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中华神经外科杂志（英文）

中华神经外科杂志（英文）

《中华神经外科杂志》是我国神经外科专业领域的高级核心期刊，总编辑为我国著名的神经外科专家、中国工程院院士王忠诚教授，他于1997年获“何梁何利基金”科学与成果奖，2001年在“世界神经外科联合会大会”上被授予世界神经外科“最高荣誉奖”。本刊编辑委员会由来自全国各地在神经外科领域有深厚造诣和学术成就的专家组成。办刊宗旨是：贯彻执行党和国家的卫生和出版工作方针政策，贯彻理论与实践相结合、普及与提高相结合的方针，反映我国神经外科临床科研工作重大进展，促进神经外科界的学术交流。该刊内容丰富，信息量大，涉及显微神经外科、颅底神经外科、血管内介入神经外科、小儿神经外科、脊柱脊髓神经外科、立体定向与功能性神经外科、立体定向放射外科、神经放射、基础研究等各个领域，有较高的学术权威性和学术导向性，内容重点报道神经外科领域的最新研究成果和最新动态，反映我国神经外科临床与科学研究的重大进展以及新技术、新经验和新方法，促进国内外学术交流。以广大神经外科医师、基础研究人员及相关领域的专业人员为主要读者对象。该刊设有专家述评、临床研究、经验介绍、专题讲座、技术改进、病例报告、论著、综述、争鸣、国内外学术动态等栏目。是我国神经外科专业学术交流的重要园地，是向世界展示我国神经外科最新成果的窗口。 作为中国科技论文统计源期刊，该刊被“中国科技论文与引文数据库”（CSTPCD）、“中文科技期刊数据库”（VIP）、“中国期刊数据库” （CNKI）、“中国生物医学文献数据库”（CBM）及“中国学术期刊文摘”、“中文科技资料目录”、“中国医学文摘”、“中国生物学文摘”等国内最具权威性和影响力的数据库和文摘期刊所收录。在
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  • 发文量：192
  • 被引量：9
  • H指数：0
  • 开始收录时间：2015,1(1)
  • CNKI综合因子：0.0
  • 维普期刊影响因子： 0.117
  • 万方期刊影响因子：0.04
  • 创刊时间：1985
  • 国内刊号/CN：10-1275/R
    国际刊号/ISSN：2095-9370
  • 发行周期：季刊
    邮发代号：
  • 主管单位：中国科学技术协会
    主办单位：中华医学会
中华神经外科杂志（英文）-联系信息
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  • 电话：010-67098478
  • 邮箱：CNJournal@126.com
  • 地址：北京市天坛西里26号
  • 邮编：100050
中华神经外科杂志（英文）-获奖情况
  • • 卓越计划期刊
  • • 1997年中国科协优秀科技期刊二等奖
  • • 1995年中华医学会成立80周年银奖
  • 收录汇总
  • 刊内文献检索
  • 投稿信息

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中华神经外科杂志（英文） >2022年第4期
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  • 摘要：Background: Cerebral cavernous malformations （CCMs）, a major neurosurgical condition, characterized by abnormally dilated intracranial capillaries, result in increased susceptibility to stroke. KRIT1 （CCM1）, MGC4607 （CCM2）, and PDCD10 （CCM3） have been identified as causes of CCMs in which at least one of them is disrupted in most familial cases. Our goal is to identify potential biomarkers and genetic modifiers of CCMs, using a global comparative omics approach across several in vitro studies and multiple in vivo animal models. We hypothesize that through analysis of the CSC utilizing various omics, we can identify potential biomarkers and genetic modifiers, by systemically evaluating effectors and binding partners of the CSC as well as second layer interactors.Methods: We utilize a comparative omics approach analyzing multiple CCMs deficient animal models across nine independent studies at the genomic, transcriptomic, and proteomic levels to dissect alterations in various signaling cascades.Results: Our analysis revealed a large set of genes that were validated across multiple independent studies, suggesting an important role for these identified genes in CCM pathogenesis.Conclusion: This is currently one of the largest comparative omics analysis of CCM deficiencies across multiple models, allowing us to investigate global alterations among multiple signaling cascades involved in both angiogenic and non-angiogenic events and to also identify potential biomarker candidates of CCMs, which can be used for new therapeutic strategies.
  • 摘要：Background: Giant serpentine aneurysms （GSA） originate from saccular or spindle aneurysm, dissimilar from dissected aneurysm, that are defined as partially thrombosed giant aneurysms with tortuous internal vascular channel. The clinical and neuroradiologic characteristics are clarified and the mechanism of formation and the efficacy of double stent implantation in GSA are discussed.Case presentation: An 18-year-old man presented himself with a GSA arising from the internal cerebral artery （ICA）. In addition, a mandibular aneurysm （MA） arose from the external cerebral artery （ECA）. Success was achieved in treating GSA through endovascular treatment with double stents implanted in the parent artery, which were LEO stent and Tubridge flow diverter. After 1 year of follow-up, three-dimensional reconstruction of blood vessels revealed the disappearance of the serpentine access of GSA, which was found to be replaced with a roughly normal vascular structure.Conclusions: Double stent implantation has provided a feasible treatment option for giant serpentine internal carotid aneurysms and eliminated the possibility of causing collateral circulation occlusion. Therefore, it represents a simple and suitable treatment method for anatomical structure and operation.
