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

{"title":"[Postoperative outcomes after simultaneous surgery for cervical radiculopathy combined with distal peripheral nerve compression].","authors":"V A Byvaltsev, A A Kalinin, A V Kukharev, A A Burnashev","doi":"10.17116/neiro20248806139","DOIUrl":"https://doi.org/10.17116/neiro20248806139","url":null,"abstract":"<p><p>To date, the optimal therapeutic and diagnostic strategy in patients with simultaneous clinical manifestations of degenerative cervical spine disease and upper-extremity nerve compression is still unclear.</p><p><strong>Objective: </strong>To analyze the results of simultaneous surgical interventions in patients with cervical radiculopathy combined with distal peripheral compression-induced ischemic neuropathy.</p><p><strong>Material and methods: </strong>We retrospectively studied postoperative outcomes in 23 patients with two-level degenerative cervical spine disease with radiculopathy and peripheral nerve compression (cubital canal, Guyon's canal or carpal tunnel syndromes). Two surgical teams performed interventions. Technical features of interventions, postoperative characteristics, clinical parameters (VAS scores of pain, NDI, SF-36 and DASH scores) and complications according to the Dindo-Clavien classification were studied.</p><p><strong>Results: </strong>Mean surgery time was 104 min, blood loss - 75 ml, length of hospital-stay - 4 days. In long-term period, cervical pain score decreased from 73 (57;88) to 6 (3;11) mm (<i>p</i>=0.006), pain in upper extremities from 85 (74;95) to 3 (2; 5) mm (<i>p</i>=0.001), NDI from 74 (60; 86) to 6 (6;10) (<i>p</i>=0.001) points. Physical component of health increased from 26.12 (19.37; 35.51) to 52.26 (50.68; 56.42) (<i>p</i>=0.007) scores, psychological component - from 32.68 (18.57;40.52) to 54.92 (50.73;56.92) scores (<i>p</i> =0.003). DASH score of upper limb function improved from 74 (62;80) to 8 (6;10) points. There were 3 (13%) minor complications Dindo-Clavien grade I, II and IIIA after cervical spine surgery and 2 (8.7%) events after peripheral nerve repair. Only 1 (4.3%) serious complication (Grade IIIB, IV and V) was identified after cervical spine surgery.</p><p><strong>Conclusion: </strong>Simultaneous surgery for cervical radiculopathy combined with peripheral nerve compression is safe and effective for appropriate patients.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 6","pages":"39-46"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819465","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":"[Our approach to the treatment of vestibular schwannomas with arachnoid dissection of the facial nerve].","authors":"I M Alekseev, V A Ovchinnikov, S M Chupalenkov, A A Zuev","doi":"10.17116/neiro20248804138","DOIUrl":"10.17116/neiro20248804138","url":null,"abstract":"<p><p>Preserving the function of the facial nerve is extremely important in surgery for vestibular schwannomas. Two methods of arachnoid dissection are described for resection of vestibular schwannoma via retrosigmoid approach (from the brain stem and internal auditory canal).</p><p><strong>Objective: </strong>To evaluate the results of arachnoid dissection of the facial nerve from internal auditory canal when resecting the vestibular schwannoma.</p><p><strong>Material and methods: </strong>We analyzed 61 patients with vestibular schwannomas. Patients were divided into 2 groups depending on surgical technique. We estimated facial nerve function before and after surgery, preoperative dimension of vestibular schwannoma and extent of resection. The influence of various factors on extent of resection and postoperative facial nerve function was studied.</p><p><strong>Results: </strong>Vestibular schwannoma resection from the brain stem was performed in 30 patients, arachnoid dissection - in 31 patients. There was no significant between-group difference. Gross total resection was performed in 78.7% of cases. Both techniques demonstrated similar results regarding extent of resection. Arachnoid dissection showed the advantage regarding facial nerve function immediately after surgery (<i>p</i>=0.012) and 6 months later (<i>p</i><0.001). Normal facial nerve function in 6 months after arachnoid dissection was observed in 80.7% of patients. Preoperative dimension of tumor influenced facial nerve function in addition to technique of resection (<i>p</i>=0.001).</p><p><strong>Conclusion: </strong>We identified the factors influencing facial nerve function after resection of vestibular schwannoma. Surgical technique was the most significant factor. These data expand and popularize arachnoid dissection in surgery of vestibular schwannomas.