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Idiopathic parkinson’s disease and fatigue 特发性帕金森病和疲劳
Pub Date : 2022-05-10 DOI: 10.29328/journal.jnnd.1001062
Erdoğan Hacı Ali, Yayla Vildan, Sözer Nejla, Aydın Filiz Yıldız, Acır Ibrahim, Vural Meltem
Introduction: Fatigue is a common non-motor symptom of Idiopathic Parkinson’s Disease (IPD). The aim is to research the relationship between fatigue of IPD patients and the clinical findings, of mood disorders. Material and methods: A total of 39 patients with IPD were included in the study. The relationship between fatigue severity and demographic characteristics and the treatment was evaluated in IPD. The severity of fatigue was evaluated by Fatigue Severity Scale (FSS). Motor impairment was scored by the modified Hoehn and Yahr scale. The patients were assessed for the presence of depression and anxiety with the Hospital Anxiety and Depression Scale (HADS). Results: The mean age of the patients was 70.62 ± 8.35 years. 23 were men and 16 were women. The mean disease duration was 6.18 ± 3.35 years. The patients were assigned into two groups according to the presence of fatigue measured by FSS with less than 5 (Group I) and 5 or more (Group II). There were no statistically significant differences between the two groups with respect to mean age, mean age of onset, and mean disease duration of the patients (p > 0.05). There were no significant differences between the two groups for HADS depression, anxiety values, and terms of antiparkinsonian therapies (p > 0.05). The severity of fatigue was correlated with the HADS anxiety levels (p < 0.05). Discussion: Fatigue is an important non-motor symptom that is underestimated in clinical follow-up. We didn’t find any correlation between fatigue and age, duration of disease onset, or drug use. There was no significant correlation between the fatigue score and depression, and pain. However, the fatigue scores were higher in patients with high anxiety scores and females.
疲劳是特发性帕金森病(IPD)常见的非运动性症状。目的是研究IPD患者疲劳与情绪障碍临床表现之间的关系。材料与方法:共纳入39例IPD患者。在IPD中评估疲劳严重程度和人口学特征与治疗之间的关系。采用疲劳严重程度量表(FSS)评价疲劳程度。采用改进的Hoehn和Yahr量表对运动障碍进行评分。采用医院焦虑抑郁量表(HADS)评估患者是否存在抑郁和焦虑。结果:患者平均年龄70.62±8.35岁。其中男性23人,女性16人。平均病程为6.18±3.35年。根据FSS测量疲劳程度分为两组,第一组小于5分,第二组大于等于5分。两组患者的平均年龄、平均发病年龄、平均病程比较,差异均无统计学意义(p > 0.05)。两组患者在抑郁、焦虑值和抗帕金森治疗方面无显著差异(p > 0.05)。疲劳程度与HADS焦虑水平相关(p < 0.05)。讨论:疲劳是临床随访中被低估的一种重要的非运动性症状。我们没有发现疲劳与年龄、疾病发作时间或药物使用之间的任何相关性。疲劳评分与抑郁、疼痛无显著相关性。然而,焦虑得分高的患者和女性的疲劳得分更高。
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引用次数: 0
Intrasellar psammomatous meningioma: a case report and review of the literature 鞍内沙瘤性脑膜瘤1例报告及文献复习
Pub Date : 2022-01-18 DOI: 10.29328/journal.jnnd.1001061
Riccioni Luca, Balestrieri Antonio, D. Fuschillo, Nasi Maria Teresa, Tosatto Luigino
Intrasellar meningioma (IM) is a rare occurrence that is difficult to distinguish preoperatively from the most common non-functioning pituitary adenoma. Here we describe a case of psammomatous IM occurring in a 68-year-old woman, presented with visual defects. On magnetic resonance imaging (MRI) she was found to have an intrasellar mass with suprasellar extension that was approached with transsphenoidal surgery. Subtle radiological hints, namely dural tail sign, intralesional calcifications and a marked and homogenous early enhancement of IM on MRI after gadolinium administration, may aid clinicians in achieving an accurate pre-operative diagnosis and choosing the proper surgical approach. The clinical and neuroradiological features of IM described in the literature has been reviewed.
