BACKGROUND: Osteophyte caused by degenerative osteoarthropathy of the cervical vertebrae may compress the vertebral artery, resulting in vertebrobasilar insufficiency, especially when the patients' head postures change, making them adapt forced head position.OBJECTIVE: To investigate successively the relationship between the change of flow velocity of the posterior circulation and the symptom of vertebrobasilar insufficiency during various head postures with transcranial Doppler ultrasound.DESIGN: Randomized grouping controlled, auto-control observation.SETTING: Department of Neurology, Guangxi Minzu Hospital and Department of Neurology, First Hospital, Peking University.PARTICIPANTS: A total of 20 patients with vertebrobasilar insufficiency and 10 normal persons were enrolled from Department of Neurology,Guangxi Minzu Hospital between March 2003 and May 2004.METHODS: Regard blood flow velocity in natural position of anterior segment of posterior cerebral artery as baseline values. Blood flow velocity was compared at left rotation, right rotation, anterior inflexion and posterior inflexion. Symptoms of vertebrobasilar insufficiency were observed. The data were collected and compared in individuals, within group, and between groups.MAIN OUTCOME MEASURES: Blood flow velocity difference of various head postures in each group; Symptoms of vertebrobasilar insufficiency were observed.RESULTS:During monitoring, there were 9 cases complained of ischemic symptoms and 11 cases without symptoms. There was no significant difference in blood flow change of left rotation, right rotation and posterior inflexion in the normal control group with natural position. The reduction of flow velocity was significant in anterior inflexion (P ＜ 0.05 ), and none appeared clinical symptom. There was significant difference in reduction of blood flow at anterior inflexion and at natural position in patients with symptom (P ＜ 0.05), and there was significant difference in reduction of blood flow at posterior inflexion and natural position (P ＜ 0.001 ). There was significant difference in reduction of blood flow at left rotation and posterior inflexion in those without symptom during monitoring as compared with that at natural position (P ＜ 0.05 ).CONCLUSION: Continuously observing the blood flow in posterior cerebral artery at different head position can objectively assess the relationship between decrease of blood flow velocity of vertebral arteries induced by neck movements and clinical symptoms.

Objective To study the effects of butylphthalide on homocysteine (Hcy) and C-reactive protein (CRP) levels in patients with acute cerebral infarction.Methods One hundred and ten patients with acute cerebral infarction were divided into control group and treatment group by random digits table,with 55 patients in each group.Two groups were given conventional treatment for 3 weeks,and treatment group was added butylphthalide 200 mg oral application,thrice a day.Two groups were compared in the total effective rate,neurological deficit scores (NDS) and serum Hcy and CRP levels.Results The total effective rate in treatment group was significantly higher than that in control group [ 89.09％ (49/55) vs.61.82％ (34/55),x2 =11.044,P＜ 0.01 ].The NDS in two groups after treatment were significantly decreased than those before treatment [treatment group:( 11.24 ± 3.19) scores vs.(23.19 ± 4.06) scores,control group:( 18.56 ± 4.03 )scores vs. (22.31 ± 4.17) scores,P ＜ 0.01 ],and NDS in treatment group after treatment was significantly lower than that in control group (P＜ 0.01 ).The serum Hcy and CRP levels in two groups after treatment were significantly lower than those before treatment [ treatment group:( 13.12 ± 3.58 ) μ mol/L vs.(27.36 ± 6.84 )μ mol/L,( 10.33 ± 3.10) mg/L vs.( 18.96 ± 5.38) mg/L;control group:( 16.41 ± 4.76) μ mol/L vs.(28.73 ±6.32) μ mol/L,(13.16±4.02) mg/L vs. (19.17 ± 5.74) mg/L,P ＜ 0.01 ],serum Hcy and CRP levels in treatment group after treatment were significantly lower than those in control group (P ＜ 0.01 ).Conclusion Butylphthalide can reduce serum Hcy and CRP levels,reduce inflammation and improve the condition of patients with acute cerebral infarction.