Volume 42 · Issue 02 · 2026

Peripheral nerve disease is a huge system associated with traumatic injury, trapping or cranial nerve compression lesions, tumors and metabolic diseases. The incidence of peripheral nerve diseases is on the rise as the population ages and the prevalence of diabetes increases. This paper analyzes the development trend of diagnosis and treatment of peripheral nerve diseases based on the etiology, diagnosis and treatment status, and proposes that in the future, multidisciplinary collaboration should be strengthened, precision medicine and personalized treatment should be promoted, and basic research should be transformed into clinical practice, so as to provide better and more personalized solutions for improving patients' quality of life, which has important practical significance for promoting discipline construction and responding to the strategic needs of "Healthy China".

Trigeminal neuralgia is a common cranial nerve disease, usually confined to one or more branches of the unilateral trigeminal nerve distribution area, characterized by recurrent, transient electroshock-like, knife-like, needle-like pain, lasting from seconds to minutes, with abrupt onset and termination, induced by harmless stimulation within the trigeminal nerve distribution area^[1,2,3,4,5]。

central retinal artery occlusion (CRAO) refers to an acute disease in which the central retinal artery (CRA) is partially or completely occluded, causing sudden blindness or sudden vision decline, and significantly increasing the risk of acute ischemic events (such as ischemic stroke, acute myocardial infarction), death, and ocular neovascularization^[1,2]。 Among them, non-arteritis CRAO accounts for 95%, and this type of CRAO is mainly discussed in the Expert Consensus on Neurointervention of Central Retinal Artery Occlusion (2026 Edition) (hereinafter referred to as this consensus). Studies have shown that retinal ischemia can cause irreversible damage for up to 105~240 min^[3]It suggests the importance of early diagnosis and treatment. CRAO is regarded as a special type of acute ischemic stroke, and conservative treatments such as eye massage and medication usually fail to significantly improve vision. intra-arterial thrombolysis (IAT) technique can quickly restore blood perfusion by superselective perfusion of drugs into the ophthalmic artery through microcatheters. However, there is no uniform standard and different conclusions in the evaluation of efficacy at present. This consensus combines the latest clinical research and expert experience to provide a reference for the endovascular treatment of CRAO.

To preliminarily explore the safety and efficacy of cervical-lumbar dual-target spinal cord stimulation (SCS) in the treatment of limb motor impairment after ischemic stroke.

A retrospective analysis was performed on 7 patients with limb motor impairment after ischemic stroke who received cervical-lumbar dual-target SCS in the Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University from February 2024 to February 2025. The Fugl-Meyer Assessment (FMA) score (an increase of ≥5 points considered significant improvement), modified Ashworth Scale (MAS) grade (an increase of ≥1 grade considered significant improvement), and Hospital Anxiety and Depression Scale (HADS) score (a decrease of ≥5 points considered significant improvement) were evaluated preoperatively, 3 months and 6 months postoperatively, and the improvements were compared and analyzed. Surgical-related complications and adverse reactions caused by electrode stimulation were observed, and the electrode position was confirmed at imaging follow-up.

All 7 patients successfully underwent electrode implantation, and no surgery-related complications, severe adverse reactions related to electrode stimulation or electrode displacement occurred. Compared with preoperative values, the total FMA score, upper limb FMA score, lower limb FMA score, MAS grade, HADS anxiety score and HADS depression score at 3 months and 6 months postoperatively were all significantly improved (all P<0.05). There were no statistically significant differences in the indicators between 3 months and 6 months postoperatively (all P>0.05). Among the 7 patients, 6 cases achieved a total FMA score increase of ≥5 points both at 3 and 6 months postoperatively; 4 cases had an upper limb FMA score increase of ≥5 points at both time points; 3 cases had a lower limb FMA score increase of ≥5 points at 3 months, and 4 cases at 6 months. At 3 and 6 months postoperatively, 6 cases had the MAS grade improvement of ≥1 grade; 4 cases had the HADS depression score decrease of ≥5 points, and 5 cases had the HADS anxiety score decrease of ≥5 points.

