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INTRODUCCIÓN: la trombosis de seno longitudinal superior es una enfermedad de difícil detección a causa de sus diferentes causas y debido al polimorfismo de sus manifestaciones neurológicas; además es común en el sexo femenino relacionado a los estímulos estrogénicos y otros factores hormonales, pero poco probable en menor de 40 años. PACIENTE: paciente menor de 40 años posterior a presentar dos episodios de accidentes cerebrovasculares isquémicos, se evalúa un año después de la lesión el estado cognitivo y funcional mediante la batería Neuropsi Atención y Memoria y el Inventario de Adaptabilidad Mayo-Portland; los procesos cognitivos afectados en un nivel de clasificación leve fueron la atención y concentración, el funcionamiento ejecutivo; en el estado funcional reportado por el cónyuge sugiere afectación de síntomas clínicos como irritabilidad, ira agresividad, dolores de cabeza, cansancio y reacciones a síntomas menores e interacción inadecuada, estos síntomas no fueron reportados por la paciente sugiriendo posible anosognosia en su proceso de adaptabilidad CONCLUSIÓN: Tras un proceso de lesión cerebral por afectación trombótica, las secuelas cognitivos y funcionales permanecen posterior a la recuperación espontanea, llevando a emplear procesos de rehabilitación.
INTRODUCTION: the superior longitudinal sinus thrombosis is a disease difficult to detect because of its different causes and because of the polymorphism of its neurological manifestations; It is also common in females related to estrogen stimuli and other hormonal factors, but unlikely in younger than 40 years. PATIENT: a patient younger than 40 years after having two episodes of ischemic strokes, cognitive and functional status is assessed one year after the injury using the neuropsi battery attention and memory and the mayo-portland adaptability inventory; Cognitive processes affected at a slight level of classification were attention and concentration, executive functioning; In the functional status reported by the spouse suggests involvement of clinical symptoms such as irritability, anger, aggression, headaches, fatigue and reactions to minor symptoms and inadequate interaction, these symptoms were not reported by the patient suggesting possible anosognosia in her process of adaptability CONCLUSIÓN: After a process of brain injury due to thrombotic involvement, the cognitive and functional sequelae remain after spontaneous recovery, suggesting the import of rehabilitation processes.
Subject(s)
Humans , Female , Adult , Cognition/physiology , Stroke/physiopathology , Intracranial Thrombosis/physiopathology , Neurobehavioral Manifestations/physiology , NeuropsychologyABSTRACT
OBJECTIVE： To study the improvement effects of Bee venom（BV） plastics on experimental cerebral thrombosis in rats. METHODS： Totally 96 SD rats were randomly divided into sham operation group （normal saline）， model group （plastics blank matrix）， Nimodipine group （positive drug， 4.00 mg/kg） and BV plastics low-dose， medium-dose， high-dose groups （1.67， 3.33， 6.67 mg/kg）， with 16 rats in each group. Rats in sham operation group and Nimodipine group were given medicine intragastrically， while rats in model group and BV plastics groups were given medicine by transdermal smearing. After 5 days of continuous administration， the experimental cerebral thrombosis model was established by ligating the right external carotid artery and pterygomandibular artery， and injecting compound thrombus inducer into the internal carotid artery. The wet mass ratio of right brain to left brain was measured to investigate the degree of brain edema on the infarcted side. The content of Evans blue （EB） in the left and right hemispheres of rats was determined by ultraviolet spectrophotometry to investigate the cerebral vascular permeability. Blood rheology and coagulation function indicators of rats were measured. The pathological changes of brain tissue in rats were observed by HE staining， and the number of survival neuron cells was counted. RESULTS： Compared with the indexes of sham operation group， the cerebral thrombosis model was established successfully. Compared with model group， the area of blue staining in the right brain （infarcted side） of rats in BV plastics groups was significantly reduced， and the right brain/left brain wet mass ratio and the content of EB in the right brain tissue were significantly reduced （P＜0.05 or P＜0.01）. The whole blood viscosity and Casson viscosity of rats in BV plastics groups， and the plasma viscosity of rats in BV plastics medium-dose and high-dose groups decreased significantly （P＜0.01）. PT and APTT of rats were prolonged significantly in BV plastics medium-dose group （P＜0.01）. The pathological changes of brain tissue in rats in BV plastics groups were significantly alleviated. The arrangement of neuron cells was more orderly， the shape and structure of cells were clear， the nucleolus was clear， the membrane was intact， and the number of survival neuron cells was significantly increased （P＜0.01）. CONCLUSIONS： BV plastics can alleviate brain edema， inhibit cerebral vascular permeability， improve hemorheology and coagulation function indicators of rats after the formation of cerebral thrombosis， and alleviate nerve cell injury after ischemia.
