OBJECTIVETo explore the influence of Chinese medicine constitution type on the susceptibility of hypertensive patients to intracerebral haemorrhage.

METHODSPrimary hypertensive patients were studied and divided into the hypertension and the hypertensive intracerebral haemorrhage groups, depending on whether or not the patients had intracerebral haemorrhage. The demographic characteristics, physiological characteristics, living habits, biochemical tests, other chronic diseases, Chinese medicine constitution type, etc. were collected and compared between the two groups. The neurological deficit in the hypertensive intracerebral haemorrhage group was also compared among the different constitution types.

RESULTSA total of 304 patients participated in this investigation, including 213 cases in the hypertension group and 91 cases in the hypertensive intracerebral haemorrhage group. The percentages of dampness-heat and qi-depression types in the intracerebral haemorrhage group were greater than those with the same types in the hypertension group (20.9% vs 6.1%, 22.0% vs 8.0%; P<0.05). The percentages of each constitution type were different between genders in both groups. In addition, there were more male cases (14/20) with qi-depression type and more female cases (7/8) with phlegm-dampness type in the hypertensive intracerebral haemorrhage group than those with the same types (3/17 and 9/34, respectively) in the hypertension group (P<0.05). The cases with phlegm-dampness and qi-depression types had greater levels of blood lipids in the intracerebral haemorrhage group than those with the same types in the hypertension group (P<0.05). Furthermore, the cases with the qi-deficiency type presented with a more severe neurological deficit than those with the other types (P<0.05).

CONCLUSIONSChinese medicine constitution type might have an impact on the susceptibility of hypertensive patients to have an intracerebral haemorrhage. The heat-dampness and qi-depression types might lead to greater susceptibility than the other types. In addition, the patient's gender and blood lipids might also influence the susceptibility along with the constitution type.

Aged ; Body Constitution ; Cerebral Hemorrhage ; etiology ; Disease Susceptibility ; pathology ; Female ; Humans ; Hypertension ; complications ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nervous System ; pathology

OBJECTIVETo investigate the value of susceptibility weighted imaging(SWI)in the diagnosis of hemorrhagic foci early after blast injury and its role in the outcome prediction.

METHODSTotally 30 rabbits with blast-induced cerebral blast injury were used in this study. After routine CT/MRI and SWI scanning,quantified analysis was performed in regions of interest using post-processing technology. After dissecting the brains of the experimental rabbits,the cerebral histopathological changes were observed,and the results were compared with SWI findings.

RESULTSIn these 30 rabbits,22,102,221,and 738 hemorrhagic foci were detected by CT,T1WI,T2WI,and SWI,respectively. The number of cerebral microbleeds detected by SWI was significantly larger than those revealed by conventional T1WI and T2WI(Χ(2)=10.00,P<0.01). Furthermore,the SWI imaging displayed the punctiform(n=315,42.7%),lamellar(n=218,29.5%),slinar(n=205,27.8%)hypointense foci,with clear margin. The number of hemorrhagic foci detected by SWI was positively correlated with survival(r=-0.667,P<0.05).

CONCLUSIONSSWI remarkably increases the detection rate of hemorrhagic foci(particularly microbleeds)in rabbits with cerebral blast injury. The number of cerebral microbleeds and location of foci are closely related with the outcomes and therefore may facilitate clinical managment.

Animals ; Blast Injuries ; complications ; diagnosis ; Brain ; pathology ; Brain Injuries ; diagnosis ; etiology ; Cerebral Hemorrhage ; diagnosis ; etiology ; Female ; Image Enhancement ; Magnetic Resonance Imaging ; methods ; Male ; Prognosis ; Rabbits

OBJECTIVETo investigate the impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) on cerebral microbleeds (CMBs) in patients with cerebral infarction.

METHODSConsecutive patients with acute cerebral infarction who had cerebral microbleeds shown by susceptibility-weighted imaging (SWI) were enrolled to undergo polysomnography (PSG). The patients were divided into two groups, namely non-OSAHS group with apnea-hypopnea index (AHI) less than 5 and OSAHS group with greater AHI, and the clinical and radiological features of cerebral microbleeds were compared between them.

RESULTSForty-nine patients were enrolled in this study, including 27 (55.1%) with both cerebral infarction and OSAHS and 22 (44.9%) with cerebral infarction but not OSAHS. A comparison of the risk factors showed that hypertension, a smoking history, and a history of stroke were more prevalent in patients with OSAHS than in those without OSAHS (P<0.05). The incidences of subclinical stroke in OSAHS and non-OSAHS patients were 37.0% (10/27) and 9.0% (2/22) (P<0.05), respectively. Neurological imaging revealed a greater number of cerebral microbleeds in OSAHS group than in non-OSAHS group (P<0.05). In OSAHS patients, 77.8% of the microbleeds were distributed in cortical-subcortical areas, 55.6% in the basal ganglia area, and 25.9% in the infratentorial area, as compared to the percentages of 50.0%, 40.9% and 50.0% in non-OSAHS patients, respectively (P<0.05). In OSAHS patients, 40.7% also had leukoaraiosis, and 48.1% had two or more causes, as compared to the percentages of 13.6% and 18.2% in non-OSAHS patients, respectively (P<0.05).