  • 摘要：Background: The purpose of this study is to report the treatment approaches and postoperative outcomes of extracranial carotid artery aneurysms （ECAAs） and discuss the symptoms, related risk factors, etiology, diagnostic methods, treatments, and follow-up period complications.Case presentation: We describe three patients with symptomatic extracranial carotid artery aneurysms; one of them was treated with end-to-end anastomosis of the extracranial internal carotid artery （EICA） after the resection of the aneurysm, while the other two patients were deployed with Willis covered stents in the extracranial internal carotid artery. All of the patients were in good condition when discharged home. After a mean follow-up period of 8 months, all the patients were alive and only one of them had the neurologic deficit. Additionally, we reviewed the relative literatures.Conclusion: Both of the surgical and endovascular treatments have relatively satisfactory outcomes in ECAA patients. However, it is necessary to provide individualized treatments to different patients according to the characteristics of the aneurysms.
  • 摘要：Background: In this retrospective single-center study, we presented our experience in the microsurgical management of incompletely coiled or recurrent aneurysms after initial endovascular coiling.Methods: During a 17-year period, 48 patients underwent microsurgical clipping of incompletely coiled or recurrent aneurysms after coiling （Gurian group B）. The clinical data, surgical technique, and postoperative outcome were recorded and analyzed.Results: Before coiling, 42 patients （87.5%） experienced aneurysm rupture. Most of the aneurysms （46/48, 96%） were located in the anterior circulation. After coiling, 6 patients had incompletely coiled aneurysms and 42 patients had recurrent aneurysms, with a mean time of 20.2 months from coiling to recurrence. Coil extrusion occurred in none of the incompletely coiled aneurysms and 71% （30/42） of the recurrent aneurysms. Clipping techniques are direct microsurgical clipping without coil removal in 16 patients, partial coil removal in 14 patients, and total coil removal in 18 patients. Postoperative and follow-up angiography revealed complete occlusion of the aneurysms in all patients. No patient died during postoperative follow-up period （mean, 78.9 months; range, 10–190 months）. Good outcomes （GOS of 4 or 5） were achieved in 87.5% （42/48） of the patients at the final follow-up.Conclusions: Microsurgical clipping is effective for incompletely coiled or recurrent aneurysms after initial coiling. For recurrent aneurysms that have coils in the neck, have no adequate neck for clipping, or cause mass effects on surrounding structures, partial or total removal of coiled mass can facilitate surgical clipping and lead to successful obliteration of the aneurysms.
  • 摘要：Transcranial magnetic stimulation （TMS） is a noninvasive neurophysiologic technique that can stimulate the human brain. Positioning of the coil was often performed based merely on external landmarks on the head, meaning that the anatomical target in the cortex remains inaccurate. Navigated transcranial magnetic stimulation （nTMS） combines a frameless stereotactic navigational system and TMS coil and can provide a highly accurate delivery of TMS pulses with the guidance of imaging. Therefore, many novel utilities for TMS could be explored due to the ability of precise localization. Many studies have been published, which indicate nTMS enables presurgical functional mapping. This review aimed to provide a comprehensive literature review on nTMS, especially the principles and clinical applications of nTMS. All articles in PubMed with keywords of "motor mapping," "presurgical mapping," "navigated transcranial magnetic stimulation," and "language mapping" published from 2000 to 2018 were included in the study. Frequently cited publications before 2000 were also included. The most valuable published original and review articles related to our objective were selected. Motor mapping of nTMS is validated to be a trustful tool to recognize functional areas belonging to both normal and lesioned primary motor cortex. It can offer reliable mapping of speech and motor regions at cortex prior to operation and has comparable accuracy as direct electrical cortical stimulation. nTMS is a powerful tool for mapping of motor and linguistic function prior to operation, has high application value in neurosurgery and the treatment of neurological and psychiatric diseases, and has gained increasing acceptance in neurosurgical centers across the world.
