［Abstract］　Objective　To explore the clinical manifestation, diagnosis and treatment strategies of venous hypertensive brain stem congestion caused by spinal or cerebral dural arteriovenous fistula. Methods　The data of five patients manifested as venous hypertensive encephalopathy treated in Xuanwu Hospital between August 2014 and August 2015 were reviewed retrospectively, including their medical history, neuroimagings, treatment and follow-up data. Results　The five cases included 2 cases of superior petrosal sinus dural arteriovenous fistula(DAVF), 1 case of hypoglossal canal DAVF, 1 case of craniocervical junction DAVF and a case of a cervical spinal dural arteriovenous fistula(SDAVF). Four patients underwent microsurgical treatment while 1 got embolization. Postoperative digital substraction angiography(DSA) confirmed the obliteration of the fistulas and magnetic resonance imaging(MRI) indicated the remission of the congestion. All the patients had clinical improvements in various degress. Conclusion　The brain stem venous hypertensive congestion caused by spinal or cerebral dural arteriovenous fistula is a severe disease. Its clinical symptoms are not specific, and MRI and DSA are of great value for diagnosis.]]> 2019/7/1 16:32:50 MA Yong-jie, LI Gui-lin, HONG Tao, et al. 5true ［Abstract］　Objective　To analysis the prognostic influencing factors of acute ischemic stroke patients with large vessel occlusions（AIS-LVO） who are 80 years old and treated with endovascular therapy. Methods　From January 2017 to December 2018, 66 elderly patients with AIS-LVO underwent endovascular therapy in Cerebrovascular Diseases Center of Changhai Hospital of Navy Medical University(Second Military Medical University) were included in this study. The modified Rankin Scale(mRS) Score was used as a prognostic indicator 3 months after therapy. The patients with mRS score≤2 points were chosen as the good prognosis group(n=20) and the patients with mRS score being 3～6 points were chosen as the poor prognosis group(n=46). The risk factors, neurological function and imaging data of the patients were compared between the two groups. Multivariate Logistic regression was used to analyze the influencing factors of the prognosis of the elderly patients undergoing endovascular therapy. Results　The good prognosis rate was 30.3% (20/66) at 3 months after treatment. There were significant differences in the baseline, National Institutes of Health Stroke Scale(NIHSS) score and core infarction volume of the patients between the good and the poor prognosis groups(P<0.05). Multivariate Logistic regression analysis showed that core infarction>20 ml(OR=3.458, 95%CI: 1.033～11.572, P=0.044) was a risk factor for poor prognosis of endovascular therapy in the elderly patients with AIS-LVO. Conclusion　Core infarction is an independent risk factor affecting the prognosis of endovascular therapy in the elderly patients with AIS-LVO. The larger the volume of core infarction, the worse the prognosis.]]> 2019/7/1 16:32:50 ZHANG Hong-jian, SHEN Hong-jian, YANG Peng-fei, et al. 4true ［Abstract］　Objective　To evaluate the clinical effects of endovascular intervention therapy on traumatic carotid-cavernous fistulas(TCCF). Methods　The therapeutic effect was retrospectively analyzed in 30 TCCF patients receiving endovascular intervention therapy. Results　Among the 30 cases, Coils and Onyx were used in 21 cases(70.0%), a covered stent in 1 case(3.3%), and a detachable balloon in 8 cases(26.7%), and no severe complications occurred after a follow-up for more than 2 years. Conclusion　The endovascular intervention has high success and low complication rates in treatment of TCCF. The key to the success of the treatment lies in the selection and application of appropriate surgical procedures and materials.]]> 2019/7/1 16:32:50 LAN Sheng-yong, PANG Gang, ZHONG Shu, et al. 3true ［Abstract］　Objective　To explore the efficacy and safety of craniotomy clipping and endovascular stent assisted embolization in the treatment of middle cerebral artery(MCA) wide-necked aneurysms. Methods　The clinical data of 73 patients with spontaneous subarachnoid hemorrhage(SAH) of MCA wide-necked aneurysms treated between January 2014 and March 2018 were retrospectively analyzed, among whom 35 cases were enrolled in the microsurgical clipping group and 38 cases in the stent assisted intravascular interventional therapy group. The characteristics of aneurysms, Hunt-Hess grade of SAH, intracranial hematoma, surgical complications such as intraoperative aneurysm rupture and re-bleeding, postoperative cerebral infarction, incision/intracranial infection and other data were analyzed. The indexes to evaluate the therapeutic effect included aneurysm occlusion rate, Glasgow Outcome Scale(GOS) at 1 month and 6 months after surgery, and digital substraction angiography(DSA) or computed tomography angiography(CTA) examination was used to evaluate the aneurysm occlusion. Results　Of the 38 cases of the interventional group, 37 cases were successfully treated with endovascular interventional therapy. Only 1 case in the interventional group was transferred to craniotomy clipping after failure of the interventional therapy. The immediate postoperative angiography results showed that there were 27 cases of aneurysm dense embolization, 9 cases of secondary complete embolization, and 2 cases of partial embolization. Of the 35 cases of the clipping group, 34 cases were successfully clipped, and 1 case was transferred to interventional therapy after clipping failure. There were no significant differences in the occlusion rate and the postoperative recurrence rate between the two groups(P>0.05). The incidence of cerebral infarction and the postoperative infection rate in the interventional group were lower than those in the clipping group, with statistically significant differences(P<0.05). There were no significant difference in the GOS scores between the two groups 1 month and 6 months after treatment(P>0.05). Conclusion　Endovascular stent assisted embolization is a safe and effective method for the treatment of intracranial aneurysms with a high success rate and less complications, but it still needs to be further validated by larger sample studies and long-term follow-up results.]]> 2019/7/1 16:32:50 ZHONG Shu, PANG Gang, TANG Xi-he, et al. 2true ［Abstract］　Acute ischemic stroke(AIS) accounts for 69.6%～70.8% of all new stroke cases. Endovascular thrombectomy(ET) can remove the thrombi from occluded intracranial large vessels and improve the outcome of AIS. The components, sources, physical characteristics of intracranial thrombi and their interactions with blood vessels might be helpful for the judgement of recanalization strategies, clinical prognosis, etiology and secondary prevention. This review summarizes the literatures published in recent years and predicts some further researches of this field in the future.]]> 2019/7/1 16:32:50 SONG Zhao-yang, ZHU Liang-fu, ZHENG Chun-ling, et al. 1true