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 4","pages":"38-49"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018881","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":"[Cerebral persistent primitive arteries. Clinical case of combination with intracranial aneurysm and review of the literature].","authors":"D I Shtadler, V D Shtadler, M S Staroverov, G A Fukalov, O G Karakulov, M A Lebedev, D V Kurnikov, S N Goryunov, A A Gagai, A S Yakunina, V A Lukyanchikov","doi":"10.17116/neiro20248802177","DOIUrl":"10.17116/neiro20248802177","url":null,"abstract":"<p><p>Cerebral persistent primitive arteries are uncommon and associated with cerebrovascular diseases, like cerebral aneurysms. They can cause vertebrobasilar ischemia and neuropathy of the cranial nerves. The authors present a patient with trigeminal artery associated with giant partially thrombosed cavernous internal cerebral artery aneurysm.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 2","pages":"77-86"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319361","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":"[Pathological tortuosity of intracranial arteries (pure arterial malformation) - diagnosis and management tactics].","authors":"A S Kheireddin, I N Pronin, S B Yakovlev, O B Belousova, A N Kaftanov, E V Vinogradov","doi":"10.17116/neiro20248802114","DOIUrl":"10.17116/neiro20248802114","url":null,"abstract":"<p><strong>Background: </strong>Tortuosity of intracranial arteries is rare and usually mistaken for arteriovenous malformations. In the world literature, the term «pure arterial malformations» is used to refer to this disease.</p><p><strong>Objective: </strong>To summarize the experience of the Burdenko Neurosurgery Center on diagnosis of intracranial artery tortuosity, management and treatment of these patients, as well as to review appropriate literature data.</p><p><strong>Material and methods: </strong>Tortuosity of intracranial arteries was detected in 11 patients (8 women and 3 men) aged 7-48 years who underwent outpatient or inpatient examination and treatment at the Burdenko Neurosurgery Center between 2009 and 2022. We analyzed angiographic, clinical and follow-up data of these patients, as well as appropriate literature data.</p><p><strong>Results: </strong>According to angiography data, all patients had moderate dilatation, elongation and tortuosity of intracranial arteries without signs of arteriovenous shunting. The most common finding was tortuosity of several segments of internal carotid artery (5 cases). Lesion of PCA, PComA, MCA and ACA was less common. In 7 cases, the walls of the deformed vessels had calcified zones. In two cases, there were saccular aneurysms in the walls of the tortuous vessels. In one case, tortuosity was combined with kinking of the left subclavian artery, in another one - tortuosity of C1 segment of the right ICA. No patient had specific clinical manifestations. The follow-up period was 1-10 years in 7 patients. There were no changes in structure of tortuosity or appearance of new aneurysms.</p><p><strong>Conclusion: </strong>Tortuosity of intracranial arteries is an extremely rare disease with the highest incidence in young women. This abnormality has no specific clinical manifestations and does not require surgical or conservative treatment. Tortuosity of intracranial arteries should be differentiated from arterial dolichoectasia, fusiform aneurysms and AVMs.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 2","pages":"14-22"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319444","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":"[Russian study on brain aneurysm surgery: a continuation (RIHA II)].","authors":"V V Krylov, T A Shatokhin, I M Shetova, Sh Sh Eliava, O B Belousova, A A Airapetyan, A G Alekseev, S A Asratyan, E Yu Bakharev, I A Vorobyov, D S Dedkov, A V Dubovoy, V V Eliseev, A V Elfimov, Z U Kozhaev, V S Kolotvinov, M V Kosmachev, L Ya Kravets, P I Kushniruk, N L Myachin, V E Parfenov, S V Rodionov, P A Semin, E M Khasanshin, P G Shnyakin, I S Yakhontov","doi":"10.17116/neiro2024880117","DOIUrl":"10.17116/neiro2024880117","url":null,"abstract":"<p><strong>Objective: </strong>To assess the main performance indicators of neurosurgical departments in surgical treatment of cerebral aneurysms in the Russian Federation.</p><p><strong>Material and methods: </strong>We analyzed 22 neurosurgical departments (19 regional and 3 federal hospitals) in 2017 and 2021. The study enrolled 6.135 patients including 3.160 ones in 2017 and 2.975 ones in 2021. We studied the features of surgical treatment of cerebral aneurysms in different volume hospitals and factors influencing postoperative outcomes.</p><p><strong>Results: </strong>The number of surgeries for cerebral aneurysms decreased from 2.950 in 2017 to 2.711 in 2021. Postoperative mortality rate was 6.3% and 5.6%, respectively. The number of microsurgical interventions decreased from 60% in 2017 to 48% in 2021. The share of endovascular interventions increased from 40% to 52%, respectively. Endovascular embolization was accompanied by stenting in 55% of cases. Simultaneous revascularization was carried out in 2% of cases. In 2021, the number of patients undergoing surgery in acute period of hemorrhage increased to 70% (in 2017 - 61%). The number of hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased from 14 in 2017 to 17 in 2021.