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Objective:To investigate the influencing factors of fluid attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) and its impacts on outcomes in patients with posterior cerebral artery infarction.Methods:Consecutive patients with posterior cerebral artery infarction admitted to the Department of Neurology, Fuyang Hospital of Anhui Medical University from January 2019 to December 2021 were retrospective enrolled. Demographic and clinical data of patients were collected. The modified Rankin Scale (mRS) score was used to evaluate the outcomes at 3 months after the onset. 0-2 were defined as good outcomes, and >2 were defined as poor outcomes. Multivariate logistic regression analysis was used to determine the independent influencing factors of FVH and poor outcomes. Results:A total of 65 patients (46 males [70.8%], aged 71.25±10.06 years) with posterior cerebral artery infarction were enrolled. There were 14 patients (21.5%) in FVH positive group and 51 (78.5%) in FVH negative group; 45 (69.2%) had a good outcome, and 20 (30.8%) had a poor outcome. There were significant differences in hypertension, history of previous stroke or transient ischemic attack, pre-onset mRS score >1, and etiology of stroke between the FVH positive group and the FVH negative group. Multivariate logistic regression analysis showed that there was a significant independent correlation between the pre-onset mRS score >1 and FVH positive (odds ratio 6.206, 95% confidence interval 1.463-26.328; P=0.013). There were significant differences in age, atrial fibrillation, history of previous stroke or transient ischemic attack, baseline National Institutes of Health Stroke Scale score, FVH positive, and anticoagulant use between the good outcome group and the poor outcome group. Multivariate logistic regression analysis showed that there was a significant independent correlation between FVH positive and poor outcomes (odds ratio 5.761, 95% confidence interval 1.477-22.466; P=0.012). Conclusion:The pre-onset mRS score >1 is independently associated with FVH positive, while FVH positive is independently associated with poor outcomes in patients with posterior cerebral artery infarction.
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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.
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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.
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Objective To investigate the predictive value of peripheral blood neutrophil-to-lymphocyte ratio (NLR) for stroke-associated pneumonia (SAP) in patients with acute stroke.Methods Consecutive patients with acute stroke were enrolled.Their clinical data were collected.The peripheral blood white blood cells,neutrophil and lymphocyte counts were detected within 24 h after admission,and the NLR was calculated.Multivariate logistic regression analysis was used to determine the independent correlation between NLR and SAP.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of NLR for SAP.Results A total of 126 patients with acute stroke were enrolled,including 45 females (35.7％) and 81 males (64.3％).Their mean age was 64.8 years.Fifty-two patients (41.3％) had intracerebral hemorrhage,and 74 (58.7％) had ischemic stroke.Thirty-nine patients (31.0％) occurred SAP,and 87 (69.0％) did not occur SAP.Univariate analysis showed that age,National Institutes of Health Stroke Scale scores,fasting glucose,total white blood cell count,neutrophil count,NLR,and proportions of patients with hyperlipidemia,ischemic heart disease,atrial fibrillation,smoking,dysphagia,using acid suppressing drugs and indwelling gastric tube in the SAP group were significantly higher than those in the non-SAP group (all P ＜0.05),and the high-density lipoprotein cholesterol level and lymphocyte count in the SAP group were significantly lower than those in the non-SAP group (all P ＜ 0.05).Multivariate logistic regression analysis showed that NLR (odds ratio 2.079,95％ confidence interval 1.174-3.194;P =0.001) was an independent risk factor for SAP after adjustment for confounding factors.ROC curve analysis showed that when the NLR cutoff value was 6.765,the sensitivity of predicting SAP was 64.1％,the specificity was 73.6％,and the area under ROC curve was 0.721 (95％ confidence interval 0.630-0.813).Conclusions The elevated NLR in peripheral blood within 24 h after admission may has a certain predictive value for SAP in patients with acute stroke.