Acute Cerebral Vascular Disease Research Articles

IS-Net: Automatic Ischemic Stroke Lesion Segmentation on CT Images

Ischemic stroke is an acute cerebral vascular disease and makes up about 80% of all stroke cases. Non-contrast computed tomography (NCCT) is a widely applied imaging technique for ischemic stroke assessment. However, it is challenging to identify ischemic lesion on NCCT images due to its high variability in location, contrast, and geometry. In this work, we propose IS-Net, an encoder-decoder convolutional neural network for automatic ischemic stroke lesion segmentation on NCCT images. The proposed IS-Net takes hierarchical network as backbone while pyramid feature aggregation (PFA) module is designed to aggregate features from multi stages of backbone, and reasonable feature fusion strategy is considered in PFA to enhance multi-level propagation. To fully mine the boundary cues, edge constraint scheme is introduced by deep supervision which broadcasts low-level features to different modules. In addition, to overcome the limitation of fixed geometric structure of convolution for multi-range dependency exploitation, non-local parallel decoder is introduced with deformable convolution and self-attention. The proposed IS-Net is evaluated on manually labeled follow-up NCCT dataset composed of 1,004 cases (totally 9,020 images). The proposed IS-Net is compared with the state-of-the-art segmentation models and illustrates the highest score on segmentation criteria and sensitivity.

Cycloastragenol Confers Cerebral Protection after Subarachnoid Hemorrhage by Suppressing Oxidative Insults and Neuroinflammation via the SIRT1 Signaling Pathway.

Subarachnoid hemorrhage (SAH) is an acute cerebral vascular disease featured by oxidative insults and neuroinflammation. Cycloastragenol (CAG), the major active component of Astragalus radix, has a wide range of biological functions. However, the potential beneficial effects and the underlying molecular mechanisms of CAG on SAH remain obscure. In the current study, the cerebroprotective effects and mechanism of CAG on SAH were evaluated both in vivo and in vitro. Our results indicated that CAG significantly suppressed SAH-triggered oxidative insults, inflammatory mediators production, microglia activation, and the neutrophil infiltration in the brain. In addition, CAG improved neurological function and ameliorated neuronal apoptosis and degeneration after SAH. In vitro results also revealed the therapeutic effects of CAG on neurons and microglia co-culture system. Mechanistically, CAG treatment upregulated sirtuin 1 (SIRT1) expression, inhibited the levels of FoxO1, nuclear factor-kappa B, and p53 acetylation, and suppressed the subsequent oxidative, inflammatory, and apoptotic pathways. In contrast, inhibiting SIRT1 by pretreatment with Ex527 abrogated the protective actions of CAG both in vivo and in vitro models of SAH. Collectively, our findings indicated that CAG could be a promising and effective drug candidate for SAH.

ROS-responsive 18β-glycyrrhetic acid-conjugated polymeric nanoparticles mediate neuroprotection in ischemic stroke through HMGB1 inhibition and microglia polarization regulation.

Ischemic stroke is an acute and serious cerebral vascular disease, which greatly affects people's health and brings huge economic burden to society. Microglia, as important innate immune components in central nervous system (CNS), are double-edged swords in the battle of nerve injury, considering their polarization between pro-inflammatory M1 or anti-inflammatory M2 phenotypes. High mobility group box 1 (HMGB1) is one of the potent pro-inflammatory mediators that promotes the M1 polarization of microglia. 18β-glycyrrhetinic acid (GA) is an effective intracellular inhibitor of HMGB1, but of poor water solubility and dose-dependent toxicity. To overcome the shortcomings of GA delivery and to improve the efficacy of cerebral ischemia therapy, herein, we designed reactive oxygen species (ROS) responsive polymer-drug conjugate nanoparticles (DGA) to manipulate microglia polarization by suppressing the translocation of nuclear HMGB1. DGA presented excellent therapeutic efficacy in stroke mice, as evidenced by the reduction of infarct volume, recovery of motor function, suppressed of M1 microglia activation and enhanced M2 activation, and induction of neurogenesis. Altogether, our work demonstrates a close association between HMGB1 and microglia polarization, suggesting potential strategies for coping with inflammatory microglia-related diseases.

