.gov (United States)

    Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V

    2014-01-01

    Summary Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms “fenestration” or “fenestrated” with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

  15. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available 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. 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.

  16. Presentation of moyamoya disease with occipital hemorrhage: a case report

    Directory of Open Access Journals (Sweden)

    Serkan Demir

    2012-12-01

    Full Text Available Moyamoya disease is a cerebrovascular disease which is characterized with stenosis and occlusions at the distal part of internal carotid artery and at the proximal part of anterior and middle cerebral arteries. It rarely causes temporary or recurrent hemiparesis due to intracranial hemorrhage while symptoms like headache, convulsion, nystagmus, aphasia and ataxia may also occur. In this paper, we present a case of Moyamoya disease which was diagnosed with a 23 year old female patient who was admitted to our emergency department with headache, nausea and vomiting complaints and whose radiological findings showed occipital lobe hemorrhage.

  17. The appraisal value of transcranial doppler and flash visual evoked potential on minimally invasive surgery for cerebral hemorrhage%经颅多普勒与闪光视觉诱发电位对脑出血微创术疗效的评估价值

    Institute of Scientific and Technical Information of China (English)

    郝丽娜; 冉晨光; 王利春; 赵荣忠

    2015-01-01

    Objective To investigate the appralsal value of the transcranial doppler (TCD) and flash visual evoked potential (FVEP) on minimally invasive surgery for cerebral hemorrhage. Methods 60 patients with hypertensive massive cerebral hemorrhage in basal ganglia and who were treated in the department of cerebral surgery of our hospital from January 2013 to December 2013 were selected as the investigation objects of this time, and all the patients were admitted within 24h after the onset of the disease. In addition, the patients were divided into the group received minimally invasive operation and the group received medical conservative treatment according to the difference of treatment methods, and all the patients of the both groups were received examinations of TCD and FVEP on the first day and the seventh day of the disease course, and hemodynamic parameters, the latency of each wave, and the results of NIHSS score and GCS score obtalned in the process of diagnosis were compared, and the intracranial pressures were predicted by the two kinds of noninvasive methods, TCD and FVEP, at the same time. Results compared with the conservative group, TCD parameters, the latencies of each wave of FVEP, NIHSS scores, GCS scores and predicted intracranial pressures on the first day in the patients of minimally invasive group did not change significantly;and cerebral blood flow velocities on the seventh day in the patients of minimally invasive group were accelerated significantly, the pulsatility indexes were decreased, all the latencies of each wave of FVEP were shortened significantly and the predicted intracranial pressures were decreased significantly. When compared with the first day, cerebral blood flow velocities on the seventh day in the patients of minimally invasive group were accelerated significantly, the pulsatility indexes were decreased, and the latencies of N2 and P3 waves of FVEP were shortened significantly, but the NIHSS and GCS scores did not change

  18. Troponin elevation in subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Ioannis N. Mavridis

    2015-03-01

    Full Text Available 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 >1 μg/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.

  19. Correlation Analysis of Peripheral WBC Count in Patients with Cerebral Hemorrhage and Prognosis%脑出血外周白细胞计数与病情及预后的相关性

    Institute of Scientific and Technical Information of China (English)

    刘武军

    2015-01-01

    Objective To investigate the relationship between patients with peripheral white blood cel count andneutrophil count and the prognosis of acute cerebral hemor hage. Methods 12 hours after the onset of the disease in the blood col ection and peripheral white blood cel count and neutrophil count in acute cerebral hemor hage. Results In severe cases, white blood cel count and neutrophil count increased significantly increased,while the white blood cel count and neutrophil count increased in patients with acute period,the mortality rate is significantly higher. Conclusion The increase of early peripheral white blood cel and neutrophil count in acute cerebral hemor hage, suggesting that severe il ness, poor prognosis, prognosis.%目的探讨急性脑出血患者周围白细胞计数及中性粒细胞计数与病情及预后的关系。方法急性脑出血发病后12h内采集静脉血周围白细胞计数及中性粒细胞计数。结果重症患者中,白细胞计数及中性粒细胞计数增高显著增加,同时在白细胞计数及中性粒细胞计数增高的患者中,急性期病死率显著增高。结论急性脑出血早期周围白细胞及中性粒细胞计数增加,提示病情重,预后差,可作为临床预后评估指标。

  20. Abordagem anestésica de grávida com malformação arteriovenosa cerebral e hemorragia subaracnoidea durante a gravidez: relato de caso Abordaje anestésico de embarazada con malformación arteriovenosa cerebral y hemorragia subaracnoidea durante el embarazo: relato de caso Anesthetic approach of pregnant woman with cerebral arteriovenous malformation and subarachnoid hemorrhage during pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Catarina Santos Carvalho

    2013-04-01

    de 39 semanas, sana antes del embarazo, con antecedentes de HSA a las 22 semanas de gestación que se manifestó por medio de cefaleas, vómitos y mareos, sin la pérdida de la consciencia u otros déficits a la hora de su entrada en el servicio de urgencia. La resonancia magnética (RM arrojó MAV frontal izquierda. Después de un breve período de ingreso para la estabilización y el diagnóstico, se decidió mantener el embarazo y el acompañamiento ambulatorio multidisciplinario por neurocirugía y obstetricia en consulta de alto riesgo. Se optó por realizar la cesárea electiva a las 39 semanas bajo anestesia epidural lumbar. En el intraoperatorio ocurrió un episodio de hipotensión que fue rápidamente revertido con fenilefrina. El Índice de Apgar del recién nacido fue de 10/10. El catéter epidural fue usado para la analgesia postoperatoria, que también cursó sin intercurrencias. CONCLUSIONES: Son muy raros los casos publicados de abordaje anestésico de embarazadas con MAV sintomáticas. Todas las decisiones tomadas por el equipo multidisciplinario, desde optar por continuar con el embarazo, hasta el momento ideal para intervenir la MAV, pasando por el tipo de anestesia y analgesia, fueron sopesadas en función del riesgo de daño cerebral. Desde el punto de vista anestésico, los autores enfatizan la necesidad de estabilidad hemodinámica.BACKGROUND AND OBJECTIVES: Subarachnoid hemorrhage (SAH during pregnancy is a rare event, and about half the cases are due to arteriovenous malformations (AVM. The authors describe the anesthetic approach of a 39 week pregnant patient scheduled for cesarean section, with a history of SAH due to AVM at 22 week gestation. CASE REPORT: 39 week pregnant patient, healthy prior to pregnancy, with a history of SAH at 22 week gestation, manifested by headache, vomiting, and dizziness without loss of consciousness or other deficits on admission to the emergency room. Magnetic resonance imaging (MRI revealed a left frontal AVM

