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A brief history of neurosurgery

Time:2016-05-10 Click:2459

China is one of the world's four major ancient civilizations in 5000 years of the course of history, health, and the proliferation of ethnic people, the contribution of Chinese medicine is indelible, but about brain surgery, but there are no records. Three Kingdoms period (BC 280- 222 BC), Hua Yu Wei Cao craniotomy to treat them in the "first illness," because no data are available, only a legend. It is worth noting: In 2001, in China's Shandong Province, found a prehistoric dawenkou complete fossil skull round drilling, which apparently prompted the first people to have sounded such surgery. According to literature: Modern Neurosurgery from English-speaking countries, after the 1930s into our country, it is from small to large development so far, its diagnosis and treatment are moving towards the world.

Historical Review (1930- 1949)

Before the founding of New China, China has no independent neurosurgery, only a few hospitals cater to individual surgeon brain surgery [1], such as: Peking Union Medical College Hospital (PUMCH) Surgical Kwan Chung-Tao doctors returning from abroad after the United States took the lead in 1930 to carry out the treatment of traumatic brain injury, trigeminal neuralgia surgery; 1940, Dr. Zhao Yicheng returned from studying in Canada, two people work together, when the disease despite treatment including brain tumors, but mostly ineffective. Then as the two continue to study and practice, treatment of diseases, better, such as the line sympathectomy treatment causalgia, thromboangiitis obliterans, surgical removal of spinal cord tumors. 1942 Pacific War, PUMCH Japanese occupation, Kwan Chung-Tao, and go to the hospital and in Peking (now Beijing University People's Hospital) continue its work until after 1949 moved to the United States. Zhao then moved to Tianjin to practice medicine in 1943, remained at home. After another Pingzhuan Yi graduated from Peking University School of Medicine in 1943, that study and work in the hospital and, under the tutelage of Kwan Chung-Tao, in July 1949 into PUMCH, continue to engage in surgery and neurosurgery. 1930s, Mukden Medical College (now Shenyang, China Medical University) Surgery Chang Charlie had studied in Britain, after the Commissioner Chung Tao doctors learn that conducted brain surgery, and issued a "Neurofibroma of the gasserian ganglion" [Chin Med J (Engl), 1935,49: 412-421] and other articles.

In addition, in the northwest of Medicine (now Xi'an Medical University) in surgery and Zhang (1902-1966) in 1928, he graduated from PUMCH, 1946 Nian the United States specializing in the chest, brain surgery, after returning the following year made a spinal tumor surgery. After Fawn and Wan keen spirit and surgical treatment of trigeminal neuralgia. Has written "frontal incision 104 cases of schizophrenia," publishing translations of "brain tumor diagnosis and treatment" (1931, United States Sachs original).

Through the above, you can imagine at the time that people (including medical personnel) for brain surgery without knowledge and understanding of the situation, coupled with the device limited conditions, can courage and the courage to carry out nerve surgery is needed how much courage and perseverance .

"Chinese Journal of Surgery"

A brief history of New China Neurosurgery

1949 founding of New China undone, medicine is no exception, where the surgery branch - Neurosurgeons still limited to the aforementioned number of people, which is far from meeting the needs of the people. In view of this, the party and government administrations, in particular the Ministry of Health to give a lot of attention in improving the people's material and cultural life priorities under the premise of Healthcare increasing investment. Related to the development of domestic neurosurgery, author experience, it can be divided into: creation and popularity of stagnation and regeneration, growth and development and to a higher level in four stages.

First, create and spread (1950- 1966)

How quickly develop neurosurgery? First, start from the foundation of the country has certain departments, according to the prevailing situation analysis to choice for Beijing, Tianjin, Shanghai and other places is appropriate, so that the backbone of the training as soon as possible, in order to enrich and expand the professional ranks. Followed by the Soviet experts could be invited to give lectures in China, but also send a doctor to go to the Soviet Union as a reserve force learning.

