Clinical classification and individualized design for the treatment of basicranial artery injuries.

This study aims to explore the principles of clinical classification and individualized treatment of basicranial artery injuries based on its anatomical correlation.The data of 172 patients with various types of basicranial artery injuries were retrospectively analyzed. Among these patients, 128 patients were male and 44 patients were female, and the average age of these patients was 28.3 years old. All patients underwent computed tomography, some patients underwent computed tomography angiography or magnetic resonance angiography, and all the diagnoses were confirmed by digital subtraction angiography (DSA). According to anatomical correlation, the injuries were classified into 5 types: vascular wall injury (type I), intradural injury (type II), epidural injury (type III), sinus injury (type IV), and skull base bone injury (type V). Individualized treatment was adopted based on the different types and characteristics of injuries.The percentages of basicranial artery injuries were as follows: type I, 4.6%; type II, 5.8%; type III, 3.5%; type IV, 77.9%; and type V, 8.1%. All 172 patients underwent DSA to demonstrate the classification. The lesion elimination rate revealed by DSA was 99.4% immediately after the operation, 98.3% at 1 week after the operation, and 98.8% at 3 months after the operation. The follow-up after 6 months revealed that the percentage of patients in whom clinical symptoms or signs completely disappeared was 97.7%, the percentage of patients with limited eye movement or visual impairment was 1.2%, and the percentage of patients with mild limb dysfunction was 0.6%.Basicranial artery injuries can be classified into 5 types. Individualized design of embolization therapy based on different characteristics might be applicable for basicranial artery injuries treatment.

[Application of 3D-CT angiography in the diagnosis and post-operative evaluation of intracranial aneurysms].

OBJECTIVE: To assess the values of three-dimensional CT (3D-CT) angiography (3D-CTA) in the diagnosis and operative follow up of intracranial aneurysms after clip. METHODS: 3D-CTA and DSA were performed on 32 patients with clinical manifestations suggestive of harboring intracranial aneurysms. DSA and operation were regarded as gold standards. Five patients who had been treated with clip underwent CTA both preoperatively and postoperatively to evaluate the effects of aneurysm clipping. RESULTS: According to DSA results and surgical findings, the sensitivity, specificity, and the accuracy of 3D-CTA for the detection of aneurysms were 100%, 100%, and 93.9% respectively. The detection rate of aneurysm with a diameter<3 mm of CTA, with the smallest diameter of 2 mm, was higher than that of DSA, however, there was no significant difference in the detection rate of aneurysm with the diameter>3 mm between CTA and DSA. Postoperative CTA displayed a remnant of aneurysm body in one case. CONCLUSION: With satisfying sensitivity and specificity, 3D-CTA is a quick, reliable, and relatively noninvasive diagnostic tool for intracranial aneurysms. 3D-CTA combined with VR delineates the aneurysmal morphology in detail, and provides useful information for choosing and planning microsurgical or endovascular treatment.