  • 摘要：Background: About 10 million individuals suffer from traumatic brain injury （TBI） each year in the world, which is one of the most serious neurological disorders. The morbidity of TBI is 55.5～6.1/100,000 in China, which takes more costing in the therapy, and the outcome of that is not well. Therefore, we expect to find new methods to treat TBI and improve the outcomes of TBI. In the previous studies reviewed, we found that stem cell transplantation may hold promising potential for modifying motor dysfunction induced by TBI.Methods: Twenty-six adult SD rats were involved in our study. Two adult SD rats were used as donors of bone marrow stem cells （BMSCs）, and the other adult SD rats were divided into four groups randomly, which were used to establish the TBI models. BMSCs were transduced with lentivirous-Sox2, and we try to examine the effects of Sox2 on the differentiation of BMSCs.Establishment of rat TBI model: Rats were anesthetized using pentobarbital sodium （at a concentration of 1.5% and a dose of 40 mg/kg） and fixed under the stereotaxic device. A 1.0-cm craniotomy was performed lateral to the sagittal suture. The skullcap was carefully removed, and rats were then subjected to TBI using a controlled cortical injury instrument. A standardized parietal contusion was performed using a 20-mg steel rod with a diameter of 4 mm, which dropped from a height of 30 cm. After injury, the incision was sutured, and rats were carefully observed and nursed.Treatments: Seven days after TBI, rats were divided into four groups and were transplanted with BMSC-Sox2, single BMSC, single Lentivirus-Sox2, and PBS into injured brain, respectively. The motor function was tested using the neurological severity score （NSS）.Results: We found that the ectopic expression of Sox2 enhanced BMSCs to differentiate into neurons. Seven days after TBI, the rats were treated with BMSC-Sox2, BMSC, Sox2, and PBS. Results showed that NSS were 3.352 ± 0.398 in the BMSC-Sox2 group, 4.013 ± 0.495 in t
  • 摘要：Background: A large craniotomy is usually the first choice for removal of traumatic acute subdural hematoma （TASDH）. To date, few studies have reported that TASDH could be successfully treated by twist drill craniostomy （TDC） alone or combined with instillation of urokinase. We aimed to define the TDC for the elderly with TASDH and performed literature review.Case presentation: A total of 7 TASDH patients, who were presented and treated by TDC in this retrospective study between January 2009 and May 2017, consisted of 5 men and 2 women, ranging in age from 65 to 89 （average, 78.9） years. The patients’ baseline characteristics, including age, sex, medical history, received ventriculoperitoneal shunt for hydrocephalus or not, reason for avoiding or refusing large craniotomy, preoperative Glasgow Coma Scale （GCS）, suffered from cerebral herniation or not, the location of TASDH, imaging characteristics of TASDH in CT scan, injury/surgery time interval, midline shift, preoperative neurologic deficit, operation time, and infusions of urokinase or not, were collected. The postoperative GCS, postoperative neurologic deficit, rebleeding or not, intracranial infection, and modified Rankin Scale （mRS） at 6 months after surgery were analyzed to access the safety and efficacy of evacuation with TDC. The results showed that the mean time interval from injury to TDC was 68.6 min （30–120 min）. The mean distance of midline shift was 14.6 mm （10–20 mm）. The preoperative GCS in all patients ranged from 4 to 13（median, 9）. The mean duration of the operation was 14.4 min （6–19 min）. Postoperative CT scan showed that hematoma evacuation rate was more than 70% in all cases. There were no cases of acute rebleeding and intracranial infection after TDC. No cases presented with chronic SDH at the ipsilateral side within 6 months after being treated by TDC alone or combined with instillation of urokinase. Favorable outcomes were shown in all cases （mRS scores 0–2） at 6 months after surgery.Con
  • 摘要：Background: Pineal cysts （PCs） are a benign lesion of the pineal gland that have been known to the medical community for a long time. With a prevalence rate of approximately 1% in the general population, PC is often a reason for medical counseling. The natural course of PC morphology has not been well described. In this study, we present a longitudinal magnetic resonance imaging （MRI） study of patients with PCs, with special focus on those who showed an increase or decrease in PC size.Methods: We enrolled all patients with a PC who were referred to our department between January 2000 and January 2018. Each patient underwent a clinical examination, and the patient’s age, sex, and presenting signs and symptoms were noted. MRI was performed during periodic examinations, and a clinical and radiological course was reassessed.Results: In total, 133 patients （99 women, 34 men） were enrolled. The mean maximum diameter was 12.7 ± 5.2 mm （range 7–35 mm）. PCs increased in size during the follow-up in seven patients （5.3%） and decreased in size in 10 （7.5%）. The remaining cysts （n = 116, 87.2%） were stable over the follow-up period. Analyzing patients according to cyst size change, we found a significant difference in the mean age between the PC progression group and PC regression group （p= 0.01）. The mean size of the PCs at the time of diagnosis did not differ significantly between the two groups （p = 0.81）. We diagnosed two cases of pineal apoplexy.Conclusion: We found that PCs are a dynamic structure that may change in size during the patient’s lifetime. Patients with an increase in PC size were significantly younger than patients with a decrease in size. Therefore, PC growth in the first, second, and third decennium is normal and does not justify medical intervention. Surgery is indicated in cases of hydrocephalus and Parinaud’s syndrome or in atypical cysts when neoplasia is suspected. The size of a PC does not predict PC behavior in terms of a future increase or decrease
  • 摘要：In modern neuroscience, the most relevant is the study of the problem of reinnervation of tissues after severe injuries. Complete restoration of lost physiological functions is still impossible with lesions of peripheral nerves with the formation of extensive diastasis between their proximal and distal sites. In this case, the standard neurorrhaphy cannot be carried out because of the eruption of the filaments during tension and convergence of the ends.
  • 摘要：Glioblastoma multiform （GBM） is the most common malignant brain tumor characterized by poor prognosis, increased invasiveness, and high relapse rates. The relative survival estimates are quite low in spite of the standard treatment for GBM in recent years. Now, it has been gradually accepted that the amount of tumor mass removed correlates with longer survival rates. Although new technique advances allowing intraoperative analysis of tumor and normal brain tissue and functional paradigms based on stimulation techniques to map eloquent areas have been used for GBM resection, visual identification of tumor margins still remains a challenge for neurosurgeons. This article attempts to review and summarize the evolution of surgical resection for glioblastomas.
