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简介：Inthispaper,afacialfeatureextractingmethodisproposedtotransformthree-dimension(3D)headimagesofinfantswithdeformationalplagiocephalyforassessmentofasymmetry.Thefeaturesof3Dpointcloudsofaninfant’scraniumcanbeidentifiedbylocalfeatureanalysisandatwo-phasek-meansclassificationalgorithm.The3Dimagesofinfantswithasymmetriccraniumcanthenbealignedtothesamepose.Themirroredheadmodelobtainedfromthesymmetryplaneiscomparedwiththeoriginalmodelforthemeasurementofasymmetry.Numericaldataofthecranialvolumecanbereviewedbyapediatriciantoadjustthetreatmentplan.Thesystemcanalsobeusedtodemonstratethetreatmentprogress.

简介：客观：在中间的头部的窝底(EHMCFB)探索临床的特征，CT表明和创伤的额外的硬脑膜下血肿的起作用的指示。方法：有到2000年5月的从1997年1月的创伤的EHMCFB的14个盒子的一个总数回顾地被分析。结果：14个盒子，维持的12个盒子(85.7%)形成水塘的禅宗ge为被压的ambiens；11个盒子收到了操作的人，都被治好；3收到了保守治疗，2更好变得，1死了。结论：在创伤的EHMCFB，形式水塘变化ambiens容易发生。因此，如果显得日益增多地加重了，形式在水塘以后水塘换掉ambiensambiens正在被压，一早nd活跃操作必要、关键。

简介：Humanheadimpactinjuriescausedbyasuddenimpactforceareverycommoninaviationlifesaving,carcrashaccident,warorsportsactivities.Yet,anintriguingexampleofnatureiswoodpeckerwhichisfreefromheadinjuryevenitdrumstrunkcontinuallyataspeedofabout6-7m/sandadecelerationofabout1000g.Woodpeckermusthavespecialcharacteristicstoattenuaterepetitiveimpactforcetosustainrapidpeckingwithoutbraininjury.Inthisstudy,theeffectofmechanicalpropertyofcranialboneonthebrainduringimpactwasinvestigatedusingthefiniteelement(FE)approach.Itwasdemonstratedthatthepressure,Von-Misesstressesandshearstressatthesamepointontheposteriorofwoodpecker'sbrainweredecreasedgreatlycomparedwithhoopoeandlark.Itwasstatedthatthehigherstrengthofwoodpecker'scranialbonemightplayanimportantroleforpreventingwoodpecker'sheadinjury.

简介：ObjectiveTo在经历了decompressive部分颅骨切除术(DC)并且在这研究被注册讨论受不了在2004年1月和2010年5月之间的严格的头损伤的389个病人的management.MethodsA总数的严格的伤害大脑的病人调查posttraumatic脑水肿(PTH)的出现。临床的数据回顾地被分析。他们，经历了DC的149个病人根据PTH的存在被划分成二个组：脑水肿组和nonhydrocephalus组。在DC的包括外科手术前的格拉斯哥昏迷20的临床的因素(GCS)，双边或单方的解压缩，和duraplasty被单个因素分析估计与PTH.ResultsOf的出现决定它的关系经历DC的149个病人，(16.8%)25开发了PTH；当23在剩余的之中开发了PTH(9.6%)时没有DC的240个病人。外科手术前的GCS，双边或单方的解压缩，在DC的duraplasty显著地与PTH的发展被联系。Ventriculoperitoneal分流在DC以后与PTH在25个病人中的23个上被执行。正面的角为导管的放置被比较喜欢。他们中的十六个被操作在之上经由正面的途径并且7经由枕骨的途径。在分流外科以后，放射学、临床的改进在19个病人被证实。放射学的改进在2个病人被发现。一个病人最后死于严重肺病。分流相关的感染发生在1个病人，它导致了catheter.ConclusionsIt的移动被表明PTH的出现在有大decompressive的病人高颅骨缺点。有低GCS和双边的解压缩的病人趋于在DC以后开发PTH。在DC的Duraplasty可能便于减少PTH的出现。有PTH伴随物颅骨缺点的病人应该故意被管理恢复解剖、生理的正直以便便于神经病学的复活。