  1. Pulmonary Hemorrhage in Cryoglobulinemia

    Directory of Open Access Journals (Sweden)

    G Kirkpatrick

    2015-01-01

    Full Text Available Pulmonary manifestations of cryoglobulinemia are uncommon and their clinical behaviour is unpredictable, ranging from mild dyspnea to life-threatening presentations. A patient with cryoglobulinemia who presented with hypoxic respiratory failure attributed to pulmonary hemorrhage is reported.

  2. 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.

  3. Mortality after hemorrhagic stroke

    DEFF Research Database (Denmark)

    González-Pérez, Antonio; Gaist, David; Wallander, Mari-Ann

    2013-01-01

    , 54.6% for 80-89 years; SAH: 20.3% for 20-49 years, 56.7% for 80-89 years; both p-trend stroke patients...... = 0.03). CONCLUSIONS: More than one-third of individuals die in the first month after hemorrhagic stroke, and patients younger than 50 years are more likely to die after ICH than SAH. Short-term case fatality has decreased over time. Patients who survive hemorrhagic stroke have a continuing elevated...

  4. 质子磁共振波谱分析创伤性蛛网膜下腔出血腰大池持续引流患者脑代谢的变化%Analysis of cerebral metabolic changes by hydrogen proton magnetic resonance spectroscopy in patients with lumbar continuous drainage of cerebrospinal fluid on traumatic subarachnoid hemorrhage

    Institute of Scientific and Technical Information of China (English)

    吴海滨; 赵冬青; 王科

    2016-01-01

    目的 探讨通过质子磁共振波谱(1 H-MRS)分析创伤性蛛网膜下腔出血腰大池持续引流患者脑内代谢物质的变化,评估腰大池持续引流对创伤所引起的蛛网膜下腔出血患者的临床疗效及预后.方法将2012年10月~2015年6月收治的80例创伤性蛛网膜下腔出血患者随机分为治疗组40例和对照组40例.治疗组患者除采用常规方法外,入院第3d行经腰大池持续引流的治疗,对照组患者只采用常规方法治疗;两组患者分别于入院后第3、8、14 d行经颅多普勒检查脑血流变化和比较其临床疗效.两组患者第14 d行质子磁共振波谱分析额叶、基底节、枕叶NAA、Cho、Cr及NAA/Cr,Cho/Cr值的变化,并对各项指标进行统计学分析.结果治疗组患者脑血管血流速度、临床疗效和主要症状消失率明显优于对照组(均P<0.05).治疗组额叶、基底节区域、枕叶NAA/Cr较对照组明显上升,Cho/Cr数值较对照组降低(均P<0.05).结论经腰大池持续引流可以缓解创伤性蛛网膜下腔出血患者的脑血管痉挛,改善患者临床症状,1 H-MRS对评估临床疗效及预后具有重要参考价值.%Objective To explore by hydrogen proton magnetic resonance spectroscopy ( 1 H-MRS) in patients with lumbar continuous drainage of cerebrospinal fluid on traumatic subarachnoid hemorrhage( tSAH) to analysis of cerebral metabolic changes.To evaluate the clinical efficacy and prognosis of patients with subarachnoid hemorrhage caused by trauma.Methods 80 patients who underwent traumatic subarachnoid hemorrhage of lumbar continuous drainage of cerebrospinal fluid from October 2012 to October 2015 were divided into the observation group and the control group (40 patients each) randomly.The observation group in addition to using the conventional method, be admitted to hospital the third heaven treated by continuous drainage of lumbar cistern.Patients of control group were only given routine treatment

  5. 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.

  6. 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

  7. 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

  8. 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

    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...

  9. Effectiveness of diagnostic strategies in suspected delayed cerebral ischemia : A decision analysis

    NARCIS (Netherlands)

    Rawal, Sapna; Barnett, Carolina; John-Baptiste, Ava; Thein, Hla Hla; Krings, Timo; Rinkel, Gabriel J E

    2015-01-01

    Background and Purpose-Delayed cerebral ischemia (DCI) is a serious complication after aneurysmal subarachnoid hemorrhage. If DCI is suspected clinically, imaging Methods designed to detect angiographic vasospasm or regional hypoperfusion are often used before instituting therapy. Uncertainty in the

  10. 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

  11. Effects of Tongfu Xingshen Granule on Brain Pathomorphological Features inRats with Hypertensive Cerebral Hemorrhage%通腑醒神胶囊对高血压性脑出血大鼠脑组织病理及超微结构的影响

    Institute of Scientific and Technical Information of China (English)

