ABSTRACT
Currently,the ideal anesthetic approach for the endovascular treatment of acute ischemic stroke remains unknown.Most retrospective studies and meta-analysis report worse outcomes from general anesthesia than from conscious sedation during endovascular treatment.However,series of randomized controlled trials have not shown the advantages of conscious sedation.The choice of anesthetic strategy should continue to be individualized in clinical practice.In order to provide references for clinician,the advantages and disadvantages of general anesthesia and conscious sedation for the endovascular treatment of acute ischemic stroke were reviewed.
ABSTRACT
Carotid web is a rare risk factor of ischemic stroke.A total of 32 (0.54％) patients with carotid web were finally diagnosed in 5 943 patients who underwent carotid computerized tomography angiography (CTA) in two hospitals.Only one patient received carotid endarterectomy that pathological findings were fibrous tissue hyperplasia of vascular wall with mucinous degeneration.Stent implantation was administrated in two cases.Among 13 asymptomatic patients,the observational follow-up period was (20.9± 12.4) months without strokes.Carotid web is a rare aberration.Asymptomatic patients with carotid web are usually silent.Large sized cohort and long-term follow-up are further needed.
ABSTRACT
Facial autologous fat transplantation is a common aesthetic procedure.Although this procedure is generally regarded as safe,several patients have experienced acute cerebral infarction after fat particles were incorrectly injected into the blood vessel.We report two cases of cerebral infarction following facial autologous fat transplantation:one patient suffered massive cerebral infarction due to the occlusion of internal carotid artery by fat embolus and died of stroke related complication,the other young women experienced acute ischemic stroke and ophthalmic artery embolism during this procedure and remained permanent blindness of right eye.Therefore,when a patient presents abrupt mental change,hemiplegia,blindness during autologous fat particle injection,doctors must consider the complication of cerebral infarction.