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Neuroprotective effects of vagus nerve stimulation on traumatic brain injury

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Neural Regeneration Research 2014年第17期9卷 1585-1591页

作者： Long Zhou Jinhuang Lin Junming Lin Guoju Kui Jianhua Zhang Yigang Yu Affiliated Dongnan Hospital of Xiamen University the 175 Hospital of Chinese PLA Trauma Neurosurgery Center of Nanjing Military Region The 73131 Corps of Chinese PLA

Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau- matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain ex- plosive injury received continuous stimulation （10 V, 5 Hz, 5 ms, 20 minutes） of the right cervical vagus nerve. Tumor necrosis factor-a, interleukin-l~ and interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-a and interleukin-1β concentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-a, interleukin-1 β and interleukin-10 in the serum and brain tissue.

关键词： nerve regeneration brain injury vagus nerve stimulation tumor necrosis factor-a interleukin- lβ interleukin-10 brain tissue pathology protection explosive injury mechanisms hydrocephalus neural regeneration

Glymphatic imaging and modulation of the optic nerve

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Neural Regeneration Research 2022年第5期17卷 937-947页

作者： Anisha Kasi Crystal Liu Muneeb A.Faiq Kevin C.Chan Department of Ophthalmology NYU Grossman School of MedicineNYU Langone HealthNew York UniversityNew YorkNYUSA Department of Radiology NYU Grossman School of MedicineNYU Langone HealthNew York UniversityNew YorkNYUSA Neuroscience Institute NYU Grossman School of MedicineNYU Langone HealthNew York UniversityNew YorkNYUSA Center for Neural Science College of Arts and ScienceNew York UniversityNew YorkNYUSA

Optic nerve health is essential for proper function of the visual ***,the pathophysiology of certain neurodegenerative disease processes affecting the optic nerve,such as glaucoma,is not fully ***,it was hypothesized that a lack of proper clearance of neurotoxins contributes to neurodegenerative *** ability to clear metabolic waste is essential for tissue homeostasis in mammals,including *** the brain lacks the traditional lymphatic drainage system identified in other anatomical regions,there is growing evidence of a glymphatic system in the central nervous system,which structurally includes the optic *** to acknowledge the supportive role of astroglial cells,this perivascular fluid drainage system is essential to remove toxic metabolites from the central nervous ***,we review existing literature describing the physiology and dysfunction of the glymphatic system specifically as it relates to the optic *** summarize key imaging studies demonstrating the existence of a glymphatic system in the optic nerves of wild-type rodents,aquaporin 4-null rodents,and humans;glymphatic imaging studies in diseases where the optic nerve is impaired;and current evidence regarding pharmacological and lifestyle interventions that may help promote glymphatic function to improve optic nerve *** conclude by highlighting future research directions that could be applied to improve imaging detection and guide therapeutic interventions for diseases affecting the optic nerve.

关键词： aquaporin-4 cerebrospinal fluid glaucoma glymphatic system hydrocephalus imaging metabolic waste clearance optic nerve perivascular pharmacological and lifestyle interventions

Application of neuroendoscopic surgical techniques in the assessment and treatment of cerebral ventricular infection

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Neural Regeneration Research 2019年第12期14卷 2095-2103页

作者： Feng Guan Wei-Cheng Peng Hui Huang Zu-Yuan Ren Zhen-Yu Wang Ji-Di Fu Ying-Bin Li Feng-Qi Cui Bin Dai Guang-Tong Zhu Zhi-Yong Xiao Bei-Bei Mao Zhi-Qiang Hu Department of Neurosurgery Beijing Shijitan Hospital Capital Medical University Beijing China Department of Neurosurgery Peking Union Medical College Hospital Beijing China Department of Neurosurgery Peking University Third Hospital Peking University Beijing China Department of Neurosurgery Beijing Tongren Hospital Capital Medical University Beijing China Department of Neurosurgery the Second Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu Province China Department of Neurosurgery Beijing Liangxiang Hospital Beijing China

