Intravenous Alteplase in a Patient With Acute Ischemic Stroke Subsequent to Purulent Meningitis: A Case Report and Literature Review.

This report highlights the outcome of intravenous alteplase in a patient with acute ischemic stroke subsequent to purulent meningitis. This type of meningitis has not been defined in the guideline for early treatment of acute ischemic stroke. A 58-year-old woman with purulent meningitis developed a sudden stroke and was admitted to our emergency department. She received 0.6 mg/kg of alteplase intravenously 90 minutes after stroke onset. At 1 hour after thrombolysis, the patient's National Institute of Health Stroke Scale score improved from 9 to 4. At 2 hours, she developed a sudden severe headache that progressed to coma, and her National Institute Health Stroke Scale score rapidly deteriorated to 20. Cranial computed tomography revealed subarachnoid hemorrhage and multiple bilateral lobar brain hemorrhages. She died of a cerebellar tonsillar hernia. Intravenous alteplase might be hazardous in patients with acute ischemic stroke subsequent to purulent meningitis.

The rs3129882/rs4248166 in HLA-DRA and rs34372695 in SYT11 are not associated with sporadic Parkinson's disease in Central Chinese population.

BACKGROUND: Parkinson's disease (PD) is a common progressive neurodegenerative disorder. Up to now, several single-nucleotide polymorphisms (SNPs) located in virulence gene sites have been reported linked to PD. Candidate gene association studies and genome-wide association studies have identified rs3129882, rs4248166 in HLA-DRA and rs34372695 in SYT11 as risk factors for familial or sporadic PD. However, the association between variants of HLA-DRA, SYT11 and PD are still controversial, especially in the Central Chinese population. We here performed a case-control study to investigate whether HLA-DRA and SYT11 genes could predispose to sporadic PD in the Chinese population. METHODS: We investigate 486 PD patients and 457 age- and sex-matched controls from Central China to assess this association. RESULTS: In the allele model, the odds ratio (OR) result of rs3129882 was 0.905 (p = 0.287). Moreover, no significant difference was observed in the association between rs424816 (OR = 0.864, p = 0.106) and rs34372695 (p = 1.0) with PD risk. Genotypic analysis in SNP rs3129882, rs4248166 and rs34372695 indicated no significant association with PD. Subgroup analysis of our data showed age-onset and gender were not associated with either genotype or minor allele frequencies of rs3129882 and rs4248166. Moreover, the negative results were also observed in a meta-analysis of studies of rs3129882 from mainland China and Taiwanese population. CONCLUSIONS: Our results reveal that rs3129882, rs4248166 and rs34372695 do not confer significant risks for sporadic PD in the Central Chinese population.