Objective:To explore the safety and efficacy of intrasaccular flow disruptor in intracranial aneurysms, including wide-necked aneurysms.Methods:A retrospective analysis was performed; 102 patients with intracranial aneurysms treated with intrasaccular flow disruptor at Department of Neurointervention, First Affiliated Hospital of Zhengzhou University from August 2022 to November 2024 were enrolled; their clinical and imaging data were collected. The aneurysm characteristics and perioperative complications were summarized; aneurysm occlusion was evaluated by Woven EndoBridge occlusion scale (WOS) immediately after surgery and during the follow-up period.Results:Among the 102 aneurysms, 33 were anterior cerebral artery aneurysms, 40 were middle cerebral artery aneurysms, 17 were internal carotid artery aneurysms and 12 were basilar artery aneurysms; 73 aneurysms were regular intracranial saccular aneurysms and 29 were irregular saccular ones (17 of them with daughter sacs); 12 aneurysms were ruptured at acute phase. The surgical success rate was 100%: single intrasaccular flow disruptor was implanted into 95 patients, and stent-assisted or salvage treatments were given to 7 patients). Immediately after surgery, WOS grading A was noted in 5 patients, grading B in 7, grading C in 31, and grading D in 59. Two patients suffered severe perioperative complications and passed away: one patient died for ischemic complications that ensued after stent salvage treatment (parent artery being compressed by intrasaccular flow disruptor); the other patient died for hemorrhagic complications triggered by rupture of an initially unruptured aneurysm following intrasaccular flow disruptor implantation. Among them, 52 patients completed postoperative DSA follow-up, with a median follow-up of 205 (168, 292) days; WOS grading A was noted in 31 patients, grading B in 9, grading C in 8, and grading D in 4 at the last follow-up; the full occlusion rate was 92.3%, and no ischemic or hemorrhagic adverse events occurred.Conclusion:Intrasaccular flow disruptor shows high short-term safety and good efficacy in the treatment of intracranial aneurysms.

Objective:To explore the safety and efficacy of intrasaccular flow disruptor in intracranial aneurysms, including wide-necked aneurysms.Methods:A retrospective analysis was performed; 102 patients with intracranial aneurysms treated with intrasaccular flow disruptor at Department of Neurointervention, First Affiliated Hospital of Zhengzhou University from August 2022 to November 2024 were enrolled; their clinical and imaging data were collected. The aneurysm characteristics and perioperative complications were summarized; aneurysm occlusion was evaluated by Woven EndoBridge occlusion scale (WOS) immediately after surgery and during the follow-up period.Results:Among the 102 aneurysms, 33 were anterior cerebral artery aneurysms, 40 were middle cerebral artery aneurysms, 17 were internal carotid artery aneurysms and 12 were basilar artery aneurysms; 73 aneurysms were regular intracranial saccular aneurysms and 29 were irregular saccular ones (17 of them with daughter sacs); 12 aneurysms were ruptured at acute phase. The surgical success rate was 100%: single intrasaccular flow disruptor was implanted into 95 patients, and stent-assisted or salvage treatments were given to 7 patients). Immediately after surgery, WOS grading A was noted in 5 patients, grading B in 7, grading C in 31, and grading D in 59. Two patients suffered severe perioperative complications and passed away: one patient died for ischemic complications that ensued after stent salvage treatment (parent artery being compressed by intrasaccular flow disruptor); the other patient died for hemorrhagic complications triggered by rupture of an initially unruptured aneurysm following intrasaccular flow disruptor implantation. Among them, 52 patients completed postoperative DSA follow-up, with a median follow-up of 205 (168, 292) days; WOS grading A was noted in 31 patients, grading B in 9, grading C in 8, and grading D in 4 at the last follow-up; the full occlusion rate was 92.3%, and no ischemic or hemorrhagic adverse events occurred.Conclusion:Intrasaccular flow disruptor shows high short-term safety and good efficacy in the treatment of intracranial aneurysms.

Objective:To observe any improvement in hemiplegic upper limb functioning when transcranial direct current stimulation (tDCS) is combined with robot-assisted upper limb treatment, and analyze the potential mechanism of neural plasticity through diffusion tensor imaging (DTI).Methods:Twenty stroke survivors with hemiplegia were randomly divided into a treatment group and a control group, each of 10, according to a random number table. Both groups were treated with conventional medication and rehabilitation training using an upper limb robot, while the treatment group also received tDCS daily, with the current increasing from 0 to 1mA over 10 seconds, and then decreasing to 0 over twenty minutes. The experiment lasted for 15 days. The upper extremity portion of the Fugl-Meyer rating scale (UE-FMA) and the Wolf Motor Function Rating Scale (WMFT) were used to evaluate motor functioning before and after the treatment. DTI was also conducted for both groups.Results:After the treatment, the average UE-FMA and WMFT scores of the two groups were significantly higher than before the treatment, with the average UE-FMA score of the treatment group (35.32±13.25), significantly higher than that of the control group (21.80±13.93). After the treatment there were significant differences between the groups in their average FA, rFA and FAasy of the posterior limb of the internal capsule, as well as in FA and the CST length of the central anterior gyrus.Conclusion:tDCS combined with robot-assisted upper limb rehabilitation training can significantly improve the motor functioning of hemiplegic upper limbs, possibly due to neuroplasticity mechanisms that promote CST integrity and symmetry changes. tDCS can be an important adjunct therapy in clinical neurorehabilitation.

Objective To investigate the ultrasonic appearance of peripheral neurilemmoma.Methods Ultrasonic appearances of 43 patients with 46 neurilemmomas confirmed by surgery and pathology were analyzed retrospectively and compared with their MRI and pathological features.Results Forty-five neurilemmomas were with regular shape and clear boundary,except one at the root of nerve C4 that was irregular in shape and unclear in boundary,like adumbbell.Sonography showed that there were 30 neurilemmomas displaying as solid tumors,15 as cystic and solid,and 1 as entirely cystic.Posterior echoenhancement,target sign,rat tail sign and vessels accompanying sign were found in 39,21,23 and 17 neurilemmomas,respectively.There were 4 neurilemmomas with ultrasound blood flow grade 0,9 with grade Ⅰ,22 with gradeⅡ,and 11 with grade Ⅲ.The target signs were found in 21 cases (21/46,45.6％) and 26 cases (26/46,56.5 ％) by ultrasound and MRI,respectively.The capability of ultrasound finding the target sign in neurilemmoma was comparable to MRI(Kappa =0.527,P ＜0.001).The diagnostic accuracy rate of neurilemmoma by ultrasonography was 73.9％(34/46).Conclusions The ultrasound has a relatively high detection of the target sign in neurilemmoma,which may provide a new basis for the ultrasonic diagnosis of neurilemmoma.