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Cortical evoked potential changes in a rat model of acute ischemic stroke Detection of somatosensory evoked potential and motor evoked potential

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Neural Regeneration Research 2010年第7期5卷 550-554页

作者： Yang Shao Department of Neurology Xiangya Hospital of Central South University Changsha 410008 Hunan Province China

BACKGROUND： Studies have shown that latency changes of some elements in a somatosensory evoked potential （SEP） and motor evoked potential （MEP） can reflect electrical activity of cerebral cortical neurons and conduction of white matter nerve fibers. However, there is a paucity of information regarding the dynamic observation of SEP and MEP following cerebral ischemic injury. OBJECTIVE： To explore SEP and MEP changes following acute ischemic stroke, and investigate the role of evoked potentials in monitoring brain function in stroke. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Chongqing Key Laboratory of Neurology, Affiliated Hospital of Chongqing Medical University from September 2007 to August 2008. MATERIALS＂ Hydrogen blood flow detector was purchased from Soochow University Medical Instrument Co., China, and Power lab system was purchased from AD Instruments, Inc., USA. METHODS A total of 36 healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups （n = 9）, including three ischemia groups （12, 24 and 72 hours of ischemia） and a sham-surgery group. The rat model of acute ischemic stroke was established by middle cerebral artery occlusion （MCAO） in the left hemisphere. MAIN OUTCOME MEASURES＂ SEP and MEP of the left limbs were detected, and cerebral blood flow was measured by the hydrogen cleaning method. RESULTS： The latency of positive wave 1 （P1）, negative wave 1 （N1） and positive wave 2 （P2） waves in SEP, and latency of negative wave 1,2 （N1, N2） waves in MEP were significantly prolonged with increasing ischemic duration following MCAO （P 〈 0.01）, but cerebral blood flow was significantly decreased （P 〈 0.05, or P 〈 0.01）. CONLUSION： ischemic stroke prolongs the latency of SEP waves （P1, N1, P2） and MEP waves （N1, N2）, and cerebral cortical evoked potential may correlate with cerebral blood flow changes. This indicates that SEP and MEP can be used to evaluate brain function following acute isch

关键词： somatosensory evoked potential motor evoked potential latency cerebral blood flow brain function acute ischemic stroke neural regeneration

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Hemorrhagic transformation after acute ischemic stroke caused by polycythemia vera:Report of two case

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World Journal of Clinical Cases 2021年第25期9卷 7551-7557页

作者： Ya-Yun Cao Jie Cao Zhua-Jin Bi Sha-Bei Xu Chen-Chen Liu Department of Neurology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430000Hubei ProvinceChina Department of Radiology Zhongnan Hospital of Wuhan UniversityWuhan 430000Hubei ProvinceChina

BACKGROUNDPolycythemia vera (PV) is a chronic myeloproliferative disorder characterized byan increase in red blood cells in the peripheral blood. Previous work has reportedthe occurrence of thrombosis or hemorrhage arising in the cerebral vasculaturesecondary to PV. However, hemorrhagic transformation after PV-associated acuteischemic stroke has not been previously *** SUMMARYWe herein present two cases of PV where hemorrhagic transformation occurredafter an acute ischemic stroke. Case 1 was a 57-year-old woman with a history ofhypertension who was admitted for left-sided weakness. Case 2 was a 68-year-oldman who was admitted for a 10-d sudden left arm weakness. Imaging examinationsfor the two patients revealed hemorrhagic transformation after acuteischemic stroke. Both patients had JAK-2-V617F mutation and receivedantiplatelet therapy. Both of them had a good prognosis during the *** report suggested that hemorrhagic transformation may occur in acuteischemic stroke caused by PV. Antiplatelet drugs do not seem to influence thelong-term outcomes in such patients. Future research should focus on establishinga standard antiplatelet treatment strategy for this condition.