  • 摘要：Background: Many neurophysiological diseases during infancy stage are associated with the morphology and size of the lateral ventricle. This research aims to measure the normal value range of lateral ventricle volume of normal infant and thus provide basic data for clinical treatment.Method: By retrospective analysis of magnetic resonance inspection （MRI） cranial image of 165 infants in the Department of Pediatric Neurosurgery, Beijing Tiantan Hospital, the infants were divided into four groups according to their age, including the first group （1～3 month,n = 12）, the second group （4～6 month,n = 33）, the third group （7～9 month,n= 51）, and the fourth group （10～12 month,n = 69）. On Neurosoft image workstation, it can measure the sectional area of the lateral ventricle volume at each layer of axis T2W image and calculate the lateral ventricle volume using the Cavalieri method. Moreover, the correlations between lateral ventricle volume and gender, side difference, and month age were analyzed.Results: 95% confidence interval of total bilateral ventricle volume of normal infant: 11920.22～14,266.28 mm3 for male infant and 9922.22～12,263.17 mm3 for female infant; 95% confidence interval of left side ventricle volume: 6254.72～7546.94 mm3 for male infant and 5206.03～6479.99 mm3 for female infant; 95% confidence interval of right side ventricle volume: 5041.56～6743.29 mm3 for male infant and 4695.00～5804.40 mm3 for female infant. The lateral ventricle volume of the male infant was normally larger than that of the female infant （p ＆ 0.05）. For both male and female infants, the left side ventricle volume was larger than the right ventricle volume （p ＆ 0.01）. There was no significant difference in lateral ventricle volume between infants over 3 months old.Conclusion: The normal value range of lateral ventricle volume of the infant can be obtained via referring MRI image. The lateral ventricle volume of infant varies upon gender and ventricle side.
  • 摘要：Background: Retinitis pigmentosa （RP） is one of the most severe hereditary retinal disorders with a worldwide prevalence reaching 1 in every 3000-5000 people and a total of almost one million affected individuals. RP is heterogeneous in its clinical presentations but typically presents as progressive visual dysfunction, including nyctalopia in adolescence, restricted peripheral vision （tunnel vision） in young adults, and loss of central vision at an advanced age.Case description: Herein, we want to report a case of RP who presented with gradual worsening of vision and headache, and further evaluation revealed a concomitant non-functional pituitary macroadenoma. Ophthalmologic evaluation revealed a little chance for him to regain his vision, so the patient refused to undergo endoscopic surgical resection. However, he is still under clinic-radiologic follow-up, to be evaluated for progression in tumor size and obstructive hydrocephalus.Conclusion: Presenting with similar symptoms of tunnel vision, the simultaneous occurrence of these two diseases in a patient may delay the diagnosis of the latter, leading to its progression.
  • 摘要：Traumatic brain injury （TBI） is exceptionally prevalent in society and often imposes a massive burden on patients’ families and poor prognosis. The evidence reviewed here suggests that gender can influence clinical outcomes of TBI in many aspects, ranges from patients’ mortality and short-term outcome to their long-term outcome, as well as the incidence of cognitive impairment. We mainly focused on the causes and mechanisms underlying the differences between male and female after TBI, from both biological and sociological views. As it turns out that multiple factors contribute to the gender differences after TBI, not merely the perspective of gender and sex hormones. Centered on this, we discussed how female steroid hormones exert neuroprotective effects through the anti-inflammatory and antioxidant mechanism, along with the cognitive impairment and the social integration problems it caused. As to the treatment, both instant and long-term treatment of TBI requires adjustments according to gender. A further study with more focus on this topic is therefore suggested to provide better treatment options for these patients.
  • 摘要：Background: Spinal cord ischaemia animal models were established by selective ligation of the lumbar artery in a craniocaudal direction between the renal artery and the aortic bifurcation. Transcranial electrical stimulation motorevoked potentials were measured to enable their use in future studies on spinal cord ischaemia protection.Methods: Thirty-three New Zealand rabbits were randomly divided into 6 groups. Transcranial electrical stimulation motor-evoked potentials were recorded before vascular ligation, 30 min after vascular ligation, and 2 days after vascular ligation. Motor functions were assessed after surgery and 2 days after vascular ligation. The specimens were taken 2 days after ligation for histopathologic observation.Results: With increased numbers of ligations, a transient extension of the latency became clear, but there were no significant differences in the statistical analysis. Analysis of variance after ligation at the same time in each group andt tests before and after ligation （P ＆ 0.05） were not significant. One or 2 ligations did not cause spinal cord ischaemic damage. There were no significant differences before and after ligation for the amplitude （P ＆ 0.05）. With increased numbers of ligations, the amplitude before and after ligation was gradually reduced in the 3-5 ligation groups （P ＆ 0.05）.Conclusions: Ligation of segmental spinal cord vessels on 1 or 2 levels did not cause ischaemic damage. Spinal cord ischaemia was observed after 3, 4, or 5 ligations. The amplitude was more sensitive to spinal cord ischaemia than latency. Spinal cord function can be predicted by early changes in the amplitude.
