Neurologist最新文献_第2页

Thrombolytic Imaging-to-Needle Time as a Metric for Comparing Telemedicine versus In-Person Evaluation in Acute Ischemic Stroke.

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-13 DOI: 10.1097/NRL.0000000000000618

Andrea Loggini, Faddi G Saleh Velez, Jessie Henson, Julie Wesler, Jonatan Hornik, Amber Schwertnam, Karam Dallow, Joaquin Grimaldi, Alejandro Hornik

{"title":"Thrombolytic Imaging-to-Needle Time as a Metric for Comparing Telemedicine versus In-Person Evaluation in Acute Ischemic Stroke.","authors":"Andrea Loggini, Faddi G Saleh Velez, Jessie Henson, Julie Wesler, Jonatan Hornik, Amber Schwertnam, Karam Dallow, Joaquin Grimaldi, Alejandro Hornik","doi":"10.1097/NRL.0000000000000618","DOIUrl":"https://doi.org/10.1097/NRL.0000000000000618","url":null,"abstract":"Objectives: Door-to-needle time (DTN) is standard for measuring the efficiency of thrombolytic administration in acute ischemic stroke, with guidelines recommending DTN <60 minutes. DTN can be divided into door-to-imaging time (DIT) and imaging-to-needle time (ITN), separated by arrival at the CT scanner. We hypothesize that ITN is more accurate for comparing the mode of evaluation for stroke patients treated with thrombolytics.Methods: This is a retrospective cohort study of stroke patients treated with thrombolytics at Southern Illinois Health care. Data on demographics, clinical presentation, stroke metrics, thrombolytic complications, and mRS at 1-month were reviewed. Multivariate logistic regression models were applied to evaluate predictors of DTN, ITN, and DIT, with OR and 95% CI. P-value was set at 0.05.Results: Out of 287 patients, 170 were evaluated by telemedicine, 117 in-person. The 2 groups were comparable in demographics and stroke severity. Telemedicine had longer median DTN, in minutes [55 (43 to 70) vs. 42 (34 to 62), P<0.01], and median ITN, in minutes [43 (35-58) vs. 32 (25-48), P<0.01]. There was no statistical difference in DIT between the 2 groups. Adjusted for stroke severity and age, telemedicine was associated with lower odds of DTN <60 minutes (OR: 0.553, 95% CI: 0.328-0.931, P=0.026) and ITN <35 minutes (OR: 0.265, 95% CI: 0.159-0.441, P<0.01). However, telemedicine was not independently associated with DIT <25 minutes, which was instead inversely correlated with age (OR: 0.974, 95% CI: 0.951-0.997, P=0.03).Conclusions: ITN represents a more accurate metric for comparing telemedicine and in-person evaluations than DTN, as it excludes stroke-specific processes of care and patient-specific factors that are intrinsic to DTN and unrelated to the modality of evaluation.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Efficacy for Hypertensive Intracerebral Hemorrhage Between Neuroendoscopic Surgery and Conservative Treatment: A Retrospective Observational Study. 神经内镜手术与保守治疗对高血压性脑出血的疗效：一项回顾性观察研究。

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000597

Guojin Huo, Yanping Lan, Yi Feng, Xiang Gao, Chen Chen

{"title":"The Efficacy for Hypertensive Intracerebral Hemorrhage Between Neuroendoscopic Surgery and Conservative Treatment: A Retrospective Observational Study.","authors":"Guojin Huo, Yanping Lan, Yi Feng, Xiang Gao, Chen Chen","doi":"10.1097/NRL.0000000000000597","DOIUrl":"10.1097/NRL.0000000000000597","url":null,"abstract":"Objectives: This study aims to investigate the efficacy of neuroendoscopic surgery in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods: A total of 193 patients diagnosed with HICH were divided into 2 groups in this study: the observation group (n=101) received neuroendoscopic surgery, whereas the control group (n=92) underwent conservative treatment. Then, the outcomes between these 2 groups were compared and assessed.Results: In the pretreatment phase, there were no significant differences in the levels of inflammation and neurological function scores between these 2 groups ( P >0.05). After 3 months of treatment, the observation group displayed significantly shorter median hospital stay, lower average hospital costs, and faster hematoma resorption time, along with reduced levels of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), interleukin (IL)-6 and IL-8, aquaporin-4 (AQP4), macrophage migration inhibitory factor (MIF), matrix metalloproteinase-9 (MMP-9), granulocyte macrophage colony stimulating factor (GM-CSF), Nerve Deficiency Scale (NDS), Graeb score, and national institute of health stroke scale (NIHSS) compared with the control group ( P <0.05). In addition, the observation group exhibited higher rate of hematoma clearance and better glasgow outcome scale (GOS) score compared with the control group ( P <0.05). The effective treatment rate in the observation group was notably superior to that in the control group (89.11% vs. 73.91%, P <0.05).Conclusions: Neuroendoscopic surgery is an effective treatment for HICH, with alleviating the inflammatory response and enhancing the neurological function. The treatment shows promising outcomes and justifies extensive implementation.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"109-115"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethnicity as a Risk Factor for Early Neurological Deterioration: A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes Trial. 种族是早期神经功能恶化的危险因素：对皮质下脑卒中二级预防试验的事后分析。

