N A Kalybaeva, A V Dimertsev, M V Mazalova, A K Kuzovkina, G E Altunina, M A Odeniyazova, A S Balatskaya, N P Utyashev, V G Bychenko, O Yu Bronov, N V Pedyash, M Yu Zemlyansky, D N Kopachev, A A Zuev, A L Golovteev
{"title":"[Surgical treatment of focal drug-resistant epilepsy associated with temporal lobe encephalocele].","authors":"N A Kalybaeva, A V Dimertsev, M V Mazalova, A K Kuzovkina, G E Altunina, M A Odeniyazova, A S Balatskaya, N P Utyashev, V G Bychenko, O Yu Bronov, N V Pedyash, M Yu Zemlyansky, D N Kopachev, A A Zuev, A L Golovteev","doi":"10.17116/neiro20248801139","DOIUrl":"10.17116/neiro20248801139","url":null,"abstract":"<p><strong>Background: </strong>In recent years, temporal lobe encephalocele has become more common in patients with focal drug-resistant epilepsy. Despite available experience, there are still no clear recommendations for choosing the extent of surgery in these patients.</p><p><strong>Objective: </strong>To evaluate the effectiveness of diagnosis and surgical treatment of focal drug-resistant epilepsy associated with temporal lobe encephalocele.</p><p><strong>Material and methods: </strong>The study included 21 patients with focal temporal lobe epilepsy and temporal lobe encephalocele. All patients underwent continuous video-EEG monitoring and MRI of the brain. There were 12 (57.4%) selective encephalocele resections and 9 (42.6%) anterior temporal lobectomies. The median follow-up period was 31 months.</p><p><strong>Results: </strong>The overall effectiveness of surgical treatment with postoperative Engel class I was 76% (16 cases). Selective encephalocele resection was followed by postoperative Engel class I in 10 patients (83%). There were 6 (67%) patients with similar outcomes after temporal lobectomy. Mean volume of resected tissue adjacent to encephalocele was 8.3 cm<sup>3</sup>.</p><p><strong>Conclusion: </strong>Surgery is a highly effective treatment for patients with epileptic seizures following temporal lobe encephalocele. In our sample, favorable postoperative outcomes were achieved in 76% of patients (Engel class I). There were no significant differences in effectiveness between selective resection and temporal lobectomy. Further research is necessary for a clear protocol of surgical treatment of focal drug-resistant epilepsy associated with encephalocele.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 1","pages":"39-47"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708032","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}
E A Moskvina, D M Belov, D R Naskhletashvili, L V Mekheda, A Kh Bekyashev, V A Aleshin, T G Gasparyan, A A Mitrofanov, N V Sevyan, E V Prozorenko, A A Tkhazeplov, K E Roshchina
{"title":"[Intrathecal chemotherapy for leptomeningeal metastases in patients with breast cancer].","authors":"E A Moskvina, D M Belov, D R Naskhletashvili, L V Mekheda, A Kh Bekyashev, V A Aleshin, T G Gasparyan, A A Mitrofanov, N V Sevyan, E V Prozorenko, A A Tkhazeplov, K E Roshchina","doi":"10.17116/neiro20248803131","DOIUrl":"https://doi.org/10.17116/neiro20248803131","url":null,"abstract":"<p><p>Leptomeningeal metastases are lesions of brain and/or spinal cord sheaths by tumor cells. They occur in 5% of patients with solid tumors, although autopsies reveal these lesions much more often (10-20% of cases). Leptomengeal metastases are an unfavorable prognostic factor. Despite the modern NCCN treatment standards, including intrathecal therapy (ITT), such patients receive only irradiation of the entire brain and/or spinal cord in most cases.</p><p><strong>Objective: </strong>To evaluate the effectiveness of ITT in patients with leptomeningeal metastases in breast cancer.</p><p><strong>Material and methods: </strong>Twenty-five patients with breast cancer and leptomeningeal metastases underwent intrathecal administration of methotrexate between 2016 and 2022. Intrathecal chemotherapy was administered through lumbar puncture. We performed an intensive course (intrathecal methotrexate 15 mg 2 times a week for 1 month (8 injections), then intrathecal methotrexate 15 mg 1 time a week (4 injections), and then 15 mg 1 time a month until progression or unacceptable toxicity).</p><p><strong>Results: </strong>The median duration of ITT was 2.5 months. Complete neurological responses were observed in 3 out of 25 (12%) patients, partial neurological response - in 15 out of 25 (60%) patients, progression of neurological symptoms - in 7 (28%) patients. The number of complete cytological responses was observed in 6 out of 25 (24%) patients. The median overall survival after ITT was 6.7 months.