Preliminary research indicates that cervical-lumbar dual-target SCS is safe for the treatment of limb motor impairment after ischemic stroke. It can improve the motor function of the hemiplegic limb in the short term and is conducive to enhancing the patient′s emotional state.

To evaluate the clinical efficacy of masseteric-facial nerve trunk anastomosis in treating severe facial paralysis.

A prospective analysis was conducted on 15 patients with severe facial paralysis (House-Brackmann grades Ⅴ-Ⅵ), treated at the Department of Neurosurgery, the Second Affiliated Hospital of Zhejiang University, School of Medicine between June 2023 and June 2024. All patients underwent masseteric-to-facial nerve trunk anastomosis. Follow-up was conducted at 3, 6 and 12 months postoperatively, documenting the outcomes of postoperative complications and the time to onset of minimal mouth corner movement. Computerized FACE-gram software 1.0 was used to objectively measure preoperative and postoperative facial static symmetry parameters and dynamic functions. Facial static symmetry was assessed based on six parameters: eyebrow, eye, nose, philtrum, lips and bilateral mouth corner symmetry. Dynamic facial muscle function assessment included eye closure and smiling states: in the eye closure state, eyebrow height displacement difference, upper eyelid displacement difference, lower eyelid displacement difference, and eyelid closure were evaluated; in the smiling state, bilateral mouth corner symmetry and affected-side facial muscle movement function were assessed. The measured parameters were compared between preoperative and the last postoperative follow-up.

All 15 patients successfully underwent the surgery. One patient developed a parotid fistula after surgery. All patients experienced immediate postoperative reduction in chewing strength on the surgical side, which recovered to normal by 3 months postoperatively. The median (Q₁, Q₃) follow-up time was 7.92 (6.12, 10.52) months, and the median time to onset of minimal mouth corner movement after clenching teeth was 3.19 (2.66, 4.18) months. At the last follow-up, the improvement rate of eye closure function was 13/14. In terms of facial static symmetry, compared with preoperative measurements, the symmetry of the eyes, nose, and lips improved at the last follow-up, with statistically significant differences (all P<0.05). However, there was no significant improvement in the eyebrow or mouth corner symmetry parameters (both P>0.05). Regarding dynamic facial muscle function, eyebrow and eye symmetry improved in the eye closure state (both P<0.05) at the last follow-up. In the smiling state, bilateral mouth corner symmetry parameters improved, with statistically significant differences (all P<0.05); except for the change in the lower lip-mouth corner angle (P>0.05). All other affected-side facial muscle movement function parameters improved, with statistically significant differences (all P<0.05).

Masseteric nerve-facial nerve trunk anastomosis can effectively improve facial static symmetry in patients with severe facial nerve palsy, restore dynamic eye closure and smiling functions, with a fast postoperative recovery time. It can be used to treat irreversible severe facial nerve palsy.

To preliminarily investigate the feasibility of designing individualized linear incisions for microvascular decompression (MVD) via the retrosigmoid approach in patients with hemifacial spasm (HFS) based on preoperative CT-measured imaging anatomical parameters combined with three-dimensional (3D) visualization simulation techniques, and to verify its effectiveness and safety in providing adequate surgical exposure.

This prospective single-arm cohort study included 142 unilateral HFS patients scheduled for MVD via the retrosigmoid approach at the Department of Neurosurgery, Peking University People′s Hospital, between June and November 2024. Five imaging anatomical parameters were measured on preoperative cranial CT: the distance from the emissary vein opening to the posterior margin of the sigmoid sinus (EV-PMSS), the distance from the digastric point to the posterior margin of the sigmoid sinus (DP-PMSS), the distance from the posterior edge of the external acoustic crest to the posterior margin of the sigmoid sinus (EC-PMSS), the mastoid bone thickness at the posterior margin of the sigmoid sinus (MBT-PMSS), and the angle between the sagittal plane and the inner surface of the petrous bone (Sag-Pet A). Differences in these parameters between male and female patients were compared. A surgical incision was then designed using 3D visualization simulation based on CT data and validated intraoperatively. Intraoperative assessments included exposure of the petrous bone surface, venous rupture during cerebrospinal fluid (CSF) release, and bleeding from the sigmoid sinus. Surgeons also provided subjective evaluations of the incision regarding adequacy of exposure, fulfillment of the required working angle and operative convenience.

