{"title":"Successful treatment with rituximab in a patient with lupus cerebritis and posterior reversible encephalopathy syndrome: a case report","authors":"Saemi Choi, Young Seo Kim","doi":"10.18700/jnc.210028","DOIUrl":"https://doi.org/10.18700/jnc.210028","url":null,"abstract":",","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47733271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ver, myalgia, and vomiting. His systolic blood pressure was below 60 mmHg, and he was admitted to the intensive care unit with the suspicion of septic shock. After admission, Streptococcus pneumonia was found in his blood, and treatment with vancomycin 2 g/day and ceftriaxone 4 g/day was initiated. Following antibiotic treatment for 4 days, his mentation deteriorated to a stupor. Brain magnetic resonance imaging (MRI) indicated hydrocephalus, ventriculitis, and choroid plexitis (Fig. 1). Cerebrospinal fluid (CSF) examination showed normal opening pressure (180 mmHg), pleocytosis (white blood cell count, 280; neutrophils, 55%), high protein level (1,448 mg/dL), and low glucose levels (CSF, 54 mg/dL; serum, 135 mg/dL). Consequently, a high dose of steroids (dexamethasone, 40 mg/day) was prescribed together with antibiotics. After 14 days of antibiotic treatment, his general condition improved. Brain MRI findings depicting pyogenic ventriculitis typically include ependymal thickening and enhancement with T2 prolongation surrounding the ventricle, hydrocephalus, and debris within the dependent aspect of the ventricles [1,2]. In addition, diffusion restriction and swelling of the choroid plexus are suggestive Serial brain magnetic resonance imaging in a patient with invasive streptococcal infection with ventriculitis and choroid plexitis Jaewoon Chung, MD; Ji Young Lee, MD, PhD; Young Seo Kim, MD, PhD Department of Neurology, Hanyang University College of Medicine, Seoul, Korea Department of Radiology, Hanyang University College of Medicine, Seoul, Korea Received: October 11, 2021 Revised: November 26, 2021 Accepted: November 26, 2021
肌肉痛，还有呕吐。收缩压低于60mmhg，怀疑感染性休克入住重症监护病房。入院后血液中检出肺炎链球菌，开始万古霉素2g /天、头孢曲松4g /天治疗。抗生素治疗4天后，患者精神状态恶化为昏迷。脑磁共振成像(MRI)显示脑积水、脑室炎和脉络膜丛炎(图1)。脑脊液(CSF)检查显示开口压正常(180 mmHg)，细胞增多(白细胞计数280;中性粒细胞，55%)，高蛋白水平(1,448 mg/dL)，低糖水平(CSF, 54 mg/dL;血清，135 mg/dL)。因此，高剂量类固醇(地塞米松，40毫克/天)与抗生素一起开处方。经过14天的抗生素治疗，他的一般情况有所改善。描述化脓性脑室炎的脑MRI表现通常包括室管膜增厚和增强，伴脑室周围T2延长、脑积水和脑室依赖面内的碎片[1,2]。此外，脑室炎和脉络膜丛炎合并侵袭性链球菌感染患者的扩散受限和脉络膜丛肿胀提示连续脑磁共振成像;Ji Young Lee, MD, PhD;Young Seo Kim, MD，博士，韩国首尔汉阳大学医学院神经内科，韩国首尔汉阳大学医学院放射学系接收日期:2021年10月11日修订日期:2021年11月26日接收日期:2021年11月26日
{"title":"Serial brain magnetic resonance imaging in a patient with invasive streptococcal infection with ventriculitis and choroid plexitis","authors":"Jaewoon Chung, Ji Young Lee, Young Seo Kim","doi":"10.18700/jnc.210026","DOIUrl":"https://doi.org/10.18700/jnc.210026","url":null,"abstract":"ver, myalgia, and vomiting. His systolic blood pressure was below 60 mmHg, and he was admitted to the intensive care unit with the suspicion of septic shock. After admission, Streptococcus pneumonia was found in his blood, and treatment with vancomycin 2 g/day and ceftriaxone 4 g/day was initiated. Following antibiotic treatment for 4 days, his mentation deteriorated to a stupor. Brain magnetic resonance imaging (MRI) indicated hydrocephalus, ventriculitis, and choroid plexitis (Fig. 1). Cerebrospinal fluid (CSF) examination showed normal opening pressure (180 mmHg), pleocytosis (white blood cell count, 280; neutrophils, 55%), high protein level (1,448 mg/dL), and low glucose levels (CSF, 54 mg/dL; serum, 135 mg/dL). Consequently, a high dose of steroids (dexamethasone, 40 mg/day) was prescribed together with antibiotics. After 14 days of antibiotic treatment, his general condition improved. Brain MRI