ABSTRACT
Objective To investigate the correlation between the distnioution of cerebral atherosclerotic stenosis and early neurologic deterioration (END) in patients with acute large artery atherosclerotic stroke.Methods Patients with acute large artery atherosclerotic stroke admitted to the Department of Neurology,the Second Affiliated Hospital of Anhui Medical University from March 2017 to May 2018 were enrolled retrospectively.END was defined as the National Institutes of Health Stroke Scale (NIHSS) score increased by 2 from the baseline within 72 h of admission,or the NIHSS consciousness level score increased by 1,or the NIHSS motor score increased by 1,or having any new neurological deficit.According to whether the patients had END or not,they were divided into END group and non-END group.According to cerebral artery stenosis (stenosis degree ＞ 50％) identified by head and neck CT angiography,magnetic resonance angiography or digital subtraction angiography,they were divided into single artery stenosis group and multiple artery stenosis group.Multivariable logistic regression analysis was used to analyze the independent risk factors for END.Results A total of 371 patients were enrolled in the study,of which 92 (24.8％) had END.In the single artery stenosis group,the incidence of END varies with the distribution of vessel stenosis:anterior cerebral artery (2.3％),middle cerebral artery (54.4％),posterior cerebral artery (9.1％),basilar artery (4.5％),intracranial internal carotid artery (11.4％),intracranial vertebral artery (6.8％),extracranial internal carotid artery (6.8％),and extracranial vertebral artery (4.5％).The incidence of middle cerebral artery stenosis was significantly higher in the END group than that in the non-END group (54.5％ vs.21.2％;x2=17.615,P ＜ 0.001).In the multiple artery stenosis group,the incidence of END was the highest in patients with only intracranial stenosis (66.7％),followed by patients with intracranial and extracranial stenosis (29.2％),and patients with only extracranial stenosis (4.2％).The incidence of only intracranial multi-artery stenosis was significantly higher in the END group than that in the non-END group (66.7％ vs.47.6％;x2 =5.262,P =0.022).Multivariate logistic regression analysis showed that middle cerebral artery stenosis (odds ratio,1.805,95％ confidence interval 1.217-2.676;P=0.003) was an independent risk factor for END.Conclusions END was associated with the distribution of cerebral atherosclerotic stenosis in patients with acute large artery atherosclerotic stroke.The middle cerebral artery stenosis was an independent risk factor for END.
ABSTRACT
Objective To investigate the effects of hypomagnesemia on the initial amount of hematoma and patient's condition at hospitalization in elderly patients with intracerebral hemorrhage (ICH).The 90 consecutive hospitalized patients with primary ICH were chosen for prospective cohort study in the Second Hospital of Anhui Medical University from February 2017 to May 2018.Methods Demographic and baseline data of patients were collected,and CT scan,serum magnesium concentration and other laboratory examinations after hospital admission were tested.Ninety patients were divided into two groups:hypomagnesemia group(serum magnesium ＜ 0.75 mmol/L,n =38) and normo-magnesemia group(0.75-1.25 mmol/L,n =52).The impact of serum magnesium level on the patient's initial volume of hematoma and critical condition at admission were analyzed.Results The median value of random blood glucose (7.29 mmol/L vs.6.44 mmol/L)and fibrinogen degradation products(3.43 mg/L vs.1.98 mg/L)were higher in the patients with hypomagnesemia than in the normal magnesium group.The median volume of initial volume of hematoma at admission was larger in patients with hypomagnesemia than in the normal magnesium group (20 cm3 vs.10 cm3).The median value of Glasgow coma scale at admission was lower in patients with hypomagnesemia than in the normal magnesium group(12.5 scores vs.14.0 scores).And their difference was statistically significant(U =-2.663,-2.951,-5.000 and-2.821 respectively,P =0.008,0.003,0.000 and 0.005).The correlation analysis showed that the initial volume of hematoma in patients with intracerebral hemorrhage was negatively correlated with the serum magnesium concentration at admission (r =-0.528,P =0.001).Conclusions Patients with hypomagnesemia has a larger hematoma volume and more serious disease condition.There is a significantly negative correlation between serum magnesium and hematoma volume of ICH.The serum magnesium level may become a predictor of ICH in the future.