难治性癫痫172例临床病理分析

Objective To discuss the clinicopathologic characteristics of surgically removed tissues in patients with intractable epilepsy. Methods From 2008 to 2009, the histological sections of 172 specimens of cerebral epileptogenic foci, which were acquired by surgery, were performed respectively by HE staining and immunohisto - chemical staining,the characteristics of clinical pathology were also analyzed. Results Of all the 172 cases, according to the pathological features of the epilepto -genic foci, there were 138 focal cortical dysp lasia (FCD) ,including 115 FCD ⅠB, 15 FCD ⅡA and 8 FCD ⅡB, 2 micro cortical dysplasia, 4 dysembryoplastic neuropithelial tumors,7 Rasmussen's encephalitis, 16 ulegyrias; 1 ganglioneuroma; 1 microgyria malformation, 1 vascular malformation, 1 hypothalamic hamartoma, 1 tuberous sclerosis. ConclusionFCD is the most commonly present in intractable epilepsy, and FCDⅠB is most common among the FCD.     

接种卡介苗异常病例1例报告

1病历摘要 患者,女,14岁,陕西省扶风县人,于2000年5月接种卡介苗2周后,左臂三角肌下缘皮肤出现1cm×2cm肿块,红色、质硬、无痛。经局部应用雷米封软膏,口服雷米封（100mg,3次/d）及Vit B6治疗。月余未见好转,且表面溃烂,有淡黄色液体胜渗出,继而逐渐增大。     

近几年流感（和甲流）流行中中医中药预防流感（和甲流）的几点方法

流感（包括甲流）在近几年多有流行,笔者这几年在该病防控过程中,收集了一些方法和中药处方,预防和控制效果显著.     

烟雾病脑血管重建术后发生脑过度灌注综合征的临床分析

目的 探讨烟雾病脑血管重建术后脑过度灌注综合征患者出现“新常春藤征”相关影响因素。方法 纳入北京航空总医院2019年1-12月收治的45例烟雾病患者,均行颞浅动脉-大脑中动脉搭桥术联合脑-硬脑膜-颞肌-动脉-骨膜瓣贴敷术且术后发生脑过度灌注综合征,记录术后“新常春藤征”出现率,单因素和多因素Logistic回归分析筛查术后出现“新常春藤征”的影响因素。结果 共45例患者,左侧手术后脑过度灌注综合征主要表现为语言障碍(96.43%,27/28)、右侧肢体感觉和运动障碍(21.43%,6/28),右侧手术后主要表现为左侧肢体感觉和运动障碍(9/17)、流涎和吞咽困难(3/17)。术后26例(57.78%)出现“新常春藤征”,分别位于大脑前动脉供血区(2例)、大脑中动脉供血区前部(9例)、大脑中动脉供血区后部(6例)、大脑前动脉供血区和大脑中动脉供血区前部(4例)、大脑中动脉供血区前部和后部(5例)。根据性别、年龄、病程、术前有无“常春藤征”、手术侧别、术后脑过度灌注综合征发生时间和恢复时间分层,术前无“常春藤征”、术后脑过度灌注综合征发生时间≤3 d和恢复时间≤7 d的患者术后“新常春藤征...     

新型联合血管重建术对成人烟雾病患者认知功能的影响

目的 探讨新型联合血管重建术对成人烟雾病患者认知功能的影响。方法 共纳入2021年5月至2022年4月在航空总医院行颞浅动脉-大脑中动脉搭桥术+脑-硬脑膜-颞肌-动脉-骨膜瓣贴敷术的23例成人烟雾病患者,于术前和术后6个月行头部MRI、DSA和CT灌注成像并采用松岛分级系统进行侧支代偿分级,采用蒙特利尔认知评价量表（MoCA）北京版评估患者认知功能。结果 23例患者术后MoCA总评分（t=4.132,P=0.000）以及视空间/执行功能（t=2.612,P=0.016）、记忆（t=5.144,P=0.000）、注意力（t=2.655,P=0.014）和定向力（t=2.105,P=0.047）分评分均增加。术后根据松岛分级系统,A级（供血区范围>大脑中动脉供血区2/3）12例、B级（供血区范围为大脑中动脉供血区的1/3～2/3）8例、C级（供血区范围<大脑中动脉供血区1/3）3例。不同松岛分级患者手术前后MoCA总评分差异具有统计学意义（F=4.096,P=0.032）,仅松岛分级C级患者术后MoCA总评分低于B级患者（t=2.715,P=0.018）。13例（56.52%）...     