Male patients (n=50) had significantly greater DP-PMSS, EV-PMSS, and MBT-PMSS values than female patients (n=92) (all P<0.001). No significant sex differences were observed in EC-PMSS or Sag-Pet A (both P>0.05). In the 3D visualization simulation, all 142 patients achieved successful simulated retraction with individualized incision design, meeting the predefined criteria of an effective exposure length of approximately 40 mm after skin-flap retraction, a bone window of 25-30 mm, and a surgical working angle ≥20°. During MVD, 137 patients (96.5%) obtained direct exposure of the petrous bone surface after dural opening and CSF release without additional cerebellar retraction, while 5 patients (3.5%) required minimal retraction. Two cases of inferior petrosal vein rupture occurred during CSF release; no superior petrosal vein ruptures occurred. No intraoperative sigmoid sinus injuries or bleeding was observed. Surgeons rated the incision as excellent in 134 cases (94.4%) and good in 8 cases (5.6%).

This preliminary study demonstrates that individualized incision design based on preoperative CT-derived anatomical parameters combined with 3D visualization simulation is feasible. When applied during MVD for HFS, this incision provides favorable surgical exposure with a good safety profile.

To investigate the efficacy of unilateral peripheral nerve decompression in the treatment of distal symmetric polyneuropathy (DSPN) in diabetic patients.

The clinical data of 15 patients with DSPN who underwent unilateral peripheral nerve decompression at the Department of Neurosurgery, the First Affiliated Hospital of Soochow University from January 2023 to December 2024 were retrospectively analyzed. All patients had bilateral symmetrical peripheral nerve compression symptoms and received either upper limb triple nerve decompression or lower limb quadruple nerve decompression based on the involved sites. Follow-up was conducted every 3 months after surgery, and the visual analogue scale (VAS) was used to evaluate the pain and numbness of both limbs. Based on the sum of the pain and numbness grades, the symptoms were classified into four levels: no symptoms, mild, moderate, and severe. The preoperative and postoperative symptom of the operative side and the non-operative side were compared.

The surgeries of all patients were successfully completed. Among them, 7 underwent upper limb triple nerve decompression surgery and 8 underwent lower limb quadruple nerve decompression surgery. No complications such as wound infection or nerve injury occurred after surgery. All patients were followed up for a period [M(Q₁, Q₃)] of 8.87 (6.24, 16.56) months. At the final follow-up, both the operative and non-operative sides showed a significant reduction in numbness and pain VAS scores compared to preoperative levels (all P<0.05). The postoperative symptoms of the operative side were 3 cases of no symptoms, 9 cases of mild, and 3 cases of moderate; the non-operative side was 3 cases of no symptoms, 8 cases of mild, and 4 cases of moderate; both sides showed significant improvement compared to preoperative symptoms (both P<0.05). In 2 patients, only pain improved on the operated side, whereas numbness showed no improvement. Three patients had relief of both pain and numbness on the operative side, but no significant improvement on the non-operative side. These 3 patients subsequently underwent a second surgery on the unimproved side at 3 months postoperatively, after which their symptoms improved. The remaining patients all showed no recurrence of numbness or pain symptoms.

Unilateral peripheral nerve decompression can effectively improve the nerve compression symptoms of bilateral limbs in patients with DSPN. It is a safe and viable treatment option.

To investigate the clinical outcomes of individualized decompression strategies based on the classification of offending vessels during microvascular decompression (MVD) for glossopharyngeal neuralgia (GPN).

