Abstract:Objective To investigate the long-term efficacy of motor cortex stimulation(MCS)in the treatment of central post-stroke pain(CPSP).Methods The clinical data of 47 patients with CPSP treated with MCS in the Department of Functional Neurosurgery,Xuanwu Hospital,Capital Medical University,between January 2012 and December 2022 were ret-rospectively analyzed.Postoperative follow-up ranged from 12 to 132 months(mean 69.27±28.32 months).Pain intensity and characteristics were assessed preoperatively and at the final follow-up using the Visual Analog Scale(VAS)score and the Neuro-pathic Pain Symptom Inventory(NPSI)score,respectively.Patient sleep quality was evaluated using the Pittsburgh Sleep Quality Index(PSQI).Pain reduction exceeding 40%was considered effective.Results At the final follow-up,the VAS score showed a significant decrease compared to the preoperative score(P<0.001),with a pain relief rate of(45.2±23.1)%.Thirty-nine patients(83%)demonstrated good therapeutic outcomes,while 8 patients(17%)had poor outcomes,among whom 2 underwent device removal due to unsatisfactory response to MCS.At the final follow-up,the total NPSI score and its sub-items including sponta-neous burning pain and paroxysmal pain attacks showed significant improvement(P<0.05),whereas the other three NPSI sub-items showed no statistically significant difference(P>0.05).The PSQI score at the final follow-up was significantly lower than the preoperative score(P<0.001).Among the 39 patients with good surgical outcomes,36 reduced their analgesic usage,while 3 showed no significant change.Among the 8 patients with poor surgical response,5 showed no significant change in analgesic use,and 3 required an increased dosage of analgesic medications.Conclusion For patients with drug-refractory CPSP,MCS can effectively alleviate pain intensity and reduce postoperative analgesic use.Greater improvement is observed in patients whose pain characteristics include spontaneous burning pain and paroxysmal pain attacks.Furthermore,MCS treatment can im-prove the sleep quality of CPSP patients.

Abstract:With the continuous advancement of interventional medicine and the widespread application of new in-terventional equipment and consumables,an increasing number of patients can achieve favorable therapeutic outcomes through interventional procedures.For vascular diseases,Digital Subtraction Angiography(DSA)remains one of the gold standards for diagnosis.Currently,DSA equipment has achieved digitalization,systematization,automation,and networking,with continuous-ly improved performance and expanding functions.It meets the diagnostic and therapeutic needs in cardiovascular,peripheral vascular,and cerebrovascular interventions,and is also suitable for various non-vascular interventional diagnostic and therapeu-tic procedures.As interventional surgeries are typically lengthy and both patients and surgeons receive higher radiation doses compared to conventional X-ray examinations,effective radiation shielding protection and management are particularly crucial to control intraoperative radiation exposure to the lowest acceptable levels.This article summarizes the routine operation meth-ods,advanced function applications,usage precautions,and daily maintenance of DSA equipment,aiming to assist interventional technicians and operators in obtaining higher-quality intraoperative imaging,thereby enhancing the efficiency and safety of in-terventional procedures.

Abstract:Prolactinoma is the most common functional pituitary adenoma,with dopamine receptor agonists being the first-line treatment.The most commonly used dopamine receptor agonists include bromocriptine and cabergoline.Cabergoline is a selective dopamine D2 receptor agonist that significantly inhibits prolactin secretion and reduces tumor volume.It is more ef-fective than bromocriptine and has fewer side effects,making it the most widely used dopamine receptor agonist globally.How-ever,as cabergoline has not yet been formally approved by the China National Medical Products Administration,bromocriptine remains the primary drug for treating pituitary prolactinomas in China,although the clinical use of cabergoline is gradually in-creasing.Therefore,this article reviews the mechanism of action,clinical efficacy,adverse reactions,and management strategies for drug resistance of cabergoline,providing a reference for its clinical application in the treatment of pituitary prolactinomas.

