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Diffusion tensor imaging (DTI) shows great advantage in the diagnosis of brain diseases, including cervical spinal cord (CSC) disease. This study aims to obtain the normal values of the DTI parameters for a healthy population and to establish a baseline for CSC disease diagnosis using DTI.A total of 36 healthy adults were subjected to magnetic resonance imaging (MRI) for the entire CSC using the Siemens 3.0 T MR System. Sagittal DTI acquisition was carried out with a single-shot spin-echo echo-planar imaging (EPI) sequence along 12 non-collinear directions. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were determined at different cervical levels using a region of interest (ROI) method, following which they were correlated with parameters, like age and sex. Further, diffusion tensor tracking (DTT) was carried out to reconstruct the white matter fiber bundles of the CSC.The full and complete fiber bundle structure of a normal CSC was confirmed in both the T2-weighted and DTI images. The FA and ADC values were significantly negatively correlated with each other and showed strongly negative and positive correlations with age, respectively, but not with sex. Additionally, there was no significant difference between the FA and the ADC values at different cervical levels.The DTI technique can act as an important supplement to the conventional MRI technique for CSC observation. Moreover, the FA and ADC values can be used as sensitive parameters in the DTI study on the CSC by taking the effects of age into consideration.

Although about 80% of patients with cerebral venous sinus thrombosis have a good prognosis, some patients develop severe complications and a small proportion do not survive. The study included patients who had been diagnosed with cerebral venous sinus thrombosis in our hospital from May 2008 to February 2014. Based on the modified Rankin Scale (mRS) scores at 3 months for outcome, the patients were divided into two groups: good prognosis (mRS score ≤ 2) and poor prognosis (mRS score > 2). Univariate and multivariate regression analysis were performed to identify significant prognostic factors for poor outcome. A total of 86 patients with cerebral venous sinus thrombosis, 54 males and 32 females, average age 41.3 years (range, 3-83 years), were enrolled. Of these 86 patients, 64 (74.4%) had a good prognosis and 22 (25.6%) a poor prognosis. Univariate analysis revealed that dyskinesia was a significant risk factor (factor with odds ratio >1) for poor prognosis. In multivariate analysis, the risk of poor prognosis in patients with dyskinesia was 23 times higher than for those without dyskinesia (p < 0.001). Thrombosis of the sinus transervus was found to reduce the risk of poor prognosis in both univariate and multivariate analysis. Most patients with cerebral venous sinus thrombosis have a good prognosis but patients with dyskinesia have a poorer prognosis.

Objective To investigate the value of virtual reality (VR) technique in the surgical planning for anterior circulation aneurysms of Willis circle. Methods A total of 50 patients with 57 aneurysms confirmed by CT angiography in the anterior circle of Willis were enrolled in this study. In preoperative Hunt-Hess scale, grade Ⅰ was designated in 7 patients, grade Ⅱ in 22, grade Ⅲ in 17, grade Ⅳ in 3, grade Ⅴ in 1 patient. Among the aneurysms, 16 were small (≤5mm in diameter), 28 medium (5-15mm), 10 large (15-25mm) and 3 giant (≥25mm) in size. The thin-slice head scanning data were achieved by 64-slice spiral CT machine. These data was then transferred into Dextroscope image workstation. The virtual imaging system generated clear and vivid virtual images. We compared the findings between simulation surgical operation and actual operation. Results VR system make the operator felt "personally on the scene" and was able to communicate with the imaging. It could not only visually display the anatomical structures in three dimensions, but also could simulate some surgical procedures, which basically simulated the same outcome of actual operation. All the 50 patients were successfully treated by microsurgical clipping of main aneurysmal or contributory aneurysmal necks. Conclusions The surgeons is able to be more confident, and the identification for the complex vascular abnormality is improved by planning operative procedure in virtual-reality environment. The virtual-reality system makes the actual operative procedure more concise, thus it is of positive value in surgery for intracranial aneurysm.

Objective To investigate the pathological features and optimal operation of the patients with late intractable epilepsy after traumatic brain injuries(TBI).Methods Fresh specimens of temporal lobe were obtained during operation from 21 patients with late intractable epilepsy after TBI to investigate the cortical structure,cellular morphology,number and distribution,and analyze the structure of hippocampus and pathological features of other tissues.Results The pathological features of brain tissue in epilepsy after TBI were encephalomalacia and hypertrophic scar,and the marked pathological changes in resected temporal lobe were hippocampal sclerosis and dysplasia of temporal cortex cells(seen in 15 of 21 cases).The therapeutic effects were assessed by a 6-month to 2-year follow-up,and satisfactory effects were obtained in 14 out of 21 patients(66.7%)(Grade Ⅰ),favorable effects were seen in 4 cases(19.0%)(Grade Ⅱ),and poor outcomes were seen in 3 cases(14.3%)(Grade Ⅲ).Conclusions Hippocampal sclerosis and construction abnormalities of temporal lobe cortex are the most common pathological features,and they always co-exist in patients with late intractable epilepsy.The resection of pathological lesion combined with standard anterior temporal lobectomy is currently the recommended operation choice for late intractable epilepsy after TBI.

To investigate the variation and significance of malondialdehyde (MDA) and superoxide dismutase (SOD) in brain tissue after secondary brain injury (SBI) with seawater immersion in rats.We randomly divided 163 male Sprague Dawley rats into 4 groups, as normal (Group A), SBI (Group B), SBI with physiological saline immersion (Group C) and SBI with seawater immersion (Group D) groups. The animal model of ischemic SBI with seawater immersion was established based on the Marmarou's model of diffuse brain injury. The water content, and the MDA and SOD contents of brain tissue were detected at 1, 3, 6, 12, 24 and 48 hours after the injury.Compared to group A, there were significant changes of various indicators in group D after injury at 1 hour after injury (P0.05). The water content and MDA contents in brain tissue were persistently elevated and significantly higher than that in groups B and C at each time phase (P0.05). The SOD content showed a persistent decline and was significantly lower than that in groups B and C at each time phase (P0.05). The SOD content was negatively correlated with the MDA content with a correlation coefficient of -0.992 (P0.01).The SBI with seawater immersion is faster and more serious than the simple SBI.

The sphenoid sinus occupies a central location in transsphenoidal surgery (TSS). It is important to identify relevant anatomical landmarks to enter the sphenoid sinus and sellar region properly. The aim of this study was to identify anatomical landmarks and their value in single-nostril endonasal TSS. A retrospective study was performed to review 148 cases of single-nostril endonasal TSS for pituitary lesions. The structure of the nasal cavities and sphenoid sinus, the position of apertures of the sphenoid sinus and relevant arteries and the morphological characteristics of the anterior wall of the sphenoid sinus and sellar floor were observed and recorded. The important anatomical landmarks included the mucosal aperture of the sphenoid sinus, a blunt longitudinal prominence on the posterior nasal septum, the osseocartilaginous junction of the nasal septum, the ‘bow sign’ of the anterior wall of the sphenoid sinus, the osseous aperture and its relationship with the nutrient arteries, the bulge of the sellar floor and the carotid protuberance. These landmarks outlined a clear route to the sella turcica with an optimal view and lesser tissue damage. Although morphological variation may exist, the position of these landmarks was generally consistent. Locating the sphenoid sinus aperture is the gold standard to direct the surgical route of TSS. The ‘bow sign’ and the sellar bulge are critical landmarks for accurate entry into the sphenoid sinus and sella fossa, respectively.