[Treatment strategies and research progress of acute ilio-femoral deep vein thrombosis]

In the past,treatment of acute ilio-femoral deep vein thrombosis (IFDVT) was mainly based on anticoagulation alone,but 30%-50% of patients will develop post-thrombotic syndrome,causing a serious medical burden.Thrombus removal technology such as catheter-directed thrombolysis and percutaneous mechanical thrombectomy can effectively remove blood clots and compensate for the deficiencies of simple anticoagulation,which is expected to improve the prognosis of such disease,but the current evidence is insufficient,and other treatments such as filter implantation and compression therapy are also controversial.This article summarizes the treatment strategies and the latest progress of acute IFDVT,hoping to help the treatment of this type of disease.

[The surgical treatment in adults with idiopathic normal pressure hydrocephalus]

Objective: To investigate the effect of Ventriculoperitoneal shunt (VPS)in adult patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: The patients with idiopathic normal pressure hydrocephalus were reviewed, who were admitted into the Peking union medical college hospital from October 2010 to October 2016.The patients treated via VPS were retrospectively analyzed by collecting the data including clinic features, iNPH score and imaging data. Results: 33 patients were included in the group.3 months after operation, the iNPH scores were significantly decreased (3.0±1.0 vs 6.0±2.5, P<0.01), and there were no difference among 3 month, 6 month and 12 month post operation.The Evans index and the width of the three ventricles were also significantly decreased.1 patient suffered from subdural hematoma and no other complications such as infection, obstruction or death occurred. Conclusions: VPS is an effective treatment approach of iNPH and multidisciplinary team is the key in diagnosis.

[The diagnosis and treatment of systemic lupus erythematosus complicated with hydrocephalus]

Objective: To investigate the pathogenesis and management of the hydrocephalus in patients with systemic lupus erythematosus (SLE). Methods: Eight cases of hospitalized lupus patients with hydrocephalus in Peking Union Medical College Hospital from Jan 1990 to Mar 2017 were analyzed retrospectively.We collected the patients' medical records including medical history, CT and/or MRI images and analysis of cerebrospinal fluid via lumbar puncture in order to investigate the pathogenesis of the hydrocephalus in patients with SLE and summarize treatment experience. Results: All the 8 patients with SLE complicated with hydrocephalus were treated with steroids or immunosuppressive agents, and 5 cases were diagnosed with the central nervous system infection. Three cases received ventriculoperitoneal shunt, 5 cases received treatment of medicine.They all were followed up for 2-12 months, of which 3 cases were markedly effective, 1 case effective and 4 cases dead. Conclusion: The pathogenesis of lupus combined with hydrocephalus may have a certain relationship with the central infection, should take effective anti-infection treatment.We recommend cerebrospinal fluid shunt surgery intervention.

[Perioperative management and surgical treatment of neurosurgical critical patients with thrombocytopenia]

OBJECTIVE

To study the perioperative management and surgical treatment of patients with neurosurgical critical diseases and thrombocytopenia.

METHODS

Eleven patients with the diagnosis of neurosurgical critical diseases and thrombocytopenia who received surgical treatment in Department of Neurosurgery, Peking Union Medical College Hospital from 2010 to 2015 were reviewed retrospectively. All eleven patients received platelet transfusions preoperatively. The safety and efficacy of surgical treatment were analyzed by GOS score at 6 months after operations.

RESULTS

Platelet counts of six patients who received minimally invasive surgery reached 80×10(9) /L by platelet transfusions preoperatively. Platelet counts of five patients who received Craniotomy and ventriculoperitoneal shunt reached 100×10(9) /L by platelet transfusions preoperatively. Eight patients received platelet transfusions postoperatively according to a low platelet count 24 hours after operations. Two patients died after surgery and one died after discharge. All other eight survival patients got well recovery with an average GOS score of 4.5 at six months after operations.

CONCLUSIONS

Patients with neurosurgical critical diseases and thrombocytopenia could receive surgical treatment in collaboration with relative departments.