BACKGROUND:The impact of parent artery stenosis on the treatment of intracranial aneurysms by using flow diversion (FD) remains unknown. This multicenter retrospective study aimed to evaluate the clinical and radiological outcomes of patients with intracranial aneurysms accompanied by parent artery stenosis of different etiologies after FD implantation. METHODS:The study cohort included patients who received FD treatment at four comprehensive centers from March 2013 to June 2024. The etiological factors underlying intracranial arterial stenosis were categorized as intracranial atherosclerosis (ICAS), intracranial arterial dissection (ICAD), and matricidal aneurysms (MA). RESULTS:A total of 161 patients with intracranial aneurysms accompanied by parent artery stenosis were ultimately included for in-depth analysis. The procedures were successfully performed in all patients, with a low incidence of periprocedural complications. In the clinical and angiographic follow-up, all patients had a favorable outcome (modified Rankin Scale score 0-2), and the complete occlusion rate of aneurysms was 64.0% at median 8.0 months (IQR 6-13.5 months). A comparative analysis revealed that, in contrast to the ICAD and MA groups, the ICAS group exhibited a significantly higher rate of in-stent restenosis (28% vs 16.7% vs 5.5%, p = 0.020). CONCLUSIONS:FDs demonstrated satisfactory performance in terms of periprocedural complications, favorable clinical outcomes, and complete occlusion on follow-up imaging in the management of intracranial aneurysms accompanied by parent artery stenosis. Notably, ICAS exerted a substantially greater influence on in-stent restenosis and entailed a higher requirement for repeat angioplasty compared with ICAD and MA.

BackgroundManaging fusiform aneurysms of the proximal (M1) segment of the middle cerebral artery (MCA) is challenging due to difficulties in both surgical and endovascular treatment. In this study, we present our experience using flow diverter stents for managing unruptured M1 segment fusiform aneurysms.MethodsWe conducted a retrospective review of the database of our institution to identify all patients who underwent flow diversion treatment for unruptured M1 segment fusiform aneurysms. We collected data on patient demographics, aneurysm characteristics, complications, angiographic follow-up results, and clinical outcomes.ResultsA total of 10 patients (five male and five female patients) with 10 unruptured M1 segment fusiform aneurysms were included in the study. The average age of the patients was 48 years (range: 16–64 years); five patients had aneurysms smaller than 10 mm, four had aneurysms measuring between 10 and 25 mm, and one patient had an aneurysm larger than 25 mm. The successful deployment of flow-diverting stents was achieved in all cases. Procedure-related morbidity was observed in 10% of patients, but there were no deaths. All patients showed good outcomes (modified Rankin Scale score of 0–1); eight out of 10 patients had available follow-up angiography results with a mean follow-up period of 11.6 months (range: 6–24 months). Complete occlusion occurred in six out of eight reviewed cases (75%).ConclusionOur preliminary findings suggest that using flow diversion for treating unruptured fusiform aneurysms in the proximal MCA is feasible and safe, with a satisfactory rate of complete occlusion. However, further studies involving larger case series are needed to validate the durability and efficacy of this treatment approach.

初步观察Pipeline栓塞装置(PED)治疗大脑中动脉M1段未破裂夹层动脉瘤的临床疗效和安全性.回顾性分析2015年1月至2021年1月上海冬雷脑科医院神经外科采用PED治疗的6例(7个动脉瘤)大脑中动脉M1段未破裂夹层动脉瘤患者的临床资料.3例患者行弹簧圈辅助PED治疗,3例患者单纯行PED治疗.6例患者共置入6个PED,支架均释放成功.1例患者术后出现手术同侧脑实质血肿.6例患者随访时间的中位数为36个月(12～80个月).至末次随访,无动脉血栓栓塞事件,改良Rankin量表评分0分5例,1分1例;5例患者的6个动脉瘤O'Kelly-Marotta(OKM)分级D级愈合,1例患者的单发动脉瘤OKM分级B级愈合.

脑积水可导致高颅压综合征,眼部表现主要为视乳头水肿、视力下降及视野缺损等.脑脊液分流术包括脑室-腹腔(P-V)分流术是缓解脑积水视神经压迫的有效手段.但是脑脊液过度引流可导致继发性中脑导水管综合征,主要表现为眼球上视运动障碍、帕金森综合征、记忆力减退及波动性意识障碍等.本文报道 1 例老年女性脑积水患者经脑室-腹腔分流后反复调节引流阀压力出现眼球运动障碍、面部及肢体帕金森样表现及记忆力下降等中脑损害症状.经腰穿及影像学检查后确诊为脑脊液过度引流导致.给予第三脑室底部造瘘后,患者症状缓解.通过本例患者的诊疗过程,提示脑脊液过度引流综合征患者可因中脑背侧病变表现首诊神经眼科,强调神经系统定位及定性诊断的重要性.