Diagnostic Value of CT Angiography Combined with High-Resolution Magnetic Resonance Angiography in Vascular Lesions in Acute Stroke

Cerebrovascular disease is increasing rapidly because of its high morbidity and high mortality, which is a serious threat to human health. For the early diagnosis and treatment of diseases, the CT vascular noise combined with high-resolution magnetic resonance angiography in acute cerebral apoplexy vascular disease is adopted. 150 patients with ischemic stroke were selected, which were admitted to the Department of Radiology, Huizhou Central People’s Hospital, from January 2020 to December 2020. All patients accepted digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and CT angiography (CTA) examination. Results. There were 76 cases of aneurysm in DSA examination, accounting for 46%; 69 cases with pulsating stenosis, accounting for 50.67%; and 5 cases of moyamoya disease, accounting for 3.33%. The number and proportion of cases of the above diseases in MRA examination were (75, 69, 71; 53.33%, 45.67%, 4%), and those in CTA examination were (71, 76, 3, 47.33%, 50.67%, 2%). Relative to the DSA gold standard, the sensitivity, specificity, and false positive rate of MRA were 81.51%, 95.19%, and 2.1, respectively, and those of CTA were 95.78%, 79.17%, and 11.0, respectively. The number of cases and accuracy of detection of cerebral aneurysms by MRA were (75, 96.57%), and those by CTA were (71, 91.2%), which was not statistically considerable, P > 0.05 . For the number of cases and the detection accuracy of cerebrovascular malformations, MRA was (38, 92.68%) and CTA was (37, 90.24%), which was not statistically considerable, P > 0.05 . Conclusion. The detection sensitivity and accuracy of MRA were better than those of CTA, while specific CTA was superior to MRA. The differences between the two detections were substantial ( P < 0.05 ), while the sensitivity and false positive rate were not remarkably different ( P > 0.05 ). Therefore, the combination of the two detections was of great significance to the diagnosis and treatment of stroke and other vascular diseases.

Deep Learning for Hemorrhagic Lesion Detection and Segmentation on Brain CT Images.

Stroke is an acute cerebral vascular disease that is likely to cause long-term disabilities and death. Immediate emergency care with accurate diagnosis of computed tomographic (CT) images is crucial for dealing with a hemorrhagic stroke. However, due to the high variability of a stroke's location, contrast, and shape, it is challenging and time-consuming even for experienced radiologists to locate them. In this paper, we propose a U-net based deep learning framework to automatically detect and segment hemorrhage strokes in CT brain images. The input of the network is built by concatenating the flipped image with the original CT slice which introduces symmetry constraints of the brain images into the proposed model. This enhances the contrast between hemorrhagic area and normal brain tissue. Various Deep Learning topologies are compared by varying the layers, batch normalization, dilation rates, and pre-train models. This could increase the respective filed and preserves more information on lesion characteristics. Besides, the adversarial training is also adopted in the proposed network to improve the accuracy of the segmentation. The proposed model is trained and evaluated on two different datasets, which achieve the competitive performance with human experts with the highest location accuracy 0.9859 for detection, 0.8033 Dice score, and 0.6919 IoU for segmentation. The results demonstrate the effectiveness, robustness, and advantages of the proposed deep learning model in automatically hemorrhage lesion diagnosis, which make it possible to be a clinical decision support tool in stroke diagnosis.

The Neurologic Manifestations of Coronavirus Disease 2019 Pandemic: A Systemic Review.

Objective: Review and integrate the neurologic manifestations of the Coronavirus Disease 2019 (COVID-19) pandemic, to aid medical practitioners who are combating the newly derived infectious disease.Methods: We reviewed the clinical research, consisting of mainly case series, on reported neurologic manifestations of COVID-19. We also reviewed basic studies to understand the mechanism of these neurologic symptoms and signs.Results: We included 79 studies for qualitative synthesis and 63 studies for meta-analysis. The reported neurologic manifestations were olfactory/taste disorders (35.6%), myalgia (18.5%), headache (10.7%), acute cerebral vascular disease (8.1%), dizziness (7.9%), altered mental status (7.8%), seizure (1.5%), encephalitis, neuralgia, ataxia, Guillain-Barre syndrome, Miller Fisher syndrome, intracerebral hemorrhage, polyneuritis cranialis, and dystonic posture.Conclusions: Neurologic manifestations in COVID-19 may alert physicians and medical practitioners to rule in high-risk patients. The increasing incidence of olfactory/taste disorders, myalgia, headache, and acute cerebral vascular disease renders a possibility that COVID-19 could attack the nervous system. The cytokine secretion and bloodstream circulation (viremia) are among the most possible routes into the nervous system.

Study of Simplified Coma Scales: Acute Stroke Patients with Tracheal Intubation.

