Brain Circulation最新文献

{"title":"The effects of stress hyperglycemia in diabetic and nondiabetic patients with large vessel occlusions undergoing mechanical thrombectomy.","authors":"Brittany M Kasturiarachi, Omar Saeed, Leila Gachechiladze, Diana Alsbrook, Savdeep Singh, Ghaida Zaid, Prasanna Eswaradass, Nitin Goyal, Cheran Elangovan, Adam S Arthur, Andrei V Alexandrov, Balaji Krishnaiah","doi":"10.4103/bc.bc_97_23","DOIUrl":"10.4103/bc.bc_97_23","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes and hyperglycemia are major risk factors that can increase infarction volume and contribute to poor functional status. Our study aim was to investigate the effect of stress hyperglycemia on various safety and efficacy outcomes in patients with large vessel occlusions (LVOs) undergoing mechanical thrombectomy (MT) with or without diabetes.</p><p><strong>Methods: </strong>A retrospective analysis of consecutive LVO patient data treated with MT at a Comprehensive Stroke Center in the Mid-South was conducted. Adult patients with LVO on computed tomography angiography (CTA) and treated with MT within 24 h of symptom onset were included. The primary outcome was to determine if there was an association in collateral flow or infarct size in the setting of hyperglycemia. Secondary outcomes included National Institute of Health Sciences Score (NIHSS) and Modified Rankin Score (mRS).</p><p><strong>Results: </strong>A total of 450 patients underwent MT, out of which 433 had baseline hemoglobin A1c recorded: mean age: 64 ± 15 years, 47% women, pretreatment NIHSS median 15 points (interquartile range 10-19), 323 (75%) with good collaterals grades >2 on multiphasic CTA, 326 (75%) were non-diabetic, and 107 (25%) were diabetic. Nondiabetics with stress hyperglycemia had a tendency toward higher pre-treatment NIHSS scores (mean 17.5 ± 7.6, <i>P</i> = 0.02) and at 24-h (12.9 ± 9.0, <i>P</i> = 0.02), poor collaterals (multiphasic CTA score ≥2; 21.4% vs. 34.5%, <i>P</i> = 0.02), larger infarct volumes (50.7 ± 63.6 vs. 24.4 ± 33.8 cc, <i>P</i> < 0.0001), and had poorer functional outcomes (good mRS 0-2 47.7% vs. good mRS 0-2 36.8%) when compared to nondiabetics without stress hyperglycemia. For every 1 mg/dL increase in admission blood glucose, there was a 0.3 cc increase in infarct volume (95% confidence intervals for β =0.2-0.4; <i>P</i> < 0.0001) after adjusting for the final thrombolysis in cerebral infarction score.</p><p><strong>Conclusions: </strong>LVO patients with stress hyperglycemia without previously diagnosed diabetes had more severe strokes, developed larger infarct volumes, poorer collaterals, and had worse functional outcomes at 90 days post-MT. In addition, LVO patients with diabetes and stress hyperglycemia exhibited more passes during MT and worse functional outcomes.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"162-167"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733633","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}

{"title":"A bibliometric review of unilateral neglect: Trends, frontiers, and frameworks.","authors":"Wanying Zhao, Linlin Ye, Lei Cao, Weiqun Song","doi":"10.4103/bc.bc_72_23","DOIUrl":"10.4103/bc.bc_72_23","url":null,"abstract":"<p><strong>Background: </strong>Owing to the adverse effects of unilateral neglect (UN) on rehabilitation outcomes, fall risk, and activities of daily living, this field has gradually got considerable interest. Notwithstanding, there is presently an absence of efficient portrayals of the entire research field; hence, the motivation behind this study was to dissect and evaluate the literature published in the field of UN following stroke and other nonprogressive brain injuries to identify hotspots and trends for future research.</p><p><strong>Materials and methods: </strong>Original articles and reviews related to UN from 1970 to 2022 were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. CiteSpace, VOSviewer, and Bibliometrix software were used to observe publication fields, countries, and authors.</p><p><strong>Results: </strong>A total of 1,202 publications were incorporated, consisting of 92% of original articles, with an overall fluctuating upward trend in the number of publications. Italy, the United Kingdom, and the United States made critical contributions, with <i>Neuropsychologia</i> being the most persuasive academic journal, and Bartolomeo P. ranked first in both the quantity of publications and co-citations. Keywords were divided into four clusters, and burst keyword detection demonstrated that networks and virtual reality might additionally emerge as frontiers of future development and warrant additional attention.</p><p><strong>Conclusions: </strong>UN is an emerging field, and this study presents the first bibliometric analysis to provide a comprehensive overview of research in the field. The insights and guidance garnered from our research on frontiers, trends, and popular topics could prove highly valuable in facilitating the rapid development of this field while informing future research directions.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"94-105"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733555","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}