灰质异位致癫痫的外科治疗及疗效分析

灰质异位（heterotopic gray matter HGM）是一种比较少见的先天性脑发育异常性疾病，临床表现主要为癫痫发作和神经功能障碍。自2000年9月至2004年10月，作者收治了8例灰质异位致癫痫的患者，现报告如下。     

创伤性神经源性肺水肿的治疗(附19例临床分析)

总结16例重型颅脑损伤致急性神经源性肺水肿的救治体会。认为预防、保持呼吸道通畅,有关药物的选择性使用,对减少本病的发生率和降低其死亡率有积极作用。     

外伤性蛛网膜下腔出血性血管痉挛的临床治疗

外伤性蛛网膜下腔出血(ｔｒａｕｍａｔｉｃｓｕｂａｒａｃｈｎｏｉｄｈｅｍｏｒｒｈａｇｅＴＳＡＨ)是颅脑损伤死亡和病残的主要因素之一。近年来,随着ＣＴ及ＭＲＩ等技术的应用,该损伤已引起国内外学者的广泛关注。我院对300例颅脑损伤病人进行了回顾性分析,发现ＴＳＡＨ患者92例,占同期颅脑损伤的30.66%,分析如下。临床资料1　一般资料本组ＴＳＡＨ92例中,男63例,女29例;年龄5～66岁,平均31岁;车祸伤46例,跌伤27例,击伤11例,砍伤8例;入院时ＧＣＳ:3～8分35例(38.4%),9～12分29例(31.5%),13～15分28例(30.4%);伤后昏迷者28例(30.4%)。无Ｔ…     

显微外科手术治疗腰椎间盘突出症

对２４例行显微外科手术治疗的腰椎间盘突出症患者进行回顾性分析，认为应用显微手术摘除突出的椎间盘具有以下特点：①手术创伤小、术中出血较少；②保持了脊柱术后的相对稳定；③术中照明理想、视野清楚；④手术时间短，术后恢复快。其主要适合于单节段的、保守治疗无效的外侧型腰椎间盘突出症，对旁中央型和中央型患者，适当延长切口，同样可获得满意的疗效。本手术不适合于椎管狭窄或多节段的腰椎间盘突出症。术前、术中准确的定位是手术成功的基础。     

惊吓性癫痫的临床、脑电图特征及手术治疗

目的 探讨惊吓性癫痫的临床、脑电图(EEG)特征及手术治疗效果.方法 回顾性分析经抗癫痫药物或手术治疗的9例惊吓性癫痫的临床资料,总结发作症状学,头皮EEG,颅内EEG及头颅MRI特点,随访手术治疗效果.结果 所有患者的多数发作均由惊吓诱发,仅2例存在少量自发发作.8例MRI发现结构性病变,头皮EEG显示多灶性或局灶性癫痫样放电.2例行颅内电极监测,对致痫灶进行了较精确的定位.5例手术治疗,3例大脑半球切除术,2例局部癫痫灶切除.术后随访6-30个月(平均18.6个月),Engel Ⅰ级4例,Engel Ⅲ例1结论多数惊吓性癫痫患者存在脑的结构性损害,损害范围通常广泛,并均包含初级感觉运动区或辅助性感觉运动区.惊吓性癫痫多药物难治,手术治疗可取得较好的效果,明显改善患者的预后.

Abstract：

Objective To study the clinical, scalp and intracranial electroencephalogram (EEG) characteristics of startle epilepsy, and its outcome of surgical treatment. Methods The clinical data of 9 patients with startle epilepsy who were treated in our hospital were reviewed retrospectively. Their scalp and intracranial EEG, and MRI were investigated. Results All of the patients were diagnosed as startle epilepsy, and most of seizures were provoked by sudden unexpected stimuli. MRI showed extensive lesions in 8 cases, scalp EEC showed mulifocality or focal epilepsic discharge in all. Intracranial electrodes monitoring were performed in 2 patients to locate the epileptogenic zone. Five patients were treated surgically, 3 of them were operated with hemispherectomy, and 2 with focal cortex resection. During 6-30 months follow up, the seizure outcome were Engel I grade in 4,and Engel Ⅲ grade in 1. Conclusions Most of the patients with startle epilepsy has brain lesions involving the perisensorimotor or supplementary sensorimotor area, and were refractory. Resective surgery may get satisfactory outcome.