Ceramics ; Esthetics, Dental ; Humans

Cerebral vasospasm is the main reasons of cerebral infarction and delayed ischemic neurological deficit in patients with spontaneous subarachnoid hemorrhage. At present, the research of cerebral vasospasm is relatively focused on the spasmogens in bloody cerebro-spinal fluid. This article reviews the mechanisms of cerebral vasospasm induced by the major spasmogens in the bloody cerebrospinal fluid after subarachnoid hemorrhage.

The annual Live Interventional Neuroradiology & Neurosurgery Course(LINNC) is one of the most important congresses in the neurosurgery and neuroradiology field.LINNC 2009 was held on May 25th this year and lasted for 3 days.In this article, the authors introduced the main points of the congress.The congress mainly discussed some hot topics at present time, including both the clinical and fundamental studies of cerebral arteriovenous malformation, ischemic cerebral disease and intracranial aneurysm, etc.Both neurological and neuroradiological case demonstrations related to the topics, and the main course of the congress were alternately performed.Recent advances in imaging technique and clinical application, such as Dyna-CT and Xper-CT, were also presented on the congress.

Objective To study the mechanism of CKLF1-plasmid transfer on the myocardial repair in rat AMI models.Methods Eighteen male SD rats were randomly divided into 3 groups and in each separate group,the rats were injected intramuscalary with plasmid DNA encoding CKLF1 gene(n=6),emptyplasmid(n=6)and saline(n=6)with in vivo electroporation respectively.Rats were subjected to left coronary artery ligation on the 6th day after gene transfer and were killed on the 21st day.The expressions of BrdU/?-actin,Ki67/?-actin were assessed by immunohistochemistry.Results BrdU-positive cells in CKLF1 group were more than those in the saline group and the empty plasmid group(cells/HP)(33.11?2.10 vs.14.16?1.63 & 18.46?2.77,P0.05).Conclusion Intramuscular injection with in vivo electroporation of CKLF1 may cause an enhanced myocardial proliferation of acute myocardial infarction tissue in experimental rat.

Objective Hyperperfusion syndrome is a rare and devastating complication of carotid artery angioplasty and stenting(CAS).We report the clinical character of this complication in a patient undergoing CAS.Methods This report is a retrospective review of one case with severe extracranial carotid stenosis of carotid angioplasty and stenting performed on March,2004.We analysesed the clinical and imagining character of this hyperperfusion syndrome related to CAS. Results The patient with subtotal occlusion of the right internal carotid artery had a 10-mm lesion treated percutaneously with implantation of 2 stents (Precise 6?30mm、10?40mm) under general anesthesia.The stenosis was postdilated with a 5?20mm balloon. Postprocedural angiography showed no significant stenosis, the blood pressure varied between 230～300/100～130mmHg,the heart rate decreased to 55/min. An urgent brain CT revealed extensive hemorrhage with 80ml in the right basal ganglia. Surgical evacuation was performed urgently under general anesthesia.After operation the patient presented with vegetative status.Conclusions Intracerebral hemorrhage is related to cerebral hyperperfusion after CAS.One of risk factors for hyperperfusion syndrome is of severe ipsilateral stenosis of 90% severity or greater with collateral carotid stenosis. Peri-and postintervention TCD monitoring is mandantory, TCD can be identified patients at risk of cerebral hyperperfusion,to decrease postintervention hemorrhage.

50% was in 72.1% of patients and

Objective We analyzed the incidence and treatment of symptomatic vasospasm after early endovascular therapy of ruptured aneurysms by endovascular embolization.Methods 329 patients classified as Hunt-Hess grades Ⅰto Ⅲ were embolized within 72 hours after aneurysm rupture. Symptomatic vasospasm was diagnosed as the onset of delayed neurological deterioration with evidence of angiographic or transcranial Doppler studies. Results Symptomatic vasospasm occurred in 62 patients (18.2%). Both Hunt-Hess grade and Fisher's scale before treatment correlated with the incidence of cerebral vasospasm. Among the 62 patients suffered from symptomatic vasospasm, 41 patients recovered well, 13 were moderately disabled, 6 were severely disabled and 2 patients died. Conclusions The incidence of symptomatic vasospasm was relatively low as compared to conventional open surgery. lumber puncture cerebral spinal fluid drainage may play an important role in reducing the incidence of cerebral vasospasm.

Objective Endovascular stenting or combined stenting and Guglielmi detachable coils packing for the treatment of intracranial fusiform and wide necked aneurysms were reported to access the feasibility of the procedures.Methods The coronary stents were implanted across the neck of 3 vertebral fusiform aneurysms and 6 wide necked aneurysms. Microcatheters were introduced into the aneurysm sacs through stent mesh, and finally GDCs were used to embolize the aneurysms. Results The stents were precisely deployed resulting in total occlusion of 7 cases with more than 90% occlusion in 2 cases. All patients recovered well with patency of the parent arteries.Conclusions Endovascular therapy with combined stent implantation and microcoil placement maybe a valid alteration for the treatment of intracranial fusiform or wide necked aneurysms.

Objective To analyze the causes, prevention and treatment of repture druing procedure for intracranial aneurysm embolization with GDC.Methods All the seven patients were embolized. Six patients were ruptured during the procedure and continuously embolized until the bleeding was halted. Another one was identified by post procedure CT. Results Four patients recovered unevent fully with one only suffering from mild deficit. Another 2 patients died of hyper intracranial pressure within one week. Conclusions Rupture during procedure of intracranial aneurysm embolization with GDC may be related to manipulation, properties of the parent artery and arneurysm. Continuous embolization with GDC will provide favorable prognosis for the patients.