ABSTRACT
Objective To investigate the clinical effect of neuronavigation combined with intraoperative ultrasound-assisted microsurgery for the treatment of supratentorial intracranial arteriovenous malformations (AVMs). Methods From March 2014 to February 2017,14 patients with supratentorial intracranial AVMs treated with neuronavigation combined with intraoperative ultrasound-assisted microsurgery at the Department of Neurosurgery,the Second Affiliated Hospital of Anhui Medical University were enrolled retrospectively.According to Spetzler-Martin (S-M)classification,there were 2 cases of grade Ⅰ,6 cases of grade Ⅱ,5 cases of grade Ⅲ,and 1 case of grade Ⅳ. The clinical data,surgical effects,and complications were analyzed. Results (1)The lesions of 13 patients were completely removed and 1 had residue. Four patients had preoperative limb hemiplegia and one had postoperative limb weakness. They were followed up for 1 to 4 years. The myodynamia was improved or returned to normal. (2)One patient had postoperative intracranial infection and was cured after anti-infective treatment. Of the 4 patients with preoperative epilepsy, 3 did not have postoperative recurrence and 1 was controlled. (3)The modified Rankin scale (mRS)scores at 3 months after operation were as follows:8 patients were 0,4 were 1,and 2 were 2. The clinical symptoms and imaging were followed up for 1-4 years,no vascular malformation recurrence and rebleeding were observed. Conclusion The preliminary observation showed that the neuronavigation and intraoperative ultrasound multimodality assisted microsurgical treatment of supratentorial AVMs had the characteristics of accurate location and high safety,and the clinical efficacy was satisfactory.
ABSTRACT
Objective To evaluate the surgical indications and treatment of spontaneous cerebellar hemor-rhage.Methods The clinical data and surgical methods of 46 patients with spontaneous cerebellar hemorrhage were retrospectively analyzed.Results Follow up 6 months,4 cases were dead.Outcomes were assessed by the ADL:17 cases wereⅠ,10 cases were Ⅱ,9 cases were Ⅲ,4 cases were Ⅳ,2 cases were Ⅴ.Conclusion The surgical way should be selected according to degree of patients,conditions severity and CT imaging of hemorrhage in the patients with spontaneous cerebellar hemorrhage.The curative of timely proper surgery on the patients with spontaneous cerebellar hemorrhages is good.
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Objective To explore the microsurgical treatment strategy of ruptured anterior communicating artery aneurysms.Methods From September 2009 to February 2013,thirty-three patients with ruptured anterior communicating artery aneurysms were treated with microsurgical clipping via modified pterion approach.The clinical and follow-up data were analyzed retrospectively.Results At 3 to 44 months period followed-up after microsurgical clipping of ruptured anterior communicating artery aneurysms were obtained in 32 patients.According to Glasgow Outcome Score,the curative effects score were 5 in 28 cases,four in 2 cases,three in 1 case and death in 1 case.Conclusion Microsurgical clipping of ruptured anterior communicating artery aneurysms via modified pterional approach was an effective method with sufficient exposure.It has less invasiveness to the brain tissue,reliable neck clipping and satisfactory results.Safety and effectiveness of this procedure are based on preoperative radiological evaluation of three-dimensional morphological specificity of aneurysms,identification of the parental arteries and its branches,as well as temporary proximal occlusion.