Post-polio syndrome (PPS) is a neurologic disorder characterized by an accumulation of symptoms, most often muscle weakness, fatigue, and pain, decades after the initial polio. Diagnosis of PPS is based on the presence of a lower motor neuron disorder which is supported by neuro-physiological findings, as well as exclusion of other disorders as causes of new symptoms. The pathogenesis of PPS is still disputed. Rehabilitation for patients with PPS should take a comprehensive approach. Evaluation of the need for orthoses is often required.

Ischemic cerebral stroke is a leading cause of death and disability globally. At present, thrombolytics, such as recombinant tissue-type plasminogen activator, are the only effective treatment for acute stroke. However, usage of thrombolytics has a strict therapeutic window and cannot be applied to a number of patients. Despite the promising effects of some neuroprotectants in preclinical studies, they failed in clinical trials as a result of poor pharmacokinetic properties, particularly with regard to solubility and permeability across the blood-brain barrier (BBB). Approaches for delivering these drugs by nanotechnologies may overcome these pharmacokinetic deficits and enhance their neuroprotective effects. However, issues such as potential side effects and biosafety properties currently limit clinical application of these approaches. In this article, we reviewed recent progress of nanotechnology-based interventions for stroke treatment, and in particular, summarized novel materials applied to synthesize nanocarriers, encapsulation with neuroprotectants, and factors impacting nanodrug bioactivities to provide a theoretical basis for the development of anti-stroke drugs.

Trigeminal neuralgia (TN) is characterized by recurrent facial acupuncture like, electric shock like, burning like pain and other common clinical cranial nerve diseases in the trigeminal nerve distribution area. Around the world, people who are 40 or more are at risk. The incidence rate of TN of female is slightly higher than that of male and most of the affecting areas are on the right side unilaterally, which affects maxillary nerve and mandibular nerve, yet seldom ophthalmic nerve. Although controversy exists in the pathogenesis of TN, the most accepted theory is microvascular compression, which forces on the demyelination of the sensory axon of the trigeminal nerve root. Additionally, slight touch, conversation and chewing may cause intolerable pain. The diagnosis of TN mainly depends on clinical manifestation. The treatment mainly includes medicine, operation, and some supplementary methods. Among them, antiepileptics and tricyclic antidepressants are the first-line treatment. Surgical treatment is mainly used for patients with TN who have failed in drug treatment or have intolerable side effects. The methods of operation include destructive or non-destructive operation. Deep brain stimulation (DBS) and motor cortex stimulation (MCS) are new therapeutic techniques emerged recently. This method is expected to alleviate the refractory TN with poor drug control or ineffective conventional surgical treatment. At present,this method has not been approved for clinical treatment. Of course, more clinical data collection processes are in progress.

Cogan’s syndrome is rare. The purpose of this article is to describe a Cogan’s syndrome case characterized by bilateral internal carotid artery occlusion and to review the literature. Treatment remedies: we showed a patient with vertigo, nausea and retching, blurred vision, unclear speech. And the whole cerebral angiogram of the patient showed bilateral internal carotid artery occlusion without obvious neurological deficit. After differential diagnosis, compared with classic Cogan’s syndrome, granulomatous polyvasculitis (GPA), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), the patient was considered as Cogan’s syndrome. Post treatment evaluating: the patient did not significantly improve vertigo after vascular bypass therapy. Conclusions: Cogan’s syndrome may cause severe vascular occlusion. The patient had no clinical symptoms; and the chronic occlusion caused by vascular inflammation may be the reason, so that there was enough time for compensation.

Glioma is the tumor with the highest incidence in the brain, and it is eager to seek new and effective treatment. The interaction of ubiquitination and deubiquitination regulates many cell activities in organisms, and participates in tumor occurrence, development, migration, invasion and other processes. This article summarized the progress of E3 ubiquitination ligase smad ubiquitination regulatory factor 2 (Smurf2) and glioma-related signaling pathways to assist clinical diagnosis and treatment of glioma.

