This case report highlights a critical and emergent condition, isolated third nerve cranial palsy due to a brain aneurysm. It emphasizes the importance of differential diagnosis and attentiveness to the physical exam ...This case report highlights a critical and emergent condition, isolated third nerve cranial palsy due to a brain aneurysm. It emphasizes the importance of differential diagnosis and attentiveness to the physical exam in an emergency setting. The detailed progression from initial symptoms and misinterpretation to final diagnosis offers valuable insight into the dangers of overlooking critical diagnoses. A bilobed intracranial aneurysm arising from the internal carotid artery (ICA) caused symptoms in this patient that could have been attributed to a less malignant etiology, such as a complex migraine. Overlooking the urgency of the situation and missing the diagnosis could have had a grave and irreversible outcome.展开更多
Neuroinflammation is a well-recognized consequence of subarachnoid hemorrhage(SAH), and Toll-like receptor(TLR) 4 may be an important therapeutic target for post-SAH neuroinflammation. Of the TLR family members, TLR4 ...Neuroinflammation is a well-recognized consequence of subarachnoid hemorrhage(SAH), and Toll-like receptor(TLR) 4 may be an important therapeutic target for post-SAH neuroinflammation. Of the TLR family members, TLR4 is expressed in various cell types in the central nervous system, and is unique in that it can signal through both the myeloid differentiation primary-response protein 88-dependent and the toll receptor associated activator of interferon-dependent cascades to coordinate the maximal inflammatory response. TLR4 can be activated by many endogenous ligands having damage-associated molecular patterns including heme and fibrinogen at the rupture of an intracranial aneurysm, and the resultant inflammatory reaction and thereby tissue damages may furthermore activate TLR4. It is widely accepted that the excreted products of TLR4 signaling alter neuronal functions. Previous studies have focused on the pathway through nuclear factor(NF)-κΒ signaling among TLR4 signaling pathways as to the development of early brain injury(EBI) such as neuronal apoptosis and blood-brain barrier disruption, and cerebral vasospasm. However, many findings suggest that both pathways via NF-κΒ and mitogen-activated protein kinases may be involved in EBI and cerebral vasospasm development. To overcome EBI and cerebral vasospasm is important to improve outcomes after SAH, because both EBI and vasopasm are responsible for delayed brain injuries or delayed cerebral ischemia, the most important preventable cause of poor outcomes after SAH. Increasing evidence has shown that TLR4 signaling plays an important role in SAH-induced brain injuries. Better understanding of the roles of TLR4 signaling in SAH will facilitate development of new treatments.展开更多
We present numerical simulations of blood flow through a brain vascular aneurysm with an artificial stent using Smoothed Particle Hydrodynamics (SPH). The aim of this work is to analyze how the flow into an aneurysm c...We present numerical simulations of blood flow through a brain vascular aneurysm with an artificial stent using Smoothed Particle Hydrodynamics (SPH). The aim of this work is to analyze how the flow into an aneurysm changes using different stent configurations. The initial conditions for the simulations were constructed from angiographic images of a real patient with an aneurysm. The wall shear stresses, pressure and highest velocity within the artery, and other particular quantities are calculated which are of medical specific interest. The numerical simulations of the cerebral circulation help doctors to determine if the patient’s own vascular anatomy has the conditions to allow arterial stenting by endovascular method before the surgery or even evaluate the effect of different stent structure and materials. The results show that the flow downstream the aneurysm is highly modified by the stent configuration and that the best choice for reducing the flow in the aneurysm is to use a completely extended Endeavor stent.展开更多
Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protec...Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protect brain, deep hypotermic circulatory arrest ( DHCA.) combined with retrograde cerebral perfusion ( RCP) June 2003 Vol11 No2 through the superior vena cava ( n = 50) and simple DHCA ( n = 15) were used during the procedure. Blood samples for lactic acid level from the jugular vein were compared in both groups at different plase, and perfusion blood distribution and oxygen content difference between the perfused and returned blood were measured in some RCP patients. Results The DHCA time was 35.9 ± 8 min (10. 0 - 63. 0 min) and DHCA+ RCP time was 45.5 ± 17. 2 min (16. 0 - 81. 0 min)The resuscitationtime was 7.1 ± 1.6 h (4.4 - 9.4H)in DHCA patients and 5.4±2.2h(2.0-9.0 h)in RCP patients. Operation death was 3/15 in the DHCA group and 1/50 in the RCP patients. Central nervous complication展开更多