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000605

Eric D Goldstein, Sabrina Q R Liew, Liqi Shu, Alicia Rocha, Shadi Yaghi

{"title":"Ethnicity as a Risk Factor for Early Neurological Deterioration: A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes Trial.","authors":"Eric D Goldstein, Sabrina Q R Liew, Liqi Shu, Alicia Rocha, Shadi Yaghi","doi":"10.1097/NRL.0000000000000605","DOIUrl":"10.1097/NRL.0000000000000605","url":null,"abstract":"Objectives: Nearly 25% of those with a small vessel stroke will develop early neurological deterioration (END). The objectives of this study were to identify clinical risk factors for small vessel stroke-related END and its associated impact on functional outcomes in an ethnically diverse data set.Methods: We performed a post hoc analysis of the \"Secondary Prevention of Small Subcortical Strokes\" trial. The primary outcome was END defined as progressive or stuttering stroke-related neurological symptoms. Standard descriptive and inferential statistical methods were used for analysis. Functional outcomes are reported by modified Rankin Scale score and analyzed by the Wilcoxon signed-rank test.Results: In all, 69 participants met the inclusion criteria; 21 (30%) had END. Of the cohort, Spanish, Hispanic, or Latino ethnicity (grouping per trial definition) most frequently developed END [11 (52.4%) vs 4 (8.3%), P < 0.001] with a higher adjusted likelihood of END (odds ratio: 14.1, 95% CI: 2.57-76.7, P = 0.002). Black or African-American race less commonly had END [3 (14.3%) vs 21 (43.8%), P = 0.03] but lost significance after adjustment (odds ratio: 1.46, 95% CI: 0.26-8.17, P = 0.67) due to powering. END was associated with a higher mean modified Rankin Scale (2.06 ± 0.94 vs 1.17 ± 0.79, P = 0.006) but did not differ in the shift analysis.Conclusions: We found that Spanish, Hispanic, or Latino ethnicity was the most consistent risk factor for END though it was without meaningful functional outcome differences.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"116-120"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Syncope Induced by Dynamic Head and Shoulder Motion in the Setting of Left Subclavian Stenosis. 左锁骨下狭窄患者动态头肩运动诱发晕厥。

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000607

Forrest W Fearington, Katarina Alajbegovic, Jonathan M Scott, Waleed Brinjikji, Carmen R Holmes, Muhib Khan

{"title":"Syncope Induced by Dynamic Head and Shoulder Motion in the Setting of Left Subclavian Stenosis.","authors":"Forrest W Fearington, Katarina Alajbegovic, Jonathan M Scott, Waleed Brinjikji, Carmen R Holmes, Muhib Khan","doi":"10.1097/NRL.0000000000000607","DOIUrl":"10.1097/NRL.0000000000000607","url":null,"abstract":"Introduction: Dynamic vertebral artery insufficiency is a rare vascular phenomenon characterized by insufficient flow of the posterior cerebral circulation induced by dynamic motion of the head. Prior case reports have been limited to vertebral artery occlusion by cervical osteophytes or other structural impingements.Case report: In this case report, we discuss the unusual case of a 61-year-old female with a history of vertigo, diplopia, nystagmus, and left subclavian stenosis admitted to the hospital for syncope elicited by a left head turn and left shoulder raise. Transcranial Doppler (TCD) ultrasound and angiography showed evidence of dynamic vertebrobasilar insufficiency elicited by a left-head turn. Percutaneous stenting of the left subclavian artery led to the resumption of normal vessel flow as assessed by TCD and the resolution of the patient's symptoms.Conclusions: This case highlights an unusual cause of dynamic vertebrobasilar insufficiency induced by head turn and/or left shoulder raise due to subclavian stenosis, diagnosed by TCD and angiography, and successfully treated with subclavian artery stenting.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"121-122"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diffusion-Weighted Imaging-Based Radiomics Features and Machine Learning Method to Predict the 90-Day Prognosis in Patients With Acute Ischemic Stroke.

