Advances in the clinical diagnosis and treatment of intracranial venous sinus thrombosis / 中国医师进修杂志

Intracranial venous sinus thrombosis is a special type of cerebral vascular disease. It usually originates from the later period of wasting disease, brain trauma, puerperium, blood disease, heart disease, eye/nasal/facial infection, meningitis and septicemia. It occurs in different age and sex. Infants, young children, frail elderly people, postpartum women, chronic disease patients are prone to be affected.Because of lacking of typical clinical manifestations, the clinical diagnosis and treatment of this disease is difficult and easily leading to misdiagnosis and mistreatment, which affects the prognosis of the patients.Because of lacking of standardized diagnosis and treatment strategy, different methods are needed. According to the proceeding reports, we reviewed the current progress of the diagnosis and treatment of intracranial venous sinus thrombosis.

Investigations on the Flat-Detector Computed Tomography-Based CBV Map Acquisition Using a Left Ventricle Contrast Media Injection Protocol.

OBJECTIVES: Cerebral blood volume (CBV) acquired with the use of flat-detector computed tomography with contrast media (CM) injected at the ascending aorta provides real-time brain functional information with minimized CM usage; however, unexpected asymmetric perfusion is observed for certain patients without cerebral circulatory disorders. This work tested the feasibility of left ventricle (LV) CM injection to achieve symmetric perfusion. METHODS: CBV maps were acquired for 10 patients without perfusion-related cerebral abnormities. Perfusion symmetry was predicted with the use of color-coded quantitative digital subtracted angiography with CM injected at ascending aorta. Time density curves were extracted at bilateral common carotid arteries with area under curves calculated. Planes were selected on CBV maps with regions of interest defined covering characteristic regions, where asymmetric perfusion most likely to appear. RESULTS: No adverse physiological changes were detected for any patient. Non-uniform CM distributions were detected for 4 patients with relative area under curves 0.66 ± 0.03, indicating asymmetric perfusion using ascending aorta injection. With LV injection, all the patients demonstrated good perfusion symmetry with relative CBV 1.03 ± 0.07. CONCLUSION: CBV maps acquisition with LV injection offered an approach to acquire immediate brain functional information for patients who are limited by asymmetric perfusion using ascending aorta injection and are sensitive to CM dose.

Quantitative anatomical study of percutaneous cannulated lag screw fixation for treatment of symphysis pubis diastasis / 中华创伤杂志

Objective To perform anatomic study on percutaneous cannulated-screw fixation of symphysis pubis diastasis in human cadaveric pelvic specimens so as to provide a basis for clinical practice of the technique.Methods Fifteen adult pelvic cadaveric specimens were dissected to expose pubic symphysis,peripheral major vascular nerve,spermatic cord and round ligament of the uterus.Thickness of pubic symphysis and distance between the outer edge of pubic tubercle and spermatic funicle or round ligament of uterus were measured respectively.Distances were measured respectively from entry and exit points to the above-mentioned structures in the direction of guide pin.Entry depth and angles of guide pin with the coronal plane and cross section of the human body were measured.Surgery was simulated to prove the surgery effect through post-surgery filming and CT.Results Thickness of symphysis pubis was gradually reduced from up to down.Pubic tubercle part was the most thick and it could accommodate a 7.3 mm cannulated-screw.Entry and exit points of cannulated-screw were in certain distances with the important nervusvascularis and spematicfunicle (or round ligament of uterus) in the periphery,which were invulnerable to damages in the process of surgery.Proper lengths of cannulated screws were (73.6 ± 1.3) mm for males and (72.4 ± 1.7)mm for females (t =3.146,P ＜ 0.05).Screw thread was completely embedded in pubic tubercle.Angles of guide pin with coronal plane and cross section of human body were (7.3 ± 1.1) °and (6.4 ± 1.0) ° for males (6.9 ± 1.5) ° and (6.1 ± 0.6) ° for females.Radiography and CT findings confirmed that all pin tracks were in the bone substances with angle and length of screws staying within the scope of experiment.Conclusion Percutaneous cannulated screw fixation is reliable and safe for symphysis pubis diastasis.