Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko最新文献

{"title":"[Surgical treatment of posthemorrhagic hydrocephalus in premature infants].","authors":"E A Bogoslovskaya, S K Gorelyshev, U V Tomale, A Yu Akimov, A V Alekseev, K A Bardeeva, V V Demyanenko, S S Zolotarev, S A Kirsanov, K A Kovalkov, I I Larkin, S B Medoev, R M Pankratiev, D R Pogosova, A V Seliverstov, A S Sukharev, A G Timershin, O A Usatova, E F Fatykhova, A S Shapovalov","doi":"10.17116/neiro2025890417","DOIUrl":"https://doi.org/10.17116/neiro2025890417","url":null,"abstract":"<p><strong>Rationale: </strong>Hydrocephalus as a consequence of intraventricular hemorrhage (IVH) in premature infants is a life-threatening complication of the neonatal period. The question remains as to which methods are best to be used for temporary drainage of cerebrospinal fluid until sufficient body mass for possible shunt implantation is achieved.</p><p><strong>Objective: </strong>Is to compare four methods of temporary treatment of posthemorrhagic hydrocephalus in terms of their safety and effectiveness.</p><p><strong>Material and methods: </strong>A multicenter (12 healthcare facilities of the Russian Federation) prospective study included 165 premature infants with IVH and signs of worsening enlargement of the ventricles. External ventricular drainage (EVD) was used in 43 observations, ventriculosubgaleal shunt (VSGS) in 93 observations, neuroendoscopic lavage (NEL) in 25 observations and Ommaya reservoir - in 4. Methods were compared by effectiveness and postoperative complications. The examination of patients in catamnesis was carried out at the age of 6, 12, 24 and 36 months.</p><p><strong>Results: </strong>Differences regarding brain tissue defect in the access zone (the highest in the NEL group and the lowest in EVD group, <i>p</i><0.001); multilocular hydrocephalus frequency (the highest in the EVD group - 33% and the lowest in the NEL group - 17%, <i>p</i><0.05); proportion of patients in need of permanent shunting (the highest indicator in the VSGS group - 88.1% and the lowest in the NEL group - 57%, <i>p</i><0.001); number of infectious complications (most of all in the EVD group - 12%, the lowest in the NEL group - 0%) have been revealed. The best indicators of children's motor development have been noted in the NEL group (2.25), the worst in the EVD group - 3.75. Long-term mortality in the distant period amounted to 7%.</p><p><strong>Conclusion: </strong>The most effective method of temporary arresting of hydrocephalus is neuroendoscopic lavage. It has a minimal number of infectious and other complications, the best hydrocephalus stabilization, low percentage of complicated hydrocephalus (multilocular) and the best motor development indicators and does not require reinterventions.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"7-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972035","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":"[Glymphatic system in health and disease: a narrative review].","authors":"A R Grishina, O M Vorobyova, I A Danilova, L B Mitrofanova","doi":"10.17116/neiro202589041112","DOIUrl":"https://doi.org/10.17116/neiro202589041112","url":null,"abstract":"<p><p>The main functional parts of the glymphatic system are perivascular spaces and surrounding astrocytes. Cerebrospinal fluid enters the brain parenchyma from subarachnoid cisterns through perivascular Virchow-Robin spaces and passes into the interstitium through aquaporin channels in astrocytes. Then, cerebrospinal fluid removes metabolic products and mixes with interstitial fluid. Outflow of cerebrospinal fluid with metabolic products from the brain parenchyma occurs in three ways. The first route is periarterial through intermuscular spaces in the middle layer of cerebral arteries. The second route is perivenous. The third route is lymphatic through meningeal or sinus-associated lymphatic vessels. They provide drainage of macromolecules and immunocompetent cells from the brain to the cervical lymph nodes. Gliomas are accompanied by inhibition of normal cerebrospinal fluid outflow pathways, mainly due to additional intracranial tissue, and compensatory cerebrospinal fluid outflow along the spinal cord. Reduced cerebrospinal fluid release with impaired outflow contribute to accumulation of toxic metabolic products, proinflammatory cytokines and chemokines. Transport of antigens to lymph nodes is inhibited that disrupts antitumor immunity. Impaired cerebrospinal fluid circulation also reduces the effectiveness of intracranial drug delivery. One of the mechanisms of pathogenesis of glioma metastasis is based on migration of tumor cells along classical and meningeal lymphatic pathways. Damage to the latter contributes to metastasis.