鞍内脑膜瘤(IM)是一种罕见的肿瘤,术前很难与最常见的无功能垂体腺瘤区分。我们在此报告一位68岁的女性,因视觉缺陷而罹患沙质性眼球炎。磁共振成像(MRI)发现她有鞍内肿块,鞍上延伸,经蝶窦手术处理。细微的放射学提示,即硬脑膜尾征、病灶内钙化和钆给药后MRI上明显且均匀的早期IM增强,可以帮助临床医生获得准确的术前诊断和选择合适的手术入路。本文回顾了文献中描述的IM的临床和神经放射学特征。
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引用次数: 0
Neurotoxicity related exposure to ambient nanoparticles 暴露于环境纳米粒子与神经毒性有关
Pub Date : 2022-01-18 DOI: 10.29328/journal.jnnd.1001060
Ehsani Mojtaba, Montazeri Zeinab, Rafati Mehravar
Air pollution exposure is among the most prevalent reasons for environmentally-induced oxidative stress and inflammation, both of which are implicated in the central nervous system (CNS) diseases. The CNS has emerged as an important target for adverse health effects of exposure to air pollutants, where it can cause neurological and neurodevelopmental disorders. Air pollution includes various components of gases, particulate matter (PM), ultrafine particulate (UFPs), metals, and organic compounds. An important source of PM and UFPM in the ambient air is associated with air pollution-related trafficking, and primarily diesel exhaust particles (DEPs). Controlled animal studies and epidemiological studies show that exposure to air pollution, and in particular urban air pollution or DEPs, may lead to neurotoxicity. In specific, exposure to air pollutants as an important factor may be in neurodevelopmental disorders (eg Autism) and neurological disorders (eg.., Alzheimer’s Disease (AD)). The most noticeable effects of exposure to air pollutants in animals and humans are oxidative stress and neurodegeneration. Studies in rats exposed to DEPs showed microglial activity, increased lipid peroxidation, and neuronal accumulation in various areas of the brain, especially the olfactory bulb (OB) and the hippocampus (HI). Disorders of adult neurogenesis were also found. In most cases, the effects of DEP are more pronounced in male mice, probably due to lower antioxidant capacity due to less expression of paraoxonase 2.
空气污染暴露是环境诱导的氧化应激和炎症的最普遍原因之一,这两者都与中枢神经系统(CNS)疾病有关。中枢神经系统已成为暴露于空气污染物对健康不利影响的一个重要目标,它可能导致神经和神经发育障碍。空气污染包括气体、颗粒物(PM)、超细颗粒物(ufp)、金属和有机化合物的各种成分。环境空气中PM和UFPM的一个重要来源与空气污染相关的贩运有关,主要是柴油排气颗粒(dep)。对照动物研究和流行病学研究表明,接触空气污染,特别是城市空气污染或dep,可能导致神经毒性。具体而言,暴露于空气污染物作为一个重要因素可能是神经发育障碍(如自闭症)和神经障碍(如…阿尔茨海默病(AD))。动物和人类暴露在空气污染物中最明显的影响是氧化应激和神经变性。对暴露于DEPs的大鼠的研究显示,在大脑的各个区域,特别是嗅球(OB)和海马(HI),出现了小胶质细胞活性、脂质过氧化增加和神经元积聚。成人神经发生障碍也被发现。在大多数情况下,DEP对雄性小鼠的影响更为明显,这可能是由于雄性小鼠抗氧化能力较低,对氧磷酶2的表达较少。
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引用次数: 4
Pediatric brainstem glioma 小儿脑干胶质瘤
Pub Date : 2022-01-03 DOI: 10.29328/journal.jnnd.1001059
Hatim Ghita, Chekrine Tarik, Houjami Majdouline, Boughafour Mouna, B. Zineb, B. Nadia, Jouhadi Hassan, T. Nezha, B. Abdelatif, Sahraoui Souha
Background and objectives: Brainstem gliomas are tumors of the central nervous system which have varying presentations and clinical courses. This study aims to analyze the frequency, clinical and therapeutic aspects of brainstem glioma. Methods: We retrospectively analyzed the data from the record of the patients treated for brainstem glioma under the age of 20 between January 2007 and July 2020 in the Radiation Oncology department of the Ibn Rochd UHC. Results: There were fifteen patients (10 males and 5 females). The mean age of onset was 12 years (range 8 - 14 years). The duration of symptoms varied from 1 month to 2 years. Nine of the patients had intracranial hypertension due to hydrocephalus, six had cranial nerve deficits at presentation, and five patients had cerebellar signs. The lesion was pontine in 12 cases. None of the patients had a tumoral resection, nine had a ventriculo-peritoneal shunt insertion for the hydrocephalus and three had a Stereotactic biopsy that revealed one astrocytoma grade 1, one low grade glioma and one glioblastoma. The radiotherapy was indicated in all the cases but only nine patients had a 3D radiotherapy with a total dose of 54 Gy. Three patients received chemotherapy. Six patients are still alive, two are lost to follow up and seven patients are dead with a mean survival period of 8 months. Conclusion: Brainstem glioma is a devastating disease with a bad prognosis. The clinical presentation is variable and the management is multidisciplinary. Our study illustrates the importance of treatment by radiation.
