Russian journal of neurosurgery最新文献

{"title":"Isthmic spondylolisthesis: the current state of the problem","authors":"B. R. Kinzyagulov, V. Lebedev, A. Zuev","doi":"10.17650/1683-3295-2022-24-4-101-10","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-101-10","url":null,"abstract":"Isthmic spondylolisthesis is a common pathology in the population, often diagnosed in people of working age. On the issues of etiopathogenesis, as well as the classification of this pathology, researchers have no consensus. Currently, the literature provides different opinions on clinical features, evaluation, and treatment tactics. The presented work includes current information from the world literature on the etiology, classification, clinics, diagnostics, and treatment of patients with isthmic spondylolisthesis.The purpose of the work is to present current information from the world literature on the features of etiology, classification, clinic, diagnosis, treatment of patients with isthmic spondylolisthesis.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129922849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical case of a combined approach to restoring post-traumatic deformation of the bones of the arch and base of the skull, bones of the middle zone of the face","authors":"V. Komar, T. M. Yaroshchik, O. Dudich, K. V. Andryuk, A. A. Vecherskaya","doi":"10.17650/1683-3295-2022-24-4-67-72","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-67-72","url":null,"abstract":"Background. The article is extremely relevant due to growing traumatism, current condition of craniofacial traumatology, debatable and incomplete tactics of restoring traumatic defects and deformations of bones of the skull and face. Plastic surgery of the skull defects has developed from simple defect closure to restoring an aesthetically attractive area of the skull, which shape repeats the individual structure of the area lost due to trauma or surgical treatment (trepanation surgery, osteoplastic trepanation, treatment of a depressed skull fracture, etc.). To restore the defects specialists use auto‑ and allografts. In recent years, materials to manufacture implants are simulated using a 3D‑shape.Aims. To describe the clinical case of a combined approach for the restoration of post‑traumatic deformation of the bones of the arch, base of the skull and bones of the middle zone of the face. To show the importance of multidisciplinary teams in providing assistance to this group of patients, as well as the use of individual 3D simulated titanium plates for reconstructive operations. Emphasize the need to perform reconstructive operations as soon as possible.Materials and methods. Patient Sh., 43 years old, was admitted to the neurosurgical department of the City Clinical Emergency Hospital (Minsk), in the long term severe traumatic brain injury, with defects of the arch and base of the skull and deformation of the bones of the facial skull on the left. Titanium implants were modeled on a 3D printer, which were used during the operation performed by a multidisciplinary team consisting of a neurosurgeon, maxillofacial surgeon and ophthalmologist‑surgeon. Us for closing defects in the cranial vault, the bottom wall of the orbit and in eliminating deformation skeleton midface line. Titanium implants are made by specialists of Medbiotech SP LLC, Minsk, Republic of Belarus.Results. The late postoperative period proceeded without peculiarities, the wounds healed by primary tension. Post-operative CT showed that the condition of the implants is satisfactory.Conclusion. This clinical observation demonstrated the need for a multidisciplinary approach, as well as the priority in using 3D simulated titanium implants to restore post‑traumatic deformation of the bones of the arch and base of the skull and midline bones.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131549120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic lavage of the cerebral ventricular system for ventriculitis treatment in a patient with complicated new coronavirus infection (COVID‑19)","authors":"K. E. Poshataev, D. L. Paskhin, A. M. Dorodov, R. V. Zabolotnyy, S. Mironov, P. V. Kuzmin, A. Avdalyan, E. Shtemplevskaya","doi":"10.17650/1683-3295-2022-24-4-73-83","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-73-83","url":null,"abstract":"Introduction. The new coronavirus infection (COVID‑19) has a wide spectrum of complications. Frequency of neurological symptoms varies between 17.3 and 36.4 %. In 8 % of cases, COVID‑19 can be accompanied by bacterial or fungal infection. Since few descriptions of bacterial meningitis in adult patients with COVID‑19 and a single