A molecular probe carrying anti-tropomyosin 4 for early diagnosis of cerebral ischemia/reperfusion injury

In vivo imaging of cerebral ischemia/reperfusion injury remains an important challenge.We injected porous Ag/Au@SiO_(2) bimetallic hollow nanoshells carrying anti-tropomyosin 4 as a molecular probe into mice with cerebral ischemia/reperfusion injury and observed microvascular changes in the brain using photoacoustic imaging with ultrasonography.At each measured time point,the total photoacoustic signal was significantly higher on the affected side than on the healthy side.Twelve hours after reperfusion,cerebral perfusion on the affected side increased,cerebrovascular injury worsened,and anti-tropomyosin 4 expression increased.Twenty-four hours after reperfusion and later,perfusion on the affected side declined slowly and stabilized after 1 week;brain injury was also alleviated.Histopathological and immunohistochemical examinations confirmed the brain injury tissue changes.The nanoshell molecular probe carrying anti-tropomyosin 4 has potential for use in early diagnosis of cerebral ischemia/reperfusion injury and evaluating its progression.

Recurrent Transient Ischemic Attacks Revealing Cerebral Amyloid Angiopathy: A Comprehensive Case

This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral angiography-MRI revealed features indicative of CAA. Symptomatic treatment resulted in improvement, but the patient later developed a fatal hematoma. The discussion navigates the intricate therapeutic landscape of repetitive TIAs in the elderly with cardiovascular risk factors, emphasizing the pivotal role of cerebral MRI and meticulous bleeding risk management. The conclusion stresses the importance of incorporating SWI sequences, specifically when suspecting a cardioembolic TIA, as a diagnostic measure to explore and exclude CAA in the differential diagnosis. This case report provides valuable insights into these challenges, highlighting the need to consider CAA in relevant cases.

Primary imaging features and recent application of PET tracers in cerebral amyloid angiopathy

Cerebral amyloid angiopathy(CAA)is a small vessel disease of the brain characterized by the progressive deposition of amyloid-β(Aβ)plaques in the walls of cerebral blood vessels.It presents with a subtle course and sudden onset,and currently,there are no specific therapeutic interventions available.Accurate diagnosis of CAA could enable targeted interventions in the early stages of the disease,potentially mitigating the disease’s effects.Herein,we review the primary imaging biomarkers used in the diagnosis of CAA,including their mechanisms,imaging characteristics,and significance.We also provide an interpretation of the latest version(v2.0)of the Boston criteria,which are commonly used in the clinical diagnosis of CAA.Additionally,this study introduces various positron emission tomography(PET)tracers for CAA and reviews their application values in the diagnosis of CAA.

Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

OBJECTIVE： To identify global research trends in neuroimaging diagnosis for cerebral infarction using a bibliometric analysis of the Web of Science. DATA RETRIEVAL： We performed a bibliometric analysis of data retrieval for neuroimaging diagnosis for cerebral infarction containing the key words ＂CT, magnetic resonance imaging, MRI, transcranial Doppler, transvaginal color Doppler, digital subtraction angiography, and cerebral infarction＂ using the Web of Science. SELECTION CRITERIA： Inclusion criteria were： （a） peer-reviewed articles on neuroimaging diagnosis for cerebral infarction which were published and indexed in the Web of Science; （b） original research articles and reviews; and （c） publication between 2004-2011. Exclusion criteria were： （a） articles that required manual searching or telephone access; and （b） corrected papers or book chapters. MAIN OUTCOME MEASURES： （1）Annual publication output; （2） distribution according to country; （3） distribution according to institution; （4） top cited publications; （5） distribution according to journals; and （6） comparison of study results on neuroimaging diagnosis for cerebral infarction. RESULTS： Imaging has become the predominant method used in diagnosing cerebral infarction. The most frequently used clinical imaging methods were digital subtraction angiography, CT, MRI, and transcranial color Doppler examination. Digital subtraction angiography is used as the gold standard. However, it is a costly and time-consuming invasive diagnosis that requires some radiation exposure, and is poorly accepted by patients. As such, it is mostly adopted in interventional therapy in the clinic. CT is now accepted as a rapid, simple, and reliable non-invasive method for use in diagnosis of cerebrovascular disease and preoperative appraisal. Ultrasonic Doppler can be used to reflect the hardness of the vascular wall and the nature of the plaque more clearly than CT and MRI. CONCLUSION： At present, there is no unified standard of classification of cerebral infarction imaging. Detection of clinical super-acute cerebral infarction remains controversial due to its changes on imaging, lack of specificity, and its similarity to a space-occupying lesion. Neuroimaging diagnosis for cerebral infarction remains a highly active area of research and development.

