Clinical study of the cerebral collateral venous circulation scale based on individualized delayed rotational phlebography / 中华放射学杂志

Objective:To investigate the correlation between venous collateral circulation and clinical data such as symptoms, parenchymal injury, and prognosis in patients with cerebral venous thrombosis(CVT).Methods:The clinical and imaging data of patients with CVT diagnosed in the department of Neurosurgery of the Third Affiliated Hospital of Southern Medical University from December 2011 to August 2018 were retrospectively analyzed. A total of 32 patients with CVT were included, 19 males and 13 females, aged from 20 to 60 (39±12) years. All patients underwent cerebral angiography, individualized delayed rotational phlebography. According to the number and diameter of collateral circulation and the phenomenon of flow delay of contrast medium, the collateral venous circulation scale (CVCS) was developed and divided into 3 levels. The clinical data (risk factors, course of disease, clinical symptoms), imaging data (parenchymal injury, thrombus site), treatment (endovascular treatment, decompressive craniectomy) and prognosis of all patients were recorded. The differences in clinical data, imaging appearances, parenchymal injury, and prognosis between patients with different CVCS were compared, and the correlation between variables with statistically significant differences and CVCS was compared using the Gamma method or Spearman correlation analysis.Results:Among the 32 patients with CVT, 9 were CVCS 0, 13 were CVCS 1 and 10 were CVCS 2. Among them, there were 19 cases of neurological deficit and 17 cases of brain parenchymal injury. There were significant differences in course of disease, neurological deficit, focal dyskinesia, language dysfunction, consciousness disorder, isolated headache, deep vein thrombosis, cortical vein thrombosis and prognosis across different CVCS ( P<0.05). Correlation analysis showed that CVCS was positively correlated with course of disease and isolated headache ( r=0.724, 0.637, P<0.001), and negatively correlated with neurological deficit symptoms, focal dyskinesia, disturbance of consciousness, brain parenchymal injury and deep vein thrombosis ( r=-0.797, -0.451, -0.782, -0.697, -0.427, P<0.05). The results of 90 days follow-up showed that there were 18 cases with mRS 0, 6 cases with mRS 1, 2 cases with mRS 2-4, and 1 case with mRS 5-6 points. There was a negative correlation between CVCs grading and mRS score at 90 days ( r=-0.732, P<0.001). Conclusion:Lower cerebral venous collateral circulation grade is associated with higher incidence of brain parenchymal injury, neurological deficit symptoms, and worse clinical prognosis.

Clinical Observations on Acupuncture Point Injection of Mouse Nerve Growth Factor for the Treatment of Sciatic Nerve Injury / 上海针灸杂志

ObjectiveTo investigate the clinical efficacy of points injection of mouse nerve growth factor in treating sciatic nerve injury.MethodAcupuncture point injection of injectable mouse nerve growth factorwas performed in 60 patients with sciatic nerve injury. Points Huantiao(GB30)and Zusanli(ST36)were selected. Treatment was given once daily, for a total of 30 times. Sensory and motor functions were assessed (MS and SS) and electromyography (EMG) was performed before and after treatment to compare motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) in the injured nerves and EMG changes in the musclescontrolled by the injured nerves.ResultAfter treatment, nerve function was restored to more than S3M3, with an efficacy rate of 81.7%, in 49 patients. Neuro-electrophysiological study showed that regenerative potentials occurred, accounting for 71.7%,in43patients. Denervated potentials were fewer after treatment than before; there was a significant difference (P<0.05). The mean MCV value increased after treatment compared with before; there was a significant difference (P<0.05). ConclusionAcupuncture point injection of mouse nerve growth factor can markedly improve sensory and motor functions in the regions controlled by the injured sciatic nerve. It provides an effective way to promote the repair of sciatic nerves and the reconstruction of limb function after the nerves are injured.

Retrieval of Distally Migrated Coils with Detachable Intracranial Stent during Coil Embolization of Cerebral Aneurysm

Migration of coils during endovascular procedures is a rare, but well-known complication. We are reporting two cases of successfully retrieving migrated coil using detachable intracranial stent. In both of our cases there was distal migration of coil during the intracranial aneurysm coiling procedure. The Solitaire® AB stent (Covidien, Irvine, CA, USA) was used to retrieve those coils. The stent was passed distal to the migrated coil using standard technique. It was then partially deployed and gradually withdrawn along with the entangled coil. Coil retrieval using the fully retrievable intracranial stent is a very simple, safe and easily available alternative for retrieval of distally migrated coil.

Microsurgical management of intracranial giant aneurysms / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the surgical timing, strategy and outcome of intracranial giant aneurysms.</p><p><b>METHODS</b>The clinical and surgical data of 15 cases of intracranial giant aneurysms treated between January, 2001 and January, 2010 were analyzed. Aneurysm clipping was performed in 8 cases, aneurysm trapping with extracranial-intracranial (EC-IC) bypass in 1 case, parent artery occlusion with EC-IC bypass using great saphenous vein graft in 3 cases, aneurysm resection with aneurysm wall suture in 1 case, and exclusive aneurysm trapping in 2 cases.</p><p><b>RESULTS</b>Deaths occurred in 2 (13%) of the cases. Good surgical outcomes were achieved in 12 cases (80%), and poor outcome was found in 1 case (7%) after the surgery.</p><p><b>CONCLUSION</b>Individualized surgical planning is suggested for microsurgical management of intracranial giant aneurysms, and the operation should be performed by surgeons having sufficient microsurgical experience and capable of vessel reconstruction.</p>

The development and application of an encapsulated aneurysm clip with biomembrane graft across the vessels / 生物医学工程学杂志

The external wrapping of intracranial aneurysm is the definitive treatment of choice for surgical clipping or endovascular occlusion, yet there may exist considerable difficulties and risks because so far neither ideal wrapping techniques nor ideal wrapping materials have been obtained. An encapsulated aneurysm clip with biomembrane graft across the vessels is introduced in this article. By clipping the neck and wrapping the sack of aneurysm simultaneously, this clip successfully solves the problems of unreasonable encapsulated materials and techniques; it has been proved to be an effective method for treating intracranial refractory aneurysms.