Ukrainian Interventional Neuroradiology and Surgery最新文献

{"title":"Summary a case of endovascular treatment of a patient with tandem occlusions of cerebral arteries caused by a mine-explosive injury","authors":"Y. Cherednychenko","doi":"10.26683/2786-4855-2022-4(42)-51-61","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-4(42)-51-61","url":null,"abstract":"One case of successful endovascular treatment of a patient with a mine blast injury is presented, which due to the action of the blast wave led to traumatic dissection of the internal carotid artery and the right anterior cerebral artery, which in turn led to the development of a secondary ischemic stroke.The patient is a combatant, a 59-year-old man. During the artillery shelling of the position, he was thrown back by the explosive wave and briefly lost consciousness. Upon regaining consciousness, within two hours there was weakness and decreased sensation in the left limbs, which completely regressed, but cognitive impairment and communication problems were observed. Computed tomography of the brain performed in the hospital closest to the hostilities did not reveal any pathological changes. Two days later, the patient was taken to the Dnipropetrovsk Regional Hospital named after I.I. Mechnikov. Repeated computed tomography revealed a small infarct in the basin of Heubner's right artery. Cerebral angiography (CT angiography and subtraction selective cerebral angiography) revealed a short occlusion of the right internal carotid artery from its ostium to the upper border of its bulb, and lack of contrast of the A1-segment of the right anterior cerebral artery. Changes on the CT perfusion maps indicated critical oligemia in the entire basin area of the right middle cerebral artery. The patient at hospitalization is conscious, with preserved movements and sensitivity. However, the patient has significant cognitive decline (MoCA (Montreal Cognitive Assessment Scale) 17). After double antiplatelet preparation, endovascular recanalization and stenting of the occluded right internal carotid artery was performed via transfemoral access using combined proximal and distal antiembolic protection (Cello 9F balloon guide catheter and SpiderFX distal antiembolic protection device) and with implantation of a carotid stent Protégé. Blood flow in the right internal carotid artery has been restored, there are no carotid artery stenoses on the right, the basin of the middle cerebral artery on the right is completely contrasted. In two days, there is normalization on the CT perfusion maps and recovery of the patient's cognitive functions to the MoCA 24.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127623422","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":"Structural characteristics of chronic subdural hematomas in elderly and senile patients and their prognostic significance","authors":"L. Borovyk, T. Malysheva","doi":"10.26683/2786-4855-2022-4(42)-20-30","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-4(42)-20-30","url":null,"abstract":"o account morphological characteristicsMaterials and methods. Retrospective analysis of the results of diagnosis and treatment of patients with CSDH treated in the neurotrauma department of the Romodanov Institute of Neurosurgery NAMS of Ukraine and the City Hospital for Emergency and Emergency Medicine of Zaporizhzhya in 2010‒2019. Among the patients were 80 elderly people, 32 senile and 6 long-lived people. Multispiral computed tomography (MSCT) was performed in 86.7 % of patients, magnetic resonance imaging (MRI) in 13.3 %. In 118 cases, surgical intervention was performed (various types and volume), in 67 % ‒ a morphological study of the fragments of the capsule of the CSDH was performed.Results. The indication for surgery in elderly and senile persons with CSDH is the presence of hematomas with a volume of ≥100 cm3, regardless of the severity of the dislocation syndrome. In 95 % of observations, accompanying somatic diseases were detected. Control of treatment effectiveness was carried out with the help of MRI (in 73.5 % of cases) and CT (in 26.5 %). According to the results of histological studies, three variants of the structure of the capsule of CSDH have been established (according to the density of the location of vessels (the level of expression of the vascular endothelial growth factor (VEGF)) and the ratio of mesenchymal cells), which, together with clinical data, makes it possible to determine the genesis of CSDH. Also, several variants of the structure of the capsule of CSDH were identified, depending on the timing of the diagnosis and morphological examination. Analysis of the relative number and ratio of different cell pools (lymphocytes, fibroblasts, fibrocytes), quantification of immunopositive cells with a reaction to VEGF antibodies, as well as determination of the number of newly formed vessels per unit area makes it possible to predict the course and risk of recurrence of CSDH. Conclusions. The clinical and diagnostic characteristic of CSDH, characteristic of the elderly and senile, is the presence of hematomas with a volume of ≥100 cm3 and the discrepancy between the severity of the condition, clinical and neurological manifestations, and the degree of expressiveness of dislocation-compression changes according to MSCT/MRI data. It is effective to remove CSDH through 1 – 2 milling holes. Microcraniotomy