</p><p><strong>Conclusion: </strong>Effectiveness of ITT is confirmed by higher quality of life (72% of patients), complete cytological responses (24%) and improvement in neuroimaging data. This is an important criterion for severe patients with limited treatment options. First-stage ITT before whole-brain irradiation is preferable, as this approach increases overall survival by 3 months. Undoubtedly, ITT is a treatment option that can be used in routine clinical practice for lesions of brain and spinal cord sheaths.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 3","pages":"31-37"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331882","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":"[Electrophysiological diagnostics in choosing treatment strategy for neuropathies in children with transcondylar fractures].","authors":"E N Plastunenko, D S Kanshina, F U Kusova","doi":"10.17116/neiro20248803138","DOIUrl":"https://doi.org/10.17116/neiro20248803138","url":null,"abstract":"<p><strong>Background: </strong>A common complication of transcondylar fractures (TCF) in children is neuropathy requiring not only therapeutic but also surgical treatment. Despite numerous reports, clear criteria for selecting patients for surgical treatment have not been defined.</p><p><strong>Objective: </strong>To clarify the role of clinical and electrophysiological diagnostics in choosing treatment tactics for neuropathies in children with TCF.</p><p><strong>Material and methods: </strong>There were 20 patients with neuropathies after TCF between 2020 and 2022. Of these, 10 ones were selected for surgical treatment according to electrophysiological diagnostic data. Inclusion criteria: age 6-12 years, closed TCF within previous 3-12 months, symptoms of neuropathy confirmed by electroneuromyography (ENMG), no nerve disruption according to ultrasound data. Exclusion criteria: elbow joint contracture and post-traumatic ulnar nerve dislocation. All patients underwent needle myography with functional assessment of motor and sensory fibers, spontaneous activity in muscles, recruitment pattern and motor unit potentials. Intraoperative electrophysiological diagnostics included stimulation of motor fascicles with registration of M-responses from the target muscles. The follow-up period was 3-6 months.</p><p><strong>Results: </strong>The study included 20 patients aged 6-12 years without peripheral nerve disruption. A group of 10 patients who required surgical treatment was identified. The control group consisted of 10 patients who did not require surgical treatment. To choose treatment tactics, we considered ENMG data. Surgical procedure was determined according to intraoperative neuromonitoring (IONM) data.</p><p><strong>Conclusion: </strong>When choosing treatment strategy, surgeons should consider objective ENMG and IONM criteria, as well as fascicular anatomy.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 3","pages":"38-44"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331878","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}
I V Chernov, A N Shkarubo, D A Konyashin, D N Andreev
{"title":"[Transoral approach in surgery for chordomas extending into craniovertebral junction: a systematic review of the literature].","authors":"I V Chernov, A N Shkarubo, D A Konyashin, D N Andreev","doi":"10.17116/neiro202488031111","DOIUrl":"https://doi.org/10.17116/neiro202488031111","url":null,"abstract":"<p><p>To date, treatment of chordomas involves maximal tumor resection followed by proton therapy. Various approaches are used depending on location of tumor (transcranial and through natural anatomical openings (nose, mouth), as well as their combinations). Although transoral approach has been introduced into neurosurgical practice for a long time, it is routinely used in patients with chordoma only in certain hospitals in the world.</p><p><strong>Objective: </strong>To analyze postoperative outcomes in patients with chordomas of skull base and craniovertebral joint after transoral surgery.</p><p><strong>Material and methods: </strong>We analyzed literature data devoted to patients with chordomas of skull base and craniovertebral joint after transoral surgery or another approach combined with transoral access. Among 111 primary articles, we selected 38 manuscripts including description of 109 patients with skull base chordoma who underwent transoral surgery or combination of approaches including transoral one.