description of surgical treatment of purulent meningitis complicated by empyema of the 4th ventricle in a patient with COVID‑19 were found, and there are no meta‑analyses in this area, descriptions of such cases are of high scientific and practical value.Aim. The describe a case of surgical treatment of purulent ventriculitis in an adult (during treatment of the new coronavirus infection COVID‑19).Materials and methods. A man, 69 years old, with previously established diagnosis of the new coronavirus infection COVID‑19 and a comorbid pathology was admitted to the Moscow City Clinical Hospital No. 40 with newly diagnosed seizure disorder. Computed tomography imaging showed ventriculitis confirmed by MRI with obstructive hypertensive triventricular hydrocephalus.Results. The patient underwent treatment: three‑time endoscopic lavage of the ventricular system, removal of newly formed fibrin membranes with interventricular septostomy, removal of obstruction at the level of the Sylvian aqueduct; the surgery was concluded by external draining of the lateral ventricles, administration of an antibiotic intro the ventricular system and intravenously. Cerebrospinal fluid flow was restored, ventriculitis manifestations completely negated.Conclusion. Development of ventriculitis as one of the first signs of bacterial infection accompanying COVID‑19 is a very rare and life‑threatening complication requiring active surgical intervention. In was shown that endoscopic lavage of the ventricular system for ventriculitis treatment is an effective action against infection and cerebrospinal fluid flow disorders. Use of intraventricular endoscopy for ventriculitis treatment has several advantages compared to needle ventriculostomy. Further studies and analysis of treatment of bacterial ventriculitis using endoscopic surgical techniques in patients with and without the new coronavirus infection are needed.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"&NA; 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126019434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary","authors":"Иван Михайлович Годков","doi":"10.17650/1683-3295-2022-24-4-84","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-84","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127555878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of cerebrovascular diseases in a hybrid operating room","authors":"A. V. Sergeev, V. Cherebillo, A. Savello, F. Chemurzieva","doi":"10.17650/1683-3295-2022-24-4-12-21","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-12-21","url":null,"abstract":"Background. Surgical treatment of complex neurovascular pathology remains an important problem requiring use of a combination of various techniques. Utilization of a hybrid operating room allows to simultaneously or sequentially combine microsurgical and endovascular surgical methods which can improve treatment outcomes.Aim. To improve surgical treatment of patients with cerebrovascular pathology by utilizing the capabilities of a hybrid operating room.Materials and methods. Surgical interventions were performed in a hybrid operating room with a combination of endovascular and microsurgical methods for treating the following cerebrovascular pathologies: complex dural fistulas, complex aneurysms, arteriovenous malformations. The type of surgical intervention – hybrid, combined, staged – was chosen in accordance with the nature of the pathology.Results. In 5 years, 41 patients underwent surgery in the hybrid operating room. Among them, 33 patients had arteriovenous malformations, 6 had complex aneurysms, 2 had complex dural fistulas. Combination interventions were performed in 27 patients, staged – in 12, hybrid – in 2. According to the Modified Rankin Scale (mRS) the following outcomes were observed: no complications in cases of complex aneurysms (6 patients) – mRS 0 (points), as well as in cases of dural fistulas (2 patients) – mRS 0 (points); in arteriovenous malformation, 30 patients did not have any complications – mRS 0; 3 patients had complications (of different types) – mRS 1.Conclusions. The combination of microsurgical and endovascular methods of treatment in a hybrid operating room allows to combine the positive features of the two methods in accordance with surgical needs which improves the outcomes of neurosurgical interventions in complex neurovascular pathology.