is considered appropriate for a hematoma with complex neuroimaging architecture (multiple septa, layers, trabeculae), in some cases of hematoma recurrence. If the inner surface of the capsule is turned to the blood clot and is represented by a layer of spindle-shaped cells, this indicates a non-traumatic origin of the hematoma. A staged complex clinical and diagnostic examination for CSDH has both clinical and purely practical significance (especially expert), justifying the costs of treatment and insurance payments, ensures the social adaptation of the patient and brings the solution of these issues closer to international","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123329162","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":"Kimmerle anomaly as a cause of extravasal compression of the vertebral artery","authors":"M.Je. Polishchuk, A.V. Muravskyi, O. Honcharuk, M. Vyval","doi":"10.26683/2786-4855-2022-4(42)-14-19","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-4(42)-14-19","url":null,"abstract":"Kimmerle anomaly, also known as ponticulus posticus, is a commonly known variant of the atlas anatomy. It occurs as a result of complete or incomplete ossification of the posterior atlanto-occipital membrane over the groove of the vertebral artery, which leads to the formation of an arcuate foramina containing the vertebral artery and the posterior branch of the C1 spinal nerve. This anatomical variation is associated with symptoms of vertebrobasilar insufficiency, various types of headache, visual impairment, photopsia, syncope, drowsiness, reduced work capacity, unsteady gait, sleep disturbance, panic attacks.Objective of the article is to highlight the attention of physicians on the widespread and not well understood Kimmerle anomaly, which is the cause of ischemic disorders in the vertebrobasilar circulation due to extravasal compression of the vertebral arteries.In the case of signs of impaired blood flow in the vertebrobasilar circulation, an X-ray of the cervical spine has to be done. In case of Kimmerle anomaly, ultrasound of neck vessels and transcranial doppler with functional tests should be performed. In the case of significant influence of disorder on the vertebrobasilar circulation, computed tomography with angiography is mandatory. If the patient's large vertebral artery is compressed, indications for surgical decompression of the vertebral artery at the level of the atlas is indicated. In cases of mild symptoms of cerebral vertebrobasilar circulation, symptomatic medication, wearing a Chance collar, physical therapy, and regimen restrictions are prescribed.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124128820","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":"Endovascular treatment of «mirror» aneurysms of the middle cerebral artery","authors":"D. Shchehlov, O.P. Hnelytsia, O.Je. Svyrydiuk, M. S. Gudym, M. Vyval, M. Mamonova","doi":"10.26683/2786-4855-2022-4(42)-31-43","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-4(42)-31-43","url":null,"abstract":"Objective ‒ to analyze the results of endovascular treatment of the «mirror» MCA aneurysms.Materials and methods. A retrospective analysis of the 172 patients with multiple cerebral aneurysms, who were treated between the period from April 2016 to February 2022 at Scientific and Practical Center of Endovascular Neuroradiology of the National Academy of Medical Sciences of Ukraine was conducted. «Mirror» MCA aneurysms were found in 20 (11.6 %) patients. Twenty patients had 54 aneurysms (8 patients had 12 aneurysms except MCA and 2 patients had 2 MCA aneurysms at one side). In one patient, a combination of «mirror» aneurysms of MCA and internal carotid artery was found. The group included 8 (40 %) men and 12 (60 %) women. The average age of the patients was (47.11 ± 11.73) years; range 23‒64 years. 8 (40 %) patients had subarachnoid hemorrhage due to MCA aneurysm rupture, in another 3 (15 %) patients another aneurysm was the cause of rupture, and 9 (45 %) of patients underwent surgery for unruptured aneurysms. The choice of treatment strategy and its staging, peri-procedural (bleeding, migration of coils, thrombus formation) and postoperative complications and the result of the treatment at the time of discharge and 3–6 months after the final treatment were analyzed. Qualitative assessment of aneurysm occlusion was performed intraoperatively and during follow-up angiographic examinations according to the modified Raymond‒Roy scale.Results. Of all 54 aneurysms in 20 patients, 49 aneurysms (40 MCA aneurysms and 9 aneurysms in other localization) were excluded endovascularly, 1 MCA aneurysm was clipped, and 4 aneurysms due to their small size were left for observation with regular follow-up examinations due to the low risk of rupture. Bilateral one-session endovascular occlusion of the «mirror» MCA aneurysms was performed in 11 patients, and staged procedure was performed in 9. Among 40 surgically treated «mirror» MCA aneurysms, 24 (60 %) were excluded with only coiling, 7 (17.5 %) with stent assistance coiling, 7 (17.5 %) with balloon assistance coiling, 1 aneurysm (2.5 %) was treated with parent artery occlusion, and 1 aneurysm (2.5 %) was clipped. Intraoperative complications occurred in 2 patients. One patient had an intraoperative rupture of an ICA aneurysm combined with «mirror» MCA aneurysms, which could not be stopped