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

{"title":"[Venous factor in surgical management of skull base meningiomas].","authors":"Yu G Yakovlenko, V A Cherekaev, A V Kozlov, N V Lasunin","doi":"10.17116/neiro20258902197","DOIUrl":"10.17116/neiro20258902197","url":null,"abstract":"<p><p>Skull base venous system is a variable anatomical formation in both health and pathology. Damage to venous structures during surgical treatment of craniobasal meningiomas can lead to formidable postoperative complications, such as hemorrhagic infarctions, cerebral edema and persistent neurological deficit. Despite the improvement of microsurgical techniques, methods of morphological and functional angiography, as well as modeling the mechanisms of compensation for venous hemodynamic disorders, the problem of preventing postoperative venous complications remains relevant.</p><p><strong>Objective: </strong>To analyze available literature data on the role of venous system in surgery for skull base meningiomas and prevention of venous outflow disorders.</p><p><strong>Material and methods: </strong>The PRISMA algorithm was used to search for publications on venous complications, venous outflow compensation and prevention of vein damage in skull base meningiomas. The PubMed and Google Scholar databases were reviewed.</p><p><strong>Results: </strong>Thirty-six manuscripts were assessed. Statistics of venous complications in neurosurgery, venous system reorganization in craniobasal meningiomas, modern methods of X-ray diagnosis and minimization of venous complications during tumor resection are described.</p><p><strong>Conclusion: </strong>Peculiarities of venous hemodynamics in skull base meningiomas are important in planning surgical treatment, as evidenced by many studies in recent years. Improvement of microsurgical techniques and highly informative methods of X-ray diagnosis reduce the likelihood of venous complications in neurosurgery. However, persistent risk of vein damage during resection of craniobasal meningiomas necessitates further improvement of diagnostic and treatment algorithms.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781247","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":"[Computer-assisted planning and modeling for the surgical treatment of patients with fibrous dysplasia of cranial vault and base].","authors":"M M Rakityansky, L A Satanin, A L Ivanov, S G Rudnev, A V Sakharov, V G Duvidzon, M A Semushin, E S Burkhan, V V Roginsky","doi":"10.17116/neiro20258902129","DOIUrl":"10.17116/neiro20258902129","url":null,"abstract":"<p><strong>Background: </strong>The probability of cranial lesions in fibrous dysplasia reaches 50%. A pre-operative computer-assisted planning provides opportunities for precise radical bone resection and customized xenograft manufacturing.</p><p><strong>Objective: </strong>To evaluate postoperative outcomes in patients with fibrous dysplasia of the cranial vault and base, achived by means of preoperative computer-assisted planning and modeling.</p><p><strong>Material and methods: </strong>There were 32 patients with fibrous dysplasia of skull cranioorbital and vault localisation in Moscow National Medical Research Center for Neurosurgery named after Academician N.N. Burdenko from 2008 to 2024. All patients underwent a virtual lesion resection, a surgical template and a customized implant or its mold modelling. Implants were mostly manufactured from polymethylmethacrylate either before or during the surgery. The peculiarities of surgeries were application of template to dysplastic bone, resection within appropriate contour and subsequent cranioplasty with customized cranial implant. After surgery, we performed CT and analyzed deviations between postoperative and virtual skull. Reconstruction quality was assessed evaluating cranial asymmetry by means of craniometric analysis.</p><p><strong>Results: </strong>Craniometric measurements of asymmetry proved the effectiveness of surgical skull correction. The part comparison analysis of skull models after a computer-assisted planning and operations revealed convenience and predictability of the chosen approach.</p><p><strong>Conclusion: </strong>The developed complex of preoperative computer-assisted planning and modeling significantly improved resection and cranioplasty quality.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781267","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":"[Influence of local anesthesia methods on the results of radiofrequency facet denervation].","authors":"P G Mytyga, Sh Sh Magomedov","doi":"10.17116/neiro20258902157","DOIUrl":"10.17116/neiro20258902157","url":null,"abstract":"<p><strong>Background: </strong>One of the elements of lower back pain is facet syndrome. Radiofrequency facet denervation is an effective minimally invasive method for this pain. There is no consensus regarding local anesthesia method for this manipulation. Researchers believe that introduction of anesthetic before denervation leads to needle displacement and deterioration of effect.