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To systematically evaluate the efficacy and safety of Shenxiong Glucose Injection in the treatment of cerebral thrombosis.Randomized controlled trials( RCTs) of Shenxiong Glucose Injection for cerebral thrombosis were screened out by searching CNKI,Wan Fang,VIP,Sino Med,Cochrane Library,PubMed,EMbase,and Web of Science in a systematic way,and the Meta-analysis on finally included studies was conducted by using Handbook 5. 1 evaluation criteria and tools and Rev Man 5. 3 software. GRADE system( GRADE pro 3. 6. 1) was used to grade the evidence quality of key outcome indicators. A total of 25 studies were included,with a total sample size of 2 286 cases,1 144 in the experimental group and 1 142 in the control group. The results of Meta-analysis showed that the total effective rate of Shenxiong Glucose Injection combined with ozagrel in the treatment of cerebral thrombosis was better than that of ozagrel alone( RR = 1. 26,95%CI [1. 20,1. 32],P<0. 000 01); the total effective rate of conventional treatment plus Shenxiong Glucose Injection and ozagrel for cerebral thrombosis was better than that of conventional treatment combined with ozagrel( RR = 1. 26,95%CI [1. 09,1. 46],P = 0. 002). In addition,Shenxiong Glucose Injection combined with ozagrel could reduce the incidence of adverse reactions( RR = 0. 38,95%CI [0. 24,0. 60],P < 0. 000 1),improve the neurological impairment( MD14 d=-7. 19,95% CI[-9. 16,-5. 22],P< 0. 000 1; MD30 d=-5. 34,95% CI [-5. 85,-4. 83],P < 0. 000 1; MD42 d=-7. 03,95% CI [-7. 79,-6. 28],P<0. 000 01; MD60 d=-6. 18,95%CI [-6. 55,-5. 81],P< 0. 000 01; MD90 d=-4. 90,95% CI [-5. 74,-4. 06],P<0. 000 01),and improve activities of daily living( ADL)( MD = 15. 00,95%CI [12. 20,17. 80],P<0. 000 01). The mortality was only included in one study,and the sample size was small,requiring to be further verified by a large sample size. The adverse reactions mainly included lung infection,skin pruritus,gastrointestinal reaction and so on,all of which could be tolerated or disappeared without affecting the treatment. Based on the available data and methods,Shenxiong Glucose Injection combined with ozagrel for cerebral thrombosis could improve the total effective rate,neurological impairment,and ability of daily living,with no serious adverse reactions. The evidence quality level of GRADE system was low in the evaluation of total effective rate,mortality and incidence of adverse reactions.However,the quality of the included researches was not high,requiring rigorously designed and internationally standardized clinical trials with a large sample size to improve the quality of evidence.