findings depicting pyogenic ventriculitis typically include ependymal thickening and enhancement with T2 prolongation surrounding the ventricle, hydrocephalus, and debris within the dependent aspect of the ventricles [1,2]. In addition, diffusion restriction and swelling of the choroid plexus are suggestive Serial brain magnetic resonance imaging in a patient with invasive streptococcal infection with ventriculitis and choroid plexitis Jaewoon Chung, MD; Ji Young Lee, MD, PhD; Young Seo Kim, MD, PhD Department of Neurology, Hanyang University College of Medicine, Seoul, Korea Department of Radiology, Hanyang University College of Medicine, Seoul, Korea Received: October 11, 2021 Revised: November 26, 2021 Accepted: November 26, 2021","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41691864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Lozada‐Martínez, Teddy Javier Padilla-Durán, Jhon Jairo González-Monterroza, Daniel Alfonso Aguilar-Espinosa, K. Molina-Perea, William Camargo-Martínez, Luz Katica Llamas-Medrano, Mariana Hurtado-Pinillos, Alejandra Guerrero-Mejía, Tariq Janjua, L. Moscote-Salazar
Magnesium (Mg) is a chemical element that is essential for human life. In the brain, it is physiologically responsible for many processes involved in intracellular homeostasis, blood-brain barrier integrity, protein synthesis, neuronal proliferation, aging, and apoptosis [1]. This element is also a special target of research and Basic considerations on magnesium in the management of neurocritical patients Ivan David Lozada-Martinez, MS; Teddy Javier Padilla-Durán, MD; Jhon Jairo González-Monterroza, MD; Daniel Alfonso Aguilar-Espinosa, MD; Kelly Nathalia Molina-Perea, MD; William Camargo-Martinez, MS; Luz Llamas-Medrano, MS; Mariana Hurtado-Pinillos, MS; Alejandra Guerrero-Mejía, MD; Tariq Janjua, MD; Luis Rafael Moscote-Salazar, MD, PhD(c) Medical and Surgical Research Center, Cartagena, Colombia Colombian Clinical Research Group in Neurocritical Care, School of Medicine, University of Cartagena, Cartagena, Colombia Latin American Council of Neurocritical Care, Cartagena, Colombia School of Medicine, Universidad del Magdalena, Santa Marta, Colombia School of Medicine, Universidad de la Sabana, Chía, Colombia School of Medicine, Fundación Universitaria Juan N Corpas, Bogotá, Colombia Colombian Clinical Research Group in Neurocritical Care, School of Medicine, Fundación Universitaria Autonoma de las Americas, Pereira, Colombia School of Medicine, Universidad de Manizales, Manizales, Colombia Department of Intensive Care, Regions Hospital, St Paul, MN, USA REVIEW ARTICLE
镁(Mg)是一种对人类生命至关重要的化学元素。在大脑中，它在生理上负责细胞内稳态、血脑屏障完整性、蛋白质合成、神经元增殖、衰老和凋亡等许多过程。这一元素也是研究的一个特殊目标和镁在神经危重症患者管理中的基本考虑。泰迪·哈维尔Padilla-Durán医学博士;Jhon Jairo González-Monterroza, MD;Daniel Alfonso Aguilar-Espinosa, MD;凯利·纳塔利亚·莫利纳-佩雷亚，医学博士;威廉·卡马戈-马丁内斯，MS;Luz Llamas-Medrano, MS;玛丽安娜·赫尔塔多-皮尼洛斯，硕士;Alejandra Guerrero-Mejía, MD;Tariq Janjua医学博士;Luis Rafael moscotes - salazar，医学博士，博士(c)哥伦比亚卡塔赫纳卡塔赫纳大学医学院哥伦比亚神经危重症临床研究小组哥伦比亚卡塔赫纳拉丁美洲神经危重症护理委员会卡塔赫纳哥伦比亚医学院马格达莱纳大学圣玛尔塔哥伦比亚医学院萨巴纳大学Chía哥伦比亚医学院Fundación波哥大胡安·N·科帕斯大学哥伦比亚哥伦比亚神经危重症临床研究小组，医学院，Fundación美洲自治大学，佩雷拉，哥伦比亚医学院，马尼萨莱斯大学，马尼萨莱斯，哥伦比亚重症监护部，地区医院，圣保罗，MN，美国
{"title":"Basic considerations on magnesium in the management of neurocritical patients","authors":"I. Lozada‐Martínez, Teddy Javier Padilla-Durán, Jhon Jairo González-Monterroza, Daniel Alfonso Aguilar-Espinosa, K. Molina-Perea, William Camargo-Martínez, Luz Katica Llamas-Medrano, Mariana Hurtado-Pinillos, Alejandra Guerrero-Mejía, Tariq Janjua, L. Moscote-Salazar","doi":"10.18700/jnc.210018","DOIUrl":"https://doi.org/10.18700/jnc.210018","url":null,"abstract":"Magnesium (Mg) is a chemical element that is essential for human life. In the brain, it is physiologically responsible for many