Keyhole Approach Endoscopic Surgery versus Stereotactic Aspiration plus Urokinase in Treating Basal Ganglia Hypertensive Intracerebral Hemorrhage / 中国医学科学院学报

To compare the short-and long-term effect of two minimal invasive surgical therapies including keyhole approach endoscopic surgery(KAES)and stereotactic aspiration plus urokinase(SAU)in treating basal ganglia hypertensive intracerebral hemorrhage(hICH). The clinical data of 117 hICH patients(63 received KAES and 54 received SAU)were retrospectively analyzed.The operation time,blood loss during surgery,and drainage time were compared between two groups.The residual hematoma volume,hematoma clearance rate(HCR),Glasgow coma scale(GCS)score,and National Institute of Health Stroke Scale(NIHSS)score were recorded at baseline and in the ultra-early stage,early stage,and sub-early stage after surgery.The 30-day mortality and serious adverse events were assessed and the 6-month modified Rankin scale(mRS)score was rated. Baseline data showed no significant difference between these two groups.Compared with the SAU group,the KAES group had significantly longer operation time,more intraoperative blood loss,and shorter drainage time(all 0.05).In the ultra-early and early stage,the GCS and NIHSS scores showed no significant differences between two groups(all >0.05),whereas in the sub-early stage,the NIHSS score was better in the SAU group(=0.034).The 30-day mortality and incidences of serious adverse events showed no significant difference(all >0.05).The good recovery(mRS≤3)at 6-months follow-up showed no significant difference between the two groups(=0.413). Both KAES and SAU are safe and effective in treating basal ganglia hICH.In the ultra-early stage after surgery,KAES achieves better residual hematoma volume and HCR,and patients undergoing SAU quickly catch up.The short-and long-term effectiveness of SAU is comparable or even superior to KAES.

Application of endoscopic biopsy and third ventriculostomy in the diagnosis and treatment of pineal germ cell tumor / 中华神经医学杂志

Objective To investigate the value of endoscopic biopsy and third ventriculostomy in the diagnosis and treatment of pineal germ cell tumors. Methods Endoscopic biopsy and third ventricuiostomy were performed in 20 patients with pineal tumors to relieve obstructive hydrocephalus and determine the nature of the neoplasms. Results CT and magnetic resonance imaging confirmed successful third ventriculostomy and biopsy in the 20 cases with total relief of obstructive hydrocephalus. The diagnoses of germ cell tumors were established in all this cases. Conclusions Endoscopic biopsy and third ventriculostomy are effective and safe neuroendoscopic procedures in minimally invasive management of pineal region germ cell tumors.

Effect of urapidil in reducing brain temperature in hot and humid environment / 中华神经医学杂志

Objective To investigate the effect ofurapidil in lowering the brain temperature in hot and humid environment. Methods Ninety soldiers stationed in Chinese Nansha Islands were divided into veteran group, untreated new recruit group and new recruit group with urapidil (tablet) treatment. All the soldiers were asked to complete a running exercise for 3000 m within 20 min in hot and humid environment, and their body temperature before and after the exercise was measured to evaluate the brain temperature changes. Results Before the running exercise, no significant differences was found in the body temperature among the 3 groups. The body temperature of the soldiers showed significant differences after the exercise, and the untreated new recruit had the most obvious elevation of the body temperature, whereas those with urapidil treatment showed the least elevation. Conclusion Veterans and new recruit show different tolerance and adaptability to hot and humid environment, and urapidil tablets can help reduce brain temperature increment induced by hot and humid environment.

Diagnosis and radiotherapy of germinomas arising in basal ganglia and thalamus / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical characteristic and radiotherapeutic effect of germinomas arising in basal ganglia and thalamus.</p><p><b>METHODS</b>The clinical data of 13 cases were reviewed retrospectively. All cases were pathologic diagnosis through stereotactic biopsy. Gamma-knife or ordinary irradiation were 2 cases respectively and the combined therapy with interstitial brachytherapy as foundation were 9 cases.</p><p><b>RESULT</b>All cases were male, median age of 16.1 years. Hemiparesis and ataxia were major symptoms, some cases were accompanied with precocious puberty. Imaging manifested intratumoral cystic components represented 76.9% of all lesions, calcification represented 30.8%, ipsilateral cerebral and brain stem hemiatrophy represented 46.2%, cerebral white matter invasion through internal capsule or corpus callosum represented 30.8%. One case died because of late complication and 12 cases had achieved satisfied therapeutic effect (the mean followed-up period was 40.6 months). Tumor-control were effective.</p><p><b>CONCLUSIONS</b>The clinical manifestation and imaging characteristics are helpful to diagnosis. Stereotactic biopsy make the affirmatory diagnosis. Operative total-removal is impossible because of deep location, neighbour of vital structure and invasion. The combined therapy with interstitial brachytherapy was effective.</p>

Clinical analysis of 1434 cases of frameless stereotactic operation / 中华外科杂志

<p><b>OBJECTIVE</b>Stereotactic operations were performed using a frameless stereotactic instrument manufactured by CAS-R-2 instead of traditional stereotactic frame. The aim of this study was to assess the clinical usefulness, accuracy and safety of frameless stereotactic instrument.</p><p><b>METHODS</b>The clinical data of 1434 patients was retrospectively reviewed. The mean age was 30.7 years (from 0.2 to 89.0 years). Each patient underwent frameless CT/MRI image-guided stereotactic surgery by this robot system from January 1997 to January 2006. The accuracy of position and improvement of symptom were observed. The averaged period of followed-up was 24 months (from 3 to 48 months).</p><p><b>RESULTS</b>The surgical procedures were performed successfully in all cases. All targets were pointed accurately at first time during the operation. The total effective rate was 93.3% without serious operation related complications.</p><p><b>CONCLUSIONS</b>Compared with the traditional stereotactic operations, this method has some advantages, such as releasing the patient's pain, convenience the doctors, extending the range of indications and increasing the safety and effective of operation.</p>