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Objective:To observe the changes of somatosensory evoked potential (SEP) in the upper limbs of patients with acute middle cerebral artery (MCA) cerebral infarction, and to explore its relationship with neurological impairment.Methods:From January 2015 to December 2016, 62 patients with 38 cases of male and 24 women of cerebral infarction who were treated in the department of neurology, Kailuan General Hospital were selected for a retrospectively prospective cohort study, including 38 males and 24 females.aged (66.7 ± 10.9) years old and ranging from 33.0 to 85.0 years old.According to the side of cerebral infarction, 37 cases were divided into left MCA group and 25 cases into right MCA group.During the 48 hours of admission, the electromyography evoked potential meter was used to detect the upper limb SEP, and the peak latency, amplitude and electrical activity waveform of the cerebral cortex potentials N20, P25 and N35 were recorded.Results:The results of SEP in the contralateral limbs of the left and right MCA cerebral infarction group were as follows: 1 case (2.70%) and 5 cases (20.00%) of normal median nerve; 36 cases (97.30%) and 20 cases (80.00%) of abnormality.The ratio of median nerve abnormalities in the group was statistically significant (χ 2=12.577, P<0.001). The ulnar nerve was normal in 3 cases (8.11%), 4 cases (16.00%); 34 cases (91.89%) and 21 cases (84.00%) were abnormal.There was no statistically significant difference between the two groups (χ 2=2.320, P=0.128). The peak latency and/or amplitude of each peak decreased in 34 groups (60.71%) and 33 cases (60.00%) of the ulnar nerve; the waveform of electrical activity disappeared, 22 cases (39.29%) of median nerve and 22 cases of ulnar nerve (40.00%). The peak latency and/or amplitude decreased, the electrical activity waveform disappeared, and the median nerve and ulnar nerve were compared, and the difference was not statistically significant (χ 2=0.021, P=0.885). The National Institue of Health Storke Scale(NIHSS) scores of left and right MCA cerebral infarction group were 34 (91.89%) and 19 (76.00%) respectively.Among them, the disappearance of electrical activity waveform were 18 cases (52.94%) and 4 cases (21.05%)of median nerve; 18 cases (52.94%) and 4 cases (21.05%) of ulnar nerve.The SEP electrical activity waveform disappeared in patients with moderate or higher neurological impairment, and the median nerve and ulnar nerve were statistically significant (χ 2=20.613, 20.613, all P<0.001). Conclusion:The median nerve and ulnar nerve SEP of the contralateral upper limb, which is dominated by the acute middle cerebral artery cerebral infarction, were abnormally changed.The main manifestations were that the latency of each peak of N20, P25 and N35 was prolonged and/or the amplitude was significantly decreased, and the waveform of SEP electrical activity disappeared.In addition, the disappearance of SEP wave activities only occurred in moderate and above neurological damage
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Objective To analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion (EICAO).Methods Ninety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group),and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade Ⅰ collateral circulation,the posterior communicating artery (PCOA),the ocular artery of the grade Ⅱ collateral circulation,and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters:(Mean blood flow velocity (Vm) and pulsatility index).Results In the left and right EICAO groups,the opening rates of collateral circulation at grade Ⅰ were 86.96％ (40/46),96.00％ (48/50) and 78.26％ (36/46) and 88.00％ (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade Ⅰ between the two groups (x2 =4.114,P =0.043).There was no significant difference in the opening rates of collateral circulation at grade Ⅱ between the two groups (x2 =3.544,P =0.060).The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08 ± 9.25) cm/s),left side of the control group (32.52±3.28) cm/s,P＜0.01);right side of the EICAO group (22.20±5.51) cm/s),right side of the control group(31.58±3.35) cm/s,P＜0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78 ±0.17),left side of control group (0.92±0.08),P ＜0.01);right side of right EICAO group (0.75 ± 0.19),right side of control group (0.91 ± 0.10),P ＜0.01),Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s,left side of control group(55.72 ±5.60) cm/s,right side of EICAO;The right side of group (37.10±19.70) cm/s),the right side of control group (53.70±6.28) cm/s,P＜0.01),the pulsation index of MCA (left side of left EICAO group(0.74±0.19),left side of control group(0.87±0.10),P＜0.01;right side of right EICAO group (0.69±0.23),right side of control group:(0.90 ± 0.08),P ＜ 0.01).There were significant differences.NIHSS score of neurological impairment:normal 17.39％ (8/46),mild 39.13％ (18/46),moderate 30.44％ (14/46),moderate severe 13.04％ (6/46) in left EICAO group,and normal 18.00％ (9/50),mild 54.00％ (27/50),moderate 24.00％ (12/50),moderate severe 4.00％ (2/50) in right EICAO group.There was no significant difference between the two groups (P =0.178).Conclusion The ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics,accompanied by neurological impairment.