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1.
Technol Health Care ; 32(3): 1967-1976, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38393863

RESUMEN

BACKGROUND: Currently, cerebral infarction (CI) is mainly treated by emergency craniotomy or conservative treatment. However, some studies have questioned the functional recovery of patients after hyperbaric oxygen therapy (HBOT)-specialized care. OBJECTIVE: This paper mainly explores the influence of HBOT-specialized care on limb motor function (LMF) and mental state of CI patients with hemiplegia. METHODS: The medical records of 113 CI patients with hemiplegia treated in our hospital from March 2020 to March 2022 were collected. Of these, 53 received routine care nursing (conventional group) and 60 cases were given HBOT-specialized care (research group). Patient general data, scores of Fugl-Meyer Assessment (FMA), National Institutes of Health Stroke Scale (NIHSS), Self-rating Anxiety/Depression Scale (SAS/SDS) and Barthel Index (BI), and nursing efficiency were comparatively analyzed. RESULTS: The two groups showed comparability in general data. FMA and BI scores were increased in the research group after rehabilitation treatment, higher than the baseline and those of the conventional group, while NIHSS, SAS, and SDS scores were reduced, lower compared with baseline and those of the conventional group. In addition, significantly higher nursing efficiency was determined in the research group. CONCLUSION: HBOT-specialized care has beneficial effects on LMF, mental state, negative emotions and self-care ability of CI patients with hemiplegia and can enhance nursing efficacy, which deserves clinical popularization.


Asunto(s)
Infarto Cerebral , Hemiplejía , Oxigenoterapia Hiperbárica , Humanos , Hemiplejía/rehabilitación , Hemiplejía/etiología , Masculino , Infarto Cerebral/complicaciones , Infarto Cerebral/terapia , Infarto Cerebral/psicología , Femenino , Oxigenoterapia Hiperbárica/métodos , Anciano , Persona de Mediana Edad , Recuperación de la Función , Rehabilitación de Accidente Cerebrovascular/métodos
2.
J Tradit Chin Med ; 44(1): 205-211, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38213256

RESUMEN

Stroke is the main cause of disability in the middle and old age. Hemiplegia, especially lower limb paralysis, often leads to the loss of self-care ability and a series of secondary injuries. The main method to improve hemiplegic limb movement is exercise therapy, but there are still many patients with disabilities after rehabilitation treatment. As one of the non-pharmacological therapies for stroke, acupuncture has been recognized to improve motor function in patients. Here, we propose a new method, anterior sciatic nerve acupuncture, which can stimulate both the femoral nerve and the sciatic nerve. We designed this study to determine the effect of this method on lower limb motor function. Sixty participants recruited with hemiplegia after cerebral infarction will be randomly assigned to the test group or control group in a 1:1 ratio. The control group will receive Xingnao Kaiqiao acupuncture, and the test group will receive anterior sciatic nerve acupuncture on this basis. All participants will get acupuncture treatment once a day, 6 times a week for 2 weeks. The primary outcome is Fugl-Meyer Assessment of Lower Extremity and the secondary outcomes are Modified Ashworth Scale and Modified Barthel Index. Data will be collected before treatment, 1 week after treatment, and 2 weeks after treatment, and then statistical analysis will be performed. This study can preliminarily verify the effect of anterior sciatic nerve acupuncture on improving lower limb motor function in patients with cerebral infarction, which may provide an alternative approach for clinical treatment of hemiplegia.


Asunto(s)
Terapia por Acupuntura , Accidente Cerebrovascular , Humanos , Hemiplejía/etiología , Hemiplejía/terapia , Resultado del Tratamiento , Accidente Cerebrovascular/complicaciones , Infarto Cerebral/complicaciones , Infarto Cerebral/terapia , Terapia por Acupuntura/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto
3.
Arch Clin Neuropsychol ; 39(2): 265-272, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-37699427

RESUMEN

OBJECTIVE: The thalamus is the integrative hub of the brain with reciprocal connections throughout the cortex. This case report describes a right-handed 81-year-old male patient who experienced sudden onset cognitive impairment following a focal left anterior thalamic infarct. METHODS: With consent/assent, the patient was seen for a short neuropsychological assessment 6 weeks post stroke. Neuropsychological assessment included review of medical history, collateral intake, the Toronto Cognitive Assessment, Frontal Systems Behavior Scale-Family Rating Form, the Neuropsychiatric Inventory Questionnaire, and piano performance. RESULTS: The assessment revealed impaired performance on measures of orientation, memory, executive function, and language, as well as symptoms including hallucinations, apathy, and hypersomnolence, consistent with thalamic dementia. Remarkably, in this context, the patient maintained an ability to play piano and read music. CONCLUSIONS: The case has implications for understanding the complex integrative functions of the thalamus, including how profound impairment can simultaneously present with cognitive strengths that may not be captured by performance on neuropsychological testing. This case also suggests that magnetic resonance imaging may be indicated in cases presenting with vascular risk factors and sudden onset cognitive impairment, given that computed tomography may not be sensitive to small subcortical infarcts.


