痛泻要方功擅调和肝脾,治疗脾虚肝郁之痛泻,配伍精当,药简力宏.在其沿革过程中,历代医家基于对病机方药之不同见解,而调整方剂的药味与剂量,其功效表现出异方同治、异方异治、同方异治之情况.本文通过辨析痛泻要方之方论及其组成药物等配伍变化,以阐明"方之用,变也"之理,即方剂之用重在变化,方剂之效靠治法彰显、由君效引领、因药力实现.

通过分析"亢害承制"的理论内涵,以及"营卫亢害"在Graves病(毒性弥漫性甲状腺肿)心悸中的作用,认为其病机为卫亢邪盛、卫亢营害、营卫俱虚.结合"营卫亢害"理论与本病病机,提出调和营卫,平其亢害的治疗大法,将Graves病心悸分三期辨治,分别选用白虎汤合桂枝汤、竹叶石膏汤合桂枝汤、炙甘草汤等方随证加减治疗.

中医认为病毒性心肌炎多以营卫失调,邪毒外侵为主要病机,其营卫俱虚,气血阴阳不足,心失所养贯穿病程始终.炙甘草汤出自《伤寒论》,是方寓调营卫于补气血阴阳之中,故对病毒性心肌炎的临床辨治体现出了较好的治疗作用,现试析其相关理论认识,以期为临床运用中医药辨治病毒性心肌炎提供遣药、组方、法则参考.

[[目的]]探讨培土生金法治疗胃食管反流性咳嗽的理论基础.[[方法]]结合历代文献的相关记述,梳理培土生金法的脉络,根据胃食管反流性咳嗽的临床特点,分析培土生金法在胃食管反流性咳嗽治疗中的应用.[[结果]]胃食管反流性咳嗽当以脾胃亏虚为发病之本,以痰浊上犯为发病之标,肺气受损,宗气与卫气不足贯穿疾病始终.治疗当以"培土生金"之法,通过健运脾胃,杜绝生痰之源;补充宗气与卫气生成之本,恢复已伤之肺气,达到标本兼治之效.经典名方参苓白术散、麦门冬汤、黄芪建中汤等皆宗"培土生金"之旨,疗效甚佳.[[结论]]培土生金法治疗胃食管反流性咳嗽具有坚实的理论基础及临床意义,通过健运脾胃治疗肺脏之伤损,对治疗胃食管反流性咳嗽具有重要的指导价值.

目的 探讨脑血管淀粉样变性相关脑出血(CAA-ICH)手术治疗的临床效果.方法 回顾性分析2014年3月～2019年3月手术治疗的33例CAA-ICH的临床资料.结果 33例中,年龄<70岁15例(低龄组),年龄≥70岁18例(高龄组).小骨窗手术5例,标准骨瓣开颅手术28例(骨瓣回置20例,去骨瓣减压8例).术后24 h复查头部CT显示血肿清除率在60～95％,平均(80.5±4.2)％.低龄组血肿清除率[(81.6±4.3)％]与高龄组[(79.4±5.1)％]无统计学差异(P>0.05).低龄组术后发生再出血发生率(6.67％)、肺部感染发生率(40.00％)、下肢静脉血栓发生率(13.33％)与高龄组(分别为11.11％、55.56％、33.33％)无统计学差异(P>0.05).术后随访1年,按GOS评分:死亡5例,植物生存5例,重残9例,中残10例,恢复良好4例.低龄组预后良好率(60.00％;GOS评分4～5分)明显高于高龄组(27.78％;P<0.05).结论 CAA-ICH术后并发症发生率高,总体预后不理想.相对年轻的CAA-ICH病人,显微手术是相对积极的治疗手段,可望获得较好的预后;但高龄CAA-ICH病人预后较差,全麻开颅手术应相对慎重.

