Objective To investigate the relationship between the serum concentration of neuron-specific enolase (NSE) and the brain damage severity and the prognosis of acute head injuried patients. Methods Early serum levels of NSE were measured in 70 patients with acute head injury by radioimmunoassay. The concentration of NSE was analysed by combining with GCS and GOS systems. Results NSE levels in serum of patients with major(a), minor(b) head injuries and control individuals(c) were (25 78 ? 10 80)ng/ml, (19 58 ? 8 91)ng/ml and (9 51 ? 2 79)ng/ml respectively, differences of which were significant (P a-b

Objective:To study the effects of combination of parenteral and enteral nutrition in sequence on prognosis of severe craniocerebral injury of geriatric patient.Methods:The method and effects of nutrition support have been studied in 84 cases of severe craniocerebral injury of geriatric patient.The patients of study group were fed by parenteral and enteral nutrition in sequence in early period,and the patients of the control group were nutritionally supported with common method for 6-7 days.Results:Nitrogen cumultive balances,nutitional index of the study group were signficantly better than that of the control group(P

OBJECTIVE: To determine the role of 3-dimensional computed tomograph angiography (3D-CTA) and neuroendoscope in intracranial aneurysm, and to analyze its benefits. METHODS: A total of 38 patients with intracranial aneurysm were confirmed by operation. All the patients were examined by 3D-CTA before the operation and surgical simulation was conducted to ensure the location of aneurysm and its relationship with parent aneurysm artery. Endoscopy was used as an adjunct before and after the microsurgical treatment to observe the neck anatomic features and perforating branches and to verify the optimal clipping position. RESULTS: Pre-operative 3D-CTA clearly displayed the aneurysm and their relation with the parent aneurysm artery, the aneurysm, the periphery vessel, and bony structures, according to demonstration during the operation. Endoscope clearly showed the anatomy around aneurysm, especially the perforating branches. Postoperative 3D-CTA showed satisfactory aneurysm clipping. CONCLUSION Simulation surgery of 3D-CTA is helpful in finding and exposing aneurysm. Neuroendoscope is very useful for protecting deep blood vessels. Combination of the two can increase the operation success ratio and reduce postoperative complications.
Adult ; Aged ; Cerebral Angiography ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; Intracranial Aneurysm ; surgery ; Male ; Microsurgery ; methods ; Middle Aged ; Neuroendoscopy ; methods ; Neurosurgical Procedures ; methods ; Radiographic Image Interpretation, Computer-Assisted ; Surgery, Computer-Assisted ; Tomography, Spiral Computed ; methods

OBJECTIVETo evaluate the effect of aneurysm clipping and partial blood clot removal in the subarachnoid space on hemorrhage volume in the subarachnoid space and cerebral vasospasm in patients with different Fisher grades.

METHODSPatients with subarachnoid space hemorrhage (SAH) of Fisher Grades I, II, and III were subdivided into control and treatment groups for comparative studies. The patients with unruptured intracranial aneurysms (UIAs) undergoing aneurysm clipping were also compared with Fisher grade I control subgroup. OxyHb levels in the cerebrospinal fluid and cerebral blood flow volume (CBFV) of the middle cerebral artery (MCA) were measured on days 3, 7, and 13 day after SAH.

RESULTSThe patients with UIAs and Fisher Grade I control subgroup showed significant differences in OxyHb levels on day 3 in CBFV of the MCA on days 3 and 7 (P<0.05). In the SAH groups, OxyHb levels increased significantly on day 3 day in the treatment subgroups of Fisher Grades I and II, but declined significantly on days 7 and 13 in Fisher Grade III treatment subgroup as compared with the corresponding control subgroups (P<0.05); in Fisher Grade I group on days 3 and 7 and in Fisher Grade II group on day 7, CBFV of the MCA increased significantly in the treatment subgroups, but in Fisher Grade III group, CBFV decreased significantly on days 7 and 13 compared with the control subgroup (P<0.05). A positive correlation was found between OxyHb levels in the cerebrospinal fluid and CBFV of the MCA (P<0.05).

