Redox status in acute ischemic stroke: correlation with clinical outcome.

Connection between oxidative stress and clinical outcome in acute ischemic stroke (AIS) has been poorly investigated. This study was aimed to assess redox state (through measurement of oxidative stress markers) of patients with acute ischemic stroke during different stages of follow-up period, and to find association between values of mentioned markers and clinical outcome. The investigation was conducted on 60 patients (both sexes, aged 75.90 ± 7.37 years) who were recruited in intensive care units at the Special Hospital for Cerebrovascular Diseases "Sveti Sava," Belgrade. After verification of AIS, patients were followed up in four interval of time: (1) at admission, (2) within 24 h after AIS, (3) within 72 h after AIS, and (4) 7 days after AIS. At these points of time, blood samples were taken for determination of oxidative stress parameters [index of lipid peroxidation (measured as TBARS), nitric oxide (NO) in the form of nitrite ([Formula: see text]), superoxide anion radical ([Formula: see text]), hydrogen peroxide (H2O2)], and enzymes of antioxidant defense system [superoxide dismutase (SOD) and catalase (CAT)] using spectrophotometer. Present study provides new insights into redox homeostasis during ischemic stroke which may be of interest in elucidation of molecular mechanisms involved in this life-threatening condition. Particular contribution of obtained results could be examination of connection between redox disruption and clinical outcome in these patients. In that sense, our finding have pointed out that [Formula: see text] and NO can serve as the most relevant adjuvant biomarkers to monitor disease progression and evaluate therapies.

Clinical characteristics and outcome in the acute phase of ischemic locked-in syndrome: case series of twenty patients with ischemic LIS.

BACKGROUND: Locked-in syndrome (LIS) is a condition characterized by quadriplegia and anarthria. The most common cause is a ventral pontine lesion due to atherosclerotic basilar artery disease. METHODS: Cases with LIS were prospectively identified among the patients with acute ischemic stroke over 3 years, between 2009 and 2011. Clinical characteristics, topographic localization of lesions, and outcome were determined during the first 6 months from onset of LIS. RESULTS: Our case series consists of 20 patients (mean age 62 ± 10 years; range 46-82). Initially 16 patients had a reduced level of consciousness (mean 3 days; range 1-15). Respiratory disturbance, mainly as impairment of the breathing pattern, was noted in all cases. Five patients died within the first 10 days due to stroke progression or cardiac arrest. In the remaining cases the most frequent causes of death were pulmonary infections and sepsis. Overall mortality in the acute phase of LIS is 75%, and the median survival time is 42 days. There was a statistically significant association between the more extensive parenchymal brain stem lesions and observed mortality. CONCLUSIONS: Ischemic LIS is commonly caused by an acute complete occlusion of the basilar artery due to atherosclerotic lesions in intracranial vertebrobasilar vessels. Mortality remains high in the acute phase of the disease.

EEG study of visual reactivity in aphasic patients.

AIM: To compare patients with good and poor recovery after 1 and 3 months from onset of poststroke aphasia and to correlate the quality of recovery with quantitative EEG (QEEG) measures (frequency analysis with the limits of variability, and index of asymmetry). METHODS: The investigation was performed on the sample of 32 patients with poststroke aphasia, 15 females (46.88%) and 17 males (53.12%), mean age +/- standard deviation (SD) being 50.65 +/- 9.93 years. QEEG measures of this sample were compared with those in a group of 86 healthy controls, 39 (45.35%) females and 47 (54.65%) males, mean age +/- SD being 51.08 +/- 10.08 years. Frequency analysis was performed in eyes closed and eyes open conditions in both controls and in aphasics who were tested just before and two month after rehabilitative treatment with speech therapy. RESULTS: We have got normal distribution for all derivations and all frequency bands in the group of healthy subjects. On the basis of this finding, we determined coefficients of variation in patients with poststroke aphasia and discovered that their maximal variability scores were significantly decreased. Compared to healthy subjects, the index of asymmetry between two hemispheres and between main brain regions was significantly higher in the aphasic patients than in controls. However, the differences in the index of asymmetry and limits of variability significantly decreased after two month treatment in the subgroup of patients with good improvement compared with the subgroup of patients with poor improvement of poststroke aphasia. CONCLUSION: QEEG measures may have predicitive value in post-stroke aphasia.