Analysis of prognostic factors on posterior communicating artery aneurysm caused oculomotor nerve palsy / 中华外科杂志

<p><b>OBJECTIVE</b>To study and analyze the factors affecting the recovery of posterior communicating artery aneurysm-induced oculomotor nerve palsy (ONP).</p><p><b>METHODS</b>The clinical and follow-up data of posterior communicating artery aneurysm-induced ONP in 23 patients from May 2005 to May 2009 were retrospectively compared. There were 7 male and 16 female with a mean age of 50.4 years. Among the 23 patients, 13 patients underwent endovascular coiling (endovascular group) and 10 patients underwent surgical clipping (surgical group).</p><p><b>RESULTS</b>Of the patients with 2 year of follow-up, 6 patients recovered completely and 7 patients recovered partially in the endovascular group, compared with 6 patients recovered completely and 4 patients recovered partially in the surgical group (P = 0.407). Compared to the patients with preoperative complete ONP, the rate of complete recovery was higher in the patients with preoperative partial ONP, while the results did not reach the significance (P = 0.095). Patients accepted treatment in 14 days since the onset of symptoms recovered significantly than who accepted treatment after 14 days since the onset of symptoms (P = 0.045).</p><p><b>CONCLUSIONS</b>There is no significant difference in recovery from ONP between endovascular coiling and surgical clipping as treatment for posterior communicating artery aneurysm patients with ONP. Timing of treatment after onset of symptoms is a factor affects the recovery of ONP.</p>

Applicative value of CT angiography in emergent operation for ruptured intracranial aneurysm caused intracerebral hematoma / 中国脑血管病杂志

Objective: To investigate the applicative value of multislice spiral computed tomography angiography (MSCTA) in the microsurgery of ruptured intracranial aneurysm caused acute intracerebral hematoma. Methods: The imaging and clinical data of 15 patients with ruptured intracranial aneurysm caused intracerebral hematomas, whom underwent emergency surgery after preoperative CT angiography (CTA) were analyzed retrospectively. The surgical plan was determined according to the CTA imaging results. The hematomas were evacuated and the aneurysm were clipped. The applicative value of CTA were evaluated. Results: All the 15 patients were confirmed as intracranial aneurysms in the operation, which was essentially consistent with the preoperative diagnosis by CTA. The size and growth direction of the aneurysms were essentially consistent with the preoperative judgement, and all the aneurysms were clipped. The prognosis of the patients was assessed by the Glasgow Outcome Scale (GOS). All the patients were followed up by the outpatient department and/or telephone for 6 to 78 months (mean 24 months). The GOS score in 2 patients was 2, in 2 was 3, in 6 was 4, and in 5 was 5. Conclusion: Head CTA can briefly and quickly identify the ruptured intracranial aneurysm caused intracerebral hematoma and provide intuitive three-dimensional morphology and anatomical localization of the aneurysms. It is helpful to hematoma evacuation and clipping of the aneurysms in emergency operation.

Expression change of interleukin-8 gene in rabbit basilar artery after subarachnoid hemorrhage / 神经科学通报·英文版

<p><b>OBJECTIVE</b>To study the expression change of interleukin-8 (IL-8) gene in the basilar artery of rabbit and the effect of IL-8 on the development of cerebral vasospasm induced by experimental subarachnoid hemorrhage (SAH).</p><p><b>METHODS</b>Thirty five healthy Japanese White Rabbits were randomly divided into saline-control group and experimental group. The experimental group was subdivided into four groups, representing day 1, 4, 7 and 14 after the first blood injection of SAH. The delayed cerebral vasospasm (DCVS) model was established by double injection of autologous blood into the cisterna magna. The expression change of cytokine IL-8 mRNA in the basilar artery was analyzed by RTPCR.</p><p><b>RESULTS</b>The expression of IL-8 gene increased on day 4-7 after the first blood injection of SAH compared with control (P< 0.001), and decreased to normal on day 14. The expression of IL-8 gene in the SAH groups were positively correlated with the degree of basilar artery stenosis (r = 0.642, P< 0.01).</p><p><b>CONCLUSION</b>The expression level of IL-8 gene in basilar arteries was intimately associated with the degree of cerebral vasospasm, suggesting that IL-8 may play an important role in the DCVS after SAH as an immunological inflammatory factor.</p>

Diagnostic value of CTA and MRA in intracranial traumatic aneurysms / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the diagnostic value of computerized tomographic angiography (CTA) and magnetic resonance angiography (MRA) for intracranial traumatic aneurysms (TAs).</p><p><b>METHODS</b>CTA and MRA of six patients with intracranial TAs verified by digital subtraction angiography (DSA) and surgery were retrospectively analysed. All patients were examined by nonenhanced computerized tomography (CT) and two by CTA. The source data were reconstructed by volume rendering (VR) and multi-planar reconstruction (MPR) from CTA. Four of them had maximum intensity project (MIP) from MRA.</p><p><b>RESULTS</b>Of the six patients, a total of seven TAs were detected by CTA and MRA examinations. Five cases had only one TA and one case had two TAs. The average diameter was 2.3 cm (1.1-3.3 cm). CTA demonstrated two TAs appeared at the cavernous segment of the internal carotid artery (ICA) and the middle cerebral artery (MCA) respectively. MCA TA was definitely and clearly demonstrated on VR images, whereas VR images failed to depict the cavernous ICA TA, which was detected on MPR images. Two TAs were found irregular saccular shape, irregular margin of parent artery and wide neck on CTA. Four MRA examinations demonstrated five TAs, including the cavernous segment ICA TAs (2 cases), the supraclinoid segment ICA TA (1 case), and the cavernous segment associated with opposite side of the petrosal segment ICA TA (1 case). In a cavernous ICA TA, MRA only revealed aneurysm body, whereas aneurysm neck and distal segment of the parent artery were not revealed. In the remaining cases, MRA clearly depicted aneurysm body and parent artery, whereas the neck was not displayed. ICA TAs showed irregular capsule-like high signal intensity on MRA images. Four TAs exhibited irregular distal segment of the parent artery. TAs at the supraclinoid segment or MCA failed to find fracture signs on nonenhanced CT.</p><p><b>CONCLUSIONS</b>Both CTA and MRA examinations are the effective non-invasive method of imageology for diagnosing intracranial TAs, while CTA is more eligible for diagnosing TAs after nonenhanced CT has demonstrated skull base fractures.</p>