Diagnostic and prognostic role of resistin and copeptin in acute ischemic stroke.

OBJECTIVES: Our aim was to evaluate (i) whether there is a difference in the concentration of resistin and copeptin between acute ischemic stroke patients and stroke-free controls; and (ii) if there is any prognostic value of resistin and copeptin in predicting stroke infarct volume, stroke severity, and outcome. METHODS: Our case-control study has recruited 112 acute ischemic stroke patients admitted within 24 h after the stroke onset. We have also included 63 age and gender matched stroke-free controls. Resistin and copeptin levels were measured by a commercial ELISA kits. Stroke severity was assessed according to the modified National Institute of Health Stroke Scale (mNIHSS) and the degree of disability was assessed using Barthel index (BI). Stroke infarct volume was determined by the volumetric estimation. RESULTS: Resistin concentrations were significantly higher in patients (3.2 mg/L; IQR: 1.9-6.4) than in stroke-free controls (2.5 mg/L; IQR: 1.4-5.2; p = 0.024) whereas the concentration of copeptin did not differ between patients and controls. Copeptin concentrations were significantly higher in patients with poor functional outcome (Barthel index <60) (p = 0.021). There was a significant negative correlation between copeptin and BI score (ρ = -0.309, p = 0.020). DISCUSSION: Resistin, but not copeptin levels are higher in acute ischemic stroke patients early after the stroke onset, than in age and gender matched stroke-free controls. Moreover, higher copeptin concentrations are predictive of poor short term functional outcome after ischemic stroke. If confirmed in larger prospective studies, resistin and copeptin could improve clinical diagnosis of stroke and effective management of patient recovery.

Short Term Changes of Serum Lipids in Acute Ischemic Stroke.

BACKGROUND: Temporal pattern of lipids changes in stroke patients and its prognostic significance has not yet been fully understood. Our aim was to assess the early temporal changes of lipids in acute ischemic stroke patients and its prognostic significance in predicting stroke outcome. METHODS: Total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were measured at admission, 24 hours, 48 hours, 72 hours, and at discharge. Stroke outcome was assessed by infarct volume, neurological deficit at discharge and 90 days stroke mortality. We have included only patients for whom blood and all clinical data were available at all time points during the follow-up period. RESULTS: In our stroke cohort (n = 52) there was a mean decrease of HDL-cholesterol from admission to discharge (0.32 mmol/L, 23%), accompanied with an increase in triglyceride concentration of 0.3 mmol/L (8%). LDL-cholesterol and total cholesterol had an initial rise at 24 hours, followed by the subsequent fall at 48 hours, 72 hours, and at discharge. Decreased HDL-cholesterol at 48 hours after stroke onset and at discharge is associated with poor patient functional outcome. Patients with large infarct volume had significantly higher concentrations of total cholesterol and LDL-cholesterol at 24 hours, 48 hours, and at discharge than patients with small and medium infarct volume. CONCLUSIONS: Early after the onset of acute ischemic stroke there is a marked change in the concentration of serum lipids. Reliable assessment of lipid status cannot be done during the early period after the stroke onset.

[Tolosa-Hunt syndrome: a case report]. / Tolosa-Huntov sindrom: prikaz bolesnika.

Tolosa-Hunt syndrome is a nonspecific granulomatous inflammation of the cavernous sinus, superior orbital fissure and apex of the orbit. It involves episodes of unilateral orbital pain which may last several weeks, lesions of cranial nerve III, IV or VI, and rarely II, V, VII and VIII. It is characterized by remissions and exacerbations, and can cause permanent neurological disorder of the affected nerves. We present the course of the disease in a patient whose initial symptom was gradual visual loss in the right eye, followed by neuralgic pain in the right orbit and face. The diagnosis was confirmed by biopsy and corticosteroid therapy was administered. Exacerbation of the disease required repeated surgery, excision of the fibrous tissue of the cavernous sinus, as well as prolonged corticosteroid therapy.