To investigate the clinical effects of atorvastatin in the treatment of postoperative recurrent chronic subdural hematoma.

From January 2014 to September 2015, 17 patients in the first people’s hospital of xiangyang were selected as research objects. These patients received oral atorvastatin and the patient’s symptoms, daily life ability ADL score, the degree of absorption of the hematoma were observed to determine the efficacy on admission and 1th, 2th week, 1th, 3th month after the therapy.

On 1th week the symptoms improved in 13 (13/16, 81.25%) cases, ADL score increased in (15/16, 93.75%) cases (P<0.05). On 2th week the hematoma were began to reduce (P<0.05). On 3th month, ADL score returned to normal, the symptoms improved completely, and the intracranial hematoma was completely absorbed in 15 cases. ADL score returned to normal, the symptoms improved significantly, most of the intracranial hematoma was absorbed in one case. One patient complicated with acute cholecystitis and abnormal liver function, his condition deteriorated with an enlarged hematoma during the 2th week of treatment and was cured by skull drilling drainage and postoperative oral atorvastatin again.

Atorvastatin in the treatment of postoperative recurrent chronic subdural hematoma has a significant effect, but caution is needed for patients with abnormal liver function.

Stroke is the leading cause of lethal and disability of human beings. Nowadays, the mobility of stroke is increasing annually, while the episode age of stroke is decreasing yearly. This review puts emphasis on the pathogenesis, risk factors, treatments, and prognosis of stroke in youth, and aima at summerizing research progress and orientation of stroke in the young, which providing related reference of the disease.

To investigate the therapeutic effect of CT-guided stereotactic minimal invasive and drainage for hypertensive cerebellar hemorrhage.

Twenty-three cases of hypertensive cerebellar hemorrhage patients treated with stereotactic minimally invasive drainage were retrospectively analyzed in our hospital from January 2013 to June 2016, compared the efficacy with the other 23 patients who underwent posterior fossa craniotomy with hematoma removal at the same time period. The amount of bleeding of two groups were both 10~20 ml. The stereotatic group was given CT-guided stereotactic minimal invasive and drainage treatment, after operation, poured urokinase into the hematoma to dissolved it. The craniotomy group was performed posterior cranial fossa craniotomy after general anesthesia and the hemotoma was removaled by the microsurgery, after operation, the hemostasis, dehydration etc were given to the patients.

The average hospitalization days of the stereotatic group was significantly shorter than the craniotomy group (P=0.01). The postoperative complication of the stereotatic group less than the craniotomy group (P=0.03). The emptying time of hematoma of the stereotatic group langer than the craniotomy group (P=0.04). The activities of daily living classification after six months treatment of the stereotatic group no statistical difference with the craniotomy group (P=0.33).

The stereotactic minimal invasive and drainage for cerebellar hemorrhage could achieve considerabl reset effect compare with the posterior cranial fossa craniotomy, and it was accurate positioning, little injury, less complication, shorter hospitalization and so on. The stereotactic minimal invasive and drainage for hypertensive cerebellar hemorrhage is worthy for the clinical popularization and application.

To investigate postoperative complications of ventriculoperitoneal shunt in treating traumatic hydrocephalus, and its prevention measures.

Seventy-eight traumatic hydrocephalus patients in Hangzhou hospital of Zhejiang armed police corps from May 2014 to April 2015 were selected in this study. All patients underwent ventriculoperitoneal shunt operation. The postoperative complications were observed.

Among all the patients, shunt obstruction occurred in 3 cases, while infection in 5 cases, intracranial hematoma in 3 cases, digestive tract symptoms in 2 cases, over drainage or insufficient drainage in 2 cases. Total incidence rate of postoperative complications was 19.23%.

There are variety of complications after ventriculoperitoneal shunt for traumatic hydrocephalus, among which shunt obstruction, postoperative infection and intracranial hematoma have the higher incidence rate. Surgeons should make relative perfect operation plan to prevent the occurrence of postoperative complications.

To investigate the mechanism and related risk factors for massive infarction in patients with severe traumatic brain injury.

Retrospectively reviewed the clinical data of the 113 paients with severe traumatic brain injury in department of neurosurgery, Shenzhen second people's hospital from January 2012 to June 2014, from which the qualified cases of severe craniocerebral injury were selected, and then divided into PTCI group and non PTCI group according to the head CT examination results whether the occurrence of PTCI. The risk factors were evaluated by univariate and multivariate study, SPSS 19.0 statistical software was applicated for analyzing, univariate analysis by Chi-square examination, multivariate analysis by Logistic regression.

By univariate analysis, the differences of these six risk factors, Low GCS scores, cerebral hernia, hypotension, Preoperative coagulation dysfunction, subarachnoid hemorrhage, the application of hemostatic agents after injury, between the two groups was statistically significant(P<0.05), they were important risk factors for PTCI. By multivariate logistic analysis, Low GCS scores, cerebral hernia, hypotension, the application of hemostatic agents after injury were the independent risk factors for PTCI.

