2015年 · 第31卷第08期

Craniocerebral trauma coma is mainly caused by injury factors to the brainstem reticular structure and its projection fibers or diffuse damage to the cortex. Patients with loss of cognition, arousal and perception are called coma, and patients lasting for more than 1 month are called long-term coma. The incidence of long-term coma caused by severe craniocerebral trauma ranged from 0.52% to 7.33%, with an average of 2.90%.

anterior communicating artery (ACoA) aneurysms are one of the most common intracranial aneurysms and are more likely to rupture than anterior circulation aneurysms at other sites^[1,2]。 The size, shape, tumor orientation and aneurysm base are important factors affecting the treatment of ACoA aneurysms^[3,4,5]。 We have briefly describe that location of the neck of the ACoA aneurysm^[4]However, this description lacks quantitative criteria, the number of cases is small, and the exact location of the aneurysm base has not been studied. Therefore, through the observation of three-dimensional image data of ACoA aneurysm patients, the image classification of ACoA aneurysm according to the position of the aneurysm base was carried out in this study, and the relationship between this classification and clinical treatment and prognosis was discussed.

Intraspinal dural dissection cyst is one of the extremely rare diseases in neurosurgery. At present, most of the clinical reports on dural dissection cyst are case studies^[1,2,3,4]There are few related studies summarizing the clinical and imaging features and treatment methods of this disease. This study retrospectively analyzed the data of 5 patients with intraspinal dural dissection cyst admitted to the Department of Neurosurgery of the First Affiliated Hospital of Zhengzhou University from January 2003 to May 2014, and discussed their clinical manifestations, imaging features and surgical methods, which are reported as follows.

With the development of skull base surgery technology up to today, there are fixed and relatively mature surgical approaches for tumors in certain specific parts of the cranium. However, for huge intracranial tumors, several important anatomical areas are often involved at the same time. To achieve total or subtotal tumor resection, several surgical approaches are required to be combined at the same time. It goes without saying that although this kind of craniotomy brings hope to patients, its huge trauma and postoperative complications often seriously threaten the quality of life of patients. With the development of neuroendoscopic technology, endoscopic assisted surgery has gradually appeared, which greatly reduces the problems caused by surgery. This paper discusses the microscopic anatomy and surgical scope of the retrosigmoid approach assisted by endoscope in the posterior fossa-cerebellopontine angle (CPA) area.

Epidural hematoma is a common type of craniocerebral trauma in clinic. At present, there are few clinical studies on pediatric epidural hematoma. From January 2002 to December 2013, a total of 106 cases of pediatric epidural hematoma were treated in the Department of Neurosurgery, General Hospital of Ningxia Medical University, and the treatment effect was good. The report is as follows.

In recent years, vascular bypass technology has been widely used in ischemic cerebrovascular diseases, complex aneurysms and skull base tumors^[1,2,3]。 Low flow (<90 ml/min) of intracranial and extracranial carotid system vascular anastomosis can no longer meet the clinical needs^[4]High-flow (≥90 ml/min) intracranial and extracranial vascular bypass surgery is increasingly used^[5,6]。 However, there are few reports of experimental research on high-flow vascular bypass using canine external carotid artery at home and abroad. The purpose of this study was to establish a high-flow bypass model of common carotid artery-external carotid artery in dogs, so as to provide a simulation platform for related technical training.

pituitary adenoma (PA) is a common intracranial tumor, accounting for about 15% of intracranial tumors. In recent years, with the development of endocrine examination and medical imaging, the detection rate of this tumor has been increasing^[1,2]。 The clinical manifestations of pituitary adenoma are mainly caused by tumor occupying effect and endocrine dysfunction. According to whether they have secretory function, pituitary adenomas are divided into functional (also known as secretory) and non-functional. The former includes prolactinoma, gonadotropin adenoma, growth hormone adenoma, adrenocorticotropin adenoma, thyrotropin tumor and mixed adenoma. Patients with such tumors show symptoms of excessive secretion of corresponding hormones, such as lactation, amenorrhea, infertility, sexual hypofunction, acromegaly, Cushing's disease, etc., which seriously affect the quality of life of patients^[3]However, cognitive function is an important part of quality of life. At present, there is no relevant research in China and relatively few abroad. In order to improve the quality of life of patients with pituitary adenoma, we reviewed the cognitive function of patients with pituitary adenoma and the influence of various treatment methods on it, as well as the possible mechanism of occurrence.

medulloblastoma (MB) is the most common malignant brain tumor in children, with the peak incidence of 4-7 years old. It can also involve infants, young children and the elderly, and is relatively rare in adults^[1]。 MB is a tumor of embryonic origin, and its etiology has not been conclusive. Genetics found that some neuroneoplastic syndromes (such as Gorlin syndrome, Turcot syndrome, Li-Fraumeni syndrome, Rubinstein-Taybi syndrome) are genetically susceptible and positively correlated with MB^[2]。 Approximately 30% of MB patients present with disseminated metastases at the first diagnosis. Clinically, the standard treatment of MB includes surgery, radiotherapy combined with chemotherapy, but the overall effect is not good. Standardized comprehensive treatment can prolong the life of some patients, and iatrogenic collateral injury also seriously affects their quality of life. In the past 20 years, clinicians have divided patients into high-risk groups and standard-risk groups according to the risk of MB recurrence or metastasis (age of onset, tumor dissemination, postoperative residual tumor burden, etc.), and given different degrees of radiotherapy and chemotherapy accordingly. Although radiotherapy and chemotherapy regimens are constantly improving, they have not changed the overall treatment strategy of MB. In recent five years, MB has made great progress in the research of tumor genomics and biological cytology. These achievements have rapidly promoted the development of MB molecular typing, revolutionized clinicians' cognition of MB, and accordingly made molecular targeted therapy an important link in comprehensive therapy^[3]。 This article will review the literature from the study of the origin of MB to the development of molecular typing, expound the influence of basic research progress on clinical treatment, and explore the best treatment options for different molecular subtypes of MB.

disorders of consciousness (DOC) include vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state (MCS), mostly due to severe brain injury^[1]。 At present, the diagnosis of these states is relatively clear, but the treatment is quite limited. Although deep brain stimulation (DBS) is invasive, research on this treatment has been steadily increasing in recent years. At present, DBS is used in the treatment of many neurological diseases, especially Parkinson's disease, and the advancement of this technology has benefited many patients. It is because of these advances that DBS has been developed in the therapeutic application of DOC. This article will summarize DBS technology and its clinical application, systematically review the research reports of DBS in the treatment of DOC, and explore the possible mechanism of DBS in the treatment of DOC.