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| 1 | Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms:comparison of LVIS stents with laser-cut stents显示文摘Background:To compare the safety and efficacy of LVIS stent-assisted coiling with those of laser-cut stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial aneurysms.Methods:Patients with acutely ruptured wide-necked intracranial aneurysms treated with LVIS stent-assisted coiling(LVIS stent group)and laser-cut stent-assisted coiling(laser-cut stent group)were retrospectively reviewed from January 2014 to December 2017.Propensity score matching was used to adjust for potential differences in age,sex,aneurysm location,aneurysm size,neck width,Hunt-Hess grade,and modified Fisher grade.Perioperative procedure-related complications and clinical and angiographic follow-up outcomes were compared.Univariate and multivariate analyses were performed to determine the associations between procedure-related complications and potential risk factors.Results:A total of 142 patients who underwent LVIS stent-assisted coiling and 93 patients who underwent laser-cut stent-assisted coiling were enrolled after 1:2 propensity score matching.The angiographic follow-up outcomes showed that the LVIS stent group had a slightly higher complete occlusion rate and lower recurrence rate than the laser-cut stent group(92.7%vs 80.6%;3.7%vs 9.7%,P=0.078).The clinical outcomes at discharge and follow-up between the two groups demonstrated no significant differences(P=0.495 and P=0.875,respectively).The rates of intraprocedural thrombosis,postprocedural thrombosis,postoperative early rebleeding,and procedure-related death were 0.7%(1/142),1.4%(2/142),2.8%(4/142),and 2.1%(3/142)in the LVIS stent group,respectively,and 4.3%(4/93),2.2%(2/93),1.1%(1/93),and 3.2%(3/93)in the laser-cut stent group,respectively(P=0.082,0.649,0.651,and 0.683).Nevertheless,the rates of overall procedure-related complications and intraprocedural rupture in the LVIS stent group were significantly lower than those in the laser-cut stent group(5.6%vs 14.0%,P=0.028;0.7%vs 6.5%,P=0.016).Multivariate analysis showed that laser-cut stent-assisted coiling was an independent predictor for overall procedurerelated complications(OR=2.727,P=0.037);a history of diabetes(OR=7.275,P=0.027)and other cerebrovascular diseases(OR=8.083,P=0.022)were independent predictors for ischemic complications,whereas none of the factors were predictors for hemorrhagic complications.Conclusions:Compared with laser-cut stent-assisted coiling,LVIS stent-assisted coiling for the treatment of acutely ruptured wide-necked intracranial aneurysms could reduce the rates of overall procedure-related complications and intraprocedural rupture. | Gaici Xue Qiao Zuo Xiaoxi Zhang Haishuang Tang Rui Zhao Qiang Li Yibin Fang Pengfei Yang Bo Hong Yi Xu Qinghai Huang Jianmin Liu | 2021 | Chinese Neurosurgical Journal2021，7，2： | 8 |
| 2 | Quality improvement of nursing on patients with complex cerebral arteriovenous malformation undergoing hybrid surgery:a prospective single-center study显示文摘Background:We sought to explore an optimal clinical nursing mode following a hybrid surgery for cerebral arteriovenous malformation.Methods:Patients with complex cerebral arteriovenous malformations seen in our neurosurgery department from January 2016 to December 2017 were prospectively enrolled.The hybrid surgery protocol included“angiographic diagnosis,surgical resection,and intraoperative angiographic evaluation”and“angiographic diagnosis and embolization,surgical resection,and intraoperative angiographic evaluation”.The patients were randomly stratified into intensive care group and routine care group.After surgery,intensive or routine care was provided,and the prognosis of patients was evaluated,with a subsequent comparative analysis.Results:A total of 109 cases were divided into the routine nursing group(n=54 cases)and intensive nursing group(n=55 cases).There were no significant differences between the two groups in baseline data before surgery.Postoperative lung infection in the intensive nursing group was significantly less frequent than those in the routine nursing group(5.5%vs.18.5%,P=0.039)with pulmonary infection and lower extremity venous thrombosis(5.5%vs.24.1%,P=0.006).The average hospital stay in the intensive nursing group was 14.4±5.78 days,which was significantly lower than that in the routine nursing group(19.3±6.38 days,P=0.013).At 3 months’follow-up after surgery,the Generic Quality of Life Inventory-74(GQOLI-74)dimension score and GQOLI-74 total score in the enhanced group were significantly better than those in the routine nursing group(P=0.017 and 0.023,respectively).Conclusions:Intensive postoperative nursing can improve the safety of patients after hybrid surgery,reduce the postoperative complications and the average length of hospital stay,and improve the quality of life of patients. | Dong-Hong Zhao Rui Xue Xiao-Rong Sun | 2021 | Chinese Neurosurgical Journal2021，7，3： | 4 |