1. Tianjin: In view of the above, Zhao Cheng (1908-1974) (Fig. 1) in Tianjin practice for many years, and in Canada under the tutelage of world-renowned master of Neurosurgery Wilder Penfield (1891-1976) [1-2], so that in 1952 Distinguished government, set up in Tianjin, Neurosurgery, General hospital, located 60 beds, built a dedicated operating room, surgical instruments purchase imports (Sweden STILL) and skull X-ray machines and other equipment. Due to improved conditions, together with Zhao into disease awareness, treatment of patients and increasing. Built by only two years, that neurosurgical patients admitted nearly 800 cases, the size of two average daily operations for the training of specialist personnel to create favorable conditions. Therefore, in March 1953 opened neurosurgery refresher courses, students from across the country, are a good basis for surgical doctors, a total of 22 (Table 1) [3], where six months of diagnosis and treatment of traumatic brain injury classes focus on learning year Some of the larger multi-master system operative principles. These doctors upon graduation active in local, business continues to mature, and gradually expand the surgical treatment of diseases, known as the multi local neurosurgery "founder," and a lot of training specialists.

Zhao paired neurosurgery diagnosis and treatment of various types of disorders have profound attainments, but he is more concerned about the treatment of traumatic brain injury, the first domestic monograph, "Diagnosis and treatment of acute brain injury" that is, in 1960. Under his guidance come out. 4070 cases of brain trauma cases in 1963, in turn accumulated Beijing and Tianjin, according to the mechanism of injury, hematoma Occurrence site and how to improve the level of treatment, etc., were summarized into four published works, the points made is still applicable, at that time it has reached the international advanced level. September 1962, Zhao was invited to visit a teacher Penfield, together with Dr. Zhao was invited to attend the National Day ceremony in Tiananmen Square boarded by Chairman Mao Zedong met with cordial conversation, which fully shows that the national attention on the work of neurosurgery.

December 1954 by the Ministry of Health to Zhao invited to undertake after Beijing and Soviet experts to train Chinese doctors task that began in Beijing and Tianjin and from work. Training tasks and work within the section of the part by the Tianjin Xueqing Cheng (1922-1991), who Xueqing Cheng Surgery in the General Hospital of Tianjin Beijing in 1946 after graduating from medical school in 1952 under the tutelage of Zhao to become engaged in neurosurgery. He helped a lot of work to Zhao, impressive, making Tianjin neurosurgery growing and development. After Zhao to death, he took over as director, has trained 21 master's degree, 8 doctoral and more than 100 neurosurgical senior personnel, editor of the publication "Neurosurgery" and co-author of several books, is a popular respected neurosurgery one of the pioneers, he is the cause of neurosurgery in China made a significant contribution.

2. Beijing: October 1954 Ministry of Health invited the former Soviet Union, director of the Kiev Institute of Neurosurgery Arutyunov Peking University First Hospital in China in the current training Chinese neurosurgeon, but please Dr. Zhao Yicheng teach, and the establishment of nerve surgical specialty groups. Medical students from Beijing have Chai Wanxing, Chen Binghuan, James Chiu degrees, Bai Guangming, Shu Zhan name, Cai Zhen Tong, have Jiangda referral, Yangde Tai, Yu Shaohua three physicians (Fig. 2) from the Shanghai School of Medicine. Professional training and study groups take sides, while work [3]. February 1955 moved to the professional group Tongren Hospital, founded neurosurgery, provided 60 beds, in April by the Tianjin Zhongcheng transferred. July 1, 1955 Soviet experts to return home. Zhao to become due in Tianjin office, continue to branch once a week for teaching, and surgical rounds, oversee the work of the two. At that time, the diagnosis of neurosurgical diseases, mainly through the brain ventricles or gas angiography, percutaneous carotid angiography foreign adoption in China has not yet carried out. 1956 Zhongcheng and several doctors carried out within the department cerebral angiography, making diagnosis technology across a big step forward.

September 1958 completion of Xuanwu Hospital, Xuanwu Hospital General moved to increase to 120 beds, and become the focus of the department, Zhao into the official as director. To speed up the development of the subject, to carry out clinical, basic scientific research, in order to become Zhao initiative, on March 9, 1960 set up the first Neurological Institute of Surgery. Beijing municipal government appointed a founding director Zhao, deputy director Wang Zhongcheng, under cell culture, neuropathological, neurochemical, electrophysiological laboratory; accompanied by nerve otology, neuro-ophthalmic and neurological radiology; ward leader Bai Guangming , James Chiu degree, to express both the inner member Zhan, the names and Keshi as a whole, based closely integrated clinical scientific research. June 1962 in order to further the development of clinical work, clinical in turn divided into four groups: group brain tumors, pediatric neurosurgery group, traumatic brain injury, cerebrovascular disease and epilepsy group, spinal cord, pain group. Since then, the department together with the completion of a number of leading domestic work, such as: the establishment of cerebral edema model established glioma strain G422, dried orbital puncture ventricle, cerebral hemisphere resection, temporal lobe epilepsy surgery, collar plate anterior surgery, intracranial aneurysm craniotomy silver clip clipping tumor pedicle, surgical treatment of hypertensive intracerebral hemorrhage, traumatic diagnosis and treatment of multiple intracranial hematoma, etc., and published "diagnosis and treatment of acute brain injury", "brain angiography, "" cerebral edema "professional books.

