ABSTRACT
La enfermedad cerebrovascular constituye la tercera causa de muerte en la población adulta, la primera causa de discapacidad a escala mundial y la segunda causa de demencia, problema de salud actual relacionado con otras enfermedades crónicas no transmisibles. Se presenta un caso de un infarto isquémico mesencefálico aterotrombótico en una anciana de 77 años con la expresión clínica de un síndrome de Weber. El síndrome de Weber es uno de los síndromes cruzados o alternos de la clínica y la neurología por lesión peduncular. Es poco frecuente y a la vez, el más frecuente de los alternos de tronco encefálico(AU)
Cerebrovascular disease is the third leading cause of death in the adult population, the leading cause of disability worldwide and the second cause of dementia. It is a current health problem related to other chronic noncommunicable diseases. We present a case of atherothrombotic mesencephalic ischemic infarction in a 77-year-old woman with the clinical expression of Weber syndrome, which is a crossed or alternating clinical syndrome and neurology by pedicle injury. It is rare and, at the same time, the most frequent alternating brainstem(AU)
Subject(s)
Humans , Female , Aged , Arteriosclerosis/etiology , Brain Stem Infarctions/epidemiology , Brain Stem Infarctions/mortality , CubaABSTRACT
Objective To observe the effect of concomitant low-frequency neural muscular electric stimulation (NMES)and alprostadil on the motion and balance in paralysis patients with acute ischemic infarction (AIS ).Methods 82 cases with AIS admitted in Ningjin Country People's Hospital,from August 2008 to August 2013 were divided into three groups.Conventional treatment group (n =26)were received conventional rehabilitation,NMES control group (n=30)were received conventional rehabilitation+NEMS(4 times a day,every 15 min)and observation group were received conventional rehabilitation+NEMS(4 times a day,every 15 min)+alprostadil (2 mL+10 mL normal saline intravenously slowly,1 times a day),all patients were treated for three weeks.Ankle dorsi-flexors tension were evaluated by comprehensive spasm scale (CSS).The ankle dorsiflexion and plantar flexor of top isometric voluntary contraction (TIVC)were tested by surface electromyography(sEMG).Quantitative detection of“integrator”EMG and the cooperative shrinkage rate of muscles were detected to evaluate patients'balance level and walking ability.Results Each index score of patients in three groups before treatment had no difference.3 weeks after treatment,the ankle plantar flexion muscle spasm in patients of observation group were aggravating,and CSS had increased highest,there were significant differences with other two groups(P<0.05).After treatment, the ankle back of MIVC pretibial muscle were increased in all three groups,which were respectively 10 ±6 nm,6 ±4 nm,5 ±4 nm.When ankle dorsiflexion,co-contraction rate were significantly lower,respectively at (9 ±0.5)%,(28 ±0.27)%,(27 ±0.19)%.3 weeks treatment,patients in observation group walk to restore balance and walking force time was 3~4 d ahead than two control groups.Conclusion Low frequency electric stimulation combined alprostadil can improve the movement function in AIS hemiplegia patients.
ABSTRACT
@#ObjectiveTo assess how transcranial electrical stimulation (TES) concurrent with rehabilitation training influences brain plasticity and behavioral functional performance in rats following a focal ischemic infarction.MethodsAfter an acute focal ischemic infarction by transient occlusion of right middle cerebral artery (MCAO), the electric stimulation concurrent with rehabilitation group was given TES, balancing and rotating and walking exercise everyday; the rehabilitation group was given only balancing and rotating and walking exercise everyday; the control group received no treatment. Growth associated protein 43(GAP-43) was examined by immunohistochemical techniques, and density of reaction product and forelimb placing test (FPT) were measured on the 3rd, 7th, 14th and 28th day after infarction respectively.ResultsThe electrical stimulation concurrent with rehabilitation group provided marked improvement in FPT on the 7th, 14th and 28th day compared with the rehabilitation group and the control group (P<0.01～0.05). The GAP-43 demonstrated statistically significant increase on the 3rd, 7th, and 14th day in the peri-infarct region in the electrical stimulation concurrent with rehabilitation group compared with other two groups(P<<0.01～0.05).ConclusionThe efficacy of transcranial electrical stimulation combining with rehabilitation training can improve functional outcome and neuronal plasticity following ischemic cerebral damage. The mechanism may be partly due to the upregulation of the expression of GAP-43 in the peri-infarct region. Meanwhile, the efficacy is superior to rehabilitation training only.
ABSTRACT
BACKGROUND: Although stroke is one of the most frequent causes of seizures in adulthood, there has been constant controversy concerning risk factors and prognosis of poststroke seizures. This study was performed to investigate clinical manifestations, risk factors and prognosis in patients with poststroke seizures (PSS). METHODS: A total of 2048 patients with cerebral infarction were recruited for this study. Patients with PSS were reviewed retrospectively regarding stroke subtype, etiology, lesion location, and functional disability of the stroke as well as seizure types, treatment and recurrence rate. Patients with traumatic or hemorrhagic brain lesion or a history of previous seizures were excluded. RESULTS: PSS developed in 4.2% of ischemic stroke patients (85/2048; 46 men and 39 women, mean age 65.4 years). PSS developed within one week of stroke onset in 18.8% (16/85) whereas after one week in 81.2% (69/85). PSS was more common in patients with cortical lesions than subcortical lesions (15.1% and 0.8%; p=0.076). Status epilepticus more frequently manifested in early onset seizures compared to late onset seizures (31.3% and 10.1%; p=0.029). Seizure recurrence was observed in 44.3% of PSS patients, mostly due to poor compliance to treatment or due to inadequate drug treatment. Only 7.1% of PSS patients were drug resistant and all of these patients had late onset seizures. CONCLUSION: Seizures after ischemic infarction developed more commonly after one week of stroke onset, and in patients with cortical lesions. Seizure recurrence occurred in about half of the patients, and the rate of drug resistance was higher in late onset seizures.