Objective:To explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma(EDH). Methods:Retrospective study was made on 135 patients with tra...Objective:To explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma(EDH). Methods:Retrospective study was made on 135 patients with traumatic EDH admitted into our hospital from June 2002 to August 2005.Sixty-five patients were treated with mini-invasive negative pressure drainage (treatment group),70 patients with comparable condition used traditional craniotomy(control group).The mean time of operation,average days in hospital,expenditure and prognosis of two groups were recorded and analyzed. Results:There was no significant difference in therapeutic efficacy between two groups.Patients in treatment group had a shorter hospital stay and less expenditure than those in control group. Conclusion:Mini-invasive negative pressure drainage is simple,effective,economical and applicable to some traumatic EDH patients.展开更多
Objective: To investigate the changes and effects of arginine vasopressin (AVP) in patients with acute traumatic subarachnoid hemorrhage (tSAH). Methods: The plasma and cerebrospinal fluid (CSF) level of AVP,...Objective: To investigate the changes and effects of arginine vasopressin (AVP) in patients with acute traumatic subarachnoid hemorrhage (tSAH). Methods: The plasma and cerebrospinal fluid (CSF) level of AVP, and intracranial pressure (ICP) were measured in a total of 21 patients within 24 hours after tSAH. The neurological status of the patients was evaluated by Glasgow Coma Scale (GCS). Correlation between AVP and ICP, GCS was analyzed respectively. Meanwhile, 18 healthy volunteers were recruited as control group. Results: Compared with control group, the levels (pg/ml) of AVP in plasma and CSF (x±s) in tSAH group were significantly increased within 24 hours (38.72±24.71 vs 4.54±1.38 and 34.61±21.43 vs 4.13± 1.26, P〈0.01), and was remarkably higher in GCS ≤8 group than GCS〉8 group (50.96±36.81 vs 25.26±12.87 and 44.68±31.72 vs 23.53±10.94, P〈0.05). The CSF AVP level was correlated with ICP (r= 0.46, P〈0.05), but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS (r= -0.29, P〉0.05 and r= -0.32, P〉0.05, respectively). The ICP (ram Hg) in tSAH patients was elevated and higher in GCS ≤ 8 group than in GCS〉8 group (25.9±9.7 vs 17.6±5.2, P〈0.05). Conclusion: Our research suggests that AVP is correlated with the severity oftSAH, and may be involved in the pathophysiological process of brain damage in the early stage after tSAH. It seems that compared with the plasma AVP concentration, CSF AVP is more related to the severity oftSAH.展开更多
Dural arteriovenous fistulae (DAVF) is a rare intracranial vascular disease. It is pathologically characterized by direct shunting of the intracranial artery and vein, which results in cerebral ischemia, intracranial ...Dural arteriovenous fistulae (DAVF) is a rare intracranial vascular disease. It is pathologically characterized by direct shunting of the intracranial artery and vein, which results in cerebral ischemia, intracranial hemorrhage, neural deficit and intracranial murmur. The etiological mechanism of DAVF is not well known, but most researchers think it is associated with congenital abnormal development, especially abnormal development of dural blood vessels at the stage of embryogenesis. Recently, some researchers have found that DAVF is also associated with some acquired factors. This article reports a case who developed DAVF within 2 years after debridement of frontal bone fragmentation, depressed fracture, left frontal lobe contusion and superior sagittal sinus injury due to forehead knife-cut injury. The pathogenic mechanism was explored through a review of the related literatures.展开更多
Pneumocephalus is the presence of air in the cranial vault. The common etiologies of pneumocephalus are brain trauma and cranial surgery. We report a case of a 26-year-old man with brain trauma who developed diffuse p...Pneumocephalus is the presence of air in the cranial vault. The common etiologies of pneumocephalus are brain trauma and cranial surgery. We report a case of a 26-year-old man with brain trauma who developed diffuse pneumocephalus after sneezing. CT scan was performed on arrival, and the image showed subarach- noid hemolxhage without pneumocephalus. On the seventh day after a big sneeze brain CT scan was re-performed, which showed pneumocephalus. After another ten days of treatment, the patient was discharged without any symptoms.展开更多
Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait...Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia.Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord.A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1.The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved.Arachnoid cyst was confirmed by histological examination.The patient recovered well postoperatively.This is the second report of such a case in the world according to the available literature.The take-home message for our case is that the surgical approach should be individualized,depending on the size and location.展开更多
文摘Objective:To explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma(EDH). Methods:Retrospective study was made on 135 patients with traumatic EDH admitted into our hospital from June 2002 to August 2005.Sixty-five patients were treated with mini-invasive negative pressure drainage (treatment group),70 patients with comparable condition used traditional craniotomy(control group).The mean time of operation,average days in hospital,expenditure and prognosis of two groups were recorded and analyzed. Results:There was no significant difference in therapeutic efficacy between two groups.Patients in treatment group had a shorter hospital stay and less expenditure than those in control group. Conclusion:Mini-invasive negative pressure drainage is simple,effective,economical and applicable to some traumatic EDH patients.
