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Single-Center Experience With Endovascular Therapy in Acute Occlusion of ICAS: Preferred Stent Thrombectomy Versus Preferred Angioplasty. ICAS 急性闭塞的血管内治疗单中心经验:首选支架血栓切除术与首选血管成形术。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-11-01 DOI: 10.1097/NRL.0000000000000578
Kechun Chen, Yin Zhou, Gang Guo, Qiuyi Wu
{"title":"Single-Center Experience With Endovascular Therapy in Acute Occlusion of ICAS: Preferred Stent Thrombectomy Versus Preferred Angioplasty.","authors":"Kechun Chen, Yin Zhou, Gang Guo, Qiuyi Wu","doi":"10.1097/NRL.0000000000000578","DOIUrl":"10.1097/NRL.0000000000000578","url":null,"abstract":"<p><strong>Objectives: </strong>The preferred endovascular therapy (EVT) for large-vessel occlusion in intracranial atherosclerosis (ICAS) is unknown. We compared the efficacy of preferred stent thrombectomy and preferred angioplasty in patients with acute large-vessel occlusion in ICAS.</p><p><strong>Methods: </strong>Data from consecutive EVT patients (May 2020 to September 2023) with acute middle cerebral artery occlusion in ICAS were retrospectively analyzed. Preferred angioplasty was performed if there was a preoperative \"microcatheter first-pass effect;\" otherwise, preferred stent thrombectomy was performed. Analyses were grouped according to the two EVT treatments. Clinical data of all patients, including the time from puncture to recanalization, rate of successful reperfusion, early neurological improvement, intracranial hemorrhage, and modified Rankin Scale score at 90 days, were recorded and analyzed.</p><p><strong>Results: </strong>Six-two patients were enrolled in this study (mean age was 60.66±13.21 y, 22.6% female). The preferred angioplasty group had a higher first-pass recanalization rate than the preferred stent thrombectomy group (61.3% vs. 21.9%, P <0.001) and a higher proportion of patients who were functionally independent (defined as a modified Rankin Scale score of 0 to 3) at 90 days [odds ratio,3.681; 95% confidence interval (CI):1.009 to 13.428; P =0.048]. There was no significant difference between the groups in the time from puncture to recanalization, the frequency of successful reperfusion, and early neurological improvement, or intracranial hemorrhage ( P >0.05).</p><p><strong>Conclusions: </strong>This study suggests that for acute middle cerebral artery occlusion in ICAS, preferred angioplasty may be a safe and effective procedure.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"323-328"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753222","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
West Nile Virus Neuroinvasive Disease: Lessons From Two Cases. 西尼罗河病毒神经侵入性疾病:从两个病例中汲取的教训。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-11-01 DOI: 10.1097/NRL.0000000000000584
Arens Taga, Angeliki Filippatou, Sai Sachin Divakaruni, Carlos Pardo, Kemar Green
{"title":"West Nile Virus Neuroinvasive Disease: Lessons From Two Cases.","authors":"Arens Taga, Angeliki Filippatou, Sai Sachin Divakaruni, Carlos Pardo, Kemar Green","doi":"10.1097/NRL.0000000000000584","DOIUrl":"10.1097/NRL.0000000000000584","url":null,"abstract":"<p><strong>Background and objective: </strong>West Nile neuroinvasive disease (WNND) displays a wide range of clinical manifestations due to its involvement of various structures within the central nervous system and peripheral nervous system, often including prolonged unresponsiveness as the presenting symptom.</p><p><strong>Methods and results: </strong>We describe 2 patients presenting with coma and bilateral thalamic lesions on brain magnetic resonance imaging, found to have WNND after extensive workup. These cases illustrate some of the challenges associated with evaluating coma in general and specifically in diagnosing WNND.</p><p><strong>Conclusion: </strong>The clinical diagnosis of WNND requires a high index of suspicion, particularly in immunocompromised and elderly patients. Brain and spine magnetic resonance imaging findings can help narrow down the differential diagnosis, although other diseases may manifest similarly. Serological studies on the cerebrospinal fluid are essential to confirm the diagnosis but have inherent limitations. Given these challenges, WNND should be considered in all patients living in endemic areas who present with unexplained altered mental status during the late summer and early fall seasons.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"356-360"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367217","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
