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Objective To compare the efficacy and safety between Solitaire AB thrombectomy and intravenous thrombolysis in cardiogenic cerebral embolism.Methods Retrospective analysis of clinical data of 41 patients with cardiogenic cerebral embolism,admitted to our hospital from January 2012 to May 2015,was performed.According to different treatments,these patients were divided into Solitaire AB thrombectomy group (n=15) and intravenous thrombolysis group (n=26);patients in the Solitaire AB thrombectomy group were performed Solitaire AB thrombectomy,and patients in the intravenous thrombolysis group were given recombinant tissue plasminogen activator (rt-PA) or urokinase to achieve thrombolysis.Clinical outcomes were compared between two groups such as recanalization rates (thrombolysis in cerebral infarction [TICI] ≥ 2B),changes of NIHSS scores after 24 hours (scores decreased equal to or at least 4 points or complete resolution of symptoms),cerebral hemorrhage rate (European Cooperative Acute Stroke Study Ⅱ standard),modified Rankin scale (mRS) score improvement and mortality 90 days after treatment.Results In patients from Solitaire AB thrombectomy group,the recanalization rate was 86.67％ (13/15),10 patients (66.67％) got good outcomes in NIHSS scores,one patient (6.67％) occurred symptomatic cerebral hemorrhage;90 days after treatment,the rate of good prognosis (mRS 0-2) was 53.33％ (8/15) and no patients died.In patients from intravenous thrombolysis group,the recanalization rate was 46.15％ (12/26),9 patients (34.62％) got good outcomes in NIHSS scores,1 1 patients (42.31％) occurred symptomatic cerebral hemorrhage;90 days after treatment,the rate of good prognosis (mRS 0-2) was 23.08％ (6/26) and 8 patients (30.77％) died.The above data comparisons between two groups were statistically significant (P＜0.05).Conclusion As compared with intravenous thrombolysis,Solitaire AB thrombectomy has better efficacy and safety in the treatment of cardiogenic cerebral embolism.
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ObjectiveToinvestigatetheriskfactorsforunfavorableoutcomeinpatientswithminor ischemic stroke. Methods Patients with minor ischemic stroke were enroled prospectively. The modified Rankin Scale ( mRS ) w as used to assess the clinical outcome at day 90 after onset, and mRS 0-2 w as defined as favorable outcome. The demographic data, vascular risk factors, clinical data, imaging data, stroke etiologic subtypes, laboratory test results, and treatment methods in the favorable outcome group and unfavorable outcome group w ere compared. Multivariate logistic regression analysis w as used to identify the independent risk factors for early poor outcome in patients w ith minor ischemic stroke. Results A total of 516 patients with minor ischemic stroke were enroled. At day 90 after onset, 90 patients (17.44%) had unfavorable outcome and 426 (82.56%) had favorable outcome. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.045, 95% confidence interval [CI] 1.017-1.074; P=0.002), heart diseases (OR 2.021, 95%CI 1.063-3.841; P=0.032), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.662, 95%CI 1.177-2.347; P=0.004), limb movement disorder ( OR 2.430, 95%CI 1.010-5.850; P=0.048), ataxia (OR 2.929, 95%CI 1.188-7.221;P=0.020), early neurological deterioration ( OR 50.994, 95%CI 17.659-147.258; P<0.001), infarct diameter ( OR 1.279, 95%CI 1.075-1.521; P=0.005), non-responsible vascular stenosis ( OR 2.518, 95%CI 1.145-5.536;P=0.022), and large artery atherosclerotic stroke ( OR 2.010, 95%CI 1.009-4.003; P=0.047) w ere the independent risk factors for unfavorable outcome in minor ischemic stroke. Conclusions The early poor outcome of minor ischemic stroke is closely associated w ith age, heart diseases, baseline NIHSS score, limb movement disorder, ataxia, early neurological deterioration, infarct diameter, non-responsible vascular stenosis, and large artery atherosclerotic stroke. The relevant examinations need to be improved early, the etiologic subtype should be identified, and the correct clinical treatment should be guided.
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Objective To investigate the changes in brain MRI scan in neuromyelitis optica (NMO).Methods MRI images in 27 cases with NMO were examined in a retrospective study.Results Twenty-two of 27 patients (81.5%) had abnormal brain MRI findings,which were classified as nonspecific (7 cases),atypical (1 case),multiple sclerosis-like (3 cases) and ventricle-aqueduct-syringocoele lesions (11 cases).The lust type is the most common (40.7%).Furthermore,the analysis showed that the number of brain lesions positively correlated with lag time from the onset to the last MRI scan (r=0.475,P=0.025).Conclusions Brain lesions in NMO are diverse,which might result from different pathogenesis.However,ventricle-aqueduct-syringocoele is the most common lesion.Early brain MRI examination of suspected cases is essential.
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Objective To investigate the characteristic MRI appearance of neuromyelitis optics (NMO) and muhip]e sclerosis (MS) in the spinal cord.Methods Twenty cases of MS and 23 cases of NMO were examined by MRL All image appearances were analyzed.Results The characteristic MRI appearance of NMO patients in the spinal cord was linear medullary lesion (LML), linear medullospinal lesion (LMSL), linear spinal lesion (LSL) and longitudinally extensive transverse myelitis (LETM), and spinal cord MRI with contiguous T2-weighted signal abnormality extending over 3 or more vertebral segments (23 cases), while in MS, spinal cord MRI with contiguous T2-weighted signal abnormality often extended less than 3 vertebral segments (only 12 cases, χ2 = 19.142, P < 0.01), and the distribution of spinal lesion usually was eccentric (17 cases, compared with NMO group, χ2 = 25.256, P < 0.01).Conclusions NMO is distinct from MS.In MRI, spinal lesion in NMO usually conforms to the distribution of aquaporin 4, while spinal lesion in MS always conforms to the demyelination.NMO has neuroimaging features that move it ever closer to distinct disease status.