中华神经外科杂志最新文献

{"title":"Discussion on the surgical methods of radiation-induced encephalopathy mainly featured with cystic change in the temporal lobe","authors":"Kaimin Huang, Lin Xie, Leping Ouyang, Jiahao Liu, Zuoyu Huang, Mingliang He","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.014","url":null,"abstract":"Objective \u0000To assess the clinical outcomes of various surgical methods of radiation-induced encephalopathy (REP) mainly featured with cystic change in the temporal lobe. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted on the clinical data of 56 patients with REP mainly featured with cystic change in the temporal lobe who underwent surgery at Department of Neurosurgrey, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University from January 2010 to December 2016. Among them, 24 peoples underwent merely lesionectomy (control group), while the other 32 peoples underwent lesionectomy and cistern opening (experimental group). According to the postoperative outcome, KPS (Karnofsky performance status) score, the volume of lesion on MRI and clinical follow-up , we compared the surgical effect between the 2 groups. \u0000 \u0000 \u0000Results \u0000In control group, 7 patients (29.2%) reported relief of chief complaint, while 23 patients (71.9%) in experimental group had relief. The difference was statistically significant (P<0.05). The KPS score was 70.13±19.10 in control group and 84.16±13.47 in experimental group, which had significant difference (P<0.05). The volume of lesion post surgery was (32.35±20.85)cm3 in group and (13.31±6.44)cm3 in experimental group, which had statistical difference (P<0.05). The follow-up data showed that the readmission rate in experimental group (18.7%, 6/32) was lower than that in control group (75.0%, 18/24). which had significant difference(P<0.05). \u0000 \u0000 \u0000Conclusion \u0000For REP mainly featured with temporal lobe cyst, the surgical operation should include further dissection of cisterna ambiens and cisterna interpeduncularis in addition to merely lesionectomy, which could help prevent the formation of isolated cyst cavity with space-occupying effect and achieve better therapeutic results. \u0000 \u0000 \u0000Key words: \u0000Temporal lobe; Radiation encephalopathy; Neurosurgical procedures; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1254-1257"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44755645","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 roles of plasma D-lactate, endotoxin and diamineoxidase in assessment of intestinal mucosal barrier function post traumatic brain injury","authors":"Ding Chunlong, Wang Yuhai, Yang Likun, Z. Jie, Shi Yaqin","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.015","url":null,"abstract":"Objective \u0000To investigate the roles of plasma D-lactate, endotoxin and diamineoxidase (DAO) in assessment of intestinal mucosal barrier function post traumatic brain injury (TBI). \u0000 \u0000 \u0000Methods \u0000We retrospectively studied 70 patients with TBI (TBI group) admitted to Department of Neurosurgery, the 904th Hospital of the Joint Service of Chinese People′s Liberation Army from January 2017 to August 2018, and 45 healthy subjects were enrolled as well (healthy control group) at the physical examination center during the same period. All TBI patients were treated conservatively or surgically. Peripheral blood of patients and healthy subjects were collected to detect levels of plasma D-lactic acid, endotoxin, and DAO. Further use of Spearman correlation analysis was conducted to determine the correlation between preoperative serum D-lactic acid, endotoxin and DAO and Glasgow Coma Scale (GCS) in patients with TBI. \u0000 \u0000 \u0000Results \u0000Compared with the healthy control group, the levels of D-lactic acid (24.7±9.4 mg/L vs. 9.8±4.0 mg/L), endotoxin (9.1±5.8 U/L vs. 4.0±2.2 U/L) and DAO (36.3±22.6 U/L vs. 15.2±3.6 U/L) were significantly increased (t=9.82, 2.84 and 3.49, respectively, all P<0.05). Further correlation analysis showed that serum D-lactic acid, endotoxin and DAO levels were negatively correlated with preoperative GCS scores (r=-0.543, -0.617 and -0.672, respectively, all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000The preliminary