The co-occurrence of pediatric-type diffuse high-grade glioma (pDHGG) and cerebral arteriovenous malformation (AVM) is exceptionally rare. This report describes the youngest documented case of this dual pathology and presents a narrative review of previously published cases to contextualize the management approach. A 14-year-old male presenting with progressive focal seizures and altered consciousness was evaluated with multimodal neuroimaging including MRI, CTA, and DSA. A staged approach was employed: preoperative endovascular embolization using N-butyl cyanoacrylate (NBCA) followed by complete microsurgical en bloc resection under intraoperative neurophysiological monitoring. Histopathological and molecular analyses were performed according to WHO 2021 criteria. A narrative review of previously reported cases was conducted through PubMed/MEDLINE search up to April 2025. Preoperative embolization achieved approximately 80

BACKGROUND:Central nervous system (CNS) metastasis is common in patients with non-small cell lung cancer (NSCLC) and is associated with poor prognosis. Evidence guiding optimal clinical management remains limited, and comprehensive studies on animal models that recapitulate different CNS metastatic patterns are lacking. METHODS:A total of 316 NSCLC patients with CNS metastases were retrospectively enrolled between May 2019 and February 2024. Patients were categorized into four groups: brain metastases only (BM, n = 145), leptomeningeal metastases only (LM, n = 43), concurrent brain and leptomeningeal metastases (BM+LM, n = 62), and brain metastases preceding leptomeningeal metastases (BM-LM, n = 66). Overall survival was analyzed using survival curves. To explore the distinct biological processes underlying BM and LM, mouse models of brain metastasis were established using tail vein, internal carotid artery, and left ventricular injection methods. RESULTS:Survival analysis demonstrated that patients with LM had significantly shorter overall survival compared with those with BM alone (P < 0.05). Patients with concurrent BM and LM also exhibited poorer overall survival than those in whom BM preceded LM (P < 0.01). In animal experiments, brain metastasis developed in one of five mice following tail vein injection, one of five following internal carotid artery injection, and two of five following left ventricular injection, indicating the highest success rate with the latter approach. None of the animal models successfully reproduced the sequential progression from brain metastasis to leptomeningeal metastasis. CONCLUSION:Leptomeningeal involvement in NSCLC is associated with significantly worse survival outcomes compared with brain metastasis alone. Although several injection strategies can generate brain metastasis in mice, current models fail to simulate the transition from brain metastasis to leptomeningeal metastasis, highlighting the need for improved and more representative animal models.

Brain parenchymal metastases (BM) and leptomeningeal metastases (LM) represent distinct subtypes of central nervous system metastases (CNSm) from lung cancer, posing significant clinical challenges. The local immune landscape of LM remains elusive. Herein, we utilized single-cell RNA sequencing to build a cell atlas of LM, and systematically examine the immune profiling and cell heterogeneity between BM and LM. Our analysis reveals that BM has more CXCL9+ macrophages, CXCL13+CD4+ T cells and B cells than LM, exhibiting the presence of tertiary lymphoid (TLS) structures, which is associated with a favorable response to tyrosine kinase inhibitors (TKI). Conversely, a remarkably immunosuppressive tumor microenvironment (TME) is detected in LM, characterized by lymphocyte depletion and a concurrent enrichment of SPP1+ macrophages, compared to BM. Furthermore, we identified significant blood-brain barrier (BBB) cell discrepancies between BM and LM, and substantial phenotypic reprogramming of BBB cells in CNSm. This reprogramming encompassed alterations in transporter gene expression, extracellular matrix production and dysregulated cell-cell interactions, potentially contributing to the metastatic process. In summary, this study highlights the divergent cellular and molecular landscapes of BM vs LM, offering critical insights into potential therapeutic targets and informing the development of improved treatment strategies for non-small cell lung cancer patients with CSNm.

[This corrects the article DOI: 10.1016/j.heliyon.2024.e36532.].

