2017年 · 第33卷第08期

Intracranial aneurysm is a cerebrovascular disease that seriously threatens human health. Its rupture and hemorrhage occupies the third place in patients with cerebrovascular accidents. The mortality rate after hemorrhage is about 40%, and the mortality rate of re-hemorrhage can be as high as 60% ~70%^[1]。 It is a consensus that ruptured aneurysms must be treated (either endovascular or craniotomy clipping) in order to avoid re-bleeding to the greatest extent. However, for unruptured aneurysms, the treatment is far more complicated than ruptured aneurysms.

Sellar diaphragmatic meningioma is adjacent to important structures such as pituitary stem, internal carotid artery, optic nerve and optic chiasm. Patients often have abnormal vision and endocrine function before and after surgery. How to protect optic nerve, internal carotid artery, pituitary stem and reduce later complications is the focus of treatment^[1,2]。 Kinjo et al.^[3]According to different positions, the meningiomas of the saddle diaphragm are divided into three types: A, B and C. Type A: the tumor starts above the saddle diaphragm, and the main body is located in front of the pituitary stem; Type B: The tumor originates above the saddle diaphragm, and the main body is located behind the pituitary stem; Type C: The tumor originates below the saddle diaphragm. Different types of sellary diaphragmatic meningiomas have different surgical approaches^[4,5]。 From January 2008 to June 2016, 11 cases of different types of sellar diaphragmatic meningiomas were resected by microsurgery in the Department of Neurosurgery of Guizhou Provincial People's Hospital. The clinical results were satisfactory, and the retrospective report is as follows.

Cerebral echinococcosis, also known as cerebral hydatidosis, is a kind of intracranial parasitic disease caused by the larvae of Echinococcus tapeworm (Echinococcus), which mostly occurs in northwest of China, especially in Xinjiang^[1]。 According to the type of infected human echinococcus, the disease can be divided into two categories: echinococcosis granulosa and alveolar echinococcosis. The former is also called hydatid cyst, which is more common; The latter are known as "parasitic tumors" because they resemble malignant tumors or multiple intracranial metastases, which are relatively rare^[2]。 Cerebral echinococcosis mostly occurs with intracranial space-occupying symptoms and progresses rapidly. This article retrospectively analyzes the clinical data of 12 patients with cerebral echinococcosis admitted to the Department of Neurosurgery, Friendship Hospital, Ili Kazakh Autonomous Prefecture, Xinjiang from January 2001 to September 2015, and summarizes the following in combination with relevant literature for clinicians' reference.

Large aneurysm of ophthalmic segment of internal carotid artery is an intracranial aneurysm with a diameter of 10~25 mm located between the origin of ophthalmic artery and the origin of posterior communicating artery. Because of its complex surrounding anatomical structure and narrow surgical operation space, it is difficult to directly clip the neck of tumor by surgery, and the mortality and disability rate are high. On May 30, 2016, the Cerebrovascular Disease Center of Beijing Tiantan Hospital affiliated to Capital Medical University treated a patient with large aneurysm of the ophthalmic segment of the internal carotid artery. He was clipped in the compound operating room and achieved good results. The report is as follows.

Freezing gait is one of the typical symptoms of patients with Parkinson's disease, which easily leads to falls and seriously affects the quality of life and social function of patients^[1,2]。 deep brain stimulation (DBS) is currently recognized as an effective method for the treatment of intermediate and advanced Parkinson's disease. High-frequency stimulation of subthalamic nucleus (STN) can effectively control the symptoms of tremor, rigidity and bradykinesia for a long time. Although it can partially improve the midline symptoms such as gait, postural stability and arthria, it may gradually deteriorate 3~5 years after operation^[3,4]。 At present, new targets (such as the pons nucleus) have been targeted^[5]And the study of exploring new stimulus modes. Some studies have found that switching to low-frequency stimulation for Parkinson's disease patients with gait disorders can improve gait, but it can't control other motor symptoms^[6]。 The emergence of variable frequency stimulation provides a new idea for STN-DBS to treat midline symptoms of Parkinson's disease such as gait and posture. In June 2016, the Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University treated a patient with Parkinson's disease with gait freezing with frequency conversion stimulation, and the follow-up effect was good. To investigate the efficacy of variable frequency electrical stimulation STN in the treatment of frozen gait in Parkinson's disease.

Intracranial aneurysm is a pathological dilatation of cerebral vessels, with an incidence of 3% to 5% in adults^[1,2]。 Intracranial aneurysms mainly occur in the age of 40 to 60, the incidence rate of women is higher than that of men, and 20% to 30% of patients have multiple aneurysms^[3]。 With the development of imaging technology, the detection rate of aneurysms is constantly increasing, but the choice of clinical treatment (surgery or endovascular treatment) is still controversial. Once an intracranial aneurysm ruptures, it will lead to subarachnoid hemorrhage (SAH), and up to 35% of them have a poor prognosis^[4]。 This paper focuses on the formation mechanism and clinical prevention management of intracranial aneurysms, and puts forward hypotheses for future clinical and experimental research.

Meningiomas originate from arachnoid epithelial cells and account for about 30% of primary intracranial tumors^[1]。 90% of meningiomas occur supratentorially, and about 90% of meningiomas are WHO grade I, which is more common in women^[2,3]。 Intraventricular meningiomas are relatively rare, accounting for 1% to 3% of all meningiomas and 12% to 20% of all intraventricular tumors^[4]。 According to statistics, 80% of intraventricular meningiomas originate in the lateral ventricle, 15% in the third ventricle, and only 5% in the fourth ventricle^[5]。 Most (70% ~80%) of meningiomas of the lateral ventricle are located in the triangular region. Clinical symptoms of lateral ventricular meningiomas usually appear late, so the tumor volume is large at the time of consultation, and symptoms include headache, visual impairment or visual field defect, seizures, etc. Neurosurgery is an effective treatment for lateral ventricular meningiomas.