processes involved in intracellular homeostasis, blood-brain barrier integrity, protein synthesis, neuronal proliferation, aging, and apoptosis [1]. This element is also a special target of research and Basic considerations on magnesium in the management of neurocritical patients Ivan David Lozada-Martinez, MS; Teddy Javier Padilla-Durán, MD; Jhon Jairo González-Monterroza, MD; Daniel Alfonso Aguilar-Espinosa, MD; Kelly Nathalia Molina-Perea, MD; William Camargo-Martinez, MS; Luz Llamas-Medrano, MS; Mariana Hurtado-Pinillos, MS; Alejandra Guerrero-Mejía, MD; Tariq Janjua, MD; Luis Rafael Moscote-Salazar, MD, PhD(c) Medical and Surgical Research Center, Cartagena, Colombia Colombian Clinical Research Group in Neurocritical Care, School of Medicine, University of Cartagena, Cartagena, Colombia Latin American Council of Neurocritical Care, Cartagena, Colombia School of Medicine, Universidad del Magdalena, Santa Marta, Colombia School of Medicine, Universidad de la Sabana, Chía, Colombia School of Medicine, Fundación Universitaria Juan N Corpas, Bogotá, Colombia Colombian Clinical Research Group in Neurocritical Care, School of Medicine, Fundación Universitaria Autonoma de las Americas, Pereira, Colombia School of Medicine, Universidad de Manizales, Manizales, Colombia Department of Intensive Care, Regions Hospital, St Paul, MN, USA REVIEW ARTICLE","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43721748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Mahesh, A. Pathak, R. Chaurasia, Anand B Kumar, V. K. Singh
Guillain-Barré syndrome (GBS) is an acute and fulminant polyradiculoneuropathy that is autoimmune in nature and characterized by acute flaccid paralysis, with or without sensory abnormalities. GBS is predominantly classified as demyelinating and axonal types. The three common subtypes are acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy (AMAN), and acute motor and sensory axonal neuropathy (AMSAN) [1]. Creatine kinase (CK) catalyzes the breakdown of creatine and adenosine triphosphate into phosphocreatine and Flaccid quadriparesis with raised creatine kinase in Guillain-Barré syndrome: a case report with review of literature
{"title":"Flaccid quadriparesis with raised creatine kinase in Guillain-Barré syndrome: a case report with review of literature","authors":"B. Mahesh, A. Pathak, R. Chaurasia, Anand B Kumar, V. K. Singh","doi":"10.18700/jnc.210011","DOIUrl":"https://doi.org/10.18700/jnc.210011","url":null,"abstract":"Guillain-Barré syndrome (GBS) is an acute and fulminant polyradiculoneuropathy that is autoimmune in nature and characterized by acute flaccid paralysis, with or without sensory abnormalities. GBS is predominantly classified as demyelinating and axonal types. The three common subtypes are acute inflammatory demyelinating polyradiculoneuropathy, acute motor axonal neuropathy (AMAN), and acute motor and sensory axonal neuropathy (AMSAN) [1]. Creatine kinase (CK) catalyzes the breakdown of creatine and adenosine triphosphate into phosphocreatine and Flaccid quadriparesis with raised creatine kinase in Guillain-Barré syndrome: a case report with review of literature","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":"505 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41282506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of extracorporeal membrane oxygenation (ECMO) to treat patients with cardiac arrest (CA) was first described in 1957 when several patients with CA refractory to conventional cardiopulmonary resuscitation (CCPR) including open cardiac massage were placed on cardiopulmonary bypass (CPB), allowing time for an attempt at definitive management [1]. A percutaneous system for ECMO cannulation initiated at the bedside was successfully implanted in five patients in 1983 by Phillips et al. [2]. PercutaneeISSN 2508-1349
