2018年 · 第34卷第08期

intracranial dissecting aneurysm (IDA) is a lesion in which pathological dissection occurs between the intima and media or between the media and adventitia of an intracranial artery, resulting in bulging of the artery wall and aneurysm-like dilation^[1]。 IDA can occur in all age groups, but the high incidence period is young and middle age, which is one of the important causes of stroke. IDA occurs in the vertebral artery, followed by the basilar artery and the internal carotid artery. The clinical manifestations of this disease are diverse, which are closely related to the pathological damage pattern and lumen configuration of the diseased blood vessel wall, such as headache, subarachnoid hemorrhage (SAH), cerebral infarction and nerve compression symptoms^[2,3,4]。 The clinical diagnosis of IDA mainly depends on imaging examination. In November 2016, the Neurointerventional Expert Committee of the Neurosurgeon Branch of the Chinese Medical Doctor Association, the Neurointerventional Branch of the Chinese Stroke Society and the Young Physician Committee of the Neurosurgeon Branch of the Chinese Medical Doctor Association jointly organized national renowned experts to write and publish the "Chinese Expert Consensus on Imaging Diagnosis of Intracranial Arterial Dissection". This consensus preliminarily proposes the clinical imaging diagnosis and classification criteria of intracranial artery dissection^[5], providing standardized diagnostic criteria for this disease.

intracranial dissecting aneurysm (IDA) refers to pathological dissection and aneurysm-like dilatation between the intima and media or between the media and adventitia of intracranial arteries. It is the main cause of ischemic and hemorrhagic stroke in young and middle-aged people^[1]。 In the past, the incidence rate of the disease was considered to be low, but in recent years, with the improvement of people's health awareness and the continuous progress of medical imaging technology, the detection rate of the disease has been increasing year by year^[2]At present, it has become one of the more common diseases in neurology, surgery and neuroimaging.

Hypertensive cerebral hemorrhage accounts for 10% ~15% of cerebrovascular diseases, and is considered to be the most devastating type of stroke because of its high disability and mortality rate^[1]。 Cerebral infarction after hypertensive cerebral hemorrhage is a serious complication, which can increase the mortality and disability rate of patients. This study retrospectively analyzed the clinical data of 12 patients with cerebral infarction after lateral fissure-insular approach microsurgery for hypertensive hemorrhage in the basal ganglia area from January 2012 to June 2016 in the Department of Neurosurgery of Jinhua Central Hospital.

As a new auxiliary stent for the treatment of intracranial aneurysms, LVIS stent is a braided, self-expanding nickel-titanium alloy closed-loop stent. It has high metal coverage, and the mesh diameter is only 1 mm, so it can effectively avoid coil protrusion and escape, and is especially suitable for auxiliary embolization of small wide-neck aneurysms^[1]。 Although theoretically, LVIS stents have ideal compliance and adherence, any type of stent may have difficulty in adherence at the arterial turning point. In particular, LVIS stents are braided stents. If the specification selection is biased or the release technique is improper, it may appear poor opening at the arterial turning point, unable to adhere to the wall, and even lead to thromboembolic complications^[2]。 The experience of embolization of aneurysms in the siphon part of internal carotid artery with LVIS stent assisted by coil is reported in 2 cases. The specification selection and release technique of LVIS stent are discussed.

Common sellar tumors include pituitary adenoma, craniopharyngioma, Rathke cyst, etc. Craniopharyngioma is the most common with calcification in imaging^[1]However, a few pituitary adenomas and Rathke cysts may be accompanied by calcification^[2,3]。 Because of the lack of clinical and imaging specific manifestations, preoperative diagnosis is very difficult and easy to be misdiagnosed. This article retrospectively analyzed the clinical data of a patient with calcified pituitary adenoma admitted to the Department of Neurosurgery of the Second Affiliated Hospital of Zhejiang University School of Medicine in April 2017, and summarized and discussed the pathogenesis and clinical characteristics of calcified pituitary adenoma in combination with previous literature.

Turcot syndrome (TS), also known as brain tumor-polyposis syndrome (BTPS), is a rare genetic disease first reported by Turcot in 1959. Its clinical features are familial multiple colon adenomas, colorectal cancer and malignant tumors of central nervous system. At present, 11 relevant reports have been retrieved in China, and more than 150 cases have been reported abroad^[1]。 A patient with Turcot syndrome was treated in the Department of Medical Oncology, Minhang Branch, Fudan University Cancer Hospital, and the report is as follows.

Fungal infections usually occur in patients with severe immunodeficiency^[1], such as human immunodeficiency virus infection^[2,3]Brain abscess after bone marrow transplantation^[4]。 Brain abscess is mostly secondary to Candida infection^{[5,6,7,8,9,10,11,12]}。 A patient with primary brain abscess caused by Candida glabrata was admitted to the Department of Neurosurgery of Sino-Japanese Friendship Hospital of Jilin University. Its peripheral blood IgG, IgM and complement C3 were all lower than normal levels, suggesting abnormal immune system. Such cases are rarely reported. The diagnosis and treatment experience is reported as follows.

Nervous system damage often leads to sensory and/or motor dysfunction, language dysfunction, and even more serious consequences. At the same time, the repair and regeneration ability of the nervous system is limited, the damage repair speed is slow and the repair is incomplete, so the complete recovery rate of nervous system damage is lower than that of other diseases^[1]。 Stem cell transplantation is an important research direction in nerve repair and regeneration. The researchers hope to repair and regenerate nerves by transplanting stem cells, especially neural stem cells (NSCs), into damaged brain tissue and differentiating into functional nerve cells^[2]。 With the establishment and development of various techniques for inducing differentiation, stem cells and NSCs can be obtained from various pathways^[3]。 However, the effect of transplantation therapy is often poor. One of the key links is that few cells of NSCs can migrate to the injured site, differentiate and replace the original nerve structure and function after transplantation^[4]。

Parkinson's dissease (PD) is a dyskinesia characterized by neurodegeneration. The diagnosis of PD mainly depends on motor symptoms such as slow movement, myotonia and tremor^[1]。 The main treatment is dopamine replacement therapy (DRT) based on nigrostriatal dopamine neuronal degeneration. However, with the progress of research, non-motor symptoms (NMS) have gradually been paid attention to. NMS clearly associated with the dopamine pathway include anosmia, rapid eye movement sleep behaviour disorder (RBD), depression, constipation, and the like. Deep brain stimulation (DBS) has been used in PD for more than 30 years, and its efficacy for tremor, rigidity, bradykinesia and other motor symptoms is clear, but the efficacy for NMS is still inconclusive. In recent years, the results of DBS in the treatment of NMS have been gradually reported. By searching the relevant literature in recent years, the current research status of DBS in the treatment of NMS is summarized as follows.