目的 分析Onyx栓塞脑膜中动脉治疗慢性硬膜下血肿(CSDH)的临床疗效和安全性.方法 回顾性连续纳入上海冬雷脑科医院神经外科于2020年4月至2021年10月期间采用Onyx栓塞脑膜中动脉治疗的CSDH患者14例.收集患者的人口学资料及临床资料,人口学资料包括性别、年龄;临床资料包括外伤史、手术史、高血压病史、糖尿病史、高脂血症、颅内动脉瘤史、口服抗血小板聚集药物史、抗凝药物史以及口服他汀类药物史、临床症状(头痛、头晕、肢体乏力)、术前改良Rankin量表(mRS)评分、血肿特征(包括侧别、最大厚度、中线偏移程度)、手术入路方式(经桡动脉或经股动脉)、麻醉方式(局部麻醉或全身麻醉)、影像学资料(头部CT或MRI)、围手术期并发症(颅内感染、出血或脑梗死、失明、面瘫)发生情况.对于术前血肿最大厚度10～<20 mm同时中线偏移<10 mm的患者,采用单纯脑膜中动脉栓塞治疗(MMAE),若病程中出现因血肿体积增加导致的症状加重,则行补救性开颅钻孔引流术;术前测量血肿厚度≥20 mm,或者血肿厚度10～<20 mm但中线偏移≥10 mm的患者,采用MMAE联合颅骨钻孔引流术.术后3个月采用头部CT和(或)MRI复查残余血肿最大厚度,术后3个月门诊或电话随访评估患者mRS评分.影像学检查资料以血肿侧数(侧)表示,其余患者资料以例数(例)表示.结果 共14例CSDH患者19侧血肿纳入本研究.术前mRS评分0分8例,1分4例,2分2例.6例(9侧)患者行单纯MMAE,8例(10侧)患者行MMAE联合颅骨钻孔引流术;共11例患者(15侧血肿)获得术后3个月CT和(或)MRI影像学随访,其中影像学治愈13/15侧,明显好转2/15侧.术后3个月随访,mRS评分0分12例,1分2例.6例头痛患者术后症状均恢复正常;3例头晕患者术后2例症状恢复正常;10例肢体乏力患者术后症状恢复正常9例.所有患者围手术期无颅内感染、出血或脑梗死、失明、面瘫等并发症,无因症状反复或加重而再次行手术患者.结论 采用Onyx对CSDH患者行MMAE技术成功率高,术后3个月随访临床疗效较好,长期临床疗效与安全性还需要进一步大样本、长期随访研究验证.

"红眼"是眼科众多疾病的共同症状.其中甲状腺相关眼病(thyroid eye disease,TED)、颈动脉海绵窦瘘(carotid cavernous fistula,CCF)等常因眶内静脉回流障碍出现球结膜充血水肿以及结膜血管粗大、迂曲表现,仅凭临床表现容易与结膜炎、巩膜炎等眼科疾病相混淆.本文报道2例因"红眼"表现而误诊的患者,眼部超声在其诊断与鉴别诊断中起重要作用,供大家学习和借鉴.

目的 探讨可解脱微导管结合近端血流阻断增压技术(PCT)栓塞脑动静脉畸形(bAVM)的疗效及并发症.方法 前瞻性队列研究2016年1月至2018年12月冬雷脑科医生集团上海浦南医院采用Onyx胶经动脉途径栓塞治疗bAVM患者133例,其中Spetzler-Martin分级Ⅰ级10例,Ⅱ级54例,Ⅲ级49例,Ⅳ级18例,Ⅴ级2例.按时间段将患者分为A组(n=70,2016年1月至2018年2月结合非解脱微导管)、B组(n=63,2018年3月至12月结合Apollo可解脱微导管),对B组中30例采用PCT.分析两组患者疗效及并发症发生率等.结果 133例患者bAVM总栓塞率为33.8％(45/133);A组栓塞率为25.7％(18/70),B组为49.2％(31/63),差异有显著统计学意义(P＜0.01);B组中PCT技术组栓塞率为66.7％(20/30),非PCT技术组为33.3％(11/33),差异有统计学意义(P＜0.05).并发症发生在A组为5.7％(术中微导管粘管1例,术中出血1例,术后出血2例,其中1例死亡),B组为4.8％(术后出血3例,其中1例转外科手术)(P＞0.05),总体并发症发生率为5.3％,无新发神经功能障碍.132例患者随访3～26个月(平均8个月),再发出血3例,其中1例死亡,完全栓塞患者无一例复发或再生血管畸形.131例患者中改良Rankin量表(mRS)评分0～1分106例,2分25例.结论 经动脉途径采用Apollo可解脱微导管结合PCT技术栓塞治疗bAVM,可在不增加相关并发症情况下提高栓塞治愈率.

