中华神经外科杂志最新文献

{"title":"Relationship between craniopharyngioma and the third ventricle floor meninges based on QST classification","authors":"S. Qi, Yi Liu, Chao-hu Wang, Jun Fan, Jun Pan, Xi'an Zhang","doi":"10.3760/CMA.J.CN112050-20191125-00497","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112050-20191125-00497","url":null,"abstract":"Objective \u0000To explore the relationship between craniopharyngioma based on QST classification with invovlement of the third ventricle floor and the third ventricle floor meninges and its clinical significance. \u0000 \u0000 \u0000Methods \u0000The clinical data of 17 primary craniopharyngioma patients with involvement of the third ventricle floor (6 cases of Q type, 3 cases of S type and 8 cases of T type) undergoing total tumor resection under neuroendoscopy from January 2018 to October 2019 at Neurosurgery Department of Nanfang Hospital, Southern Medical University were retrospectively analyzed. Tumor tissue samples were taken from all patients during operation. The specimens of the normal sellar region were derived from the fetus (8 cases) of the artificial or spontaneous abortion at Nanfang Hospital of Southern Medical University during the same period. Samples were stained by hematoxylin eosin (HE) and immunofluorescence double staining. The dura was labelled with vimentin antibody, arachnoid with type I collagen antibody, pia with glial fibrillary acidic protein antibody and laminin antibody, adenohypophysis with CK18 antibody and craniopharyngioma with CK5 / 6 antibody. We then observed the meningeal staining of fetal brain tissue and relationship between different QST types of craniopharyngioma tissue and the third ventricle floor meninges. \u0000 \u0000 \u0000Results \u0000The dura mater, arachnoid and pia mater of 8 fetuses were labelled successfully. HE staining and immunofluorescence double staining of craniopharyngioma showed that in type Q tumor (6/6), there were dura mater (diaphragma sellae) between tumor and the third ventricle floor. In type S tumor (3/3), there were arachnoid membrane and pia mater between tumor and the third ventricle floor. There were 3 patterns regarding the relationship between type T tumor and the third ventricle floor: mantle-like relationship, moat-like and mortise-like types. There was pia mater between type T tumor (8/8) and the third ventricle floor, and the pia mater could gradually disappear at the origin point of tumor. Although the tumor could remarkably compress the third ventricle and occupy the space of ventricle, the ependymal layer of the third ventricle remained intact. \u0000 \u0000 \u0000Conclusions \u0000All QST types of craniopharyngioma could involve the third ventricle floor and there are various membrane layers between tumor and the third ventricle floor, which could provide natural interface for safe removal of craniopharyngioma with the third ventricle floor involvement. \u0000 \u0000 \u0000Key words: \u0000Craniopharyngioma; Third ventricle; Sella turcica; Meninges; Pathology","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"232-237"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48090634","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":"Pathological characteristics of recurrent glioma and its prognosis analysis","authors":"Cong Li, S. Xi, Yinsheng Chen, M. Deng, Qunying Yang, Chao Ke, K. Sai, Jian Wang, Y. Mou","doi":"10.3760/CMA.J.CN112050-20190727-00328","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112050-20190727-00328","url":null,"abstract":"Objective \u0000To explore the pathological characteristics of recurrent glioma and its relationship with the patient′s prognosis. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on the clinical data of 54 patients with recurrent glioma treated at Neurosurgery Department, Sun Yat-sen University Cancer Center from August 2002 to December 2016. All patients underwent a second operation of tumor resection and postoperative pathological examinations including the World Health Organization (WHO) classification of the tumor, Ki-67 index, O6-methylguanine-DNA-methyltransferase (MGMT) status and isocitrate dehydrogenase 1 (IDH1) status. The histopathological features of recurrent samples were classified according to presence of necrosis and tumor cells as well as activity of tumor cells. The