Clinical Characteristics as Predictors of Early and Delayed Cerebral Infarction in Aneurysmal Subarachnoid Hemorrhage Patients: A Meta-Analysis of 4527 Cases.

BACKGROUND: Predictors of delayed cerebral infarction (DCI) and early cerebral infraction (ECI) among aneurysmal subarachnoid hemorrhage (aSAH) patients remain unclear. We aimed to systematically review and synthesize the literature on predictors of ECI and DCI among aSAH patients. METHODS: We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases comprehensively from inception through January 2024 for observational cohort studies examining predictors of DCI or ECI following aneurysmal SAH. Studies were screened, reviewed, and meta-analyzed, adhering to PRISMA and Cochrane guidelines. The data were pooled as Odds ratios (OR) with 95% confidence intervals (CI) using RevMan 5.4 software. Methodologic quality was assessed with the Newcastle-Ottawa Scale. RESULTS: Our meta-analysis included 12 moderate to high-quality cohort studies comprising 4527 patients. Regarding DCI predictors, Higher severity scores (O.R.=1.49, 95%CI [1.12,1.97], P=0.005) and high Fisher scores (O.R.=2.23, 95%CI [1.28,3.89], P=0.005) on presentation were significantly associated with an increased risk of DCI. Also, the female sex and the presence of vasospasm were significantly associated with an increased risk of DCI (O.R.=3.04, 95%CI [1.35,6.88], P=0.007). In contrast, preexisting hypertension (p=0.94), aneurysm treatment (p=0.14), and location (p=0.16) did not reliably predict DCI risk. Regarding ECI, the pooled analysis demonstrated no significant associations between sex (P=0.51), pre-existing hypertension (P=0.63), severity (P=0.51), or anterior aneurysm location versus posterior (P=0.86) and the occurrence of ECI. CONCLUSION: Female sex, admission disease severity, presence of vasospasm and Fisher grading can predict DCI risk post-aSAH. Significant knowledge gaps exist for ECI predictors. Further large standardized cohorts are warranted to guide prognosis and interventions.

Understanding the mechanism of acupuncture in acute cerebral infraction through a proteomic analysis: protocol for a prospective randomized controlled trial.

Background: Acute cerebral infarction (ACI), being the predominant form of stroke, presents challenges in terms of the limited effectiveness of various treatments in improving the neurological function. Although acupuncture shows promise in addressing ACI, the availability of high-quality evidence regarding its efficacy, safety, and underlying mechanism remains insufficient. In this study, we design a multicenter, prospective, single-blind, randomized controlled trial with the aim of evaluating the efficacy and safety of acupuncture for ACI, making an attempt to unveil the molecular mechanisms by proteomic. Methods: A total of 132 patients involving four hospitals will be randomized at a 1:1:1 ratio in the acupuncture group, control group, and sham acupuncture group. All the patients will receive basic treatment, and the patients in the acupuncture and sham acupuncture groups will also receive either acupuncture or sham acupuncture treatment, respectively, at six sessions each week for a 2 weeks period, followed by 3 months of follow-up. The primary outcome will be the change in the National Institute of Health Stroke Scale (NIHSS) scores after treatment. The secondary outcomes will include the Fugl-Meyer Assessment (FMA) scale scores and the Barthel Index (BI). Adverse events that occur during the trial will be documented. To discover differentially expressed proteins (DEPs) and their roles between the ACI subjects and healthy controls, we will also perform 4D-DIA quantitative proteomics analysis, and the DEPs will be confirmed by enzyme-linked immunosorbent assay (ELISA). This study was approved by the institutional review board of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (TYLL2023043). Written informed consent from patients is required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2300079204). Trial results will be published in a peer-reviewed academic journal. Discussion: The results of this study will determine the preliminary efficacy and safety of acupuncture in ACI patients and whether the mechanism of this form of non-pharmacologic stimulation is mediated by a novel therapeutic target for neurorehabilitation through our proteomic analysis. Clinical trial registration: https://www.chictr.org.cn, identifier ChiCTR2300079204.

Effectivity and safety of endovascular coiling versus microsurgical clipping for aneurysmal subarachnoid hemorrhage: A systematic review and meta-analysis.

