Cerebral Infarction Clinical Trial
Official title:
Study on the Relationship Between Asymmetric Vascular Sign of Cortex and Cerebral Edema and Prognosis of Massive Cerebral Infarction
Susceptibility weighted imaging (SWI) technology has developed in the decade which is being a
kind of cerebrovascular disease diagnostic tools in the clinical application, especially for
paramagnetic material (such as DNA hemoglobin and hemosiderin) has a high sensitivity.
The change of the signal on SWI bases on the change of local oxygenated hemoglobin content in
the blood and deaeration hemoglobin content ratio, which can be used to indirectly reflect
the hypoxia group oxygen intake fraction (OEF) and cerebral metabolic rate. When the
intracranial vascular occlusion, corresponding responsibility vascular blood flow area of
brain tissue will occur hypoperfusion, brain tissue will improve the compensation in
accordance with its own OEF, causing ischemia area inside the venous drainage of deaeration
hemoglobin content ratio increases and the hypointensity on SWI ,which display the asymmetric
cortical vessel sign (ACVS). Studies have suggested that ACVS is more prone to early
neurological deterioration and has a poor long-term outcome. After recanalization of ischemic
stroke, the presence of equal CVS(return to normal) on SWI is associated with a good clinical
outcome. In addition, the relationship between ACVS grade and collateral circulation in
patients with acute ischemic stroke has been studied. For patients with massive cerebral
infarction, the relationship between ACVS on SWI and the clinical prognosis of cerebral edema
and cerebral hemodynamics is not completely clear. In this study, the clinical data of
patients with massive cerebral infarction will be analyzed to explore the relationship
between ACVS, cerebral edema , cerebral hemodynamic and clinical prognosis.
Sodium aescinate is widely used in cerebral edema caused by cerebral hemorrhage or cerebral
infarction.The main mechanism of sodium aescinate is anti - inflammatory, anti - exudate,
anti - oxygen free radical, anti - edema, increase vein tension, improve blood circulation
and nerve protection. In this study, investigators will investigate whether the application
of sodium aescinate had an effect on ACVS on SWI in patients with massive cerebral
infarction. Plasma s100-β, procalcitonin, neutrophil count, serum fibronectin, and
endothelin-1 could predict cerebral edema in patients with cerebral infarction, this study
will analyze the relationship between these markers and ACVS on SWI in patients with massive
cerebral infarction.
Status | Recruiting |
Enrollment | 150 |
Est. completion date | September 9, 2021 |
Est. primary completion date | June 9, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - =18 years old - Massive cerebral infarction within 72 hours from onset to admission - Without other intracranial lesions or severe disease - Agrees to participate in the study and sign the informed consent Exclusion Criteria: - Cerebral vascular malformation - Cranial trauma and cranial surgery history - With severe cardiac, hepatic and renal insufficiency - With blood disorder, immune rheumatism (hormone abuse) - Expected survival of less than 3 months - Refuse to participate in this study |
Country | Name | City | State |
---|---|---|---|
China | Second hospital of hebei medical university | Shijiazhuang | Hebei |
Lead Sponsor | Collaborator |
---|---|
The Second Hospital of Hebei Medical University |
China,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and age | To evaluate whether ACVS and age are related | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and sex | To evaluate whether ACVS and sex are related | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and TOAST subtypes | Classification of causes of stroke --TOAST classification include Large-artery atherosclerosis( LAA),Cardioembolism(CE) ,Small-artery occlusion(SAO),Stroke of other determined cause(ODC) and Stroke of undetermined cause(UND). | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and smoking history | To evaluate whether ACVS and smoking history are related | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and NIHSS score at admission | The NIHSS score is 0 to 42 points. The higher the score, the more severe the nerve damage. | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and mRS on 90 day | The mRs score is used to measure the recovery of neurological function in patients after stroke. The mRs score is 0 to 6 points. The higher the score, the worse the neurological function recovery. | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and DWI ASPECT | ASPECT is a scale suitable for evaluating ischemic changes in the supply area of the middle cerebral artery with a total score of 10.A score of 10 indicates no signs of ischemia, while a score of 0 indicates extensive ischemia in the middle cerebral artery | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and midline shift | To evaluate whether ACVS and midline shift are related | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and offending stenosis | To evaluate whether ACVS and offending stenosis are related | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and serum factor S100-B | In acute ischemic stroke, the astroglial protein S100B is released into peripheral blood, reaching maximum serum concentrations between day 2 and day 4, correlating with infarct size. | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and serum factor procalcitonin | Procalcitonin is a stronger predictor of long-term functional outcome and mortality in patients with ischemic stroke. | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and cellular-fibronectin | A high plasma cellular-fibronectin concentration at admission is associated with the development of m-MCA infarction with high sensitivity and specificity. | 2 hour | |
Primary | The correlation between asymmetric cortical vessel sign(ACVS) and serum factor endothelin - 1 | endothelin - 1 may be a diagnostic marker for development of severe brain edema in patients with acute ischemic stroke. | 2 hour | |
Primary | Changes of aescinin on asymmetric cortical vessel sign (ACVS). | This study investigates whether the application of sodium aescinate has an effect on ACVS on SWI in patients with massive cerebral infarction. | 2 hour |
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