Treatment possibilities of basal ganglia hemorrhage: Retrospective trial of fifty-four patients

WCN 2013 No: 2498 Topic: 3 — Stroke Treatment possibilities of basal ganglia hemorrhage: Retrospective trial of fifty-four patients A. Soldo, N. Koruga, S. Butkovic Soldo, D. Stimac, I. Hecimovic. Neurology, Clinical Hospital Center Osijek, Osijek, Croatia; Neurosurgery, Clinical Hospital Center Osijek, Osijek, Croatia Background: Intracerebral hemorrhage presents a challenge for both neurologists and neurosurgeons and constitutes up to 15% of the total number of cerebrovascular incidents. Objective: The aim of this trial is to present an outcome of conservative and surgical treatment of intracerebral hemorrhage in our hospital. Patients and methods: All patients underwent CT on admission. The treatment depended on CT confirming intracerebral hemorrhage and regarding progressive neurological deterioration of consciousness, brain edema or shift effect. These patients underwent a prompt surgical treatment with decompressive craniotomy and clot removal or external ventricular drainage as standard approach. The other patients underwent conservative treatment which consisted of antiedematous therapy and blood pressure regulation. Results: In a group of fifty-four patients, fifty-one patients were treated conservatively and three patients were treated surgically. Conservatively treated patients and three patients treated surgically showed clinical improvement with satisfying additional postoperative CT scan within 48–72 h. Conclusion: The trial showed that there is no difference between conservative and surgical treatment, although surgical treatment was superior in cases of progressive neurological deterioration with GCS 5–11. According to our retrospective trial, we can conclude that there was no significant difference between conservative and surgical treatment during the follow-up period of three months. doi:10.1016/j.jns.2013.07.943 Abstract — WCN 2013 No: 2477 Topic: 3 — Stroke Impact of heat shock protein on ischemic stroke risk Z. Banecka-Majkutewicz, R. Hebel, A. Papkov, A. Wegrzyn, B. Banecki, W.M. Nyka. Department of Neurology, Medical University of Gdansk, Poland; Department of Molecular and Cellular Biology, University of Gdansk, Gdansk, Poland; Department of Microbiology, University of Szczecin, Szczecin, Poland Heat shock protein 72 (HSP72) has been found to reduce ischemic injury. HSP72 itself may be a marker for neuroprotection in ischemic stroke. The aim of the study was to investigate the association between HSP plasma concentration and risk of ischemic stroke. We also investigated MTHFR and CBS genotypes. Methods: We have measured the level of antibodies against HSPs in vitro, in serum of ischemic stroke patients and control group using ELISA. We study the prevalence of MTHFR (C677T, A1298T) and CBS (T833C, insertion 68 bp in position 844) genotypes. Results: Heterozygotic genotype C677T of MTHFR was detected in 45% of patients, and A1298T in 43%. 5% of homozygotic C677C and 8% of T1298T were detected. In 87.5% of subjects at least one heterozygotic mutation was detected. Hyperhcy was correlated with mutations in either gene (p= 0.04). The level of antibodies against one of the bacterial HSPs, GroEL, correlates with the level of serum hcy. It points at the possible significance of autoimmune reactions contributing to atherosclerosis. We have also purified MTHFR and tested the influence of HSPs of the KJEB system in vitro, using spectrophotometric test for MTHFR activity. We found that MTHFR is partially protected from the effect of heat shock by KJEB system and that KJEB proteins can restore that activity of the enzyme when it is lost due to thermal denaturation. Conclusions:Our study confirmsdiagnostic significance of antibodies to HSP in stroke. HSPs can be involved in the development of atherosclerosis, as well as protection against stroke. doi:10.1016/j.jns.2013.07.944 Abstract — WCN 2013 No: 2463 Topic: 3 — Stroke Tympanic temperature matches the brain temperature, fact or fiction? WCN 2013 No: 2463 Topic: 3 — Stroke Tympanic temperature matches the brain temperature, fact or fiction? P. Kordestani Moghadam, P. Mirzavand, F. Manteghi. ICSS, Institute for Cognitive Science Studies, Tehran, Iran; LUMS, Lorestan University of Medical Sciences, Iran; ICU of Shohada Hospital, LUMS, Lorestan University of Medical Sciences, Khorramabad, Iran This study is a case series, which was conducted on 10 CVA patients whowere admitted in the ICUward. These subjects consist of unilateral or bilateral ICH. GCS, vital sign and tympanic temperature were controlled for the subjects within one week. Tympanic temperature measured from the left and the right ear. After this time we observed the meaningful difference between the left and the right tympanic temperature in patients with a unilateral lesion, but this difference was not seen in patients with bilateral lesions. Based on these results, it seems that we used tympanic temperature in early diagnosis of hemorrhagic lesion in the affected side of the brain, just as the case in unilateral hemorrhagic lesion in patients with different etiologies. doi:10.1016/j.jns.2013.07.945 Abstracts / Journal of the Neurological Sciences 333 (2013) e215–e278 e243