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简介：AbstractSimulation plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety. Several models have been used for simulation purposes. Non-living animal models offer a range of benefits, including affordability, availability, biological texture, and a comparable similarity to human anatomy. In this paper, we review the available literature on the use of non-living animals in neurosurgical simulation training. We aim to answer the following questions: (1) what animals have been used so far, (2) what neurosurgical approaches have been simulated, (3) what were the trainee tasks, and (4) what was the experience of the authors with these models. A search of the PubMed Medline database was performed to identify studies that examined the use of non-living animals in cranial neurosurgical simulation between 1990 and 2020. Our initial search yielded a total of 70 results. After careful screening, we included 22 articles for qualitative analysis. We compared the reports in terms of the (1) animal used, (2) type of surgery, and (3) trainee tasks. All articles were published between 2003 and 2019. These simulations were performed on three types of animals, namely sheep, cow, and swine. All authors designed specific, task-oriented approaches and concluded that the models used were adequate for replicating the surgical approaches. Simulation on non-living animal heads has recently gained popularity in the field of neurosurgical training. Non-living animal models are an increasingly attractive option for cranial neurosurgical simulation training. These models enable the acquisition and refinement of surgical skills, with the added benefits of accessibility and cost-effectiveness. To date, 16 different microneurosurgical cranial approaches have been replicated on three non-living animal models, including sheep, cows, and swine. This review summarizes the experience reported with the use of non-living animal models as alternative laboratory tools for cranial neurosurgical training, with particular attention to the set of tasks that could be performed on them.

简介：Twohundredcatesofnasopharyngealcarcinoma(NPC)admittedtothisdepartmentfromFeb.1985toMay.1988wereanalysedaccordingtotheCTscanningandclinicalfindingsoftheprimarylesionspriortoradiotherapy.TheresultsshowedthatinvolvementofparapharyngealspacewasverycommoninNPC,about80%(160/200cases);particularlyunilateralorbilateralretro-styloidspaces,about69.5%(139/200cases).ItwasproposedthatpatientswithNPChadahighIncidenceofipsilateralcervicalnodemetastasis.Contralateralcervicalnodemetastasiswasrare.ThedevelopmentofcervicalnodemetastastoinNPChastwomodes:oneIsdirectInfiltrationoftheretro-styloldspacebythelesion;theotherIsalongthenasopharyngeallymphaticrete.ThedataalsoshowedthatpatientswithNPCwhopresentedsymptomsofⅨ-Ⅲcranialnerveparalysesalwayshadipsilateralorbilateralretro-styloidspaceInfiltrations.

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简介：AbstractBackground:Basilar invagination (BI) with atlantoaxial dislocation (AAD) is not uncommon in patients with scoliosis, Klippel-Feil syndrome (KFS), and other bone deformities. Cases with combinations of the abovementioned dislocations and deformities with posterior cranial fossa teratoma are rare in the clinic and difficult to handle.Case presentation:This case presents a 34-year-old woman diagnosed with atlantoaxial dislocation and posterior cranial fossa mass. After two surgeries, the posterior cranial teratoma was completely removed with satisfactory atlantoaxial reduction. The postoperative 1-year follow-up examination showed that the bone graft fusion was successful, without remaining significant dysfunction.Conclusions:The surgical risk of irreducible atlantoaxial dislocation combined with posterior cranial fossa tumor is huge. Thus, it needs to be fully preoperatively evaluated and managed carefully in accordance with sound surgical principles.

简介：BACKGROUND:Duringthecellularagingprocess,thenumberofmitochondria,generationofadenosinetriphosphate(ATP),activityofrespiratorychainenzymecomplex1and4,andoxidationdecrease.OBJECTIVE:Toobservetheeffectsofaqueousandspirituousextract,aswellaspolysaccharidesfromFructusschizandrae(MagnoliaVine)onenergymetabolismandmitochondrialanti-oxidationincranialnervecellsofaD-gal-inducedagingmousemodel.DESIGN,TIMEANDSETTING:Arandomized,controlled,animalstudy.TheexperimentwasconductedattheDepartmentofBiochemistry,QiqiharMedicalCollegebetweenMarchandJuly2006.MATERIALS:Fiftyhealthy,Kunmingmiceofbothsexes,aged2-3monthsoldandweighing18-22g,wereusedforthepresentstudy.FructusschizandraewaspurchasedfromtheMedicalCollegeofJiamusiUniversity.Aqueousextracts,spirituousextracts,andpolysaccharidesfromFructusschizandraewereprepared.D-galactose(D-gal)isaproductoftheSecondReagentFactory,ShanghaiCity,China.Mn-superoxidedismutase(Mn-SOD)kit,malonaldehyde(MDA)kit,proteinquantificationkit,andinorganicphosphorustestingkitwerepurchasedfromJianChengBioeng.Co.,China.METHODS:Fiftymicewererandomlydividedintofivegroups,with10miceineachgroup:youngcontrol,agingmodel,aqueousFructusschizandraeextract,spirituousFructusschizandraeextract,andFructusschizandraepolysaccharides.Overacourseof30days,miceinagingmodel,aqueousFructusschizandraeextract,spirituousFructusschizandraeextract,andFructusschizandraepolysaccharidesgroupswereinjectedsubcutaneouslywithD-gal(100mg/kg)intothenapeoftheneckdaily,andadministeredintragastricallywithanequalvolumeofsterile,warmwater(agingmodel),aqueousFructusschizandraeextract(2g/kg),spirituousFructusschizandraeextract(2g/kg),orFructusschizandraepolysaccharides(0.2g/kg),respectively.Miceintheyoungcontrolgroupwereinjectedintothenapeoftheneckwithphysiologicalsaline

