Posttraumatic acute diffuse brain swelling (PADBS), as a severe pathological phenomenon of traumatic brain injury, has long faced challenges such as inconsistent diagnostic criteria and suboptimal treatment outcomes. Therefore, breakthrough explorations into the pathogenesis and treatment strategies of PADBS are urgently needed. This article systematically integrates and reviews the concept, pathogenesis, pathogenic factors, and treatment strategies of PADBS by combining domestic and international literature with research progress from our team. The aim of this article is to provide a new theoretical framework and research approach for the clinical management of PADBS patients, laying a theoretical foundation for precise and effective diagnosis and treatment.

To analyze the clinical characteristics and risk factors affecting prognosis of traumatic brain injury (TBI) in children in Xinjiang region, and explore prevention and treatment plans that are in line with local characteristics.

A retrospective analysis was conducted on the clinical data of 398 children with TBI admitted to the Pediatric Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from January 2014 to January 2023. The gender, age, location of injury, cause of injury, location of injury, severity, whether surgery was performed, treatment status, and prognosis of children with TBI were collected. Multivariate Logistic regression analysis was used to screen for independent risk factors that affect the severity of children with TBI.

Among the 398 patients, there were 241 males and 157 females, with a male to female ratio of 1.56∶1; The proportion of children aged 4-6 years (98 cases) and 7-17 years (126 cases) was the highest; The main cause of injury is falling/injury (59.3%); 283 cases had mild injuries, 61 cases had moderate injuries, and 54 cases had severe injuries. Mild and moderate TBI were mainly caused by falls/injuries, while severe injuries were mainly caused by traffic accidents; 98 cases underwent surgical treatment and 300 cases underwent non-surgical treatment. There were statistically significant differences in the location, severity, cause, location, and length of hospital stay of children of different age groups (P<0.05); The age distribution, injury location, injury cause, and injury site of mild, moderate, and severe pediatric patients showed statistically significant differences (P<0.05); There was no statistically significant difference in the distribution of hospitalization months among children of different genders and age groups (P>0.05). Multivariate Logistic regression analysis showed that car accident injury is an independent risk factor for severe TBI in children. After 6-12 months of follow-up after discharge, 375 patients had a good prognosis, with 9 cases of moderate disability, 8 cases of severe disability, 1 case in vegetative state, and 5 cases of death.

Children with TBI in Xinjiang are mainly boys and preschool children, and falls/injuries and traffic accidents are the main causes of injury. Among them, car accidents are an independent risk factor for severe TBI. The degree of injury is mainly mild TBI, and most children have a good prognosis after conservative treatment. Clinical evaluation and personalized treatment should be based on the age differences of children, and safety education for parents should be strengthened to enhance risk prevention awareness.

To investigate the clinical efficacy of a multi-technique-assisted trans-sulcal approach for resection of deep-seated gliomas in eloquent brain areas.

A retrospective analysis was conducted on clinical data from 24 patients with deep-seated eloquent-area gliomas treated at the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2022. During surgery, ultrasound-assisted localization, fluorescence-guided visualization, and a "dynamic retraction" microsurgical technique were comprehensively employed for deep-seated eloquent-area gliomas removal. Data on operative duration, blood loss, extent of resection, postoperative complications, and preoperative and postoperative Karnofsky functional status (KPS) scores were statistically analyzed.

Among the 24 patients, 18 (75%) achieved complete resection and 6 (25%) underwent subtotal resection. The average surgical time was (4.57±0.68) h, the average blood loss was (533.33±192.62) mL, and 6 patients experienced postoperative complications. The KPS score at 3 d after surgery was lower than that before surgery, and the difference was statistically significant (Z=-4.267, P<0.001); The KPS score 9 months after surgery was higher than before surgery, and the difference was statistically significant (Z=-2.065, P=0.039).

Intraoperative multi-technique assisted trans-sulcal approach allows for safe and effective resection of deep-seated gliomas in eloquent brain areas, while preserving the anatomical integrity of functional regions and neural pathways under minimally invasive conditions, leading to favorable postoperative neurological function preservation.

To evaluate the safety and efficacy of Pipeline embolization device (PED) in the treatment of large intracranial aneurysms (LIA) and giant intracranial aneurysms (GIA).

A retrospective analysis was conducted on the clinical data of 35 patients with LIA and GIA who received PED treatment in the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from October 2019 to March 2024. The surgical methods, perioperative complications, and imaging results of the patients were collected. During postoperative and follow-up periods, DSA was used to assess the recurrence of aneurysms, Kamran occlusion grading criteria were used to evaluate the degree of aneurysm occlusion, and modified Rankin scale (mRS) was used to evaluate neurological function prognosis.

