Objective To study the expression of neuroglobin (Ngb) in brain tissue in rats with intracerebral hemorrhage (ICH) and the relationship between the expression of Ngb and brain edema following ICH. Methods The rats were randomly divided into normal control group, sham-operated group and ICH group. Sham-operated group and ICH group were divided into 5 subgroups respectively according to 1, 6, 24, 48 and 72 h after the animal modal formation. ICH was induced by stereotaxic injection of autologous blood into right caudate nucleus of rats (saline was injected in sham-operated group). Wet and dry weight methods were used to measure the changes of brain water content, and Western blot were used to detect the expression of Ngb in brain tissue. Results Compared with normal control group or sham-operated group, the expression of Ngb in peri-hematomal brain tissue started to increase at 1 h (P0.05), and the brain water content increased at 24 h in ICH group (P0.05). Both peaked at 48 h and maintained the level until 72 h (P0.01) in ICH group.Conclusion Expression of Ngb increases in brain tissue after ICH. The change of Ngb expression is not totally coincident with the formation of brain edema after ICH.
Objective To investigate the clinical features of recurrent epileptic seizures and perioperative management principles and methods of neurosurgical patients with recurrent epileptic seizures.Methods The clinical data,reasons for aggravated seizures,seizure characteristics,and treatment methods and results of 9 patients with recurrent epileptic seizures were analyzed retrospectively.Results Of all the 9 patients,3 were combined with glioma,1 with arachnoid cyst,1 with cavernous hemangioma and 1 with encephalomalacia; epilepsy history was noted in 7 patients; frontal lobe epilepsy was noted in 7,and temporal lobe epilepsy in 2.The reasons for seizure aggravation included drug-decrement(n=3),recent-diagnosed brain tumor(n=2)and surgical operation during intracranial electrode implantation(n=1); and unknown reason was noted in the other 3.Epileptic seizure types included partial seizure and secondary generalized seizure; the frequency of seizure ranged from 3 minutes of interval to several hours of interval.Patients given multiple antiepileptic drugs,including oral and parenteral administration,received good seizure-control; and levetiracetam showed good curative effect during the treatment.Conclusion Recurrent seizures show drug refractory,and is hard to control.The AEDs having good curative effect in partial seizure should be combined used in these patients with higher dosage than conventional initial dose; intravenous and intramuscular administration can be used; the seizures should be controlled as soon as posible.Levetiracetam has good curative effect on patients with recurrent seizures for its fast oral-absorption,rapid onset of action and good antiepileptic effect.
Key words:
Epileptic seizure; Levetiracetam
Objective To discuss the surgerical treatment for severe brain injury in high-altitude area.Methods Totally 40 cases,The GCS scale of which were all below 8,and all were treated by operation,including evacuation of intracranial hematoma decompressive,dehydration therapy to depress intraeranial pressure,craniectomy and correlative department treatment.Results About 20 cases(50.0%) had a good recovery,9 cases(22.5%) had a slight disability,2 cases(5.0%) had a persistent vegetative state,and the other 3 dead after therapy. Conclusion The key for patients with severe brain injury was to provide immediate treatment,and decrease the operation by-injury,the second brain injury could be reduced by giving observation,drug treatment and complication treatment after operation.Early hyperbaric oxygen therapy was help to improve lack-oxygen of brain,hydrocephalus and accelerate the healing of patients.
To investigate the effect and indication of one stage posterior debridement and bone grafting fusion and internal fixation for thoracic tuberculosis.From January 2005 to May 2011,12 patients with thoracic tuberculosis were treated with one stage posterior debridement and pedicle screw fixation combined with regular anti-tuberculosis treatment before and after operation. There were 7 males and 5 females,with an average age of 45 years and average course of 15 months. Information of operative time, blood loss, bony fusion, local kyphosis and neurologic functional were evaluated.All infective focus were thoroughly removed and bone graft obtained fusion. The mean of operative time and blood loss were 170 min (120-210 min) and 510 ml (200-1 000 ml),respectively. Cobb angle from (28.7 +/- 9.2) degrees preoperatively decreased to (8.2 +/- 3.5) degrees postoperatively(P<0.05). No kyphosis correction loss,tubercular recurrence or failure of internal fixation was found. According to Frankel grade to evaluate neurological function, all patients arrived to grade E.One stage posterior debridement and bone grafting fusion and internal fixation is an effective method in treating thoracic tuberculosis. It has advantages such as thorough debridement, short operative time, less blood loss, more kyphosis correction and higher bony fusion rate.
Lysyl oxidase (LOX) is a copper-dependent amine oxidase that plays important roles in the development and homeostasis of primary brain tumors such as glioma. The aim of this study was to investigate whether polymorphisms in the LOX gene were associated with susceptibility to glioma. We tested two functional polymorphisms of LOX, −22G/C and 473G/A, and compared them between 466 glioma cases and 502 healthy controls in the Chinese population. Results showed that the prevalence of 473AA genotype was significantly increased in cases than in controls (p = 0.001). Individuals who carried 473A allele had a 1.44-fold of increased risk for glioma than those with 473G allele (p = 0.002). In addition, when analyzing the survival time of glioma patients with LOX 473G/A polymorphism, cases with AA genotype had significantly shorter survival time compared to the patients carrying G allele (25.0 months vs 43.0 months, p = 0.0009). These results suggested that polymorphism in LOX gene was associated with increased susceptibility to glioma and could be used as prognostic factor for this malignancy.