目的:观察揿针结合于氏丛刺治疗卒中后抑郁的临床疗效.方法:将90例患者随机分为对照组30例、传统针刺组30例和联合针刺组30例.对照组在基础治疗基础上,予以口服舍曲林,传统针刺组在对照组基础上予以传统针刺干预,联合针刺组在对照组的基础上,予以揿针结合额区丛刺干预,3组均每日1次,每周7次,连续治疗6周.3组患者分别于治疗前和治疗6周时运用24项汉密尔顿抑郁量表(HAMD)、改良爱丁堡-斯堪的那维亚神经功能缺损评分量表(MESSS)以及测定5-HT水平比较3组间的疗效差异.结果:治疗后,3组患者HAMD评分和MESSS评分均较治疗前显著下降,差异具有统计学意义(P＜0.01),传统针刺组和联合针刺组优于对照组,差异具有统计学意义(P＜0.05或P＜0.01).治疗后3组患者5-HT水平较治疗前水平显著增高,差异具有统计学意义(P＜0.01),传统针刺组和联合针刺组优于对照组,差异具有统计学意义(P＜0.01).疗效评定方面,对照组总有效率65.52％ (19/29),传统针刺组和联合针刺组总有效率分别为78.57％ (22/28)和89.66％(26/29).结论:在舍曲林基础上揿针结合于氏丛刺或传统针刺治疗卒中后抑郁比单独应用舍曲林更为有效、安全.揿针联合于氏丛刺较传统针刺疗效更优,值得临床推广应用.

Objective. At present, no effective noninvasive method is currently available for the differential diagnosis of high-grade glioma and intracranial lymphoma. In the present study, we aimed to screen microRNA (miRNA) markers in serum exosomes for differential diagnosis of high-grade glioma and intracranial lymphoma using high-throughput sequencing technology. Methods. Patients with intracranial lymphoma or high-grade glioma and healthy controls were included in this study (training cohort (n=10) and validation cohort: intracranial lymphoma (n=10), high-grade glioma (n=32), and healthy controls (n=20)). After RNA was extracted from serum exosomes, the high-throughput sequencing was used to determine the expression profiles of serum exosomal miRNAs and screen the differentially expressed miRNAs. RT-qPCR was used to verify the expressions of the selected miRNAs. The differences of miRNA expressions between groups were assessed by the Kruskal-Wallis test. The diagnostic value was analyzed using the receiver operating characteristic (ROC) curve. Results. High-throughput sequencing demonstrated that 170 miRNAs, including 109 upregulated ones and 61 downregulated ones, were differentially expressed in serum exosomes between the patients with intracranial lymphoma and high-grade glioma. Compared with the healthy controls, the number of differential serum exosomal miRNAs in the high-grade glioma group and intracranial lymphoma group was 130 and 173, respectively. RT-qPCR proved that both miR-766-5p and miR-376b-5p were significantly downregulated in high-grade glioma and intracranial lymphoma patients compared with the healthy controls (all p<0.001), and the expression of serum exosomal miR-766-5p in the intracranial lymphoma group was lower compared with the high-grade glioma group (p<0.05). The areas under ROC curve (AUCs) of serum exosomal miR-766-5p and miR-376b-5p for the diagnosis of glioma were 0.8883 (p<0.001) and 0.7688 (p=0.001), respectively, and they were 0.9271 (p<0.001) and 0.8542 (p<0.001), respectively, for the diagnosis of intracranial lymphoma. Moreover, the AUC value of serum exosomal miR-766-5p for the differential diagnosis of glioma and intracranial lymphoma was 0.7201 (p=0.026). Conclusions. miR-766-5p and miR-376b-5p in serum exosomes might be used as auxiliary diagnostic indicators for high-grade glioma and intracranial lymphoma, and miR-766-5p might be used as a differential diagnostic marker for both diseases.