A retrospective analysis was conducted on the clinical data of 24 patients with refractory GPN admitted to the Department of Neurosurgery, Zhongnan Hospital of Wuhan University from September 2020 to January 2025. All patients were definitively diagnosed with GPN and underwent MVD. Based on the intraoperatively confirmed types of offending vessels, patients were categorized into three types: small artery compression (anterior inferior cerebellar artery or posterior inferior cerebellar artery), composite compression type with vertebral artery (VA) involvement, and venous compression. Individualized decompression strategies were applied. For small artery compression, padding was primarily used to insulate the offending artery from the nerve; for VA and other offending arteries compression, multi-point padding was used to displace the VA while insulating other offending arteries; for venous compression, the offending vein was electrocoagulated and divided. Postoperative pain control was quantified using the Barrow Neurological Institute (BNI) Pain Intensity Scale via clinical and telephone follow-up. Quality of life was assessed using the Short Form-36 (SF-36) questionnaire at 6 months postoperatively, and swallowing function was evaluated using the Swallowing Quality of Life (SWAL-QOL) scale at 6 and 12 weeks postoperatively. Postoperative complications were also documented.

Neurovascular compression was confirmed intraoperatively in all 24 patients. There were 20 cases of small artery compression, 2 cases of composite compression type with VA involvement and 2 cases of venous compression. Immediate postoperative pain relief (BNI Grade Ⅰ) was achieved in 100%(24/24) of patients. During a mean follow-up of 24.2±18.8 months (range: 8-42 months), 23 patients (95.8%) maintained BNI Grade Ⅰ. SF-36 scores across all eight domains at 6 months postoperatively were significantly higher than preoperative scores (all P<0.001). SWAL-QOL scores at 6 weeks (89.2±10.5) were higher than preoperative scores (70.3±10.4), with further improvement observed at 12 weeks (90.4±9.2) (both P<0.05). One case of minor cerebellar hemorrhage resolved following conservative management. One patient developed new-onset contralateral pain 38 months postoperatively, which was effectively managed with conservative treatment. No permanent neurological deficits or deaths occurred.

Individualized MVD strategies based on the classification of offending vessels demonstrate excellent efficacy and minimal complications in the treatment of GPN, warranting broader clinical application.

To assess the feasibility and efficacy of vertical hemispherotomy for the treatment of drug-resistant epilepsy (DRE) in patients with unilateral hemispheric disease.

A total of 16 DRE patients treated with vertical hemispherotomy at the Epilepsy Center of Kunming Sanbo Brain Hospital between May 2021 and December 2024 were included. All patients received regular, adequate doses of antiseizure medicines postoperatively. A retrospective analysis was conducted to observe the surgical complications and outcomes. The Engel classification was used to assess the control of epileptic seizures.

All 16 patients had successful operations, with a mean surgical duration of 297.6±90.0 minutes and an average intraoperative blood loss of 243.8±85.4 ml. No patients required intraoperative blood transfusion. Postoperative imaging confirmed complete hemispherotomy. Postoperative complications included one case of intracranial infection and one case of isolated hydrocephalus, both of which were resolved with treatment. One patient died six months postoperatively due to non-primary disease. The remaining 15 patients had a mean follow-up period of 32.7±13.8 months (range: 13-56 months). Among them, 13 patients were seizure-free with Engel class Ⅰ, and 2 patients had seizures with Engel class Ⅱ. Postoperative motor impairments on the affected side were observed in all 16 patients, which improved with rehabilitation, with 6 patients returning to preoperative functional levels.

Vertical hemispherotomy is an effective approach for the treatment of DRE with unilateral hemispheric involvement, demonstrating good seizure control and minimal intraoperative blood loss.

To analyze the connectivity characteristics between the cortex and the centromedian nucleus (CM) during seizures in patients with drug-refractory epilepsy based on stereo-electroencephalography (SEEG), and to reveal the dynamic changes in the cortical-thalamic network during ictal periods.

The clinical data and ictal SEEG data of 10 patients who underwent intracranial electrode implantation in the Department of Neurosurgery at Xuanwu Hospital, Capital Medical University between November 2023 and July 2024 were retrospectively analyzed. Coherence analysis was performed to examine the trends of coherence between the seizure onset zone (SOZ) and the CM across Delta, Theta, Alpha, Beta, and Gamma (30~100 Hz) frequency bands during seizure onset. Granger causality analysis (GCA) was used to investigate the bidirectional causal relationships between the SOZ and the CM, and to analyze the dynamic changes in each frequency band activities to summarize the directional information transfer characteristics during seizure evolution.