神经介入医学的发展,得益于介入材料的进步和DSA机功能的改进.西门子Artis Q系列双大平板DSA机除了具有可同时多角度显示病变、节省造影时间和减少对比剂剂量等优势外,还有一些新开发的影像后处理功能,可帮助术者更好地判断脑血管病变结构和特征、介入治疗效果及识别并发症,有利于提高神经介入治疗的安全性、有效性.该文结合临床实践中实际病例,就DSA机影像后处理功能作一简单介绍.

目的 探讨Onyx胶主导栓塞脑动静脉畸形(arteriovenous malformation,AVM)的疗效.方法 2015年9月 ～2017年10月我科应用Onyx胶栓塞84例AVM,其中Speztler-Martin(S-M)分级Ⅰ级10例,Ⅱ级32例,Ⅲ级22例,Ⅳ级18例,Ⅴ级2例.单纯Onyx胶栓塞67例,联合Glubran胶和(或)弹簧圈栓塞17例.结果 S-MⅠ级完全栓塞治愈率60.0％(6/10),Ⅱ ～ Ⅲ级33.3％(18/54),Ⅳ ～ Ⅴ级25.0％(5/20),完全栓塞率34.5％(29/84).术中微导管断管、留置各1例,术中出血1例,术后出血4例((3例保守治疗成功,1例死亡),无新发神经功能障碍,并发症发生率8.3％(7/84).83例随访3～30个月,中位随访时间7.5月,再次出血4例,其中死亡1例;完全栓塞的29例无一例复发或再生;栓塞导致出血的5例除1例死亡外,其余均恢复良好.结论 Onyx胶联合不同栓塞材料个体化治疗脑AVM,可以获得较为满意的效果.

Objective To explore the efficacy of surgical removal of intracranial arteriovenous malformation (AVM) immediately after embolization according to the results of Lawton-Young supplementary grading scale (LYS).Methods We retrospectively analyzed the data of 9 patients with intracranial AVM admitted to Department of Neurosurgery,Shanghai Punan Hospital of Pudong New Area from June 2016 to December 2017,accounting for 10.6％ of all AVM patients admitted during the same period (85 cases).Nine patients were assessed by LYS grading and a surgical plan was developed based on the results of the assessment.LYS scores were grade 4 in 2 cases,grade 5 in 3 cases,grade 6 in 3 cases and grade 7 in 1 case.All patients underwent surgical resection of AVM immediately after interventional embolization.Digital subtraction angiography (DSA) was performed for imaging evaluation and the clinical efficacy was evaluated based on the modified Rankin Scale (mRS) after operation.Results All malformations of the 9 patients were resected successfully.Seven cases underwent elective microsurgery following partial embolization,1 case underwent immediate surgery after embolization because the drainage vein was clogged,and 1 case underwent immediate surgery due to bleeding after embolization.The postoperative complications occurred in 3 cases,including 1 patient with hemianopia and 2 patients with intracranial infection.All patients were followed up for 6 -15 months(median time:7 months),DSA results showed that all the malformations completely disappeared,the cure rate was 100％.The mRS score was 0-1 in 8 cases and 2 in 1 case.Conclusion According to preoperative risk assessment based on LYS grading,selective endovascular embolization combined with subsequent microsurgery could provide a new surgical treatment approach for intracranial AVM patients with a relatively high cure rate.

原发性中枢神经系统淋巴瘤(Primary Central Nervous System Lymphoma,PCNSL),占颅内肿瘤的0.3％ ～ 1.5％,约占非霍奇金淋巴瘤的1％[1],约95％为弥漫性大B细胞淋巴瘤(Diffuse Large B-cell lymphoma,DLBCL),T细胞淋巴瘤极罕见.大部分位于幕上,小部分位于幕下.我院201 8年9月份收治1例原发于小脑的T细胞淋巴瘤.

