左侧颈内动脉中段狭窄改变。术前诊断：右侧颈内动脉颅外段动脉瘤；.脑梗塞

The stenosis of the left internal carotid artery changes. <br>Preoperative diagnosis: <br>aneurysm of the extracranial segment of the right internal carotid artery <br>;. Cerebral infarction; <br>3. Stenosis of the left internal carotid artery; <br>High-risk grade 3 hypertension; <br>Type 2 diabetes. <br>Treatment: Cerebral angiography under general anesthesia and interventional treatment of intracranial right internal carotid artery aneurysm and left internal carotid artery stenosis; antispasmodic, symptomatic and supportive treatments are given after surgery. <br>After the operation, he took aspirin for life, and took clopidogrel to 3M after the operation. <br>Main complaint: Sudden weakness of the right limbs with unclear speech for 7+ months. <br>Medical history: 7+ months before admission, there was no obvious inducement, sudden slurred speech accompanied with vomiting, brainstem hemorrhage, and slurred speech improved after treatment, and right limbs still restricted . <br>Past history: <br>Laser lithotripsy for kidney stones was performed in 2011. Lumbar disc herniation was discovered 3+ years ago, and blood pressure was found to be elevated 2+ years ago, up to 170+mmHg, and medication was not taken regularly. <br>Nervous system examination: clear consciousness, poor utterance, left eyeball adduction and abduction activities slightly restricted, double vision, right tongue extension, hypopharyngeal reflex, mouth angle skewed to the right, upper right muscle strength is about 4 , The right lower limb muscle strength is 4+, the left limb muscle strength is 5, the right face, trunk and limbs have decreased pain and touch, and the right lower limb Babinski sign (+). <br>The nose test of the left finger was not stable and the test of both lower limbs and knee shin was positive. <br>Imaging examination: CTA: The end lumen of the petrosal segment of the left internal carotid artery is widened, scaphoid swelling toward the medial side, and double lumens can be seen, suggesting the formation of localized dissection and aneurysm. <br>Preoperative diagnosis: 1. Dissecting aneurysm of the left internal carotid artery 2. Cerebral hemorrhage recovery period 3. High-risk grade 2 hypertension. <br>Cerebral angiography under general anesthesia, stent placement of the left internal carotid artery dissecting aneurysm. <br>After the operation, low molecular weight heparin was injected subcutaneously with 3D. The <br>main complaint: memory loss with weakness of the right upper limb for 3 months.<br>Medical history: Family members complained of sudden instability of holding objects without obvious inducement 3 months ago, and no response. At that time, there was no painful face, limb twitching, incontinence and other symptoms. Head CT showed "cerebral infarction". Thrombolytic treatment was given. recovery treatment. <br>Past history: unknown; I did not ask about special medical history. <br>Nervous system examination: Shenqing, right upper limb distal muscle strength level 3, proximal muscle strength level 4, right finger to palm can not be completed, right lower limb muscle strength level 5, left limb muscle strength level 5, double Tendon hyperreflexia, pathological signs on the right side (+). <br>Imaging examination: CTA: A double-lumen shadow was seen in the proximal left internal carotid artery, and a low-density intimal membrane was seen in it, suggesting a localized arterial dissecting aneurysm with an extent of about 1.67 cm. <br>DSA: The dissection of the initial segment of the left internal carotid artery has changed with irregular shape. <br>Preoperative diagnosis: 1. Dissecting aneurysm of the left internal carotid artery; 2. Recovery period of cerebral infarction. <br>Cerebral angiography under general anesthesia, dissection and isolation of the left internal carotid artery stent. <br>Main complaint: Repeated dizziness with visual rotation for 20 years, and then with limb shaking for 1 day. <br>Medical history: The patient reported recurrent dizziness with visual rotation 20 years before admission. <br>One day before admission, dizziness, rotation of vision, vomiting, accompanied by limb shaking occurred again during sleep one day before admission, mainly manifested as mouth-mandibular and upper limb shaking, which continued to improve for several minutes and repeated attacks. <br>Past history: No specific medical history was asked. <br>Nervous system examination: <br>clear, large round pupils with a diameter of about 0.25cm, sensitive light reflection, no nystagmus, bilateral nasolabial folds are basically symmetrical, tongue is still in the middle, neck is soft, limb muscles are normal , Bilateral tendon reflexes are symmetrical, and bilateral pathological signs are negative. <br>Imaging examination: DSA: 1. Main aneurysm of the left internal carotid artery, about 13*10mm in size. <br>Preoperative diagnosis: 1. Left internal carotid artery aneurysm.