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Humans , Activities of Daily Living , Drugs, Chinese Herbal , Therapeutic Uses , Glucose , Therapeutic Uses , Intracranial Thrombosis , Drug Therapy , Randomized Controlled Trials as TopicABSTRACT
Background: Antiphospholipid syndrome is a multisystem auto-immune disordercharacterized by arterial or venous thrombosis in children. Case characteristics: 11-year-old child with pneumococcal meningitis also had cerebral sinus vein thrombosis andpulmonary artery segmental thrombosis. Observation: Pro-thrombotic evaluation showedpositive lupus anticoagulant at baseline and after 12 weeks. Investigations for lupus werenegative at admission and after one year of follow-up. Message: Antiphospholipidsyndrome is a possibility even in thrombosis occurring in the setting of meningitis
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Objective To explore the diagnostic value of serum lipoprotein(a)[Lp(a)]in cerebral infarction by a model of Logistic regression and receiver operating characteristic(ROC)curve.Methods A total of 316 patients with cerebral thrombosis from Foshan Hospital Affiliated to Southern Medical University were col-lected.According to the diagnostic criteria,the patients were divided into cerebral thrombosis group(196 ca-ses)and non-cerebral thrombosis group(120 cases).All the subjects were tested for Lp(a)by immune turbi-dimetry.To evaluate the diagnostic value of Lp(a)by applying logistic regression model,drawing ROC curves and calculating the area under the curve(AUC).Results The P25,P50,P75of Lp(a)in cerebral thrombosis group and non-cerebral thrombosis group were 97.23,238.22,430.01 and 29.80,92.27,233.86,the average rank were 185.42 and 114.52,the differences in the two groups were significant(P<0.05).Logistic regres-sion showed that the correlation between Lp(a)level and cerebral thrombosis was positive,the partial regres-sion coefficient(B)was 0.005,Wald value was 31.295.It suggested that when the levels of Lp(a)was higher the risk of cerebral thrombosis increased.The most valuable diagnosis level was 305.80 mg/L.And the area under the ROC curve(AUC)was 0.724,which has moderate diagnostic efficacy.Diagnostic specificity was 91.7%,misdiagnosis rate was 8.3%,negative predictive value was 48.7%,sensitivity was 40.8%,omission rate was 59.2%,positive predictive value was 88.9%.Conclusion The level of serum Lp(a)has high diag-nostic specificity for the diagnosis of cerebral thrombosis.
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Objective To investigate the improvement role of aspirin combined with statins on carotid plaque of patients with cerebral thrombosis.Methods80 cases of patients with cerebral thrombosis in our hospital from May 2014 to May 2016 were selected, these patients were divided into aspirin combined with statins treatment group (combined treatment group, 40 cases) and single aspirin treatment group (single treatment group, 40 cases) two groups according to the treatment methods, the NIHSS scores, Barthel indexes, clinical curative effects, IMT, plaque areas of the two groups were statistically analyzed.ResultsThe NIHSS score of the combined treatment group was significantly lower (P<0.05), the Barthel index was significantly higher (P<0.05), the total treatment efficiency 95.0% (38/40) was significantly higher than the single treatment group 80.0% (32/40) (P<0.05), the IMT was significantly shorter (P<0.05), the plaque area was significantly smaller than the single treatment group (P<0.05).ConclusionAspirin combined with statins can more effectively improve the carotid plaque of patients with cerebral thrombosis than aspirin alone, so is worthy of promotion and use in the clinical.
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Objective To evaluate the effect of Qixuoxue Huoxue Tongluo decoction combined with ozagrel sodium on cerebral thrombosis and to improve cerebral ischemia-reperfusion injury. Methods 106 patients of cerebral thrombosis from April 2015 to April 2016 were divided into control group and observation group, each group of 53 patients. The patients in the control group were treated with ozagrel sodium for reperfusion. The observation group was treated with Qixiqi Huoxue Tongluo decoction and ozagrel sodium for treatment. Resulrs The levels of inflammatory factors (hs-CRP, TNF-α, etc.) in the observation group were lower than those in the observation group (P<0.05), and the two groups were compared with the observation group (P<0.05). The adverse effects of NIHSS and ADL were higher than those of the control group (P<0.05). The adverse effects of NIHSS and ADL were significantly lower than those of the control group (P<0.05) ; Conclusion Qixie Huoxue Tongluo Decoction combined with ozagrel sodium for cerebral thrombosis patients have a good therapeutic effect, for cerebral ischemia and reperfusion injury also have some improvement.
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Objective To investigate the medication combined with early rehabilitation nursing intervention to reduce the disability rate of the patients with cerebral thrombosis. Methods 80 cases of acute cerebral thrombosis patients from January 2014 to December 2016 were selected as the research object. According to the principle of single blind random allocation, patients were randomly divided into two groups with 40 cases in each group. The control group received routine treatment and nursing intervention, and the observation group was given early rehabilitation nursing intervention on the basis of the control group. Neurological deficit scores, Barthel index, FMA limb function score, quality of life score and prognosis were compared between the two groups. Results After the intervention, the neurological deficit scores of the two groups were significantly decreased (P<0.05), and the scores of Barthel index and FMA were significantly increased (P<0.05), and the scores of the intervention group were better than those of the control group (P<0.05). The quality of life of the observation group was significantly higher than that of the control group (P<0.05). The prognosis was superior to the control group (P<0.05). Conclusion Early rehabilitation nursing intervention can effectively promote the neurological function, daily self-care ability and recovery of limb motor function in patients with acute cerebral thrombosis, which is beneficial to reduce morbidity and improve the quality of life and prognosis of patients.