The establishment of large numbers of neurosurgery patients are treated, but also found time scale can not meet the needs of patients. Thus, since 1957 by the Department of Neurosurgery, Xuanwu Hospital, Ministry of Health designated recruiting for advanced students, each 8 to 10, 1-year study period, to "Cultural Revolution" has trained a total of more than 120 specialists for the popularization and development of China neurosurgery foundation. During this period, except in Beijing Pingchuan Yi led PUMCH neurosurgery, there are training troops through our department doctors also work to popularize and promote neurosurgery also contributed.

In addition, in September 1958, Beijing Sino-Soviet Friendship Hospital (now Friendship Hospital) in order to receive postoperative ward director of Moscow Burdenko Neurosurgical Institute Salaski work in China, tune Chai Wanxing Song Zunwu to set up the hospital neurosurgery, provided 30 beds, In addition to treated patients also train the practitioner training and a few doctors. 1960 Sino-Soviet relations deteriorate, Salaski home, but so far there has been the Section.

3. Shanghai: Shi Yuquan (1919-) 1944, Shanghai Medical College graduate, is one of the pioneers and founders of neurosurgery. 1950 Shanghai Zhongshan Hospital surgeon Shen Ke Fei, Shi Yuquan as assistant, successfully removed a case of frontal lobe brain tumor, from Shi Yuquan began a career in neurosurgery. 1952 Shi Yuquan became neurosurgery specialists, and with Zhu Zhen Qing (1956 moved to Chongqing Medical College, founded neurosurgery), Jiang Tai Kai and Yang Detai create Neurosurgery at Shanghai Medical College Hospital Medicine (now the Shanghai Huashan Hospital), set up beds 8 . Early craniotomy more need to study in the UK Department of Neurology Professor Zhang Yuan Chang consultation, although due to limited conditions, but no more misdiagnosis, very good effect. Thereafter Shi Yuquan twice participated in the Korean medical team, launched a lumbar sympathectomy closed and surgery has cured hundreds of cases of stump pain of the wounded, and presided over the missile brain wound treatment. 1954 will be increased to more than 20 beds, the doctors began to recruit training, main learning brain injury treatment. In the same year the Section has been designated by the Ministry of Health for the neurosurgery unit training, students are enrolled each year, until the "Cultural Revolution" is suspended. The late 1950s began to recruit graduate students, such as Zang people, Tang Zhensheng, Fengzu Yin, and many were later to become the backbone of neurosurgery. Shi Yuquan knowledgeable and innovation, namely in 1951 for the successful development of brain surgery hemostatic agent - gelatin sponge, the first in China to carry out excision treatment of infantile cerebral hemisphere (1955), brain aneurysm ligation (1956), temporal lobe epilepsy surgery (1956) and stereotactic trigeminal neuralgia blocking therapy [4]. In addition, Shi Yuquan Movement Research on the brain and the proposed classification AVM form, by the international attention. Shi Yuquan domestic neurosurgery construction and development has made an indelible contribution.

1954 Branch within Jiangda mediator, Yang Detai Beijing to attend the training of Soviet specialists in neurosurgery, successively in 1955, 1956 back to the department, Jiangda referral (1926-2013) in the 1960s developed the stereotactic positioning accuracy, it has been used 20 years, and a number of surgical instruments has been improved, carried out many difficult surgery, worthy of one of the pioneers of neurosurgery renowned domestic [5]. Yangde Tai is committed to focus on minimally invasive surgery pituitary tumor, his rich experience, we developed a series of standardized diagnosis and treatment strategies. They have a lifetime of effort dedicated to this noble cause. 1960 study in the Soviet Union returned Chen white male, no doubt more to add to this base neurosurgery strength.