</p><p><strong>Objective: </strong>To evaluate the influence of local anesthesia methods on the results of radiofrequency facet denervation.</p><p><strong>Material and methods: </strong>A single-center retrospective study included adults with typical pain syndrome who underwent radiofrequency facet denervation L3-S1 between 2022 and 2024. Patients were divided into three groups depending on anesthesia. In the control group («K»), patients did not receive injection of anesthetic in ablation area. In the main groups, patients received injection of anesthetic before (group «A») and after (group «B») denervation. Intensity of pain syndrome during denervation and 24 hours later was assessed using the VAS scale. After 6 months, effectiveness of the procedure was assessed using the SF-36 and ODI.</p><p><strong>Results and discussion: </strong>The study involved 351 people. Of these, 131 ones were excluded for various reasons. Patients were divided into groups: control - 67, group «A» - 87, group «B» - 66 people. Six months after denervation, all patients demonstrate significant reduction in pain syndrome and QoL improvement without significant between-group differences. Pain syndrome during denervation and on the first day after surgery was significantly lower in the group «A».</p><p><strong>Conclusion: </strong>Injection of anesthetic before denervation does not affect the result, while this approach significantly reduces pain syndrome during intervention.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"57-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781281","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":"[Prolactin-secreting pituitary carcinomas with intra- and extracranial metastasis: case report and review].","authors":"L I Astafieva, I V Chernov, G L Kobyakov, Yu Yu Trunin, L V Shishkina, A N Shkarubo, D V Fomichev, Yu G Sidneva, G R Vagapova, P L Kalinin","doi":"10.17116/neiro20258901183","DOIUrl":"10.17116/neiro20258901183","url":null,"abstract":"<p><p>According to the modern WHO classification, pituitary carcinomas (or metastatic neuroendocrine pituitary tumors) are pituitary tumors with confirmed craniospinal and/or distant metastases. The main goal of histological analysis of pituitary carcinomas is to confirm pituitary origin of metastases. Treatment usually includes surgery and radiotherapy, dopamine agonists in maximum possible doses in case of prolactin-secreting pituitary carcinomas and chemotherapy with preferable temozolomide.</p><p><strong>Objective: </strong>To present the results of diagnosis and treatment of two patients with prolactin-secreting pituitary carcinomas.</p><p><strong>Material and methods: </strong>The authors describe 2 patients with prolactin-secreting pituitary carcinomas arising from drug-resistant aggressive prolactinomas with histologically confirmed metastases. In both cases, combined treatment included surgery, radio- and chemotherapy (cabergoline and temozolomide).</p><p><strong>Results: </strong>A 47-year-old patient underwent surgery, radio- and dopamine agonist therapy with subsequent regression of tumor growth in the follow-up period. However, progressive increase in prolactin concentration necessitated PET/CT with detection of multiple metastases in bones and lymph nodes. Temozolomide therapy led to temporary shrinkage of metastatic foci with subsequent progression. The second case was characterized by multiple brain and spinal cord metastases in a 47-year-old woman. Resection of intracranial metastasis and temozolomide therapy stabilized the disease and normalized serum prolactin throughout 2-year follow-up with subsequent progression.</p><p><strong>Conclusion: </strong>Pituitary carcinoma is a rare tumor with unfavorable prognosis. Treatment is currently not standardized and determined by available world experience regarding various chemotherapeutic drugs. Temozolomide is the most effective drug. However, short-term remission is usually followed by subsequent disease progression in most cases.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"83-93"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190780","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":"[C-Mill sensory treadmill in the treatment of idiopathic normotensive hydrocephalus].","authors":"S A Abytov, G V Gavrilov, T A Skoromets, A V Stanishevskiy, V Yu Cherebillo, D V Svistov","doi":"10.17116/neiro20258901175","DOIUrl":"10.17116/neiro20258901175","url":null,"abstract":"<p><p>The authors studied motor disorders in idiopathic normotensive hydrocephalus (iNPH, Hakim-Adams syndrome) using C-Mill treadmill.</p><p><strong>Objective: </strong>To present the first experience of C-Mill in assessing the motor function in patients with iNPH.</p><p><strong>Material and methods: </strong>The study is carried out at the Pavlov State Medical University and Hospital for War Veterans. To date, we enrolled 10 patients with iNPH and examined these ones using a unique multifunctional tool C-Mill before surgery, after tap test and after cerebrospinal fluid bypass surgery.