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Objective:To observe the clinical and imaging features of cortical laminar necrosis (CLN) after acute cerebral infarction, and to explore its possible mechanism.Methods:Five hundred and three patients were recruited into study with acute anterior circulation cerebral infarction confirmed by magnetic resonance imaging in People′s Hospital of Zhengzhou University from June 2019 to June 2020. They were divided into 24 patients with CLN (CLN group) and 479 patients without CLN (NCLN group). The general information and clinical manifestations of the patients were recorded. National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment Scale (MoCA) scores and cranial magnetic resonance imaging characteristics were compared between the two groups, and the possible mechanism was discussed.Results:After acute cerebral infarction, the incidence of CLN was 4.77% (24/503). CLN group had more cognitive impairment (MoCA total score 15.17±2.67; NCLN group 18.12±2.49) and less neurological impairment (NIHSS total score 6.93±3.63; NCLN group 8.86±3.26),and there were significant differences between the two group ( t=-5.58, t=-2.75; P<0.05). In the CLN group, the proportion of perfusion-weighted imaging showing hyper-perfusion in the laminar necrosis area (increased relative cerebral blood volume) was 87.5% (21/24), while in the NCLN group, the proportion of hyper-perfusion was lower [1.25% (6/479)]. There was statistically significant difference in the perfusion between the two groups (χ2=143.06, P<0.01). In the CLN group, CT angiography or magnetic resonance angiography showed common atherosclerotic stenosis or occlusion of the large intracranial arteries. Conclusion:CLN after cerebral infarction is relatively rare in clinical practice, and its occurrence may be related to local cortical hyper-perfusion.
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Objective To investigate the neuroprotective effect of Ghrelin on traumatic brain injury (TBI) in mice.Methods TBI model of C57BL/6 mice was established by electronic cortical impact instrument (eCCI).According to the random figure table method,twenty-four mice were randomly divided into sham group(Sham group),TBI group and Ghrelin intervention group(Ghrelin group) with 8 mice in each group.The model of TBI was established in TBI group and Ghrelin group.The mice in Ghrelin group was injected intraperitoneally 0.5 g/kg before and 1 h after injury respectively.And the mice Sham group and TBI group were injected with the same amount of normal saline.The changes of cerebral blood perfusion (CBP)were monitored in real time by laser speckle contrast analysis(LSCI),the changes of neuroelectrophysiology were observed by monitoring motor evoked potential (MEP),and the status of neurological deficit was evaluated by modified neurological deficit score (mNSS).Results Compared with Sham group,the mice in TBI group had significantly lower cerebral blood perfusion(CBP) (t=-12.36,P＜0.01),longer latency and lower amplitude of motor evoked potential (MEP) (t=5.03,-11.55,all P＜0.01),and significantly higher mNSS scores (t=9.34,P＜0.01).However,compared with the TBI group,the cerebral blood perfusion(CBP) of Ghrelin group increased significantly at 12 h after TBI((196.87± 17.36) PU/mm2 vs (123.62±8.04)PU/mm2,t=10.45,P＜0.01),while the latency of MEP decreased((5.30±0.33) ms vs (6.80±0.97) ms,t =-5.01,P＜0.01),the amplitude of MEP increased ((2.21 ± 0.16) mV vs (1.27± 0.27) mV,t =9.65,P＜0.01).And compared with the TBI group,the neurological deficit score of Ghrelin group decreased significantly at 24 h after TBI((4.9±1.2) vs (8.4±2.6),t=-3.87,P＜0.01).Conclusion Ghrelin exhibits a significant neuroprotective role by increasing cerebral blood flow perfusion,reducing the degree of neurological deficit and promoting motor function recovery in TBI mice.
