Objectives: To investigate the potential predictive value of serum adiponectin (APN) and hemoglobin (Hb) levels for the occurrence of vascular cognitive impairment in ischemic stroke patients. Methods: Eighty ischemic stroke patients, admitted to our hospital between June 2019 and November 2020, were retrospectively divided into no cognitive impairment (NCI) group (n=43) and cognitive impairment (CI) group (n=37) based on Montreal Cognitive Assessment (MoCA) scale scoring at three months follow-up. ELISA was used to assess serum Hb and APN levels and receiver operating characteristic (ROC) curves were created to evaluate correlation. Results: Serum APN and Hb levels were lower in the vascular cognitive impairment group compared to non-impaired counterparts. Pearson correlation analysis showed that both APN and Hb levels were positively correlated with MoCA scores. Area under curve analysis indicated predictive value for serum APN and Hb for predicting cognitive impairment in ischemic stroke patients. Conclusion: Serum APN and Hb levels in ischemic stroke patients have value for predicting vascular cognitive impairment and may be suitable for helping dictate treatment planning. doi: https://doi.org/10.12669/pjms.38.3.5204 How to cite this:Li Z, Zhu M, Meng C, Lin H, Huang L. Predictive value of serum adiponectin and hemoglobin levels for vascular cognitive impairment in ischemic stroke patients. Pak J Med Sci. 2022;38(3):705-710. doi: https://doi.org/10.12669/pjms.38.3.5204 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Rationale: Neurologic deficits are rare in patients with extranodal natural killer/T-cell lymphoma (NKTL), nasal type. We present a case that was initially suspected as tuberculous meningitis, but later diagnosed as central nervous system metastasis of NKTL, nasal type, which has never been published previously. Patient concerns: A 55-year-old Chinese man presented with persistent headache and fever. The initial head computed tomography and magnetic resonance imaging (MRI) scan was normal. Low glucose, elevated protein, and pleocytosis of cerebral spinal fluid led to a diagnosis of tuberculous meningitis. The patient did not respond to anti-tuberculosis treatment, and his symptoms aggravated. MRI showed abnormal lesions in the right hemisphere and a lesion in the maxillary sinus region. Diagnosis: Endoscopic biopsy of the maxillary lesion showed features consistent with NKTL. Positron emission tomography revealed a hypermetabolic mass involving the right maxillary sinus and brain. Interventions: The patient received chemotherapy. Outcomes: The patient died 30 days after chemotherapy. Lessons: Lymphoma of the nasal cavity and paranasal sinuses is extremely rare and may be easily misdiagnosed. Nasal NKTL metastasis should be considered when a patient presents with symptoms of leptomeningeal involvement.

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