results have suggested that the levels of D-lactic acid, bacterial endotoxin and DAO in the serum could be used as important indexes in evaluation of the intestinal mucosal barrier function in patients post TBI. \u0000 \u0000 \u0000Key words: \u0000Traumatic brain injury; Diamineoxidase; D-lactate; Endotoxin; Intestinal mucosa barrier","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1258-1261"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47848573","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 feature change and prognostic role of primary and local recurrent chordoma in skull base","authors":"Liang Wang, Kaibing Tian, Junpeng Ma, X. Huo, Junting Zhang, Liwei Zhang, Zhen Wu, Guilin Li, Jiang Du","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.012","url":null,"abstract":"Objective \u0000To investigate the pathological characteristics and changing trend in primary and local recurrent skull base chordoma, and to analyze their correlation with the outcomes. \u0000 \u0000 \u0000Methods \u0000A total of 89 samples of primary and local recurrent tumors pathologically confirmed from 38 patients who were treated in Neurosurgery Department of Beijing Tiantan Hospital, Capital Medical University between February 2005 and December 2014 were retrospectively enrolled into this self-control study. After HE staining, the pathological features such as nuclear atypia, mitosis, matrix ratio, necrosis, bone invasion and pathological subtypes were analyzed. The expressions of p53, Ki-67, EGFR, VEGFR and TRAF6 were detected by immunohistochemical staining. The changes of pathological indexes as above in primary and recurrence stages were compared. Cox analyses were used to analyze the effects of above pathological indexes on the progression-free survival (PFS) of patients with primary tumor, and the effects of the changes regarding those factors on the overall survival (OS). \u0000 \u0000 \u0000Results \u0000Ten cases (35.7%) of classical subtype changed to myeloid subtype, while none of chondroid chordoma changed to myeloid subtype after recurrence. Twelve cases (31.6%) demonstrated necrosis companied with tumor recurrence. Twenty-five cases (73.5%) of primary tumor showed high-expression of TRAF6, and 19 cases (50.0%) had decreased expression intensity of TRAF6 after tumor recurrence. There were 16 cases (42.1%) and 15 cases (39.5%) with upregulation of P53 and EGFR respectively. Necrosis (HR=7.1, 95% CI: 1.4-37.1, P=0.006), pathological subtype (HR=3.9, 95% CI: 1.2-7.2, P=0.040) and TRAF6≥3 grade (HR=0.2, 95% CI: 0.1-0.5, P<0.001) in primary tumors were directly related to PFS, and TRAF6≥3 grade (HR=0.2, 95% CI: 0.1-0.5, P<0.010) was an independent protective factor for PFS. There was no significant difference in the OS rate among the above pathological changes. \u0000 \u0000 \u0000Conclusions \u0000Classical chordoma shows malignant transformation to the myeloid subtype, which is not found in chondroid subtype. The expression of TRAF6 decreases gradually with tumor recurrence, and its high expression in primary tumor is an independent protective factor for PFS. \u0000 \u0000 \u0000Key words: \u0000Chordoma; Skull base neoplasms; Pathology; TNF receptor-associated factor 6; Prognosis","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1243-1248"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47995176","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":"Analysis of pediatric neurosurgical diseases: A single-center study","authors":"Chuiguang Kong, W. Bai, Yuqin Ye, Yongxiang Yang, Xinhong Su, Xin Zhang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.009","url":null,"abstract":"Objective \u0000To summarize the clinical epidemiological characteristics of pediatric neurosurgical diseases at a single center. \u0000 \u0000 \u0000Methods \u0000A total of 5 790 children (≤15 years old) with neurosurgical diseases admitted to Department of Neurosurgery, Xijing Hospital, Air Force Medical University from January 2008 to June 2018 were retrospectively enrolled. Their clinical data were analyzed and included the distribution of various diseases and clinical characteristics such as age, gender and lesion location. \u0000 \u0000 \u0000Results \u0000All 5 790 children included 2 