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Objective To evaluate the effect of Qixuoxue Huoxue Tongluo decoction combined with ozagrel sodium on cerebral thrombosis and to improve cerebral ischemia-reperfusion injury. Methods 106 patients of cerebral thrombosis from April 2015 to April 2016 were divided into control group and observation group, each group of 53 patients. The patients in the control group were treated with ozagrel sodium for reperfusion. The observation group was treated with Qixiqi Huoxue Tongluo decoction and ozagrel sodium for treatment. Resulrs The levels of inflammatory factors (hs-CRP, TNF-α, etc.) in the observation group were lower than those in the observation group (P<0.05), and the two groups were compared with the observation group (P<0.05). The adverse effects of NIHSS and ADL were higher than those of the control group (P<0.05). The adverse effects of NIHSS and ADL were significantly lower than those of the control group (P<0.05) ; Conclusion Qixie Huoxue Tongluo Decoction combined with ozagrel sodium for cerebral thrombosis patients have a good therapeutic effect, for cerebral ischemia and reperfusion injury also have some improvement.
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Objective To investigate the medication combined with early rehabilitation nursing intervention to reduce the disability rate of the patients with cerebral thrombosis. Methods 80 cases of acute cerebral thrombosis patients from January 2014 to December 2016 were selected as the research object. According to the principle of single blind random allocation, patients were randomly divided into two groups with 40 cases in each group. The control group received routine treatment and nursing intervention, and the observation group was given early rehabilitation nursing intervention on the basis of the control group. Neurological deficit scores, Barthel index, FMA limb function score, quality of life score and prognosis were compared between the two groups. Results After the intervention, the neurological deficit scores of the two groups were significantly decreased (P<0.05), and the scores of Barthel index and FMA were significantly increased (P<0.05), and the scores of the intervention group were better than those of the control group (P<0.05). The quality of life of the observation group was significantly higher than that of the control group (P<0.05). The prognosis was superior to the control group (P<0.05). Conclusion Early rehabilitation nursing intervention can effectively promote the neurological function, daily self-care ability and recovery of limb motor function in patients with acute cerebral thrombosis, which is beneficial to reduce morbidity and improve the quality of life and prognosis of patients.
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Objective To explore the clinical features of systemic lupus erythematosus (SLE) combined with antiphospholipid syndrome (APS) and cerebral thrombosis in a child. Method The clinical data of SLE combined with APS and cerebral thrombosis in a child was retrospectively analyzed, and the related literature was reviewed. Results This was a 12-year-old boy. The disease onset with recurrent fever, confusion and rash in cheek. He had anemia and thrombocytopenia, and positive antinuclear antibody (ANA) and anticardiolipin antibody (aCL). Magnetic resonance imaging showed multiple cerebral infarction. The diagnosis of SLE combined with APS and cerebral thrombosis was clearly made. Methylprednisolone, cyclophosphamide, warfarin, meropenem and acyclovir were used for the treatment. At the same time, the patient also received intravenous immunoglobulin. Conclusion SLE combined with APS and cerebral thrombosis in children was usually in a severe condition, the prognosis of which can be effectively improve by early diagnosis and reasonable treatment.
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Thrombin activated fibrinolysis inhibitor ( TAFI) is a kind of plasma enzymes that can be activated by thrombin.TAFI regulates blood coagulation and fibrinolysis and has a strong fibrinolytic and anti-inflammatory ac-tivity.Its inhibitor is expected to minimize the risk of bleeding when thrombolytic recanalization .Also, studies found that TAFI played an important role in the development of cerebral thrombosis;atherosclerosis and so on .