Objective To analyze the indications and operation skills of neurologic surgical keyhole approach in treatment of posterior communicating artery aneurysm.Methods A retrospective analysis had been made in 32 cases of ruptured middle cerebral artery aneurysm(MCA).All cases had been diagnosed by distal subtraction angiography(DSA) or computed tomography angiography(CTA).The ruptured aneurysms were all treated with microsurgery by keyhole approach two weeks after bleeding.Results The ruptured aneurysms were clipped successfully in 32 cases,the curative rate reaching 100% with no case died.The artery clipper was fixed well,the aneurysm was disappeared and supply artery was maintained smoothly.No recurrence was found in the follow-up(CTA or DSA) of 3～6 months in 10 cases.Conclusion The keyhole surgery is a technique of minimally invasive in treating MCA.It is helpful to reduce the mortality and morbidity.Applying microsurgery technique in the right timing is the key point of the treatment.
Objective To study the role of wingspan stent in treatment of intracranial arterial stenosis,including its feasibility,safety,efficacy and operating skills.Method27 cases of intracranial arterial stenosis treated with wingspan stent was retrospectively studied.There was no response to drug control in all patients.The stenosis located in 3 internal arteries,13 middle cerebral arteries,4 vertebral arteries and 7 basal arteries.Results All stents were successfully deployed with satisfied opening of the narrow paragraph.All patients were followed up after the procedures.There was I case of occasional attack of TIA,1 case of asymptomatic cerebral infarction.There was no ischemic attack occurred in other patients.Conclusions Wingspan stent is safe and effective in treatment of intracranial artery stenosis.
Key words:
Cerebralvascular disorders; Carotid stenosis; Stents; Wingspan
Objective To evaluate the application of endovascular therapy in the treatment of arterio-venous malformation (AVM) with Onyx glue. Methods Eleven complicated AVM patients, including 6 giant AVMs and 5 AVMs located in functional area, were enrolled in the study. Angioarchitecture and embolization technique were analyzed. Results The success rate reached 100%. Among the 11 patients, 2 acquired 90% embolization, four 80% embolization, three 50%-80% occlusion, and 2 less than 50% occlusion. Conclusion Endovascular treatment with Onyx glue can effectively improve the outcome of patients with AVM.
Background: Distal cerebellar artery aneurysms are difficult to treat both surgically and endovascularly. The purpose of this study is to assess the efficacy and safety of intra-aneurysmal Onyx embolization of these lesions with parent artery preservation.Methods: Ten consecutive patients harboring 10 distal cerebellar aneurysms were treated with intra-aneurysmal Onyx embolization. Locations of the aneurysms were as follows: superior cerebellar artery in three patients, anterior inferior cerebellar artery in two, and posterior inferior cerebellar artery in five. The technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated.Results: In every case, endovascular treatment was achieved. Immediate angiography demonstrated that all of 10 aneurysms were completely occluded, with parent artery preservation in nine of them. Procedure-related complication occurred in one patient with transient neurological sequelae. None of the treated aneurysms experienced rebleeding or recanalization during the follow-up time (mean, 12·7 months).Conclusion: We found that the intra-aneurysmal Onyx embolization was helpful in the treatment of distal cerebellar aneurysms in which selective occlusion of the aneurysmal sac with coils or open clipping cannot be achieved.
Objective To explore the techniques and efficacy of Neuroform stent -assisted coiling of intracranial wide - necked aneurysms. Method 187 consecutive patients with 190 wide - necked intracranial aneurysms were treated with the Neuroform stent - assisted coiling. The technical feasibility of the procedure, procedure - related complications, angiographic results, clinical outcome and follow - up angiography were evaluated retrospectively. Results In each cases, the Neuroform stent system was delivered and deployed accurately, and occlusion was achieved. Immediate angiography demonstrated complete occlusion in 88. 9% , neck remnant in 6.9% , and incomplete occlusion in 4. 2%. Procedure - related morbidity was 5.9% and procedure - related mortality was 1. 1% . Favorable clinical outcome (Modified Rankin Scale score 0～2) was observed in 87. 7 % of the patients(average follow - up time,47. 3 months). No rehemorrhage of treated aneurysm occurred. Angiography follow - up was obtained in 47. 9% (89/187 patients;91/190 aneurysms; average follow - up time,40. 8 months). The overall recanalization rate was 8. 7%. Comparison of occlusion class immediately after treatment and at last follow - up showed 86. 8 % of the 91 aneurysms had stable or improved class. 7 aneurysms (41. 2% ) that were not initially completely occluded converted to complete occlusion on follow - up. No delayed coil or stent migration was found. One patient with in - stent stenosis and one with penetrating artery occlusion occurred as delayed complications. Conclusions In treating wide - necked intracranial aneurysms, the Neuroform stent - assisted coiling is a secure and effective technique.
Key words:
Intracranial aneurysm; Wide-neck; Endovascular embolization; Stent
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)
'%3e%3ccircle r='20' fill='%23008'/%3e%3ccircle r='17.5' fill='%23fff'/%3e%3ccircle r='3.5' fill='%23008'/%3e%3cg id='d'%3e%3cg id='c'%3e%3cg id='b'%3e%3cg id='a' fill='%23008'%3e%3ccircle r='.875' transform='rotate(7.5 -8.75 133.5)'/%3e%3cpath d='M0 17.5.6 7 0 2l-.6 5L0 17.5z'/%3e%3c/g%3e%3cuse xlink:href='%23a' transform='rotate(15)'/%3e%3c/g%3e%3cuse xlink:href='%23b' transform='rotate(30)'/%3e%3c/g%3e%3cuse xlink:href='%23c' transform='rotate(60)'/%3e%3c/g%3e%3cuse xlink:href='%23d' transform='rotate(120)'/%3e%3cuse xlink:href='%23d' transform='rotate(-120)'/%3e%3c/g%3e%3c/svg%3e)