</p><p><strong>Results: </strong>Gross total resection was achieved in 45.9% (<i>n</i>=50) of cases including 1 patient after en bloc resection. Subtotal resection was carried out in 28.4% of cases, partial - in 24.8%, biopsy - in 0.9% of cases. The complication rate in this group was 30%. The most common events were swelling of the tongue (10%) and diastasis of posterior pharyngeal wall sutures (8.2%) that required redo surgery. CSF leakage and meningitis were rare (1.8% and 3.6%, respectively).</p><p><strong>Conclusion: </strong>Transoral access allows for gross total resection of midline tumors with low incidence of severe complications. Combination of transoral and transcranial approaches is advisable to increase extent of resection.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 3","pages":"111-119"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331888","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}
D N Okishev, An N Konovalov, A A Artemyev, E A Okisheva, Yu V Pilipenko, Sh Sh Eliava
{"title":"[Comparison of polymethyl methacrylate skull implant fixation by three types of titanium fasteners].","authors":"D N Okishev, An N Konovalov, A A Artemyev, E A Okisheva, Yu V Pilipenko, Sh Sh Eliava","doi":"10.17116/neiro20248802123","DOIUrl":"10.17116/neiro20248802123","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate mechanical strength of three methods of polymethyl methacrylate skull implant fixation in two experimental models.</p><p><strong>Material and methods: </strong>The first experiment was performed on a plastic model that was as close as possible to bone in structural characteristics. The second experiment was performed on a biological specimen (a ram's head). We assessed the quality of implant fixation to bone window edges by craniofixes, ties and microscrews and lateral intercortical screws.</p><p><strong>Results: </strong>Craniofixes are feasible for small flat flaps, but not advisable for wide highly curved implants. They are also the most expensive method of fixation. Implant fixation by ties and microscrews is a universal method comparable in price to craniofix. Lateral intercortical fixation is effective both for small flat implants and wide implants with large curvature. However, this method is not always applicable.</p><p><strong>Conclusion: </strong>Combined fixation by lateral intercortical screws and ties allows for the most effective fixation while reducing the overall price of consumables.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 2","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319362","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}
K V Efremov, A V Kozlov, S V Tanyashin, K A Kuldashev, R V Zabolotny
{"title":"[Convexity hyperostotic meningioma en plaque: a systematic review].","authors":"K V Efremov, A V Kozlov, S V Tanyashin, K A Kuldashev, R V Zabolotny","doi":"10.17116/neiro202488011103","DOIUrl":"10.17116/neiro202488011103","url":null,"abstract":"<p><strong>Background: </strong>Planar hyperostotic meningiomas account for 2-9% of intracranial meningiomas. They are characterized by planar node following the contours of the inner surface of the skull. Hyperostosis is present in most cases. Timely diagnosis of skull base tumors is usually simple due to early involvement of the cranial nerves. However, convexity meningiomas en plaque usually reach large dimensions that complicates surgery and radiotherapy.</p><p><strong>Objective: </strong>To analyze the current state of diagnosis, molecular biology and surgical treatment of hyperostotic meningiomas en plaque.</p><p><strong>Material and methods: </strong>A systematic review was performed in accordance with the PRISMA guidelines. Searching for literature data included the following keywords: «planar meningioma», «hyperostotic meningioma», «meningioma en plaque», «infiltrative meningioma». We reviewed the PubMed and Google Scholar databases until May 2023 and enrolled only full-text Russian-, English- or French-language reports.</p><p><strong>Results and discussion: </strong>Among primary 332 reports, 35 references met the inclusion criteria. We found less severity or absence of focal neurological symptoms, comparable incidence of intracranial hypertension and no histological differences between planar and nodular meningiomas. Analysis of molecular biological features of planar meningiomas, including cell cultures, is feasible. There is no consensus regarding surgical treatment and radiotherapy. Most publications are case reports.</p><p><strong>Conclusion: </strong>The results of treatment of planar hyperostotic meningiomas, especially large and giant ones, are unsatisfactory. There is no a generally accepted algorithm for treating patients in the literature. This problem requires further research.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 1","pages":"103-108"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708066","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}