Differentiation and diagnosis of migrating cerebral sparganosis: 2 case reports from China

Human cerebral sparganosis is a rare but neglected parasitic disease. We present details of the diagnosis of two cases of migrating cerebral sparganosis from China based on computed tomography and magnetic resonance imaging combined with epidemiological information and serology. Its differentiatial diagnosis from other parasitic diseases, tuberculoma and brain tumor by neuroimaging is briefly discribed.

Isolated cerebral mucormycosis that looks like stroke and brain abscess:A case report and review of the literature

BACKGROUND Cerebral mucormycosis is an infectious disease of the brain caused by fungi of the order Mucorales.These infections are rarely encountered in clinical practice and are often misdiagnosed as cerebral infarction or brain abscess.Increased mortality due to cerebral mucormycosis is closely related to delayed diagnosis and treatment,both of which present unique challenges for clinicians.CASE SUMMARY Cerebral mucormycosis is generally secondary to sinus disease or other disseminated disease.However,in this retrospective study,we report and analyze a case of isolated cerebral mucormycosis.CONCLUSION The constellation of symptoms including headaches,fever,hemiplegia,and changes in mental status taken together with clinical findings of cerebral infarction and brain abscess should raise the possibility of a brain fungal infection.Early diagnosis and prompt initiation of antifungal therapy along with surgery can improve patient survival.

Cerebral proliferative angiopathy in pediatric age presenting as neurological disorders:A case report

BACKGROUND Cerebral proliferative angiopathy(CPA)is a rare subtype of arteriovenous malformation.It is extremely rare in pediatric patients and has serious implications for developing children.However,reports of these disorders worldwide are limited,and no uniform reference for diagnosis and treatment options exists.We report the case of a 6-year-old with CPA having predominantly neurological dysfunction and review the literature on pediatric CPA.CASE SUMMARY We report the case of a pediatric patient with CPA analyzed using digital subtraction angiography(DSA)who presented initially with a neurological disorder as the main manifestation.This case is the basis for further discussion of the clinical presentation,pathogenesis,diagnosis,and treatment of CPA in children.After the cerebral DSA,the patient was treated conservatively with sedation,fluid replacement,and blood anticoagulation.She could not cooperate with the followup magnetic resonance imaging examination because of her young age,and her family declined further treatment because of the surgery’s high risk.She was followed up for 3 months;her symptoms did not worsen.CONCLUSION This report of rare pediatric CPA can inform and advance clinical research on congenital cerebrovascular diseases.

CLINICAL OBSERVATION ON TREATMENT OF CEREBRAL APOPLEXY-INDUCED APHASIA BY ACUPUNCTURE

Acupuncture therapy was adopted in the present study to treat aphasia caused by cerebral apoplexy. Among the 24 patients in treatment group, 13 cases were cured, 6 were markedly improved, 4 improved and 1 ineffective. The total effective rate of this group was 95. 8%. Of the patients in the control group, 6 cases were cured, 5 markedly improved, 10 improved and 3 ineffective.The overall curative rate was 87. 5%. The therapeutic results of these two groups were statistically significantly different (P<0.05), the result of the treatment group superior to that of the control group. The obtained results indicate that the acupuncture therapy is an effective way for this illness.

Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage

Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation. Methods: From June 1994 to Oct., 2000, 83 patients admitted to our service with acute intracerebral hemorrhage (ICH) were investigated retrospectively; 41 patients with his-tologically proven diagnosis of cerebral amyloid angiography and 42 patients with clear history of hypertension were investigated. Results: Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74.0 years vs 66.5 years, P<0.05). There was a significantly higher number of hematomas> ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN. In CAA-related ICH, su-barachnoid hemorrhage (SAH) was seen in 26 patients (63.4%) compared to only 11 patients (26.2%) in HTN-related ICH. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Typical features of CAA-related ICH included lobar distribution affecting mainly the lobar superficial areas, lobulated appearance, rupture into the subarachnoid space, and secondary IVH from the lobar hemorrhage. More specifically, multiplicity of hemorrhage, bilaterality, and repeated episodes also strongly suggest the diagnosis of CAA. Multiple hemorrhages, defined as 2 or more separate he-matomas in multiple lobes, accounted for 17.1% in CAA-related ICH. Conclusion: There are certain features in CAA on CT and MRI and in clinical settings. To some extent, these features may contribute to distinguishing CAA from HTN related ICH.

CHARACTERISTIC MAGNETIC RESONANCE ENHANCEMENT PATTERN IN CEREBRAL SCHISTOSOMIASIS

Objective To describe the characteristic magnetic resonance imaging （MRI） appearance of cerebral schistosomiasis. Methods Twenty-five patients whose diagnosis of central nervous system （CNS） schistosomiasis had been pathologically （n = 8 ） and clinically （n = 17） confLrmed were randomly selected. MRI was performed on a Signal 1.5T MRI scanner before and after the intravenous administration of gadopentetate dimeghimine constrast medium. We reviewed the MRI studies obtained at the time of initial presentation, as well as follow-up studies obtained during and after medical treatment Results ImmunoLogicaL tests in L5 patients indicated schistosomiasis haematobium. Contrast-enhanced TL-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which ap- peared “arborized”. Through operation and pathological examination, 8 cases had the granuloma formation of schistoso- mal eggs extensive surrounded by inflammation and venous congestion. And 17 cases were treated with praziquantel and corticosteroid therapy. And they were followed up for 2 months by taking MRI, which turned out to be complete resolution of the enhancing structure and edema. At follow-up, all the patients＇ initial symptoms also resolved. Conclnsion The specified MRI enhancement pattern of cerebral schistosomiasis is common in most cases of CNS schistosomiasis, so it should be taken account into the diagnosis of cerebral schistosomiasis.

Hemorrhagic transformation of ischemic cerebral proliferative angiopathy: A case report

BACKGROUND Cerebral proliferative angiopathy(CPA)is a rare vascular disease characterized by the presence of diffuse vascular proliferation,progressive vascular hyperflow and vasodilation of multiple vessels in the normal brain parenchyma.Unlike cerebral arteriovenous malformations,CPA has a mixed appearance between that of lesions with cell proliferation and endothelial proliferation.To date,the pathogenesis of CPA is unclear,in which changes induced by cortical ischemia in the elastic layer of the blood supply artery and smooth muscle cells may be involved.CASE SUMMARY In this article,we retrospectively analyzed a case of hemorrhagic transformation of ischemic CPA diagnosed by digital subtraction angiography and reviewed the related literature for further exploration of its pathogenesis,diagnosis and treatment.CONCLUSION The information in the present case report may facilitate further clinical research on this cerebrovascular disease.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ENCLOSING NEEDLING UNDER CT ORIENTATION FOR TREATMENT OF ISCHEMIC CEREBRAL STROKE AND ITS INFLUENCE ON PLASMA NO

In the present paper, 61 cases of ischemic cerebral apoplexy were randomly divided into enclosing needling group (n=31) and scalpacupuncture group (n=30). After 30 sessions of treatment, there was a significant difference between the two groups in the therapeutic effect (P<0.05), indicating enclosing needling being superior to scalpacupuncture. Both enclosing needling and scalpacupuncture could lower plasma NO content while the former was more apparent in lowering plasma NO level.