overall survival (OS) of patients was analyzed using the Kaplan-Meier method. The univariate and multivariate Cox regression analysis was further conducted to determine the clinical factors affecting OS in patients with recurrent glioma. \u0000 \u0000 \u0000Results \u0000Pathological test results in 54 patients were as follows: (1) In terms of WHO grade, there were 6 cases of grade Ⅱ(11.1%), 14 cases of grade Ⅲ(25.9%), 30 cases of grade Ⅳ(55.6%), and 4 cases (7.4%) without tumor cells. Compared with the first operation, there was no change in the WHO grade in 32 patients (59.2%), 7 (13.0%) had lower WHO tumor grades and 15 (27.8%) had higher grades; (2) In terms of Ki-67 index, out of 32 cases undergoing two times of testing, 15 cases had decreased Ki-67 index, 14 had increased Ki-67 index, and 3 cases had unchanged index; (3) In terms of IDH1 status, out of 29 cases undergoing two times of relevant tests, 9 cases were mutant and 20 were wild type; (4) In terms of MGMT status: out of 8 cases undergoing two times of relevant tests, 6 cases consisting of 3 cases with positive expression and 3 cases with negative expression had no change, and the remaining 2 changed from positive expression in the first test to negative expression in the second test; (5) In terms of pathological classification, 4 cases were necrosis type, 20 were mixed type, and 30 were active type. The follow-up time of 54 patients was 16.1±3.2 months (1.3-160.3 months). The Kaplan-Meier analysis showed a median OS of 14.4 months in 54 patients. The result of multivariate Cox regression analysis showed that high WHO grade of recurrence tumor (HR=2.80, 95% CI: 1.42-5.53, P<0.01) and absence of postoperative radiotherapy (HR=4.05, 95% CI: 1.41-11.64, P=0.01) were independent risk factors affecting OS in patients with recurrent glioma. \u0000 \u0000 \u0000Conclusions \u0000This preliminary study has suggested that recurrent gliomas might have changed pathological results revealed post re-surgery, and low WHO tumor grade and postoperative radiotherapy seem to be predictive factors of better prognosis. \u0000 \u0000 \u0000Key words: \u0000Glioma; Recurrence; Pathology; Prognosis","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"227-231"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46050550","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":"Experimental study on the expression of ubiquitin-specific protease-25 in temporal cortex of epileptic rats","authors":"Ye Chen, Yujiao Wang, Zhong-fang Shi, Xu Yan, Li-xin Xu, Li-ping Dong, Zhenrong Sun, F. Yuan","doi":"10.3760/CMA.J.CN112050-20191105-00476","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112050-20191105-00476","url":null,"abstract":"Objective \u0000To study the expression of ubiquitin-specific protease 25 (USP25) in the temporal cortex of the kainic acid (KA) induced epilepsy rat model. \u0000 \u0000 \u0000Methods \u0000Fifty-two male SD rats were randomly divided into the epilepsy model group (n=39) and sham-operated control group (n=13) with the random number table. The epilepsy model group was established by injecting KA into the amygdala, then the epileptic rats were randomly divided into 3 groups according to the modeling success time: 1 day for acute period, 7 days for latent period and 30 days for chronic period (13 rats in each group). Those rats were sampled at the end of observation. Rats in the control group were injected with normal saline into the amygdala and sampled together with those in the experimental group. Immunohistochemistry and immunofluorescence double labeling was used to test USP25 expression and its co-expression with neurons (NeuN) and astrocytes (GFAP). Quantitative real-time PCR and Western blot were used to assess the change of USP25 in the temporal cortex of rats. \u0000 \u0000 \u0000Results \u0000In the ipsilateral temporal cortex, the positive cells of co-expression of USP25 and NeuN were increased in the later stage of epilepsy in the epilepsy model group, and the expression levels of USP25 mRNA and protein in different stages of epilepsy varied significantly (F= 25.48 and 7.68 respectively, both P<0.05). Compared with the control group (mRNA level: 1.00±0.36, protein level: 1.00±0.46), the expression of USP25 in the latent group (mRNA level: 10.80±4.82, protein level: 1.88±0.32) and the