INTRODUCTION:The incidence of brain metastases in patients diagnosed with ad-vanced lung cancer is high, drawing significant attention to the risk factors associated with this progression. METHODS:A total of 252 advanced non-small cell lung cancer (NSCLC) patients with brain metastases were enrolled in this study between July 2018 and December 2023 from our hos-pital. Additionally, driver genes, including EGFR, ALK, ROS1, KRAS, and RET, were doc-umented. Next-generation targeted sequencing of a 168-gene panel was conducted on all col-lected samples to explore the association between tumor genomic complexity and risk factors for NSCLC with brain metastases. RESULTS:Among 252 lung cancer patients with brain metastases enrolled in this research, the most prevalent driver gene was EGFR, accounting for 39.29% (99 patients). Other driver gene mutations, such as KRAS, ALK, ROS1, and RET, accounted for 3.57%, 7.14%, 2.78%, and 0.4%, respectively. Kaplan-Meier analysis showed that patients with EGFR mutations had a more favorable overall survival (OS) compared to those without the mutation (P < 0.0001). Additionally, patients with ALK fusions had longer survival times compared to those with wild-type genes (P = 0.0021). In this study, patients were divided into two groups based on the presence or absence of copy-number alterations. Further survival analysis revealed that patients with copy-number alterations experienced significantly shorter overall survival com-pared to the control group (P = 0.041). DISCUSSION:This study underscores the crucial role of driver mutations and genomic instability in advanced NSCLC with brain metastases, where EGFR and ALK alterations are linked to better survival. In contrast, high genomic complexity is associated with worse outcomes. CONCLUSION:Driver gene mutations are present in more than half of the patients with central nervous system (CNS) failure. Genomic instability, characterized by the number of co-occur-ring mutated genes and copy-number alterations, is a risk factor associated with shorter sur-vival time.

Objective:To evaluate the diagnostic yield and diagnostic accuracy of intraoperative frozen sections obtained through robot-assisted stereotactic biopsy of brain lesions. Methods:The medical records of 87 patients who underwent 89 robot-assisted stereotactic biopsies of brain lesions at our institution between June 2015 and January 2024 were retrospectively reviewed. All patients were assessed using hematoxylin/eosin (HE) staining of intraoperative frozen sections, and intraoperative immunohistochemical examination when necessary. A final diagnosis derived from integrated diagnostics (neoplastic diseases) or final histopathologic examination (non-neoplastic diseases) was the 'gold standard'. Intraoperative frozen section results were divided into 3 categories: confirmed diagnosis, tentative diagnosis, and misdiagnosis. Subgroup analyses of negative intraoperative frozen section results, tentative diagnoses or misdiagnoses were conducted stratified by lesion size and lesion type. Results:Mean turn-around time for intraoperative frozen sections was 26 ± 5.6 min (range, 20-62 min). 1 (FS-1) to 4 (FS-N) (median, 1) intraoperative frozen sections were evaluated per patient. There was a significant increase in positive results from FS-1 (79.77%; n = 71/89) to FS-N (92.13%; n = 82/89) (p = 0.018). FS-1 results were negative in 18 (20.22%) patients. Among these, FS-N results were positive after adjusting the puncture depth or changing the target in 11 patients. The overall concordance rate of intraoperative frozen section to final diagnosis was 91.1% (confirmed diagnosis, n = 73; tentative diagnosis, n = 8). Intraoperative immunohistochemistry was performed on the frozen sections of 38 patients (42.7%). Among the patients with negative FS-1 results, tentative diagnoses or misdiagnoses, there were 12, 6 and 7 patients with medium sized lesions, respectively. Eight patients with negative FS-1 results had high-grade glioma. Conclusion:The diagnostic yield of intraoperative frozen sections obtained through robot-assisted stereotactic biopsy of brain lesions is high. If the first frozen section result is negative, additional specimens should be obtained after adjusting the puncture depth or the target. Lesions that are difficult to distinguish morphologically on HE staining may be examined using intraoperative immunohistochemistry. High-grade glioma may be more prone to tentative or misdiagnosis due to heterogeneity of the lesion.

