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Objective To explore the effect of cisterna magna plastic repairing (posterior vertebral column resection and cerebella tonsillectomy and reconstruction of the cisterna magna by artificial dura) on cerebrospinal fluid dynamics in Chiari malformation type Ⅰ with syringomyelia and evaluate the efficacy of this surgical method.Methods Forty patients with Chiari malformation type Ⅰ with syringomyelia (CMI-SM),admitted to and diagnosed by MRIin our hospital from January 2011 to December 2013,were selected.All patients were treated with cistema magna plastic repairing.Phase-contrast MR imaging (PC-MRI) was performed,changes of cerebrospinal fluid dynamics indicators of cerebral aqueduct,pons ventral side and C3 ventral side were detected and compared and Japanese Orthopaedic Association (JOA) scale scores were evaluated 24 h before operation and 12 months after operation.Results No neurological deterioration or death was noted;JOA scores in all patients were increased from 7.89±3.52 to 12.53±4.32,with significant difference (P＜0.05);post-operated PC-MRI indicated that the cistema magna formed well,spinal subarachnoid space was clear,syringomyelia in 30 patients was significantly reduced;as compared with those before operation,the stroke volume and mean flux were significantly increased,but maximum peak velocity was significantly reduced (P＜0.05).Conclusion Cisterna magna plastic repairing can reduce syringomyelia,increase cerebrospinal fluid flow,and reduce peak flow of cerebrospinal fluid,which is an effective surgical procedure for Chiari malformation type I with syringomyelia.
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Objective To investigate the risk factors and preventive strategies of patients with diffuse axonal injury(DAI) with deep veins thrombosis in lower limbs (LDVT).Methods One hundred and thirty cases of diffuse axonal injury patients with lower limb vascular were divided into LDVT group(22 cases) and non LDVT group(108 cases) based on ultrasound.The information including long-term bed,plasma fibrinogen level,varicose veins,hypertention,sex,age,smoking,alcohol drinking,diabetes,obesity,Glasgow Coma Scale (GCS) were collected.Results There were significant different between LDVT and non-LDVT group in terms of longterm bed time,hypertension,smoking,diabetes,high plasma fibrinogen,age,low GCS score correlated with LDVT (x2 =7.08,5.99,5.17,4.70,3.55,12.72,t =27.80,P ＜ 0.05).Gender,drinking,obesity,varicose vein factors had no correlation with LDVT(P ＞ 0.05).Conclusion Diffuse axonal injury in patients with LDVT is more common in patients with older age,hypertension,low GCS score,the higher the plasma fibrinogen.