通络扶正汤对脑卒中后遗症患者血清Wnt3a、Wnt5a表达量及神经功能影响分析

【目的】分析通络扶正汤(由胆南星、法半夏、桃仁、天麻、全蝎、红花、地龙等中药组成)对脑卒中后遗症患者神经功能及血清分泌型糖蛋白(Wnt)3a、Wnt5a表达量的影响。【方法】采用回顾性研究方法,根据治疗方案的不同将146例脑卒中后遗症风痰瘀阻证患者分为观察组和对照组,每组各73例。对照组给予常规西药及康复治疗,观察组在对照组的基础上给予通络扶正汤治疗,疗程为3周。观察2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Berg平衡量表(BBS)评分、Fugl-Meyer量表(FMA)评分、Holden步行功能分级(FAC)、躯干屈伸肌群表面肌电均方根值(RMS)及血清Wnt3a、Wnt5a表达量的变化情况,并比较2组患者的临床疗效和不良反应发生率。【结果】(1)治疗3周后,观察组的总有效率为95.89%(70/73),对照组为79.45%(58/73),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的NIHSS评分均较治疗前明显降低(P<0.05),BBS、FMA评分均较治疗前明显升高(P<0.05),且观察组对NIHSS评分的降低幅度及对BBS、FMA评分的升高幅度均明显优于对照组(P<0.01)。(3)治疗后,2组患者的FAC分级均较治疗前改善(P<0.05),且观察组对FAC分级的改善作用明显优于对照组(P<0.05)。(4)治疗后,2组患者的竖脊肌、腹直肌表面肌电RMS值均较治疗前明显升高(P<0.05),且观察组对竖脊肌、腹直肌表面肌电RMS值的升高幅度均明显优于对照组(P<0.01)。(5)治疗后,2组患者的血清Wnt3a、Wnt5a表达量均较治疗前明显升高(P<0.05),且观察组对血清Wnt3a、Wnt5a表达量的升高幅度均明显优于对照组(P<0.01)。(6)观察组的不良反应发生率为4.11%(3/73),对照组为6.85%(5/73),组间比较,差异无统计学意义(P>0.05)。【结论】通络扶正汤可有效减轻脑卒中后遗症患者神经功能受损程度及运动障碍,提高平衡能力及治疗效果,增强躯干屈伸肌群肌力,上调血清Wnt3a、Wnt5a表达量,且不良反应发生率低,具有较高的安全性。

龙胆汤联合足浴治疗脑卒中后失眠临床观察

目的研究龙胆汤内服联合足浴在脑卒中后失眠老年患者中的临床疗效。方法选取66例脑卒中后失眠患者,随机分为对照组和观察组,每组33例。对照组采用艾司唑仑片口服治疗,观察组采用龙胆汤内服联合足浴治疗。疗程均为4周,比较2组患者的临床疗效。结果治疗后观察组总有效率为93.94%(31/33),明显高于对照组的66.67%(22/33),差异有统计学意义(P<0.01)。结论采用龙胆汤内服联合足浴治疗脑卒中后失眠,可有效改善患者睡眠质量,且无明显不良反应,值得临床推广。