Abstract Background Lung adenocarcinoma metastasizing to the brain results in a notable increase in patient mortality. The high incidence and its impact on survival presents a critical unmet need to develop an improved understanding of its mechanisms. Methods To identify genes that drive brain metastasis of tumor cells, we collected cerebrospinal fluid samples and paired plasma samples from 114 lung adenocarcinoma patients with brain metastasis and performed 168 panel-targeted gene sequencing. We examined the biological behavior of PMS2 (PMS1 Homolog 2)-amplified lung cancer cell lines through wound healing assays and migration assays. In vivo imaging techniques are used to detect fluorescent signals that colonize the mouse brain. RNA sequencing was used to compare differentially expressed genes between PMS2 amplification and wild-type lung cancer cell lines. Results We discovered that PMS2 amplification was a plausible candidate driver of brain metastasis. Via in vivo and in vitro assays, we validated that PMS2 amplified PC-9 and LLC lung cancer cells had strong migration and invasion capabilities. The functional pathway of PMS2 amplification of lung cancer cells is mainly enriched in thiamine, butanoate, glutathione metabolism. Conclusion Tumor cells elevated expression of PMS2 possess the capacity to augment the metastatic potential of lung cancer and establish colonies within the brain through metabolism pathways.

To assess the genetic characteristics of central nervous system (CNS) metastases from non-small-cell lung cancer (NSCLC), we gathered the genetic profiles of brain metastases (BM) and leptomeningeal metastases (LM). Our objective was to identify genetic factors contributing to poorer overall survival (OS) in NSCLC patients with LM. This study included 25 consecutive patients with BM and 52 patients with LM from Guangdong Sanjiu Brain Hospital. All participants underwent 168-target panel sequencing. Among the 25 patients with BM, TP53 was the most frequently mutated gene (44

Osteoradionecrosis (ORN) of the upper cervical spine is a rare but severe complication of head and neck cancer radiotherapy. To raise awareness of this condition, we describe a patient with a history of nasopharyngeal carcinoma who developed ORN of the upper cervical spine and review the published literature reporting surgical management. A 59-year-old female patient with persistent neck pain for one month and limited range of neck motion who had undergone radiotherapy for nasopharyngeal carcinoma with a total dose of 69.96 Gy 15 years ago presented to our hospital. The patient underwent endoscopic transnasal and transoral resection of the odontoid process and C1 anterior arch, combined with occipitocervical fusion. To better understand surgical management of ORN of the upper cervical spine, the literature published in the PubMed, Ovid MEDLINE, and Embase databases was reviewed. Our patient experienced alleviation of cervical pain and did not exhibit any postoperative complications. Since 2005, 11 cases of surgical management of ORN of the upper cervical spine (including the present case) have been published. Basilar invagination and/or atlantoaxial subluxation were observed in 4 /11 cases. Endoscopic procedures were performed in 4/11 cases, and occipitocervical fusion was performed in 8 /11 cases. Endoscopic transnasal and transoral resection of the odontoid process and C1 anterior arch is a safe and effective treatment option for ORN of the upper cervical spine. Occipitocervical fusion is useful in patients with basilar invagination and atlantoaxial subluxation.

