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Objective:To analyze the effect and influencing factors of embolotherapy on headache in elderly patients with unruptured intracranial aneurysms.Methods:A retrospective analysis of clinical data of elderly patients(aged≥61 years)with unruptured intracranial aneurysms admitted to our hospital from January 2018 to December 2020 was performed.Headache assessment was performed by a quantitative 11-point headache scale in all patients preoperatively and at 6 months after endovascular treatment, and the difference between them was analyzed.Univariate analysis was applied to test the association between headache outcomes and clinical variables.Results:A total of 73 patients(mean age: 68.4 years old; age range: 61-86 years; 47 women)fulfilled the inclusion criteria.There were 53 patients(72.6%)who presented with preoperative headache(headache score≥1). Among them, 39 cases(73.6%)had an improvement in headache, 11(20.8%)remained unchanged, and 3(5.7%)aggravated, after endovascular treatment.The average preoperative headache score was 5(4, 6) vs.postoperative 3(1, 4), with statistical significance( Z=-5.036, P=0.000). Only the preoperative headache score was associated with outcomes of headache, and a higher headache score predicted a lack of headache relief( Z=-2.819, P=0.005). Conclusions:Embolotherapy of unruptured intracranial aneurysms can relieve headache in most elderly patients.Preoperative headache severity is correlated with postoperative headache outcomes.
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Objective To investigate the clinical effect of endovascular interventional treatment of intracranial peripheral aneurysms. Methods From January 2013 to December 2016,the clinical data of 31 patients with intracranial peripheral aneurysm admitted to the Department of Neurosurgery,Anhui Provincial Hospital were analyzed retrospectively.Among them,12 patients had saccular aneurysms,10 had narrow-neck aneurysms,and 2 lacked clear aneurysm necks;19 patients had fusiform aneurysms,they all lacked clear aneurysm necks.Ten patients with narrow-neck saccular aneurysm were treated with coil embolization, of the 2 lacked clear neck saccular aneurysms,1 was treated with stent-assisted coil embolization,1 was treated with coil occlusion of the aneurysm and parent artery;4 patients with fusiform aneurysm were treated with coil occlusion of the aneurysms and parent arteries,11 with fusiform aneurysm were treated with Onyx glue occlusion of the aneurysms and parent arteries,and 4 with fusiform aneurysm were treated with coils in combination with Onyx glue occlusion of the aneurysms and parent arteries.They were followed up for 6 to 36 months after procedure. Results All patients were successfully treated with endovascular intervention,no rebleeding cases were found.Immediate postoperative angiography showed that 11 patients with saccular aneurysm were totally occluded.The aneurysms and parent arteries in 1 patient with saccular aneurysm and 19 with fusiform aneurysm were totally occluded.The aneurysms and parent arteries of 8 patients were occluded with Onyx glue,cranial CT revealed different degrees of cerebral infarction (6 patients without new neurological deficits,2 new neurologic deficits).CT revealed cerebral infarction in 1 patient treated with coils in combination with Onyx glue for occlusion of the aneurysm and parent artery(no new neurologic deficit),other patients did not have cerebral infarction and new neurologic deficits.DSA follow-up revealed aneurysm neck recurrence in 1 patient with saccular aneurysm,no obvious aneurysm recurrence was observed in all other patients. Conclusions Endovascular treatment of intracranial peripheral aneurysms is safe and effective.Choose what specific intervention therapy base on the aneurysm morphology,location, tortuous degree of the parent artery,and the importance of the blood supply area.
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AIM:To investigate the effect of microRNA ( miRNA)-21 on the PC12 cells with hypoxic-ischemic damage.METHODS:The PC12 cells were cultured in vitro, and the cell model of oxygen-glucose deprivation (OGD) was established .In accordance with the following requirements , the cells were randomly divided into control group , OGD group, negative control sequence +OGD group, miRNA-21 inhibitor +OGD group and miRNA-21 mimic+OGD group. The effects and mechanism of miRNA-21 on the protection of PC12 cells from OGD damage were determined by CCK-8 as-say, real-time PCR and Western blot .RESULTS:Decrease in the expression of miRNA-21 by transfection with miRNA-21 inhibitor inhibited the viavility of the PC 12 cells subjected to OGD damage .Increase in the expression of miRNA-21 by transfection with miRNA-21 mimic promoted the viability of the PC 12 cells subjected to OGD damage .It was further con-firmed that miRNA-21 promoted the AKT phosphorylation in OGD-damaged PC12 cells.CONCLUSION: miRNA-21 sig-nificantly increases the viability of PC 12 cells subjected to OGD damage , which may be related to the activation of PI 3K/AKT signaling pathway .
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Objective To evaluate endovascular embolization with Onyx in treating brain arteriovenous malformations(AVM) located in the centre-encephalic region.Methods Eighteen patients with AVM in the brain centre-encephalic region were treated with embolization by using Onyx.According to Drake criteria of the AVM type,small type was seen in 10,medium type in 6 and large type in 2 cases.By using Onyx as embolization material,a total of 24 endovascular procedures were carried out.Results After treatment,complete obliteration was obtained in 12 cases(66.7%),disability(symptoms worsened) resulted in 2 cases(11.2%) and no death occurred.In the medium type group and the small type group complete obliteration was seen in 3(50%) and 9(90%) cases respectively,the difference between the two groups was significant(P 2 cm and the patients with the feeding artery