Objective To evaluate the efficacy and safety of Willis covered stent in the treatment of traumatic carotid cavernous fistulae (tCCF).Methods The imaging and clinical data of 7 patients with tCCF treated with Willis covered stent in Shanghai Punan Hospital from November 2015 to June 2018 were analyzed retrospectively.Results Seven Willis covered stent were used in 7 patients.Immediately after stent release,angiography showed that the fistulae completely disappeared in 6 cases.One patient had a small amount of endoleak,and there was still a small amount of endoleaks after balloon dilatation.It was not further treated.There were no operative complications.During 3-12 months follow-up,no new neurological deficits were found in all patients.Angiographic follow-up of 2 patients showed that the fistulae completely disappeared without recurrence.The internal carotid arteries were patent,no in-stent stenosis and stent displacement.Conclusions Wills covered stent can be used as a treatment for tCCF.Its efficacy is satisfactory and the safety is good.

Objective To investigate the medium- and long-term effects and safty of Pipeline embolization device ( PED) for the treatment of large and giant intracranial anterior circulation aneurysms. Methods From December 2014 to December 2016,the data of 36 consecutive patients with large and giant aneurysm ( 36 large and giant intracranial anterior circulation aneurysms ) treated with PED in Donglei Brain Doctor Group were analyzed retrospectively. The diameter of the aneurysms was 12 -33 mm, (mean16.6±4.5mm),andthenecksizewas4-10mm(mean6.1±1.5mm).Eightaneurysmswere located in the carotid cavernous sinus segment,22 in the ophthalmic artery segment,5 in the internal carotid artery posterior communicating segment, and 1 in the M1 segment of middle cerebral artery. Seven aneurysms were only treated by PED,28 aneurysms were treated by PED in combination with coil embolization,and 1 aneurysm was treated by double PEDs. The modified Rankin scale ( mRS) score was used to evaluate the prognosis of the patients. Results (1) The clinical prognosis of the patients was followed up by telephone and outpatient department for 6-33 months. Twenty-five patients were followed up by DSA,23 aneurysms (92%) were occluded totally (Raymond gradeⅠ) and 2 (8％) were occluded near totally ( Raymond grade Ⅱ) . ( 2 ) Seven patients were treated with PED alone. Four patients were cured totally after 6 months follow-up,1 was occluded subtotally,2 were not cured;6 were cured in the last follow-up (33 months),and the other aneurysm was gradually reduced;17 of 28 patients treated with PED in combination with coils received DSA follow-up. They were followed up for 6-8 months. All the aneurysms were totally occluded ( Raymond grade Ⅰ) . 1 aneurysm was treated by 2 PEDs, DSA revealed micro-aneurysm-like development at 8 months after procedure. The aneurysms were basically occluded after 15-month follow-up. (3) MRI confirmed after operation that 10 patients had asymptomatic scattered spotted ischemic foci,4 had cerebral parenchymal hemorrhage,1 of them died,1 recovered well after treatment (mRS 1),and the other 2 were asymptomatic cerebral hemorrhage. The occupying effect of 24 cases disappeared, 8 had obvious improvement,and 3 did not have any obvious change. Conclusions The occlusion rate of the treatment of large and giant intracranial aneurysms with PED was high. The results of medium-term follow-up showed that the occlusion rate of PED in combination with coils in the treatment of aneurysms was higher than that of PED alone. The long-term follow-up results showed that the occlusion rate of patients treated with PED alone (including one or more) was gradually increased with time. The safety of the surgery needs to be further confirmed by a large sample study.

目的 评价Willis覆膜支架治疗颅内复杂动脉瘤的临床效果及安全性.方法 回顾性纳入2015年10月至2018年1月上海冬雷脑科医生集团神经外科连续收治的应用覆膜支架治疗的颅内动脉瘤8例,所有患者术前脑血管造影明确诊断,术后3～12个月进行临床随访和影像随访.8例中颈内动脉眼动脉段2例,后交通段1例,海绵窦段3例,椎动脉V4段2例;血泡样动脉瘤1例,梭形动脉瘤1例,假性动脉瘤1例,囊性动脉瘤5例;动脉瘤直径4～18(9±4)mm,瘤颈4～6(4.9±1.0)mm;破裂动脉瘤2例.结果 8例患者共使用8枚支架,6例患者支架释放后即刻造影动脉瘤不显影;2例患者存在内漏,予以再次球囊扩张后1例内漏完全消失,1例内漏明显减少,未再进一步处理.无患者发生手术操作相关并发症.1例大动脉瘤伴有内漏患者术后3d动脉瘤再出血,予以闭塞载瘤血管,患者出院时改良Rankin量表(mRS)评分3分.随访3～12个月,所有患者无新发神经功能障碍,3例DSA随访患者动脉瘤完全治愈,无复发,载瘤动脉通畅,无支架内狭窄,无支架移位.结论 Willis覆膜支架治疗颅内复杂动脉瘤疗效较满意,内漏的存在可能是导致动脉瘤术后出血的原因.