4. Shenyang: Duan Guosheng (1919-2012) is the creator of one of the military and neurosurgery. In 1942 he graduated from Liaoning Medical College (formerly Mukden Medical University and Liaoning Medical College) in surgery after 1949 into the Shenyang Military Region General Hospital Surgery, since 1950 diagnosis and treatment of traumatic brain injury patients, the same year the winter after the Korean War broke out, gradually admitted craniocerebral firearm and causalgia wounded patients, the line of brain surgery and thoracic sympathectomy mostly cured. Due to the wounded, better established in 1952 Neurosurgery, 30 beds, Zhao Chongzhi transferred from the general surgery. During segment Guosheng went to Changchun treatment of head trauma over a hundred, and then back to Shenyang has treated more than 180 patients treated only 3 died, the efficacy of the international advanced level. Paragraph Guosheng experienced in the treatment of traumatic brain injury battle, his department is focused on the military field surgical units, 1958 Renquan Jun neurosurgery team. Paragraph Guosheng comprehensive technology in neurosurgery disease in 1955 first in the country to carry out the third ventricle tumor resection, and soon to carry out the treatment of malignant glioma Hemispherectomy series surgery. In order to learn from international experience, in 1964 the main Chilean Asenjo translated book "neurosurgical technology." 20th Century 50--60 years held a number of refresher courses for the troops to train and a lot of professionals.

1969 segment Guosheng transferred to the PLA General Hospital, he served as chief of neurosurgery. He led the Section first in the country spinal surgery, resection of intramedullary spinal cord tumors, spinal cord trauma anterior decompression. 1975 in the country earlier microsurgical technique intracranial aneurysm, cerebral vascular malformations and deep brain tumor surgery, and had generalized and co-author of "Practical Neurosurgery" (published 1978), the book is domestic peer recognized as classics. In the section of the country rose leadership, the division gradually expanded, talented people, such as: scaling Zhou, Xu Bainan, POSTGRADUATE, and many others, clinical diagnosis and treatment of domestic advanced ranks.

5. Xi'an: 1951 sent by the State applied through today (1914-) went to Moscow to Burdenko Neurosurgical Institute study, under the tutelage of Egolov, PhD returning in 1956. That same summer, painted through this with Zhao in Beijing to meet, to discuss matters relating to build China Institute of Neurosurgery, but then applied through now sent to Xi'an Fourth Mil Affiliated Hospital (now the Xijing Hospital) established neurosurgery, and OK to PUMCH Fengzhuan Yi, Wang Maoshan, Yin Yan and Zhao had generalized fourth Military medical University as the basic force, and then transferred easy sound Yu (Nanjing), Liu Duo (Guangzhou), more than 10 doctors and other neurosurgery, and neurology, ophthalmology, ear nerve and radiologist with specialized clinical work of the Section. Early located only 10 beds, expanded to 40 months after surgery increasing from two to four per week. Tu-pass system rounds this special attention and sum up the experience of diagnosis and treatment, surgery continues to improve, patients admitted to also gradually increase, only 1956--1959 year of surgical treatment of 100 cases of intracranial tumors. Tu pass today in the domestic first reported trigeminal tract amputation (1961), by the removal of acoustic neuroma on the screen (1961) and the rear of the third ventricle tumor surgical treatment (1963) and other difficult surgery [6]. Subsequently, Zhang Ji, Wang returned to study in the Soviet Union, the department has added strength. In the training of specialists, they take the "edge Jianke, side run classes," as soon as possible recruit advanced students, only forces at the start of training, after local doctors also participated. Today, still is one of the key training base for domestic neurosurgery.

In summary, as of the 1960s, a number of domestic provinces and cities have a neurosurgeon, and some have established an independent department, initially achieved the goal of universal neurosurgery. But in addition to the foregoing several centers, the treatment of diseases mainly head trauma, brain tumor surgery a few units to do superficial and clear spontaneous intracerebral hemorrhage, basically meet the needs of patients. During this initial phase, 1960 in Zhengzhou City, Henan Province held a Chinese Medical Association Seventh Surgery Conference, neurosurgery main participants were: Zhao Cheng, Tu pass today, Shi Yuquan, Duan Guosheng, Xueqing Cheng, Wang Zhongcheng, etc. [6 ]. Developed and adopted the "Sort by traumatic brain injury," the meeting. 1965 Beijing conferences on brain injury and coma after injury, according to the time, and vital signs show positive signs, divided into mild, moderate and severe type, and then separated from the heavy in heavy special. Above all contribute to the understanding of brain injury and the development of appropriate disposal, improve diagnosis and treatment.

