BackgroundSurgical treatment of giant pituitary adenomas is difficult due to complicated dissection of the sellar area. The extent of tumor resection affects the efficacy of surgical treatment. This study is to investigate the efficacy of microsurgical treatment for giant pituitary adenoma and to analyze the relationship between treatment efficacy and tumor resection extent.MethodsA retrospective analysis was performed in 36 patients who received microsurgery to remove giant pituitary adenomas. The sizes of tumors before and after surgery were calculated with a novel method called the “platform-like volume calculation formula”. The relationships between extent of resection and the visual impairment recovery, and improvement of serum hormone level before and after operation were analyzed.ResultsTwo deaths were observed after surgery. And the gross and near-total resection was achieved in 8 cases, subtotal resection in 8 cases, mostly partial resection in 15 cases, and partial resection in 5 cases. The average resection rate was 72.8%. The resection rate of tumor with cavernous sinus invasion was significantly lower than those of patients without cavernous sinus invasion (P < 0.05). The improvement rate of hormone level in functional adenoma was 80.0%. Follow-up observations were carried out for 3 ~ 28 months in 25 cases. Visual improvement was observed in 64.0% of the cases.ConclusionsMicrosurgical treatment can improve the visual impairment of the majority of cases and significantly decrease the serum hormone levels of functional adenoma. The extent of resection was significantly associated with cavernous sinus invasion.

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The DTI technique can act as an important supplement to the conventional MRI technique for CSC observation. Moreover, the FA and ADC values can be used as sensitive parameters in the DTI study on the CSC by taking the effects of age into consideration.

Clinical studies have shown that SBI can happen in only a few hours to a few days after the primary injury (18). On the way to the hospital, about 37% of patients with severe craniocerebral injury were complicated by hypoxemia events and more than one-third of patients in pre-hospital emergency had experienced at least one of the SBI-induced factors, with an increased death rate (7). Even in the intensive care unit, 25% of patients with severe brain injury showed SBI-induced factors, such as hypotension (5). Patients with severe brain injury were found to have a change in intracranial pressure. Through the regulation and control of the intracranial perfusion pressure, it was found that maintaining effective oxygen content in brain █ INTRODUCTIONResearches on traumatic craniocerebral injury, a disorder with a high incidence of morbidity and mortality, have positive social and clinical value. In 1978, Miller, a neurosurgeon in University of Edinburgh, UK, first put forward the concept of secondary brain injury (SBI). After primary brain injury, the abnormal changes of blood pressure, body temperature, intracranial pressure, cerebral blood flow and cerebral perfusion pressure could cause secondary brain injury to aggravate the primary brain injury and traumatic brain edema, resulting in increased mortality rate and disability rate and decreased quality of life in patients with brain injury (15). AIM:To investigate the variation and significance of malondialdehyde (MDA) and superoxide dismutase (SOD) in brain tissue after secondary brain injury (SBI) with seawater immersion in rats. MATERIAL and METHODS:We randomly divided 163 male Sprague Dawley rats into 4 groups, as normal (Group A), SBI (Group B), SBI with physiological saline immersion (Group C) and SBI with seawater immersion (Group D) groups. The animal model of ischemic SBI with seawater immersion was established based on the Marmarou's model of diffuse brain injury. The water content, and the MDA and SOD contents of brain tissue were detected at 1, 3, 6, 12, 24 and 48 hours after the injury. RESULTS:Compared to group A, there were significant changes of various indicators in group D after injury at 1 hour after injury (P < 0.05). The water content and MDA contents in brain tissue were persistently elevated and significantly higher than that in groups B and C at each time phase (P < 0.05). The SOD content showed a persistent decline and was significantly lower than that in groups B and C at each time phase (P < 0.05). The SOD content was negatively correlated with the MDA content with a correlation coefficient of -0.992 (P < 0.01). CONCLUSION:The SBI with seawater immersion is faster and more serious than the simple SBI.