Objective To analyze the indication,ways,therapeutic effect,dose prescription and complication of skull base tumor treated by Gamma Knife.Methods Clinical data,including general information,method of treatment and therapeutic effect of 278 benign skull base tumors treated by Gamma Knife were studied retrospectively.Results All patients were followed up for at least 2 years.The clinical conditions improved significantly in 130 patients,remained stable in 125 patients,and worsened in 23 patients.The 5 years progression-free survival rate was 89.5%(249/278)by Kaplan-Meier analysis.The results of Log-rank analysis revealed that better results appeared in patients with smaller tumors.≤3 cm compared with those tumors＞3 am(X2=5.41,P=0.02),and in patients experiencing tumor resection compared with those without history of su~ery respectively(X2=3.96,P=0.047).10 of the 11 cases with tumors＞3 cm who were treated by volume-staged prescription achieved local tumor control.Brain edema occurred in 3 patients,apoplexy of tumor in 1 patient,hydrocephalus in 3 patents,dysfunction of cranial nerves in 12 patients.Conclusion For skull base tumor,Gamma Knife is a major choice,with low risk and maybe an alternative for those small tumors.For those residues after craniotomy,Gamma Knife maybe an auxiliary treatment,and it can be cautiously applied in those with large tumors who cannot tolerate surgery for various reasons.

BACKGROUND:Repairing integrity of the dura mater is very important for the prognosis of patients with convex meningioma.
OBJECTIVE:To investigate the application value of bio-artificial dura mater on giant convex meningioma.
METHODS:The retrospective analysis of 56 cases of dural defects due to tumor erosion in patients with giant convex meningioma was carried out. Meanwhile, the clinical efficacy, complications and fol ow-up results of the repair with artificial dura mater were analyzed.
RESULTS AND CONCLUSION:Except two cases complicated with local effusion, one case with a smal volume of subdural effusion in operative side, one case with tardive epidural hematoma, the remaining patients had no cerebrospinal fluid leakage, intracranial infection, epilepsy, tissue rejection and other adverse reactions. Postoperative CT and MR examinations confirmed the site of implantation of artificial dura without abnormal radiographic changes. Five patients underwent cranioplasty of skul repair in 3 months postoperatively, and the intraoperative findings showed that the artificial dura mater had a good fusion with normal dura mater, with no adhesions and inflammatory reactions. These findings indicate that bio-artificial dura mater can reshape the original anatomical level, protect the cerebral cortex, and reduce the incidence of various complications significantly.

Objective To investigate the expression of angiopoietin 2 gene in glioma and its relationship with angiogenesis.Methods The expression of angiopoietin 2 were examined by RT-PCR in 52 cases of glioma and 8 normal brain tissues.The vascular development was measured by microvessel count(MVC) which was immunostained with anti-CD34 monoclonal antibody.Results The expression of ang2 mRNA was found in 50 cases of gliomas and 8 normal brain tissues,and the expression of ang2 mRNA was significantly positively correlated with MVC(r=0.821,P

Objective To explore the influence of peritumoral edema (PTE) on the tendency of recurrent location and morphological character after total resection using MRI. Methods MRI data was collected from 43 patients with recur-rent brain glioma after total resection from four clinical centers and then the influence of of PTE on recurrence patterns af-ter total resection was retrospectively analyzed based on the T2 weighted image. Results The PTE had a significant influ-ence on the recurrent patterns of brain gliomas after total resection. When PTE was mild, the shapes of recurrent gliomas tended to be focal (6/8) and the recurrent locations tended to be local (5/8). When PTE was severe, the shapes of the recur- rent gliomas tended to be spread(30/35 and the recurrent locations tended to be distant (25/35), followed by marginal (7/35), In addition, the morphological patterns and locations of recurrent gliomas were significantly different among different PTE types (all P<0.001). When PTE was ring shape, the shapes of recurrent gliomas tended to be focal (7/9) and the recur-rent locations tended to be local (6/9), followed by marginal (2/9) and distant (1/9). When PTE was irregular shape, most of recurrent locations tended to be distant (25/34), followed by marginal (7/34) but rarely local (2/34). Conclusions The de-grees and the types of brain glioma PTE can significantly influence the locations and morphological patterns of recurrent gliomas after total resection.

Aim To explore whether 5-lipoxygenase inhibitor zileuton attenuates neuroinflammation and brain damage via modulating ERK1/2 signaling path-way in rats of cerebral ischemia, and further investigate the possible mechanisms. Methods Sprague-Dawley rats underwent the cerebral ischemic injury by the su-ture occlusion model, and were randomly divided into sham operation, MCAO, zileuton-treated and PD98059 groups. Neurological deficit scores, cerebral infarct volume, and cerebral water content were measured, myeloperoxidase ( MPO ) activities in rat brain were measured as an index of neutrophil infiltration;content of TNF-α in blood was determined by the method of ELISA;expression of p-ERK1/2 and t-ERK1/2 in rat brain were detected by Western blot. Results Zileu-ton reduced neurological deficit scores, cerebral infarct volume, cerebral water content, MPO activity and TNF-α content, all of which were abolished by PD98059 administration. Zileuton up-regulated the ex-pression of p-ERK1/2 , which was inhibited by PD98059 administration. Conclusions Zileuton at-tenuates neuroinflammation and ischemic brain damage through the activation of ERK1/2 signaling pathway.

Objective The purpose of this study was to assess the imaging features of newly diagnosed high-grade glioma and the effect of relevant factors such as postoperative radiotherapy and chemotherapy on progression-free sur-vival (PFS) time. Methods A total of 54 patients with recurrent high-grade glioma confirmed by pathology or progressive malignant glioma proved by clinical follow-up were included in this retrospective study from 4 clinical centers. The prog-nostic factors selected included MR image features at initial diagnosis (including the maximum diameter of tumor, peritu-moral edema, degree of enhancement, degree of necrosis and presence of cystic or satellite), postoperative radiotherapy and chemotherapy. Kaplan-Meier method and Cox’s proportion-hazards model were used to analyse the factors influenc-ing the progression free survival (PFS) time. Results The univariate Kaplan-Meier analysis revealed that the degree of peritumoral edema (PTE, P=0.001), degree of necrosis (P<0.001) , degree of enhancement (P<0.001), postoperative radio-therapy (P=0.008) and chemotherapy(P=0.035) were significant factors for PFS. Cox multivariate analysis also showed that the degree of PTE(P=0.019),degree of necrosis (P<0.001) were all significantly correlated with PFS. The less edema or necrosis was associated with the longer PFS. In addition, postoperative radiotherapy (P=0.035) and chemotherapy (P=0.049) were also significantly correlated with PFS. The normative chemotherapy and radiotherapy were associated with longer PFS. Conclusions The PTE and necrosis on preoperative MR images can be used to predict the PFS of glioma af-ter total resection. Adjuvant normative chemotherapy and radiotherapy should be recommend for supratentorial high-grade glioma including those even with MRI confirmed total resection.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*