Objective To summarize the experiences of microsurgery for treatment of middle cerebral artery aneurysms (MCAA). Methods The clinical data of 35 patients with MCAA treated by microsurgery in General Hospital of PLA from 2004 to 2008 were retrospectively reviewed. Of them there were 20 males and 15 females, aged 18 to 72 years with a mean of 40 years. Of the 35 patients, subarachnoid hemorrhage occurred formerly in 22, intracerebral hemorrhage occurred in 11 and subdural hematoma in one patient. The MCAA located in the middle cerebral artery trunk in 10 patients, at the bifurcation in 20 patients (including one patient with 2 MCAAs), and in the distal segment in 5 patients. MCAA located on the left side in 13 and on right side in 22 patients. There were 7 patients with giant aneurysms, 11 with large aneurysms and 17 with small aneurysms. Microneurosurgery was performed in all cases, and different approaches were taken according to the locations of aneurysms. Superior temporal gyrus approach was conducted in 3 patients with giant intracerebral hematoma. Bypass of superficial temporal artery to middle cerebral artery was performed before occlusion of the afferent artery in one patient with giant aneurysm. Bypass with saphenous vein to middle cerebral artery was performed in another patient with giant aneurysm. Results The giant and large MCAAs consisted of 51.4% of all cases. Excellent outcomes were achieved in 20 patients, no marked change in 12 patients, and post-operative complications were observed in 3 patients. No perioperative death occurred. Conclusions Giant and large aneurysms are more common in middle cerebral artery aneurysms. Proper surgical approaches based on different situations during operation should be considered to achieve satisfactory outcome.

Objective:To investigate the effect of monosialotetrahexosylganglioside sodium treatment on neurological function, inflammatory factor, and blood coagulation function in patients with traumatic brain injury.Methods:The clinical data of 90 patients with traumatic brain injury who received treatment in Taizhou Central Hospital from February 2018 to May 2020 were retrospectively analyzed. These patients were divided into a control group ( n = 46) and an observation group ( n = 44) according to different treatment methods. The control group was given routine symptomatic treatment and the observation group was given monosialotetrahexosylganglioside sodium treatment based on routine symptomatic treatment. Remission rate, inflammatory factor level, the National Institutes of Health Stroke Scale score, Glasgow Outcome Scale score, and coagulation function were compared between the two groups at each time point. Results:At 3 days and 2 weeks post-surgery, neuropeptide Y in the observation group was (121.13 ± 12.68) ng/L and (68.52 ± 10.21) ng/L, tumor necrosis factor α was (96.15 ± 8.16) ng/L and (46.68 ± 5.95) ng/L, interleukin-6 was (231.26 ± 9.41) ng/L and (126.74 ± 12.23) ng/L, C-reactive protein was (47.52 ± 4.32) μg/L and (18.65 ± 1.32) μg/L, the National Institutes of Health Stroke Scale score was (20.12 ± 2.22) points and (17.67 ± 1.31) points. They were significantly lower than those in the control group [neuropeptide Y: (135.69 ± 15.42) ng/L, (79.36 ± 11.15) ng/L; tumor necrosis factor-α: (108.56 ± 10.13) ng/L, (69.33 ± 6.42) ng/L; interleukin-6: (264.13 ± 10.24) ng/L and (157.89 ± 12.13) ng/L; C-reactive protein: (65.19 ± 5.17) μg/L and (24.39 ± 3.45) μg/L; the National Institutes of Health Stroke Scale score: (24.56 ± 2.54) points and (20.39 ± 2.55) points] ( t3 days post-surgery = 4.88, 6.38, 15.83, 17.55, 8.81; t2 weeks post-surgery= 4.80, 17.33, 12.12, 10.33, 6.32, all P < 0.001). At 3 days and 2 weeks post-surgery, the Glasgow Outcome Scale score in the observation group was (3.65 ± 0.35) points and (4.65 ± 0.26) points, respectively, which was significantly higher than (3.15 ± 0.10) points and (4.11 ± 0.11) points in the control group ( t = 9.30, 12.93, both P < 0.05). At 3 days and 2 weeks post-surgery, fibrinogen in the observation group was (4.52 ± 0.39) g/L and (3.12 ± 0.10) g/L, thrombin time was (18.46 ± 2.95) seconds and (21.79 ± 2.45) seconds, prothrombin time was (12.42 ± 1.33) seconds and (15.79 ± 2.36) seconds, activated partial thromboplastin time was (34.59 ± 2.64) seconds and (38.98 ± 2.78) seconds, which were significantly superior to those in the control group [fibrinogen: (5.02 ± 0.13) g/L and (4.29 ± 0.16) g/L; thrombin time: (17.36 ± 1.56) seconds and (19.63 ± 1.62) seconds; prothrombin time: (10.69 ± 1.21) seconds and (13.26 ± 1.78) seconds; activated partial thromboplastin time: (32.16 ± 2.59) seconds and (35.69 ± 2.91) seconds] ( t3 days post-surgery = 8.23, 2.22, 6.46, 4.40; t2 weeks post-surgery = 41.38, 4.95, 5.75, 5.48, all P < 0.001). At 1 and 2 weeks post-surgery, the remission rate in the observation group was significantly higher than that in the control group ( χ2 = 4.75, 4.44, both P < 0.05). Conclusion:Monosialotetrahexosylganglioside sodium treatment for a traumatic brain injury can inhibit inflammatory reactions, improve blood coagulation and protect brain tissue.