Kongcun Town Asymptomatic Intracranial Artery Stenosis study in Shandong, China: cohort profile
Xiang WangYuanyuan ZhaoXiaokang JiShaowei SangSai ShaoPeng YanShan LiJifeng LiGuangbin WangMing LüYifeng DuFuzhong XueChengxuan QiuQinjian Sun
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Purpose The population-based Kongcun Town Asymptomatic Intracranial Artery Stenosis (KT-aICAS) study aims to investigate the prevalence of aICAS and major cardiovascular risk factors (CRFs) or biomarkers related to the development and prognosis of aICAS. Participants The KT-aICAS study included 2311 rural residents who were aged ≥40 years and living in Kongcun Town, Shandong Province, China. Baseline examination was conducted from October 2017 to October 2018, during which information on demographics, socioeconomics, personal and family medical history, and lifestyle factors was collected through face-to-face interviews, physical examination and blood tests. aICAS was initially screened using transcranial Doppler examination and then diagnosed using magnetic resonance angiography. Atherosclerosis in carotid arteries was diagnosed via carotid ultrasonography. High-resolution MRI was further used to evaluate the vessel wall of aICAS. Neuropsychological assessments were performed in the participants diagnosed with aICAS and the age-matched and sex-matched controls. Findings to date Of the 2311 participants, 2027 (87.7%) completed the diagnostic procedure and aICAS was detected in 154 persons, resulting in an overall prevalence of 7.6%. The prevalence of aICAS increased with advancing age from 5.1% in participants aged 40–49 years to 12.7% in those aged ≥70 years (p<0.001). aICAS was detected in 305 intracranial arteries, including 221 (72.5%) in the anterior circulation and 84 (27.5%) in the posterior circulation (p<0.001). In addition, major CRFs were highly prevalent among middle-aged and elderly rural dwellers who were free of clinical stroke. Future plans Follow-up examinations will be performed every 3 years following the baseline examination. This study will increase our knowledge about the natural history of aICAS and facilitate studies of aICAS-associated disorders among rural-dwelling Chinese adults, such as ischaemic stroke and vascular cognitive impairment. Trial registration number ChiCTR1800017197.Keywords:
Stroke
Carotid ultrasonography
Neurological examination
Magnetic resonance angiography
Medical History
Transcranial Doppler
Neurological localisation is dependent on history and physical examination and demands that the clinician is aware of those features, encompassed within the clinical setting, that define the neuroanatomy and neurophysiology that defines the focus of any neurological lesion. The paper to follow provides an approach to the neurological evaluation of patients that employs the traditional methods of history, stylised physical examination, incorporating: Higher centres; cranial nerves.
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Cranial nerves
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The case history is the cornerstone for the diagnosis of carpal tunnel syndrome (CTS). The value of neurological examination in CTS seems limited. In this study, we investigated the interobserver agreement in case history of CTS and the potential additional value of neurological examination.Case history was taken and neurological examination was done in all patients referred for a possible CTS during a 6-month period. This was done independently by 2 senior neurologists.We studied 119 patients. The interobserver agreement for the conclusion of CTS after history was high (k = 0.79). Neurological examination rarely changed the diagnosis based on the case history.This study shows a high interobserver agreement in the diagnosis of CTS based on patient history alone. Neurological examination rarely changed this diagnosis, suggesting a prominent role for the case history and a limited role for neurological examination. This may have practical implications.
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Blurred vision
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Introduction: Epilepsy describes a condition in which a person has unprovoked, recurrent seizures due to a chronic, underlying process. Several studies have estimated the prevalence of epilepsy ranging from 5-30 persons per 1000 population. Most of the patients suffering from epilepsy have good control on seizures with the use of antiepileptic medications, however most of the patients with intractable epilepsy have seizures that are focal and can be potentially treated. Objectives of our study: The objective of our study to find out the role of MRI in evaluating the aetiologies of seizures in subjects with seizure disorder. Methodology: We included a total of 150 subjects after taking voluntary consent from the study subjects based on inclusion and exclusion criteria. A detailed proforma was recorded which included subject’s socio demographic data, medical history, personal history, past-history, family history and general physical examination, blood pressure measurement, systemic examination etc. The points noted were duration of illness, type of seizures, and any associated illness. Detailed clinical and neurological examination were done to find out any neurological deficit. Based on the history and examination, a clinic etiological diagnosis was made. Follow up of subjects were done until the completion of treatment (maximum 6 months).
Etiology
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Epilepsy syndromes
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Objective To investigate the clinical application of transcranial Doppler(TCD)in patients with ischemic cerebrovascular diseases(ICVD).MethodsPatients complaining hemiplegia(n=38)or dizziness(n=35)after ICVD were detected with TCD and magnetic resonance angiography(MRA).ResultsThe incidence of abnormal intracranial large arteries detection was similar in patients complaining hemiplegia(χ2=1.03,P0.05)between TCD and MRA,but different in patients complaining dizziness(χ2=10.76,P0.05).ConclusionIn the patients with ICVD,TCD can be used in those complaining hemiplegia as a screening test before vascular interventional therapy,but be worthless in those complaining dizziness.
Transcranial Doppler
Magnetic resonance angiography
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Transcranial Doppler
Circle of Willis
Magnetic resonance angiography
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Stroke
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