Glioma is the most common and destructive tumor of primary brain tumor types in the central nervous system. After comprehensive treatment including surgical treatment, radiation therapy and chemical drug treatment, the survival period of the glioma patients is still very short. In recent years, cancer immunotherapy methods have achieved great success in the treatment of solid tumors, but the application in the treatment of gliomas has not been universal yet. This review discussed the immunotherapy and latest progress in glioma study, hoping to bring new ideas for treatment of gliomas.

Human umbilical cord mesenchymal stem cells (HuMSCs) have the multi-differentiation potential to differentiate into various types of cells without immune rejection. They are considered to be an ideal source of neural stem cells and also an ideal cell carrier for gene therapy. Because of the invasive growth of brain gliomas, most of them have no obvious boundaries with normal brain tissues. It is difficult to completely remove them by surgery and the remaining cells become the main source of tumor recurrence. In recent years, gene therapy has become a new method for the treatment of gliomas. The vector carrying the target gene is introduced into HuMSCs in a certain way to correct gene defects or play other roles. The differentiation potential of HuMSCs makes it an ideal source of nerve cells to play a greater role in gene therapy of glioma. Therefore, this article reviews the current status and prospects of HuMSCs as cell carriers in the treatment of glioma.

Objective: to investigate the effect of improving prehospital hypotension and hypoxemia on the prognosis of different subgroups of patients with traumatic brain injury (TBI). Methods: medical staff were trained about the prehospital first aid for 2 months to fully master the methods of improving prehospital hypotension and hypoxemia, then the prognosis of TBI patients pre- and post-training for 12 months was collected and recorded. The prognostic differences of different TBI subgroups were discussed through data analysis. Results: after the training, the proportion of prehospital hypotension and hypoxemia in TBI patients decreased by 77% (8.5% vs. 1.9%) and 63% (9.9% vs. 3.6%, P < 0.05), respectively. However, only the prognosis of moderate and severe TBI patients was improved, the proportion of patients with “good prognosis” increased by 14% (61.4% vs. 70.5%, respectively) and 62% (35.6% vs. 58%), and no significant effect showed in mild and critical TBI patients.Conclusion: reducing the incidence of prehospital hypoxemia and hypotension can improve the prognosis of moderate and severe TBI patients, while no significant effect on mild and critical TBI patients.

Objective: to evaluate the clinical efficacy and safety of ultra-early lumbar puncture drainage of cerebrospinal fluid (CSF) in patients with aneurysmal subarachnoid hemorrhage (SAH). Methods: patients (n=140) with aneurysmal SAH were randomly divided into observation group (n=70) and control group (n=70). After admission, CSF was drained by ultra-early lumbar puncture in the observation group and intermittent lumbar puncture after aneurysm operation in the control group. The incidences of early aneurysm rupture, acute hydrocephalus and delayed hydrocephalus were compared between the two groups. Results: there was no significant difference in the incidence of early-ruptured aneurysm and acute hydrocephalus between the two groups, but the incidence of delayed hydrocephalus in the observation group was significantly lower than that in the control group. Conclusion: ultra-early lumbar puncture drainage of CSF in aneurysmal SAH can effectively reduce the incidence of long-term delayed hydrocephalus and it is a safe and effective treatment.

Intraventricular hemorrhage (IVH) is a dangerous acute cerebrovascular disease. The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage. In recent years, more and more studies have shown that timely clearance of intraventricular hematoma is closely related to good prognosis. The advantages of surgical intervention in patient management are impressive. This article briefly reviews the positive advances in the surgical treatment of IVH such as external ventricular drainage (EVD) combined with intraventricular fibrinolysis (IVF) and continuous lumbar cistern drainage (LCD), as well as their safety and efficacy, especially the remarkable role of neuroendoscopy in the removal of intraventricular hematomas.