Clinical Observation of Infarct Volume ≥150 mL in Endovascular Thrombectomy Treatment. 血管内血栓切除术治疗中梗塞体积≥150 mL 的临床观察。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-11-01 DOI: 10.1097/NRL.0000000000000574
Hai Zeng, Jia Zhou, Qing Xue, Fengli Zhao, Tingyu Liu, Qingfeng Zhu
{"title":"Clinical Observation of Infarct Volume ≥150 mL in Endovascular Thrombectomy Treatment.","authors":"Hai Zeng, Jia Zhou, Qing Xue, Fengli Zhao, Tingyu Liu, Qingfeng Zhu","doi":"10.1097/NRL.0000000000000574","DOIUrl":"10.1097/NRL.0000000000000574","url":null,"abstract":"<p><strong>Objectives: </strong>Whether patients with infarct volume ≥150 mL could benefit from endovascular thrombectomy (EVT) remains unclear.</p><p><strong>Methods: </strong>Patients (n=104) with anterior circulation Alberta Stroke Program Early Computed Tomography Score <6 were screened for infarct volume ≥150 mL using the Pullicino formula × (1-22%). The following were compared with the baseline at 90 days: the modified Rankin scale score (mRS) ≤3, mortality rate, symptomatic intracranial hemorrhage and any intracranial hemorrhage within 48 hours, and modified Thrombolysis in Cerebral Infarction (mTICI) ≥2b between the EVT and drug therapy (DT) groups.</p><p><strong>Results: </strong>In patients with infarct volumes ≥150 mL, mRS≤3 at 90 days was higher in the EVT group than in the DT group [adjusted odds risk (aOR), 5.52; 95% CI: 1.10-28.24, P =0.04), and mTICI ≥2b at 82.8%. Intracranial hemorrhage within 48 hours occurred in 7 (24.1%) patients in the EVT group and 5 (14.7%) in the DT group (aOR, 0.75; 95% CI: 0.16-3.46; P =0.71). Older age (aOR, 0.94; 95% CI: 0.90-0.99, P =0.01), EVT treatment (aOR, 4.51; 95% CI: 1.60-12.78, P =0.01), and infarct volume ≥150 mL (aOR, 0.11; 95% CI: 0.04-0.31, P <0.01) were significantly associated with patient prognosis.</p><p><strong>Conclusions: </strong>Patients with infarct volume ≥150 mL who received EVT had a higher proportion of mRS≤3 compared with those who received DT. However, there was no statistically significant difference in intracranial hemorrhage and death between the groups. EVT, smaller infarct volume, and younger age were associated with a good prognosis. The findings require large sample data verification.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"311-316"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421643","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
Central Positional Nystagmus Can Be the Sole Presentation of Cerebellar Nodulus Infarction. 中央位置性眼球震颤可能是小脑结节梗死的唯一表现形式
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000575
Gülcan Neşem Baskan, Neşe Çelebisoy
{"title":"Central Positional Nystagmus Can Be the Sole Presentation of Cerebellar Nodulus Infarction.","authors":"Gülcan Neşem Baskan, Neşe Çelebisoy","doi":"10.1097/NRL.0000000000000575","DOIUrl":"10.1097/NRL.0000000000000575","url":null,"abstract":"<p><strong>Objectives: </strong>To draw attention to acute positional vertigo and central positional nystagmus (CPN) developing as the sole features of cerebellar nodulus infarction.</p><p><strong>Background: </strong>The cerebellar nodulus is vascularized by the medial branch of the posterior inferior cerebellar artery, which also supplies the uvula, tonsil, tuber, and pyramid of the vermis, and the inferior part of the cerebellar hemisphere, making isolated cerebellar nodulus infarction extremely rare. CPN occurs after a change in head position with respect to gravity and is caused by pathologies involving the vestibulo-cerebellar pathways. CPN is rarely seen in isolation. Additional neurological signs and ocular motor abnormalities are generally present.