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Magnetic resonance-guided focused ultrasound for essential tremor:a prospective,single center,single-arm study

Neural Regeneration Research 2024年第9期19卷 2075-2080页

作者： Rui Zong Xuemei Li Chunyu Yin Jianfeng He Dekang Zhang Xiangbing Bian Lichao Huang Jiayou Zhou Zhipei Ling Lin Ma Xin Lou Longsheng Pan Xinguang Yu Seniro Department of neurosurgery The First Medical Center of the PLA General HospitalBeijingChina Clinics of Cadre Department of OutpatientThe First Medical Center of the PLA General HospitalBeijingChina Department of radiology The First Medical Center of the PLA General HospitalBeijingChina

The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential *** 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the PLA General *** prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(*** Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local *** 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm *** treatment efficacy was determined using the Clinical Rating Scale for *** was evaluated according to the incidence and severity of adverse *** of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate *** the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as *** most common intraoperative adverse events were nausea and *** most frequent postoperative adverse events were paresthesia and equilibrium *** of the adverse events were mild and usually disappeared within a few *** findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.

关键词： efficacy essential tremor magnetic resonance-guided focused ultrasound(MRgFUS) movement disorder safety stereotactic therapy thalamotomy ventral intermediate nucleus

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Multiomics and blood-based biomarkers of moyamoya disease: protocol of Moyamoya Omics Atlas (MOYAOMICS)

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中华神经外科杂志(英文) 2024年第3期10卷 1-9页

作者： Ge Peicong Yin Zihan Tao Chuming Zeng Chaofan Yu Xiaofan Lei Shixiong Li Junsheng Zhai Yuanren Ma Long He Qiheng Liu Chenglong Liu Wei Zhang Bojian Zheng Zhiyao Mou Siqi Zhao Zhikang Wang Shuang Sun Wei Guo Min Zheng Shuai Zhang Jia Deng Xiaofeng Liu Xingju Ye Xun Zhang Qian Wang Rong Zhang Yan Zhang Shaosen Wang Chengjun Yang Ziwen Zhang Nijia Wu Mingxing Sun Jian Zhou Yujia Shi Zhiyong Ma Yonggang Zhou Jianpo Yu Shaochen Li Jiaxi Lu Junli Gao Faliang Wang Wenjing Chen Yanming Zhu Xingen Zhang Dong Zhao Jizong Department of neurosurgery Beijing Tiantan Hospital Capital Medical University Beijing China China National Clinical Research Center for Neurological Diseases Beijing China Department of neurosurgery Beijing Hospital National Center of Gerontology Beijing China Department of radiology Beijing Tiantan Hospital Beijing China Department of Ultrasound Beijing Tiantan Hospital Capital Medical University Beijing China Department of Neurology Beijing Tiantan Hospital Beijing China Department of neurosurgery Beijing Friendship Hospital Capital Medical University Beijing China Department of neurosurgery Beijing Chaoyang Hospital Capital Medical University Beijing China Department of neurosurgery Beijing Childrens Hospital Capital Medical University Beijing China Department of neurosurgery The Affiliated Children’s Hospital Capital Institute of Pediatrics Beijing China Department of neurosurgery Beijing Changping District Hospital Beijing China Department of neurosurgery Dongfang Hospital Beijing University of Chinese Medicine Beijing China Department of neurosurgery Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China Department of NeuroInterventional Surgery Binzhou Medical University Hospital Binzhou Shandong China Department of neurosurgery Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China Department of neurosurgery The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou China Department of neurosurgery The First Affiliated Hospital of Xi’an Jiaotong University Shaanxi Xi’an China Department of neurosurgery West China Hospital Sichuan University Chengdu China Department of neurosurgery Center for Rehabilitation Medicine Zhejiang Provincial Peoples Hospital Affiliated Peoples Hospital Hangzhou Medical College Hangzhou Zhejiang China Beijing Institute of Hepatology Beijing YouAn Hospital Capital Medical University Beijing China Department of Neu

