Background: The rate of brain death organ donation is continuously increasing worldwide. Intracerebral hemorrhage (ICH) is the leading cause of brain death and accounts for 30-68% of organ transplant cases. Aim: To identify the predictors of brain death (BD) upon admission to the intensive care unit (ICU) of comatose patients with spontaneous intracerebral hemorrhage (ICH). Materials and Methods: A prospective observational study was conducted on ICH deaths in the Stroke Department of Third State Central Hospital from January 1 to December 31, 2018, and statistical analysis was performed using SPSS 22.0. Approval for the study was obtained from the Research Council of the Third State Central Hospital. Result: The study included 138 (13.1%) inpatient stroke deaths in the Stroke Unit, of which 90 were ICH, 30 subarachnoid hemorrhage, and 18 ischemic strokes (p=0.006). Considering the age limit of up to 70 years, which is the criterion for brain-dead donors in Mongolia, out of the 42 ICH cases, 24 (57.1%) were male, and 18 (42.9%) were female (p=0.326). The mean age of these cases was 52.88±7.34, the mean GCS score at the time of hospitalization was 4.55±2.56, the mean NIHSS score was 31.5±7.81, and the mean volume of hematoma formed in 30 cases was 175.92±169.96 cm3 (each p<0.05). Mechanical ventilation durations occurred mostly in the first 0-2 hours and 2-6 hours (31% each), with the longest duration at 6-12 hours. Conclusion Patients with ICH who present with poor mental status on hospital admission (GCS<7), severe stroke on clinical assessment (NIHSS>32), extensive cerebral hemorrhage on computed tomography (CT) imaging, and early requirement for mechanical ventilation have a high likelihood of progression to brain death. These patients therefore represent a significant potential pool of organ donors.

Background: Cerebral cavernous malformations (CCM) present with varied symptoms and are diagnosed only on MRI, which shows characteristic appearances. Genetic factors play a role, with familial cases following an autosomal dominant inheritance pattern. Case: This is the clinical case of a 48-year-old woman with a history of long-standing arterial hypertension. She was admitted to the Stroke Department with headache, nausea, vomiting, right-sided sensory disturbance, and dysarthria. Based on the clinical presentation and MRI, multiple supra- and infratentorial and intraxial lesions with heterogeneous components were identified, exhibiting hypointense rings on T1- and T2-weighted sequences and a “blooming” effect on T2*/GRE sequences, characteristic of cerebral cavernomas, displaying a “popcorn” appearance. Conclusion In CCM, management requires a multidisciplinary approach, with surgical resection the gold standard for symptomatic cases. Accurate determination of familial or sporadic origin is crucial for tailored treatment.

Background: A child’s physical growth is fundamentally dependent on hormonal regulation, metabolism, and oxygen supply, within which bone mineralization specifically calcium (Ca²⁺) levels acts as a primary factor determining bone mineral density (BMD), muscle function, and hormonal activity. In cardiovascular disease (CVD), multiple physiological processes are disrupted at various levels, including decreased blood circulation and oxygen supply, increased energy expenditure, and reduced absorption of nutrients and micronutrients. In this context, research linking calcium levels in 6–7-year-old children with electrocardiographic (ECG) changes to physical growth has been scarce, which provided the rationale for conducting this study. Aim: To investigate the association between calcium levels and physical growth among 6–7-year-old children with electrocardiographic (ECG) abnormalities detected through early screening. Materials and Methods: This study was conducted using a case-control design. The case group included 143 children aged 6–7 with ECG changes, and the control group included 153 children without ECG changes, totaling 296 voluntary participants. Serum total calcium and albumin levels in both groups were measured using a fully automated biochemical analyzer. Statistical analysis was performed using SPSSv27, applying independent samples t-tests, ANOVA, and correlation analysis to compare means between the two groups. Results: The control group’s serum total calcium was 2.65±0.15 mmol/L, corrected calcium was 2.58±0.13 mmol/L, and the case group’s serum total calcium was 2.64±0.18 mmol/L, corrected calcium was 2.59±0.17 mmol/L, with no statistically significant difference observed between the study groups (p>0.05). When comparing total calcium in case-group children with normal height (2.66±0.20) versus those with stunted growth (2.61±0.13), a statistically significant difference was found (p<0.05). Correlation analysis between total and corrected calcium levels and physical growth indicators across study groups showed no statistically significant association. When height measurements were divided into four quartiles (Q1–Q4) and compared against total and corrected serum calcium, no statistically significant differences were found between the groups. Conclusions Comparison of physical growth and development Z-scores between children with and without ECG abnormalities revealed no statistically significant differences. However, total calcium levels tended to be lower among children with normal growth compared with those with growth retardation in the case group (p < 0.05). No statistically significant differences were observed in serum total or albumin-corrected calcium levels between the study groups (p > 0.05). When height measurements in the study groups were categorized into quartiles, no statistically significant differences in total or albumin-corrected calcium levels were observed between the groups. This suggests that calcium levels alone may not be a decisive determinant of physical growth in children of the same age.

Background: Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a rare neurodegenerative disease characterized by cerebral white matter abnormalities, which leads to progressive cognitive and motor dysfunction that usually presents in a middle-age. We present the pedigree, clinical, and imaging findings of familial cases with similar clinical features suggestive of progressive multiple sclerosis. Among our cases, two had died and the remaining one case is still alive, but with clinical symptoms getting worse, such as unable to verbally express themselves, unable to take care of themselves, worsening social relations and work abilities. Conclusion Because the clinical features and neuroimaging findings of inflammatory and neurodegenerative disorders of the nervous system often overlap, the definitive diagnostic test for ALSP (Adult-onset Leukoencephalopathy with Axonal Spheroids and Pigmented Glia) is genetic testing to identify CSF1R gene mutations. Although genetic testing is currently unavailable, it is advisable in clinical practice to apply diagnostic criteria and pay close attention to family history and characteristic neuroimaging findings when evaluating patients with progressive motor, cognitive, and language decline in order to suspect this condition.

Introduction: In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few clinical studies have been performed to date. Timely identification and control of cardiovascular risk factors are priority objectives for adequate primary and secondary prevention of CES. Goal: The goal of this study was to describe risk factors for CES in our setting. Results: The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of 176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%). The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main cerebrovascular risk factors were hypertension and dyslipidemia. Conclusion CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all patients with hypertension and non-valvular AF should be meticulously screened for prevention of CES.