Table of Content

20 May 2008, Volume 3 Issue 05

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主编手记

Team and Treatment

2008, 3(05):  305-308. 

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述评

How Important for Early Neurosurgery Treatment of Acute Spontaneous Subarachnoid Hemorrhage and the Clinical Guidelines

2008, 3(05):  309-310. 

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论著

Clinical Features of Perimesencephalic Nonaneurysmal Subarachnoid Hemorrhage

LIU Ai-Hua;LI You-Xiang;YANG Zhong-Hua;et al

2008, 3(05):  311-314. 

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Objective To investigate the clinical and radiological features and prognosis of perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSH).Methods Total 34 cases whose subarachnoid hemorrhage lesions were found only within perimesencephalic cisterns were retrospectively investigated, including the clinical data, radiological features, treatments and prognosis.Results All the patients were conscious, whose Hunt-Hess scale were Grade I to II and they were all cured, without serious cerebral vasospasms, hydrocephalus, or rebleeding.Conclusion It is important for correct analysis of PNSH to improve correct diagnosis and treatments.

The Dynamic Expression of AQP-4 in Cerebral Ischemic-Reperfussion Model in Rats and the Correlation with Brain Edema

DI Nan;ZHANG Xiang-Jian;HU Ming;et al

2008, 3(05):  315-320. 

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Objective To investigate the Aquaporin-4(AQP-4) expression after cerebral ischemic-reperfussion of rats and the relationship between AQP-4 expression and brain edema.Methods Total 60 adult male Sprague-Dawley rats were randomly divided into sham operation group and middle cerebral artery occlusion/reperfussion(MCAO/R) group. All the rats were tested for neurological behavior by using three different methods: Longa, Berderson and balance beam tests. Brain water content was measured by the wet-dry method and we observed the pathology changes by hematoxylin and eosin(HE) dyeing,the expression of AQP-4 by immunohistochemistry staining.Results In MCAO/R group: the behavioral outcomes were most serious at 48 h and 72 h , back to normal at 7 d; the brain water content increased at 24 h[(82.42±0.12)%], reached to maximum at 48 h [(85.40±0.10)%]and continued to 72 h [(84.87±0.15)%],decreased to normal at 7 d; conspicuous edema and inflammatory cell infiltrating observed by HE dyeing, were most obviously at 48 h and 72 h but disappeared at 7 d; the expression of AQP-4 gradually increased at 6 h (110.0±4.4), reached its peak at 48 h - 72 h (126.2±2.6; 140.1±1.2), and reduced at 7 d (111.3±8.0), but also higher than sham operation group significantly, P<0.05.Conclusion The phase consistency is obvious between the change of expression of AQP-4 and dynamic state process of brain edema, which suggest AQP-4 probable take effect in pathophysiological course of brain edema in the early phase of phase of cerebral ischemic-reperfusion. And inthe late phase AQP-4 may play an important role in the clearance of redundant brain water.

A Brief Cognitive Battery for Mild Vascular Cognitive Impairment

ZHOU Ai-Hong;JIA Jian-Ping;Wang Hai-Tao;et al

2008, 3(05):  321-325. 

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Objective To develop a screening battery for mild vascular cognitive impairment (mVCI).Methods Eighty mVCI patients (mVCI with subcortical small vessel disease, mVCI-SSVD, n = 56; mVCI with multi-infarct or strategic infarct, mVCI-MI/SI, n=24) and 80 normal control subjects were evaluated with cognitive measures tapping executive function and mental processing speed. Tests with fair discriminating validity were selected to form a screening battery. The sensitivity and specificity of the battery in detecting mVCI and its subtypes were determined.Results mVCI and its subtype groups were all impaired in executive function and mental processing speed. Four individual tests were chosen for the screening battery. The battery achieved good sensitivity (80.0%-85.7%) and specificity (88.8%-96.3%) in differentiating mVCI, mVCI-SSVD, and mVCI-MI/SI patients from normal controls. Similarly high validity was obtained in discriminating mVCI, mVCI-SSVD versus controls with MMSE scores of 28 or above.Conclusion The screening battery shows good discrimination in detecting mVCI and its subgroups from normal controls although further confirm is essential through more cases.

Measurement of Cerebrovascular Reserve to Posterior Circulation with Gantry Angled Perfusion CT and CO₂ Test in Symptomic Vetebral-Basilar Artery Stenosis Patients

LIU Ming-Yong;ZHOU Li-Chun;WANG Yong-Jun;et al

2008, 3(05):  326-329. 

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Objective To explore the feasibility of the cerebrovascular reserve assessment with gantry angled perfusion computed tomography(CT) and carbon dioxide(CO2) test in patients with posterior circulation hemodynamic impairment.Methods Perfusion CT with 5% CO2 and 95% oxygen(O2) was used to investigate 9 symptomic vertebral-basilar artery stenosis patients with posterior circulation hemodynamic impairment. CT gantry angle was selected from -13 degree to -23.5 degree (mean -14.7±1.7degree) for the purpose that base line paralleled to vertical line of the level. This protocol could avoid bone artifacts furthest.Results The cerebrovascular reserve of brainstem ranged from -19.83% to 53.36% and of cerebellum ranged from -20.58% to 45.50%.Conclusion It is safe and feasible to assess cerebrovascular reserve with gantry angled perfusion CT and CO2 test in patients with posterior circulation hemodynamic impairment.

专题论坛

Progression of Mechanism Research inCerebtal Vasospasm after Subarachnoid Hemorrhage

2008, 3(05):  331-335. 

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Management of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

2008, 3(05):  336-343. 

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Progression of Clinical Studies in Aneurysmal Subarachnoid Hemorrhage

2008, 3(05):  344-351. 

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综述

Research of Neural Stem Cell and the Treatment of Ischemic infarction

ZHOU Sheng-Nian;SUN Xian;HAN Yong-Tao;et al

2008, 3(05):  381-384. 

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As to the increasing knowledge in neural stem cells, this paper reviewed proliferation of endogenous neural stem cells activated by the ischemic infarction and exogenous neural stem cells transplanted to treat ischemic infarction, so as to provide the new clinical clues for the treatment of cerebral ischemic disease by the neural stem cells.