Cranial neurovascular compression syndromes are mainly represented by classical trigeminal neuralgia, idiopathic hemifacial spasm, and glossopharyngeal neuralgia. Microvascular decompression (MVD) is an important etiological surgical treatment for these disorders. With the widespread application of MVD, several problems remain in clinical practice, including overly broad surgical indications, insufficient identification of offending vessels, inadequate decompression, nonstandard application of intraoperative monitoring, and incomplete quality control systems at primary medical institutions. This article reviews the surgical indications, effective decompression, intraoperative neurophysiological monitoring, stratified management of difficult cases, standardized dissemination, and quality control of MVD for cranial nerves, aiming to promote the transition of MVD from simple widespread application to high-quality development centered on long-term efficacy, low recurrence rates, low complication rates, and homogeneous diagnosis and treatment.

To evaluate the causal relationships between gut microbiota (GM) and diabetic neuropathy (DN) using Mendelian randomization (MR), and to identify circulating metabolites and proteins that may mediate these associations.

Genome-wide association study (GWAS) data for GM and DN were derived from the MiBioGen consortium and the FinnGen R12 dataset, respectively. GWAS summary statistics for 529 circulating metabolites and 2994 proteins were obtained from two published articles, and their corresponding GWAS results have been deposited in the GWAS Catalog database. The Steiger directionality test was employed to exclude reverse causation between GM and DN. Two-sample MR analysis was conducted to assess the causal effect of GM on DN. Two-step MR, MR mediation analysis, and multivariable MR were further utilized to screen for circulating metabolites and proteins that may mediate the aforementioned causal pathways.

A total of six GM taxa were causally associated with DN. Specifically, Eubacterium coprostanoligenes group (P=0.031) and Eubacterium xylanophilum group (P<0.001) were inversely associated with DN, whereas Firmicutes (P=0.026), Adlercreutzia (P=0.022), Alistipes (P=0.046), and Christensenellaceae R-7 group (P=0.009) were positively associated with DN. MR mediation analysis revealed that Eubacterium xylanophilum group alleviated DN by upregulating myeloid cell leukemia-1 protein (MCL-1) (P=0.003) and downregulating HIV-1 Tat interactive protein 2 (HTATIP2) (P<0.001) and matrix metalloproteinase-16 (MMP-16) (P=0.002). Conversely, Firmicutes promoted DN progression by reducing circulating levels of sphingomyelin phosphodiesterase acid-like 3A (SMPDL3A) (P=0.008), while Alistipes facilitated DN progression by elevating circulating levels of X-11423—O-sulfo-L-tyrosine (P=0.014).

Eubacterium xylanophilum group exerts a protective effect against DN by upregulating MCL-1 and downregulating HTATIP2 and MMP-16. In contrast, Firmicutes promotes DN progression by decreasing SMPDL3A levels, and Alistipes enhances DN progression by increasing X-11423—O-sulfo-L-tyrosine levels. These findings provide novel candidate targets for microbiota- and metabolite-based interventions in DN.

To investigate influencing factors for the occurrence of early neurological deterioration (END) in young and middle-aged patients with hypertensive intracerebral hemorrhage (HICH).

A retrospective study was used to analyze the clinical data of 205 young and middle-aged patients with HICH admitted to Neurosurgery Department of the Second Affiliated Hospital of Fuyang Normal University from January 2018 to December 2024. The patients were divided into END group and non-END group according to whether the patients suffered from END within 72 h after admission. Independent influencing factors for the occurrence of END were determined by multivariate Logistic regression analysis, and the Logistic regression prediction model was constructed based on them. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were employed to assess the capacity of different influencing factors in determining END.

Among 205 HICH patients, 35 cases showed END (the END group), and the incidence of END was 17.1%, the remaining 170 patients were in the non-END group. There was statistically significant difference in age, admission GCS score, admission volume of hematoma, site of HICH, rupturing into the ventricular system, first CT scan time, recurrent vomiting, systolic blood pressure at admission, diastolic blood pressure at admission and level of fibrinogen between the two groups (P<0.05). Multivariate binary Logistic regression analysis showed age, admission volume of hematoma, first CT scan time, recurrent vomiting were independent influencing factors for END. ROC curves showed that AUC of age, admission volume of hematoma, first CT scan time, recurrent vomiting were 0.700 (47 years as the threshold for age), 0.880 (15 mL as the threshold for admission volume of hematoma), 0.843 (2.1 h as the threshold for first CT scan time), 0.824. The AUC of the influencing factors combined to predict END was 0.948 (95%CI: 0.908-0.974, P<0.001), demonstrating superior predictive performance compared with individual single indicators.

Young and middle-aged patients with HICH show a high incidence of END, which is associated with age, admission hematoma volume, first CT scan time, and recurrent vomiting. In clinical practice, attention should be paid to these features to enable early identification and intervention of END, thereby improving patient prognosis.

To explore the relationship between electroencephalogram (EEG) parameters combined with inflammatory index and cerebral edema after acute ischemic stroke due to anterior circulation large vessel occlusion (AIS-LVO) surgery.

A total of 120 patients with AIS-LVO admitted to Function Department of Handan Central Hospital from October 2022 to December 2023 were selected and divided into the cerebral edema group and the non-cerebral edema group according to whether cerebral edema occurred after mechanical thrombectomy. The basic data of the two groups were statistically analyzed. Quantitative EEG examinations were performed with a digital EEG monitoring system to calculate the (δ+θ)/(α+β) ratio (DTABR) and δ-to-α ratio (DAR). Blood samples were collected to measure laboratory indicators and the systemic immunoinflammatory index (SII) and C-reactive protein-albumin-lymphocyte (CALLY) index were calculated. The clinical data of the two groups were analyzed. The influencing factors of cerebral edema after mechanical thrombectomy were analyzed using the multivariate Logistic regression model. A risk nomogram was constructed based on the above influencing factors, and the model fit was verified and the predictive efficacy was evaluated.

