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Successful Intravenous Thrombolytic Therapy in a Patient with Tetralogy of Fallot Presenting with Stroke 法洛四联症卒中患者静脉溶栓治疗成功
Pub Date : 2023-10-30 DOI: 10.29011/2688-8734.100165
Abstract Congenital heart disease patients would have an elevated stroke risk compared to the general population. The prevalence of adults living with this condition is increasing, and knowledge of their risks and management should be of common knowledge to adult clinicians. The mechanisms of stroke implicate right to left shunt allowing paradoxical embolization. Anticoagulation of patients with complex congenital heart disease is preferred with vitamin K antagonist. We describe a successful thrombolysis case of a patient with Tetralogy of Fallot who presented at the emergency room with an ischemic stroke in time for intravascular thrombolysis treatment and had favorable outcomes.
与一般人群相比,先天性心脏病患者卒中风险较高。患有这种疾病的成年人的患病率正在增加,对其风险和管理的了解应该成为成年临床医生的常识。中风的机制涉及右至左分流,允许矛盾栓塞。复杂先天性心脏病患者抗凝首选维生素K拮抗剂。我们描述了一个成功的溶栓病例的法洛四联症患者谁提出在急诊室缺血性脑卒中及时血管内溶栓治疗,并有良好的结果。
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引用次数: 0
Suicidal Ideation in a Severe Case of NonPulsatile Tinnitus Caused by a Dural Arteriovenous Fistula 硬脑膜动静脉瘘所致严重非搏动性耳鸣的自杀意念
Pub Date : 2023-10-23 DOI: 10.29011/2688-8734.100164
Abstract Pulsatile tinnitus is often the initial presentation of a dural arteriovenous fistula, so a high index of suspicion is needed to avoid misdiagnoses and possible fatal consequences. Although pulsatile tinnitus commonly originates from a vascular malformation and non-pulsatile tinnitus from a neurodegenerative one, pulsatile and non-pulsatile presentations can result from other underlying pathologies. If a vascular pathology causes a non-pulsatile complaint that cannot be heard by the examiner or detected clinically or radiologically, it is bound to be misdiagnosed as central tinnitus. Herein, we report a rare presentation of a dural arteriovenous fistulas contributing to subjective, non-pulsatile tinnitus. The 50-year-old male patient in this case presented with 2 years of tinnitus, refractory to several treatment approaches that eventually lead to suicidal ideation. Magnetic resonance imaging of the head, magnetic resonance angiography of the head and neck, and computerized tomography scan of the temporal bone did not reveal any acute pathology. Cerebral angiogram revealed a dural arterio-venous malformation in the left sigmoid and transverse sinus. The patient was treated with transarterial Onyx18 embolization of the dural arterio-venous malformation. His symptoms resolved by 50% following treatment and by 80% at 6-month reevaluation. Dural arteriovenous fistulas are rare vascular malformations that, if left untreated, have fatal complications. These vascular malformations may not be detected by physical examination or audiometric evaluation alone. In the absence of neurologic deficits and retrograde leptomeningeal or cortical venous drainage, selective angiographic embolization appears to be an efficient and low-risk modality for symptomatic treatment.
搏动性耳鸣往往以硬脑膜动静脉瘘为首发表现,因此需要高度的怀疑,以避免误诊和可能的致命后果。虽然搏动性耳鸣通常起源于血管畸形和非搏动性耳鸣,但搏动性和非搏动性耳鸣可由其他潜在病理引起。如果血管病变引起的非搏动性主诉不能被检查人员听到,也不能被临床或放射学检测到,则必然会被误诊为中枢性耳鸣。在此,我们报告一个罕见的硬脑膜动静脉瘘导致主观,非搏动性耳鸣。本病例患者为50岁男性,耳鸣2年,多次治疗无效,最终产生自杀意念。头部磁共振成像、头颈部磁共振血管造影和颞骨计算机断层扫描未发现任何急性病理。脑血管造影显示左乙状窦及横窦有硬脑膜动静脉畸形。采用经动脉Onyx18栓塞术治疗硬脑膜动静脉畸形。治疗后症状缓解50%,6个月再评估时症状缓解80%。硬脑膜动静脉瘘是一种罕见的血管畸形,如果不及时治疗,会有致命的并发症。这些血管畸形可能无法通过体检或听力评估单独检测到。在没有神经功能缺损和逆行小脑膜或皮质静脉引流的情况下,选择性血管造影栓塞似乎是一种有效和低风险的对症治疗方式。
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引用次数: 0
Reliability and Validity of the Greek Version of Sickness Impact Profile Questionnaire 希腊版本疾病影响概况问卷的信度和效度
Pub Date : 2023-10-05 DOI: 10.29011/2688-8734.100163
Background: The objectives were to assess the validity and reliability of the Greek version of the Sickness Impact Profile (SIP-GR) questionnaire. Methods: SIP-GR was tested for test-retest reliability, internal consistency and validity in 90 participants (54.4% males and 45.6% females) with obesity, cardiac, pulmonary and musculoskeletal problems. The questionnaire was administrated twice by one examiner, within an interval of 1-week. During this period, participants with cardiac, pulmonary and musculoskeletal problems underwent 2-weekly physiotherapy sessions. Treatment related effects were considered in the analysis. Results: SIP-GR demonstrated an excellent internal consistency. The overall Cronbach’s alpha for SIP-Total score >0.9, for SIP-Psychological was >0.8 and for SIP-Physical >0.9. The categories scores were all >0.5 except for Communication and Work category. Test-retest reliability for the total score was ICC=0.691 for all subjects, 0.562 for those that reported a subjective change in their health status due to