| 3 | Glioblastoma vaccine tumor therapy research progress显示文摘Glioblastoma(GBM)is the most common primary malignancy of the central nervous system in adults.The prognosis for late-stage glioblastoma(World Health Organization grade IV astrocytic glioma)is very poor.Novel treatment options are sought after and evaluated by clinicians and researchers,and remarkable advances have been made in surgical techniques,radiotherapy,and chemotherapy.However,the treatment of glioblastoma remains extremely difficult and it can extend the lives of patients by only a few months.There has been notable progress in the field of immunotherapy,particularly with the use of tumor vaccines,for treating glioblastoma;especially peptide vaccines and cell-based vaccines such as dendritic cell vaccines and tumor cell vaccines.However,the results of the current clinical trials for vaccination are not satisfactory.This article reviews the progress in the development of vaccines for glioblastoma. | Tong Zhao Chunwang Li Hongliang Ge Yuanxiang Lin Dezhi Kang | 2022 | Chinese Neurosurgical Journal2022，8，2： | 3 |
| 4 | Diagnosis, treatment, and misdiagnosis analysis of 28 cases of central nervous system echinococcosis显示文摘Background:To explore central nervous system(CNS)involvement in this disease,from the perspectives of diagnosis,treatment,and misdiagnosis Methods:Twenty-eight patients with CNS echinococcosis were included in this retrospective study,including 18 males(64.3%)and 10(35.7%)females.The average age of all the patients were 23.5 years(ranged 4–60 years).Twenty-three(23)patients(82.1%)received the first surgical resection in our hospital.Five(5)patients(17.9%)gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals,and albendazole was applied for a long-term(3–6 months)adjunct therapy for the 5 patients.The average follow-up time was 8 years.Results:For the 28 patients,23 cases received surgical treatments,and the diagnosis was confirmed by pathological examinations.The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed,resulting in a misdiagnosis rate of 21.4%(6/28).For the pathological examination,a total of 17 cases were infected with Echinococcus granulosus(including 2 cases of spinal cord echinococcosis),and 6 cases were infected with Echinococcus alveolaris.Conclusion:The diagnosis should be specifically considered in endemic regions.The clinical features of CNS hydatidosis were intracranial space-occupying lesions.For the treatment,the surgical removal of cysts should be necessary.In addition,the adjuvant therapy with drug and intraoperative prophylaxis is also suggested.The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations,as well as the accuracy of hydatid immunologic test. | Guojia Du Yandong Li Pan Wu Xin Wang Riqing Su Yandong Fan Dangmurenjiafu Geng | 2021 | Chinese Neurosurgical Journal2021，7，4： | 3 |
| 5 | Risk factors for the incidence of apoplexy in pituitary adenoma: a single-center study from southwestern China显示文摘Background:Although the incidence and clinical manifestations of pituitary apoplexy were reported by a few researches,the results are not consistent.This study aimed to explore the risk factors associated with an incidence of apoplexy in pituitary adenomas.Methods:The clinical information of 843 patients with pituitary adenoma from the Department of Neurological Surgery,1st Affiliated Hospital of Kunming Medical University,was reviewed.The incidence,clinical manifestation,and potential risk factors for pituitary apoplexy were analyzed by a case-control study.Results:In total,121 patients(14.4%)with macroadenoma were suffered from pituitary apoplexy.Headache,vomiting,and visual impairment are the top 3 symptoms for the pituitary apoplexy.Logistic regression results showed that the hypertension(hypertension vs non-hypertension OR=2.765,95%CI:1.41~5.416),tumor type(negative staining vs.positive staining,OR=1.501,95%CI:1.248~5.235),and tumor size(diameter>2 cm vs.diameter≤2 cm,OR=3.952,95%CI:2.211~7.053)are independent factors associated with pituitary apoplexy.Conclusion:Our results indicate that the risk factors for the incidence of pituitary apoplexy depend mainly on properties of the tumor itself(tumor size and pathologic type)and the blood pressure of patients. | Yao Li Yuan Qian Yisheng Qiao Xiaoxiang Chen Jiaotian Xu Chao Zhang Wei Wang Junjun Li Xingli Deng | 2020 | Chinese Neurosurgical Journal2020，6，4： | 3 |
