Caffeinol confers cortical but not subcortical neuroprotection after transient focal cerebral ischemia in rats
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Histopathology
The aim of this study was to correlate the magnetic resonance (MR) imaging findings in pituitary apoplexy with histopathological results and determine whether the histopathology influences clinical presentation and outcome.The records of 36 patients with histologically confirmed pituitary apoplexy, who were treated surgically at the University of Virginia Health System between 1996 and 2006, were retrospectively reviewed. The MR images were divided into 3 groups: 1) infarction alone; 2) hemorrhage with or without infarction; and 3) tumor only with no evidence of apoplexy. The histological examination was divided into infarction alone or hemorrhagic infarction/hemorrhage. The MR imaging findings were then correlated with the histopathological results to assess how accurately the histopathology was predicted by the MR imaging. The clinical features and outcomes of the two histopathological groups were also compared.The MR imaging findings were able to predict the histopathology accurately in the majority of cases. The group of patients with infarction had less severe clinical features and a better outcome than those with hemorrhagic infarction/hemorrhage.Magnetic resonance imaging findings in the setting of pituitary apoplexy accurately predict the nature of the apoplectic process and help to guide the type and timing of therapy.
Histopathology
Pituitary apoplexy
Histopathological examination
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Objective To research the characteristics or intelligence damage and the influence of different infarcted parts on intelli.gence in cerebral infarction patients. Methods The intelligence test and analysis was performed in 48 cases of cerebralinfarction add 43 normal subjects by WAIS-RC. The dysnoisia degree of patients were compared with that of normal subjects, the relationship between dysnoisia and region of infarction was analyzed. Results For every tested items, the scores of cerebral infarction group are significantly lower than that of control group (P 0.01),the dysnoisia scores of left part infarcted cases are lower than that of right part infarcted, the cerebral cortex infarction are significantly lower than cerebral subcortex (P 0.01). Conclusion Cerebral infarction can cause obvious intellectual dysfunction.The influences of left side infarction on intelligence is more serious than thatof right side, especially for that of language expression and abstract thought. The damage of intelligence of cerebral cortex infarction is more serious than that of cerebral subcortex infarction.
Brain damage
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Patients with disseminated intravascular coagulation (DIC) due to sepsis often develop cerebral infarction; but the frequency, mechanism of onset and prognosis have not been fully elucidated. We reported courses and characteristics of septic DIC cases hospitalized in our hospital in the present study.Patients with septic DIC who underwent brain imaging were selected. Vital signs, disorders of consciousness and blood test results at the time of onset were compared between cases that developed cerebral infarction (cerebral infarction group) and those that did not (non-infarction group).In cases of cerebral infarction, the site and the size of the infarct lesion were also described.In 27 septic DIC patients who underwent brain imaging, eight patients had cerebral infarction. Although the percentage of patients who survived in the cerebral infarction group (2/8, 25%) was lower than that in the non-infarction group (7/17, 37%), , no significant difference was observed as both group showed poor prognoses. Those two patients who survived in the cerebral infarction group had severe consciousness disturbance and poor functional prognosis. Although the body temperature was significantly lower and the blood pressure was higher in the cerebral infarction group, no significant difference was found in general blood tests, so we thought it would be necessary to look for other markers that could be indicators for the risk of cerebral infarction.In the cerebral infarction group, two cases had a single lesion, and six cases had multiple lesions. Of the latter, two cases had massive lesions with a diameter of 1.5 cm or greater, four cases had only small lesions with a diameter of less than 1.5 cm, and two cases had a mixture of both. Most of the patients had lesions in the vertebrobasilar artery, which suggested that the pathogenesis involves not only embolism due to microthrombi, but also vasculitis and intravascular inflammation.Cerebral infarction was observed highly frequently; eight out of 27 cases (29.6%) when brain imaging was undergone in septic DIC patients. The prognosis of patients with cerebral infarction was poor, but no difference from the non-infarction group was observed. In addition to embolism, the presence of inflammation is considered to be important for the onset. In order to predict the prognosis and determine a suitable treatment, it would be recommended to undergo brain imaging when patients with septic DIC have consciousness disturbance or elevated blood pressure, and do not have fever.
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Objective Observe the dynamic changes of EAA in patients with cerebral infarction and the relation of EAA levels to infarct size and intensity of neurological deficit, the EAA in blood and cerebrospinal fluid(CSF) were detected to investigation the effect of EAA to the time course of in Ischemic stroke. Methods High performance liquid chromatography(HPLC) was use to detected the levels of Glu and Asp in blood and CSF. The samples were taken from 33 cases of patients with cerebral infarction during 7 hours～10 days after the ictus and 10 healthy persons were detected as the normal control. Results Concentrations of Glu and Asp began to increase significantly in 24 hours, and in the 3rd day reached the peak. It began to decrease after the 5th day and 7 days after infarction it returned to normal level. The concentration of Glu and Asp in blood correlated positively to that in CSF after infarction.The levels of Glu significantly correlated with the diameter of the infarction site,stage and neurological functional scales. Conclusion The Glu and Asp played the important roles in the pathologic process of cerebral infarction, the detection of Glu and Asp were helpful to the study of basis and clinic of cerebral infarction.