Background:Whether the Glasgow Coma Scale (GCS) can assess intubated patients is still a topic of controversy. We compared the test performance of the GCS motor component (GCS-M)/Simplified Motor Score (SMS) to the total of the GCS in predicting the outcomes of intubated acute severe cerebral vascular disease patients.Methods:A retrospective analysis of prospectively collected observational data was performed. Between January 2012 and October 2015, 106 consecutive acute severe cerebral vascular disease patients with intubation were included in the study. GCS, GCS-M, GCS eye-opening component, and SMS were documented on admission and at 24, 48, and 72 h after admission to Neurointensive Care Unit (NCU). Outcomes were death and unfavorable prognosis (modified Rankin Scale: 5–6) at NCU discharge. The receiver operating characteristic (ROC) curve was obtained to determine the prognostic performance and best cutoff value for each scoring system. Comparison of the area under the ROC curves (AUCs) was performed using the Z-test.Results:Of 106 patients included in the study, 41 (38.7%) patients died, and 69 (65.1%) patients had poor prognosis when discharged from NCU. The four time points within 72 h of admission to the NCU were equivalent for each scale's predictive power, except that 0 h was the best for each scale in predicting outcomes of patients with right-hemisphere lesions. Nonsignificant difference was found between GCS-M AUCs and GCS AUCs in predicting death at 0 h (0.721 vs. 0.717, Z = 0.135, P = 0.893) and 72 h (0.730 vs. 0.765, Z = 1.887, P = 0.060), in predicting poor prognosis at 0 h (0.827 vs. 0.819, Z = 0.395, P = 0.693), 24 h (0.771 vs. 0.760, Z = 0.944, P = 0.345), 48 h (0.732 vs. 0.741, Z = 0.593, P = 0.590), and 72 h (0.775 vs. 0.780, Z = 0.302, P = 0.763). AUCs in predicting death for patients with left-hemisphere lesions ranged from 0.700 to 0.804 for GCS-M and from 0.700 to 0.824 for GCS, in predicting poor prognosis ranged from 0.841 to 0.969 for GCS-M and from 0.875 to 0.969 for GCS, with no significant difference between GCS-M AUCs and GCS AUCs within 72 h (P > 0.05). No significant difference between GCS-M AUCs and GCS AUCs was found in predicting death (0.964 vs. 0.964, P = 1.000) and poor prognosis (1.000 vs. 1.000, P = 1.000) for patients with right-hemisphere lesions at 0 h. AUCs in predicting death for patients with brainstem or cerebella were poor for GCS-M (<0.700), in predicting poor prognosis ranged from 0.727 to 0.801 for GCS-M and from 0.704 to 0.820 for GCS, with no significant difference between GCS-M AUCs and GCS AUCs within 72 h (P > 0.05). The SMS AUCs (<0.700) in predicting outcomes were poor.Conclusions:The GCS-M approaches the same test performance as the GCS in assessing the prognosis of intubated acute severe cerebral vascular disease patients. The GCS-M could be accurately and reliably applied in patients with hemisphere lesions, but caution must be taken for patients with brainstem or cerebella lesions.

Fully automatic acute ischemic lesion segmentation in DWI using convolutional neural networks.

Stroke is an acute cerebral vascular disease, which is likely to cause long-term disabilities and death. Acute ischemic lesions occur in most stroke patients. These lesions are treatable under accurate diagnosis and treatments. Although diffusion-weighted MR imaging (DWI) is sensitive to these lesions, localizing and quantifying them manually is costly and challenging for clinicians. In this paper, we propose a novel framework to automatically segment stroke lesions in DWI. Our framework consists of two convolutional neural networks (CNNs): one is an ensemble of two DeconvNets (Noh et al., 2015), which is the EDD Net; the second CNN is the multi-scale convolutional label evaluation net (MUSCLE Net), which aims to evaluate the lesions detected by the EDD Net in order to remove potential false positives. To the best of our knowledge, it is the first attempt to solve this problem and using both CNNs achieves very good results. Furthermore, we study the network architectures and key configurations in detail to ensure the best performance. It is validated on a large dataset comprising clinical acquired DW images from 741 subjects. A mean accuracy of Dice coefficient obtained is 0.67 in total. The mean Dice scores based on subjects with only small and large lesions are 0.61 and 0.83, respectively. The lesion detection rate achieved is 0.94.