259 cases (39.0%) of congenital malformation, 1 561 cases of tumor (27.0%), 953 cases of trauma (16.5%), 360 cases of cerebrovascular disease (6.2%), 159 cases of inflammation (2.7%), 91 cases of functional disorder (1.6%) and 407 cases of other diseases (7.0%). The gender ratio (male ∶female) was 1.76 ∶1.00. In all kinds of diseases, the proportion of male children was higher than that of female children, and the difference was statistically significant (P<0.001). The overall peak age of onset was 0-3 years old. Congenital malformations and tumors were predominant in 0-3 years old (42.9%) and 13-15 years old (26.3%), respectively. Three most frequent congenital malformations were arachnoid cyst (29.6%), hydrocephalus (28.2%) and tethered cord syndrome (20.0%). Temporal lobe was the most common site of arachnoid cyst (45.4%). Three most common tumors were glioma (19.7%), craniopharyngioma (9.0%) and medulloblastoma (8.8%). The ratios of brain tumors to spinal canal tumors, supratentorial tumors to infratentorial tumors and low-grade tumors to high-grade tumors were 5.61 ∶1.00, 1.73 ∶1.00 and 1.67 ∶1.00, respectively. Primary brain injury(365 cases) accounted for 58.6% of traumatic diseases and 59.2% (the highest proportion) of primary brain injury was brain contusion and laceration. In cerebrovascular diseases, the proportion of spontaneous hemorrhage (27.2%) was the highest. The most common inflammatory disease was inflammatory granuloma(22.6%). In addition, with the increase of age, the incidence of congenital malformation decreased gradually, while the incidence of cerebrovascular diseases increased gradually(both P<0.001). \u0000 \u0000 \u0000Conclusions \u0000Pediatric neurosurgical diseases have unique clinical epidemic characteristics. Congenital malformations and tumors are more common, and the incidence of arachnoid cysts and gliomas seems to be the highest. In various diseases, the incidence of male is higher than that of female, and the peak ages are different. \u0000 \u0000 \u0000Key words: \u0000Child; Neurosurgery; Epidemiology; Single-center study","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1231-1235"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41713804","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":"A comparative study of endoscopy and microscopy in exposure of posterior fossa through the intradural subtemporal keyhole approach","authors":"Zhemin Ding, Qing Wang, Xiaojie Lu, Bing Li, Xinwei Qian","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.12.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.12.017","url":null,"abstract":"Objective \u0000To comparatively analyze the differences between endoscopy and microscopy in area of exposure and surgical freedom in posterior fossa through the intradural subtemporal keyhole approach and to explore the advantages of neuronavigation in that approach. \u0000 \u0000 \u0000Methods \u0000Twenty endoscopic intradural subtemporal keyhole approaches (EISKA) were performed on 10 cadaveric adult heads. An intradural Kawase approach and a navigation-assisted intradural Kawase approach were then carried out on a random side of each specimen. Related anatomic structures were observed through endoscope and microscope at the end of each approach. Anatomic exposure and surgical freedom were measured by transparent graph paper and were analyzed. \u0000 \u0000 \u0000Results \u0000Compared with microscopy, the superior, inferior and medial limits through endoscopic exposure were increased by 2.9±1.0 mm, 15.7±1.5 mm and 10.2±1.1 mm, and the surgical freedom was increased by 2.9±1.0 mm, 7.6±1.9 mm and 6.0±1.7 mm (P<0.05) in the intradural subtemporal keyhole approach. In intradural Kawase approach, the anatomic exposure was increased by 2.7±0.9 mm, 20±1.2 mm and 29.5±0.7 mm and the surgical freedom was increased by 2.7±0.9 mm, 14.8±1.4 mm and 8.8±1.4 mm (all P<0.05). In navigation-assisted intradural Kawase approach, the anatomic exposure was increased by 3.1±1.0 mm, 20.3±2.4 mm and 29.9±0.7 mm, and the surgical freedom was increased by 3.1±1.0 mm, 15.3±1.6 mm and 8.8±1.3 mm (P<0.05). Using a frameless navigational device, the inferior limit of the anatomic exposure was increased by 3.8±2.2 mm in endoscopy and 3.5±0.7 mm in