{"title":"Erratum: Compromised dynamic cerebral autoregulation is a hemodynamic marker for predicting poor prognosis even with good recanalization after endovascular thrombectomy.","authors":"","doi":"10.4103/BC.BC_60_24","DOIUrl":"10.4103/BC.BC_60_24","url":null,"abstract":"<p><p>[This corrects the article on p. 77 in vol. 10, PMID: 38655440.].</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"192"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733561","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}

{"title":"Unraveling belly dancer's dyskinesia and other puzzling diagnostic contortions: A narrative literature review.","authors":"Jamir Pitton Rissardo, Nilofar Murtaza Vora, Irra Tariq, Vanshika Batra, Ana Letícia Fornari Caprara","doi":"10.4103/bc.bc_110_23","DOIUrl":"10.4103/bc.bc_110_23","url":null,"abstract":"<p><p>Belly dancer's dyskinesia (BDD) is characterized by involuntary abdominal wall movements that are rhythmic, repetitive, and dyskinetic. The present study aims to review BDD's etiology, pathophysiology, and management. We searched six databases to locate existing reports on BDD published from 1990 to October 2023 in electronic form. A total of 47 articles containing 59 cases were found. The majority of the patients affected by BDD were female, accounting for 61.01% (36/59) of the cases. The mean and median ages were 49.8 (standard deviation: 21.85) and 52 years (range: 7-85), respectively. The BDD was unilateral in only 3.38% (2/59). The most commonly reported causes associated with BDD were 17 idiopathic, 11 drug-induced, 11 postsurgical procedures, 5 pregnancies, and 4 Vitamin B12 deficiencies. BDD is a diagnosis of exclusion, and other more common pathologies with similar presentation should be ruled out initially. Differential diagnostic reasoning should include diaphragmatic myoclonus, cardiac conditions, truncal dystonia, abdominal motor seizures, propriospinal myoclonus, and functional or psychiatric disorders.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"106-118"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736332","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}

{"title":"Primary antiphospholipid syndrome in the elderly: Four strokes and mechanical thrombectomies until the diagnosis - A case report.","authors":"Anatoli Anastasiadi, Chiara Bott, Daniel Kitterer, Elke Roser, Hans Henkes, Hansjörg Bäzner, Marc E Wolf","doi":"10.4103/bc.bc_67_23","DOIUrl":"10.4103/bc.bc_67_23","url":null,"abstract":"<p><p>Antiphospholipid syndrome (APS) is known as a rare etiology of embolic ischemic stroke. In individuals below 50 years, up to 20% of strokes are associated with APS, whereas in patients >50 years, it is considered a very seldom cause of stroke. We describe the course of a 66-year-old white woman, who experienced four embolic strokes with large vessel occlusion over a period of 2 years, which were repeatedly and successfully treated by mechanical thrombectomy. Initially attributed to atrial fibrillation and treated with direct oral anticoagulants, the patient was finally diagnosed with primary APS due to isolated anti-beta 2-glycoprotein antibodies and successfully treated after several stroke recurrences. After initiation of Vitamin K antagonist therapy, no further strokes occurred. For recurrent embolic stroke despite oral anticoagulation, late-onset APS might be considered a rare etiology also in the elderly.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"184-187"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733562","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}

