Chinese Journal of Stroke

Value of the Technology

WANG Yong-Jun

2014, 9(11): 891-893.

Asbtract ( )

PDF (3089KB) ( )

References | Related Articles | Metrics

Prospect for “China Style” —the Management of Intravenous Thrombolysis in Acute Ischemic Stroke

LOU Min, ZHANG Sheng

2014, 9(11): 895-898.

Asbtract ( )

PDF (1505KB) ( )

References | Related Articles | Metrics

Magnetic Resonance Perfusion Parameter to Predict Hemorrhagic Transformation after
Intravenous Thrombolysis

CHEN Wei-Li, ZHANG Sheng, ZHANG Shun-Kai, LOU Min.

2014, 9(11): 899-904.

Asbtract ( )

PDF (2530KB) ( )

References | Related Articles | Metrics

Objective To test whether Tmax of magnetic resonance imaging (MRI) could predict cerebral parechymal hemorrhage (PH) after intravenous thrombolysis and then investigate its optimal threshold. Methods Acute ischemic stroke patients undergoing intravenous thrombolysis were retrospectively analyzed. Follow-up imaging of MRI or computed tomography (CT) within 24 hours was assessed for hemorrhagic transformation according to European Cooperative Acute Stroke Study (ECASS Ⅱ) system. The optimal threshold and the optimal volume of Tmax to predict PH were analyzed with receiver operating characteristic curve (ROC). The association of Tmax with PH was examined using Logistic regression. Results One hundred and twelve patients were analyzed, of whom 11 (9.8%) deveolped PH after thrombolysis. Tmax>8 s was the optimal threshold to predict PH (area under curve [AUC]=0.706, P =0.025). The volume >45 ml of hypoperfusion region (Tmax>8 s) was independently predictive of PH (P =0.014, odds ratio [OR]=13.95). There were no significant differences of the Tmax>14 s volumes or the ratio of Tmax>14 s/Tmax>8 s between PH group and non-PH group (P =0.064; P =0.74). Conclusion The MR perfusion parameter of Tmax>8 s was the optimal threshold to predict PH. Hypoperfusion volume, rather than hypoperfusion intensity, was associated with PH.

Analysis of the Effectiveness and Safety of Recombinant Tissue Type Plasminogen
Activator Therapy for Elder Patients with Acute Ischemic Stroke

YANG Jian-Dao, HU Li-Yan, SONG Yan-Yan, SHEN Lin-Da, WANG Shao-Shi.

2014, 9(11): 905-910.

Asbtract ( )

PDF (2646KB) ( )

References | Related Articles | Metrics

Objective To investigate the safety and effectiveness of recombinant tissue plasminogen activator (rt-PA) therapy without endovascular therapy for acute ischemic stroke (AIS) patients (≥80 years old). Methods The data were collected from January 2011 to December 2013. Intravenous rt-PA was administered to patients within 4.5 hours of stroke onset. The patients who received rt-PA therapy were stratified into two age groups: an old group (n =118, >60 and <80 years) and an elder group (n =62, ≥80 years) and the other elder group without rt-PA therapy (n =74, ≥80 years). The National Institutes of Health Stroke Scale (NIHSS) scores between three groups were compared before thrombolysis. The incidence of hemorrhage transformation (HT), incidence of fatal intracerebral hemorrhage (ICH) within 7 days, mortality and modified Rankin Scale (mRS) score at 90 days were examined. Results There is no difference of NIHSS score between groups (13.0±5.3 vs 15.1±6.6 vs 14.1±6.6; P =0.523). The incidence of fatal ICH within 7 days was also not significantly different (3.3% vs 9.6% vs 7.4%, P <0.2). Odds ratio was 2.08, 95% confidence interval (CI) was 1.11~3.86 for mRS 0 to 2 at 90 days between rt-PA therapy groups (P =0.021); The median of mRS score was significantly higher 2(1~3) vs 3(1~5), P =0.025. Odds Ratio was 1.81, 95%CI was 0.8~4.06 between the elder groups with or without rt-PA therapy (P =0.098). The median of mRS score 3(1~5) vs 5(2~5), P =0.008. There are no difference of 90-day mortality in the three groups (11% vs 22.6% vs 16.2%; P =0.12). Conclusion rt-PA therapy appears to be as safe for AIS patients ≥80 years as it is for old patients. Elder patients still could benefit from rt-PA therapy, though not as effective as old patients. This therapy should not be withheld because of age.

