Analysis of delayed cerebral ischemia after coiling and clipping of intracranial aneurysms / 天津医药

Objective To compare and analyze the occurrence of delayed cerebral ischemia(DCI)after coiling and clipping of intracranial aneurysms, and explore the risk factors of DCI. Methods A total of 236 patients with aneurysms diagnosed by CT angiography (CTA) or digital subtraction angiography (DSA) in Department of Neurosurgery, Tianjin Medical University General Hospital were enrolled in this study from March 2011 to May 2014. Patients were divided into clipping group(n=135) and coiling group(n=101). The clinical characteristics were compared between two groups, including gender, age, medical history, GCS score, Hunt-Hess grade, Fisher grade, WFNS grade, aneurysm location, prognosis and incidence of DCI. Risk factors for DCI were investigated by Logistic regression analysis. Results DCI was occurred in 36 patients (26.7%) underwent clipping operation while in 11 patients (10.9%) underwent coiling operation. The incidence was significantly higher in clipping group compared with that of coiling group (P 0.01). The overall mortality was 11.0%, the former had a lower mortality rate (5.9% vs. 17.8%, P <0.01). According to Logistic regression analysis, Fisher Grade 3-4, postoperative pulmonary infection and surgical procedure were independent risk factors for DCI (P<0.01). Conclusion DCI is one of the most significant factors for high fatality and morbidity of postoperative aneurysm patients. There is a low occurrence of DCI after coiling compared with that of clipping. If we pay more attention to risk factors associated with the DCI, it will improve the prognosis of postoperative aneurysm patients greatly.

Pathology, imaging and treatment of rare types of intracranial aneurysms / 中华外科杂志

The formation mechanisms of rare intracranial aneurysms are various, which lead to various kinds of treatment methods. The present article summarized the pathogenesis, pathologic changes in vascular walls and imaging features of rare intracranial aneurysms including segmental ectasia, aneurysms with dissection, aneurysms with intramural hemorrhage, mycotic aneurysms, aneurysms related to HIV, neoplastic aneurysms and traumatic aneurysms through literature review.

Screening for risk factors of stroke in people with family history of stroke / 天津医药

Objective To investigate the characteristics of cerebral vascular imaging and risk factors of stroke in popu?lation with family history of stroke in rural areas of Ji County, Tianjin. Methods The volunteers with family history of stroke were recruited in the study to undergo computed tomography and computed tomography angiography (CTA) of head as well as physical and laboratory examinations. A total of 281 subjects, including 153 male and 128 female, underwent exami?nation, and were divided into stroke group and non-stroke group. Results The detection rates were significantly higher in male subjects than those of female subjects, including smoking rate, drinking rate, educational level, and decreased level of high density lipoprotein cholesterol (HDL-C), whereas the detection rate of high level of triacylglycerol (TG) was significant?ly higher in female than that of male subjects (P<0.05). There were 38 subjects in stroke group. The age, internal carotid ar?tery calcification rate (ICAC) and internal carotid artery tortuosity (ICAT) rate were significantly higher in stroke group than those of non-stroke group (P<0.05) . The results of multivariate Logistic regression analysis indicated that age, hyperten?sion, ICAC, and ICAT were independent risk factors for stroke. Conclusion For population with family history of stroke, age, hypertension, ICAC and ICAT were risk factors of stroke.