Asunto(s)
Demencia , Música , Masculino , Humanos , Anciano de 80 o más Años , Pruebas Neuropsicológicas , Tálamo/diagnóstico por imagen , Tálamo/irrigación sanguínea , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/psicología , Imagen por Resonancia Magnética/efectos adversos , Demencia/complicaciones
4.
Int Marit Health ; 74(4): 265-271, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38111247

RESUMEN

BACKGROUND: Cerebral stroke is the third leading cause of death after cardiovascular disease, cancer and the leading cause of disability for patients. Hyperbaric oxygen is a non-drug treatment that has the potential to improve brain function for patients with ischaemic stroke. The objective of this study was to evaluate the results of treatment of acute cerebral infarction with hyperbaric oxygen therapy (HBOT). MATERIALS AND METHODS: This was a case-control study. One hundred ninety-five patients diagnosed with cerebral infarction, with signs of onset within 24 hours, were treated at the Centre for Underwater Medicine and Hyperbaric Oxygen of Vietnam National Institute of Maritime Medicine during the period from January 2020 to December 2022. Study group included 100 patients with acute cerebral infarction treated with a combination of HBOT and medication and reference group included 95 patients treated by medication only (antiplatelets drugs, statins, control of associated risks factors) RESULTS: After 7 days of treatment with hyperbaric oxygen (HBO), symptoms such as headache, dizziness, nausea, sensory disturbances, and Glasgow score of the study group improved better than that of the reference group (p < 0.01). Movement recovery in the study group was better than the reference group: the percentage of patients with mild and moderate paralysis in the study group increased higher than that of the reference group (86.0% and 68.4%), the degree of complete paralysis of the study group decreased more than that of the reference group (14.0% and 31.6%). The degree of independence in daily activities in the study group was better than the reference group. In the study group, the percentage of patients with complete independence in daily life increased from 27.0% to 84.0%. In the reference group, the rate of patients who were independent in their daily activities increased from 37.9% to 51.6%. The average number of treatment days of the study group was 10.32 ± 2.41 days and it the reference group 14.51 ± 3.24 days. CONCLUSIONS: Hyperbaric oxygen therapy is a non-drug treatment with many good effects in the treatment of cerebral infarction, especially acute cerebral infarction. HBOT reduces and improves functional symptoms, improves mobility, and reduces treatment time for patients.


Asunto(s)
Isquemia Encefálica , Oxigenoterapia Hiperbárica , Accidente Cerebrovascular , Humanos , Oxigenoterapia Hiperbárica/efectos adversos , Isquemia Encefálica/complicaciones , Isquemia Encefálica/terapia , Accidente Cerebrovascular/terapia , Estudios de Casos y Controles , Infarto Cerebral/terapia , Infarto Cerebral/complicaciones , Parálisis/complicaciones , Parálisis/terapia
5.
Rinsho Shinkeigaku ; 63(10): 643-649, 2023 Oct 25.
Artículo en Japonés | MEDLINE | ID: mdl-37779025

RESUMEN

A 76-year-old male patient was admitted to our hospital for the treatment of acute cerebral infarction in the right temporal stem, right lateral thalamus, and right pulvinar regions. Although his overall cognitive function was almost normal, he exhibited reduced visual sensitivity in the homonymous lower left quadrant of the visual field, left unilateral spatial neglect (USN), and simultanagnosia. Left USN improved 4 months after the onset of infarction; however, simultanagnosia persisted. To the best of our knowledge, this is the first case of simultanagnosia caused by cerebral infarction in the right temporal stem, right lateral thalamus, and right pulvinar regions.


