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A case of suppurative meningitis caused by Streptococcus suis infection is reported. The patient was an elderly female with an atypical epidemiological history. The common symptoms included fever, headache and cervicodynia. According to the results of blood bacterial culture and next-generation sequencing of cerebrospinal fluid, the patient was considered purulent meningitis caused by Streptococcus suis. After treatment with the third generation cephalosporins, the symptoms improved significantly. One week after the onset of the disease, herpes labialis occurred, followed by hearing loss about 1 week later. The patient was treated with antiviral and hormone therapy, and was discharged after improvement.
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Objective To investigate the efficacy and safety of endovascular therapy for small unruptured intracranial aneurysms (sUIAs). Methods Patients with unruptured intracranial aneurysms who underwent endovascular therapy in the Department of Neurology, Guangzhou First People's Hospital from January 2008 to January 2018 were retrospectively included. According to the size of the aneurysms, they were divided into the sUIAs group (diameter <5 mm) and the non-sUIAs group (diameter ≥5 mm). Demographics, vascular risk factors, aneurysm characteristics, and treatment method, effectiveness, perioperative complications, and outcomes of endovascular therapy were compared between the two groups. Results A total of 80 patients with unruptured intracranial aneurysms were enrolled, including 33 patients with sUIAs (41.25% ) and 47 patients with non-sUIAs. The age of patients (51.1 ± 9.7 years vs. 61.2 ± 8.1 years; t=5.058, P<0.001), and the maximum diameter (3.6 ± 1.1 mm vs. 8.2 ± 3.2 mm; t=7.923, P<0.001) and neck width (3.1 ± 0.5 mm vs. 4.5 ± 2.5 mm; t=3.167, P=0.002) of aneurysms as well as the proportion of patients with wide-neck aneurysm (3.0% vs. 21.3% ; χ2 =7.213, P=0.007) and stent-assisted embolization (6.1% vs. 23.4% ; χ2 =4.285, P=0.038) in the sUIA group were significantly less than those of the non-sUIAs group. The embolization results, the perioperative complication rate and the good outcome rate were comparable between the two groups. Conclusion For sUIAs, endovascular therapy is effective and safe, comparable to endovascular therapy for non-sUIAs.
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Objective To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) at admission for large vessel occlusion (LVO) in patients with acute ischemic stroke. Methods The clinical data of patients with acute ischemic stroke admitted to Guangzhou First People's Hospital from January 2016 to November 2017 were enrolled retrospectively. NLR was calculated according to results of blood routine examination within 6 h after admission. Multivariate logistic regression analysis was used to determine the independent correlation between NLR and LVO. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for LVO. Results A total of 109 patients with acute ischemic stroke were enrolled, including 42 females (38. 5％) and 67 males (61. 5％). Their mean age was 63. 6 years. Forty-six patients (42. 2％) had LVO. The proportions of patients with atrial fibrillation, previous stroke or transient ischemic attack, and the National Institutes of Health Stroke Scale score, white cell count, NLR, neutrophil count, and fasting blood glucose in the LVO group were significantly higher than those in the non- LVO group, while lymphocyte count was significantly lower than that in the non-LVO group (all P < 0. 05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for LVO after adjusting for the confounding factors (odds ratio 2. 768, 95％ confidence interval, 2. 272-4. 984; P = 0. 001). The ROC curve analysis of NLR predicting LVO showed that the area under the curve was 0. 712 (95％ confidence interval 0. 638-0. 793), and the sensitivity and specificity were 79. 3％ and 73. 6％ respectively as the optimal cut-off value was 4. 18. Conclusions Increased NLR in early peripheral blood may effectively predict LVO in acute ischemic stroke.
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Objective:To explore therapeutic effect and safety of endovascular stenting on transient ischemic attack (TIA) caused by atherosclerotic vascular stenosis .Methods:A total of 100 patients with TIA caused by vascular ste-nosis in our hospital from Jan 2011 to Feb 2013 were enrolled ,and equally divided into combined treatment group (received endovascular stenting combined medication ) and routine treatment group (received medication treat-ment) .After 12-month treatment ,recurrence rate of TIA ,incidence rate of stroke and vascular stenosis rate before and after treatment were compared between two groups .Results:Compared with before treatment ,there was no significant change in all above-stated indexes after treatment in routine treatment group;were significant reduction in vascular restenosis rate [ (73.31 ± 12.76)% vs .(25.01 ± 5.73)% ] in combined treatment group ,and it signifi-cantly reduced than that of routine treatment group (74.33 ± 12.96)% ,P<0.01 both ;during the 12-month follow-up ,compared with routine treatment group , there were significant reductions in percentages of recurrent TIA (16.0% vs .2.0% ) and cerebral stroke (12.0% vs .0) in combined treatment group ,P<0.05 both Conclusion:En-dovascular stenting can significantly improve clinical therapeutic effect and prognosis in patients with atherosclerotic vascular stenosis ,and is worth clinical extension in some condition .
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Objective To compare the efficacy and safety of intravenous thrombolysis on cardiogenic cerebral infarction and noncardiac infarction by recombinant tissue plasminogen activator (rt-PA). Methods Comparations of NIHSS, mRS and adverse events before and after treatment were made between the cardiogenic group and the noncardiac group. Results No significant differences in the NIHSS and mRS were found between the two groups. The incidence of brain hernia and dermatorrhagia in the cardiogenic group was higher than that in the noncardiac group. Conclusion Rt-PA therapy in cardiogenic cerebral infarction was effective and safe in spite of higher incidence of hemorrhage and brain hernia.