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

{"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":"[Percutaneous ultrasound-guided neurolysis with local administration of betamethasone in the treatment of Morton's neuroma].","authors":"Z Kh Plieva, M A Razin, A G Fedyakov, A V Baskov, A V Gorozhanin, A V Kuznetsov, O V Mukhina, E V Batalova","doi":"10.17116/neiro20258901152","DOIUrl":"10.17116/neiro20258901152","url":null,"abstract":"<p><p>Morton's neuroma is one of the most common entrapment mononeuropathies of peripheral nerves. The main clinical manifestation is neuropathic pain syndrome in the foot. Currently, many methods of treatment are proposed. Despite the advantages of each method, the main disadvantages are low effectiveness, aggravation of symptoms due to scar-related complications, or relatively high incidence of complications following surgical invasion.</p><p><strong>Objective: </strong>To evaluate the effectiveness of percutaneous ultrasound-guided neurolysis with local administration of betamethasone in patients with Morton's neuroma.</p><p><strong>Material and methods: </strong>The study included 14 female patients aged 24-56 years (mean 44.7±6.4). We analyzed VAS scores of pain syndrome (mean 7.1±1.1) and DN4 scores of neuropathic pain (mean 4.9±0.9). Ultrasound imaging was performed to estimate localization and volume of neuroma. Mean volume of neuroma was 226±142 mm³.</p><p><strong>Results: </strong>Mean follow-up was 12 months. In 12 out of 14 patients, there was a significant decrease in pain intensity to VAS score 1.1±0.6 and regression of neuropathic pain to DN4 score 0.5±0.5. In 2 cases, neuropathic pain recurred after 6 months with enlargement of neuromas (to 429 and 452 mm³). There were no complications in any patient.</p><p><strong>Conclusion: </strong>Percutaneous ultrasound-guided neurolysis of Morton's neuroma with local administration of betamethasone is an effective and promising minimally invasive method. Selection criterion for this procedure may be small volume of neuroma. Further research is required to clarify the indications for this procedure.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190779","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":"[Selective dorsal rhizotomy in children with hereditary spastic paraplegia].","authors":"E I Smolyankina, D Yu Zinenko","doi":"10.17116/neiro20258901146","DOIUrl":"10.17116/neiro20258901146","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the results of selective dorsal rhizotomy (SDR) in children with hereditary spastic paraplegia (Strumpell disease, HSP).</p><p><strong>Material and methods: </strong>SDR was performed in 8 patients with genealogical or genetic verification of HSP between 2022 and 2024. Mean age of patients was 10.3±4.9 years. We analyzed the results via testing spasticity and goniometry before surgery, on the third postoperative day and in delayed postoperative period. Mean follow-up period was 11±7.5 months.</p><p><strong>Results: </strong>All children improved lower limb movements. There was regression of spasticity in most cases. Three children had significant impairment of movements in some joints due to orthopedic deformities. No regression of the post-surgery movements level and even increase later in some cases was observed. There were no complications.</p><p><strong>Conclusion: </strong>SDR is effective and safe in patients with HSP. Long-term follow-up of larger samples is required.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"46-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190781","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":"[Microsurgical resection of dominant hemisphere gliomas with intraoperative speech mapping by a staff neurologist].","authors":"A V Semenov, K A Rumyantseva, M E Eroshenko, V V Egorenkov, V M Moiseenko, M V Sinkin","doi":"10.17116/neiro20258902114","DOIUrl":"10.17116/neiro20258902114","url":null,"abstract":"<p><p>Intraoperative awakening with speech mapping is used to minimize the risk of irreparable neurological deficit in patients with tumors located near speech zones. However, the lack of staff neurolinguist or neuropsychologist in the majority of neurosurgical departments is one of the limiting factors.</p><p><strong>Objective: </strong>To analyze surgical treatment of patients with glial tumors near speech and motor centers using intraoperative awakening with speech mapping by staff neurologist.</p><p><strong>Material and methods: </strong>We analyzed postoperative outcomes in 15 patients with dominant hemisphere gliomas of functionally significant areas between 2020 and 2024. All surgeries were accompanied by multimodal neurophysiological monitoring including intraoperative awakening and mapping by staff neurologist without neuropsychologist or neurolinguist. Intraoperative contrast-enhanced MRI was performed in 3 (20.0%) patients (T2WI and T1WI). Postoperative MRI was performed on the first postoperative day in all patients for objective assessment of resection quality.</p><p><strong>Results: </strong>Total resection was achieved in 13 (86.7%) cases, subtotal - in 2 (13.3%) cases. In 11 (73.3%) patients, no postoperative neurological deficit was detected. Three (20.0%) patients had transient speech impairment with regression throughout a month. Persistent deficit developed in 1 (6.7%) patient.</p><p><strong>Conclusion: </strong>Standardized speech mapping methods and staff neurologist for cortical mapping during resection of gliomas near functionally significant speech zones maintain high extent of resection without higher risk of permanent speech disorders. Widespread speech mapping by staff neurologists of neurosurgical departments will increase the number of function-preserving surgeries in all regions of the Russian Federation.