Chinese Journal of Stroke

Cooperation For a new platform of Neuropsychiatry--Reports of the 2nd Chinese Neuropsychiatry Summit

ZHANG Ning;QIN Hai-Qiang;WANG Chun-Xue;et al

2010, 5(01): 13-14.

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Psychiatry on the Crossroad: the Right Moment of Making Decision

YU Xin

2010, 5(01): 16-17.

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Development Tendency of Neuropsychiatry in 21st Century

ZHANG Zhi-jun

2010, 5(01): 18-19.

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A Prospective Study of The Incidence of Post-Stroke Depression And Its Related Risk Factors

LUAN Jun-Xiang;ZHANG Xiang-Rong;ZHANG Zhi-Jun.

2010, 5(01): 20-26.

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Objective To investigate the incidence of post-stroke depression (PSD) and its related risk factors.Methods The incidence of PSD was evaluated with 17 items Hamilton depressive scale (HAMD)at 2 weeks, 3 and 6 months after acute stroke of 101 inpatients. The Modified Rankin Scales (mRS),mini-mental state examination (MMSE) and the National Institutes of Health Stroke Scale (NIHSS)were also assessed. We investigated the incidence of PSD and analyzed the impact of post-strokedepression clinical factors associated risk.Results (1) The incidence of first episode PSD was significantly higher in 2 weeks (45.5%)than 3 months (6.4%) or 6 months (7.3%)(P <0. 01). There was no significant difference abouttotal incidence of PSD between 2 weeks, 3 and 6 months. The remission incidence of PSD wassignificantly higher in 3 months (23.9%) than 3 to 6 months (3.1%)(P =0.029) period. The mortalityof PSD patients was significantly higher than that of the non-PSD patients (P <0.05). (2) Theincidence of PSD was significantly higher in the patients with the left hemisphere lesion than thepatients with bilateral or right hemisphere in 2 weeks (P <0.05). The MMSE score of the PSDpatients was significantly lower than that of the non-PSD patients at both 2 weeks, 3 and 6 months(P <0.01). The mRS and NIHSS score of PSD patients were significantly higher than those ofthe non-PSD patients at all the three time points (P <0.01). (3) The related factors of post-strokedepression at 2 weeks included the lesion location in the left hemisphere of lesion, NIHSS and mRS.The related factors of post-stroke depression at 3 months and 6 months included NIHSS and mRS(P <0.05). The incidence of PSD was not related with MMSE at 2 weeks ,3 or 6 months (P >0.05).(4) We found no statistically significant difference in sex, age, stroke type, stroke localization, focusnumbers, hypertension, diabetes, culture degree (P >0.05).Conclusion PSD might have high incidence in 2 weeks after stroke. The degree of NIHSS andmRS, the left hemisphere lesion in 2 weeks showed a significant relationship with the PSD.

Distribution and Evolution of Cerebral Artery Stenosis in Ischemic Cerebrovascular Patients

WU Hong-Liang;LIU Chuan-Yu;LI Bing;et al.

2010, 5(01): 27-31.

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Objective To study the distribution and evolution of cerebral artery stenosis in ischemiccerebrovascular patients.Methods Two hundred and thirty patients with ischemic cerebrovascular disease were detected bycerebral angiography. They were divided into <60 years old group and ≥60 years old group, thencomparing the differences of cerebral arteries stenosis between the two groups.Results The percentage of extracranial carotid arteries stenosis and extracranial arteries stenosis inposterior circulation in ≥60 years old group were higher than those in <60 years old group(P <0.01).The occlusion of intracranial arteries in <60 years old group was more frequent than those in ≥60years old group(P <0.01), and in <60 years old group, it was more frequent than the occlusion ofextracranial arteries(P <0.01).Conclusion The distribution of cerebral artery stenosis varies with age, and the evolution areaffected by the distribution and age.

Study of CT Perfusion Imaging in Cerebral Blood Flow of Hypertensive Cerebral Hemorrhage

ZHANG Kun;ZHANG Xin-Qing;ZHANG Zhi-Min;et al.

2010, 5(01): 32-35.

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Objective To observe hemodynamic alteration of the perihematomal and the remote brain regionin hypertensive cerebral hemorrhage patients with CT perfusion imaging.Methods CT perfusion imaging was performed after two weeks treatment in 20 hypertensivecerebral hemorrhage patients. Computer-aided system was used to produce CT perfusion parametersmap. The parameters regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV)and mean transit time (MTT) were measured and compared with the corresponding point of thecontralateral hemisphere for reference.Results There were diverse degree of hypoperfusion in perihematomal region against contralateralhemisphere. The rCBF and rCBV adjancent to the hematomas were lower than those of outerregion,and MTT significantly longer(P <0.05). The rCBF, rCBV and MTT of adjancent to thehematomas and outer region were significantly different from those of mirror points (P <0.05).Conclusion There was significantly decreased cerebral blood flow in perihematomal region. CTperfusion imaging could clearly demonstrate the abnormal cerebral hemodynamic change occurredin the region surrounding the hematoma and could provide valuable information to the clinicaltreatment after cerebral hemorrhage.

