Table of Content

20 January 2008, Volume 3 Issue 01

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Growth

WANG Yong-Jun

2008, 3(01):  1-2. 

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Creation,Style and Feature

YUAN Gui-Qing

2008, 3(01):  3-4. 

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Highlight Report of the Seventh Ultrasound of Brain and Carotid Arteries

HUA Yang

2008, 3(01):  5-6. 

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会议报道

Highlight Report of the Third Intemational Stroke Summit

LI Yun;XU Ge-Ling

2008, 3(01):  7-8. 

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述评

Status and Necessity of Standard Operation of Transcranial Doppler Sonography in China

HUA Yang

2008, 3(01):  9-10. 

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论著

Monitoring of Microemboli during the Middle Cerebral Artery Angioplasty and Stenting

XU Xiao-Tong;GU Jia-Li;JIANG Wei-Jian.

2008, 3(01):  11-14. 

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Objective TCD was applied to detect the microemboli signal during the middle cerebral arteryangioplasty and stenting procedure.Methods Eight consecutive patients (3 females and 5 males, average age 45.5±10.5 years old)were selected in the study since Jan 2006 to Dec 2006. The data was recorded and emphasizedduring the four phases as follows: (1) putting guide catheter; (2) sending microwire through thelesion; (3) stenting delivering system span across the lesion; and (4) primary balloon dilatationperiod. TCD was used continually in this stenting implantation period to record the microemboliof middle cerebral arteries simultaneously, also to record the peak systolic velocity before and afterthe stenting.Results There were no complications related to the procedure. The percentage of stenosis was79.4%±7.8% preoperation, and 9.4%±8.2% postoperation. Peak systolic velocity where the stenosislocated was 305.3±61.5cm/s preoperation, 201.1±40.5cm/s immediately postoperation. Highintensitytransient signals indicative of microemboil could be observed in all four phases (3.5±4.2,8.9±7.2, 4.6±5.8 and 14.5±7.0, respectively), but appeared to be more frequent in the phase 4.Conclusion Angioplasty and stenting implantation is a method in the treatment of the middlecerebral artery stenosis, and can improve cerebral blood flow. Although high-intensity transient signalsare observed in these cases, the relationship between high-intensity transient signals and ischemicevents need to be further explored.

Prognostic Analysis of 156 Patients with Posterior Circulation Infarction

SHI Guo-Wen;LI Yan-Sheng;LIN Yan;et al.

2008, 3(01):  15-19. 

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Objective To evaluate the determinants of the prognosis of patients with posterior circulationischemic stroke.Methods Total 156 patients with posterior circulation ischemic stroke within 7 days admittedduring 2004-2006 were analyzed retrospectively. All patients were undertaken magnetic resonanceimaging(MRI) on admission and ischemic lesions were identified at the posterior circulationterritories. The patients were evaluated within 2 years by modified Rankin scale(mRS) and Bathelindex(BI) to investigate the relationships between risk factors, lesion locations and prognosis.Results Of the 156 patients, 76.3% showed no or mild disability(mRS 0-3) and 19.9% showedsevere disability(mRS 4-5) within 2 years. Mortality was 3.8% of all the patients. There wassignificant coincidence between mRS and BI(P <0.01). When evaluated by BI, prognosis within 2years of the patients were associated with age(OR 1.079, 95%CI 1.034-1.125, P <0.01), multiplelesions(OR 3.463, 95%CI 1.294-9.267, P =0.013), stroke history(OR 2.505, 95%CI 1.103-5.685,P =0.025) by the logistic procedure.Conclusion Majority of the patients with posterior circulation ischemic stroke have goodprognosis. Patients who are young, with single lesion and no stroke history have better prognosis.

Observation of Hemodynamics in Patients with Traumatic Carotid-cavernous FistulaInterventional Therapy

JIN You-He;XIAO Liang;WANG Hong;et al.

2008, 3(01):  20-24. 