背景和目的:脑干胶质瘤是中枢神经系统的肿瘤,具有不同的表现和临床病程。本研究旨在分析脑干胶质瘤的发病频率、临床及治疗特点。方法:回顾性分析2007年1月至2020年7月伊本罗氏UHC放射肿瘤科治疗的20岁以下脑干胶质瘤患者的记录数据。结果:15例患者(男10例,女5例)。平均发病年龄为12岁(8 - 14岁)。症状持续时间从1个月到2年不等。9例患者因脑积水而出现颅内高压,6例患者首发时有颅神经缺损,5例患者有小脑体征。12例呈桥状病变。所有患者均未行肿瘤切除术,9例脑积水患者行脑室-腹膜分流术,3例立体定向活检显示1例星形细胞瘤、1例低级别胶质瘤和1例胶质母细胞瘤。所有病例均行放射治疗,但仅有9例患者行三维放射治疗,总剂量为54 Gy。3例患者接受了化疗。存活6例,失访2例,死亡7例,平均生存期8个月。结论:脑干胶质瘤是一种预后不良的恶性疾病。临床表现是多变的,治疗是多学科的。我们的研究说明了放射治疗的重要性。
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引用次数: 0
Differential roles of trithorax protein MLL-1 in regulating neuronal Ion channels 三胸蛋白MLL-1在调节神经元离子通道中的差异作用
Pub Date : 2021-09-08 DOI: 10.29328/journal.jnnd.1001057
Dave Sonya, Z. An
Repressive regulation of potassium channel genes by Polycomb group (PcG) proteins contributes to PcG protein-mediated neuroprotection against neuronal ischemic injury, as seen in an ischemic stroke. Here we asked the question whether Trithorax group (TrxG) proteins, the antagonistic partners of PcG proteins (i.e, epigenetic activators targeting the same genes) may also regulate potassium channels. Results of patch-clamp studies on cultured neuronal cells showed that inhibition of TrxG protein MLL-1 led to an increase in potassium channel activity, an unexpected effect for a presumed gene activator. In contrast, decreased sodium currents were observed with MLL-1 inhibition. Increased or decreased levels of potassium channel protein Kv2.1 or sodium channel protein Nav1.2, respectively, were seen with MLL-1 inhibition, as determined by immunocytochemistry. These results, for the first time, demonstrate an involvement of TrxG protein MLL-1 in regulating neuronal ion channels, potentially repressing potassium channel genes.