</p><p><strong>Methods: </strong>A 62-year-old man was admitted to the emergency department with acute-onset positional vertigo and CPN as the sole finding on examination. Cranial magnetic resonance imaging revealed an acute infarction involving the nodulus. Results: Infarcts restricted to nodulus can cause positional vertigo and CPN without any associated neurological signs or ocul ar motor abnormalities.</p><p><strong>Conclusion: </strong>Though very rare, cerebellar nodulus stroke must be searched in patients with positional vertigo of acute onset and isolated CPN on examination.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"308-309"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285162","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
Low Dose Aspirin Initiation 18 Hours After Thrombolytic Therapy in Acute Ischemic Stroke. 急性缺血性脑卒中患者在接受溶栓治疗 18 小时后开始服用小剂量阿司匹林。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000566
Aubrey Murphy, Leslie A Hamilton, Kalene Farley, Shaun A Rowe, Thomas Christianson, Brittny Medenwald
{"title":"Low Dose Aspirin Initiation 18 Hours After Thrombolytic Therapy in Acute Ischemic Stroke.","authors":"Aubrey Murphy, Leslie A Hamilton, Kalene Farley, Shaun A Rowe, Thomas Christianson, Brittny Medenwald","doi":"10.1097/NRL.0000000000000566","DOIUrl":"10.1097/NRL.0000000000000566","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety of administering low-dose aspirin (81 mg) 18 hours after intravenous thrombolytic therapy.</p><p><strong>Methods: </strong>This is a retrospective cohort investigation. Individuals received either alteplase or tenecteplase for acute ischemic stroke followed by aspirin 81 mg (after follow-up imaging). An institutional change moved follow-up post-thrombolytic CT scans to 18 hours, and qualifying patients were grouped based on whether they received aspirin ≤24 hours or >24 hours. Chart reviews were conducted to assess the primary outcome of new or worsening intracranial hemorrhage, as well as secondary outcomes of change in stroke scale scores at discharge and 3 months, lengths of stay, favorable outcomes at 3 months, hospital readmission, and mortality.</p><p><strong>Results: </strong>Out of 350 patients screened, 130 qualified for inclusion-50 of whom received aspirin ≤24 hours (mean 21.1 hours, SD±6.2), and 80 who received aspirin >24 hours (mean 34 hours, SD±8.2). Only 1 new intracranial bleed occurred following aspirin administration in the >24-hour group. No statistically significant differences were observed in any of the secondary outcomes, although there was higher mortality (3/50 vs. 2/80, P =0.372) and shorter hospital length of stay (median difference -1.0 day, P =0.0336) in the <24 hours group.</p><p><strong>Conclusions: </strong>Low-dose aspirin administration sooner than 24 hours following thrombolytic therapy did not increase bleeding events. Sooner aspirin administration after ischemic stroke can potentially enhance the prevention of secondary embolization and did not demonstrate worse clinical outcomes; however, further randomized controlled trials are needed.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"294-298"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285163","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
Education and Age in Return to Work After Ischemic Stroke: A Danish Nationwide Registry-based Cohort Study. 缺血性脑卒中后重返工作岗位的教育程度和年龄:丹麦全国登记队列研究》。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000563
Eva Rosendahl, Nicholas Carlson, Kristian Kragholm, Jawad H Butt, Emil L Fosbøl, Gunnar Gislason, Christian Torp-Pedersen, Christine Benn Christiansen