Background Moyamoya disease (MMD) is a rare and complex cerebrovascular disorder characterized by the progressive narrowing of the internal carotid arteries and the formation of compensatory collateral vessels. The etiology of MMD remains enigmatic, making diagnosis and management challenging. The MOYAOMICS project was initiated to investigate the molecular underpinnings of MMD and explore potential diagnostic and therapeutic *** The MOYAOMICS project employs a multidisciplinary approach, integrating various omics technologies, including genomics, transcriptomics, proteomics, and metabolomics, to comprehensively examine the molecular signatures associated with MMD pathogenesis. Additionally, we will investigate the potential influence of gut microbiota and brain-gut peptides on MMD development, assessing their suitability as targets for therapeutic strategies and dietary interventions. Radiomics, a specialized field in medical imaging, is utilized to analyze neuroimaging data for early detection and characterization of MMD-related brain changes. Deep learning algorithms are employed to differentiate MMD from other conditions, automating the diagnostic process. We also employ single-cellomics and mass cytometry to precisely study cellular heterogeneity in peripheral blood samples from MMD *** The MOYAOMICS project represents a significant step toward comprehending MMD’s molecular underpinnings. This multidisciplinary approach has the potential to revolutionize early diagnosis, patient stratification, and the development of targeted therapies for MMD. The identification of blood-based biomarkers and the integration of multiple omics data are critical for improving the clinical management of MMD and enhancing patient outcomes for this complex disease.

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Intra-arterial tenecteplase during thrombectomy for acute stroke(BRETIS-TNK II):rationale and design

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Stroke & Vascular Neurology 2024年第1期9卷 59-65页

作者： Zi-Ai Zhao Jing Qiu Wei Li Thanh Nguyen Shouchun Wang Huaizhang Shi Ming Wei Feng Wang Di Li Hui-Sheng Chen Department of Neurology General Hospital of Northern Theater CommandShenyangLiaoning ProvinceChina Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA Department of Neurology First Affiliated Hospital of Jilin UniversityChangchunJilinChina Department of neurosurgery First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina Department of neurosurgery Tianjin Huanhu HospitalTianjinTianjinChina Department of Interventional Therapy First Affiliated Hospital of Dalian Medical UniversityDalianChina Neurological Intervention Department Dalian Municipal Central HospitalDalianLiaoningChina

Background Our recent pilot study suggests intra-arterial tenecteplase(TNK)during the first pass of endovascular treatment(EVT)seems safe,may increase first-pass reperfusion and good outcome in acute ischaemic stroke(AIS)patients with large-vessel occlusion(LVO).Aims To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom *** size estimates A maximum of 380 patients are required to test the superiority hypothesis with 80%power according to a two-side 0.05 level of significance,stratified by age,gender,baseline systolic blood pressure,prestroke modified Rankin Scale(mRS),baseline National Institute of Health stroke scale,baseline ASPECTS,time from onset to groin puncture,intravenous thrombolysis before EVT,stroke territory and stroke *** Intra-arterial TNK during thrombectomy for acute stroke(BRETIS-TNK II)study is a prospective,randomised,adaptive enrichment,open-label,blinded end point,multicentre *** AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:*** experimental group will be treated with intra-arterial infusion of TNK during *** control group will be treated with standard *** The primary end point is a favourable outcome,defined as an mRS score of 0–2 at 90 *** primary safety end point is symptomatic intracranial haemorrhage within 48 hours,which is defined as an increase in the National Institutes of Health Stroke Scale score of≥4 points as a result of the intracranial *** The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.

关键词： rational stratified TNK

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The clinical,radiological,and surgical characteristics of anterior perforated substance glioma:a retrospective study

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Chinese Neurosurgical Journal 2024年第1期10卷 28-34页

作者： Zhiliang Wang Lianwang Li Zheng Wang Xuzhu Chen Zhong Zhang Department of neurosurgery Beijing Tiantan HospitalCapital Medical UniversityNo.119 South 4th Ring West RoadBeijing 100070People’s Republic of China Department of Molecular Neuropathology Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina Department of radiology Beijing Neurosurgical InstituteCapital Medical UniversityBeijingChina Department of radiology Beijing Tiantan HospitalCapital Medical UniversityNo.119 South 4th Ring West RoadBeijing 100070People’s Republic of China

Background To explore the clinical,radiological,and surgical characteristics of anterior perforated substance(APS)*** Twenty patients with APS glioma who were treated with surgery between March 2019 and January 2022 from Tiantan hospital were retrospectively *** clinical,histological and radiological data were *** Twenty patients,including 7 males(55%)and 13 females(45%),with a mean age at diagnosis of 37.9 years(range,28-53 years)underwent operative intervention for *** and dizziness were the most common preoperative symptoms in the majority patients(14,70%).Based on radiological features of MRI,the APS was classified into two subtypes,type A and type *** patients(40%)in type A indicated a clear tumor margin,while 13 patients(60%)in type B showed an ill-defined *** surgical approach including frontal,temporal,and coronal frontal incisions for type A and type B tumors,*** patients in type A received total resection,while one patient in type B were total ***,12 cases(60%,12/20)were diagnosed as astrocytoma and 8 cases(20%,8/20)were ***,17 cases(85%,17/20)had MGMT promotor *** In this study,we performed the first systematic research of patients with APS *** of patients with APS presented headaches and dizziness *** APS glioma was further divided into two major radiological subtypes with relevant different surgical *** APS glioma in type A were more likely to receive total resection.