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"112-118"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972038","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":"[Review of the book by A.A. Skoromets, A.V. Amelin, E.R. Barantsevich, I.A. Voznyuk, A.P. Skoromets, T.A. Skoromets, V.A. Sorokoumov, N.V. Shuleshova Cerebral Angioneurology, ed. by Academician of the Russian Academy of Sciences Yu.A. Shcherbuk: in 2 vols. St. Petersburg: Polytechnic; 2024].","authors":"G E Chmutin","doi":"10.17116/neiro202589041127","DOIUrl":"https://doi.org/10.17116/neiro202589041127","url":null,"abstract":"<p><p>Review of the book by A.A. Skoromets, A.V. Amelin, E.R. Barantsevich, I.A. Voznyuk, A.P. Skoromets, T.A. Skoromets, V.A. Sorokoumov, N.V. Shuleshova Cerebral Angioneurology, ed. by Academician of the Russian Academy of Sciences Yu.A. Shcherbuk: in 2 vols. St. Petersburg: Polytechnic; 2024.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972044","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":"[Aptamer-based conjugated molecules in experimental and clinical approaches to treatment of glioblastoma].","authors":"G L Kobyakov, G V Pavlova, A M Kopylov, T S Bezbabicheva, D Yu Usachev","doi":"10.17116/neiro20258906244","DOIUrl":"10.17116/neiro20258906244","url":null,"abstract":"<p><p>Glioblastoma is the most common primary malignant tumor of nervous system and one of the most incurable human tumors. The median of overall survival is 16-17 months after comprehensive treatment. Among various difficulties for new therapeutic approaches, we should emphasize the blood-brain barrier complicating delivery of anti-cancer drugs to neoplasm and perifocal area. A promising approach is aptamer molecules as synthetic amino acid analogs capable of interacting and regulating activity of target proteins based on their spatial structural interactions. Aptamers possess high specificity and affinity to various receptors on cell surface and inside its structures if they penetrate cell membrane. In this review, we present various approaches to development of aptamer-based drugs against glioblastoma. Kopylov A.M. et al. synthesized a series of aptamers targeting EGFR and capable for delivery of toxic agents to tumor cells. Important clinical successes include the results of NOX-A12 drug and data on combined drugs based on trastuzumab in patients with metastatic breast cancer. NOX-A12 is an aptamer blocking <i>CXCL-12</i> gene and reducing resistance to irradiation of glioblastoma cells. Furthermore, very high control of breast cancer brain metastases in HER-2 positive cases was demonstrated for trastuzumab-emtansine and trastuzumab-deruxtecan. The last finding indicates the perspective for aptamer targeting glioblastoma tumor cells in conjugation with emtansine or deruxtecan.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 6. Vyp. 2","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960385","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":"[TERTp mutation screening using digital droplet PCR of collection of 52 paired DNA samples from blood plasma and tumor tissue in patients with glioblastoma].","authors":"T N Hasanau, E K Pisarev, A V Sergeev, S F Drozd, S A Pavlova, D Yu Panteleev, G V Pavlova, I N Pronin, M E Zvereva","doi":"10.17116/neiro20258905187","DOIUrl":"https://doi.org/10.17116/neiro20258905187","url":null,"abstract":"<p><strong>Objective: </strong>To test the possibility of creating a non-invasive system for differential diagnosis and molecular-genetic characterization of tumor lesions of the CNS based on the determination of mutations of promoter of telomerase (<i>TERTp</i>) C228T and C250T catalyst subunit through the example of glioblastoma.</p><p><strong>Material and methods: </strong>The collection of blood plasma samples and tissues of freshly frozen tumor samples was obtained in pairwise correspondence from 52 patients, who were treated in NMRC of Neurosurgery named after Academician N.N. Burdenko in 2022-2023. The digital droplet PCR (ddPCR) method using fluorescently labeled TaqMan probes was used for absolute quantification of C228T and C250T <i>TERTp</i> mutations in DNA samples extracted from the collection by commercial kits. The analysis of ddPCR data was performed with a baseline depending on the level of control reaction signal without adding a DNA matrix.