OBJECTIVE:To observe the clinical effect of Shu’nao capsules for cerebral edema.METHODS:42preoperative patients with glioma above tentorium of cerebellum and meningioma complicated with cerebral edema were randomly divided into control group and treatment group:the control group was assigned to receive carbamazepine and VitB 6 ,and the treatment group to receive Shu’nao Capsules in combination with the drugs as stated in the control group for an average of4.5d,during which the clinical symptoms and urine volume changes were monitored.RESULTS:The effective rates of the treatment group and the control group against headache or dizziness were85.00%and27.27%,respectively(P

Objective To investigate the surgical method of treating the third ventricle cysticercosis with neuroendoscopy and to discuss the related problems. Methods Clinical data of 7 cases of the third ventricle cysticercosis from July 2009 to December 2014 were retrospectively analyzed. Patients aged from 12 to 49 and all of them received endoscopic resection of the third ventricle cysticercosis and orally taken Albendazole after surgery. Results The symptoms of high intracranial pressure in patients show different levels of releasing, except 1 case with postoperative fever symptoms, the other patients had no other palpable complications. After rechecked by CT and MRI, the size and shape of ventricle of all patients improved to varying degrees and hydrocephalus symptoms was relieved that all cases were satisfactory. Conclusions The treatment of neuroendoscopy aimed to the third ventricle cysticercosis is simple, safe and with less postoperative complications, which should be the preferred treatmnt to the third ventricle.

Objective To investigate the clinical utility of keyhole craniotomy for Cholesteatmas in the cerebello-pontine angle region presenting as Trigeminal neuralgia by using keyhole craniotomy. Methods Clinical data of 35 pa-tients with Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia was analyzed retrospec-tively. All patients received suboccipital retrosigmoid keyhole craniotomy. Thirty cases who received conventional craniot-omy group were served as control group. A comparative analysis was conducted to assess the difference between these two groups in microsurgical methods, effects and complications. Results All patients were confirmed with MR diagnosis. In keyhole group, all patients had no pain symptoms of trigeminal neuralgia after surgical operation. The symptoms disap-peared immediately in 33 cases and gradually disappeared in 2 cases within one month following keyhole craniotomy. The tumors were totally removed in 25 cases and almost completely in 10 cases. The surgical duration was shorten in key-hole group than in conventional group (126±48 vs. 216±66 min;t=2.536, P<0.05). The amount of bleeding was smaller in keyhole group than in conventional group (91.3±52.2 vs. 186.3±65.4 mL;t=2.163, P<0.05). Postoperative neurologi-cal function was assessed in House-Brackmann. In keyhole group, there were 32 cases in class Ⅰ and 3 in grade Ⅱ. Two patients had hearing loss which was improved gradually in three months. In conventional group, there were 25 cases in class Ⅰ and 5 in grade Ⅱ (χ2=4.158, P<0.05). Postoperative hearing evaluation (AAO-HNS) revealed that there were 33 cases in grade A , and 2 in grade B in the keyhole group, whereas there were 27 cases in grade A and 3 in grade B in the conventional group(χ2=5.167, P<0.05). There were no relapse of tumors and death during 3 month to 5 years follow-up. Conclusions The suboccipital retrosigmoid keyhole craniotomy is a valid choice for Cholesteatmas in the cerebellopontine angle region presenting as Trigeminal neuralgia.

Objective To determine the contents and dynamics of excitatory amino acids (EAAs), glutamate (GLU) and aspartate (ASP) in the cerebrospinal fluid (CSF) of patients with acute head injury and to clarify the relationship of EAAs with clinical features and outcomes.Methods Forty-two adults with acute head injury were included. Glasgow coma scale (GCS) obtained at admission and Glasgow outcome scale (GOS) obtained three months post-injury were assessed. Samples of CSF were obtained via ventricular or lumbar puncture every 24 hours. GLU and ASP in CSF were analyzed by reversed-phase HPLC with a fluorescent detector. Nine control subjects were adults with lumbar anesthesia but without neurological diseases.Results The peak concentration of GLU and ASP of head-injured group was significantly higher than that of the control group. Dynamic research on severely injured ones indicated that the peak value of GLU mostly appeared within 48 hours post-injury; it decreased with the improving or remaining of the neurological status, and increased with the deterioration, but was still higher than that of the control seven days post-injury. The peak value of EAAs of severely injured patients was conspicuously higher than that of mildly injured group. There was a significant negative correlation between the peak values of GCS and EAAs. The peak value of EAAs in patients with poor outcome was remarkably higher than that in patients with good outcome. GOS was closely correlated to the peak value of EAAs. When the concentration of GLU was over 7 μmol/L, the rate of poor-outcome increased markedly. Conclusion The content of EAAs in CSF increases following acute head injury and remains higher at least a week post-injury in severely injured patients. The more severe the trauma, the more obvious the excitotoxicity induced by EAAs; the more serious the secondary brain insult and the brain edema will be, the worse the outcome, naturally.

OBJECTIVE: To investigate the efficacy of endoscopic third ventriculostomy (ETV) for infantile hydrocephalus. METHODS: Retrospectively reviewed the 17 infantile hydrocephalus cases who were treated with ETV between July 2009 and June 2013. The study includes 17 patients (4 Han and 13 Hui) between the ages of 51 and 337 days. Five cases with encephalitis history and 2 cases with cerebral hemorrhage, with the remaining 10 cases congenital hydrocephalus. ETVs were performed for all patients with 1 case failing because the severe ventricle inflammatory adhesion, excessive exudation, and vague basilar artery. RESULTS: Among the 16 successful cases 7 cases improved remarkably : heads and ventricles reduced and cerebral cortexes thickening morphologically. The ventricles of the remaining cases were unchanged. CONCLUSION: The ethnic minority account for the majority of the patients in this study. ETV is effective for infantile obstructive hydrocephalus.
Basilar Artery ; Cerebral Cortex ; Cerebral Hemorrhage ; Encephalitis ; Head ; Humans ; Hydrocephalus* ; Infant ; Retrospective Studies ; Ventriculostomy*

Focal cortical dysplasia(FCD)is one of the most common etiologies leading to drug-resistant epilepsy(DRE),and its neuroimaging features are an important part of clinical evaluation.Only some types of FCD can show abnormalities on MRI,and there are still many difficulties in the diagnosis and treatment of MRI-negative FCD.Morphology-based image post-processing technology is developing rapidly,and various image post-processing tools to assist diagnosis and treatment,such as Matlab,3D slicer,SinoPlan,MRIcro,etc.,are increasingly favored by the majority of scholars in epilepsy surgery,which can not only strip and 3D reconstruct abnormal lesions shown by MRI,but also assist in the appearance of potential abnormal sites which are difficult to recognize with the naked eye.This has greatly improved the detection rate of FCD foci and further met the demand for accurate diagnosis and treatment of FCD,thereby creating new ideas and methods for the diagnosis and treatment of intractable epilepsy,and providing more references for more comprehensive and scientific clinical diagnosis and treatment.