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Objective:To characterize clinical and neuroimaging features, etiologies, and mechanisms of bilateral middle cerebellar peduncle (MCP) infarctions.Methods:Consecutive patients with bilateral MCP infarctions treated in the Beijing Tiantan Hospital, Capital Medical University between January 1, 2020 and April 30, 2022 were enrolled in this retrospective study. The demographic data, vascular risk factors, clincial manifestations and the National Institutes of Health Stroke Scale (NIHSS) scores were collected. Brain diffusion-weighted imaging was used to assess the regions of cerebral infarction, and the extracranial and intracranial segments of the vertebrobasilar artery were evaluated using magnetic resonance angiography, or computed tomography angiography. The stroke etiology and underlying mechanism were evaluated according to the Chinese Ischemic Stroke Subclassification.Results:Ten patients with bilateral MCP infarctions (8 men and 2 women) were analyzed ultimately. The onset age were 51.0-86.0 (64.8±11.4) years. NIHSS scores were 2.0-12.0 (4.9±2.9) points at admission. All patients had vascular risk factors, most of which were hypertension (10 cases) and dyslipoproteinemia (8 cases). The most common clinical manifestations were vertigo (10 cases), followed by ataxia (9 cases) and dysarthria (8 cases). Four cases were isolated bilateral MCP infarctions, while 6 patients were combined with other vertebrobasilar artery infarctions, 4 of which were combined with cerebellar hemisphere infarctions, consistent with the clinical symptoms. The etiology in all patients was large atherosclerosis (severe stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery; 9 cases). Five patients were classified as hypoperfusion/impaired emboli clearance, while 4 patients were considered as artery-to-artery embolism, and 1 was considered as the parent artery (plaque or thrombosis) occluding penetrating artery.Conclusions:Bilateral MCP infarctions are an extremely rare cerebrovascular disease characterized by vertigo, ataxia, and dysarthria. Cerebral infarction can be isolated or often combined with cerebellar hemisphere infarction. The etiology was mostly stenosis or occlusion of V4 segment of vertebral artery and anterior inferior cerebellar artery.
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Objective To explore the clinical characteristics, treatment and prognosis of bronchopulmonary dysplasia (BPD) in extremely preterm infants. Method The clinical data of extremely preterm infants with gestational age ＜ 28 weeks hospitalized between August 2014 and August 2017 were retrospectively analyzed. According to oxygen inhalation and BPD clinical grading at 28 days after the birth, extremely preterm infants were divided into non-BPD group, mild, moderate and severe BPD groups, and their clinical characteristics, treatment and prognosis were discussed. Results A total of 205 extremely preterm infants were enrolled, with an average gestational age of (26.2±1.2) weeks and an average birth weight of (0.87±0.19) kg. Among them, 46 infants were gave up treatment, 15 died, and 144 (70.3％) were discharged eventually. There were statistically significant differences in the rates of patent ductus arteriosus (PDA) and infection among groups with different degrees of BPD (P＜0.01) . The incidence of PDA was higher in the moderate and severe BPD groups, and the infection rate was higher in the severe BPD group. The oxygen use time, length of stay, hospitalization cost, glucocorticoid treatment rate and incidence of pulmonary sequelae among groups with different degrees of BPD were significantly different (P＜0.01) . With oxygen use time, length of hospital stay and hospitalization cost increased gradually over the aggravation of BPD. Glucocorticoids were used in all moderate and severe children, and the incidence of pulmonary sequelae was higher. Conclusion BPD still is an important complication affecting the prognosis of extremely preterm infants. Early prevention and systematic treatment can alleviate severe sequela.
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Stroke is the leading cause of death in China and confers a huge burden and effort on patients and health professionals. China has the world's largest population and has been experiencing a rapid economic development. In this article, we review the current status of stroke epidemiological features and risk factors, and the recently ongoing stroke epidemiological survey in China. Epidemiological studies suggested that stroke incidence increases with age and that the elderly population is expected to increase over time in China. Stroke mortality increased gradually from 1990 to 2000 but declined since the beginning of the 21st century, probably related to better control of vascular risk factors and the advances in acute stroke care. The Chinese lifestyle has changed rapidly during the past 3 decades. Moreover, China is a big country with substantial geographic disparities. The geographical variation and chronological trend of vascular risk factors may determine changes in the prevalence and subtypes of stroke in China. In this review, the current Chinese researches on the critical management of stroke and the potential direction and support of the Chinese government are discussed.