{"title":"Education and Age in Return to Work After Ischemic Stroke: A Danish Nationwide Registry-based Cohort Study.","authors":"Eva Rosendahl, Nicholas Carlson, Kristian Kragholm, Jawad H Butt, Emil L Fosbøl, Gunnar Gislason, Christian Torp-Pedersen, Christine Benn Christiansen","doi":"10.1097/NRL.0000000000000563","DOIUrl":"10.1097/NRL.0000000000000563","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate return to work and workforce detachment in ischemic stroke, including the association with age and level of education.</p><p><strong>Methods: </strong>Patients in the workforce aged 18 to 60 with first-time ischemic stroke between 1997 and 2017 were identified in Danish registers and followed for 5 years. The cumulative incidence of return to work and subsequent workforce detachment was computed overall and stratified according to age group and education level. Cox regression analysis was used for multivariate analysis.</p><p><strong>Results: </strong>A total of 28,325 patients were included (median age 52.3 (interquartile range (IQR) 46.1 to 56.6) and 64.3% male). After 1 year, 62.0% were in the workforce, highest in age group 18 to 30 (80.0%) and lowest in patients aged 51 to 60 (58.5%). One-year cumulative incidence of return to work overall was 73.4% (20,475), highest in the young age group (87.0%, 76.7%, 74.5%, and 71.3% for age group 18 to 30, 31 to 40, 41 to 50, and 51 to 60, respectively) and high education (80.3%, 72.1%, and 71.3% for long higher, basic or vocational education, respectively). One-year cumulative incidence of subsequent workforce detachment was 25.6% (5248), lowest in young age (22.4%, 23.1%, 24.1%, and 27.2% for age groups 18 to 30, 31 to 40, 41 to 50, and 51 to 60, respectively) and high level of education (13.0%, 28.4%, and 27.2% for long higher, basic, and vocational education, respectively). During the full follow-up, 10,855 (53.0%) left the workforce again.</p><p><strong>Conclusions: </strong>A high proportion of patients returned to work within 1 year, but more than half left the workforce again. Young age and long education were associated with a higher incidence of return to work and lower subsequent workforce detachment.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"299-305"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318716","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
Framingham Stroke Risk Profile Score and White Matter Disease Progression. 弗雷明汉卒中风险档案评分与白质疾病进展。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000567
Hossam Youssef, Mutlu Demirer, Erik H Middlebrooks, Bhrugun Anisetti, James F Meschia, Michelle P Lin
{"title":"Framingham Stroke Risk Profile Score and White Matter Disease Progression.","authors":"Hossam Youssef, Mutlu Demirer, Erik H Middlebrooks, Bhrugun Anisetti, James F Meschia, Michelle P Lin","doi":"10.1097/NRL.0000000000000567","DOIUrl":"10.1097/NRL.0000000000000567","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between Framingham Stroke Risk Profile (FSRP) score and rate of white matter hyperintensity (WMH) progression and cognition.</p><p><strong>Methods: </strong>Consecutive patients enrolled in the Mayo Clinic Florida Familial Cerebrovascular Diseases Registry (2011-2020) with 2 brain-MRI scans at least 1 year apart were included. The primary outcome was annual change in WMH volume (cm 3 /year) stratified as fast versus slow (above vs. below median). Cognition was assessed using a Mini-Mental State Exam (MMSE, 0-30). FSRP score (0 to 8) was calculated by summing the presence of age 65 years or older, smoking, systolic blood pressure greater than 130 mmHg, diabetes, coronary disease, atrial fibrillation, left ventricular hypertrophy, and antihypertensive medication use. Linear and logistic regression analyses were performed to examine the association between FSRP and WMH progression, and cognition.</p><p><strong>Results: </strong>In all, 207 patients were included, with a mean age of 60±16 y and 54.6% female. FSRP scores risk distribution was: 31.9% scored 0 to 1, 36.7% scored 2 to 3, and 31.4% scored ≥4. The baseline WMH volume was 9.6 cm 3 (IQR: 3.3-28.4 cm 3 ), and the annual rate of WMH progression was 0.9 cm3/year (IQR: 0.1 to 3.1 cm 3 /year). A higher FSRP score was associated with fast WMH progression (odds ratio, 1.45; 95% CI: 1.22-1.72; P<0.001) and a lower MMSE score (23.6 vs. 27.1; P<0.001). There was a dose-dependent relationship between higher FSRP score and fast WMH progression (odds ratios, 2.20, 4.64, 7.86, 8.03 for FSRP scores 1, 2, 3, and ≥4, respectively; trend P <0.001).</p><p><strong>Conclusions: </strong>This study demonstrated an association between higher FSRP scores and accelerated WMH progression, as well as lower cognition.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"259-264"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312061","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