chronic group (mRNA level: 12.97±4.48, protein level: 1.92±0.26) were increased significantly (all P<0.05). In the contralateral temporal cortex, the expression levels of USP25 mRNA and protein in different stages of epilepsy also varied significantly (F=86.86 and 6.65 respectively, both P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The increased expression of USP25 in the temporal cortex after the latent period has suggested that the deubiquitination pathway is involved in the chronic pathological process of temporal lobe epilepsy. \u0000 \u0000 \u0000Key words: \u0000Epilepsy, temporal lobe; Ubiquitin-specific protease 25; Rats","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"281-287"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45362287","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":"Microsurgical treatment of large and giant parasagittal meningioma invading the superior sagittal sinus","authors":"G. Lin, Jian-jun Sun, Su Chen, Jing-cheng Xie, C. Ma, Xiao Dong Chen","doi":"10.3760/CMA.J.CN112050-20190912-00396","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112050-20190912-00396","url":null,"abstract":"Objective \u0000To investigate the method and effect of microsurgical removal of large and giant parasagittal meningioma invading the superior sagittal sinus. \u0000 \u0000 \u0000Methods \u0000The clinical data of 154 cases with large and giant parasagittal meningioma invading the superior sagittal sinus admitted to Department of Neurosurgery, Peking University Third Hospital from May 2009 to May 2019 were retrospectively analyzed. The diameter of the tumors ranged from 4 cm to 8 cm, with an average of 5.5±1.2 cm. Microsurgical resection was carried out along the midline and longitudinal fissure with a horse-shoe shaped skin incision turning to the temporal side. The degree of resection was evaluated by Simpson grading system. The results of clinical follow-up were evaluated by Karnofsky performance score (KPS), and the tumor recurrence was evaluated by imaging follow-up. \u0000 \u0000 \u0000Results \u0000Among the 154 cases, Simpson grade Ⅰ resection was achieved in 112 (72.7%) and grade Ⅱ resection in 42 cases (27.3%). All of them were proved to be meningiomas (World Health Organization grade Ⅰ). The operation time ranged from 30 minutes to 210 minutes (median: 60 minutes), and the length of stay ranged from 5 days to 10 days with an average of 7.2±1.1 days. There was no infection, cerebrospinal fluid leakage, death or permanent aggravation of neurological dysfunction. The patients were followed up for 3 months to 123 months, with an average of 63.5±0.7 months. The KPS score ranged from 80 points to 100 points, with an average of 93.6±0.3 points. Tumor recurrence occurred in 14 patients (9.1%), including 7 in Simpson Ⅰ resection group and 7 in Simpson Ⅱ resection group. There was significant difference in recurrence rate between the 2 groups (χ2=4.01, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Simpson grade Ⅰ microsurgical resection can be pursued for large and giant parasagittal meningioma invading the superior sagittal sinus which helps minimize the recurrence rate. \u0000 \u0000 \u0000Key words: \u0000Meningioma; Microsurgery; Treatment outcome; Sagittal sinus; Large and giant","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"243-247"},"PeriodicalIF":0.0,"publicationDate":"2020-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43133392","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":"Expression and clinical significance of calumenin in brain gliomas","authors":"P. Kang, Chuan-bao Zhang, Linhao Yuan, Jiayi Peng, Yangyang Wang, Wang Jia, K. Qian","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.02.005","url":null,"abstract":"Objective \u0000To detect the expression of calumenin (CALU) in human brain glioma samples, to explore its effect on the patient′s outcome, and to analyze the related biological functions of the genes co-expressed with CALU. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on CALU sequencing expression and clinical data of 288 glioma patients with positive CALU expression in the mRNAseq_325 database of Chinese Glioma Genome Atlas (CGGA). We analyzed the effects of CALU expression levels on survival in different types of glioma patients. The multivariate Cox regression method was used to determine the relevant factors affecting the survival of glioma patients. Pearson correlation analysis was employed to screen the related genes co-expressed with CALU and their biological functions were explored using the online bioinformatic analysis tools. \u0000 \u0000 \u0000Results \u0000Among the 288 patients, the expression of CALU was 4.74±0.68, 5.49±1.12 and 6.17±0.94 in World Health Organization (WHO) grade Ⅱ, Ⅲ, and Ⅳ patients respectively, and 6.13±1.17 and 5.08±0.76 in isocitrate dehydrogenase l (IDH1) wild-type and IDH1 mutant gliomas respectively, and 5.79±0.07 and 4.71±0.07 in gliomas with 1p/19q non-codeletion and 1p/19q co-deletion. The comparative differences in the above indicators were statistically significant (all P 0.05). The median survival of CALU patients with high and low expression levels (144 cases in each) was 13.0(1-132)months and 82.5(2-149)months, respectively, which had statistically significant difference (P<0.01). In patients with WHO grade Ⅱ-Ⅳ gliomas, the high expression of CALU mainly reduced the survival time of grade Ⅲ and Ⅳ patients (both P<0.01). The multivariate Cox regression analysis showed that CALU expression was an independent factor influencing the survival of glioma patients (RR=2.193, 95%CI: 1.507-3.192, P<0.01). In the CGGA database, there were 325 genes that were positively correlated with CALU expression. The biological functions of those genes were mainly signal transduction, cell adhesion and cellular metabolism, and were mainly involved in endoplasmic reticulum protein processing, adhesion and cancer pathways. \u0000 \u0000 \u0000Conclusion \u0000CALU is significantly related to the malignancy of brain glioma and may serve as an independent prognostic factor in high grade glioma patients, which thus provides a potential therapeutic target in the future research. \u0000 \u0000 \u0000Key words: \u0000Glioma; Gene expression; Prognosis; Calumenin","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"130-135"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48227289","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":"Application of direct electrical stimulation in awake craniotomy for glioma resection in the motor area","authors":"Hongmin Bai, Sijie Zhou, Huan Yang, Guo-liang Wang, Weimin Wang, Xiaoyan Zhu, Limin Wang","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.02.007","url":null,"abstract":"Objective \u0000To explore the effect of direct electrical stimulation in awake craniotomy for glioma resection in the motor area. \u0000 \u0000 \u0000Methods \u0000We conducted a retrospective analysis of clinical data of 34 patients with gliomas in the motor area who were admitted to Department of Neurosurgery, General Hospital of Southern Theatre Command from March 2015 to July 2017. The tumor was located in the left hemisphere in 16 patients and right hemisphere in 18. The gliomas were in supplementary motor area or premotor cortex in 23 cases, the central area in 9 cases, and supplementary motor area or premotor cortex invading the central area in 2 cases. All patients underwent awake craniotomy under general anesthesia. Neuronavigation and/or intraoperative ultrasound were employed to locate the lesion. Direct electrical stimulation was used for cortical and subcortical mapping of the important eloquent areas. The tumors were removed according to the functional boundary.Neural function and the degree of tumor resection were evaluated after operation. \u0000 \u0000 \u0000Results \u0000Of the 34 patients, 24 had a motor response after direct cortical electrical stimulation, 13 had abnormal sensations, and 10 revealed language-related cortices through mapping. For subcortical electrical stimulation, there were 24 cases of motor response, 1 case of abnormal sensation, and 8 cases of language disorders. A total of 30 cases (88.2%) of tumor removal reached functional boundaries, and subcortical electrical stimulation did not identify functional fiber in the remaining 4 (11.8%) cases which were all high-grade gliomas. Within 48 hours post surgery, the head MRI indicated total resection of tumor in 22 cases (64.7%), subtotal resection in 9 (26.5%), and partial resection in 3 (8.8%). The follow-up time of 34 patients was (23.6 ± 8.6) months (11.3-39.3)months.There were 29 cases (85.3%) which