ObjectiveTo review the diagnosis, clinical characteristics and treatment of Arachnoid cyst rupture associated with epilepsy.
MethodsThe clinical data of one patient with arachnoid cyst rupture associated with epilepsy was reported and diagnosis, clinical characteristics, the treatment options were discussed with literature reviewed.
ResultsWe arranged the operation:arachnoid cyst resection and the left anterior temporal lobe resection and colostomy, the patient recovered well postoperatively, without special discomfort, epilepsy did not attack again.
ConclusionsArachnoid cyst rupture associated with epilepsy is extremely rare, postoperative effect is good through strict preoperative assessment.
摘要:目的:探討老年慢性硬膜下血腫術后腦梗死的發病特點及防治措施。方法:總結分析21例老年慢性硬膜下血腫術后出現腦梗死患者。結果:多數患者具有高血壓、高血脂、冠心病及糖尿病等多個腦梗死高危因素。術后腦梗死發生于術后1周內者18例,其中3天以內者16例;腦梗死發生于手術區域附近者14例,非手術區域附近者7例,其中5例的腦梗死發生于上述兩個區域。結論:腦梗死發病的高危因素是顱腦術后腦梗死發生的主要原因。Abstract: Objective: To investigate and search for the causes of cerebral infarction after operation for subdural hematoma in senile patients and discuss the remedies for its prevention. Methods: Twentyone senile patients with cerebral infarction after operation for subdural hematoma were reviewed retrospectively. Results: Most of the patients were found to be suffered with several risk factors of cerebral infarction such as hypertension, coronary cardiac diseases, diabetes mellitus and so on. Eighteen cases of infarctions occurred within a week after operation, including 16 cases within 3 days. Fourteen cases of the infarctions located in regions around the operative field, while 7 cases in non operation related area, and 5 cases in both areas. Conclusions: Risk factors of cerebral infarction were the main causes to result in cerebral infarction after operation for subdural hematoma.
ObjectiveTo explore the advantages and disadvantages of using two intracranial EEG (iEEG) monitoring methods—Subdural ectrodes electroencephalography (SDEG)and Stereoelectroencephalography (SEEG), in patients with “difficult to locate” Intractable Epilepsy. MethodsRetrospectively analyzed the data of 60 patients with SDEG monitoring (49 cases) and SEEG monitoring (11 cases) from January 2010 to December 2018 in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical. Observe and statistically compare the differences in the evaluation results of epileptic zones, surgical efficacy and related complications of the two groups of patients, and review the relevant literature. ResultsThe results showed that the two groups of SDEG and SEEG had no significant difference in the positive rate and surgical resection rate of epileptogenic zones, but the bilateral implantation rate of SEEG (5/11, 45.5%) was higher than that of SDEG (18/49, 36.7%). At present, there was no significant difference in the postoperative outcome among patients with epileptic zones resected after SDEG and SEEG monitoring (P>0.05). However, due to the limitation of the number of SEEG cases, it is not yet possible to conclude that the two effects were the same. There was a statistically significant difference in the total incidence of serious complications of bleeding or infection between the two groups (SDEG 20 cases vs. SEEG 1 case, P<0.05). There was a statistically significant difference in the total incidence of significant headache or cerebral edema between the two groups (SDEG 26 cases vs. SEEG 2 cases, P<0.05). There was a statistically significant difference in the incidence of cerebrospinal fluid leakage, subcutaneous fluid incision, and poor healing of incision after epileptic resection (SDEG 14 cases vs. SEEG 0 case, P<0.05); there were no significant differences in dysfunction of speech, muscle strength between the two groups (P>0.05). ConclusionSEEG has fewer complications than SDEG, SEEG is safer than SDEG. The two kinds of iEEG monitoring methods have advantages in the localization of epileptogenic zones and the differentiation of functional areas. The effective combination of the two methods in the future may be more conducive to the location of epileptic zones and functional areas.
摘要:目的:探討慢性硬膜下血腫(chronic subdural hematoma, CSDH)鉆孔沖洗引流術后的復發因素。方法：回顧性分析165例CSDH鉆孔沖洗+閉式引流術的治療效果,并結合患者年齡、術后引流量、血腫腔是否有間隔、血腫厚度、引流管安放方向等因素進行相關分析。結果:本組治愈151例,血腫復發14例。〖HTH〗結論〖HTSS〗:患者年齡、術后引流量、血腫腔是否有間隔、血腫厚度、引流管安放方向是影響復發的主要因素。Abstract: Objective: To explore the related factors of recurrence of chronic subdural hematoma after burr hole drainage.Methods:The related aspects that affected the recurrence in 165 cases with chronic subdural hematomas after burr hole drainage were reviewed,and patient’s age,drainage volume,thickness of hematoma, septal hematoma cavity and direction of drain pipe were evaluated.Results:Clinical outcomes were satisfactory.151 patients completely recovered after burr hole drainage,there were 14 patients with hematoma recurrence. Conclusion : Age, drainage volume, thickness of hematoma, septal hematoma cavity and direction of drain pipe would affect the prognosis.
ObjectiveThe purpose of this study was to compare the value of SEEG and subdural cortical electrodes monitoring in preoperative evaluation of epileptogenic zone.
MethodsFeatures of patients using SEEG (48 cases) and subdural cortical electrodes monitoring (52 cases) to evaluate the epileptogenic zone were collected from June 2011 to June 2015. And the evaluation results, surgical effects and complications were compared.
ResultsThere was no significant difference between SEEG and subdural cortical electrodes monitoring in identifying the epileptogenic zone or taking epileptic surgery, but SEEG could monitor multifocal and bilateral epileptogenic zone. And there was no significant difference in postoperative seizure control and intelligence improvement (P > 0.05). The total complication rate of SEEG was lower than subdural cortical electrodes monitoring, especially in hemorrhage and infection (P < 0.05).
ConclusionsThere was no difference among SEEG and subdural cortical electrodes monitoring in surgical results, but SEEG with less hemorrhagic and infectious risks. SEEG is a safe and effective intracranial monitoring method, which can be widely used.