OBJECTIVE:To explore the surgical efficacy of microvascular decompression(MVD) when the recent magnetic resonance tomography angiography(MRA) is unable to determine the relationship between blood vessels and nerves in patients with trigeminal neuralgia(TN).MATERIALS AND METHODS:The MRI images of 146 patients with TN who underwent MVD from January 2016 to December 2019 were analyzed retrospectively. The relationship between nerves and vessels was categorized as no contact, suspicious contact, and clear contact. Suspicious contact and clear contact were both defined as positive neurovascular relationship, whereas no contact was defined as negative neurovascular relationship. The efficacy of MVD in positive and negative groups was compared.RESULTS:1. A total of 146 TN patients underwent MVD. Intraoperative examination revealed that out of 146, 143 patients exhibited contacts, including 110 cases with arterial contact, 22 cases with combined arterial and venous contact, and 11 cases with venous contact. Considering the surgical result as a gold standard, the sensitivity of three-dimensional time leap angiography (3D-TOF-MRA) in assessing vascular compression in TN was 74.0 %; and the sensitivity of three-dimensional steady-state precession rapid imaging sequence (3D-FIESTA) in determining vascular compression was 82.2 %. Out of a total of 17 cases demonstrating negative neurovascular relationship by 3D-TOF-MRA together with 3D-FIESTA, 14 cases were found to have vascular contact during the surgery, and the sensitivity was determined to be 88.4 %. 2.Among the 38 patients with a negative neurovascular relationship demonstrated by 3D-TOF, postoperative efficacy was noted as a cure: 30 cases, improved: 5 cases, no effect: 3 cases. 3D-FIESTA showed 26 cases of negative neurovascular relationship, among them, cured: 20 cases, improved: 3 cases, no effect: 3 cases. A total of 17 patients with negative neurovascular relationships were established by 3D-TOF-MRA together with 3D-FIESTA, and the postoperative effects were found to be cure: 13 cases, improvement: 2 cases, and no effect: 2 cases. There was no statistically significant difference between the negative group and the positive group (x2 test; p > 0.05).CONCLUSION:To conclude, 3D-TOF-MRA, together with 3D-FIESTA, can illustrate the large blood vessels surrounding the trigeminal nerve efficiently, and determine whether it is the offending blood vessel. The interpretation would help reproduce the local anatomical spatial structure of the site before surgery, yet it is impossible to assess the peripheral anatomical relationship of the trigeminal nerve cistern comprehensively and accurately. This hints that a perfect prediction of the surgical effect of MVD is not possible at present. Thus, typical symptoms of TN are the most critical indicators for MVD surgery.

AIM: To evaluate and compare the long-term efficacy and safety of microvascular decompression (MVD) and glossopharyngeal nerve roots rhizotomy (GNR) in the treatment of glossopharyngeal neuralgia (GN). MATERIAL and METHODS: The data of 37 patients with glossopharyngeal neuralgia undergoing MVD alone and MVD + GNR from July 2004 to March 2017 were analyzed retrospectively. RESULTS: Efficacy: In the 22 cases of the MVD group, 19 cases were cured and 3 cases were improved. In the 15 cases of the MVD + GNR group, 14 cases were cured and 1 case improved. There was no significant difference between the two groups (chi-square test, p>0.05). Complications: Postoperative complications in the MVD group: 2 patients had short-term hoarseness and drinking cough, 1 case had cerebrospinal fluid leakage, 1 case had intracranial infection, and 1 case had ipsilateral hearing loss, with no deaths. Postoperative complications in the MVD + GNR group: permanent hoarseness in 2 cases, short-term drinking cough and hoarseness in 4 cases, ipsilateral facial paralysis in 1 case, and cerebrospinal fluid leakage in 1 case, with no intracranial infection or death. The incidence of postoperative hoarseness and drinking cough in the MVD + GNR group was higher than that in the MVD group (chi-square test, p<0.05). CONCLUSION: MVD alone was a safe and effective method for the treatment of primary glossopharyngeal neuralgia. The efficacy was equivalent to MVD + GNR, and there was a lower incidence of hoarseness and drinking cough.

AIM:To evaluate and compare the long-term efficacy and safety of microvascular decompression (MVD) and glossopharyngeal nerve roots rhizotomy (GNR) in the treatment of glossopharyngeal neuralgia (GN). MATERIAL and METHODS:The data of 37 patients with glossopharyngeal neuralgia undergoing MVD alone and MVD + GNR from July 2004 to March 2017 were analyzed retrospectively. RESULTS:Efficacy: In the 22 cases of the MVD group, 19 cases were cured and 3 cases were improved.In the 15 cases of the MVD + GNR group, 14 cases were cured and 1 case improved.There was no significant difference between the two groups (chi-square test, p>0.05).Complications: Postoperative complications in the MVD group: 2 patients had short-term hoarseness and drinking cough, 1 case had cerebrospinal fluid leakage, 1 case had intracranial infection, and 1 case had ipsilateral hearing loss, with no deaths.Postoperative complications in the MVD + GNR group: permanent hoarseness in 2 cases, short-term drinking cough and hoarseness in 4 cases, ipsilateral facial paralysis in 1 case, and cerebrospinal fluid leakage in 1 case, with no intracranial infection or death.The incidence of postoperative hoarseness and drinking cough in the MVD + GNR group was higher than that in the MVD group (chi-square test, p<0.05).CONCLUSION: MVD alone was a safe and effective method for the treatment of primary glossopharyngeal neuralgia.The efficacy was equivalent to MVD + GNR, and there was a lower incidence of hoarseness and drinking cough.