A V Stanishevskiy, M A Legzdain, N R Saburov, D V Svistov, G V Gavrilov
{"title":"[Intracardiac migration of a ventriculoperitoneal shunt. A systematic literature review and case report].","authors":"A V Stanishevskiy, M A Legzdain, N R Saburov, D V Svistov, G V Gavrilov","doi":"10.17116/neiro20248806188","DOIUrl":"10.17116/neiro20248806188","url":null,"abstract":"<p><p>CSF shunting procedures are common in neurosurgery. A rare complication of these procedures is migration of distal catheter. We present a case of peritoneal catheter migration into the right heart chambers. A systematic review of appropriate literature data was carried out.</p><p><strong>Material and methods: </strong>We present a patient with communicating hydrocephalus after previous penetrating traumatic brain injury. Migration of peritoneal catheter into the right heart chambers occurred in 5 days after ventriculoperitoneal shunting. We performed a systematic review of literature data and analyzed all similar cases of intracardiac migration of ventriculoperitoneal catheter, risk factors of migration, possible complications and surgical treatments.</p><p><strong>Results: </strong>There were 38 articles describing 40 cases of distal catheter migration into the right heart chambers meeting the inclusion criteria. In 65% of patients, catheter migration was diagnosed after ≥2 months. Migration was asymptomatic in 21% of cases. Additionally, less than 50% of patients had no complications. Surgical treatment required complex techniques such as endovascular removal or thoracotomy in nearly 50% of cases.</p><p><strong>Conclusion: </strong>Migration of ventriculoperitoneal catheter into the right heart chambers is a rare and dangerous complication of CSF shunting procedures. Risk factors of this complication should be considered when scheduling surgical treatment and follow-up examinations.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 6","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":"142819452","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}
B A Bashiryan, O A Gadzhieva, L A Satanin, N A Mazerkina, E A Khukhlaeva, E A Lavrenyuk, V A Tere, O K Kwan, V V Roginsky
{"title":"[Prospective assessment of surgical stress response in patients with craniosynostosis: comparison of clinical and laboratory data].","authors":"B A Bashiryan, O A Gadzhieva, L A Satanin, N A Mazerkina, E A Khukhlaeva, E A Lavrenyuk, V A Tere, O K Kwan, V V Roginsky","doi":"10.17116/neiro20248804162","DOIUrl":"10.17116/neiro20248804162","url":null,"abstract":"<p><strong>Background: </strong>Highly traumatic surgical correction of craniosynostosis (CS) is usually followed by severe postoperative period and high risk of complications. Surgical stress response (SSR) is an important and often neglected cause of severe early postoperative period.</p><p><strong>Objective: </strong>To compare clinical and laboratory parameters of SSR in children who underwent various surgeries for CS.</p><p><strong>Material and methods: </strong>The study included 63 patients aged 7.02±4.12 months. All ones underwent surgery for CS between October 2021 and June 2022. We analyzed clinical and laboratory markers of SSR, as well as correlation with severity of surgical stress.</p><p><strong>Results: </strong>No surgical complications were observed. There were postoperative complications in 12 (19.0%) cases including febrile fever in 9 (14.3%) patients, severe pain and edematous syndromes with prolonged hospital-stay in 3 (4.8%) cases. Significant correlations were revealed between severity of surgical stress and certain laboratory markers (CRP, ACTH, T3, insulin, HOMA-IR). The last ones characterized SSR severity. Patients with high scores of stress response demonstrated more severe course of early postoperative period.</p><p><strong>Conclusion: </strong>Surgical stress scale makes it possible to predict early postoperative period and optimize patient management. Lower severity of surgical stress response following endoscopic interventions is another reason for the wider use of low-traumatic surgical methods in pediatric neurosurgery.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 4","pages":"62-70"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018883","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}
