Discussion on Clinical Treatment Strategy and Effect of Acute Cerebrovascular Disease Complicated with Disturbance of Consciousness

2021 ◽  
The Breast ◽  
2005 ◽  
Vol 14 (6) ◽  
pp. 624-630 ◽  
Author(s):  
V. Craig Jordan ◽  
Joan S. Lewis ◽  
Clodia Osipo ◽  
Dong Cheng

2017 ◽  
Vol 4 (3-4) ◽  
pp. 107-114
Author(s):  
Chuanhe Sun ◽  
Weilong Liao ◽  
Wenfei Jiang ◽  
Penglin Gao ◽  
Weidong Pan

Hypertensive intracerebral hemorrhage (HICH) is a type of acute cerebrovascular disease with high rates of incidence, mortality, and disability, and is a cause of more frequent instances of secondary brain insult (SBI). In-depth study of the pathogenesis and pathophysiological mechanisms of SBI in HICH contributes to its clinical treatment and prognosis. This article presents a brief summary of the pathophysiological mechanism and treatment of SBI after HICH.


2020 ◽  
Author(s):  
Liang Wu ◽  
Jiang Xiao ◽  
Yangzi Song ◽  
Guiju Gao ◽  
Hongxin Zhao

Abstract Background We collected the clinical data of hospitalized AIDS patients who complicated with cryptococcal meningitis (CM) in nearly 10 years, to analyze the influencing factors of prognosis and provide help for early identification of severe patients, timely rescue measures and improvement of prognosis. Methods The 128 subjects were divided into two groups according to the effective/ineffective clinical treatment. Analyzed and compared the data from various aspects. Results 119 cases (93.0%) had headache, 109 (85.2%) had fever, 95 (74.2%) had nausea and vomiting, 52 (40.6%) had consciousness disorder. 101 patients (78.9%) were effective in clinical treatment, while 27 (21.1%) were ineffective. Multivariate Logistic regression analysis showed that the occurrence of cerebral herniation increased the risk of poor prognosis by 405 times, and the occurrence of disturbance of consciousness increased the risk of poor prognosis by 4.4 times. However, each week of extension of the course of induction therapy reduced the risk of poor prognosis by 0.683 times, and increased the effective outcome of clinical treatment by 1.5 times. In addition, the prognosis of patients with ventriculoperitoneal shunt or lumbar cisterna shunt decompression was better than that of patients without shunt therapy. Conclusions Cerebral hernia and disturbance of consciousness are risk factors for prognosis of AIDS patients with CM, and duration of induction therapy is a protective factor for prognosis. Anticryptococcal therapy with high efficiency and sufficient treatment time during induction period is especially critical for improving prognosis. Shunt decompression therapy may improve the prognosis of patients with AIDS complicated with CM.


2022 ◽  
Vol 2022 ◽  
pp. 1-13
Author(s):  
Ying Yu ◽  
Gong Zhang ◽  
Tao Han ◽  
Hongjie Liu ◽  
Hailiang Huang

Background. Poststroke depression (PSD) is a serious complication of clinical cerebrovascular disease. Patients not only have depression-related emotional symptoms but also have physical symptoms, such as autonomic dysfunction. At the same time, patients with varying degrees of depression will delay the neurological function of stroke patients. The recovery time of cognitive function and limb function will increase the risk of accidental death and even aggravate the mortality of cerebrovascular disease. Through combining data analysis and related literature, seven types of Chinese patent medicines (CPMs) widely used in the clinical treatment of PSD have been screened out. These herbs exhibit some clinical comparability under the conditions that the syndrome type and dosage form are relatively uniform. Therefore, in this study, the network meta-analysis method was used to evaluate the safety and efficacy of the seven CPMs screened out, and the probability ranking was performed to screen the best clinical auxiliary treatment plan of CPM. Methods. We searched the Chinese databases, including CNKI, WANFANG, and VIP, as well as the English databases, including the Cochrane Library, EMBASE, and PubMed, from inception to May 31, 2020, to identify randomized controlled trials (RCTs) on seven kinds of CPMs that were the subjects of the clinical research. The bias risk and quality of the included studies were analyzed with the Cochrane Handbook (version 5.1), ADDIS, and R software, and the results were compared in a network meta-analysis (NMA). Results. In terms of clinical effectiveness, the seven kinds of CPMs all improved clinical curative effects, with Jieyu Anshen capsule adjuvant treatment having the most significant effect [odds ratio (OR) = 5.00, 95% CI (1.72–9.48)]. Wuling capsule AT can effectively reduce the score index of scale factors for the HAMD score, NIHSS score, and TESS score [mean difference (MD) = −3.95, 95% CI (−4.88–3.00); OR = −3.25, 95% CI (−5.46)–1.05); OR = 0.22, 95% CI (0.05–0.79), resp.]. Conclusion. The mechanisms of seven CPMs in the adjuvant treatment of PSD have advantages. In terms of safety and efficacy, the CPMs had better clinical adjuvant treatment performance. Although this study concluded that the Jieyu Anshen capsule is the preferred drug for clinical treatment, a clear conclusion still needs to be verified in a high-quality randomized controlled study. In clinical practice, accurate selection and application can be carried out according to the specific characteristics of patients.