BACKGROUND Innominate artery aneurysms (IAAs) are relatively rare. Endovascular therapy has been an alternative to open surgery in some IAA cases, but open repair is still necessary in complicated cases. CASE SUMMARY ...BACKGROUND Innominate artery aneurysms (IAAs) are relatively rare. Endovascular therapy has been an alternative to open surgery in some IAA cases, but open repair is still necessary in complicated cases. CASE SUMMARY We report a 35-year-old female who suffered from Takayasu’s arteritis. The patient did not get regular treatment, and IAA and right common carotid artery aneurysm developed, which complicated with occlusion of the left carotid artery, subclavian artery, and the initial part of the left vertebral artery. The patient also had moderate aortic valve insufficiency. With inflammation being controlled well, the patient received the surgery for arterial aneurysms of innominate and right common carotid arteries and aortic valve insufficiency. The shunts for cerebral blood supply were designed to protect the brain and the surgery was conducted successfully under extracorporeal circulation. CONCLUSION The case illustrates that open surgery may be appropriate for some complicated IAAs, and brain protection is important.展开更多
The value of combined application of both ECG gated cine MRA and 3D CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty fo...The value of combined application of both ECG gated cine MRA and 3D CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery ( n= 12), vertebral artery ( n= 3), basilar artery ( n= 4), anterior cerebral artery ( n= 2), middle cerebral artery ( n= 2), anterior communicate artery ( n= 2) and posterior communicate artery ( n= 1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG gated cine MRA was performed with 2D multi phase fast gradient recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analzsed by statistic " t " test. 3D CEMRA was performed with spoiled gradient recalled echo and one dose of Gd DTPA. All data was processed with multi plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D CEMRA. Compared to DSA and conventional 3D MOTSA, its sensitivity and specificity figures were both 100 %. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8±37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2±6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue ( P =0.025, <0.05). 3D CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.展开更多
Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular...Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.展开更多
BACKGROUND: Hemodynamic changes accompany the initiation, development and rupture of middle cerebral artery (MCA) aneurysms. The complexity of the intraaneurysmal hemodynamic factors has not been completely clarified ...BACKGROUND: Hemodynamic changes accompany the initiation, development and rupture of middle cerebral artery (MCA) aneurysms. The complexity of the intraaneurysmal hemodynamic factors has not been completely clarified by the indirect measures and methods used in previous studies. OBJECTIVE: To evaluate correlations of intraoperative hemodynamic factors to initiation and rupture of MCA aneurysms. DESIGN, TIME AND SETTING: A case-control study was performed at the Department of Neurosurgery, Tiantan Hospital Affiliated to Capital Medical University, China between March and October 2008. PARTICIPANTS: A total of 12 consecutive patients diagnosed with MCA aneurysms (MCA aneurysms group) and five patients without middle cerebral artery aneurysms (with aneurysms located at other arteries, control group) were enrolled at the Department of Neurosurgery, Tiantan Hospital Affiliated to Capital Medical University, China. METHODS: The proximal and distal arteries of MCA aneurysms were exposed visibly in the MCA aneurysm group. The M1 segment of MCA without the aneurysm and the aneurysm on other arteries were also exposed visibly in the control group. Hemodynamic indices were then measured using an intraoperative 16 MHz probe installed in a Multi-Dop TCD8X4 device. MAIN OUTCOME MEASURES: Mean (time-averaged velocity) difference, maximum mean, pulsatility index difference, maximum pulsatility index, resistance index difference, maximum resistance index; correlation of development and rupture of MCA aneurysms to intraoperative hemodynamic factors of the parent artery. RESULTS: A total of 12 