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Endovascular intervention in treating acute cerebral stroke: a report of 32 cases

Yingchao JING ; Xiaoteng YAO ; Dingke ZHENG ; Kejun LIU ; Yituan XIE ; Guojie JING

Chinese Journal of Neuromedicine.2014;13(6):610-613. doi:10.3760/cma.j.issn.1671-8925.2014.06.016

Objective To evaluate the effectiveness of endovascular intervention in treating acute cerebral stroke.Methods Thirty-two patients with acute cerebral stroke (22 with middle cerebral artery occlusion and 10 with internal carotid artery occlusion),admitted to and treated with endovascular intervention in our hospital from January 2010 to October 2013,were chosen in our study;14 were performed arterial thrombolysis+mechanical fragrnengation and 18 were performed mechanical fragrnengation+ solitaireAB stent thrombectomy.Retrospective analysis was performed on the clinical data and treatment efficacy,and the prevention experience of complications was concluded.Results CTA showed that complete recanalization was noted in 18 patients and partial recanalization in 5,with a recanalization rate reaching 7 1％.Postoperative symptomatic intracerebral hemorrhage was noted in 2 patients (6％) and 1 (3.1％) had large area of cerebral infarction.One month after the treatment,MRI indicated decreased areas of infarction in all patients.NIHSS scores were 4-6 points of all patients;favorable prognosis was noted in 23 patients (72％).Nine patients had heavy neurological dysfunction,with limb muscle strength less than grade Ⅲ.Conclusion Endovascular intervention in treating acute cerebral stroke can get high recanalization rate,and achieve good clinical outcome.

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Measurement of ankle-brachial index in patients with stroke subtypes and its clinical significance

Guoqiang ZHOU ; Jinsheng ZENG ; Zongqing HUANG ; Hongtao LIU ; Juan ZHANG

Chinese Journal of Neuromedicine.2014;13(6):614-620. doi:10.3760/cma.j.issn.1671-8925.2014.06.017

Objective To investigate the differences of ankle-brachial index (ABI) in patients with stroke subtypes to explore the clinical significance of ABI in stroke subtypes.Methods Four hundred and seventy-five patients,admitted to our hospital from January 1,2011 to December 30,2012,were classified into the different stroke subtypes by standard of the fourth national cerebrovascular conference:188 patients with atherothrombotic infarction,95 with lacunar infarction,73 with cardiogenic cerebral embolism,85 with intracerebral hemorrhage and 34 with subarachnoid hemorrhage.The normal controls consisted of patients who had no cerebrovascular diseases.ABI was measured in all subjects with Doppler ultrasonic measurement.Statistical analysis was used to analyze the influences of atherosclerosis hazards (including ABI) in stroke,and the difference of ABI in different subtypes of stroke.After adjusting other risk factors,the influence of ABI in stroke subtypes was evaluated alone.Results (1)Multiple factor logistic regression analysis showed that hypertension (odds ratio [OR]=3.963,95％confidence interval[CI]:2.128-6.982,P=0.0001),diabetes mellitus (OR=3.413,95％CI:1.785-4.905,P=0.039),smoking (OR=2.216,95％CI:1.942-6.025,P=0.020),and ABI (OR=2.425,95％CI:1.405-3.512,P=0.012) were significantly correlated with the presence of stroke.(2) Analysis of variance showed that there were significant differences in ABI between the atherothrombotic infarction group and the normal control group (P=0.015),between the lacunar infarction group and the normal control group (P=0.020),between the cardiogenic cerebral embolism group and the normal control group (P=0.037),and between the intracerebral hemorrhage group and the normal control group (P=0.023).After adjusting the risk factors of stroke,disorder multi-classification Logistic regression analysis showed that ABI was negatively correlated to atherothrombotic infarction (OR=2.832,95％CI:1.776-5.273,P=0.011),lacunar infarction (OR=2.527,95％CI:1.548-5.152,P=0.026),cardiogenic cerebral embolism (OR=1.922,95％CI:1.336-3.525,P=0.030),and intracerebral hemorrhage (OR=2.332,95％CI:1.243-4.165,P=0.021).Conclusions ABI is independently and strongly related to the risk of stroke.ABI can serve as screening index of atherothrombotic infarction,lacunar infarction,cardiogenic cerebral embolism,and intracerebral hemorrhage.

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Carotid artery plaque burden and composition characteristics measured by 3.0T MRI and its relationship with ischemic stroke

Jing ZHANG ; Xianlong WANG ; Hao YU ; Lyujin FENG ; Zhibo WEN

Chinese Journal of Neuromedicine.2014;13(6):621-626. doi:10.3760/cma.j.issn.1671-8925.2014.06.018

Objective To investigate the differences of carotid plaque burden,composition characteristics between index side and non-index side in patients with ischemic stroke by multi-contrast 3.0T MRI,and analyze their relationships with cerebral ischemic events.Methods Sixty-two ischemic stroke patients,admitted to our hospital from 2012 August to 2013 December,were chosen in our study;they all underwent brain routine 3.0T MR imaging examinations within 2 weeks of stoke onset; according to the ischemic signs,the index side and non-index side of the patients were recognized and noted; carotid artery multi-contrast MR imaging was,then,employed to distinguish the discriminant carotid artery plaque components (such as calcification,lipid rich necrotic core [LRNC],intraplaque hemorrhage [IPH])and measure the corresponding volume,to judge the carotid artery plaque fibrous cap surface state (complete or broken) measure the total vessel area,lumen area,wall thickness and calculation wall area and normalized wall index.Results A total of 120 carotid arteries met the inclusion criteria,including 85 in the index side and 35 in the non-index side.LRNC and IPH incidence rates between the index side and non-index side (71.7％ vs.22.8％; 12.9％ vs.0％) and volume (19.96 mm3 [0 mm3,61.91 mm3] vs.0mm3 [0 mm3,0 mm3]; [0 mm3,58.73 mm3] vs.[0 mm3,0 mm3]) were statistically different (P＜0.05).FCR incidence rate showed no significant difference between the index side and non-index side (P＞0.05).The carotid artery average and maximum wall area ([28.06±10.06] mm2 and [47.61±16.82] mm2),average and maximum wall thickness ([1.07±0.37] mm and [2.88±1.72] mm),and average and maximum wall standard index ([0.41 ±,0.09] and [0.54±0.16]) of index side had significant difference as compared with the non-index side([22.50±5.04] mm2 and [36.22±10.53] ram2; [0.88±0.18] mm and [1.91±1.00] mm;[0.36±0.05] and [0.45±0.10],P＜0.05).Conclusion The 3.0T multi-contrast high resolution MRI of the carotid artery can quantitatively measure the carotid plaque burden and evaluate the plaque characteristics; the heavier the plaque burden,the more complex the components,the higher the cerebral ischemic events.