Second, the stagnation (1966- 1978) Regeneration

"Cultural Revolution" ten years of chaos, seriously hindered the development of the medical profession. Neurosurgery is a high risk profession, a lot of time untruths the buckle on the Section, experts and even some old work just a few years doctors have been put on "bourgeois reactionary academic authority" hat, suspended decentralized work, research work is dispensable, a waste of money, disband gone. This decade, all "taking class struggle as the key link", few people dare to openly studying business, "take special white road", so most of the work is to deal with clinical traumatic brain injury as well as some larger safety factor disease, scientific research only the implementation of acupuncture anesthesia in brain surgery applications, analgesic mechanism and preferred points. "Cultural Revolution" so that the original flourish neurosurgery essentially moribund.

We have serious repercussions on neurosurgery during the "Cultural Revolution." 1972 Keio University in Japan for many years neurosurgeon Dr. Du Ziwei back to Suzhou Medical College, he brought a surgical microscope, cerebral aneurysm clip (Scoville clip), bipolar coagulation and other domestic kind never seen before and also donated a set of advanced research equipment, and to Beijing, Shanghai and other places neurosurgery academic report. No doubt his patriotic activities for domestic micro-surgery carried out later, the development of domestic micro-surgical instruments play a great role in promoting.

The end of 1976 the "Cultural Revolution" ended, the whole country rejoiced, neurosurgery various groups is more confident, celebrating regeneration, vows to recapture the lost decade, ready to start again, science and technology to meet the arrival of spring.

Third, the growth of the (1978-2000) Development

After the implementation of reform and opening up in 1978, greatly contributed to the growing neurosurgery, reflected in the increase in the number of specialists and highly qualified personnel continued to emerge. "Cultural Revolution" before the National Statistics neurosurgeon only a few hundred people; in 2006 and 2011, statistics show that the attending physician and the doctor is more than 6400 to 8 600 [7]. 1980s, many units recruit postgraduates and doctors, they not only have good professional knowledge, but also have a certain scientific research ability. In addition, many doctors abroad, brought back some foreign advanced concepts and technologies. All this undoubtedly contributed to the growth of neurosurgery. Currently most of these doctors have become the backbone of discipline or leaders. "Cultural Revolution", an independent neurosurgery hospital only 38; in 2013 the domestic part of the survey showed that the top three hospitals has increased to 108, more than 400 neurosurgical beds are two, more than 300 of four, over 200 Zhang 12, more than 100 of the 43. Neurological Institute also made a surgical increased 13. Among them, the Beijing Municipal Institute of Neuroscience Surgery restored, along with the clinical section in May 1982 moved from the Tiantan Hospital, Xuanwu Hospital. Zhongcheng (1925-2012) dean and director, specializing in neurosurgery is divided into 13 different wards, more than 400 beds in total, in 1983 the Institute building was completed, preliminary design 12 laboratory, and later increased to 16 a, advanced research equipment, basically meet the requirements of a high starting point of scientific research. Like other studies, like bear different levels of research projects.

Neurosurgery, although fast, but there is no independent specialist magazine. To this end, Wang Zhongcheng, Shi Yuquan, para States Shengdeng positive appeal and application, the 1985 Chinese Medical Association agrees founded "Neurosurgery", when he was Minister of Health Cui plow wrote Chuangkan Ci to show congratulations. The following year (1986) and the establishment of the Chinese Medical Association Branch of Neurosurgery, painted through this honorary chairman, honorary consultant Fengchuan Yi, Wang Zhongcheng director members, Shi Yuquan, Duan Guosheng, Xueqing Cheng, deputy chairman of the Standing Committee set up 11 secretary 2, the Institute was established to expand the influence of the profession at home and abroad.