patients underwent microsurgery for treatment to occlude 15 MCA aneurysms. Of the 15 MCA aneurysms, 12 were located at the bifurcation, two at the M1 segment, and one at the M3 segment; eight of the aneurysms were unruptured and seven were ruptured. The whole indices with combination mean difference, maximum mean, and maximum pulsatility index of the aneurysms were important factors influencing the rupture of MCA aneurysms (t = 2.92, P = 0.03, constant). A higher velocity intraaneurismal flow at the bifurcation was identified (t = 3.48, P = 0.01, constant). After the aneurysm was completely occluded, global high-velocity flow could not be detected in the parent arteries (t = 2.57, P = 0.03, constant). CONCLUSION: When short-term high-velocity blood flow is present, aneurysms can be easily initiated and ruptured at the bifurcation of MCA.展开更多
目的探讨宁神止痉汤对颅内动脉瘤破裂所致蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)介入术后脑血管痉挛患者脑损伤、自由基、脑血流及神经功能的影响。方法选取治疗的aSAH患者80例,随机分为对照组与研究组,每组40例,患...目的探讨宁神止痉汤对颅内动脉瘤破裂所致蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)介入术后脑血管痉挛患者脑损伤、自由基、脑血流及神经功能的影响。方法选取治疗的aSAH患者80例,随机分为对照组与研究组,每组40例,患者给予尼莫地平等药物常规治疗,研究组在对照组治疗基础上给予宁神止痉汤口服治疗,治疗时间14 d,观察患者治疗前后血清神经元特异性烯醇化酶(neuron specific enolase,NSE)、星形胶质源性蛋白(astroglia-derived protein,S100β)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、内皮素-1(endothelin-1,ET-1)、一氧化氮(nitric oxide,NO)变化,大脑中动脉平均血流速度(median cerebral artery velocity,Vm)、脑血管痉挛指数(linde-gard)、血管自我调节功能指标脉冲指数(impulse index of vascular self-regulation function,PI)变化,采用格拉斯哥(Glasgow coma scale,GCS)和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分对患者神经功能状况进行评价。结果两组患者治疗前血清NSE及S100β水平比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05);两组患者治疗前血清SOD、MDA、ET-1、NO水平比较差异无统计学意义(P>0.05),MDA、ET-1治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05),SOD、NO治疗后较治疗前升高(P<0.05),且研究组升高程度大于对照组(P<0.05),比较差异有统计学意义(P<0.05);两组患者治疗前大脑中动脉Vm、linde-gard、PI比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05);两组患者治疗前血清GCS及NIHSS评分比较差异无统计学意义(P>0.05),NIHSS治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05),GCS治疗后较治疗前升高(P<0.05),且研究组升高程度大于对照组(P<0.05)。结论aSAH介入术后脑血管痉挛患者采用宁神止痉汤治疗,可有助于减轻脑损伤,降低自由基,改善脑血流,促进神经功能的恢复。展开更多
文摘This case report highlights a critical and emergent condition, isolated third nerve cranial palsy due to a brain aneurysm. It emphasizes the importance of differential diagnosis and attentiveness to the physical exam in an emergency setting. The detailed progression from initial symptoms and misinterpretation to final diagnosis offers valuable insight into the dangers of overlooking critical diagnoses. A bilobed intracranial aneurysm arising from the internal carotid artery (ICA) caused symptoms in this patient that could have been attributed to a less malignant etiology, such as a complex migraine. Overlooking the urgency of the situation and missing the diagnosis could have had a grave and irreversible outcome.
基金supported by a Grant-in-Aid for Scientific Research from Mie Medical Research Foundation to Dr.Suzuki
文摘Neuroinflammation is a well-recognized consequence of subarachnoid hemorrhage(SAH), and Toll-like receptor(TLR) 4 may be an important therapeutic target for post-SAH neuroinflammation. Of the TLR family members, TLR4 is expressed in various cell types in the central nervous system, and is unique in that it can signal through both the myeloid differentiation primary-response protein 88-dependent and the toll receptor associated activator of interferon-dependent cascades to coordinate the maximal inflammatory response. TLR4 can be activated by many endogenous ligands having damage-associated molecular patterns including heme and fibrinogen at the rupture of an intracranial aneurysm, and the resultant inflammatory reaction and thereby tissue damages may furthermore activate TLR4. It is widely accepted that the excreted products of TLR4 signaling alter neuronal functions. Previous studies have focused on the pathway through nuclear factor(NF)-κΒ signaling among TLR4 signaling pathways as to the development of early brain injury(EBI) such as neuronal apoptosis and blood-brain barrier disruption, and cerebral vasospasm. However, many findings suggest that both pathways via NF-κΒ and mitogen-activated protein kinases may be involved in EBI and cerebral vasospasm development. To overcome EBI and cerebral vasospasm is important to improve outcomes after SAH, because both EBI and vasopasm are responsible for delayed brain injuries or delayed cerebral ischemia, the most important preventable cause of poor outcomes after SAH. Increasing evidence has shown that TLR4 signaling plays an important role in SAH-induced brain injuries. Better understanding of the roles of TLR4 signaling in SAH will facilitate development of new treatments.