Asunto(s)
Agnosia , Trastornos de la Percepción , Pulvinar , Masculino , Humanos , Anciano , Pulvinar/diagnóstico por imagen , Tálamo/diagnóstico por imagen , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen , Agnosia/diagnóstico , Agnosia/etiología , Trastornos de la Percepción/etiología
6.
Acta Neurol Taiwan ; 32(4): 202-206, 2023 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-37723912

RESUMEN

PURPOSE: While the gustatory pathway of animals has been well-researched, that of humans is still a mystery. Several theories have been established, and some earlier reports hypothesized the relation to laterality. However, some cases could not be fully explained by the laterality theory (1). To clarify the gustatory pathway, we reported a case with bilateral hypogeusia after right thalamic infarction. CASE: This 55-year-old, right-handed man suffered from sudden decreased sensitivity of taste. He was unable to differentiate sweetness and saltiness at bilateral anterior parts of tongue. Additionally, there was numbness at the upper palate and the lips. Neurological examination revealed decreased taste sense at both sides of his anterior tongue and decreased pin-prick sensation of the left part of his lips. Brain magnetic resonance imaging (MRI) revealed acute ischemic stroke at the right ventral posteromedial nucleus (VPM). Thus, single antiplatelet therapy was administered. Two weeks later, the symptoms improved significantly and completely recovered without sequelae. CONCLUSION: The exact gustatory pathway in humans remains uncertain nowadays. First, there were few reports about dysgeusia, which might be related to clinical neglect of taste deficits. Second, our knowledge of the human gustatory pathway depends solely on sporadic cases of taste-involved brain lesions. We reported a case of bilateral hypogeusia after right thalamic infarction. This finding indicates that, although there might be laterality of gustatory fibers to the left hemisphere, anatomical variations may exist in the human gustatory system. More research is needed to elucidate the understanding of the gustatory pathway in humans.


Asunto(s)
Ageusia , Accidente Cerebrovascular Isquémico , Accidente Vascular Cerebral Lacunar , Animales , Masculino , Humanos , Persona de Mediana Edad , Ageusia/etiología , Tálamo/diagnóstico por imagen , Núcleos Talámicos Ventrales , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen
7.
Neurol India ; 71(4): 754-759, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37635510

RESUMEN

Background: Bilateral thalamic infarction, especially the medial thalamus, has been characteristically described in the artery of Percheron (AOP) affection. However, bilateral thalamic restriction has been described in many entities beyond the AOP infarction. Objective: Here we describe a case series (three cases) with infection as an etiology for bilateral thalamic lesions in the topographic distribution of the AOP from a tertiary care center in tropical India. Materials and Methods: : Case series during a 1-year period collecting cases with bilateral thalamic diffusion restriction on MRI who did not have thalamic infarcts and their outcomes. Results: : Bilateral thalamic lesion can occur in both bacterial and viral infections such as tuberculosis, dengue, and SARS-COV-2. Thus, we intend to add infections as one of the etiologies in the ever-expanding list of conditions that produce bilateral thalamic restriction. Conclusions: All the acute symmetric thalamic lesions are not always secondary to vascular insult. Accurate assessment and prompt diagnosis can prevent unnecessary delays in treatment. To our knowledge, this is the first case series in the literature that throws light on the bilateral thalamic lesions in the topographic distribution of the AOP secondary to infections in a tropical country like India.


Asunto(s)
Arterias , Infarto Cerebral , Humanos , Infarto Cerebral/complicaciones , Imagen por Resonancia Magnética , Tálamo/patología , India
8.
Altern Ther Health Med ; 29(7): 41-45, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37499150

RESUMEN

Objective: This study aimed to investigate the impact of combining transcranial magnetic stimulation (TMS) with argatroban on balance function and activities of daily living in patients with hemiplegia following cerebral infarction (CI). Methods: A retrospective analysis was conducted on the clinical data of 104 patients with hemiplegia after CI who were admitted to our hospital from July 2020 to July 2021. The patients were randomly assigned to either the experimental group (EG) or the control group (CG), with 52 patients in each group. The EG received TMS in combination with argatroban, while the CG received argatroban alone. The Berg Balance Scale (BBS) and modified Barthel index (BI) were used to assess the balance function and activities of daily living in both groups after treatment. Results: After treatment, the EG demonstrated significantly higher BBS and BI scores compared to the CG (P < .001). Additionally, the EG showed significantly improved upper limb and lower limb Functional Ambulation Profile (FAM) scores compared to the CG (P < .05). Conclusions: The combination of TMS and argatroban proves to be an effective approach for enhancing balance function and activities of daily living in hemiplegic patients with CI. Therefore, it is recommended as a valuable rehabilitation treatment for such patients.


