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 cere...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.展开更多
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 ang...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.展开更多
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 retri...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.展开更多
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 i...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.展开更多
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 infarct...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.展开更多
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...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.展开更多
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 p...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) confirmed were randomly selected. MRI was performed on a Signal 1.5T MRI scanner before and after the intravenous administration of gadopentetate dimeglumine 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 15 patients indicated schistosomiasis haematobium. Contrast-enhanced T1-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which appeared “arborized”. Through operation and pathological examination, 8 cases had the granuloma formation of schistosomal 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. Conclusion 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.展开更多
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...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 histologically 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≥30ml 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, subarachnoid 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 hematomas 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.展开更多
Diagnosis of neurocysticercosis(NCC)based merely on computed tomography(CT)and magnetic resonance imaging may be doubtful when considering that parenchymal and extraparenchymal NCC are practically distinct clinical an...Diagnosis of neurocysticercosis(NCC)based merely on computed tomography(CT)and magnetic resonance imaging may be doubtful when considering that parenchymal and extraparenchymal NCC are practically distinct clinical and pathophysiological entities.In this letter,we comment on a recent case report by Rizvi et al.展开更多
Human cysticercosis is a neglected tropical parasitic zoonotic disease with high public health concerns. Infection of Taenia solium cysticerci in the brain commonly known as neurocysticercosis is a cause to over 29% o...Human cysticercosis is a neglected tropical parasitic zoonotic disease with high public health concerns. Infection of Taenia solium cysticerci in the brain commonly known as neurocysticercosis is a cause to over 29% of all epileptic cases in endemic countries. Unfortunately, this infection can go unnoticed for over 10 years. The objective of this review was to characterize the diagnostic approaches accessible in endemic poor resource countries. The review sought literature from library catalogues and public databases for studies on epidemiology and diagnosis challenges of human cysticercosis. The search key words included “Taenia solium, T. solium cysticercosis, human cysticercosis, neurocysticercosis and diagnosis”. Most of the diagnostic procedures rely on serology. Neuroimaging tools which would confirm and thus enable the assessment of the burden of the disease in endemic countries are rarely used. Therefore assessing the estimate on prevalence and burden of the disease fallacious is owing to the low sensitivity of serological tools and the inhibition of humoral, cellular immune responses, inflammatory reaction and cytokines by the living cysticerci.展开更多
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 no...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.展开更多
Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they m...Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they may also localize in a variety of tissues, including the tongue. Here, we described a case of a 21-year-old woman with a painless, firm, smooth, mucosa-colored nodule located in the lateral region of the tongue was seen by a dentist. An excisional biopsy was performed, and the surgical specimen was examined histomorphologically. The analysis revealed the presence of a cystic lesion containing a serrated larva (Cysticercus cellulosae) as well as a cystic capsule with predominantly mononuclear inflammation. The morphological findings were consistent with the diagnosis of cysticercosis of the tongue. The patient was followed for 22 months and showed no signs of recurrence.展开更多
目的探讨血清IL-11在急性脑梗死诊断和预后评估中的价值及其与血清脑源性神经营养因子(BDNF)的相关性。方法收集102例急性脑梗死患者(脑梗死组)和64名正常对照者(正常对照组)的一般临床资料。根据90 d mRS评分将脑梗死组分为预后良好亚...目的探讨血清IL-11在急性脑梗死诊断和预后评估中的价值及其与血清脑源性神经营养因子(BDNF)的相关性。方法收集102例急性脑梗死患者(脑梗死组)和64名正常对照者(正常对照组)的一般临床资料。根据90 d mRS评分将脑梗死组分为预后良好亚组和预后不良亚组。采用Pearson相关性分析血清IL-11和NIHSS评分、脑梗死体积、血清BDNF的相关性,Logistics回归分析脑梗死预后的影响因素,并绘制IL-11在脑梗死诊断和预后预测中的ROC曲线。结果脑梗死组高血压比率及糖化血红蛋白、低密度脂蛋白水平显著高于正常对照组(均P<0.05)。预后不良亚组的年龄、糖尿病比率、糖化血红蛋白水平、入院时NIHSS评分、脑梗死体积显著高于预后良好亚组(均P<0.05)。脑梗死组血清IL-11水平显著低于正常对照组(t=10.123,P<0.001)。脑梗死预后不良亚组血清IL-11水平显著低于预后良好亚组(t=7.438,P<0.001)。脑梗死患者血清IL-11表达与NIHSS评分(r=-0.603,P<0.001)及脑梗死体积(r=-0.681,P<0.001)呈负相关关系。Logistics回归分析显示,IL-11为影响脑梗死患者预后的保护性因素(OR=0.814,P=0.009),脑梗死体积(OR=2.262,P<0.001)和NIHSS评分(OR=2.107,P=0.006)为影响脑梗死预后的危险因素。当IL-11应用于脑梗死的诊断时,ROC曲线下面积为0.841,灵敏性为91.18%,特异性为72.42%,截断值为378.47;当IL-11应用于脑梗死预后预测时,ROC曲线下面积为0.786,灵敏性为67.09%,特异性为87.93%,截断值为310.94。脑梗死患者血清IL-11水平与血清BDNF水平的相关系数为r=0.711、P<0.01。结论脑梗死患者血清IL-11水平显著降低,且预后不良患者的IL-11水平显著低于预后良好亚组。同时,IL-11水平与血清BDNF水平呈负相关,可能可以用于脑梗死的辅助诊断和预后评估。展开更多
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...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。展开更多
基金supported by the National Natural Science Foundation of China,No.81730050(to WH).