  • 摘要：Background: Pediatric epidural hematomas （EDH） represent a neurosurgical emergency. Both surgical and conservative treatment can lead to a good clinical outcome. The aim of the study was to review our series of pediatric EDH and to determine the clinical and radiologic factors, which can influence the final outcome.Methods: All children aged from 0 to 16 that have been treated between 2013 and 2017 for cranial EDH have been selected.Results: Thirty children have been included in the study. Seventeen cases have been treated with surgical evacuation and 13 conservatively. Six months after the trauma, the outcome was excellent （mRS 0） in 25/30 （83.3%） cases, mild deficits （mRS 1-2） were present in 4/30 （13.3%）, and severe deficits （mRS 3-5） in 1/30 （3.3%） cases. Only a GCS （Glasgow Coma Scale） below 8 at admission was significantly related to the presence of a neurologic deficit at 6 months （p= 0.048）.Conclusions: EDH can be managed with excellent outcomes. Even in the presence of bad initial clinical and radiologic conditions, a correct treatment strategy can lead to a good recovery. In our series, only a GCS below 8 at admission was significantly related to the presence of neurological sequelae.
  • 摘要：Background: Dysregulation of microRNAs （miRNAs） plays a critical role during the occurrence and progress of pituitary adenomas （PAs）. However, the roles of miRNAs in the invasiveness of PA are poorly understood. This study aims to more comprehensively and specific define the relationship between altered miRNA and PA invasion.Methods: The differential expression of miRNAs （DEMs） between invasive PAs （IPAs） and non-invasive PAs （NPAs） was explored by RNA sequencing and which functions were analyzed by gene ontology （GO） as well as Kyoto Encyclopedia of Genes and Genomes （KEGG）. The miRNA-mRNA network was predicted with bioinformatics.Results: We identified 31 upregulated miRNAs and 24 downregulated miRNAs in IPAs compared with NPAs. GO analysis and KEGG pathway analysis showed the DEMs were mainly associated with cell proliferation and cell cycle pathway. In addition, on the count of predicted miRNA-mRNA network, two hub miRNAs were identified.Conclusions: Our results demonstrate the miRNA-mRNA network in detail, which suggest that miRNA may be a promising target in diagnosis and therapy for IPAs.
  • 摘要：Background: Intraparenchymal cerebral cavernous malformation is difficult to localize intraoperatively with conventional frameless navigation due to the "brain shift" effect. We conducted this study to evaluate the efficacy and safety of intraoperative magnetic resonance image （iMRI）-assisted neuro-port surgery for the resection of cerebral intraparenchymal cavernous malformation.Methods: Between April 2016 and December 2017, 54 consecutive patients with intraparenchymal cerebral cavernous malformation who get surgical treatment in our hospital were enrolled into this study. Twenty-one patients were treated using iMRI-assisted neuro-port surgery （experiment group）, and 33 patients underwent treatment by conventional microsurgery （control group）. The iMRI was used in all cases for the compensation of the "brain shift" effect and keeping the navigation system up-to-date. The surgical resection rate, the total operation time, and the preoperative and postoperative Karnofsky Performance Status （KPS） scores were determined to evaluate the operative procedures.Results: There were no significant differences between the two groups in mean age, gender ratio, and volume of lesions （P ＆ 0.05）. For the experiment group, the average duration of the procedure was 188.8 min with total resection of the lesions achieved in all 21 cases. For the control group, the average duration of the procedure was 238.2 min with total resection of the lesions achieved in 25 of 33 cases. The differences in the average duration of the procedure and the number of totally resected lesions between the two groups were statistically significant （P ＆ 0.05）. Regarding postoperative neurological function, postoperative KPS scores for the experiment group were significantly higher than those of the control group （P = 0.018）.Conclusion: Our results show that iMRI-assisted neuro-port surgery is helpful for intraparenchymal cerebral cavernous malformation surgery. The method provides high accuracy and ef
  • 摘要：Background: The detection of a feeder aneurysm and an arteriovenous malformation （AVM） is relatively rare for the intracranial AVM. The distal posterior inferior cerebellar artery aneurysm （DPICAAn） is reported to coexist or relate with the cerebellar AVM. In previous reports about the treatment of a DPICAAn and a cerebellar AVM, endovascular embolization with the sacrifice of the posterior inferior cerebellar artery （PICA） has often been selected. However, there have been few reports of simultaneous open surgery for coexistent cases of DPICAAn and cerebellar AVM.Case description: A 67-year-old male presented with a headache. We detected a right DPICAAn in the telovelotonsillar segment and a cerebellar AVM primarily fed by the left superior cerebellar artery （SCA）. In addition, the nidus was located medially in the left upper cerebellar hemisphere. Magnetic resonance imaging raised suspicions of asymptomatic past hemorrhage in the cerebellar AVM. The left PICA was agenesis, and the right PICA perfused the bilateral inferior cerebellar hemispheres; thus, the right PICA could not be sacrificed. We selected open surgery to prevent any hemorrhagic event from the DPICAAn and the cerebellar AVM. The cerebellar AVM was completely removed, and the DPICAAn was successfully clipped in a single-session open surgery.Conclusions: Open surgery can be considered for DPICAAn and cerebellar AVM. The anatomical location of the DPICAAn and AVM contributed to the success of a single-session open surgery.