The stenosis change sespan in the middle artery in the left neck.<br>Preoperative diagnosis:<br>right intra-cervical artery anterior aneurysm;<br>cerebral infarction;<br>3. The left neck artery stenosis;<br>High blood pressure level 3 is extremely high risk;<br>Type 2 diabetes.<br>Treatment: full hemp hypothromytoma and intracranial right cervical aneurysm, left cervical stenosis interventional therapy; postoperative antispasm, conjugation and supportive treatment.<br>Take aspirin for life after surgery, take clopidogrel to 3M after surgery.<br>Main complaint: sudden right limb powerless to spit words unclear for 7 plus months.<br>Medical history: 7 plus months before admission no obvious trigger suddenly appear speech confusion with the right limb activity adverse, accompanied by vomiting, head CT prompt "brain stem bleeding", after treatment speech confusion improved, the right limb is still limited in activity.<br>Past history:<br>In 2011, there were kidney stones laser gravel, 3 plus years ago found lumbar disc protrusion, 2 plus years found that blood pressure increased, the highest 170 mmHg, irregular medication.<br>Nervous system check: consciousness clear, spitting words are not clear, left eye internal collection, outreach activity is slightly restricted, visual reshadow, stretch right side, pharynx reflection reduction, mouth angle right skew, right upper muscle force about 4 levels, right lower limb muscle force 4 plus level, left limb muscle strength 5 level, right face, torso and limb pain touch reduction, right lower limb Babinski signs.<br>The left finger nose test was not accurate, and the test of both lower limbs and knee shins was positive.<br>Imaging examination: CTA: left neck artery section end tube cavity widening, to the inner boat-like bulge, visible double cavity, indicating the limitation of the mezzanine and aneurysm formation.<br>Preoperative diagnosis: 1. Left cervical artery mezzanine aneurysm 2. Brain haemorrhage recovery period 3. Hypertension level 2 extremely high risk.<br>Full hemp downstream cerebrovascular angiography, left neck artery mezzanine aneurysm stent placement.<br>After surgery, low-molecular heparin subcutaneous injection 3D.<br>Main complaint: Memory loss accompanied by weakness in the upper right leg in March.<br>Medical history: family complaints before March no obvious trigger suddenly appear edicombe, call no response, when no pain face, limb convulsions, size incontinence and other symptoms, skull CT show "brain infarction", to thrombosis and other treatment, post-rehabilitation treatment.<br>Past history: unknown; Yu did not ask about a special medical history.<br>Nervous system check: Shenqing, right upper limb far end muscle force level 3, near end muscle force 4 level, right finger 対 finger-to-palm can not be completed, right lower limb muscle force 5-level, left limb muscle force 5 level, double tendon reflex, right pathological signs ( . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .<br>Imaging examination: CTA: the left cervical artery near the double cavity shadow, which can be seen in the low-density endothelial diaphragm, suggesting the limitation of arterial mezzanine aneurysm, the range is about 1.67cm.<br>DSA: The artery mezzanine of the artery starting section of the left cervical is changed and the morphology is irregular.<br>Preoperative diagnosis: 1. left cervical artery mezzanine aneurysm; 2. recovery period of cerebral infarction.<br>Full hemp downstream cerebrovascular angiography, left cervical artery stent placed in the mezzanine isolation.<br>Main complaint: repeated dizziness with the visual rotation for 20 years, and then accompanied by limb shake for 1 day.<br>History: Patients describe their own recurrent dizziness and rotating in the 20 years prior to admission.<br>1 day before admission in the sleep process again appear dizziness, visual rotation, vomiting, with limb shaking, mainly manifested as mouth-jaw, double upper limb jitter, lasting several minutes of improvement, repeated seizures.<br>Past history: No special medical history was asked.<br>Nervous system check:<br>Shenqing, double-shaped and other large circle, diameter of about 0.25cm, light reflection sensitive, no eye shock, two-sided nasal lip ditch basic symmetry, tongue extension is still center, neck soft, limb muscle force muscle tone normal, double-sided tendon reflection symmetry, two-sided pathological negative.<br>Imaging examination: DSA:1, left cervical artery artery aneurysm, size of about 13 x 10mm.<br>Preoperative diagnosis: 1. Left cervical aneurysm.

