ABSTRACT
Background: digital subtraction angiography [DSA] is important diagnostic tool for evaluation of cerebral vasculature and provides essential information regarding hemodynamic status and collateral circulation in patients with stroke and vascular malformations, so it is ideal imaging method of choice for diagnosis of cerebrovascular diseases
Aim of the Work: to register all cases undergoing diagnostic cerebral angiography in Al-Hussein University hospital, neuro-intervention unit performed by a neuro-interventional team and evaluate the results, and outcome of this procedure
Materials and Methods: the present study is single-center study included all patients subjected to diagnostic cerebral angiography during period from 2006 to 2018. The study protocol was approved by the local Ethics Committee in Al-Azhar University. The patients had been recruited from Al-Hussein and Sayed Galal Hospital outpatient's clinics, internal departments and stroke units, which indicated for diagnostic cerebral angiography
Results: in the present study the mean age of patients with arterial stenosis was [55.47 +/- 8.80], 1049[51%] of them were males, 1009[49%] were females. In our study, mild stenosis was present in 254 [12.3%], moderate stenosis in 525 [25.5%], severe stenosis in 567 [27.6 %], subtotal occlusion in 315 [15.3%] and total occlusion in 397 [19.3%] of the patients which detected by DSA
Conclusion: arterial stenosis is more common than cerebral aneurysms and AVM in the patients who subjected to DSA. The presence of hypertension and diabetes mellitus were found to be significantly more prevalent among patients with arterial stenosis. However, the prevalence of hypertension and smoking were more prevalent in cerebral aneurysms
ABSTRACT
Plasmid-encoded resistance to extended-spectrum cephalosporins and aztreonam due to extendedspectrum beta-lactamases [ESBLs] production is becoming a widespread dilemma in medical practice. Nosocomial pneumonia, urinary tract and bloodstream infections by ESBL-producing K. pneumoniae are difficult to treat, leading to high morbidity and mortality especially among patients in intensive-care units. The high prevalence of resistance to extended-spectrum cephalosporins among K. pneumoniae strains in our hospital directed the attention for further ESBLs confirmatory assays and investigations. In this work, all K. pneumoniae clinical strains [n=125] isolated from patients in critical care units during the year 2005 were characterized by CLSI standard screening and confirmatory methods for ESBL production, as well as detection of ESBL blaTEM and blaSHV plasmid genes. Thirty-four strains [27%] were confirmed to produce ESBLs, by the confirmatory methods, and all of them showed either blaSHV and/or blaTEM plasmid sequences. Some strains showed discrepancy among different cephalosporins tested, either by screening or confirmatory methods. Plasmid gene amplification confirmed the acquisition of resistant genes. In conclusion, despite being time-consuming and costly, complete characterization of ESBL strains using phenotypic standard confirmatory tests, combined with genotypic methods, is necessary for accurate ESBLs detection. Applying such strategy could promote patient recovery, minimize complications, and decrease the total hospital stay and treatment expenses, especially for intensive care patients
ABSTRACT
Cerebral palsy [CP] is a static encephalopathy that may be defined as non progressive disorder of posture and movement often associated with epilepsy and abnormalities of speech, vision and intelligence. The aim of our study was to assess haemodynamic alterations that might take place in children with CP using Transcranial Doppler [TCD] and to find out the correlation between Haemodynamic and structural abnormalities of the brain in CP. 40 patients with CP [age 1-10 years] were subjected to history, clinical examination and MRI brain and TCD was done for all patients and 20 children as control group to assess thmiddle cerebral artery [MCA] on both sides under sedation by chloral hydrate. Abnormal MRI findings were present in 92.5% of cases and normal MRI was found in 7.5% of cases. A significant correlation between MRI finding and clinical types was observed; atrophy was present in 50% of cases with spastic quadriplegia and periventricular leukomalacia diplegia. No significant difference between right and left side in both cases and control group in all parameters. A high statistical significant difference in the mean of flow velocities and indices was present between cases and control, the cases showed marked lowering of velocity in comparison to the control. No significant difference between different age groups of cases in TCD readings .No relation between clinical picture of CP and TCD readings. No relation between different MRI findings and TCD readings. All the hemiplegic cases showed reduction in the velocities at the affected side
Subject(s)
Humans , Male , Female , Magnetic Resonance Imaging/methods , Ultrasonography, Doppler, Transcranial/methods , ChildABSTRACT
Background and purpose: Changes of flow velocities have been well demonstrated in patients with subarachnoid hemorrhage, but the clinical significance of these changes has not been clearly defined. We try to approach this area during the time course of S AH using TCD
Methods: Serial TCD examinations were performed in 25 patients with SAIL TCD parameters were correlated with clinical SAH grades, radiological findings, timing of aneurysm surgery and time of complications in which specifically the data selected from the first week from onset as it may be of predictive value
Results: Time trend of relative changes of FV from onset showed increase between days 3 to 12. The higher and lower clinical grade [WFNS grade] recorded at admission had no marked changes during the time course of SAH. In late surgery the difference between the mean flow velocities [FVta] in pre-operative to post- operative was significant [P<0.03]
Conclusion: Follow up TCD measurements can assist in identifying patients at risk. Higher blood pressure at admission and increase FVconsequently in the early days of the course of SAH can harbour serious problem as rebleed or ischaemia
ABSTRACT
This study aimed to evaluate blood flow velocity [FV] and pulsatility index in patients with unilateral headache. Sixty-six patients were examined during headache-free period, three patients during attack of migraine and fourteen as control healthy volunteers who were migraine - free individuals and without cerebrovascular diseases. Mean flow velocity and pulsatility index was measured in the middle cerebral artery using transcranial Doppler. The sixty-six patients were divided into three subgroups as followed; 34 patients as non-dominant sided headache, 27 patients as dominant-sided headache and 5-patients with definite brain lesions. The FV mean of patients with definite brain lesion significantly increased on comparison with the control group, the non-dominant sided headache and the dominant sided headache. There was no significant difference between FV mean of the side of headache and the other side [non-painful side] in patients with dominant sided headache