| 6 | Reconstruction clipping of ruptured anterior circulation aneurysms via supraorbital lateral keyhole approach显示文摘Background:Intracranial aneurysm(IA)is a serious disease.Analyze and review the cases of anterior circulation ruptured IA by supraorbital lateral keyhole approach,and summarize the experiences of this approach.Methods:Retrospective analysis of 16 cases of ruptured anterior circulation IA in our department from January 2019 to June 2020,CT angiography(CTA)was performed before operation.Analyzing the IA’s parameters by 3D-CT reconstruction.The IA was clipped by supraorbital lateral keyhole approach combined with the 3D-skull reconstruction.Extraventricular drainage was performed before craniotomy.Intraoperative neurophysiological monitoring was performed during the operation.After operation,fluorescein angiography and vascular ultrasound were performed to check the clipping effect.Intracranial pressure monitor was performed postoperatively.CTA was reexamined one week after operation.The modified Rankin Scale(MRS)was performed 6 months after operation.Results:There were 7 males(43.8%)and 9 females(56.2%),and the average age is 52.31±11.12 years old.Among them,11 patients(68.8%)were anterior communicating artery aneurysms and 5(31.2%)were middle cerebral artery aneurysms.All patients were out of hospital within 10 days without any death,without cerebral infarction,cerebrospinal fluid leakage and neurological impairments.About mRS score,after 6 months follow-up,8 cases(50%)had 0 point,4 cases(25%)had 1 point,and 4 cases(25%)had 2 points.Conclusions:For ruptured anterior circulation IA,the supraorbital lateral keyhole approach combined with ventricular drainage,intraoperative electrophysiological monitoring,and intraoperative vascular ultrasound is a safe and minimally invasive treatment.The application of reconstruction clipping can reconstruct the diameter of parent vessel and reduce the recurrence rate of IA. | Yuzhang Wu Yan Zhao Shengping Yu Fan Li Shifei Cai Chao Peng Zhen Wang Yifan Yang Bangyue Wang Xinyu Yang | 2022 | Chinese Neurosurgical Journal2022，8，2： | 2 |
| 7 | Endoscopic third ventriculostomy in children:problems and surgical outcome:analysis of 34 cases显示文摘Background:Endoscopic third ventriculostomy(ETV)has been established as a viable treatment option for obstructive hydrocephalus of children over 6 weeks of age.ETV in pediatric groups may be unsuccessful due to the failure of absorption of cerebrospinal fluid(CSF)or reclosure of ventriculostomy stoma or due to infection.The exact cause is still debatable.Some issues like failure to eliminate the second membrane during the procedure or formation of the new arachnoid membrane at the stoma are still not clear.This study aims to assess the surgical failure of ETV and its predisposing factors.Methods:Thirty-four pediatric patients with hydrocephalus were analyzed retrospectively.The patients’age limit was between 2.5 months and 14 years.This is a retrospective study of 34 patients in a single private hospital between June 2012 and January 2018.Patients having hydrocephalus in pediatric groups more than 6 weeks of age were included in the study.Results:The mean age of all patients was 51.25±53.90 months and the mean follow-up period was 50.47±20.84 months.Of 34 surgeries,the success rate was 79%and the failure rate was 21%.Within 2 years,the success rate was 68.42%and above 2 years’success rate was 93.33%.In this series,7 cases of ETV were re-explored and found ventriculostomy stoma closure in 3 cases,the presence of the second membrane in re-exploration 2 cases,and presence of inflammatory arachnoid membrane in re-exploration 2 cases.The use of dexamethasone around the stoma in inflammatory stoma was useful,having no recurrence.In one patient of the second membrane probably due to absorption failure in communicating hydrocephalus re-exploration was failed and was managed successfully with VP shunt.Conclusions:Predisposing factors causing ETV failure are ventriculostomy stoma closure by new arachnoid granulation tissues,remnants of the second membrane inside the stoma,CSF absorption failure,infection/high protein in CSF and inappropriate patient selection. | Md Moshiur Rahman S.I.M.Khairun Nabi Khan Robert Ahmed Khan Rokibul Islam Mainul Haque Sarker | 2021 | Chinese Neurosurgical Journal2021，7，2： | 2 |