Clinical Study of Application Value of Three Dimensional-T2 Weighted Imaging-
Sampling Perfection with Application Optimized Contrasts Using Different Flip Angle
Evolutions Sequence in Carotid Plaques High-Resolution Magnetic Resonance Imaging

SUI Bin-Bin*, GAO Pei-Yi, LIN Yan, JING Li-Na, QIN Hai-Qiang.

2014, 9(11): 911-916.

Asbtract ( )

PDF (3629KB) ( )

References | Related Articles | Metrics

Objective To study the application value of three dimensional-T2 weighted imaging-sampling perfection with application optimized contrasts using different flip angle evolutions (3D-T2WISPACE) sequence in carotid high-resolution magnetic resonance imaging (MRI). Methods Thirty patients with suspected carotid disease were recruited in this study. Highresolution multicontrast MRI was performed using 3.0T MRI with a 4-channel surface carotid coil. 3D-T2WI-SPACE sequence was applied by coronal plane; and oblique saggital and axial images were reconstructed using post-processing software. Signal-to-noise ratio, image quality of 3D-T2WI-SPACE sequence and axial high-resolution T2WI sequence, as well as scan coverage and diagnostic information were compared. Results Among all sixty carotids, thirteen vessels are normal, and forty-four carotids were found plaques; one was carotid dissection; and two were idiopathic stenosis. For the image quality of 3D-T2WI-SPACE sequence and T2WI sequence, there were 5 cases and 4 cases with II grade, and 25 cases and 26 cases with III grade, respectively. 3D-T2WI-SPACE can provide more diagnostic information than T2WI. The coverage of SPACE and T2WI sequence were (114.7±22.4) mm and 46 mm, respectively. There was no significant difference between signal-to-noise ratio of 3D-T2WISPACE (15.7±3.5) and T2W (22.7±14.7) (P =0.163). Conclusion 3D-T2WI-SPACE sequence can be used as an important sequence in carotid highresolution MRI. This 3D sequence can provide large scan coverage and more important information for carotid imaging.

Impact of Different Pathways about Leptomeningeal Anastomoses on the Prognosis of
Patients with Symptomatic Middle Cerebral Artery Stenosis or Occlusion

ZHANG You-Lin, JI Rui-Jun, WANG Chun-Juan, WANG Yong-Jun.

2014, 9(11): 917-923.

Asbtract ( )

PDF (2254KB) ( )

References | Related Articles | Metrics

Objective To investigate the effects of different pathways about leptomeningeal anastomoses (LMA) of patients with symptomatic middle cerebral artery (MCA) stenosis or occlusion on the prognosis by the examination of magnetic resonance angiography (MRA). Methods Patients with unilateral symptomatic MCA stenosis or occlusion, who received treatment at the Department of Neurology of Beijing Tiantan Hospital, Capital Medical University from January, 2009 to January, 2012, were selected, and their LMA status were ascertained with MRA evaluation. We aimed to explore the influence of different LMA pathways on the patients' prognosis by combining the results of follow-up and comparing with end point events. Results There were statistically significant differences among different LMA pathways in recurrent ischemic stroke, total events, but cerebral hemorrhage, all-cause death without difference. Pairwise comparisons in groups revealed:compared with no LMA group, there were statistically significant differences in recurrent ischemic stroke, total events in double pathway LMA group; there was statistical significant difference in total events between the group of anterior cerebral artery (ACA) pathway LMA and no LMA group. Conclusion This study showed that double pathway LMA demonstrated a protective role in patients with symptomatic MCA stenosis or occlusion, could effectively reduce the incidence of recurrent ischemic stroke, the overall adverse events within 1 year onset, but had no effects on the prognosis of cerebral hemorrhage and all-cause death. In terms of overall events.