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La trombosis venosa cerebral es una enfermedad poco frecuente, pero de pronóstico potencialmente grave. Debido a los cambios hemostáticos durante la gestación, es una patología que puede asociarse al embarazo. Presenta un amplio rango de signos y síntomas. El diagnóstico y tratamiento precoz mejoran el pronóstico. Presentamos el caso de una mujer de 30 años, que en la semana 8 de gestación acude a Urgencias por cefalea intensa y cuya resonancia magnética reveló una trombosis venosa cerebral. La paciente presentó un segundo episodio en la semana 33, a pesar del correcto tratamiento anticoagulante recibido.
Cerebral venous thrombosis is a rare disease, but with a potentially serious prognosis. It is a condition that can be associated with pregnancy because of the hemostatic changes during gestation. It has a wide range of signs and symptoms. Early diagnosis and treatment improve prognosis. We report the case of a 30-year-old woman, at week 8 of pregnancy, who came to the emergency department for severe headache and whose magnetic resonance imaging revealed a cerebral venous thrombosis. The patient had a second episode at week 33, despite correct anticoagulation received.
Subject(s)
Humans , Adult , Pregnancy Complications, Cardiovascular , Intracranial Thrombosis/diagnosis , Intracranial Thrombosis/drug therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/drug therapy , Anticoagulants/therapeutic use , Heparin/therapeutic useABSTRACT
Objective To observe the safety issues of antiplatelet agents in the acute-phase treatment and secondary prevention of cerebral thrombosis in patients with history of cerebral hemorrhage. Methods The 149 cerebral thrombosis patients with history of cerebral hemorrhage were assigned to the test group, while the 405 cerebral thrombosis patients without history of hemorrhage stroke were assigned to the control group. The patients in the two groups were continuously treated with antiplatelet agents during hospitalization and after discharge. Cumulative incidences of cerebral hemorrhage were observed during hospitalization and 1.5 years after discharge.Results During hospitalization, 7 patients in the test group and 16 patients in the control group were noted with cerebral hemorrhage attack (no death were recorded because of cerebral hemorrhage).And at 1.5 years after discharge, 15 patients in the test group and 36 patients in the control group were noted with cerebral hemorrhage attack (no death were recorded because of cerebral hemorrhage).Conclusions There are no increased cerebral hemorrhage risks for patients who have a history of cerebral hemorrhage to take antiplatelet agents during the acute phase and secondary prevention of cerebral thrombosis.
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Nephrotic syndrome is associated with proteinuria, hypoalbuminemia, edema, hyperlipidemia, and thromboembolic complications. Thromboembolic complications of nephrotic syndrome are common, especially in the renal vein, while cerebral venous thrombosis is a less frequent complication of minimal change nephrotic syndrome. The pathophysiology remains unclear, but various changes in coagulant and anticoagulant factors may be responsible. We report a case of cerebral venous thrombosis associated with nephrotic syndrome. A 19-year-old man was admitted with a headache and nausea. Cerebral thrombosis was diagnosed on brain computed tomography and magnetic resonance imaging. He recovered gradually after treatment with anticoagulants and achieved control of the nephrotic syndrome. A discussion of this case, coupled with a review of the literature, emphasizes that an early diagnosis is essential for anticoagulation therapy and a successful outcome.
Subject(s)
Humans , Young Adult , Anticoagulants , Brain , Early Diagnosis , Edema , Headache , Hyperlipidemias , Hypoalbuminemia , Intracranial Thrombosis , Magnetic Resonance Imaging , Nausea , Nephrosis, Lipoid , Nephrotic Syndrome , Proteinuria , Renal Veins , Thrombosis , Venous ThrombosisABSTRACT
Throttling is usually a homicidal act and generally the assailant continues the compression until the victim is dead. Pressure applied on the neck for about 3 -4 minutes consistently or more, is considered to be sufficient to cause death; the survival time depending upon the degree and duration of compression of the neck. The death may either be instantaneous or may be delayed for a few hours to a few days but in rare circumstances, the victim may survive, if rescue measures and treatment are promptly instituted. One such case of a male aged about 60 years, who was hospitalized after attempted manual strangulation for about 19 days and died thereafter, is being discussed. Medico legal autopsy findings of such a case are being evaluated in the light of existing literature.
