No abstract

Associations between cognitive decline and cerebral microbleeds (CMBs) have received increasing attention. An association between CMB distribution (deep or lobar) and cognitive decline has been reported, but these findings are controversial. We investigated the association between magnetic resonance imaging (MRI) findings, including CMBs, and cognitive function in patients with first-ever lacunar infarction. We retrospectively included consecutive patients admitted with first-ever lacunar infarction identified by MRI from July 1, 2011, to December 31, 2018. We excluded patients diagnosed with dementia, including strategic single-infarct dementia, before or after the onset of stroke. The Mini-Mental State Examination (MMSE) was performed within 3 days of admission. We searched the records of 273 patients (age 72.0 ± 11.2 years, 95 females). The median MMSE score was 27 (interquartile range 25.5–29). In a univariate analysis, the MMSE score was associated with age, body mass index (BMI), education, dyslipidemia, chronic kidney disease (CKD), periventricular hyperintensity, medial temporal atrophy, lobar CMBs, and mixed CMBs (p < 0.20). The lacunar infarction location was not associated with the MMSE score. In a multivariate analysis of these factors, lobar CMBs (p < 0.001) and mixed CMBs (p = 0.008) were independently associated with the MMSE score. Lobar CMBs were associated with cognitive impairment.

We investigated the association between the results of a simplified cough test and pneumonia onset in 226 patients with acute stroke admitted to Suiseikai Kajikawa Hospital from April to December, 2018. For the simplified cough test, performed on admission, patients orally inhaled a mist of 1% citric acid-physiological saline using a portable mesh nebulizer. When the first cough was evoked or if it remained absent for 30 seconds (indicating an abnormal result), the test was ended. Patients also completed the repetitive saliva swallowing test (RSST) and modified water swallowing test. We monitored patients for pneumonia signs for 30 days post-admission. Eighteen patients exhibited an abnormal simplified cough test result. On multivariate analysis, an abnormal RSST result was independently associated with an abnormal simplified cough test result. Seventeen patients developed pneumonia. The adjusted Cox proportional hazard model for pneumonia onset revealed that the simplified cough test had predictive power for pneumonia onset (hazard ratio, 10.52; 95% confidence interval, 3.72-29.72). The simplified cough test is a strong indicator for predicting the pneumonia development in patients with acute stroke; it should be added to existing bedside screening tests for predicting pneumonia risk, allowing appropriate and timely intervention.

suppression images demonstrated abnormal enhancement, "tram track" sign on the axial view (arrows) and "doughnut" sign on the coronal view (broad arrow), of the right optic nerve sheath. The similar hyperintensity configurations (arrow heads) to both signs could be recognized on T 2 -weighted MR (C, D, F). These intensity changes were suggested to be due to tissue edema.A: axial T 1 weighted image (1.5 T, TR 654 ms, TE 10 ms), B; contrast enhanced axial T 1 weighted image with fat suppression (1.5 T, TR673 ms, TE 10 ms), C; contrast enhanced axial T 2 weighted image with fat suppression (1.5 T, TR 5,000 ms, TE 90 ms), D; contrast enhanced coronal T 2 weighted image with fat suppression (1.5 T, TR 5,000 ms, TE 90 ms), E; axial FLAIR image (1.5 T, TR 5,000 ms, TE 87 ms), F; axial T 2 weighted image with fat suppression (1.5 T, TR 4,930 ms, TE 88 ms), G; contrast enhanced axial T 1 weighted image with fat suppression (1.5 T, TR 778 ms, TE 13 ms), H; contrast enhanced coronal T 1 weighted image with fat suppression (1.5 T, TR 554 ms, TE 13 ms). 57：719Review of the literature for cases of idiopathic optic perineuritis in Japan.