The Application of Bispectral Index in Sedative Treatment for Anterior Communicating Aneurysm Subarachnoid Hemorrhage

WEN Miao;WANG Xue-Mei;JU Yi.

2010, 5(01): 36-40.

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Objective To investigate the quantificat sedation value of bispectral index (BIS) in anteriorcommunicating aneurysms patients with psychiatric symptom.Methods Twenty-eight acute subarachnoid hemorrhage patients with psychiatric symptom whohad been confirmed with anterior communicating aneurysms by DSA were included. All patientsaccepted Midazolam. They were divided randomly into two groups, 14 in BIS group with adjustingsedative sedation between BIS 70-85, and other 14 in control group with experience dosage.BIS,HR, BP, SPO2, dosage, badness were monitored continuously and Ramsay sedation scale wasassessed.Results Accompanying longer treatment, the BIS, Ramsay sedation scale and SPO2 of BIS groupwere higher gradually than those of control group. The fluctuate of MABP, HR was obviouslyincreased in control group. The total continuing medication dose was decrease in BIS group, whichwithout badness happening.Conclusion The BIS is suitable for monitoring the depth of sedation of anterior communicatinganeurysms patients with psychiatric symptom.

Investigation on the Level of Trace Elements in Blood for the Patients with Vascular Parkinsonism and Parkinson’s Disease

ZHANG Wei;LEI Zheng-Lin;CHEN Hai-Bo.

2010, 5(01): 41-45.

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Objective The aim of the study is to investigate the level of four trace elements, including copper(Cu), selenium (Se), zinc (Zn) and lead (Pb) in blood for the patients with vascular parkinsonism(VP) and Parkinson’s disease (PD).Methods The level of Cu, Zn and Pb in blood were measured in 20 VP patients, 17 PD patientsand 10 control subjects by graphite furnace atomic absorption spectrophotometer and Se in bloodby fluorophotometry.Results (1) The total level of Cu and Se in blood were significantly higher than that of control group(P <0.05) and no significant difference was found between VP and PD groups (P >0.05). (2) The totallevel of Zn and Pb in blood for VP and PD groups were not significantly different when comparedwith control group (P >0.05). (3) The level of Cu, Se and Zn in blood were all significantly higherthan that of control group (P <0.05) in VP patients with duration <5 years, whereas Cu and Zn weresignificantly lower than that of control group (P <0.05) in those with duration >5 years. (4) Thelevel of Cu, Se and Zn in blood were all significantly higher than that of control group (P <0.05) inPD patients who were in stage of I-II, whereas Cu and Pb were significantly higher, and Se and Znwere significantly lower than that of control group (P <0.05) in PD patients who were in stage ofIII-V.Conclusion The overall level of Cu and Se in blood were obviously high. Elevated levels of Cu, Seand Zn in blood were found in VP patients with duration <5 years and declined levels of Cu and Znin those with duration >5 years. The enhanced levels of Cu, Se and Zn in blood were observed inPD patients who were in the stage of I-II, the increased levels of Cu and Pb, and dropped levels ofSe and Zn were showed in those who were in stage of III-V. The trace elements might play a pivotalrole in the pathogenesis, progression and prognosis of VP and PD.

Clinical Analysis of 11 Cases of Superior Sagittal Sinus Thrombosis

CHANG Da-Wei;TAN Jun-Jie;LIU Tian-Ming.

2010, 5(01): 46-50.

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Objective To explore the etiopathogenisis, diagnosis, clinical manifestation and treatments ofsuperior sagittal sinus thrombosis(SSST).Methods The clinical data of 11 patients with SSST, including course, symptoms, risk factors,image findings and treatmens, was analyzed retrospectively.Results Among 11 cases, 7 cases has risk factors.The most common symptoms were performanceof intracranial hypertension, limb paralysis and seizures. Head MRI showed abnormal signals onthe sagittal sinus. Nine cases imploved in clinical symptoms and 2 cases died caused by cerebralherniation.Conclusion The clinical manifestation of SSST was various and nonspecific,most patients hao riskfactors. low-molecular-weight heparin showed a relatively confirmative effect in SSST patients.

Study on the Characteristics and Clinical Manifestations of Intra-and Extra-Cranial Elongation and Stenosis and Their Risk Factors

JIA Xiao-Jun;CHEN Dong-Wan;YANG Heng;et al.

2010, 5(01): 51-57.