Low GCS scores, cerebral hernia, hypotension, Preoperative coagulation dysfunction, subarachnoid hemorrhage, the application of hemostatic agents after injury are the important risk factors of PTCI, Low GCS scores, cerebral hernia, hypotension, Preoperative coagulation dysfunction,subarachnoid hemorrhage, the application of hemostatic agents after injury are the independent risk factors for PTCI. It has important clinical significance for the prevention and treatment of PTCI to focus on these risk factors assessment and reasonable intervention.

To investigate the risk factors of incontinent-associated dermatitis in the acute severe stroke patients.

Incontinent-associated dermatitis were assessed by application of Incontinence-associated Dermatitis and Its Severity Instrument(IADS) and Perineal Assessment scale(PAT) in the patients of acute severe stroke, and their risk factors were analyzed.

(1)128 cases of patients with acute cerebral stroke were 36 cases of pre-hospital IAD, the incidence of 28.13%. There were 20 cases were mild; 9 cases were of moderate; 7 cases were severe. (2)The risk factors of IAD for the pre-hospital IAD included age≥65 years, history of stroke, diabetes, coma, period≥12 h, the temperature≥38.0 ℃, fecal incontinence, urinary incontinence, NIHSS score≥12, poor nutritional status and immune function, that were relatively higher risk of pre-hospital IAD in the patients of acute cerebral stroke.

There was higher incidence rate of pre-hospital IAD in the acute severe stroke patients. The risk factors had characteristic. This study could provid individualized nursing care for patients admitted to hospital.

Acute carbon monoxide poisoning is a common disease in the north of China, and the mortality rate and disability rate are very high. Acute carbon monoxide poisoning can lead to multiple organ damage in cardiovascular system and central nervous system damage in patients. Although most patients can be cured by clinical comprehensive effective treatment, but severe carbon monoxide poisoning patients prone to delayed encephalopathy after the false, its incidence is about 10%-30%. The pathogenisis is not elucidated well, but comprehensive risk factors, early prediction and proper diagnosis and treatment of delayed encephalopathy is a difficult problem to be solved in clinical work. The pathogenesis, risk factors, diagnosis and treatment of delayed encephalopathy after acute carbon monoxide poisoning were described in this paper.

To explore the risk factors of acute encephalocele during operation in patients with PADBS(post-traumatic acute diffuse brain swelling).

Gender, age, time from injured to operation,deceleration craniocerebral injury, multiple injuries,cranial CT scan hematoma thickness,hernia, GCS scale before operation, hypotension during operation, operation methods were recorded and analyzed the risk factors in 58 acute encephalocele during operation in patients with PADBS(study group)and 47 patients without acute encephalocele (control group)by multi-factor regression analysis.

Deceleration craniocerebral injury, hernia, GCS scale before operation, hypotension during operation were closely correlated with the occurrence of acute encephalocele during operation.

Deceleration craniocerebral injury, hernia, GCS scale before operation, hypotension during operation are the risk factors for acute encephalocele during operation. Precise evaluation before operation and active control during operation will reduce the risk of acute encephalocele during operation in patients with PADBS.

To investigate the characteristics of traumatic intracranial pseudoaneurysms and the surgical treatment ethods and outcome.

The information of a total of 14 cases of traumatic intracranial pseudoaneurysms from October 2008 to December 2014 was analyzed retrospectively about the clinical manifestations, imaging characteristics and surgical method. One case with cavernous sinus segment carotid pseudoaneurysm underwent ECA-MCA bypass and aneurysm isolated after blood flow after blocking test (Matas test); ten patients underwent endovascular interventional embolization; three patients underwent pseudoaneurysm neck reinforcement or clipping.

Three cases underwent surgical removal of the aneuryms and had the pathological specimens. The pathological examination showed compound for a large number of thrombosis and machine, without inelastic fiber or smooth muscle cells and other normal blood vessels. It conforms to the characteristics of pseudoaneurysms. These patients’ GOS score when discharged from hospital including 5 in 6 cases, 4 in 4 cases and 3 in 4 cases. All the patients were followed up from 6 months to 6 years, 10 cases DSA and CTA examination showed aneurysms disappear and the parent artery patency. All patients were followed up without bleeding again.

Traumatic intracranial pseudoaneurysms is a special kind of aneurysm, with high operation risk and difficult. It is necessary to fully understand the characteristics of pseudoaneurysms and the status of compensatory intracranial vascular preoperative. If the characteristics of pseudoaneurysms can be fully understood and individualized surgical treatment can be undergone, the patients could have a good outcome.

To observe the curative effect of subdural effusion treated and prevented with bandage secondary to decompressive craniectomy performed in patients with traumatic brain injury.

55 cases of traumatic brain injury were undergone decompressive craniectomy from September 2009 to April 2015 in department of neurosurgery of the second people’s hospital of Jingzhou, and those cases were randomly divided into bone window compression bandage group(n=26) and normal group (n=29). Analysis the difference of the incidence of subdural effusion, the occurrence time and postoperative GOS score between two groups. And observation the curative effective of subdural effusion treated with bone window compressive bandage.

