The Difference Of Brain Perfusion Between The Intracranial Aneurysm Patients After Clipping And Interventional Theraphy:A CTP Study

Objective: Intracranial aneurysm is the vascular sample protrusions of brain due to the abnormal changes of local blood vessels,which is the first cause of subarachnoid hemorrhage.The statistics show that the incidence of intracranial aneurysms in cerebrovascular disease is in the third place,the leading two disease are cerebral thrombus and hypertensive cerebral hemorrhage.The Intracranial aneurysm can happen in the whole life,likely in age 30 to 60.Which cause intracranial aneurysm is very complicated.Most scholars believe that intracranial aneurysms is the joint product by nature and nurture factors.Intracranial arterial wall partial birth defects is congenital factor;Increasing pressure in the cavity is the nurture factor.The occurrence and development of aneurysms is associated with hypertension,cerebral arteriosclerosis,blood vessel,blood flow impact.Intracranial aneurysms most likely happen in the circle of Willis,as aslo in the first half.There are two ways of aneurysm rupture hemorrhage.One is pure SAH,accounted for 85%.Another is intracranial hematoma,accounting for 15%.Aneurysmal subarachnoid hemorrhage caused by cerebral vasospasm is the important reason for the patient to death and disability.Digital subtraction angiography is mainly used to observe the great vessels spasm degree,does not show microcirculation status.Aneurysm clipping and interventional embolization are the two main methods for the treatment of intracranial aneurysms.Therefore this article mainly explore the change of cerebral microcirculation between clipping and interventional embolization of intracranial aneurysm by using CTP imaging.Methods:1 Select 40 patients with ruptured intracranial aneurysm which are diagnoseds by CT and DSA.Exclude the patients with Coagulopathy,and other paitients with the disease which affect cerebral blood flow perfusion.2 They were divided into two groups according to the difference of the therapies.A group: clipping of intracranial aneurysm(20 cases),B group: interventional embolization of intracranial aneurysm(20 cases).CBV/CBF/MTT were measured in two groups 12 hours before and after the surgery,and analyzed statistically.(1)MTT is mainly used for judging delayed cerebral vasospasm,which is very sensitive.(2)CBF mainly reflects cerebral perfusion,by which the change of cerebral perfusion can be quantitatively analyzed.(3)CBV decrease marks the possibility of happening cerebral infarction.As a result,the decreasing degree of CBF and CBV at the same time indicates the scope and the degree of the irreversible brain damage,and also indicates prognosis.Compare two groups of patients with the change of CBV,CBF,and MTT.The postoperative CBV/CBF/MTT was compared with the preoperative data.There were statistically significant in CBVA/BCBFA/B and MTTA/B during the surgery(P<0.05),which indicate the change of erebral perfusion,the possibility of cerebral infarction,and the aggravating degree of vasospasm.If P<0.05,there were statistically significant in ?CBVA/B?CBFA/B and ?MTTA/B during the surgery,which indicate that there are difference between the change of erebral perfusion,the possibility of cerebral infarction,and the aggravating degree of vasospasm.Results: 1 The postoperative CBV/CBF/MTT was compared with the preoperative data.There were statistically significant in CBVA/BCBFA/B during the surgery(P<0.05).There were no statistically significant in the MTTA/B during the surgery(P>0.05).2 There were statistically significant in ?CBVA/B?CBFA/B during the surgery(P<0.05).There were no statistically significant in the ?MTTA/B during the surgery(P>0.05).Conclusions:1 Clip ruptured aneurysm surgery and interventional embolization affact patients with brain perfusion in the short term.2 The change of cerebral microcirculation caused by interventional embolization of intracranial aneurysm was less than clipping of it for the patients with ruptured intracranial aneurysm.