简介：AbstractPurpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.Methods:Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman's classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference).Results:A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivity was significantly higher in the HRCT-positive group (20/30, 66.7%) than in the HRCT-negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion.Conclusion:By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

简介：AbstractBackground:Early neurologic deterioration (END) may occur in patients with anterior circulation ischemic stroke (ACIS) after receiving endovascular treatment (EVT). Hemodynamic insufficiency, re-occlusion, and post-re-canalization hyper-perfusion are likely to play a critical role in END. We hypothesized that hemodynamic changes can predict END in patients with ACIS post-successful EVT using trans-cranial Doppler (TCD).Methods:We utilized a prospectively maintained database of ACIS patients treated with EVT between September 2016 and June 2018 in the Xuanwu Hospital, Capital Medical University. TCD parameters including peak systolic velocity (PSV), bilateral mean flow velocity (MFV), and pulse index (PI) were determined via the middle cerebral arteries within 72 h post-EVT. A logistic regression model was applied to detect independent predictors for END.Results:Totally, 112 EVT patients were included in this study and 80/112 patients experienced successful re-canalization with <50% residual stenosis, while 17/80 (21.3%) patients suffered END, for which vasogenic cerebral edema (11/17) was considered as a leading role and followed by symptomatic intra-cranial hemorrhage (4/17) and ischemia progression (2/17). For the 80 patients, the PSV (median: 127 cm/s vs. 116 cm/s, P = 0.039), the ratio of ipsilateral-MFV/contra-lateral-MFV (iMFV/cMFV) (median: 1.29 vs. 1.02, P = 0.036) and iMFV/mean blood pressure (MBP) (median: 0.97 vs. 0.79, P = 0.008) in END patients were higher than those of non-END. Using the receiver-operating characteristic curve to obtain cut-off values for PSV, PI, iMFV/cMFV, and iMFV/MBP for END, we found that PI ≥0.85 (odds ratio: 11.03, 95% confidence interval: 1.92-63.46, P = 0.007) and iMFV/MBP ≥0.84 (odds ratio: 9.20, 95% confidence interval: 2.07-40.84, P = 0.004) were independent predictors of END in a multivariate logistic regression model, with a sensitivity of 82.4% and 76.5% and a specificity of 42.9% and 66.7%, respectively, and had the positive predictive values of 29.0% and 38.2%, and negative predictive values of 90.0% and 91.3%, with an area under the receiver-operating characteristic curve of 0.57 and 0.71, respectively.Conclusion:TCD examination of EVT patients may be used as a real-time tool to detect END predictors, such as the higher PI and iMFV/MBP, allowing for better post-thrombectomy management in ACIS patients.

简介：目的目前,国外研发的Neuromate、Rosa等立体定向手术机器人已通过美国FDA、欧洲CE标准认证,从而使得立体定向电极植入术逐渐在神经外科展开使用。北京天坛医院充分利用立体定向手术技术的优势,与北京天智航公司合作开展应用,研究TirobotCranial机器人辅助颅内电极植入定位的精准性,并分析影响电极植入定位精确度的相关因素。方法北京天坛医院神经外科与北京天智航公司合作,以家猪头颅为实验对象,进行TirobotCranial机器人辅助脑深部电极植入实验。术后复查CBCT验证入颅点及靶点的偏差,计算平均值及标准差,以评价机器人定位精准性;并进行误差影响因素分析。结果共进行7次实验,计划植入电极35根,术中实际植入电极35根,成功率达100%。电极平均植入长度（43.17±6.64）mm,植入电极平均入颅点误差为（0.63±0.23）mm,平均靶点定位误差为（0.96±0.41）mm。误差影响因素分析显示,入颅点偏离与靶点偏离的误差呈正相关（r=0.399,P〈0.05）。结论通过修正电极植入工具参数的偏差,以及预先使用螺纹针钻孔,防止打滑等措施;TirobotCranial系统辅助颅内电极植入整体最佳的定位精度达到0.5mm,具有良好的精准性及稳定性;电极植入的准确性可基本满足临床定位的需求。

简介：PURPOSE:Toreviewtheefficacyandpatternsoffailureinaverage-riskmedulloblastomapatientstreatedwithconcurrentchemotherapyandreduced-dosecranialspinalirradiationandaconformaltumorbedboost.METH-ODSANDMATERIALS:Thirty-threepatientswithaveragerisk(definedas<==1.5cm(2)ofresidualtumorafterresection,age>3years,andnoinvolvementofthecerebrospinalfluidorspine)medulloblastomawerediagnosedatourinstitutionbetweenJanuary1994andDecember2001.Theywereenrolledinaninstitutionalpilot