脑卒中康复期患者社会疏离、病耻感及生存质量的相关性研究

目的对脑卒中康复期患者社会疏离、病耻感及生存质量进行现状调查、分析其相关性,并探讨生存质量的影响因素。方法选取2022年1月至2023年6月就诊于本院的110例脑卒中患者为研究对象,采用一般资料问卷、一般疏离感量表、社会影响量表、健康调查简表对入组脑卒中患者进行问卷调查。结果共有110例脑卒中患者进入本研究,其中,缺血性卒中82例,出血性卒中28例,年龄48~79岁,平均(54.53±7.45)岁,男性69例,占比62.73%,女性41例,占比37.27%。量表评估结果显示:社会疏离得分(48.58±5.46)分、病耻感得分(70.64±6.45)分、生存质量得分(50.26±6.42)分。脑卒中康复期患者社会疏离得分与病耻感得分间呈现正相关关系(r=0.425,P=0.013);社会疏离得分与生存质量得分间呈负相关关系(r=-0.326,P=0.009);病耻感得分与生存质量得分间负相关关系(r=-0.315,P=0.022)。影响因素分析结果显示:月收入、受教育程度、社会疏离得分及病耻感得分是脑卒中康复期患者生存质量得分的影响因素(P<0.05)。结论脑卒中康复期患者社会疏离水平较高、病耻感水平一般、生存质量水平一般。提示临床护理人员应根据患者具体疾病情况,不仅需要密切关注患者疾病及康复情况,也需要最大限度的降低患者出现的社会疏离和病耻感水平,改善患者可能出现的社会性衰弱,对提高脑卒中康复期患者的生存质量有积极意义。

脑小血管病的诊治现状及未来探索之路

脑小血管病(cerebral small vessel disease,CSVD)是一组临床、影像、病理综合征,主要累及颅内小血管,起病隐匿。CSVD与卒中、认知下降、情感障碍、步态异常及尿便失禁密切相关,给家庭和社会带来沉重的疾病负担和经济负担。但CSVD的致病机制仍不明确,临床诊断标准不统一,临床诊疗和试验研究面临重大挑战。本文旨在汇总当前CSVD的可能病因、发病机制和临床诊疗研究的进展及局限性,展望CSVD未来可能的临床研究方向。

热敏灸治疗脑卒中后痉挛性偏瘫患者的热敏化穴位分布情况及疗效观察

目的探查热敏灸治疗脑卒中后痉挛性偏瘫患者热敏化穴位的分布情况,观察热敏灸治疗痉挛性偏瘫患者的临床疗效。方法将70例脑卒中后痉挛性偏瘫患者随机分为对照组和热敏灸组,每组35例;对照组采用常规康复治疗和针刺治疗,热敏灸组在对照组治疗基础上采用热敏灸治疗;观察热敏灸组患者热敏化穴位分布情况,比较两组患者治疗前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分和改良Rankin量表(modified Rankin scale,MRS)评分、徒手肌力检查(manual muscle testing,MMT)评分、Fugl-Meyer评估(Fugl-Meyer assessment,FMA)量表评分、Wolf运动功能测试(Wolf motor function test,WMFT)量表评分、日常生活活动能力(activity of daily living,ADL)量表评分、世界卫生组织生活质量简表(World Health Organization quality of life brief,WHOQOL-BREF)评分以及临床疗效。结果共有35例患者出现热敏化穴位现象,共出现119个热敏化穴位;热敏化穴位中出现频率最高的5个穴位依次为足三里、曲池、悬钟、外关和阳陵泉。热敏灸组NIHSS评分、MRS评分均显著低于对照组(P<0.05),MMT评分、FMA量表评分、WMFT量表评分、ADL量表评分、WHOQOL-BREF各维度评分均显著高于对照组(P<0.05)。热敏灸组临床疗效显著优于对照组(P<0.05)。结论热敏灸联合常规针刺和康复治疗脑卒中后痉挛性偏瘫,能够显著改善患者肢体功能障碍,提高生活质量,疗效确切;应用热敏灸治疗该病时可优先选择足三里、曲池、悬钟、外关、阳陵泉穴进行治疗。

