Encephalo-duro-arterio-synangiosis for intracranial arterial steno-occlusive disease: a retrospective case series study of 40 cases / 国际脑血管病杂志

Objective:To investigate the efficacy and safety of encephalo-duro-arterio-synangiosis (EDAS) for intracranial atherosclerotic steno-occlusive disease (ICASD).Methods:Patients with symptomatic ICASD received EDAS treatment in the Department of Neurosurgery, the PLA General Hospital from January 2018 to January 2019 were retrospectively included. The baseline information, perioperative complications, primary endpoint events, and changes in modified Rankin Scale (mRS) scores before and after surgery were collected. The primary endpoint event was any stroke/death that occurred within 30 d after enrollment. The secondary endpoint events were any stroke/death, non-stroke bleeding (subdural or epidural bleeding), and clinical functional improvement after 30 d. The clinical functional improvement was defined as a decrease of ≥1 in the mRS score compared to before surgery.Results:A total of 40 patients were included, including 30 males and 10 females, aged 53.9±8.6 years old. The clinical symptoms were mainly limb weakness and dizziness. One case of ischemic stroke and one case of hemorrhagic stroke occurred during the perioperative period. The primary endpoint event incidence was 2.5%. The patients were followed up for 49.75±2.99 months after surgery. One patient died of cerebral hemorrhage 31 months after surgery, and one patient developed acute ischemic stroke 35 months after surgery. The postoperative mRS scores of 34 patients decreased compared to before surgery, and the clinical function improvement rate was 85%. The mRS score increased in 2 cases after surgery compared to before surgery and 4 cases had no change.Conclusion:EDAS can improve the clinical function of patients with symptomatic ICASD and reduce the incidence of long-term stroke.

Vision deterioration after transsphenoidal surgery for removal of pituitary adenoma / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the mechanism and strategies of prevention and treatment of vision deterioration after transsphenoidal surgery for removal of pituitary adenoma.</p><p><b>METHODS</b>From January 1980 to February 2001, 1 412 patients were operated on by transsphenoidal surgery to remove pituitary adenoma. Fourteen patients experienced vision deterioration after operation. Clinical data from the 14 patients with vision deterioration were analyzed retrospectively.</p><p><b>RESULTS</b>In this group, the incidence of vision deterioration was 0.99%. Over packing of the adenoma bed was seen in 5 patients, apoplexy of residual tumor in 3, high intracranial pressure in 2, vascular spasm in 2, injury of the optic nerve in the cannel in 1 and unknown reason in 1.</p><p><b>CONCLUSIONS</b>Vision deterioration is a severe complication after transsphenoidal surgery. Early diagnosis and treatment can greatly improve the vision.</p>

Preliminary study on serial observation of rabbit carotid arteriosclerosis model before and after carotid endarterectomy with high resolution MRI / 解放军医学杂志

Objective To serially observe carotid arteriosclerosis in rabbit model before and after CEA using high-resolution MRI. Methods Using New Zealand rabbits, lesions were created by air-drying an isolated segment of common carotid artery (120ml/min for 15min) and feeding the rabbits with a diet of 2% cholesterol, 6% peanut oil mixed with normal diet for 2 months. High-resolution MRI examinations were performed for 1 normal rabbit, 4 rabbits with replicated arteriosclerosis before CEA, and 2 rabbits with arteriosclerosis 10 days after CEA, and the results were compared with pathological findings. Results High-resolution MRI revealed the contour and shape of the type II to type IV lesions of rabbit carotid arteriosclerosis model. The MRI images of the lesions corresponded well with the pathological findings. The fibrous plaques were showed as low signals on TOF film, gray images on T 1, T 2, and PDW film, and were obviously enhanced by Gd-DTPA. The MRI images obtained 10 days after CEA also corresponded well with the neo-intima. Conclusion High-resolution MRI can be used as an effective non-invasive method to serially observe the arteriosclerosis lesion of rabbit carotid artery before and after CEA.