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1092 Thalamic Hemorrhage: predictors of mortality and comparison of outcomes
Journalof lbe
Ne o!ogical clences ELSEVIER
Journal of the Neurological Sciences 238 (2005) $379-$476 www.elsevier, com/locate/jns
Poster Abstracts
10 November 2005 1092 Thalanfie Hemorrhage: predieto~cs of ino~talily and comparison of outcomes Abao, MA 1, Corral, E 1, Collantes, M A 1. 2Department of
Neuroseienees, Philippine General Hospital, Philippines Baekgronnd: Surgical management of patients with thalamic haemor,hage lacks evidence of benefit. Tiffs study compared the outcomes of patients with thalamic haemorrhage managed surgically and nonsurgically, and determined the predictors of mortality. Specific objectives were: to describe baseline demographic, and clinical characteristics of patients with thalamic haemorrhage, to determine which are predictors o f mortality, and to compare the mortality rate of those managed surgically and non-surgically. Methods: Data from patients with thalamic haemorrhage admitted within July 1, 2000 to June 30, 2003 were recorded. Univariate and multivariate analyses were done using SPSS for Windows v9.0. P < 0.05 was considered significant. Results and Conclusions: Among 119 patients, average age was 58 years, predominantly males (68.3%), hypertensive (90.8%) and had intraventricalar extension (79%). Obstructive hydrocephalus was present in 43.7%. Most common sign and symptom was hemiparesis. Prognostic factors significantly associated with mortality were GCS _< 12 (iJ -- 0.026), hematoma size _>30 co. (p - 0.023), presence of obstructive hydrocephalus (p - 0.003), hypertension (iJ 0.005) and ischemic heart disease (0.009). Patients in the surgical arm had a higher mortality rate (65% vs 37%), but surgery was not shown to be a significant predictor of mortality (p - 0.23). Tire higher mortality rate in surgical patients may be secondary to their having lower GCS scores, bigger hematoma sizes and greater frequency of hydrocephalus; hence surgery is not recommended for patients with factors for poor outcome. It may still have a role in reatnrent of patients with thalanffc haemorrhage, but further studies would need to be done to determine which patients would benefit from surgery. 1093 Cerebral Atherosderosis in Egyptian Patients with Stroke Abdulghmfi, M O 1, Aref, tt 1, Zakeildine, H 1. lain Shams Universi(v,
Cairo, Egypt Background: Caucasian patients presenting with stroke were usually found to have more frequent extracranial than intracranial atherosclerosis. To the contrary, black Americans and Asians usually have more frequent intracrmffal lesions. Studies in Arabs were too scarce before the year 2000. During the last 4 years we conducted 2 studies in our department to study atherosclerosis in Egyptian patients. Method: We studied 2 groups of patients. The first were 100 patients and the second were 111 patients. We used carotid duplex, transcranial Doppler, M R A and DSA in some patients.
Results: Among the first group only 15% had extracanial stenosis more than 50%, while 70% of patients had intracranial lesions. In the second group 18% had significant extracranial stenosis, while 63% had intracranial lesions. Intracranial lesions involved more frequently the MCA and the siphon o f ICA. Conclusion: It is clear that Egyptian patients with stroke have more frequent intracanial than extracranial atherosclerosis. Tiffs might be related to the racial differences including differences in the inddence of risk factors. These facts contribute sigtffficantly to stroke protocol in our patients and had stimulated us to recognize more the value of cerebral angiography in them. 1094 Gene therapy and stem cell activation against stroke K. Abe~, K. Deguclff 1, S. Nagotmff ~, T. Hayaslff ~, T. Murakanff ~, M. Shoji 1. ~Departmentof Neurology, Graduate School of Medicine and
Dentistry, Okayama University, Olrayama, Japan Backg~round and Method: In order to examine a protective effect of neurotrophic factors to reduce ischenffc brain damage, an adenovirus vector-mediated glial cell line-derived neurotroplffc factor (GDNF) gene (Ad-GDNF) was topically adnffnistered into the cerebral cortex before or after 90 min of transient middle cerebral artery occlusion in rat. Results: Pretreatment of animals with A d - G D N F 48 hr before the subsequent stroke effectively reduced infract volunre without affecting regional cerebral blood flow, as well as effective even when administered after the stroke. We further fomrd that the nmnber of BrdU-labeled cells increased in dentate gyrus of hippooampus and periventricular region at 3, 7, and 10 days after 10 rain of transient forebrain ischemia in gerbils. Expression o f highly polysialylated neural cell adhesion molecule (PSA-NCAM) in mossy fiber of dentate granule cells in adult brain could be interesting in migration of stem cells. Conclusion: Activation of neural stem cell suggests a future potential against ischemic stroke as well as transplantation of stem cells. 1095 Characterisation of Synehiria and sensory changes in the early post-Stroke population Acerra, NE to, Souvlis, T 1, Moseley, GL 3. ~Division o/Physiotherapy,
The University of Queensland, Brisbane, Australia; ZPhysiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia; 3School of Physiotherapy, The University of Sydney, Sydney, Australia Backg*omul: A standard neurological exanffnation includes the assessment of sensory dysfunction post-stroke. Interestingly, there are no data that charaotedse early post-stroke sensory changes. Many clinicians depend on patients volunteering sensory changes or on touching patients bilaterally and asking them to report any
