Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2011
[Prognostic value of ICP, CPP and regional blood flow monitoring in diffuse and focal traumatic cerebral lesions].
Forty patients with severe traumatic brain injury (GCS score 8 and less) aged 16-54 years treated in our clinic were analyzed. Correlations between clinical symptoms, CT signs of diffuse and focal traumatic lesions, intracranial hemorrhage, indices of cerebral blood flow (CBF) according to perfusion CT study, intracranial pressure (ICP) and cerebral perfusion pressure (CPP) were assessed. Main mechanism of injury in 27 of 40 (67.5%) patients was acceleration-deceleration due to traffic accidents which usually leads to diffuse axonal injury (DAI) of different severity. ⋯ In 3 patients with DAI the CBF in the midbrain varied from 12.5 to 30.1 ml/100 g/min with the lowest levels in hemorrhagic focus in cerebral peduncle. It corresponded to cystic-atrophic alterations found on subsequent follow-up MRI. Thus, reduction of CBF and episodes of low CPP were the leading pathophysiological phenomena of diffuse and focal brain damages.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2011
[Radiofrequency denervation of intervertebral joints in management of facet pain syndrome].
Back pain is very widespread and represents a socially significant problem of modern health care. During lifetime 90% of population experiences 1 or more episodes of back pain. This study focuses on assessment of effectiveness of radiofrequency denervation of intervertebral joints in management of patients with low back pain caused by facet pain syndrome. ⋯ In 112 (80%) patients pain regressed. Clinical series was analyzed using the scale for assessment of severity of lumbosacral spinal degenerative disease developed in Burdenko Neurosurgical Institute (Moscow, Russia). The performed study confirmed effectiveness of the assessed technique which allowed including of radiofrequency denervation of intervertebral joints in the algorithm of management of patients with degenerative changes in the lumbosacral spine as the surgical method used in case of ineffectiveness of conservative treatment.