中华神经外科杂志最新文献

{"title":"Application of domestic Tubridge flow diverter in the treatment of unruptured intracranial aneurysms","authors":"Li Li, Tianxiao Li, Qiuji Shao, Guanglin Zhang, Liang-fu Zhu, Jiang-yu Xue, Zi-liang Wang, W. Bai","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.09.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.09.009","url":null,"abstract":"Objective \u0000To investigate the efficacy and safety of domestic Tubridge flow diverter in the treatment of unruptured intracranial aneurysms. \u0000 \u0000 \u0000Methods \u0000From April 2018 to January 2019, data were collected from 23 patients with 33 unruptured intracranial aneurysms admitted to Department of Neurosurgery, People′s Hospital of Zhengzhou University. All patients were treated with domestic Tubridge flow diverter. Among them, 28 aneurysms were treated with Tubridge alone and 5 were treated with Tubridge combined with coiling. Digital subtraction angiography (DSA) was used to evaluate the conditions of stent implantation. The efficacy of emobolization was evaluated by Raymond classification.Clinical outcomes were assessed based on the modified Rankin scale (mRS). \u0000 \u0000 \u0000Results \u0000The success rate of stent implantation was 96% (26/27). Ischemic postoperative complications occurred in 2 cases. All patients were followed up for 6 months. DSA results from 5 patients with 11 aneurysms showed that 8 aneurysms were completely occluded and non-symptomatic stenosis of parent artery was found in 1 case. The mRS score was 0 in 21 cases, 1 in 1 case and 2 in 1 case. \u0000 \u0000 \u0000Conclusions \u0000The short-term effect of Tubridge flow diverter in the treatment of unruptured intracranial aneurysms seems to be satisfactory with low postoperative complication rate. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Endovascular procedures; Treatment outcome; Postoperative complications; Flow diverter","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"909-913"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49351280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxia-inducible factor 1α regulates chemoresistance of glioma cells in hypoxia environment: A preliminary study","authors":"Junwei Wang, Pan Wang, Dewei Zou, Bin Liao, Sheng Gong, Lu Zhao","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.09.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.09.015","url":null,"abstract":"Objective \u0000To confirm that hypoxia can induce reverse differentiation of glioma cells or maintain the stemness of glioma cells, leading to chemotherapeutic resistance and to explore its mechanism by in vitro studies. \u0000 \u0000 \u0000Methods \u0000U87 and GL261 cells were considered as glioma cells line in this study. CD133+ CD15+ Nestin+ and CD133-CD15-Nestin- glioma cells were sorted through magnetic activated cell sorting and cultured in normoxia and hypoxia environments. CD133+ CD15+ Nestin+ and CD133-CD15-Nestin- glioma cells were cultured in hypoxia to detect the expressions of CD133, CD15, Nestin and hypoxia-inducible factor (HIF) 1α by Western blot and immunofluorescence assay. Cell apoptosis and half maximal inhibitory concentration (IC50) values were assessed after temozolomide (TMZ) treatment. HIF1α knocked-out glioma cells were cultured in hypoxia and the expressions of CD133, CD15 and Nestin were determined by Western blot. Besides, we compared cells apoptosis rate and IC50 values after TMZ treatment between HIF1α knocked-out glioma cells and control group. \u0000 \u0000 \u0000Results \u0000GL261 CD133+ CD15+ Nestin+ cells showed lower cells apoptosis and higher IC50 value compared with Gl261 CD133-CD15-Nestin- cells after TMZ treatment (both P<0.05). The results of Western blot showed that the expression levels of CD133, CD15, Nestin and HIF1α in CD133+ CD15+ Nestin+ and CD133-CD15-Nestin- U87 cells in hypoxia were higher than those in control group cultured in normoxia, which were barely expressed in the latter (all P<0.05). There were lower cells apoptosis and higher IC50 value after TMZ treatment in hypoxia in CD133+ CD15+ Nestin+ and CD133-CD15-Nestin- U87 and GL261 glioma cells (all P<0.05). The expressions of CD133, CD15 and Nestin were decreased in HIF1α knocked-out glioma cells compared with those in cells without knocking out HIF1α. Higher cells apoptosis rate and lower IC50 value were reported for HIF1α knocked-out glioma cells after TMZ treatment (all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Hypoxia could induce chemotherapy resistance by maintaining the stemness of glioma stem cells or promoting the reverse differentiation of normally differentiated glioma cells. \u0000 \u0000 \u0000Key words: \u0000Glioma; Cell hypoxia; Hypoxia-inducible factor 1, alpha subunit; Chemoresistance","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"938-945"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48728071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of neuronavigation-assisted endoscopic transsphenoidal surgery for invasive pituitary adenomas","authors":"Wei Wei, Xin Chen, Jun Yu, Xuqin Li","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.09.011","url":null,"abstract":"Objective \u0000To explore the effect of neuronavigation-assisted endoscopic transsphenoidal surgery for invasive pituitary adenomas. