Background: Isolated medullary hemorrhage (MH) is an uncommon presentation of spontaneous intraparenchymal hemorrhage. The relationship between MH and neurological outcome is not well known. This study aims to assess predictive parameters for the outcome of medullary hemorrhage.
Methods: We conducted an extensive search of the literature for cases with spontaneous, isolated MH. The study was conducted according to the statement of Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA). Forty-three cases diagnosed by CT or MRI have been reported in the literature, to which we add three confirmed by MRI. The ventrodorsal size of hemorrhage was taken into account as a parameter of outcome. Early neurologic deterioration (END) was defined as an incremental increase in the National Institutes of Health Stroke Scale score by ≥1 point in motor power, or ≥2 points in the total score within the first week after admission. Modified Rankin Score (mRS) 0-2 was presumed as favorable outcome (FO) and mRS 3-6 score as unfavorable outcome (UO) at discharge and at 3 months after stroke.
Results: We enrolled 46 patients, and 17 (37%) patients were diagnosed with END. The cause of medullary hemorrhage was mostly vascular malformations, including cavernous malformation (33%) and arteriovenous malformation (11%). In univariate analyses, neither arteriovenous malformations (OR, 1.04; 95%CI, 0.10-10.53; P = 0.68) nor cavernomas (OR, 1.04; 95%CI, 0.22-4.89; P = 0.62) were associated with UO. Acute respiratory distress syndrome was higher in patients with UO group (44%) compared to those with FO group (16%), but this difference did not reach to a significant level (OR, 4.13; 95%CI, 0.85-20.04; P = 0.09). The diameter of hemorrhage was significantly larger (≥1 cm) in patients with UO compared to those with FO (OR, 16.67; 95%CI, 1.87-148.89; P = 0.003). Three months after stroke, 37 patients (80%) had FO and 9 (19.5%) had UO, and 5 (11%) died. Multiple logistic regression analysis using predetermined variables found to be significant in univariate analyses (END, consciousness disturbance at admission, hemorrhage size, and hypertension) showed that END at stroke onset was significantly associated with UO (OR, 4.97; CI95%, 1.13-21.94; P = 0.03).
Conclusions: These results suggest that the END is a predictor for UO in patients with medullary hemorrhage. The extent of the medullary hemorrhage along the conduction tract may contribute to deterioration.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105337 | DOI Listing |
Life (Basel)
January 2025
Department of Medical Imaging, China Medical University Hospital, Taichung 40402, Taiwan.
Blood pressure measurement is important in monitoring hypertension. However, blood pressure does not provide much information about renal condition in treated hypertension. This study aimed to evaluate renal oxygenation in hypertensive patients using T2* mapping.
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January 2025
Department of Oncologic Dermatology, "Elias" Emergency University Hospital, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
In the context of modern cancer therapy, the management of adverse effects of systemic therapies can lead to the avoidance of underdosing and withdrawal and increases in the quality of the therapeutic act and the quality of life. This review offers an overview of the skin-related toxicities associated with Cabozantinib, a multikinase inhibitor (MKI) that is approved for treating advanced kidney cancer, hepatocellular carcinoma, and medullary thyroid cancer. It covers the most common dermatological side effects, such as palmar-plantar erythrodysesthesia, stomatitis, hair alterations, xerosis, scrotal erythema, and subungual splinter hemorrhages.
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January 2025
Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry Branch, Russian Academy of Sciences, Pushchino, Russia.
Poloxamer 188 (P188) was tested for effect on medullary hematopoiesis in aplastic anemia. P188 was administered to CBA mice with developing anemia via oral gavage at doses of 10, 100, and 500 mg/kg. A dose-dependent effect was observed, including an increase in erythrocyte count, hemoglobin, and reticulocyte count.
View Article and Find Full Text PDFAsian Spine J
January 2025
Department of Spinal Surgery, Henan Provincial People's Hospital, Zhengzhou, China.
Study Design: This was a retrospective study.
Purpose: The current study aimed to investigate the clinical efficacy of atlantodentoplasty using the anterior retropharyngeal approach against irreducible atlantoaxial dislocation with atlantodental bony obstruction.
Overview Of Literature: In cases of atlantoaxial dislocation with atlantodental bony obstruction, owing to the presence of an osteogenic mass between the atlas and odontoid process, reduction is challenging to complete using the posterior approach.
Lab Invest
January 2025
Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, China.
Cardiovascular disease (CVD) is the leading cause of death worldwide and has been confirmed to be associated with a common oral bacterial infection-chronic apical periodontitis (CAP). However, the detailed mechanisms remain controversial. CAP can potentially alter systemic inflammation, lipid metabolism, and gut microbiota, all of which contribute to the progression of the aortic inflammatory response.
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