{"title":"Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage.","authors":"Georgia Wong, Gnel Pivazyan, Jeffrey M Breton, Ehsan Dowlati, Daniel R Felbaum","doi":"10.4103/bc.bc_99_23","DOIUrl":"10.4103/bc.bc_99_23","url":null,"abstract":"<p><p>Spinal arachnoid web (AW) is a rare condition causing spinal cord-related issues. Its cause is often idiopathic but can be linked to past trauma or spine surgery. We describe two cases of AWs that developed after subarachnoid hemorrhage (SAH). Case #1 is a 71-year-old male with nonaneurysmal SAH who developed myelopathy 1 year later. Magnetic resonance imaging revealed upper thoracic cord edema and an AW. Case #2 is a 57-year-old female who underwent coiling of a ruptured basilar artery aneurysm and ventriculoperitoneal shunting for hydrocephalus. Twenty months later, she developed mid-thoracic AW requiring surgical resection. Both patients showed symptom improvement postresection avoiding further reoperation. History of SAH is emerging as a risk factor for AW development, emphasizing the importance of monitoring delayed-onset myelopathy and back pain in recent SAH patients.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"89-93"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733558","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}

{"title":"The impact of high-altitude and cold environment on brain and heart damage in rats with hemorrhagic shock.","authors":"Jun Xu, Wantong Yu, Ning Li, Sijie Li, Xiaojie Wang, Chen Gao, Feng-Yong Liu, Xunming Ji, Changhong Ren","doi":"10.4103/bc.bc_24_24","DOIUrl":"10.4103/bc.bc_24_24","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic shock (HS) causes severe organ damage, worsened by high-altitude conditions with lower oxygen and temperatures. Existing research lacks specific insights on brain and heart damage under these conditions. This study hypothesizes that high-altitude and cold (HAC) environments exacerbate HS-induced damage in the brain and heart, aiming to improve treatment strategies.</p><p><strong>Materials and methods: </strong>Twenty-four male Sprague-Dawley (SD) rats (200-250 g of weight) were randomly assigned into sham, HS + normal, HS + HAC (4,000 m), and HS + HAC (6,000 m). The HS model was established in SD rats (35% loss of total blood volume), and histopathological injuries of the brain and heart were detected using hematoxylin and eosin staining, Sirius red staining, and immunohistochemistry. Apoptosis of the brain and heart tissues was detected by terminal transferase-mediated dUTP nick end labeling (TUNEL) immunofluorescence staining. To determine the levels of tumor necrosis factor-α (TNF-α), interferon-gamma (IFN-γ), monocyte chemoattractant protein-1 (Mcp-1), BCL2-associated X (BAX), and myeloid cell leukemia-1 (Mcl-1) protein, western blotting assay was used.</p><p><strong>Results: </strong>The HAC environment induced pathological damage to the brain and heart and aggravated the degree of cardiac fibrosis in HS rats. However, it did not cause apoptosis of the brain and heart. In addition, it upregulated TNF-α, IFN-γ, Mcp-1, and BAX protein levels, but downregulated Mcl-1 protein levels (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>The HAC environment aggravated the degree of brain and heart damage in HS rats, which may be related to neuron nucleus pyknosis, myocardial fibrosis, and inflammatory and apoptosis activation.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 2","pages":"174-183"},"PeriodicalIF":2.3,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733634","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}

{"title":"The development of the neurocritical care specialty in China based on the analysis of neurocritical care unit volume and quality.","authors":"Yingying Su, Junfang Teng, Suyue Pan, Wen Jiang, Furong Wang, Fei Tian, Jing Jing, Huijin Huang, Jie Cao, Huaiqiang Hu, Liping Liu, Wei Li, Cheng Liang, Liansheng Ma, Xuegang Meng, Linyu Tian, Changqing Wang, Lihua Wang, Yan Wang, Zhenhai Wang, Zhiqiang Wang, Zunchun Xie, Mingyao You, Jun Yuan, Chaosheng Zeng, Li Zeng, Le Zhang, Lei Zhang, Xin Zhang, Yongwei Zhang, Bin Zhao, Saijun Zhou, Zhonghe Zhou","doi":"10.4103/bc.bc_71_23","DOIUrl":"https://doi.org/10.4103/bc.bc_71_23","url":null,"abstract":"<p><strong>Purpose: </strong>Through three neurocritical care unit (NCCU) surveys in China, we tried to understand the development status of neurocritical care and clarify its future development.</p><p><strong>Methods: </strong>Using a cross-sectional survey method and self-report questionnaires, the number and quality of NCCUs were investigated through three steps: administering the questionnaire, sorting the survey data, and analyzing the survey data.</p><p><strong>Results: </strong>At the second and third surveys, the number of NCCUs (76/112/206) increased by 47% and 84%, respectively. The NCCUs were located in tertiary grade A hospitals or teaching hospitals (65/100/181) in most provinces (24/28/29). The numbers of full-time doctors (359/668/1337) and full-time nurses (904/1623/207) in the NCCUs increased, but the doctor-bed ratio and nurse-bed ratio were still insufficient (0.4:1 and 1.3:1).</p><p><strong>Conclusion: </strong>In the past 20 years, the growth rate of NCCUs in China has accelerated, while the allocation of medical staff has been insufficient. Although most NCCU hospital bed facilities and instruments and equipment tend to be adequate, there are obvious defects in some aspects of NCCUs.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"67-76"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847805","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}