BACKGROUND: There is an ongoing lack of consensus among clinicians regarding on the optimal aneurysmal subarachnoid hemorrhage (aSAH) management approach between endovascular coiling and microsurgical clipping. METHODS: Comprehensive literature search for randomized controlled trials (RCTs) was conducted in Medline and Cochrane databases until January 1st, 2023 without language constraints. Effectivity outcomes included one-year mortality, one-year poor outcomes, and one-year complete aneurysmal occlusion, while safety outcomes comprised the incidence of vasospasms, rebleeding, post-operative complications, and cerebral ischemia. RESULTS: Eight RCTs, involving 3585 aSAH patients, underwent comprehensive quantitative analysis. Among them, 1792 underwent endovascular coiling and 1773 patients had microsurgical clipping. Regarding effectivity, the rates of one-year mortality (OR: 0.79, 95% CI: 0.61-1.03, p = 0.08) exhibited no significant difference. However, endovascular coiling demonstrated an inferior one-year complete aneurysmal occlusion rate (OR: 0.33, 95% CI: 0.21-0.53, p < 0.00001), although with significantly lower rates of poor outcomes (OR: 0.68, 95% CI: 0.57-0.81, p < 0.00001) compared to the microsurgical clipping group. As for safety, endovascular coiling group exhibited lower rates of vasospasm (OR: 0.58, 95% CI: 0.36-0.92, p = 0.02), post-operative complications (OR: 0.40, 95% CI: 0.23-0.71, p = 0.02), and cerebral ischemia (OR: 0.36, 95% CI: 0.20-0.63, p = 0.0004). No significant effect on the incidence of rebleeding was observed (OR: 1.09, 95% CI: 0.73-1.63, p = 0.68). CONCLUSIONS: Endovascular coiling proves superior and safer for aSAH patients, but consideration of resources, patient condition, and surgeon preferences is crucial for selecting the optimal approach.

Lung cancer is associated with acute ongoing cerebral ischemia: A population-based study.

BACKGROUND AND OBJECTIVES: Cerebral microinfarcts (CMIs) are the most common type of brain ischemia; however, they are extremely rare in the general population. CMIs can be detected by magnetic resonance diffusion-weighted imaging (MRI-DWI) only for a very short period of approximately 2 weeks after their formation and are associated with an increased stroke risk and cognitive impairment. We aimed to examine CMI detection rate in patients with lung cancer (LC), which is strongly associated with ischemic stroke risk relative to other cancer types. METHODS: We used the Clalit Health Services record (representing more than 5 million patients) to identify adults with LC and breast, pancreatic, or colon cancer (non-lung cancer, NLC) who underwent brain magnetic resonance diffusion (MRI) scan within 5 years following cancer diagnosis. All brain MRI scans were reviewed, and CMIs were documented, as well as cardiovascular risk factors. RESULTS: Our cohort contained a total of 2056 MRI scans of LC patients and 1598 of NLC patients. A total of 143 CMI were found in 73/2056 (3.5%) MRI scans of LC group compared to a total of 29 CMI in 22/1598 (1.4%) MRI scans of NLC (p < 0.01). Cancer type (e.g. LC vs NLC) was the only associated factor with CMI incidence on multivariate analysis. After calculating accumulated risk, we found an incidence of 2.5 CMI per year in LC patients and 0.5 in NLC. DISCUSSION: CMIs are common findings in cancer patients, especially in LC patients and therefore might serve as a marker for occult brain ischemia, cognitive decline, and cancer-related stroke (CRS) risk.

A Case of Aplastic Anemia Complicated With Cerebral Infarction.

Aplastic anemia is usually associated with hemorrhagic stroke. Here, we report a case of ischemic stroke secondary to aplastic anemia in a 28-year-old male who presented with sudden-onset right hemiplegia and aphasia when he was not on any immunosuppression for five months. His laboratory findings showed pancytopenia, and his peripheral blood smear showed no atypical cells. Magnetic resonance imaging of the brain with magnetic resonance angiography (MRA) of the neck and brain vessels revealed an infarct in the left cerebral hemisphere in the middle cerebral artery territory, and no significant stenosis or aneurysm was observed on MRA. The patient was managed conservatively and discharged in stable condition.

Analysis on application effect and prognostic factors of medical care combined with nursing in the elderly with T2DM and Cerebral Infarction based on targeted management mode.

