Table of Content

20 October 2011, Volume 6 Issue 10

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主编手记

Listen to the Voice in Your Heart

WANG Yong-Jun

2011, 6(10):  765-767. 

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述评

With Historical and Developmental Vision to Look on Idiopathic Intracranial Hypertension

ZHANG Xiao-Jun

2011, 6(10):  768-771. 

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论著

China Ischemic Stroke Subclassification Subclassification and Related Risk Factors of 170 cases of Ischemic Stroke

MA Zhong-Hua;SUN Lin;TIAN Guo-Hong;et al

2011, 6(10):  772-777. 

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Objective To investigate the distribution of different acute ischemic stroke subtypes according to the China ischemic stroke subclassification(CISS) criteria and its related risk factors.Methods One hundred and seventy patients with acute ischemic stroke in our hospital were collected from March 2011 through July 2011. The clinical characteristic and examination results of each patient including blood test, ultrasound and brain computed tomography/magnetic resonance imaging were collected. All patients were subclassified according to the CISS criteria. Retrospective analysis of the proportion of each subtype of acute ischemic stroke in in-patient was taken. The presentation of common risk factors(hypertension, diabetes mellitus, lipid disorders, heart diseases and smoke history) in each group were measured and compared with others.Results Among the 170 patients studied, the etiology subtypes included 128 cases(75.3%) of large artery atherosclerosis(LAA), 25 cases(14.7%) of cardiogenic stroke(CS), 14 cases(8.2%) of penetrating artery disease(PAD), 1 in other etiologies, and 2 in undetermined etiology. Theunderlying mechanism subtypes included 87 patients of parent artery(plaque or thrombus) occluding penetrating artery, 24 cases of artery-to-artery embolism, 17 cases of hypoperfusion/impaired emboli clearance and 0 case of multiple mechanism. Hypertension was the most common condition(81.1%) but no statistically difference was found among the CISS groups. Lipid metabolic disorder and smoke history were found in 75(58.6%) and 61(47.7%) of LAA group, which is statistically higher than those of the other two groups(P<0.05). While the frequency of patients with heart diseases(100%) in CS group was statistically higher than the other groups(P<0.01), patients with diabetes mellitus(57.1%) was significantly more common in PAD(P<0.05). No further significantly difference was found among different subtypes regarding the related risk factors.Conclusion LAA is the most common cause of ischemic stroke while parent artery occluding penetrating artery play the main role in pathogenesis of acute infarction. Smoking and lipid metabolic disorder were more correlated to LAA, and diabetes mellitus was suggested to be the main related risk factor of PAD.

Etiology and Clinical Features of Intracranial Hypertension Mainly Presented as Papilledema

CUI Shi-Lei;ZHANG Xiao-Jun;YAN Rong;et al

2011, 6(10):  778-783. 

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Objective To investigate the causes and clinical features of intracranial hypertension mainly presented as papilledema.Methods The medical records of patients with diagnosis of intracranial hypertension mainly presented as papilledema were reviewed. Clinical features and imaging data were retrospectively analyzed and etiological diagnosis were defined according to the relevant diagnosis criteria.Results In totally 174 cases included, 127(73.0%) met the diagnostic criteria of idiopathic intracranial hypertension(IIH). Twenty cases(11.5%) were diagnosed as cerebral venous sinus thrombosis(CVST). Other causes included benign intracranial mass for 7 cases, dural arterio-veous fistula(DAVF) for 6 cases, surgery related complication for 6 cases and other causes of single case including Castleman disease, lymphoma, meningeal carcinomatosis, churg-strauss syndrome, cysticercosis, Arnold-Chiari malformation. Two cases were classified as uncertain intracranial infection. Female cases(96/127, 75.6%) and overweight(73.4%) were common In IIH group while male predominance(13/20, 65%) was seen in CVST group. Isolated Lateral sinus thrombolysis was found in 13 of 20(65%) in CVST patients.Conclusion IIH is the most common cause in this group of intracranial hypertension patients mainly presented as papilledma. Female overweight patients are common in IIH group; some patients may have severe visual loss. CVST was the second commonest cause, of which isolatedlateral sinus thrombosis is common. Even rarely, some malignant entity can be the cause of intracranial hypertension mainly presented as papilledema.