| 8 | Initial leucocytosis and other significant indicators of poor outcome in severe traumatic brain injury: an observational study显示文摘Background:Globally,severe traumatic brain injury(TBI)has been the principal cause of mortality among individuals aged 45 and below.The incidence of road traffic accidents in Malaysia is one of the highest in the world with thousands of victims sustaining severe disabilities.The aim of this study is to determine the association between leucocytosis and extended Glasgow Outcome Scale(GOSE)scores as well the relationship of other factors and the outcomes of severe TBI.Methods:This was a retrospective observational study.A total of 44 consecutive patients who were admitted to Sarawak General Hospital from January 1,2018,to September 30,2018,with severe TBI were included.Data were collected from discharge summaries and hospital medical records.Chi-square and t test were used.SPSS was employed.Results:Of a total of 44 patients with severe TBI,18 patients(41%)died during the same admission.The mean age of patients was 37.1 years with 93.2%of affected patients being male.56.9%of patients presented with a Glasgow Coma Scale(GCS)of 6 and less.A large percentage(86.3%)were discharged with a GOSE of less than 7.Older age and low admission GCS(6 and less)were significantly associated with poor GOSE scores on discharge and after 6 months(p<0.05)on multivariate analysis.Leucocytosis on admission was also associated with poor outcomes where patients with higher total white counts on presentation attaining lower GOSE scores(p<0.05).Conclusion:We concluded that leucocytosis was significantly associated with poor outcomes in severe TBI patients in addition to other factors such as advanced age and poor GCS on arrival. | Kugan Vijian Eu Gene Teo Davendran Kanesen Albert Sii Hieng Wong | 2020 | Chinese Neurosurgical Journal2020，6，4： | 2 |
| 9 | Clinical features and outcomes of PComA aneurysms originating from fetal posterior communicating arteries in a single institution显示文摘Background:The aim of this study was to retrospectively analyze our experience with the patients who underwent surgical treatment of posterior communicating artery(PComA)aneurysms originating from fetal posterior cerebral artery(fPCA)and analyze the risk factors for the postoperative radiological infarction and outcome.Methods:From 2011 to 2020,we retrospectively reviewed 74 PComA aneurysms originating from fPCA in terms of the clinical and radiological features and obtained the follow-up data from the Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University.The relationships between these features and follow-up data were assessed with the univariate and multivariate analysis.Results:In this series,74 aneurysms were occurring at the origin of fPCAs.All the patients showed complete obliteration of their aneurysms.Full fPCA type tends to be a predictive factor for radiological infarction(univariateχ^(2)=5.873,P=0.027;multivariate OR=0.264,P=0.060).Postoperative radiological infarction(univariateχ^(2)=12.611,P=0.001;multivariate OR=6.033,P=0.043),rupture(univariateχ^(2)=4.514,P=0.047;multivariate OR=57.966,P=0.044),and hypertension(univariateχ^(2)=5.301,P=0.024;multivariate OR=24.462,P=0.029)tend to be the independent predictive factors for poor prognosis at 3 months after discharge.Conclusions:In conclusion,we report a series of patients harboring aneurysms originating from the fPCA.Surgical clipping is a reliable strategy.Full fPCA type is related to postsurgical infarction.Postoperative radiological infarction,rupture,and hypertension tend to be the independent predictive factor for poor prognosis at 3months after discharge. | Xin Chen Hao Li Ming-Ze Wang Mao-gui Li Yong Cao Dong Zhang Yan Zhang Hao Wang Shuo Wang | 2020 | Chinese Neurosurgical Journal2020，6，4： | 2 |
| 10 | The formation mechanism of acute dissection of blood blister-like aneurysm and its implication of endovascular treatment显示文摘Background:Acute mural dissection of the anterior wall of the internal carotid artery which may contribute to the development of blood blister-like aneurysms(BBLAs)was postulated,and stenting or flow diversion treatment across the soi-disant aneurysm was reported in this study.Methods:From December 2016 to December 2018,8 patients presenting with subarachnoid hemorrhage(SAH)due to BBLA were subjected to endovascular treatment with stent-assisted coiling.Clinical outcomes were evaluated using a clinical outcome score scale.Results:Based on angiograms,pathologic change involving the supraclinoid segments of the internal carotid artery(ICA)adjacent to BBLA was found in all patients.This pathologic change meant a