To explore the analysis on application effect and prognostic factors of medical care combined with nursing in the elderly with type 2 diabetes mellitus (T2DM) and cerebral infraction (CI) based on targeted management mode. The clinical data of 180 elderly patients with T2DM and CI in our hospital from August 2017 to August 2019 were selected for retrospective analysis. Their cognitive function and daily living ability before and after intervention were evaluated, using the National Institutes of Health Stroke Scale (NIHSS) to evaluate their prognosis. They were divided into good prognosis group (n = 134) and poor prognosis group (n = 46) according to the score. Binary Logistic regression analysis was adopted to analyze the prognostic factors of such patients. After intervention, patients had visibly lower indexes of blood glucose fluctuation and lower average scores of ADL and MMSE (P < 0.001), with differences in body mass index, systolic pressure, diastolic pressure, fasting blood glucose and triglyceride in both groups (P < 0.001). Binary Logistic regression analysis showed that systolic pressure, diastolic pressure and triglyceride were risk factors affecting patients' prognosis (P < 0.05). Medical care combined with nursing based on targeted management mode has a remarkable control effect on blood glucose, and has a positive effect on improving cognitive function and living ability of elderly patients with T2DM and CI. In addition, attention should be paid to monitoring systolic and diastolic blood pressures, and triglyceride in patients to improve the prognosis.

A Psychological Intervention Program for Patients with Cerebral Infarction.

INTRODUCTION: Cerebral infarction is one of the most common cerebrovascular diseases. The sequelae caused by cerebral infarction, including limb paralysis, crooked mouth corners, language barriers, etc., seriously affect the patient's physical and mental health and enthusiasm for rehabilitation training. Therefore, psychological intervention has important positive significance for the rehabilitation and nursing of patients with cerebral infarction. METHODS: This is a single-blind controlled study. 168 patients with cerebral infarction who met the inclusion criteria and visited our hospital from January 2018 to January 2020 were randomly divided into a control group (n = 84) and an intervention group (n = 84). The patients in the intervention group received an additional 3-month psychological treatment on the basis of the patients in the control group. The National Institutes of Health Stroke Scale (NIHSS), Activities of Daily Living (ADL) scale, Mini-Mental State Examination (MMSE), and Hamilton Depression Rating Scale (HAMD) were measured before and after the psychological intervention. RESULTS: The 3-month psychological intervention we designed significantly reduced the NIHSS and HAMD scores of patients with cerebral infarction compared with traditional rehabilitation care for cerebral infarction, implying that our psychological intervention courses can improve patients' cognitive function and suppress patients' depression. Consistently, our psychological intervention also significantly improved ADL and MMSE scores 3 months after the onset of cerebral infarction patients, implying that this psychological intervention helped patients recover their daily functions relative to conventional care. CONCLUSION: Psychological intervention can be used as an adjunct therapy in the treatment and nursing of patients with cerebral infarction.

Danshensu Enhances Cerebral Angiogenesis in Mice by Regulating the PI3K/Akt/Mtor/VEGF Signaling Axis.

BACKGROUND: Cerebral infraction seriously affects the life quality of patients. Danshensu has been reported to exhibit anti-inflammatory and vascular protective effects. However, the therapeutic function of Danshensu in cerebral vascular injury is still unclear. METHODS: Middle cerebral artery occlusion (MCAO) was used to construct the cerebral infraction model. Wound healing and tube formation assays were used to evaluate angiogenesis in vitro. Western blot assay was used to evaluate the activation of the PI3K/Akt/mTOR signaling pathway. The laser Doppler scanner was used to measure the regional cerebral blood flow (rCBF) in the area around the infarction, and the adhesion removal test was used to measure the sensorimotor function. The Modified Neurological Severity Score was performed to evaluate the cognitive functions of mice. RESULTS: Danshensu promoted the proliferation of bEnd.3 cells and angiogenesis in vitro. Danshensu upregulated the expression of VEGF through PI3K/Akt/mTOR signaling pathway in bEnd.3 cells. Danshensu improved rCBF restoration and attenuated the behavioral deficits in mice post-MCAO/R. CONCLUSION: Danshensu enhances angiogenesis through the PI3K/Akt/mTOR/VEGF signaling pathway in a mouse model of cerebral ischemic injury.

Simultaneous acute cardio-cerebral infarction associated with isolated left ventricle non-compaction cardiomyopathy.