背景 本声明旨在复习目前脑动静脉畸形(brain arteriovenous malformations, bAVMs)的临床资料，为破裂或未破裂bAVMs的诊断和治疗提供建议。 方法 写作组通过面谈和电话会议的方式确定搜索关键词，讨论描述性文字和制定建议。作者通过PubMed、Medline或Embase完成各自相关章节的文献检索，时间截止到2015年1月底。声明草稿由同行评议专家以及卒中委员会科学监督委员会和卒中委员会领导委员会进行预先审查。 结果 本科学声明的重点细分为流行病学、诊断、自然史、治疗方案(包括开颅手术、立体定向放射外科和栓塞治疗的作用)以及破裂和未破裂bAVMs的处理，并且确定了需要更多证据支持的领域。 结论 bAVMs是一种相对少见但非常重要的出血性卒中病因，尤其是在年轻成人中。本声明描述了目前关于破裂和未破裂bAVMs的自然史和治疗方法的知识现状，同时提供了处理建议以及对将来研究的提示。

Objective To investigate the clinical application value and technical characteristics of pipeline embolization device (PED) for the treatment of intracranial aneurysms.Methods From December 2014 to December 2015,the clinical data of 20 patients with intracranial aneurysm treated with PED at the Department of Neurosurgeries,Shanghai Punan Hospital of Pudong New District and Donglei Brain Surgeon Group were analyzed retrospectively.Fifteen patients had one aneurysm and 5 had multiple aneurysms.The diameters of 28 aneurysms were 2-33 mm (15.2 ± 9.9 mm).The aneurysm necks of all patients were covered with 1 PED,and 8 of them were treated with the combined aneurysm coil embolization.Results The release of PEDs in all 20 patients was completed successfully.The coverage of aneurysm necks was satisfactory.PEDs were found well adhering to the wall.Immediately after surgery,it showed that contrast agents in aneurysm cavities were obviously detained.Three patients had complications of cerebral hemorrhage after procedure,including 1 died and 1 had hemiparesis at discharge.Eight patients were followed up by digital subtraction angiography (DSA) 6 months later,6 were cured completely,the aneurysm of 1 case was nearly completely occluded,and the size of a large aneurysm did not have obvious change.Two patients had asymptomatic anterior cerebral artery stenosis.The head MRI follow-up revealed that the mass effect of the large and giant intracranial aneurysms were significantly relieved or disappeared.The remaining 11 cases had to be followed up.Conclusions The efficacy of PED for the treatment of large and giant intracranial aneurysms,tandem multiple small aneurysms and intracranial blood blister-like aneurysms is satisfactory.This device has just begun to be applied in clinical practice in China.The complications and long-term efficacy of the large sample case analysis and research are needed.

Objective To preliminarily discuss the technical points and clinical efficacy of the" pressure cooker technique" (PCT)for embolization of intracranial arteriovenous malformation (AVM). Methods From April 2015 to May 2015,7 patients with AVM were treated at the Department of Neurosurgery, Shanghai Deji Hospital. The AVMs of 2 patients were embolized with PCT. (both were Spetzler-Martin gradeⅡ). A sonic and an echelon microcatheter were implanted side by side into the same blood supply artery of an AVM. "A coil + α-isobutyl cyanoacrylate (NBCA)plug" was formed between the sonic microcatheter tip and the detachable point through the echelon microcatheter in order to prevent Onyx reflux when the glue was injected into a nidus via a sonic microcatheter,achieving the embolization effect of sustained,rapid and high efficient. Results Two patients achieved complete embolization immediately. The symptoms of the patients improved or disappeared within 1 month. The whole brain DSA showed the AVM of one patient did not have recurrence at 4 month after embolization. Two patients did not have any complications or sequelae at the follow-up study. Conclusion PCT can improve the efficiency of embolization. It is suitable for small, medium,superficial,non-major functional area,less feeding artery AVMs,and AVMs with less blood flow in nidus. Its safety and clinical effect still need to be observed with more samples.