{"title":"Brain injury in extracorporeal cardiopulmonary resuscitation: translational to clinical research","authors":"C. Wilcox, C. Choi, Sung-Min Cho","doi":"10.18700/JNC.210016","DOIUrl":"https://doi.org/10.18700/JNC.210016","url":null,"abstract":"The use of extracorporeal membrane oxygenation (ECMO) to treat patients with cardiac arrest (CA) was first described in 1957 when several patients with CA refractory to conventional cardiopulmonary resuscitation (CCPR) including open cardiac massage were placed on cardiopulmonary bypass (CPB), allowing time for an attempt at definitive management [1]. A percutaneous system for ECMO cannulation initiated at the bedside was successfully implanted in five patients in 1983 by Phillips et al. [2]. PercutaneeISSN 2508-1349","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44954331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ing tooth scaling. After 4 minutes, the return of spontaneous circulation (ROSC) was achieved. She was stuporose, but other neurological examinations were within normal limits. The patient had a history of meningitis, and she had undergone ventriculoperitoneal shunt surgery for hydrocephalus in her 20s. Brain computed tomography performed immediately after ROSC showed cerebral air emboli (Fig. 1A). Brain magnetic resonance imaging (MRI) after 5 hours showed no acute lesions (Fig. 1B). Targeted temperature management was performed. Her consciousness improved to a drowsy state, but left hemiparesis was observed. Brain MRI performed on the 6th day showed gyriform infarction in both frontoparietal cortices that were consistent with air emboli (Fig. 1C-E). Cerebral air embolism can lead to arterial and venous infarctions [1,2]. They can lead to blood flow obstruction and induce an inflammatory reaction with the breakdown of the blood-brain barrier [3]. In this case, the delayed cerebral infarction was detected by follow-up brain imaging. Cerebral venous air emboli can cause delayed cerebral infarction because the collateral circulation in the cerebral venous system allows for compensation. Even if the Delayed cerebral infarction due to cerebral venous air emboli after cardiac arrest Yoon-Kyung Lee, MD; Jin-Heon Jeong, MD Department of Neurology, Stroke Center, Dong-A University Hospital, Busan, Republic of Korea Department of Intensive Care Medicine, Dong-A University Hospital, Busan, Republic of Korea IMAGES IN NEUROCRITICAL CARE
{"title":"Delayed cerebral infarction due to cerebral venous air emboli after cardiac arrest","authors":"Yoon-Kyung Lee, Jin-Heon Jeong","doi":"10.18700/jnc.210012","DOIUrl":"https://doi.org/10.18700/jnc.210012","url":null,"abstract":"ing tooth scaling. After 4 minutes, the return of spontaneous circulation (ROSC) was achieved. She was stuporose, but other neurological examinations were within normal limits. The patient had a history of meningitis, and she had undergone ventriculoperitoneal shunt surgery for hydrocephalus in her 20s. Brain computed tomography performed immediately after ROSC showed cerebral air emboli (Fig. 1A). Brain magnetic resonance imaging (MRI) after 5 hours showed no acute lesions (Fig. 1B). Targeted temperature management was performed. Her consciousness improved to a drowsy state, but left hemiparesis was observed. Brain MRI performed on the 6th day showed gyriform infarction in both frontoparietal cortices that were consistent with air emboli (Fig. 1C-E). Cerebral air embolism can lead to arterial and venous infarctions [1,2]. They can lead to blood flow obstruction and induce an inflammatory reaction with the breakdown of the blood-brain barrier [3]. In this case, the delayed cerebral infarction was detected by follow-up brain