Résumé
Objective To investigate clinical characteristics and medium-term prognosis of the advanced elderly patients with mild ischemic stroke,and to evaluate the risk factors for poor clinical outcome.Methods The 574 elderly patients with mild acute ischemic stroke admitted in neurology department of our hospital were retrospectively studied from January 2016 to December 2017.All cases were divided into the advanced elderly group(n=276,≥80 years old)and elderly patient group(n=298,60-79 years old).Clinical characteristics were analyzed.After 12-month follow-up,the mid-term prognosis and risk factors for poor clinical outcome(mRS≥ 3)were analyzed in the two groups.Results Compared with the elderly patients,the advanced elderly patients were more often complicated with history of atrial fibrillation,diabetes and stroke(P ＜0.05).The scores of National Institute of Health stroke scale(NIHSS)and Modified Rankin Scale(mRS)were higher in the advanced elderly patients than in the elderly patients(1.37± 1.03 vs.0.94 ±0.43,2.79± 1.27 vs.1.92 ± 0.66,P＜0.001).The proportion of patients receiving anticoagulation treatment were lower in the advanced elderly patients than in the elderly patients,with no significant difference(P ＞0.05).After an average follow-up of(11.3 ± 1.5) months,the proportions of poor clinical outcome and mortality were higher in the advanced elderly patients than in the elderly patients(63.4％ or 175/276 vs.48.0％ or 143/298,25.7％ or 71/276 vs.16.1％ or 48/298,P＜0.05).Cox proportional hazard model analysis showed that age,baseline NIHSS score and mRS score,diabetes and stroke history were the risk factors for poor clinical outcome in elderly patients with mild ischemic stroke(all P＜0.05).Conclusions The advanced elderly patients with mild ischemic stroke have a severe clinical condition,higher rates of atrial fibrillation,diabetes and stroke history,and poor mid-term prognosis.Age,baseline scores of NIHSS and mRS,diabetes and stroke history are the risk factors for poor clinical outcome in elderly patients with mild ischemic stroke.
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Objective To explore the neuropsychological disorders and its mechanism of tuberothalamic artery infarction.Methods Clinical data of 9 patients with tuberothalamic artery infarction were analyzed retrospectively.Results Primary clinical manifestation of 9 patients were abulia,behavior disorders,thalamic aphasia,left spatial neglect,visual space function disorders,memory disorders.All of them,however,did not exist brain nerves lesion and disorders of motor and sense.Conclusion The clinical manifestation of tuberothalamic artery infarction patients are mainly neuropsychological disorders.
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Objective To evaluate the diagnostic values of MRA,TCD and ultrasonography in carotid territory transient ischemic attacks (TIAs). Methods 42 patients with carotid territory TIAs were examined by MRA, TCD and ultrasonography. Results MRA showed abnormalities of carotid arteries in 12 cases (28.6%) and abnormalities of intracranial arteries in 32 cases (76.2%). 8 cases presented abnormalities both in carotid arteries and intracranial arteries. Abnormalities of intracranial arteries were detected by TCD in 30 cases (71.4%) and abnormalities of carotid arteries were detected by ultrasonography in 16 cases (38.1%).Conclusion MRA, TCD and ultrasonography are useful in the evaluation of etiological factors of carotid territory TIAs.