Objective The predictive indexes which affect early neurological deterioration ( END) of patients with acute la-cunar stroke still remain unclear .The purpose of the article was to investigate the correlation between the location and numbers of cere -bral microbleeds (CMBs) and END in patients with first-onset lacunar stroke. Methods 217 patients with acute lacunar stroke hos-pitalized in Anhui Provincial Hospital within 24 hours after occurrence from Mar 2009 to May 2012 were prospectively enrolled .All pa-tients underwent susceptibility-weighted imaging MRI right after admission , followed by the investigation on the relationship of the loca-tion and numbers of CMBs and END . Results END occurred in 76 (35.0%) patients.Among these patients, there were 33 positive cases with CMBs (43.3%).There were no significant difference in END incidence between positive group and negative group (P=0.173).In the comparison of the numbers of CMBs foci , patients with more than 5 foci were more prone to END (P=0.005).Logistic regression analysis showed there was relation between CMBs foci numbers>5 and END (OR=3.14, 95% CI: 1.22 ~8.13), and there was no relation between CMBs foci numbers≤5 and END ( OR=1.12, 95%CI:0.53~2.37)as to CMBs negative patients.No signifi-cant relationship was found in CMBs location and END occurrence ( P>0.05). Conclusion The distribution of CMBs foci has nothing to do with early neurological fluctuation .However , more than 5 CMBs foci might be the independent prediction cause of END .

Objective To investigate the impact of digital subtraction angiography (DSA)-guided neurointerventional thrombus removal combined with intravenous thrombolysis by tirofiban on the rate of recanalization of blood vessels, endothelial function, hemodynamics, and the degree of neurological deficit in patients with acute cerebral infarction. Methods Eighty patients with acute cerebral infarction were selected as study subjects and randomly divided into observation group and control group using the random number table method, with 40 patients in each group. The control group was treated with DSA-guided neurointerventional thrombus removal, and the observation group was treated with intravenous thrombolysis with tirofiban on the basis of the control group. The rates of recanalization of blood vessels, endothelial function index levels, hemodynamic index levels, and the degree of neurological deficit were compared between the two groups. Results The rates of recanalization of blood vessels in the observation group and control group were 90.00%(36/40) and 65.00%(26/40), respectively, with a significant difference (P < 0.05). After treatment, the serum endothelin-1 (ET-1) levels in both groups were lower than those before treatment, and the nitric oxide (NO) levels were higher than those before treatment, and the ET-1 level in the observation group was lower than that in the control group, and the NO level was higher than that in the control group (P < 0.05). After treatment, the carotid extracranial resistance and characteristic impedance in both groups were lower than those before treatment, and the mean blood flow and mean blood flow velocity were higher than those before treatment, and the carotid extracranial resistance and characteristic impedance in the observation group were lower than those in the control group, and the mean blood flow and mean blood flow velocity were higher than those in the control group (P < 0.05). After treatment, the National Institutes of Health Stroke Scale (NIHSS) scores in both groups were lower than those before treatment, and the NIHSS score in the observation group was lower than that in the control group (P < 0.05). Conclusion DSA-guided neurointerventional thrombus removal combined with intravenous thrombolysis by tirofiban can effectively increase the rate of recanalization of blood vessels in patients with acute cerebral infarction, improve endothelial function, alleviate neurological deficit symptoms, increase blood flow velocity and blood flow at ischemic lesion sites, and reduce carotid extracranial resistance and characteristic impedance.