Asunto(s)
Infarto Cerebral , Hemiplejía , Rehabilitación de Accidente Cerebrovascular , Humanos , Actividades Cotidianas , Infarto Cerebral/complicaciones , Infarto Cerebral/rehabilitación , Hemiplejía/rehabilitación , Estudios Retrospectivos , Estimulación Magnética Transcraneal
9.
Neurocrit Care ; 39(1): 104-115, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37308727

RESUMEN

BACKGROUND: Nimodipine is recommended to prevent delayed cerebral ischemia in patients with spontaneous subarachnoid hemorrhage (SAH). Here, we studied hemodynamic side effects of different nimodipine formulations (per os [PO] and intravenous [IV]) in patients with SAH undergoing continuous blood pressure monitoring. METHODS: This observational cohort study includes consecutive patients with SAH (271 included in the IV group, 49 in the PO group) admitted to a tertiary care center between 2010 and 2021. All patients received prophylactic IV or PO nimodipine. Hemodynamic responses were evaluated based on median values within the first hour after continuous IV nimodipine initiation or PO nimodipine application (601 intakes within 15 days). Significant changes were defined as > 10% drop in systolic blood pressure (SBP) or diastolic blood pressure from baseline (median values 30 min before nimodipine application). With the use of multivariable logistic regression, risk factors associated with SBP drops were identified. RESULTS: Patients were admitted with a median Hunt & Hess score of 3 (2-5; IV 3 [2-5], PO 1 [1-2], p < 0.001) and were 58 (49-69) years of age. Initiation of IV nimodipine was associated with a > 10% SBP drop in 30% (81/271) of patients, with a maximum effect after 15 min. A start or increase in noradrenaline was necessary in 136/271 (50%) patients, and colloids were administered in 25/271 (9%) patients within 1 h after IV nimodipine initiation. SBP drops > 10% occurred after 53/601 (9%) PO nimodipine intakes, with a maximum effect after 30-45 min in 28/49 (57%) patients. Noradrenaline application was uncommon (3% before and 4% after nimodipine PO intake). Hypotensive episodes to an SBP < 90 mm Hg were not observed after IV or PO nimodipine application. In multivariable analysis, only a higher SBP at baseline was associated with a > 10% drop in SBP after IV (p < 0.001) or PO (p = 0.001) nimodipine application, after adjusting for the Hunt & Hess score on admission, age, sex, mechanical ventilation, days after intensive care unit admission, and delayed cerebral ischemia. CONCLUSIONS: Significant drops in SBP occur in one third of patients after the start of IV nimodipine and after every tenth PO intake. Early recognition and counteracting with vasopressors or fluids seems necessary to prevent hypotensive episodes.


Asunto(s)
Isquemia Encefálica , Hipotensión , Hemorragia Subaracnoidea , Humanos , Nimodipina , Hemorragia Subaracnoidea/complicaciones , Hemorragia Subaracnoidea/tratamiento farmacológico , Presión Sanguínea , Hipotensión/tratamiento farmacológico , Isquemia Encefálica/etiología , Infarto Cerebral/complicaciones , Norepinefrina
10.
Med Sci Monit ; 29: e939623, 2023 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-37365796

RESUMEN

BACKGROUND Post-stroke spastic dysarthria (PSSD) is a motor speech impairment that impacts patient communication and quality of life. Liuzijue Qigong (LQG), a traditional Chinese method of breath training, could serve as an effective treatment for PSSD. This study compared the effects of conventional speech therapy and conventional speech therapy combined with LQG in patients with PSSD. MATERIAL AND METHODS Seventy patients with PSSD were randomly divided into a control group (conventional speech therapy, n=35, 77.14% cerebral infarction, 22.86% cerebral hemorrhage) and experimental group (LQG combined with conventional speech therapy, n=35, 85.71% cerebral infarction, 14.29% cerebral hemorrhage). Conventional speech therapy included relaxation, breath control, organ articulation, and pronunciation training. LQG involved producing 6 different sounds (Xu, He, Hu, Si, Chui, and Xi) accompanied by breathing and body movements. Patients were treated once a day, 5 times a week, for 4 weeks. The Frenchay Dysarthria Assessment scale (FDA), speech articulation, maximum phonation time (MPT), loudness, and Montreal Cognitive Assessment scale (MoCA) were evaluated. RESULTS At 4 weeks, the experimental group showed significant improvements compared with the control group in the change of FDA (13.26±6.84 vs 18.03±5.32, P=0.028), speech articulation (63.17±22.40 vs 76.51±15.28, P=0.024), MPT (1.34±1.30 vs 3.89±3.98, P<0.001), loudness (3.46±2.74 vs 7.14±2.56, P=0.009), MoCA (19.40±3.72 vs 22.20±5.30, P=0.020), total effective rate (68.57% vs 88.57%, P=0.041). CONCLUSIONS LQG, when combined with conventional speech therapy, enhanced the comprehensive speech ability of patients with PSSD compared with conventional treatment alone.


