Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
-
Zh Vopr Neirokhir Im N N Burdenko · Jan 2016
[Spinal cord stimulation in the treatment of chronic pain syndromes].
The study objective was to estimate the efficacy of chronic epidural spinal cord stimulation in the treatment of patients with neuropathic pain syndrome. ⋯ Chronic epidural spinal cord stimulation is an effective and safe technique for the treatment of drug-resistant chronic neurogenic pain syndromes.
-
Zh Vopr Neirokhir Im N N Burdenko · Jan 2016
[Diffusion tensor imaging tractography and intraoperative neurophysiological monitoring in surgery of intracranial tumors located near the pyramidal tract].
Practical application of methods for intravital examination of the brain pathways, such as preoperative diffusion tensor imaging (DTI) tractography and intraoperative neurophysiological monitoring, facilitates safer resection of intracranial tumors located near the pyramidal tracts (PTs). ⋯ 1. Patients with an infiltrated or displaced pyramidal tract had significantly more often hemiparesis before surgery and aggravation of hemiparesis after the surgery compared to patients with an intact tract. 2. In the case of direct electrical stimulation of the PT, motor responses (according to preoperative DTI tractography) were significantly more often observed for the pyramidal tract infiltrated and displaced by the tumor. 3. A reduction in the motor neurologic deficit in the postoperative period was significantly more often observed for application of a larger current strength during direct electrical stimulation. 4. Persistence of the TCMEP amplitude during surgery is a reliable predictor for no aggravation of the motor neurological deficit after surgery. Postoperative aggravation of hemiparesis was significantly more often observed when TC MEPs decreased during surgery.
-
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.
-
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.
-
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.