Introduction and importance: The co-occurrence of acute ischemic stroke and acute myocardial ischemia; cardio-cerebral infarction (CCI) has been linked to increased morbidity and mortality. The incidence of these conditions to occur simultaneously has been reported to be less than 1% according to the published data. Left Ventricular Non-Compaction (LVNC), on the other hand, is characterized by large left ventricular (LV) trabeculae, a thin compacted layer, and deep intertrabecular recesses. In the inter-trabecular recesses, where blood flow is slow, cardiac mural thrombi may form, which can lead to systemic embolization. Case presentation: In this report, we describe a 51-year-old male patient with a history of hypertension and diabetes who developed a non-ST segment elevated myocardial infraction and an acute ischemic stroke that were thought to be related to left ventricular hypertrabeculation. Clinical discussion: Although it is rare, the simultaneous occurrence of myocardial infarction and an acute ischemic stroke can be fatal. There are numerous potential mechanisms for CCI, including cardiac thrombi-embolism, hypoperfusion during AMI. Both conditions have a narrow therapeutic window and management is very crucial. Conclusion: To the best of the author's knowledge, this is the first reported case of cardiocerebral infraction (CCI) in the setting of non-compaction left ventricle. Early and precise diagnosis is critical to the successful management of these conditions.

An emergency nursing and monitoring procedure on cognitive impairment and neurological function recovery in patients with acute cerebral infarction.

BACKGROUND: The optimization and standardization of emergency nursing and monitoring procedures are of great significance for thrombolytic treatment of acute cerebral infarction. OBJECTIVE: Studies on the emergency nursing and monitoring procedure on cognitive impairment and neurological function in patients with acute cerebral infarction are still limited. METHODS: The study was a randomized controlled trial and 134 patients with acute cerebral infarction were recruited. They were randomly arranged into the control group (n = 67) receiving normal nursing procedure and the intervention group (n = 67) receiving emergency nursing and monitoring procedure after pre-intervention assessment. The cognitive impairment, neurological function and levels of inflammatory biomarkers and neuron-specific enolase of the participants were evaluated and analyzed. RESULTS: Emergency nursing and monitoring procedure improved Mini-mental State Examination and Montreal Cognitive Assessment scores of patients with cerebral infraction compared with the control group. It also improved the scores of National Institutes of Health Stroke Scale, activities of daily living scale, Fugl-Meyer scale in the participants. Emergency nursing and monitoring procedure led to significantly decreased neuron-specific enolase and inflammatory cytokines in the serum of the participants. CONCLUSION: Emergency nursing and monitoring procedure are beneficial for cognitive impairment and neurological function recovery in patients with acute cerebral infarction.

The Joint Effect of a Combination of Components From the Fruit of Crataegus pinnatifida Bge. Var. major N.E. Br. and the Root of Salvia miltiorrhiza Bge. With Exercises on Swimming in Focal Cerebral Infraction in Rat.

Background: In our previous study, we found that the combination of a traditional Chinese medicine (TCM) and swimming could prevent atherosclerosis through a synergistic interaction. However, whether the combined application of active components from the fruit of Crataegus pinnatifida Bge. Var. major N.E. Br. and the root of Salvia miltiorrhiza Bge. (CPSM) and swimming has been effective in the prevention and treatment of focal cerebral infraction remained unclear. This work aimed to conduct detailed investigation on the joint effects of CPSM extract with swimming on focal cerebral infraction in rats and its underlying mechanisms. Method: A photochemical method of the combination of Rose Bengal (RB) injection and cold-light source irradiation was performed to establish the rat focal cerebral thrombosis model. The pathological changes of the brain were observed by a DCP-7030 laser multifunction machine, and the protein levels of von Willebrand factor (vWF), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) were detected by Western blotting. Blood samples were collected to assay tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1), endothelin-1 (ET-1), 6-keto-prostaglandin F1α (6-keto-PGF1α), and thromboxane B2 (TXB2). Finally, the gene expression of t-PA, PAI-1, and ICAM-1 in human umbilical vein endothelial cells (HUVECs) stimulated by tumor necrosis factor-α (TNF-α) was assayed via real-time (RT) quantitative PCR (qPCR). Results: The joint effects of CPSM extract and swimming demonstrated significant interactions, which including increased blood perfusion, increased serum t-PA and 6-keto-PGF1α, decreased serum PAI-1 and TXB2, decreased protein levels of vWF, VCAM-1 and ICAM-1, and decreased ICAM-1 gene expression. Conclusion: This research demonstrated that the combined therapy of CP and SM extracts with swimming could prevent focal cerebral infraction through interactions on the regulation of vascular endothelial functions and inflammatory factors. It stresses the promising effects of the drugs and shear stress of blood flow in prevention and treatment of thrombosis. The mechanism may be related to regulating the protein expression of vWF, VCAM-1, and ICAM-1, and downregulating the gene expression of ICAM-1.