  • 摘要：Background: As chordomas are slow growing and locally invasive with high recurrence rates, initial recommendations include complete surgical resection with or without radiation therapy. A large proportion of recurrences occur years after initial resection necessitating lengthy follow-up. The novel biomarker brachyury and the repurposing of pharmaceutical products have the potential to substantially impact long-term recurrence rates.Case presentation: A 43-year-old woman presented with an isolated, cervical extraosseous intradural extramedullary chordoma attached to a nerve root underwent a C3-5 laminectomy, C3-5 lateral mass screw instrumentation, and mass resection. All symptoms resolved by the 12-month postoperative follow-up visit.Conclusions: This is the first report of an isolated, cervical extraosseous intradural extramedullary chordoma attached to a nerve root, and this case adds to the previous six Type IV chordomas in the literature. Unfortunately, the very rare form of extraosseous intradural chordoma is poorly understood: the lack of detailed knowledge in how they are differentiated from other forms of chordoma confounds the development of optimal treatment strategies and follow-up guidelines.
  • 摘要：Plasma is an ionized gas. It is typically formed at high temperature. As a result of both the development of lowtemperature plasma sources and a better understanding of complex plasma phenomena over the last decade, "plasma medicine" has become a booming interdisciplinary research topic of growing importance that explores enormous opportunities at the interface of chemistry, plasma physics, and biomedical sciences with engineering. This review presents the latest development in plasma medicine in the area of the central nervous system and aims to introduce cutting-edge plasma medicine to clinical and translational medical researchers and practitioners.
  • 摘要：Background: There is associating with incidence of unfavorable outcomes compared to microsurgical clippings. We are in order to investigate the outcomes of microsurgical clipping for intracranial aneurysms and determine the ideal clipping methods for different aneurysm subtypes.Method: Retrospectively analyzed the clinical characteristics and follow-up data （completely recorded） of 123 patients with 128 aneurysms were treated. 20 cases were treated as control group from October 2013 to December 2013. Since January 2014, aneurysms were classified base on the 20 cases of aneurysm imaging data. 103 patients were treated as experimental group, the classification of aneurysms previously proposed was used to estimate the way of surgery, and the guiding value of the genotype was verified according to the intraoperative findings. The proposed aneurysm classification is based on the virtual surface of the aneurysm and the parent artery, the aneurysm neck was classified as follows: subtype I, the curved surface of the neck is a single curved surface; subtype II, the neck is hyperboloid; subtype III, neck is a three-curved surface. Aneurysms were divided into further subtypes according to the ratio of the width of the aneurysm neck surface and the length of the artery circumference: subtype A, the ratio of the aneurysm neck surface to the parent artery was not more than 0.5; subtype B, more than 0.5. There are some clamping methods include simple, sliding, interlocking and hybrid.Results: In the control group, patients did not undergo a suitable clipping scheme without classification of aneurysm neck （unclassed clipping）. While causing the occurrence of occlusion adverse events, including neck residual, Tumor artery stenosis, electrophysiological changes, the lack of blood supply and so on. The experimental[page1image12073600]group was analyzed by using a predetermined clipping scheme （classed clipping）, and the use of aneurysms clamps was approximately the same as expected. C
  • 摘要：Background: Pulmonary alveolar proteinosis （PAP） poses a risk of opportunistic infections with a variety of organisms withNocardia being the most common pathogen followed by mycobacteria and fungi.Case presentation: A 7-year-old female child, presented with headache and multiple episodes of vomiting. There was no fever or altered sensorium. On examination, there were no focal deficits or cranial nerve palsies. An MRI brain showed a small T2 hyperintense lesion in the left superior parietal lobe suggestive of an abscess. She was diagnosed as PAP based on CT chest and bronchioloalveolar lavage 7 months earlier and treated with corticosteroids. A left parieto-occipital craniotomy was done with drainage of abscess and abscess wall excision. Histopathology revealed a suppurative lesion with slender septate acute angle branching hyphae which were positive on fungal stains. Culture done on the pus was positive forAspergillus fumigatus. The patient was treated with voriconazole and stable at 1 year follow-up.Conclusion: Opportunistic infections are common in patients diagnosed with PAP. High index of clinical suspicion and early diagnosis are important for favorable outcome.
  • 摘要：Background: Cranial hemophilic pseudotumor （cHPT） is a very rare disease, which is easy to misdiagnose. It is also difficult to manage such patients. We reported the first case of occipital cHPT.Case presentation: Here, we presented a rare case of an occipital bone mass in a 3-year-old boy who was diagnosed with hemophilia A. The mass was misdiagnosed as an aneurysmal bone cyst by pathological examination. After resection, the patient underwent one-stage cranioplasty. However, the patient was admitted again for hematoma caused by an invasive procedure. A second surgery and one-stage cranioplasty were performed at the same time. A follow-up 3 months after discharging showed the patient was uneventful, and the titanium mesh was well fixed.Conclusion: The diagnosis of cHPT requires the combining of history, radiological examination, and pathological examination. Resection is the best choice for symptomatic cHPT. Replacement treatment and less invasive treatment can make perioperative management safer. One-stage cranioplasty for resection of an occipital cHPT can improve the quality of life.
