Sleep disorders after acute ischemic stroke / 国际脑血管病杂志

Ischemic stroke is the most common type of cerebrovascular disease, which has the characteristics of high morbidity, high disability, and high mortality. Sleep disorder is a common complication after ischemic stroke, which can increase the risk of stroke recurrence and seriously affect the outcome of patients. This article reviews the classification and mechanism of post-stroke sleep disorders, the impact on the outcome of patients, the changes in sleep structure of patients with stroke, and the diagnosis and treatment of post-stroke sleep disorders, in order to improve clinicians' understanding of post-stroke sleep disorders.

Treatment of MRA-DWI mismatched patients with mild ischemic stroke caused by middle cerebral artery M1 segment occlusion: comparison of endovascular treatment and intravenous thrombolytic therapy / 国际脑血管病杂志

Objective To investigate the effect of different treatment regimens guided by magnetic resonance angiography (MRA) and diffusion weighted imaging (DWI) mismatch on the outcomes of patients with mild ischemic stroke caused by acute middle cerebral artery (MCA) M1 segment occlusion. Methods From January 2013 to February 2018, the clinical data of patients with mild ischemic stroke caused by acute MCA M1 segment occlusion and admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were analyzed retrospectively. Mild stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5, and the MRA-DWI mismatch was defined as MCA M1 segment occlusion confirmed by MRA and the DWI-Alberta Stroke Program Early Computed Tomography Score ≥6. According to the clinical decision, they were divided into endovascular treatment group and intravenous thrombolytic therapy group. The primary outcome measure was the modified Rankin Scale score at 90 days after onset, ≤2 was defined as good outcome. The secondary outcome measure was the incidence of symptomatic intracranial hemorrhage (sICH) within 7 days after treatment and the mortality rate at 90 d. Multivariate logistic regression analysis was used to determine the independent effects of different treatment regimens on outcomes. Results A total of 38 patients were enrolled, 19 (50. 00％) in the intravenous thrombolytic therapy group, and 19 in the endovascular treatment group (50. 00％, including 5 patients with intratracheal thrombectomy after intravenous thrombolysis); 27 patients had good outcomes (71. 05％) and 11 had poor outcomes (28. 95％). Except for total cholesterol level, there were no significant differences in demography, vascular risk factors, and all baseline clinical data between the endovascular treatment group and the intravenous thrombolytic therapy group. The rate of good outcome in the endovascular treatment group was significantly higher than that in the intravenous thrombolytic therapy group (89. 47％ vs. 2. 63％; P = 0. 029), and there was no significant difference between the incidence of sICH within 7 days (15. 79％ vs. 5. 26％; P = 0. 604) and 90-day mortality (0％ vs. 10. 53％; P = 0. 486). The proportion of patients who underwent endovascular treatment in the good outcome group was significantly higher than that in the poor outcome group (62. 96％ vs. 18. 18％; P = 0. 029). Multivariate logistic regression analysis showed that endovascular treatment was an independent predictor of good outcome (odds ratio 0. 103, 95％ confidence interval 0. 015-0. 714; P = 0. 021). Conclusion Endovascular treatment is an independent predictor of good outcome in patients with mild ischemic stroke caused by acute MCA M1 segment occlusion.

Mild stroke caused by large vessel occlusion: clinical features and reperfusion treatment / 国际脑血管病杂志

The incidence of mild stroke is high.If accompanied by large vessel occlusion,the risk of poor outcome is significantly increased,and even death,so early reperfusion therapy is needed.This article reviews the clinical features and treatment of mild stroke caused by large vessel occlusion.