Background:The Middle cerebral artery (MCA) aneurysm is a common type of craniocerebral aneurysm that is prone to rupture and high mortality. The classic surgical approaches are the Pterional approach and the Lateral ...Background:The Middle cerebral artery (MCA) aneurysm is a common type of craniocerebral aneurysm that is prone to rupture and high mortality. The classic surgical approaches are the Pterional approach and the Lateral Supraorbital (LSO) approach, but there are shortcomings. Methods:This study retrospectively analyzed clinical and imaging data from 181 patients with MCA aneurysm clipping in the Department of Neurosurgery, First Affiliated Hospital of Soochow University between 2011 and 2017. Statistical analysis using parametric and nonparametric tests showed that P values below 0.05 were considered statistically significant. Results: The preoperative GCS score (P=0.003), Hunt-Hess scale (P < 0.001) and the operating habits of the surgeon (P < 0.001) affected the surgeon to choose a surgical approach. The choice of two surgical methods on the operation time (P < 0.001), skin incision (P < 0.001), complications (P=0.026), tracheotomy (P=0.014), prognosis (P=0.002) were significantly different. Different surgical approaches (P=0.002), Hunt-Hess scale (P <0.001), GCS scale (P < 0.001), GCS sorse (P < 0.001), skin incision (P=0.031) and complications (P < 0.001) are closely related to the prognosis of patients. Conclusions: Modified LSO approach provides another surgical approach for MCA aneurysm clipping, while avoiding the drawbacks of the LSO approach in the clipping of MCA distal aneurysm.展开更多
Traumatic brain injury(TBI)is exceptionally prevalent in society and often imposes a massive burden on patients'families and poor prognosis.The evidence reviewed here suggests that gender can influence clinical ou...Traumatic brain injury(TBI)is exceptionally prevalent in society and often imposes a massive burden on patients'families and poor prognosis.The evidence reviewed here suggests that gender can influence clinical outcomes of TBI in many aspects,ranges from patients'mortality and short-term outcome to their long-term outcome,as well as the incidence of cognitive impairment.We mainly focused on the causes and mechanisms underlying the differences between male and female after TBI,from both biological and sociological views.As it turns out that multiple factors contribute to the gender differences after TBI,not merely the perspective of gender and sex hormones.Centered on this,we discussed how female steroid hormones exert neuroprotective effects through the anti-inflammatory and antioxidant mechanism,along with the cognitive impairment and the social integration problems it caused.As to the treatment,both instant and long-term treatment of TBI requires adjustments according to gender.A further study with more focus on this topic is therefore suggested to provide better treatment options for these patients.展开更多
文摘Background:The Middle cerebral artery (MCA) aneurysm is a common type of craniocerebral aneurysm that is prone to rupture and high mortality. The classic surgical approaches are the Pterional approach and the Lateral Supraorbital (LSO) approach, but there are shortcomings. Methods:This study retrospectively analyzed clinical and imaging data from 181 patients with MCA aneurysm clipping in the Department of Neurosurgery, First Affiliated Hospital of Soochow University between 2011 and 2017. Statistical analysis using parametric and nonparametric tests showed that P values below 0.05 were considered statistically significant. Results: The preoperative GCS score (P=0.003), Hunt-Hess scale (P < 0.001) and the operating habits of the surgeon (P < 0.001) affected the surgeon to choose a surgical approach. The choice of two surgical methods on the operation time (P < 0.001), skin incision (P < 0.001), complications (P=0.026), tracheotomy (P=0.014), prognosis (P=0.002) were significantly different. Different surgical approaches (P=0.002), Hunt-Hess scale (P <0.001), GCS scale (P < 0.001), GCS sorse (P < 0.001), skin incision (P=0.031) and complications (P < 0.001) are closely related to the prognosis of patients. Conclusions: Modified LSO approach provides another surgical approach for MCA aneurysm clipping, while avoiding the drawbacks of the LSO approach in the clipping of MCA distal aneurysm.
基金We thank all the participants for their support of this research.
文摘Traumatic brain injury(TBI)is exceptionally prevalent in society and often imposes a massive burden on patients'families and poor prognosis.The evidence reviewed here suggests that gender can influence clinical outcomes of TBI in many aspects,ranges from patients'mortality and short-term outcome to their long-term outcome,as well as the incidence of cognitive impairment.We mainly focused on the causes and mechanisms underlying the differences between male and female after TBI,from both biological and sociological views.As it turns out that multiple factors contribute to the gender differences after TBI,not merely the perspective of gender and sex hormones.Centered on this,we discussed how female steroid hormones exert neuroprotective effects through the anti-inflammatory and antioxidant mechanism,along with the cognitive impairment and the social integration problems it caused.As to the treatment,both instant and long-term treatment of TBI requires adjustments according to gender.A further study with more focus on this topic is therefore suggested to provide better treatment options for these patients.