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000599

Guirui Li, Yueling Zhang, Jian Tang, Shijian Chen, Qianqian Liu, Jian Zhang, Shengliang Shi

{"title":"Diffusion-Weighted Imaging-Based Radiomics Features and Machine Learning Method to Predict the 90-Day Prognosis in Patients With Acute Ischemic Stroke.","authors":"Guirui Li, Yueling Zhang, Jian Tang, Shijian Chen, Qianqian Liu, Jian Zhang, Shengliang Shi","doi":"10.1097/NRL.0000000000000599","DOIUrl":"10.1097/NRL.0000000000000599","url":null,"abstract":"Objectives: The evaluation of the prognosis of patients with acute ischemic stroke (AIS) is of great significance in clinical practice. We aim to evaluate the feasibility and effectiveness of diffusion-weighted imaging (DWI) image-based radiomics features and machine learning methods in predicting 90-day prognosis among patients with AIS.Patients and methods: We enrolled a total of 171 patients with AIS in this study, including 134 patients with a good prognosis and 37 patients with a poor prognosis, and collected the patients' clinical and DWI image data. Radiomics features from manually sketched ischemic lesions were extracted using the Pyradiomics package of Python, and the best radiomics features were selected by a t test and the least absolute shrinkage and selection operator. The radiomics model and clinical model were constructed using support vector machine and logistic regression, respectively, and the predictive performance of each model was evaluated.Results: We selected 9 features from a total of 851 radiomics features to build the final radiomics model. For predicting the poor prognosis of patients with AIS, the area under the curves, accuracy, sensitivity and specificity of the clinical model, radiomics model in the training set and radiomics model in the testing set were 0.865, 0.930 and 0.906, 81.3%, 92.0% and 90.0%, 81.1%, 76.0% and 75.0%, and 81.3%, 97.0% and 95.0%, respectively.Conclusions: DWI image-based radiomics features and machine learning methods can accurately predict the 90-day prognosis of patients with AIS, and the radiomics model is superior to the clinical model in predicting prognosis.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":"30 2","pages":"93-101"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes and Antithrombotic Regimens in Nonvalvular Atrial Fibrillation Patients With Acute Ischemic Stroke and Competing Large-Artery Atherosclerosis. 急性缺血性卒中合并大动脉粥样硬化的非瓣膜性心房颤动患者的预后和抗血栓治疗方案

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000590

Sufang Xue, Risu Na, Jing Dong, Xue Qiu, Min Wei, Qi Kong, Qiujia Wang, Fangyu Li, Yan Wang

{"title":"Outcomes and Antithrombotic Regimens in Nonvalvular Atrial Fibrillation Patients With Acute Ischemic Stroke and Competing Large-Artery Atherosclerosis.","authors":"Sufang Xue, Risu Na, Jing Dong, Xue Qiu, Min Wei, Qi Kong, Qiujia Wang, Fangyu Li, Yan Wang","doi":"10.1097/NRL.0000000000000590","DOIUrl":"10.1097/NRL.0000000000000590","url":null,"abstract":"Objectives: This study aimed to investigate the outcomes and effectiveness of different antithrombotic regimens at discharge in nonvalvular atrial fibrillation (NVAF) patients with acute ischemic stroke (AIS) and competing large artery atherosclerosis (LAA) mechanisms.Methods: In an observational study, we retrospectively analyzed the clinical and follow-up data of NVAF patients with AIS from January 2018 to December 2021 (NCT04080830). The subjects were grouped into 2 groups based on the presence or absence of competing LAA mechanisms. Stroke severity, short-term prognosis, and ischemic recurrence (a composite of ischemic stroke/TIA, myocardial infarction, or systemic embolism after index stroke), were compared between the 2 groups. Antithrombotic regimens at discharge were further categorized into antiplatelet and anticoagulant subgroups to analyze their effectiveness.Results: Five hundred-one NVAF patients with AIS (129 with and 372 without competing LAA mechanisms) were included. Compared with the other group, the group with competing LAA mechanisms had a higher proportion of patients with a nondisabling mRS score (P <0.001), lower mortality rates at the 90-day follow-up ( P =0.048), and higher 180-day ischemic outcomes ( P =0.023). Subgroup analysis showed that the ischemic outcomes were not significantly different ( P =0.166) between the anticoagulant and antiplatelet subgroups in patients with competing LAA mechanisms. In contrast, it was numerically higher in the anticoagulant subgroup.Conclusion: NVAF patients with AIS due to competing LAA mechanisms had mild severity and a comfortable short-term prognosis; however, these patients had a higher risk of ischemic events. The optimal antithrombotic regimens in these patients remain unclear, and stroke mechanisms should be considered.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"102-108"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiphase CTA Collateral Score to Identify Intracranial Atherosclerotic Stenosis-Related Large Vessel Occlusion.

