2015年 · 第31卷第12期

sponteneoues intracerebral hemorrhage (hereinafter referred to as cerebral hemorrhage) refers to intraparenchymal hemorrhage caused by spontaneous rupture of large, small arteries, veins and capillaries in the cranium in adults caused by non-trauma. According to the cause of the disease, it can be divided into primary and secondary cerebral hemorrhage. Among them, primary cerebral hemorrhage accounts for about 80% ~85% of cerebral hemorrhage, mainly including hypertensive cerebral hemorrhage (about 50% ~70%^[1]), amyloid angiopathy cerebral hemorrhage (CAA, accounting for about 20% ~30%) and unexplained cerebral hemorrhage (accounting for about 10%). Secondary cerebral hemorrhage mainly includes cerebral hemorrhage caused by arteriovenous malformations, aneurysms, cavernous vascular malformations, arteriovenous fistulas, Moyamoya disease (Moyamoya disease), blood diseases or coagulation dysfunction, intracranial tumors, vasculitis, hemorrhagic cerebral infarction, venous sinus thrombosis and adverse drug reactions.

Acute lung injury is a common respiratory disease and one of the serious complications of severe traumatic brain injury (STBI)^[1,2]。 Current studies confirm that acute lung injury is an independent risk factor for cerebral hypoxia after STBI^[3]Intracranial hypertension is closely related to the occurrence of acute lung injury after STBI^[4]。 The authors' previous study revealed that the Glasgow Coma Score (GCS) at admission is an independent risk factor for acute lung injury in patients with STBI^[5]。 These studies suggest that acute lung injury may be significantly associated with STBI prognosis. This study retrospectively analyzed a group of patients with STBI to further reveal the relationship between acute lung injury and death during hospitalization in patients with STBI, thus exploring its clinical value.

Cerebral hemorrhage refers to non-traumatic hemorrhage caused by rupture of intraparenchymal blood vessels, accounting for 20% ~30% of all strokes, and the cause of occurrence is mainly related to cerebral vascular lesions^[1]。 High blood pressure is the most common cause. Middle-aged and elderly patients suddenly develop disease during activity or emotional agitation, and quickly develop symptoms of focal neurological deficit, headache, vomiting and other symptoms of intracranial hypertension. CT examination of the head can quickly confirm the diagnosis^[2]。 For the treatment of hypertensive cerebral hemorrhage in China, routine craniotomy, small bone window hematoma removal, stereotactic and CT-guided puncture and drainage of hematoma are often used^[3]。 From August 2014 to June 2015, the Department of Neurosurgery of Beijing Jiangong Hospital applied BrainLab neuronavigation-guided small bone window craniotomy to remove hematoma in 43 patients with hypertensive intracerebral hemorrhage and achieved good results. The report is as follows.

traumatic brain injury (TBI) frequently occurs with coagulation dysfunction^[1,2]This coagulation abnormality leads to prolonged hospital stay and poor prognosis. However, through literature search, there are few studies on the onset time and duration of intermediate TBI coagulation dysfunction. This study was conducted to evaluate the time course (time of onset and duration) of coagulation dysfunction in intermediate TBI and its association with complications and case mortality.

chronic subdural hematoma (CSDH) is a common disease in neurosurgery, and burr hole craniostomy (BHC) is the most widely used surgical method for the treatment of CSDH. Weigel et al.^[1]And Lega et al.^[2]It is agreed that BHC is the best treatment option for "uncomplicated" CSDH. From September 2007 to September 2014, the Department of Neurosurgery of Kaifeng Longhai Brain Hospital selected "Y-shaped double-lumen drainage tube" as the drainage tube, and treated 70 patients with CSDH with satisfactory results. The report is as follows.