关键词： Anterior perforated substance Glioma Magnetic resonance imaging Operation

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Ruptured venous aneurysm associated with a dural arteriovenous fistula:Two case reports

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World Journal of Clinical Cases 2024年第29期12卷 6314-6319页

作者： You Sub Kim Woong Yoon Byung Hyun Baek Seul Kee Kim Sung Pil Joo Tae Sun Kim Department of neurosurgery Chonnam National University Hospital and Medical SchoolGwangju 61469South Korea Department of radiology Chonnam National University Hospital and Medical SchoolGwangju 61469South Korea Department of radiology Chonnam National University Hwasun HospitalHwasungun 58128South Korea

BACKGROUND In general,venous aneurysm associated with dural arteriovenous fistula(dAVF)is considered to be developed under long standing venous hypertension and manifested as venous ectasia of draining vein ***,discrete saccular shaped venous aneurysm without angiographic evidence of venous hypertension arising from the draining vein,like cerebral arterial aneurysm,is quite rare and its pathomechanism remains unclear in patients with *** SUMMARY In this report,we present two cases of ruptured saccular venous aneurysms associated with dAVF without venous hypertension or venous *** both cases,significant curve or stenosis is observed in draining vein,which is located in just distal portion of the venous *** aneurysms were successfully treated with a transarterial *** mechanism of venous aneurysms in these cases is *** Although there is little doubt that hemodynamic stress has a critical role in the development of venous aneurysms in patients with dAVF,preceding venous hypertension or venous ectasia is not necessary for development and enlargement of venous *** the significant risk of rupture,a careful review of draining vein features including tortuosity or stenosis is needed,especially in venous aneurysms without evidence of venous hypertension.

关键词： Dural arteriovenous fistula Venous aneurysm Hemodynamic stress Intracranial hemorrhage Embolization Case report

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Upper extremity motor function before and after the cerebrospinal fluid tap test in patients with idiopathic normal pressure hydrocephalus:A retrospective study

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Chinese Medical Journal 2024年第7期137卷 877-879页

作者： Caiyan Liu Junji Wei Liling Dong Chenhui Mao Jie Li Xinying Huang Bo Hou Feng Feng Liying Cui Jing Gao Department of Neurology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of neurosurgery Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of neurosurgery and radiology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China

To the Editor:Idiopathic normal pressure hydrocephalus(iNPH)patients present disturbances in gait,cognition,and/or control of urination with neuroimaging characterized by enlargement of the cerebral ***,gait disturbance in iNPH patients is the initial and most prominent symptom,but motor impairments can also extend to upper *** cerebrospinaluid(CSF)tap test(TT),in which the symptoms of iNPH patients are assessed before and after drainage of 30-50mL CSF by lumbar puncture,is a commonly used auxiliary test for predicting shunt *** methods for determining the CSF TT response are based on the clinical impression of changes in gait after lumber *** patients who are unable to ambulate(e.g.,the patient is wheelchair bound)may not be able to comply with the gait evaluation but still benet from shunt *** grooved pegboard test(GPT)and symbol-digit modalities test(SDMT)are psychometric measures of upper extremity motor and psychomotor ***,we sought to identify whether these tests could be used to objectively assess responsiveness to the CSF TT.

关键词： patients cerebrospinal Upper

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Pseudoaneurysm formation following transarterial embolization of traumatic carotid-cavernous fistula with detachable balloon:An institutional cohort long-term study

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World Journal of radiology 2024年第4期16卷 94-108页

作者： Prasert Iampreechakul Korrapakc Wangtanaphat Songpol Chuntaroj Yodkhwan Wattanasen Sunisa Hangsapruek Punjama Lertbutsayanukul Pimchanok Puthkhao Somkiet Siriwimonmas Department of neurosurgery Neurological Institute of ThailandBangkok 10400Thailand Department of Neuroradiology Neurological Institute of ThailandBangkok 10400Thailand Department of Medical Services Neurological Institute of ThailandBangkok 10400Thailand Department of radiology Bumrungrad International HospitalBangkok 10110Thailand

BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent *** treatment for TCCF has evolved from surgery to endovascular management using detachable balloons,coils,liquid embolic agents,covered stents,or flow-diverter stent through arterial or venous *** the withdrawal of detachable balloons from the market in the United States since 2004,transarterial embolization with detachable balloons has currently remained the best initial treatment for TCCF in several ***,the pseudoaneurysm formation following transarterial detachable balloon embolization has rarely been observed in long-term *** To determine the occurrence and long-term follow-up of pseudoaneurysm after transarterial detachable balloon for *** Between January 2009 and December 2019,79 patients diagnosed with TCCF were treated using detachable latex balloons(GOLDBAL)of four *** sizes were stratified into five grades for *** and follow-up assessments involved computed tomography angiography at 1 month,6 month,1 year,and longer intervals for significant *** follow-ups occurred semi-annually for 2 years,then *** analyzed included sex,age,fistula size and location,and balloon *** In our cohort of 79 patients treated for TCCF,pseudoaneurysms formed in 67.1%,with classifications ranging from grade 0 to grade 3;no grade 4 or giant pseudoaneurysms were *** majority of pseudoaneurysms did not progress in size,and some regressed *** developed in most large pseudoaneurysms over 5-10 *** artery occlusion occurred in 7.6%and recurrent fistulas in 16.5%.The primary risk factors for pseudoaneurysm formation were identified as the use of specific balloon sizes,with balloon SP and No.6 significantly associated with its occurrence(P=0.005 and P=0.002,respectively),whereas sex,age,f

关键词： Pseudoaneurysm formation Traumatic carotid-cavernous fistula Direct carotid-cavernous fistula Transarterial embolization Detachable balloon Endovascular treatment Computed tomography angiography Long-term follow-up

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Epidemiological and Computed Tomography Aspects of Facial Trauma at Kira Hospital in Bujumbura

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Open Journal of radiology 2024年第2期14卷 83-91页

作者： Sébastien Manirakiza Jean Marie Banziriyubusa Stany Harakandi Patrice Barasukana Chantal Murekatete Daniel Nduwayo Jean Bosco Bizimana Léopold Nzisabira Department of radiology Teaching Hospital of Kamenge Bujumbura Burundi Department of Anesthesia and Resuscitation Teaching Hospital of Kamenge Bujumbura Burundi Department of Internal Medicine (Neurology) Teaching Hospita lof Kamenge Bujumbura Burundi Department of Surgery (neurosurgery) Teaching Hospital of Kamenge Bujumbura Burundi

Background: Maxillofacial trauma affects young adults more. The injury assessment is difficult to establish in low-income countries because of the imaging means, particularly the scanner, which is poorly available and less financially accessible. The aim of this study is to describe the epidemiological profile and the various tomodensitometric aspects of traumatic lesions of the face in patients received in the radiology department of Kira Hospital. Patients and methods: This is a descriptive retrospective study involving 104 patients of all ages over a period of 2 years from December 2018 to November 2019 in the medical imaging department of KIRA HOSPITAL. We included in our study any patient having undergone a CT scan of the head and presenting at least one lesion of the facial mass, whether associated with other cranioencephalic lesions. Results: Among the 384 patients received for head trauma, 104 patients (27.1% of cases) presented facial damage. The average age of our patients was 32.02 years with extremes of 8 months and 79 years. In our study, 87 of the patients (83.6%) were male. The road accident was the circumstance in which facial trauma occurred in 79 patients (76% of cases). These injuries were accompanied by at least one bone fracture in 97 patients (93.3%). Patients with fractures of more than 3 facial bones accounted for 40.2% of cases and those with fractures of 2 to 3 bones accounted for 44.6% of cases. The midface was the site of the fracture in 85 patients (87.6% of cases). Orbital wall fractures were noted in 57 patients (58.8% of cases) and the jawbone was the site of a fracture in 50 patients (51.5% of cases). In the vault, the fractures involved the extra-facial frontal bone (36.1% of cases) and temporal bone (18.6% of cases). Cerebral contusion was noted in 41.2% of patients and pneumoencephaly in 15.5% of patients. Extradural hematoma was present in 16 patients and subdural hematoma affected 13 patients. Conclusion: Computed tomography is

关键词： Road Accident CT-Scan Facial Trauma

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C1C2 Wiring and Posttraumatic Atlantoaxial Dislocation: An Effective and Cheap Surgical Procedure in a Developing Country

