Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2013
Review Case Reports[Flexible endoscopy in surgical treatment of spinal adhesive arachnoiditis and arachnoid cysts].
Thecaloscopy is less invasive exploration of spinal subarachnoid space with ultra-thin flexible endoscope and endoscopic fenestration of scars and adhesions. Thecalopscopy was used in Russian neurosurgery at the first time. Since 2009 we operated 32 patients with following diagnosis: 17--spinal adhesive arachnoiditis (8--local forms, 9--diffuse forms), 12--spinal arachnoid cysts (7--posstraumatic cysts, 5--idiopathic cysts), 3--extramedullary tumors (thecaloscopic videoassistance and biopsy). ⋯ Mean term of hospitalization was 7.6 days. According to our data, we suppose that thecaloscopy is efficient and safe method, and should be widely used for spinal arachnopaties, adhesive arachnoiditis and arachnoid cysts. Taking into account that adhesive spinal arachnoiditis is systemic process and spinal arachnoid cysts can be extended as well, thecaloscopy may be regarded as the most radical and less-invasive way of surgical treatment existing currently in neurosurgery.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2013
Review[Management of postoperative analgesia in patients after craniotomy].
In a review paper, an analysis of publications in the world literature on the problem of acute postoperative pain in neurosurgical patients who underwent craniotomy is performed. Is shown that problem of acute postoperative pain in patients after craniotomy was underestimated for a long time. ⋯ Unarrested postoperative pain could cause a number of serious secondary complications. This article demonstrates basic approaches to the prevention and treatment of acute postoperative pain in neurosurgical patients after craniotomy--first of all, the use of narcotic analgesics, NSAIDs, and other approaches.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2013
Case Reports[Intra-arterial injection of verapamil in treatment of cerebral vasospasm in a patient with acute subarachnoid hemorrhage from an aneurysm: case report].
Cerebral vasospasm is a major cause of cerebral ischemia and neurological deficits in patients after SAH from the aneurysm. According to angiorraphy cerebral vasospasm in acute rupture of an aneurysm is detected in 50-70% of cases, and the risk of ischemia on it's background is 19-46%. One of the new trends of treatment of cerebral vasospasm is the intra-arterial injection of calcium channel blockers. The article presents a case of selective intra-arterial injection of verapamil for the treatment of cerebral vasospasm in patient after severe subarachnoid and parenchymal hemorrhage of the internal carotid artery bifurcation aneurysm with a good clinical outcome.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2013
Case Reports[Damage to the cavernous segment of internal carotid artery in transsphenoidal endoscopic removal of pituitary adenomas (report of 4 cases)].
Endoscopic endonasal transsphenoidal approach (EETA) is an effective and relatively safe to remove pituitary adenomas and other sellar region tumors. One of the most serious complications of transsphenoidal surgery is damage to the cavernous segment of the internal carotid artery, which by different authors occurs at 0 to 3.8%. In the period from 2005 to March 2013 in Burdenko neurosurgical institute 3,000 patients with pituitary adenomas were operated by standard endoscopic transsphenoidal approach. ⋯ Damage to the internal carotid artery may be associated with the wrong orientation in the surgical wound, or excessively aggressive manipulations in the cavernous sinus. Damage to the cavernous segment of the ICA during transsphenoidal surgery is a rare but potentially fatal complication. Extremely important is the correct localization of the middle line and ICA using navigation systems and Doppler ultrasound.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2013
[Nanostructural analysis of the lumbar intervertebral disc on the various stages of degenerative process].
Intraoperative specimens of lumbar intervertebral disc (IVD) on the various stages of degeneration was studied by the method of atomic-force microscopy using hardware complex (probe nanolaboratory with video microscope Ntegra Prima). New nanostructural data, characterizing the staging of degenerative changes of IVD were revealed.