showed early postoperative neurofunctional disorders or worsening of pre-existing neurological deficits. Three cases (8.8%) developed late postoperative neurological dysfunction worse than preoperative conditions, of which 1 case was mild, 1 case was moderate and 1 case (2.9%) was severe. Of the 16 patients with preoperative neurological dysfunction or increased intracranial pressure, 13 had improved neurological function in 3 months after surgery, 2 were maintained in preoperative state and 1 had severe neurological deficits. \u0000 \u0000 \u0000Conclusions \u0000Functional mapping through direct electrical stimulation and continuous monitoring of the cortical and subcortical white fibers in the motor area during awake craniotomy could maximize the safe resection of glioma in the motor area, the incidence of long-term severe neurological deficits is low, and the quality of life could be improved after surgery. \u0000 \u0000 \u0000Key words: \u0000Glioma; Motor area; Supplementary motor area; Pyramid tract; Direct electrical stimulation","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"141-145"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44620974","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":"Language mapping and surgical efficacy of multimodal techniques combined with awake anesthesia for gliomas involving Broca′s area","authors":"Bin Wu, Junfeng Lu, J Zhang, T. Qiu, Dongxiao Zhuang","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.02.004","url":null,"abstract":"Objective \u0000To investigate language mapping and surgical efficacy of multimodal techniques combined with awake anesthesia for gliomas involving Broca′s area. \u0000 \u0000 \u0000Methods \u0000A total of 42 patients with gliomas involving Broca′s area underwent surgical resection under awake anesthesia at Department of Neurosurgery, Huashan Hospital, Fudan University from January 2011 to December 2017 and were enrolled into this retrospective study. Language cortical activated areas and subcortical pathways were preoperatively reconstructed for surgical planning with functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) tractography respectively. During the craniotomies, direct electrical stimulation was used to localize language cortical areas and subcortical pathways, and resection of tumor was assisted with intraoperative magnetic resonance image-guided real-time neuronavigation system. According to whether the gliomas invaded ventral premotor cortex (vPMC), the patients were divided into 2 groups. Out of the 42 patients, 24 did not show invasion of vPMC (with merely invasion of posterior inferior frontal gyrus) and 18 did. The language mapping outcomes and surgical efficacy were evaluated and compared. \u0000 \u0000 \u0000Results \u0000Intraoperative language mapping was successfully performed in all patients, and in 34 patients (81.0%) at least 1 positive functional site was detected. Three patients (7.1%) experienced focal seizure attack during the mapping process. Gross total resection was achieved in 25 patients, and subtotal resection in 17. Histopathological results indicated 23 cases of World Health Organization (WHO) grade Ⅱ gliomas, 14 cases of grade Ⅲ gliomas and 5 cases of grade Ⅳ gliomas. Sixteen patients (38.1%) experienced short-term language deficits after surgeries, out of whom 12 recovered in 3 months post operation and 4 (9.5%) did not recover. The median follow-up time was 24 months (6-84 months) in 42 patients.Tumour progression was seen in 14 of the 42 patients, and 11 patients died.Compared to the group with tumors that not invaded vPMC, the group with tumors invading vPMC had higher WHO grades(P=0.011) and higher occurrence of short-term language deficits [10/18 vs. 25.0% (6/24), P=0.044] and shorter progress-free survival (28.4±5.2 months vs. 80.7±3.2 months, P<0.001) and overall survival (38.8±5.8 months vs. 80.8±3.2 months, P<0.001). \u0000 \u0000 \u0000Conclusions \u0000The combination of multimodal techniques and awake anesthesia in the surgical treatment of gliomas involving Broca′s area could help protect the patient′s language function while maximizing the removal of tumors. Among them, tumors with invasion of vPMC may cause a higher rate of short-term speech dysfunction and a worse prognosis than those with merely invasion of