Abstract:Objective To construct a nomogram risk prediction model for postoperative nausea and vomiting(PONV)after intracranial tumor surgery and evaluate its predictive efficiency,discrimination,calibration,and clinical appli-cability.Methods The clinical data of 400 patients with intracranial tumors who underwent craniotomy at the First Affil-iated Hospital of Anhui Medical University from January 2021 to October 2023 were retrospectively analyzed.PONV was diagnosed within 24 hours postoperatively based on patient complaints and clinical manifestations.Multivariate logistic re-gression analysis was used to identify independent predictors of PONV.The R software was used to construct the nomogram prediction model and perform internal validation and evaluation.Results Among the 400 patients with intracranial tumors,141 developed PONV,with an incidence rate of 35.25%.Multivariate logistic regression analysis showed that female gender,history of motion sickness,history of preoperative nausea and vomiting,infratentorial tumor,operation time≥4 h,and tumor nature were independent predictors of PONV in patients with intracranial tumors(P<0.05).A nomogram prediction model was successfully constructed based on these six factors.The Hosmer-Lemeshow goodness-of-fit test showed no statistical-ly significant deviation between the predicted probability and the actual occurrence frequency(χ²=10.790,P=0.148).Dis-crimination analysis using the ROC curve showed an area under the curve of 0.783(95%CI:0.735-0.831),indicating good discrimination of the nomogram.Decision curve analysis demonstrated good clinical applicability of the nomogram mod-el.Conclusion The incidence of PONV is relatively high in patients undergoing intracranial tumor surgery.The nomogram prediction model for PONV risk,constructed based on the six factors of female gender,history of motion sickness,history of preoperative nausea and vomiting,infratentorial tumor,operation time≥4 h,and tumor nature,has good calibration and dis-crimination,and certain clinical applicability.

Abstract:Objective To explore the independent risk factors for postoperative intracranial infection following craniotomy and to construct a nomogram prediction model for clinical guidance.Methods The clinical data of 419 patients who underwent craniotomy at Zhongshan City People's Hospita from May 2017 to April 2022 were retrospectively analyzed.Postoperative intracranial infection was diagnosed based on the 2021 Chinese Expert Consensus on Diagnosis and Treatment of Central Nervous System Infections in Neurosurgery.Multivariate logistic regression analysis was used to identify independent risk factors for postoperative intracranial infection,and a nomogram prediction model was constructed.A web-based dynamic nomogram was developed using the shinyapps.io software.Results Among the 419 patients,53 developed postoperative intra-cranial infection,with an incidence rate of 12.6%.Multivariate logistic regression analysis showed that prolonged surgery dura-tion,large intraoperative blood loss,postoperative cerebrospinal fluid leakage,≥2 surgical operations,and frequent cerebrospi-nal fluid sampling or drug administration via drainage tubes were independent risk factors for postoperative intracranial infection(P<0.05).Based on these five independent risk factors,a nomogram prediction model for postoperative intracranial infection was successfully established.ROC curve analysis indicated good discrimination of the model[area under the curve:0.826(95%CI 0.768～0.884)].The Hosmer-Lemeshow goodness-of-fit test showed that the predicted curve of the nomogram model largely overlapped with the ideal curve.Decision curve analysis demonstrated high clinical utility of the nomogram model.A dynamic nomogram was developed using R software and transformed into a web-based version via shinyapps.io,accessible at: Prolonged surgery duration,large intraoperative blood loss,postoperative ce-rebrospinal fluid leakage,≥2 surgical operations,and frequent cerebrospinal fluid sampling or drug administration via drainage tubes are independent risk factors for postoperative intracranial infection.The nomogram prediction model based on these risk factors exhibits good predictive performance.The developed web-based dynamic nomogram is user-friendly,provides accurate calculations,and is applicable in clinical practice.