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on 40 patients with invasive pituitary adenomas admitted to Department of Neurosurgery, Affiliated Dalian Municipal Central Hospital, Dalian Medical University from January 2010 to March 2018. Among those patients, 20 were treated with neuronavigation-assisted endoscopic transnasal sphenoidal surgery (endoscopic group) and the other 20 were treated with traditional transnasal microsurgery (control group). The complete tumor resection rate, postoperative complication rate and tumor recurrence rate were compared between the 2 groups. \u0000 \u0000 \u0000Results \u0000There were no significant differences in gender, age, clinical manifestations, endocrine examination results, Knosp classification of pituitary adenomas or maximum diameter of tumors between the 2 groups (all P>0.05). The total resection rate of endoscopic group was higher than that in the control group[65.0% (13/20) vs. 20.0% (4/20), P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Neuronavigation-assisted endoscopic transnasal sphenoidal surgery for invasive pituitary adenomas is associated with higher total resection rate and lower recurrence rate compared with traditional transnasal sphenoidal microsurgery. \u0000 \u0000 \u0000Key words: \u0000Pituitary neoplasms; Neoplasm invasiveness; Neuronavigation; Natural orifice endoscopic surgery; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"919-922"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41552043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factor analysis of ischemic stroke following flow diverter placement for paraclinoid aneurysms","authors":"Z. Tian, Xinzhi Wu, Wenqiang Li, Wei Zhu, Xinjian Yang, Yisen Zhang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.09.006","url":null,"abstract":"Objective \u0000To evaluate risk factors for acute ischemic stroke following treatment of paraclinoid aneurysms using flow diverters. \u0000 \u0000 \u0000Methods \u0000Between September 2015 and July 2018, 205 consecutive patients with 229 paraclinoid aneurysms were treated with Pipeline embolization device (PED) at Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University. The aneurysm size and parent artery size were measured. According to the length, proximal and distal diameter of the parent artery, appropriate size of PED was deployed with or without coiling. Various potential risk factors associated with acute ischemic stroke following PED treatment were documented. Univariate and multivariate logistic regression analyses were applied to identify risk factors. \u0000 \u0000 \u0000Results \u0000Among the 205 patients with 229 paraclinoid aneurysms, 110 aneurysms were treated by PED and 119 aneurysms received PED with coiling, all PED were delivered and implanted successfully. Eighteen (8.8%) patients with 20 aneurysms had acute ischemic stroke after PED deployment. Univariate analysis suggested that ADP inhibition, high MA-ADP value, clopidogrel non-response, application of complex intraoperative techniques, and long operation time were associated with the acute ischemic stroke following PED treatment (all P<0.05). Further multivariate logistic regression analysis showed the clopidogrel non-response (OR=6.161, 95% CI: 1.480-25.649, P=0.012), application of complex intraoperative techniques (OR=8.405, 95% CI: 1.437-49.146, P=0.018) and operation time (OR=1.011, 95% CI: 1.002-1.020, P=0.022) were independent factors for acute ischemic stroke following PED treatment. \u0000 \u0000 \u0000Conclusions \u0000Clopidogrel non-response, application of complex intraoperative techniques and long operation time may increase the risk of ischemic events. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Stroke; Factor analysis, statistical; Flow diverter; Paraclinoid","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"895-899"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47651665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of 3D-TOF-MRA and 3D-FIESTA fusion three-dimensional images in judgment of offending vessel in primary trigeminal neuralgia","authors":"Yingbin Jiao, F. Duan, Zhiyong Yan, Qing-hai Meng, Yugong Feng","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.09.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.09.013","url":null,"abstract":"Objective \u0000To investigate the value of three-dimensional time-flying magnetic resonance angiography (3D-TOF-MRA) and three-dimensional fast imaging employing steady-state acquisition sequence (3D-FIESTA) fusion three-dimensional image in identification of offending vessels of primary trigeminal neuralgia (PTN). \u0000 \u0000 \u0000Methods \u0000A total of 48 patients with PTN who underwent microvascular decompression (MVD) from January 2016 to June 2019 at Department of Neurosurgery, Affiliated Hospital of Qingdao University were retrospectively enrolled into this study. All patients underwent 3D-TOF-MRA and 3D-FIESTA sequence examinations before operation. The 3D-slicer software was used to fuse 3D-TOF-MRA and 3D-FIESTA sequence images and