</p><p><strong>Conclusion: </strong>Certain changes in neurosurgical service occurred in 2021 compared to 2017. Lower number of surgical interventions for cerebral aneurysms, most likely caused by the COVID-19 pandemic, is accompanied by lower postoperative mortality. Endovascular interventions and revascularization techniques became more common. The number of surgeries in acute period after aneurysm rupture and hospitals performing more than 50 surgical interventions for cerebral aneurysms annually increased.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 1","pages":"7-20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708029","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 brain tumors adjacent to corticospinal tract in children].","authors":"R A Kakhkharov, Sh U Kadyrov, A A Ogurtsova, A A Baev, R M Afandiev, I N Pronin","doi":"10.17116/neiro20248801197","DOIUrl":"10.17116/neiro20248801197","url":null,"abstract":"<p><p>An urgent problem in modern neurosurgery is resection of brain tumors adjacent to corticospinal tract (CST) due to high risk of its damage and subsequent disability. The main methods for prevention of intraoperative damage to CST are preoperative MR tractography and intraoperative electrophysiological monitoring. Both methods are used in pediatric neurosurgery. We reviewed the PubMed database since 2000 using the following keywords: «tumors of the hemispheres in children», «corticospinal tract», «MR tractography», «intraoperative electrophysiological monitoring». We present available literature data on preoperative MR tractography and intraoperative electrophysiological monitoring in children with supratentorial tumors near CST. Algorithm of intraoperative electrophysiological monitoring is often missing or insufficiently described. MR tractography is usually presented in case reports. Researchers do not compare the effectiveness of MR tractography and intraoperative electrophysiological monitoring. In case of MR tractography, a limitation is impossible CST reconstruction in children 2-3 years old. This may be due to unformed pyramidal system in these children.</p><p><strong>Conclusion: </strong>Preoperative MR tractography and intraoperative electrophysiological monitoring are valid methods for assessment of CST. Optimal research parameters in children require careful study that will allow objective planning of each stage of preoperative management and increase resection quality for gliomas near CST in children without neurological deterioration.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 1","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708031","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":"[Femoral nerve repair with autografts for proximal retroperitoneal damage (case report and literature review)].","authors":"F S Govenko, A A Gusev, V N Komantsev, E Yu Maletsky, A D Khalikov","doi":"10.17116/neiro20248801188","DOIUrl":"10.17116/neiro20248801188","url":null,"abstract":"<p><p>Femoral nerve damage, especially in proximal retroperitoneal space, is rare. Therefore, surgical strategy is still unclear for these patients. Various specialists discuss repair with autografts or neurotization by the obturator nerve or its muscular branch.</p><p><strong>Objective: </strong>To demonstrate the diagnostic algorithm for proximal femoral nerve injury and favorable outcomes after repair with long autografts.</p><p><strong>Material and methods: </strong>We assessed movements and sensitivity using a five-point scale, as well as ultrasound, magnetic resonance imaging and electroneuromyography data in a patient with extended iatrogenic femoral nerve damage before and after repair with long autografts (10.5 cm).</p><p><strong>Results and discussion: </strong>The patient had complete femoral nerve interruption in proximal retroperitoneal space with 10-cm defect that required repair with five autografts from two sural nerves. Postoperative ultrasound and magnetic resonance imaging revealed signs of graft survival and no neuroma within the nerve suture lines. The first signs of motor recovery occurred after 10 months. After 14 months, strength of quadriceps femoris muscle comprised 4 points, and electroneuromyography confirmed re-innervation.</p><p><strong>Conclusion: </strong>Femoral nerve repair with autografts for complete proximal anatomical interruption can provide sufficient restoration of movements and sensitivity. Therefore, this surgical option should be preferred instead of neurotization. Ultrasound, MRI and ENMG are valuable to clarify the diagnosis and state of the autografts.