Asunto(s)
Ejercicios Respiratorios , Qigong , Accidente Cerebrovascular , Humanos , Hemorragia Cerebral/complicaciones , Infarto Cerebral/complicaciones , Disartria/terapia , Disartria/complicaciones , Calidad de Vida , Habla , Logopedia/métodos , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/terapia
11.
BMC Neurol ; 23(1): 184, 2023 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-37149608

RESUMEN

BACKGROUND: Bilateral anterior thalamic symmetrical infarction is very rarely observed in clinical practice and has rarely been reported in the literature. In this paper we introduce a patient with bilateral anterior thalamic symmetrical infarction and discuss his symptoms, treatment process, and follow-up visit results, as well as the potential pathological mechanisms of the disease. CASE PRESENTATION: A 71-year-old male had a sudden cognitive decline four days prior to medical consultation. The patient's brain MRI showed symmetrical high signals in the anterior part of both sides of the thalamus. The patient's head MRV and immunological tests were normal, and we considered that this patient had a rare case of bilateral anterior thalamic infarction. After 10 days of anti-platelet aggregation that lowered blood lipids and improved circulation, the patient's symptoms significantly abated. Two years later, we found through telephone follow-up that the patient's symptoms had not relapsed substantially and that he was able to perform self-care, having only continued to suffer a slight decline in short-term memory. CONCLUSION: For patients with bilateral prethalamic lesions who have only acute cognitive impairment, if the lesions conform to the blood supply area of both thalamic nodular arteries and DWI shows a high signal, the diagnosis of acute cerebral infarction should be considered, and the standard treatment plan for cerebral infarction should be given as soon as possible.


Asunto(s)
Accidente Cerebrovascular , Tálamo , Masculino , Humanos , Anciano , Tálamo/patología , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/patología , Imagen por Resonancia Magnética , Accidente Cerebrovascular/patología , Arterias
12.
Dement Geriatr Cogn Disord ; 52(3): 184-192, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36948166

RESUMEN

INTRODUCTION: Vascular factors have been shown to be associated with increased risk of dementia. However, clinical trials have so far been unsuccessful, suggesting new approaches are needed. The aim of this study was to use population-based real-world data to investigate risk factors and preventive factors for dementia, including the effects of traditional Chinese medicine (TCM). METHODS: This is a retrospective cohort study using LHID2000, a dataset randomly selected from Taiwan's National Health Insurance Research Database. Subjects with occlusion and stenosis of precerebral and cerebral arteries, cerebral atherosclerosis without mention of cerebral infarction, and transient cerebral ischemia were included. Subjects with dementia at baseline were excluded. The primary endpoint was dementia. Data for demographic and clinical comorbid status and treatments administered at baseline in 2000 and at the end of follow-up in 2013 were included. RESULTS: A total of 4,207 subjects with cerebral vascular disease and no cognitive impairment were included, of whom 392 converted to dementia during an average 5.15-year (SD: 3.79) follow-up. Depression (adjusted HR: 1.54, 95% confidence interval [CI]: 1.13-2.09), osteoporosis (adjusted HR: 1.34, 95% CI: 1.04-1.74), and the use of enalapril (adjusted HR: 1.37, 95% CI: 1.09-1.73) were risk factors for dementia, while nitroglycerin (adjusted HR: 0.67, 95% CI: 0.53-0.85) was a protecting factor, in subjects with cerebrovascular diseases without mention of cerebral infarction. In total, statins were shown to be associated with decreased risk of dementia (HR: 0.73, 95% CI: 0.59-0.91); however, no one statin subtype or TCM had such an effect. CONCLUSION: Depression, osteoporosis, and the use of enalapril were associated with a higher risk of dementia, while nitroglycerin might be a protecting factor for dementia, in subjects with cerebrovascular diseases without mention of cerebral infarction.


Asunto(s)
Trastornos Cerebrovasculares , Demencia , Osteoporosis , Humanos , Estudios Retrospectivos , Demencia/complicaciones , Taiwán/epidemiología , Nitroglicerina/uso terapéutico , Trastornos Cerebrovasculares/epidemiología , Factores de Riesgo , Osteoporosis/complicaciones , Infarto Cerebral/complicaciones , Enalapril/uso terapéutico
14.
Nurs Open ; 10(2): 861-868, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36161708

RESUMEN

AIM: To explore the actual experience of training effect of Baduanjin on patients with hemiplegic limb dysfunctions after cerebral infarction through semistructured interviews and promote Baduanjin training application in clinical and community settings. DESIGN: This qualitative study was conducted using the conventional content analysis approach. METHODS: Twenty-five patients with hemiplegic limb dysfunctions after cerebral infarction were recruited as participants by applying purposive sampling method between September 2017-December 2020 in the physical therapy department of a rehabilitation hospital affiliated with Fujian University of Traditional Chinese Medicine in China. Semistructured interviews were conducted after patients participated in Baduanjin training for 6 weeks. Data were analysed using qualitative content analysis method of Graneheim and Lundman. RESULTS: Three major themes were identified after analysis, namely improving functions of hemiplegic limbs, improving the condition of the entire body and the feelings of practice. The participants indicated that Baduanjin could improve the limb functions and general conditions of hemiplegic patients. Their experience in practicing Baduanjin was generally positive, and they were willing to continue practicing.


