关键词： MRI   general movements assessment   Hammersmith infant neurological exam   cerebral palsy  

摘要： Objective To evaluate the prevalence and associations between structural magnetic resonance imaging (sMRI) injury/abnormality at term-equivalent age and absent fidgety General Movements Assessment (GMA) and abnormal Hammersmith Infant Neurological Examination (HINE) scores among infants born very preterm at 3-4 months of corrected age. Study design This prospective cohort study enrolled 392 infants born <= 2 weeks of gestation from 5 neonatal intensive care units in the greater Cincinnati area between September 2016 and October 2019. Infants completed sMRI at term-equivalent age and GMA and HINE at 3-4 months of corrected age. All assessors were blinded. Results Of 392 infants, 375 (96%) had complete data. Of these, 44 (12%) exhibited moderate or severe brain abnormalities, 17 (4.5%) had abnormal GMA, and 77 (20.3%) had abnormal HINE. Global and regional abnormality scores on sMRI were significantly correlated with GMA (R-2 range 0.05-0.17) and HINE at 3-4 months of corrected age (R-2 range 0.01-0.17). These associations remained significant in multivariable analyses after adjusting for gestational age and sex. There was a significant but low correlation (R-2 0.14) between GMA and HINE. Conclusions We observed a low prevalence of moderate or severe brain abnormalities in survivors born very preterm in this geographically defined cohort. The much greater prevalence of abnormal motor examination on the HINE compared with GMA and their low correlation suggests that these tests evaluate different constructs and, thus, should be used in combination with sMRI rather than interchangeably.

关键词： Collateral circulation   Magnetic resonance angiography   Middle cerebral artery   Neurological function   Rehabilitation nursing  

摘要： OBJECTIVE: To analyze neurological function recovery and the impact of rehabilitation nursing in patients with cerebral stroke after treatment to aid clinical diagnosis and treatment of cerebral stroke. METHODS: The study comprised 140 patients who were hospitalized in the neurology department for magnetic resonance angiography examination. Patients were divided into a treatment group (70 patients) and a control group (70 patients) based on treatment plan. Digital subtraction angiography was regarded as the gold standard diagnostic examination. In patients in both groups, magnetic resonance angiography features of the M1 segment of the middle cerebral artery and diagnostic specificity and sensitivity were recorded. An activities of daily living score was used to assess neurological function of patients before and after rehabilitation. RESULTS: The activities of daily living scores of patients in both groups increased significantly after treatment (P < 0.05);the scores of patients in the treatment group increased more significantly (P < 0.05). The total effective rate was 89% in the treatment group and 60% in the control group. The difference between the 2 groups was statistically significant (P < 0.05). After treatment, the degree of M1 segment stenosis in both groups was better than before treatment, and the number of collateral circulation branches was increased;the improvements in the treatment group were more significant (P < 0.05). CONCLUSIONS: Rehabilitation nursing could greatly improve the stenosis of blood vessels in patients with acute cerebral stroke and promote the establishment of collateral circulation, thereby effectively enhancing the recovery of neurological function and strengthening the ability of patients to perform activities of daily living.

关键词： 临床医学  

ISBN: (纸本)9787030681768

摘要： 神经系统疾病是当今社会面临的严重问题之一。脑脊液检验是当今国际上具有良好临床应用价值和广阔发展前景的一门新兴学科，对神经系统疾病的早期、精准诊治具有重要作用。本书一方面回溯“脑脊液”的提出、发现的数千年纵深历史，探讨脑脊液检验学的发展方向；另一方面又注重实践应用，详细介绍了从脑脊液采集、脑脊液细胞学和各类检验项目的分析前处理、检测方法、临床意义及其在主要神经系统疾病中的应用情况。另外，就近年来国内外新开展的脑脊液生物标志物在常见中枢神经系统疾病中的应用情况，本书也有较为综合全面的阐述。

关键词： Noncardiac chest pain   Neurologic pain   Migraine   Multiple sclerosis   Epilepsy   Guillain-Barre syndrome  