{"title":"Overt nickel and cobalt hypersensitivity after pipeline embolization device placement: A case report.","authors":"Artur Eduardo Martio, Daniel Marchi Kieling, Luciano Bambini Manzato, José Ricardo Vanzin","doi":"10.4103/bc.bc_85_23","DOIUrl":"https://doi.org/10.4103/bc.bc_85_23","url":null,"abstract":"<p><p>Nickel and cobalt are frequently found in metallic alloys used in the manufacture of aneurysm clips and endovascular prostheses, such as the pipeline embolization device (PED). Nickel hypersensitivity can affect up to 15% of the population, however, it is very rarely overt in patients who undergo endovascular stent placement. Here, we present the case of a 35-year-old woman who developed allergic symptoms after PED placement and was later confirmed to be allergic to both nickel and cobalt by patch testing. Fortunately, she responded well to pharmacologic treatment, rendering surgical intervention unnecessary. To the best of our knowledge, this is the first report of symptomatic nickel hypersensitivity, and the second report of symptomatic cobalt allergy caused by the PED. Despite its low prevalence, we believe that surgeons should actively inquire patients in the postoperative period about allergic symptoms, to facilitate early diagnosis and treatment.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"85-88"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847940","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}

{"title":"Endogenous defense mechanism-based neuroprotection in large-vessel acute ischemic stroke: A hope for future.","authors":"Deepak Goel, Sushant Shangari, Manish Mittal, Ashwani Bhat","doi":"10.4103/bc.bc_56_23","DOIUrl":"https://doi.org/10.4103/bc.bc_56_23","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of morbidity and mortality worldwide and a leading cause of disability. None of the neuroprotective agents have been approved internationally except edaravone in Japanese guidelines in acute ischemic stroke. We here discuss that there are two types of endogenous defense mechanisms (EDMs) after acute stroke for neuromodulation and neuroregeneration, and if both can be activated simultaneously, then we can have better recovery in stroke.</p><p><strong>Aims and objectives: </strong>We aimed to study the effect of combination of neuroprotection therapies acting on the two wings of EDM in acute large-vessel middle cerebral artery (LMCA) ischemic stroke.</p><p><strong>Methods: </strong>Sixty patients of LMCA stroke were enrolled and randomized within 72 h into two groups of 30 patients each. The control group received standard medical care without any neuroprotective agents while the intervention group received standard medical care combined with oral citicoline with vinpocetine for 3 months with initial 1 week intravenous and edaravone and cerebrolysin injection, started within 72 h of onset of stroke. Patients were assessed on the basis of the National Institutes of Health Stroke Scale, Fugl-Meyer Assessment Score, Glasgow Coma Scale, and Mini-Mental Status Examination at admission, discharge, and after 90 days.</p><p><strong>Results: </strong>The intervention group showed significant and early improvements in motor as well as cognitive recovery.</p><p><strong>Conclusion: </strong>Combination therapy for neuroprotection which is acting on two pathways of EDM can be useful in functional recovery after acute ischemic stroke.</p>","PeriodicalId":9288,"journal":{"name":"Brain Circulation","volume":"10 1","pages":"51-59"},"PeriodicalIF":1.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856022","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}