Research progress of cerebral hemorrhage after intravenous thrombolytic therapy for acute cerebal infartion / 中国中西医结合急救杂志

Cerebral hemorrhage is a serious complication after intravenous thrombolysis of acute cerebral infraction (ACI), which leads to low thrombolysis rate. In this paper, the factors such as definition and type of cerebal hemorrhage after intravenous thrombolysis of ACI, the baseline NIHSS score, the time from onset to hrombolysis, age, blood pressure, atrial fibrillation (AF), blood glucose, etc were reviewed in combination with recent litrrature. The risk factors of cerebral hemorrhage were analyzed to provide basis for achieving individualized hrombolysis, improving thrombolytic efficacy and reducing the risk of hemorrhagic transformation.

Fever, cough, consciousness disturbance and physical activity disorder, is severe Mycoplasma pneumoniae pneumonia complicated with cerebral infarction? / 中华实用儿科临床杂志

The school-age boy was admitted to Tianjin Children's Hospital for "fever and cough for 6 days".After detail examinations,the diagnosis of severe Mycoplasma pneumoniae pneumonia was proved.Treatments:anti-infection with Azithromycin and Meropenem;the obstruction of air way was relieved;assisted with symptomatic and supportive treatment.During the treatment,disorder of consciousness and hemiplegia of right limbs occurred,cerebral infarction was proved later by magnetic resonance angiography(MRA).Severe Mycoplasma pneumoniae pneumonia complicated with cerebral infarction is clinically rare with a high morbidity and mortality.Attention should be paid to body examination and Laboratory test.Multi-disciplinary cooperation is helpful.

Effects of Rosuvastatin Combined with Berberine Hydrochloride on Related Indexes of Patients with Acute Cerebral Infarction / 中国药房

OBJECTIVE:To investigate the effects of rosuvastatin combined with berberine hydrochloride on related indexes in patients with acute cerebral infarction.METHODS:Medical information of 120 patients diagnosed as acute ischemic cerebral infarction were analyzed retrospectively,and they divided into observation group (65 cases) and control group (55 cases) according to route of administration.Both groups were given routine treatment;control group was additionally given Rosuvastatin calcium tablets 10 mg orally before bedtime,once a day;observation group was additionally given Berberine hydrochloride tablets 0.3 g orally,3 times a day,on the basis of control group.Treatment courses of 2 groups lasted for 14 d.The levels of TC,TG,LDL-C,HDL-C,hs-CRP,ox-LDL,NIHSS score,ADL score,TPA,IMT,Crouse score,the number of unstable plaque and ADR were observed and compared between 2 groups before and after treatment.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).After treatment,the serum levels ofTC,TG,LDL-C,hs-CRP and ox-LDL in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).After treatment,NIHSS score of 2 groups were significantly lower than before,and ADL score,HDL-C levels were significantly higher than before,with statistical significance (P＜0.05);there was no statistical significance between 2 groups (P＞0.05).After treatment,there was no statistical significance in IMT,Crouse score and the number of unstable plaque in control group compared to before treatment (P＞0.05),but in observation group were significantly lower than before treatment,and also lower than control group at corresponding period,with statistical significance (P＜0.05).There was no statistical significance in TPA between 2 groups before and after treatment(P＞0.05).There was no statistical significance in the indcidence of ADR between 2 groups during treatment(P＞0.05).CONCLUSIONS:Based on routine treatment,rosuvastatin combined with berberine hydrochloride could effectively reduce blood lipid levels in patients with acute cerebral infarction,stabilize or reverse atherosclerotic plaque,and reduce inflammation and oxidative stress with good safety.

