Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Awake craniotomy is recognized as method that can decrease the frequency of neurological complications after surgery for gliomas located near eloquent brain regions. Unfortunately good neurological outcome can't be ensured even by using of this technique. This paper discusses reasons and possible ways of prevention of such complications. ⋯ Awake craniotomy is effective instrument of brain language mapping and prevention of neurological deterioration. Severe neurological complications of awake craniotomy are associated with underestimate neurosurgical risks, especially in terms of blood vessel injury and depth of resection. The main way of prevention of such complications is meticulous planning of operation and adequate using of mapping facilities.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2015
[Guidelines for the management of severe head injury. Part 1. Neurotrauma system and neuroimaging].
Traumatic brain injury is one of the main causes of mortality and disability in young and middle-aged individuals. The patients with severe traumatic brain injury who are in coma are the most difficult to deal with. ⋯ In addition, we used the materials of international and Russian recommendations on the diagnosis, intensive care, and surgical treatment of severe traumatic brain injury published in recent years. The proposed recommendations are related to organization of medical care and diagnosis of severe traumatic brain injury in adults and are primarily addressed to neurosurgeons, neurologists, neuroradiologists, anesthesiologists, and emergency room doctors, who are routinely involved in management of these patients.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2015
Case Reports[Cardiac arrest after induction of anesthesia in neurosurgical patients].
The paper reports two clinical cases observed with a time lag of four years. In both cases, there were severe clinical symptoms of intracranial hypertension before the surgery. ⋯ In one case, cardiac activity was successfully recovered by complex resuscitation with the emergency drainage of the cerebral ventricles. The possible causes of complications and preventive measures were discussed.
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To substantiate the reasonability and duration of angiographic follow-up of patients operated on for cerebral aneurysms to rule out de novo aneurysm formation. ⋯ The patient groups with the high risk of de novo aneurysm formation are as follows: 1) young smokers with hypertension; 2) patients who developed clinical signs of the disease when being young; 3) patients subjected to proximal exclusion of the main artery; and 4) patients with multiple and familial forms of the pathology. Dynamic angiographic follow-up (SCT angiography or magnetic resonance angiography) for 1-3 years is recommended for these patients.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2015
[Results of motor cortex stimulation in the treatment of chronic pain syndromes].
The article is aimed to demonstrate our experience in motor cortex stimulation (MCS) in patients with chronic neuropathic pain syndromes, assess the clinical efficacy of the technique in short-term and long-term follow-up, and analyze potential predictors of the MCS efficacy. ⋯ Chronic epidural MCS is an effective and safety method for the treatment of some chronic neurogenic medically-refractory pain syndromes. Further research is necessary to specify the patient selection criteria and the MCS efficacy predictors.