关键词： Polycythemia vera acute ischemic stroke Hemorrhagic transformation Antiplatelet treatment Thrombosis Case report

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Severe acute Respiratory Syndrome Coronavirus 2 Infection as A Risk Factor for Thromboembolic and acute ischemic stroke:A Case Report

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Journal of Cerebrovascular Disease 2023年第4期6卷 26-30页

作者： Zhe-Chung Tan Department of Emergency Medicine The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Increasing evidence reports a greater incidence of stroke in patients with coronavirus disease 2019(COVID-19)than in the non-COVID-19 population and suggests that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection represents a risk factor for thromboembolic and acute ischemic *** people have higher risk factors for acute ischemic stroke or embolic vascular events,and advanced age is strongly associated with severe COVID-19 and *** reported,instead,a case of an ischemic stroke in a young woman during her hospitalization for COVID-19-related pneumonia.A 29-year-old woman presented to the emergency department of the First Affiliated Hospital,Zhejiang University School of Medicine with progressive respiratory distress associated with a 2-day history of fever,nausea,and *** patient was transferred to the intensive care unit(ICU),where she underwent tracheostomy for mechanical ventilation due to her severe clinical condition and very low arterial partial pressure of *** nasopharyngeal swab test confirmed SARS-CoV-2 *** tests revealed neutrophilic leukocytosis,prolonged prothrombin time,and elevated D-dimer and fibrinogen *** hemiplegia was reported 18 days later during her stay in the ICU after discontinuation of the sedative *** facial palsy on the left side,dysarthria,and facial droop were present,with complete paralysis of the ipsilateral upper and lower *** tomography(CT)of the head and magnetic resonance imaging of the brain confirmed the presence of lesions in the right hemisphere affecting the territories of the anterior and middle cerebral arteries,consistent with ischemic *** and splenic infarcts were also found after CT of the *** age of the patient and the absence of serious concomitant cardiovascular diseases place the emphasis on the capacity of SARS-CoV-2 infection to be an independent cerebrovascular risk *** levels of D-dime

关键词： Coronavirus disease 2019 Severe acute respiratory syndrome coronavirus 2 acute ischemic stroke Computed tomography Risk factor

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Application of MAGnetic resonance imaging compilation in acute ischemic stroke

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World Journal of Clinical Cases 2021年第35期9卷 10828-10837页

作者： Qi Wang Gang Wang Qiang Sun Di-He Sun Department of Radiology The Stroke Hospital of Liaoning ProvinceShenyang 110101Liaoning ProvinceChina

BACKGROUND Synthetic magnetic resonance imaging(MRI)MAGnetic resonance imaging compilation(MAGiC)is a new MRI *** T1,T2,T2-fluidattenuated inversion recovery(FLAIR)contrast images,quantitative images of T1 and T2 mapping,and MAGiC phase sensitive inversion recovery(PSIR)Vessel cerebrovascular images can be obtained simultaneously through post-processing at the same time after completing a *** recent years,studies have reported that MAGiC can be applied to patients with acute ischemic *** hypothesized that the synthetic MRI vascular screening scheme can evaluate the degree of cerebral artery stenosis in patients with acute ischemic *** To explore the application value of vascular images obtained by synthetic MRI in diagnosing acute ischemic *** A total of 64 patients with acute ischemic stroke were selected and examined by MRI in the current retrospective cohort *** scanning sequences included traditional T1,T2,and T2-FLAIR,three-dimensional time-of-flight magnetic resonance angiography(3D TOF MRA),diffusion-weighted imaging(DWI),and synthetic *** contrast images(T1,T2,and T2-FLAIR)and intracranial vessel images(MAGiC PSIR Vessel]were automatically reconstructed using synthetic MRI raw *** contrast-to-noise ratio(CNR)values of traditional T1,T2,and T2-FLAIR images and MAGiC reconstructed T1,T2,and T2-FLAIR images in DWI diffusion restriction areas were measured and *** PSIR Vessel and TOF MRA images were used to measure and calculate the stenosis degree of bilateral middle cerebral artery stenosis *** consistency of MAGiC PSIR Vessel and TOF MRA in displaying the degree of vascular stenosis with computed tomography angiography(CTA)was *** Among the 64 patients with acute ischemic stroke,79 vascular stenosis areas showed that the correlation between MAGiC PSIR Vessel and CTA(r=0.90,P<0.01)was higher than that between TOF MRA and CTA(r=0.84,P<0.01).With a degree of vas

关键词： acute ischemic stroke Magnetic resonance imaging Magnetic resonance angiography Computed tomography angiography Phase sensitive inversion recovery

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Treatment of acute ischemic stroke by minimally manipulated umbilical cord-derived mesenchymal stem cells transplantation:A case report