    梁伟雄; 陈根成; 黄燕; 杨志敏; 石灵春; 区勇全; 孙景波; 刘茂才; 雷娓娓

    2001-01-01

    【Objective】 To explore the mechanism of Tongfu Xingshen Granule(TXG) for hypertensive middle- and large-amount cerebral hemorrhage.【Methods】Rat mod e ls with renal vascular hypertensive cerebral hemorrhage were established by occl usion of bilateral renal arteries and injection of collagenase and heparin,and t hen were allocated to TXG treatment group(Group A),mannitol treatment group(grou p B)and model control group (Group C).Indices such as brain pathomorphological f eatures,ultrastructure,vascular permeabilit y and water volume were observed.【Results】The above indices were improved in G roup A as compared Group C(P<0.05). 【Conclusion】 TXG can protect brain tissue and improve nervous fu n ction.Its possible mechanism is by reducing the permeability of cerebral capilla ries and brain water volume,enhancing the absorption of hematoma,lowering the c erebral pressure,improving microcirculation and the supply of blood and oxygen.%【目的】探讨中药通腑醒神胶囊(由番泻叶、虎杖、人工牛黄粉等组成)治疗高血压性中、大量脑出血的作用机理。【方法】观察该方对双肾双夹法和注射胶原酶Ⅶ及肝素造成肾血管性高血压性脑出血模型大鼠的脑组织病理学、超微结构、脑血管通透性和脑组织含水量等指标的影响。【结果】通腑醒神胶囊灌胃组大鼠在脑组织病理学、超微结构的损伤方面较模型对照组轻,在改善脑血管通透性和降低脑组织含水量等方面与模型对照组比较差异均有显著性(P<0.05)。【结论】该方可以改善脑出血后大鼠脑毛细血管通透性及减轻脑水肿,促进血肿吸收,减轻脑组织受压,改善微循环和脑组织供血供氧而达到保护脑组织、改善神经功能的目的,这是该方治疗高血压性中、大量脑出血临床有效的可能作用机理之一。

  12. 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。

  13. Delayed rebleeding of a spontaneously thrombosed aneurysm after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Muhammad Omar Chohan

    2014-01-01

    Full Text Available Background: This report provides a rare documentation of spontaneous thrombosis of a ruptured aneurysm followed by delayed recanalization and subsequent rerupture. Case Description: A 47-year-old female presented with spontaneous subarachnoid hemorrhage (SAH. Four aneurysms were identified on CT angiogram including a basilar apex aneurysm, considered source of bleeding. Cerebral angiogram on postbleed day (PBD #1 showed spontaneous thrombosis of basilar apex aneurysm. The patient was discharged to a nursing home on PBD #18 after two subsequent studies showed no recanalization of the basilar aneurysm. The patient returned on PBD #26 with a second episode of spontaneous SAH. The previously thrombosed basilar aneurysm had recanalized and reruptured, which was now treated with coil embolization. Conclusion: We are not aware of a previous report of saccular cerebral aneurysm documenting spontaneous thrombosis after SAH and recanalization with second hemorrhage. This occurrence presents a dilemma regarding the timing and frequency of subsequent cerebrovascular imaging and treatment.

  14. 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

  15. Adult hemorrhagic moyamoya disease: The paradoxical role of combined revascularization

    Directory of Open Access Journals (Sweden)

    Vikas C Jha

    2012-01-01

    Full Text Available Background: Moyamoya disease (MMD in adults often manifests with hemorrhage. Combined revascularization in hemorrhagic MMD is controversial as improvement in hemodynamics may be offset by hypervascularity-induced rebleeding. Aim: Long-term outcome assessment of adult patients from non-endemic region with hemorrhagic MMD undergoing combined revascularization. Setting: Tertiary care, academic setting. Materials and Methods: Both Suzuki′s internal carotid artery (ICA grade (1-6 and Mugikura′s posterior cerebral artery (PCA grade (1-4 were applied to 11 patients with hemorrhagic MMD (mean symptom duration 6.11±6.46 months undergoing direct [superficial temporal artery-middle cerebral artery (STA-MCA bypass] and indirect encephalomyosynangiosis (EMSA revascularization. They were clinically graded at follow-up (F/U as: excellent, preoperative symptoms resolved; good, preoperative symptoms resolved, neurological deficits remained; fair, symptom frequency decreased; and poor, symptoms unchanged/worsened. Digital subtraction angiogram/magnetic resonance angiography (DSA/MRA assessed the patency of anastomosis and cerebral hemodynamics as: 0 = non-patent; 1 = patent bypass, STA perfused recipient artery, moyamoya vessels unchanged; and, 2 = patent bypass, STA widely perfused MCA territory, moyamoya vessels diminished. An acetazolamide stimulated single photon emission computed tomography (SPECT study evaluated regional cerebral vascular reserve (RCVR. Results: Angiographic ICA grades were 5 (n=2, 4 (n=2, 3 (n=4, and 2 (n=3, and PCA grades were 1 (n=8 and 3 (n=3. At F/U (mean: 36.55±21.6 months, clinical recovery was excellent in eight and fair in one. Two patients developed delayed re-hemorrhage (in one at a site remote from previous bleed. F/U DSA/MRA (n=6 showed a good caliber, patent anastomosis with collaterals in five patients, and a narrow caliber anastomotic vessel in one patient. SPECT (n=6 revealed improved perfusion in two and normal

  16. 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)

  17. Ruptured Dissecting Aneurysm of the Middle Cerebral Artery with Spontaneous Resolution: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [Dept. of Radiology, St Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of)

    2011-11-15

    Dissecting aneurysms of the middle cerebral artery (MCA) are known to cause cerebral infarcts in younger people and can also cause subarachnoid hemorrhage (SAH) or intracranial hemorrhage. Bleeding caused by an isolated dissecting aneurysm of the MCA is relatively rare. We report the case of a young woman with SAH that occurred subsequent to a ruptured dissecting aneurysm of the MCA which resolved spontaneously as demonstrated by angiography.

  18. 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.

  19. [Simulation of repeated local hemorrhagic stroke in rats].

    Science.gov (United States)

    Makarenko, A N; Morozov, S G; Savosko, S I; Vasil'eva, I G

    2013-01-01

    The processes of developed in CNS the complicated stroke and developments of fittings for their pharmaceutical therapy were developed and offering by standardized method of the experimental secondary stroke in rats, suitable for the use in sharp and chronic researches. Variant of repeated hemorrhagic stroke consist of autohemorrhagic right hemisphere stroke by the mechanical damage of brain tissue after 10-daily occlusion of right common carotid artery was studied. A model is comfortable for reproducing of the repeated standardized local damage of brain, is more adequate form of design of transient and chronic cerebrovascular pathology, than the independent use of local hemorrhage of autoblood in the brain of animals. The morphological description of model approaches the clinical variants of development and flow of sharp hemorrhagic stroke after a previous chronic cerebral insufficiency on an ischemic type.

