Role of CT angiography in diagnosis and prognosis of acute ischemic stroke

Neuroimaging revolution has led to a much better understanding of cerebrovascular and tissue pathology, creating a wide array of opportunities for acute treatment and secondary prevention. The study was performed to assessment of the intracranial arterial system by CT angiography and evaluation of its role in prediction of the functional outcome in patients with acute ischemic stroke. This study included 42 patients with acute ischemic stroke within 24 hours of onset of symptoms. They were recruited from the stroke units and neurology departments at Al-Azhar University hospitals. All selected patients, were subjected to medical and neurological examination with special emphasis on neurovascular assessment. CT brain was performed at the time of admission to exclude cerebral hemorrhage and mass lesion and CT angiography of intracranial arterial blood vessels. National institute of health stroke scale [NIHSS] was performed on admission to assess stroke severity and routine searching for stroke risk factors. Outcome after 3 months was measured using the modified Rankin Disability Scale [mRS] and the patients divided into two groups; Group 1: included 26 patients with good outcome and Group II: included 16 patients with poor outcome. NIHSS score >/= 7 represented the optimal value for predicting arterial occlusion in patients within 24 hr of stroke onset. Mean NIHSS was significantly higher for patients with complete occlusion than those with non-occlusive intra-cerebral blood vessels [p<0.001]. According to the Oxford shire classification of stroke, total anterior cerebral infarction [TACI] and partial anterior cerebral infarction [PACI] were significantly higher in group [II] than in group [I] [p<0.01]. The frequency of DM, age and NIHSS were significantly higher in group [II] than group [I] [p<0.01]. Patients with good collateral flow on CTA showed a better clinical outcome compared to those with poor collaterals [p>0.05]. In univariate analysis; age, DM, baseline NIHSS score and intracranial large-vessel status were significant predictors of outcome. Both baseline NIHSS score and large vessel occlusion independently predict short-term poor outcome in multivariate models. CT angiography adds important information to conventional CT studies in cases of acute ischemic stroke. It shows the site of occlusion and collateral blood flow to choose the optimal treatment. Outcome of acute ischemic stroke depends on the age, severity of neurological signs and presence or absence of occlusion

Progesterone and estrogen serum level, and menstrual disorders in epileptic women

This work aimed to evaluate progesterone and estrogen in some epileptic women during childbearing period with reference to menstrual irregularities. The study was conducted on three groups: Group I consisted of 20 women with temporal lobe epilepsy [TLE], Group II consisted of 20 women with generalized tonic clonic epilepsy [GTCE] and Group III included 20 women with normal menstrual cycles and normal EEGs and no manifestations of epilepsy [control group]. The study revealed that ten women with TLE and five women with GTCE had menstrual disturbances. The mean level of progesterone was significantly low in women with TLE and GTCE in comparison with the control group, while estrogen level showed no significant difference between women in all groups