D I Pitskhelauri, N S Grachev, E S Kudieva, A Z Sanikidze
{"title":"[Microsurgical ventriculostomy of the third ventricle with access through a burrhole in the treatment of midly located deep-seated brain tumors].","authors":"D I Pitskhelauri, N S Grachev, E S Kudieva, A Z Sanikidze","doi":"10.17116/neiro2024880215","DOIUrl":"10.17116/neiro2024880215","url":null,"abstract":"<p><strong>Background: </strong>Currently, endoscopic third ventriculostomy and simultaneous biopsy of deep midline brain tumors are a generally accepted option in neurooncology. Nevertheless, effectiveness of this surgery and diagnostic accuracy of biopsy are not without drawbacks. An alternative to endoscopic surgery may be simultaneous microsurgical third ventriculostomy and biopsy of deep midline tumors.</p><p><strong>Objective: </strong>To evaluate effectiveness and safety of burr hole microsurgical third ventriculostomy in the treatment of deep midline brain tumors.</p><p><strong>Material and methods: </strong>We used transcortical (25 cases) and transcallosal (8 cases) approaches for microsurgical third ventriculostomy.</p><p><strong>Results: </strong>Initially scheduled biopsy was performed in 19 cases, partial resection in 6 cases, subtotal resection in 4 cases and total resection in 4 cases. All patients underwent microsurgical third ventriculostomy. In 12 cases, stenting of stoma was performed in addition to ventriculostomy. Biopsy was informative in all cases. Postoperative follow-up period ranged from 3 to 44 months (mean 29 months). There was no postoperative hydrocephalus and need for shunting procedure.</p><p><strong>Conclusion: </strong>Burr hole microsurgery may be an alternative to endoscopic surgery for the treatment of pineal, periaqueductal and third ventricular tumors.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 2","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":"140319366","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":"[Safety of robot-assisted implantation of deep electrodes for invasive stereo-EEG monitoring].","authors":"I M Alekseev, Zh Zh Pekov, N V Pedyash, A A Zuev","doi":"10.17116/neiro20248801128","DOIUrl":"10.17116/neiro20248801128","url":null,"abstract":"<p><p>Robot-assisted implantation of deep electrodes for stereo-EEG monitoring has become popular in recent years in patients with drug-resistant epilepsy. However, there are still few data on safety of this technique.</p><p><strong>Objective: </strong>To assess the incidence of complications in patients with drug-resistant epilepsy undergoing robot-assisted implantation of stereo-EEG electrodes.</p><p><strong>Material and methods: </strong>We retrospectively studied the results of implantation of stereo-EEG electrodes in 187 patients with drug-resistant epilepsy. All patients underwent non-invasive preoperative examination (video-EEG, MRI, PET, SPECT, MEG). In case of insufficient data, stereo-EEG monitoring was prescribed. We determined electrode insertion trajectory using a robotic station and MR images. Implantation of electrodes was carried out using a Rosa robot (Medtech, France). All patients underwent invasive EEG monitoring after implantation.</p><p><strong>Results: </strong>There were 11.25±3 electrodes per a patient. Implantation of one electrode took 7.5±4.9 min. Postoperative MRI revealed electrode malposition in 2.3% of cases. None was associated with complications. The complication rate per electrode was 0.6%. Complications affected stereo-EEG monitoring only in 3 cases (1.6%). The mortality rate was 0.5%. Bilateral implantation (<i>p</i>=0.005), insular (<i>p</i>=0.040) and occipital (<i>p</i>=0.045) deep electrode implantation were associated with lower incidence of complications. Longer duration of the procedure influenced the incidence of electrode placement in the lateral ventricle (<i>p</i>=0.028), and implantation in the frontal lobe was more often associated with epidural placement of electrodes (<i>p</i>=0.039).</p><p><strong>Conclusion: </strong>Robot-assisted implantation of stereo-EEG electrodes is a safe procedure with minimal risk of complications. Rare electrode malposition does not usually affect invasive monitoring.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"88 1","pages":"28-38"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708030","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}