  • 摘要：Background: Various computed tomography （CT） appearances of cerebral venous sinus thrombosis （CVST） were associated with different prognosis and the patients with large intracranial hematoma will have adverse outcomes, but no in-depth study of non-contrast CT image appearances was carried out. We aimed to test the hypothesis that non-contrast CT image characteristics on admission are associated with and predict the outcome of CVST at 3 months.Methods: Three hundred and six patients with CVST between 2008 and 2017 were collected. Age, sex, onset of CVST（acute, subacute, or chronic）, etiology, clinical manifestations, midline shift, occluded venous sinus, location of infarction, non-contrast CT image characteristics, and the 3-month outcome were recorded. In addition, we established a non-contrast CT image-based classification and grading system to test the hypothesis; the CVST patients were classified into four grades （namely non-contrast CT image-based classification）: grade I, no obvious abnormality; grade II, simple vein infarction without hemorrhage or with subarachnoid hemorrhage; grade III, cerebral venous infarction with subarachnoid hemorrhage; and grade IV, cerebral vein infarction with hematoma. All enrolled patients had received subcutaneous injections of low molecular weight heparin subcutaneous injection for 14 days. Thereafter, oral anticoagulant therapy with warfarin was continued. Patients with epilepsy were given antiepileptic drugs, and patients with cerebral herniation received decompressive craniotomy.Results: Our observational findings revealed that midline shift （＆ 5 mm）, location of lesion （frontal lobe and temporal lobe）, and cerebral venous infarction with subarachnoid or hematoma （grade III and IV） were associated with 3-month poor outcome （p ＆ 0.05）; the respective increased risks were 12.730 [risk ratio （RR） 12.730, 95% confidence interval （CI） 1.680–96.490,p = 0.014], 46.538 （RR 146.538, 95% CI 6.222–348.079,p = 0.000）, 32.549 （RR 3
  • 摘要：Background: Posterior circulation intracranial aneurysm （IA） treatment remains challenging, due to the anatomy of the area and the high rupture possibility. Endovascular treatment seems to be more suitable for these aneurysms, but studies focused on endovascular treatment demonstrate a high rate of re-intervention needing. A meta-analysis might offer a clearer view, being useful in a more effective treatment planning.Methods: A systematic search was performed, using the PubMed database platform. The final article pool contained 20 articles. Studied parameters were operative mortality, late mortality, permanent neurologic deficit （PND）, and the need for re-intervention （Re-int）. We divided patients into two subgroups, those with ruptured and those with unruptured aneurysm. Statistical analysis was performed using appropriate software.Results: In the total population （645 patients）, there was a superiority of coiling over clipping in terms of PND and of coiling in terms of Re-int. As regards mortality, there was no clear superiority of one method over the other.Conclusions: The current study came to the conclusion that there is a superiority of coiling over clipping in terms of PND. On the other hand, clipping seems to be superior to coiling in terms of the need for re-intervention. As regards mortality （both operative and late）, there is no clear superiority of one method over the other. Studying subgroups of patients （ruptured and unruptured posterior circulation IAs）, in terms of PND, there is no superiority of one method over the other. The same goes for Op-Mo on ruptured aneurysms.
  • 摘要：Background: Surgical interventions including ventriculostomy and ventriculo-peritoneal shunt were usually administrated in pineal germ cell tumor patients with symptomatic hydrocephalus. Considering higher sensitivity of germinoma to anti-tumor therapy, we explored emergency irradiation as non-invasive measure in this situation.Methods: Data of 35 germinoma patients with symptomatic hydrocephalus who received emergency irradiation of 3. 4 Gy/2f were studied retrospectively. The maximum width of frontal horn and the minimum width of trunk of corpus callosum （TCC） were measured to evaluate hydrocephalus changing. Besides, mean deviation （MD） of Humphrey perimetry was employed to evaluate visual field defect. Correlations between hydrocephalus changing and clinical factors, including age, percentage of tumor regression, radiographic re-evaluation interval, and serum beta-human chorionic gonadotropin （β-HCG） level, were analyzed.Results: The median maximum diameter and volume of pineal lesions was 27 mm （range 10–55 mm） and 6.5cm3 （range 0.4–74.1 cm3）, respectively. At median 8 days after irradiation, the median percentage of tumor remission was 55% （range 10–100%）. The median maximum width of FN and the median minimum width of TCC were 11.6 mm and 39.0 mm, and 8.0 mm and 31.4 mm, before and after irradiation, respectively. The improvement of both parameters reached significant level （p ＆ 0.001）. However, none clinical factor was found to have correlation with their improvement. In 14 patients with paired data of pre- and post-irradiation MD, its change did not reach the significant level for both eyes. All patients successfully received subsequent chemoradiotherapy without surgical intervention.Conclusions: Emergency irradiation of 3.4 Gy/2f was an effective non-invasive measure to relief hydrocephalus in pineal germinoma patients.
  • 摘要：Background: The accuracy and safety of pedicle screw insertion was markedly improved with the introduction of intraoperative three-dimensional navigation system during the last decade. This study aimed to evaluate the accuracy of pedicle screw placement using O-arm-based navigation system versus conventional freehand technique.Methods: We reviewed the accuracy of 341 thoracic （n = 173） and lumbosacral （n = 168） pedicle screws placed in 60 consecutive patients using either O-arm-based navigation or freehand technique in the Department of Neurosurgery of Beijing Tsinghua Changgung Hospital between January 2015 and June 2018. Patient-specific characteristics, treatment-related characteristics, and screw-specific accuracy were analyzed. The accuracy of pedicle screw placement was measured by Gertzbein-Robbins scale and screw grades A and B were clinically acceptable.Results: One hundred ninety-one screws were inserted in the O-arm-based navigation group and 150 in the freehand group. One hundred eighty-three （95.81%） clinically acceptable screws were placed in the navigation group and 135 （90.00%） in the freehand group （p = 0.034）. Twenty-three （6.74%） screw revisions were performed in the two groups （8 screws in the navigation group and 15 screws in the freehand group） and significant difference was observed in thoracic spine （p = 0.018）, while no statistical significance was presented in lumbosacral spine （p ＆ 0.05）. Twenty-four （12.57%） screws in the navigation group and 24 （16.00%） in the freehand group violated the cortex （p ＆ 0.05）. Medial screw deviation was the most common problem in the two groups.Conclusion: The O-arm-based navigation exhibits higher accuracy for pedicle screw insertion than the freehand insertion technique.
