OBJECTIVE: To explore the treatment and pathophysiology of extra-axil cerebrospinal fluid accumulation aft er skull surgery. METHODS: The treatment of 46 cases of pineal regional tumor was retrospectively studied. RESULTS: The CT showed that all patients had postoperative extra-axil cerebrospinal fluid accumulation in 6 hours after operation. 5 cases displayed symptomatic accumulation of extra-axil cerebrospinal fluid. 1 died 30 days aft er discharge, 4 performed S-P shunt and 3 of them switched to V-P shunt after S-P shunt failed. CONCLUSION Much more attention should be paid to postoperative accumulation of extra-axil cerebrospinal fluid. Both V-P and S-P are the effective strategies of therapy.
Cerebrospinal Fluid Shunts ; Humans ; Pinealoma ; cerebrospinal fluid ; surgery ; Postoperative Period ; Retrospective Studies ; Skull ; surgery

Intracranial Rosai-Dorfman disease (RDD) is a rare clinical histiocytosis proliferative disease. A 12-year-old boy with dizziness and headache for 1 month was admitted into Pediatric Neurosurgery of Xiangya Hospital, Central South University. The patient underwent total tumor resection and postoperative application of hormones and chemotherapy. During follow-up of 8 months, patient's condition was stable and no tumor recurrence was observed. For patient with a trend of tumor progression, stereotactic biopsy can help to confirm the diagnosis and determine the surgical strategy such as disposal of bone flaps. The treatment is mainly based on surgical intervention, supplemented by radiotherapy, chemotherapy and hormone therapy. Without affecting the nerve function, the surgeon should try to completely resect the tumor.
Biopsy ; Child ; Histiocytosis, Sinus ; Humans ; Male ; Neurosurgical Procedures ; Postoperative Period

To explore the clinical characters, treatment and prognosis for pediatric optic pathway gliomas (OPGs).
 Methods: A total of 26 patients with OPGs, who were diagnosed and treated at Neurosurgery of Xiangya Hospital of Central South University between June 2010 and November 2017, were retrospectively reviewed, and their average age was 5.5 years old. The influential factors for patients' progression-free survival (PFS) and overall survival (OS) were analyzed.
 Results: All patients were classified into Type II and Type III based on Dodge classification and received surgery treatment. Vision was improved after surgery in 20 patients. Twenty-four patients (92.3%) were continually followed up, and 14 patients (58.3%) received post-radiation treatment. Twenty-one patients were still alive and 15 patients' symptoms were not progressed. The PFS and OS in patients received radiation therapy were better than those without radiation therapy (PFS: P<0.01; OS: P<0.05). The postoperative visual prognosis might be related to the choice of surgical approach.
 Conclusion: Treatment of children with OPGs should include surgery and postoperative radiotherapy. The eyesight protection in surgery is as important as tumor resection.
Child, Preschool ; Disease-Free Survival ; Glioma ; Humans ; Neurosurgical Procedures ; Prognosis ; Retrospective Studies

Tumor-associated macrophages （TAMs）， as the main immune cells in the human body， are key factors in maintaining the homeostasis of the tumor microenvironment. With high plasticity， they can polarize into the classically activated （M1） macrophages or alternatively activated （M2） macrophages under different conditions. M1 macrophages can inhibit tumor growth by phagocytosis， and M2 can inhibit the immune microenvironment to promote tumorigenesis and immune escape. Small molecules of traditional Chinese medicine have been widely studied in gastrointestinal tumors. These small molecules exert anti-tumor activity by enhancing TAM activity and promoting the polarization of macrophages. Targeted intervention in TAMs with these molecules has the potential to inhibit the development of gastrointestinal tumors. This article summarizes the research status and significance of small molecules of traditional Chinese medicine targeting TAMs against gastrointestinal tumors， aiming to provide reference for the future studies in this field.

OBJECTIVE: To evaluate the time and effect of shunt operation on cryptococcal meningitis.
 METHODS: A total 7 patients received shunt operation for the therapy of cryptococcal meningitis patients and the data was retrospectively analyzed.
 RESULTS: Intracranial hypertension-caused symptoms were resolved immediately. There was no complication, no infection dissemination and no recrudescence of cryptococcal meningitis. 
 CONCLUSION Shunt operation is effective for intracranial hypertension caused by cryptococcal meningitis. It does not affect the antifungal treatment.
Antifungal Agents ; therapeutic use ; Drainage ; Humans ; Intracranial Hypertension ; surgery ; Meningitis, Cryptococcal ; drug therapy ; surgery ; Recurrence ; Retrospective Studies