Objective:To investigate the effect of transcranial clipping in the treatment of intracranial aneurysms and its influence on hemodynamics, neuron specific enolase(NSE) and S100B expression.Methods:A retrospective analysis was made in 47 patients with intracranial aneurysms who admitted to Taizhou Hospital of Zhejiang Province from January 2017 to June 2019, all patients were treated by transcranial clipping.The hemodynamics, NSE and S100B levels were compared before operation and 1 week after operation.All patients were followed up for 6 months to evaluate the prognosis.Results:All patients completed the operation, the operation time was (2.79±0.43)h, the intraoperative bleeding volume was (243.51±28.73)mL, the incidence of postoperative complications was 6.38%(3/47), and the average hospitalization time was (16.74±1.86)d.One week after operation, the cerebral blood volume [(27.98±3.24)mL/100g] and cerebral blood flow [(2.08±0.34)mL·100g -1·min -1] were higher than those before operation [(23.41±2.36)mL/100g and (1.56±0.27)mL·100g -1·min -1] ( t=7.816, 8.211, all P<0.05). The serum NSE[(15.28±2.18)μg/L] and S100B[(0.83±0.16)μg/L] were lower than those before operation [(26.39±4.25)μg/L and (1.59±0.27)μg/L]( t=15.946, 16.601, all P<0.05). After follow-up for 6 months, 38 cases(80.85%) had a good prognosis. Conclusion:Transcranial clipping is effective in the treatment of intracranial aneurysms, and can improve hemodynamics, reduce the expression of NSE and S100B in serum, and reduce complications.

Venous thromboembolism is a common comorbidity in neurosurgery department that can lead to life-threatening pulmonary embolism, endangering patient health. The unique characteristics of neurosurgical conditions often present a high risk of bleeding, which complicates the treatment of venous thrombosis. Although numerous observational studies and meta-analyses support the feasibility of initiating early anticoagulation prevention or treatment after hemorrhage stabilization in intracranial hemorrhagic conditions such as traumatic brain injury and cerebral hemorrhage, there is a lack of high-quality clinical research. As a result, neurosurgeons tend to adopt a conservative approach regarding pharmacological prophylaxis and anticoagulant treatment for venous thromboembolism. Key aspects such as the timing of prevention, monitoring, and discontinuation of treatment still require high-quality research to establish definitive guidelines.

With the aging population, the burden of diseases such as atrial fibrillation and venous thrombosis is gradually increasing. Anticoagulant therapy has a positive significance in preventing ischemic stroke, pulmonary embolism, and other related conditions in these patients. However, anticoagulant therapy can have the opposite effect on diseases caused by intracranial hemorrhage, such as falls in the elderly, cerebrovascular accidents, and car accidents. It is still difficult to determine whether and when to restart anticoagulation after cerebral hemorrhage. Although most studies have shown that restarting anticoagulant therapy can reduce stroke risk without significantly increasing bleeding risk, they are mostly based on observational studies, so more high-quality research is needed to guide clinical decision-making. This article reviews the research progress on restart anticoagulation, aiming to provide some assistance for clinical applications.

Objective: To study the clinical efficacy of microsurgical clipping treatment for intracranial aneurysm rupture and optimal timing. Methods: From January 2016 to December 2017, 80 patients with intracranial aneurysm rupture in Taizhou Enze Medical Center(Group) Hospital were randomly divided into the control group (24-72h after rupture) and the observation group (within 24h after rupture) according to the digital table, with 40 patients in each group.The pre- and intra-surgical re-rupture and surgical clipping, post-surgical complications, and clinical efficacy of 6-month follow-up in the two groups were observed and compared. Results: Compared with the control group, the incidence rate of pre-surgical re-rupture was significantly reduced in the observation group (0.0% vs.10.0%, χ²=4.21, P<0.05). Compared with the control group, the incidence rate of post-surgical complications was obviously reduced in the observation group (20.0% vs.42.5%, χ²=4.71, P<0.05). Compared with the control group, the excellent rate of treatment was significantly improved in the observation group (87.5% vs.65.0%, χ²=5.59, P<0.05). Conclusion The microsurgical clipping treatment can improve the clinical efficacy of intracranial aneurysm rupture and sooner surgery with better prognosis.