护理中风后失语患者73例体会

中风(Stroke)也叫脑卒中。中风是中医学对急性脑血管疾病的统称。它是以猝然昏倒，不省人事，伴发口角歪斜、语言不利而出现半身不遂为主要症状的一类脑血液循环障碍性疾病。大多数中风的患者都会留下失语、偏瘫等后遗症。本研究选取我院患有中风后失语的患者进行早期的干预，通过相关的功能恢复及锻炼，使患者在语言恢复方面良好。康复治疗的成功或失败，患者的康复欲望占大部分决定性因素。因此，在康复训练时，首先要对患者的心理进行疏导，使患者树立能够战胜疾病、重新恢复健康的信心。其次在对患者进行语言恢复的康复训练时，应根据患者的性格特点、教育程度、文化水平等因素因材施教，比较有针对性地对其进行心理康复，以获取患者的信任和配合，从而可以更好地达到康复训练的目的。 Stroke is also called cerebral apoplexy. Stroke is a general term for acute cerebral vascular disease in Chinese medicine. It is of a kind of cerebral blood circulation disorders with sudden fainting, unconscious, accompanied by the main symptoms of the mouth skew, the language negative and the hemiplegia. Most stroke victims leave behind sequelae such as aphasia and hemiplegia. In this study, patients with aphasia suffered from apoplexy were selected to perform early intervention, and the patients were able to recover and exercise well. The patient's recovery desire accounts for most of the decisive factors in the success or failure of rehabilitation treatment. Therefore, in rehabilitation training, first of all, the patient's psychology should be channeled, so that the patient can build up the confidence to overcome the disease and restore health. Second, in the recovery of patients with language rehabilitation training, nurses should carry out a targeted treatment for psychological rehabilitation according to patients' personality characteristics, education level, cultural level and other factors, in order to get the patient's trust and cooperation, therefore, it can achieve the rehabilitation much better.

急性期脳血管障害患者に対して看護師が提供する “からだを起こす” 看護ケアの現状 ―先駆的脳神経外科病院1施設の結果から―

急性期脳血管障害患者に対して看護師が提供する “からだを起こす” 看護ケアの現状 ―先駆的脳神経外科病院1施設の結果から―

急性期脳血管障害患者に対する “からだを起こす” 看護ケアプログラムの構築

急性期脳血管障害患者に対する “からだを起こす” 看護ケアプログラムの構築

Retinal Vascular Changes are a Marker for Cerebral Vascular Diseases.

The retinal circulation is a potential marker of cerebral vascular disease because it shares origin and drainage with the intracranial circulation and because it can be directly visualized using ophthalmoscopy. Cross-sectional and cohort studies have demonstrated associations between chronic retinal and cerebral vascular disease, acute retinal and cerebral vascular disease, and chronic retinal vascular disease and acute cerebral vascular disease. In particular, certain qualitative features of retinopathy, retinal artery occlusion, and increased retinal vein caliber are associated with concurrent and future cerebrovascular events. These associations persist after accounting for confounding variables known to be disease-causing in both circulations, which supports the potential use of retinal vasculature findings to stratify individuals with regards to cerebral vascular disease risk.

Progress on diabetic cerebrovascular diseases.

Diabetic cerebrovascular diseases are defined as cerebral vascular diseases induced by diabetes with sugar, fat and a series of nutrient substance metabolic disorders, resulting in intracranial large and small vessel diseases. About 20%-40% patients with type 2 diabetes suffer from cerebral blood vessel diseases. Diabetic cerebrovascular diseases are the main causes of death in patients with diabetes mellitus. The major clinical manifestations are asymptomatic cerebral atherosclerosis, stroke, cerebral small vessel disease and acute cerebral vascular disease. The pathogenesis, clinical characteristics, treatment and prognosis of diabetic cerebrovascular disease are obviously different from non-diabetic cerebral vascular diseases. This paper will focus on the diabetic cerebrovascular disease, including its latest research progress. Diabetic cerebral large vascular disease and diabetic cerebral small vessel disease will be reviewed here.

