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Ke C, Zheng CN, Wang J, Yao D, Fang X, Luo Y, Wu J, Zheng X, Wang P. Evaluation on the application of transcranial Doppler (TCD) and electroencephalography (EEG) in patients with vertebrobasilar insufficiency. J Orthop Surg Res 2020; 15:470. [PMID: 33050913 PMCID: PMC7557013 DOI: 10.1186/s13018-020-01915-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the diagnostic value of transcranial Doppler (TCD) and electroencephalography (EEG) in patients with vertebrobasilar insufficiency (VBI) during clinical diagnosis and treatment METHODS: Eighty patients diagnosed with VBI in our hospital from June 2018 to December 2019 were randomly selected as the observation group, and 80 healthy people who received physical examination in the same period were selected as the control group. The abnormal rate, main performance and results, and the peak velocity of blood flow and vertebrobasilar artery blood flow of the two groups were compared. RESULTS The abnormal rate of EEG and TCD in VBI patients was 38.75% (31/80) and the 93.75% (75/80), respectively. In TCD examination, ACA, PCA, MCA, and VA of both sides of the observation group were higher than those of the control group, while BA was lower than that of the control group (P < 0.05). The Vs, Vd, and Vm on both sides of BA and VA in the observation group were lower than those in the control group, while PI and RI were higher than those in the control group (P < 0.05). CONCLUSIONS TCD examination is highly sensitive to the degree and pattern of cerebral ischemia in VBI patients. EEG examination will define the changes of brain cell function after cerebral ischemia. Therefore, EEG and TCD have their own advantages. The application of TCD and EEG can be considered in the early diagnosis, curative effect, and prognosis evaluation of VBI patients, so as to improve the accuracy of diagnosis and prognosis.
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Affiliation(s)
- Changmin Ke
- Neurology Department, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai city, 519000, Guangdong Province, China
| | - Chu-Na Zheng
- Department of Dermatology, The Fifth Affiliated Hospital of Sun Yat-sen University, No.52, Meihua East Road, Xiangzhou District, Zhuhai City, 519000, Guangdong Province, China
| | - Juan Wang
- Department of Health Management Centre, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai city, 519000, Guangdong Province, China
| | - Dongying Yao
- Department of Burns and Plastic Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai city, 519000, Guangdong Province, China
| | - Xiaojuan Fang
- Department of Psychiatry and Psychology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai city, 519000, Guangdong Province, China
| | - Yan Luo
- Neurology Department, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai city, 519000, Guangdong Province, China
| | - Jianglin Wu
- Department of Orthopedics, No.6, Dongguan TCM Hospital, Dongguan city, 523000, Guangdong Province, China
| | - Xiaoqing Zheng
- Department of Urinary Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, No.52, Meihua East Road, Xiangzhou District, Zhuhai City, 519000, Guangdong Province, China.
| | - Peiping Wang
- Department of Health Management Centre, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai city, 519000, Guangdong Province, China.
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Hirtz D, Kirkham FJ. Sickle Cell Disease and Stroke. Pediatr Neurol 2019; 95:34-41. [PMID: 30948147 DOI: 10.1016/j.pediatrneurol.2019.02.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 01/04/2023]
Abstract
Cerebral infarction is a common complication of sickle cell disease and may manifest as overt stroke or cognitive impairment associated with "silent" cerebral infarction on magnetic resonance imaging. Vasculopathy may be diagnosed on transcranial Doppler or magnetic resonance angiography. The risk factors in sickle cell disease for cognitive impairment, overt ischemic stroke, silent cerebral infarction, overt hemorrhagic stroke, and vasculopathy defined by transcranial Doppler or magnetic resonance angiography overlap, with severe acute and chronic anemia, acute chest crisis, reticulocytosis, and low oxygen saturation reported with the majority. However, there are differences reported in different cohorts, which may reflect age, geographic location, or neuroimaging techniques, for example, magnetic resonance imaging field strength. Regular blood transfusion reduces, but does not abolish, the risk of neurological complications in children with sickle cell disease and either previous overt stroke or silent cerebral infarction or abnormal transcranial Doppler. There are relatively few data on the use of hydroxyurea or other management strategies. Early assessment of the risk of neurocognitive complications is likely to become increasingly important in the management of sickle cell disease.
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Affiliation(s)
- Deborah Hirtz
- University of Vermont School of Medicine, Burlington, Vermont
| | - Fenella J Kirkham
- Developmental Neurosciences Section and Biomedical Research Unit, Clinical and Experimental Sciences, University of Southampton, UCL Great Ormond Street Institute of Child Health, London, UK.
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