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 1","pages":"88-96"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708069","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":"[Problems in organizing neurosurgical care for patients with Parkinson's disease in the Russian Federation].","authors":"A A Tomskiy, E V Bril, A A Gamaleya, A A Poddubskaya, N V Fedorova, O S Levin, S N Illarioshkin","doi":"10.17116/neiro2024880315","DOIUrl":"https://doi.org/10.17116/neiro2024880315","url":null,"abstract":"<p><strong>Background: </strong>Currently, there are some problems in the Russian Federation complicating development of neurosurgical care for patients with Parkinson's disease (PD).</p><p><strong>Material and methods: </strong>In 2022, neurologists - movement disorders specialists were surveyed to analyze situation with PD pharmacological treatment and referral of patients for surgical treatment in Russian constituent entities. Data on neurosurgical treatment of PD were obtained by collecting information on the surgical activity of medical institutions in the Russian Federation. Most hospitals involved in PD treatment took part in this study.</p><p><strong>Results: </strong>The state of neurosurgical care for patients with PD is analyzed and possible ways to improve the quality of treatment are discussed.</p><p><strong>Conclusion: </strong>Over the past 20 years, a system of neurosurgical care for patients with PD has been formed in 14 centers in the Russian Federation (2022). Obstacles to its further development can be divided into 3 categories: problems of patient selection and routing, complexity of organization and financing surgeries, and imperfect postoperative patient management. Ways to overcome these obstacles imply expanding the network of centers for extrapyramidal diseases, development of domestic neurostimulation systems, improving the distribution of quotas taking into account the capabilities of hospitals, specialized training of neurologists for extrapyramidal centers and neurosurgeons for deep brain stimulation centers, adequate financing and systematization of postoperative management of patients with PD.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 3","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331886","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":"[Accessory nerve meningioma. A case report and literature review].","authors":"N G Kobyakov, T S Bezbabicheva, L V Shishkina, S R Arustamyan, D I Pitskhelauri","doi":"10.17116/neiro20248803190","DOIUrl":"10.17116/neiro20248803190","url":null,"abstract":"<p><p>Meningiomas arising from accessory nerve sheath without dural attachment are rare. To date, only 5 cases are described in the literature. A 53-year-old male presented with long history of occipital pain and headaches. Magnetic resonance imaging revealed a small intradural extramedullary contrast enhanced tumor at the level of foramen magnum. The patient underwent microsurgical resection through minimally invasive midline suboccipital approach. According to intraoperative findings, cystic tumor arose from the left accessory nerve without dural attachment. Gross total resection was achieved without damage to the nerve. Histological analysis revealed angiomatous meningioma. Postoperative period was uneventful without new neurological symptoms. Meningiomas can rarely arise from accessory nerve sheath and mimic schwannoma. These tumors may be totally resected without damage to accessory nerve using minimally invasive surgical approaches.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 3","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331875","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 use of biomaterials and revascularisation in autoplasty of ulnar nerve].","authors":"A G Fedyakov, O N Dreval, A V Gorozhanin, D N Grekov, L A Sidneva, Z Kh Plieva, M A Razin, G N Chapandze","doi":"10.17116/neiro20248805187","DOIUrl":"10.17116/neiro20248805187","url":null,"abstract":"<p><p>Surgical treatment of peripheral nerve injuries is effective in only 50% of cases. This is primarily due to the significant extent of the diastasis between the fragments of the damaged nerve, in which autoplasty has to be performed. The drawbacks of this technique are the formation of scar tissue, possible necrotisation of the autograft, mismatch of the donor and recipient nerve diameters. In order to overcome these drawbacks and improve the efficiency of surgical intervention, the study presents a clinical case of successful multifascicular ulnar nerve autoplasty with the use of domestic biodegradable biomaterials SpheroGel and ElastoPob, revascularization of the autograft with a connective tissue flap on a vascular pedicle. A persistent regression of local pain syndrome was observed in the early postoperative period. The effectiveness of the performed surgical intervention was confirmed by ultrasound examination: there was no evidence of neuroma in the area of the operation, regeneration of nerve bundles was noted at the site of stitching. Positive dynamics was observed in the results of VAS, DN4, DASH questionnaires.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 5","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476319","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}