2016年 · 第32卷第12期

In the history of spinal neurosurgery in the United States, it has been suggested that neurosurgeons should not only perform cervical spine surgery, but also actively perform thoracolumbar spine surgery, which is considered a very visionary suggestion. In 1993, this recommendation was included in the Neurosurgery Residency Program by the American Academy of Neurosurgery (AANS) and the Association of Physicians (CNS)^[1]。 At present, the specialized training of neurosurgery residents in China is in its infancy, and spinal cord and spinal diseases have been included in the training plan. However, the requirements for diseases are questionable, and most of them are limited to traditional intraspinal tumors. Therefore, the active diagnosis and treatment of lumbar degenerative diseases in domestic neurosurgery is also of great significance to the future development of spine subspecialty in neurosurgery.

deep brain stimulation (DBS) is an important method for the treatment of Parkinson's disease (PD). 2012 "Expert Consensus on Deep Brain Electrical Stimulation Therapy for Parkinson's Disease in China" was released^[1,2], standardized the indications and procedures of DBS therapy in my country, and strengthened the cooperation between neurology and neurosurgery. In recent years, great progress has been made in the diagnosis and treatment of PD at home and abroad. In 2015, the International Society of Movement Disorders (MDS) developed new clinical diagnostic standards for PD^[3]China has also formulated the "Diagnostic Criteria for Parkinson's Disease in China (2016 Edition)"^[4]And "Chinese Parkinson's Disease Treatment Guidelines (Third Edition)"^[5]Standardizes the diagnosis and treatment of PD in China.

Chiari malformation, also known as cerebellar subtonsillar hernia, is a congenital developmental malformation characterized by the reduction of the volume of the posterior cranial fossa and the downward entry of the cerebellar tonsil into the spinal canal lumen^[1]Often complicated with syringomyelia and skull base depression, odontoid dislocation, atlanto-occipital fusion and other craniocervical junction deformities. Clinically, Chiari malformation is mainly type Ⅰ, and its clinical manifestations are variable, and there are many surgical methods in the treatment^[2,3,4,5,6]。 If the surgical method is improperly selected, it may lead to difficulty in alleviating or even aggravating the clinical symptoms of patients. From January 2011 to October 2015, 72 patients with Chiari malformation type I were treated with different surgical methods in the Department of Neurosurgery of the First Affiliated Hospital of Anhui Medical University, with satisfactory results. The report is now as follows.

Isolated temporal horn syndrome is a local obstructive hydrocephalus caused by obstruction of ventriculotemporal horn outflow tract and continuous secretion of cerebrospinal fluid by the choroid plexus of the temporal horn. This syndrome was first reported by Cairns et al. in 1947. So far, less than 30 cases have been reported in the literature^[1,2,3,4]。 This article retrospectively analyzed the clinical data and treatment results of 3 patients with isolated temporal horn syndrome admitted to the Department of Neurosurgery of Beijing Tiantan Hospital affiliated to Capital Medical University from 2014 to now.Figure 1)。 The report is below.

Supratentorial intracranial cavernous malformation (CM) is one of the common intracranial vascular malformations. For superficial non-functional CM lesions with obvious symptoms, surgery is the main treatment, but for CM lesions involving functional areas in the deep supratentorial (especially located in the thalamus and basal ganglia areas), the risk of comorbidity after surgery is higher^[1]The choice of treatment modalities has always puzzled clinicians. In March 2012, the Department of Neurosurgery of Beijing Tiantan Hospital affiliated to Capital Medical University operated on a patient with giant cavernous vascular malformation in the basal ganglia and thalamus region with a history of gamma knife treatment and surgical resection, and the curative effect was satisfactory. The report is now as follows.

Angiolipomas of the central nervous system are extremely rare, with about 90% occurring in the spinal canal and only 10% occurring in the cranium, and all of them are reported as individual cases. Histologically, angiolipoma consists of vascular tissue and adipose tissue. In April 2014, a case of angiolipoma involving intrasellar, suprasellar and parasellar was admitted to the Department of Neurosurgery of Weihai Central Hospital, which is now reported as follows.

Pituitary thyrotropinoma is very rare, accounting for about 1% to 2% of pituitary tumors^[1]。 ectopic thyrotropin-secreting pituitary adenoma (ETPA) is rarer and only a case report. Since Cooper reported ETPA in 1996, only seven cases have been reported at home and abroad^{[2,3,4,5,6,7,8]}(Table 1)。 Because it is a rare cause of hyperthyroidism, it is easy to miss the diagnosis and delay the treatment. A patient with ETPA was admitted to the Department of Neurosurgery of Wuxi Second Hospital affiliated to Nanjing Medical University in September 2015. The report is as follows.

hemifacial spasm (HFS), also known as hemifacial twitch, is a benign functional disease in middle-aged and elderly people. The clinical manifestation is paroxysmal involuntary twitching of one facial muscle. The vast majority of patients start with mild unilateral involuntary twitching of orbicularis oculi muscle, which aggravates when emotionally excited and stops after sleep. Most scholars agree that one of the important causes of HFS is the compression of facial nerve by blood vessels. microvascular decompression (MVD) can cure HFS safely and effectively, and has been widely carried out all over the world. This article reviews the surgical evaluation, monitoring and surgical approach of MVD in the treatment of HFS as follows.

Idiopathic hemifacial spasm (HFS), also known as hemifacial twitch or hemifacial spasm, manifests as involuntary, intermittent, painless spastic contraction of muscles in the area of facial nerve distribution on one side of the face. The disease progresses slowly and generally does not improve naturally. It usually starts with the spasm and contraction of the orbicularis oculi muscle, gradually involves the whole half of the face, and the frequency gradually increases, which can eventually lead to the impairment of the visual ability of the affected side. In severe cases, it can involve the neck and shoulder muscles, and excessive fatigue and emotional excitement can induce its aggravation. Foreign epidemiological investigation showed that the incidence rate was 7.4~8.1/1 million, and the ratio of male to female was about 1: 2^[1]。 In the 1960s, Jannetta first proposed the concept of microvascular decompression (MVD) after using surgical microscopy to treat HFS^[2]After decades of development and improvement, it has become the preferred treatment for HFS. In recent years, with the deepening of understanding of the pathogenesis of HFS and the continuous improvement of surgical techniques, the effective rate of MVD surgery has improved to some extent, while the incidence of postoperative ineffectiveness, recurrence and complications has decreased. The hearing impairment of the affected side after MVD is one of the most common serious complications, especially the permanent hearing loss of the affected side after operation, which causes great pain to patients and hinders the further application of MVD to some extent. This article reviews the related situation and prevention and treatment of hearing impairment after HFS MVD in recent years.