Myocardial ischemic changes of electrocardiogram in intracerebral hemorrhage: A case report and review of literature

BACKGROUND Cardiac injury may occur after acute pathology of central nervous system(CNS)without any evidence of primary cardiac diseases.The resulting structural and/or functional changes are called cerebrocardiac syndrome(CCS).The great majority of studies have been performed in patients with subarachnoid hemorrhage(SAH),while CCS data after intracerebral hemorrhage(ICH)are rare.It may cause diagnostic and therapeutic pitfalls for the clinician due to a lack of specific clinical manifestations and diagnostic methods.Understanding the underlying pathophysiological and molecular mechanism(s)following cerebrovascular incidents will help to implement prevention and treatment strategies to improve the prognosis.CASE SUMMARY A 37-year-old man with a history of hypertension presented to our department on an emergency basis because of a sudden dizziness and left limb weakness.Cerebral computed tomography(CT)suggested ICH in the occipital and parietal lobes,and the chosen emergency treatment was hematoma evacuation.Left ventricular(LV)dysfunction occurred after the next 48 h and the electrocardiogram(ECG)showed non-ST elevation myocardial infarction.CCS was suspected first in the context of ICH due to the negative result of the coronary CT angiogram.CONCLUSION Misinterpretation of ischemic-like ECGs may lead to unnecessary or hazardous interventions and cause undue delay of rehabilitation after stroke.Our objective is to highlight the clinical implications of CCS and we hope the differential diagnoses will be considered in patients with acute CNS diseases.

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia

AIM:To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens(IOL)implantation for surgical management of microspherophakia.METHODS:A retrospective case series include 10 microspherophakic patients(15 eyes)who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation.The primary outcomes involved visual acuity,intraocular pressure(IOP).Secondary outcomes were spherical equivalent(SE),anterior chamber depth(ACD),corneal endothelial cell density and postoperative complications.RESULTS:After a postoperative follow-up of 17.60±15.44mo,improved visual outcomes can be observed.The uncorrected distance visual acuity(UCVA)log MAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively(P=0.001),and best corrected visual acuity(BCVA)log MAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively(P=0.003).Moreover,the SE decreased from-9.58±7.47D preoperatively to-0.65±2.21 D postoperatively(P<0.001).In terms of safety profile,the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively(P=0.044),and the previously elevated IOP of three eyes decreased to the normal range.The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively(P=0.017).The density of corneal endothelial cells did not change significantly after surgery(P=0.140).The posterior chamber IOLs were well centered and no severe complications were found.CONCLUSION:Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity,which can be regarded as a relative safe method for the surgical management of microspherophakia.