treatment and 0.999 for those that reported no change in health status. Similar results were found for the Physical and Psychological component. Strong negative correlation was found between SIP-Gr total score and Short Form Health Survey SF-36 (SF-36) total score (r=-0.66), physical component of SIP-GR and Physical Health of SF-36 (r=-0.62) and between psychological component of SIP-GR and Mental health of SF-36 (r=-0.61) at the initial assessment. At reassessment the same correlations were moderate due to different treatment effects in the scores of the two questionnaires. Finally, minimum detectable change (MDC) was 4.6-5.5 points for the overall score, 6.4-7 for Physical component and 3.5-4.9 for psychosocial component, at initial assessment and re-assessment respectively. Conclusion: SIP-GR has shown to be valid and reliable for the assessment of patients with cardiac, pulmonary, musculoskeletal diagnosis and obesity. Further studies should assess its ability to identify clinically meaningful changes.
{"title":"Reliability and Validity of the Greek Version of Sickness Impact Profile Questionnaire","authors":"","doi":"10.29011/2688-8734.100163","DOIUrl":"https://doi.org/10.29011/2688-8734.100163","url":null,"abstract":"Background: The objectives were to assess the validity and reliability of the Greek version of the Sickness Impact Profile (SIP-GR) questionnaire. Methods: SIP-GR was tested for test-retest reliability, internal consistency and validity in 90 participants (54.4% males and 45.6% females) with obesity, cardiac, pulmonary and musculoskeletal problems. The questionnaire was administrated twice by one examiner, within an interval of 1-week. During this period, participants with cardiac, pulmonary and musculoskeletal problems underwent 2-weekly physiotherapy sessions. Treatment related effects were considered in the analysis. Results: SIP-GR demonstrated an excellent internal consistency. The overall Cronbach’s alpha for SIP-Total score >0.9, for SIP-Psychological was >0.8 and for SIP-Physical >0.9. The categories scores were all >0.5 except for Communication and Work category. Test-retest reliability for the total score was ICC=0.691 for all subjects, 0.562 for those that reported a subjective change in their health status due to treatment and 0.999 for those that reported no change in health status. Similar results were found for the Physical and Psychological component. Strong negative correlation was found between SIP-Gr total score and Short Form Health Survey SF-36 (SF-36) total score (r=-0.66), physical component of SIP-GR and Physical Health of SF-36 (r=-0.62) and between psychological component of SIP-GR and Mental health of SF-36 (r=-0.61) at the initial assessment. At reassessment the same correlations were moderate due to different treatment effects in the scores of the two questionnaires. Finally, minimum detectable change (MDC) was 4.6-5.5 points for the overall score, 6.4-7 for Physical component and 3.5-4.9 for psychosocial component, at initial assessment and re-assessment respectively. Conclusion: SIP-GR has shown to be valid and reliable for the assessment of patients with cardiac, pulmonary, musculoskeletal diagnosis and obesity. Further studies should assess its ability to identify clinically meaningful changes.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135483657","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}
引用次数: 0
PRES Secondary to the LenvatinibPembrolizumab Combination in a Patient with Serous Endometrial Adenocarcinoma LenvatinibPembrolizumab联合治疗浆液性子宫内膜腺癌患者继发的PRES
Pub Date : 2023-09-11 DOI: 10.29011/2688-8734.100162
to the
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引用次数: 0
Stroke and Multi-Organic Infarction Revealing Peri-Partum Cardiomyopathy, an Unusual Presentation: About a Case 卒中和多器质性梗死显示围产期心肌病,一个不寻常的表现:关于一个病例
Pub Date : 2023-09-02 DOI: 10.29011/2688-8734.100160
Antoine Salambo Mabila, Donald Accrombessi, Patrick Lisasi, Job Osango, Elisé Kisioko, Robert Mutombo, Aurélien Darrigol, A. Woga, Martial Zossou, A. Landais, Annie Lannuzel
Revealing Peri-Partum Cardiomyopathy, an Unusual Presentation: About a Case
揭示围产期心肌病,一个不寻常的表现:关于一个病例
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引用次数: 0
Normal MRI Stroke in a Resource-Limited Setting: About a Case 在资源有限的情况下,MRI正常脑卒中:1例
Pub Date : 2023-07-20 DOI: 10.29011/2688-8734.100155
Salambo Mabila, Ntalaja Kabuayi, L. Patrick, Kongolo Wa, Nzambi Gérard, Kibokela Ndembe Dalida, Tshangala Kavunga, Okitundu Luwa
. In are source-limited environment in which urgent revascularization therapies are not available, it seems wise to us to have urgent recourse to a brain scan without injection, which is much more available and which will effectively eliminate cerebral haemorrhageand initiate antithrombotic treatment.