imaging. Cerebral venous air emboli can cause delayed cerebral infarction because the collateral circulation in the cerebral venous system allows for compensation. Even if the Delayed cerebral infarction due to cerebral venous air emboli after cardiac arrest Yoon-Kyung Lee, MD; Jin-Heon Jeong, MD Department of Neurology, Stroke Center, Dong-A University Hospital, Busan, Republic of Korea Department of Intensive Care Medicine, Dong-A University Hospital, Busan, Republic of Korea IMAGES IN NEUROCRITICAL CARE","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43424471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji-Na Shin, Nawon Oh, J. Huh, C. Hyun, Joong-Goo Kim, Sa-Yoon Kang, J. Oh
Lumbar epidural varix (LEV) is a very rare condition caused by dilation of the internal vertebral venous plexus, and can result in lumbosacral radiculopathy by irritating or compressing the epidural or intervertebral foramen [1]. According to previous studies, 0.067% to 1.2% of patients with lower back pain or leg paresthesia are diagnosed with LEV [2]. Clinically, LEV is often confused with lumbosacral herniated intervertebral disc (HIVD), a common cause of lumbosacral radiculopathy, and it is usually diagnosed during or after surgery [3]. Here, we report a rare case of Radiculopathy caused by lumbar epidural varix Jiyong Shin, MD; Nawon Oh; Jisoon Huh, MD; Chang Lim Hyun, MD, PhD; Joong-Goo Kim, MD; Sa-Yoon Kang, MD; Jung-Hwan Oh, MD Department of Neurology, Jeju National University School of Medicine, Jeju, Republic of Korea Jeju National University School of Medicine, Jeju, Republic of Korea Department of Neurosurgery, Jeju National University School of Medicine, Jeju, Republic of Korea Department of Pathology, Jeju National University School of Medicine, Jeju, Republic of Korea CASE REPORT
{"title":"Radiculopathy caused by lumbar epidural varix","authors":"Ji-Na Shin, Nawon Oh, J. Huh, C. Hyun, Joong-Goo Kim, Sa-Yoon Kang, J. Oh","doi":"10.18700/jnc.200029","DOIUrl":"https://doi.org/10.18700/jnc.200029","url":null,"abstract":"Lumbar epidural varix (LEV) is a very rare condition caused by dilation of the internal vertebral venous plexus, and can result in lumbosacral radiculopathy by irritating or compressing the epidural or intervertebral foramen [1]. According to previous studies, 0.067% to 1.2% of patients with lower back pain or leg paresthesia are diagnosed with LEV [2]. Clinically, LEV is often confused with lumbosacral herniated intervertebral disc (HIVD), a common cause of lumbosacral radiculopathy, and it is usually diagnosed during or after surgery [3]. Here, we report a rare case of Radiculopathy caused by lumbar epidural varix Jiyong Shin, MD; Nawon Oh; Jisoon Huh, MD; Chang Lim Hyun, MD, PhD; Joong-Goo Kim, MD; Sa-Yoon Kang, MD; Jung-Hwan Oh, MD Department of Neurology, Jeju National University School of Medicine, Jeju, Republic of Korea Jeju National University School of Medicine, Jeju, Republic of Korea Department of Neurosurgery, Jeju National University School of Medicine, Jeju, Republic of Korea Department of Pathology, Jeju National University School of Medicine, Jeju, Republic of Korea CASE REPORT","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42478375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stroke is a disease with a heterogeneous pathomechanism, and is primarily considered to be hemorrhagic or ischemic. Hemorrhagic stroke is the result of ruptured blood vessels in the brain, resulting in intracerebral hemorrhage (ICH). This includes ruptured perforator vessels in the deep structures of the brain, including the basal ganglia, thalamus, pons, and cerebellum [1]. In cases of lobar hemorrhage, two potential causes are underlying cerebral amyloid antipathy or cancer metastases. The rupture of an intracranial aneurysm may lead to subarachnoid hemorrhage (SAH), which Blood pressure management in stroke patients Seung Min Kim, MD, PhD; Ho Geol Woo, MD, PhD; Yeon Jeong Kim, MD, PhD; Bum Joon Kim, MD, PhD Department of Neurology, VHS Medical Center, Seoul, Republic of Korea Department of Neurology, Kyung Hee University School of Medicine, Seoul, Republic of Korea Department of Neurology, Asan Medical Center, Seoul, Republic of Korea REVIEW ARTICLE