Effect of comprehensive nursing intervention on expectoration in patients with acute cerebral vascular ;disease combined with acute lung injury

Objective To explore the effect of comprehensive nursing intervention on expectoration in patients with acute cerebral vascular disease combined with acute lung injury （ALI）.Methods One hundred and fifteen patients with acute cerebral vascular disease combined with ALI were randomly divided into the intervention group （ n=58 ） and the control group （ n=57 ） according to random number table .The intervention group received the comprehensive nursing intervention including the breathing exercises , sputum induction and chest percussion therapy , and the control group received the conventional sputum nursing according to the acute cerebral vascular disease combined with ALI , and the effect of expectoration was compared in two groups . Results No difference was found in the oxygen saturation before the intervention in two groups （P＆gt;0.05）. The oxygen saturation is （96.58 ±2.31）% after the expectoration in the intervention group , and was higher than （92.53 ±2.73）% in the control group, and the difference was statistically significant （t=8.594, P＆lt;0.01）.The PaO2 was （81.05 ±1.23） mmHg after the expectoration in the intervention group , and was higher than （77.18 ±1.37） mmHg in the control group, and the difference was statistically significant （t=15.945, P＆lt;0.01）.The time of effective expectoration , alleviating the symptoms of asthma hold , the disappearance of sputum, body temperature returned to normal and ICU monitoring were respectively （3.57 ±1.25） h, （5.26 ± 1.53） h, （3.52 ±1.63） d, （5.32 ±1.65） d, （7.52 ±1.67） d in the intervention group, and were less than （5.72 ±1.52） h, （9.57 ±2.05） h, （5.93 ±2.15） d, （7.82 ±1.87） d, （11.65 ±2.31） d in the control group, and the differences were statistically significant （ t =8.291, 12.792, 6.781, 7.605, 11.001, respectively;P 〈0.01）.The total efficiency of the recovery of respiratory function after the effective expectoration in the intervention group was 96.55%, and was higher than 82.46%in the control group, and the difference was statistically significant （χ2 =6.116, P 〈0.01 ）.Conclusions Comprehensive nursing intervention can promote the expectoration , increase gas exchange efficiency , improve hypoxia as soon as possible, alleviate the symptoms of asthma hold , and enhance the effect of treatment in patients with acute cerebral vascular disease combined with ALI . Key words: Acute lung injury; Cerebral vascular disease; Expectoration; Comprehensive nursing intervention

Cerebral-cardiac syndrome caused by acute cerebral vascular disease

目的 探讨脑血管病后脑心综合征(CCS)的临床特点、发病机制及其与预后的关系.方法对166例急性脑血管病合并CCS患者的临床资料进行回顾性分析.结果 CCS发病率为38.2%,出血性脑卒中发生CCS明显高于缺血性脑卒中(P＜0.05);脑干、小脑及基底节丘脑病灶合并CCS明显高于脑叶病灶(P＜0.05);CCS心电图主要表现为心肌缺血,心律失常.结论 CCS发生与脑卒中类型及部位等因素有关,其发病机制可能为脑卒中直接或间接导致植物神经功能失调、神经体液功能紊乱有关。

Nutrición basada en la evidencia en las enfermedades neurológicas

Neurological disease causes considerable morbidity in developed countries and frequently leads to alterations in the level of consciousness or in the mechanisms of swallowing, which may necessitate artificial nutritional support. The present review aims to evaluate nutritional support in acute cerebral vascular disease, dementia and amyotrophic lateral sclerosis, as well as the utility of a ketogenic diet in the treatment of epilepsy, based on the best available scientific evidence. A literature search was performed in Medline (PubMed) and in the Cochrane Library Plus in Spanish. Randomized clinical studies, systematic reviews, and metaanalyses were selected. There are few prospective randomized studies on nutritional support in neurological diseases. The FOOD study shows that the nasogastric tube is a better route of administration than percutaneous endoscopic gastrostomy for enteral nutrition in the first month after stroke. In the case of dementia and other neurodegenerative diseases, the available evidence is weak. There are no reliable data from randomized controlled trials that support the use of ketogenic diets in patients with epilepsy.

W12-P-020 Influence of age and sex on levels of anti-oxidized LDL antibodies and anti-LDL immune complexes in the general population

