Publications (3)3.83 Total impact
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ABSTRACT: Intracranial epidermoid cysts are rare, potentially curable, benign lesions that are sometimes associated with severe postoperative complications, including hemorrhage. Delayed hemorrhage, defined as one that occurred after an initial unremarkable postoperative CT scan, contributed to most cases of postoperative hemorrhage in patients with epidermoid cyst. In this study, the authors focus on delayed hemorrhage as one of the severe postoperative complications in epidermoid cyst, report its incidence and its clinical features, and analyze related clinical parameters. There were 428 cases of intracranial epidermoid cysts that were surgically treated between 2002 and 2008 in Beijing Tiantan Hospital, and these were retrospectively reviewed. Among them, the cases with delayed postoperative hemorrhage were chosen for analysis. Clinical parameters were recorded, including the patient's age and sex, the chief surgeon's experience in neurosurgery, the year in which the operation was performed, tumor size, adhesion to neurovascular structures, and degree of resection. These parameters were compared in patients with and without delayed postoperative hemorrhage to identify risk factors associated with this entity. The incidences of postoperative hemorrhage and delayed postoperative hemorrhage in patients with epidermoid cyst were 5.61% (24 of 428) and 4.91% (21 of 428), respectively, both of which were significantly higher than that of postoperative hemorrhage in all concurrently treated intracranial tumors, which was 0.91% (122 of 13,479). The onset of delayed postoperative hemorrhage ranged from the 5th to 23rd day after the operation; the median time of onset was the 8th day. The onset manifestation included signs of intracranial hypertension and/or meningeal irritation (71.4%), brain herniation (14.3%), seizures (9.5%), and syncope (4.8%). Neuroimages revealed hematoma in 11 cases and subarachnoid hemorrhage in 10 cases. The rehemorrhage rate was 38.1% (8 of 21). The mortality rate for delayed postoperative hemorrhage was 28.6% (6 of 21). None of the clinical parameters was correlated with delayed postoperative hemorrhage (p > 0.05), despite a relatively lower p value for adhesion to neurovascular structures (p = 0.096). Delayed postoperative hemorrhage contributed to most of the postoperative hemorrhages in patients with intracranial epidermoid cysts and was a unique postoperative complication with unfavorable outcomes. Adhesion to neurovascular structures was possibly related to delayed postoperative hemorrhage (p = 0.096).Journal of Neurosurgery 01/2011; 114(6):1592-602. · 2.96 Impact Factor
Article: [Value of intra-operative ultrasound in detecting the boundaries of intra cranial gliomas].[show abstract] [hide abstract]
ABSTRACT: To evaluate the application of intra-operative ultrasound (IOUS) in detecting the boundaries of intracranial gliomas. One hundred and five consecutive patients with supra-tentorial glioma were included, male: 42 cases, female: 46 cases, age ranged from 15 - 67 years (mean 41 yrs), intra-operative ultrasound B was used to detect tumour boundaries before and after resection in 88 cases, tissues with suspicious echo was taken for verification by histological examination. And repeated MRI scan was received within 3 day after operation to judge the resection extent. The result was judged by Ultrasound doctor, neurosurgeon and pathologist, respectively. Eighty-eight patients were operated assisted by IOUS B. Tumour was nearly total removed in 83 cases and subtotal removed in 5 cases. Histological examination showed WHO Grade II 30 cases, Grade III 31 cases and Grade IV 27 cases. One hundred and twenty samples were taken and 101 were verified as tumours. And residual tumours were found in 17 cases and brain contusion and laceration was found in 1 case. The sensitivity of IOUS was 80.1% and the specificity was 69.8%. IOUS could produce a marked effect in judging boundaries of glioma, especially in low grade gliomas. IOUS could be a routine technique in intracranial glioma operation.Zhonghua yi xue za zhi 06/2009; 89(19):1305-8.
Article: Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma.[show abstract] [hide abstract]
ABSTRACT: Although various monitoring techniques have been used routinely in the treatment of the lesions in the skull base, iatrogenic facial paresis or paralysis remains a significant clinical problem. The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function. From January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation (TCEMEP) for preservation of facial nerve function. The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed. MEP amplitude decreased more than 75% in 11 patients, of which 6 presented significant facial paralysis (H-B grade 3), and 5 had mild facial paralysis (H-B grade 2). In the other 8 patients, whose MEP amplitude decreased less than 75%, 1 experienced significant facial paralysis, 5 had mild facial paralysis, and 2 were normal. Intraoperative TCEMEP can be used to predict postoperative function of the facial nerve. The decreased MEP amplitude above 75 % is an alarm point for possible severe facial paralysis.Chinese medical journal 03/2007; 120(4):323-5. · 0.86 Impact Factor