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000592

Jiajie Xia, Chuanjian Tu, Hui Qian, Zhiwei Gu, Dagang Song, Lei Xu

{"title":"Multiphase CTA Collateral Score to Identify Intracranial Atherosclerotic Stenosis-Related Large Vessel Occlusion.","authors":"Jiajie Xia, Chuanjian Tu, Hui Qian, Zhiwei Gu, Dagang Song, Lei Xu","doi":"10.1097/NRL.0000000000000592","DOIUrl":"10.1097/NRL.0000000000000592","url":null,"abstract":"Objective: Identification of acute ischemic stroke with large vessel occlusion (AIS-LVO) etiology is crucial for effective revascularization therapy. As collaterals are pivotal in maintaining cerebral perfusion in intracranial atherosclerotic stenosis (ICAS), we investigated whether multiphase CT angiography (mCTA) collateral score can be a diagnosis marker of ICAS-related LVO.Methods: We reviewed clinical and imaging data from 92 patients who presented with AIS-LVO and underwent mCTA (57 ICAS-related LVO and 35 embolic LVO). Logistic regression was used to identify ICAS-related LVO. The diagnostic accuracy of the mCTA collateral score for identifying ICAS-related LVO was determined using receiver operating characteristic (ROC) analysis.Results: Compared with patients with embolic LVO, those with ICAS-related LVO had a high median mCTA collateral score (4 vs. 3; P<0.0001). The multinomial logistic regression analysis revealed a significant increase in the mCTA collateral score (OR: 3.717, 95% CI: 2.009-6.876, P<0.0001) in patients with ICAS-related LVO. ROC analysis revealed that the optimal cutoff point of the mCTA collateral score to diagnosis the ICAS-related LVO was 3.5, the area under the curve (AUC) was 0.817 (95% CI: 0.736-0.899; P<0.0001), sensitivity was 80.7%, and specificity was 74.3%. Further analysis revealed that patients with a 4 to 5 mCTA collateral score exhibited a significantly higher median modified Rankin Scale (mRS) at discharge compared with those with a 0 to 3 score (P=0.0464).Conclusions: The mCTA collateral score may be associated with ICAS-related LVO and could be beneficial in identifying the etiology of AIS-LVO.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":"30 2","pages":"87-92"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stem Cells Treatment for Subarachnoid Hemorrhage. 干细胞治疗蛛网膜下腔出血。

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000589

Wei Wang, Ying Wang, Liansheng Gao

{"title":"Stem Cells Treatment for Subarachnoid Hemorrhage.","authors":"Wei Wang, Ying Wang, Liansheng Gao","doi":"10.1097/NRL.0000000000000589","DOIUrl":"10.1097/NRL.0000000000000589","url":null,"abstract":"Background: Subarachnoid hemorrhage (SAH) refers to bleeding in the subarachnoid space, which is a serious neurologic emergency. However, the treatment effects of SAH are limited. In recent years, stem cell (SC) therapy has gradually become a very promising therapeutic method and advanced scientific research area for SAH.Review summary: The SCs used for SAH treatment are mainly bone marrow mesenchymal stem cells (BMSCs), umbilical cord mesenchymal stem cells (hUC-MSCs), dental pulp stem cells (DPSCs), neural stem cells (NSCs)/neural progenitor cell (NPC), and endothelial progenitor cell (EPC). The mechanisms mainly included differentiation and migration of SCs for tissue repair; alleviating neuronal apoptosis; anti-inflammatory effects; and blood-brain barrier (BBB) protection. The dosage of SCs was generally 10 6 orders of magnitude. The administration methods included intravenous injection, nasal, occipital foramen magnum, and intraventricular administration. The administration time is generally 1 hour after SAH modeling, but it may be as late as 24 hours or 6 days. Existing studies have confirmed the neuroprotective effect of SCs in the treatment of SAH.Conclusions: SC has great potential application value in SAH treatment, a few case reports have provided support for this. However, the relevant research is still insufficient and there is still a lack of clinical research on the SC treatment for SAH to further evaluate the effectiveness and safety before it can go from experiment to clinical application.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"80-86"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive Value of Serum Inflammatory Factors and FT 3 for Stroke-Associated Pneumonia in Patients With Acute Ischemic Stroke. 急性缺血性脑卒中患者血清炎症因子和 FT3 对脑卒中相关肺炎的预测价值