Analysis of Clinical Characteristics and Influencing Factors of Early Neurological Deterioration in Patients With Mild Stroke by Intravenous Alteplase Therapy. 静脉注射阿替普酶治疗轻度脑卒中患者的临床特征及早期神经功能恶化的影响因素分析
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000553
Xin-Lei Mao, Si-Si He, Cai-Dan Lin, Xiang-Dong Huang, Jun Sun
{"title":"Analysis of Clinical Characteristics and Influencing Factors of Early Neurological Deterioration in Patients With Mild Stroke by Intravenous Alteplase Therapy.","authors":"Xin-Lei Mao, Si-Si He, Cai-Dan Lin, Xiang-Dong Huang, Jun Sun","doi":"10.1097/NRL.0000000000000553","DOIUrl":"10.1097/NRL.0000000000000553","url":null,"abstract":"<p><strong>Objectives: </strong>Thrombolysis treatment for patients with mild stroke is controversial. The aim of our study was to investigate the clinical characteristics and influencing factors of early neurological deterioration (END) in this group of patients.</p><p><strong>Methods: </strong>A retrospective analysis was performed on ischemic stroke patients with intravenous thrombolysis (IVT) in Wenzhou Central Hospital. Subgroup analyses were performed for the mild stroke group and nonmild stroke group, END group, and non-early neurological deterioration group in mild stroke patients, respectively.</p><p><strong>Results: </strong>A total of 498 patients were included in this study. Compared with the control group, the mild stroke group was younger age, less atrial fibrillation, previous history of stroke and less use of antithrombotic drugs, more dyslipidemia, smoking, and drinking. Small artery occlusion type was more common in mild stroke, cardioembolism and stroke of undetermined etiology type were less. In the mild stroke group, the symptomatic intracerebral hemorrhage (sICH) rate was 2.54%, and the END rate was 16.1%. Predictors of END included systolic blood pressure, blood glucose, cardioembolism subtype, sICH, and large vessel occlusion. In END patients, the sICH rate was 10.53%, and 84.21% of cases started to worsen within 12 hours after IVT. There was no statistically significant difference in the time to exacerbation among different subtypes.</p><p><strong>Conclusions: </strong>The occurrence of mild stroke in young patients was largely related to unhealthy lifestyles. The incidence of END in mild stroke IVT patients was low, with most occurring within 12 hours of IVT. There were many risk factors for END: large vessel occlusion and hyperglycemia were independent risk factors for END after IVT. sICH was an important but rare risk factor for END.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"275-279"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514290","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
Stop Ischemic Event to the Brain: Screening Risk Factors of Cerebrovascular Stenosis in Coronary Artery Disease Patients. 阻止脑缺血事件:筛查冠心病患者脑血管狭窄的风险因素。
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000568
Shi-Chang Yang, Xing-Wen Zhang, Xi-Ting Nie, Ying-Lu Liu, Hui Su, Yan Wang, Ya Cao, Hui-Juan Yuan, Zhe Yu, Shan-Shan Kong, Sheng-Yuan Yu
