Background: Decreased organ function and poor physical compensatory capacity in elderly patients diagnosed with spontaneous intracerebral hemorrhage (ICH) can make surgical treatment procedures challenging and risky. Minimally invasive puncture drainage (MIPD) combined with urokinase infusion therapy is a safe and feasible method of treating ICH. This study aimed to compare the treatment efficacy of MIPD conducted under local anesthesia using either 3DSlicer + Sina application or computer tomography (CT)-guided stereotactic localization of hematomas in elderly patients diagnosed with ICH. Methods: The study sample included 78 elderly patients (> 65 years of age) diagnosed with ICH for the first time. All patients exhibited stable vital signs and underwent surgical treatment. The study sample was randomly divided into two groups, either receiving 3DSlicer+Sina or CT-guided stereotactic assistance. The preoperative preparation time; hematoma localization accuracy rate; satisfactory hematoma puncture rate; hematoma clear-ance rate; postoperative rebleeding rate; Glasgow Coma Scale (GCS) score after 7 days; and modified Rankin scale (mRS) score 6 months after surgery were com-pared between the two groups. Results: No significant differences in gender, age, preoperative GCS score, preoperative hematoma volume (HV), and surgical dura-tion were observed between the two groups (all p-values > 0.05). However, the pre-operative preparation time was shorter in the group receiving 3DSlicer + Sina assistance compared to that receiving CT-guided stereotactic assistance (p-value < 0.001). Both groups exhibited significant improvement in GCS scores and reduction in HV after surgery (all p-values < 0.001). The accuracy of hematoma localization and puncture was 100% in both groups. There were no significant differences in sur-gical duration, postoperative hematoma clearance rate, rebleeding rate, postopera-tive GCS and mRS scores between the two groups (all p-values > 0.05). Conclusions: A combination of 3DSlicer and Sina is effective in accurately identifying hematomas in elderly patients with ICH exhibiting stable vital signs, thus simplify-ing MIPD surgeries conducted under local anesthesia. This procedure may also be preferred over CT-guided stereotactic localization in clinical practice due to its ease of use and accuracy in hematoma localization.(c) 2023 Elsevier Inc. All rights reserved.

Objective:To explore the effect of minimally invasive hematoma puncture and drainage in the treatment of elderly patients with cerebral hemorrhage by using 3D slicer and Sina software to conduct 3D reconstruction and preoperative localization of intracerebral hematoma.Methods:A total of 74 elderly patients with a first-onset intracerebral hematoma aged ≥75 years, having surgical indications and stable vital signs were grouped into 3D slicer plus Sina software localization group(as group A, n=40)or CT localization group(as group B, n=34). Based on the localization, hematoma puncture and drainage were performed after local anesthesia.Preoperative preparation time, hematoma location, puncture success rate, postoperative hematoma clearance rate, postoperative re-bleeding rate and GCS score were statistically analyzed.Glasgow coma scale(GCS)scores were used in predicting the mortality.Results:The preoperative preparation time was significantly shorter in group A than in group B[(5.5±3.4)min vs.(8.5±2.7)min, t=3.337, P=0.001]. The success rate of hematoma puncture and drainage(90.0% and 70.6%, χ2=4.51, P=0.034)and postoperative hematoma clearance rate[(87.5±3.4)% and(80.3±2.7)%, t=10.10, P=0.000]were higher in group A than in group B. There were no significant differences in operative time, the accuracy of hematoma localization, re-bleeding rate and GCS score between the two groups( P>0.05). Conclusions:3D slicer plus Sina software can precisely locate the intracerebral hematoma, and minimally invasive hematoma puncture and drainage of intracerebral hematoma under local anesthesia were safe and effective in the treatment of elderly patients with intracerebral hemorrhage.

Objective:To investigate the value of Xuefu Zhuyu Decoction in the treatment of acute cerebral hemorrhage and the effect of non-invasive brain edema dynamic monitor on its treatment and guidance.Methods:40 patients with acute cerebral hemorrhage were randomly divided into treatment group and control group,20 cases in each group.The patients in the control group were treated only with conventional Western medicine,and the treatment group was treated with Xuefu Zhuyu Decoction on the basis of it.The following items were observed on l st,3rd,Sth and 8th days after admission:dynamic detection of synthetic disturbance coefficients with noninvasive brain edema dynamic monitor,the volume of brain hematoma and the size of the low-density volume by CT examination,NIHSS scores.The perturbation coefficients of bilateral cerebral hemisphere and the volume of low density around hematoma were compared between the two groups.Results:With the progress of treatment,the difference was statistically significant in the disturbance coefficient,edema degree and neurological function score between the treatment group and the control group on the third,fifth and eighth days;the treatment group was better than the control group.The change of the low-density volume around the hematoma was consistent with the change of the coefficient of disturbance and the score of the two groups.On the third,fifth and eighth days,the NIHSS score in the treatment group was significantly lower than that in the control group.Conclusions:Xuefu Zhuyu Decoction combined with routine Western medicine treatment can obviously reduce the secondary brain edema and improve the nerve function of the patients.The noninvasive dynamic monitoring of cerebral edema can be used to observe the dynamic evolution of brain edema after intracerebral hemorrhage.The change of comprehensive perturbation coefficient reflects the formation process of edema and realizes dynamic monitoring and evaluation.It is practical,noninvasive,accurate and sensitive,and has certain guiding significance for the diagnosis and treatment of the disease.