Awareness and control rates of diabetes and hyperlipidemia in hypertensive cerebral infraction patients / 现代临床护理

Objective To explore the prevalence of diabetes and hyperlipidemia in cerebral infraction patients with hypertension and look into the rates of awareness, treatment and control. Methods Blood pressure, blood glucose and blood lipids were measured in 238 cerebral infraction patients with hypertension. Meanwhile, the rate of awareness, treatment and control of hypertension, diabetes and hyperlipidemia were investigated by questionnaire. Results Among 79.41％of the patients had abnormal blood pressure and cerebral infaction on admission, the rates of awareness , treatment and control of hypertension were 74.79％, 67.23％, 20.59％. 10.11％of them never took antihypertensive drugs in spite of their awareness of hypertension. 32.35％ of the patients were combined with diabetes, the rates of awareness, treatment and control were 79.22％, 62.34％, 12.99％respectively, and among them 21.31％never tookantidiabetic drugs in spite of awareness of diabetes. 81.51％ of the patients were combined with hyperlipidemia, the rates of awareness, treatment and control were 23.20％, 6.70％, 1.55％respectively, and among them 71.11％never took lipid-lowering drugs with awareness of high blood lipid. Conclusions 79.41％ of the incidence of cerebral infraction was related to abnormal blood pressure. 32.35％cerebral infarction patients with hyperlipdemioa are complicated with hypertension diabetes;81.51％are complicated with 28.57％cerebral infraction patients with hypertension were complicated with diabetes and hyperlipidemia as well, but the rate of awareness, treatment and control were relatively low. In order to improve the secondary prevention, we should pay more attention to the stroke risk factors, and help make the individualized medicine-taking plan to improve the control rate.

Clinical Observation of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in the Treatment of Vertebro-basilar Artery Insufficiency after Cerebral Infraction / 中国药房

OBJECTIVE:To investigate therapeutic efficacy and safety of Salviae miltiorrhizae and ligustrazine hydrochloride injection in the treatment of vertebro-basilar artery insufficiency(VBI)after cerebral infraction. METHODS:128 patients with VBI after cerebral infraction were divided into observation group and control group according to random number table,with 64 cases in each group. Both group received general treatment. Control group was additionally given Shuxuetong injection 6 ml added into 0.9%Sodium chloride injection 250 ml,ivgtt,qd. Observation group was additionally given Salviae miltiorrhizae and ligustrazine hy-drochloride injection 10 ml into 0.9% Sodium chloride injection 250 ml,ivgtt,qd. Both groups received treatment for consecutive 2 weeks. Clinical efficacies of 2 groups were observed as well as blood lipid,vertebro-basilar artery blood velocity and blood viscosity before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:The total effective rate of observa-tion group was 95.31%,which was significantly higher than 79.69% of control group,with statistical significance(P0.05). After treatment,above indexes of 2 groups were improved significantly,and blood lipid and vertebro-basilar ar-tery blood velocity of observation group were significantly better than control group,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Salviae miltiorrhizae and ligustrazine hydrochloride injection shows significant therapeutic efficacy for VBI after cerebral infraction,can significantly improve blood lipid,vertebro-basilar artery blood velocity and blood viscosity with good safety.

Multiple Cerebral Infarctions with Neurological Symptoms and Ophthalmic Artery Occlusion after Filler Injection

PURPOSE: To report a case of visual loss, side weakness and facial palsy due to ophthalmic artery occlusion with diffuse multiple cerebral infarctions after injection of hyaluronic acid. CASE SUMMARY: A 50-year-old female visited our clinic for visual loss in the left eye after filler injection in the glabella. Her best corrected visual acuity was 1.0 in the right eye and hand motion in the left eye. The intraocular pressure was 8 mm Hg in the right eye and 14 mm Hg in the left eye. In the left eye, there was abnormal pupillary light reflex and complete extra-ocular muscles palsy with blepharoptosis. A pale retina with a cherry-red-spot also appeared in the left fundus. A central retinal artery occlusion was observed on fluorescein angiography and brain magnetic resonance imaging showed multiple cerebral infarctions at the frontal, temporal, parietal and occipital lobes. Four days later, the motor weakness was aggravated and dysarthria and aphasia became worse. According to symptoms, a hemorrhagic transformation in subacute infarctions developed based on brain computed tomography. After 3 months of follow up, the visual acuity in the left eye was no light perception. However, the general conditions including ophthalmoplegia and motor weakness were improved.

