Among the 135 million births in 2020,0.6 million were extremely preterm(<28 weeks’gestation),and 1.4 million were very preterm(between 28 and<32 weeks’gestation)[1].Intraventricular hemorrhage(IVH)remains a ma...Among the 135 million births in 2020,0.6 million were extremely preterm(<28 weeks’gestation),and 1.4 million were very preterm(between 28 and<32 weeks’gestation)[1].Intraventricular hemorrhage(IVH)remains a major concern for these infants,particularly those<29 weeks’gestation[2].Midline head positioning(MHP)is a widely adopted intervention in care bundles for IVH prevention in preterm infants.However,high-quality evidence supporting the efcacy and efectiveness of MHP for IVH prevention is lacking.Here,we summarize the issues with the existing evidence on MHP,including its widespread adoption in care bundles on the basis of poor quality of evidence,and highlight the urgent need for a defnitive trial to determine the causal role,if any,of MHP in IVH prevention.展开更多
Background:At present,the optimal head position for stroke patients undergoing reperfusion therapy remains unclear.Because different head positions may exert distinct effects on dynamic cerebral autoregulation(dCA).Me...Background:At present,the optimal head position for stroke patients undergoing reperfusion therapy remains unclear.Because different head positions may exert distinct effects on dynamic cerebral autoregulation(dCA).Methods:In this self-controlled study,the cerebral blood flow velocity(CBFV)in the middle cerebral artery and finger blood pressure at the 0°and 30°head positions were continuously recorded using transcranial Doppler combined with servo-controlled finger plethysmography at 24 h,3 days,and 7 days after reperfusion.These data were then used to calculate the dCA parameters(phase difference[PD],gain,and coherence function)through transfer function analysis.Meanwhile,30 healthy controls were included.Results:Finally,83 patients who underwent reperfusion therapy were included in the final analysis.For both sides,the phase difference in the 30°head position was significantly higher at 24 h(affected side:p=0.047;unaffected side:p=0.003),3 days(affected side:p=0.040,unaffected side:p=0.016)),and 7 days(affected side:p<0.001;unaffected side:p<0.001)than that in the 0°head position.There was no significant difference in cerebral blood flow velocity between the 0°and 30°head positions on both affected and unaffected sides.Additionally,no difference of dCA and cerebral blood flow velocity was found in different head positions among healthy controls.展开更多
Background: Acquired See-saw Nystagmus (SSN) is a rare form of nystagmus characterized by elevation and intorsion of one eye with synchronous depression and intorsion of the contralateral eye in the first half cycle, ...Background: Acquired See-saw Nystagmus (SSN) is a rare form of nystagmus characterized by elevation and intorsion of one eye with synchronous depression and intorsion of the contralateral eye in the first half cycle, followed by a reversal in the direction of the movements during the next half cycle. We herein report a case of a 47-year-old woman with a 3-year history of constant diplopia as a consequence of multiple neurosurgical interventions due to hemorrhage from a cavernous angioma located in the subthalamic region. She also had a history of major depressive disorder and ulcerative colitis. The patient underwent a surgical intervention with a 5 mm bilateral recession of the superior and inferior rectus muscles. Five years after surgery, the patient reported less recurrent and prominent episodes of transient horizontal deviation with horizontal diplopia, with a prevalence of well-being and comfort.展开更多
文摘Among the 135 million births in 2020,0.6 million were extremely preterm(<28 weeks’gestation),and 1.4 million were very preterm(between 28 and<32 weeks’gestation)[1].Intraventricular hemorrhage(IVH)remains a major concern for these infants,particularly those<29 weeks’gestation[2].Midline head positioning(MHP)is a widely adopted intervention in care bundles for IVH prevention in preterm infants.However,high-quality evidence supporting the efcacy and efectiveness of MHP for IVH prevention is lacking.Here,we summarize the issues with the existing evidence on MHP,including its widespread adoption in care bundles on the basis of poor quality of evidence,and highlight the urgent need for a defnitive trial to determine the causal role,if any,of MHP in IVH prevention.
基金supported by the National Natural Science Foundation of China[grant number 82271303]the Talent Reserve Program of the First Hospital of Jilin University[grant number JDYYCB-2023002]to ZNG+1 种基金the Jilin Provincial Health Commission[grant number 2023LC006]to XLYthe Jilin Provincial Health Commission[grant number 2022LC099]to QXD.
文摘Background:At present,the optimal head position for stroke patients undergoing reperfusion therapy remains unclear.Because different head positions may exert distinct effects on dynamic cerebral autoregulation(dCA).Methods:In this self-controlled study,the cerebral blood flow velocity(CBFV)in the middle cerebral artery and finger blood pressure at the 0°and 30°head positions were continuously recorded using transcranial Doppler combined with servo-controlled finger plethysmography at 24 h,3 days,and 7 days after reperfusion.These data were then used to calculate the dCA parameters(phase difference[PD],gain,and coherence function)through transfer function analysis.Meanwhile,30 healthy controls were included.Results:Finally,83 patients who underwent reperfusion therapy were included in the final analysis.For both sides,the phase difference in the 30°head position was significantly higher at 24 h(affected side:p=0.047;unaffected side:p=0.003),3 days(affected side:p=0.040,unaffected side:p=0.016)),and 7 days(affected side:p<0.001;unaffected side:p<0.001)than that in the 0°head position.There was no significant difference in cerebral blood flow velocity between the 0°and 30°head positions on both affected and unaffected sides.Additionally,no difference of dCA and cerebral blood flow velocity was found in different head positions among healthy controls.
文摘Background: Acquired See-saw Nystagmus (SSN) is a rare form of nystagmus characterized by elevation and intorsion of one eye with synchronous depression and intorsion of the contralateral eye in the first half cycle, followed by a reversal in the direction of the movements during the next half cycle. We herein report a case of a 47-year-old woman with a 3-year history of constant diplopia as a consequence of multiple neurosurgical interventions due to hemorrhage from a cavernous angioma located in the subthalamic region. She also had a history of major depressive disorder and ulcerative colitis. The patient underwent a surgical intervention with a 5 mm bilateral recession of the superior and inferior rectus muscles. Five years after surgery, the patient reported less recurrent and prominent episodes of transient horizontal deviation with horizontal diplopia, with a prevalence of well-being and comfort.