Glial tumors constitute the majority of primary intracranial brain tumors. The expression of specific markers of lymphangiogenesis in gliomas still remains unclear. A total of 40 surgical specimens from 20 patients with recurrent gliomas were included in the study. The expression of D2-40, vascular endothelial growth factor (VEGF)-C, VEGF-D, and VEGF receptor-3 (VEGR-3) was detected by immunohistochemistry (IHC). The clinicopathologic data (p53 and Ki67) were also collected and analyzed. At relapse malignant transformation rate was 65% (13/20 cases). D2-40, VEGF-C. VEGF-D, and VEGFR-3 were expressed in 20%, 30%, 60%, and 20% of primary and 45%, 30%, 75%, and 35% of recurrent glioma tumors (P <.01, P=1.00, P=.03, P=.03). In 13 cases with increased malignancy grade, the expression of Ki67 and p53 were higher at relapse compared with the primary tumors (P=.001, P=.045). Multivariate survival analysis showed VEGF-D was an independent prognostic factor for malignant transformation (HR =0.376. P=.045). Glioma is easy to relapse with tumor progression. VEGF-D was an independent prognostic factor for malignant transformation.

Objective: To evaluate and compare the long-term efficacy and safety of microvascular decompression (MVD) and glossopharyngeal nerve roots rhizotomy (GNR) in the treatment of glossopharyngeal neuralgia (GN). Patients and Methods: The data of 37 patients with glossopharyngeal neuralgia undergoing MVD alone and MVD + GNR from July 2004 to March 2017 were analyzed retrospectively. Among them, 22 were MVD alone and 15 were MVD + GNR. All patients underwent preoperative cocaine experiments to verify diagnoses, preoperative magnetic resonance imaging examinations to detect compressing vessels near the root entry zone of the glossopharyngeal nerve. Operation via retrosigmoid approach, keyhole craniotomy, and postoperative efficacy was followed up. Results: Efficacy: In the 22 patients with MVD alone, 19 patients were cured and 3 patients improved. In the 15 patients with MVD + GNR, 14 patients were cured and 1 patient improved. There was no significant difference between the 2 groups (χ2 test, P > 0.05). Complications: Postoperative complications in MVD group: 2 patients had short-term hoarseness and drinking cough, 1 patient with cerebrospinal fluid leakage, 1 patient with intracranial infection, 1 patient with ipsilateral hearing loss, and no deaths; postoperative complications in MVD + GNR group: permanent hoarseness in 2 patients, short-term drinking cough and hoarseness in 4 patients, ipsilateral facial paralysis in 1 patient, 1 patient with cerebrospinal fluid leakage, no intracranial infection and death. The incidence of postoperative hoarseness and drinking cough in MVD + GNR group was higher than that in MVD group (χ2 test, P < 0.05). Conclusion: The MVD alone was a safe and effective method for the treatment of primary glossopharyngeal neuralgia, the efficacy was equivalent to MVD + GNR, and had low incidence of hoarseness and drinking cough.

Objective: The aim of the study was to evaluate the efficacy of microvascular decompression (MVD) and stereotactic gamma knife surgery (GKS) in the treatment of trigeminal neuralgia (TN) in the elderly. Patients and Methods: Retrospective analysis of 137 elderly cases with TN underwent MVD, partial sensory rhizotomy (PR) treatment from August 2007 to March 2017 and 56 cases underwent GKS treatment from May 2014 to February 2017 was made, compared the efficacy of MVD and GKS in different age groups. Results: In 125 patients of MVD alone, the responsible vessels included 60 cases of superior cerebellar artery, 55 cases of anterior inferior cerebellar artery, 4 cases of venous vascular compression, 13 cases of mixed arteriovenous compression and 3 cases of vertebral artery, and 2 cases of no responsible vessel. Operation methods: MVD 125 cases, MVD + PR 10 cases, PR 1 cases, simple exploration in 1 case. Results of MVD surgery: Among 125 patients of MVD alone, 95 cases were cured, 15 cases improved, and 15 cases were ineffective. Among 10 cases of MVD + PR, cured in 9 cases and improved in 1 case. PR and simple exploration in 2 cases got pain disappeared. Postoperative complications of MVD: No deaths, CSF leakage in 2 cases, intracranial infection in 3 cases, ipsilateral hearing loss in 1 case, and ipsilateral facial paralysis in 1 case, delayed intracranial hematoma in 2 cases. After GKS treatment, the shortest onset time was from 9 days up to 6 months, an average of 2.2 months. Among 56 patients, 30 cases were cured, accounting for 53.6%, 20 cases improved, accounting for 35.7%, 6 cases were ineffective, accounting for 10.7%. Postoperative complications were facial numbness and dysesthesia, 7 cases, the incidence was 12.5%. In the group of 60 to 70 years old and the group of 70 to 80 years old, the treatment effect of MVD was better than that of GKS (χ2 test, P < 0.05); there was no significant difference between MVD and GKS in >80 years old group (χ2 test, P > 0.05). There was no significant difference in the therapeutic effect of TN underwent GKS among all age groups (χ2 test, P > 0.05). Conclusion: Microvascular decompression should be performed more prudently in elderly patients (>80 years old), and the indications for PR should be relatively relaxed. MVD + PR could improve the curative effect in patients with trigeminal neuralgia >80 years. Gamma knife treatment of trigeminal neuralgia had high safety, less complications, and positive curative effect, especially suitable for patients >80 years.