.在资源有限的环境中,紧急血运重建治疗是不可用的,对我们来说,紧急求助于不注射的脑部扫描似乎是明智的,这是更容易获得的,将有效地消除脑出血和启动抗血栓治疗。
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引用次数: 0
Indirect Left Coraticocavernous Fistula 间接左冠海绵状瘘
Pub Date : 2023-05-22 DOI: 10.29011/2688-8734.100152
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引用次数: 0
Safety and Efficacy Outcomes of Off-Label Tenecteplase versus Alteplase for Acute Ischemic Stroke: Real-World Experience 说明书外替奈普酶与阿替普酶治疗急性缺血性卒中的安全性和有效性:真实世界经验
Pub Date : 2023-05-08 DOI: 10.29011/2688-8734.100150
Emily J Farina, G. Kelly, M. Sturgill, D. Dixit
Background: Tenecteplase offers several practical advantages over alteplase; recent comparative studies have demonstrated tenecteplase to be non-inferior to alteplase in terms of its safety and efficacy in acute ischemic stroke (AIS). We recently switched to Tenecteplase for AIS from alteplase and describe our real-world outcome data. Objectives: To compare the efficacy and safety of alteplase with tenecteplase for AIS. Methods: We conducted a retrospective study of patients’ thrombolysis with alteplase or Tenecteplase from January 1 st , 2021, to December 31 st , 2021. Patients were included if they had received alteplase or tenecteplase within 4.5 hours of symptom onset. Patients with wake-up stroke were excluded. The primary outcome was a composite of bleeding-related adverse events. Secondary outcomes included door-to-needle (DTN) time, median 24-hour National Institute of Health Stroke Scale (NIHSS) score, discharge NIHSS score
背景:与阿替普酶相比,Tenecteplase具有几个实际优势;最近的比较研究表明,在急性缺血性卒中(AIS)的安全性和有效性方面,替奈普酶不逊于阿替普酶。我们最近将治疗AIS的药物从阿替普换成了Tenecteplase,并描述了我们真实世界的结果数据。目的:比较阿替普酶与替尼替普酶治疗AIS的疗效和安全性。方法:对2021年1月1日至2021年12月31日阿替普酶或替奈替酶溶栓患者进行回顾性研究。如果患者在症状出现后4.5小时内接受阿替普酶或替奈替普酶治疗,则纳入研究。排除醒脑卒中患者。主要结局是出血相关不良事件的综合。次要结局包括从门到针(DTN)时间、24小时美国国立卫生研究院卒中量表(NIHSS)评分中位数、出院NIHSS评分
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引用次数: 0
NG Tube Confirmation by Using the Chest X-ray 利用胸部x线确认NG管
Pub Date : 2023-05-01 DOI: 10.29011/2688-8734.100049
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引用次数: 0
Histopathological Profile of Thrombi Differs Depending on Pathogenesis of Embolic Cerebral Infarction and Evidence of Intracardiac Thrombus 血栓的组织病理学特征取决于栓塞性脑梗死的发病机制和心内血栓的证据
Pub Date : 2023-04-28 DOI: 10.29011/2688-8734.100047
V. Meļņikova, K. Jurjāns, Katrīna Kupča, J. Vētra, Daira Lapse, A. Veiss, Jurijs Nazarovs, E. Miglāne, V. Meļņikova
Histopathological Profile of Thrombi Differs Depending on Pathogenesis of Embolic Cerebral Infarction and Evidence of Intracardiac Thrombus
血栓的组织病理学特征取决于栓塞性脑梗死的发病机制和心内血栓的证据
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引用次数: 0
期刊
International journal of cerebrovascular disease and stroke
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