患者男，55岁，因发现颅内动脉瘤40 d于2014年2月7日收住上海德济医院脑血管病中心。患者在2013年11月30日因交通事故致头部外伤，昏迷2 d后清醒，醒后诉右眼失明，3周后康复出院。2013年12月28日患者出现头痛，头部MRI检查提示右侧颈内动脉床突上段动脉瘤。体格检查：患者意识清楚，问答切题，右侧瞳直径为5 mm，无光感，直接光反应消失，间接光反应存在，眼底视乳头苍白，左侧瞳孔直径3 mm，国际标准视力表为1．0，直接及间接光反应敏感，眼底正常，视野正常。右眶及颞部可闻及吹风样杂音，压迫颈动脉后杂音消失。眼球各向活动正常，其他脑神经检查无阳性发现，四肢感觉、肌力正常。头部CT提示右基底池不规则高密度影，边界清楚，朝侧裂方向生长，瘤壁无钙化。头部MRI检查T1和T2加权像提示右鞍旁有约直径3 cm血管流空影，邻近中脑及颞叶海马区，瘤内有少量血栓形成（图1，2）。全脑DSA提示右颈内动脉终末端巨大动脉瘤，呈哑铃状，三维重组影像也未显示出瘤颈，瘤体朝上、外、后方向生长，包绕右侧大脑中动脉。同时发现右侧颈内动脉海绵窦瘘（CCF），经同侧岩上窦向乙状窦回流，经海绵间窦、对侧岩上窦向左侧乙状窦引流（图3）；右侧中颅底硬脑膜动静脉瘘（DAVF），颌内动脉供血，向翼窝静脉丛引流（图4）。行右侧颈内动脉球囊闭塞试验（BOT），患者不能耐受（图5）。

目的 探讨一体化急救在重型颅脑损伤救治中的临床应用价值.方法 对2011年1月～2012年9月诊治的112例重型颅脑损伤患者启用一体化救治方案(一体化急救组),急救120负责院前急救,送入医院后由神经外科医师首诊负责,开通绿色通道,全程组织抢救.选择2010年1 ～12月收治的重型颅脑损伤患者158例作为常规组,采用传统救治方法.结果 一体化急救组112例重型颅脑损伤患者,随访3个月,死亡21例,植物生存20例,重度伤残18例,轻度伤残28例,恢复正常25例.与常规组比较,术前准备时间大大缩短(25 min vs 50 min,P＜0.05),外伤性脑梗死发生率有统计学差异(9.8％ vs 19.0％,P＜0.05),病死率有统计学差异(18.8％vs 32.2％,P＜0.05),预后良好率有统计学差异(47.3％vs 33.5％,P＜0.01).迟发性颅内血肿发生率无统计学差异(21.4％vs 20.2％),肺部感染发生率无统计学差异(58.9％ vs 62.0％,P＞0.05).结论 颅脑损伤一体化急救流程的建立,大大缩短了手术准备时间,降低了患者病死率,改善了患者生存质量.

[Objective]To explore the safety and value of middle and low dose of recombinant Ⅶa factor (rFⅦa)for the treatment of patients with hypertensive cerebral hemorrhage.[Methods]A prospective single-centre case control study was conducted.A total of 168 patients with hypertensive cerebral hemorrhage from Aug 2011 to Jan 2013 were admitted in our hospital.According to the recruitment criteria,86 patients were enrolled in this study including 27 patients in experiment group and 59 patients in control group.In the experi-ment group,patients were injected with rFⅦa 20 μg/kg within 2 hours after admission.Glasgow coma scale (GCS)and coagulation parameters of two groups at admission were recorded and compared.The amount of blood transfusion,length of stay in ICU,medical expense,mortality on day 30,and GOS on day 90 were fol-lowed up.[Results]Compared with before treatment,coagulation parameters in two groups after treatment were improved.Compared with control group,international normalized ratio(INR)was decreased(0.29±0.23 v.s 0.11 ± 0.39)and prothrombin time(PT)was shortened in the experiment group(3.26±2.53 v.s 1.85± 4.5)which were better than the control group,and there were significant differences(P <0.05).GOS score of patients was evaluated during 3 months of follow up.The prognosis of patients in the experiment group showed slight better,but there was no significant difference.[Conclusion]rFⅦa for the treatment of cerebral hemorrhage can improve the coagulation of patients,but its correlation with the prognosis needs further inves-tigation by large-sample clinical data.