Cerebral ventricular infection (CVI) is one of the most dangerous complications in neurosurgery because of its high mortality and disability rates. Few studies have examined the application of neuroendoscopic surgical techniques (NESTs) to assess and treat CVI. This multicenter, retrospective study was conducted using clinical data of 32 patients with CVI who were assessed and treated by NESTs in China. The patients included 20 men and 12 women with a mean age of 42.97 years. NESTs were used to obliterate intraventricular debris and pus, fenestrate or incise the intraventricular compartment and reconstruct cerebrospinal fluid circulation, and remove artificial material. Intraventricular irrigation with antibiotic saline was applied after neuroendoscopic surgery (NES). Secondary hydrocephalus was treated by endoscopic third ventriculostomy or a ventriculoperitoneal shunt. Neuroendoscopic findings of CVI were used to classify patients into Grade Ⅰ(n = 3), Grade Ⅱ(n = 13), Grade Ⅲ(n = 10), and Grade Ⅳ(n = 6) CVI. The three patients with grade ⅠCVI underwent one NES, the 23 patients with grade Ⅱ/Ⅲ CVI underwent two NESs, and patients with grade Ⅳ CVI underwent two (n = 3) or three (n = 3) NESs. The imaging features and grades of neuroendoscopy results were positively related to the number of neurosurgical endoscopic procedures. Two patients died of multiple organ failure and the other 30 patients fully recovered. Among the 26 patients with secondary hydrocephalus, 18 received ventriculoperitoneal shunt and 8 underwent endoscopic third ventriculostomy. There were no recurrences of CVI during the 6- to 76-month follow-up after NES. Application of NESTs is an innovative method to assess and treat CVI, and its neuroendoscopic classification provides an objective, comprehensive assessment of CVI. The study trial was approved by the Institutional Review Board of Beijing Shijitan Hospital, Capital Medical University, China.

关键词： nerve regeneration neuroendoscopy surgery cerebral ventricular infection assessment treatment hydrocephalus irrigation neural regeneration

Chiari malformations in children:An overview

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World Journal of Clinical Cases 2021年第4期9卷 764-773页

作者： Peter Spazzapan Roman Bosnjak Borut Prestor Tomaz Velnar Department of Neurosurgery University Medical Centre LjubljanaLjubljana 1000Slovenia

Chiari malformations encompass various radiological and clinical entities,sharing the herniation of the rhombencephalic structures through the foramen magnum as a common *** can be symptomatic or *** therapeutic strategies for these malformations differ on the basis of the diverse pathophysiologic processes that cause *** Chiari malformations are caused by various pathophysiologic processes,they must be recognized promptly to select the best treatment for each single case.

关键词： Chiari malformation hydrocephalus Intracranial pressure Craniocervical junction Foramen magnum Treatment

Risk factors for delayed intracranial hemorrhage secondary to ventriculoperitoneal shunt:A retrospective study

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World Journal of Clinical Cases 2022年第21期10卷 7302-7313页

作者： Jun-Chen Chen Shou-Xing Duan Ze-Bin Xue Sen-Yuan Yang Yong Li Run-Long Lai Dian-Hui Tan Department of Neurosurgery First Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina Department of Pediatric Surgery First Affiliated Hospital of Shantou University Medical CollegeShantou 515041Guangdong ProvinceChina Department of Pediatric Surgery Huazhong University of Science and Technology Union Shenzhen HospitalShenzhen 518052Guangdong ProvinceChina

BACKGROUND Delayed intracranial hemorrhage(DICH),a potential complication of ventriculoperitoneal(VP)shunts,has been associated with high mortality,but its risk factors are still *** To investigate the risk factors of DICH after VP *** We compared the demographic and clinical characteristics of DICH and non-DICH adult patients with VP shunts between January 2016 and December *** The 159 adult VP shunt patients were divided into 2 groups according to the development of DICH:the DICH group(n=26)and the non-DICH group(n=133).No statistically significant difference was found in age,sex,laboratory examination characteristics or preoperative modified Rankin Scale(mRS)score between the DICH and non-DICH groups(P>0.05);however,a history of an external ventricular drain(EVD)[P=0.045;odds ratio(OR):2.814;95%CI:1.024-7.730]and postoperative brain edema around the catheter(P<0.01;OR:8.397;95%CI:3.043-23.171)were associated with a high risk of DICH.A comparison of preoperative mRS scores between the DICH group and the non-DICH group showed no significant difference(P=0.553),while a significant difference was found in the postoperative mRS scores at the 3-mo follow-up visit(P=0.024).CONCLUSION A history of EVD and postoperative brain edema around the catheter are independent risk factors for DICH in VP shunt *** patients with a high mRS score are vulnerable to poor clinical outcomes.