The seizure types included focal to bilateral tonic-clonic seizures (n=6), automotor seizures (n=1), focal impaired awareness seizures (n=2), and myoclonic seizures progressing to bilateral tonic-clonic seizures (n=1). Ictal SEEG recordings revealed that CM discharge patterns included slow-wave rhythms, sharp/spike-wave rhythms, and low-amplitude fast activity, accounting for 50%, 30% and 20% respectively. The average time interval from seizure onset to the appearance of rhythmic discharges in the CM was 10 seconds. Coherence analysis between the cortex and thalamus showed that in the Gamma band activity, coherence at seizure termination was significantly higher than at seizure onset, with statistically significant difference (P=0.013). At seizure onset, coherence between the cortex and CM showed an increasing trend across all frequency bands, with Delta and Gamma bands exhibiting more prolonged and significantly enhanced increases in both duration and magnitude. Standardized frequency-domain Granger causality analysis results indicated that at seizure onset, Granger causality values in the direction from the SOZ to the CM significantly increased, particularly showing prolonged and significant rises in the Delta, Beta and Gamma bands (all P<0.05). In the Gamma band, Granger causality values from the cortex to the CM showed a significant increase even before seizure onset (P=0.003). In the direction from the CM to the cortex, transient increases in Granger causality were observed in Beta and Gamma band activities, but the overall magnitude was lower and the duration was shorter.

Typical ictal discharge patterns can be recorded in the CM in patients with drug-refractory epilepsy, and the CM is involved early in the seizure. The sustained increase in low-frequency (Delta) and high-frequency (Gamma) coherence reflects a dynamic connectivity pattern of low-frequency driving and high-frequency integration. The CM may serve a role in integrating and relaying information from the cortex to the thalamus within the seizure network. During the early stage of seizures, information primarily flows unidirectionally from the cortex to the thalamus, while in the mid-to-late stages, the thalamus exerts feedback regulation on the cortex.

To investigate the clinical characteristics and prognosis of spinal cord injury without radiographic abnormality (SCIWORA) in children resulting from dance-related hyperextension of the lower back.

A total of 22 pediatric patients with SCIWORA caused by dance-related hyperextension of the lower back, who were admitted to the neurosurgery departments of four centers including the Children′s Hospital of Soochow University between December 2013 and December 2022, were included. Spinal cord function was assessed using the American Spinal Injury Association (AIS) Impairment Scale (AIS, grades A-E, with A being the most severe and E being normal). All patients received conservative treatment, with only those complicated by tethered cord syndrome undergoing filum terminale transection. The clinical characteristics of SCIWORA and the prognosis of patients with different characteristics were retrospectively analyzed.

Among the 22 patients, 21 were female and 1 was male, with a mean age of 6.9 ± 1.5 years. They were divided into a ≤7 years group (n=14, 63.6%) and a >7 years group (n=8, 36.4%). Progressive worsening of spinal cord function occurred within 15 minutes to 18 hours post-injury. Seven patients were complicated by fatty filum terminale. At admission, AIS grades were A in 7 cases, B in 6, C in 4, and D in 5. Initial spinal MRI revealed abnormal signals in 16 patients (72.7%): 3 involved both the conus medullaris and thoracic cord, 2 involved both the cervical and thoracic cord, and the remaining 11 involved only the thoracic cord; 6 patients showed no significant abnormalities. The severity of spinal cord injury was greater in the ≤7 years group compared to the >7 years group, and in the MRI-abnormal group compared to the no-abnormality group, with statistically significant differences (both P<0.05). The median follow-up time for the 22 patients was 56 months (range: 28-136 months). At the final follow-up, AIS grades were A in 7 cases, C in 2, D in 5, and E in 8. Among the 7 patients with AIS grade A at admission, none showed functional improvement, while all 15 patients with other grades improved (8 of whom recovered completely). The AIS grades at final follow-up were worse in the ≤7 years group compared to the >7 years group, and worse in the initial MRI-abnormal group compared to the no-abnormality group, with statistically significant differences (both P<0.05). The presence or absence of tethered cord syndrome had no significant impact on either injury severity or prognosis (both P>0.05).