Background: The purpose of this study is to explore whether there are lymphatic vessels in the human leptomeninges, and their potential role in the immune response to central nervous system tumors, in order to determine their significance in the field of tumor biology, especially the role they play in the growth, metastasis, and immune response of tumors. Methods: We used immunohistochemistry and immunofluorescence techniques to examine the leptomeninges in 46 patients diagnosed with leptomeningeal metastasis in cerebrospinal fluid cytology (29 positive biopsy specimens, 17 negative) as well as 11 epilepsy patients. We visualized lymphatic vessels in the human leptomeninges using LYVE1 and PDPN antibodies, labeled tumor cells with CK, T cells with CD3, and blood vessels with CD31 and α-smooth muscle actin. By comparing the lymphatic vessel density and T cell count in tumor areas versus non-tumor areas, and observing whether there was infiltration of tumor cells into the lymphatic vessels, we analyzed the presence and function of human leptomeningeal lymphatic vessels. Results: The research results confirmed the existence of lymphatic vessels in the human leptomeninges, with a significant increase in lymphatic vessel density and T cell count around the tumor compared to non-tumor areas (P < 0.05). At the same time, infiltration of tumor cells was observed within the lymphatic vessels. Conclusions: These findings suggest that the lymphatic vessels in the leptomeninges not only structurally resemble extracranial brain lymphatic vessels, but also function similarly in tumor immune response and metastasis pathways. These findings challenge traditional understanding of immune responses to central nervous system tumors and provide important clues for further research on the role of intracranial lymphatic vessels in tumor biology.

Background The discovery of driver genes such as EGFR, KRAS, and ALK, has dramatically shifted treatment patterns in patients harboring these oncogenes. However, dissemination into the central nervous system (CNS) is a severe complication. In addition, the particular anatomical structure of the CNS has made it difficult to obtain tissue specimens from brain metastases (BM) to generate a gene map, as such, potential predictive markers for survival in patients with non-small cell lung cancer (NSCLC) and BM (NSCLC-BM) remain unclear. Methods Data from 28 patients diagnosed with NSCLC-BM between June 2019 and May 2021 at Guangdong Sanjiu Brain Hospital (Guangzhou, China), were reviewed. Targeted next-generation sequencing (NGS) of a 168 cancer-related gene panel was available for surgically resected brain tissues from all patients. In addition, molecular characteristics and overall survival (OS) were analyzed to determine potential predictive markers. Results Among patients with NSCLC-BM, NGS revealed that TP53 was the most frequent mutation (61%), with a detection rate of 39%, closely by EGFR amplification. Additionally, CDKN2A, MYC, LRP1B, and RNF43 were frequently observed (18%). The median OS was significantly shorter in the TP53 mutation group than in the wildtype group (14 versus undefined months, p =0.014). Similar results were also found in the genetic alteration of EGFR amplification, suggesting that EGFR amplification was associated with worse OS (14 vs. 24 months, p =0.039). Interestingly, NGS revealed that gene alternations such as TP53, EGFR amplification, and CDKN2A, tended to coexist and such a co-alteration panel indicated worse clinical outcomes (median OS, 5 months). In addition, the detection rate of negative survival genes, including TP53 or EGFR amplification, was much higher in tumor tissues than in plasma samples, indicating the limited predictive value of matched PLA samples. Conclusions Gene signatures, such as TP53 or EGFR amplification, were associated with worse survival in patients diagnosed with NSCLC-BM. These valuable findings may shed light on new strategies for the prognostic assessment of specific patient groups.

Immunotherapy is a vital treatment for patients with cutaneous melanoma (CM), but effective predictors to guide clinical immunotherapy are lacking. Cuproptosis is a newly discovered mode of cell death related to tumorigenesis. Exploring the relationship between the mode of cuproptosis and the effect of immunotherapy on CM could better guide clinical management. We clustered all patients with CM in the Cancer Genome Atlas (TCGA) database based on cuproptosis-related genes (CRGs). Prognosis, immunotherapeutic effect, tumor microenvironment score, expression of CD274, CTLA4, and PDCD1, and abundance of CD8 + T infiltration in group A were higher than in group B. Using a combination of LASSO and COX regression analysis, we identified 10 molecules significant to prognosis from differentially expressed genes between the two groups and constructed a cuproptosis-related scoring system (CRSS). Compared with the American Joint Committee on Cancer (AJCC) staging system, CRSS more accurately stratified CM patient risk and guided immunotherapy. CRSS successfully stratified risk and predicted the effect of immunotherapy in 869 patients with eight CM immunotherapy datasets and multiple other tumor immunotherapy cohorts. The nomogram model, which combined AJCC stage and CRSS, greatly improved the ability and accuracy of prognosis prediction. In general, our cuproptosis-related scoring system and nomogram model accurately stratified risk in CM patients and effectively predicted prognosis and the effect of immunotherapy in CM patients.

