Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

脸色腰段椎间盘突出症21例临床分析

胸腰段椎间盘突出症罕见,约占椎间盘突出的0.6％～4％。随着CT及MRI的应用,其发病率有增加的趋势。因其发病率低,报道较少。但由于病变位于脊髓圆椎段,其发病较下腰段椎间盘突出有很大的特殊性,故有必要结合我院近年收治的21例对其作一回顾性分析。1 临床资料     

缩短肝脏移植无肝期的护理探讨

肝移植手术是治疗终末期肝病的根本治疗手段，由于手术常伴有大量出血、渗血、渗液及输血治疗，而在无肝前期、无肝期、新肝期这三个不同阶段中，无肝期为病肝切除至新肝的大血管吻合开放，期间纤维蛋白原和凝血酶原等凝血因子不能合成，而类肝素样物质增加，出现明显的纤溶亢进，如伴有供肝情况不良，凝血因子合成减少而合成不能，就会产生凝血功能障碍，在无肝期中一旦发生则出血情况较为严重。     

巡回性诊疗护理与老年人保健

饭富病院地处日本本州山黎县,远离大都市,地偏人稀,但环境优美,气候宜人,的确是疗养的好地方。饭富病院属公立医院,虽规模较小,但是一所综合性医院。我们在此院研修3个月,时间虽短,但期间的所见所闻,尤其护理方面给我们的启发和教益却是十分深刻的。现介绍几个片断,以飨读者。1     

异位心(胸腹型)1例报告

异位心是罕见的先天性畸形,以胸部型心异位最为常见。我们遇到1例胸腹型异位心,为明确心内畸形作了全面检查,现报告如下.患者,女,19岁,自幼发现心脏杂音,平时易受凉发烧,活动后气喘,一岁后逐渐出现紫绀,无蹲踞及晕厥史.发育营养较差,口唇、面部紫绀,杵状指趾。BP110/70mmHg,P88次/分。胸部对称,     

东芝KXO-15C 500mA X线机点片系统故障2例

故障现象1 点片架不能升降. 故障分析开机发现无论操作spotup或spotdown,升降电机都不运转,但继电器RY5、RY6、与RY9都动作,用万用表测得RY9(32、42)触点提供给电机运转绕组的电压正常,但给电机启动绕组供电的继电器RY7不动,说明RY7的线圈没有得电.     

微创穿刺治疗重度脑室出血26例临床分析

目的 探讨微创穿刺治疗重度脑室出血的疗效.方法 微创穿刺侧脑室引流,加腰穿脑脊液置换.结果 抢救成功21例,死亡5例,病死率19.2%,抢救成功病例无1例发生梗阻性脑积水.结论 本方法治疗重度脑室出血效果良好.