Objective To explore the treatment effect of hypertonic saline on the brain herniation due to hyponatremia in Neurosurgery patient. Methods The clinical data of 5 patients enrolled in our department from January 2014 to November 2016 were retrospectively analyzed. All the neurosurgery patients had brain herniation due to hyponatremia. Their diagnoses included head trauma, brain tumor, and spontaneous subarachnoid hemorrhage due to aneurysm. The brain herniation happened 4 to 16 d after brain injury or operation, because of the increased intracranial pressure (ICP) due to hyponatremia and brain edema subsequently. As the brain herniation occurred due to hyponatremia, the infusion of 2% hypertonic saline was intitated immediately. The goal of treatment was the serum sodium level being 145-155 mmol/l. Results The patients accepted hypertonic saline injection immediately, and the conditions ameliorated when the hyponatremia was corrected. The brain herniation was reversed, and no patient underwent decompressive craniectomy. The serum sodium level when brain herniation occurred was (121.80±5.12) mmol/l, then increased to (144.60±5.13) mmol/l when the brain herniation was reversed. The paired t test showed the difference between the two groups of the serum sodium levels was statistically significant (t=-5.419, P<0.05). The 5 patients were all recovered smoothly. The GOS of 4 patients were 5, and 1 patient scored 4. No complications such as central pontine myelinolysis occurred. Conclusion The brain edema duration of Neurosurgery patients is prolonged, and the pathophysiology of brain edema is complex, so water-electrolyte disturbance is readily to occur. Hyponatremia may cause brain edema and increased ICP, even brain herniation, with the characteristic of sudden onset and fast exacerbation. Hypertonic saline infusion could have potent effect to ameliorate such condition, may even reverse brain herniation and gain good outcome. Key words: Hyponatremia; Hypertonic Saline solution; Brain herniation

BackgroundTo investigate the role of pregnancy-associated plasma protein A (PAPP-A) in the outcome of ischemic cerebrovascular disease. MethodsWe analyzed the levels of PAPP-A in the transient ischemic attack (TIA) patients, ischemic stroke (IS) patients and normal control, and followed up the outcome of the patients in the following 2years. Blood samples were drawn at admission, prior to treatment with heparins. ResultsThe levels of PAPP-A in TIA patients, IS patients and normal control were 4.91 (2.11, 6.48) mIU/L, 6.77 (3.31, 10.23) mIU/L and 4.25 (1.76, 5.22) mIU/L, respectively. The follow-up results of TIA patients and IS patients indicated the PAPP-A concentration in the poor prognosis group were higher than those in the good prognosis group (5.90 vs 4.46mIU/L, P<.05, 10.06 vs 5.12mIU/L, P<.05, respectively). Serum PAPP-A concentration emerged as a predictor of risk stratification with an OR of 1.41 and 1.25 (P<.05, P<.05). ConclusionsHigher PAPP-A concentration has a forecasting value on prognosis in ischemic cerebrovascular disease.