There were 55 patients in the cerebral edema group and 65 patients in the non-cerebral edema group. There were significant differences in the excellent conditions of collateral circulation, SII, CALLY index, and quantitative electroencephalogram parameters between the two groups (P<0.05). The multivariate Logistic regression model showed that SII index, DTABR, and DAR were risk factors for cerebral edema after mechanical thrombectomy in patients with AIS-LVO, while CALLY index was a protective factor (P<0.05). A nomogram prediction model for the risk of postoperative cerebral edema was constructed based on the four independent influencing factors above. Internal validation revealed favorable goodness-of-fit of the model. The area under the receiver operating characteristic curve was 0.871 (95%CI: 0.812-0.917, P<0.05). The sensitivity, specificity and Youden's index were 93.02%, 72.52% and 0.628 respectively, which demonstrated that this nomogram possessed satisfactory predictive performance for clinical application.

Quantitative electroencephalogram parameters and SII are risk factors for cerebral edema after mechanical thrombectomy in patients with AIS-LVO, and CALLY index is a protective factor. The risk prediction model constructed based on this has a high predictive efficacy.

To evaluate the safety and clinical efficacy of endovascular treatment for acutely ruptured aneurysms located in the superior cerebellar artery.

A retrospective analysis was conducted on the clinical data of 34 patients with ruptured superior cerebellar artery aneurysms who underwent endovascular treatment at Neurosurgery Department of the First Affiliated Hospital of Harbin Medical University from October 2011 to October 2024. The incidence of in-hospital complications was evaluated. Clinical outcomes were assessed using the modified Rankin scale (MRS), and aneurysm occlusion status was evaluated according to the Raymond-Roy Occlusion Classification.

Among the 34 patients included in this study, 9 underwent stent-assisted coiling, whereas 25 were treated with simple coil embolization. In-hospital complications occurred in 11 patients (32.4%), including hemorrhagic complications in 4 patients (11.8%), with 1 in-hospital death (2.9%), ischemic complications in 5 patients (14.7%), and shunt-dependent hydrocephalus in 3 patients (8.8%). One patient developed both shunt-dependent hydrocephalus and a hemorrhagic complication. All 34 patients completed clinical follow-up, with a median follow-up duration of 41.5 (26.5-61.8) months. During follow-up, 3 patients (8.8%) experienced complications, including 2 patients (5.9%) who developed their first complication after discharge. Two patients (5.9%) suffered aneurysm rebleeding during follow-up, resulting in death in one patient and cerebral infarction in the other. The overall mortality rate in this cohort was 8.8% (3/34). Angiographic follow-up was available for 24 patients, with a median follow-up duration of 9 (6-12) months. According to the Raymond-Roy occlusion classification, complete occlusion (Grade Ⅰ) was achieved in 20 patients (83.3%), residual neck (Grade Ⅱ) was observed in 3 patients (12.5%), and residual aneurysm (Grade Ⅲ) was identified in 1 patient (4.2%).

Endovascular treatment for acutely ruptured superior cerebellar artery aneurysms is feasible and demonstrates favorable clinical efficacy. However, procedure-related and disease-related complications remain a significant concern and warrant close attention.

Aneurysmal subarachnoid hemorrhage (aSAH) is a cerebrovascular emergency associated with extremely high morbidity and mortality. Although surgical interventions and intensive care techniques have been continuously improved, the overall prognosis of patients remains poor, since early brain injury, delayed cerebral ischemia, and chronic complications severely hinder neurological rehabilitation. Stem cell therapy, owing to its multidirectional differentiation potential, potent immunomodulatory functions, and neurorestorative properties, serves as a promising novel therapeutic strategy for aSAH. This article systematically elaborates the pathological mechanisms of aSAH, systematically analyzes the therapeutic potential and mechanisms of action of stem cell therapy, reviews preliminary clinical evidence, and discusses current translational challenges and future research directions, aiming to provide a theoretical basis for basic research and clinical translation of stem cell therapy in aSAH treatment.

Stroke is a major cerebrovascular disease with high mortality and disability rates that seriously threaten human health. Conventional pharmacotherapy serves as the main treatment for stroke. Nevertheless, restricted by the blood brain barrier (BBB) and other obstacles, drugs fail to achieve satisfactory targeted efficacy and biosafety, leaving much room for improvement. With the rapid development of nanomedicine, nanomaterials have been widely adopted in various medical fields, offering novel research avenues for stroke diagnosis and treatment. Benefiting from unique properties including nanoscale size effects, nanomaterials can elevate the resolution and sensitivity of imaging modalities for early lesion identification, and cross the BBB to boost the efficiency of targeted drug delivery. At present, the clinical translation of nanomaterials is hampered by multiple challenges such as biosafety risks and standardized quality control. Along with sustained advances in fundamental research and manufacturing technology, nanomaterial-based platforms are expected to address current bottlenecks and emerge as critical therapeutic tools for cerebrovascular disorders. This review recapitulates cutting-edge research progress of nanomaterials in stroke theranostics, analyzes translational barriers and prospective development trends, and intends to provide references for further investigation and clinical transformation of innovative nano-theranostic strategies against stroke.