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World Journal of Stem Cells 2021年第8期13卷 1151-1159页

作者： Hyunjun Ahn Sang Yeon Lee Won Ju Jung Kye-Ho Lee bio Beauty&Health Company(bBHC)-Stem Cell Treatment&Research Institute(STRI) Seoul 04420South Korea 97.7 Beauty&Health(B&H)Clinics Seoul 04420South Korea

BACKGROUND stroke is one of the major causes of disability and death *** treatments for stroke exist,but existing treatment methods have limitations such as difficulty in the regeneration of damaged neuronal cells of the ***,mesenchymal stem cells(MSCs)have been studied as a therapeutic alternative for stroke,and various preclinical and case studies have been *** SUMMARY A 55-year-old man suffered an acute stroke,causing paralysis in the left upper and lower *** intravenously transplanted the minimally manipulated human umbilical cord-derived MSCs(MM-UC-MSCs)twice with an 8-d *** 65 wk after transplantation,the patient returned to his previous occupation as a veterinarian with no adverse *** MM-UC-MSCs transplantation potentially treats patients who suffer from acute ischemic stroke.

关键词： acute ischemic stroke Behavioral disorder Umbilical cord-derived mesenchymal stem cells Allogenic Cell therapy Minimal manipulation Case report

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Admission clinical characteristics and early clinical outcomes among acute ischemic stroke patients

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The Journal of Biomedical Research 2012年第3期26卷 152-158页

作者： Xin Gao Jintao Zhang Ying Peng Huanqing Fan Mei Chen Tan Xu Yonghong Zhang Department of Epidemiology School of Public Health Medical College of Sooehow University Suzhou Jiangsu 215123 China Department of Neurology The 88th Hospital of PLA Taian Shandong 271000 China.

The purpose of the present study was to investigate the association between admission clinical characteristics and outcomes at discharge among acute ischemic stroke patients in the Chinese population. A total of 2,673 patients with acute ischemic stroke were included in the present study. The clinical characteristics at admission and other study variables were collected for all patients. The study outcome was defined as neurological deficiency （National Institute of Health stroke Scale score ≥ 10） at discharge or in-hospital death. Compared with the subjects without neurological deficiency at discharge or in-hospital death, the subjects with neurological deficiency at discharge or in-hospital death had a significantly higher prevalence of hyperglycemia or history of atrial fibrillation at admission. Age ≥ 80 years, hyperglycemia, hypertension, and history of atrial fibrillation were significantly associated with neurological deficiency at discharge or in-hospital death after adjustment for other variables. It is concluded that old age （ ≥ 80 years）, hyperglycemia, hypertension and history of atrial fibrillation are significantly associated with neurological deficiency at discharge or in-hospital death among patients with acute ischemic stroke.

关键词： acute ischemic stroke clinical characteristics death neurological deficiency discharge outcome

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Neutrophil to Lymphocyte Ratio in acute ischemic stroke

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Neuroscience & Medicine 2020年第2期11卷 52-62页

作者： Menat-Allah Mohamed Lashin Salma Hamed Khalil Taha Kamel Alloush Sherif Anis Mohamed Mahmoud Fouad Department of Neurology Faculty of Medicine Ain Shams University Cairo Egypt Department of Anesthesia Faculty of Medicine Ain Shams University Cairo Egypt

Introduction: The neutrophil to lymphocyte ratio (NLR) can be used as a marker of subclinical inflammation, and may have a predictive power in prognosis and severity of atherosclerosis-related diseases. This study aimed to assess an association between the NLR, and clinical characteristics and one-month outcome in acute ischemic stroke (AIS). Subjects and Methods: This case-control observational prospective study included 75 patients admitted to stroke unit of Ain Shams University hospitals with AIS, sub grouped into 3 equal groups according to subtype of AIS, in addition to 25 healthy individuals. The demographic characteristics of the patients, complete blood picture test results at presentation, National Institutes of Health stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores were recorded. The clinical outcome was assessed by the NIHSS and mRS scores after one month. Results: The total leucocyte count was significantly higher in large artery atherosclerosis (P = 0.004) and cardioembolic (P = 0.020) stroke groups, unlike lacunar stroke group (P = 0.082), when compared to controls. The neutrophils count was higher (P stroke groups compared to the control group. The NLR was higher among all the stroke groups compared to the control group (P stroke with a sensitivity of 89.33% and specificity of 72% and accuracy reached 88.6%. There was non-significant association between NLR and each of NIHSS and mRS after one month from onset of AIS. Conclusion: NLR was significantly higher among AIS subtypes compared to controls, but not a good predictor for one month outcome.

