血栓切除术后的基底腺缺血性心脏病发作:在急性阶段的认知障碍
Valeria Guglielmi1, Davide Quaranta1,2,3, Giovanna Masone Iacobucci4
1Dipartimento Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
European journal of neurology
|June 19, 2023
概括
对中风的机械血栓切除术可能会导致认知障碍,即使功能恢复良好. 这项研究发现,一些患者在术后一周内经历了影响多个领域的显著认知缺陷.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 脑卒中研究 脑卒中研究
背景情况:
- 机械血栓切除术对于中脑动脉封闭是有效的.
- 基础性腺梗塞是血栓切除术后的一个常见并发症.
- 血栓切除术后的认知结果比功能结果了解得更少.
研究的目的:
- 在中风机械血栓切除术后一周内评估认知障碍.
- 为了研究基底腺损伤和认知缺陷之间的关系.
主要方法:
- 一组43名患者使用蒙特利尔认知评估 (MoCA) 和详细的神经心理测试电池进行认知评估.
- 患者被归类为认知障碍 (CImp),如果他们的MoCA得分低于18分.
主要成果:
- 认知障碍 (CImp) 患者在出院时,与非认知障碍 (noCImp) 患者相比,显著提高了国家卫生研究院中风量表 (NIHSS) 和修改的兰金量表 (mRS) 的得分.
- 在基线NIHSS,mRS,Fazekas得分或阿尔伯塔中风计划早期计算机断层扫描得分 (ASPECTS) 中,Cimp和noCImp组之间没有发现显著差异.
- 神经心理测试显示,两组的认知概况相似,这表明CImp患者的广泛缺陷.
结论:
- 机械血栓切除术后一周内可以检测到认知障碍,并且与更糟糕的功能结果 (更高的NIHSS和mRS) 有关.
- 观察到的认知缺陷涉及多个领域,这表明基底腺损伤可能导致复杂的功能障碍.
- 需要进一步的研究来了解长期的认知后果和潜在的干预措施.
相关概念视频
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
01:22Dementia l: Introduction
Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...