脑小血管病(cerebral small vessel disease,CSVD)是导致缺血性卒中和血管性痴呆的重要原因,给家庭和社会带来沉重负担。CSVD的预防和治疗一直是研究热点,但其发病机制目前尚不完全清楚。文章对CSVD的发病机制进行综述,包括慢性脑灌注...脑小血管病(cerebral small vessel disease,CSVD)是导致缺血性卒中和血管性痴呆的重要原因,给家庭和社会带来沉重负担。CSVD的预防和治疗一直是研究热点,但其发病机制目前尚不完全清楚。文章对CSVD的发病机制进行综述,包括慢性脑灌注不足、血脑屏障功能障碍、血管内皮功能障碍、组织间液回流障碍、炎症反应和遗传因素,以期为CSVD的及早干预和治疗提供更充分的理论依据。展开更多
Background Cerebral amyloid angiopathy （CAA） is one of the main causes of spontaneous intracranial hemorrhage （ICH）. No established link is available between pathological scores of CAA and its outcome. This study ...Background Cerebral amyloid angiopathy （CAA） is one of the main causes of spontaneous intracranial hemorrhage （ICH）. No established link is available between pathological scores of CAA and its outcome. This study aimed to identify the correlations between pathological severity and poor postoperative outcome in the Chinese population. Methods Between May 2006 and April 2011, 367 consecutive patients who underwent surgery for CAA-related ICH in 71 hospitals throughout the mainland of China were enrolled in this study. Twelve months after surgery, we evaluated these patients＇ outcomes according to the modified Rankin Scale （mRS） and statistically correlated risk factors （demographics, medical history, pathological results, and surgical details） that are associated with a favorable （mRS 〈3） and poor （mRS 〉3） outcome groups. Results Risk factors for poor postoperative outcome in 367 patients with CAA-related ICH included advanced age （OR 1.034, 95% CI 1.001-1.067, P=0.042）, CAA pathology severity （OR 2.074, 95% CI 7.140-16.25, P 〈0.001）, lobar hematoma （OR 0.225, 95% CI 0.104-0.486, P 〈0.001）, presence of intraventricular hemorrhage （OR 0.478, 95% CI 0.229-1.001, P=0.050）, and/or subarachnoid hemorrhage （OR 2.629, 95% CI, 1.051-6,577, P=0.039）. Conclusions Poor postoperative outcome of patients with CAA-related ICH was more related to the severe pathological manifestation instead of other factors. Prior ischemia may present an early stage of CAA.展开更多
This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral ang...This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral angiography-MRI revealed features indicative of CAA. Symptomatic treatment resulted in improvement, but the patient later developed a fatal hematoma. The discussion navigates the intricate therapeutic landscape of repetitive TIAs in the elderly with cardiovascular risk factors, emphasizing the pivotal role of cerebral MRI and meticulous bleeding risk management. The conclusion stresses the importance of incorporating SWI sequences, specifically when suspecting a cardioembolic TIA, as a diagnostic measure to explore and exclude CAA in the differential diagnosis. This case report provides valuable insights into these challenges, highlighting the need to consider CAA in relevant cases.展开更多
文摘脑小血管病(cerebral small vessel disease,CSVD)是导致缺血性卒中和血管性痴呆的重要原因,给家庭和社会带来沉重负担。CSVD的预防和治疗一直是研究热点,但其发病机制目前尚不完全清楚。文章对CSVD的发病机制进行综述,包括慢性脑灌注不足、血脑屏障功能障碍、血管内皮功能障碍、组织间液回流障碍、炎症反应和遗传因素,以期为CSVD的及早干预和治疗提供更充分的理论依据。
文摘Background Cerebral amyloid angiopathy （CAA） is one of the main causes of spontaneous intracranial hemorrhage （ICH）. No established link is available between pathological scores of CAA and its outcome. This study aimed to identify the correlations between pathological severity and poor postoperative outcome in the Chinese population. Methods Between May 2006 and April 2011, 367 consecutive patients who underwent surgery for CAA-related ICH in 71 hospitals throughout the mainland of China were enrolled in this study. Twelve months after surgery, we evaluated these patients＇ outcomes according to the modified Rankin Scale （mRS） and statistically correlated risk factors （demographics, medical history, pathological results, and surgical details） that are associated with a favorable （mRS 〈3） and poor （mRS 〉3） outcome groups. Results Risk factors for poor postoperative outcome in 367 patients with CAA-related ICH included advanced age （OR 1.034, 95% CI 1.001-1.067, P=0.042）, CAA pathology severity （OR 2.074, 95% CI 7.140-16.25, P 〈0.001）, lobar hematoma （OR 0.225, 95% CI 0.104-0.486, P 〈0.001）, presence of intraventricular hemorrhage （OR 0.478, 95% CI 0.229-1.001, P=0.050）, and/or subarachnoid hemorrhage （OR 2.629, 95% CI, 1.051-6,577, P=0.039）. Conclusions Poor postoperative outcome of patients with CAA-related ICH was more related to the severe pathological manifestation instead of other factors. Prior ischemia may present an early stage of CAA.
文摘This case report investigates the manifestation of cerebral amyloid angiopathy (CAA) through recurrent Transient Ischemic Attacks (TIAs) in an 82-year-old patient. Despite initial diagnostic complexities, cerebral angiography-MRI revealed features indicative of CAA. Symptomatic treatment resulted in improvement, but the patient later developed a fatal hematoma. The discussion navigates the intricate therapeutic landscape of repetitive TIAs in the elderly with cardiovascular risk factors, emphasizing the pivotal role of cerebral MRI and meticulous bleeding risk management. The conclusion stresses the importance of incorporating SWI sequences, specifically when suspecting a cardioembolic TIA, as a diagnostic measure to explore and exclude CAA in the differential diagnosis. This case report provides valuable insights into these challenges, highlighting the need to consider CAA in relevant cases.