Dance-related backbend movements predominantly cause SCIWORA in the thoracic spinal cord in children. Patients aged ≤7 years and those with initial abnormal spinal MRI findings tend to have more severe spinal cord injury and poorer outcome.

To investigate the surgical strategy and outcomes for sacral canal terminal filum cysts with tethered cord syndrome.

A retrospective analysis was conducted on the clinical data of 17 patients with sacral canal terminal filum cysts and tethered cord syndrome who underwent surgical treatment in the Department of Neurosurgery, Peking University People′s Hospital from March 2018 to January 2025. All patients underwent surgery involving terminal filum sectioning and tethered cord release + fistula ligation and cyst wall resection + reconstruction of the posterior sacral canal wall. Follow-up was conducted via outpatient visits at 3, 6, and 12 months postoperatively and annually thereafter. The visual analog scale (VAS) score was used to assess pain improvement, and the Japanese Orthopaedic Association (JOA) score was used to evaluate neurological function. Lumbosacral MRI was performed to observe cyst recurrence and recovery of tethered cord.

All 17 patients successfully underwent surgery. Total cyst wall resection was achieved in 13 cases and subtotal resection in 4 cases. Symptoms improved in all patients postoperatively. Transient new-onset symptoms occurred in 4 patients: saddle numbness in 1 case, unilateral low back pain in 2 cases, and difficulty urinating in 1 case, all of which improved or resolved after treatment. All patients were followed up with a median follow-up time duration of 3.5 (range: 0.5-7.5) years. At the last follow-up, lumbosacral MRI in none of the 17 patients showed cyst recurrence, and no significant fluid accumulation was observed in the surgical cavity or subcutaneous tissue. The median VAS score decreased from a preoperative value of 5 (range: 3-8) to 2 (range: 0-4) (T=0, P<0.001). The median JOA score increased from a preoperative value of 20 (range: 16-26) to 26 (range: 23-29) (T=0, P<0.001). Neurological function evaluation of the patients showed that 3 cases were cured, 9 cases showed significant improvement, 5 cases were effective.

The surgical procedure of terminal filum sectioning and tethered cord release + fistula ligation and cyst wall resection + reconstruction of the posterior sacral canal wall can effectively improve symptoms in patients with sacral canal terminal filum cysts and tethered cord syndrome, with no significant postoperative complications. It can serve as a treatment option for patients who do not respond to conservative management.

To investigate the clinical efficacy of percutaneous microchannel-microscopic surgery in the treatment of lumbar disc herniation.

Clinical data of 156 patients with lumbar disc herniation who underwent percutaneous microchannel-microscopic surgery in the Department of Neurosurgery, the 904th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army between June 2022 and June 2024 were retrospectively analyzed. The Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) score, and Oswestry disability index (ODI) were assessed preoperatively, and at 1 day, 1 week, 1 month, 3 months and 7 months postoperatively. Clinical efficacy was evaluated using the modified MacNab criteria.

All 156 patients successfully completed the surgery. The operative time was 65.4±12.5 min (60-100 min), and intraoperative blood loss was 28.3±10.6 ml (20-60 ml). Dural tears occurred in 3 cases and all repaired under microscopic suture intraoperatively. Postoperative ipsilateral lower limb numbness persisted in 5 cases, with no cases of infection or nerve root avulsion complications. Postoperative JOA, VAS, and ODI scores showed significant improvement (F_JOA=115.32, F_VAS=216.57, F_ODI=687.20, all P<0.001). The JOA, VAS, and ODI scores at 1 day, 1 week, 1 month, 3 months, and 7 months after the operation were significantly different from preoperative scores (all P<0.05). The median follow-up period of the 156 patients was 7 (3-14) months. At the final follow-up, according to the modified MacNab criteria, outcomes were excellent in 106 cases, good in 38 cases, and fair in 12 cases, with an excellent and good rate of 92.3% (144/156).