conduct three-dimensional reconstruction. Using MVD as a standard, 3D-TOF-MRA, 3D-FIESTA and fused images were evaluated to determine the offending vessels and their compressive degree on the nerves. \u0000 \u0000 \u0000Results \u0000In MVD, except for 1 patient who had no offending vessel, the other 47 patients had clear offending vessels. The offending vessels were merely arteries in 40 cases, veins in 2, and both arteries and veins in 5. The 3D-TOF-MRA results showed that 5 patients had no offending vessels, and the remaining 43 patients had arteries as offending vessels. The 3D-FIESTA showed that 4 cases had no offending vessels; the offending vessels were arteries in 36 cases, veins in 3 cases, and both arteries and veins in 5 cases. The fused images showed that there were 2 cases without offending vessels; the offending vessels were arteries in 39 cases, veins in 2 cases, and both arteries and veins in 5 cases. Using the MVD as the standard, the accuracy of 3D-TOF-MRA, 3D-FIEST and fusion 3D images for determining the presence/absence offending vessels was 91.7% (44/48), 93.8% (45/48) and 97.9%(45/48), respectively. The accuracy of correct identification of offending vessels by 3D-TOF-MRA, 3D-FIEST and fused images was 54.2% (26/48), 89.6% (43/48) and 93.8% (45/48), respectively. Compared with intraoperative findings, those 3 types of images commonly showed lighter degree of nerve compression, and the differences were statistically significant (all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Compared with 3D-TOF-MRA and 3D-FIESTA single sequences, the fused images seem to be more accurate in identification of the offending vessels of PTN, which, however, is still associated with underestimation of the nerve compression degree. \u0000 \u0000 \u0000Key words: \u0000Trigeminal neuralgia; Offending vessel; Three-dimensional time-of-flight magnetic resonance angiography; Three-dimensional fast imaging employing steady-state acquisition; Microva-scular decompression","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"928-932"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45567218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effect of Pipeline Flex embolization device in the treatment of complex intracranial aneurysms","authors":"Yunyu Wen, Gang Wang, Y. Liao, Guo-zhong Zhang, Ming-zhou Li, Qiao Deng, Siyuan Chen, S. Qi","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.09.008","url":null,"abstract":"Objective \u0000To investigate the short-term efficacy of Pipeline embolization device (PED) in the treatment of complex intracranial aneurysms. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis of clinical data was conducted on 37 patients who underwent endovascular treatment with PEDs at Neurosurgery Department of Nanfang Hospital, Southern Medical University from January 2018 to March 2019. There were 45 aneurysms in 37 patients (including 7 cases with tandem wide-necked small aneurysms) which were distributed in internal carotid artery (38 cases), vertebral artery (3 cases), middle cerebral artery (3 cases) and anterior cerebral artery (1 case). The maximum diameter of aneurysm ranged from 2.0 to 34.8 mm. In this series, the diameters in 22 aneurysms were no longer than 10 mm and those in the other 23 aneurysms were larger than 10 mm. The modified Rankin scale (mRS) was used to evaluate the prognosis. \u0000 \u0000 \u0000Results \u0000A total of 37 PEDs were placed for 37 patients with 45 intracranial aneurysms in this study (Pipeline Flex stent-assisted embolization performed in 13 cases and stent-only treatment in 24). Retentions of contrast agent in the aneurysm cavity were detected by immediate postoperative radiography for 37 aneurysms, which showed that the aneurysm-bearing arteries were smooth and had no stenosis. All PEDs were well attached according to DynaCT fusion 3D reconstruction. Perioperative complications occurred in 11 patients, among whom 2 died. There were 35 patients followed-up for 1 month after discharge and no neurological symptoms were observed. \u0000 \u0000 \u0000Conclusions \u0000The treatment of complex intracranial aneurysms with PEDs is relatively safe and effective. Further optimization may still be needed for the perioperative anti-platelet aggregation regimen. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Endovascular procedures; Flow diverter; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"904-908"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48971108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of facial nerve F wave in facial paralysis after acoustic neuroma surgery","authors":"Yang Liu, Qi Chai, Ping Li","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.08.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.08.015","url":null,"abstract":"Objective \u0000To investigate the predictive value of preoperative facial nerve F wave in postoperative facial paralysis following acoustic neuroma surgery. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on 37 patients with unilateral cerebellopontine angle acoustic neuroma without facial paralysis admitted to Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from January 2016 to January 2017. The latency parameters of facial nerve F wave in healthy and affected sides were measured before operation. Facial nerve function was evaluated based on the House-Brackmann (H-B) grading system at 12 months post surgery. Patients with Grade Ⅲ-Ⅵ were categorized into postoperative facial paralysis group (8 cases) and those with Grade Ⅰ was classified as postoperative non-facial paralysis group (29 cases). The preoperative F wave latency, F-M wave latency, F wave side-to-side difference, and F-M wave side-to-side difference were compared between the 2 groups. The operating characteristic curve (ROC) was plotted and the area under the curve (AUC) was calculated to evaluate the predictive value of F wave of facial nerve before operation in postoperative facial paralysis. \u0000 \u0000 \u0000Results \u0000The latency of F wave and F-M wave on the affected side was longer than that on the affected side (both P<0.05). The latencies of F wave and F-M wave on the affected side in the facial paralysis group were longer than that in the non-facial paralysis group (both P<0.05), and the latencies of F wave and F-M wave side-to-side difference in the facial paralysis group were larger than those in the non-facial paralysis group (both P<0.05). The preoperative F-wave latency, F-M wave latency, F-wave latency side-to-side difference and F-M wave latency side-to-side difference could be used to predict the H-B grade of facial nerve after operation (AUC: 0.813, 0.920, 0.793 and 0.996, respectively, all P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The latency and latency side-to-side difference of F wave and F-M wave of preoperative facial nerve in patients with acoustic neuroma seem to be able to predict the risk of postoperative facial paralysis. \u0000 \u0000 \u0000Key words: \u0000Neuroma, acoustic; Facial nerve; Facial paralysis; Latency of F-wave","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"829-832"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44465713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose cisplatin combined with etoposide in the treatment of low-grade glioma in the sellar region of children with diencephalic syndrome: A report of four cases","authors":"W. Shi, P. Xue, R. Zhao","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.08.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.08.007","url":null,"abstract":"Objective \u0000To investigate the therapeutic effect of low-dose cisplatin combined with etoposide on low-grade glioma in the sellar region of children with diencephalic syndrome. \u0000 \u0000 \u0000Methods \u0000The clinical characteristics, treatment and outcomes of 4 children with diencephalic syndrome secondary to low-grade glioma in the sellar region were retrospectively analyzed who were admitted to Department of Neurosurgery, Children's Hospital of Fudan University from January 2015 to December 2017. Of 4 cases, 2 were females and 2 were males. The range of age was 6 months to 34 months, with the median age of 16 months. One case with severe hydrocephalus was treated with ventriculoperitoneal shunt surgery. Surgical biopsy or resection was not performed in this series. Low doses of cisplatin (1 mg·kg-1·d-1 d0-d2) and etoposide (5 mg·kg-1·d-1, d0-d2) were used for 10 cycles of chemotherapy to observe the clinical effect. \u0000 \u0000 \u0000Results \u0000All cases successfully completed chemotherapy and no obvious side effects of chemotherapy were reported. Follow-up post chemotherapy lasted for 6 to 20 months (with the median duration of 12 months). The clinical symptoms were better than before and the weight was about 29.3%-50.0% higher than before. The starting time to gain weight was 3 to 12 months after the initiation of chemotherapy (with the median duration of 7 months). There was no progress in the review of cranial MRI saddle area in 2 cases, tumor reduction in 1, substance decrease in 1, disappearance of cisterna ambiens lesion in 1 and disappearance of the fourth ventricular lesion in 1. There was no significant change in hormone level compared with conditions prior to chemotherapy. One case gained weight at 1 year post chemotherapy and presented good clinical performance. Partial resection of tumor was performed. Its final pathological result was pilocytic astrocytoma (WHO Ⅰ) and further radiotherapy was administered. \u0000 \u0000 \u0000Conclusions \u0000The chemotherapy regimen of low-dose cisplatin combined with etoposide seems to have a good effect which was to improve the clinical symptoms and postpone the tumor progression of children with diencephalic syndrome secondary to low-grade gliomas in the sellar region. \u0000 \u0000 \u0000Key words: \u0000Glioma; Child; Cisplatin; Etoposide; Diencephalic syndrome; Sellar region; Low-grade","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"788-791"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45813403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes of temporal lobe epilepsy in children","authors":"Guangbiao Qin, K. Ma, Linhua Yi, Bojing Tan, Qian Chen, Shuhua Chen, Yanfei Luan","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.08.