Objective: to compare the methods of petrous apical bone removal and to explore the applicable scope of Kawase approach and retrosigmoid sinus-internal auditory canal approach. Methods: one group of cadaveric head specimens simulated Kawase approach to measure the data of “Kawase triangle”, the other group simulated retrosigmoid sinus-internal auditory canal approach to measure the safety range of the grinding bone window. Then we explored the clinical indications of the two surgical approaches. Result: the grinding depth of Kawase triangle was 11.6±0.14mm, and the range of clival exposed after grinding Kawase triangle was 22.4±1.22mm, which could effectively expose the ventrolateral brainstem, the midline of clivus and the area above the facial acoustic nerve. The diameter of the anterior and posterior of the grinding bone window in the retrosigmoid sinus-internal auditory canal approach was 21.95±2.23mm. In front of the exposure area were the internal carotid artery, the cavernous sinus, and the upper trigeminal nerve; the lower part was the connection between the facial acoustic nerve and the abducent nerve. Conclusion: Kawase approach is suitable for lesions of ventrolateral brainstem, middle superior clivus, with or without invasion of middle cranial fossa; the retrosigmoid sinus-superior internal auditory canal approach is suitable for lesions mainly in cerebellopontine angle area and only slightly invading Meckel’s cavity.

Objective: to explore the changes of the F-wave in the posterior tibial nerve of rabbits after different levels of lumbar spinal cord ischaemic injury and its correlation with motor function and the extent of lumbar spinal cord pathological damage. Methods: thirty New Zealand rabbits were randomly divided into 6 groups. The control group (n=5) was used to exclude the influence of anaesthesia and surgery on the F-wave. Different levels of lumbar arteries were ligated in the five experimental groups (n=5). The F-wave was recorded to observe the changes in the acute phase of spinal cord ischaemia. The correlation between the changes of the F-wave in the acute reversible phase and the motor function of the spinal cord was analysed. Motor functions were assessed after surgery and 2 d after vascular ligation. The specimens were taken 2 d after ligation for histopathologic observation. Results: the results for the control group indicated that anaesthesia and surgery did not affect the F-wave results. There was no statistically significant difference in the F-wave amplitudes and latency before and after ligation in the 1 and 2 level ligation groups. The F-wave changed immediately after ligation in the 3, 4 and 5 ligation groups. The latency of the F-wave gradually extended, the amplitude of the F-wave gradually reduced. The amplitude variations of the F-wave were positively correlated with the motor function 2 d after ligation, there was a statistically significant difference. With the increase in the number of vascular ligation, the degree of destruction of the motor neurons in the anterior horn of the spinal cord in the pathological specimens increased. Conclusion: the F-waves in the posterior tibial nerve of rabbits were found to be sensitive to the lumbar spinal cord ischaemic injury and specific to predict motor function.

Fibromuscular dysplasia (FMD) is a rare disease with a typical clinical manifestations. This article will describe the clinical features of a FMD case with severe headache misdiagnosed as cerebral artery dissection (CAD). Treatment remedies: we collected the clinical data of a patient with severe headache and performed brain MRI (magnetic resonance imaging) and cerebral arteriovenous MRA (magnetic resonance angiography). The preliminary diagnosis was considered as right vertebral artery dissection, and then cerebral DSA (digital subtraction angiography) was performed for further diagnosis. Post treatment evaluating: cerebral angiography showed that the vessel wall was stiff, with multiple (insect phagocytic)-like changes, and severe stenosis of local long segments. Some vessels showed “double lumen sign”, which was consistent with the performance of FMD. After anticoagulant treatment, the patient’s condition was improved. Conclusions: for severe headache, in addition to common diseases, the possibility of FMD should also be paid great attention. Early cerebrovascular screening is conducive to early diagnosis and timely treatment.

This article describes the clinical characteristics of a case of cerebral infarction complicated with pulmonary embolism (PE), and elaborates the therapeutic strategies of intravenous thrombolysis and anticoagulation. Treatment remedies: the medical history and examination data of a patient with aphasia and right hemiplegia were collected. After intravenous thrombolysis and pulmonary artery CTA (computed tomographic angiography), the patient was found to have low blood oxygen saturation and PE. And the patient was treated with anticoagulant therapy. Post treatment evaluating: cerebral hemorrhage was excluded by craniocerebral CT (computed tomographic), and left basal ganglia infarction was diagnosed. After thrombolysis, the symptoms of aphasia and hemiplegia were significantly improved. For PE, after anticoagulant therapy, the patient’s breathing was stable and blood oxygen saturation was normal. For deep venous thrombosis of both lower extremities, anticoagulant therapy was continued. Conclusion: patients with thrombophilia are prone to cerebral embolism, PE and deep venous thrombosis of lower limbs. Intravenous thrombolytic therapy in acute phase and heparin anticoagulant therapy in recovery period can effectively control the disease.