Asunto(s)
Terapia por Ejercicio , Hemiplejía , Humanos , Terapia por Ejercicio/métodos , Hemiplejía/etiología , Proyectos de Investigación , Infarto Cerebral/complicaciones , China
15.
Neurologist ; 28(2): 117-122, 2023 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-35776691

RESUMEN

BACKGROUND: About 75% of patients with cerebral infarction suffer from sensory impairment in varying degrees. It prolongs the time for patients to resume normal life and work. The aim of this study was to retrospectively investigate the clinical characteristics affecting the recovery of sensory impairment. MATERIALS AND METHODS: This was a retrospective case-control study. Data of inpatients at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were investigated. We collected information on the patients with sensory disturbances after cerebral infarction. Cases were defined according to whether the National Institutes of Health Stroke Scale (NIHSS) and visual analogue scale (VAS) scores improved. A total of 1078 inpatients from January 1, 2019, to December 31, 2021, were screened. Among those, 187 cases included in this study were divided into no improvement and improvement groups. We compared the clinical characteristics affecting the rehabilitation of these patients. RESULTS: The number of patients aged between 63 and 73 years in the no improvement group were significantly higher ( P <0.05). The incidence of coronary heart disease and thalamus infarction was significantly higher in patients in the no improvement cohort ( P <0.05). Furthermore, coronary heart disease [odds ratio=0.466, 95% confidence interval (0.252, 0.863), P =0.015] and thalamic infarction [odds ratio=0.457, 95% confidence interval (0.230, 0.908), P =0.025] were the independent risk factors against the recovery of sensory disturbance after cerebral infarction. CONCLUSIONS: Patients with thalamus infarction and coronary heart disease may be more inclined to recover poorly from somatosensory deficits.


Asunto(s)
Infarto Cerebral , Estados Unidos , Humanos , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Estudios de Casos y Controles , Infarto Cerebral/complicaciones , Factores de Riesgo , Incidencia
16.
Eur Rev Med Pharmacol Sci ; 26(23): 8852-8859, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36524504

RESUMEN

OBJECTIVE: We performed this longitudinal 2-year follow-up study to determine the incidence and risk factors associated with MCI in middle-aged and older adults. SUBJECTS AND METHODS: This community-based longitudinal study was conducted in adults aged ≥ 50 years with normal cognitive function in Shanghai community, China, over a period of two years. Information about the socio-demographic, behavioral, anthropometric, and biochemical parameters was obtained at the baseline and cognitive function was assessed at the end of the follow-up period using the Montreal cognitive assessment tool. RESULTS: A total of 985 participants aged ≥ 50 years were included in the analysis. Incidence of MCI during the 2-year follow-up period among the study participants was 26.7% (95% CI: 24.0%-29.6%). Participants with lower level of education [primary - adjusted RR=2.79 (95% CI: 1.38-5.64 and secondary - adjusted RR=1.62 (95% CI: 1.17-2.24)], with history of cerebral infarction (adjusted RR=1.49; 95% CI: 1.05-2.12), history of cerebral hemorrhage (adjusted RR=3.20; 95% CI: 1.22-8.40) were found to have significantly higher risk of MCI. Regular tea consumption was associated with significantly reduced risk of MCI development (adjusted RR=0.69; 95% CI: 0.49-0.96). CONCLUSIONS: Our study found that one in four participants developed MCI during the 2-year follow-up period. Lower educational level, history of cerebral infarction, cerebral hemorrhage and tea consumption were significant determinants of MCI incidence. The target groups identified in this study should be closely monitored with regular follow-up investigations for early diagnosis and appropriate management of the condition.


