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Objective To evaluate the clinical effects of percutaneous micro-balloon compression (PBC) trigeminal ganglion for the treatment refractory trigeminal neuralgia. Methods Surgical results of 452 patients with trigeminal neuralgia treated by PBC from October 2009 to May 2013 were analyzed retrospectively. 125 cases aged over 80 years old and 70 cases′ pain belongs to the first branch neuralgia. Such procedures as Meckle′s cave cannulated with No.4 Forgarty catheter and the balloon inflated and compressed the gasserian ganglion monitored by X-ray were observed by PBC. Follow-up interview and curative effects were recorded. Results The average hospitalization was 6.1 days. Among them, 432(95.6%) cases had immediate relief from pain. The overall pain relief rate was 97.8% in our group without serious surgical complications. Postoperative complications include hemifacial numbness in 385 patients (85.2%), mild masseter muscle weakness in 248 patients (54.9%), diplopia in 2 patients. All symptoms relived or disappeared within 1 ~ 6 months. The average follow-up intervier period is 23.5 months. The recurrence rate is 10.2% (46 cases). Conclusion PBC is a safe and effective method with high pain relief rate in the treatment of refractory trigeminal neuralgia , especially for the treatment of the high risk patients , patients with recurrent symptoms or the patients suffered from the first branch neuralgia.
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Objective To compare clinical outcome of microvascular decompression (MVD) and percutaneous balloon compression (PBC) by using a prospective cohort study in order to provide a reliable evidence for the clinical decision-making. Methods Patients with trigeminal neuralgia hospitalized at Hangzhou First People′s Hospital in 2010 were chosen as database for cohort study. The patients were divided into MVD group (30 cases) and PBC group (30 cases). The clinical efficacy was followed by independent observers for 36 months after surgery. Chi-square test for hierarchical data, t test for quantitative data, and Kaplan-Meier plot for clinical outcomes were applied in the research. The endpoint was follow-up accomplishment or severe occurrence. Results Sixty patients were included in the research till the endpoint. The general records before surgery were almost the same with the literature records. By comparing painless period, mild and severe relapse, MVD group was superior to PBC group (P < 0.05). As for the painless survival period, MVD group was 96.7% of pain free after 1 year, 93.3% after 3 years, while PBC group was 90.0% after 1 year and 83.3% after 3 years. Regarding 3 years of follow-up, the relapse seemed occurred after 1 year in both groups. Conclusions As a curative and nondestructive procedure , MVD is more effective and has longer lasting pain free period , which should be considered as the first choice of treatment for trigeminal neuralgia in healthy people.
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Objective To investigate the expression of osteopontin(OPN) mRNA and its correlation with clinicopathologic features of glioma. Methods The expression of OPN mRNA was detected by semi-quantitive RT-PCR in 60 cases of gliomas and their correspondent normal tissues.The relationship between the relative content of OPN mRNA and clinicopathologic features of glioma was also analyzed. Results The positive rate of OPN mRNA expression was 73.3%(44/60) in our group.The OPN mRNA expression in normal brain tissue was all negative.Furthermore,the OPN mRNA expression was associated with the pathological grade of glioma.All patients were followed up for an average of 12 months.We did observed that the OPN mRNA expression positive group(44 cases) had recurrence in 36 patients and the negative group(16 cases) had only 2 case with recurrence (P
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Purpose Progressive hypertensive intracerebral hemorrhage (PHICH) is often observed in clinical ward,but its prognosis is undetermined.This study is to investigate the duration and the risk factors of progressive hypertensive intracerebral hemorrhage.Methods The diagnosis of PHICH was determined by comparing the first and second CT scans.Potential risk factors including the sex,age,location of hematoma,blood pressure,coagulopathy and the duration of admission to the first CT scan were analyzed.Results In a cohort 143 patients,the PHICH were found in 41 cases(28.7%)after the second scan,and among them,32 patients(22.4%)were necessary to perform craniotomy for evacuation of hematoma,most of the PHICH occurred within 24 hours after onset.Older age,thalamus bleeding,high systolic blood pressure within 6 hours,coagulapathy and shorter duration from admission to the first CT scan were the predictors associated with PHICH.Conclusion PHICH occurs in almost 1/4 of hypertensive intracerebral hemorrhage,predominantly in elder,thalamus bleeding,coagulapathy,high systolic blood pressure within 6 hours and shorter duration between onset and the first CT scan.CT examination within 24 hours after admission is crucial to reveal the exact condition of the patient.