多发性硬化临床表现多样,其中大脑半球型多表现为精神症状、癫痫、偏瘫或感觉异常等,而以截瘫及排尿障碍为表现者少见。本文对表现为“脑性截瘫”的3 例MS患者的临床和MRI特点进行回顾分析,以此提高对于MS的认识水平。
ObjectiveTo study the etiology and clinical features of patients with ophthalmoplegia resulting in vertigo. MethodsWe retrospectively analyzed the clinical data of 45 patients with vertigo caused by ophthamloplegia treated between January 2010 and December 2013. The causes and features of the disease, treatment and outcome were summarized. ResultsAmong the factors responsible for ophthalmoplegia resulting in vertigo, myasthenia gravis (MG) took the first place (20/45, 44.4%), followed by Graves' ophthalmopathy (9/45, 20.0%), diabetes (5/45, 11.1%), intracranial infection (4/45, 8.9%), medial rectus injury (3/45, 6.7%), orbital tumor (2/45, 4.4%), and Lambert-Eaton Myasthenic Syndrome (2/45, 4.4%). In 36 patients, the lesions located in the neuromuscular junction or muscles (80.0%). The pathogenesis of ophthalmoplegia were almost all caused by systemic diseases (88.9%), and the occurrence of local ophthalmology diseases was fewer (11.1%). Etiological treatments achieved beneficial effects. ConclusionThe etiology of ophthalmology diseases resulting in vertigo is confusing. We should care more for patients with ophthalmoplegia caused by systemic diseases resulting in ophthalmologic vertigo without vision damage. Careful examinations and proper treatments for etiological factors are necessary in clinical options.
ObjectiveTo analyze the cases of cryptogenic cerebral infarction complicated with patent foramen ovale (PFO) treated by interventional occlusion, and evaluate the efficacy and safety of occlusion of PFO on preventing the recurrence of cerebral infarction.MethodsA total of 24 patients with cerebral infarction complicated with PFO who underwent interventional occlusion from January 2015 to August 2018 in Mianyang Central Hospital were retrospectively analyzed. The data of these patients was collected, including relevant medical history, clinical examinations, and treatment processes. Detailed examinations (electrocardiogram, right heart contrast echocardiography, transcranial Doppler ultrasound foaming test, cranial imaging, etc.) were performed and the clinical manifestations were evaluated when patients returned to the outpatient department. Combining with regular telephone calls and outpatient follow-up, the recurrence of cerebral infarction and postoperative complications were evaluated.ResultsAmong the 24 patients, there were 11 males and 13 females, who were aged from 16 to 72 (with an average age of 49); the National Institutes of Health Stroke Scale Score was ≤5 in 19 patients, and was >5 in 5. The preoperative MRI and other examinations of the 24 patients showed that there were 21 cases of unilateral cerebral infarctions and 3 cases of bilateral cerebral infarctions; 10 cases of single lesions and 14 cases of multiple lesions; 9 cases of cortical infarctions and 15 cases of subcortical infarctions; 11 cases of lacunar infarctions and 13 cases of non-lacunar infarctions. Anterior circulation was involved in 14 cases, posterior circulation was involved in 8 cases, and both anterior and posterior circulations were involved in 2 cases. All the 24 patients underwent interventional occlusion successfully. No complications occurred during hospitalization or 3, 6, and 12 months of follow-up visits. No cerebral infarctions reoccurred.ConclusionsInterventional occlusion of PFO is effective on preventing the recurrence of cerebral infarction. And the operation is safe with rare complications.
Objective?To explore the clinical and imaging features of cranial venous sinus thrombosis (CVST). MethodsThe clinical data of 20 patients with CVST treated between January 2008 and December 2012 were retrospectively analyzed, including the clinical manifestations, neuroimaging characters and treatment outcomes. ResultsAmong the 20 patients, there were 10 infected cases; D-dimer was detected positively in only 2 cases; cerebrospinal fluid pressure increased in 13 patients; and red blood cell population of cerebrospinal fluid increased in 12 patients. The common clinical symptoms included headache in 16 cases, eye symptoms in 12 cases, and vomiting in 10 cases. CT showed the direct signs of CVST in 3 cases, and MRI showed the direct signs of CVST in 6 cases. The common disease regions were in left transverse sinus and sigmoid sinus in 5 cases, superior sagittal sinus in 5 cases, and multiple venous sinus in 5 cases. Eighteen patients only received anticoagulation, and 2 received anticoagulation and local thrombolytic treatment. Fourteen cases recovered fully, 6 had dysfunctions. ConclusionThe clinical manifestations of CVST are nonspecific. This disorder predominantly affects childbearing women. Infection is a common cause of CVST. The occlusive venous sinus can be confirmed by enhanced magnetic resonance venography or digital subtraction angiography. Anticoagulation and local thrombolytic therapy are both proved to be safe and effective in the treatment of CVST. The early diagnosis rate of CVST remains to be improved.