The incidence of subdural effusion post decompressive craniectomy is 7.7%(2/26) in bandage group, 27.6%(8/29) in normal group, the average appear time of subdural effusion post decompressive craniectomy in bandage group (38.5±3.7) d is longer than normal group(13±2.9) d, there are significant differences between two groups(P<0.05). The number of GOS score >3 was 18(69.2%) in bandage group, 21(73.2%) in normal group, there is no significant difference between two groups(P>0.05). After average 23.9 d bandage treatment, the subdural effusion of 10 cases were absorbed disappear, there was no case needed operation.

Bone window compression bandage after decompressive craniectomy performed in patients with traumatic brain injury can obviously reduce the incidence of subdural effusion, and it played an import role in preventing and treating the subdural effusion. This method is simple, safe, and effective, and it is worthy of clinical application.

To evaluate the efficacy of ventriculoscope and continued lumbar cerebrospinal fluid drainage in the treatment of severe primary intraventricular hematoma.

Sixty-two patients with severe primary intraventricular hematoma patients in Luohe Central Hospital from July 2007 to November 2015 were retrospectively analyzed and divided into group A(n=27, before May 2010)and group B (n=35, after May 2010) according to the time sequence. Twenty-seven patients in group A were treated with ventriculopuncture and intermittent lumbar puncture. Thirty-five patients in group B were treated with ventriculoscope and continued lumbar cerebrospinal fluid drainage. Hematoma evacuation rate 48 hours after operation and ADL grades 6 months after operation were compared.

(1)Hematoma evacuation rate >90% were found in 1 cases in group A 48 hours after operation, and hematoma evacuation rate 60%-90% were found in 9 cases, hematoma evacuation rate<60% were found in 17 cases; Hematoma evacuation rate >90% were found in 15 cases in group A 48 hours after operation, and hematoma evacuation rate 60%-90% were found in 18 cases, hematoma evacuation rate <60% were found in 2 cases, the differences were statistically significant(P<0.01). (2)6 months after operation, in group A, 5 cases of ADL grade Ⅰ, 8 cases of ADL grade Ⅱ, 6 cases of ADL grade Ⅲ, 6 cases of ADL grade Ⅳ, 2 case of ADL grade Ⅴ, good recovery rate was 70.37%; In group B, 16 cases of ADL grade Ⅰ, 10 cases of ADL grade Ⅱ, 5 cases of ADL grade Ⅲ, 3 cases of ADL grade Ⅳ, 1 case of ADL grade Ⅴ, good recovery rate was 88.57%, the difference was statistically significant (P<0.01).

Ventriculoscope and continued lumbar cerebrospinal fluid drainage for severe primary intraventricular hematoma is a better surgical treatment because of its effective hematoma evacuation and excellent postoperative outcome.

To discuss the clinical features of closed craniocerebral trauma in the elderly and to summarize the therapies. Some essays, reviews and guidelines in this field are collected to find difference between elderly patients and the other people. The features and the basic condition of the patients were collected for individual assessment, in order to choose treatment plan. The elderly due to the characteristics and other basic diseases, need early diagnosis and active treatment. And according to the basic health condition, to choice conservative treatment or proper operative treatment is necessary. So actively treating the primary disease, at the same time, attaching great importance to find the diseases before injury and the prevention of complications after injury is significant for improving the prognosis and survival rate.

Glioma stem cells exist in the micro environment, which contains a variety of cell signal transduction molecules, and biological behavior of glioma is regulated by extracellular microenvironment on the intracellular signal. Glioma stem cell signaling pathways study has become the hot topics in the study of glioma. This review focuses on several important in glioma stem cells related to neural stem cell signaling pathways, for a more comprehensive understanding of glioma cell signal, and provide basic evidence to explore new glioma treatment.

To compare the efficacy between lower temporal large decompressive craniectomy and standard large trauma craniectomy in the treatment of patients with severe head injury.

The data of 173 patients in Armed Police Jiangxi Corps Hospital from January 2008 to March 2014 with severe head injury, who received lower temporal large decompressive craniectomy(the research group)or standard large trauma craniectomy(the control group), were retrospectively analyzed. Lower temporal large decompressive craniectomy was conducted in the research group(92 cases), while standard large trauma craniectomy was conducted in the control group(81 cases). GCS rating, incidence rate of complications, prognosis and other indicators were observed and compared between two groups.

At 6 months after surgery, no statistically significant differences were reported between these two groups in terms of good recovery, moderate disability, severe disability, vegetative state and dead as defined by GOS rating (27.2%, 15.2%, 29.3%, 8.7% and 19.6% in the research group vs. 22.2%, 21.0%, 23.5%, 7.4% and 25.9% in the control group, respectively) (P>0.05). The average incidence rate of postoperative complications (8.1%) in the research group was lower than that in the control group (11.8%), suggesting a statistically significant difference (P<0.05).

In the treatment of severe head injury, lower temporal large decompressive craniectomy can achieve a comparable prognosis to standard large trauma craniectomy while effectively reduce the complications, demonstrating it is worth clinical promotion.