Which is the best peri-operative anti-coagulative therapy of transverse sinus stenting for refractory idiopathic intracranial hypertension? / 中华医学杂志(英文版)

Treatment of refractory idiopathic intracranial hypertension (IIH) is a challenging problem. We reported a refractory IIH patient who manifested with typical intracranial hypertensive symptoms successfully treated with endovascular stent implantation. Pre-operative cerebrospinal fluid (CSF) opening pressure is 36 cmH2O. Cerebral angiography demonstrated a stenotic lesion located at the right transverse sinus (TS). The stenotic TS returned to its normal caliber and the pressure gradient deceased from 36 mmHg to 4 mmHg after the stent placement. The intracranial hypertensive symptoms resolved and one month later, the CSF opening pressure decreased to 14 cmH2O.

Acute paraplegia following embolization of spinal dural arteriovenous fistula / 中华医学杂志(英文版)

Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.

Endovascular embolization for posterior cerebral artery aneurysms / 中国脑血管病杂志

Objective: To investigate the methods and safety of endovascular embolization for treatment of posterior cerebral artery aneurysms. Methods: Eight patients with posterior cerebral artery aneurysms treated by using endovascular embolization were analyzed retrospectively. The clinical features, method of treatment and prognosis of the patients were summarized. Results: Circled digit oneThere were eight patients with 8 aneurysms. Of those, one aneurysm was located at the P1 segment, 2 were at the P1-P2 segment, 3 were at the P2 segment, and 2 were at the P3 segment. There were 6 patients with fusiform or dissecting aneurysm and 2 with saccular aneurysm. Circled digit twoOne patient was treated by balloon occlusion of parent artery. Five patients were treated by coil packing of the aneurysmal sacs and parent artery occlusion. Two patients were treated by coil packing of the aneurysmal sacs only. Circled digit threeAfter the procedure, DSA showed that all the aneurysms disappeared completely. There were no ischemic symptoms in the six patients with parent arteries occlusion after the procedure. No neurological deficits and other intervention-related complications were found in all the patients. Circled digit fourNo recurrence of the aneurysm was observed under DSA re-examination 3 to 6 months after the procedure. The patients were followed up for 1 to 12 years and all returned to their normal life. Conclusion: Endovascular embolization is a safe and effective therapeutic approach for posterior cerebral artery aneurysms.