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Objective To characterize the imaging features of cerebral vascular fenestrations and the clinical features of patients with cerebral infarction.Methods We retrospectively analyzed the magnetic resonance or CT imaging data of 135 cases of cerebral vascular fenestrations from January 2015 to July 2017 in the First Affiliated Hospital of Fujian Medical University.The location,morphology and the other associated vascular diseases were described.The patients who had cerebral infarction were also analyzed.Results One hundred and thirty-five fenestrations were noted at our institution,129 in arteries,and six in veins,the detection rate being 1.1％ (135/12 232).Basilar arteries were most common,which accounted for 53.3％ (72/129) of the fenestrations.Twenty-eight (20.7％) of these patients had other vascular malformations,with a total of 15 aneurysms,two moyamoya diseases,five venous malformations,two arteriovenous fistulas,and four cavernous hemangiomas.Nine patients had cerebral infarctions,of which five patients had fenestration-relevant cerebral infarctions,and no risk factors for cerebral infarctions were found except fenestration in one patient who was diagnosed with cryptogenic stroke.No acute cerebral infarctions or transient ischemic attack occurred in patients with fenestration-relevant cerebral infarctions who had long-term antiplatelet and statin therapy during follow-up.Conclusions Cerebral vascular fenestrations occur most frequently in the basilar artery and may combine with other malformations.Long-term antiplatelet and statin therapy can be used for cerebral infarctions patients with cerebral vascular fenestrations.
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Objective To investigate the clinical characteristics, diagnosis, treatment and prognosis of varicella zoster virus myelitis. Methods The clinical data of 7 varicella zoster virus myelitis patients were retrospectively analyzed and clinical follow-up was conducted. Results Seven patients had characteristic skin rash and symptoms of spinal cord injury. The initial symptoms including rash in 5 cases and spinal cord damage symptoms in 2 cases. The affected skin sections were consistent with the spinal cord segment in 4 cases, and below the level of spinal cord injury in 3 cases. All 7 cases were confirmed by spinal MRI with segmental spinal cord lesions as evidenced by long T1and long T2signals in the affected spinal cord including enhancing lesion in 2 cases. Lesions located in thoracic cord in 5 cases and in cervical cord in two cases.All patients received steroid hormone treatment.Among them,5 patients received additional antiviral treatment. After 12~36 months follow-up, 5 cases were cured, 1 case left with sphincter dysfunction and 1 case with slight numbness of hands. Conclusion Varicella zoster virus myelitis is characterized by characteristic rash and spinal cord symptoms.Antiviral drugs and corticosteroid therapy can yield better prognosis.
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Objective We characterized the clinical features of sporadic Creutzfeldt-Jakob disease(sCJD)in or?der to diagnose it at the early stage. Methods Seventeen patients with sCJD were enrolled in the study. The clinical data, symptoms at the early stage, result of auxiliary examinations and survival time were analyzed. Results The ratio of male to female was 1:1.83 and the average age of onset was 60 ± 8.8 years old. Most of them presented with walking unstable (82.4%)and hypomnesia (64.7%) as the initial symptom. The occurrence rate was 82.4%, 76.5%and 58.8%for myoclo?nus, colored-ribbon-shaped high signals in cerebral cortex and high signals in basal ganglia of MRI. Periodic synchro?nous discharge (PSD) of electroencephalography(EEG) was seen in 82.4% cases, while cerebrospinal fluid analysis re?vealed positive results for 14-3-3 protein in 70%cases. Twelve patients had been dead in our study. The median surviv?al time was 12±7.7 months. Conclusions sCJD is more frequently occurred in mid-aged and older without specific symp?toms in early stage and positive rate of high signals in cerebral cortex of MRI and PSD of EEG is high.
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Objective To evaluate the efficacy and safety of oral prednisone in patients with relapsing neuromyeli?tis optica. Methods Seventeen patients with relapsing neuromyelitis optica receiving long-term oral prednisone had been followed. The Expanded Disability Status Scale (EDSS) and annualized relapse rates were used to evaluate curative effect. Results During long-term oral prednisone treatment, patients had a significant reduction in the EDSS [(3.09 ± 0.85) vs. (4.06 ± 0.80), P<0.05] and the median annualized relapse rate was significant reduced [(0.34 ± 0.31) vs. (1.51 ± 0.57), P<0.005]. But the effect of different dosage of prednisone on annualized relapse rates was not different. No severe adverse re?actions were observed. Conclusions Treatment with long-term oral prednisone in patients with NMO significantly reduces relapse rates, improves neurological function and the treatment was well-tolerated.
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Objective To investigate the relationship between the gene polymorphism of the inducible costimulatory molecules (ICOS),CD_(28),CD_(24) and susceptibility to multiple sclerosis(MS). Methods 83 patients with MS and 110 controls selected from healthy individuals and hospital staff in Chinese Han people with non-autoimmune diseases were studied by detecting genotype of the 3 genes using PCR-RFLP method. Results The frequency of ICOS-2394 TT genotypes was significantly higher in MS patients than in controls (MS 33.7%vs controls 10.9%, P