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Objective@#To investigate the neuroprotective effect of Ghrelin on traumatic brain injury (TBI) in mice.@*Methods@#TBI model of C57BL / 6 mice was established by electronic cortical impact instrument (eCCI). According to the random figure table method, twenty-four mice were randomly divided into sham group(Sham group), TBI group and Ghrelin intervention group(Ghrelin group) with 8 mice in each group. The model of TBI was established in TBI group and Ghrelin group.The mice in Ghrelin group was injected intraperitoneally 0.5 g/kg before and 1 h after injury respectively. And the mice Sham group and TBI group were injected with the same amount of normal saline. The changes of cerebral blood perfusion (CBP) were monitored in real time by laser speckle contrast analysis(LSCI), the changes of neuroelectrophysiology were observed by monitoring motor evoked potential (MEP), and the status of neurological deficit was evaluated by modified neurological deficit score (mNSS).@*Results@#Compared with Sham group, the mice in TBI group had significantly lower cerebral blood perfusion(CBP) (t=-12.36, P<0.01), longer latency and lower amplitude of motor evoked potential (MEP) (t=5.03, -11.55, all P<0.01), and significantly higher mNSS scores (t=9.34, P<0.01). However, compared with the TBI group, the cerebral blood perfusion(CBP) of Ghrelin group increased significantly at 12 h after TBI((196.87±17.36) PU/mm2 vs (123.62±8.04)PU/mm2, t=10.45, P<0.01), while the latency of MEP decreased((5.30±0.33)ms vs (6.80±0.97)ms, t=-5.01, P<0.01), the amplitude of MEP increased((2.21±0.16)mV vs (1.27±0.27)mV, t=9.65, P<0.01). And compared with the TBI group, the neurological deficit score of Ghrelin group decreased significantly at 24 h after TBI((4.9±1.2) vs (8.4±2.6), t=-3.87, P<0.01).@*Conclusion@#Ghrelin exhibits a significant neuroprotective role by increasing cerebral blood flow perfusion, reducing the degree of neurological deficit and promoting motor function recovery in TBI mice.
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Objective To study the effect of breviscapine injection on cerebral blood perfusion in patients with hypoperfusion/decreased embolic clearance type cerebral infarction.Methods 100 patients with hypoperfusion/decreased embolic clearance type cerebral infarction in our hospital were selected and randomly divided into two groups.Both group were treated with conventional western medicines, and the experimental group was additionally treated with breviscapine injection.The plasma D-dimer (D-D), fibrinogen (Fib), systolic and diastolic blood pressure and recovery of neurological function were compared between the two groups.Results D-D and Fib levels and NIHSS score in the experimental group were significantly lower than those in the control group (P< 0.05), while the systolic blood pressure was significantly higher than that in the control group (P< 0.05).Conclusion Breviscapine injection can reduce the plasma D-D and Fib levels, increase cerebral vascular blood flow and improve the neurological function in patients with hypoperfusion/decreased embolic clearance type cerebral infarction.
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Objective To investigate the regional cerebral blood flow perfusion in fetuses with congenital heart disease (CHD)by three-dimensional power Doppler ultrasound (3D PD).Methods The vascular index (VI),flow index (FI)and vascular/flow index (VFI)in the main arterial territories [middle cerebral artery (MCA ),anterior cerebral artery (ACA ) and posterior cerebral artery (PCA )] were prospectively compared in 1 12 fetuses with CHD and 1 12 normal fetuses using 3D PD.Correlations between the 3D PD indices and neurodevelopment scores were assessed.Results Compared with the controls,the VI,FI and VFI of the three main arteries were significantly increased in fetuses with hypoplastic left heart syndrome (HLHS)and left sided obstructive lesions (LSOL)(P < 0.001 ).The mean psychomotor development index (PDI)and mental development index (MDI)scores were significantly lower than normal (P <0.001).ACA VI and ACA VFI were positively correlated with PDI (r =0.377,P =0.01 5 and r =0.389,P = 0.012,respectively)but were not correlated with MDI.Conclusions Cerebral blood flow perfusion in three main arteries was significantly increased in fetuses with HLHS/LSOL,and blood flow perfusion in ACA area was significantly increased in fetuses with TGA.ACA-VI,ACA-FI had association with neurodevelopment scores.3D PD ultrasound might help to identify cases of brain vasodilatation earlier and inform parental counseling.