Frameless stereotactic ventriculoperitoneal shunt / 中华神经医学杂志

Objective To explore the clinical efficacy of simple frameless stereotactic ventricle peritoneal shunt.Methods Retrospective analysis was performed in 128 patients with hydrocephalus,admitted to and performed ventriculoperitoneal shunt in our hospital from March 2012 to March 2016:simple frameless stereotactic ventricle peritoneal shunt was performed in 47,traditional occipital horn puncture in 23,and traditional triangle puncture in 58.The respective end of shunt tube placement position and recent end shunt tube adjustment were analyzed retrospectively.Results Inappropriate position was achieved in one patient performed simple frameless stereotactic biopsy,and no recent change or reset the shunt pipe was performed.In patients accepted traditional pillow angle puncture,head end improper placement happened in 5 patients,adjustment of recent tip was performed in 3.In patients accepted traditional triangle puncture,incorrect triangle needle tip was placed in 20 patients,and recent change or reset the head end shunt was performed in 7.Conclusion Simple frameless stereotactic puncture is effective in shunt placement of head end,which can lower the head end shunt recent change or reset the risk.

Clinical analysis of early lumbar drainage combined with antibiotic therapy in ventricular peritoneal shunt infection / 中华神经医学杂志

Objective To explore the effectiveness of early lumbar pool drainage combined with antibiotics treatment in remedying ventricle peritoneal shunt infection and the problems needed to be paid attention during the process of treatment.Methods Twenty-two patients with infection after ventricle peritoneal shunt,admitted to our hospital from January 2008 to June 2015,were given lumbar pool drainage combined with antibiotics treatment,including 16 with early lumbar pool drainage combined with antibiotics treatment (3-7 d of infection) and 6 with late lumbar pool drainage combined with antibiotics treatment (8-10 d of infection).The clinical data and treatment efficacy were retrospectively analyzed.Results Bacterial culture of cerebrospinal fluid in the 22 patients indicated negative results in 5,coagulase negative staphylococcus in 10,staphylococcus aureus in two,enterococcus in two and klebsiella bacillus in three;the cure rate of patients with staphylococcus aureus was the lowest (0％);after lumbar pool drainage combined with antibiotics treatment,the cure rate of these patients reached to 72.7％ (16/22);the infection of the left 6 patients could not be controlled,and therefore ventriculoperitoneal shunt was removed.The cure rate in patients with early treatment was better than that in patients with late treatment (88％ vs.33％).Conclusion Early lumbar drainage combined with antibiotics can effectively control the ventricle peritoneal shunt infection,avoid risk of second operation and save economic burden.

Treatment strategies of medulla oblongata cavernous malformations / 中华神经医学杂志

Objective To discuss the strategies and efficacies of surgical treatment in medulla oblongata cavernous malformations.Methods The clinical and follow-up data of 9 patients with medulla oblongata cavernous malformations,admitted to our hospital from October 201 1 to February 2015,were retrospectively analyzed.Five patients underwent surgical treatment:posterior midline transcerebellomedullary fissure approach was used in 4,far-lateral transcondylar approach in one,and all cavernous malformations were excised completely.Conservative treatment and regular observation were done in 4 patients.Follow-up was performed for 10-40 months.Results Symptoms improved after surgery in 4 patients;postoperative hemiplegia appeared in one,and at the end of follow-up,the muscle strength of hemiplegic limbs recovered to level Ⅳ.Minor re-hemorrhage was noted in one of the 4 patients with conservative treatment at the end of the follow-up,and no changes were noted in the rest patients.Karnofsky Performance Scale scores were 82.2 ±6.7,which were significantly increased as compared with those before treatment (73.3±11.2,P＜0.05).Conclusion After strict preoperative evaluation,surgical treatment is a feasible way,enjoying good prognosis in medulla oblongata cavernous malformations;but,patients with deep site,small malformations or no obvious bleeding symptoms should not be operated.

Clinical Research On Fast Track Surgery in Neurosurgery / 中国神经精神疾病杂志

Objective To investigate the feasibility and effectiveness of fast track surgery (FTS) in neurosurgery. Methods One hundred fifteen patients who underwent neurosurgery surgery in Henan Province People's Hospital from June 2012 to March 2014 were enrolled in this study. All the patients were divided into FTS group (62 cases) and the tra?ditional operation group (53 cases). The clinical index, postoperative hospital stay and hospitalization cost were compared between the two groups. Results The clinical index were significantly lower in FTS group than in traditional operation group (P<0.05). Length of hospital stay (days) and hospitalization cost of FTS group were significantly shorter and lower in FTS group compared with traditonal operation group (8±1 vs. 11±2 days and RMB 4.58 ±0.75 vs. 5.78 ±0.64 ten thou?sand, respectively) (P<0.05). Conclusion FTS in neurosurgery operation is an all-new concept for surgery which can ef?fectively reduce postoperative complications, shorten length of hospital stay, decrease hospitalization cost and promote postoperative recovery.

DIAGNOSIS AND TREATMENT OF CYSTICERCOSIS OF CEREBRAL VENTRICLES / 中国寄生虫学与寄生虫病杂志

31 patients with cysticercosis of cerebral ventricles verified by operation or pathological investigation were reported. All patients were between 7 and 64 years of age and 14 were females. All had a single cyst. Since 29 patients (94%) were without a history of intestinal taeniasis, it was proposed that most patients of cysticercosis of cerebral ventricles were caused by hetero-infection and the entrance of Cysticercus into brain ventricle was through choroid plexus along the cerebro-spinal fluid. This is probably the reason why it occurs mostly in the 4th ventricle. The clinical manifestation of cysticercosis of cerebral ventricles were paroxysmal headache and vomiting caused by increased intracranial pressure. Ventricu-lography and CT scanning have considerable diagnostic value. Removal of Cysticercus by surgical operation is successful (Figs. 1 - 8).