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134513883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic navigation during brain tumor surgery: analysis of a series of 403 patients","authors":"S. Goryaynov, A. Potapov, V. Okhlopkov, A. Batalov, R. Afandiev, A. Belyaev, A. Aristov, T. A. Caveleva, V. Zhukov, V. Loshchenov, D. Gusev, N. E. Zakharova","doi":"10.17650/1683-3295-2022-24-4-46-58","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-46-58","url":null,"abstract":"Introduction. Metabolic navigation with 5‑ALA is one of methods for intraoperative imaging in neuro‑oncology.Aim. To perform a comparative analysis of sensitivity of metabolic navigation with 5‑ALA during surgery of primary and secondary brain tumors of various histological nature and degree of malignancy.Materials and methods. During the period from 2013 to 2020, our group have performed surgery to 403 patients using metabolic navigation: microsurgical resections were performed in 384 people with brain tumors, 220 of them were with glial tumors, 101 were with intracranial meningiomas, 63 were with metastatic brain damage. Among patients with metastases, 39 patients had a solitary injury, 16 had a multi‑focal injury, so 72 cases of metastatic nodes were considered in this group. Stereotactic biopsies with 5‑ALA‑assistance were performed in 19 people. Metabolic navigation was performed with the drug 5‑ALA, which was taken orally at a dose of 20 mg/kg 2 hours before surgery. Intraoperative fluorescence was evaluated using microscope with a fluorescent module.Results. Metabolic navigation using microscope has a high sensitivity when employed during microsurgery (including repeated implementation of surgery) in cases of anaplastic gliomas (65 % in total, 58 % with bright glow), glioblastomas (94 % in total, 53 % with bright glow), intracranial meningiomas (94 % in total, 64 % – with bright glow). The use of 5‑ALA has significant limitations in sensitivity in cases of diffuse gliomas (46 % – in total, 27 % – with bright glow) and brain metastases (in total 87 % – for the solid part, 52 % – for the bed, with bright glow – 51 %). In diffuse gliomas, the glow areas had significantly higher proliferative index and cell nuclei density than the fluoronegative zones. Among the most important factors affecting the glow of gliomas it can be noted: the status of the IDH1 mutation, the volume of the contrasting part of the glioma according to MRI data, the methionine accumulation index according to positron emission tomography, the tumor blood flow indicators according to the arterial spin marking method – ASL perfusion.Conclusions. Implementation of 5‑ALA navigation with the use of microscope provides high sensitivity in cases of glioblastomas, anaplastic gliomas (especially for detecting of non‑contrasting part of tumor that is not visually altered in the white light of operating microscope) and brain meningiomas. The method is less effective in low‑grade gliomas and intracranial metastases.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130908446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of safe posterior C1–2 transarticular screw fixation: CT morphometric study","authors":"I. Lvov, A. Grin, A. Talypov, S. Y. Roshchin, V. A. Sharifullin, Z. Barbakadze, E. E. Alekhin, A. V. Tupikin, E. A. Sosnovskiy, R. A. Nikogosyan, D. A. Talypova, N. B. Zhadova, O. A. Minkina, D. V. Shmeleva, L. T. Khamidova","doi":"10.17650/1683-3295-2022-24-4-59-66","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-59-66","url":null,"abstract":"Background. C1–2 transarticular fixation according to the F. Magerl technique is one of the most reliable methods of C1–2 screw stabilization. An important aspect of the precise placement of implants during transarticular fixation under X‑ray control is the use of correct selection of start‑ and end‑points of the installation trajectory. At certain values of the height and width of C2 isthmus some screw installation trajectories may be accompanied by a zero probability of vertebral artery damage that might be due to the screw malposition.Aim. To evaluate CT morphometric characteristics of the C2 vertebra to assess the possibility of safe C1–2 transarticular fixation.Materials and methods. The analysis performed was based on the data obtained from 7672 patients having admitted with suspected injury to the N.V. Sklifosovsky Research Institute of Emergency Medicine during the period from 01.01.2019 to 31.07.2019. The study involved 6 neurosurgeons and 6 medical doctors of the X‑ray diagnostics department. The measurements were carried out in 2 stages. Each parameter (isthmus height – IsthH, isthmus width – IsthW, lateral mass height – LmH) was measured 2 times. In case of high intraclass correlation, the mean value of the measurements was calculated, which was included in the final analysis.Results. The intraclass correlation coefficient for all measurements approached an excellent correlation values