摘要： Purpose of ReviewChest pain is a very common presenting complaint among patients in the hospital, a large proportion of whom have non-cardiac chest pain (NCCP). Neurological causes of NCCP have not been previously reviewed although several causes have been *** FindingsChest pain has been reported as a symptom of multiple neurological conditions such as migraine, epilepsy, and multiple sclerosis, with varying clinical presentations. The affected patients are often not formally diagnosed for long periods of time due to difficulties in recognizing the symptoms as part of neurological disease *** paper will briefly summarize well-known etiologies of chest pain and, then, review neurological causes of NCCP, providing an overview of current literature and possible pathophysiologic mechanisms.

关键词： clinically isolated syndrome   multiple sclerosis   myelin   optic neuritis   transverse myelitis  

摘要： Although child inflammatory demyelinating diseases (CIDD) are rare they can present to the general paediatrician as an acute neurological deficit with or without encephalopathy. Some have a monophasic disease course while others are chronic and relapse. Establishing the correct diagnosis is paramount as the treatment differs for the chronic disorders. Further, early treatment can significantly reduce long-term disability. Therefore, it is essential that the attending physician in the emergency department knows when to suspect demyelinating disease, is able to produce an accurate differential, and is able to investigate appropriately. This review describes the different CIDDs, their presentation, key investigations and management including multiple sclerosis, acute disseminated encephalomyelitis, neuromyelitis optica spectrum disorders, clinically isolated syndrome and myelin oligodendrocyte glycoprotein antibody-associated disease. © 2021

关键词： Aortic stenosis?TAVI?Stroke?Aortic   stenosis?TAVI?Stroke?Aortic   stenosis?TAVI?Stroke?Aortic intima-media thickness  

摘要： Objectives: Neurological complications associated with transcatheter aortic valve implantation (TAVI) are important due to its morbidity and mortality risks. The purpose of this study was to investigate the importance of the features of the aortic valve and ascending aorta to predict the neurological complications associated with TAVI. Methods: The patients for whom the heart team decided to perform TAVI were included in the study. In order to assess possible neurological complications, cerebral diffusionweighted magnetic resonance imaging(MRI) was performed pre-and post-operatively. The diameter of the patients' aortic root and ascending aorta, aortic valve scores, intima media thickness of the ascending aorta were measured from their transesophageal echocardiography records. Results: A total of 108 patients constituted the study population. 31 patients were found to develop a new lesion (MR+) detected on MRI after TAVI, while 76 patients did not have any new lesions (MR-). The groups did not have any significant differences in their aortic valve features and scores. However, AA-IMT was found to be higher in the MR+ group (1.8mm [1.6-2.3] vs 1.4mm [1.2-1.8] interquartile range). The multivariate logistic regression analysis conducted to detect new lesions revealed that AA-IMT led to a significantly increased risk. Conclusion: The features of the ascending are more important than the demographic characteristics of patients and features of the native valve in predicting new lesions on MRI scans and thus neurological events after TAVI. (c) 2021 Elsevier Inc. All rights reserved.

关键词： neurological disease   acute   pain   local anesthetics   drugs   regional   pain   muscle disorders  

摘要： Preexisting neurological disease in pediatric patients presents unique challenges to the anesthesiologist. In-depth knowledge of the disease processes and awareness of sequalae that uniquely influence the risks and benefits of anesthetics are needed to make informed decisions. Because these vulnerable populations are often susceptible to perioperative airway or cardiopulmonary complications, the use of regional anesthesia can be advantageous. However, these clinical conditions already involve compromised neural tissue and, as such, create additional concern that regional anesthesia may result in new or worsened deficits. The following discussion is not intended to be a full review of each disease process, but rather provides a concise, yet thorough, discussion of the available literature on regional anesthesia in the more common, but still rare, pediatric neurological disorders. We aim to provide a framework for pediatric anesthesiologists to reengage in a healthy discussion about the risks and benefits of utilizing regional anesthesia in this vulnerable population.