CONCLUSIONSOSAHS can be a risk factor for cerebral microbleeds. Patients with both cerebral infarction and OSAHS tend to have greater and more extensive lesions of cerebral microbleeds, more complicated cause of the disease, and a grater likeliness of stroke recurrence.

Aged ; Cerebral Hemorrhage ; etiology ; pathology ; Cerebral Infarction ; pathology ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Sleep Apnea, Obstructive ; complications ; pathology

OBJECTIVETo observe the effects of electroacupuncture (EA) on the apoptosis of brain tissue cells and the expression of Caspase-3 in the rats with cerebral-cardiac syndrome (CCS).

METHODSA total of 70 healthy SD rats were selected. Ten was randomly recruited as the sham-operation group, and the rest were used for CCS model preparation. Thirty successfully modeled rats were divided into the model group, the EA group, and the non-EA group, 10 in each group. The model was prepared using injecting collagenase + heparin into the caudate nucleus. Equal volume of 0.9% sodium chloride injection was injected to rats' caudate nucleus in the sham-operation group. EA was started on the 1st day of modeling. Shuigou (GV26), Fengfu (GV16), Neiguan (PC6), and Xinshu (BL15) were needled in the EA group. Four points in the hips were needled in the non-EA group. The EA needling lasted for 20 min each time, once daily, for 3 successive times. No EA was administered to the sham-operation group or the model group. The apoptosis of brain tissue around the hematoma and the expression of Caspase-3 were detected using TUNEL and immunochemical assay.

RESULTSTUNEL cells could be occasionally seen with fewer Caspase-3 expression in the sham-operation group. More TUNEL positive cells appeared in the tissue around the hematoma of the model group with a large amount of Caspase-3 expression. The TUNEL positive cells and Caspase-3 expression were obviously less in the EA group than in the model group and the non-EA group (P < 0.01).

CONCLUSIONSEA could inhibit the apoptosis of brain tissue cells in CCS rats. Its mechanisms might be associated with down-regulating the Caspase-3 expression of the brain tissue around the hematoma.

Animals ; Apoptosis ; Brain ; metabolism ; Caspase 3 ; metabolism ; Cerebral Hemorrhage ; complications ; metabolism ; pathology ; Electroacupuncture ; Heart Diseases ; etiology ; metabolism ; pathology ; Rats ; Rats, Sprague-Dawley

Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.
Animals ; Anthelmintics/therapeutic use ; Brain/parasitology/pathology ; Cerebral Hemorrhage/*etiology ; Child ; Dysarthria/etiology ; Facial Paralysis/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Paragonimiasis/*diagnosis/drug therapy/parasitology ; Paragonimus/isolation & purification ; Praziquantel/therapeutic use ; Tomography, X-Ray Computed ; Vascular Malformations/etiology

Paragonimiasis is caused by ingesting crustaceans, which are the intermediate hosts of Paragonimus. The involvement of the brain was a common presentation in Korea decades ago, but it becomes much less frequent in domestic medical practices. We observed a rare case of cerebral paragonimiasis manifesting with intracerebral hemorrhage. A 10-yr-old girl presented with sudden-onset dysarthria, right facial palsy and clumsiness of the right hand. Brain imaging showed acute intracerebral hemorrhage in the left frontal area. An occult vascular malformation or small arteriovenous malformation compressed by the hematoma was initially suspected. The lesion progressed for over 2 months until a delayed surgery was undertaken. Pathologic examination was consistent with cerebral paragonimiasis. After chemotherapy with praziquantel, the patient was monitored without neurological deficits or seizure attacks for 6 months. This case alerts practicing clinicians to the domestic transmission of a forgotten parasitic disease due to environmental changes.
Animals ; Anthelmintics/therapeutic use ; Brain/parasitology/pathology ; Cerebral Hemorrhage/*etiology ; Child ; Dysarthria/etiology ; Facial Paralysis/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Paragonimiasis/*diagnosis/drug therapy/parasitology ; Paragonimus/isolation & purification ; Praziquantel/therapeutic use ; Tomography, X-Ray Computed ; Vascular Malformations/etiology

Aged, 80 and over ; Amyloid beta-Peptides ; metabolism ; Brain ; pathology ; Cerebral Amyloid Angiopathy ; complications ; metabolism ; pathology ; Cerebral Hemorrhage ; etiology ; pathology ; Consciousness Disorders ; etiology ; pathology ; Humans ; Male

BACKGROUNDCerebral microbleeds (CMBs) occur frequently in patients suspected of cerebrovascular disease and they are the principle radiographic findings in patients with sub-clinical neurological impairment. The objective of this study was to assess the prevalence, distribution, severity and associated clinical features of CMBs in a prospective hospital patient based cohort undergoing brain MRI for suspected cerebrovascular disease, excluding cases with known intracranial hemorrhage or prior large-area stroke.