Purpose:This study aims to compare the short-term surgery outcomes of the resection of meningiomas and clinical characteristics between elderly and non-elderly patients.Patients and Methods:This retrospective study included patients who underwent a resection of middle third parasagittal and parafalcine meningiomas between January 2011 and December 2020. All lesions arise from the middle third of the parafalcine or infiltrate superior sagittal sinus (SSS). The clinical characteristics studied included neurological deficit, peritumoral brain edema (PTBE), SSS invasion, tumor size, and symptoms; perioperative complications, and short-term surgery outcomes including neurological deficit, operative blood loss, postoperative hospitalization duration, and WHO classification were compared.Results:A total of 43 elderly patients and 63 non-elderly patients were included. Compared with non-elderly patients, elderly patients had larger lesions (P = 0.013) and presented with a larger PTBE (P = 0.019). SSS blockage was identified in 28.57% of elderly patients and 19.57% of non-elderly patients. Compared with non-elderly patients, elderly patients tended to suffer from more aggressive lesions (WHO II/III meningioma 6 vs 3, P = 0.154) and presented with longer postoperative hospital stays (17.25 ± 5.8 vs 13.50 ± 3.8, P = 0.009); conversely, while the non-elderly patients experienced more blood loss (P = 0.022) and had more perioperative reoperations (3 vs 1). No significant difference in neurological deficit was detected between the two groups (P = 0.97). After total tumor resection, patients with neurological deficits in both groups can recover during the follow-up period.Conclusion:Among the 106 patients with middle third parasagittal and falx meningiomas in our hospital, elderly patients had larger lesions, presented with more severe PTBE, and had longer postoperative hospital stays than younger patients. Conversely, younger patients had more blood loss and serious complications than elderly patients. Postoperative neurological dysfunction in elderly patients was similar to that in middle-aged and young patients.

目的 探讨机器人辅助立体定向活检术在脑深部病变中的应用价值.方法 2015年6月至2021年5月实施机器人辅助脑内深部病变活检术38例,对病人的临床资料进行回顾性分析.结果 38例行41个靶点活检(3例行双靶点活检).7例首次穿刺术中冰冻切片病理检查结果为阴性,其中6例通过调整穿刺点再次穿刺为阳性,1例术后常规病理为阳性.所有病人均得到确诊,确诊率为100%.38例术后病理结果显示胶质瘤 24例(WHO分级Ⅰ～Ⅱ级4例,Ⅲ～Ⅳ级 20例),淋巴瘤9例,生殖细胞瘤4例,淀粉样变性1例.术后发现术区血肿6例,包括5例无症状性小出血和1例严重迟发性脑出血导致死亡.结论 神经外科机器人引导下脑深部病变活检术具有精准、微创、阳性率高的特点,选择合适的病人并掌握神经外科机器人的使用方法,结合术前影像确定靶点、术中冰冻切片病理检查等方法是提高脑深部病变立体定向活检术确诊率并减少相关并发症的关键.