Treatment effect of 650 nm LLLT on cerebral infraction combined with hypertension / 国际生物医学工程杂志

Objective To explore the therapeutic effect of low level laser irradiation (LLLI) on cerebral infraction combined with hypertension.Methods Two groups were divided, conventional treatment group and laser irradiation combined with conventional treatment group.LLLI (650 nm, 20 mW, 20 min, twice a day, two weeks therapy) was used by extravascular way in addition to conventional treatment, while control group employed conventional treatment only.Whole blood viscosity, plasma blood pressure, lipid and neurological function were assessed by comparing the index of the two groups.Results Whole blood viscosity, plasma viscosity, whole blood high shear reductive viscosity, hematokit (HTC), erythrocyte deformation index, erythrocyte rigidity index, fibrinogen and blood lipid level of both groups decreased and the decrease of the testing group was more significant than that of control group (P＜0.05 or P＜0.01).Neurological deficit score an blood pressure of both groups showed significant decrease (P＜0.05), and the decrease in blood pressure of testing group was significant than that of the control group (P＜0.05 or P＜0.01).Conclusions 650 nm extravascular LLLI may be effective in treatment of cerebral infraction combined with hypertension, and has a good application prospect.

Effects of occupational therapy on the cognitive function and event-related potentials of patients with acute cerebral infraction / 中华物理医学与康复杂志

Objective To explore the effect of occupational therapy on the cognitive function and P300 event-related potentials (ERPs) of patients with acute cerebral infraction.Methods Ninety-eight acute cerebral infarction patients with cognitive impairment were selected using the mini-mental state examination (MMSE).They were randomly divided into an observation group (n =49) who received occupational therapy plus routine rehabilitation treatment and a control group (n =49) who received only the routine rehabilitation treatment.Before and after 8 weeks of treatment,the patients' cognitive function and their ability in the activities of daily living(ADL) were evaluated using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel index (MBI),respectively.P300 ERPs were also detected.Results There was no significant difference between the two groups with regard to various scores before the treatment (P ＞ 0.05).After 8 weeks of treatment,the LOTCA and MBI scores and the latency and amplitude of ERPs were significantly better than those before treatment in both groups (P ＜ 0.05).In the observation group,the scores of LOTCA (99.4 ± 8.4),MBI (80.7 ± 5.9) and the latency and amplitude of ERPs [(373.45 ± 52.13) ms and (5.87 ± 2.63) μV,respectively] were significantly better than those in the control group(P ＜ 0.05).Conclusion Occupational therapy program based on conventional rehabilitation training can promote the ADL ability and cognitive function of patients with acute cerebral infraction.It is worth applying in clinical practice.

Decision-making processing on patients with cerebral infraction in different regions / 中华行为医学与脑科学杂志

Objective To explore the decision-making processing changes of patients with cerebral infarction in different regions.Methods The patients with cerebral infarction were divided into 21 cases of frontal lobe infarction,11 cases of temporal lobe infarction,19 cases of the medial temporal lobe infarction,25 cases of basal ganglia infarction;25 cases of the anterior infarction,51 cases of the posterior infarction,62 cases of depression,64 cases of anxiety ;and there were 125 cases in normal control group.All subjects completed the test of the six kinds of choice situational problems,and used MMSE to evaluate cognitive function,the Hamilton Depression and anxiety Scale Evaluation to evaluate emotion.Results All cerebral infarction patients (CI group) and normal control group in low-risk and no-risk of loss situation(choice scenario 2),high-risk and the no-risk of gain or loss situation(choice scenario 3 and 4),high-risk and low-risk of gain or loss situation(choice scenario 5 and 6) tended to choose conservative scheme,and the selection probability of conservative scheme were obviously higher than that of the normal group,and the differences were statistically significant (P ＜ 0.05).In choice scenario 3,the basal ganglia infarction group with frontal lobe infarction group,the medial temporal lobe infarction group comparison,the conservative income scheme selection probability increased significantly,all difference were statistically significant (P ＜ 0.01,P ＜ 0.05).In choice scenario 5 of the posterior infarction group,a higher probability of conservative income scheme was selected than the anterior infarction,and the difference was statistically significant (P ＜0.05).Accompanied with depression and anxiety,the basal ganglia infarction tended to select more conservative income program than the frontal lobe infarction group and the medial temporal lobe infarction group in choice scenario 3,and the program infarction group selected a higher probability comparative differences were statistically significant (P＜ 0.01,P＜ 0.05).The posterior infarction group selected a higher probability of conservative income scheme than the anterior infarction in choice scenario 5,and the difference was statistically significant (P ＜ 0.05).Conclusion Cerebral infarction in patients exist decision-making processing abnormally,and perform as income conservative and loss risk averse.Whether associated with depression,anxiety,the basal ganglia infarction and posterior cerebral infarction patients are inclined to income conservative.