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DOI: 10.3969/j.issn.1672‑6731.2024.03.014

Severe cerebral venous thrombosis (CVT) is a rare type of stroke with poor prognosis and high mortality. The pathophysiological mechanism of severe CVT at present only focus on the onslaught of CVT as a venous return disorder and fails to elucidate the process of occurrence and development of the disease. Recently, studies on the relationship between severe CVT and inflammation have found that inflammation is involved in the pathophysiology of severe CVT, and a variety of inflammatory markers are correlated with its poor prognosis, suggesting that targeted inflammation therapy for severe CVT is a very promising treatment. This paper reviews the basic and clinical research on the relationship between inflammation and severe CVT to understand the role of inflammation in the pathophysiology of severe CVT and provide ideas for the development of new treatment strategies for severe CVT.

Objective To report a case of subdural hematoma (SDH) puncture and drainage combined with epidural blood patch (EBP) in the treatment of spontaneous intracranial hypotension (SIH) complicated with SDH and venous cerebral infarction, and summarize the diagnostic and treatment ideas. Methods and Results A male patient presented with sudden headache accompanied by hemiplegia, the headache was relieved in recumbent position and aggravated when standing or sitting for a long time. He was initially diagnosed as acute cerebral infarction before hospitalization and was given rt⁃PA intravenous thrombolysis. And then was diagnosed as cerebral venous thrombosis (CVT), which was treated through dehydration and anticoagulation, during which bilateral SDH occurred and progressive aggravated, and sent to Department of Emergency of Xuanwu Hospital, Capital Medical University. He was diagnosed as bilateral frontotemporal parietal SDH and effusion, CVT with venous cerebral infarction, and SIH. Soft channel twist drill craniotomy was performed firstly, then targeted autologous EBP were performed when the condition came to steady. The patients' symptoms improved, and residual SDH absorbed gradually. Conclusions For CVT patients accompanied by focal nerve dysfunction and SDH showed postural headache, the possibility of SIH could be considered, and stereotactic soft channel SDH puncture and drainage combined with targeted autologous EBP can play a curative effect.

Objective According to the diagnosis and treatment process of a case of spontaneous intracranial hypotension (SIH) with cerebral venous sinus thrombosis (CVST), the etiology, diagnosis and treatment were analyzed in order to improve the clinicians' understanding. Methods and Results A 34⁃year⁃old male patient developed persistent headache in the occipital region accompanied by intermittent throb⁃like pain. The onset was independent of body position or circadian rhythm, and the symptoms were progressively aggravated. The patient was initially diagnosed with CVST, and gained a poor curative effect of endovascular treatment and anticoagulant therapy. The subsequent diagnosis of SIH with CVST was corrected by head MRI and magnetic resonance myelography (MRM). After bedrest, hydration, steroids, anticoagulation and defibration therapy, the headache symptoms disappeared and the laboratory test results returned to the normal range. There was no recurrence after discharge. Conclusions For CVST patients without typical orthostatic headache, more attentions should be paid to the analysis of imaging findings and clinical data, in order to avoid the possibility of missed diagnosis of intracranial hypotension syndrome (IHS).

Objective This paper reports a case of malignant intracranial hypertension, reviews his diagnosis and treatment, and analyzes his etiology, in order to improve the clinicians' cognition of this disease. Methods and Results The patient was a 19⁃year⁃old male with subacute onset and chronic course of disease, presenting with amaurosis, headache, neck and shoulder pain, blurred vision and tinnitus disease. Imaging findings showed cerebral venous sinus stenosis (VSS) with obvious pressure difference at both ends of stenosis. However, venous sinus stenting was ineffective. After optic nerve sheath decompression, the symptoms of headache and blurred vision were not significantly improved. Finally, the patient was diagnosed as glioblastoma (WHO Ⅳ), and died 8 months after removal of the tumor foci. Conclusions Patients with the pressure difference at both ends of malignant intracranial hypertension with VSS should not take stenting. Clarifying the cause and type of stenosis is very important for correct diagnosis and guide treatment.

doi：10.3969/j.issn.1672⁃6731.2021.03.017

Stroke is the second leading cause of death in the world and the main cause of death in China. Ischemic stroke accounts for 70% of the total number of stroke. Endovascular mechanical thrombectomy has been recognized as an effective treatment for acute ischemic stroke (AIS) recently, however, the percentage of patients who were subject to poor prognosis and had relatively high morbidity and mortality is about 50%. The development of mechanical thrombectomy makes it possible to collect thrombus retrieved from intravascular therapy for more histopathological researches. It allows more complete extraction of human thrombus for histological analysis, while avoiding the limitations of invitro and animal experiments. This article reviews the progress of thrombus histopathology, thrombus imaging, thrombus histopathology and etiology classification, thrombus histopathology and intravascular therapy, in order to explore the pathophysiological mechanism of thrombosis and provide potential targets for the diagnosis and treatment of acute ischemic stroke.

The pathogenesis and pathophysiological process of cerebral venous sinus thrombosis (CVST) are different from that of ischemic stroke. The establishment of an appropriate animal model of CVST is helpful to the further research of pathogenesis, pathophysiological process and the choice of treatment strategy. However, at present, most animal models are only short-term observations, which are not suitable for long-term studies and can not well simulate the pathogenesis and pathophysiology of human CVST. This article reviews the preparation, advantages and disadvantages of various animal models of CVST, and the current research status, in order to lay a theoretical foundation and clear development direction for the study of a new method of preparing animal models of CVST with high success rate and high fitting degree. [ABSTRACT FROM AUTHOR]

Diabetes can cause more than double risk of ischemic stroke and is associated with with poor long-term prognosis after ischemic stroke. Surprisingly, intensively treating hyperglycemia has not been shown to have beneficial outcomes in either primary or secondary prevention in stroke disease. Encouragingly, multifactorial management of risk factors of ischemic stroke, in particular, lifestyle, glucose concentration, hypertension, and dyslipidemia will prevent a substantial number of ischemic stroke and improve the prognosis in diabetic patients. Antithrombotic treatment and carotid surgery are also essential for primary and secondary stroke prevention in selected diabetic patients. Evidence for primary and secondary prevention of ischemic stroke in diabetic patients is steadily evolving, and it is imperative that clinicians are actively informed regarding the latest advance in order to better implement stroke prevention in diabetic patients. [ABSTRACT FROM AUTHOR]

Objective: To study the possible role of ganglioside GM1 in proliferation and differentiation of neural stem cells (NSCs) of rats in vitro., Methods: (1) Fetal rats were employed to this study. The primary cells isolated from the cerebral cortex and hippocampus were cultured with serum-free incubation technique and then the cellular differentiation were induced with serum. (2) The proliferation and differentiation features of NSCs were observed under phase contrast microscope after the GM1 with different concentrations were added into NSCs' and serum-free DMEM/F12 culture media., Results: (1) Comparing with control, no significant proliferation of NSCs was coming to pass when the GM1 with low concentration was added into the cell culture medium; however, the size of NSCs clones gradually decreased and the cells were dying when the GM1 with high concentration was added into NSCs' culture medium. (2) NSCs, cultured in DMEM/F12 culture medium only containing GM1, neither proliferated nor differentiated, but were dying soon., Conclusion: GM1 of low concentration (12.5 microg/mL) has no significant influence on proliferation of NSCs, but GM1 of higher concentration can inhibit the NSCs' proliferation in culture medium.