and ICA sacrifice was performed. In another, the coils migrated into the artery. In the first patient, the course of the disease was complicated with brain infarction in the left ICA region. Another patient was prescribed antiplatelet therapy in postoperative period, which was uneventful. Follow-up angiography studies were available in 16 patients. At the follow-up examination, significant recanalization of one of the MCA aneurysm was detected in two patients, who were successfully occluded during the second procedure without negative clinical outcome. In 15 patients at the control examination, the evaluation of the result accord","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126471254","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":"Analysis of the results of treatment of patients with gunshotwound to the head in acute and early postoperative period","authors":"Yu.М. Yu.М.","doi":"10.26683/2786-4855-2022-4(42)-44-50","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-4(42)-44-50","url":null,"abstract":"Objective ‒ to evaluate the results of treatment of gunshot wounds to the head in the conditions of a specialized neurosurgical center and to determine the factors that negatively affected the results of treatment.Materials and methods. The study is retrospective. 109 cases with open and closed craniocerebral injuries, which came to the military medical center during the hostilities in the East of Ukraine in the period from March 2014 to the end of December 2017 were analyzed. All patients were treated at the National Military Medical Clinical Center «Main Military Clinical Hospital». Collected information on demographic indicators, features of assistance provided at the stages of evacuation, type of injury. The Glasgow outcome scale (GOS) was used to evaluate the results. Results. Shrapnel injuries prevailed in 82 (75.23 %) cases, bullet wounds were diagnosed less frequently in 17 (15.6 %) cases, and 10 (9.17 %) servicemen were injured as a result of the blast wave. The vast majority of the wounded were admitted to the military medical center in good condition – 81 (74.32 %) patients, in moderate condition – 15 (13.75 %), in coma I – 5 (4.59 %), in coma II – 3 (2.75 %), in coma III – 3 (2.75 %). Computed tomography was performed in all patients upon admission. The frequency of infectious complications was 31.19 %. 45 patients underwent repeated surgeries, 26 were operated on three times for gunshot wounds in different medical institutions at different stages, 5 patients were operated on more than three times. 52 (47.7 %) of the wounded had a good recovery result (GOS 4, 5). 44 (40.36 %) of the wounded were discharged with the result of GOS 3, 3 patients were in a vegetative state (GOS 2), 10 (9.17 %) patients died (GOS 1). Statistically significant (p<0.05) factors that had a negative impact on the treatment results are GCS <12 at admission, Injury severity score >25, CSF leak, infectious complications, repeated operations.Conclusions. All patients with gunshot wounds to the head should have a CT scan of the head immediately upon admission to a medical facility. Patients should be hospitalized in specialized centers where there is a full examination, CT and the possibility of providing specialized neurosurgical care. This reduces the number of repeated surgical interventions and, accordingly, complications.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129233074","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":"Determining the etiology of cerebral stroke: from the most prevalent to rare causes","authors":"Y. Flomin, T.V. Hetman, M. Guliaieva, I.R. Havryliv, O. Tsurkalenko","doi":"10.26683/2786-4855-2022-2(40)-14-40","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-2(40)-14-40","url":null,"abstract":"Cerebral stroke remains the leading cause of death and disability worldwide as well as in Ukraine. After a cerebral stroke, there is an increased risk of a new cerebral stroke (9‒15 % within 1 year), and about a quarter of all cerebral stroke are recurrent. Up to 80 % of recurrent cerebral stroke can be avoided through lifestyle modifications (healthy diet, sufficient amount of physical activity, normalization of body weight, cessation of smoking and alcohol abuse) and control of chronic diseases such as hypertension, diabetes, hyperlipidemia and atrial fibrillation. The key to effective secondary prevention is determining the etiology of cerebral stroke, which requires a primary examination in all cases and a number of additional tests as needed. The most common causes of ischemic cerebral stroke are cardiogenic embolism, atherosclerosis of the large cerebral arteries (macroangiopathy), and brain small vessels disease (microangiopathy), but approximately 1/3 of cerebral stroke have other, rear, determined cause or the cause remains unknown despite the appropriate workup (cryptogenic cerebral stroke). In the review, we discuss modern approaches to ischemic cerebral stroke classification and determination of their etiology, from the most prevalent to the rarest causes. A careful search for the cause of cerebral stroke is particularly important in young patients (aged 18 to 50 years) with a high life expectancy. We have reviewed in detail the possibilities of screening for subclinical atrial fibrillation by long-term cardiac monitoring with implantable devices and the diagnosis of monogenetic causes of cerebral stroke, with a particular focus on Fabry disease, for which there is an effective treatment.