文摘We present numerical simulations of blood flow through a brain vascular aneurysm with an artificial stent using Smoothed Particle Hydrodynamics (SPH). The aim of this work is to analyze how the flow into an aneurysm changes using different stent configurations. The initial conditions for the simulations were constructed from angiographic images of a real patient with an aneurysm. The wall shear stresses, pressure and highest velocity within the artery, and other particular quantities are calculated which are of medical specific interest. The numerical simulations of the cerebral circulation help doctors to determine if the patient’s own vascular anatomy has the conditions to allow arterial stenting by endovascular method before the surgery or even evaluate the effect of different stent structure and materials. The results show that the flow downstream the aneurysm is highly modified by the stent configuration and that the best choice for reducing the flow in the aneurysm is to use a completely extended Endeavor stent.
文摘Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protect brain, deep hypotermic circulatory arrest ( DHCA.) combined with retrograde cerebral perfusion ( RCP) June 2003 Vol11 No2 through the superior vena cava ( n = 50) and simple DHCA ( n = 15) were used during the procedure. Blood samples for lactic acid level from the jugular vein were compared in both groups at different plase, and perfusion blood distribution and oxygen content difference between the perfused and returned blood were measured in some RCP patients. Results The DHCA time was 35.9 ± 8 min (10. 0 - 63. 0 min) and DHCA+ RCP time was 45.5 ± 17. 2 min (16. 0 - 81. 0 min)The resuscitationtime was 7.1 ± 1.6 h (4.4 - 9.4H)in DHCA patients and 5.4±2.2h(2.0-9.0 h)in RCP patients. Operation death was 3/15 in the DHCA group and 1/50 in the RCP patients. Central nervous complication
文摘BACKGROUND Innominate artery aneurysms (IAAs) are relatively rare. Endovascular therapy has been an alternative to open surgery in some IAA cases, but open repair is still necessary in complicated cases. CASE SUMMARY We report a 35-year-old female who suffered from Takayasu’s arteritis. The patient did not get regular treatment, and IAA and right common carotid artery aneurysm developed, which complicated with occlusion of the left carotid artery, subclavian artery, and the initial part of the left vertebral artery. The patient also had moderate aortic valve insufficiency. With inflammation being controlled well, the patient received the surgery for arterial aneurysms of innominate and right common carotid arteries and aortic valve insufficiency. The shunts for cerebral blood supply were designed to protect the brain and the surgery was conducted successfully under extracorporeal circulation. CONCLUSION The case illustrates that open surgery may be appropriate for some complicated IAAs, and brain protection is important.
文摘The value of combined application of both ECG gated cine MRA and 3D CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery ( n= 12), vertebral artery ( n= 3), basilar artery ( n= 4), anterior cerebral artery ( n= 2), middle cerebral artery ( n= 2), anterior communicate artery ( n= 2) and posterior communicate artery ( n= 1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG gated cine MRA was performed with 2D multi phase fast gradient recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analzsed by statistic " t " test. 3D CEMRA was performed with spoiled gradient recalled echo and one dose of Gd DTPA. All data was processed with multi plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D CEMRA. Compared to DSA and conventional 3D MOTSA, its sensitivity and specificity figures were both 100 %. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8±37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2±6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue ( P =0.025, <0.05). 3D CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.
文摘Basilar artery fenestration is a rare anatomical variation resulting from the failed fusion of the two vertebral arteries during embryonic life. In order of frequency, it is the second most common location of vascular fenestrations after the anterior communicating artery. Vertebrobasilar junction aneurysms are uncommon but often associated with basilar artery fenestration. We report the case of a fenestrated vertebrobasilar junction saccular aneurysm in a 57-year-old woman. The diagnosis was incidentally made on CT angiography which found the anatomical variant and the aneurysm. The radiological features illustrating this association are detailed here and a brief discussion of its pathogenesis and management was made. Vertebrobasilar junction aneurysms are rare and their presence should suggest an associated basilar fenestration.