</p><p><strong>Results: </strong>In all cases, we obtained positive postoperative results with improvement of motor function.</p><p><strong>Conclusion: </strong>C-Mill is a special treadmill with built-in tools designed to analyze human gait and balance, as well as for rehabilitation to improve gait and balance disorders in virtual reality. C-Mill sensory treadmill is valuable to assess motor disorders in patients with iNPH before surgery, improve the diagnostic process when selecting patients for surgery using invasive diagnostic methods and significantly improve the accuracy of postoperative evaluating the effectiveness of surgical treatment by quantifying the regression of motor disorders.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"75-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190657","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":"[HARDI-CSD tractography in determining the structure of diencephalic pathways in craniopharyngiomas].","authors":"V V Ivanov, A N Konovalov, N E Zakharova, R M Afandiev, E L Pogosbekyan, I N Pronin, A N Shkarubo, P L Kalinin","doi":"10.17116/neiro20258901130","DOIUrl":"10.17116/neiro20258901130","url":null,"abstract":"<p><p>Craniopharyngioma is a benign tumor in adults and children characterized by local invasion of surrounding brain structures. HARDI-CSD tractography is one of the modern MR methods for comprehensive visualization of functionally significant conduction pathways.</p><p><strong>Objective: </strong>To determine the possibility of visualizing some structures of chiasmatic-sellar region and third ventricle (hypothalamic-pituitary tract (pituitary stalk), optic pathways, fornix, mammillothalamic tract) using HARDI-CSD tractography in patients with suprasellar craniopharyngiomas, especially after failed CT and standard MRI of these structures.</p><p><strong>Material and methods: </strong>A pilot study included 4 patients (2 adults and 2 children) with craniopharyngiomas who underwent surgical treatment at the Burdenko Neurosurgery Center between January and July 2024. Patients underwent MR tractography before and after surgery.</p><p><strong>Results: </strong>HARDI-CSD tractography reconstructed optic tracts in 3 patients before and after surgery. Simultaneous visualization of several structures (pituitary stalk, fornix, optic tracts) was performed before and after surgery in 1 case. These data were useful for planning surgery and evaluating postoperative outcomes. In one patient, imaging of mammillothalamic tract was obtained after resection of large cystic intra-extraventricular craniopharyngioma.</p><p><strong>Conclusion: </strong>HARDI-CSD tractography provides valuable information about basal cerebral pathways (optic pathways, pituitary stalk, fornix, mammillothalamic tract) when planning and evaluating the results of surgical treatment of craniopharyngiomas.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"30-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190666","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":"[Combined extravasal compression of the right subclavian artery caused by stellate ganglion schwannoma and additional rudimentary cervical rib. Clinical case and literature review].","authors":"D Yu Usachev, V A Lukshin, A A Shulgina, E V Vinogradov, A S Nazarova, G A Denisova, A D Akhmedov","doi":"10.17116/neiro20258902172","DOIUrl":"10.17116/neiro20258902172","url":null,"abstract":"<p><p>Unlike widespread and well-studied atherosclerosis of supra-aortic arteries, non-atherosclerotic vascular diseases are less common. Of these, one of the most unusual is extravasal compression by additional structures between scalene muscles. Close topographic and anatomical connections of scalene muscles, vertebral and subclavian arteries, brachial plexus and stellate ganglion can lead to complex syndrome including impaired blood supply to the arm, brachial plexus compression and vertebrobasilar circulatory disorders. The main treatment method for supraclavicular compression syndromes is surgery. However, differential diagnosis, indications for surgical treatment and optimal technique are still discussable due to small incidence of disease. The key factor in determining treatment strategy is the cause of compression (congenital or acquired scalene muscle hypertrophy, age-related ptosis of the shoulder girdle; neck injuries; cervical spine degeneration). One of the rarest causes of compression is rudimentary additional cervical rib («cervical rib syndrome») and vessels. Combination of these factors is a casuistic etiology. The authors present a 25-year-old patient with stellate ganglion schwannoma whose mass effect caused dislocation and compression of subclavian artery by rudimentary additional cervical rib and scalene muscle. Surgical treatment including resection of tumor, release of the artery and scalenotomy restored arterial patency and eliminated clinical symptoms.