关键词： Neutrophil to Lymphocyte Ratio acute ischemic stroke

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Oral Glibenclamide Improves Clinical Outcome after acute ischemic stroke

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神经药理学报 2019年第Z1期 44-45页

作者： PAN Su-yue Department of Neurology Nanfang HospitalSouthern Medical University

Objectives:Intravenous glibenclamide(GBC) exerts neuroprotection in both preclinical and preliminary clinical studies. This study explored the safety and potential efficacy of oral GBC in patients with acute hemispheric infarction. Methods:During January 2017 and August 2017,adult volunteers were recruited to receive oral GBC treatment,if they presented with an acute anterior ischemic stroke and an National Institute of Health stroke Score of ≥8. Controls were those who met the above inclusion criteria and had not been on GBC or other sulfonylureas prior to stroke or after hospitalization. Propensity score matching(PSM) was performed to balance baseline characteristics. The primary endpoint was the score on the modified Rankin Scale(mRS) at 6 months. Results:We included 213 patients in the unmatched cohort(20 in the GBC group and 193 in the control group) and 40 patients(20 in each group) in the matched cohort. Although the proportion in mRS of 0-2 did not differ between the two groups,more GBC-treated patients achieved mRS of 0-4 compared to the controls(95% vs. 62%,P = 0.001),even after adjustment for baseline imbalances(95% vs. 65%,P = 0.022). In terms of safety outcomes,oral GBC treatment did not increase 30-day mortality,episodes of hypoglycemia and early neurological deterioration. Moreover,after baseline adjustment,we observed lighter brain edema in the GBC group. Conclusions:Oral GBC treatment is associated with improved clinical outcome after acute hemispheric infarction,without additional safety concern. An adequately powered and randomized trial is warranted.

关键词： acute ischemic stroke brain edema glibenclamide prognosis sulfonylurea receptor 1

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Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase:a meta-analysis

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Aging Communications 2023年第1期5卷 12-19页

作者： Yan-Chao Huo Lu Yang Wen-Jing Zhou Meng Geng Meng Zhang Wen-Bo Zhao Yao-Ming Xu Graduate School Inner Mongolia Medical UniversityHohhot 010110China Department of Neurology Tongliao City HospitalTongliao 028000China Department of Neurology Xuanwu HospitalCapital Medical UniversityBeijing 100053China

Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor *** tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional ***,the rationality of this remedy is a *** purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September *** ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 ***:Five clinical trials with 725 patients were *** study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional ***:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.

关键词： acute ischemic stroke tirofiban alteplase intravenous thrombolysis meta-analysis

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The Effect of the Early Application of Tirofiban on acute ischemic stroke (AIS) after Intravenous Thrombolysis with Urokinase

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Journal of Clinical and Nursing Research 2023年第4期7卷 201-204页

作者： Mingfen Li Department of Neurology Yibin Fourth People’s HospitalYibin 644600China

Objective:Discussion and analysis of the effect of the early application of Tirofiban on acute ischemic stroke(AIS)after intravenous thrombolysis with ***:The subjects of this study are 40 patients with AIS admitted at the Yibin Fourth People’s Hospital,of which were computer-randomized into a control group(20 cases,with regular urokinase intravenous thrombolysis therapy)and a research group(20 cases,combined with early Tirofiban treatment)from January 2018 to December *** intervention outcomes between these two groups were compared and ***:The blood platelet-related parameters before treatment had no statistical difference between the two groups(P>0.05),but the research group was higher than that of the control group after treatment(P0.05),but the research group was higher than that of the control group after treatment(P<0.05).Conclusion:Early Tirofiban treatment for patients with AIS after intravenous thrombolysis with urokinase could effectively regulate the blood platelet-related parameters,hence improving treatment benefits and living capacity for patients,with definite clinical benefits.

关键词： acute ischemic stroke Intravenous thrombolysis with urokinase Tirofiban,Treatment effect

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