Abstract:Rupture of intracranial aneurysms is one of the leading causes of subarachnoid hemorrhage,with a relative-ly high incidence and mortality rate.Although there is a clinical consensus on the treatment of ruptured intracranial aneurysms,the optimal management strategy for unruptured intracranial aneurysms still requires comprehensive consideration of multiple factors.In this context,studying the pathogenesis of intracranial aneurysms and identifying noninvasive therapeutic targets are of significant importance.As direct human experiments are not feasible,the establishment of induced animal models provides a crucial approach for gaining indepth insights into the mechanisms underlying the formation,progression,and rupture of intracra-nial aneurysms.This article reviews the current research status of production methods for intracranial aneurysm models,aiming to provide references for future model development.

Abstract:Intraventricular hemorrhage has a high incidence,disability rate,and mortality rate.Currently,there is a lack of ideal treatment methods,primarily because its pathophysiological mechanisms remain unclear.Stable and reliable animal models are crucial for studying the pathophysiology,prevention,and treatment of intraventricular hemorrhage.This article re-views the common types,modeling methods,applications,and future development directions of current animal models for intra-ventricular hemorrhage,aiming to provide references for research in this field.

Abstract:Objective To investigate the efficacy of intravascular lithotripsy(IVL)combined with rapamycin-coated stents in treating severe stenosis with calcified plaque at the vertebral artery orifice.Methods The clinical data of one patient with severe stenosis and calcified plaque at the vertebral artery orifice treated with IVL combined with rapamycin-coated stent implantation was retrospectively analyzed,along with a review of the relevant literature.Results Immediate postoperative an-giography showed satisfactory lumen opening at the vertebral artery orifice with a residual stenosis rate of approximately 10%.The patient's symptoms resolved postoperatively.Follow-up CTA at one month demonstrated a patent stent lumen,and the patient remained asymptomatic.Conclusion IVL combined with rapamycin-coated stent implantation is a feasible option for treating calcified severe stenosis at the vertebral artery orifice.It can improve luminal shaping and facilitate stent expansion.

Abstract:Objective To explore the real experiences of patients with kinesiophobia during early rehabilita-tion activities after intraspinal tumor surgery.Methods Fifteen patients with intraspinal tumors and kinesiophobia ad-mitted to the Department of Neurosurgery of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from April to September 2023 were selected for semi-structured interviews.The interview data were analyzed,summarized,and themed using Colaizzi's phenomenological analysis method.Results The real experiences of patients with kinesiophobia during early rehabilitation activities after intraspinal tumor surgery were summarized into four themes:fear of pain,limitations due to various tubes,psychological stress,and weak support systems.Common issues among postoperative intraspinal tumor patients included fear of pain,poor adherence to functional exercise,low self-efficacy,significant psychological stress,and a lack of adequate and effective support systems.Conclusion Health-care professionals should pay close attention to early postoperative pain management in patients with intraspinal tumors,adopt multifaceted and effective analgesic measures,emphasize patients'attitudes and adherence to functional exercise,provide psychological care and comprehensive health guidance,and assist patients in actively seeking social support to promote disease recovery.

Abstract:Objective Based on real-world clinical data from the Chinese population and from the perspective of the Chinese healthcare system,this study compares the long-term health outcomes and economic outputs of the Woven Endo-Bridge(WEB)device versus stent-assisted coiling(SAC)for the treatment of intracranial unruptured wide-neck aneurysms.Methods A patient-level simulation study was conducted,enrolling patients with intracranial unruptured wide-neck aneurysms(mean age 61 years,diameter 4～10 mm).The simulation assessed the performance of the WEB treatment strategy versus the SAC strategy in terms of initial treatment efficacy,follow-up outcomes,retreatment needs,and associated costs for rehabilitation and management of hemorrhagic/ischemic events.The incremental cost-effectiveness ratio(ICER)was calculated to evaluate the cost per additional quality-adjusted life year(QALY)gained.Deterministic and probabilistic sensitivity analyses were performed to explore the impact of model parameters on the results.Results The base-case analysis showed that,compared with the SAC strategy,the WEB strategy saved CNY 12 476.52 in lifetime treatment costs and provided an additional 0.97 QALYs,making it a dominant treatment strategy(negative ICER).Deterministic sensitivity analysis indicated that material costs,their quantities,and the complete occlusion rate at initial treatment were key factors influencing the ICER.Conclusion The WEB device demon-strates economic advantages over SAC in the treatment of intracranial unruptured wide-neck aneurysms.The WEB device is a cost-effective treatment option.It is recommended that decision-making consider potential influences from patient preferences,treatment protocols,changes in material prices,and the technical learning curve.