Influence of Sleep Quality on Young Ischemic Stroke in Short-term Prognosis

ZHANG Shun-Qing*,ZHANG Juan, XU Yu-Ming, CHANG Cheng, SONG Bo, FANG Hui.

2014, 9(11): 924-928.

Asbtract ( )

PDF (2180KB) ( )

References | Related Articles | Metrics

Objective To study the short-term prognosis of ischemic stroke (IS) in youth. Methods Two hundred twenty-three patients aged 18 to 45 years who were admitted to Puyang People's Hospital from June 2011 to February 2013 with a first-ever ischemic stroke were selected as the research cases. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to analyse the correlation between sleep quality and youth IS incidence; The U.S. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) scores were used to assess cases' state of illness and prognosis three months after IS. Univariate and multivariate statistical analyses were used to examine risk factors related to youth IS, prognostic factors related to youth IS and the influence of sleep quality on youth ischemic stroke prognosis. Results Of the 223 cases in the observation group, 170 (76.2%) were male, and 53 (23.8%) were female. Univariate analysis showed that risk factors for youth IS prognosis, including, NIHSS score, high homocysteine, poor quality of sleep. Multivariate Logistic regression analysis showed that the association of these risk factors with youth IS prognosis, from NIHSS, high homocysteine, and the quality of sleep. Poor sleep quality was positively correlated with poor prognosis for youth IS patients (odds ratio [OR]:1.829; 95% confidence interval [CI]:1.014~3.301). Conclusion Sleep quality is an important factor in the prognosis of youth IS.

Research of Risk Factors of Reflex Sympathetic Dystrophy after Stroke

YE Qing, LI Chang-Qing, WANG Lei, ZHANG Zhong, GAO Li.

2014, 9(11): 929-935.

Asbtract ( )

PDF (2293KB) ( )

References | Related Articles | Metrics

Objective To investigate the relationship between reflex sympathetic dystrophy (RSD) and the clinical characteristics of patients with stroke. Methods Totally 127 cases of acute stroke, who were admitted at the Department of Neurology, Neurosurgery and Physiotherapy, the Third People's Hospital of Chengdu during April 2011 and January 2013, were consecutively recorded from admission to 3 months after hospitalization. The subjects were finally divided into 2 groups:one is the non-RSD group which included patients without RSD after stroke, and the other is the RSD group which included patients with RSD after stroke. The relationship between RSD and clinical characteristics of patients with stroke was evaluated by univariate analysis and multivariate COX regression analysis. Results No significant difference was found between non-RSD group and RSD group regarding to age, gender, stroke type, past history, sensory disability and anxiety. RSD after stroke was related to complications, National Institutes of Health Stroke Scale (NIHSS) score, depression, Brunnstorm Improvement Stages, muscular tension and Barthel index (BI) by univariate analysis. Complication score (harzard ratio [HR] 1.018, 95% confidence interval [CI] 1.006~1.163), NIHSS score (HR 1.157, 95%CI 1.062~1.261), depression score (HR 4.975, 95%CI 1.839~13.460), shoulder subluxation (HR 4.627, 95%CI 2.383~8.984) and Brunnstorm Improvement Stages (HR 0.577, 95%CI 0.358~0.930) were the independent risk factors of RSD after stroke. Conclusion Complication score, NIHSS score, depression, shoulder subluxation, and Brunnstorm Improvement Stages were the independent risk factors of RSD after stroke.

Prediction of Hemorrhagic Transformation in Acute Ischemic Stroke Using Magnetic Resonance Imaging

JIN Xin-Chun, LOU Min

2014, 9(11): 937-941.

Asbtract ( )

PDF (2209KB) ( )

References | Related Articles | Metrics

Remote Hemorrhage after Intravenous Thrombolysis in Ischemic Stroke: a Case Report

CAO Jin, YAN Shen-Qiang, LOU Min

2014, 9(11): 942-945.

Asbtract ( )

PDF (2671KB) ( )

References | Related Articles | Metrics