Wenfeng Feng

Association of interleukin-6-572G/C gene polymorphisms in the Cantonese population with intracranial aneurysms

Recent studies have demonstrated that cytokines play an important role in the pathogenesis of intracranial aneurysms (IAs). Interleukin-6 (IL-6) is an important proinflammatory cytokine. In our study, we investigated the association of genetic variants within the gene encoding interleukin-6-572G/C (IL-6-572G/C) with IAs in the Cantonese population. The IL-6-572G/C gene polymorphisms in 182 IA cases and 182 controls were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Differences in genotype and allele frequencies between patients and controls were tested. There is significant difference of IL-6-572G/C genotype frequencies in IA group compared with control group (P=0.01), and significant difference of IL-6-572G/C allele frequency in IA group (11.54%) compared with control group (4.95%) (P=0.001). Polymorphisms within IL-6-572G/C gene are associated with IAs in the Cantonese population suggesting that the IL-6-572G/C gene is an important candidate gene for IAs.

Relationship between the morphology of A-1 segment of anterior cerebral artery and anterior communicating artery aneurysms

BACKGROUND The anterior communicating artery (ACoA) is one of the most frequent sites for cerebral aneurysm. The peculiar directions of projection of aneurysms offer great challenges to clinical treatment. OBJETIVES To establish the relationship between morphology of A-1 segment of anterior cerebral artery (ACA) and aneurismal projection. METHODS Randomly selected digital subtraction angiography data of 264 anterior communicating artery aneurysms (ACoAA) cases and 296 cases of other cerebral vascular diseases in the same period were retrospectively analyzed. RESULTS Among 264 ACoAA patients, the morphology of A-1 segment showed type 1a in 158 sides, type 1b in 11, type 2a in 35, type 1 2b in 87, type 3 in 171 and absence in 66. The morphology of A-1 segment in 296 patients with other cerebral vascular diseases displayed type 1a in 195 sides, type 1b in 20, type 2a in 47, type 2b in 74, type 3 in 217 and absence in 39. The non-visualization of A-1 segment in the group of ACoAA occurred more than in the control group (χ(2)=11.482, p=0.001). The classifications of ACoAAs in 264 patients were confirmed as anterior-superior type in 121 cases, anterior-inferior type in 105, complicated type in 16, posterior-inferior type in 12 and posterior-superior type in 10. The correlation between morphology of A-1 segment of ACA and classifications of ACoAA was significant (p=0.000; C=0.619, p=0.000). The direction of ACoAA was downward when the A-1 segment of ACA was Type 1a or Type 2a, and was upward when it was Type 1a or Type 2a and was upward or downward or complicated when it was Type 3. CONCLUSION The relationship between morphology of A-1 segment of ACA and classification of ACoAA is clarified in the present study, which is helpful to surgical treatment.

Gliosarcoma occurrence after surgical clipping of aneurysm - coincidence or causal relationship?

Gliosarcoma is relatively rare brain tumor of glial and sarcomatous origin. The occurrence of this highly malignant brain tumor in the vicinity of the clipped aneurysm has not been reported in the literature. The authors report a case of 37-year-old man who developed sudden onset severe headache. Angiogram displayed a saccular aneurysm located on the bifurcation of left internal carotid artery, and a fusiform aneurysm on the M-1 segment of the left middle cerebral artery. The patient underwent successful surgical clipping of the aneurysms. Three years later, a mass lesion in the vicinity of the clipped aneurysm was detected on magnetic resonance imaging; gliosarcoma was pathologically confirmed after complete tumor extirpation. Despite postoperative radiotherapy and temozolomide chemotherapy, reoccurrence and subarachnoid metastasis unavoidably emerged. Brain injury, co-existence of two pathologies, metal ions released from aneurysm clips, and radiation might have led to tumorigenesis.

Endovascular Intervention for Repositioning the Distal Catheter of Ventriculo-Atrial Shunt

Displacement of distal ventriculo-atrial (VA) shunt is not uncommon. However, misplacement of the distal catheter of VA shunt in the internal jugular vein is a possibility, especially when conducted without intraoperative monitoring. We describe a patient in whom a VA shunt was performed due to failure of ventriculo-peritoneal shunt and the distal catheter of the shunt was found to be misplaced in the left internal jugular vein. Endovascular intervention via femoral vein was used to retrieve the distal catheter.