2020 ◽  
Author(s):  
Liang Wu ◽  
Jiang Xiao ◽  
Yangzi Song ◽  
Guiju Gao ◽  
Hongxin Zhao

Abstract Background: We collected the clinical data of hospitalized AIDS patients who complicated with cryptococcal meningitis (CM) in nearly 10 years, to analyze the influencing factors of prognosis and provide help for early identification of severe patients, timely rescue measures and improvement of prognosis. Methods: The 128 subjects were divided into two groups according to the effective/ineffective clinical treatment. Analyzed and compared the data from various aspects. Results: 119 cases (93.0%) had headache, 109 (85.2%) had fever, 95 (74.2%) had nausea and vomiting, 52 (40.6%) had consciousness disorder. 101 patients (78.9%) were effective in clinical treatment, while 27 (21.1%) were ineffective. Multivariate Logistic regression analysis showed that the occurrence of cerebral herniation increased the risk of poor prognosis by 405 times, and the occurrence of disturbance of consciousness increased the risk of poor prognosis by 4.4 times. However, each week of extension of the course of induction therapy reduced the risk of poor prognosis by 0.683 times, and increased the effective outcome of clinical treatment by 1.5 times. In addition, the prognosis of patients with ventriculoperitoneal shunt or lumbar cisterna shunt decompression was better than that of patients without shunt therapy. Conclusions: Cerebral hernia and disturbance of consciousness are risk factors for prognosis of AIDS patients with CM, and duration of induction therapy is a protective factor for prognosis. Anticryptococcal therapy with high efficiency and sufficient treatment time during induction period is especially critical for improving prognosis. Shunt decompression therapy may improve the prognosis of patients with AIDS complicated with CM.


2009 ◽  
Vol 14 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Jacqueline Hinckley

Abstract A patient with aphasia that is uncomplicated by other cognitive abilities will usually show a primary impairment of language. The frequency of additional cognitive impairments associated with cerebrovascular disease, multiple (silent or diagnosed) infarcts, or dementia increases with age and can complicate a single focal lesion that produces aphasia. The typical cognitive profiles of vascular dementia or dementia due to cerebrovascular disease may differ from the cognitive profile of patients with Alzheimer's dementia. In order to complete effective treatment selection, clinicians must know the cognitive profile of the patient and choose treatments accordingly. When attention, memory, and executive function are relatively preserved, strategy-based and conversation-based interventions provide the best choices to target personally relevant communication abilities. Examples of treatments in this category include PACE and Response Elaboration Training. When patients with aphasia have co-occurring episodic memory or executive function impairments, treatments that rely less on these abilities should be selected. Examples of treatments that fit these selection criteria include spaced retrieval and errorless learning. Finally, training caregivers in the use of supportive communication strategies is helpful to patients with aphasia, with or without additional cognitive complications.


2005 ◽  
Vol 173 (4S) ◽  
pp. 300-301
Author(s):  
Michaella E. Maloney ◽  
Pei Zhong ◽  
Charles G. Marguet ◽  
Yufeng F. Zhou ◽  
Jeffrey C. Sung ◽  
...  

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