Abstract:Objective To explore the clinical application value of noninvasive dynamic brain edema monitoring tech-nology in patients with acute anterior circulation large vessel occlusion undergoing interventional therapy.Methods From March 2022 to March 2023,60 patients with acute anterior circulation large vessel occlusion were prospectively enrolled and randomly divided into an observation group(n=30)and a control group(n=30)using a random number table.After interventional therapy,the observation group received treatment guided by noninvasive dynamic brain edema monitoring,while the control group re-ceived conventional empirical treatment.Results Compared with the control group,the observation group showed a significant-ly higher rate of favorable prognosis(modified Rankin Scale score 0～2)at 3 months after discharge(40.0%vs.26.7%,P=0.035),a significantly lower mean daily dosage of mannitol[(292.5±94.6)mL vs.(352.6±112.4)mL,P=0.029],a significantly shorter duration of mannitol use[(12.1±5.2)days vs.(15.2±6.1)days,P=0.038],and a significantly lower incidence of renal impairment(6.7%vs.26.7%,P=0.038).The noninvasive dynamic brain edema monitoring results indicated that in the observation group,the electromagnetic disturbance coefficient peaked at 3 days after onset and then gradually declined.After mannitol treatment,the electromagnetic disturbance coefficient decreased significantly,with the most pronounced decrease at 1 hour post-treatment,grad-ually stabilizing by 3 hours post-treatment.Among the 30 patients in the observation group,17(56.7%)underwent decompressive craniectomy after interventional therapy,while 13(43.3%)did not.Compared to patients who did not undergo decompressive craniectomy,those who did showed a significantly lower electromagnetic disturbance coefficient[(116.3±8.7)vs.(127.1±14.1),P=0.016].ROC curve analysis revealed that the electromagnetic disturbance coefficient had certain predictive value for the need of decompressive craniectomy after interventional therapy in patients with acute anterior circulation large vessel occlusion.The area under the curve was 0.756(95%CI 0.565-0.893,P=0.005),with an optimal cut-off value of 112.5.The sensitivity,specificity,and Youden index were 52.9%,92.3%,and 0.453,respectively.Conclusion For patients with acute intracranial anterior circula-tion large vessel occlusion undergoing interventional therapy,noninvasive dynamic brain edema monitoring technology can guide the use of mannitol,reduce complications,and improve patient prognosis.

Abstract:Objective To summarize the nursing experience for patients with spinal venous hypertensive syn-drome(SVHS)who experienced misdiagnosis.Methods The clinical data of 34 patients with misdiagnosed SVHS admitted to the Department of Neurosurgery,General Hospital of Central Theater Command from 1998 to 2024 were ret-rospectively analyzed,and nursing experience was summarized.Results Among the 34 patients,10 were misdiagnosed with myelitis,15 with intervertebral disc herniation or spinal stenosis,5 with prostatic hyperplasia,and 4 with other dis-eases.The longest duration of misdiagnosis reached 3 years.After admission,all 34 patients were definitively diagnosed:14 with spinal dural arteriovenous fistula,6 with intracranial dural arteriovenous fistula,3 with spinal epidural arterio-venous fistula,3 with left renal vein stenosis,3 with left third lumbar transverse venous membranous stenosis,1 with left internal iliac artery arteriovenous malformation,1 with nutcracker syndrome,and 1 each with left and right internal iliac artery arteriovenous fistulas.One patient underwent comprehensive examinations in multiple hospitals but no spinal vascular disease was detected;follow-up over 20 years showed persistent muscle weakness below the knees without pro-gression of muscle atrophy.After admission,targeted individualized nursing care was provided,including preoperative psychological support,perioperative nursing,prevention of postoperative complications,and rehabilitation guidance,significantly improving patient outcomes.Conclusion For patients with misdiagnosed SVHS,targeted individualized nursing care can effectively improve prognosis and quality of life,while long-term rehabilitation guidance is crucial for the recovery of spinal cord neurological function.