</p><p><strong>Results: </strong>Analysis of the sample of 52 patients' paired DNA (plasma-tissue) has shown the presence of C228T and C250T mutations in tumor samples: C228T was found in 33 cases (63.5%), and C250T in 14 cases (26.9%). In samples of cell-free DNA (CFDNA), 5 samples with C228T mutation and 3 samples with C250T mutation were found. C228T mutation was found in 15.1% and C250T mutation - in 21.4%.</p><p><strong>Conclusion: </strong><i>TERTp</i> mutations, specific for tumor DNA of glioblastomas, are determined by ddPCR in both the tumor sample and the CFDNA of the blood plasma, which indicates the transition of tumor DNA into the circulating (ctDNA) and that the ctDNA passes through the blood-brain barrier (BBB) of patients. The possibility of non-invasive molecular genetic characterization of tumor lesions of the CNS in blood plasma of patients with glioblastoma has been tested. The obtained results' analysis shows the need to optimize the extraction of CFDNA and modify the testing system to improve the method's effectiveness.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 5","pages":"87-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303699","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":"[Pilocytic astrocytomas with aggressive clinical course: a single-center experience].","authors":"Yu M Poluektov, D Yu Usachev, N A Konovalov, D S Kim, I N Pronin, G V Pavlova, N I Bychkovsky","doi":"10.17116/neiro20258906229","DOIUrl":"10.17116/neiro20258906229","url":null,"abstract":"<p><p>Pilocytic astrocytomas (PA) are benign CNS tumors with high 5- and 10-year survival rates. Data on aggressive course of PA have occurred since the late 20th century. The purpose of this study was to summarize data on patients with aggressive course of PA. We analyzed own patients with conventional PA, PA with aggressive clinical course and literature data on HGAP. Aggressive group is highly heterogeneous without significant differences in anatomical location between groups. Patients with aggressive course and HGAP were older (M=41, 45.5, and 34 years). Overall 5-year survival in patients aggressive PA was 45%, while no deaths were recorded in the group of conventional PAs. Signs of anaplasia according to histological data and Ki-67 index >8 distinguish conventional PA and tumors with aggressive course. Next-generation sequencing and methylation profiling will improve detection of HGAP.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 6. Vyp. 2","pages":"29-37"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960415","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":"[Hypofractionated irradiation for intracranial meningiomas].","authors":"M V Galkin, A V Golanov, N A Antipina, G V Danilov, A V Kozlov","doi":"10.17116/neiro20258906221","DOIUrl":"10.17116/neiro20258906221","url":null,"abstract":"<p><p>Hypofractionated irradiation of meningiomas is a relevant fractionation regimen that occupies an intermediate position between radiosurgery and standard fractionation. This study analyzed the experience with this regimen in the Radiotherapy Department of the Burdenko National Medical Research Center of Neurosurgery to evaluate the method's efficacy and safety. A retrospective analysis included patients who underwent radiation therapy between 2017 and 2020. The study included 73 patients. The median age was 56, and the male-to-female ratio was 1:5. Nine patients were diagnosed with schwannomatosis (neurofibromatosis type 2), and 12 had multiple meningiomas. A total of 94 meningiomas were treated with hypofractionation in regimens of 3 and 5 fractions. Twenty eight tumors (29.8%) were previously verified as WHO grade 1 (25) and grade 2 (3). The median target volume was 5.6 cm³ (range 0.2 to 28.9 cm³). Data for analysis were available for 60 patients with 80 tumors, which did not differ significantly in baseline characteristics from the entire group. The local 3-year and 5-year control rate for meningiomas was 95%. Local control did not differ between sporadic tumors and those associated with schwannomatosis and multiple meningiomas. Tumor control was not influenced by volume, number of fractions, dose, treatment platform, histological verification status, or tumor location (skull base vs. convexity). Radiation reactions within 12 months after treatment were detected in 5 tumors (6.3%). The presence of pre-existing peritumoral edema significantly increased the risk of radiation reactions to 60%. A reduction in meningioma size was observed in 61.3% of cases. The median tumor volume reduction was 37% (range 8-84%). This study identified 2 cases (2.5%) of radiation-induced pathomorphosis in the form of appearance and prolonged existence/progression of cysts, which is generally an uncharacteristic clinical course for meningiomas. Thus, hypofractionation is an effective and sufficiently safe method of radiation therapy for meningiomas, enabling the more frequent use of shortened radiation treatment courses instead of prolonged standard fractionation regimens. Given the rare recurrence of meningiomas and the low complication rate, larger and longer-term studies are needed to clarify all factors influencing the outcomes of radiation therapy.