  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. Right Sensory Alien Hand Phenomenon from a Left Pontine Hemorrhage

    OpenAIRE

    Rafiei, Nastaran; Chang, Gregory Youngnam

    2009-01-01

    Background Acute onset of a sensory alien hand phenomenon has been observed only from a supratentorial lesion involving the non-dominant hand, mostly from a right posterior cerebral artery infarction. A single acute vascular lesion resulting in a dominant hand sensory alien hand syndrome has not been previously documented. Case Report A 78-year old right-handed woman exhibited right sensory alien hand phenomenon from a left pontine hemorrhage. Disturbance of proprioceptive input and visuospat...

  2. 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.

  3. 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.

  4. Marburg Hemorrhagic Fever (Marburg HF)

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is ... first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, ...

  5. 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

  6. 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.

  7. Transient Oliguria during Anesthesia in Cerebral Salt Wasting Syndrome.

    Science.gov (United States)

    Lee, Kwang Ho; Park, Jong Taek; Cho, Dong Woo; Song, Seung Woo; Lim, Hyun Kyo

    2016-09-01

    Cerebral salt wasting syndrome is a hyponatremic and hypovolemic condition caused by intracranial disorders, such as head injury, subarachnoid hemorrhage, brain tumor, and brain operations. We report a case of a 5-year-old girl that had cerebral salt wasting syndrome with marked polyuria who showed transient oliguria during general anesthesia. The patient had undergone an operation for traumatic intracranial hemorrhage three months prior and has had marked polyuria and hyponatremia since then. After induction of anesthesia for cranioplasty, the patient had oliguria during surgery and then resumed polyuria in the post-operative period.

  8. Ethical Issues and Prevention of Tanshinone Application of Medical Care in the Acute Stage of Cerebral Hemorrhage%脑出血急性期丹参酮应用医疗护理中的伦理问题与防范

    Institute of Scientific and Technical Information of China (English)

    邓书梅; 陈健; 苏文理; 蔡文岚; 邓宝珍

    2014-01-01

    Objective:To explore the ethical issues and its effective prevention in medical care of applying tanshinone in the acute stage of cerebral hemorrhage.Method:126 cases of the acute cerebral hemorrhage were selected in our hospital from January 2009 to January 2012,they were randomly divided into the experimental group for 59 cases and the control group for 67 cases.Two groups were given conventional treatment,the experimental group was given tanshinone therapy and nursing after onset at 72 h on the basis of routine treatment:careful observation of disease,work confidently and unflappable;guide the family assistance and participation in bedside care;humanistic health education,correct guidance,and actively resolve contradictions.Result:The selected patients had no major complications;and without any significant doctor-patient conflicts and disputes. The clinical efficacy(NIHSS score)and duration of the experimental group were significantly better than the control group,there were statistically significant differences(P<0.01).Conclusion:Medical exploration and clinical research have some ethical risks.Nurses have to deal with complain and incomprehension of patients,meanwhile they have to cooperate and follow the treat instructions of doctors.To effectively avoiding these risks,nurses should adhere to the basic ethical principles,and should possess professional qualities.Pay attention to ethical issues in medical care has benefits to make up the defect in medical research and promote the project progress smoothly.%目的:探讨脑出血急性期应用丹参酮所面临的医疗护理伦理问题与防范。方法:选取2009年1月-2012年1月本科收治的符合条件的126例急性脑出血患者,按照随机数字表法将其分为试验组59例和对照组67例,两组均给予常规治疗,试验组于发病后72 h在常规治疗基础上给予丹参酮治疗并实施护理:严密观察病情,处事果敢自信,临危不乱;指导家属协助并

  9. 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...

  10. 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.

  11. Comparison on clinical efficacy between oxiracetam and piracetam in treatment of elderly cognitive dysfunction after cerebral hemorrhage%奥拉西坦和吡拉西坦治疗老年脑出血后认知功能障碍的疗效比较

    Institute of Scientific and Technical Information of China (English)

    吴海宽; 王晓青

    2014-01-01

    Objective To compare the clinical efficacy and safety between oxiracetam and piracetam in the treatment of elderly cognitive dysfunction after cerebral hemorrhage. Methods Elderly cerebral hemorrhage patients (104 cases) who came to Zhongye Worker Hospital in Shanghai from February 2012 to December 2013 were randomly divided into control and treatment groups, and there were 52 cases in each group. The patients in the control group were po administered with Piracetam Tablets, 4 tablets/time, three times daily. The patients in the treatment group were po administered with Oxiracetam Capsules, 2 capsules/time, three times daily. The patients in the two groups were treated for 6 months. Cognitive function was assessed by Montreal cognitive assessment (MoCA) scale, minimum mental state examination (MMSE) activities and daily living (ADL) before and after the treatment. Results After the treatment, project scores of MoCA and MMSE scales were significantly improved, and the difference was statistically significant before and after the treatment in the same group (P<0.05). After the treatment, the executive function and calculation scores of MoCA scale in the treatment group were higher than those in the control group, while immediate recall force, computing power, language ability, and total scores of MMSE scale were higher than those in the control group, and there were differences between the two groups (P < 0.05). There was no difference on the incidence of adverse drug reactions (ADR) between the two groups. Conclusion Compared with piracetam, oxiracetam can effectively improve the cognitive dysfunction of elderly patients after cerebral hemorrhage, and have good clinical efficacy and safety with less ADR.%目的:比较奥拉西坦和吡拉西坦治疗老年脑出血后认知功能障碍的临床疗效和安全性。方法上海中冶职工医院2012年2月-2013年12月收治的老年脑出血患者104例,随机分为对照组和治疗组,每组各52例。对

  12. 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

  13. 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

  14. [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.

  15. Massive cerebral arterial air embolism following arterial catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)

    2005-12-01

    Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

  16. 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...

  17. Severe cerebral vasospasm after traumatic brain injury.

    Science.gov (United States)

    Fehnel, Corey R; Wendell, Linda C; Potter, N Stevenson; Klinge, Petra; Thompson, Bradford B

    2014-07-01

    Severe traumatic brain injury is associated with both acute and delayed neuro- logical injury. Cerebral vasospasm is commonly associated with delayed neurological decline in aneurysmal subarachnoid hemorrhage patients. However, the role played by vasospasm in traumatic brain injury is less clear. Vasospasm occurs earlier, for a shorter duration, and often without significant neurological consequence among traumatic brain injury patients. Detection and management strategies for vasospasm in aneurysmal subarachnoid hemorrhage are not easily transferrable to traumatic brain injury patients. We present a patient with a severe traumatic brain injury who had dramatic improvement following emergent decompressive hemicraniectomy. Two weeks after initial presentation he suffered a precipitous decline despite intensive surveillance. This case illustrates the distinct challenges of diagnosing cerebral vasospasm in the setting of severe traumatic brain injury.