Asunto(s)
Disfunción Cognitiva , Persona de Mediana Edad , Humanos , Anciano , Incidencia , Estudios Longitudinales , Estudios de Seguimiento , China/epidemiología , Disfunción Cognitiva/diagnóstico , Factores de Riesgo , , Hemorragia Cerebral/complicaciones , Infarto Cerebral/complicaciones
17.
Zhongguo Zhen Jiu ; 42(11): 1211-5, 2022 Nov 12.
Artículo en Chino | MEDLINE | ID: mdl-36397216

RESUMEN

OBJECTIVE: To observe the effect of Huayu Tongluo (resolving stasis and promoting collateral circulation) moxibustion combined with intradermal needling on depressive symptoms, quality of life and cognitive impairment in patients with mild to moderate depression after cerebral infarction on the basis of western medicine treatment. METHODS: Fifty patients with mild to moderate depression after cerebral infarction were randomly divided into an acupuncture combined with western medication group (group A, 25 cases) and a western medication group (group B, 25 cases). In the group B, paroxetine hydrochloride tablets were taken orally, 20 mg after breakfast, once a day, and the dose could be adjusted to the maximum 40 mg/d according to the patients' condition, for 4 weeks totally. On the basis of the treatment in the group B, the group A was treated with Huayu Tongluo moxibustion, namely aconite cake-separated moxibustion at Baihui (GV 20) and suspended moxibustion at Dazhui (GV 14) and Shenting (GV 24), combined with intradermal needling at Shenmen (HT 7), Jianshi (PC 5), Zusanli (ST 36), etc. Huayu Tongluo moxibustion was performed 6 times a week, and intradermal needling was performed 3 times a week,for 4 weeks totally. In the two groups, the scores of Hamilton depression scale (HAMD), stroke specific quality of life scale (SS-QOL) and mini mental state examination (MMSE) were observed before and after treatment, and the clinical efficacy and safety were compared. RESULTS: After treatment, the HAMD score in the each group was decreased compared with that before treatment (P<0.05), and that in the group A was lower than the group B (P<0.05); after treatment, the SS-QOL score in the group A and MMSE score in the two groups were increased compared with those before treatment (P<0.05), and the SS-QOL score in the group A was higher than the group B (P<0.05). The total effective rate was 88.0% (22/25) in the group A, which was higher than 60.0% (15/25) in the group B (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (4.0% [1/25] vs 16.0%[4/25], P>0.05). CONCLUSION: On the basis of the treatment of western medication paroxetine hydrochloride tablets, Huayu Tongluo moxibustion combined with intradermal needling therapy can effectively improve the depressive symptoms, quality of life and cognitive impairment of patients with mild to moderate depression after cerebral infarction.


Asunto(s)
Moxibustión , Humanos , Calidad de Vida , Paroxetina , Depresión/etiología , Depresión/terapia , Infarto Cerebral/complicaciones , Infarto Cerebral/terapia
18.
Rinsho Shinkeigaku ; 62(10): 781-786, 2022 Oct 22.
Artículo en Japonés | MEDLINE | ID: mdl-36184412

RESUMEN

A 44-year-old woman was admitted to our hospital due to dizziness and ataxia of the trunk and right upper limb. Brain MRI revealed an acute infarct lesion in the right posterior inferior cerebellar artery territory. In addition to the cognitive deterioration observed in the subacute phase, a change was noted in her food preference-from light-tasting, low-caloric Japanese cuisine, sugarless coffee, and hot drinks to strong-tasting, high-caloric Western cuisine, sugar-rich coffee, and iced drinks. Single-photon emission computed tomography showed hypoperfusion in the bilateral frontal lobes and right cerebellum. These cognitive and food preference-related changes were gradually restored over six months after the onset. The reduced cerebral blood flow in the bilateral frontal lobes also restored along with the clinical improvement, with the maximal changes in the bilateral subcallosal areas. This case suggests that changes in food preference can occur as a symptom of cerebellar infarction, possibly by the mechanism similar to cerebellar cognitive affective syndrome.


Asunto(s)
Isquemia Encefálica , Enfermedades Cerebelosas , Humanos , Femenino , Adulto , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen , Preferencias Alimentarias , Café , Enfermedades Cerebelosas/diagnóstico , Enfermedades Cerebelosas/patología , Isquemia Encefálica/patología , Cerebelo/patología , Azúcares
19.
Zhen Ci Yan Jiu ; 47(10): 859-65, 2022 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-36301161