中风是一种具有多种病理机制的疾病，主要被认为是出血性或缺血性的。出血性中风是大脑血管破裂的结果，导致脑出血(ICH)。这包括脑深部结构穿支血管破裂，包括基底节区、丘脑、脑桥和小脑。在大叶出血的病例中，两个潜在的原因是潜在的脑淀粉样蛋白反感或癌症转移。颅内动脉瘤破裂可能导致蛛网膜下腔出血(SAH)，这是中风患者的血压管理。胡浩杰，MD, PhD;Yeon Jeong Kim, MD, PhD;Bum Joon Kim，医学博士，韩国首尔VHS医疗中心神经内科，韩国首尔庆熙大学医学院神经内科，韩国首尔牙山医疗中心神经内科
{"title":"Blood pressure management in stroke patients","authors":"S. M. Kim, H. Woo, Y. Kim, B. Kim","doi":"10.18700/jnc.200028","DOIUrl":"https://doi.org/10.18700/jnc.200028","url":null,"abstract":"Stroke is a disease with a heterogeneous pathomechanism, and is primarily considered to be hemorrhagic or ischemic. Hemorrhagic stroke is the result of ruptured blood vessels in the brain, resulting in intracerebral hemorrhage (ICH). This includes ruptured perforator vessels in the deep structures of the brain, including the basal ganglia, thalamus, pons, and cerebellum [1]. In cases of lobar hemorrhage, two potential causes are underlying cerebral amyloid antipathy or cancer metastases. The rupture of an intracranial aneurysm may lead to subarachnoid hemorrhage (SAH), which Blood pressure management in stroke patients Seung Min Kim, MD, PhD; Ho Geol Woo, MD, PhD; Yeon Jeong Kim, MD, PhD; Bum Joon Kim, MD, PhD Department of Neurology, VHS Medical Center, Seoul, Republic of Korea Department of Neurology, Kyung Hee University School of Medicine, Seoul, Republic of Korea Department of Neurology, Asan Medical Center, Seoul, Republic of Korea REVIEW ARTICLE","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41436048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Blood viscosity (BV) is a measurement of the intrinsic resistance of blood to flow, and high BV increases thromboembolic risk. Although laboratory documentation of clopidogrel resistance has been shown to predict an increased risk of cardiovascular events in patients with ischemic stroke, there is no evidence that cytochrome P450 2C19 (CYP2C19) polymorphisms in clopidogrel-treated patients influence BV after ischemic stroke. Methods: Patients with ischemic stroke or transient ischemic attack within 7 days of symptom onset from April 2018 to October 2019 were included. Patients were classified into the good genotype group for clopidogrel metabolism (ultrarapid or extensive metabolizer) and poor genotype group (intermediate/unknown or poor metabolizer) based on their CYP2C19 genotype status. A scanning capillary-tube viscometer was used to assess whole BV, and patients were divided into decreased BV and increased BV groups. Results: The final analyses included 174 patients (109 men and 65 women) with a mean age of 66.4±11.2 years. The good genotype was found in 44% of patients with decreased systolic BV (SBV) and 27% of those with increased SBV (P=0.029), suggesting that BV changes were related to the CYP2C19 genotype for clopidogrel metabolism. Binary logistic regression analysis showed that CYP2C19 genotype status (P=0.024) and baseline SBV (P<0.001) were significantly associated with decreased BV. The good genotype for clopidogrel metabolism was associated with decreased BV in patients with ischemic stroke treated with clopidogrel. Conclusion: The present results indicate that the effect of clopidogrel treatment on ischemic stroke prevention could be modulated not only by inhibition of platelet function but also by changes in the hemorheological profile.