posterior inferior frontal gyrus. \u0000 \u0000 \u0000Key words: \u0000Glioma; Broca area; Awake anesthesia; Language mapping; Multimodal techeniques","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"124-129"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42738783","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":"Treatment outcome of optic pathway glioma in children with diencephalon syndrome","authors":"Tianlei Zhang, Jia Wang, Jia Yu, Xiao Peng, Shanshan Zhang, Kaikun Huang","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.02.006","url":null,"abstract":"Objective \u0000To explore the clinical treatment outcomes of the optic pathway glioma in children with diencephalic syndrome. \u0000 \u0000 \u0000Methods \u0000The clinical data of 8 cases of optic pathway glioma with diencephalic syndrome were analyzed retrospectively who were admitted to Department of Neurosurgery, Beijing Children′s Hospital, Capital Medical University from July 2015 to December 2018. The range of the children′s ages was from 8.0 to 42.2 months. No weight gain was reported in all those patients before the age of 1 year, and they showed a cachexia state of extreme emaciation at admission. The range of children′s preoperative weights was from 5.5 to 11.5 kg. The weight-for-age Z score was lower than -2 in all 8 patients who underwent microsurgical resection of tumor followed by chemotherapy post operation. \u0000 \u0000 \u0000Results \u0000Among the 8 cases of optic pathway glioma combined with diencephalic syndrome, subtotal resection was achieved in 7 cases, near-total resection in 1, and there was no death related to operation. Postoperative pathological examination confirmed 2 cases of pilocytic astrocytoma and 6 cases of pilomyxoid astrocytoma. The range of follow-up period of 8 children was from 1 to 18 months, the range of postoperative weight was from 8.0 to 20.0 kg, the weight of all patients increased to various degrees, and some of the patients′ clinical symptoms were alleviated. One patient died after discharge, and chemotherapy was applied to the rest of 7 patients. Residual tumor shrank in 4 patients, progressed in 2 and disseminated in 1. \u0000 \u0000 \u0000Conclusions \u0000Subtotal tumor resection in children with optic pathway gliomas and diencephalic syndrome could significantly improve the symptom of emaciation and alleviate some other symptoms. There seems to be great variability in the tumor sensitivity to postoperative chemotherapy. \u0000 \u0000 \u0000Key words: \u0000Glioma; Child; Optic pathway glioma; Diencephalic syndrome; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44809077","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":"Application of intraoperative ultrasound in microsurgical treatment of intramedullary ependymoma and astrocytoma of the spinal cord","authors":"Qungen Xiao, Xiang Guo, Anyu Tao, Qiaoying Tang, Weihua Liu, Changshu Ke, K. Shu, T. Lei","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.02.010","url":null,"abstract":"Objective \u0000To evaluate the role of intraoperative ultrasound (IoUS) in the microsurgical treatment of intramedullary ependymoma and astrocytoma of the spinal cord. \u0000 \u0000 \u0000Methods \u0000A retrospective review was performed on 78 cases of intramedullary ependymoma and 34 cases of intramedullary astrocytoma which were treated microsurgically between January 2010 and May 2018 at Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. All cases of ependymoma or astrocytoma were divided into IoUS group(44 cases of ependymomas, 18 cases of astrocytomas) and control group(34 cases of ependymomas, 16 cases of astrocytomas) according to whether IoUS was employed during operation. All patients were followed up in the clinic or by telephone to assess tumor recurrence and spinal function recovery by radiographic reexamination and Modified McCormick Scale (MMS), which were then compared between IoUS and control group in ependymomas and astrocytomas, respectively. The accuracy of intraoperative ultrasound in evaluating the gross total resection (GTR) rate was also evaluated. \u0000 \u0000 \u0000Results \u0000No significant differences were observed in age, sex, presenting symptoms, MMS or spinal cord segment of tumor location between IoUS and control groups in ependymoma or astrocytoma (all