[The efficacy of donepezil for post-stroke aphasia: a pilot case control study.].

OBJECTIVE: To evaluate the efficacy of donepezil for post-stroke aphasia. METHODS: Sixty patients with acute post-stroke aphasia were divided into treatment group and a control group. All patients had been treated for secondary prevention according to the guideline. The treatment group received donepezil hydrochloride (5 mg/d) for 12 weeks. The efficacy of treatment was measured by comparing the changes of scores of Western Aphasia Battery (WAB) between baseline and 12 weeks later. RESULTS: Compared with the baseline, the changes of scores of all items of WAB and Aphasia Quotient (AQ) in both group after 12 weeks follow-up were great, however, the change of AQ was significantly greater in donepezil group (34.14 +/- 17.70)than that in control group (20.69 +/- 17.26)(P = 0.004). The patients in donepezil group also showed significant recovery in spontaneous speech, comprehension, repetition, and naming than those in control group (P < 0.05). The rate of significant improving in donepezil group was 60.0% which was significantly greater than that in control group (26.7%) (P = 0.009). CONCLUSION: There are spontaneous recovery of post-stroke aphasia within 3 months. Donepezil may facilitate the recovery in spontaneous speech, comprehension, repetition, and naming functions.

[The clinical characteristics of patients with posterior circulation ischemic stroke].

OBJECTIVE: To describe the clinical features of patients with posterior circulation ischemic stroke. METHODS: 216 patients with posterior circulation ischemic stroke admitted in our department during 2004-2006 were analyzed retrospectively. All patients were undertaken MRI on admission and responsible lesions were identified at the posterior circulation territories. The patients' clinical symptoms and signs were evaluated and the relationships between lesion locations and clinical characteristics were analyzed. RESULTS: The common symptoms of posterior circulation ischemic stroke were unilateral limb weakness (81.9%), speech difficulty (46.3%), dizziness (33.8%), and unilateral limb numbness (31.0%). The common signs of posterior circulation ischemic stroke were unilateral limb weakness (81.9%), central facial or lingual palsy (61.1%), dysarthria (46.3%), unilateral limb sensory loss (31.0%), and ataxia (30.1%). The incidence of crossed paralysis was low (2.8%). Isolated vertigo was rare (1.4%). Predominant clinical features such as bulbar paralysis, unconsciousness, visual disorder and amnesia can help to localize the lesions. Typical brainstem syndromes had topographic meanings. CONCLUSIONS: The clinical features of patients with posterior circulation ischemic stroke were complex. Predominant symptoms can help to diagnose the posterior circulation ischemic stroke.

[The impact of stroke clinic on improving the compliance with the guidelines for secondary prevention of ischemic stroke].

OBJECTIVE: With the physician training program and stroke clinic, the gap between clinical practice and the guideline for secondary prevention of ischemic stroke can been narrowed. METHODS: 305 patients with ischemic stroke were enrolled in a stroke clinic after their discharge from the hospital. Among the 305 patients, 87 were discharged before the institution of a physician training program (pre-training group) and 218 after the institution (post-training group). Their usage of antithrombotic agents, statins, non-standardized therapies and antihypertensive agents were compared at the time of discharge from the hospital and follow-up in the stroke clinic comparison was also made for the two groups of patients discharged before and after the physician training program. RESULTS: After the physician training program, implementation rates increased for antithrombotic agents (79.3% vs 93.1%, P < 0.01) and statins (19.5% vs 59.2%, P < 0.01), using of non-standardized therapies decreased (47.1% vs 27.5%, P = 0.001), but no change was found for using of antihypertensive agents (88.4% vs 94.0%, P > 0.05). Comparing with the usage of medications at the time of discharge, the usage of antithrombotic agents and statins after discharge i,e. in the stroke clinic were further increased (for antithrombotics, in the pre-training group 79.3% vs 86.2%, P = 0.229, in the post-training group 93.1% vs 94.0%, P = 0.696; for statins, in the pre-training group 19.5% vs 39.1%, P = 0.005, in the post-training group 59.2% vs 69.7%, P = 0.021), while the usage of non-standardized therapies decreased further (in the pre-training group 47.1% vs 17.2%, P < 0.01, in the post-training group 27.5% vs 14.2%, P = 0.001). Implement of guideline at discharge influenced the compliance as the patients with high rates of usage of antithrombotic agents and statins at the time of discharge had also high rates of the usage of them at follow-up in the stroke clinic. CONCLUSIONS: Physician training program increases the implement of the guideline for secondary stroke prevention and stroke clinic can improve the compliance with it. Usage of medications at the time of discharge influences the compliance with them during the follow-up period.

Age- and gender-specific prevalence of risk factors in patients with first-ever ischemic stroke in china.

Background. Evidences are accumulating that age and gender have great impact on the distribution of stroke risk factors. Such data are lacking in Chinese population. Methods. 1027 patients with first-ever ischemic stroke (IS) were recruited and divided into young adult (<50 years), middle-aged (50∼80 years), and very old (>80 years) groups according to stroke onset ages. Vascular risk factors were collected and compared among groups. Results. Female patients were globally older than male patients at stroke onset and having higher prevalence of diabetes mellitus (DM), heart diseases, and atrial fibrillation (AF). However, females were less likely to drink heavily or smoke than males. Young patients had a much higher proportion of smoking and drinking than middle-aged and very old patients and the highest family history of hypertension, while very old patients had the highest prevalence of heart diseases and AF but lowest proportion of positive family history of vascular diseases. Hypertension and DM were equally frequent among three groups. Conclusion. Our study showed that vascular risk factors had a specific age and gender distribution pattern in Chinese IS patients. Secondary prevention strategy should emphasize on the control of different risk factors based on patient's age and gender.