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.08.011","url":null,"abstract":"Objective \u0000To explore the surgical treatment and outcomes of temporal lobe epilepsy in children. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on 21 children with temporal lobe epilepsy admitted to Department of Neurosurgery, Children's Hospital Affiliated to Capital Institute of Pediatrics from September 2016 to June 2018. Individualized surgical treatment plan was formulated according to the semeiology, imaging and electroneurophysiological findings of the children. Standard anterior temporal lobectomy was undergone in 13 cases, enlarged resection of temporal lobe lesion in 3, selective hippocampal amygdala resection in 2, simple resection of medial temporal lobe lesion in 1, vascular malformation resection in 1, and anterior temporal lobe resection plus frontal lobe nodule resection in 1. All patients were followed up clinically after operation. The follow-up included cranial MRI, electroencephalogram and Engle rating. \u0000 \u0000 \u0000Results \u0000All 21 patients underwent successful operation. No serious complications occurred after surgery. The pathological results were mixed neuronal-glial tumor in 14 cases, pleomorphic xanthoastrocytoma in 1, hippocampal sclerosis in 3, focal cortical dysplasia IIb in 1, tuberous sclerosis in 1, and cerebral arteriovenous malformation in 1. The follow-up duration of 21 patients was 18.0±5.9 months (9-30 months). A review of head MRI showed that all tumors were completely resected and no recurrence was seen of the patients with tumor. A review of the EEG showed that there was still a large amount of epileptic discharges in the temporal lobe of 1 patient, and the epileptic discharges of the remaining 20 cases were significantly reduced or disappeared compared with preoperative conditions. Eighteen patients were followed up for more than 12 months. Up to the last follow-up, 17 cases were classified as Engle Ⅰ and 1 as Engle Ⅳ. \u0000 \u0000 \u0000Conclusion \u0000Individualized surgical procedures based on comprehensive assessment of the semeiology, imaging and electroneurophysiology of children with temporal lobe epilepsy could lead to good outcomes. \u0000 \u0000 \u0000Key words: \u0000Epilepsy; Temporal lobe; Child; Neurosurgical procedures; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"807-811"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47875099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive and behavioral changes in children with craniopharyngioma before and after surgery","authors":"Xiao-Qian Zhang, Yuqi Zhang, Xin Pan, Junhua Wang, B. Luo, Qinglin Zhang, Tuoyu Chen, C. Xue, Po-Zi Liu","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.08.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.08.012","url":null,"abstract":"Objective \u0000To explore the differences of brain cognitive function and behavior in children with craniopharyngioma during perioperative period. \u0000 \u0000 \u0000Methods \u0000The clinical data of 19 patients with craniopharyngioma were retrospectively enrolled who underwent craniotomy at Department of Neurosurgery, Tsinghua University Yuquan Hospital from February 2015 to February 2017. The mean age of patients was 9.10±3.53 (6-15) years old. Twelve cases were primary tumors and 7 were recurrent tumors. Craniotomy was conducted for tumor resection in all patients. Fourteen cases were treated through frontal coronal incision approach, 3 through corpus callosum -transparent compartment-dome approach and 2 through small incision of pterional approach. The intelligence test was performed using the fourth edition of the Wechsler Intelligence Test Scale before and after surgery. The Conners Child Behavior Scale (for parents) was used for behavioral testing. The cognitive function and behavioral changes of the brain in 19 children with craniopharyngioma before and 2 weeks after operation were compared. \u0000 \u0000 \u0000Results \u0000Among the 19 children with craniopharyngiomas, total tumor resection was achieved in 17 cases and subtotal resection in 2. There was no operative death. The preoperative and postoperative total IQ (intelligence quotient) scores (101.68±18.50 vs. 103.05±15.67), verbal comprehension indexes(98.00±13.51 vs. 101.00±17.07), perceptual reasoning indexes (94.11±12.60 vs. 95.26±15.05), working memory indexes (87.00±14.15 vs. 92.16±19.12), processing speed indexes (92.95±17.17 vs. 95.47±16.91) had no significant difference (all P>0.05). There were no significant differences in behavior scores of the children before and 2 weeks after operation (all P>0.05). \u0000 \u0000 \u0000Conclusion \u0000There seems to be no significant decrease in postoperative intelligence and behavioral level in children with craniopharyngioma. It shows that the surgical resection itself would not cause damage to the cognitive function of the child. \u0000 \u0000 \u0000Key words: \u0000Craniopharyngioma; Child; Cognition; Child behavior; Neurosurgical procedures","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"812-816"},"PeriodicalIF":0.0,"publicationDate":"2019-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45800167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}