2018年 · 第34卷第09期

Epilepsy is one of the most common chronic neurological diseases in childhood. Epileptic seizures are extremely harmful to children's nervous system and development, especially drug-refractory epilepsy drug resistant epilepsy (DRE). At present, there are about 10.5 million cases of epilepsy in children worldwide^[1]Many children suffer from epileptic seizures while also suffering from comorbidities such as learning difficulties, mental retardation, developmental delay, mental behavioral disorders and psychosocial diseases, which are more obvious in children with DRE. According to statistics, about 35% of patients have unsatisfactory seizure control, most of them are children, and 25% of these patients are DRE^[2]。 Poor seizure control will have a serious impact on the growth, development and cognition of children, especially infants and young children. Frequent and severe seizures will cause development to stop or even regress, and in severe cases, they will develop into epileptic encephalopathy, which will eventually cause irreversible damage to the nervous system. Therefore, the importance of completely eliminating the attacks caused by DRE in children cannot be overemphasized clinically.

The anti-slip stripping airbag controllable flow lumbar puncture and drainage device system (invention patent number: ZL 2015 1 0593810.7) designed by Wuxi Huishan District People's Hospital has the advantages of simple operation, easy catheter placement, prevention of slippage and no tube breakage, and has achieved good clinical efficacy, which is now introduced as follows.

cervical artery dissection (CAD) refers to the flow of blood from the carotid artery through the damaged intima of the artery into the vessel wall, causing the separation of the intima and subintima structures, resulting in vessel stenosis, occlusion or pseudoaneurysm formation. Among the causes of ischemic stroke in young and middle aged, CAD accounts for 10% ~25%^[1]。 Therefore, timely diagnosis of CAD has important clinical significance. Digital subtraction angiography (DSA) is the gold standard for diagnosis of CAD, but vascular lumen imaging techniques including DSA cannot directly display the typical signs of diagnosis of CAD, such as "double lumen sign" and "inner membrane patch". Three-dimensional fast spin echo imaging technology (three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions, 3D-SPACE) It can effectively display the lumen and wall structure of blood vessels, which has obvious advantages over DSA. In November 2016, the Interventional Department of the First Affiliated Hospital of Zhengzhou University treated a patient with multiple carotid artery dissection and ipsilateral middle cerebral artery tandem occlusion. The diagnosis was confirmed by 3D-SPACE. The specific reports are as follows.

Choriocarcinoma is a malignant gestational trophoblast neoplasia (GTN). It is a treatable gynecological tumor, but nearly 10% of patients have a poor prognosis, especially when metastasis occurs^[1,2]。 Brain is one of the sites of choriocarcinoma metastasis, and about 60% of patients with brain metastasis have secondary intraparenchymal hemorrhage^[3]。 Heze Municipal Hospital admitted a patient with brain metastasis of choriocarcinoma complicated by cerebral hemorrhage in November 2017. The report is as follows.

Chondrosarcoma often occurs in the long bones and pelvis, and its intracranial incidence is less than 10%^[1]。 Intracranial chondrosarcoma is a rare malignant tumor originating from cartilage tissue, accounting for about 0.15% of intracranial tumors. The disease often occurs in the skull base, accounting for about 6% of skull base tumors; The peak incidence was 30-50 years old, and there was no gender difference^[2]。 The clinical manifestations of intracranial chondrosarcoma are not specific, and the most common clinical manifestations in patients with skull base are dizziness and diplopia. Intracranial chondrosarcoma is slow-growing but locally invasive, and can cause fatal complications if it compresses or invades surrounding structures such as the brainstem^[3]。 Distant metastasis of intracranial chondrosarcoma is rare. Although the prognosis of this disease is quite different from that of chordoma, it is difficult to distinguish between the site of occurrence, imaging and histopathological characteristics^[4]。 Common skull base chondrosarcoma is difficult to resect, and it is insensitive to classical radiotherapy. The effective treatment method needs to be further explored^[5]。 This article will review the recent progress in the diagnosis and treatment of intracranial chondrosarcoma.

Cranial nerve root diseases include idiopathic hemifacial spasm, primary trigeminal neuralgia, and primary glossopharyngeal neuralgia. Because the cerebellopontine angle vessels compress different cranial nerve roots into or out of the brainstem area (root entry/exit zoon, REZ), that is, neurovascular compression or aseptic inflammatory reaction adhesion causes local nerve demyelination, and abnormal nerve impulse conduction leads to the syndrome of hyperexcitation and hyperfunction of corresponding cranial nerves. microvascular decompression (MVD) is a safe and effective surgical method for the treatment of cranial nerve root diseases, and has been widely recognized by scholars at home and abroad. Cranial nerve root disease is more common in middle-aged and elderly patients. Because it is often combined with hypertension, atherosclerosis and other diseases, it is easy to lead to long and tortuous intracranial blood vessels and focal arteriosclerosis, which then compresses cranial nerves to produce corresponding clinical symptoms. When the patient is ≤18 years old, it is called juvenile cranial nerve root disease, which is clinically rare and has the same pathogenesis as that of adults, mainly neurovascular compression. However, adolescent patients usually have no underlying diseases such as hypertension and atherosclerosis, so the mechanism leading to neurovascular compression may be different, and there are many differences from adults in surgical strategy, intraoperative findings, postoperative efficacy and complications. This article reviews the recent studies on cranial nerve root diseases in adolescents.

traumatic brain injury (TBI) is a brain tissue injury caused by trauma. It has a high disability rate and mortality rate, and its injury mechanism is complex, involving cell necrosis and apoptosis, inflammatory reaction, glial cell activation, fibrous scar formation, etc. In the past, the treatment methods of TBI mainly included neurotrophic factor therapy and cell replacement therapy, but the clinical effect was not good. The detailed mechanism of pathogenesis of TBI and its repair therapy have become one of the hotspots in neuroscience research in recent years. Studies have found that exosomes derived from marrow mesenchymal stem cells (MSCs) can promote nerve regeneration and repair. Therefore, the application and research progress of exosomes derived from MSCs in the treatment of TBI are reviewed in this paper.