Among the 35 patients, 32 (91.4%) had unruptured aneurysms and 3 (8.6%) had ruptured aneurysms. Thirty-six PEDs were successfully implanted during the operation, including 1 case of double stent implantation. Sixteen patients received simple PED implantation, 19 patients received PED combined with coil embolization, and 1 patient with ruptured aneurysm and proximal stenosis underwent balloon dilation treatment. Two patients experienced complications during the perioperative period, with an incidence rate of 5.7%. Postoperative Kamran grading showed 12 cases at grade 1, 18 cases at grade 2, and 5 cases at grade 3. At discharge, the mRS score showed that 31 cases scoring 1, 1 case scoring 3, 1 case scoring 4, and 2 cases scoring 5. The follow-up period was 5-53 months (median 9 months), and a total of 30 patients completed the follow-up. The mRS score showed that 22 cases scoring 0, 7 cases scoring 1, and 1 case scoring 2; Kamran grading shows 3 cases at grade 2, 4 cases at grade 3, and 23 cases at grade 4.

PED treatment has a high technical success rate and good safety for LIA and GIA surgeries, but the risk of perioperative complications still needs to be monitored.

To analyze the clinical efficacy of intracranial-extracranial bypass surgery for the treatment of posterior circulation aneurysms.

A retrospective analysis was conducted on the clinical data of six patients with posterior circulation aneurysms who underwent intracranial and extracranial vascular bypass surgery in the Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from May 2020 to February 2023. All patients completed imaging evaluation, cerebral blood flow compensation function evaluation, and clinical grading evaluation of subarachnoid hemorrhage before surgery. Intracranial and extracranial vascular bypass surgery was performed, and the blood supply artery was the occipital artery or radial artery. Postoperative head and neck CTA was used to observe the patency of bridging vessels, and the modified Rankin scale (mRS) was used to evaluate the patients' prognosis.

Among the 6 patients with posterior circulation aneurysms, 2 cases were located in the posterior inferior cerebellar artery, 2 cases in the basilar artery, 1 case in the vertebral artery, and 1 case in the posterior cerebral artery. Among them, 3 cases of ruptured aneurysms were manifested as subarachnoid hemorrhage. Intraoperative ICG imaging or vascular ultrasound showed patency of the bridging vessel in all patients; 1 patient had postoperative occlusion of the bridging vessel, brainstem infarction, and ultimately died of a severe pulmonary infection, and 1 patient developed mild limb paralysis. Five patients were followed up for 6-24 months, and the mRS score was 0 to 2 points.

Intracranial-extracranial bypass surgery is an effective modality to treat posterior circulation aneurysms, with high patency rate and good prognosis.

Optic nerve injury is a common and severe neurological disorder that can lead to severe visual dysfunction or even blindness. As the optic nerve belongs to the central nervous system, it has traditionally been considered to possess limited regenerative capacity, making the repair process highly challenging. In recent years, with advancements in regenerative medicine and cell therapy, autologous olfactory ensheathing cells (OECs) have garnered increasing research attention for neural injury repair due to their abilities to support axonal regeneration, secrete multiple neurotrophic factors, and modulate the injury microenvironment. This review will focus on the mechanisms of action and recent research progress of OECs in experimental studies, particularly in animal models of optic nerve injury, aiming to provide theoretical support and references for basic research and the development of cell-based therapeutic strategies for optic nerve injury repair.

Severe traumatic brain injury (sTBI) in children is a leading cause of mortality and disability, often resulting in persistently elevated intracranial pressure, which can cause neurological damage or even death. Decompressive craniectomy (DC) reduces intracranial pressure by removing part of the skull, allowing the brain to expand beyond the confines of the cranial cavity. This procedure increases intracranial volume, improves cerebral perfusion pressure, and reduces the risk of midline shift, brainstem compression, and herniation. However, after DC in children, complications such as new-onset hematomas, subdural effusions, hydrocephalus, infections, scalp invagination, paradoxical herniation, and trephine syndrome often occur. Some children require secondary or multiple surgeries. Therefore, the application of DC in children with sTBI has always been controversial, and existing high-level evidence-based research support is limited. This review focuses on the indications for DC in children and its recent research advances, aiming to provide theoretical reference for surgical decision-making in pediatric sTBI.

To investigate the therapeutic efficacy and underlying mechanisms of methacryloyl gelatin (GelMA) hydrogel loaded with active mitochondria in promoting repair after spinal cord injury (SCI) in rats.