  18. 针刺“百会”透“曲鬓”穴拮抗急性脑出血大鼠炎性损伤的机制研究%Penetrative Needling from“Baihui ”(GV 20)to“Qubin”(GB 7)Antagonizes Inflammatory In-jury in Rats with Cerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    陈秋欣; 马慧慧; 邹伟; 孙晓伟; 于学平; 戴晓红; 牛明明; 滕伟; 包宇; 于薇薇

    2016-01-01

    Objective To observe the effect of penetrative needling of “Baihui”(GV 20)to “Qubin”(GB 7)on neuro-logic functions and expression of tumor necrosis factor (TNF)-α,interleukin (IL)-6 and toll-like receptor 4 (TLR-4,involving in in-flammatory reactions)in the tissue around the local cerebral hematoma in rats with intracerebral hemorrhage (ICH),so as to pro-vide evidence for clinical treatment of ICH.Methods Fifty-four male Wistar rats were randomly divided into sham control,mo-del and acupuncture groups,and then further divided into three time-point subgroups (1 ,3,7 days after modeling,n = 6/sub-group).The ICH model was established by injection of the rat’s autoblood (50 μL)into the putaman region (P:0.2 mm,R:3.5 mm)in a stereotaxic apparatus and confirmed by Berderson’s neurologic examination grading system (0-3 points).The neuro-logic function was assessed by using Longa’s scoring (5-points)and footfault asymmetry testing [footfault index=(contra faults-ipsi faults)/total steps in 2 min].For penetrative needling,an acupuncture needle was inserted into GV 20 and controlled to ad-vance to GB 7 on the affected side and retained for 30 min,once daily.The expression of TNF-α,IL-6 and TLR-4 in the cerebral tissue around the putaman was detected by immunohistochemistry.Results After penetrative needling stimulation,the increased Longa’s score and footfault asymmetry score in ICH rats were significantly decreased on day 1 ,3 and 7 after modeling (P <0.0 1 ),suggesting an improvement of neurologic function after the treatment.Immunohistochemical staining outcomes of the cerebral tissue surrounding the autoblood injection site showed that the expression levels of TNF-α,IL-6 and TLR-4 proteins on day 1 ,3 and 7 were considerably higher in the model group than in the control group (P <0.0 1 ),and markedly lower in the acupunc-ture group than in the model group (P <0.0 1 ),suggesting a suppression of the proinflammatory factors and TLR-4 levels around the

  19. 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.

  20. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  1. Focal cerebral hyperemia in postconcussive amnesia.

    Science.gov (United States)

    Nariai, T; Suzuki, R; Ohta, Y; Ohno, K; Hirakawa, K

    2001-12-01

    Transient amnesia caused by minor head injury is commonly encountered in daily neurosurgical practice, but the mechanism of such amnesia has not been extensively studied. We measured the regional cerebral blood flow (rCBF) of patients with postconcussive amnesia with Xe/CT CBF to examine whether a focal disturbance of CBF exists. The Xe/CT CBF study was performed in eight patients with closed head injury without organic cerebral lesion while they were suffering from posttraumatic amnesia (concussion group). The time interval between accident and CBF measurement was less than 2 h in three patients, 5-6 h in two, 8-9 h in two, and 18 in one. The results were compared with those of nine normal volunteers and eight other age-matched patients who recovered without any neurological deficit despite the presence of hemorrhagic regions (mild hemorrhage group). The rCBF of the concussion group was significantly elevated in the bilateral mesial temporal cortex in comparison to the normal group. The rCBF in the mild hemorrhage group was lower than that of normal controls in all regions. The analysis of right-left difference in CBF indicated that there was significant asymmetry (right > left) in the frontal and temporal cortex in the concussion group, but not in the normal and mild hemorrhage group. This Xe/CT CBF study in acute stages of cerebral concussion, in which patients were amnestic, detected focal cerebral hyperemia. Such hyperemia in regions closely related to human memory function may be the result of vasoparalysis or the compensatory activation of memory circuits after denervation injury.

  2. Neuroinflammation responses after subarachnoid hemorrhage: A review.

    Science.gov (United States)

    Zheng, Vera Zhiyuan; Wong, George Kwok Chu

    2017-03-13

    Subarachnoid hemorrhage (SAH) is an important cause of stroke mortality and morbidity, especially in the young stroke population. Recent evidences indicate that neuroinflammation plays a critical role in both early brain injury and the delayed brain deterioration after SAH, including cellular and molecular components. Cerebral vasospasm (CV) can lead to death after SAH and independently correlated with poor outcome. Neuroinflammation is evidenced to contribute to the etiology of vasospasm. Besides, systemic inflammatory response syndrome (SIRS) commonly occurs in the SAH patients, with the presence of non-infectious fever and systematic complications. In this review, we summarize the evidences that indicate the prominent role of inflammation in the pathophysiology of SAH. That may provide the potential implications on diagnostic and therapeutic strategies.

  3. 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.