{"title":"Stop Ischemic Event to the Brain: Screening Risk Factors of Cerebrovascular Stenosis in Coronary Artery Disease Patients.","authors":"Shi-Chang Yang, Xing-Wen Zhang, Xi-Ting Nie, Ying-Lu Liu, Hui Su, Yan Wang, Ya Cao, Hui-Juan Yuan, Zhe Yu, Shan-Shan Kong, Sheng-Yuan Yu","doi":"10.1097/NRL.0000000000000568","DOIUrl":"10.1097/NRL.0000000000000568","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we investigated the difference in risk factors between the 2 diseases, aiming to further clarify who needs to do ischemic cerebrovascular disease (ICVD)-related screening among coronary artery disease (CAD) patients.</p><p><strong>Methods: </strong>Clinical data of 326 patients with first-episode CAD from June 1, 2017, to July 31, 2020, in the Chinese PLA General Hospital were retrospectively reviewed. Outcomes, including clinical features and laboratory examination, were taken. Features related to ICVD including the extension of intracranial arterial (internal carotid artery intracranial segment, middle cerebral artery M1 segment, anterior cerebral A1 segment, vertebrobasilar artery intracranial segment, posterior cerebral artery P1 segment) and carotid arterial (internal carotid artery extracranial segment, common carotid artery, subclavian artery) stenosis were detected. Risk factors for the occurrence of ICVD in patients with CAD were analyzed.</p><p><strong>Results: </strong>Among patients with the onset of CAD, in comparison of the nonstenosis and stenosis of intracranial artery subgroups, there were statistical differences in the onset age, hypertension, and duration of hypertension as well as the biochemical indicators, including high-density lipoprotein and glycosylated hemoglobin. In addition, statistical differences were detected in the onset age as well as the biochemical indicators, including glycosylated hemoglobin and blood glucose serum protein, along with the difference in the degree of cardiovascular stenosis.</p><p><strong>Conclusions: </strong>The onset age of CAD was shown to serve as a vital risk factor for ICVD. The primary prevention of ICVD in patients with CAD should lay more emphasis on the management of hypertension and diabetes.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"265-274"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297181","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
Symptomatic Unilateral Carotid Artery Disease: An Uncommon but Reversible Cause of Corticobasal Syndrome. 症状性单侧颈动脉疾病:皮质基底综合征:一种不常见但可逆的病因
IF 1.1 4区 医学
Neurologist Pub Date : 2024-09-01 DOI: 10.1097/NRL.0000000000000573
Konstantinos Melanis, Athanasia Athanasaki, Eleni Bakola, Maria Chondrogianni, Andreas Lazaris, Alexandra Akrivaki, Alexandros Stavros Triantafyllou, Vasiliki Kotsali-Peteinelli, Anastasios Bonakis, George P Paraskevas, Georgios Tsivgoulis
{"title":"Symptomatic Unilateral Carotid Artery Disease: An Uncommon but Reversible Cause of Corticobasal Syndrome.","authors":"Konstantinos Melanis, Athanasia Athanasaki, Eleni Bakola, Maria Chondrogianni, Andreas Lazaris, Alexandra Akrivaki, Alexandros Stavros Triantafyllou, Vasiliki Kotsali-Peteinelli, Anastasios Bonakis, George P Paraskevas, Georgios Tsivgoulis","doi":"10.1097/NRL.0000000000000573","DOIUrl":"10.1097/NRL.0000000000000573","url":null,"abstract":"<p><strong>Introduction: </strong>Symptomatic carotid artery disease (CAD) represents an uncommon but treatable cause of corticobasal syndrome.</p><p><strong>Case report: </strong>We present the clinical details and successful management of a previously healthy 77-year-old patient who presented with 1-year cognitive dysfunction, alien limb syndrome, limb kinetic apraxia, and ipsilateral cortical sensory deficit, fulfilling the criteria of the diagnosis of probable corticobasal syndrome. Imaging modalities, including magnetic resonance imaging and time-of-flight magnetic resonance angiography, revealed acute external borderzone infarcts of the right hemisphere due to symptomatic CAD causing near occlusion of the vessel. The patient underwent a right carotid endarterectomy, leading to a marked improvement in mobility and neuropsychological evaluation.</p><p><strong>Conclusion: </strong>This case highlights the importance of swift diagnosis of symptomatic CAD in patients with corticobasal syndrome. Moreover, it emphasizes the efficacy of carotid endarterectomy in achieving symptom improvement in such cases.</p>","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"306-307"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285164","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}
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