Objective We analyzed the incidence and treatment of symptomatic vasospasm after early endovascular therapy of ruptured aneurysms by endovascular embolization.Methods 329 patients classified as Hunt-Hess grades Ⅰto Ⅲ were embolized within 72 hours after aneurysm rupture. Symptomatic vasospasm was diagnosed as the onset of delayed neurological deterioration with evidence of angiographic or transcranial Doppler studies. Results Symptomatic vasospasm occurred in 62 patients (18.2%). Both Hunt-Hess grade and Fisher's scale before treatment correlated with the incidence of cerebral vasospasm. Among the 62 patients suffered from symptomatic vasospasm, 41 patients recovered well, 13 were moderately disabled, 6 were severely disabled and 2 patients died. Conclusions The incidence of symptomatic vasospasm was relatively low as compared to conventional open surgery. lumber puncture cerebral spinal fluid drainage may play an important role in reducing the incidence of cerebral vasospasm.

ObjectiveTo assess the value of stent-assisted angiopl asty in the treatment of extracranial carotid stenosis.Methods A total o f 164 cases of ex tracranial carotid stenosis from October 2000 to December 2002, including 146 ca ses of carotid bifurcation stenosis, 13 cases of extracranial internal carotid s tenosis, and 5 cases of common carotid stenosis, were treated by self-expandable stent placement and angioplasty.ResultsStent placement and angioplasty was successfully accomplished in all the 164 patients. The degree of stenosis was re duced from (78 8?13 6)% before the treatment to (10 2?7 5)% after the oper atio n. There were 1 case of transient ischemic attack (TIA) (0 6%) and 1 case of mi n or stroke (0 6%) during the peri-operative period, but no death or major stroke took place. Follow-up for 3～30 months (mean, 8 9 months) in 145 cases found no T IA, cerebral apoplexy or death. Forty-five patients were followed by digital sub traction angiography (DSA) 6 months after the treatment, and asymptomatic re-ste nosis occurred in 1 case (2 2%).ConclusionsEndovascular ste nt-assisted angio plasty for extracranial stenosis is safe and effective, with favorable short-ter m outcomes.

Objective Endovascular stenting or combined stenting and Guglielmi detachable coils packing for the treatment of intracranial fusiform and wide necked aneurysms were reported to access the feasibility of the procedures.Methods The coronary stents were implanted across the neck of 3 vertebral fusiform aneurysms and 6 wide necked aneurysms. Microcatheters were introduced into the aneurysm sacs through stent mesh, and finally GDCs were used to embolize the aneurysms. Results The stents were precisely deployed resulting in total occlusion of 7 cases with more than 90% occlusion in 2 cases. All patients recovered well with patency of the parent arteries.Conclusions Endovascular therapy with combined stent implantation and microcoil placement maybe a valid alteration for the treatment of intracranial fusiform or wide necked aneurysms.

Objective To analyze the causes, prevention and treatment of repture druing procedure for intracranial aneurysm embolization with GDC.Methods All the seven patients were embolized. Six patients were ruptured during the procedure and continuously embolized until the bleeding was halted. Another one was identified by post procedure CT. Results Four patients recovered unevent fully with one only suffering from mild deficit. Another 2 patients died of hyper intracranial pressure within one week. Conclusions Rupture during procedure of intracranial aneurysm embolization with GDC may be related to manipulation, properties of the parent artery and arneurysm. Continuous embolization with GDC will provide favorable prognosis for the patients.

Objective To evaluate the endovascular embolization treatment of large and giant ophthalmic aneurysms. Methods Three aneurysms were embolized with coils only and 5 aneurysms were treated with stent placement togather with subsequent coiling. Results In the 3 aneurysms treated only with GDC, total embolization was achieved in 1 and partial embolization in 2. In the stent placement and coiling case, 4 aneurysms were densely packed and another one was partially packed. Conclusions Combined stenting and coiling is effective and safe for the treatment of large and giant ophthalmic artery aneurysm with the preservation of parent artery.

Objective To evaluate the safety and short term outcome of stent assisted angioplasty for extracranial carotid stenosis. Methods From October 2000 to September 2002, 93 cases of extracranial carotid stenosis, including 86 cases of carotid bifurcation stenoses, 4 of extracranial internal carotid stenoses, 2 of common carotid stenoses and 1 of functional external carotid stenosis, were treated by self expandable stent placement and angioplasty. Results Stent placement and angioplasty were successfully administered in all the 93 patients. The average stenosis rate was reduced from (79.5?14.6)% before treatment to (11.2?7.8)% after stent assisted angioplasty. There were only 1 case of TIA (1.1%) and 1 case of minor stroke (1.1%) during the operation, without mortality or major stroke. No cerebral ischemic attach occurred in the 91 patients during clinical follow up for a period of 3 25 months with an average of 7.9 months. Twenty nine patients were angiographically followed up 6 months after treatment with only one asymptomatic restenosis (3.4%). Conclusions Endovascular stent assisted angioplasty for extracranial stenosis is safe and effective with considerable good short term outcome.

Objective To report experience of endovascular stenting combined with coiling for intracranial wide necked aneurysms and to investigate its indication, technical tip, prevention and treatment of complication, safety and efficacy. Methods The coronary stents were implanted across the neck of intracranial wide necked aneurysms in 105 patients (78 located in anterior circulation and 27 in posterior circulation). Microcatheters were introduced into the aneurysm sac through stent mesh. GDCs were used to embolize the aneurysms . Results The stents were deployed in 104 patients and total occlusion was obtained in 80 cases and more than 90% in 24 cases. The patients recovered well with patency of the parent arteries except one with cerebral infarction and another with carotid dissection during the procedure. The stent collapsed in one case after coiling.No re bleeding or symptom related to thrombosis occurred during clinical follow up for 3 28 months. Follow up angiogram in 62 cases showed no recanalization in all patients, but two with further thrombosis and one with mild stenosis in proximal segment of the stent. Conclusions Endovascular therapy combined stent implantation and microcoil placement would be a valid alteration for the treatment of complicated intracranial aneurysms. However, long term outcome need further study.

90%) and partial in 46 (

Atomoxetine is a noradrenaline transmitter reuptake inhibitor which can selectively inhibit presynaptic noradrenaline transport protein,strengthen noradrenaline's resupination effect,and increases noradrenaline's activity released by synaptic cleft to improve the symptoms of the attention deficit hyperactivity disorder(ADHD)patients.ADHD patients often accompany with other psychological diseases like oppositional defiant disorder,anxiety disorder,which may hinder the diagnosis of ADHD.There is still no accepted effective medicine nowadays.Currently,research on the treatment of the ADHD is more and more popular.Good therapeutic effect of atomoxetine to treat ADHD has been found in resent studies.This article summarized the current management of using atomoxetine to treat ADHD.