Objective The waist large pool peritoneal shunt technology right surgery effect of hydrocephalus after traumatic brain injury. Methods Selection of 12 cases admitted in our hospital in recent years, patients with craniocerebral trauma combined hydrocephalus, adopt waist bigger pools operate peritoneal shunt. Results Effective treatment in all 12 cases, but a 33.33% complications. Conclusion Large pool of peritoneal shunt treatment effect is good, but must pay attention to the treatment of patients with postoperative complications prevention.

Objective To explore the changes of preoperative and postoperative electroencephalograms of video-electroencephalography(V-EEG) in monitoring fourth ventricular tumor resection in order to found an electrophysiological basis to diagnose or differential diagnose early postoperative epilepsy caused by fourth ventricular tumor.Methods Preoperative and postoperative EEG and clinical characteristics of 23 patients with fourth ventricular tumor in our hospital from Jan.2009 to Dec.2011 were retrospectively analyzed.Results These 23 patients all had hydrocephalus at various degrees but no history of seizures before surgery.Preoperative EEG displayed there were 9 patients of normal EEG,8 of increased sporadic slow waves in all electrodes,and 6 of paroxysmal rhythmic slow waves.Hydrocephalus was obviously alleviated after surgery.Perioperative EEG indicated that 16 patients with background moderation and slower EEG frequencies,3 patients with background moderation,synchronous rhythmic slow wave and sporadic single suspicious negative sharp wave/sharp slow wave but with no epileptic seizure after continuous observation,4 patients with synchronous rhythmic slow wave and sporadic bursts of spike/multi-spike slow waves,and 1 patient with eyelid twitching and 3 patients without obvious clinical seizures,but with various disturbance of consciousness observed by video.Consciousness improved significantly after antiepileptic treatment.Conclusion V-EEG monitoring is useful to diagnose or differential diagnose early postoperative epilepsy,especially non-typical seizures.

目的介绍立体定向微电极导向射频毁损术治疗帕金森病及术后可能出现的并发症.方法采用CT定位,立体定向微电极细胞电生理记录技术进行术中靶点监测,对240例帕金森病人的苍白球和(或)丘脑腹外侧核进行射频毁损术治疗.结果手术效果优良,原有症状术后改善率97.6%.结论立体定向微电极导向射频毁损术是目前治疗帕金森病的一种安全有效方法.

目的探讨三磷酸胞苷结合中药治疗重型颅脑损伤.方法采用三磷酸胞苷(CTP)与黄芪、川芎嗪注射液或红花注射液治疗.结果三磷酸胞苷结合中药组治疗效果较单纯西医组治疗效果更为满意,有统计学意义.结论三磷酸胞苷结合中药治疗重型颅脑损伤是一种有效的方法.

颅脑外伤后发生外伤性低颅压综合征较为常见,一般不引起重视,对严重低颅压综合征认识不够,往往延误治疗.现将我院1997～2000年发生低颅压综合征的病例结合文献做一回顾,报告如下.

我院采用脑立体定向微电极导向射频毁损术治疗帕金森病,从1999年8～11月,共治疗患者104例,治疗效果较好,但术后近期也出现了不同程度的偏瘫、面瘫、平衡障碍、语言障碍及嗜睡或昏睡等并发症.本文旨在讨论通塞脉片在治疗此类并发症中的效果,报告如下.

目的介绍立体定向微电极导向射频毁损术治疗帕金森病及术后可能出现的并发症.方法采用CT定位,立体定向微电极细胞电生理记录技术进行术中靶点监测,对108例帕金森病人的苍白球和(或)丘脑腹外侧核进行射频毁损术治疗.结果手术效果优良,原有症状术后改善率98.1%,无永久并发症.结论立体定向微电极导向射频毁损术是目前治疗帕金森病的一种安全有效方法.

目的:观察补阳还五汤对立体定向微电极导向射频毁损术治疗帕金森病后出现的并发症的疗效.方法:采用CT定位,立体定向微电极细胞电生理记录技术进行术中靶点监测,将240例帕金森病人的苍白球和(或)丘脑腹外侧核进行射频毁损术治疗后出现半身不遂、走路不稳、口眼(口呐)斜患者,随机分为两组,分别给予单纯西医或中西医结合治疗.结果:中西医结合组显效率与单纯西医组比较,差异有统计学意义(P＜0.05).结论:补阳还五汤对立体定向微电极导向射频毁损术治疗帕金森病后出现的并发症有治疗效果.

脑射频治疗术是治疗帕金森病的一种有效方法,但也相应产生了一些短期并发症如偏瘫、意识障碍、多尿等影响病人康复.我院根据射频损伤机制,辨证施治,采用中药静脉配方"脑脉通注射液”治疗取得满意效果,现报告如下.

1994年9月～1999年12月,我院脑外科共收治慢性硬膜下血肿46例.采用中西医结合治疗,获得了较为满意的疗效,现予以临床分析,报告如下.

1999年8月至1999年11月,我科共收治帕金森病人137例,采取立体定向微电极导向射频毁损术治疗108例,其中术后出现半身不遂、口眼(口呙)斜者76例,用中西医结合与单纯西医对照治疗,现将治疗情况报告如下.