Percutaneous microchannel-microscopic surgery for lumbar disc herniation demonstrates good efficacy and high safety, making it worthy of clinical application.

To comparatively analyze the effects of neuroendoscopic and microscopic surgeries on perihematoma edema in patients with spontaneous intracerebral hemorrhage.

A retrospective analysis was conducted on 146 patients with spontaneous cerebral hemorrhage who underwent neurosurgery at the Department of Neurosurgery, People′s Hospital of Henan University from September 2022 to December 2024. Patients underwent hematoma evacuation under neuroendoscopy (neuroendoscopy group) or microscopic craniotomy (microscopic group) for hematoma evacuation respectively. The 3D Slicer software was applied to calculate and compare the hematoma volume, perihematoma edema volume (PHE), residual hematoma volume, periluminal edema volume (PCE), relative PHE (rPHE), hematoma clearance rate and relative PCE (rPCE) of the two groups of patients. The baseline data, surgical efficacy, complications and prognosis of the two groups of patients were compared.

A total of 146 patients were enrolled, among which 60 were in the neuroendoscopy group and 86 were in the microscopy group. There were no statistically significant differences between the two groups in terms of age, gender, Glasgow Coma Scale (GCS) score, history of primary hypertension, history of diabetes, location of bleeding, duration from onset to surgery, preoperative hematoma volume, PHE volume, and rPHE volume (all P>0.05). Compared with the microscope group, the operation time of the neuroendoscopy group was shortened [(169.58±36.74) min vs. (210.40±32.49) min], and the intraoperative blood loss was reduced [(50.00±14.95) cm³vs. (218.00±20.48) cm³], the postoperative PCE volume [median (Q₁, Q₃)] was smaller [18.5 (6.2, 38.0) cm³vs. 48.6 (32.8, 105.8) cm³], the rPCE value was lower (0.51±0.27 vs. 1.01±0.69), and the edema evolution value [median (Q₁, Q₃)] improved significantly [-2.0 (-8.2, 13.4) cm³vs. 21.8 (12.6, 82.4) cm³], the differences were all statistically significant (all P<0.05). However, there were no statistically significant differences in the residual hematoma volume and hematoma clearance rate between the two groups (all P>0.05). There were no statistically significant differences in the incidence rates of postoperative intracranial infection, pulmonary infection, secondary surgery and secondary bleeding between the two groups (all P>0.05). In terms of postoperative patient recovery and prognosis, there were no statistically significant differences between the two groups in terms of the length of stay in the intensive care unit, the total length of stay, the GCS score at discharge, and the modified Rankin scale score at 6 months after surgery (all P>0.05).

There is no significant difference in complications and prognosis between neuroendoscopic and microscopic surgeries for patients with SICH. However, the operation time, intraoperative blood loss and postoperative PHE indicators of neuroendoscopic surgery are superior to those of microscopic surgery.

To explore the regulation of phosphorylation of H2A.XY39 (H2A.X^Y39ph) by Jumonji C-domain containing protein 6(JMJD6) and EYA2 and their effects on the sensitivity to temozolomide (TMZ) of glioma cells.

Transcriptome data of 689 glioma samples and clinical data of 1 069 glioma patients were obtained from TCGA (The Cancer Genome Atlas) database. Transcriptome data of 1 152 normal brain tissue samples were obtained from the GTEx (Genotype-Tissue Expression) database. The correlations of JMJD6, EYA2, and H2A.X levels with glioma tissue characteristics, pathological grades and patient survival probability were analyzed. Cells were transfected with si-JMJD6 (named as JMJD6 knockdown group), EYA2 overexpression plasmid (named as EYA2 overexpression group), or co-transfected with H2A.X^Y39E overexpression plasmid (named as JMJD6 knockdown + H2A.X^Y39E group, EYA2 overexpression + H2A.X^Y39E group). Western blot (WB) was used to detect H2A.X^Y39ph levels in the JMJD6 knockdown and EYA2 overexpression groups. All groups of cells were treated with TMZ at a final concentration of 500 μmol/L for 48 h. Cell viability was detected by CCK8 assay, and apoptosis rate was measured by TUNEL staining. WB was used to determine the protein levels related to apoptosis, autophagy, and DNA damage repair. P value < 0.05 was considered statistically significant.

