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Objective To investigate the relationship between apolipoprotein E (APOE) genotype and onset of hypertensive intracerebral hemorrhage (HICH). Methods One hundred and twenty-eight patients with HICH,admitted to our hospital from September 2007 to December 2010,and 84 healthy controls clinically flee from neurology disease were chosen in our study.A POE genotype was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP); the distribution ofAPOE genotype and allele fiequency between the 2 groups were compared; the age of onset,gender,blood pressure,blood fat,bleeding part and size of haematoma in patients with different APOE genotype were further studied. Results The subjects with smoking hobby,diabetes history and higher concentrations of TC and LDL-C in the HICH group were obviously more than those in the control group (P＜0.05).As compared with those in the controls,the distributions of the APOEε3/4 and APOEε4 in the HICH group were significantly higher, and the distributions of the APOEε3/3 and APOEε3 in the HICH group were significantly lower (P＜0.05). The APOEε3/4 and APOEε4 carriers enjoyed higher percentages of onset age less than 45 years and superficial haematoma than A POEε3/3 and the A POEε3 carriers. The onset systolic blood pressure in APOEε3/4 and APOEε4 carriers was obviously lower than that in A POEε3/3 and A POEε3 carriers (P＜0.05). The plasma concentrations of LDL-C and TC in APOEε3/4 and APOEε4 carriers was significantly higher than those in APOEε3/3 and APOEε3 carriers (P＜0.05). Conclusion The APOE genotype influences the onset of HICH, and its influence factors included onset age, blood pressure,blood fat and bleeding part,which may concern with the cerebral artherosclerosis or amyloidosis.
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Objective To explore the diagnosis of small anterior communicating artery aneurysms and discuss the microsurgical techniques and the timing of surgical intervention.Methods Thirty-two cascs of small anterior communicating artery aneurysms were reviewed for the methods for lesion detection,imaging features of the lesions,microsurgical procedures and the patients'clinical outcome. Results CT displayed subarachnoid hemorrhage(SAH)in all the 32 cases.Magnetic resonance angiography(MRA) was performed in 13 cases and computed tomographic angiography (CTA)in 8 cases. All the 32 patients underwem a total of 35 examinations With digital subtract angiography(DSA).The time between operation and aneurysm rupture was less than 3 daysin 6 cases,4 to 14 days in 10 cases.10 to 14 days in 13 cases and over 30 days in 3 cases.Neck clipping of the aneurysm through the pterional approach was performed in all thc cases with tracheal intubation and general anesthesia,and hemorrhage due to ancurysm ruptures occurredin 5 cases during the operation.Death occurred in 1 case after the operation,and 5 patients developed hydrocephalus and received subsequent ventriculoperitoneal shunting.After the operation,22 patients showed good recovery,6 were capable of independent living, 2 needed assistance for walking and in daily activities, and 1 patient remained bed-ridden and needed nursing care.Follow-up of 27 patients for 3 to 12 months found no occurrence of hemorrhage or death.Conclusion DSA Can be the primary choice for diagnosis of small anterior communicating artery aneurysms.Earlyinterventions should be administered for grade I or Ⅱpatients,but for the other patients,the surgeries can be performed 2 or 3 weeks after the hemorrhage.Proficient microsurgical skills can be crucial for successful clipping of the aneurysms and for prevention and effective management of hemorrhage due to aneurysm rupture.