Abstract:Objective To investigate the imaging features,pathological characteristics,and surgical treatment out-comes of adult cranial eosinophilic granuloma.Methods The clinical data of 10 adult patients with pathologically confirmed cranial eosinophilic granuloma from January 2014 to April 2024 were retrospectively analyzed,and relevant literature was re-viewed.Results The lesions were located in the parietal bone in 5 cases,frontal bone in 4 cases,and occipital bone in 1 case.Noncontrast CT showed roundlike osteolytic lesions with higher density than surrounding soft tissues.On MRI,lesions appeared hypointense on T1weighted imaging(T1WI)and hyperintense on T2weighted imaging(T2WI).All 10 patients underwent extend-ed resection of the cranial lesion combined with artificial titanium mesh cranioplasty.One patient underwent resection of a right frontal lobe lesion due to dural breach.Postoperative immunohistochemical staining showed positive expression of S100,langer-in/CD207,CD68,and CD1a.The Ki-67 index ranged from 1%to 30%,with a mean of(12±10)%.BRAFV600E mutation was detected in 2 cases.Postoperative cranial CT at 24 hours confirmed complete resection of the lesions without complications.No recurrence was observed during the followup period of 6-24 months.Conclusion Adult cranial eosinophilic granuloma exhibits characteristic imaging features.Immunohistochemical staining showing CD1a(+),langerin/CD207(+),and S100(+)is essential for diagnosing Langerhans cell histiocytosis(LCH).A typically high Ki67 index indicates relatively high proliferative activity.For unifocal cranial eosinophilic granuloma,extended resection combined with titanium mesh cranioplasty yields excellent outcomes.

Abstract:The dura mater serves as a critical barrier protecting the central nervous system,and its repair is essential for preventing serious complications such as cerebrospinal fluid leakage,intracranial infection,and cerebral adhesion.This arti-cle systematically reviews the evolution of dura mater substitute materials since 1893.The development process can be divided into three main stages:first,the early exploration phase(circa 1890-1940),where the clinical goal was primarily to prevent post-traumatic epilepsy-related meningeal adhesions,with attempts including metal foils,autologous tissues(such as fascia lata),and early synthetic materials;second,the standardized development phase(circa 1940-1980),which focused on achieving watertight closure to prevent cerebrospinal fluid leakage in addition to preventing adhesions,leading to the widespread research and application of non-absorbable synthetic materials(such as polyethylene and ePTFE)and absorbable natural materials(such as collagen and lyophilized human dura mater);third,the bioengineering and composite materials phase(circa 1980-present),driven by the"Lyodura incident,"where material safety became the primary concern,shifting research emphasis toward ani-mal-derived decellularized matrices with better biocompatibility and tissue regeneration guidance,functionally modified com-mercialized collagen,and composite materials combining the advantages of both.In the future,the development of dura mater substitutes will shift from pursuing"universal"materials to precise and multifunctional designs tailored to specific clinical sce-narios,potentially integrating with technologies such as cranial repair and biological adhesives to meet the evolving demands of minimally invasive and refined neurosurgery.

