While imaging studies with English-speaking children showed that reading achievement of children is associated with their brain profiles during speech perception tasks, little is known about the neurocognitive processing of normal
Chinese students with different reading proficiencies: To study the neurocognitive processing on Chinese and the input of reading level on the process, seventeen six year old students with Chinese as their first language were recruited for the research study. These students were further assessed by a reading test to distinguish their Chinese reading ability. Those scored 2/3 deviation
below the cultural mean score were classified as low-proficiency readers. Those scored between 2/3 below or above the mean score were classified as intermediate-proficiency readers. Those scored 2/3 standard deviation above the mean score were regarded as high-proficiency readers. During the experiment, 12 pairs of Chinese syllables evenly distributed in three stimuli blocks were presented to the students acoustically and they had to judge whether each pair of syllables was the same in rhyme
or not. Throughout the whole process the students' brain activation profiles were assessed by FMRl examination using the BOW (blood oxygen level dependent) contrast method in a 1. 5 T MRI system. Result analysis was focussed on the possible neurocognitive discrepancies between students of varying reading proficiency on phonological sensitivity.
Abstract Although most therapeutic efforts and experimental stroke models focus on the concept of complete occlusion of the middle cerebral artery as a result of embolism from the carotid artery or cardiac chamber, relatively little is known about the stroke mechanism of intrinsic middle cerebral artery stenosis. Differences in stroke pathophysiology may require different strategies for prevention and treatment. We prospectively studied 30 consecutive acute ischemic stroke patients with middle cerebral artery stenosis detected by transcranial Doppler and magnetic resonance angiography. Patients underwent microembolic signal monitoring by transcranial Doppler and diffusion‐weighted magnetic resonance imaging. Characteristics of acute infarct on diffusion‐weighted magnetic resonance imaging were categorized according to the number (single or multiple infarcts) and the pattern of cerebral infarcts (cortical, border zone, or perforating artery territory infarcts). The data of microembolic signals and diffusion‐weighted magnetic resonance imaging were assessed blindly and independently by separate observers. Diffusion‐weighted magnetic resonance imaging showed that 15 patients (50%) had single acute cerebral infarcts and 15 patients had multiple acute cerebral infarcts. Among patients with multiple acute infarcts, unilateral, deep, chainlike border zone infarcts were the most common pattern (11 patients, 73%), and for single infarcts, penetrating artery infarcts were the most common (10 patients, 67%). Microembolic signals were detected in 10 patients (33%). The median number of microembolic signals per 30 minutes was 15 (range, 3–102). Microembolic signals were found in 9 patients with multiple infarcts and in 1 patient with a single infarct ( p = 0.002, χ 2 ). The number of microembolic signals predicted the number of acute infarcts on diffusion‐weighted magnetic resonance imaging (linear regression, adjusted R 2 =0.475, p < 0.001). Common stroke mechanisms in patients with middle cerebral artery stenosis are the occlusion of a single penetrating artery to produce a small subcortical lacuna‐like infarct and an artery‐to‐artery embolism with impaired clearance of emboli that produces multiple small cerebral infarcts, especially along the border zone region.
To investigate the optimal values of flow velocity on transcranial Doppler (TCD) in grading the severity of middle cerebral artery (MCA) stenosis in comparison with magnetic resonance angiography (MRA).Both TCD and MRA examinations were performed on 148 asymptomatic patients. The peak flow velocities of each MCA were recorded. Severity of MCA stenosis on MRA was classified as normal-mild (< 50% lumen diameter reduction), moderate (50%-75%), and severe-void (> 75% and void of flow signal).Among 296 MCAs evaluated, normal-mild stenosis was found in 75 (25%), moderate stenosis in 112 (38%), and severe stenosis in 109 (37%). The mean of systolic velocity (Vs) of MCA differed significantly among these three groups: mean Vs = 121.83 +/- 22.52 cm/s in the normal-mild group; 155.96 +/- 21.62 cm/s for the moderate group; and 199.39 +/- 43.86 cm/s for the severe group (P < .001). The optimal cutoff velocity for detection of MCA (> 50%) stenosis was found at Vs > 140 cm/s on TCD (area under the ROC curve is 0.87, P < 0.001). The best cutoff points for grading severity of on TCD were 140 cm/s and 180 cm/s.TCD enables grading of the severity of MCA stenosis according to the flow velocity. This method provides a noninvasive and reliable method for grading MCA stenosis and allows longitudinal monitoring of the relationship between clinical outcome and hemodynamic change.