  • 摘要：Autophagy is an intracellular degenerative pathway which is responsible for neuronal survival. Under the condition of nutrient deprivation, autophagy can lead to dysfunction in memory consolidation. AMPK/mTOR pathway is currently the most studied autophagy mechanism, while recently researchers have proved ACSS2 can also affect autophagy. ACSS2 is phosphorylated at Ser659 by AMPK and then forms a translocation complex with Importin α5 to translocate into the nucleus. This process interacts with TFEB, resulting in upregulated expression of lysosomal and autophagosomal genes. These upregulations inhibit synaptic plasticity and hence memory functions. On the other hand, ACSS2 is also recognized as a regulator of histone acetylation. After recruiting CBP/p300 and activating CBP’s HAT activity in the nucleus, ACSS2 maintains the level of localized histone acetylation by recapturing acetate from histone deacetylation to reform acetyl-CoA, providing substrates for HAT. The increase of histone acetylation locally enhanced immediate early gene transcription, includingEgr2,Fos,Nr2f2,Sgk1, andArc, to benefit neuronal plasticity and memory in many ways.
  • 摘要：Background: This study aimed to investigate the value of high field-strength intraoperative magnetic resonance imaging （iMRI）-guided stereotactic biopsy in the surgery of intracranial space-occupying lesions.Methods: A total of 87 patients who underwent stereotactic biopsy of intracranial lesions in the Peking University International Hospital from March 2016 to August 2018 were retrospectively surveyed; among these, 50 patients underwent MRI-guided stereotactic biopsy using the Leksell frame （iMRI group） and 37 cases received traditional stereotactic biopsy using the Leksell frame （control group）. The accuracy rates and complications of the two groups were compared.Results: A 100% positive diagnosis was observed in all cases （n = 50） in the iMRI group. In 4 cases, the biopsy site was clearly found to have deviated from the target point, and the biopsy was performed again. The control group had 33 cases （86.5%） with positive diagnosis. No severe complications like neural functional deficit were observed in the iMRI group, while two patients developed bleeding at the puncture site （1 case receiving surgery to remove the hematoma） in the control group. There were no deaths in either group.Conclusion: iMRI-assisted stereotactic biopsy can confirm the target position and adjust the puncture path in real time. Compared to the traditional stereotactic biopsy technique, the iMRI method has a higher positive diagnostic rate, though surgical trauma and complications have no significant difference.
  • 摘要：Background: Ewing’s sarcoma family of tumors consists of small round cell neoplasms, inclusive of primitive neuroectodermal tumor （PNET）, Askin’s tumor, and PNET of the bone. Extraosseous Ewing’s sarcoma occurs commonly at bones of lower extremities and paravertebral region of the spine. It rarely presents as a primary intracranial lesion. When intracranial, it can be misdiagnosed as central PNET （e.g., medulloblastoma, pinealoblastoma, or supratentorial PNET）, other intracranial lesions, or even as an epidural hematoma.Case presentation: We report the case of a 20-year-old patient who presented to the emergency department with complaints of drowsiness, headache, and fever for 1 day. On initial computed tomography （CT） scan of the brain, a right temporal biconvex epidural lesion involving squamous-temporal bone with periosteal reaction was noted. The patient underwent urgent craniotomy, and a tumor was found and excised. Biopsy report confirmed Ewing’s sarcoma.Conclusion: Ewing’s sarcoma is a rare intracranial malignancy with only a few cases reported in literature. In a young patient with a biconvex epidural lesion, in the absence of trauma or ongoing infection, the possibility of Ewing’s sarcoma should be considered as well.

    中华神经外科杂志（英文）的期刊信息

    • 曾用名：Chinese Neurosurgical Journal
    • 创刊时间：1985
    • 地区：CN
    • 语言：中文
    • 热门主题：CASE_REPORT PATIENTS LITERATURE_REVIEW ANEURYSM INTRACRANIAL ANEURYSMS CHINESE NEUROSURGICAL ARTERIOVENOUS AN
    • 学科分类：

    中华神经外科杂志（英文）的获奖情况

    • • 卓越计划期刊
    • • 1997年中国科协优秀科技期刊二等奖
    • • 1995年中华医学会成立80周年银奖

    中华神经外科杂志（英文）的收录情况

    • • 北大核心期刊（2004版）
    • • 北大核心期刊（2008版）
    • • 北大核心期刊（2011版）
    • • 中国科学引文数据库（2015-2016）
    • • 中国科学引文数据库（2019-2020）

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