Subject(s)
Asphyxia/complications , Asphyxia/etiology , Asphyxia/mortality , Autopsy/legislation & jurisprudence , Cause of Death , Humans , Intracranial Thrombosis/etiology , Intracranial Thrombosis/mortality , Ligation/mortality , Male , Middle Aged , Time FactorsABSTRACT
@# ObjectiveTo explore the relationship between plasma homocysteine (Hcy), polymorphism in 5,10-methylenetetrahydrofolate reductase (MTHFR) and cystathionine-β-synthase (CBS), and cerebral thrombosis.Methods87 subjects with first-ever acute cerebral thrombosis and 80 controls were studied. The plasma Hcy levels were measured using high-performance liquid chromatography-fluorescence detection (HPLC-FD). The polymorphism in MTHFR was determined by a polymerase chain reaction (PCR) assay and subsequent restriction enzyme digestion and that in CBS was determined by amplification refractory mutation system (ARMS).ResultsThe fast plasma Hcy level in the patient group was (15.28±4.33)μmol/L significantly higher than that ( 11.32 ±3.86)μmol/L in the control group (P<0.001). Different genotype had different influence on the plasma Hcy levels. There were no differences in genotype frequencies or allele frequencies between the patient group and control group (P>0.05).ConclusionCommon mutations in MTHFR, CBS G919A and CBS T833C lead to hyperhomocysteinemia. Hyperhomocysteinemia, but not common mutations in MTHFR and CBS is associated with the increased incidence of cerebral thrombosis.
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We describe a rare case of cerebral venous thrombosis and liver infarction with HELLP syndrome in a 25-year-old woman with eclampsia. She had complained of epigastric pain and had visited a local hospital for treatment. Also, signs of fetal distress were presented. After an emergency cesarean section, generalized tonic-clonic seizure occurred twice at a 10-minute interval. The patients was transferred to our emergency room, and the neurologic examination at that time, revealed a deep drowsy mentality and positive Babinski's sign; the deep tendon reflex was two positive. The laboratory findings revealed thrombocytopenia, an elevated liver function test, abnormal coagulation profiles. A bilateral ischemic change with left basal ganglia hemorrhage was seen on brain CT, and multiple foci of ill defined low-density lesions, mainly in the subcapsular portion of the liver and perivascular space, were visible on the abdominal CT. There was a faint showing of the deep venous system on the angiogram of both carotid arteries and a cerebral venous thrombosis was confirmed by using 4-vessel angiography. During the following 2 days, the cerebral hemorrhage and the low-density lesion were resolved through applications of heparin, and the patient returned to a nearly alert mental status. Finally she died of a hemorrhagic shock as a complication of disseminated intravascular coagulation.
Subject(s)
Adult , Female , Humans , Pregnancy , Angiography , Basal Ganglia Hemorrhage , Brain , Carotid Arteries , Cerebral Hemorrhage , Cesarean Section , Disseminated Intravascular Coagulation , Eclampsia , Emergencies , Emergency Service, Hospital , Fetal Distress , HELLP Syndrome , Heparin , Infarction , Intracranial Thrombosis , Liver Function Tests , Liver , Neurologic Examination , Reflex, Babinski , Reflex, Stretch , Seizures , Shock, Hemorrhagic , Thrombocytopenia , Tomography, X-Ray Computed , Venous ThrombosisABSTRACT
@#ObjectiveTo study the effect of facilitation antagonism acu-therapy in early rehabilitation of patients with cerebral thrombosis.Methods60 patients with cerebral thrombosis were divided randomly into two groups, Group A received facilitation antagonism acu-therapy, Group B received traditional acu-therapy. Fugl-meyer(FMA), MBI, etc were applied to assess effect before and after treatment.ResultsBoth groups had a great improvement after treatment(P<0.01).The effect in Group A was better than that in Group B compared in two groups (P<0.01 or P<0.05).ConclusionThere is effective in early rehabilitation of patients with cerebral thrombosis using facilitation antagonism acu-therapy.It is better than traditional acu-therapy.
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Objective To investigate the relationship between the platelet activation and cor pulmonale cerebral thrombosis. Methods Platelet-activating markers CD 62p and P 10 on platelet surface were assayed using FCM, and cerebral CT were also performed at the same time. Results The patients with cor pulmonale had abnormal platelet activation, which had significant difference compared with the control group(P