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"72-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781252","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":"[Combined treatment of high-risk cerebral arteriovenous malformations according to Spetzler-Martin classification].","authors":"I V Senko, K Yu Orlov, S D Zalogin, M S Staroverov, P D Matveev, I V Grigoriev","doi":"10.17116/neiro202589021104","DOIUrl":"10.17116/neiro202589021104","url":null,"abstract":"<p><strong>Background: </strong>High-risk cerebral AVMs (Spetzler-Martin grade IV-V) are characterized by higher cumulative risk of hemorrhage during life, as well as higher mortality and disability rates in case of rupture compared to low-risk AVMs. Nevertheless, there are currently no clear indications for surgical intervention for high-risk AVMs, and most patients with this disease are followed-up. However, available data on less favorable course of high-risk AVMs requires active surgical tactics to reduce long-term disability and mortality.</p><p><p>Currently, the following strategies are preferable for high-risk AVMs: combination of preoperative embolization with microsurgical resection and combination of partial endovascular embolization with subsequent radiosurgery.</p><p><strong>Objective: </strong>To analyze the most common treatment combinations for high-risk AVMs regarding resection quality, functional outcomes and complications.</p><p><strong>Material and methods: </strong>The study was carried out in accordance with international recommendations for systematic reviews and meta-analyses (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Searching was conducted in the Pubmed/Medline and eLibrary databases using the keywords «High grade», «Arteriovenous Malformations», «Management», «IV-V» and «AVM» for English-language search engines, \"high-grade arteriovenous malformations.\" for Russian-language systems. Available full-text English- and Russian-language articles were selected between 1981 and 2024.</p><p><strong>Results: </strong>Among 371 articles, 6 studies met the inclusion criteria. There were 478 patients who underwent two most common strategies for combined treatment of high-risk AVMs.</p><p><strong>Conclusion: </strong>At present, there is no consensus on the advantage of certain combined method. There are data on less favorable course of high-grade AVMs and unsatisfactory outcomes after monomodal treatment. Thus, combined methods may be valuable for such AVMs.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"104-112"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781258","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 intracerebral metastases of Ewing sarcoma in children. Case report and review].","authors":"A V Sanakoeva, A E Samarin, E I Konopleva, A V Tarakanova, I V Sidorov, A E Druy, A I Karachunsky","doi":"10.17116/neiro20258902192","DOIUrl":"10.17116/neiro20258902192","url":null,"abstract":"<p><strong>Background: </strong>Metastatic brain lesions following Ewing sarcoma of bones and soft tissues in children are extremely rare and have unfavorable prognosis. There are few publications devoted to this issue. Survival rates after craniotomy are extremely low.</p><p><p>The authors describe a patient with metastatic form of Ewing sarcoma and two intracerebral (supra- and infratentorial) metastases. Total resection with subsequent radio- and chemotherapy were followed by stable remission for 23 months.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781226","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":"[Surgery for enlarged perivascular spaces: primary experience].","authors":"A A Veselkov, A V Gavryushin, S A Maryashev, D I Pitskhelauri, T L Bekhtereva, A N Konovalov","doi":"10.17116/neiro20258902123","DOIUrl":"10.17116/neiro20258902123","url":null,"abstract":"<p><p>Perivascular spaces are cavities surrounding cerebral and spinal cord vessels and filled with cerebrospinal or intercellular fluid. Abnormal enlargement of these spaces can lead to neurological symptoms. Currently, there are no clear approaches to surgical treatment of this pathology. We set ourselves the task of analyzing the literature data, as well as presenting own clinical observations and sharing the experience of microsurgical treatment of this pathology.</p><p><strong>Material and methods: </strong>We reviewed the PubMed databases between 2009 and 2024. We analyzed own small sample (<i>n</i>=5) of patients with dilated perivascular spaces who underwent microsurgical treatment between 2009 and 2024. Four patients underwent microsurgical cystoventriculostomy, one patient - microsurgical cystocysternostomy and biopsy.</p><p><strong>Results: </strong>Microsurgical cystoventriculostomy and cyst drainage were less effective than expected. Four out of five patients developed new neurological symptoms after surgery, while baseline symptoms did not significantly regress.</p><p><strong>Conclusion: </strong>To date, cerebrospinal fluid shunting is still the main surgical method for dilated perivascular spaces accompanied by intracranial hypertension.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781291","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}