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"14-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781283","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":"[Professional realization of female neurosurgeons in context of the main indicators of quality of life].","authors":"A E Bykanov, A D Gurkina, O A Rastvorova, E I Konovalova, I O Kurzakova, Yu V Strunina","doi":"10.17116/neiro20258902162","DOIUrl":"10.17116/neiro20258902162","url":null,"abstract":"<p><strong>Objective: </strong>To investigate realization of expectations of female neurosurgeons in professional and personal terms and influence of profession on the quality of life.</p><p><strong>Material and methods: </strong>We surveyed 44 female neurosurgeons from 17 hospitals of the Russian Federation and CIS between 2020 and 2023. Survey was voluntary and anonymous.</p><p><strong>Results: </strong>Mean age of women was 32 years (45% were younger than 30 years, 55% were older), more than half of them had more than 5-year experience. Almost half of female neurosurgeons were dissatisfied with results of their professional activity. Most of the women felt that they needed to work harder than their male colleagues to be recognized equally in professional environment. One third of respondents (32%) are considering quitting specialty completely and devoting themselves to their families in the future.</p><p><strong>Conclusion: </strong>Female neurosurgeons often have to sacrifice personal life and family to achieve the results similar to those in men. This can lead to emotional burnout.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"62-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781286","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 orbitocranial and orbital cavernous venous malformations (ophthalmological aspects)].","authors":"A P Trunova, N K Serova, N V Lasunin, N N Grigorieva","doi":"10.17116/neiro20258902148","DOIUrl":"10.17116/neiro20258902148","url":null,"abstract":"<p><strong>Background: </strong>Orbital cavernous venous malformation is a vascular malformation with slow blood flow velocity and common orbital lesion in adults.</p><p><strong>Objective: </strong>To analyze surgical treatment of orbitocranial and orbital cavernous venous malformations and factors influencing the outcomes.</p><p><strong>Material and methods: </strong>The study included 54 patients with apical orbital cavernous venous malformation extending into the cranial cavity (group I) and 31 patients with cavernous venous malformation of anterior and/or middle third of the orbit (group II) between 2004 and 2024.</p><p><strong>Results: </strong>The following approaches were used for resection of malformations: osteoplastic lateral orbitotomy, supraorbital, orbitozygomatic, endoscopic transnasal, transconjunctival approach. In early postoperative period, 15 patients in the 1^st group had deterioration of visual function. Of these, 8 ones developed blindness due to occlusion of central retinal artery. Most often, deterioration of visual functions was associated with extension of malformation into the optic canal, moderate-to-severe visual impairment and late preoperative stage of visual impairment (<i>p</i><0.05). There was no deterioration of visual functions in the 2^nd group. Deterioration of oculomotor function was noted in 70% and 24% of cases, respectively. Exophthalmos partially or completely regressed in both groups.</p><p><strong>Conclusion: </strong>Spread of cavernous venous malformation into the optic canal, preoperative state of visual functions and stage of visual impairment influence visual functions after surgery. Oculomotor function in delayed postoperative period is restored more often than visual functions.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781228","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":"[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":"[Laparoscopic resection of neurogenic presacral tumors].","authors":"Y E Kubetsky, E E Labzina, M A Kosimshoev, D P Kholtobin, R V Khalepa, A O Nabiev, D A Rzaev","doi":"10.17116/neiro20258901159","DOIUrl":"10.17116/neiro20258901159","url":null,"abstract":"<p><p>Laparoscopic approach is common in pelvic tumor surgery. Several small samples of patients after laparoscopic resection of presacral neurogenic tumors were described. Safety and advantages of this intervention are interesting.</p><p><strong>Objective: </strong>To analyze clinical outcomes of laparoscopic resection of presacral neurogenic tumors.</p><p><strong>Material and methods: </strong>Eleven patients including 2 children aged 11 and 17 years underwent laparoscopic tumor resection between 2021 and 2024. We estimated tumor size and localization, surgery time, blood loss, complications, postoperative hospital-stay, histological diagnosis and continued growth or recurrence in the follow-up period. The median follow-up was 19.2 (3-36) months.</p><p><strong>Results: </strong>Tumor size ranged from 4 to 10 cm, mean surgery time - 153.6 min, blood loss - 356.4 ml. Postoperative complications developed in 7 patients, including acute urinary retention, neuropathic pain syndrome, hematomas and dynamic intestinal obstruction. Total resection was achieved in 8 (72.7%) patients, subtotal resection - 2 (18.2%), partial resection - 1 (9.1%) case. Tumors were predominantly neurogenic: 6 (54.5%) - sacral nerve schwannomas, 1 (9%) - <i>NF1</i>-related schwannomatosis, 1 (9%) - meningioma, 1 (9%) - ganglioneuroma, 1 (9%) - fibromyxoid sarcoma, 1 (9%) - solitary fibrous tumor. There were no recurrences, continued growth or recurrence of preoperative symptoms in the follow-up period.</p><p><strong>Conclusion: </strong>Laparoscopic resection of presacral neurogenic tumors is an effective surgical technique with good visualization of surgical field and possible gross total resection.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"59-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190674","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":"[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":"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}