  4. Nonthyroidal illness syndrome in patients with subarachnoid hemorrhage due to intracranial aneurysm Sindrome da doença não tiroideana em pacientes com hemorragia subaracnoidea devida a aneurisma cerebral

    Directory of Open Access Journals (Sweden)

    Luiz Augusto Casulari

    2004-03-01

    Full Text Available We have previously reported that subarachnoid hemorrhage due to ruptured intracranial aneurysm (SH is associated with changes in the hormonal profile in the first 24 hours after the event. We proposed that the hormonal changes observed are due to the intense stress to which the patients are exposed. However, the thyroidal hormonal profile is indicative of the presence of a nonthyroidal illness syndrome (NTIS. In this paper, we examined whether the change in the thyroid hormone profile is compatible with a NTIS. Two groups of patients were included in the study: A 30 patients with SH (21 females and 9 males; 41.7±11.4 years and B a control group including 25 patients with benign diseases of the spine (BDS (lumbar disc hernia or stable spinal trauma (8 females and 17 males; 41.3±14.2 years. In a subgroup of eight patients of each group serum triiodothyronine (T3 and reverse T3 levels were measured. The blood samples were obtained between 8:00 and 9:00 AM. The following results were obtained: The SH group had smaller serum T3 and free T4 levels than the BDS group (pNós apresentamos previamente que a hemorragia subaracnoidea devido à ruptura de aneurisma intracraniano (SH está associada com alterações no perfil hormonal nas primeiras 24 horas após o evento. Nós propusemos que as alterações hormonais observadas são devidas ao intenso estresse ao qual os pacientes estão expostos. Contudo, o perfil hormonal tireoidiano é indicativo da presença da síndrome da doença não tireoidiana (NTIS. Neste trabalho, examinamos se as alterações no perfil dos hormônios tireoidianos são compatíveis com a NTIS. Dois grupos de pacientes foram incluídos no estudo: A 30 pacientes com SH (21 mulheres e 9 homens; 41,7±11,4 anos e B um grupo controle incluindo 25 pacientes com doenças benignas da coluna (BDS (hérnia de disco lombar ou estável trauma da coluna (8 mulheres e 17 homens; 41,3±14,2 anos. Em um subgrupo de oito pacientes de cada grupo

  5. 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.

  6. Diagnostic usefulness of periIesional edema around intracerebral hemorrhage in predicting underlying causes

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Nam Yeol; Seo, Jeong Jin; Yoon, Woong; Shin, Sang Soo; Lim, Hyo Soon; Chung, Tae Woong; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National Univ. Hospital, Gwangju (Korea, Republic of)

    2004-07-01

    We attempted to evaluate the diagnostic usefulness of the degree of perilesional edema around intracerebral hematoma in predicting the underlying cause. This study included 54 patients with intracerebral hematoma for whom the underlying cause was confirmed by biopsy, radiological or clinical methods. Cases of subarachnoid hemorrhage, hemorrhagic transformation of cerebral infarction and intraventricular hemorrhage were excluded. The lesion size was defined as the average value of the longest axis and the axis perpendicular to this. The size of the perilesional edema was defined as the longest width of the edema. In all cases, the sizes of the lesion and edema were measured on the T2 weighted image. We defined the edema ratio as the edema size divided by the lesion size. 23 cases were diagnosed as intracerebral hemorrhage due to neoplastic conditions, such as metastasis (n=17), glioblastoma (n=5), hemangioblastoma (n=1). 31 cases were caused by non-neoplastic conditions, such as spontaneous hypertensive hemorrhage (n=23), arteriovenous malformation (n=4), cavernous angioma (n=3), and moya-moya disease (n=1). In fourteen cases, which were confirmed as malignant intracerebral hemorrhage, the edema ratio was more than 100%. Of the other cases, only 8 were confirmed as malignant intracerebral hemorrhage. It was found that the larger the edema ratio, the more malignant the intracerebral hemorrhage, and this result was statistically significant (p<0.001). Measurement of perilesional edema and the intracerebral hematoma ratio may be useful in predicting the underlying causes.

  7. 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

  8. 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

  9. Physiologic Tolerance of Descending Thoracic Aortic Balloon Occlusion in a Swine Model of Hemorrhagic Shock

    Science.gov (United States)

    2013-01-10

    using a modified Seldinger technique. This permitted transduction of the carotid arterial catheter to enable cartoid- flow monitoring, intra- venous ...ameliorated with resuscitation and critical care . Central aortic pressure and cerebral oxygen delivery is significantly improved by the use of REBOA...minutes of hemorrhage shock Resuscitation Phase Resuscitation with shed blood, intra- venous fluid and inotropes Critical Care Phase Sedation

  10. Towards use of MRI-guided ultrasound for treating cerebral vasospasm

    OpenAIRE

    2016-01-01

    Cerebral vasospasm is a major cause of morbidity and mortality in patients with subarachnoid hemorrhage (SAH), causing delayed neurological deficits in as many as one third of cases. Existing therapy targets induction of cerebral vasodilation through use of various drugs and mechanical means, with a range of observed efficacy. Here, we perform a literature review supporting our hypothesis that transcranially delivered ultrasound may have the ability to induce therapeutic cerebral vasodilation...

  11. CaMKII inhibition with KN93 attenuates endothelin and serotonin receptor-mediated vasoconstriction and prevents subarachnoid hemorrhage-induced deficits in sensorimotor function

    DEFF Research Database (Denmark)

    Edvinsson, Lars; Povlsen, Gro Klitgaard; Ahnstedt, Hilda

    2014-01-01

    BACKGROUND: It has been suggested that transcriptional upregulation of cerebral artery contractile endothelin (ETB) and 5-hydroxytryptamine (5-HT1B) receptors play an important role in the development of late cerebral ischemia and increased vasoconstriction after subarachnoid hemorrhage (SAH). We...

  12. 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.

  13. 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.

  14. Impact of Enteral Nutrition Suspension on Nutritional Status and Infection in Acute Cerebral Hemorrhage Patients Com­ plicated with Dysphagia%肠内营养混悬液对急性脑出血并吞咽障碍患者营养状况及感染的影响研究

    Institute of Scientific and Technical Information of China (English)