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Objective To investigate the clinical manifestations, characteristics, and risk factors of intra-andextra-cranial elongation and stenosis.Methods Two thousand two hundred and eighteen patients aged 45 to 89 years old were enrolledto perform aortocranial angiography. Arterial abnormality were classified as arterial elongation andstenosis based on the DSA images. The clinical manifestation was categorized as dizziness, TIAand cerebral infarction, while the risk factors included advanced age, primary hypertension anddiabetes mellitus. Distribution of arterial elongation and stenosis and their clinical manifestationswere compared using Chi-Square test, and multiple risk factors of intra-and extra-cranial elongationand stenosis were analysed by Logistic regression analysis.Results Arterial elongation and stenosis were observed in 1816 patients from 2218 patients,occurence of arterial elongation and stenosis was 76.1% or 23.9% separately. For patients withS- or O-typed elongation in internal carotid arteries, occurence of cerebral infarction was 40.0%or 47.9%. For patients with S- or O-typed elongation in vertebro-basilar arteris, the occurenceof TIA was 57.6% or 25.0%. For severe stenosis in internal carotid artery, occurence of TIA andcerebral infarction was 45.3% or 35.8%. For moderate and severe stenosis in vertebro-basilar artery,occurence of TIA was 48.6% or 48.4% separately. In addition, age (OR=3.28, 95% CI 2.16-4.75),BMI (OR =2.95, 95% CI 2.02-4.31), primary hypertension (OR =3.17, 95% CI 2.12-4.69) anddiabetes mellitus (OR =2.82, 95% CI 1.96-3.87) were related to the occurence of intra-and extracranialelongation and stenosis.Conclusion The arterial elongation and stenosis severity exhibited a significant correlation to theclinical manifestation. And age, BMI, primary hypertension and diabetes were risk factors of theintra-and extra-cranial elongation and stenosi

With Cerebrovascular Disease as the Performance of Neuropsychiatric Lupus Report of 4 Cases

LI Guo-mei;BIAN Wen-wen;WANG Mei;et al.

2010, 5(01): 58-62.

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For the Assessment and Management of People with Recent Transient Ischemic Attack

LENG Xin-Yi;WANG Yi-Long;WANG Yong-Jun

2010, 5(01): 63-69.

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Brief Review of Apoptosis after Cerebral Ischemia

JI Kang-Xiang;LI jie;QIU Cai-Xia;et al.

2010, 5(01): 66-72.

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Animal experiments has revealed that there are much of apoptotic cells inischemic region, especially in penumbra during the first several hours or days after an ischemicevent, which accounts for the parts of the total lesions during the initial stages of ischemia. It iscurrently accepted that cerebral ischemia triggers two general pathways of apoptosis: the intrinsicand extrinsic pathway. This brief review provides a general overview of current knowledges ofapoptotic mechanisms after ischemia.

Risk Factors of Acute Cerebral Stroke Complicated with Stress Ulcer

FENG Rui-Jing;ZHAO Xing-Quan.

2010, 5(01): 77-80.

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Stress Ulcer is one of the most heavily complications of cerebral stroke. Thepathological mechanism is unclear. It mostly represents of hematemesis, hemafecia or both of them.The most serious consequence is occur of hemorrhage shock. The incidence rate of Stress ulcer (SU)in the cases of acute cerebral hemorrhage is higher than that of acute cerebral infarction, especiallyin the cases of brain stem stroke. The incidence rate of SU is higher in patients with consciousdisturbance.The occurance makes brain damage more seriously and may result in multipleorgan failure. The incident rate of death is especially higher in patients of acute cerebral strokecomplicated by SU than in patients of non-complicated by SU. The patients of acute cerebral strokecomplicated by SU have a poor prognosis, and preventive measures should be made at early stage.

Glutamate and Post-Stroke Depression

ZHANG Ning;WANG Yong-Jun;WU Yan;et al

2010, 5(01): 81-85.

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Post-stroke depression (PSD) is one of the most common complications aftercerebral vascular disease, which can have a severe influence on the life of the patients, prolongsthe rehabilitation time, increases the rate of disability and fatality, and increases the load of bothpatients and their relatives. Its pathogenesis isn’t known completely. The main treatment of PSDis antidepressive drug. Drugs increasing the synaptic availability of serotonin and norepinephrinehave been used to treat depression for many years in clinical. However, significant symptomimprovement requires 2-4 weeks of treatment and a first course of therapy provides symptomrelief to only 60%-65% of patients. The increasing understanding of the molecular mechanismsof depression shows that glutamate and its receptors are also involved in depression .Here wedescribes the relationship of glutamate and its receptors between PSD.

Medical Education Teaching Experience of Cerebrovascular Disease Neurology

WANG Wei;BI Qi

2010, 5(01): 86-89.

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