ABSTRACT
BACKGROUND AND PURPOSE: Health-related quality of life (HRQoL) is a multidimensional concept that signifies a subjective evaluation of perceived health; hence, it has gained wide acceptance in geriatrics. However, its application has not been tested in patients with post-stroke cognitive impairment with no dementia (PSCIND). We investigated whether PSCIND interferes with HRQoL measured by EQ-5D, compared the findings to those of healthy people with normal cognition, and evaluated the influence of each cognitive domain on this score. METHODS: In total, 1,528 subjects were identified who had undergone neuropsychological assessment using the 60-min protocol of the Korean version of Vascular Cognitive Impairment Harmonization Standards, EQ-5D, and magnetic resonance imaging at the stroke prevention clinic. Fifty PSCIND patients were matched to 50 post-stroke dementia (PSD) patients and 50 normal age- (+/-3 years) and sex-matched controls. The effects of PSCIND, PSD, and control groups upon the EQ-5Dindex score were tested by generalized estimating equation modeling. RESULTS: Estimated means+/-standard errors of EQ-5Dindex scores were as follows: 0.94+/-0.06 (control group), 0.86+/-0.08 (PSCIND group), and 0.61+/-0.32 (PSD group); and the difference among the three groups was statistically significant (P<0.0001). Pairwise comparisons showed that EQ-5Dindex scores in the PSCIND group differed from those in the PSD and control groups (both P<0.01). No cognitive domain was specifically associated with EQ-5Dindex scores after adjusting for functional status. CONCLUSIONS: This study shows that PSCIND may interfere with the quality of life in stroke victims.
Subject(s)
Humans , Cognition , Dementia , Geriatrics , Magnetic Resonance Imaging , Quality of Life , StrokeABSTRACT
Stroke in young adults are relatively uncommon. To investigate the causes, clinical findings and prognosis of cerebral infarction (CI), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in young patients, we reviewed the medical records of 103 young patients(age: 15-45 years) who had been admitted to Yeungnam University'Hospital from Jan. 1986 to Dec. 1990. The proportion ol young adults was 6.1% in all cerebrovascular disease patients in our hospital during the same period. The mean age was 36.38 +/- 7.27 years. About two third of the patients were older than 35 years old. The ratio of male to female patients was 1.39 to 1. The percentage of patients with ICH was 45.6%, CI, 37.9%, and SAH, 16.5%. The causes of cerebral infarction were atherosclerosis (38.4%), cardiogenic cause (28.2%), nonatherosclero tic vasculopathy (10.3%), and hematologic abnormality (7.7%) in order of frequency, and the most involoved site was the carotid territories (79.4%). The major causes of intracerebral hemorrhage were hypertension (59.6%) and arteriovenous malformation (8.5%). The locations of the hematoma on brain CT scan were the basal ganglia (42 : 5%), lobe (34%), thalamus (8.5%), pons (6.4%) and ventricle (4.3%) in that order of frequency. Subarachnoid hemorrhage was mainly due to ruptured aneurysm (76.4%). Undetermined causes noted in 15 cases (14.6%). The overall mortality of this group of patients was 23.3%. Most of the patients (83.3%) with fatal outcome died within the first 2 weeks. The degree of neurologic sequelae among survivors was mild (45.6%) to moderate (22.3%).
Subject(s)
Adult , Female , Humans , Male , Young Adult , Aneurysm, Ruptured , Arteriovenous Malformations , Atherosclerosis , Basal Ganglia , Brain , Cerebral Hemorrhage , Cerebral Infarction , Fatal Outcome , Hematoma , Hypertension , Medical Records , Mortality , Pons , Prognosis , Stroke , Subarachnoid Hemorrhage , Survivors , Thalamus , Tics , Tomography, X-Ray ComputedABSTRACT
The author studied 20 healthy adults (20 hands) as a control and 30 patients (40 hands) with carpal tunnel syndrome to evaluate the clinical usefulness of measuring nerve conduction velocity after wrist flexion in diagnosis of carpal tunnel syndrome. The median nerve conduction velocity over wrist to finger segment was measured before and after wrist flexion for 1, 2 and 5 minutes, using belly-tendon method for motor nerve distal latency (MNDL) and antidromic method for sensory nerve conduction velocity (SNCV). The results were as follows: 1. In control group, MNDL increased in 1 hand and SNCV decreased in 2 hands after wrist flexion. In patient group, MNDL increased in 2 hands and SNCV decreased in 3 hands after wrist flexion. 2. In both control and patient group, there were no significant changes in mean values of SNCV and MNDL between before and after wrist flexion. 3. Phalen's wrist flexion test was positive in 5 percent of control and 60 percent of patient group. 4. Tinel's sign was present in 10 percent of control and 33 percent of patient group.
Subject(s)
Adult , Humans , Carpal Tunnel Syndrome , Diagnosis , Fingers , Hand , Median Nerve , Methods , Neural Conduction , WristABSTRACT
Cerebellar infarction (CbI) is rare but because of its location it can give vital influence on the neighbouring structures. Therefore, it is important to make correct diagnosis and know general clinical pictures including prognosis. We studied 25 cases of CbI about their C.T. findings and clinical pictures, and the following results were obtained. 1. Location of the CbI was in inferior cerebellum 20 cases, superior 4 cases. Prognosis was good in 17 inferior and 2 superior cases. 2. Size of the CbI was variable, but fatal cases showed more than 5-6cm in diameter. 3. Deformity of the 4th. Ventricle and slight hydrocephalus were seen in 12 among 20 acute cases. 2 cases expired. 4. Among the total 25 cases 20 cases showed clinically complete cure or improvement, 2 cases worse, 1 cases undetermined, and 2-cases expired.
Subject(s)
Cerebellum , Congenital Abnormalities , Diagnosis , Hydrocephalus , Infarction , PrognosisABSTRACT
Since opening of the Yeungnam University Hospital in March 1983 till the end of 1986, total 156 cases of brain atrophy and encephalopathy (control) diagnosed at the neurology department were investigated, adopting C.T. criteria of brain atrophy. Among the 156 only 77 cases had available C.T. films. Of the 77,35 cases were normal (control) and 42 had brain atrophy. The following results are obtained: 1. A new C.T. criteria of brain atrophy and its degree were devised. (Table 8.9) 2. As the age increased, number of brain atrophy cases increased. 3. Degree of EEG abnormalities were not parallel with the degree of brain atrophy. 4. The most frequent EEG abnormalities with or without brain atrophy were moderate abnormalities. 5. The EEG abnormalities were improved with treatment in most of the cases. 6. The group with suspected organic brain lesions had 69% cases of brain atrophy, whereas the group with only headache or dizzines had 57% of no atrophy. 7. There exists a clinical entity of "Cryptogenic Brain Atrophy". (Park) 8. Recent literatures of Brain Atrophy were reviewed.