基金the National Science & Technique Sup-porting Program in the 11th Five-Year Plan of China
文摘BACKGROUND: Hemodynamic changes accompany the initiation, development and rupture of middle cerebral artery (MCA) aneurysms. The complexity of the intraaneurysmal hemodynamic factors has not been completely clarified by the indirect measures and methods used in previous studies. OBJECTIVE: To evaluate correlations of intraoperative hemodynamic factors to initiation and rupture of MCA aneurysms. DESIGN, TIME AND SETTING: A case-control study was performed at the Department of Neurosurgery, Tiantan Hospital Affiliated to Capital Medical University, China between March and October 2008. PARTICIPANTS: A total of 12 consecutive patients diagnosed with MCA aneurysms (MCA aneurysms group) and five patients without middle cerebral artery aneurysms (with aneurysms located at other arteries, control group) were enrolled at the Department of Neurosurgery, Tiantan Hospital Affiliated to Capital Medical University, China. METHODS: The proximal and distal arteries of MCA aneurysms were exposed visibly in the MCA aneurysm group. The M1 segment of MCA without the aneurysm and the aneurysm on other arteries were also exposed visibly in the control group. Hemodynamic indices were then measured using an intraoperative 16 MHz probe installed in a Multi-Dop TCD8X4 device. MAIN OUTCOME MEASURES: Mean (time-averaged velocity) difference, maximum mean, pulsatility index difference, maximum pulsatility index, resistance index difference, maximum resistance index; correlation of development and rupture of MCA aneurysms to intraoperative hemodynamic factors of the parent artery. RESULTS: A total of 12 patients underwent microsurgery for treatment to occlude 15 MCA aneurysms. Of the 15 MCA aneurysms, 12 were located at the bifurcation, two at the M1 segment, and one at the M3 segment; eight of the aneurysms were unruptured and seven were ruptured. The whole indices with combination mean difference, maximum mean, and maximum pulsatility index of the aneurysms were important factors influencing the rupture of MCA aneurysms (t = 2.92, P = 0.03, constant). A higher velocity intraaneurismal flow at the bifurcation was identified (t = 3.48, P = 0.01, constant). After the aneurysm was completely occluded, global high-velocity flow could not be detected in the parent arteries (t = 2.57, P = 0.03, constant). CONCLUSION: When short-term high-velocity blood flow is present, aneurysms can be easily initiated and ruptured at the bifurcation of MCA.
文摘目的探讨宁神止痉汤对颅内动脉瘤破裂所致蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)介入术后脑血管痉挛患者脑损伤、自由基、脑血流及神经功能的影响。方法选取治疗的aSAH患者80例,随机分为对照组与研究组,每组40例,患者给予尼莫地平等药物常规治疗,研究组在对照组治疗基础上给予宁神止痉汤口服治疗,治疗时间14 d,观察患者治疗前后血清神经元特异性烯醇化酶(neuron specific enolase,NSE)、星形胶质源性蛋白(astroglia-derived protein,S100β)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、内皮素-1(endothelin-1,ET-1)、一氧化氮(nitric oxide,NO)变化,大脑中动脉平均血流速度(median cerebral artery velocity,Vm)、脑血管痉挛指数(linde-gard)、血管自我调节功能指标脉冲指数(impulse index of vascular self-regulation function,PI)变化,采用格拉斯哥(Glasgow coma scale,GCS)和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分对患者神经功能状况进行评价。结果两组患者治疗前血清NSE及S100β水平比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05);两组患者治疗前血清SOD、MDA、ET-1、NO水平比较差异无统计学意义(P>0.05),MDA、ET-1治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05),SOD、NO治疗后较治疗前升高(P<0.05),且研究组升高程度大于对照组(P<0.05),比较差异有统计学意义(P<0.05);两组患者治疗前大脑中动脉Vm、linde-gard、PI比较差异无统计学意义(P>0.05),治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05);两组患者治疗前血清GCS及NIHSS评分比较差异无统计学意义(P>0.05),NIHSS治疗后较治疗前下降(P<0.05),且研究组下降程度大于对照组(P<0.05),GCS治疗后较治疗前升高(P<0.05),且研究组升高程度大于对照组(P<0.05)。结论aSAH介入术后脑血管痉挛患者采用宁神止痉汤治疗,可有助于减轻脑损伤,降低自由基,改善脑血流,促进神经功能的恢复。
