Intracranial aneurysms are a severe cerebrovascular disease.Its incidences ranged from 2% to 4% in general population.With the population aging and the development of imaging technique,the prevalence of intracranial aneurysm is increasing year by year.The research of natural course of aneurysm has important significance for neurosurgeons to evaluate the validity of therapeutic measures.There are significant differences between the patients with aneurysm who have had subarachnoid hemorrhage and those who have not.The rates of ruptured intracranial aneurysms per year ranged from 0.066% to 2%.The risk factors that affect ruptured intracranial aneurysms including the size and place of aneurysm,whether it is multiple aneurysms or not,growth rate,and self-factors of patients,such as age,sex,and history of hypertension and smoking,etc.

Objective To investigate the therapeutic efficacy and side effect of regional blockade using diprospan combined with oxycodone and acetaminophen taking orally which called balanced analgesia on severe tension-type headache. Methods 32 patients diagnosed as severe tension-type headache were treated with regional blockade using diprospan mixed with 0.4% lidocaine, combined with oxycodone and acetaminophen. The severity of pain (using numeric rating scales, NRS) and the duration of headache were observed and the side effects were recorded. Results There was a significant decrease in the severity of pain and the duration of headache after treatment compared with those before (P<0.01). No serious side effects were observed. Conclusion The balanced analgesia therapy mainly including regional blockade and oxycodone and acetaminophen can be significantly effective on the severe tension-type headache.

BACKGROUND: Disoprofol has anti-apoptosis impact so that it can protect the neurons from damage caused by ischemia. However, it needs further study on the mechanism of anti-apoptosis of it. OBJECTIVE: To investigate the effects of disoprofol to cell apoptosis and expression of apoptosis-associated gene in rats during reperfusion after global ischemia.DESIGN: A randomized controlled trial.SETTING: Department of Neurosurgery of Beijing Tiantan Hospital.MATERIALS: The experiment was conducted in Beijing Neurological Surgery Research Institute of Capital University of Medical Sciences during January 2003 to January 2004. A total of 23 adult male Wistar rats were randomly divided into ischemic group( n =9), disoprofol group( n =9) and sham operation group( n = 5).INTERVENTIONS: To prepare global ischemia-reperfusion model of rats. Disoprofol was injected into vein with dose of 1.5 mL/hour after reperfusion started in disoprofol group and lasted for 30 minutes. Five rats were selected from each group to be removed brain after reperfusion for 24 hours. Apoptosis rate and necrosis rate were detected by flow cytometer. Four rats selected from ischemic and disoprofol group were detected differential expression of apoptosis associated genes by gene chip combining image analysis techniques.MAIN OUTCOME MEASURES: ① apoptosis rate and necrosis rate; ②expression of apoptosis-associated gene detected by gene chip.RESULTS: The apoptosis rate[(7.01 ±0.79)% ] and necrosis rate[ ( 12. 80 ± 0. 92) % ] of neurons of hippocampus in disoprofol group were much lower than those of ischemic group [ (10. 89 ± 0. 80)%, (16. 67 ± 1.04)% ](P ＜ 0.01) . Compared with ischemic group, the three apoptosis associated genes including apoptotic prote ase activating factor 1 (APAF1), death effector domain containing testicular molecular mRNA(DEFT) and STM-2 were down regulated.CONCLUSION: Disoprofol can protect the brain and its mechanism might be related to the down regulation of three apoptosis associated genes including APAF1, DEFT and STM-2.

This study was made in order to esablish the method of the stature estimation of Chinese fe- males by measurement of the lumbar vertebrae.10 measurements for 37 lumbar vertebrae form Chinese fe- males of known age and stature were measured by the anthropometry.The analysis of the correlation be- tween the measurement results and the stature as well as the regression equations were made with the SPSS soft wear.The regression equations for the stature estimation of the Chinese females were as followsL1-5. L_1:Y= 592.010+0.161X_1+16.596X_2+13.922X_4+3.428X_5;r=0.751;s=45.0171.L_2:Y=641.280+19.733X_2- 0.420X_5+9.981X_6;r=0.698;s=48.2804.L_3:Y=516.200+26.079X_2+8.081X_6;r=0.758;s=43.3508.L_4:Y =1071.436+11.1133X_5;r=0.497;s=56.0890.L_5:Y=1111.890+4.17820X_5+10.335X_9;r=0.606;s= 53.3158.The regression equations can be used for the stature estimation of Chinese females.

