Balloon-Assisted Coils Embolization for Ophthalmic Segment Aneurysms of the Internal Carotid Artery.

Objective: To explore the role of balloon-assisted coils technique for ophthalmic segment aneurysms (OSAS). Methods: Clinical data of 30 patients with OSAS were reviewed between December 2017 and December 2018. OSAS were defined as arising from the internal carotid artery (ICA), reaching from the distal dural ring to the origin of the posterior communicating artery. OSAS were classified into four types based on the angiographic findings. The balloon-assisted coils technique was used for the embolization of aneurysms. The duration of balloon inflation cycles, as well as difficulty and complications during the embolization procedure, were recorded. The immediate angiographic results were evaluated according to the Raymond scale. Clinical results were evaluated based on the MRS score. Follow-ups were performed at 18 months post-embolization by DSA or MRA at our institution. Results: Thirty-two aneurysms in 30 patients were detected by digital subtraction angiography (DSA), which included 30 unruptured and two ruptured cases. The patients with ruptured aneurysms were grade II status according to the Hunt-Hess scale. Three cases were type A, nine cases were type B, 17 cases were type C, and three cases were type D. According to aneurysm size, there were 19 cases of small, 11 cases of medium, two cases of large aneurysm. Thirty-two aneurysms were successfully embolized in 30 patients by balloon-assisted coils technique. The ophthalmic artery could be protected by an engorged balloon in the procedure, especially for type A aneurysms. Considering that type D aneurysm arises from the side-wall of the artery and near to tortuous ICA siphon, the balloon catheter was inflated to stabilize the microcatheter allowing for overinflation when necessary. The average duration of balloon dilatation was 4 min, and the average time was 2.5 times. Raymond class was one in 28 aneurysms and two in four aneurysms according to the immediate post-embolization angiographic results. All the patients achieved good clinical effects, except for one patient who presented with brain ischemia resulting in dizziness and contralateral limb weakness for 10 h due to prolonged temporary clamping of the responsible ICA. The follow-up angiography results were satisfactory at 18 months post-embolization. Conclusion: OSAS endovascular treatment with balloon-assisted coils has different advantages in a different classification. The technique is safe, effective, and relatively inexpensive, especially for small and medium OSAS.

Embolization of Ruptured Distal Lenticulostriate Artery Aneurysms.

OBJECTIVE: To describe the critical role of endovascular treatment and safety for the patients who presented with intraventricular hemorrhage owing to rupture of the distal lenticulostriate artery aneurysms. METHODS: Three patients who underwent endovascular treatment for distal lenticulostriate artery aneurysms related to intraventricular hemorrhage were selected and retrospectively reviewed. RESULTS: Patients were treated successfully using endovascular embolization without any complications. CONCLUSIONS: Endovascular therapy is available and safe as a treatment option for distal lateral lenticulostriate artery aneurysms.

Balloon-assisted coil embolization for ruptured wide-necked posterior communicating aneurysms in elderly patients / 中华神经医学杂志

Objective To explore the role of balloon-assisted coil embolization for ruptured wide-necked posterior communicating aneurysms in elderly patients. Methods Twenty-nine elderly patients with ruptured wide-necked posterior communicating aneurysms, admitted to and accepted balloon-assisted coil embolization in our hospital from September 2016 to December 2017, were chosen in our study. Eighteen patients had 0-2 of modified Rankin scale (mRS) scores on admission, 7 had 3 scores, and 4 had 4 scores. Twenty-one patients had Hunt-Hess grading I-II, and 8 had Hunt-Hess grading III-IV. Clinical data and treatment efficacy of the patients were retrospectively analyzed. Results Twenty-eight aneurysms were embolized successfully by balloon-assisted coil technique; one aneurysm due to unstable coil frame was treated by stent remolding. Raymond grading 1 was noted in 25 aneurysms and Raymond grading 2 in 4 aneurysms according to immediate post-embolization angiographic results. The mRS scores were 0-2 in 24 patients, 3 in 2 patients and 4 in one patient. Two patients died from systemic diseases (acute pneumonia with diabetic ketoacidosis and heart stroke). Three patients had complications associated with operation, including one with intraoperative aneurysmal rupture, one with laterality limb weakness, and one with contralateral limb paralysis; all recovered after treatment. Conclusion The balloon-assisted coil embolization is safe and effective for coil embolization for ruptured wide-necked posterior communicating aneurysms in elderly patients.

Effect of different treadmill training on cognitive function and TGF-β1 expression in rats / 中华行为医学与脑科学杂志

Objective To observe the effects of different modes treadmill training on cognitive func-tion and transforming growth factor β1 ( TGF-β1 ) expression in cerebral cortex of rats. Methods Two months old rats were divided into the control group,piecewise training group and intermittent training group ( n=10 in each group) . The training was performed five times a week for 6 weeks. Learning and memory a-bility of all rats was detected by water maze at 6 weeks after the training. TGF-β1 expression and localization in cerebral cortex was tested by QRT-PCR and immunofluorescence, respectively. Results The platform time in piecewise group ((30±28) s) and intermittent group ((25±23)s) was both significantly shorter than that in control group ((58±50)s). In the space exploration,the time around Ⅳ quadrant platform in piecewise group((23.6±3.9)s) and intermittent group ((24.3±8.9)s) was significantly higher than that in the control group((17.7±2.0)s). The expression of TGF-β1 mRNA in cerebral cortex in intermittent group (0.0067±0.0043)was obviously higher than that in piecewise group (0.0035±0.0006) and control group (0.0041±0.001). TGF-β1 was located in cell membrane and cytoplasm,and the relative optical density of intermittent group (0.0045±0.0017) was significantly higher than that of control group (0.0019±0.0004) and staging group (0.00175±0.00045). Conclusion (1)Learning and memory function both were im-proved after treadmill six weeks with piecewise and intermittent training models. ( 2) The level of TGF-β1 gene and protein was significantly increased after interval training in cortex of rats.

Clinical analysis of combined direct and indirect extracranial-intracranial bypass in 25 adult patients with Moyamoya disease / 中国神经精神疾病杂志

[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.

The designing and clinical application of score table and focus nursing sheet in brain trauma diseases / 中国实用护理杂志

Objective By the designing and clinical application of score table and focus nursing sheet to brain trauma patients,paramedics can observe state of illness individually,optimize the nursing care in a further performance,and ensure the security of brain trauma patients more profitably.Methods To design the score table and focus nursing sheet according to the disease species and symptoms,contrast to the previous nurse observing table in noting time,error rate,exam results and surgeon satisfaction degree.Results By evaluating 130 cases in this test,the score table and focus nursing sheet were superior to the previous nurse observing table.Conclusions With the score table and focus nursing sheet,nurses can observe the illness and note the progress more scientifically and conveniently,the concept of individuation and specialization are worthy of recommending.