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000570

Xin Li, Xiaomei Xie, Shenju Cheng, Shan Luo, Yancui Zhu, Kun Wu

{"title":"Predictive Value of Serum Inflammatory Factors and FT 3 for Stroke-Associated Pneumonia in Patients With Acute Ischemic Stroke.","authors":"Xin Li, Xiaomei Xie, Shenju Cheng, Shan Luo, Yancui Zhu, Kun Wu","doi":"10.1097/NRL.0000000000000570","DOIUrl":"10.1097/NRL.0000000000000570","url":null,"abstract":"Objective: The ability of serum inflammatory factors and free triiodothyronine (FT 3 ) in predicting the occurrence of stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS) was assessed in this study.Methods: A retrospective analysis was conducted on 285 consecutive patients with AIS initially diagnosed and admitted to our hospital from January to December 2022. Patients were categorized into SAP and non-SAP groups based on the presence of SAP. Both groups were compared in terms of baseline characteristics, including National Institute of Health Stroke Scale (NIHSS) score, SAP risk assessment (A 2 DS 2 ), TOAST classification. Independent risk factors for SAP were identified using multivariate logistic regression analysis, and the predictive value of inflammatory markers was evaluated through ROC curves.Results: Among 285 patients with AIS, 40 (14.03%) were found to have developed SAP. Higher NIHSS and A 2 DS 2 scores, elevated serum IL-1β, IL-8, and IL-33 levels, increased age, atrial fibrillation, swallowing difficulties, and a higher proportion of patients with low FT 3 levels were observed in the SAP group compared with the non-SAP group (all P <0.05). Significant risk factors for SAP in patients with AIS were identified through multivariate logistic regression analysis, including age, swallowing difficulties, NIHSS, A 2 DS 2 , IL-1β, IL-8, IL-33, and FT 3 ( P <0.05). The highest predictive values were observed for A 2 DS 2 , FT 3 , and IL-8 with AUC values of 0.854, 0.844, and 0.823, respectively.Conclusion: SAP can be highly predicted by A 2 DS 2 , FT 3 , and IL-8, enabling the early identification of patients with high-risk SAP and facilitating timely intervention and treatment.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"69-74"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

MELAS Presenting as Bilateral Symmetric Occipital and Temporal Cortices Lesions: A Case Report and Literature Review. 表现为双侧对称性枕叶和颞叶皮质病变的 MELAS：病例报告与文献综述

IF 1.1 4区医学

Neurologist Pub Date : 2025-03-01 DOI: 10.1097/NRL.0000000000000588

Qing Liu, Zhaoxia Wang, Jing Shi, Wenxia Wang, Chao Wen, Yanping Zhu, Xuan Chen, Xiaolian Xing, Yangli Su

{"title":"MELAS Presenting as Bilateral Symmetric Occipital and Temporal Cortices Lesions: A Case Report and Literature Review.","authors":"Qing Liu, Zhaoxia Wang, Jing Shi, Wenxia Wang, Chao Wen, Yanping Zhu, Xuan Chen, Xiaolian Xing, Yangli Su","doi":"10.1097/NRL.0000000000000588","DOIUrl":"10.1097/NRL.0000000000000588","url":null,"abstract":"Introduction: Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode (MELAS) is one of the most common maternally inherited mitochondrial diseases. The stroke-like episode affecting the cortical cortex is the hallmark of MELAS; however, it rarely presents as simultaneously bilateral symmetric cortices lesions.Case report: We reported a case of MELAS in a 46-year-old female patient with bilateral symmetric occipital and internal temporal cortices involvements on brain magnetic resonance imaging (MRI). A literature review of MELAS patients and a retrospective analysis were performed. She had a family history of diabetes. Although she denied a history of diabetes, elevated blood glucose was noted after admission, and diabetes was diagnosed. Laboratory examination revealed elevated lactate acid and creatine kinase levels in blood. Cranial computed tomography (CT) image demonstrated basal ganglia calcification, as well as subtle decreased attenuation in bilateral symmetric occipital and internal temporal cortices. Brain magnetic resonance imaging (MRI) demonstrated symmetric gyriform hyperintensity in bilateral occipital lobes and internal temporal lobes in both grey and white matter on fluid-attenuated inversion recovery (FLAIR) images with restricted diffusion on diffusion weighted images (DWI). A genetic test revealed a point mutation in the mtDNA(3243A > G) by blood examination. Literature review showed that there were 231 eligible patients with MELAS identified from 212 published papers. Symmetric cortical involvements were seen in 15 (6.5%) patients on brain MRI.Conclusions: MELAS should be considered as a potential diagnosis in the patients with bilateral symmetric stroke-like cortices lesions.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"75-79"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0