Angioplasty and stenting for severe vertebral artery orifice stenosis: effects on cerebellar function remodeling verified by blood oxygen level-dependent functional magnetic resonance imaging

Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood flow and perfusion in the posterior circulation after interventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso- nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery orifice stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat- ment only. The intervention group received vertebral artery orifice angioplasty and stenting ＋ identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent functional magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery orifice stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.

Severe pseudo-stenosis of intracranial segment of verte-bral artery:a case report

Objective:To describe the clinical fea-tures of a case of ischemic stroke caused by pseudo severe stenosis of vertebral artery(VA).Methods:The clinical history and image data of a 52-year-old man with ischemic stroke were collected.Results:Computerized tomography angiography(CTA)revealed stenosis of V1 and V4 of the left VA.DSA confirmed that the anterior blood flow recov-ered after stent implantation,and the V4 segment of the left VA was normal without stenosis.Conclusions:It is spec-ulated that the upper stenosis is due to local hemodynamic changes rather than real stenosis.This case suggests that the interpretation of stenosis on CTA should consider cere-bral vascular anatomy and hemodynamic changes.

Diagnosis Experience of Patients with Cervical, Thoracic and Lumbar Multi-Segment Spinal Stenosis: A Case Report and Literature Review

Background: The incidence of cervical, thoracic and lumbar spinal canal stenosis is low. It is difficult to identify the main focus and responsible segment, and it is also difficult to select the sequence of staging surgery. We report a patient with triple stenosis. Case Presentation: In this paper, we introduced a 61-year-old female patient with cervical, thoracic and lumbar spinal canal stenosis who had previously undergone “lumbar discectomy” in the outer hospital. The postoperative effect was not good and the symptoms were poor. The diagnosis was “cervical spinal stenosis and lumbar postoperative surgery”. The staged spinal canal decompression operation and Duhuo Jisheng Decoction (DHJSD) treatment were conducted in our hospital. After three months of follow-up, the functional and imaging results were satisfactory. Conclusions: The main focus and responsible spinal segment should be determined by the comprehensive analysis of medical history, signs, and images. Surgery combined with Chinese herbal medicine DHJSD therapy may be an effective treatment for this kind of disease.

Establishment of a rat model of chronic thoracolumbar cord compression with a flat plastic screw

Previous studies of animal models of chronic mechanical compression of the spinal cord have mainly focused on cervical and thoracic lesions, but few studies have investigated thoracolumbar injury. The specific pathophysiological mechanism of chronic thoracolumbar cord injury has not yet been elucidated. The purpose of this study was to improve animal models of chronic thoracolumbar cord compression using the progressive screw. A custom-designed flat plastic screw was implanted in the spinal cord between thoracic vertebrae 12 and lumbar 1 of rats. The screw was tightened one complete turn（0.5 mm） every 7 days for 4 weeks to create different levels of chronic spinal cord compression. Following insertion of the screw, there was a significant decline in motor function of the hind limbs, and severe stenosis of micro-computed tomography parameters in the spinal cord. Cortical somatosensory evoked potential amplitudes were reduced remarkably, and latencies were prolonged at 30 minutes after surgery. The loss of motor neurons in the gray matter was marked. Demyelination and cavitation were observed in the white matter. An appropriate rat model of chronic thoracolumbar cord compression was successfully created using the progressive screw compression method, which simulated spinal cord compression injury.