microscopy, and the surgical freedom was increased by 2.7±0.9 mm in endoscopy mm and 2.2±1.2 mm in microscopy (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The EISKA could provide more anatomic exposure and surgical freedom mainly in the superior, inferior and medial directions of the brainstem regions. More inferior anatomic exposure and surgical freedom of the posterior cranial fossa could be obtained by navigational assistance. \u0000 \u0000 \u0000Key words: \u0000Natural orifice endoscopic surgery; Microsurgery; Neuronavigation; Subtemporal approach; Key hole; Kawase approach","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1266-1270"},"PeriodicalIF":0.0,"publicationDate":"2019-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42524187","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":"ACT001 inhibits the neurosphere formation and stemness maintenance of U87-MG glioma stem cells through STAT3 signaling pathway","authors":"Jiabo Li, Luqing Tong, L. Yi, Peidong Liu, Yang Xie, Xuya Wang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.11.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.11.019","url":null,"abstract":"Objective \u0000To investigate the effect of sesquiterpene lactone derivative (ACT001) on the neurosphere formation and stemness maintenance of U87-MG glioma stem cells. \u0000 \u0000 \u0000Methods \u0000Bioinformatics was used to analyze the relationship between STAT3 mRNA and different grades of human glioma as well as the overall survival in 1 477 glioma patients in CGGA, TCGA, and GEO (GSE4290, GSE16011) databases. Magnetic activated cell sorting method was used to obtain CD133-positive U87-MG cells. The effect of ACT001 on the survival viability of U87-MG GSCs was detected via Cell Counting Kit-8 (CCK-8). The effect of ACT001 on the ability of neurosphere formation was observed by single-cell neurosphere formation assay. Immunofluorescence staining was used to measure the effect of ACT001 on stem cells markers (CD133、CD44 and Nestin) in neurospheres of U87-MG GSCs. The expressions of STAT3, p-STAT3, CD44 and CD133 were detected using western blot after treatment of ACT001. \u0000 \u0000 \u0000Results \u0000Bioinformatics analysis showed that as the grades of glioma increased, the expression of STAT3 mRNA also increased (all P 0.05), while the protein expression of p-STAT3 was decreased through assessment by Western blot (all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000ACT001 could suppress the neurosphere formation ability and reduce the stemness maintenance in U87-MG glioma stem cells by inhibiting STAT3 signaling pathway. \u0000 \u0000 \u0000Key words: \u0000Glioma; Neoplastic stem cells; Sesquiterpene lactone derivative; STAT3 signaling pathway","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1160-1166"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48424874","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":"Efficiency and influence factors of stereotactic precision aspiration in the treatment of primary brain stem hemorrhage","authors":"Liu Fengqiang, Wang Zefeng, Yu Xiaobo, Zheng Jian, Zhang Yang, Chen Gao, Z. Jianmin","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.11.004","url":null,"abstract":"Objective \u0000To investigate the efficiency and influence factors of stereotactic precise aspiration in treatment of primary brainstem hemorrhage. \u0000 \u0000 \u0000Methods \u0000A total of 47 patients with primary brainstem hemorrhage who underwent stereotactic precision aspiration from March 2014 to September 2018 at Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine were enrolled and their clinical data were collected. Surgical approach was chosen according to the location of the pons where the hematoma was located. Meanwhile, patients with postoperative hydrocephalus underwent external ventricular drainage. Intracranial residual hematoma volume was evaluated by CT scan on the first day post operation. Further follow-up at 30 days post surgery by phone or clinic was conducted to confirm the status of all patients. Univariate analysis and logistic regression analysis were performed to investigate the clinical factors associated with survival of patients.