Abstract:Objective To analyze the clinical characteristics of patients with spina bifida in the Tibet region and explore the treatment and efficacy of spina bifida in this area.Methods A retrospective analysis was conducted on the clinical data of 55 patients with spina bifida who were treated at the People's Hospital of Tibet Autonomous Region from September 2013 to October 2023.Results Among the 55 patients with spina bifida,except for 2 adults,the ages of the remaining pa-tients ranged from 38 minutes to 4 years after birth,with an average age of 4.5 months.There were 29 males(52.7%)and 26 females(47.3%).The cases included 44 myelomeningoceles(80%),10 meningoceles(18.2%),and 1 lipomyelomeningocele(1.8%).A total of 40 patients(72.7%)underwent surgical treatment.Conclusion Spina bifida occurs sporadically in the Ti-bet region,with myelomeningocele being the most common type.Microsurgery serves as the primary treatment for patients with spina bifida in Tibet,which has to some extent alleviated clinical symptoms and improved the quality of life for patients..

Abstract:Objective To investigate the clinical significance of ophthalmic examination in the evaluation of venous return and cerebrospinal fluid circulation disorders in patients with Chiari malformation.Methods A retrospective analysis was performed on the cranial MRI and fundus examination data of 138 patients with Chiari malformation admitted to the First Affili-ated Hospital of Army Medical University from 2017 to 2023.The optic nerve sheath diameter(ONSD)and the fundus artery-to-vein diameter(A/V)ratio were measured,and fundus edema and optic nerve sheath morphology were observed.Results Among the 138 cases of Chiari malformation,there were 48 cases of isolated tonsillar herniation(Group A),11 cases of tonsillar her-niation+ventriculomegaly(Group B),55 cases of tonsillar herniation+syringomyelia(Group C),and 24 cases of tonsillar herniation+ventriculomegaly+syringomyelia(Group D).The ONSD was largest in Group B patients[5.82(4.56-6.49)mm],followed by Group D[5.05(4.83-5.55)mm],Group C[5.00(4.66-5.47)mm],and smallest in Group A[4.97(4.67-5.58)mm].The incidence of fundus edema and optic nerve sheath morphological changes was highest in Group B patients[81.82%(9/11)],significantly higher than that in Group A[6.25%(3/48)],Group C[7.28%(4/55)],and Group D[4.17%(1/24)].The incidence of decreased fundus A/V ratio was high in all four groups:37.50%(18/48)in Group A,45.45%(5/11)in Group B,50.91%(28/55)in Group C,and 41.67%(10/24)in Group D.Conclusion Chiari malformation patients with concomitant ventriculomegaly alone have a high incidence of cerebrospinal fluid circulation disorders;regardless of whether ventriculomegaly or syringomye-lia is present,Chiari malformation patients have a high incidence of intracranial venous return disorders.This suggests that the pathogenesis and clinical manifestations of Chiari malformation may result from the combined effects of cerebrospinal fluid cir-culation disorders and intracranial venous return disorders.

Abstract:Stroke is a leading cause of death and disability,with ischemic stroke accounting for approximately 85%of cases.The neutrophil-to-lymphocyte ratio(NLR),as a reliable and easily accessible marker of immune response,is widely used in clinical practice.NLR reflects the linear dynamic relationship between innate(neutrophils)and adaptive cellular immune responses(lymphocytes)under pathological conditions.Both are activated after cerebral ischemia and play critical roles in the clearance of tissue debris and the resolution of inflammation.NLR is influenced by many factors,including age,diet,medica-tion,chronic diseases(such as coronary heart disease),and stroke.This article reviews the role of NLR in the pathogenesis of ischemic stroke and its progress in clinical application,aiming to provide a reference for clinical practice.