在缺血性中风中,Polycomb group (PcG)蛋白对钾通道基因的抑制调控有助于PcG蛋白介导的神经保护,防止神经元缺血性损伤。在这里,我们提出了Trithorax group (TrxG)蛋白,PcG蛋白的拮抗伙伴(即针对相同基因的表观遗传激活因子)是否也可能调节钾通道的问题。膜片钳对培养的神经细胞的研究结果表明,抑制TrxG蛋白MLL-1导致钾通道活性增加,这是一种意想不到的基因激活剂。相比之下,MLL-1抑制可降低钠电流。通过免疫细胞化学测定,MLL-1抑制分别导致钾通道蛋白Kv2.1或钠通道蛋白Nav1.2水平升高或降低。这些结果首次证明了TrxG蛋白MLL-1参与调节神经元离子通道,潜在地抑制钾通道基因。
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引用次数: 0
Five-year follow up on the single level corpectomy 对单节段切除进行了五年的随访
Pub Date : 2021-07-27 DOI: 10.29328/journal.jnnd.1001055
Castro Frank Phillip
Single-level Anterior Cervical Decompression and Fusion (ACDF) was initially performed using Iliac Crest Bone Graft (ICBG) [1]. Fusion rates improved when a surgical technique change, the addition of anterior plate ixation, was incorporated decades later [2,3]. Single level ACDFs with a machined allograft and plate ixation technique eventually became the industry standard as it demonstrated equivalent fusion rates with fewer complications than single level ACDFs with ICBG. This surgical technique was extended for use in patients with contiguous disk herniations. Multilevel ACDFs performed with machined allografts or interbody spacers and a two-level plate offered shorter operative times, less blood loss, better restoration of lordosis, and less immediate pain [4]. Successful multi-level ACDFs were strongly in luenced by the bone graft source [5], the smoking addiction [6], and the construct stability [7]. Placement of two additional ixation screws in the central vertebral body, another improvement in the surgical technique, increased the construct strength compared to constructs with screws only placed into the end vertebral bodies [8]. Using allografts for multilevel ACDFs was a device disadvantage as they often resulted in high nonunion rates [9,10].
单节段颈椎前路减压融合(ACDF)最初采用髂嵴骨移植(ICBG)进行[1]。几十年后,随着手术技术的改变,加入前钢板固定术,融合率提高了[2,3]。机械同种异体移植和钢板固定技术的单节段ACDFs最终成为行业标准,因为它显示出与ICBG的单节段ACDFs相同的融合率和更少的并发症。该手术技术被扩展用于连续椎间盘突出患者。采用机械同种异体移植物或椎间间隔器和两节段钢板进行多节段ACDFs,可缩短手术时间,减少出血量,更好地恢复前凸,减少即时疼痛[4]。成功的多级ACDFs受植骨来源[5]、吸烟成瘾[6]和构建体稳定性[7]的强烈影响。在中央椎体放置两枚额外的固定螺钉是手术技术的另一项改进,与仅在末端椎体放置螺钉相比,增加了构建体的强度[8]。使用同种异体移植物治疗多节段ACDFs是一个设备缺点,因为它们通常导致高不愈合率[9,10]。
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引用次数: 0
Facial-onset sensory-motor neuronopathy, a rare variant of Huntington’s disease or chance association? 面发感觉-运动神经病变,罕见的亨廷顿氏病变种还是偶然关联?
Pub Date : 2021-07-15 DOI: 10.29328/JOURNAL.JNND.1001053
R. Juntas-Morales, E. D. L. Cruz, F. Esselin, N. Pageot, G. Taieb, W. Camu
Objectives: To describe a patient with facial-onset sensory-motor neuronopathy (FOSMN) that later developed Huntington’s disease (HD). Case report: A 62-year-old woman complained of progressive dysphagia 8 years before referral. At initial evaluation, there was excessive salivation, dysphagia, and sensory-motor trigeminal impairment. Denervation was noted on the upper limbs and the tongue. Blink reflexes were abolished. Genetic study of amyotrophic lateral sclerosis (ALS)-related genes was normal. She was diagnosed with FOSMN syndrome. Her clinical state progressively worsened with corneal anesthesia, severe denutrition, right arm and axial weakness. Seven years after referral, she was unable walk and developed generalized chorea. Abnormal huntingtin gene repeat expansion confirmed the diagnosis of HD. She died 16 years after onset of dysphagia. Conclusion: Cases with both HD and ALS have already been reported but not FOSMN and HD, to our knowledge. Some FOSMN cases have been linked to ALS-related gene mutations and HD phenocopies have been associated with C9ORF72 repeat expansions. Recently, huntingtin repeat expansions were described in the ALS population. Although a chance association cannot be excluded, data from the literature are in favor of a pathogenic relationship between FOSMN and HD in this particular case. We suggest that huntingtin gene be more systematically studied in patients with FOSMN.