(ROC) curvecurve was further drawn to judge its predictive value. \u0000 \u0000 \u0000Results \u0000Among 47 patients, no death was reported during the operation. CT scan at day 1 post surgery showed that the average of intracranial residual hematoma volume in 47 patients was (2.7±0.9) ml (0-15.5 ml), and the clearance rate of hematoma was (75.0±24.2)%. In this series, 7 cases died and 40 survived within 30 days. The mortality rate was 14.9%. Univariate analysis revealed that classification of hematoma was the factor influencing postoperative mortality (χ2=13.689, P=0.033), which was confirmed by multiple logistic regression analysis (OR=0.053, 95% CI: 0.744-0.992, P=0.004). Further ROC curve results showed that the sensitivity and specificity of hematoma classification in predicting the prognosis of patients were 85.7% and 82.5%, respectively. \u0000 \u0000 \u0000Conclusions \u0000The new classification of brainstem hematoma is suitable for surgical planning and beneficial for prediction of the 30-day mortality. \u0000 \u0000 \u0000Key words: \u0000Cerebral hemorrhage; Brain stem; Treatment outcome; Factor analysis, statistical","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1094-1098"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44955568","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":"Analysis of influencing factors of cognitive impairment after moderate traumatic brain injury","authors":"W. Hongren, Wang Zhifei","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.11.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.11.015","url":null,"abstract":"Objective \u0000To analyze the influencing factors of cognitive impairment after moderate traumatic brain injury and to develop prognostic models for cognitive impairment after moderate traumatic brain injury. \u0000 \u0000 \u0000Methods \u0000A prospective study was performed on 104 patients with moderate traumatic brain injury at Department of Neurosurgery, the Third Xiangya Hospital, Central South University from November 2016 to February 2018. The cognitive function at 3 months after injury was assessed using the Montreal cognitive assessment (MoCA) score. The impact of various lesions on cognitive function was analyzed using univariate and multivariate logistic regression. Prognostic models was established based on logistic regression analysis results. The validation sampling was used to compute the accuracy, sensitivity and specificity of the prognostic models. \u0000 \u0000 \u0000Results \u0000Logistic regression analysis revealed that age (OR=1.118, 95%CI: 1.000-1.250, P=0.049), education (OR=0.202, 95%CI: 0.041-0.988, P=0.045), Glasgow coma scale (GCS) score (OR=2.582, 95%CI: 1.242-5.369, P=0.011) and injury cause (OR=0.429, 95%CI: 0.201-0.915, P=0.029) were independent risk factors of cognitive impairment after moderate traumatic brain injury. The prognostic model based on the risk factors of admission had favorable performance (P>0.05 for partial chi square test, 0.902 for area under curve). The accuracy of the prognostic model was 88.6%. The sensitivity and specificity were 55.6% and 100.0% respectively. \u0000 \u0000 \u0000Conclusions \u0000Age, education, GCS score and injury cause are influencing factors of cognitive impairment after moderate traumatic brain injury, based on which the established model could be used to timely and accurately predict the prognosis of cognitive impairment after moderate traumatic brain injury. \u0000 \u0000 \u0000Key words: \u0000Craniocerebral trauma; Cognitive disorder; Logistic models; Forecasting models","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"65 4","pages":"1143-1147"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41246888","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 analysis of microsurgical management of the anterior choroidal artery aneurysm: A report of 94 cases","authors":"Yugong Feng, Chunli Lu, Liyun Zhang, Huanting Li, Shifang Li, Wei Liu, Pin Guo, Pining Zhang","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.11.006","url":null,"abstract":"Objective \u0000To explore the efficacy and safety of microsurgical treatment of choroidal artery aneurysm (AChAA). \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on the clinical data of 94 patients with AChAA admitted to Department of