Abstract:Rhabdomyolysis is a common condition,often presenting with acute muscle weakness,muscle pain or swelling,and dark-colored urine.However,its symptoms can be relatively insidious in patients with impaired consciousness.Concurrently,acute kidney injury(AKI)associated with rhabdomyolysis has a high mortality rate.This article reports a case of rhabdomyolysis following interventional therapy in a 58-year-old female with a ruptured intracranial aneurysm associated with COVID-19.The patient was admitted due to sudden headache,vomiting,and impaired consciousness for 2 days.Digital subtrac-tion angiography(DSA)diagnosed a ruptured anterior communicating artery aneurysm with subarachnoid hemorrhage,and coil embolization was performed.The patient remained comatose postoperatively and tested positive for COVID-19.Elevated serum creatine kinase led to a consideration of rhabdomyolysis,and treatment with fluid resuscitation and urine alkalinization was initi-ated.However,serum creatinine and blood urea nitrogen progressively increased,accompanied by anuria,leading to a diagnosis of severe rhabdomyolysis complicated by AKI.Continuous renal replacement therapy(CRRT)was immediately administered for 7 days.Subsequently,renal function gradually improved,24-hour urine output recovered,and serum CK and myoglobin lev-els gradually decreased.At the 3-month follow-up after discharge,serum CK and myoglobin had returned to normal.This case suggests that patients with ruptured intracranial aneurysms undergoing multiple surgical procedures within a short period and complicated by viral infection fit the profile of a high-risk population for rhabdomyolysis,warranting clinical vigilance.Early detection and timely treatment of rhabdomyolysis-associated AKI are crucial.

Abstract:Objective To investigate the etiological characteristics and risk factors for multidrug-resistant organism(MDRO)infections in critically ill neurological patients,and to provide a theoretical basis for the prevention and control of MDRO in severely ill patients with neurological diseases.Methods A retrospective analysis was conducted on the clinical data of 1 406 critically ill neurological patients admitted to the neurosurgical intensive care unit of the First Affiliated Hospital of Air Force Medical University from January 2019 to December 2022.Results Among the 1 406 patients,191 developed MDRO infections,with an incidence rate of 13.58%.Methicillin-resistant Staphylococcus consistently ranked first in composition ratio over the four-year period.The primary specimen source was sputum(83.19%),and the main infection site was the lower respi-ratory tract(72.84%).Multivariate logistic regression analysis showed that a total ICU stay≥11 days,impaired consciousness upon admission,≥3 surgeries during the current hospitalization,central venous catheterization,and ventilator use were indepen-dent risk factors for MDRO infections in critically ill neurological patients.Conclusion Critically ill neurological patients have a high rate of MDRO infections,with a predisposition to lower respiratory tract infections.Clinically,it is essential to strictly control the number of surgeries and the duration of ICU stay.For critically ill neurological patients with impaired consciousness,central venous catheterization,or ventilator use,attention should be paid to the prevention of MDRO infections.

Abstract:Severe traumatic brain injury(STBI)is a critical neurological condition characterized by severe illness,poor prognosis,and high mortality.Its hypermetabolic state and intense stress response make patients highly susceptible to mal-nutrition.Malnutrition not only affects the body's immune function and tissue repair capacity but also significantly increases the risk of infection and prolongs hospital stay,becoming a crucial factor influencing the prognosis of STBI patients.Therefore,scientific nutritional assessment tools are of great significance for timely identification of high-risk patients and the development of individualized nutritional intervention plans.This article systematically reviews the nutritional risk screening and assessment tools currently commonly used for STBI patients,including the Nutritional Risk Screening 2002(NRS 2002),the Critical Care Nutrition Risk Score,the Subjective Global Assessment(SGA),the Controlling Nutritional Status(CONUT)score,the Global Leadership Initiative on Malnutrition(GLIM)criteria,and muscle mass measurement,analyzing their applicability,advantages,disadvantages,and current application status in clinical practice.Furthermore,it introduces the exploration and application of ar-tificial intelligence in the dynamic monitoring of nutritional status and risk prediction,offering new technological approaches for the nutritional assessment of STBI patients.