focal dissection of the supraclinoid segment of the ICA which constituted the pathogenesis of BBLAs.Closed-cell,open-cell,and braided stents were used in 1,1,and 6 patients,respectively.Complete obliteration was achieved following endovascular treatment among all 8 patients harboring BBLA.One re-bleeding successive to a closed-cell stent across the aneurysmal neck was observed.Follow-up angiograms revealed stable complete exclusion of all BBLAs from the parent vessel at 3 to 8 months.All patients had a favorable clinical outcome score of 0–1.Conclusions:Acute dissection of a focal point of the intracranial vessels underlies the development of BBLAs.Open-cell and braided-cell stent-assisted coiling may constitute appropriate treatment due to good apposition against the vascular walls.Adjunctive coils may facilitate immediate complete occlusion of BBLAs. | Zhongyin Ye Xianli Lv | 2021 | Chinese Neurosurgical Journal2021，7，3： | 2 |
| 11 | The biology of bone morphogenetic protein signaling pathway in cerebrovascular system显示文摘Bone morphogenetic protein belongs to transcription growth factor superfamilyβ;bone morphogenetic protein signal pathway regulates cell proliferation,differentiation,and apoptosis among different tissues.Cerebrovascular system supplies sufficient oxygen and blood into brain to maintain its normal function.The disorder of cerebrovascular system will result into serious cerebrovascular diseases,which is gradually becoming a major threat to human health in modern society.In recent decades,many studies have revealed the underlying biology and mechanism of bone morphogenetic protein signal pathway played in cerebrovascular system.This review will discuss the relationship between the two aspects,aiming to provide new perspective for non-invasive treatment and basic research of cerebrovascular diseases. | Haishuang Tang Xiaoxi Zhang Gaici Xue Fengfeng Xu Qingsong Wang Pengfei Yang Bo Hong Yi Xu Qinghai Huang Jianmin Liu Qiao Zuo | 2021 | Chinese Neurosurgical Journal2021，7，4： | 2 |
| 12 | The protean manifestations of central nervous system IgG4-related hypertrophic pachymeningitis:a report of two cases显示文摘Background:IgG4-related hypertrophic pachymeningitis is a relative newly recognized and rare manifestation of IgG4-related disease,an immune-mediated fibroinflammatory tumefactive disorder.Fewer than 80 patients have been reported in the literature,and it can mimic common neurosurgical conditions.We describe the clinical presentation of two patients that were initially considered to have a subdural collection,tuberculous meningitis,and a cervical spinal meningioma,but were eventually diagnosed with this disease.Case presentation:Two ethnic Chinese men,86 and 62 years old,experienced a 4-week history of headache.Both patients had a history of autoimmune disease,namely glomerulonephritis and Grave’s disease,respectively.Magnetic resonance brain imaging revealed diffuse dural thickening with the latter patient exhibiting homogeneous and intense gadolinium-contrast enhancement.Since the 86-year-old patient also had progressive bilateral visual loss,giant cell arteritis was suspected and a 2-week course of glucocorticoid therapy was prescribed,but his symptoms failed to improve.The 62-year-old patient also had accompanying low-grade fever and was treated empirically as having tuberculous meningitis although there were no confirmatory microbiological findings.This patient further developed right hemiparesis,and additional imaging revealed a C4/5 intradural-extramedullary contrast-enhancing lesion resembling a meningioma causing cord compression.Both patients underwent neurosurgical intervention with the former undergoing a dural biopsy and the latter having the cervical lesion resected.The final diagnosis was IgG4-related hypertrophic pachymeningitis with the hallmark histological features of lymphoplasmacytic infiltration of IgG4+plasma cells,storiform fibrosis,and obliterative phlebitis.In addition,their serum IgG4 levels were elevated(i.e.,>135 mg/dL).Both patients received at least 6 months of glucocorticoid therapy while the latter also had azathioprine.Their symptoms improved significantly and recurrent lesions were not detected on follow-up imaging.Conclusions:A high index of suspicion for this condition is suggested when a male patient with a history of autoimmune disease and compatible radiological findings,experiences subacute headache that is disproportionate to the degree of dural involvement.Neurosurgeons should consider early meningeal biopsy to establish a definitive histological diagnosis in order for early effective immunosuppressive treatment to be initiated and to avoid unnecessary morbidity. | Peter Y.M.Woo Ben C.F.Ng June H.M.Wong Oliver K.S.Ng Timothy S.K.Chan Ngai-Fung Kwok Kwong-Yau Chan | 2021 | Chinese Neurosurgical Journal2021，7，4： | 2 |
