1.Influencing factors of hematoma enlargement after spontaneous intracerebral hemorrhage
International Journal of Cerebrovascular Diseases 2016;24(12):1080-1084
Objective To investigate the influencing factors of hematoma enlargement after spontaneous intracerebral hemorrhage. Methods The patients with spontaneous intracerebral hemorrhage were enrolled retrospectively in the study. The demographics, vascular risk factors, and baseline clinical data of the patients were collected. Hematoma enlargement was defined as CT scan within 48 h showed that the increased hematoma volume was more than >1/3 of the baseline. The demographics, vascular risk factors, and baseline clinical data of the hematoma enlargement group and the non-hematoma enlargement group were compared. Multivariate logistic regression analysis was use to identify the risk factors for hematoma enlargement. Results A total of 121 patients with spontaneous intracerebral hemorrhage were enrolled, including 69 males and 52 females, their ages were 24 to 89 years (mean 59.16 ±12.68). Forty-five patients (37.2%) had combined hypertension, 5 (4.1%) had diabetes, and 11 (9.1%) had hyperlipoidemia. Thirty patients (24.79%) had hematoma enlargement within 48 h. The time from ictus to the first CT scan was 4.21 ±1.57 h and the time from ictus to CT scan again was 34.78 ±6.90 h. Univariate analysis showed that the proportion of patients drinking alcohol (46.7% vs.26.4%; χ2 =4.313, P =0.038), as well as systolic blood pressure (174.53 ±20.02 mmHg vs.160.63 ±19.79 mmHg, t = -3.327, P = 0.001; 1 mmHg = 0.133 kPa), fasting blood glucose (7.67[6.70-9.47]mmol/L vs.6.78[5.81- 7.79]mmol/L; Z = -2.266, P =0.023), National Institutes of Health Stroke Scale (NIHSS) score (10.00[8.00-12.00] vs.5.00[3.00-8.00]; Z = -5.468, P < 0.001) in the hematoma enlargement group were significantly higher than those in the non-hematoma enlargement group, while low-density lipoprotein cholesterol (2.60[2.10- 2.91]mmol/L vs.3.00[2.60-3.41]mmol/L; Z = -3.905, P <0.001) was significantly lower than that in the nonhematoma enlargement group. Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio [OR] 1.036, 95% confidence interval [CI] 1.007-1.065; P =0.014) and NIHSS score (OR 1.310, 95% CI 1.111-1.544; P =0.001) were the independent risk factors for hematoma enlargement, while low –density lipoprotein cholesterol (OR 0.279, 95% CI 10.105-0.742; P =0.011) was the independent protective factor for hematoma enlargement. Conclusions Systolic blood pressure and NIHSS score were the independent risk factors for hematoma enlargement after spontaneous intracerebral hemorrhage, while low -density lipoprotein cholesterol was the independent protective factor for hematoma enlargement.
2.Decision-making under risk condition in patients with Parkinson' s disease
Huijuan MA ; Sunhong YAN ; Xianwen CHEN ; Kai WANG
Chinese Journal of Neurology 2011;44(12):810-813
Objective To investigate the ability of decision making under risk condition in patients with Parkinson' s disease (PD),and to explore the neural relationship between basal ganglia and the decision-making ability.Method Twenty-five PD patients and 25 healthy controls (HC) were investigated by Game of Dice Test (GDT) with explicit probability.Results PD patients performed poorly in the entire task,selecting more risky options ( PD:10.88 ± 5.58 ; HC:5.72 ± 3.69 ; t =3.86,P < 0.01 ),compared with healthy controls.In general,the final asset of PD group was negative while the result of HC group was always profitable and the difference was significant ( PD:- 3748.00 ± 3923.87 ; HC:684.00 ± 1764.62 ; t =-5.15,P < 0.01 ).The most frequent choice made by PD patients was one number,which is the most risky one.Accordingly,the most frequent choice made by HC group was three numbers (one number:PD:6.48 ±5.81;HC:1.00 ± 1.44;t =4.58,P <0.01; three numbers:PD:2.64 ±2.14;HC:7.04 ±2.54;t =-6.62,P < 0.01 ).The frequency of choosing the risky options was correlated with the rate of using negative feedback( r =-0.59,P =0.003 ),and the result of Stroop test( r =0.55,P =0.004).Conclusion Present study has shown that PD patients have significant impairments in decision-making under risk condition,and the impairments are correlated with executive function and negative feedback.
3.Correlation between white matter hyperintensity and early neurological deterioration after intravenous recombinant tissue plasminogen activator thrombolysis in acute ischemic stroke patients
Xueyun LIU ; Qi FANG ; Xiaosan WU ; Sunhong YAN ; Long WANG ; Chuanqin FANG
Chinese Journal of Neuromedicine 2022;21(3):257-262
Objective:To investigate the effects of white matter hyperintensity (WMH) of different lesion areas and severities on early neurological deterioration (END) in acute ischemic stroke (AIS) patients after intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis.Methods:Three hundred and seventy-three AIS patients, admitted to our hospital from April 2019 to July 2021, were chosen in our study. These patients were treated with intravenous rt-PA thrombolysis within 4.5 h of onset. According to the presence or absence of END, these patients were divided into END group ( n=89) and non-END group ( n=284). Fazekas scale was used to assess the periventricular WMH (PVWMH) and subcortical WMH (SCWMH): none-mild PVWMH/SCWMH was defined at 0-1 score and moderate to severe PVWMH/SCWMH was defined at 2-3 scores; the sum scores of the two sites were calculated, and none-mild WMH was defined at 0-2 scores and moderate-severe WMH was defined at 3-6 scores. Univariate analysis was used to compare the baseline data of the two groups, and multivariate Logistic regression was used to determine the correlations of END with WMH lesion areas and severities. Results:Univariate analysis showed that there was significant difference between the END group and non-END group in age, baseline blood glucose, baseline National Institutes of Health Stroke Scale (NIHSS) scores, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification, hemorrhagic transformation after thrombolysis, and PVWMH, SCWMH, and WMH scores ( P<0.05). Multivariate Logistic analysis showed that only baseline NIHSS scores ( OR=1.064, 95%CI: 1.019-1.111, P=0.005), hemorrhagic transformation after thrombolysis ( OR=3.931, 95%CI: 2.007-7.701, P=0.000), moderate-severe WMH ( OR=4.736, 95%CI: 2.737-8.195, P=0.000), and moderate-severe SCWMH ( OR=5.557, 95%CI: 3.156-9.783, P=0.000) were independently related to the occurrence of END. Conclusion:Patients with moderate-severe SCWMH, moderate-severe WMH, or high NIHSS scores after thrombolysis trend to have END.