Objective To investigate the cytokine levels in patients in acute stage of intracranial ar-terial occlusion and its correlation with infarct volume and functional prognosis.Methods A total of 168 patients with large artery intracranial occlusion admitted in Department of Neurosurgery of Huaihe Hospital from January 2021 to December 2023 were enrolled and then divided into good prognosis group(54 cases)and poor prognosis group(114 cases)according to their functional prognosis within 90 d after onset.The cytokine levels in acute stage and infarct volume were col-lected,and their correlation with infarct volume and functional prognosis was analyzed.Results The poor prognosis group had significantly larger proportion of hypertension,longer time from onset to admission,higher NIHSS score at admission,larger infarct core volume,and elevated lev-els of IL-1,IL-6,IL-8,TNF-α,MMP-9,reactive oxygen species(ROS)and VEGF than the good prognosis group(P＜0.05,P＜0.01).Pearson correlation analysis showed that infarct core volume was positively correlated with the levels of IL-1,IL-6,IL-8,TNF-α,MMP-9,ROS and VEGF(P＜0.01).Multivariate logistic regression analysis indicated that after removing confounding var-iables(time from onset to admission,NIHSS at admission and infarct core volume),IL-1(OR=1.723,95％CI:1.333-2.227,P=0.000),IL-6(OR=1.475,95％CI:1.190-1.830,P=0.000),TNF-α(OR=1.392,95％CI:1.167-1.661,P=0.000),MMP-9(OR=1.062,95％CI:1.031-1.094,P=0.000)and ROS(OR=1.020,95％CI:1.007-1.034,P=0.003)were still independent influencing factors for poor functional prognosis in the patients.Conclusion Infarct core volume is positively correlated with IL-1,IL-6,IL-8,TNF-α,MMP-9,ROS and VEGF.In the acute stage,cy-tokines IL-1,IL-6,TNF-α,MMP-9 and ROS are independent influencing factors for poor function-al prognosis in patients with intracranial arterial occlusion.

Objective To investigate the cytokine levels in patients in acute stage of intracranial ar-terial occlusion and its correlation with infarct volume and functional prognosis.Methods A total of 168 patients with large artery intracranial occlusion admitted in Department of Neurosurgery of Huaihe Hospital from January 2021 to December 2023 were enrolled and then divided into good prognosis group(54 cases)and poor prognosis group(114 cases)according to their functional prognosis within 90 d after onset.The cytokine levels in acute stage and infarct volume were col-lected,and their correlation with infarct volume and functional prognosis was analyzed.Results The poor prognosis group had significantly larger proportion of hypertension,longer time from onset to admission,higher NIHSS score at admission,larger infarct core volume,and elevated lev-els of IL-1,IL-6,IL-8,TNF-α,MMP-9,reactive oxygen species(ROS)and VEGF than the good prognosis group(P＜0.05,P＜0.01).Pearson correlation analysis showed that infarct core volume was positively correlated with the levels of IL-1,IL-6,IL-8,TNF-α,MMP-9,ROS and VEGF(P＜0.01).Multivariate logistic regression analysis indicated that after removing confounding var-iables(time from onset to admission,NIHSS at admission and infarct core volume),IL-1(OR=1.723,95％CI:1.333-2.227,P=0.000),IL-6(OR=1.475,95％CI:1.190-1.830,P=0.000),TNF-α(OR=1.392,95％CI:1.167-1.661,P=0.000),MMP-9(OR=1.062,95％CI:1.031-1.094,P=0.000)and ROS(OR=1.020,95％CI:1.007-1.034,P=0.003)were still independent influencing factors for poor functional prognosis in the patients.Conclusion Infarct core volume is positively correlated with IL-1,IL-6,IL-8,TNF-α,MMP-9,ROS and VEGF.In the acute stage,cy-tokines IL-1,IL-6,TNF-α,MMP-9 and ROS are independent influencing factors for poor function-al prognosis in patients with intracranial arterial occlusion.

Objective:To explore the reasons and management strategies for re-rupture during clipping of ruptured intracranial aneurysms.Methods:Twenty-one patients with ruptured intracranial aneurysms, accepted clipping by micro-craniotomy in Department of Neurosurgery, Huaihe Hospital of Henan University from May 2015 to October 2021, were chosen in our study. All patients suffered re-rupture at different intraoperative stages. The clinical characteristics, aneurysm parameters, prognoses and complications were retrospectively analyzed. Combined with the relevant literature, the causes and essential treatments for re-rupture at different intraoperative stages were summarized.Results:The average age of these 21 patients was 65 years. All patients were accompanied by disturbance of consciousness at admission. Hunt-Hess grading III was noted in 16 patients and Hunt-Hess grading IV in 5. Anterior communicating artery aneurysms were noted in 12 patients, posterior communicating artery aneurysms in 6, and middle cerebral artery aneurysms in 3; multiple saccular aneurysms were noted in 12 patients and irregular aneurysms in 4; large aneurysms were noted in 18 patients and giant aneurysms in 3. Among the 3 patients with re-rupture at the early stage of clipping (before aneurysm separation), 2 were died and 1 was severely disabled; among the 14 patients with re-rupture at the middle stage of clipping (during separation of aneurysm from its parent artery), 3 had cerebral infarction and 3 had severe disability after surgery; among the 4 patients with re-rupture at the late stage of clipping (after clipping of the aneurysm neck), 2 had cerebral infarction and 2 had severe disability.Conclusion:Patients would trend to have re-rupture during clipping of ruptured intracranial aneurysms in cases that patients have older age, severe diseases and special parameters (locations, shapes, volumes) of the aneurysms, surgeries are operated by inexperienced operator, or surgeries have improper intraoperative operations; during any period of the surgery, the separation and clamping should be fine and gentle to avoid excessive traction.