ABSTRACT
Aortic atheroma is not only a sign of systemic atherosclerosis, but also an important embolus source of cerebral embolism. While relatively more attention is paid to complex aortic plaque (CAP), which refers to aortic plaque with a thickness of 4 mm or more, ulceration, or mobile components, clinical manifestations of CAP related cerebral embolism has not been properly investigated. This paper reports a case of aortogenous cerebral embolism attributed to CAP with the main clinical symptoms of slow response, auditory hallucination and dysphagia, and the course in the form of advancing stepwisely with multiple symptoms cumulation. The imaging characteristics, clinical manifestations, diagnosis and treatment of the patient are analyzed in combination with the literatures, through which hoping to improve the understanding, diagnosis and treatment of CAP related cerebral embolism for clinicians.
ABSTRACT
Objective To explore the value of MRA-DWI mismatch (MDM) in predicting ischemic penumbra in acute posterior cerebral infarction with basilar artery occlusion. Methods From September 2015 to July 2018, 58 acute posterior cerebral infarction patients with basilar artery occlusion within 24 hours from symptom onset in the Department of Neurology, the Fourth Affiliated Hospital of China Medical University were retrospectively recruited. The thirty-eight patients with DWI- ASPECTS ≥7 were divided into the MDM-P group and twenty patients with DWI- ASPECTS 0. 05); the differences in NIHSS (3 [2, 12] vs. 11[4, 26], Z=2.434) and DWI-ASPECTS (8[7, 8]vs. 4[3, 5] , Z = 12.950)were statistically significant (all P 0. 05), but significant difference in reperfusion therapy (42.9% [9/21] vs. 67. 6% [25/37], χ2 =3.372) and MDM-P (85.7% [18/21] vs. 54. 1% [20/37], χ2 =5.944) (all P<0.05). Logistic regression analysis showed MRA-DWI mismatch (OR, 4. 914, 95% CI 1. 158 -20. 860, P = 0. 031) was an independent predictor of early neurological deterioration in acute posterior cerebral infarction. Conclusions MRA-DWI mismatch may be a predictor of END in acute posterior cerebral infarction with basilar artery occlusion, indicating that ischemic penumbra may be present in these patients, and it provides evidence for guiding reperfusion therapy.
ABSTRACT
Sleep deprivation due to extended work hours and circadian disruptionhas long been a concern in medicine.Clinicians who have been deprived of sleepfailed to ensure that patients are safe or that the quality of care they receive is high.So it can not be ignored to solve the tense relationship between the clinicians and the patients in China.As a result,to pay attention to the fatigue among clinicians and the safety of patients in our country has its practical significance.Take an active strategy to properly resolve the problem of fatigue among clinicians to ensure medical security,the establishment of safe,high-quality health care system,not only directly related to the treatment of patients,but also to the harmonious relations between clinicians and patients to ensure the safety of health care are very important.