The middle segment stenosis of left internal carotid artery was changed.<br>Preoperative diagnosis:<br>Aneurysm of extracranial segment of right internal carotid artery;<br>. cerebral infarction;<br>3. Left internal carotid artery stenosis;<br>Hypertension grade 3 is extremely high risk;<br>Type 2 diabetes.<br>Treatment: cerebral angiography and interventional therapy of intracranial right internal carotid artery aneurysm and left internal carotid artery stenosis under general anesthesia; postoperative spasmolysis, symptomatic and supportive treatment were given.<br>The patients were treated with aspirin for life and clopidogrel for 3 m.<br>Chief complaint: sudden right limb weakness with unclear words for 7 + months.<br>History: 7 + months before admission, there was no obvious inducement, and the speech was not clear, accompanied with adverse movement of right limbs and vomiting. Cranial CT showed "brain stem hemorrhage". After treatment, the unclear speech was improved, and the activity of right limb was still limited.<br>Past history:<br>Laser lithotripsy for renal calculi was performed in 2011. Lumbar disc herniation was found 3 + years ago and elevated blood pressure was found 2 + years ago, with a maximum of 170 + mmHg.<br>Physical examination of nervous system: clear consciousness, unclear enunciation, slightly limited adduction and abduction of left eyeball, double vision, right deviation of tongue extension, hypopharyngeal reflex, angle of mouth deviation to the right, muscle strength of right upper limb is about grade 4, muscle strength of right lower limb is grade 4 +, muscle strength of left limb is grade 5, pain and tactile loss of right face, trunk and limb, Babinski sign of right lower limb is (+).<br>The finger nose test of the left hand was not stable and accurate, and the heel knee tibia test of both lower limbs was positive.<br>Imaging examination: CTA: the lumen of the left internal carotid artery at the end of the petrous segment was widened and expanded to the medial scaphoid shape with double lumen, indicating localized dissection and aneurysm formation.<br>Preoperative diagnosis: 1. Left internal carotid artery dissecting aneurysm; 2. Recovery period of cerebral hemorrhage; 3. High risk of grade 2 hypertension.<br>Under general anesthesia, cerebral angiography and stenting were performed on left internal carotid artery dissection aneurysm.<br>After operation, low molecular weight heparin was injected subcutaneously in 3D<br>Chief complaint: memory loss with right upper limb weakness for 3 months.<br>Medical history: family members complained that there was no obvious inducement 3 months ago, and there was no sudden instability of holding objects and no response to breathing. At that time, there was no pain and bitter face, limbs convulsion, incontinence and other symptoms. The head CT showed "cerebral infarction". Thrombolytic therapy was given and later rehabilitation treatment was given.<br>Previous history: unknown; I did not ask about special medical history.<br>Physical examination of nervous system: Shenqing, right upper limb distal muscle strength 3, proximal muscle strength 4, right hand finger to palm can not be completed, right lower limb muscle strength 5-grade, left limb muscle strength 5-grade, double tendon reflex hyperactivity, right side pathological sign (+).<br>Imaging examination: CTA: double lumen shadow was seen in the proximal segment of the left internal carotid artery, and low-density intimal film was seen in it, indicating a localized dissecting aneurysm with a length of about 1.67cm.<br>DSA: the dissection of the left internal carotid artery was irregular.<br>Preoperative diagnosis: 1. Left internal carotid artery dissecting aneurysm; 2. Convalescence of cerebral infarction.<br>Cerebral angiography was performed under general anesthesia, and left internal carotid artery stenting was performed.<br>Chief complaint: repeated dizziness with visual rotation for 20 years and limb shaking for 1 day.<br>History: the patient reported recurrent dizziness with visual rotation 20 years before admission.<br>One day before admission, dizziness, visual rotation, vomiting, and limb shaking occurred again during sleep. The main manifestations were mouth jaw and upper limb shaking, which lasted for several minutes for improvement and repeated attacks.<br>Past history: no special history was asked.<br>Physical examination of nervous system:<br>Shenqing, double pupil and other large round shape, about 0.25cm in diameter, sensitive light reflex, no nystagmus, bilateral nasolabial groove is basically symmetrical, tongue extension is in the middle, neck is soft, muscle tension of limbs is normal, bilateral tendon reflex is symmetrical, bilateral pathological signs are negative.<br>Imaging examination: DSA:1 The size of the aneurysm was about 13 * 10 mm.<br>Preoperative diagnosis: 1. Left internal carotid artery aneurysm.<br>