Objective To study the characteristics of Ag NORs in the peripheral blood T lymphocytes (PBL) of patients with intracranial tumors. Methods Ag NORs in PBL was detected by a cell image analysis of KL 2 in 40 normal volunteers and 79 patients(intracranial benign tumor group, 27 patients;intracranial malignant tumor group, 20; other malignant tumors group, 32). Results Ag NORs in the intracranial benign tumor group was (6.42%?0.16)%, lower than (7.87%?0.10)% in the normal group that ( P

Objective Moyamoya disease is a progressive cerebrovascular occlusive disease. The etiology of the disease is unknown. most think that Moyamoya usually presents with cerebral ischemia in children and intracranial hemorrhage in adults. But we have some adults present with cerebral ischemia .This article will help us know better about moyamoya disease in adults present with cerebral ischemia. And will let us know better about treatment and prognosis of this disease.Methods We reviewed our experience 88 adults angiographically diagnosed patients with moyamoya. There are 49 patients with moyamoya disease initially present with cerebral ischemia. We report their clinical presentation, radiological findings, management, and clinical outcomes. Results The incidence of moyamoya disease presents with cerebral ischemia is 55.7% in adults .The mean age of patients at symptom onset was 32 years (range, 18~64 years). Ischemic strokes or transient ischemic attacks were the predominant initial presentations.7 cases present intracranial haemorrhage in follow-up period. There was no difference in clinical representation, image and cerebral infarction in this 7 case.Conclusions Moyamoya usually presents with cerebral ischemia in adults higher than we think. diagnosis and treatment of moyamoya disease in adults is essential to minimize residual mental and physiologic deficits. If we find patients 30-40 years old ,with cerebral infarction that can’t explain in conventional mode, we should pursuit these patients, in order to exclude Moyamoya disease .Structured multicenter randomized clinical trials are needed to further assess the best treatment modalities for patients with moyamoya.

ObjectiveTo investigate the changes of ultrastructure of global cerebral ischemia and reperfusion damage in rats.MethodsSix adult male Wistar rats were randomly divided into the ischemia group (n=3), and sham injury group (n=3). Global cerebral ischemia and reperfusion model were established with Pulsinelli's method. Cortical ultrastructure changes were investigated on the first hour after reperfusion.ResultsIn the ischemia group, different degrees of pyconosis neurons, abnormal organell and microtube of neurons were observed. In addition, glial cell and microvessels were damaged in ischemia group, but that in sham injury group were not demaged.ConclusionCortical neurons, neuroglia cells, cytoskeleton and blood-brain barrier changed at early stage of reperfusion damage.

Objective To investigate the effect of radiofrequency on trigeminal neuralgia as the chief complaint of intracranial benign tumor. Methods 18 patients with intracranial benign tumor mainly presenting with trigeminal neuralgia were treated with radiofrequency thermocoagulation guided by CT scanning. The numeric rating scales (NRS) of pain and the complication were observed. Results The scores of NRS decreased significantly after treatment (P<0.01). The common complications included facial numbness and masticatory movement obstacle. One patient recurred 13 months and another patient recurred 24 months after operation. Both were treated with radiofrequency once again, and the pain ceased. Conclusion Radiofrequency is effective on secondary trigeminal neuralgia after intracranial benign tumor.

Objective To explore the effect of the combined therapy on tension-type headache after acute brain trauma.Methods Fourteen patients with mild brain trauma and complained severe headache diagnosed as tension-type headache were treated by nerve and pain points block with a mixture of 0.4% lidocaine, triamcinolone acetonide 10 mg accompanied by celecoxib and eperisone. After the block, the degree of pain severity and the duration of headache were observed and recorded. The therapeutic effects were evaluated with visual analogue scale (VAS).Results There was a significant decrease in the degree of pain severity and the duration of headache after treatment ( P<0.01).Conclusion The combined therapy mainly including nerve block has a significant effect on tension-type headache after acute brain trauma.

Objective To analyse the therapeutic effect and safety of radiofrequency thermocoagulation on refractory neuralgia after craniotomy.MethodsFourteen patients with refractory neuralgia after craniotomy were treated by radiofrequency thermocoagulation. The pain degree (Numeric Rating Scales, NRS) and the complication were observed.ResultsNRS decreased significantly after treatment(P<0.01). No serious complication was observed after radiofrequency thermocoagulation except numbness. No patients recurred after one year follow-up.ConclusionRadiofrequency thermocoagulation is effective on refractory neuralgia after craniotomy.