Aim To evaluate the efficacy and safety of different routes for vinpocetine injection by intravenous or trans-angiographic catheter on cerebral vasospasm(CVS).Methods A total of 105 aneurysmal subarachnoid hemorrhage(aSAH)patients with CVS following intracranial aneurysm embolization were chosen and randomly divided into group C, B and A, with 35 cases in each group.Patients in group C were treated with 3H therapeutic regimen, while those in group B and A were with 3H therapeutic regimen plus vinpocetine by intravenous injection or trans-angiographic catheter, respectively.The index including middle cerebral artery(MCA) blood flow velocity, National Institutes of Health stroke scale(NIHSS) score, Glasgow outcome scale(GOS) grading, clinical efficacy, hypotension rate and rehaemorrhagia rate were detected and compared among three groups.Results After the 7 d and 14 d treatment, the MCA blood flow velocity of group A and B was observed to be significantly lower than that of group C(P<0.05), and the MCA blood flow velocity of group A was significantly lower than that of group B(P<0.05).The NIHSS score of group A and B was significantly lower than that of group A(P<0.05), and the score of group A was significantly lower than that of group B(P<0.05) following 28 d treatment.Moreover,the clinical efficacy of group A and B was significantly higher than that of group C(P<0.05), and the clinical efficacy of group A was significantly higher than that of group B(P<0.05).After the 28 d treatment, the hypotension rate of group B was found to be significantly higher than that of group C and A(P<0.05), while there was no statistical difference(P>0.05) observed in the hypotension rate between group A and C.Also, there was no statistical difference(P>0.05)found in the rehaemorrhagia rate among three groups.However, the GOS grading of group A and B was significantly better than that of group C(P<0.05), and the grading of group A was significantly better than that of group B(P<0.05)after 3 months treatment.Conclusions Using vinpocetine by intravascular injection or by trans-angiographic catheter could be the efficient treatment for the CVS after intracranial aneurysm embolization, and vinpocetine injection by trans-angiographic catheter is the better mode of administration with the consideration of efficacy and safety.

Migraine is a common primary headache. At present, the rhythm of migraine attacks has been observed in some patients, but its concrete form and mechanism have not been reached a consensus. This paper reviews the research progress of migraine biological rhythm (circadian rhythm and seasonal rhythm), and expounds the distribution of attack rhythm time, the relationship with clinical characteristics and the mechanism of producing rhythm. It provides scientific basis for mastering the attack law of migraine patients, finding individualized preventive treatment time and improving the effectiveness and compliance of treatment.

Objective To explore the surgical treatment of epilepsy in rolandic and immediate perirolan dic cortex.Methods 376 patients accepted surgical treatment in our hospital from January 2010 to January 2016,of whom 48 patients fulfilled eligibility criteria and were included in the study.Patients were divided into 2 groups for analysis:patients with resections in the rolandic cortex (A group,n =28),and patients with resections in immediate perirolandic cortex and simultaneous sensorimotor multiple subpial transections (B group,n =20).Postoperative seizure outcome and neurologic deficits were analyzed.Results According to classification of Engel,Engel Ⅰ was in 22 (45.8％),Engel Ⅱ in 7 (14.6％),Engel Ⅲ in 10 (20.8％) and Engel Ⅳ in 9(18.8％).Seizure outcome satisfaction rate (Engel Ⅰ +Engel Ⅱ) in the group A was significantly higher than the group B (P =0.036);temporary and transient neurological deficits in the two groups had no statistically significant (P =0.569,P =0.418).Conclusions It is possible to achieve complete dissection of epileptic foci in rolandic and immediate perirolandic cortex without damage.The good prognosis is not related to the degree of excision of epilepsy and has no definite correlation with neurological dysfunction.

Objective To explore the surgical efficacy of meningioma patients with epilepsy as the main symptoms. Methods A retrospective analysis of 124 meningioma patients with epilepsy as the main symptoms between January 2010 and January 2016,follow-up effect of epilepsy control. Results There were 94 cases of Simpson I orⅡgrade resection,27 cases of gradeⅢresection and 3 cases of grade Ⅳ resection. The surgical out-comes of patients were evaluated based on Engel′s classification. There were 98 cases(79.0%)of EngelⅠgrade, 11 cases(8.9%)of EngelⅡgrade,Engel Ⅲ and Ⅳ grade were 12 cases(9.7%)and 3 cases(2.4%). Among them,87 of 94 patients with Simpson I orⅡ grade resection epilepsy were well controlled,the satisfaction rate of epilepsy control was 92.6%. Conclusions Epilepsy as the main symptoms of meningioma patients need to clear about the seizure onset area preoperative,need to pay special attention to whether there is an independent epilepsy starting area of the distant site of the tumor. On the basis of the tumor resection as much as possible,at the same time dealing with the abnormal release of the cortex can effectively improve the efficacy of postoperative epilepsy control.