| 13 | Postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease:a meta-analysis of single rate显示文摘Background:Surgery is a conventional mature treatment for moyamoya disease(MMD).However,whether surgery is also an effective therapy for epileptic type MMD has seldom been investigated systematically.The study aims to summarize the pooled postoperative incidence of seizure and cerebral infarction in pediatric patients with epileptic type moyamoya disease.Method:The study was a systematic review and critical appraisal with a meta-analysis of cohort studies,both prospective and retrospective.Studies were identified by a computerized search of PubMed,Embase,Web of Science,Wanfang,and CNKI databases.In a literature search,a total of 7 cohort studies were identified.The I2statistic was used to quantify heterogeneity.A fixed-effect model was used to synthesize the results.The linear regression test of funnel plot asymmetry was used to estimate the potential publication bias.Results:The pooled estimated postoperative incidence of seizure in pediatric patients with epileptic type moyamoya disease was 23.44%.The pooled estimated postoperative incidence of cerebral infarction in pediatric patients with epileptic type moyamoya disease was 9.12%.Low substantial heterogeneity and potential publication bias were present.Conclusions:Evidence from this study suggests that the postoperative incidence of seizure and cerebral infarction is relatively low.Surgery is an effective and secure therapy for pediatric patients with epileptic type moyamoya disease. | Jingjing Liu Qinlan Xu Hongchuan Niu Rong Wang Xun Ye Xianzeng Liu | 2021 | Chinese Neurosurgical Journal2021，7，3： | 1 |
| 14 | Correlation of periodontal diseases with intracranial aneurysm formation:novel predictive indicators显示文摘Background:We investigated whether periodontal diseases,specifically,periodontitis and gingivitis,could be risk factors of the incidence of intracranial aneurysms(IAs).Methods:We performed a case–control study to compare the differences in the periodontal disease parameters of 281 cases that were divided into the IAs group and non-IAs group.All cases underwent complete radiographic examination for IAs and examination for periodontal health.Results:Comparing with those in the non-IAs group,the cases in the IAs group were older(53.95±8.56 vs 47.79±12.33,p<0.001)and had a higher incidence of hypertension(76 vs 34,p=0.006).Univariate logistic regression analysis revealed that age(>50 years)and hypertension were predictive risk factors of aneurysm formation(odds ratio[OR]1.047,95%confidence interval[95%CI]1.022–1.073,p<0.001 and OR 2.047,95%CI 1.232–3.401,p=0.006).In addition,univariate and multivariate logistic regression analyses showed that the parameters of periodontal diseases,including gingival index,plaque index,clinical attachment loss,and alveolar bone loss,were significantly associated with the occurrence of IAs(all p<0.05).For further statistical investigation,the parameters of periodontal diseases were divided into four layers based on the quartered data.Poorer periodontal health condition(especially gingival index>1.1 and plaque index>1.5)had the correlation with IAs formation(p=0.007 and p<0.001).Conclusion:Severe gingivitis or periodontitis,combining with hypertension,is significantly associated with the incidence of IAs. | Keyun Liu Jia Sun Lingling Shao Hongwei He Qinglin Liu Youxiang Li Huijian Ge | 2021 | Chinese Neurosurgical Journal2021，7，3： | 1 |
| 15 | Quantified assessment of deep brain stimulation on Parkinson’s patients with task fNIRS measurements and functional connectivity analysis:a pilot study显示文摘Background:Deep brain stimulation(DBS)has proved effective for Parkinson’s disease(PD),but the identification of stimulation parameters relies on doctors’subjective judgment on patient behavior.Methods:Five PD patients performed 10-meter walking tasks under different brain stimulation frequencies.During walking tests,a wearable functional near-infrared spectroscopy(fNIRS)system was used to measure the concentration change of oxygenated hemoglobin(ΔHbO_(2))in prefrontal cortex,parietal lobe and occipital lobe.Brain functional connectivity and global efficiency were calculated to quantify the brain activities.Results:We discovered that both the global and regional brain efficiency of all patients varied with stimulation