Study On The Factors Of Cerebral Hernia Inpatients With Massive Cerebral Infarction And Relationship With Cerebral Vascular Abnormalities

Part one Analysis of the factors of cerebral hernia inpatients with massive cerebral infarctionObjective: To investigate the risk factors of cerebral hernia in patients with massive cerebral infarction;to provide a theoretical basis for the prevention of the occurrence of cerebral hernia.Methods:1 220 cases of massive cerebral infarction patients admitted to our hospital from January 2011 to December 2015 were selected as the objective.All patients were divided into cerebral hernia(100 cases)and non-cerebral hernia group(120 cases).2 The general data of all patients were collected including gender,age,history of alcohol drinking,smoking history,whether with atrial fibrillation,hypertension,diabetes.The information of onset were collected including whether the onset of emotional excitement,resting state or active state,the incidence of time to visit;Data were collected from all patients after the onset including the infarction size,whether there was a headache,aphasia,vomiting,gaze,awareness ambiguity,bilateral pathology,NIHSS score,mRS score,BI index,GCS score.3 After statistical analysis of all the data,the Logistic regression analysis was performed with statistical differences factors between the two groups.Results:1 Smoking,atrial fibrillation,hypertension,diabetes,treatment time,after the onset of gaze,awareness,NIHSS score,mRS score and BI index and GCS score of two groups were statistically significant differences(P<0.05).2 Smoking history,atrial fibrillation,gaze,confusion and GCS score and massive cerebral infarction were associated with cerebral hernia.Part two To study the relationship between massive cerebral infarction and cerebral vascular anomalyObjective: To study the relationship between cerebral vascular abnormalities and massive cerebral infarction,and to provide reference for the selection of appropriate treatment in clinical.Methods:1 The research object was the same as the section one.2 CT angiography and CT perfusion imaging were performed in all patients after admission.The imaging scanning performed by the professional staff using 128-slice spiral CT scanner(Siemens).The dynamic images were reconstructed and processed by CT Perfusion software.The blood flow of anterior cerebral artery,posterior cerebral artery,middle cerebral artery and internal carotid artery in all patients were detected by transracial color Doppler detector.Cerebral vascular stenosis and cerebral perfusion and intracranial vascular blood flow condition in the healthy side and affected side was analyzed.Results:1 Only 86 cases(39.1%)large blood vessels was normal.Cerebral tissue perfusion was obviously abnormal.2 The cerebral blood flow and cerebral blood volume were significantly smaller than that of the healthy side;the difference was statistically significant(P<0.05).The blood flow velocity,arterial index and systolic peak velocity were significantly higher in the healthy side than in the affected side,and the difference was statistically significant(P<0.05).Conclusion:1 Smoking history,atrial fibrillation,gaze,confusion and GCS score and massive cerebral infarction were associated with cerebral hernia.2 Cerebral vascular anomalies in a certain extent can response in patients with disease progression and prognosis of massive cerebral infarction.