Most studies of antibodies to oxidized LDL have been undertaken in patients with different diseases and cardiovascular risk factors. However, very few studies have researched the distribution and determining factors of antibodies to oxidized LDL in the general population. A total of 1,354 persons (817 females and 537 males) aged 5–65 years were included in this study. They were selected randomly from the population census of Malaga, in southern Spain. The females had lower levels of total cholesterol and triglycerides and higher levels of HDL-cholesterol and a very significant increase ( P 0.0001) in levels of anti-oxidized LDL [low density lipoprotein modified by malondialdehyde (MDA-LDL)] antibodies but no difference in levels of immune complexes consisting of LDL and IgG antibodies (anti-LDL immune complex). Younger persons (16–35 years) had higher levels of anti-oxidized LDL (MDA-LDL) antibodies than persons older than 35 years ( P 0.05). Levels of immune complexes were significantly higher ( P 0.05) in persons aged 5–15 years than in persons older than 40 years. A very weak association was found between levels of anti-oxidized LDL (MDA-LDL) antibodies and anti-LDL immune complexes. The higher prevalence of anti-oxidized LDL (MDA-LDL) antibodies in females and young persons is in agreement with studies that found an inverse association between atherosclerosis and the level of these antibodies. —Tinahones, F. J., J. M. GomezZumaquero, L. Garrido-Sanchez, E. Garcia-Fuentes, G. RojoMartinez, I. Esteva, M. S. Ruiz de Adana, F. Cardona, and F. Soriguer. Influence of age and sex on levels of anti-oxidized LDL antibodies and anti-LDL immune complexes in the general population. J. Lipid Res. 2005. 46: 452–457. Supplementary key words low density lipoprotein • oxidized low density lipoproteins • atherosclerosis Several lines of evidence have determined that the oxidized products of LDLs are involved in atherogenesis (1, 2). Oxidative modification of LDLs may be a prerequisite for the rapid accumulation of LDLs within macrophages to form foam cells; indeed, oxidized LDL has been found in extracts from atherosclerotic lesions (3). Oxidative modification of LDLs induces the formation of immunogenic epitopes in the LDL molecule, which leads to the formation of antibodies against oxidized LDLs that can be detected in serum (4). These antibodies have been detected in patients with advanced atherosclerotic lesions (5). Levels of anti-oxidized LDL antibodies are increased in patients with coronary atherosclerosis (6, 7), acute myocardial infarction (8), and cerebral or peripheral vascular disease (9), and they have been shown to predict the progression of carotid atherosclerotic lesions (10). Nevertheless, the clinical importance of these autoantibodies is still under discussion. For example, in patients with diabetes, no association has been found between antioxidized LDL antibodies and microvascular complications (11), nor has an association been found between their levels and levels of cholesterol in patients with heterozygous hypercholesterolemia (12) or with the degree of oxidizability in serum (13). In fact, our group found an inverse relation between levels of cholesterol and levels of antioxidized LDL antibodies in the general population (14). Recent studies have found no association between the levels of anti-oxidized LDL antibodies and coronary artery disease (15), and others have detected an inverse relation between IgM autoantibodies to oxidized LDL and carotid artery atherosclerosis (16). The methodological approach for the detection of antioxidized LDL antibodies is subject to much variation. Moreover, oxidized LDL autoantibodies have been found both free and forming immune complexes (17). Thus, difAbbreviations: MDA, malondialdehyde; MDA-LDL, low density lipoprotein modified by malondialdehyde. 1 To whom correspondence should be addressed. e-mail: fjtinahones@terra.es Manuscript received 2 August 2004 and in revised form 22 October 2004 and in re-revised form 8 December 2004. Published, JLR Papers in Press, December 16, 2004. DOI 10.1194/jlr.M400290-JLR200 by gest, on Jne 7, 2013 w w w .j.org D ow nladed fom

Study on the relationship between plasma homocysteine and acute cerebral vascular disease.

The levels of plasma homocysteine were determined by using high-performance liquid chromatographic method. It was found that plasma homocysteine levels were significantly higher in the patients with stroke than that in the controls. There was no correlation between plasma homocysteine levels and hypertension, smoking, concentrations of blood glucose or hypertriglyceridesemia. It was suggested that hyperhomocysteinemia may be an independent risk factor for acute cerebral vascular disease.

Electronystagmographic Findings in Patients with Acute Cerebral Vascular Disease and Vertigo

A neurootologist examined 233 successive cases of acute disabling vertigo from the Clinic of Neurology of Turku University Central Hospital. On magnetic resonance imaging (MRI), 24 patients had evidence of acute cerebral or cerebellar brain infarction. The examination scheme included a case history analysis, clinical neurootological examination and electronystagmography (ENG). The audiological examination included pure-tone thresholds and speech audiometry. The ENG analyses were done by two neurootologists who had no information about the aetiology of the diseases. A central disturbance in ENG was observed in 59% (10/17) of the patients with cerebral brain infarction and 71% (5/7) of the patients with cerebellar brain infarction. ENG is not valid as a screening method for the central aetiology of vertigo; imaging of the central nervous system is needed.

Somatosensory evoked potential (SEP) topography in normal people and acute cerebral vascular disease (ACVD) patients

Somatosensory evoked potential (SEP) topography in normal people and acute cerebral vascular disease (ACVD) patients