parameters,and the DBS pattern enabling the highest brain efficiency was optimal for each patient,in accordance with the clinical assessments and DBS treatment decision made by the doctors.Conclusions:Task fNIRS assessments and brain functional connectivity analysis promise a quantified and objective solution for patient-specific optimization of DBS treatment.Trial registration:Name:Accurate treatment under the multidisciplinary cooperative diagnosis and treatment model of Parkinson’s disease.Registration number is ChiCTR1900022715.Date of registration is April 23,2019. | Ningbo Yu Siquan Liang Jiewei Lu Zhilin Shu Haitao Li Yang Yu Jialing Wu Jianda Han | 2021 | Chinese Neurosurgical Journal2021，7，3： | 1 |
| 16 | Civilian gunshot wounds to the head:a case report,clinical management,and literature review显示文摘Background:Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion.Gunshot wounds to the head are the deadliest of all gun injuries.According to literature statistics,the survival rate of patients with gunshot wounds to the head is only 9%.Due to the strict management of various types of firearms,they rarely occur,so the injury mechanism,injury and trauma analysis,clinical management,and surgical standards are almost entirely based on military experience,and there are few related reports,especially of the head,in which an individual suffered a fatal blow more than once in a short time.We report a case with a return to almost complete recovery despite the patient suffering two gunshot injuries to the head in a short period of time.Case presentations:We present a case of a 53-year-old man who suffered two gunshot injuries to the head under unknown circumstances.On initial presentation,the patient had a Glasgow Coma Scale score of 6,was unable to communicate,and had loss of consciousness.The first bullet penetrated the right frontal area and finally reached the right occipital lobe.When the patient reflexively shielded his head with his hand,the second bullet passed through the patient’s right palm bone,entered the right frontotemporal area,and came to rest deep in the lateral sulcus.The patient had a cerebral hernia when he was admitted to the hospital and immediately entered the operating room for rescue after a computed tomography scan.After two foreign body removals and skull repair,the patient recovered completely.Conclusions:Gunshot wounds to the head have a high mortality rate and usually require aggressive management.Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital,followed by proactive treatment against infection,seizure,and increased intracranial pressure.Surgical intervention is usually necessary,and its key points include the timing,method,and scope of the operation. | Haoyi Qi Kunzheng Li | 2021 | Chinese Neurosurgical Journal2021，7，3： | 1 |
| 17 | Expert consensus on drug treatment of chronic subdural hematoma显示文摘Chronic subdural hematoma(CSDH)is a chronic space-occupying lesion formed by blood accumulation between arachnoid and dura mater,which is usually formed in the third week after traumatic brain injury.Surgical treatment is usually the first choice for patients with CSDH having a significant space-occupying effect.Most of the patients showed good results of surgical treatment,but still some patients had a postoperative recurrence(the recurrence rate was up to 33%).Because CSDH is often seen in the elderly,patients are weak and have many basic diseases.The risk of surgical treatment is high;serious complications and even death(the death rate is up to 32%)can often occur.The overall good prognosis rate of patients aged more than 90 years is 24%.The drug treatment can provide a safe and effective treatment for elderly patients who are weak,intolerable to surgery,or failed in surgery.Low-dose and long-term use of atorvastatin(20mg/d)is suggested for continuous treatment for at least 8 weeks,while low-dose and short-term use of dexamethasone can improve the therapeutic effect of atorvastatin on CSDH.Patients should undergo CT or MRI scanning at least one time within 2 weeks after the start of drug treatment. | Jianning Zhang Chinese Society of Neurosurgery Chinese Medical Association Chinese Neurosurgical Critical Care Specialist Council Collaborational Group of Chinese Neurosurgical Translational and Evidence-based Medicine | 2022 | Chinese Neurosurgical Journal2022，8，1： | 1 |