Neurosurgery, Affiliated Hospital of Qingdao University from December 1997 to December 2018. Among them, 90 patients underwent aneurysm clipping with the Yasargil pterional approach, and 4 patients underwent modified pterional approach for decompressive craniectomy. After surgery, all patients were followed up clinically to assess the outcomes based on the Glasgow outcome scale(GOS) system. \u0000 \u0000 \u0000Results \u0000A total of 120 aneurysms were successfully clipped in 94 patients. Three patients developed cerebral hemorrhage after operation, including 1 case of epidural hematoma on the contralateral side of the lesion, 1 case of ipsilateral frontal lobe hematoma, and 1 case of contralateral basal ganglia hemorrhage. Seven patients developed cerebral infarction, including 1 case of large-scale cerebral infarction and 6 cases of basal ganglia infarction with paralysis. One case suffered from pulmonary embolism 3 days after operation. Three cases developed hydrocephalus and returned to independent life after ventriculoperitoneal shunting. The follow-up time in 94 patients was 6 to 120 months. Of the 94 patients, 84 (89.4%) were GOS Ⅳ, 3 (3.2%) were grade Ⅲ, 2 (2.1%) were grade Ⅱ, and 5 (5.3%) were grade Ⅰ. \u0000 \u0000 \u0000Conclusion \u0000Open microsurgical clipping remains important treatment for AChA aneurysms, for which sufficient understanding of microanatomy of the AchA combined with skilled microsurgical clipping techniques would help achieve satisfactory clinical outcomes. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Anterior choroidal artery; Neurosurgical procedures; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1103-1106"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47103426","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":"Revascularization treatment for complex intracranial aneurysms","authors":"Li Li, Liao Yin, Gu Chi, Wang Yongjie, Shi Jian, Z. Xiangdong, Wang Lin, Chen Gao, Z. Jianmin","doi":"10.3760/CMA.J.ISSN.1001-2346.2019.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-2346.2019.11.002","url":null,"abstract":"Objective \u0000To investigate the role of revascularization in the treatment of complex intracranial aneurysms. \u0000 \u0000 \u0000Methods \u0000From January 2014 to March 2019, a total of 22 patients with complex intracranial aneurysms were treated with extracranial-intracranial (14 cases) or intracranial-intracranial (8 cases) revascularization at Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University School of Medicine. The treatment methods of intracranial aneurysm included intraoperative isolation, proximal ligation, distal ligation, plastic clamping, encapsulation, intravascular embolism and postoperative embolism. The patency of anastomotic vessels, obliteration of the aneurysms and postoperative complications were observed after operation. Outcomes of patients were evaluated with Glasgow Outcome Scale (GOS). \u0000 \u0000 \u0000Results \u0000In this series, 22 cases successfully underwent revascularization. Intraoperative fluorescein angiography or DSA revealed the patency of anastomotic vessels. Postoperative angiographies were performed and patency of anastomotic vessels was confirmed in 18 patients (81.8%) and obliteration of aneurysms was confirmed in 20 patients (90.9%). Five patients (22.7%) developed various degrees of cerebral infarction. One patient was discharged because of poor prognosis and lost to follow-up. The other 21 patients were followed up for 1-59 months. No aneurysm recurred or ruptured during the follow-up period. GOS was Ⅴ in 20 cases and Ⅳ in 1 case. \u0000 \u0000 \u0000Conclusion \u0000With the proper selection of individualized revascularization based on the characters of aneurysms and cerebral blood flow requirement, revascularization seems an effective and safe method for the treatment of complex intracranial aneurysms. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Cerebral revascularization; Treatment outcome","PeriodicalId":10100,"journal":{"name":"Chinese Journal of Neurosurgery","volume":"35 1","pages":"1084-1088"},"PeriodicalIF":0.0,"publicationDate":"2019-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45061748","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}