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Objective To evaluate the efficacy of endovascular embolization in intracranial aneurysm treatment .Methods We retrospectively analyzed 130 patients with different locations and types intracranial aneurysms treated by variety endovascular em‐bolization .The postoperative and long‐term follow up results was examined .Results 124 cases with 139 aneurysms was successful‐ly embolized ,1 case failed but clipping successfully .6 cases suffered from intraoperative bleeding ,3 cases died ,3 cases had a good recovery .The results of Glasgow Outcome Scale after operation:1 score 3 cases ,2 score 0 case ,3 score 1 case ,4 score 3 cases ,5 score 123 cases .119 cases(91% ) were followed up for 3‐48 months with an average of 12 months .33 cases(27% ) achieved long‐term follow‐up(exceeded 6 months) .During follow‐up ,1 case had severe stenosis of the parent artery and received angioplasty .The other cases didn′t see aneurysms in cerebral angiography and showed different degree of neurological function recovery .Conclusion According to the different intracranial aneurysm with endovascular treatment of corresponding intravascular can effectively im‐prove the clinical treatment effect ,reduce the risk of aneurysm rupture ,improve the prognosis of the patients .
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Objective To retrospectively review the efficacy of large craniotomy with subtemporal decompression in the treatment of severe craniocerebral injury combined with cerebral infarction.Methods Forty-eight patients suffering from severe craniocerebral injury combined with cerebral infarction were randomized into the treatment group (managed by large craniotomy decompression) and the control group (managed by clearance of hematoma by routine craniotomy ).A retrospective analysis was carried out to compare the cerebral infarction size between the two groups before operation and at day 1 and 1 week after operation and the outcomes of the two corresponding groups three months post-operatively.Results The infarction size of the treatment group was insignificant in comparison with that of the control group pre-operatively and at day 1 post-operatively,but was significantly smaller than that of the control group one week post-operatively (P ＜ 0.05 ).The mortality and moderate disability/good rate of the treatment and control groups presented significant differences three months post-operatively (21％,42％ vs 33％,25％ respectively,P ＜ 0.05 ).Conclusion Large craniotomy decompression is effective in treating severe craniocerebral injury combined with cerebral infarction and plays an important role in reducing disability and mortality.
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ObjectiveTo observe the early changes of N-methyl-D-aspartic acid (NMDA) receptor subunit NR1 and NR2B expressions in the hypothalamus so as to discuss the underlying mechanism of the excitability alternation of hypothalamus-pituitary-adrenal (HPA) axis following severe burn in rats.MethodsA total of 40 Sprague-Dawley rats were randomized into the control group and the experimental groups ( including 6,24 and 48 hours after burn) and a 30％ total body surface area full-thickness burn was induced by immersing the shaved dorsum into boiling water for 40 s.Then,the expression changes of the NMDA receptor subunits NR1 and NR2B in the hypothalamus tissue were examined by using immunohistochemistry and Western blot.Results There was an obvious enhancement of the excitability of HPA axis and obvious changes of serum concentration of cortisol and hemodynamics.The serum concentrations of cortisol of the experimental groups reached the peak at 6 hour after burn and were significantly higher than the control group even 48 hours later (P ＜ 0.05 ).Systolic pressure (SP),diastolic pressure (DP) and left ventricular systolic pressure (LVSP) of the experimental groups were all decreased at 6 hours after burn,of which SP and DP were still lower than the control group at 48 hours after burn (P ＜0.05).Based on the Western blot assay,the NR1 level was increased and reached the peak (1.12 ±0.27) in the experimental groups and 0.45 -±0.15 in the control group at 24 hours after burn (P ＜ 0.05).In the meantime,the NR2B level was decreased significantly and reached the lowest for 0.65 ±0.21 at 6 hours after burn,with statistical difference in comparison with 1.38 ±0.51 in the control group (P ＜0.05.The NR2B level recovered to pre-burn level for 1.25 ±0.30 at 48 hours in the experimental groups,with no statistical difference compared with 1.38 ± 0.51 in the control group (P ＞ 0.05 ).The immunohistochemistry results on hypothalamus paraventricular nucleus (PVN) was consistent with the Western blot results.ConclusionThe persistent plasticity changes of hypothalamus subunits NR1 and NR2B may be on of important mechanisms for early excitability alteration of HPA axis after severe burn.