RESUMEN

OBJECTIVE: To explore the effect of eye acupuncture on autophagy and expressions of autophagy-related proteins Beclin1, LC3B, ATF6 and XBP1 in the infarction area of brain tissue in rats with acute cerebral ischemia-reperfusion injury (CIRI), so as to explore its mechanisms underlying improvement of CIRI. METHODS: Male SD rats were randomly divided into sham operation, model and eye acupuncture groups (n=16 in each group). The CIRI model was prepared by occlusion of the middle cerebral artery. Eye acupuncture stimulation was applied to bilateral "Gan"(Liver), "Shangjiao"(Upper-energizer), "Xiajiao"(Lower-energizer) and "Shen"(Kidney) regions at 0, 12 and 24 h after CIRI, 30 min each time. The neurological deficit score was given by referring to Longa's method, and TTC staining used to determine the success of model replication. After the treatment, the pathological changes of the cerebral infarction area were observed under light microscope, and the autophagosomes were observed by electron microscope. The protein expression levels of LC3B, Beclin1, ATF6 and XBP1 in the infarction area of brain tissue were detected by Western blot. The immunoactivity of Beclin1 and the immunofluorescence density of ATF6 and XBP1 in the infarction area of brain tissue were determined by immunohistochemistry. RESULTS: The Longa's score, and the protein expression levels of LC3B, Beclin1, ATF6 and XBP1 and immunoactivity or immunofluorescence density of Beclin1, ATF6 and XBP1 were significantly higher in the model group than those in the sham operation group (P<0.01), and considerably lower in the eye acupuncture group than those in the model group (P<0.01). Under light microscope, the model group had typical ethmoidal reticular cerebral infarction, while the eye acupuncture group had significantly smaller areas and clearer edges. Under electron microscope, there were more autophagosomes in the cytoplasm of neurons in the model group, and fewer autophagosomes in the eye acupuncture group (in contrast to the model group). CONCLUSION: Eye acupuncture can improve the neurological function and mitigate cerebral injury in CIRI rats which may be associated with its function in inhibiting autophagy in the brain tissue by regulating ATF6 pathway.


Asunto(s)
Terapia por Acupuntura , Isquemia Encefálica , Daño por Reperfusión , Animales , Masculino , Ratas , Factor de Transcripción Activador 6/genética , Autofagia/genética , Beclina-1/genética , Isquemia Encefálica/genética , Isquemia Encefálica/terapia , Infarto Cerebral/complicaciones , Ratas Sprague-Dawley , Daño por Reperfusión/genética , Daño por Reperfusión/terapia
20.
Stroke ; 53(8): 2607-2616, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35674046

RESUMEN

BACKGROUND: Rescue treatment for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage can include induced hypertension (iHTN) and, in refractory cases, endovascular approaches, of which selective, continuous intraarterial nimodipine (IAN) is one variant. The combination of iHTN and IAN can dramatically increase vasopressor demand. In case of unsustainable doses, iHTN is often prioritized over IAN. However, evidence in this regard is largely lacking. We investigated the effects of a classical (iHTN+IAN) and modified (IANonly) treatment protocol for refractory DCI in an observational study. METHODS: Rescue treatment for DCI was initiated with iHTN (target >180 mm Hg systolic) and escalated to IAN in refractory cases. Until July 2018, both iHTN and IAN were offered in cases refractory to iHTN alone. After protocol modification, iHTN target was preemptively lowered to >120 mm Hg when IAN was initiated (IANonly). Primary outcome was noradrenaline demand. Secondary outcomes included noradrenaline-associated complications, brain tissue oxygenation, DCI-related infarction and favorable 6-month outcome (Glasgow Outcome Scale 4-5). RESULTS: N=29 and n=20 patients were treated according to the classical and modified protocol, respectively. Protocol modification resulted in a significant reduction of noradrenaline demand (iHTN+IAN 0.70±0.54 µg/kg per minute and IANonly 0.26±0.20 µg/kg per minute, P<0.0001) and minor complications (15.0% versus 48.3%, unadjusted odds ratio, 0.19 [95% CI, 0.05-0.79]; P<0.05) with comparable rates of major complications (20.0% versus 20.7%, odds ratio, 0.96 [0.23-3.95]; P=0.95). Incidence of DCI-related infarction (45.0% versus 41.1%, odds ratio, 1.16 [0.37-3.66]; P=0.80) and favorable clinical outcome (55.6% versus 40.0%, odds ratio, 1.88 [0.55-6.39]; P=0.32) were similar. Brain tissue oxygenation was significantly higher with IANonly (26.6±12.8, 39.6±15.4 mm Hg; P<0.01). CONCLUSIONS: Assuming the potential of iHTN to be exhausted in case of refractory hypoperfusion, additional IAN may serve as a last-resort measure to bridge hypoperfusion in the DCI phase. With close monitoring, preemptive lowering of pressure target after induction of IAN may be a safe alternative to alleviate total noradrenaline load and potentially reduce complication rate.


Asunto(s)
Isquemia Encefálica , Hipertensión , Hemorragia Subaracnoidea , Vasoespasmo Intracraneal , Isquemia Encefálica/epidemiología , Infarto Cerebral/complicaciones , Infarto Cerebral/tratamiento farmacológico , Protocolos Clínicos , Humanos , Hipertensión/complicaciones , Nimodipina/uso terapéutico , Norepinefrina/uso terapéutico , Estudios Observacionales como Asunto , Hemorragia Subaracnoidea/complicaciones , Vasoespasmo Intracraneal/etiología
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