关键词： Delayed intracranial hemorrhage Ventriculoperitoneal shunt hydrocephalus Risk factor Retrospective study

Displacement of peritoneal end of a shunt tube to pleural cavity: A case report

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World Journal of Clinical Cases 2020年第19期8卷 4676-4680页

作者： Jie Liu Mian Guo Department of Neurosurgery The Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086Heilongjiang ProvinceChina

BACKGROUND The common treatment for hydrocephalus is insertion of a ventriculoperitoneal *** tube displacement is one of the common *** shunt tube displacements occur in children and has a reportedly lower incidence in *** SUMMARY This study reports an adult patient(male,56 years)who suffered from intracranial aneurysm and subarachnoid hemorrhage and underwent aneurysm clipping following *** month post onset of the disease,the patient underwent ventriculoperitoneal shunt due to *** peritoneal end of the shunt tube was displaced in the peritoneal cavity 9 years after the aneurysm *** peritoneal end of the shunt tube was removed and ventriculoperitoneal shunt was re-performed after anti-inflammatory *** Shunt tube displacement has a low incidence in *** order to avoid shunt tube displacement,there is a need to summarize its causative factors and practice personalized medicine.

关键词： Ventriculoperitoneal shunt hydrocephalus Shunt tube displacement Pleural cavity Intracranial aneurysm Case report Subarachnoid hemorrhage

Closed cranial window rodent model for investigating hemodynamic response to elevated intracranial pressure

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Animal Models and Experimental Medicine 2021年第4期4卷 391-397页

作者： Matt T.Oberdier James F.Antaki Alexander Kharlamov Stephen C.Jones Department of Biomedical Engineering Carnegie Mellon UniversityPittsburghPennsylvaniaUSA Department of Anesthesiology Allegheny-Singer Research InstitutePittsburghPennsylvaniaUSA

Background:Elevated intracranial pressure(ICP)occurs in several physiological and pathological conditions,yet long-term sequellae are not common,which implies that blood flow is preserved above ischemic ***:This pilot study sought to confirm this hypothesis using a closed cranial window model in a rat in which ICP was elevated to 120 mmHg for 12 min,and superficial cortical perfusion was measured by laser Doppler flowmetry and laser speckle ***:Following a transient increase,cortical blood flow decreased to between 25%and 75%of *** levels correspond to disrupted metabolism and decreased protein synthesis but did not exceed thresholds for electrical signaling or membrane *** may partially explain how some episodes of elevated ICP remain ***:The closed cranial window model provides a platform for prospective study of physiologic responses to artificially elevated ICP during neurosurgery to promote hemostasis.

关键词： cerebrovascular circulation craniotomy hemodynamics hydrocephalus intracranial pressure perfusion

Vein of Galen malformations—report of 2 cases and literature review

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Frontiers of Medicine 2008年第3期2卷 317-322页

作者： Chunquan CAI Qingjiang ZHANG Changhong SHEN Department of Neurosurgery General Hospital of Tianjin Medical UniversityTianjin 300052China Department of Pediatric Neurosurgery Tianjin Children’s HospitalTianjin 300074China

Vein of Galen malformations(VGMs)are rare,consisting approximately 1%of intracranial vascular mal-formations,but nearly one third of pediatric vascular mal-formations,which can cause severe morbidity and mortality in infants and older children,but more particu-larly in *** presented 2 patients with VGMs which were confirmed by characteristic clinical symptoms and neuroradiological findings(including CT,MRI and/or angiography).One patient underwent embolization fol-lowed by CT,MRI and conventional *** patient’s neurological and cognitive status was normal at *** other neonate died of congestive heart failure 36 h after birth.

关键词： vein of Galen malformations hydrocephalus congestive heart failure treatment

Concomitant achondroplasia and Chiari II malformation: A double-hit at the cervicomedullary junction

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World Journal of Clinical Cases 2014年第11期2卷 711-716页

作者： Al-Wala Awad Kyrieckos A Aleck Ratan D Bhardwaj College of Medicine-Phoenix University of Arizona Phoenix AZ 85004 United States Division of Genetics and Metabolism Phoenix Children’s Hospital Phoenix AZ 85016 United States Division of Neurological Surgery Barrow Neurological Institute at Phoenix Children’s Hospital PhoenixAZ 85016 United States

We report the first case of a neonate with concurrent Chiari II malformation and achondroplasia. Although rare, both these conditions contribute to several deleterious anatomical changes at the cervicomedullary junction and thus predispose to acute hydrocephalus. Although our patient was initially asymptomatic, hydrocephalus ensued several weeks after birth and required cerebral spinal fluid diversion. We discuss the potential links between the two conditions, the pathophysiology, and the important clinical implications for the management of the increased risk of hydrocephalus.

关键词： Achondroplasia Chiari II malformation hydrocephalus Shunt failure Cervicomedullary junction Cerebral spinal fluid diversion