    王文斌; 黄翼

    2014-01-01

    Objective To investigate the impact of enteral nutrition suspension on nutritional status and infection in a­ cute cerebral hemorrhage patients complicated with dysphagia. Methods From February 2013 to February 2014,78 acute cere­ bral hemorrhage patients complicated with dysphagia were selected in the Second People's Hospital of Baoan District,Shenz­ hen. According to random,parallel,control principle,all patients were divided into control group and observation group,each of 39 cases. Based on conventional therapy,control group given self - made ordinary liquid diet,observation group given enteral nutrition suspension. Nutritional status after 6 weeks of treatment,nutrition index(including serum levels of Hb,ALB,IgG, IgA,IgM)before treatment and after 6 weeks of treatment,and incidence of infection during hospitalization between the two groups were compared. Results Nutritional status of observation group after 6 weeks of treatment was better than that of control group,and severity of poor nutrition was slighter than that of control group(P 0. 05),while serum levels of Hb, ALB,IgG,IgA,IgM of observation group after 6 weeks of treatment were higher than those of control group(P < 0. 05). The incidence of infection of observation group during hospitalization was 38. 5% ,was lower than that of observation group( P <0. 05). Conclusion Enteral nutrition suspension can certainly improve the nutritional status and immunity of acute cerebral hemorrhage patients complicated with dysphagia,reduce the severity of poor nutrition and incidence of infection during hospitali­ zation.%目的:探讨肠内营养混悬液对急性脑出血并吞咽障碍患者营养状况及感染的影响。方法选择深圳市宝安区第二人民医院2013年2月—2014年2月收治的急性脑出血并吞咽障碍患者78例,按照随机、平行、对照原则分为对照组和观察组,每组39例。对照组患者在常规治疗基础上给予家属自制的普通流质饮食,

  15. 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

  16. Assessment of Cerebral Hemodynamics in Traumatic Brain Injury

    Science.gov (United States)

    2006-11-01

    haemorrhage, and 6 with subarach- noid hemorrhage from ruptured aneurysm . There were 4 cases of cerebral contusions and a single case of traumatic...B. Goldstein, 2003: Significance of Intracranial Pressure Pulse Morphology in Pediatric Traumatic Brain Injury. IEEE, 2491-2494. Anile, C., H. D

  17. Hemorrhagic Fever with Renal Syndrome (HFRS)

    Science.gov (United States)

    ... this page: About CDC.gov . Share Compartir Hemorrhagic Fever with Renal Syndrome (HFRS) On this Page What ... is HFRS prevented? Suggested Reading What is hemorrhagic fever with renal syndrome? Hemorrhagic fever with renal syndrome ( ...

  18. 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.

  19. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  20. 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.

  1. GUSS作为脑出血术后留置胃管患者拔管指征的效果评价%The application of GUSS swallowing evaluation as a symbol of pulling out the tube in cerebral hemorrhage patients with indwelling gastric tube

    Institute of Scientific and Technical Information of China (English)

    祝晓娟; 柏慧华; 范莉花; 姚秋近; 陈静; 张一

    2013-01-01

    Objective To compare the difference between GUSS swallowing evaluation and traditional evaluation as a symbol of pulling out stomach tube.Methods 60 patients with cerebral hemorrhage combined with indwelling tube were divided into two groups,the GUSS group and the traditional group,according to the symbol of pulling out the gastric tube.Each group contained 30 cases.The GUSS score ≥ 15 points was used as the symbol of pulling out the gastric tube in the GUSS group,while being able to eat 200 ml liquid without any trouble in two days was used as the symbol in the traditional group.Then we compared the incidence of gastric tube reinsertion and aspiration pneumonitis between the two groups.Results No gastric tube reinsertion and aspiration pneumonitis occurred in the GUSS group,while 7 cases accepted gastric tube reinsertion and 3 cases diagnosed as aspiration pneumonitis in the traditional group.The incidence of gastric tube reinsertion and aspiration pneumonitis in the GUSS group were obviously lower than those in the traditional group.Conclusions GUSS evaluation score ≥ 15 points could be used as a symbol of pulling out gastric tube.%目的 比较Gugging吞咽功能评估表(Gugging swallowing screen,GUSS)与传统方法作为留置胃管拔管标准的效果.方法 选择2011年10月至2012年6月我科脑出血术后留置胃管患者60例,其中GUSS组30例,以GUSS评分≥15分作为拔管标准;传统组30例,采取传统方法即每餐能进食200 ml以上流食,观察2d无不适作为拔管标准,比较2组间拔管后复插率及吸入性肺炎发生率.结果 GUSS组拔管后无一例复插胃管及发生吸入性肺炎.传统组拔管后有7例复插胃管,5例发生吸入性肺炎.GUSS组复插率及吸入性肺炎发生率明显低于传统组.结论 GUSS吞咽评估≥15分可作为脑出血术后留置胃管患者的拔管指征,且操作方便,具有可行性.

  2. Post-tonsillectomy hemorrhage

    DEFF Research Database (Denmark)

    Heidemann, Christian; Wallén, Mia; Aakesson, Marie;

    2008-01-01

    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...... as surgical technique" [relative risk (RR) = 5.3], "peritonsillar abscess as indication for surgery" (RR = 0.3) and "age equal to or above 15 years at the time of surgery" (RR = 5.4). It is concluded that patient age, PTA as indication for surgery and the use of coblation significantly affect the occurrence...

  3. 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.

  4. Anosmia After Perimesencephalic Nonaneurysmal Hemorrhage

    NARCIS (Netherlands)

    Greebe, Paut; Rinkel, Gabriel J. E.; Algra, Ale

    2009-01-01

    Background and Purpose-Anosmia frequently occurs after aneurysmal subarachnoid hemorrhage not only after clipping, but also after endovascular coiling. Thus, at least in part, anosmia is caused by the hemorrhage itself and not only by surgical treatment. However, it is unknown whether anosmia is rel

  5. 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.

  6. Evaluation by computed tomography of the destruction of the internal capsule in hypertensive intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Tomita, Yukio; Ohuchi, Tadao; Yukawa, Hideki; Konno, Jyoji; Saiki, Iwao (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1983-12-01

    Seventy-five patients, 37 with putaminal hemorrhage and 38 with thalamic hemorrhage. were examined by CT immediately after the ictus and while the patients were undergoing conservative treatment. The distance was measured on every CT from the center of the pineal body to the inside edge of the hematoma in the putaminal hemorrhage and to the outside edge in the thalamic hemorrhage, by using a slice 5 cm above the orbitomeatal line on which the pineal body was clearly recognizable. At 6 months after ictus, recuperations from hemiplegia were estimated in all patients and compared with the degree of the measured distance on CT. In the group of patients who had recovered completely from hemiplegia, the degrees were more than 28 mm in the cases of putaminal hemorrhage and less than 32 mm in the cases of thalamic hemorrhage. If the degrees were under 25 mm in the putaminal hemorrhage or over 36 mm in the thalamic hemorrhage, no rehabilitation was effective for their paralytic upper extremities. Measurements of the internal capsule were also performed on three fresh brains without cerebral disease. The normal values of the distance were 34.7+-1.0 mm from the center of the pineal body to the outside edge of the posterior limb of the internal capsule and 25.0+-0.9 mm to its inside edge. Judging from these results, it is thought that the attainable limits of avoiding destruction of the posterior limb of the internal capsule by the hematoma are 28 mm in the case of a putaminal hemorrhage and 32 mm in the case of a thalamic hemorrhage. Therefore, it was considered that the internal capsule can be shifted about 7 mm to the medial or lateral side without any direct or indirect effects from the hematoma.

