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Leucine rich glioma inactivated 1 (LGI1) is a protein which is identified as the target involving in autoimmune encephalitis. Seizures and cognitive declines are two main symptoms of LGI1-antibody encephalitis. However, autonomic dysfunction symptoms are not prominent as seizures and cognitive defection and are easily overlooked by physicians. We reported a case with LGI1-antibody encephalitis whose onset symptoms were autonomic dysfunction including sweating, orthostatic hypotension. The features of this case was described in detail and the related literatures were reviewed in order to enhance the knowledge of the disease.
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Objective To compare the clinical characteristics of patients with non-valve atrial fibrillation(NAVF)and acute ischemic stroke(AIS) between two groups:aged ≥80 years versus 60-79 years.Methods One hundred and five inpatients with NVAF and AIS,treated in Neurological Department Beijing Hospital from November 2009 to November 2014,were divided into two groups of the very elderly patients (≥ 80 years,n =44) and old patients (60-79 years,n =61).Baseline data and clinical characteristics of patients with NAVF and AIS were retrospectively compared between the two groups to explore their risk factors,subtypes of AIS,the complications and prognosis.Results Age was the risk factor for stroke in the very elderly patients with NAVF.Compared with old patients group,the very elderly patients were associated with significantly higher baseline NIHSS(National Institutes of Health Stroke Scale) (11.59 ± 7.76 vs.6.03±7.12,t=3.80,P=0.000).The rates of mRS(modified Rankin Scale)≥3(poorer clinical turnover)1 or more month after AIS was 21.3％ in the old patients versus 56.8％ in the very elderly patients(x2 =13.96,P＜0.01).Moreover,anterior circulation infarction was the main subtypes of AIS in the very elderly patients versus old patients(x2 =12.28,P =0.020).Meanwhile,the very elderly patients versus the old patients had markedly higher rates of complications of AIS,such as pneumonia (65.9％ vs.27.9％;x2 =14.53,P ＜ 0.05),gastrointestinal bleeding(36.4％ vs.13.1％;x2 =7.84,P＜0.05),acute coronary syndrome or heart failure(34.1％ vs.11.5％;x2 =7.89,P＜0.05).Conclusions The very elderly patients versus the old patients show that risk factors for NVAF with AIS are more often the ageing and smoking,and that anterior cerebral circulation is more often affected.The degrees of NVAF and AIS severity are higher,the more complications are found,and the prognosis is worse.
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We reviewed medical data of 22 patients receiving intravenous thrombolysis therapy for acute isehemic stroke and evaluated our efforts of promoting intravenous thrombolysis for acute ischemic stroke.The mean in-hospital delay was 107 minutes.The most common reason was waiting for the results of laboratory tests.Only 6 cases received a standard dose of recombinant tissue plasminogen activator (rtPA) at 0.9 mg/kg.Only one patient had asymptomatic intracranial hemorrhage.No symptomatic hemorrhage occurred.Intravenous thrombolysis for ischemic stroke had excellent safety profile.Intravenous thrombolysis for ischemic stroke should be promoted under the guidance of standardized protocol according to the national guideline.
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@#ObjectiveTo analyze cerebral hemorrhagic infarction (HI) and relative factors with the database of Standard Stroke Registry (SSR).Methods1 487 consecutive patients with acute ischemic stroke admitted within 3 days after onset were analyzed with SSR.ResultsHI was observed in 11% of patients, of whom 51% were diagnosed as having cardiogenic embolism. In patients with supratentorial infarction of cardiac origin, 28% had HI (mild 67%, moderate 23, hematoma 10%). On multiple logistic regression analysis, independent factors related with HI were found to be age, prosthetic cardiac valve and NIHSS scores at admission. Patients with more severe HI were associated with a poorer outcome at discharge. Clinical outcome tended to be better in patients receiving thrombolytic agents than in those without receiving agents, while the incidence of HI was slightly more frequent in the former.Conclusion It is confirmed that the SSR database is useful for understanding and analyzing the status of stroke diagnosis and management throughout the nation, and revisions are needed in some formats.
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<p><b>OBJECTIVE</b>To report the initial application of brain protection device in the dilatation and stenting of atherosclerotic stenosis of the carotid and vertebral artery.</p><p><b>METHODS</b>Eighteen patients with 21 atherosclerotic stenoses of the carotid or vertebral artery underwent dilatation and/or stenting with brain protection device (filterwire or angioguard). The clinical results were summarized and the indispensability and feasibility of the device was discussed.</p><p><b>RESULTS</b>With the aid of brain protection device, endovascular dilatation and (or) stenting were performed in all the patients with 21 stenoses of the carotid or vertebral artery. The interventional manipulation was successful and no complications occurred.</p><p><b>CONCLUSIONS</b>Brain protection device is helpful to decrease the embolic complication caused by atherosclerotic plaque and thromboembolus and to increase the security of interventional therapy, during the dilatation and/or stenting of stenosis of the carotid or vertebral artery.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon , Methods , Carotid Stenosis , Therapeutics , Follow-Up Studies , Intracranial Embolism , Protective Devices , Stents , Vertebrobasilar Insufficiency , TherapeuticsABSTRACT
Objective To observe the efficacy of low dose aspirin(ASA) on the platelet aggregation in aged patients with ischemic cerebrovascular diseases(ICVD). Methods Platelet aggregation by arachidonic acid(AA, 500 ?g/ml), adenosine diphosphate (ADP,5 ?mol/L), epinephrine(EPI, 5 ?mol/L), and collagen (COL,2 ?g/ml) using Born's method was induced in 70 elderly with ICVD treated with ASA (40 mg/d) and in 30 untreated patients as well as in 50 healthy controls. Results A high coefficient of variation of the maximum aggregation rate induced by AA, COL and EPI were observed in the ASA (40 mg/d) treated group. Twenty-five out of the 70 patients in the ASA treated group (40 mg/d) were found that their platelet aggregation induced by AA were not markedly inhibited. Ten patients were randomly selected from the above 25 patients to receive an increasing dose to 80 mg/d. At repeated tests, 8 of these 10 achieved marked inhibition, and 2 of the 10 who showed no inhibition continued receiving an increasing dose to 100 mg/d and then achieved marked inhibition. Conclusions There is a great individual variation in response to low dose aspirin in aged patients with ICVD, and the laboratory evaluation of aspirin efficacy and its individualization is necessary in clinical practice.