Since the reform and opening up, constantly visiting foreign counterparts, many of whom are internationally renowned everyone. Such as: Yasargil, Drake, Hardy, Cloward, Samii, Zuo Yegui Division, Suzuki Jiro, Sugita Qian Ichiro etc; they not only introduced the subject areas in the latest international developments, but also to understand the rapid development of Chinese neurosurgery, to promote mutual cooperation laid the foundation. Chinese Medical Association Neurosurgery club members also contributed to the establishment of the World Federation of Neurosurgical Societies (World Federation of Neurosurgical Societies, WFNS) of Walder China twice to the Chinese Medical Association to discuss the matter of China's accession to the Union, our country finally in 1989 He joined WFNS. In the same year, held in New Delhi, India 9th WFNS General Assembly, Zhu Jianhong he received the Young Physician academic award, which is China's first international award neurosurgeon. After the Society for Neuroscience Surgery since joining WFNS, every four years in different countries of the General Assembly was held, were sent our delegation to participate in, and the number is increasing. Since then, participation in the annual meetings or international conferences in Europe, the United States, Japan and other countries held, the number of participants has gradually increased, and some articles have been selected as the conference presentations, posters (poster) and the like. As we more cases, good effect, good topics, often praised by foreign counterparts, not only to promote mutual understanding and expand the influence.

WHO Mental Health Department (Division of Mental Health) that is organized every year since 1979, foreign experts (eg MNI Canadian director Feindel, professor UCSD Shoenberg, etc.) to visit China domestic related disciplines, and held academic lectures. Finalized in 1982: Beijing Neurological Institute of Surgery and Neurosurgery, Huashan Hospital of Shanghai "WHO Collaborating Centre for Neuroscience Research and Training" [1]. Shi Yuquan and James Chiu of the Advisory Committee were invited to go as in 1981-1984, respectively (4) and 1982,1995- 1996 (4) WHO Headquarters (Geneva), participation in discussion, including: GM1 clinical applications of neural plasticity, brain trauma, cerebral vascular disease, neurological disorders phosphorus metabolism, experts from various countries, the number of people in about 10 people, responsible for the invitation by the wHO, after communications or printing booklet for reference.

Discipline development and growth, the key is you want to accomplish something in the professional. In order to keep up with the latest developments on the international neurosurgery, at the end of the 1970s, namely the introduction of domestic surgical microscope. 1978 Shanghai Huashan Hospital, purchased from Japan, China's first CT, 1985 Guangzhou Nanfang Hospital, the introduction of China's first magnetic resonance (trade name Bruker, machine-based ultra-low magnetic field). Since then, the country has equipped with these devices, to launch a new operation to expand the diagnosis and treatment of diseases to create the conditions. In the consolidation of the results already achieved on the basis of this new period and carried out some work.

1978 PUMCH Yin Zhao Yan United States, Dr. Wilson at UCSF study tour through the nose and mouth transsphenoidal pituitary adenoma surgery under a microscope. After returning home, home-made surgical instruments, the first in the country to carry out the surgery. Zhang Ji (Beijing), Yang Detai (Shanghai) and other doctors to Beijing to learn, gradually promote together. Since then several reform, optimize the approach, currently only endonasal approach, in line microscopic or endoscopic resection with nerve. This is the earliest of the minimally invasive surgery.

The late 1980s, through the brainstem Zhongcheng depth study and refer to literature, began brainstem lesions underwent surgery in 2001 to the team total of 612 cases of surgery, and the accumulation of the number of cases among the world's surgery forefront. 2004 published the "brain stem tumor and its treatment." This treatment concept has dramatically changed the traditional view of the brain stem, which is operative in the country has been promoted.

Skull base tumors deep, complex anatomical relationships, previously intractable or more is considered incurable. After the 1980s, with the deepening of domestic microscopic anatomy research, the development aid of neuroimaging, surgical instrument improvements, especially micro-manipulation level continues to improve, the major center began to try to overcome this problem [8 ]. During calibration, etc. week published "skull base tumor operation", ZHOU Liang-fu improved surgical approach in the treatment of skull base tumors of scientific and technological progress awards, Tiantan Hospital is accumulated a lot of cases, continue to describe their experiences. Above all practice greatly contributed to the development of this specialty. Currently, a number of diseases such as rock meningioma treatment has reached the international advanced level.

