Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
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Zh Vopr Neirokhir Im N N Burdenko · Jul 2000
[Diffusion-weighted image in the study of brain tumors and peritumoral edema].
The informative value of the technique of diffusion-weighted images (DWI) and diffusion maps was studied in diagnosing supratentorial tumors of the brain. Sixty four patients were examined. Among them there were 35 patients with glial brain neoplasms of varying malignancy [benign astrocytomas (asc) in 15 patients, anaplastic asc in 10, and glioblastomas in 10)], 15 patients with meningiomas, 5 with hydrocephalus, 9 with cerebral circulatory disorders. ⋯ Meningiomas had a greater MR signal in response to DWI and low ADC values [(0.97 +/- 0.17) x 10(-3) mm2/sec]. Particular emphasis is laid on the study of different types of brain edema. ADC in the area of vasogenic (peritumoral), cytotactic (ischemic), and interstitial edema was (1.30 +/- 0.11) x 10(-3), (1.04 +/- 0.05) x 10(-3), and (1.91 +/- 0.1) x 10(-3) mm2/sec, respectively (p < 0.05) and sharply distinct in ADC maps.
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Zh Vopr Neirokhir Im N N Burdenko · Apr 2000
Comparative Study[An epileptic syndrome in patients with the sequelae of gunshot craniocerebral wounds].
To study the specific features of the epileptic syndrome after present-day gunshot cranial wounds (GCW), as well as risk factors of its occurrence, 56 victims were examined prospectively (within at least a year after their admission). The epileptic syndrome developed in 18 (32.1%) patients within 1 to 15 months following GCW; there were prevalent generalized convulsive (in 13 of the 18 patients) and focal (in 12 of the 18 ones) seizures. ⋯ As compared to other patients, epileptics were more commonly found to have: 1) frontoparietal lesion; 2) multiple bony defects of the vault of the skull; 3) enlargement of the lateral ventricle of the brain on CT scans; 4) primary coma for > 2 hours and other depressed consciousness syndromes for > 1 day; 5) signs of left-handedness. The findings suggest that there is a need for studies of the functional asymmetry of the brain to gain a better insight into the problem.
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Zh Vopr Neirokhir Im N N Burdenko · Apr 2000
[The surgical treatment of traumatic dislocations of the cervical spine].
Thirty patients with injury-induced complete and incomplete dislocations and of the cervical vertebral column were operated on. New and old dislocations (up to 28 days) were managed by the open reduction and stabilization of an injured segment by a two-vane monolithic corundum ceramic endoprosthesis. If there was a significant stability of the injured segment and if temporary external fixation could not be applied, C-shaped braces providing effects of thermomechanical shape memory were used. In old injury, corporectomy was performed by means of anterior wedging corporodesis with an autogenous bone graft or implants made from porous nickelled titanium.
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Zh Vopr Neirokhir Im N N Burdenko · Jan 2000
[The characteristics of epidural analgesia during the removal of lumbar intervertebral disk hernias].
Epidural analgesia (EA) was used in 29 patients undergoing surgical removal of lumbar discal hernia. Marcain EA with controlled medicinal sleep and non-assisted breathing allowed to perform the whole operation in 27 patients. EA may be ineffective in combination of sequestrated disk hernia with scarry adhesive process. The technique of the operation demands a single use of the anesthetic drug which is potent enough to make blockade throughout the operation up to the end.