Brain metastasis (BM) is an important cause of mortality for cancer patients. Many patients were diagnosed with brain metastases at their first visit who have not received any treatment while a subset of patients did not have distant metastases at the first visit and brain metastases were detected during the course of systemic therapies. The difference in their genomic characterization is unclear. 96 lung adenocarcinoma patients were enrolled in our study. 53 patients (55%) had synchronous metastatic brain tumors. 43 (45%) patients had metachronous brain metastases. We performed 168 panel-targeted gene sequencing cerebrospinal fluid (CSF) and plasma samples from patients to identify genomic features of synchronous brain metastases (SBM) and metachronous brain metastases (MBM). In conclusion, CSF liquid biopsies have a priority in detecting gene alteration. A comprehensive comparison of molecular profiling between SBM and MBM revealed the most frequently altered genes in both groups were EGFR and TP53, but with different exon point mutations. RTK-RAS and TP53 pathways were the most affected pathways.

OBJECTIVE:To explore the relationship between spinous process deviation and lumbar disc herniation in young patients.METHODS:From March 2015 to January 2022, 30 treated young (under the age of 30) patients with lumbar disc herniation were included as the young group. In addition 30 middle-aged patients (quinquagenarian group) with lumbar disc herniation and 30 patients with non-degenerative spinal diseases (young non-degenerative group) were selected as control groups. The angle of the spinous process deviation was measured on CT and statistically analyzed by various groups. All the data were measured twice and the average value was taken and recorded.RESULTS:The average angle of spinous process deviation in the degenerative lumbar vertebra of young patients were (3.89±3.77) degrees, similar to the (3.72±2.98) degrees of quinquagenarian patients(P=0.851). The average angle of s spinous process deviation young non-degenerative group were (2.20±2.28) degrees, significantly less than young group(P=0.040). The spinous process deviation angle of the superior vertebral of the degenerative lumbar in the young group was (4.10±3.44) degrees, which similar to the (3.47±2.87) degrees in the quinquagenarian group (P=0.447). A total of 19 young patients had the opposite deviation direction of the spinous process of the degenerative lumbar vertebra and upper vertebra, while only 7 quinquagenarian patients had this condition(P=0.02). The type of lumbar disc herniation in young patients had no significant relationship with the direction of spinous process deflection of the degenerative or upper lumbar vertebra (P>0.05).CONCLUSION:Spinous process deviation is a risk factor of young lumbar disc herniation patients. If the deviation directions of adjacent lumbar spinous processes are opposite, it will increase the incidence of lumbar disc herniation in young patients. There was no significant correlation between the type of disc herniation and the deviation direction of the spinous process of the degenerative or upper lumbar vertebra. People with such anatomical variation can strengthen the stability of spine and prevent lumbar disc herniation through reasonable exercise.

Objective:To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods:Forty-three elderly patients with meningiomas in the central cortex area (≥60 years old) and 63 middle-aged and young patients with meningiomas in the central cortex area (18-59 years old), accepted surgery in Department of Neurosurgery, Guangdong 999 Brain Hospital from January 2011 to December 2020, were chosen. The differences of symptom, gross tumor volume, peritumoral edema degrees, intraoperative blood loss, tumor resection degrees, complications, and hospital stays between the 2 groups were analyzed.Results:The elderly patients had significantly higher proportion of preoperative muscle strength decline, lower proportion of preoperative headache, larger preoperative tumor volume, more severe peritumoral edema degrees before and after surgery, small volume of intraoperative blood loss, and longer hospital stays compared with the middle-aged and young patients ( P<0.05). However, no significant differences in distributions of tumor resection Simpson grades, proportion of new neurological dysfunction, incidence of postoperative complications, and proportions of reoperations and tumor recurrence were noted between the 2 groups ( P>0.05). Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group ( P<0.05), and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group ( P<0.05). Conclusions:Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area, no significant difference in surgical efficacy is noted between the 2 groups. The peritumoral edema degree in the elderly patients is related to tumor pathological grades, while that in middle-aged and young patients is related to tumor volumes.