A Chinese woman aged 41 years sought treatment at the Prince of Wales Hospital in Hong Kong in November 2001 for sudden-onset right eye blindness. She had good heath in the past and had a normal spontaneous nontraumatic delivery 2 months previously. She had acute loss of vision predominantly affecting the lateral aspect of right eye, which gradually resolved in few days with mild residual blurred vision. There was no preceding headache, neck pain, or other neurologic complaints. There was no recent history of trauma or exercise that involved excessive neck movement, such as yoga. On detailed questioning about any recent abnormal posture or exercise, she reported she had constant neck tilting to the right side every night since her baby was born 2 months earlier, so that her head was in constant contact with her newborn baby during sleep …
Blood Flow Volume Quantification of Cerebral IschemiaComparison of Three Noninvasive Imaging Techniques of Carotid and Vertebral ArteriesStella Sin Yee Ho1, Yu Leung Chan1, David Ka Wai Yeung1 and Constantine Metreweli1Audio Available | Share
Abstract Advances in technology have made possible the clinical application of magnetic resonance cholangiography, endoscopic, intra‐operative and laparoscopic ultrasound in the study of the biliary tree, in addition to conventional magnetic resonance imaging and transabdominal ultrasound. The role of the conventional, as well as the newer techniques, in the diagnosis of bile duct disease and the limitations and pros and cons of each technique, will be the subject of the present discussion.
Background and Purpose —Intracranial large-artery occlusive disease is the predominant vascular lesion found in stroke patients of Asian, African, and Hispanic ancestry, making it numerically perhaps the most common vascular cause of stroke in the world. Relatively little is known about the clinical significance of finding such lesions. We investigate whether the presence and the extent of these vascular lesions help predict outcome after stroke. Methods —On the basis of transcranial Doppler of the intracranial arteries with supplementary duplex ultrasound of the carotid arteries, we determined the number of occlusive arteries in the craniocervical circulation of consecutive patients who were hospitalized for acute cerebral ischemia. Patients were followed for 6 months for further vascular events (including transient ischemic attack, stroke, and acute coronary syndrome) or death. Results —Among 705 consecutive Chinese patients studied, occlusive arteries were found in 345 patients (49%): 258 patients (37%) had intracranial lesions only, 71 (10%) had both extracranial and intracranial lesions, and 16 (2.3%) had extracranial lesions only. Sixty-three (18%) of the 345 patients with occlusive arteries and 35 (9.7%) of the 360 patients without occlusive arteries had further vascular event or death within 6 months. The risk of vascular events or death increased rapidly with rising numbers of occlusive arteries, after adjustment for vascular risk factors and stroke severity (adjusted odds ratio [OR] 1.25 per occlusive artery, 95% CI 1.12 to 1.39). Other independent risk factors included age (OR 1.03 per year of age, 95% CI 1.01 to 1.05) and atrial fibrillation (OR 3.00, 95% CI 1.40 to 6.69). Conclusions —In patients with predominantly intracranial large-artery occlusive disease, the presence and the total number of occlusive arteries in the craniocervical circulation predict further vascular events or death within 6 months after stroke. Transcranial Doppler ultrasound is an important investigation for the evaluation of patients with stroke in populations at risk of intracranial atherosclerotic disease.
'/%3e%3cuse xlink:href='%23a' transform='rotate(144 450 300)'/%3e%3cuse xlink:href='%23a' transform='rotate(216 450 300)'/%3e%3cuse xlink:href='%23a' transform='rotate(288 450 300)'/%3e%3c/svg%3e)
'/%3e%3cpath d='M200 752.362h200v300H200z' style='fill:%23fff;fill-opacity:1;stroke:none' transform='translate(0 -752.362)'/%3e%3cpath d='M400 752.362h200v300H400z' style='fill:%23ff883e;fill-opacity:1;stroke:none' transform='translate(0 -752.362)'/%3e%3c/svg%3e)