2018年 · 第34卷第04期

In the historical development of neurosurgery, technological changes often bring revolutionary changes to treatment results. The development of auxiliary technology, especially the application of advanced imaging technology, has begun to guide clinical diagnosis and treatment^[1,2]。 Nowadays, the integration of various imaging modes and new technologies with surgery is changing the diagnosis and treatment mode of neurosurgery. Neurosurgeons have gradually developed from paying attention to the changes of lesions on the anatomical structure of the brain to paying attention to the influence of lesions on cranial nerve function. In different historical periods of the development of neurosurgery, the understanding of neuroanatomy and brain function has been very different. The development and changes of neurosurgery have obvious characteristics of times and scientific changes like other disciplines. At present, the biggest change in neurosurgery is to integrate advanced technology and brain function protection awareness into the development process of the discipline, change the diagnosis and treatment mode, and improve the diagnosis and treatment effect and research level. In today's era of precision medicine, the application value of multimodal fusion technology in neurosurgical treatment has been clearly shown.

hypertensive intracerebral hemorrhage (HICH) is a common complication of hypertension, accounting for 20% of all stroke cases. 50% of HICH is located in the basal ganglia region, which has become an important public health problem in China and the world because of its high morbidity, mortality and disability rate^[1,2,3]。 The fundamental measures for the treatment of HICH are to effectively relieve the compression of hematoma, reduce intracranial pressure, protect penumbra brain tissue, and reduce or reverse the damage of brain tissue around hematoma in the ultra-early stage (within 7 hours after onset). From January 2014 to July 2016, 68 cases of HICH in the basal ganglia area were treated with keyhole approach ultra-early craniotomy microsurgery in the Department of Neurosurgery of the 171st Hospital of the People's Liberation Army, and remarkable results were achieved.

Clinically, apart from the common cerebral atherosclerosis rupture hemorrhage and middle cerebral artery (MCA) aneurysm rupture hemorrhage, the arteriovenous malformation (AVM) hemorrhage in this area is also a factor that cannot be ignored. However, part of AVM in this area is the main blood supply artery from MCA, the location is deep, not exposed to the cortex, and the deformity mass is not large, although this kind of AVM is rare in clinic^[1]But it has important significance. This article retrospectively analyzed the clinical data of 17 patients with small and medium-sized AVM in the lateral fissure area, which is the main blood supply of MCA, treated by surgery in the Department of Neurosurgery, Affiliated Hospital of North Sichuan Medical College from January 2008 to December 2016, and now reported as follows.

Rathke's cleft cyst (RCC) has the same histological origin as pituitary adenomas and is a rare congenital non-neoplastic disease^[1]。 With the extensive application of MRI in clinical practice, the related reports of RCC are gradually increasing^{[2,3,4,5,6,7,8,9,10,11,12,13]}However, RCC hemorrhage accompanied by fluid-fluid plane formation is rare, and it is very similar to pituitary adenoma stroke, and is often misdiagnosed. This article reports a case of RCC hemorrhage with fluid-fluid level admitted to the Department of Neurosurgery of Fuzhou General Hospital in June 2011, so as to enhance the understanding of this rare phenomenon and help the clinical differentiation between panneoplastic pituitary stroke and RCC hemorrhage.

Cranial metastasis of thyroid cancer is very rare, and it is mostly reported in individual cases at present, with an incidence of about 2.5%^[1]。 In December 2013, a patient with cranial metastasis of thyroid cancer was admitted to the Department of Neurosurgery of Cangzhou Central Hospital. He relapsed in situ 2 years after surgical treatment, and was operated again, and good results were obtained. The report is as follows.

Diabetic peripheral neuropathy is one of the most common and serious complications of diabetes. Up to 50% of diabetic patients will eventually complicate diabetic peripheral neuropathy, which is mainly manifested as numbness, pain and weakness in the extremities distributed like stockings and gloves. It is the main cause of death and disability of diabetes^[1,2]。

Solitary plasmacytoma is a malignant tumor caused by abnormal proliferation of monoclonal plasma cells, accounting for less than 10% of plasmacytomas, and can be divided into bone solitary plasmacytoma and extramedullary plasmacytoma^[1]。 Among them, bone solitary plasmacytoma is a single plasmacytoma originating from bone, which is more common in axial bones such as vertebrae, ribs, skull, pelvis, etc. About 75% will progress to multiple myeloma, and the prognosis will deteriorate^[2]。 Solitary plasmacytoma occurring at the base of the skull is very rare. It has a slightly better prognosis than multiple myeloma and most malignant tumors of the skull base, but has a worse prognosis than solitary plasmacytoma at the top of the skull. Its clinical manifestations lack specificity, and it is difficult to differentiate from other skull base tumors. It is easy to miss the best treatment opportunity^[3]。 This article reviews the clinical characteristics, pathology, imaging features and treatment of solitary plasmacytoma of the skull base.