P>0.05). Compared with control group in ependymoma, the IoUS group had slightly higher GTR rate [97.7% (43/44) vs. 91.2% (31/34)], slightly higher rate of good outcomes in terms of spinal function [36.4% (16/44) vs. 32.4% (11/34)] and slightly lower incidence of complications [8.8% (3/44) vs. 11.8% (4/34)], which, however, were not significantly different (all P>0.05). For astrocytoma, the IoUS group had significantly higher GTR rate [16/18 vs. 9/16, P 0.05] and slightly lower incidence of complications [0/18 vs. 2/16, P>0.05] compared with control group. However, those differences were not significant (P>0.05). Postoperative enhanced MRI was used as the gold standard for verification of GTR. The accuracy rate of IoUS for prediction of GTR was 97.7% (43/44) in ependymoma and 14/16 in astrocytoma. \u0000 \u0000 \u0000Conclusion \u0000The intraoperative ultrasound technique could facilitate the real-time and accurate judgement of tumor resection extent, which might have greater application value in the astrocytoma. \u0000 \u0000 \u0000Key words: \u0000Ependymoma; Astrocytoma; Microsurgery; Intraoperative ultrasound; Intrame-dullary tumor","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"156-161"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43852066","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":"Clinical characteristics and treatment of high-grade gliomas in the elderly patients","authors":"Yaning Wang, Y. P. Wang, Z. Kong, Congxin Dai, Yi Guo, Renzhi Wang, Wenbin Ma","doi":"10.3760/CMA.J.ISSN.1001-2346.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2020.02.008","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics and treatment regimens of high-grade gliomas in the elderly patients. \u0000 \u0000 \u0000Methods \u0000A retrospective study including 32 elderly patients with high-grade gliomas was conducted. Those patients were consecutively admitted to Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from April 2012 to August 2017 and enrolled into this study. Clinical characteristics, Karnofsky performance status (KPS), comorbidities (Charlson comorbidity index), tumor pathology classification, treatment regimen and overall patient survival were analyzed. All patients underwent tumor resection or biopsy, followed by concurrent chemoradiotherapy, chemotherapy, or targeted therapy. The Kaplan-Meier method was used to explore the effects of surgical methods, comorbidities and KPS on the overall survival of patients. \u0000 \u0000 \u0000Results \u0000The patients enrolled into this study included 21 males and 11 females. Their age ranged from 65 to 79 years old with an average of 71.9±6.9 years old. Among them, there were 22 (68.7%) cases with glioblastoma [World Health Organization (WHO) grade Ⅳ] and 10 (31.3%) cases with WHO grade Ⅲ gliomas. The median KPS score was 78.1 (range: 40-90). The range of assessment results based on Charlson comorbidity index was 4 to 8 with a median of 5.7. Of the 32 patients, 21 patients (65.6%) underwent resection and 11 (34.4%) underwent biopsy. Seven patients underwent standard Stupp regimen after operation, 9 patients received temozolomide adjuvant chemotherapy without radiotherapy, 1 patient received targeted therapy, and 11 patients received no further treatment. Four cases were lost to follow-up. The median survival time of 32 patients was 15.8 months(range: 1.2-73.3 months). Survival analysis showed that surgical methods, preoperative KPS, and Charlson comorbidity index were not factors influencing overall survival of patients (all P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Elderly patients with high-grade gliomas are generally in poor health conditions and have multiple comorbidities. Despite having undergone comprehensive treatment, including surgery, radiotherapy and chemotherapy, survival of those patients still seems to be relatively short. Therefore, when deciding treatment regimen, a relatively favorable treatment plan should be selected according to the specific conditions of the patient. \u0000 \u0000 \u0000Key words: \u0000Glioma; Aged; Disease attributes; Treatment; High grade glioma","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"36 1","pages":"146-150"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49144071","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}