Radiation therapy is an important part of the comprehensive treatment of brain tumors and one of the most effective treatment methods. However, brain injury is a serious complication. In regards to long-term brain injury caused by radiation therapy, cognitive dysfunction is the most common and serious. As the treatment of brain tumors improves, the survival time of patients with malignant brain tumors is significantly prolonged and the probability of cognitive dysfunction after radiation therapy is increased. Eliminating the delayed side effects caused by radiation therapy will significantly improve the quality of life of patients with malignant brain tumor and reduce the social burden. Therefore, the study of the pathogenesis and treatment of cognitive dysfunction after radiation therapy is of great significance. This review focuses on the pathogenesis and treatment of cognitive dysfunction after radiation therapy.

Ischemic stroke is a leading cause of death and disability. Despite extensive research, treatment for ischemic stroke is limited to thrombolytic therapy and symptom management. Identifying and testing new therapeutic targets is therefore critical for future clinically viable stroke therapies. Noncoding RNAs, especially microRNAs (miRNAs), are one of many classes of molecules that cause functional changes before, during, and after ischemic stroke. Current research finds that expression levels of many miRNAs are altered in the blood and brain of rodents and humans after stroke. In addition, miRNA can be regulated by external factors to improve functional outcomes after ischemic stroke. In certain studies, induction of ischemic tolerance by preconditioning (PC) also altered the levels of many miRNAs. This review focuses on miRNAs that modulate stroke-related risk factors and pathologic mechanisms of post-stroke brain injury.

Cerebrovascular disease is a disease with high morbidity, disability and mortality rates, which seriously affects the daily life of patients and is a heavy burden on families and society. Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI) technology that uses the magnetic labeling of hydrogen atoms in arterial blood as tracers to noninvasively evaluate brain blood flow. ASL does not require injection of an exogenous contrast agent, and has the advantages of no radiation, simplicity and low cost. In cerebrovascular diseases, ASL can evaluate the collateral cerebrovascular circulation and abnormal perfusion of brain tissue, which can provide a reliable basis for early diagnosis and clinical decision-making. This study reviewed ASL and its application in the diagnosis, treatment and prognosis of cerebrovascular diseases.

The main pathological feature of Alzheimer’s disease (AD) is the extracellular deposition of β-amyloid (Aβ) in the brain, which forms insoluble Aβ plaques, and tau protein hyperphosphorylation in neurons, which forms intracellular fibrillary tangles. So far, none of the drugs targeting Aβ have been successful in the treatment of AD. Some studies have shown that brain iron deposition may be one of the important factors in AD pathogenesis; the distribution of iron deposition has been found to be consistent with the distribution of Aβ senile plaques in the brain. Effectively reducing brain iron load might therefore be a good therapeutic approach to prevent and treat AD.

Anxiety disorder is one of the most common emotional disorders, but its pathogenesis remains unclear. Research has shown that iron deficiency is more common in people with emotional disorders and that these disorders can improve after taking iron supplements. Many factors can cause anxiety disorders, including external stress, genetic factors, impaired neurodevelopment, and abnormal monoamine metabolism. Studies have shown that abnormal monoamine metabolism and impaired neurodevelopment can contribute to the severity of emotional disorders. The synthesis of serotonin (5-HT) and dopamine (DA) require iron as a cofactor in the synthesis of monoamine metabolism, and the release of epinephrine (E) was potentially associated with labile iron in plasma. At the same time, iron is also directly involved in myelin synthesis as a cofactor in neural development. Therefore, iron maybe involved some of the main causes of the onset of anxiety disorders.