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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.
文摘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) confirmed were randomly selected. MRI was performed on a Signal 1.5T MRI scanner before and after the intravenous administration of gadopentetate dimeglumine 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 15 patients indicated schistosomiasis haematobium. Contrast-enhanced T1-weighted images in 22 cases showed central linear enhancement surrounded by multiple enhancing punctate nodules, which appeared “arborized”. Through operation and pathological examination, 8 cases had the granuloma formation of schistosomal 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. Conclusion 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.
文摘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 histologically 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≥30ml 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, subarachnoid 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 hematomas 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.
文摘Diagnosis of neurocysticercosis(NCC)based merely on computed tomography(CT)and magnetic resonance imaging may be doubtful when considering that parenchymal and extraparenchymal NCC are practically distinct clinical and pathophysiological entities.In this letter,we comment on a recent case report by Rizvi et al.
文摘Human cysticercosis is a neglected tropical parasitic zoonotic disease with high public health concerns. Infection of Taenia solium cysticerci in the brain commonly known as neurocysticercosis is a cause to over 29% of all epileptic cases in endemic countries. Unfortunately, this infection can go unnoticed for over 10 years. The objective of this review was to characterize the diagnostic approaches accessible in endemic poor resource countries. The review sought literature from library catalogues and public databases for studies on epidemiology and diagnosis challenges of human cysticercosis. The search key words included “Taenia solium, T. solium cysticercosis, human cysticercosis, neurocysticercosis and diagnosis”. Most of the diagnostic procedures rely on serology. Neuroimaging tools which would confirm and thus enable the assessment of the burden of the disease in endemic countries are rarely used. Therefore assessing the estimate on prevalence and burden of the disease fallacious is owing to the low sensitivity of serological tools and the inhibition of humoral, cellular immune responses, inflammatory reaction and cytokines by the living cysticerci.
基金Supported by National Natural Science Foundation of China,No.81771154.
文摘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.
文摘Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they may also localize in a variety of tissues, including the tongue. Here, we described a case of a 21-year-old woman with a painless, firm, smooth, mucosa-colored nodule located in the lateral region of the tongue was seen by a dentist. An excisional biopsy was performed, and the surgical specimen was examined histomorphologically. The analysis revealed the presence of a cystic lesion containing a serrated larva (Cysticercus cellulosae) as well as a cystic capsule with predominantly mononuclear inflammation. The morphological findings were consistent with the diagnosis of cysticercosis of the tongue. The patient was followed for 22 months and showed no signs of recurrence.
文摘目的探讨血清IL-11在急性脑梗死诊断和预后评估中的价值及其与血清脑源性神经营养因子(BDNF)的相关性。方法收集102例急性脑梗死患者(脑梗死组)和64名正常对照者(正常对照组)的一般临床资料。根据90 d mRS评分将脑梗死组分为预后良好亚组和预后不良亚组。采用Pearson相关性分析血清IL-11和NIHSS评分、脑梗死体积、血清BDNF的相关性,Logistics回归分析脑梗死预后的影响因素,并绘制IL-11在脑梗死诊断和预后预测中的ROC曲线。结果脑梗死组高血压比率及糖化血红蛋白、低密度脂蛋白水平显著高于正常对照组(均P<0.05)。预后不良亚组的年龄、糖尿病比率、糖化血红蛋白水平、入院时NIHSS评分、脑梗死体积显著高于预后良好亚组(均P<0.05)。脑梗死组血清IL-11水平显著低于正常对照组(t=10.123,P<0.001)。脑梗死预后不良亚组血清IL-11水平显著低于预后良好亚组(t=7.438,P<0.001)。脑梗死患者血清IL-11表达与NIHSS评分(r=-0.603,P<0.001)及脑梗死体积(r=-0.681,P<0.001)呈负相关关系。Logistics回归分析显示,IL-11为影响脑梗死患者预后的保护性因素(OR=0.814,P=0.009),脑梗死体积(OR=2.262,P<0.001)和NIHSS评分(OR=2.107,P=0.006)为影响脑梗死预后的危险因素。当IL-11应用于脑梗死的诊断时,ROC曲线下面积为0.841,灵敏性为91.18%,特异性为72.42%,截断值为378.47;当IL-11应用于脑梗死预后预测时,ROC曲线下面积为0.786,灵敏性为67.09%,特异性为87.93%,截断值为310.94。脑梗死患者血清IL-11水平与血清BDNF水平的相关系数为r=0.711、P<0.01。结论脑梗死患者血清IL-11水平显著降低,且预后不良患者的IL-11水平显著低于预后良好亚组。同时,IL-11水平与血清BDNF水平呈负相关,可能可以用于脑梗死的辅助诊断和预后评估。
文摘脑小血管病(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。