There are conflicting reports concerning signal intensity changes in transient global amnesia (TGA) using diffusion weighted imaging (DWI).We prospectively an alysed DWI signal intensity changes in TIA and TGA patient...There are conflicting reports concerning signal intensity changes in transient global amnesia (TGA) using diffusion weighted imaging (DWI).We prospectively an alysed DWI signal intensity changes in TIA and TGA patients, and compared the clinical ch aracteristics and risk factors of both groups. Using DWI and conventional T1 and T2 weighted turbo spin echo sequences, 28 patients with acute TGA (13 men, mean age 61.5years) and 74 TIA patients (47 men, mean age 62.4 years) were studied w ithin 48 hours after symptom onset. Every patient underwent an intensive diagnos tic investigation. In 10/28 (36%) of the TGA patients and 21/74 (28%) of the T IA patients, DWI signal intensity changes occurred. The time to DWI and the dura tion of symptoms were comparable in TIA and TGA patients.Overall, TIA patients s howed an increased prevalence of vascular risk factors compared with TGA patient s. In the TGA group, patients with abnormal DWI showed carotid atherosclerosis s ignificantly more frequently. Based on our data,we suggest that the aetiology of TGA could be explained by an ischaemic event; due to arterial thrombembolic isc haemia in one subgroup, particularly in those patients with increased vascular r isk factors, and due to venous ischaemia in another subgroup with valsalva-like activities before symptom onset.展开更多
Background and Purpose:The prognostic value of cardiac troponins and natriure tic peptide in acute ischemic stroke is uncertain. We measured cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-bra...Background and Purpose:The prognostic value of cardiac troponins and natriure tic peptide in acute ischemic stroke is uncertain. We measured cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic pept ide (NT-proBNP) at admission in acute ischemic stroke patients without evident myocardial damage. Methods:In 174 consecutive patients with MRI-confirmed isch emic stroke, serial measurements of cTnT, cTnI, and NT-proBNP were performed at 3 different time points in the hyperacute phase (at admission,on days 1 and 2). Relation of laboratory values to risk factors, stroke subtype classification, a nd clinical outcome after 3 months was analyzed. Results:The highest proportion of raised parameters was found at day 2 for cTnI in 8 of 103(7.8%), at day 3 fo r cTnT in 8 of 174 (4.6%), and NT-proBNP in 114 of 174 (65.5%) patients. Prop ortion of patients with good outcome was significantly reduced in the group with highest NT-proBNP quartile. However, using multivariate regression analysis, n o significant relation to morbidity and mortality was found for cTnT, cTnI, or N T-proBNP. Significant impact on the outcome was detected for lesion size, insul ar involvement,sex, age, and stroke severity. Conclusions:NT-proBNP is raised in nearly two thirds of acute stroke patients, whereas elevated cardiac troponin s are found only in a small number of acute ischemic stroke patients. Neither NT -proBNP nor cardiactroponins influence clinical outcome if other risk factors a re considered.展开更多
文摘There are conflicting reports concerning signal intensity changes in transient global amnesia (TGA) using diffusion weighted imaging (DWI).We prospectively an alysed DWI signal intensity changes in TIA and TGA patients, and compared the clinical ch aracteristics and risk factors of both groups. Using DWI and conventional T1 and T2 weighted turbo spin echo sequences, 28 patients with acute TGA (13 men, mean age 61.5years) and 74 TIA patients (47 men, mean age 62.4 years) were studied w ithin 48 hours after symptom onset. Every patient underwent an intensive diagnos tic investigation. In 10/28 (36%) of the TGA patients and 21/74 (28%) of the T IA patients, DWI signal intensity changes occurred. The time to DWI and the dura tion of symptoms were comparable in TIA and TGA patients.Overall, TIA patients s howed an increased prevalence of vascular risk factors compared with TGA patient s. In the TGA group, patients with abnormal DWI showed carotid atherosclerosis s ignificantly more frequently. Based on our data,we suggest that the aetiology of TGA could be explained by an ischaemic event; due to arterial thrombembolic isc haemia in one subgroup, particularly in those patients with increased vascular r isk factors, and due to venous ischaemia in another subgroup with valsalva-like activities before symptom onset.
文摘Background and Purpose:The prognostic value of cardiac troponins and natriure tic peptide in acute ischemic stroke is uncertain. We measured cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic pept ide (NT-proBNP) at admission in acute ischemic stroke patients without evident myocardial damage. Methods:In 174 consecutive patients with MRI-confirmed isch emic stroke, serial measurements of cTnT, cTnI, and NT-proBNP were performed at 3 different time points in the hyperacute phase (at admission,on days 1 and 2). Relation of laboratory values to risk factors, stroke subtype classification, a nd clinical outcome after 3 months was analyzed. Results:The highest proportion of raised parameters was found at day 2 for cTnI in 8 of 103(7.8%), at day 3 fo r cTnT in 8 of 174 (4.6%), and NT-proBNP in 114 of 174 (65.5%) patients. Prop ortion of patients with good outcome was significantly reduced in the group with highest NT-proBNP quartile. However, using multivariate regression analysis, n o significant relation to morbidity and mortality was found for cTnT, cTnI, or N T-proBNP. Significant impact on the outcome was detected for lesion size, insul ar involvement,sex, age, and stroke severity. Conclusions:NT-proBNP is raised in nearly two thirds of acute stroke patients, whereas elevated cardiac troponin s are found only in a small number of acute ischemic stroke patients. Neither NT -proBNP nor cardiactroponins influence clinical outcome if other risk factors a re considered.