Sixty-three adult male SD rats (aged 8-10 weeks, SPF grade) were randomly assigned using a random number table into the Sham group (n=3), SCI group (n=15), SCI+GelMA group (hydrogel transplantation alone, n=15), SCI+Mito group (mitochondria transplantation alone, n=15), and SCI+GelMA+Mito group (combined hydrogel and mitochondria transplantation, n=15). The Sham group was only used for footprint analysis. A right-sided spinal cord hemisection injury model was established at the thoracic T10 level. According to the group assignment, corresponding materials were injected into the spinal cord lesion gap, followed by suturing of the overlying muscle and tissue. Prior to surgery, rheological characterization and scanning electron microscopy of the hydrogel were performed. At 24 h post-surgery, rats were euthanized, and tissue samples were collected to assess cell death by measuring Drp1 protein expression using Western blotting. At 7 d post-surgery, the expression of ARG1 was evaluated using Western blotting and immunofluorescence to assess inflammatory levels in the injured spinal cord region. At 28 d post-surgery, axonal regeneration was evaluated by detecting NF200 expression using Western blotting and immunofluorescence. From 7 to 28 d post-surgery, motor functional recovery of the hind limbs was assessed at multiple time points using the Basso-Beattie-Bresnahan locomotor rating scale and footprint analysis.

At 24 h post-surgery, compared with the SCI group, SCI+GelMA group, and SCI+Mito group, the Drp1 expression level in the SCI+GelMA-Mito group was significantly lower, with statistically significant differences (P<0.05). At 7 d post-surgery, compared with the SCI group, SCI+GelMA group, and SCI+Mito group, the ARG1 fluorescence intensity and protein expression level in the SCI+GelMA-Mito group were significantly enhanced, and the differences were statistically significant (P<0.05). The footprint analysis experiment showed that compared with the SCI group and the SCI+GelMA group, the SCI+Mito group and the SCI+GelMA+Mito group had longer front and back step widths on the right hind limb, and narrower left and right step widths, with statistically significant differences (P<0.05). The BBB scores of the 4 groups of rats showed varying degrees of improvement over time at postoperative days 7, 14, 21, and 28, with SCI+GelMA+Mito group>SCI+Mito group>SCI+GelMA group>SCI group, and the differences were statistically significant (P<0.05).

GelMA hydrogel combined with mitochondrial transplantation has an obvious therapeutic effect on SCI, which can reduce cell death in the injured area, suppress inflammatory responses, promote axonal regeneration, and improve motor functional recovery. Therefore, this strategy may represent a feasible and promising therapeutic method for SCI in the future.

To explore the potential risk factors for the progression of non-traumatic subdural effusion (NTSE) to chronic subdural hematoma (CSDH).

NTSE patients who met the criteria and were screened at Xiaolan Clinical Institute of Shantou University Medical College (Xiaolan People's Hospital of Zhongshan City) and Luhe County People's Hospital of Shanwei City from June 2021 to March 2025 were selected as the study subjects. Patients were divided into hematoma group and effusion group based on whether they progressed to hematoma. Clinical data of the two groups were compared, and multiple Logistic regression analysis was used to screen for independent risk factors for NTSE progression to CSDH. Based on the regression model results, receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic efficacy of the model.

This study ultimately included 82 NTSE patients, including 31 cases (37.8%) in hematoma group and 51 cases (62.2%) in effusion group. Compared with the effusion group, the hematoma group had higher proportion of patients taking anticoagulant/antiplatelet medications, higher CT attenuation values of subdural effusion, and greater effusion asymmetry, larger maximum outer diameter of the lateral ventricular body, lower lateral ventricular body index and lateral ventricular body width index, with statistical significance (P<0.05). Multivariate Logistic regression analysis showed that increased CT attenuation values of subdural effusion and asymmetric fluid accumulation were independent risk factors for the progression of NTSE to CSDH. ROC curve analysis showed that the overall area under the curve (AUC) of the model was 0.866 (95%CI: 0.805-0.967), the AUC of CT attenuation values of subdural effusion was 0.828 (95%CI: 0.713-0.944), and the AUC of effusion symmetry was 0.772 (95%CI: 0.649-0.895). The predictive performance of the overall model and the CT value of fluid accumulation is higher than that of fluid symmetry.

High CT attenuation values of subdural effusion and effusion asymmetry were independent risk factors for the progression of NTSE to CSDH. The Logistic regression prediction model based on risk factors and CT attenuation values of subdural effusion have shown good predictive performance, which can effectively quantify the risk probability of NTSE progressing to CSDH.

After severe traumatic brain injury (sTBI) surgery, post-traumatic cerebral infarction (PTCI) often presents as a hidden disease due to the combined effects of multiple factors, including age, gender, degree of traumatic brain injury, increased intracranial pressure, cerebrovascular injury, coagulation dysfunction, and decompressive craniectomy. Clarifying the mechanisms of risk factors can help achieve early diagnosis and timely treatment of PTCI, and treatment, and effectively reducing the mortality and disability rates of patients. This article reviews the risk factors and pathogenesis of secondary PTCI after sTBI surgery, in order to provide reference for clinical diagnosis and treatment.