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Diagnosis and treatment characteristics of patients with pituitary adenomas having onset symptom of hyponatremia

Chunming XIAN ; Bing XING ; Renzhi WANG ; Wei LIAN ; Yong YAO ; Kan DENG

Chinese Journal of Neuromedicine.2014;13(6):627-629. doi:10.3760/cma.j.issn.1671-8925.2014.06.019

Objective To discuss the etiology,clinical features and treatments of patients with pituitary adenomas having onset symptom of hyponatremia.Methods Retrospective analysis was performed on etiology,clinical features and treatment methods of 28 patients with pituitary adenomas having onset symptom ofhyponetramia,admitted to our hospital from Jantary 2003 to December 2012.Results Among 28 patients,27 had non-functional pituitary adenomas and one prolactinoma; 23 had pituitary macroadenomas and 5 giant adenomas; 22 achieved total tumor resection through transsphenoidal approach,2 subtotal removal and 4 received conservative therapy.In total,13 were combined with hypocortisolism,8 with hypothyroidism,5 with both hypocortisolism and hypothyroidism,and 2 with hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone in preoperative evaluation.Hyponatremia was corrected by hormone replacement therapy and water limitation during perioperative and postoperative period.Conclusions Pituitary adenomas with onset symptom of hyponatremia are mostly non-functional pituitary macroadenomas.Pituitary adenoma resection is the first-line treatment; hyponatremia and anterior pituitary hypofunction should be corrected in perioperative period,and close postoperative follow-up is necessary.

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Ruptured central nervous system tumors with fat droplets in the cerebrospinal fluid :a report of three cases and literature review

Linghui MENG ; Jie HE ; Jianling CUI

Chinese Journal of Neuromedicine.2014;13(6):630-632. doi:10.3760/cma.j.issn.1671-8925.2014.06.020

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Molecular mechanism of protection of uric acid on dopaminergic neurons

Ning ZHANG ; Qilin ZHANG ; Weifeng LUO

Chinese Journal of Neuromedicine.2014;13(6):635-638. doi:10.3760/cma.j.issn.1671-8925.2014.06.022

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Recent advance in molecular imaging tracing endogenous neural stem cells involved in neurogenesis

Yuqin YE ; Xiaosheng HE

Chinese Journal of Neuromedicine.2014;13(6):639-642. doi:10.3760/cma.j.issn.1671-8925.2014.06.023

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Recent advance in dural tail sign of meningiomas

Huaibin CHEN ; Jian ZHANG ; Xueyuan HENG ; Chang FEI

Chinese Journal of Neuromedicine.2014;13(6):643-644. doi:10.3760/cma.j.issn.1671-8925.2014.06.024

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Recent advance in magnetic resonance imaging in brain lesions of neuromyelitis optica

Chen CHENG ; Xueqiang HU

Chinese Journal of Neuromedicine.2014;13(6):645-648. doi:10.3760/cma.j.issn.1671-8925.2014.06.025

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Effect of plumbagin on growth and invasion of glioma cell lines and its underlying mechanism

Chang CHAI ; Shuangyin HAN ; Laijun SONG

Chinese Journal of Neuromedicine.2014;13(7):654-658. doi:10.3760/cma.j.issn.1671-8925.2014.07.002

Objective To detect the effect of plumbagin on proliferation,apoptosis and invasion ofglioma cell lines,and investigate the underlying mechanism.Methods Glioma cell lines SWO-38 and U251 were routinely cultured in vitro,and treated with various concentrations of plumbagin (0-50 μmol/L) for 48 h; cell viability changes were detected by MTT assay,and median inhibitory concentration (IC50) was calculated; after 0,2.5,5 and 10 μmol/L plumbagin treatment for 48 h,cell apoptosis was detected by annexin V/propidium iodide double-labeled flow cytometry; scratch test was used to observe the cell invasion and migration; Western blotting was used to assess the SOX2 protein expression; MiR200b,miR200c,miR-203 and miR-21 expression changes were examined by real-time quantitative PCR.Results Plumbagin dose-dependently inhibited the proliferation of the glioma cells;the IC50 values ofplumbagin in SWO-38 and U251 cells were 6.8 and 7.4 μmol/L,respectively.After 0,2.5,5 and 10 μmol/L plumbagin treatment for 48 h,cell apoptosis ratio was gradually increased,and MiR200b,miR200c,miR-203 expressions gradually increased,with significant differences (P＜0.05).Cell invasion and migration in these two cell lines were decreased and the SOX2 protein expression was decreased.Conclusion Plumbagin inhibits cell growth,induces apoptosis,and decrease cell invasion and migration,which might be related to the increase ofmiR200b,miR200c and miR-203 expressions and the decrease of SOX2 protein expression.

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