Relationship Between Serum Lipid Levels and the Short-Term Prognosis of Acute Ischemic Stroke

WANG Ping-Li;YE Zu-Sen;FAN Kai;et al

2011, 6(10):  784-789. 

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Objective To clarify the relationship between serum lipids and prognosis of acute ischemic stroke.Methods We collected data of patients with a acute brain infarction. Divide the patients into two parts. One is atherothrombosis, the other is non-atherothrombosis. Survival and dependency were assessed at 3 months. Using logistic regression model to estimate the relationship between serum lipids and prognosis.Results A total of 459 patients were included, 310 were identified as atherothrombosis. Compared to non-atherosclerosis-based stroke patients, atherosclerosis groups were older, higher triglyceride, higher cholesterol total, higher rates of diabetes mellitus and hypertension(P=0.000, 0.000, 0.001, 0.018, 0.015). On non-atherosclerotic stroke patients, HDL-C had an independent negative correlation with poor prognosis(OR 0.068, 95%CI 0.005-0.897).Conclusion HDL-C level is one of the prognosis of non-atherosclerotic stroke protective factors.

专题论坛

Idiopathic Intracranial Hypertension and Cerebral Venous Sinus Thrombosis

YAN Rong;ZHANG Xiao-Jun

2011, 6(10):  791-796. 

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Different Imaging Techniques for Diagnosis in Patients with Cerebral Venous Sinus Thrombosis Presenting as Isolated Intracranial Hypertension

SUN Hou-Liang;ZHANG Xiao-Jun;LIYong

2011, 6(10):  797-801. 

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病例讨论

One Case of Cerebral Venous Sinus Thrombosis Presenting as Idiopathic Intracranial Hypertension

YAN Rong;YANG Qing-Lin;SUN Hou-Liang

2011, 6(10):  802-805. 

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One Case of Meningeal Carcinoma Combined with Venous Sinus Thrombosis

ZHAO Jin-Xing;HAN Hui-Jun;HAN Di

2011, 6(10):  806-808. 

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综述

Recent Progress in Detection and Prevention of Clopidogrel Resistance

SHI Hong-Ting ZHOU Bo-Rong

2011, 6(10):  832-838. 

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Clopidogrel is a widely used antiplatelet aggregation drug. However, Clopidogrel-induced platelet inhibition is patient-specific. The benefits of using clopidogrel are not guaranteed. Various platelet-function tests include light transmission aggregometry(LTA), and platelet function analyzer 100(PFA-100), and flow cytometer(FCM). The prevention of clopidogrel resistance has versatile measures. The possible measures include avoiding drug interactions, augment dosage and therapeutic alliance.

Research Progress of Posterior Circulation Ischemia

SUN Xiao-Ying;JU Yi;ZHAO Xing-Quan

2011, 6(10):  839-843. 

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In recent years, there has been a common perspective among experts that posterior circulation ischemia(PCI) includes posterior circulation transient ischemic attack(TIA) and posterior circulation infarction. The usual causes of PCI are atherosclerosis, embolism, subclavian steal syndrome, and so on. The typical clinical appearance is vertigo, usually accompanied by symptom and sign of brain stem and cerebellum. We have to diagnose PCI through history, physical examination and neuroimaging. Major treatment is medicine, supplemented by surgical and endovascular treatment. So this article provides an overview of epidemiology, etiology, clinical characters, diagnosis, and therapy of the PCI according to the papers in recent 10 years.

教学园地

Implementation of Bilingual Education Model in the Teaching of Cerebrovascular Disease

GONG Xi-Ping;ZHANG Zai-Qiang;ZHAO Xing-Quan

2011, 6(10):  844-846. 

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