Background Since the emergence of COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals. Methods Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran between June and July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, prominent COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated. Results Six patients (31–62 years-old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four patients died. SARS-COV-2 associated CVST patients were older (49.26 vs. 37.77 years-old), had lower female/male ratio (1.42 vs. 2.19), and higher mortality rate (35.29% vs. 6.07%) than CVST not associated with COVID-19. Conclusions The role of SARS-CoV-2 as a “cause” versus an “additive contributor” remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10450-8.
IntroductionCell‐based therapy is considered as promising strategy to cure stroke. However, employing appropriate type of stem cell to fulfill many therapeutic needs of cerebral ischemia is still challenging. In this regard, the current study was designed to elucidate therapeutic potential of epidermal neural crest stem cells (EPI‐NCSCs) compared to bone marrow mesenchymal stem cells (BM‐MSCs) in rat model of ischemic stroke.MethodsIschemic stroke was induced by middle cerebral artery occlusion (MCAO) for 45 minutes. Immediately after reperfusion, EPI‐NCSCs or BM‐MSCs were transplanted via intra‐arterial or intravenous route. A test for neurological function was performed before ischemia and 1, 3, and 7 days after MCAO. Also, infarct volume ratio and relative expression of 15 selected target genes were evaluated 7 days after transplantation.ResultsEPI‐NCSCs transplantation (both intra‐arterial and intravenous) and BM‐MSCs transplantation (only intra‐arterial) tended to result in a better functional outcome, compared to the MCAO group; however, this difference was not statistically significant. The infarct volume ratio significantly decreased in NCSC‐intra‐arterial, NCSC‐intravenous and MSC‐intra‐arterial groups compared to the control. EPI‐NCSCs interventions led to higher expression levels of Bdnf, nestin, Sox10, doublecortin, β‐III tubulin, Gfap, and interleukin‐6, whereas neurotrophin‐3 and interleukin‐10 were decreased. On the other hand, BM‐MSCs therapy resulted in upregulation of Gdnf, β‐III tubulin, and Gfap and down‐regulation of neurotrophin‐3, interleukin‐1, and interleukin‐10.ConclusionThese findings highlight the therapeutic effects of EPI‐NCSCs transplantation, probably through simultaneous induction of neuronal and glial formation, as well as Bdnf over‐expression in a rat model of ischemic stroke.
Background: Migraine headache is an episodic abnormality which usually presents with a severe headache, accompanied by nausea, photo and sound sensitivity, and autonomic symptoms. Iron accumulation in brain, especially peri-aqueductal grey is associated with duration of the disease, and apparently there is an association between body iron storage status and the incidence of migraine; hence, the present study was conducted to investigate the plausible association between iron-deficiency anemia and migraine in a casecontrol design. Materials and Methods: After signing the written informed consent, the blood samples were collected by a well-trained technician from the patients proved to have migraine, those having migraine clinical criteria and those having migraine attack frequency as high as that prophylaxis was required, and non-migraine healthy individuals, those having not migraine and anemia except iron-deficiency anemia. Based on the sample size, each group composed of samples with at least 100 individuals. Results: There were statistically significant differences between female cases and controls regarding hemoglobin, serum ferritin levels and iron-deficiency anemia (P-value: .0004; .006; .001), but no differences were observed among males (P-value: .606; .38; .303). Furthermore, the case-control comparisons revealed a significant difference in iron-deficiency anemia (P-value: .032), but no significant difference was seen in hemoglobin and serum ferritin levels (P-value: .161; .178). Conclusion: The present study suggests an association between iron-deficiency anemia, hemoglobin and serum ferritin levels and the incidence of migraine in females. As a result, there might be an association between body iron storage status and the incidence of migraine, especially among females, reflecting the fact that iron supplements might be an effective treatment or prophylaxis in patients with migraine associated with iron-deficiency anemia. However, further studies are required to provide a conclusive answer to the issues remained controversial.
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