Objective To investigate the experience of continuous intracranial pressure monitoring in the treatment of patient with frontal lobe contusions. Methods The patients were selected from April 2011 to October 2014 in the Second Hospital of Shandong University treated as brain contusion in frontal lobe. The clinical data of 13 patients with frontal lobe contusions were retrospectively analyzed. All patients accepted conservative treatment or operation treatment, and continuous intracranial pressure (ICP) monitoring, the prognosis of the patients were evaluated by Glasgow Outcome Scale. Results Four patients passed the brain edema peak period and recovered completely. Nine patients accepted removal of contusion operation and decompressive craniectomy. All patients were followed-up for 6 months. seven patients obtained good recovery (53.8%), 1 patient was mild disability (7.7%), 3 patients were severe disability (23.1%), and 2 patients died (15.4%). Conclusions The disease course of frontal lobe contusions had the characteristics of better conscious condition, abrupt deterioration, and prolonged brain edema duration. The intracranial pressure monitoring could insure the security of conservative treatment, and once the condition deteriorated, it could detect the brain herniation in advance, so the decompressive craniotomy would be carried out accordingly, the patient could havea better outcome.

Objective To investigate the clinical effects of decompressive craniotomy combined with temporal muscle sticking on massive cerebral infarction. Methods Eighty patients with massive cere-bral infarction were divided into two groups,40 patients in the treatment group underwent decompressive craniotomy combined with temporal muscle sticking,and 40 patients in the control group were given medi-cal treatment. The mortality rate and Glasgow outcome scale(GOS)scores were compared between the two groups. Results The mortality rate in the treatment group was 27. 5% . The survivors were followed up for 3 months to 6 months after surgery,and according to GOS,8 cases were graded as good,13 cases were gra-ded as moderate disability,5 cases were graded as severe disability,and 3 cases were graded as vegetative state. While in the control group,the mortality rate was 77. 5% . The survivors were followed up for 3 months to 6 months after surgery,and according to GOS,1 case was graded as good,3 cases were graded as moderate disability,3 cases were graded as severe disability,and 2 cases were graded as vegetative state. Conclusions Decompressive craniotomy combined with temporal muscle sticking can obviously re-duce the mortality rate of patients with massive cerebral infarction,and improve the neurological function in different degrees. Early stage surgical intervention is recommended if the disease condition permits.

Objective To investigate the surgical techniques of carotid endarterectomy (CEA) for treating carotid artery stenosis, in order to improve the surgical efficacy and reduce intraoperative adverse events and complications after operation. Methods Retrospective analysis was carried out on surgical data of 53 cases who were performed CEA from October 2010 to October 2013 in Department of Neurosurgery in Tianjin Huanhu Hospital. There were 39 males and 14 females, aged from 40 to 78 years old and mean age (60.34 ± 8.92) years old; the course of disease was from 2 d to 4 years. Twenty-six cases were diagnosed as right carotid stenosis, 15 cases left carotid stenosis and 12 cases double-sided carotid stenosis. Among all of those cases, 35 cases were diagnosed as moderate stenosis (30%-69%), 16 cases severe stenosis (70%-99% ), and 2 cases complete occlusion. Results Among 53 patients, 50 patients underwent CEA; 2 cases underwent CEA and aneurysm clipping; one case underwent stent removal surgery and CEA because restenosis was found after carotid artery stenting (CAS). Postoperative neck CTA and fMRI showed good morphology of carotid artery, fluent blood flow and improved cerebral perfusion after operation. All of those patients were followed up for 3 to 24 months. One case died of myocardial infarction; 2 cases appeared skin numbness on the operating side of the neck, and the symptom disappeared 3 months later; one case appeared hoarseness after operation; 3 cases experienced mild transient ischemic attack (TIA) and the symptom disappeared 2 months later. No case of stroke was found. Conclusions CEA is a safe and effective surgical approach to treat carotid stenosis. Correct and reasonable choices of the surgical indications and skilled surgical technique are the key to ensure the success of operation and to improve efficacy of the therapy. doi：10.3969/j.issn.1672-6731.2014.02.006Video: http://www.cjcnn.org/index.php/cjcnn/pages/view/v14n2a6

目前对老年人脑膜瘤术后复发的研究未见报道，本研究旨在探讨老年人脑膜瘤切除手术后复发的相关因素，以寻找老年人高复发脑膜瘤的临床特点。

我国高血压脑出血占全部脑卒中病人的21％ ～48％,存活者中超过30％遗留神经功能障碍[1].其中≥60岁老年人脑出血占所有脑出血的40％左右[2],是脑出血发病的主体.对于Ⅱ～Ⅳ级高血压脑出血[3]的患者,手术治疗能挽救患者的生命、改善患者的意识和神经功能状态[4].本研究回顾分析采用小骨瓣开颅及传统额颞开颅血肿清除老年患者的手术疗效.