成人烟雾病不同临床表现患者全脑CTP与CTA影像特征研究

目的通过观察分析成人烟雾病的脑动脉CT血管成像(CTA)及全脑CT灌注成像(CTP)图像的特点,探讨成人烟雾病出血型、缺血型及无症状型患者的影像学特征。方法回顾性分析82例成人烟雾病患者的临床资料、全脑CTA和CTP图像,以20例健康人作为对照组。根据82例成人烟雾病患者临床表现分为脑出血组(32例,64个大脑半球)、脑缺血组(26例,52个大脑半球)和无症状组(24例,48个大脑半球),分析各组CTA改良法Suzuki分级差异、CTP灌注参数值[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)]的差异。结果CTA改良法Suzuki分级结果为无症状组患者多为Ⅰ级(39.6%),脑缺血组患者多为Ⅳ级(59.6%),脑出血组患者多为Ⅱ~Ⅲ级(68.7%),无症状组、脑缺血组、脑出血组任意两组间改良法Suzuki分级情况比较,差异均有统计学意义(P<0.05)。无症状组CBV、CBF、MTT及TTP与对照组比较,差异均无统计学意义(P>0.05)。脑缺血组CBV、CBF明显低于对照组,MTT、TTP较对照组明显延长,差异均有统计学意义(P<0.05)。脑出血组CBV、CBF与对照组比较,差异均无统计学意义(P>0.05),但MTT、TTP较对照组明显延长(P<0.05)。脑缺血组CBV、CBF与脑出血组相比,差异均有统计学意义(P<0.05);无症状组的CBV、CBF、MTT、TTP与脑缺血组相比,差异均有统计学意义(P<0.05);无症状组MTT、TTP与脑出血组相比,差异均有统计学意义(P<0.05)。结论成人烟雾病出血型、缺血型及无症状型患者的脑动脉CTA改良法Suzuki分级及全脑CTP灌注参数具有一定的差异,对临床个性化诊疗具有指导意义。

靳三针联合康复训练在脑卒中后假性球麻痹吞咽功能障碍中的应用价值研究

目的:探究靳三针联合康复训练在脑卒中(CA)后假性球麻痹(PBP)吞咽功能障碍中的应用价值。方法:将符合纳入标准的92例CA后PBP吞咽功能障碍患者进行研究,按照简单随机法分为观察组和对照组各46例,对照组给予康复训练治疗,观察组行康复训练及靳三针治疗,比较两组临床疗效、吞咽功能、舌喉吞咽能力[改良曼恩吞咽能力评估量表(MMASA)]、血清神经性因子水平及不良反应。结果:观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);治疗两周后,两组洼田饮水试验分级及评分均显著降低,差异有统计学意义(P<0.05),MMASA各维度评分、血清NGF、BDNF及IGF-1水平均显著升高,差异有统计学意义(P<0.05),NSE水平显著降低(P<0.05),且组间比较差异有统计学意义(P<0.05);治疗期间,两组患者均无明显不良反应。结论:CA后PBP吞咽功能障碍患者采用靳三针、康复训练联合治疗临床疗效可观,患者舌喉吞咽能力、神经功能均明显改善。

互动式头针对脑卒中恢复期患者平衡功能障碍的临床研究

目的探讨互动式头针对脑卒中恢复期患者平衡功能障碍的临床疗效。方法采用随机对照研究方法,收集2020年9月—2021年10月期间在该院就诊的97例患者,互动式头针组采用头针同时+平衡功能康复训练,传统头针组采用头针后+平衡功能康复训练。分析治疗前后的NIHSS、Berg平衡、Barthel评分的变化。结果治疗4周后,互动式头针组、传统头针组的NIHSS、Berg平衡、Barthel评分均较治疗前改善(均P<0.05),且互动式头针组改善NIHSS、Berg平衡、Barthel评分幅度优于传统头针组(均P<0.05)。结论互动式头针治疗脑卒中后平衡功能障碍较头针后平衡功能训练更有利于患者平衡功能的恢复及日常生活能力的提高,值得临床应用。