CONCLUSIONFor patients with Fisher Grades I and II aneurysms, craniotomy may increase hemorrhage volume in the subarachnoid space and exacerbate cerebral vasospasm, but for Grade III patients, aneurysm clipping and blood clot removal shows beneficial effects in terms of reducing hemorrhage volume and relieving cerebral vasospasm.

Aged ; Aneurysm, Ruptured ; surgery ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Middle Aged ; Subarachnoid Hemorrhage ; cerebrospinal fluid ; surgery ; Vasospasm, Intracranial ; surgery

OBJECTIVETo study the role of transforming growth factor-β1 (TGF-β1) levels and other risk factors in the occurrence of chronic hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH).

METHODSPatients treated for aSAH in our hospital between January, 2007 and June, 2012 were divided into non-hydrocephalus group and hydrocephalus group. TGF-β1 levels in the cerebrospinal fluid (CSF) were compared between the two groups at different time points. A retrospective analysis was conducted to identify the potential risk factors for chronic hydrocephalus, which were subsequently confirmed by Logistic regression analysis.

RESULTSOf the 129 patients enrolled, 16 (12.4%) developed chronic hydrocephalic with an average diagnosis time of 31.6∓17.0 days. In patients with chronic hydrocephalus, TGF-β1 level in the CSF increased significantly on the 13th day following aSAH (P<0.05). Retrospective analysis showed that the patients with hydrocephalus and those without had significant differences in history of hypertension, times of SAH, Hunt-Hess classification, ventricular expansion, aneurysm position, Fisher classification, ventricular hemorrhage score and intracranial infections (P<0.05). Logistic regression analysis identified ventricular expansion, aneurysm position, Fisher classification, ventricular hemorrhage score and postoperative intracranial infections as significant risk factors for the occurrence of chronic hydrocephalus (P<0.05).

CONCLUSIONSIn adult patients with aSAH, the risk factors for chronic hydrocephalus include ventricular expansion, aneurysm position, Fisher classification, ventricular hemorrhage score and postoperative intracranial infections. These risk factors can have greater clinical value than TGF-β1 levels in the CSF in predicting the occurrence of chronic hydrocephalus following aSAH.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hydrocephalus ; etiology ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage ; cerebrospinal fluid ; complications ; Transforming Growth Factor beta1 ; cerebrospinal fluid

OBJECTIVETo investigate the protective effect of Apelin-13 on focal cerebral ischemia-reperfusion injury in rats.

METHODSFocal transient cerebral ischemia-reperfusion injury was induced in male SD rats using modified suture occlusion technique. The rats were randomly divided into 5 groups: Sham group, Model group, Apelin-low dose (A) group, Apelin-middle dose (B) group and Apelin-high dose (C) group. Apelin-13 was injected into lateral cerebral ventricle, and the neurological function score, brain edema, infarct volume, apoptosis, malondialdehyde (MDA), superoxide dismutase (SOD) and extracellular regulated kinase1/2 (ERK1/2) protein were measured.

RESULTSNeurological function scores, percentage of brain water content, infarct volumes and TUNEL-positive cells in B and C groups were lower than those in Model group (P<0.05). The level of MDA in the tissue bomogenate of brain tissue in the surrounding area of ischemia of B and C groups was lower than that of Model group, while the activity of SOD was higher (P<0.05). There was no significant difference in ERK1/2 protein expression among the groups (P>0.05). P-ERK1/2 increased in Model group and A, B, and C groups compared with Sham group (P<0.05), and that of A, B, and C group was higher than that of Model group (P<0.05).

CONCLUSIONApelin-13 may play an important role by inhibiting oxidative stress to protect against focal cerebral ischemia-reperfusion injury; ERK1/2 signaling pathway may be involved in the protective mechanism of Apelin-13.

Animals ; Apoptosis ; Brain Edema ; Brain Ischemia ; drug therapy ; Intercellular Signaling Peptides and Proteins ; pharmacology ; Male ; Malondialdehyde ; metabolism ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; drug therapy ; Signal Transduction ; Superoxide Dismutase ; metabolism