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Objective To investigate the clinical manifestation,neuroimaging characteristics and follow-up results of chorea associated with non-ketotic hyperglycemia (C-H-BG).Methods Clinical data of six patients with C-H-BG were analyzed retrospectively.Results The average age of the six patients (five female and one male) was 65.8±13.9 years,All patients had acute-subacute course.Patients presented with choreic movements involving facial muscles (n=6) and unilateral (n=5) or bilateral limbs (n=1).The average value of plasma glucose at admission was 9.21 ± 5.15 mmol/L.All patients had significantly elevated HbA1c (14.1 ±3.5％).The brain MRI T1 imaging from all patients showed hyperintensity in the basal ganglia,putamen,lenticular nucleus and caudate nucleus.SWI imaging revealed corresponding hypointensity signal in the basal ganglia in three patients.Two patients had severe stenosis of the MCA.Five patients were followed up for an average of 16.2 ±7.2 months.Three patients died.Conclusion The high T1 hypertense lesions in the basal ganglia are the mainly radiological feature of C-H-BG which may be accompanied by SWI hytointense signals in the basal ganglia.
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Objective To investigate the clinical manifestation,neuroimaging characteristics and follow-up results of chorea associated with non-ketotic hyperglycemia (C-H-BG).Methods Clinical data of six patients with C-H-BG were analyzed retrospectively.Results The average age of the six patients (five female and one male) was 65.8±13.9 years,All patients had acute-subacute course.Patients presented with choreic movements involving facial muscles (n=6) and unilateral (n=5) or bilateral limbs (n=1).The average value of plasma glucose at admission was 9.21 ± 5.15 mmol/L.All patients had significantly elevated HbA1c (14.1 ±3.5％).The brain MRI T1 imaging from all patients showed hyperintensity in the basal ganglia,putamen,lenticular nucleus and caudate nucleus.SWI imaging revealed corresponding hypointensity signal in the basal ganglia in three patients.Two patients had severe stenosis of the MCA.Five patients were followed up for an average of 16.2 ±7.2 months.Three patients died.Conclusion The high T1 hypertense lesions in the basal ganglia are the mainly radiological feature of C-H-BG which may be accompanied by SWI hytointense signals in the basal ganglia.
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Objective To investigate the clinical, neuroimaging and serum risk factors of cerebral microbleeds (CMBs) in patients with ischemic stroke and find the associations between these risk factors and the location and num?bers of CMBs were also analyzed. Methods One hundred and fifty-three patients with acute ischemic stroke were re?cruited in this study and their data werewas retrospectively analyzed. All of the patients underwent MRI- susceptibility weighted imaging (SWI). The location and numbers of CMBs were recordedexamined. The severity of WMLs was assessed using the Fazekas scale. Logistic regressions were performed to find the predictors of the presence of CMBs. The relation?ships between these risk factors and the location and numbers of CMBs were also analyzed. Results Fifty-nine(38.6%) cases had at least one CMB. The frequency of cortical-subcortical, deep and infratentorial CMBs were 34.0%, 24.8%and 27.5%, respectively. Multivariate logistic regression showed that male sex, hypertension and moderate-to-severe deep white matter hyperintensities (DWMH) were independent risk factors of the presence of CMBs. Adjusted with age and sex, partial correlation showed that hypertension only correlated with the numbers of deep CMBs significantly (r=0.174, P=0.032). Moderate-to-severe DWMH significantly correlated with the numbers of cortical-subcortical and deep CMBs (r=0.285, P<0.001 and r=0.258, P=0.001, respectively). Conclusion Male sex, hypertension and moderate-to-severe DWMH were are independent risk factors of CMBs in patients with ischemic stroke. Hypertension correlates with Deep deep CMBs, while Moderatemoderate-to-severe DWMH correlates with cortical-subcortical and deep CMBs.
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Post-stroke infection mainly includes stroke-associated pneumonia and urinary tract infection.It is one of the major causes of increasing disability and mortality in patients with stroke.Its occurrence and development is associated with the basal state,stroke location,infarct volume,severity,dysphasia,aphasia and other factors of the whole body system in patients with stroke.In recent years,stroke-induced immunosuppression is receiving increasing attention.
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Objective To evalue the effects of elevation epidural block with 0.2% ropivacaine on lung function. Methods fifty ASA Ⅰ-Ⅱ patients undergoing elective radical mastectomy were anesthetized with method of epidural block .T 2-3 or T 3-4 were selected as puncture site. A catheter was inserted into the epidural space in a cephalad direction for 3-4cm. Nasal catheter oxygen inhalation was used in routine method. A loading dose of 0.2% Ropivacaine 15-20ml was given after a test dose of 1% lidocaine 5ml or 0.2% ropivacaine 5ml. Generally, the first dosage was at 25-30ml. The anesthesia effect, segments of block were measured and heart rates (HR),blood pressure (BP), blood oxygen saturation(SpO 2) were assessed before anesthesia, after anesthesia and at the end of surgery, meanwhile the breathing frequency, minute ventilation and maximal voluntary ventilation(MVV) were monitored. Blood gas, lactic acid and serum glucose were detected from 25 of the total case before and after anesthesia. Levels of sense obstacle and movement of bilateral upper limbs were recorded after operation. Results All 50 patients but one were finely anesthetized by elevation epidural block with 0.2% ropivacaine. Among them 39(78%) patients were blocked at C 5-T 8. No significant difference existed before and after anesthesia on breathing frequency, minute ventilation and maximal voluntary ventilation, and the values of blood gas in all those patients analysed were normal. Over 20% of decline on BP and obvious reduction on HR were found in 8 patients after anesthesia (P