目的 探讨术中冰冻病理检查在立体定向脑病变活检的应用价值.方法 回顾性分析2015年6月—2021年10月收治的44例接受神经外科机器人辅助立体定向活检的脑深部病变患者临床资料.所有患者行术中冰冻病理,必要时行术中冰冻免疫组化检查.常规病理结果作为诊断金标准,判断冰冻结果的确诊率、延迟诊断率和误诊率,分析术中冰冻病理的诊断阳性率、诊断符合率及其影响因素.结果 44例患者接受46次活检手术,有9例患者首次术中冰冻结果为阴性,其中7例调整穿刺深度再次活检后取得冰冻阳性结果.23例患者通过术中免疫组化及时判断肿瘤类别.最终44例患者(96.65％)术中冰冻结果阳性,诊断符合率91.3％(35例确诊+7例延迟诊断).穿刺活检结果为胶质瘤27例(WHO Ⅰ-Ⅱ级6例,WHO Ⅲ-Ⅳ级21例),淋巴瘤12例,生殖细胞瘤4例,淀粉样变性1例.结论 虽然术中冰冻病理会导致手术耗时增多,但能快速判断立体定向活检标本的性质,避免了过度取材,提高手术效率,减少活检损伤,可应用在神经外科机器人引导下脑病变活检手术中.

Objective Stroke is a rare but fatal complication of advanced cancer with Trousseau syndrome, especially as initial symptoms. Here, we report the clinical characteristics, treatment, and prognosis of patients with non-small cell lung cancer (NSCLC) who initially presenting with acute multiple cerebral infarction. Methods The clinical characteristics, imaging, treatment, and oncological outcomes of 10 patients diagnosed with Trousseau syndrome and NSCLC between 2015 and 2021 at Guangdong Sanjiu Brain Hospital were retrospectively collected and analyzed. The clinical course of two typical cases were presented. Results All 10 patients with pathologically confirmed lung adenocarcinoma initially presented with neurological symptoms, including hemiplegic paralysis (7 patients, 70%), dizziness (5 patients, 50%), and unclear speech (3 patients, 30%). The median age was 63.5 years. Eight and two cases were stage III and IV, respectively, at the initial diagnosis. Five patients underwent driver gene testing, revealing three patients with EGFR-sensitive mutations, one patient with ALK fusion, and one patient with wild-type EGFR. All 10 patients received antiplatelet therapy, and six patients subsequently received anti-cancer treatment. The median overall survival of the patients was 8.5 months (95% confidence interval) and 1-year survival rate was 57.1%. Patients who received antitumor treatment, especially those harboring driver gene mutations and received tyrosine kinase inhibitors, had better neurological symptom recovery and superior oncological prognosis (median overall survival, not reached versus 7.4 months, p = 0.038). Conclusion Trousseau syndrome, presenting as multiple cerebral infarctions, is a rare complication of lung adenocarcinoma. Both antiplatelet and antitumor treatment are recommended to achieve better neurological recovery and oncological prognosis in these patients.

目的 总结脑膜血管瘤病的临床特点、治疗经验及预后.方法 回顾性分析广东三九脑科医院2016年6月-2021年1月期间收治的6例脑膜血管瘤病患者的临床资料,并结合相关文献进行复习.结果 6例患者中,临床发作表现为全身强直阵挛发作1例,部分发作继发全身强直阵挛发作5例.术中皮层监测提示所有患者病变部位有癫痫样放电,均在术中皮层脑电图监测引导下行病灶+病灶周围皮层致痫灶切除手术治疗.术后均给予抗癫痫药物治疗,术后Engel分级均为Ⅰ级,术后近期及远期均无明显并发症出现.结论 反复癫痫发作的患者,如果颅脑MRI提示长T1长T2异常信号影,T2 Flair呈内低外高信号影,T1增强可见部分强化,CT扫描提示,钙化病变应考虑脑膜血管瘤病的诊断可能.脑膜血管瘤病经过电生理评估和多学科讨论确定致痫区后,给予病灶和周围致痫区切除术,手术疗效好,术后复发风险低,所以脑膜血管瘤病伴癫痫患者可通过手术获得良好受益,早期手术受益远远大于风险.