Hong-Kyun Park

Hypertriglyceridemia as a possible predictor of early neurological deterioration in acute lacunar stroke

BACKGROUNDnEarly neurological deterioration (END) is not uncommon in lacunar stroke and may lead to poor outcome. Several predictors for END have been previously reported, however, well-designed, MRI-based studies are rare in lacunar stroke. We prospectively enrolled consecutive patients with acute lacunar infarct (≤ 48 h) confirmed by MRI to investigate possible predictors for END.nnnMETHODSnDemographic data, vascular risk factors, laboratory findings, and neurological status were obtained. END was defined as an increment of the National Institutes of Health Stroke Scale (NIHSS), ≥ 1 in motor power, or ≥ 2 in any scores during the first week.nnnRESULTSnA total of 131 patients were recruited and 17 (13%) developed END after admission. Univariate analysis revealed that diabetes, systolic blood pressure, triglyceride (TG), total cholesterol, low density lipoprotein-cholesterol, and homocysteine were associated with END. After multiple logistic regression analysis, the highest quartile of TG level (>145 mg/dL) remained independent [adjusted odds ratio (OR) = 11.46, 95% confidence interval (CI) = 1.07-122.87, P = 0.044].nnnCONCLUSIONnHypertriglycedemia may be a possible predictor for END in acute lacunar stroke. Thrombogenecity and microcirculatory disturbance augmented by hypertriglyceridemia may be suggested as potential mechanisms. Further studies are warranted to confirm these results. Pathophysiological and therapeutic considerations remain to be determined.

Klüver-bucy syndrome with isolated bilateral hippocampal atrophy following status epilepticus.

Klüver-Bucy syndrome may result from affection of various location of brain. We report a case of Klüver-Bucy syndrome associated with isolated bilateral hippocampal atrophy without any abnormal lesion in other areas following status epilepticus. A 31-year-old man who had no significant medical history presented with status epilepticus after encephalitis of unknown etiology. He had been recovered from status epilepticus three weeks later, but afterwards he developed Klüver-Bucy syndrome: hyperphagia, hypersexuality, hypermetamorphosis, anterograde amnesia and dysosmia. Initial brain MRI showed T2 hyperintensity and swelling of isolated bilateral hippocampus, especially CA1 region without any abnormal lesion in other areas. One month later, follow-up brain MRI showed isolated bilateral hippocampal atrophy. This is a meaningful case report because this case differs from other reports of Klüver-Bucy syndrome in humans in that the anatomic abnormalities revealed by MRI were very selective. We report this case because this case is very educative for above reason. Moreover, this report would give us additional information of the relationship between human behavior and limbic system.