and was 0.852 (95 % CI 0.844–0.860). Morphometric characteristics were calculated basing on data from 795 patients. The IsthH value was 7.45 ± 1.66, IsthW – 8.56 ± 1.48, LmH – 5.56 ± 1.84 mm. In men, the transarticular fixation was significantly more likely to be performed without injury of the vertebral artery (in 66.1 % of cases; χ2‑test, p <0.000001), whereas in women – only in 29.9 % of cases.Conclusions. The results obtained suggest that percutaneous bilateral transarticular fixation with the use of posterior spinolaminar point and middle of the atlas anterior arch as landmarks potentially serves as a method of choice in 88.3 % of patients. Of all patients with normal anatomy of C2 isthmus, men are twice more likely to undergo transarticular fixation without damage of vertebral artery than women, the probability exceeds 66 %. However, the risk of injury of this blood vessel in other patients does not exceed 2.3 %, which is comparable with outcomes of other methods of C1–2 screw stabilization.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123476457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radicality of lateral ventricular neoplasms removal and risk factors of postoperative hemorrhagic complications","authors":"S. Maryashev, G. Danilov, Y. Strunina, A. I. Batalov, Y. Vologdina, I. Pronin, D. Pitskhelauri","doi":"10.17650/1683-3295-2022-24-4-32-45","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-32-45","url":null,"abstract":"Introduction. Lateral ventricular neoplasms (tumors, vascular neoplasms, cysts) are rare and according to different sources comprise between 0.64 and 3.5 % of all brain tumors. Due to relatively slow growth, tumors can reach significant size before patient develops neurological symptoms. Surgery is the main method of treatment of lateral ventricular neoplasms, and in many cases radical removal can be achieved. The main complications after surgery are hydrocephalus and hemorrhages. The later frequently lead to escalation of neurological symptoms and sometimes require repeat surgical intervention. The success of intraventricular surgery consists of reasonable radicality and absence of complications.Aims. To evaluate the radicality and safety of lateral ventricular tumor removal through traditional approaches–transcallosal and transcortical – using arterial spin labeling (ASL perfusion) and to analyze the risk of hemorrhagic complications in the early postoperative period in the context of tumor location and blood supply.Materials and methods. At the N.N. Burdenko National Medical Research Center of Neurosurgery between 2017 and 2019 48 patients with space‑occupying lesions of the lateral ventricles were examined and treated with surgery. All patients were examined using the same MRI protocol before and after surgery: Т1‑weighted, Т1‑weighed contrast‑enhanced, 3D SPGR, Т2‑weighted, Т2‑FLAIR, DWI, T2‑FLAIR CUBE, SWAN, ASL perfusion. In 28 (58 %) cases, transcortical approach was used (through the frontal lobe in 24 cases, through the upper temporal lobe in 2 cases, through the parietal lobe in 2 cases); transcallosal approach was used in 16 (33 %) cases; combination approach (for advanced tumors of the lateral ventricles) was used in 3 (6 %) cases; supracerebellar infratentorial approach was used in 1 (2 %) case. Radicality of lateral ventricular tumor removal and risk factors for postoperative hemorrhagic complications using different approaches were evaluated based on the following parameters: tumor volume and location, sex, blood flow characteristics, presence of hydrocephalus.Results. In the compared groups I and II, similar rates of radical tumor removal were observed: 63 % for transcortical approach and 71 % for transcallosal approach. Hematomas in the tumor bed were more frequently observed in patients operated through transcortical approach (64 % vs. 31 % in transcallosal) without statistical significance. Generally, there were no statistically significant differences between surgical treatment results in groups I and II (p >0.05); this conclusion was confirmed in pseudo‑randomized patient subgroups selected through propensity score matching. Analysis of the association between hematoma in the postoperative period and baseline blood flow level showed that in the group with such hematomas mean tumor blood flow prior to surgery was almost twice as high as in the group without hemorrhagic complications after resection (80.6 vs. 49.4 ml/100 g/min","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122007399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of adenoid cystic carcinomas of sinonasal