persistent vegetative state (PVS): Loss of any evidence of cognition or ability to express conscious emotional and behavioral responses to external events or stimuli, but with a sleep-wake cycle, complete or partial preservation of autonomic nerve function in the hypothalamus and brainstem. When this cognitive loss persists for more than a period of time, it is called PVS^[1]While the Chinese Society of Neurosurgery identified those with 3 months of unconscious activity and sleep-wake cycles as PVS^[2]。 A significant proportion of patients remain in PVS after severe craniocerebral injury. In recent years, with the development of neuromodulation technology, electrical spinal cord stimulation (SCS) has been applied in clinic, and has obvious effect as a therapeutic method to promote awakening of PVS patients^[3]。 In Kanno et al.^[4]Of the 201 PVS patients treated by SCS, up to 54.2% experienced positive responses such as recovery of consciousness. In 2008, two patients with PVS admitted to the Department of Neurosurgery of Tongmei Group General Hospital in Datong, Shanxi Province were treated with satisfactory results by SCS, which are reported below.

internal carotid artery occlusion (ICAO) is one of the main causes of cerebral ischemic events. An epidemiological study showed that the incidence of symptomatic ICAO in white Americans is 6 per 100,000, resulting in between 15,000 and 20,000 ischemic cerebrovascular events per year in the United States^[1]。 The clinical manifestations of ICAO patients are diverse and may be asymptomatic (often discovered accidentally during physical examination). Symptomatic patients may be manifested as transient ischemic attack (TIA), hemiplegia or even fatal stroke, but the incidence of stroke is relatively low^[2,3,4]。 Disability and mortality rates of ICAO patients were 40%-69% and 16%-55%, respectively^[5,6,7]。 In recent years, some progress has been made in the research of ICAO at home and abroad, which is summarized as follows.

With the continuous development of neurosurgery and intensive care technology, the number of patients in vegetative state (VS) is increasing day by day, and the explanation of VS from the perspective of pathophysiological function is more and more clear. However, a basic problem-the number of VS patients is still unclear.

intraventricular hemorrhage (IVH) usually refers to spontaneous IVH, that is, the rupture of intracranial blood vessels and the rupture of blood into the ventricular system under the action of non-traumatic factors. IVH is a common complication of cerebral hemorrhage and subarachnoid hemorrhage, and the incidence of IVH complicated by cerebral hemorrhage is 42% ~52%^[1]The fatality rate of IVH is 50% ~80%^[2]。 It is reported in the literature that the incidence of IVH in low birth weight premature infants is 15% ~20%, and the mortality rate is 20% ~50%^[3]。 IVH has a high mortality and disability rate, and poor efficacy of medical treatment. Therefore, in recent years, researchers have been exploring more ideal surgical treatment methods.

Primary CNS tumors exhibit great heterogeneity in histology, molecular genetics, and prognosis. WHO classification of central nervous system tumors is mainly based on tumor tissue morphology, occurrence site, age distribution and biological behavior, and the tumors are classified into grade Ⅰ ~ Ⅳ^[1]。 However, relying solely on pathological typing has certain limitations. In recent years, with the application of high-throughput molecular analysis methods, the research progress of molecular genetics of central nervous system tumors has further revealed the mechanism of nerve tumor formation, and provided new ideas for the diagnosis, classification, prognosis and even treatment of nerve tumors.

There are many causes of skull defects, such as craniocerebral trauma, brain tumor, cerebrovascular disease, and congenital diseases, etc., and skull repair is very necessary. First, it can protect brain tissue, restore intracranial and extracranial anatomical structures, achieve the aesthetic outline, and provide support for craniofacial soft tissue; Second, it can relieve the serious psychological burden on patients due to skull defects^[1]。 Although there are many skull repair materials, autologous skull is still unanimously recognized by many experts as the most ideal repair material. Autologous skull repair faces many problems and challenges. This article focuses on the following aspects.

Glioblastoma (GBM) is the most common and most malignant brain tumor. With the development of immunohistochemical technology, the idea that the secondary GBM developed from astrocytoma is a tumor that is essentially different from the primary GBM is finally confirmed by the molecular expression similarity and homology between astrocytoma and secondary GBM^[1]Secondary GBM and primary GBM are two completely different tumors, both from clinical prognosis and from the point of view of molecular pathology and epigenetics. In this article, the molecular pathological manifestations of secondary GBM will be reviewed in combination with recent reviews as follows.