目的:描述一名面部发病的感觉-运动神经病变(FOSMN)后来发展为亨廷顿病(HD)的患者。病例报告:一名62岁妇女在转诊前8年主诉进行性吞咽困难。在最初的评估中,有过多的唾液,吞咽困难和感觉-运动三叉神经损伤。上肢和舌头的神经支配缺失。眨眼反射被取消。肌萎缩性侧索硬化症(ALS)相关基因遗传研究正常。她被诊断为FOSMN综合征。她的临床状况逐渐恶化,角膜麻醉,严重营养不良,右臂和轴向无力。转诊7年后,她不能行走并发展为全身性舞蹈病。异常亨廷顿基因重复扩增证实了HD的诊断。她在出现吞咽困难16年后去世。结论:据我们所知,已报道了HD和ALS的病例,但尚未报道FOSMN和HD。一些FOSMN病例与als相关的基因突变有关,HD表型与C9ORF72重复扩增有关。最近,在ALS人群中发现了亨廷顿蛋白重复扩增。虽然不能排除偶然关联,但文献数据支持FOSMN和HD在这一特殊病例中的致病关系。我们建议对FOSMN患者的亨廷顿蛋白基因进行更系统的研究。
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引用次数: 0
Multimodal treatment strategies in Huntington’s disease 亨廷顿舞蹈病的多模式治疗策略
Pub Date : 2021-07-15 DOI: 10.29328/JOURNAL.JNND.1001054
Dutta Rajib
Huntington’s disease (HD) is an incurable neurodegenerative disease that causes involuntary movements, emotional lability, and cognitive dysfunction. HD symptoms usually develop between ages 30 and 50, but can appear as early as 2 or as late as 80 years. Currently no neuroprotective and neurorestorative interventions are available. Early multimodal intervention in HD is only possible if the genetic diagnosis is made early. Early intervention in HD is only possible if genetic diagnosis is made at the disease onset or when mild symptoms manifest. Growing evidence and understanding of HD pathomechanism has led researchers to new therapeutic targets. Here, in this article we will talk about the multimodal treatment strategies and recent advances made in this field which can be used to target the HD pathogenesis at its most proximal level.
亨廷顿氏病(HD)是一种无法治愈的神经退行性疾病,会导致不自主运动、情绪不稳定和认知功能障碍。HD症状通常在30岁到50岁之间出现,但也可能早在2岁或80岁时出现。目前还没有神经保护和神经修复的干预措施。只有在早期进行基因诊断的情况下,HD的早期多模式干预才有可能。只有在疾病发病时或出现轻微症状时进行基因诊断,才有可能对HD进行早期干预。越来越多的证据和对HD病理机制的了解使研究人员找到了新的治疗靶点。在本文中,我们将讨论多模式治疗策略和该领域的最新进展,这些策略可用于在最近的水平上靶向HD发病机制。
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引用次数: 0
Role of neuron specific enolase as a biomarker in Parkinson’s disease 神经元特异性烯醇化酶作为帕金森病生物标志物的作用
Pub Date : 2021-07-06 DOI: 10.29328/JOURNAL.JNND.1001052
Dutta Rajib
Parkinson’s disease (PD) is thought to be the most common neurodegenerative disease with movement disorder. The key motor symptoms are rigidity, tremor, akinesis/hypokinesia/bradykinesia, and postural instability. However, in our day-to-day clinical practice we tend to see several other symptoms which may be motor or non-motor. Non-motor symptoms (NMS) are quite common and debilitating. The pathological hallmarks of PD are loss of dopaminergic neurons in the substantia nigra pars compacta (SNPc) and accumulation of unfolded or misfolded alpha-synuclein. Diagnosis of PD is difficult in the pre-motor stage. Late diagnosis renders a substantial loss of dopaminergic neurons in SNPc and spread of disease in other parts of the brain. This may manifest as either full blown symptoms requiring multiple medications or may even lead to life threatening condition due to lack of early diagnostic tools and techniques. Biomarkers are required to diagnose PD at a very early stage when prevention is possible. Hence, we see a lot of interest among researchers involved in finding a biomarker specific to the disease. Biomarkers may be clinical, image based, genetic, and biochemical. Cerebrospinal fluid (CSF) and serum markers which may correlate with disease pathophysiology are of great significance. One such molecule which recently gained a lot of attention is neuron-specific enolase (NSE). The main aim of this paper is to highlight the role of NSE in predicting neurodegeneration and neuroinflammation ultimately reflecting damage of brain cells in PD.
