Ryuta Okabe

Utility of chest X-ray in predicting left atrium dimension and brain natriuretic peptide

Objective: Detection of paroxysmal atrial fibrillation (PAF) in patients with acute stroke is often difficult. Dilatation of left atrium dimension (LAD) and increased levels of brain natriuretic peptide (BNP) are reported to indicate cerebral embolism due to PAF. We assessed the usefulness of chest X-ray in predicting LAD and BNP among patients with acute cerebral infarction. Methods: We included 141 consecutive patients with cerebral infarction [107 cerebral thromboses (cerebral thrombosis group)] and 34 cardiogenic cerebral embolisms due to PAF (PAF group). Transthoracic echocardiography (TTE) was used to evaluate LAD (TTE-LA). On chest X-ray, heart diameter at the third aortic arch (XPLA) and XP-LA divided by maximum intrathoracic diameter (XP-LA ratio) were measured. Results: TTE-LA, XP-LA, XP-LA ratio and BNP levels were significantly higher in PAF group compared with those in cerebral thrombosis group. XP-LA had a significant positive correlation with TTE-LA (r = 0.332, p < 0.0001) and BNP (r = 0.292, p < 0.001). XP-LA ratio also showed a significant correlation with TTE-LA (r = 0.210, p = 0.0126) and BNP (r = 0.515, p < 0.0001). Conclusion: We suggest chest X-ray is a simple and useful tool for predicting LAD and BNP.

Influence of pulsed wave doppler angle on diagnosis of internal carotid artery stenosis

WCN17-1276 SHIFT 3 STROKE Significance of hyperintense vessels in negative DWI area as a prognostic factor after thrombolysis M. Ichijo, S. Ishibashi, K. Miki, S. Itaya, T. Amino, T. Kamata, T. Yokota. Musashino Red Cross Hospital, Department of Neurology, Tokyo, Japan; Tokyo Medical and Dental University, Department of Neurology and Neurological Science, Tokyo, Japan; Tokyo Medical and Dental University, Department of Endovascular Surgery, Tokyo, Japan

Risk factors for deep venous thrombosis in patients with acute stroke

脳卒中の急性期では下肢麻痺や長期臥床,うっ血性心 不全の併発による静脈還流のうっ滞により,下肢深部静 脈血栓(deep venous thrombosis: DVT)を併発する例 が存在する .DVTは肺塞栓症の原因となり,予後不 良の転帰を示すことから,急性期からDVTの予防,早 期発見が重要となる. 脳卒中に対するDVT予防に明確なエビデンスはない ものの,弾性ストッキングの着用が勧められていた . しかし脳卒治療ガイドライン 2015では,脳出血に対し て弾性ストッキングの使用は推奨されておらず,脳梗塞 に対しても明らかな予防効果は示されていない .し たがって,現在では間欠的空気圧迫法による予防が主体 となるが,医療資源の問題からすべての脳卒中患者に対 して施行するのは困難と考えられる. そこでわれわれは脳卒中の急性期においてDVTを併 発する患者の危険因子を明らかにするため,急性期脳卒 28 Neurosonology 29(1):2016