Neurosurgery: new technology leading multidisciplinary coalition

In the fourth global meeting of Congress of neurological surgery, exchanged in recent years in the field of Neurosurgery and new technology.

Minimally invasive neurosurgery (MINS), magnetic resonance diffusion tensor Imaging (DTI) and diffusion tractography (DTT) and other new technologies in neurosurgery in new applications.

"The last two years, neurosurgical field a lot of progress, such as navigation technologies, electrophysiology, molecular markers in research in the field of neurosurgery, Anesthesiology, orthopedics, ophthalmology, nursing, and multidisciplinary integration with neurosurgery.

"Recently, in the fourth global meeting of Congress of neurological surgery, the General Assembly, the Secretary-General Professor John Zhang ya.

Held every two years the Chinese of the Congress of neurological surgery is neurosurgery a gathering of academic exchange, in the current session of the General Assembly held in Chengdu, exchanged in recent years in the field of Neurosurgery and new technology.

New technology application

Minimally invasive neurosurgery (MINS) is the modern neurosurgery in the history of the second milestone is modern optical technology, electronics and space navigation technology and many other modern technologies and clinical medical product of the combination.

To endoscopic techniques, for example, endoscopic resection and skull base tumors have gradually unfold. This Conference, Zhang ya Lee on endoscopic intracranial chordomas applications and attendees.

It is learnt that the chordoma intracranial tumor incidence only 0.1% ~ 0.7%, but clinical failure, mainly manifested as cranial nerve damage and occupying effect, the average lifetime of only 12 ~ 41 months.

Chordoma into neural surgeon an unavoidable challenges. Chordomas treatment is aimed at total tumor as possible, for further treatment for more time, try to ensure that patients have a certain quality of life.

Zhang ya Lee believes that the current approach is still to Endonasal, supplemented by oral approach, some circumstances may also be oral, nasal joint approach, Endonasal joint microscope craniotomy or oral approach combined with microscope craniotomy.

Approaches should be based on tumor site, for example, when the tumor is located in front of the skull is the highest slopes range preferred Endonasal; when the tumor is located mainly in the slopes of nasal or oral approach, but the former is more ideal.

Various approaches to programme has advantages and disadvantages, for example through the mouth into the road traction and visibility, but as the chordoma on surrounding structure of high destructive result in the formation of postoperative easily, then with dead space, serious infection can develop meningitis.

Therefore, the operation should try to keep the existing muscle tissue as the anatomy of a tiered suture, and at least two suture.

In addition, Zhang Zhuo pointed out that not all chordoma are suitable for pure neural therapy, and tumor characteristics, growth orientation, and closely related to the blood supply.

Surgery success also depends on the hardness of the tumor, blood supply, important structural damage as well as the reconstruction of the skull base. In addition, neuroendoscopic as minimally invasive neurosurgery, lighting clearly, fully perspectives exposed, but relatively few complications. But in the intraoperative bleeding, special equipment requirements, and professional skills training is still lacking.

Magnetic resonance diffusion tensor Imaging (DTI) and diffusion tractography (DTT) in an application in the field of neurosurgery.

The West China hospital affillated tour DTI, Professor use DTT observed the 20 patients with hypertensive intracerebral hemorrhage, discovery using DTT can visualize their damage, DTI joint DTT technology on hypertensive intracerebral hemorrhage operation scheme of choice is important, and there are important prognostic value.

New areas of exploration

Brainstem hemorrhage caused by hypertension with dangerous, patients are often secondary to a variety of complications, prognosis is extremely poor.

Because of the surgery is difficult, high-risk, previous to medical treatment, surgical treatment is generally on passivity, surgical treatment is almost empty. In this new area, the Assembly will be a discussion on the Exchange.

It is reported that for the brainstem hemorrhage has not been targeted treatment guide, generally follow the United States Heart Association 2007 spontaneous intracerebral hemorrhage Guide principles for treatment.

At present, the purpose of the surgical treatment is mainly reduce extraction hematoma of oppression and the peripheral nerve stimulation; extraction residue of vascular disease, prevent bleeding again.

This Conference, visit tide reports 11 cases of hypertension brainstem hemorrhage patients for microsurgery.

The 11 patients have a history of hypertension, male and female 7 cases in 4 cases, the average age of 63.7, course 3h ~ 24h. These GCS score 3 ~ 5 minutes 5 cases; 6 ~ 7 min 5 cases; > 7 1 cases. 11 patients are brain CT scan, including bleeding sites in 2 cases of cerebral hemorrhage, cerebral Pons junction in 3 cases, Pontine hemorrhage in 5 cases, 1 case of Medullary bleeding, average amount about 6.7ml bleeding, haematoma rupture into the third ventricle 1 cases, broken into 5 cases of fourth ventricle, 9 cases of obstructive hydrocephalus. 8 routine emergency craniotomy hematoma, SUBDURAL hematomas in the brain and in parts of the brain-Pons junction select infratemporal via surgical approach tentorium, Pons ventrolateral select the suboccipital-retrosigmoid, Pons and medulla oblongata dorsal select pillow in the middle of the road under. 4 cases of postoperative patients with neurological disorders, 4 cases of patients are located in the Pons. 2 patients symptoms increase the sustained coma, brain 1 cases in which, at the junction of brain-Pons in 1 case. 1 cases in the brain, the medulla oblongata 1 patients suffered from respiratory tract infections, death of brainstem dysfunction.

"Using Microsurgical technique in the treatment of hypertension brainstem hemorrhage indications specifically, Pontine hemorrhage operation effect good, relatively good prognosis, midbrain, medulla oblongata at the worst effect.

"Tide concluded that tours.