  7. Rodent neonatal germinal matrix hemorrhage mimics the human brain injury, neurological consequences, and post-hemorrhagic hydrocephalus.

    Science.gov (United States)

    Lekic, Tim; Manaenko, Anatol; Rolland, William; Krafft, Paul R; Peters, Regina; Hartman, Richard E; Altay, Orhan; Tang, Jiping; Zhang, John H

    2012-07-01

    Germinal matrix hemorrhage (GMH) is the most common neurological disease of premature newborns. GMH causes neurological sequelae such as cerebral palsy, post-hemorrhagic hydrocephalus, and mental retardation. Despite this, there is no standardized animal model of spontaneous GMH using newborn rats to depict the condition. We asked whether stereotactic injection of collagenase type VII (0.3 U) into the ganglionic eminence of neonatal rats would reproduce the acute brain injury, gliosis, hydrocephalus, periventricular leukomalacia, and attendant neurological consequences found in humans. To test this hypothesis, we used our neonatal rat model of collagenase-induced GMH in P7 pups, and found that the levels of free-radical adducts (nitrotyrosine and 4-hyroxynonenal), proliferation (mammalian target of rapamycin), inflammation (COX-2), blood components (hemoglobin and thrombin), and gliosis (vitronectin and GFAP) were higher in the forebrain of GMH pups, than in controls. Neurobehavioral testing showed that pups with GMH had developmental delay, and the juvenile animals had significant cognitive and motor disability, suggesting clinical relevance of the model. There was also evidence of white-matter reduction, ventricular dilation, and brain atrophy in the GMH animals. This study highlights an instructive animal model of the neurological consequences after germinal matrix hemorrhage, with evidence of brain injuries that can be used to evaluate strategies in the prevention and treatment of post-hemorrhagic complications.

  8. 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.

  9. Effect of pregnancy and nitric oxide on the myogenic vasodilation of posterior cerebral arteries and the lower limit of cerebral blood flow autoregulation.

    Science.gov (United States)

    Chapman, Abbie C; Cipolla, Marilyn J; Chan, Siu-Lung

    2013-09-01

    Hemorrhage during parturition can lower blood pressure beyond the lower limit of cerebral blood flow (CBF) autoregulation that can cause ischemic brain injury. However, the impact of pregnancy on the lower limit of CBF autoregulation is unknown. We measured myogenic vasodilation, a major contributor of CBF autoregulation, in isolated posterior cerebral arteries (PCAs) from nonpregnant and late-pregnant rats (n = 10/group) while the effect of pregnancy on the lower limit of CBF autoregulation was studied in the posterior cerebral cortex during controlled hemorrhage (n = 8). Pregnancy enhanced myogenic vasodilation in PCA and shifted the lower limit of CBF autoregulation to lower pressures. Inhibition of nitric oxide synthase (NOS) prevented the enhanced myogenic vasodilation during pregnancy but did not affect the lower limit of CBF autoregulation. The shift in the autoregulatory curve to lower pressures during pregnancy is likely protective of ischemic injury during hemorrhage and appears to be independent of NOS.

  10. The Variation of CRP and the TNF-α in the Vupratentorial Hypertensive Cerebral Hemorrhage after Surgical Treated with Small Bone and the Relationship to the Patient's Condition and Prognostic%幕上高血压脑出血小骨窗开颅术后C反应蛋白及TNF-α的变化及对转归影响的临床分析

    Institute of Scientific and Technical Information of China (English)

    廖鑫; 王佳唐; 罗东; 何俊; 吴昌松; 梁敬心

    2012-01-01

    Objective: To investigate the role and the rules of Tumor necrosis factor alpha and C-reactive protein of patients after surgical treated with small bone with supratentorial hypertensive cerebral hemorrhage and relation with the GCS. Methods: 38 cases diagnosed supratentorial hypertensive intracerebral hemorrhage were given surgery underwent eraniotomy with small bone window after a clear indication. The levels of CRP and TNF-αwere detected before and at 1 day, 7 days and 14 days after surgical treatment, and the Glasgow coma score (GCS) also determination. We also have 30 cases as control of the CRP and TNF-α. Results: Preoperative serum CRP and TNF-α levels were significantly higher than the control group. Postoperative CRP and TKF-α levels continued to rise,but decreased after 7 days of surgical treatment. The levels of CRP and TNF-α are closely associated with the GCS score. Conclusions: CRP and TNF-α levels may reflect patient's condition and prognostic with hypertensive intracerebral hemorrhage.%目的:探索幕上高血压脑出血术前及小骨窗开颅术后C反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)的变化与病情的关系及对患者临床预后的预测价值.方法:38例诊断为幕上高血压脑出血的患者,在明确手术指征后行小骨窗开颅术,于术前,术后第1天,第7天,第14天监测患者的CRP及TNF-α的水平;并同时测定格拉斯哥昏迷评分(GSS).另设30例作为正常对照病例,一次性抽取静脉血进行CRP及TNF-α进行检测.结果:①术前脑出血患者血中CRP与TNF-α的水平显著高于正常对照组;②术后CRP与TNF-α的水平仍继续上升,术后第7天显著下降;③CRP及TNF-α的水平与GCCS评分密切相关.结论:CRP与TNF-α的水平可反映脑出血患者的病情,对病情转归有预测意义.