Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Apr 2004
[Differential approach to the application of hyperventilation in acute period of severe brain injury in relation to cerebral circulation].
Seventeen patients with severe brain injury (Glasgow-8 Coma Scale 3-8 scores) complicated by traumatic subarachnoidal hemorrhage and severe cerebral hemodynamic disorders (hyperemia, vasospasm) were examined. Hyperventilation was performed in different phases of cerebral circulation under multiparametrical monitoring (intracranial pressure, cerebral perfusion pressure, jugular oximetry, Doppler study using the carotid compression test). ⋯ The application of hyperventilation to eliminate intracranial hypertension in vasospasm leads to a temporary reduction in intracranial pressure, but simultaneously causes cerebral circulatory changes that do not correspond to cerebral oxygen demands, as well as lowered cerebral perfusion pressure, which increases a risk for ischemic brain tissue lesion. This requires a strict rationale for the use of hyperventilation and for multiparametrical monitoring of cerebral functions, which includes jugular oximetry, Doppler transcranial study, and measurement of intracranial pressure throughout the hyperventilation period in order to prevent secondary brain lesion.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2004
Case Reports[Massive pulmonary artery thromboembolism after removal of sphenoid wing meningioma (clinical case with good outcome)].
The paper describes a clinical case of the severe potentially fatal postoperative complication--massive pulmonary thromboembolism--in a patient after uncomplicated removal of meningioma of the wing of os basilare. It also describes the problems in the diagnosis, treatment, prevention of perioperative deep venous thrombosis of the shin and subsequent pulmonary thromboembolism in neurosurgery patients.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2004
Clinical Trial[Percutaneous laser denervation of the zygapophyseal joints in the pain facet syndrome].
Percutaneous laser denervation of archoappendicular joints in spinal pain was made in 15 patients from a study group. Percutaneous high-frequency denervation of archoappendicular joints was performed in a control group consisting of 15 patients with facet syndrome. A preoperative protocol for each patient included at least two diagnostic segmental blocks. ⋯ The similar results were obtained in the control group. There were no postoperative infectious complications in the patients of both groups; transient pain dysesthesia was registered in one case. The findings have led to the conclusion that laser denervation of archoappendicular joints is effective in the pain facet syndrome.
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Zh Vopr Neirokhir Im N N Burdenko · Apr 2003
Review Case Reports[Primary meningioma of the ventricle IV].
A clinical observation of a rare neurosurgical pathology, i.e. meningioma growing in the cavity of ventricle IV, is reported. The female patient underwent a surgery of tumor eradication. Issues related with diagnostics, treatment tactics and disease prognostication are discussed on the basis of literature survey. Practical recommendations on treatment tactics are provided with regard for the discussed published data and the mentioned clinical case.