The incidence of intracranial aneurysms less than people in Western countries, and the higher incidence of cerebral vascular malformations, the 20th century 50--60 years, the country was once considered both a ratio of 1:5 to 1/6. After the reforms, raise the level of domestic medical, improve people's medical conditions, this proportion has been rewritten as 1:1. Surgical treatment, thanks to the different types of aneurysm clips, and operates under the microscope, the success rate is much higher, but the refractory, giant and multiple intracranial aneurysm treatment remains very difficult. ZHOU Liang-fu was first reported in 1979, a huge middle cerebral artery (MCA) after tumor resection, the MCA stump line - end anastomosis success; in 1981 for giant aneurysms surgery parallel rows isolated extracranial - intracranial arterial bypass (EIAB) success. 1983 Zhongcheng a successful craniotomy clipping four aneurysms; ZHOU Liang-fu in 1984, with bilateral multiple (5) line the side of the aneurysm craniotomy, clipping a success. These are difficult surgery for open ground. Liu Chengji published "cerebrovascular surgery" in 1987 to promote and develop this area has played a significant impact. At present, the country to carry aneurysm surgery has become more common, where SHEN Jian-kang, Xu Bainan, Jizong and many doctors have made a contribution.

Zang March 1976 and the first in China as one case in patients with vascular occlusive cerebrovascular row superficial temporal artery (STA) -MCA consistent treatment success. For a time the country rise EIAB climax. According to incomplete statistics, China made a total of more than 2,000 cases. But in 1985, "an international randomized study" negation of the procedures in the treatment of ischemic stroke, after gradually discontinued. Having said that, while filling many domestic neurosurgeons to learn and master the small vessel anastomosis. Thereafter, the clinical study showed EIAB and can not be neglected, it has a certain indications, can rebuild cerebral blood flow, prevent or reduce the occurrence of cerebral ischemia. 1980s to Liujing Fang (Hebei Medical College), Zouxiong Wei (Xuzhou Medical College) is represented by some scholars who praised the "omentum intracranial transplantation" treating cerebral ischemia patients. The operation is divided into free and omental pedicle greater omentum, which is required with the superficial temporal or occipital arteriovenous anastomosis; meanwhile, had requested the surgical Goldsmith, founder of China to do the report, but not the end result of uncertain efficacy can be extended.

Ischemic attack and carotid atherosclerosis and plaque causing arterial stenosis due to its formation is closely related to the shedding of emboli in the past few neurosurgeons domestic processing, and foreign counterparts, but each year using carotid endarterectomy ( CEA) treating a large number of such cases. Zhou calibration since the United States to study the return of that in 1987 launched a CEA, due to the selection of cases strict procedures were received good results, and published the "carotid endarterectomy" monograph, led the domestic neurosurgeon involved in this area in. Currently, a number of top three hospitals have been carried out CEA surgery.

Functional neurosurgery treatments include extrapyramidal disorders [such as Parkinson's disease (PD), torsion spasm, spasmodic torticollis, etc.], epilepsy, pain (such as cancer pain, phantom limb pain, etc.), multiple mental disorders and other diseases . Treatment use of stereotactic techniques. 20 Century 50 - Notwithstanding the 1960s to carry out, but only for PD, epilepsy, etc., and a limited number of cases. After the reforms, the introduction of advanced equipment and technology, expanding international exchanges, the rapid development of the profession. For example, to carry out nerve tissue transplantation in the treatment PD, that is, by the revelation of Sweden Backlund. 1986 Beijing Zhang Mandalay, Ding Yuji and Shanghai, respectively, the first in China to implement Jiang Chengchuan autologous adrenal medulla, fetal brain substantia nigra line caudate nucleus transplantation to treat the national total in 1994, more than 1 500 cases [9]. But because the effects are uncertain and subject to the transplanted tissue source and ethical issues, it has been stopped. 1983 Anhui Stereotactic Surgery Neurological Institute was founded, Xu Jianping, Wang Han has been responsible for industry. The following year the establishment of the Association, two years later founded the "Stereotactic and Functional Neurosurgery", also have developed a "Hsu XZI-Ⅴ type stereotactic", led to the development of the country in this field. Xuanwu Hospital, Li Yongjie in the United States upon graduation, will be the world's advanced level of treatment philosophy and technology back, expanding the field of treatment, involving a wide range of diseases, surgical treatment has more than ten thousand cases, efficiency up to 98%. Tang Du Hospital in 1997 to establish PD treatment center, 5 more than 200 cases have been treated, become the largest number of cases of surgical treatment center in the world. High Guodong also the world's first successfully carried out neurosurgery damage bilateral nucleus accumbens withdrawal addiction. In 1997 the Navy General Hospital and University of Aeronautics and Astronautics Tian Zengmin cooperation successfully developed the first generation of robot-assisted frameless stereotactic surgical system, satisfactory clinical effect, it has now developed to the fifth generation. 2005 using the system, through the Internet, the successful completion of Beijing to Yan'an remote control operation stereotactic surgery in 10 cases, fully demonstrated its unique advantages. In epilepsy surgery treatment, Tan Qifu accomplished deep, first in the country to carry out the corpus callosum incision, functional hemispherectomy, the successful development of cortical electrodes and depth electrodes, and Li Ling, WU far eds "Epilepsy surgery", in China has played a significant role in promoting. In recent years, deep brain stimulation (DBS) has been developed by Tsinghua University and the success of Tiantan Hospital, and has been verified by the State FDA for clinical good results, it will greatly benefit patients.