localization","authors":"D. S. Spirinrin, I. Reshetov, V. Cherekaev, I. Chernov, G. Kobyakov, A. Golanov, M. Tlisova, A. Donskoy, E. Vetlova, V. Ivanov, P. Kalinin","doi":"10.17650/1683-3295-2022-24-4-22-31","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-4-22-31","url":null,"abstract":"Background. Tumors of the sinonasal region represent a large group of both benign and malignant formations affecting the nasal cavity, paranasal sinuses, structures of the anterior and middle cranial pits of the base of the skull.Aim. Evaluation of the results of surgical treatment of patients with adenoid cystic carcinomas of sinonasal localization treated in the period from 2007 to 2021.Material and methods. The present study is a retrospective analysis of the results of surgical treatment of patients with adenoid cystic cancer of the base of the skull operated at the N.N. Burdenko National Medical Research Center of Neurosurgery in the period from 2007 to 2021.Results. The radicality of tumor removal was assessed based on an MRI analysis performed no earlier than 3 months after surgery. Total (95–100 %) tumor removal was achieved in 8 (25 %), subtotal (80–95 %) in 15 (46.9 %), partial (50–80 %) in 5 (15.6 %) patients; extended biopsy was performed in 4 (12.5 %) cases. At the same time, total and subtotal removal was more often achieved with open surgery, which was due to the topographic and anatomical features of the location of tumors.Discussion. In this paper, we present an analysis of the results of treatment of 32 patients with adenocystic cancer of sinonasal localization.The main method of treatment is an integrated approach – radical surgical resection of the tumor together with adjuvant radiation therapy. Surgical treatment is aimed at the maximum possible resection of pathological tissues to prevent recurrence of the disease.One of the most common approaches is transfacial with or without bifrontal craniotomy, which includes craniofacial resection.Conclusion. Adenoid cystic carcinoma is an aggressive malignant tumor that requires a comprehensive approach to treatment. Important factors that positively affect the results of treatment are the conduct of chemoradiation treatment and the age of patients, as well as the initial stage of the disease at which treatment was initiated, which necessitates strengthening dispensary monitoring and raising awareness of the population about the possibility of developing such diseases for timely access to a doctor.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132519833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of distal cerebral aneurysms","authors":"I. Senko, V. Krylov, V. Dashyan, I. Grigoriev","doi":"10.17650/1683-3295-2022-24-3-12-22","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-12-22","url":null,"abstract":"Background. Distal cerebral aneurysms are very rare. To date, there are very few publications on distal cerebral aneurysms and they are mostly limited to clinical case series.Aim. To analyze anatomical characteristics of distal cerebral aneurysms and surgical outcomes, as well as to identify risk factors for a poor outcome and develop a treatment algorithm on this basis; to determine the role of neuronavigation and revascularization in the surgical treatment of distal cerebral aneurysms.Materials and methods. We performed a retrospective analysis of surgical outcomes of 153 patients with distal cerebral aneurysms treated in N.V. Sklifosovsky Research Institute for Emergency Medicine (Moscow Healthcare Department) between January 1, 2000 and December 31, 2019.Results. Distal cerebral aneurysms were identified in 4.5 % cases of all cerebral aneurysms; 81.7 % of patients with distal cerebral aneurysms were admitted to the hospital with ruptured aneurysms. The most frequent locations of distal cerebral aneurysms were pericallosal and middle cerebral arteries. Distal cerebral aneurysms were usually small (77.5 %), had a wide neck (31.8 %), and fusiform structure (15.7 %). Aneurysm clipping was performed in 74.5 % cases; parent artery trapping, in 23.5 % of patients; revascularization, in 5.9 % of patients. The main risk factors for a poor outcome included aneurysm size and location, patient grade on the modified scale of the World Federation of Neurosurgical Societies (mWFNS), and presence of severe vasospasm.Conclusion. The developed surgical algorithm for distal cerebral aneurysms (based on the assessment of a poor outcome risk factors, the use of neuronavigation, arterial patency control, and revascularization) could improve surgical outcomes of patients with distal cerebral aneurysms.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115747944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}