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

{"title":"[Pituitary adenoma combined with craniopharyngioma. Case reports and literature review].","authors":"A N Konovalov, I V Chernov, M V Ryzhova, O I Sharipov, D Sh Adueva, D A Konyashin, P L Kalinin","doi":"10.17116/neiro20258903168","DOIUrl":"https://doi.org/10.17116/neiro20258903168","url":null,"abstract":"<p><strong>Background: </strong>Combination of different intracranial tumors is an infrequent phenomenon. Combination of pituitary adenomas with craniopharyngiomas is extremely rare.</p><p><strong>Objective: </strong>To present exceptionally rare combinations of pituitary adenomas and craniopharyngiomas.</p><p><strong>Results: </strong>We present two patients with combinations of pituitary adenomas and adamantinomatous craniopharyngiomas. Due to topographic and anatomical features of neoplasms, combined access was used for resection of both tumors in the first case (transcallosal and transnasal in different surgeries). The second patient required simultaneous endoscopic transnasal resection of both tumors. Baseline symptoms (decreased vision in both cases and mental disorders in the first case) partially regressed, and patients were discharged.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"68-74"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188169","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":"[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":"[Endoscopic interventions for gunshot craniocerebral injuries].","authors":"M N Kravtsov, A E Chistyakov, M A Legzdain, D V Svistov","doi":"10.17116/neiro20258903148","DOIUrl":"https://doi.org/10.17116/neiro20258903148","url":null,"abstract":"<p><p>Full-endoscopic (neuroendoscopic) removal of foreign bodies from the cranial cavity is a relatively new technique with limited information available in the literature. Compared to open surgeries, this minimally invasive approach is associated with less impact on the surrounding brain tissues and fewer complications. The safety of such procedures is enhanced by the use of CT navigation. This article describes the surgical technique of endoscopic removal of metallic fragments in combat-related gunshot cranial injuries, based on five clinical cases, and presents the results of a systematic literature review.</p><p><strong>Objective: </strong>To evaluate the capabilities and effectiveness of fully endoscopic surgery in combat-related gunshot cranial injuries and to compare the obtained results with the data available in the global literature.</p><p><strong>Material and methods: </strong>In the neurosurgery clinic of the Military Medical Academy named after S.M. Kirov, from March 2023 to June 2024, 5 patients with shrapnel wounds to the head underwent removal of foreign bodies using endoscopic techniques. The databases of scientific publications PubMed, Google Scholar, and eLibrary searched for publications in accordance with the rules of systematic review, and 12 articles were found that fully meet the search criteria.</p><p><strong>Results: </strong>All 5 patients were successfully operated using endoscopic techniques. Endoscopic rehabilitation of a gunshot wound is an optional minimally invasive neurosurgical procedure and can be effectively applied in a specialized hospital to remove foreign bodies localized deep in the brain, ventricles, and base of the skull, with a high risk of their removal during primary surgical treatment or its non-radical implementation.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"48-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188151","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 epilepsy associated with tuberous sclerosis in children: a single-center retrospective study].","authors":"F B Berdinov, A V Levov, V B Solovev, A A Kuznetsova, M Yu Dorofeeva, A N Kislyakov, V N Umerenkov, M I Livshits, G E Chmutin","doi":"10.17116/neiro20258903117","DOIUrl":"https://doi.org/10.17116/neiro20258903117","url":null,"abstract":"<p><strong>Background: </strong>The most common symptom of CNS damage in tuberous sclerosis is epilepsy. The last one is drug-resistant in most cases. Surgical treatment should be considered in these patients.</p><p><strong>Objective: </strong>To analyze the results of surgical treatment of drug-resistant epilepsy in children with tuberous sclerosis, to identify predictors of successful treatment.</p><p><strong>Material and methods: </strong>A retrospective study included 45 children between 2017 and 2023. In addition to standard non-invasive procedures, preoperative management included stereo-EEG in 19 cases, subdural EEG in 2 cases and staged subdural and stereo-EEG in 1 case. Selective tuberectomy was performed in 15 patients, tuberectomy (+) - in 16 children, lobectomy - in 6, multilobar resection - in 4, posterior quadrant disconnection - in 2, hemisphrotomy - in 2, repeated surgeries - in 6 children.</p><p><strong>Results: </strong>The median follow-up was 27 months. Postoperative outcomes ILAE grade I, IV, V and VI were observed in 62%, 25%, 11% and 2% of cases, respectively. Antiepileptic therapy was discontinued in 4.4% of cases. In 22.2% of patients, doses of drugs were reduced. Epileptogenic zone in frontal lobe favorably affected postoperative outcome (<i>p</i>=0.027). Transient hemiparesis occurred in 5 (11.1%) cases, persistent expected hemiparesis - in 1 (2.2%) case.</p><p><strong>Conclusion: </strong>Surgical treatment is effective for epilepsy in children with tuberous sclerosis. It is advisable to refer children with epilepsy and tuberous sclerosis to specialized centers for preoperative examination if therapy with two drugs is ineffective.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"17-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188174","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":"[Risk factors of unfavorable outcome after decompressive craniectomy in children with severe traumatic brain injury].","authors":"Zh B Semenova, S V Meshcheryakov, E A Rogozhin, V I Lukyanov","doi":"10.17116/neiro20258903142","DOIUrl":"https://doi.org/10.17116/neiro20258903142","url":null,"abstract":"<p><p>Although the first publication devoted to early decompressive craniectomy in children with TBI and refractory intracranial hypertension occurred more than two decades ago, the issue of effectiveness and functional outcomes continues to be discussed. Variability of data and methods for assessing the effectiveness of decompressive craniectomy in children with severe TBI does not allow for convincing recommendations.</p><p><strong>Objective: </strong>To identify the risk factors of unfavorable outcomes after decompressive craniectomy in children with severe TBI.</p><p><strong>Material and methods: </strong>The study included 64 patients with refractory intracranial hypertension over 20 mm Hg. Age, GCS score at admission, GOS grade after 6 months, intracranial pressure and cerebral perfusion pressure before surgery, energy of ICP fluctuations process-E², pupil status and ISS score were analyzed. Treatment outcomes were assessed after 6 months.</p><p><strong>Results: </strong>GOS grade 4-5 was observed in 45.3% of cases, grade 3 - in 31% of cases, grade 1-2 - in 23.4% of cases. Mortality rate was 18.7% (12 patients). There are significant predictors of unfavorable outcome: GCS score, ICP ≥40 mm Hg, wide pupils, impaired photoreaction, type of injury (isolated/combined), midline shift (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>Risk factors of unfavorable outcome after decompressive craniectomy in children include independent factors (severity of primary brain injury) and controllable factors (ICP and its derivatives). ICP ≥40 mm Hg increases the risk of unfavorable outcome after decompressive craniectomy. Decompressive craniectomy is a preventive measure and should be considered as a tool for dislocation syndrome control.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188170","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}