Ne o!ogical clences ELSEVIER
Journal of the Neurological Sciences 238 (2005) $379-$476 www.elsevier, com/locate/jns
Poster Abstracts
10 November 2005 1092 Thalanfie Hemorrhage: predieto~cs of ino~talily and comparison of outcomes Abao, MA 1, Corral, E 1, Collantes, M A 1. 2Department of
Neuroseienees, Philippine General Hospital, Philippines Baekgronnd: Surgical management of patients with thalamic haemor,hage lacks evidence of benefit. Tiffs study compared the outcomes of patients with thalamic haemorrhage managed surgically and nonsurgically, and determined the predictors of mortality. Specific objectives were: to describe baseline demographic, and clinical characteristics of patients with thalamic haemorrhage, to determine which are predictors o f mortality, and to compare the mortality rate of those managed surgically and non-surgically. Methods: Data from patients with thalamic haemorrhage admitted within July 1, 2000 to June 30, 2003 were recorded. Univariate and multivariate analyses were done using SPSS for Windows v9.0. P < 0.05 was considered significant. Results and Conclusions: Among 119 patients, average age was 58 years, predominantly males (68.3%), hypertensive (90.8%) and had intraventricalar extension (79%). Obstructive hydrocephalus was present in 43.7%. Most common sign and symptom was hemiparesis. Prognostic factors significantly associated with mortality were GCS _< 12 (iJ -- 0.026), hematoma size _>30 co. (p - 0.023), presence of obstructive hydrocephalus (p - 0.003), hypertension (iJ 0.005) and ischemic heart disease (0.009). Patients in the surgical arm had a higher mortality rate (65% vs 37%), but surgery was not shown to be a significant predictor of mortality (p - 0.23). Tire higher mortality rate in surgical patients may be secondary to their having lower GCS scores, bigger hematoma sizes and greater frequency of hydrocephalus; hence surgery is not recommended for patients with factors for poor outcome. It may still have a role in reatnrent of patients with thalanffc haemorrhage, but further studies would need to be done to determine which patients would benefit from surgery. 1093 Cerebral Atherosderosis in Egyptian Patients with Stroke Abdulghmfi, M O 1, Aref, tt 1, Zakeildine, H 1. lain Shams Universi(v,
Cairo, Egypt Background: Caucasian patients presenting with stroke were usually found to have more frequent extracranial than intracranial atherosclerosis. To the contrary, black Americans and Asians usually have more frequent intracrmffal lesions. Studies in Arabs were too scarce before the year 2000. During the last 4 years we conducted 2 studies in our department to study atherosclerosis in Egyptian patients. Method: We studied 2 groups of patients. The first were 100 patients and the second were 111 patients. We used carotid duplex, transcranial Doppler, M R A and DSA in some patients.
Results: Among the first group only 15% had extracanial stenosis more than 50%, while 70% of patients had intracranial lesions. In the second group 18% had significant extracranial stenosis, while 63% had intracranial lesions. Intracranial lesions involved more frequently the MCA and the siphon o f ICA. Conclusion: It is clear that Egyptian patients with stroke have more frequent intracanial than extracranial atherosclerosis. Tiffs might be related to the racial differences including differences in the inddence of risk factors. These facts contribute sigtffficantly to stroke protocol in our patients and had stimulated us to recognize more the value of cerebral angiography in them. 1094 Gene therapy and stem cell activation against stroke K. Abe~, K. Deguclff 1, S. Nagotmff ~, T. Hayaslff ~, T. Murakanff ~, M. Shoji 1. ~Departmentof Neurology, Graduate School of Medicine and
Dentistry, Okayama University, Olrayama, Japan Backg~round and Method: In order to examine a protective effect of neurotrophic factors to reduce ischenffc brain damage, an adenovirus vector-mediated glial cell line-derived neurotroplffc factor (GDNF) gene (Ad-GDNF) was topically adnffnistered into the cerebral cortex before or after 90 min of transient middle cerebral artery occlusion in rat. Results: Pretreatment of animals with A d - G D N F 48 hr before the subsequent stroke effectively reduced infract volunre without affecting regional cerebral blood flow, as well as effective even when administered after the stroke. We further fomrd that the nmnber of BrdU-labeled cells increased in dentate gyrus of hippooampus and periventricular region at 3, 7, and 10 days after 10 rain of transient forebrain ischemia in gerbils. Expression o f highly polysialylated neural cell adhesion molecule (PSA-NCAM) in mossy fiber of dentate granule cells in adult brain could be interesting in migration of stem cells. Conclusion: Activation of neural stem cell suggests a future potential against ischemic stroke as well as transplantation of stem cells. 1095 Characterisation of Synehiria and sensory changes in the early post-Stroke population Acerra, NE to, Souvlis, T 1, Moseley, GL 3. ~Division o/Physiotherapy,
The University of Queensland, Brisbane, Australia; ZPhysiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia; 3School of Physiotherapy, The University of Sydney, Sydney, Australia Backg*omul: A standard neurological exanffnation includes the assessment of sensory dysfunction post-stroke. Interestingly, there are no data that charaotedse early post-stroke sensory changes. Many clinicians depend on patients volunteering sensory changes or on touching patients bilaterally and asking them to report any