Ling Feng went to France in 1983 after learning the first in China to carry out endovascular treatment. Shortly thereafter another horse Lian Ting, Wu secondary schools participate. Initially used to treat multiple carotid - cavernous fistula (CCF) and cerebral arteriovenous malformation, after due involvement of the materials and equipment continue to improve, and gradually expand to intracranial aneurysm, extracranial cerebral arteries and intracranial arterial stenosis and certain preoperative embolization of tumor therapy, both received good results. Also some of the materials involved in the development, so that localization of production of the coil (coil), intravascular stent (Apollo) and blood flow divider (flow diversion device, FDD, Tubridge) and the like. Previous spinal vascular malformations poorly understood, although the incidence of the disease is low, but its dangers can not be underestimated. Ling Feng in the 1980s, namely to carry out super-selective spinal angiography, diagnosis and treatment of the disease, according to statistics 1986--2003 total of 549 cases of diagnosis and treatment. She proposed classification and individualized treatment, get attention and international recognition. In recent years, a number of neurosurgical interventional therapy and vascular surgery carried out within the same period (ie hybrid operation) has started to implement fully demonstrates that the profession has broad prospects for development.

Early 1990s, Beijing Tiantan Hospital, Shanghai Huashan Hospital, Sweden has introduced Leksell Gamma Knife. Because of its need craniotomy, it is a minimally invasive treatment, and treatment of diseases and more, such as skull base meningiomas, acoustic neuromas, brain metastases, vascular malformations and functional neurosurgery disorders (such as PD, epilepsy, trigeminal neuralgia) etc., so popular. Thus, the domestic purchasing competing machines such treatment, including domestic Gamma Knife (hobo company). With advances in technology, escalating treatment machine, so there are X- knife, Cyber- Knife, Perfexion new generation of imported equipment, in addition, the country also imports a small number of proton beam therapy device (proton beam therapy). According to statistics, the highest in the world as well as the sum of the number of cases of domestic treatment have such treatment machine home. But, as Pan Li, Liu Ali and other experts repeatedly stressed: First, we must strictly abide by therapeutic indication, second is to have a complete follow-up data, to assess its short-term and long-term effect. These principles have attracted attention and follow.

Neuroendoscopy since the 1990s into the country, since the endoscopic treatment for minimally invasive surgery, it is very valued. Initially only for cystic lesions removed by suction, and the third ventriculostomy or assisted craniotomy lesions observed deep structure. With endoscopic improvement, improve operating proficiency and in-depth understanding of the microscopic anatomy had been carried out by a single nostril approach of pituitary tumors, skull base chordoma, craniopharyngioma resection, and intraventricular tumor resection , repair of cerebrospinal fluid leakage and other difficult surgery. At present, some large central China are carried out to varying degrees, endoscopic treatment. Among them, Zhang Yazhuo most surgical cases, many published articles, published a "nerve endoscopic surgery technology", "Endoscopic Neurosurgery" monograph. And held several workshops to promote the professional development.

As the domestic neurosurgery started much later than orthopedics, and mainly treated brain disorders, it is traditionally associated with spinal disorders to the continuation of the practice has been performed by the surgeon process. In many foreign neurosurgical center, spine surgery accounts for more than 1/3 of the total amount of surgery. Journal of the American Association of Neurological Surgeons J Neurosurg, since 1999, publishes the spine Volume JNeurosurg: Spine. This information will undoubtedly revelation domestic counterparts with international standards.







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