帕金森病(PD)被认为是最常见的伴有运动障碍的神经退行性疾病。主要的运动症状是强直、震颤、运动不足/运动不足/运动迟缓和姿势不稳定。然而,在我们日常的临床实践中,我们往往会看到其他一些可能是运动性或非运动性的症状。非运动症状(NMS)非常常见且使人虚弱。PD的病理特征是黑质致密部(SNPc)多巴胺能神经元的缺失和未折叠或错误折叠的α -突触核蛋白的积累。在运动前期诊断PD是困难的。晚期诊断导致SNPc中多巴胺能神经元的大量丧失和疾病在大脑其他部位的扩散。这可能表现为需要多种药物治疗的全面症状,或者由于缺乏早期诊断工具和技术,甚至可能导致危及生命的状况。在可能预防的早期阶段,需要生物标志物来诊断PD。因此,我们看到研究人员对寻找针对该疾病的生物标志物非常感兴趣。生物标志物可以是临床的、基于图像的、遗传的和生化的。脑脊液(CSF)和血清标志物可能与疾病病理生理相关,具有重要意义。神经元特异性烯醇化酶(neural -specific enolase, NSE)是近年来备受关注的一类分子。本文的主要目的是强调NSE在预测PD患者神经退行性变和神经炎症中的作用,最终反映出PD患者脑细胞的损伤。
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引用次数: 0
Endovascular management of tandem occlusions in stroke: Treatment strategies in a real-world scenario 脑卒中串联闭塞的血管内管理:现实世界场景中的治疗策略
Pub Date : 2021-06-29 DOI: 10.29328/JOURNAL.JNND.1001051
Cirio Juan J, Ciardi Celina, Lopez Matias, Scrivano Esteban V, Lundquist Javier, Lylyk Ivan, Perez Nicolas, Lylyk Pedro
The association between intracranial large vessel occlusion (LVO) and concurrent steno-occlusive lesion of an ipsilateral extracranial internal carotid artery (ICA) is considered a tandem occlusion (TO) [1]. In approximately half of TO, the irst clinical manifestation are acute occlusions of the extracranial ICA associated with occlusion of the middle cerebral artery (MCA), with additional occlusion of the intracranial ICA in up to 25% of these cases.[2] This particular lesion subset is technically challenging for endovascular treatment (EVT) and is also characterized by lower success rates of intravenous thrombolysis [3], worse prognosis compared to intracranial occlusions alone, and higher rates of symptomatic intracranial hemorrhage [4]. The optimal approach regarding EVT of TO remains controversial, and reports in this regard are scarce. There are two proposed strategies according to the selection of the irst lesion to be treated. The proximal approach comprises stenting of the proximal cervical ICA followed by mechanical thrombectomy (MT) of the intracranial vessel, whereas the distal approach involves MT followed by stenting of the cervical ICA [3–14].
颅内大血管闭塞(LVO)与同侧颅外颈内动脉(ICA)并发狭窄闭塞病变之间的关联被认为是串联闭塞(TO)[1]。在大约一半的TO中,第一个临床表现是颅内外ICA的急性闭塞,并伴有大脑中动脉(MCA)的闭塞,其中高达25%的病例伴有颅内ICA的闭塞这种特殊的病变亚群在技术上对血管内治疗(EVT)具有挑战性,并且与单独颅内闭塞相比,静脉溶栓[3]的成功率较低,预后较差,症状性颅内出血[4]的发生率较高。关于肺组织EVT的最佳方法仍然存在争议,这方面的报道很少。根据首先治疗的病变的选择,有两种建议的策略。近端入路包括近端颈内动脉支架置入,然后机械取栓(MT)颅内血管,而远端入路包括MT后颈内动脉支架置入[3-14]。
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引用次数: 1
期刊
Journal of Neuroscience and Neurological Disorders
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