Database analysis showed that the expression levels of JMJD6 and EYA2 in glioma tissues were significantly higher than those in normal brain tissues (all P<0.01). The expression levels of JMJD6, EYA2, and H2A.X increased with the elevation of tumor pathological grade (all P<0.01). The survival probability of JMJD6, EYA2 and H2A.X low expression groups were significantly higher than those of high expression groups (all P<0.01). In vitro experiments with U251 and U87 cells demonstrated that compared with the control group, H2A.X^Y39ph levels were significantly decreased both in the JMJD6 knockdown and EYA2 overexpression groups (all P<0.05). Compared with the control group, the JMJD6 knockdown+ TMZ group and EYA2 overexpression+ TMZ group exhibited reduced cell viability, increased apoptosis rate, upregulated expression of pro-apoptotic proteins Bax and Caspase3, downregulated expression of anti-apoptotic protein Bcl-2, decreased expression of autophagy-related protein LC3-Ⅱ, increased expression of p62, and reduced protein levels of DNA damage repair-related factors γ-H2A.X, H2A.X^Y39ph, MDC1, and ATM (all P<0.05). Compared with the JMJD6 knockdown+ TMZ group and EYA2 overexpression+ TMZ group respectively, the JMJD6 knockdown+ H2A.X^Y39E+ TMZ group and EYA2 overexpression+ H2A.X^Y39E+ TMZ group exhibited increased cell viability, decreased apoptosis rate, downregulated expression of Bax, Caspase3, and p62, and upregulated expression of Bcl2, γ-H2A.X, H2A.X^Y39ph, MDC1, and ATM (all P<0.05).

JMJD6, EYA2, and H2A.X are correlated with the pathological grade and survival rate of glioma patients. JMJD6 and EYA2 bidirectionally regulate H2A.X^Y39ph level in glioma cells through interaction with H2A.X and enhance cell sensitivity to TMZ by affecting cell proliferation, apoptosis, autophagy and DNA damage repair.

Neurogenic stress cardiomyopathy in children is rare. This paper reports a case of stroke in a child with right temporal lobe tumor diagnosed and treated in the neurosurgical department of Linyi People's Hospital, who was complicated by neurogenic stress cardiomyopathy. Echocardiography showed left ventricular wall motor dysfunction, with decreased contractility in the middle of the left ventricle as the main manifestation, accompanied by significant left ventricular dysfunction. The children presented with severe acute heart failure, which was significantly different from the characteristics of apical spheroidal wall dyskinesia in typical stress cardiomyopathy. After active treatment, the child's cardiac function gradually recovered, his consciousness became clear, he was successfully detached from the ventilator and the tracheal intubation was removed, and finally he was transferred out of the intensive care unit.

Neurosurgical diseases are complicated and the treatment risk is high. It is very important to build a perfect medical quality control system for neurosurgery. At present, medical quality control management at home and abroad has been gradually refined, and many medical centers in the world have established relatively mature quality control management systems. Although relevant organizations in China started late, they developed rapidly and showed Chinese characteristics. This article systematically reviews the core organization system, implementation path and development trend of neurosurgery quality control at home and abroad, aiming to provide reference for improving the global neurosurgery medical quality.

Intracranial aneurysm is a common cerebrovascular disease. Patients with ruptured intracranial aneurysm have a higher risk of aneurysm rupture again than healthy people. Early screening and prognostic evaluation of intracranial aneurysms are crucial, and intracranial aneurysm-related metabolites are of great value in them. This article focuses on the study of metabolites related to the diagnosis and prognosis of intracranial aneurysm, and reviews the relationship between lactic acid, citric acid, glutamine, taurine, pyruvate and fumaric acid and aneurysm.