| 18 | Performance of automated CT ASPECTS in comparison to physicians at different levels on evaluating acute ischemic stroke at a single institution in China显示文摘Background:Our aim was to evaluate the sensitivity and specificity of the automated computer-based Alberta Stroke Program Early CT Score(e-ASPECTS)for acute stroke patients and compare the result with physicians at different levels.Methods:In our center,e-ASPECTS and 9 physicians at different levels retrospectively and blindly assessed baseline computed tomography(CT)images of 55 patients.Sensitivity,specificity,receiver-operating characteristic curves,Bland–Altman plots with mean score error,and Matthews correlation coefficients were calculated.Comparisons were made between the scores by physicians and e-ASPECTS with diffusion-weighted imaging(DWI)being the ground truth.Two methods for clustered data were used to estimate sensitivity and specificity in the region-based analysis.Results:In total,1100(55 patients×20 regions per patient)ASPECTS regions were scored.In the region-based analysis,sensitivity of e-ASPECTS was better than junior doctors and residents(0.576 vs 0.165 and 0.111,p<0.05)but inferior to senior doctors(0.576 vs 0.617).Specificity was lower than junior doctors and residents(0.883 vs 0.971 and 0.914)but higher than senior doctors(0.883 vs 0.809,p<0.05).E-ASPECTS had the best Matthews correlation coefficient of 0.529,compared to senior doctors,junior doctors,and residents(0.463,0.251,and 0.087,respectively).Conclusions:e-ASPECTS showed a similar performance to that of senior physicians in the assessment of brain CT of acute ischemic stroke patients with the Alberta Stroke Program Early CT score method. | Xiaochuan Huo Raynald Hailan Jin Yin Yin Guangming Yang Zhongrong Miao | 2021 | Chinese Neurosurgical Journal2021，7，4： | 1 |
| 19 | A decreased risk of meningioma in women smokers was only observed in American studies rather than studies conducted in other countries:a systematic review and meta-analysis显示文摘Background:Whether smoking is related to a decreased risk of meningioma in women is still controversial.We conducted a systematic review and meta-analysis examining the association between smoking and risk of meningiomas in women.Methods:Two authors independently performed a systematic literature review in the PubMed,Cochrane Library,and EMBASE databases.We identified case-control and cohort studies quantifying associations between smoking and risk of meningioma in women.A meta-analysis by pooling studies was performed according to the multivariate-adjusted risk estimates and 95%confidence intervals(CIs)preferentially.We further conducted additional subgroup and sensitivity analyses to explore possible explanations of the results.Results:A total of seven observational studies were included,with a total of 2132 female patients diagnosed with meningiomas.Ever smoking was associated with a significantly reduced risk of meningioma in women,with pooled odds ratio(OR)of 0.83(95%CI 0.70–0.98).Similar findings were noted for current(OR 0.78,95%CI 0.66–0.93)and past(OR 0.82,95%CI 0.71–0.94)smokers.However,considering the areas,the OR of ever smoking was 0.77(95%CI 0.68–0.87)in three American studies,but 0.99(95%CI 0.73–1.35)in four studies conducted in other countries.Conclusions:Based on limited epidemiological evidence,a decreased risk of meningioma in women smokers was only observed in American studies rather than studies conducted in other countries. | Ping Zhong Yiting Lin Ting Chen | 2021 | Chinese Neurosurgical Journal2021，7，4： | 1 |
| 20 | Diffuse intrinsic pontine glioma:current insights and future directions显示文摘Diffuse intrinsic pontine glioma(DIPG)is a lethal pediatric brain tumor and the leading cause of brain tumor–related death in children.As several clinical trials over the past few decades have led to no significant improvements in outcome,the current standard of care remains fractionated focal radiation.Due to the recent increase in stereotactic biopsies,tumor tissue availabilities have enabled our advancement of the genomic and molecular characterization of this lethal cancer.Several groups have identified key histone gene mutations,genetic drivers,and methylation changes in DIPG,providing us with new insights into DIPG tumorigenesis.Subsequently,there has been increased development of in vitro and in vivo models of DIPG which have the capacity to unveil novel therapies and strategies for drug delivery.This review outlines the clinical characteristics,genetic landscape,models,and current treatments and hopes to shed light on novel therapeutic avenues and challenges that remain. | Dilakshan Srikanthan Michael S.Taccone Randy Van Ommeren Joji Ishida Stacey L.Krumholtz James T.Rutka | 2021 | Chinese Neurosurgical Journal2021，7，4： | 1 |
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