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Surgical Science 2024年第5期15卷 357-370页

作者： Ibrahim Dao Massimiliano Visocchi Salah Sow John Jabang Ousmane Ouattara Astride Somda Abdoulaye Sanou Elie Dibloni Nassoum Arsène Tossou Narcisse Ouedraogo Frédéric Bako Massadiami Soulama Malick Diallo Patrick Wendpouiré Hamed Dakouré Department of neurosurgery University Hospital Souro Sanou Nazi Boni University Bobo Dioulasso Burkina Faso High Institute of Health Sciences Nazi Boni University Bobo Dioulasso Burkina Faso Military Hospital Colonel Major Tanguet Ouattara Bobo Dioulasso Burkina Faso Institute of neurosurgery Craniovertebral Junction Surgery Unit School of Medicine Catholic University Rome Italy Department of radiology and Medical Imaging University Hospital Yalgado Ouedraogo Joseph Ki-Zerbo University Ouagadougou Burkina Faso Department of neurosurgery (Unit) Edward Francis Small Teaching Hospital Banjul Gambia Department of neurosurgery University Hospital Yalgado Ouedraogo Joseph Ki-Zerbo University Ouagadougou Burkina Faso Department of neurosurgery Military Hospital Capitaine Halassane Coulibaly Ouagadougou Burkina Faso Department of Orthopedic Surgery University Hospital Souro Sanou Nazi Boni University Bobo Dioulasso Burkina Faso

Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for neurosurgeons. Several technics have been described such as wiring, trans articular screwing, C1C2 screwing with plate and screw introduced by Goel et al., and modified by insertion of polyaxially screw and rod many years later by Harms. Unavailability and expensiveness of upper cervical spine instrumentation device led us to C1C2 Wiring resulting in a good outcome. Finally, a quadriplegic patient with a more comfortable financial condition had ordered devices from abroad and benefit for Goel and Harms screwing technique and improved dramatically from ASIA A to ASIA E. Material and methods: This is a retrospective study of patients managed in our department by a same neurosurgeon from January 2019 to April 2024. Results: We defined 6 men and 1 woman with an average age of 33 years. Unrestrained driver in a rollover motor vehicle accident was most common. Only one patient was neurologically intact on admission. Neurovegetative disorders were noticed in one patient. Dislocation was associated to a fracture of the dens in two patients. Three patients have been successfully operated with remarkable outcome, mostly from ASIA A to E. Conclusion: C1C2 dislocation is a serious condition and C1C2 Wiring represents an effective and cheaper technic. Therefore, this technic should deserve consideration above all in low incomes countries when screwing devices are not available. Seatbelt should be demanded for motor vehicle drivers and passengers.

关键词： Superior Cervical Spine Dislocation Fracture Wiring Screwing Neurovegetative Disorders

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Co-alteration of Myc and RTK-RAS pathways defines a liver-metastatic propensity and immune-cold subgroup of pancreatic adenocarcinoma

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Genes & Diseases 2024年第3期11卷 47-50页

作者： Yuyuan Zhang Ziyang Zu Hui Xu Siyuan Weng Yuqing Ren Quan Cheng Peng Luo Jian Zhang Zaoqu Liu Xinwei Han Department of Interventional radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan450052China Interventional Institute of Zhengzhou University ZhengzhouHenan450052China Interventional Treatment and Clinical Research Center of Henan Province ZhengzhouHenan 450052China Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Department of Respiratory and Critical Care Medicine The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan450052China Department of neurosurgery Xiangya HospitalCentral South UniversityChangshaHunan 410008China Department of Oncology Zhujiang HospitalSouthern Medical UniversityGuangzhouGuangdong 510280China

Co-altered pathways refer to the phenomenon where multiple biological pathways exhibit aberrant changes simultaneously within the same tumor *** phenomenon can facilitate a better understanding of the mechanism and evolution of tumors and serve as a biological marker for diagnosing,classifying,and treating tumors.1 However,the nature of alteration occurrence and the impact on pancreatic adenocarcinoma(PAAD)remain *** SELECT algorithm was originally designed to systematically assess the evolutionary dependencies and their impact between altered genes in cancer for anticipating drug resistance and proposing alternative ***,to better characterize the etiology of PAAD and develop an improved risk assessment strategy,2 by utilizing SELECT,we identified a co-altered pathway subgroup of PAAD that demonstrated an elevated risk for unfavorable prognosis,a propensity for liver metastasis,and an immunologically cold microenvironment.

关键词： adenocarcinoma elevated alteration

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