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Objective To observe hemodynamic changes by using Transcranial Doppler(TCD) in patients withtraumatic carotid-cavernous fistula(TCCF) before and after the interventional therapy(detachableballoon embolization).Methods We retrospectively analyzed(from Feb 2000 to Oct 2007) the TCD results of 18patients with TCCF before and after the operation and compared with the digital subtractionangiography(DSA) results.Results Of all the patients diagnosed TCCF through DSA before the operation, 15 patientsunderwent detachable balloon embolization and DSA confirmed a successful surgery; 2 patients hadto be changed to the affected internal carotid artery (ICA) occlusion and DSA images displayed theaffected ICA complete occlusion; one patient was forced to give up any operation for the vascularspasm. Before the treatment, the results showed a group of characteristic hemodynamic changes: (1)The higher velocity of blood flow and the lower pulsatility index (PI) in the extracranial segmentand/or the siphonic segment of ICA were showed in 17 patients and the spectra of the siphonicsegment of the affected ICA disordered. (2)The velocity of blood flow and PI were reduced in10 patients of the affected middle cerebral artery (MCA) and 16 patients of the anterior cerebralartery (ACA). (3)The velocity of blood flow was accelerated with normal spectra in 11 patientsof the affected posterior cerebral artery (PCA) and 14 patients of the contralateral ACA. (4) Theblood flow of the superior ophthalmic vein (SOV) was reversed and its abnormal frequencyspectra showed arterializational manifestation of the affected in 16 patients and of bilateral in 2patients. Seventeen patients were followed up with TCD at 1 week and 6 months. The abnormalhemodynamics of ICA and SOV in 15 patients were recovered or approached normally afterdetachable balloon embolization. The TCD in 2 patients after ICA occlusion showed the affectedICA complete occlusion (high velocity of blood flow of the affected PCA and the contralateralACA).Conclusion TCD provides a dynamic and real-time observation of the blood flow in theintracranial and extracranial blood vessels accurately, and also provides reliable hemodynamic datafor CCF in clinical diagnosis and treatment.

编者按

Hemodynamics of Cerebrovascular Disease-part1

yanghua

2008, 3(01):  27-27. 

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病例讨论

Hemodynamics Monitoring of Intravenous Thrombolysis in Patient with Acute Cerebral Infarction:A Case Report

XUE Suang;GUI De-Chao;WEI Kun;etal.

2008, 3(01):  51-53. 

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指南与规范

Practice Standards for Transcranial Doppler Ultrasound:Part1-Test Performance

XU Xiao-Tong;Han Ying;Ling Jin-Xi;etal.

2008, 3(01):  54-60. 

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综述

Aspirin Resistance: An Idea without Clinically Practical Significance

Shizhongwei

2008, 3(01):  61-64. 

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Aspirin resistance has two definitions. Clinical aspirin resistance is defined aspatients taking aspirin unable free from ischemic cardiovascular events. This definition ignores thecomplexity of pathogenesis of cardiovascular diseases. Furthermore, it is not realistic to expectthat all vascular complications can be prevented by single preventive strategy. Biochemical aspirinresistance means aspirin cannot produce an anticipated effect on one or more laboratory testsof platelet function when taking aspirin, such as inhibiting platelet aggregation or biosynthesisof thromboxane. However, the methodologies of these tests have not yet been standardized. Theresults of these experiments are lacking in specificity, sensitivity and reproducibility. The clinicalrelevance has not been established. Therefore, at present, aspirin resistance is only an idea withoutclinical significance.

Focal Hemodynamics and Carotid Atherosclerotic Plaque

QIN Hai-Qiang;WANG Yong-Jun

2008, 3(01):  65-69. 

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Cerebrovascular events are believed to be related to carotid atherosclerotic plaque.Focal hemodynamics has a prominent impact on the initiation and development of carotid plaque.Many factors, such as carotid bifurcations, pulsatile flow conditions and arterial geometries, havebeen proposed as important factors to focal hemodynamics mechanism. Plaque stenosis may set uphemodynamic conditions causing distal arterial wall collapse.