METHODSThe study population consisted of 447 patients who were evaluated with T2*-gradient echo sequences to detect the CMBs lesion number, location, and their association with white matter hyperintensities and clinical parameters, including blood pressure.

RESULTSCMB lesions were presented in 95 of the 447 patients (21.3%). The distribution of CMBs was 43.95% cortical, 19.77% thalamic, 14.41% in the brainstem, 11.58% cerebellar, 6.21% periventricular white matter, 5.64% involving the basal ganglia regions, and 0.28% involving the hippocampus. There was a statistically significant association between the presence of CMBs and advancing age (adjusted OR 2.082, P < 0.01), the severity of hypertension (adjusted OR 2.208, P < 0.01). Also there was a statistically significant (P < 0.01) correlation between the presence of CMBs and the severity of hypertension and white matter lesions.

CONCLUSIONSCMBs occur frequently in patients with no prior large-area stroke who were referred for brain MRI for suspected cerebrovascular disease. The severity of CMBs correlates with the severity of hypertension and the presence of cerebral white matter changes detected by MRI.

Aged ; Cerebral Hemorrhage ; epidemiology ; etiology ; pathology ; Female ; Humans ; Hypertension ; physiopathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Risk Factors ; Stroke ; complications ; epidemiology

Periventricular-intraventricular hemorrhage (PV-IVH) is a major cause of neurological disabilities in preterm newborns. This study aimed to determine the perinatal factors associated with PV-IVH. We conducted a retrospective case-control study from preterm infants born at < or =34 weeks of gestation and admitted to Neonatal Intensive Care Units of Seoul National University Children's Hospital and Seoul National University Bundang Hospital between June 2003 and December 2007. Neonates with no cranial sonographic data or infants transferred from other centers after three days of age were excluded. Of 1,044 eligible subjects, 59 infants with PV-IVH grade 2, 3, and 4 were allocated to the case group. The control group consisted of 118 infants without PV-IVH who were matched for gestational age and birth weight to each case of PV-IVH. At the multivariate logistic regression model, metabolic acidosis (odds ratio [OR]: 6.94; 95% confidence interval [CI]: 1.12-43.23) and use of inotropes (OR: 3.70; 95% CI: 1.16-11.84) were associated with an increased risk of PV-IVH. Maternal use of antenatal corticosteroids decreases the risk of PV-IVH (OR: 0.36; 95% CI: 0.14-0.92).
Acidosis/complications ; Adult ; Birth Weight ; Cardiotonic Agents/adverse effects ; Case-Control Studies ; Cerebral Hemorrhage/*etiology/pathology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/*etiology/pathology ; Male ; Odds Ratio ; Pregnancy ; Retrospective Studies ; Risk Factors

OBJECTIVETo analyze the risk factors of cerebral microbleeds (CMBs).

METHODSA total of 113 patients with cerebrovascular diseases underwent examinations of magnetic resonance imaging (MRI) of the brain (including T1WI, T2WI, FLAIR, and SWI) and blood biochemical tests, and the brain regions, number and grades of the CMBs were analyzed. The association between CMBs and the cardiovascular risk factors were analyzed.

RESULTSA The occurrence and grade of CMBs were associated with the patients' age, hypertension, diabetes, lacunar infarction, diastolic blood pressure, systolic blood pressure and high-density lipoprotein (HDL) levels (P<0.05). CMB occurrence was significantly associated with diabetes, hypertension, and lacunar infarction (P<0.05), and its incidence varied significantly between different brain regions (P<0.05).

CONCLUSIONAge, hypertension, diabetes, lacunar infarction, diastolic blood pressure, systolic blood pressure, and HDL are all risk factors for CMBs, among which diabetes, hypertension, and lacunar infarction are significant risk factors. CMBs occurs most frequently in the cortex and subcortical region, followed by the basal ganglia, thalamus, and the cerebellum, and most unlikely in the brainstem.

Cerebral Hemorrhage ; epidemiology ; etiology ; pathology ; China ; epidemiology ; Diabetes Complications ; Female ; Humans ; Hypertension ; complications ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Risk Factors