Susceptibility vessel sign in subacute stroke patients with large vessel occlusion / 北京大学学报(医学版)

OBJECTIVE@#To investigate the presentation of susceptibility vessel sign (SVS) in subacute stroke patients with large vessel occlusion.@*METHODS@#We collected consecutive stroke patients who were admitted to Peking University First Hospital from December 2017 to August 2019 retrospectively. Those who had intracranial large vessel occlusion and received sensitivity weighted imaging (SWI) within 3 to 14 days after stroke onset were included in our analysis. The diagnosis of large vessel occlusion was based on magnetic resonance angiography (MRA), CT angiography (CTA) or digital subtraction angiography (DSA). The demographic information, clinical characteristics and imaging results were obtained from medical record. The occurrence rates of SVS sign were compared between stroke patients with cardioembolism (CE) and large artery atherosclerosis (LAA). In the sensitivity analysis, we performed a subgroup analysis in those patients who received SWI within 7 to 14 days after stroke onset. We also compared the occurrence rate of SVS sign between the patients with and without atrial fibrillation.@*RESULTS@#A total of 51 patients, 19 females and 32 males, with an average age of (63.04±11.23) years were analyzed in this study. Compared with LAA group, the patients in CE group were older and more likely to have an atrial fibrillation (P < 0.05). There were no significant differences between the CE group and LAA group in gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, smoking, or National Institute of Health stroke scale(NIHSS) score at admission. SVS sign was found in 30 patients. Of whom, 3 were in CE group and 27 in LAA group. The occurrence rate of SVS sign was higher in the LAA group than in the CE group significantly (65.9% vs. 30.0%, P=0.039). The subgroup analysis showed that, in the patients who received SWI examination within 7 to 14 days after stroke onset, the differences between the two groups were still statistically significant (0 vs. 72.7%, P=0.006). Another sensitivity analysis showed that, the rate of SVS in the patients with atrial fibrillation was significantly lower than those patients without atrial fibrillation (25% vs. 65.1%, P=0.043).@*CONCLUSION@#In subacute stroke patients, the occurrence rate of SVS sign in CE group was lower than that of LAA group. The significance of SVS sign in the differentiation of stroke subtype needs further validation.

Therapeutic effect of electric-balance stimulation with scalp acupuncture for motor aphasia after cerebral infarction / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between scalp acupuncture electrical stimulation and routine scalp acupuncture for motor aphasia in subacute stage of cerebral infarction.@*METHODS@#A total of 54 patients with motor aphasia in subacute stage of cerebral infarction were randomly divided into an observation group (27 cases, 1 case dropped off) and a control group (27 cases, 2 cases dropped off ). Both groups were treated with routine medication and language training. In the observation group, scalp acupuncture was given at bilateral lower 2/5 of the parietal and temporal anterior oblique line and temporal frontline; after the arrival of @*RESULTS@#After treatment, the scores of listening comprehension, retelling, naming, spontaneous conversation and BDAE grade in the two groups were improved compared with those before treatment (@*CONCLUSION@#The scalp acupuncture electrical stimulation could improve cerebral circulation, activate specific functional areas of cerebral cortex, and promote the reconstruction and recovery of brain language function. Its curative effect is better than conventional scalp acupuncture.

Effect of low-dose dexamethasone at different stages of cerebral infarct / 实用医学杂志

Objective To study the effect of low-dose dexamethasone after acute and subacute cerebral infarct.Methods One hundred and forty patients with acute ischemic stroke were randomly divided into acute ischemic stroke group (acute stage group),subacute ischemic stroke group (subacute stage group),placebo and control groups.Subjects in acute stage groups received conventional therapy and 1 mL (5 mg) dexamethasone injection from 1 day to 3 day after admission and in subacute stage group,received the same treatment as acute stage group from 4 day to 6 day after admission.In control and placebo groups,subjects received conventional therapy and conventional therapy + 1 mL normal saline for injection respectively.One week after treatments,complete blood count and erythrocyte sedimentation rate were tested.One month and three month after treatments,neurological function were evaluated by Barthel Index and modified Rankin Scale (mRS).Results The valuate of erythrocyte sedimentation rate in acute stage group were significantly different from it of placebo and control groups (P ＜ 0.05).Moreover,neurological function of subjects in acute stage group was significantly improved than that in placebo and control groups in by Barthel Index and mRS (P ＜ 0.05).However that in subacute stage group was not different from that placebo and control groups (P ＞ 0.05).Conclusion Low-dose dexamethasone plays a neuroprotection role after acutc cerebral ischemia.