Pure Motor Stroke Secondary to Cerebral Infarction of Recurrent Artery of Heubner after Mild Head Trauma: A Case Report

Post-traumatic ischaemic stroke in a teenager after head trauma: A case report

Background

Lacunar strokes in the pediatric population are very uncommon, as well as trauma-induced strokes. It is extremely rare for a head trauma induced ischaemic stroke to occur in children and young adults.

Case report

We describe a case of a 13-year-old boy who reported acute ischaemic lesions, and in particular a right basal ganglia ischaemic stroke after falling from a height of 10 m, presumably secondary to the stretching-induced occlusion of the recurrent artery of Heubner, with a favorable outcome.

Conclusion

Ischaemic strokes can rarely be subsequent to head trauma in young adults, in relationship with the degree of maturity of the perforating vessels. Although very rare, it is important to avoid the lack of recognition of this condition, thus awareness is necessary.

Observation of the Effect of Nursing BPR on Thrombolytic Efficacy and Prognosis of Patients with Cerebral Infarction Based on CT Images

Cerebral infarction has become the main cause of death among Chinese residents, especially ischemic cerebral infarction. The existing CT technology is not very effective for the detection of cerebral infarction, and some angiography has problems such as blurring and shadowing. In order to understand the treatment methods and effects of patients with cerebral infarction, this article observes the effect of nursing BPR on thrombolytic efficacy and prognosis of patients with cerebral infarction based on CT images. The patients were divided into thrombolytic group and nonthrombolytic group, and a simple rating scale was used to assess the motor function of the patients' limbs, and the stroke scale was used to assess the patient's neurological function. Compare the baseline data, the time of admission, 24 hours and 7 days, the scores before and after treatment, and the ratio between the two groups. According to the monitoring, record each time point. The analysis of the occurrence of primary endpoint was events and secondary endpoint events and risk factors affecting limb motor function. The results of the study found that, based on the computer scanning observation of nursing BPR, compared with the traditional model, the patient's bleeding was significantly reduced, and the time required for nursing was also reduced by more than 50% compared with the traditional model. Compared with the traditional nursing model, the satisfaction of patients with the BPR nursing model is nearly 40% higher than that of the traditional nursing model. This shows that the observation of thrombolytic effect in patients with cerebral infarction based on computed tomography and BPR nursing can produce good therapeutic effects.

Developmental venous anomaly associated ischemic stroke caused by minor head trauma: A case report

RATIONALE

A developmental venous anomaly (DVA) is the most common intracranial congenital anomaly and is mostly asymptomatic. Thrombosis rarely develops in a DVA due to hypercoagulation. We report a case of ischemic stroke in the area of a DVA after minor head trauma in a patient with DVA and without a predisposition thrombosis.

PATIENT CONCERNS

A healthy 17-year-old male was admitted to the emergency room due to left hemiparesis, which was caused by a ball hitting the right side of his head during a soccer game.

DIAGNOSIS

Brain magnetic resonance (MR) susceptibility-weighted image showed several small veins draining to the central vein in the area from the right posterior putamen to the periventricular white matter.

INTERVENTIONS

We diagnosed the patient with an ischemic stroke associated with a DVA and administered antiplatelet agents. The patient's autoantibodies (including antiphospholipid antibody) and factors of blood coagulation were normal.

OUTCOMES

The left hemiparesis of the patient worsened by the second day of admission. Moreover, high signal intensity was observed in the DVA region of the diffusion weighted image of brain MR. The patient's symptoms gradually improved afterward, and left hemiparesis recovered fully 3 weeks after the onset.

LESSONS

DVAs may predispose to ischemic stroke due to thrombosis and hypercoagulation, although it is rare. It is necessary to consider the possibility of ischemic stroke due to minor head trauma, even without factors causing hypercoagulation.

Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction

Objective

To investigate the efficacy of recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction.

Methods

One hundred and thirty-two patients with acute cerebral infarction who were admitted to our hospital were selected and grouped into a control group and an observation group, 66 each group. Patients in the control group were given conventional treatment in combination with local mild hypothermia therapy, and patients in the observation group were given rt-PA intravenous thrombolysis on the basis of conventional treatment and local mild hypothermia therapy. National institute of health stroke scale (NIHSS) score and intracranial pressure (ICP) of the two groups before and after treatment was recorded. The efficacy of the two groups was evaluated. The modified Rankin scale (MRS) score was followed up for three months. The blood samples of the patients were collected before and after thrombolysis. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels in the plasma were detected.

Results

The NIHSS score of the two groups decreased in the 1^st, 3^rd and 7^th day after treatment compared to before treatment (p<0.05), but the NIHSS score of the two groups had no significant difference at different time points after treatment (p>0.05). The ICP of the two groups decreased in the 1^st, 3^rd and 7^th day after treatment compared to before treatment (p<0.05), and the decrease of ICP of the observation group was more significant than that of the control group at the same time point (1^st, 3^rd and 7^th day after treatment) (p<0.05). The clinical efficacy of the observation group was higher than that of the control group after treatment, and the difference was statistically significant (p<0.05). The MDA concentration of both groups decreased at different time points after treatment (p<0.05), but the SOD concentration increased (p<0.05). The MDA concentration of the observation group was lower than that of the control group at different time points after treatment (p<0.05), and the SOD concentration of the observation group was higher than that of the control group (p<0.05).

Conclusion

rt-PA intravenous thrombolysis in combination with mild hypothermia therapy has significant efficacy in the treatment of acute cerebral infarction. It can effectively relieve neurological function. Its action mechanism may be realized by relieving oxidative stress response.