{"title":"The good genotype for clopidogrel metabolism is associated with decreased blood viscosity in clopidogrel-treated ischemic stroke patients","authors":"J. Park, S. Han, Hyun-jeung Yu","doi":"10.18700/jnc.200023","DOIUrl":"https://doi.org/10.18700/jnc.200023","url":null,"abstract":"Background: Blood viscosity (BV) is a measurement of the intrinsic resistance of blood to flow, and high BV increases thromboembolic risk. Although laboratory documentation of clopidogrel resistance has been shown to predict an increased risk of cardiovascular events in patients with ischemic stroke, there is no evidence that cytochrome P450 2C19 (CYP2C19) polymorphisms in clopidogrel-treated patients influence BV after ischemic stroke. Methods: Patients with ischemic stroke or transient ischemic attack within 7 days of symptom onset from April 2018 to October 2019 were included. Patients were classified into the good genotype group for clopidogrel metabolism (ultrarapid or extensive metabolizer) and poor genotype group (intermediate/unknown or poor metabolizer) based on their CYP2C19 genotype status. A scanning capillary-tube viscometer was used to assess whole BV, and patients were divided into decreased BV and increased BV groups. Results: The final analyses included 174 patients (109 men and 65 women) with a mean age of 66.4±11.2 years. The good genotype was found in 44% of patients with decreased systolic BV (SBV) and 27% of those with increased SBV (P=0.029), suggesting that BV changes were related to the CYP2C19 genotype for clopidogrel metabolism. Binary logistic regression analysis showed that CYP2C19 genotype status (P=0.024) and baseline SBV (P<0.001) were significantly associated with decreased BV. The good genotype for clopidogrel metabolism was associated with decreased BV in patients with ischemic stroke treated with clopidogrel. Conclusion: The present results indicate that the effect of clopidogrel treatment on ischemic stroke prevention could be modulated not only by inhibition of platelet function but also by changes in the hemorheological profile.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48734089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kyoungnam Woo, J. Roh, S. Baik, D. Shin, Ki-Seok Park, M. Park, K. Park, Sung-Ho Ahn
Skull base osteomyelitis (SBO) is a rare but life-threatening disease usually seen as a complication of otitis externa [1]. It initially involves the lateral part of the temporal bone and extends to the petrous apex and clivus [2], accompanied by bone erosion, thrombophlebitis, and hematogenous seeding [3]. Thus, patients with SBO typically present with otalgia, otorrhea, hearing loss, and cranial nerve dysfunction in the immunocompromised, particularly older diabetic patients [4]. Central skull base osteomyelitis due to nasopharyngeal Klebsiella infection Kyoung-Nam Woo, MD; Jieun Roh, MD; Seung-Kug Baik, PhD; Dong-Hyeon Shin, MD; Ki-Seok Park, MD; Min-Gyu Park, PhD; Kyung-Pil Park, PhD; Sung-Ho Ahn, MD Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea CASE REPORT
颅底骨髓炎（SBO）是一种罕见但危及生命的疾病，通常被视为外耳炎的并发症[1]。它最初涉及颞骨的外侧部分，并延伸至岩尖和斜坡[2]，伴有骨侵蚀、血栓性静脉炎和血行播种[3]。因此，SBO患者通常表现为耳痛、耳漏、听力损失和免疫功能低下的脑神经功能障碍，尤其是老年糖尿病患者[4]。鼻咽克雷伯菌感染引起的中央颅底骨髓炎Kyoung Nam Woo，医学博士；Jieun Roh，医学博士；Seung Kug Baik，博士；Dong Hyeon Shin，医学博士；Ki Seok Park，医学博士；Min Gyu Park，博士；Kyung Pil Park，博士；Sung Ho Ahn，医学博士，生物医学科学与技术融合研究所，釜山国立大学杨山医院，釜山大学医学院，大韩民国釜山放射科，生物医学科学和技术融合研究院，釜山州立大学杨山医院，韩国釜山釜山国立大学医学院病例报告
{"title":"Central skull base osteomyelitis due to nasopharyngeal Klebsiella infection","authors":"Kyoungnam Woo, J. Roh, S. Baik, D. Shin, Ki-Seok Park, M. Park, K. Park, Sung-Ho Ahn","doi":"10.18700/jnc.200017","DOIUrl":"https://doi.org/10.18700/jnc.200017","url":null,"abstract":"Skull base osteomyelitis (SBO) is a rare but life-threatening disease usually seen as a complication of otitis externa [1]. It initially involves the lateral part of the temporal bone and extends to the petrous apex and clivus [2], accompanied by bone erosion, thrombophlebitis, and hematogenous seeding [3]. Thus, patients with SBO typically present with otalgia, otorrhea, hearing loss, and cranial nerve dysfunction in the immunocompromised, particularly older diabetic patients [4]. Central skull base osteomyelitis due to nasopharyngeal Klebsiella infection Kyoung-Nam Woo, MD; Jieun Roh, MD; Seung-Kug Baik, PhD; Dong-Hyeon Shin, MD; Ki-Seok Park, MD; Min-Gyu Park, PhD; Kyung-Pil Park, PhD; Sung-Ho Ahn, MD Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, Republic of Korea CASE REPORT","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47289359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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