基金This study was supported by grants from Science and Technology Department of Zhejiang Province, China (No. 2004C33048) and Zhejiang Natural Science Foundation, China (Y205096).
文摘Objective: To investigate the changes and effects of arginine vasopressin (AVP) in patients with acute traumatic subarachnoid hemorrhage (tSAH). Methods: The plasma and cerebrospinal fluid (CSF) level of AVP, and intracranial pressure (ICP) were measured in a total of 21 patients within 24 hours after tSAH. The neurological status of the patients was evaluated by Glasgow Coma Scale (GCS). Correlation between AVP and ICP, GCS was analyzed respectively. Meanwhile, 18 healthy volunteers were recruited as control group. Results: Compared with control group, the levels (pg/ml) of AVP in plasma and CSF (x±s) in tSAH group were significantly increased within 24 hours (38.72±24.71 vs 4.54±1.38 and 34.61±21.43 vs 4.13± 1.26, P〈0.01), and was remarkably higher in GCS ≤8 group than GCS〉8 group (50.96±36.81 vs 25.26±12.87 and 44.68±31.72 vs 23.53±10.94, P〈0.05). The CSF AVP level was correlated with ICP (r= 0.46, P〈0.05), but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS (r= -0.29, P〉0.05 and r= -0.32, P〉0.05, respectively). The ICP (ram Hg) in tSAH patients was elevated and higher in GCS ≤ 8 group than in GCS〉8 group (25.9±9.7 vs 17.6±5.2, P〈0.05). Conclusion: Our research suggests that AVP is correlated with the severity oftSAH, and may be involved in the pathophysiological process of brain damage in the early stage after tSAH. It seems that compared with the plasma AVP concentration, CSF AVP is more related to the severity oftSAH.
文摘Dural arteriovenous fistulae (DAVF) is a rare intracranial vascular disease. It is pathologically characterized by direct shunting of the intracranial artery and vein, which results in cerebral ischemia, intracranial hemorrhage, neural deficit and intracranial murmur. The etiological mechanism of DAVF is not well known, but most researchers think it is associated with congenital abnormal development, especially abnormal development of dural blood vessels at the stage of embryogenesis. Recently, some researchers have found that DAVF is also associated with some acquired factors. This article reports a case who developed DAVF within 2 years after debridement of frontal bone fragmentation, depressed fracture, left frontal lobe contusion and superior sagittal sinus injury due to forehead knife-cut injury. The pathogenic mechanism was explored through a review of the related literatures.
文摘Pneumocephalus is the presence of air in the cranial vault. The common etiologies of pneumocephalus are brain trauma and cranial surgery. We report a case of a 26-year-old man with brain trauma who developed diffuse pneumocephalus after sneezing. CT scan was performed on arrival, and the image showed subarach- noid hemolxhage without pneumocephalus. On the seventh day after a big sneeze brain CT scan was re-performed, which showed pneumocephalus. After another ten days of treatment, the patient was discharged without any symptoms.
文摘Congenital spinal intradural arachnoid cyst associated with intrathoracic meningocele is very rare.We report a case in a 9-year-old Chinese boy who presented with a two-week history of progressive paraparesis and gait ataxia.Magnetic resonance imaging revealed that a dorsal intradural extramedullary cystic lesion extended from T1 to T5 and compressed the spinal cord.A left lateral intrathoracic meningocele pouch was found incidentally at the level of T1.The arachnoid cyst as well as meningocele was removed and the spinal cord compression was relieved.Arachnoid cyst was confirmed by histological examination.The patient recovered well postoperatively.This is the second report of such a case in the world according to the available literature.The take-home message for our case is that the surgical approach should be individualized,depending on the size and location.