Objective To discuss the application effect of LVIS stent-assisted coil embolization in intracranial wide-neck small aneurysms.Methods The clinical data of 32 patients with intracranial wide-neck small aneurysms treated with stent-assisted coil embolization were analyzed retrospectively and evaluated.Results In 32 cases,the embolization grade was Raymond Ⅰ in 23 cases,Raymond grade Ⅱ in 7 cases,and Raymond Ⅲ in 2 cases.The successful embolization rate was 93.8%.No aneurysm was ruptured during embolization.One patient had thrombotic event in the surgery,but the occluded artery was recanalized after the treatment of immediate thrombolysis.Disorder of contralateral limb's activity and confusion were appeared in two patients after surgery.The symptoms improved by giving clopidogrel,aspirin and increasing the dosage of nimodipine.All the survival patients recovered well after 6 months of follow-up.No recurrence of aneurysm was confirmed by DSA and parent artery was patent.Conclusion Lvis stent is simple to be operated and has various models,suitable for most intracranial aneurysms,showing good performance.It suits embolization therapy in intracranial wide-neck small aneurysms,but the strong thrombosis should be valued.

Objective To discuss the application of early time window modified stereotaxic aspiration in converting operation therapy on the specified acute epidural hematoma.Methods 21 patients with the specified acute epidural hematoma were treated with early time window modified stereotaxic aspiration drainage,using YL-1 hematoma puncture needle with silica gel ventricular drainage tube.Results The successful rate of puncture was 100％.Hematoma was completely cleared in 19 cases.A small amount of epidural effusion was remained in 2 cases.1 case had concomitant rebleeding during the puncture,and shifted to craniotomy.Conclusion Early time window modified stereotaxic aspiration drainage is a minimally invasive,safe and effective treatment on the specified acute epidural hematoma when mastering the indications,timing and skills of puncture.

Objective To compare the differences of hospital stays,hospitalization costs and effectiveness via keyhole hematoma debridement (KHED) and internal medicine conservative treatment (IMCT) in treating 30-40 mL hypertensive intracerebral hemorrhage.Methods Fifty-eight patients with hypertensive intracerebral hemorrhage whose bleeding was 30-40 mL,admitted to our hospital from January 2014 to September 2015,were chosen in our study;according to the will of the patients and their family members,the patients were divided into KHED group (n=31) and IMCT group (n=27).The differences of hospital stays,hospitalization costs,neurological dysfunction rate at hospital and three months after discharge,and recovery results were compared between the two groups.Results The average hospital stays of KHED group were (7.4±2.3) d and those of IMCT group were (14.5±5.1) d,with significant difference (P=0.012);the hospitalization costs for the two groups were (36 296.28±5292.12)yuan,and (41 769.48±6342.83) yuan,with significant difference (P=0.027).Glasgow outcome scale of KHED group at discharge indicated 29 patients with good recovery and 2 with poor recovery;that of IMCT group indicated 20 with good recovery and 7 with poor recovery,including two with cerebral edema accepted craniotomy operation in second time.Follow-up for three months showed that the KHED group had basic activities of daily living in 16 patients,mild hemiplegia in 11 and severe hemiplegia in 4,and IMCT group had basic activities of daily living in 9 patietns,mild hemiplegia in 13 and severe hemiplegia in 5;significant differences were noted between the two groups (Z=2.499,P=0.001).Conclusion KHED in treatment of 30-40 mL hypertensive intracerebral hemorrhage can shorten hospitalization time,reduce cost,have better prognosis and better short-term and long-term effectiveness than IMCT.