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 6. Vyp. 2","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960492","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":"[Isoforms of glial cell line-derived neurotrophic factor and their therapeutic potential].","authors":"V V Parshina, A V Revishchin, G V Pavlova","doi":"10.17116/neiro20258906238","DOIUrl":"10.17116/neiro20258906238","url":null,"abstract":"<p><p>Glial cell-derived neurotrophic factor (<i>GDNF</i>), first purified from glial cell culture medium, immediately attracted the interest of researchers due to its ability to enhance survival of midbrain dopaminergic neurons. This property suggested its therapeutic potential for Parkinson's disease as a socially significant disease. Numerous academic and preclinical studies in animal models supported this hypothesis, but clinical trials yielded conflicting results. For this reason, <i>GDNF</i> is not currently used clinically. However, robust and perspective results in experiments justify further research and overcoming the causes of absent therapeutic effect. Research of <i>GDNF</i> gene alternative splicing products has emerged as a promising avenue. Several <i>GDNF</i> isoforms exhibit effects similar to those of <i>GDNF</i> and differ by smaller size and less dose-response relationship. This makes small <i>GDNF</i> isoforms potentially successful as therapeutic components for some CNS diseases.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 6. Vyp. 2","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960465","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 eccentric-fusiform aneurysm of proximal basilar artery. Case report and literature review].","authors":"A O Sosnov, A V Dubovoy, S Yu Yulusov, D M Galaktionov, A V Gogolev","doi":"10.17116/neiro20258903192","DOIUrl":"10.17116/neiro20258903192","url":null,"abstract":"<p><p>Basilar artery aneurysm is a rare and difficult pathology that can require combination of various surgical methods. The authors present successful combined endovascular and microsurgical treatment of fusiform aneurysm of proximal basilar artery and confluence of vertebral arteries with high origin of the left posterior inferior cerebellar artery from aneurysm dome. The choice of preliminary revascularization of functionally significant artery involved in aneurysm and subsequent endovascular occlusion of aneurysm are considered.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"92-99"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188173","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":"[Internal thoracic artery for high-flow extra-intracranial bypass graft. Case report and literature review].","authors":"O A Pavlov, A V Dubovoy, K N Babichev, M A Snegirev","doi":"10.17116/neiro202589031100","DOIUrl":"10.17116/neiro202589031100","url":null,"abstract":"<p><strong>Objective: </strong>To describe the first experience of internal thoracic artery for high-flow extra-intracranial bypass.</p><p><strong>Material and methods: </strong>Internal thoracic artery was used for high-flow extra-intracranial bypass in a patient with giant aneurysm of internal carotid artery. Internal thoracic artery harvesting technique is presented. A systematic review is devoted to the role of internal thoracic artery in neurosurgery. The main advantages and disadvantages of internal thoracic artery are described.</p><p><strong>Results: </strong>High-flow extra-intracranial bypass through internal thoracic artery allowed safe ICA occlusion. CT- angiography confirmed graft patency.</p><p><strong>Conclusion: </strong>We present the first experience of internal thoracic artery for high-flow bypass. The advantages and disadvantages are described. A final decision in favor of one or another graft requires further research.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188152","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}