Stroke
Brain infarction
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Objective:To explore the relationship between the serum level change of adiponectin(ADP) and the infarction volume of patients with acute cerebral infarction.Methods:The serum level of ADP of patients in cerebral infarction group and control group was detected by ELISA.The cerebral infarction group was divided into lacunar infarction group and cerebral infarction group.Results:The serum level of ADP was obvious lower in 48 hours after infarction in cerebral infarction group than control group,and was obvious negative relation with the infarction volume.The serum level of ADP was obvious higher in lacunar infarction group than cerebral infarction group.Conclusion:The serum level of ADP of patients with acute cerebral infarction decreases obviously in 48 hours after infarction and is negative relation with the infarction volume.The detection of serum ADP can help to diagnose the acute cerebral infarction early and judge the severity of patients' condition.
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Objective The CT values and glial fibrillary acidic Drotein (GFAP) expression changes within 24 hours in the cerebral infarction of rats were observed in order to evaluate the time of infarction indirectly. Methods The animal models of cerebral infarction due to the embolism of middle cerebral arteries were replicated reference to Longa’s thread embolism method. The rats with cerebral infarction in right hemisphere and without cerebral infarction in left cerebral hemisphere were scanned with CT at different time after cerebral infarction,then the CT values were measured and their differences were calculated. At the same time,the GFAP expression changes were detected by immunohistochemical technique (SP method). Results The infarction focuses were observed in all rats in 6 hours group. The differences of the CT values in the infarction hemisphere (right side in brain) and non-infarction (left side in brain) hemisphere had in linear relationship,and the GFAP expression also related to the time of infarction to certain degree. Conclusion Cerebral infarction due to embolism of blood vessel could be diagnosed at least 6 hours after middle cerebral artery occlusion. The time of cerebral infarction could be inferred by the difference of CT values between the infarction and non-infarction hemispheres and the changes of GFAP expression.
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Stroke
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Objective The similarities and differences of patients with cerebral infarction by comparing the infarction of patients with middle cerebral artery (MCA) aneurysms to the infarction of patients with Moyamoya diseases, and the characteristics of these two diseases were summed up. Methods Between Jun. 2008 and Jun. 2009, 26 patients suffered with cerebral infarction were hospitalized in Beijing Tian-tan hospital. Among these 26 patients, 10 cases were combined with MCA aneurysms, and another 16 were with Moyamoya diseases. The data of patients were retrospectively collected, such as age, gender, smoking, site and volume of infarction. Results Among 10 cases with cerebral infarction and MCA aneurysms, four were male, six were female, and their aged was (57.3 ±4.11) years old. The sites of infarction were multiple lacouna infarction in 7 cases, and basal ganglia and corpus callosum in 3 cases. The volume of cerebral infarction was (4.82±2.05)cm 3 . Among 16 cases with cerebral infarction and Moyamoya diseases, nine were male, seven were female, and their age was 28.6±10.06 years old. The sites of infarction involving four brain lobes were found in 2 cases, three lobes were found in 4 cases, two lobes were in 8 cases, multiple lacouna infarction were in 1 case, and basal ganglia and centrum ovale were in 1 case. The volume of cerebral infarction was (22.3±12.06)cm 3 . Conclusion The patients suffered with cerebral infarction and MCA aneurysms are older than the patients with infarction and Moyamoya diseases. The size of cerebral infarction in patients with MCA aneurysms is smaller than the size in patients with Moyamoya diseases.
Moyamoya Disease
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To investigate whether transient ischemic attack (TIA) had an ischemic preconditioning neuroprotective effect on subsequent cerebral infarction.232 patients with cerebral infarction were selected and divided into Group A (<55 years old), Group B (55-75 years old) and Group C (>75 years old), according to age. Each group was further divided into sub-groups A1, A2, B1, B2, C1, C2, according to whether there was any TIA within 48 hours after cerebral infarction or not, to compare the neurological deficit scores and the size of cerebral infarction in different groups.Neurological deficit scores and the size of cerebral infarction in Group A1 and Group B1 were significantly lower than those in Group A2 and Group B2 (p<0.05); Differences between Group C1 and Group C2 were similar (p>0.05).TIA before cerebral infarction may have a neuroprotective effect on subsequent cerebral infarction, which was closely related to the age of patients.
Neurological deficit
Brain infarction
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Objective :To investigate the correlation of D-dimer(DD) and cerebral infarction subtype.Methods :156 patients with cerebral infarction and the onset less than 72 hours were tested by CT and accorded with the cerebral infarction standard;their serous DD were examined through the latex agglutination test(LX) and were compared in different groups.Results: The serous DD in embolism was the highest(p0.01);the DD in thrombosis was higher than lacunar infarction group and watershed infarction group(p0.01);the DD in watershed infarction group was the lowest(p0.01) and compared with lacunar infarction group had no difference(p0.05).Conclusion: The serous DD was distinctly high in the onset of cerebral infarction and the degree was different in the subtypes;these are important to classify the acute cerebral infarction in the onset and to the therapy.
Lacunar infarction
Cerebral embolism
D-dimer
Latex fixation test
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