1.Rapid dura-mater reticular incision in acute severe subdural hematoma evacuation
Wang'an LI ; Guojie JING ; Xiaoteng YAO ; Yifan LYU
Chinese Journal of Neuromedicine 2014;13(4):407-408
Objective To research the application of rapid dura-mater reticular incision in the evacuation of acute severe subduml hematoma.Methods The clinical data of 30 patients performed evacuation of acute severe subdural hematoma in our hospital were retrospectively analyzed; the dumra maters was rapidly incised after the first bore hole being drilled,and then the dura mater was incised in reticular shape after the bone flap was formed.The subdural hematoma could effuse slowly and uniformly,and intmcranial hypertension would reduce effectively.Results The subdural hematoma of all patients was removed totally.Based on the Glasgow outcome scale (GOS) scores three months after surgery,8 patients got recovered,13 were referred to moderate maim,5 were severe disability and 4 died.By using this modified method,the acute cenencephalocele rate decreased to 23.3%,which was more effective as compared with that using traditional method (48.2%).Conclusion In acute severe subdural hematoma operation,reticular incision of dura mater may achieve rapid hematoma evacuation and controllable and balanceable decompression,increase curative rate and decrease mortality.
2.Endovascular intervention in treating acute cerebral stroke: a report of 32 cases
Yingchao JING ; Xiaoteng YAO ; Dingke ZHENG ; Kejun LIU ; Yituan XIE ; Guojie JING
Chinese Journal of Neuromedicine 2014;13(6):610-613
Objective To evaluate the effectiveness of endovascular intervention in treating acute cerebral stroke.Methods Thirty-two patients with acute cerebral stroke (22 with middle cerebral artery occlusion and 10 with internal carotid artery occlusion),admitted to and treated with endovascular intervention in our hospital from January 2010 to October 2013,were chosen in our study;14 were performed arterial thrombolysis+mechanical fragrnengation and 18 were performed mechanical fragrnengation+ solitaireAB stent thrombectomy.Retrospective analysis was performed on the clinical data and treatment efficacy,and the prevention experience of complications was concluded.Results CTA showed that complete recanalization was noted in 18 patients and partial recanalization in 5,with a recanalization rate reaching 7 1%.Postoperative symptomatic intracerebral hemorrhage was noted in 2 patients (6%) and 1 (3.1%) had large area of cerebral infarction.One month after the treatment,MRI indicated decreased areas of infarction in all patients.NIHSS scores were 4-6 points of all patients;favorable prognosis was noted in 23 patients (72%).Nine patients had heavy neurological dysfunction,with limb muscle strength less than grade Ⅲ.Conclusion Endovascular intervention in treating acute cerebral stroke can get high recanalization rate,and achieve good clinical outcome.