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126066971","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 revascularization (bypass surgery) in the treatment of complicated cerebral aneurysms","authors":"V. Moroz, O. Harmatina, I. Skorokhoda, N. Shakhin, R. Ghanem, U. Maliar","doi":"10.26683/2786-4855-2022-2(40)-55-71","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-2(40)-55-71","url":null,"abstract":"The aim of surgical treatment of any cerebral aneurysm is to achieve its total exclusion from the bloodstream. Although the progress in the development and implementation of microsurgical and the latest endovascular technologies, in many cases, the treatment of complex cerebral aneurysms is not an easy task. Unsatisfactory results of the exclusion of complicated cerebral aneurysms are due to many factors, for instance: gigantic size, fusiform or dolichoectatic configuration of the cerebral aneurysm, the presence of atherosclerotic changes, anatomical features of the departure of functionally important arteries directly from the cerebral aneurysm. Such cerebral aneurysms are quite problematic both for microsurgical remodeling clipping and for endovascular exclusion. At the current stage, the introduction and use of the microanastomosis technique provides additional options and expands the possibilities of surgical treatment of complex cerebral aneurysms.Objective ‒ to analyze the possibilities and results of surgical treatment of complicated cerebral aneurysms using the technique of surgical revascularization (bypass surgery).Materials and methods. An analysis of the results of the examination and surgical treatment of 16 patients with complicated cerebral aneurysms for the period from 2016 to 2020, who were treated and operated on in the emergency vascular neurosurgery department with the X-ray operating department Romodanov Institute of Neurosurgery of NAMS of Ukraine. All patients diagnosed with complicated cerebral aneurysms had gigantic sizes. All cases of surgical intervention included placement of extra-intracranial microanastomosis or intra-intracranial anastomosis, sometimes a combination of it, to ensure normal blood supply to the vessel of complicated cerebral aneurysm that were planned to be devascularized. In 14 observations, one-time anastomosis and exclusion of complicated cerebral aneurysms were performed. In 2 observations, the first stage was an anastomosis without exclusion of the complicated cerebral aneurysms due to insufficient vascularization of the distal arterial branch for deconstructive exclusion of aneurysm.Results. Satisfactory results of surgical treatment (grade 1 and 2 of Modified Rankin Scale (MRS)) in the general group of patients were observed in 13 (81 %) patients with complicated cerebral aneurysms. Unsatisfactory results of surgical treatment occurred in 3 (19 %) observations. Profound disability (MRS grade 5) as a result of surgical treatment was recorded in 1 (6 %) patient. Cases that ended fatally occurred in 2 (13 %) observations of the total group of patients. In the group of patients with surgical revascularization and excluded complicated cerebral aneurysms, satisfactory results were observed in 13 (92.9 %) patients. Fatal results of surgical treatment were recorded in 2 patients with a hemorrhagic course of complicated cerebral aneurysms, in which surgical revascularization was performed as first stage","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126762533","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 endovascular and microsurgical treatment of multiple cerebral aneurysms","authors":"D. Shchehlov, O.P. Hnelytsia, M. S. Gudym, O. Svyrydiuk, M. Vyval","doi":"10.26683/2786-4855-2022-1(39)-14-21","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-1(39)-14-21","url":null,"abstract":"Recent advances in interventional neuroradiology brought all multiple cerebral aneurysms (MCA) could be occluded using endovascular techniques. A multimodal approach (combined microsurgical and endovascular) should be considered as a possible treatment option for MCA to improve treatment outcomes by simplifying the technical complexity of endovascular occlusion and providing sustained long-term occlusion.Objective ‒ to analyze the results of combined microsurgical and endovascular treatment of MCA.Materials and methods. A retrospective analysis of the results of evaluation and surgical treatment of 172 patients with MCA in Scientific-practical Center of Endovascular Neuroradiology NAMS of Ukraine from April 2016 to February 2022. In 7 (4.1 %) patients, combined endovascular and microsurgical treatment of MCA was done.Results. In 7 patients (4 women and 3 men, mean age ‒ 39.3 years), 19 aneurysms (size from 3 to 15 mm) were detected, of which 15 (78.9 %) were located in the anterior semicircle, 4 (21.1 % ) ‒ in the posterior. All aneurysms of the basilar circulation were excluded using endovascular approach. In 4 (57.1 %) patients, the aneurysms were ruptured. Ten (52.6 %) aneurysms were occluded endovascularly (6 with coil s only, 2 with balloon-assisted coiling, 1 with stent-assisted coiling, and 1 with flow-deverter stent), 9 (47.4 %) aneurysms were clipped. One (5.3 %) periprocedural complication after endovascular treatment was noted ‒ prolapse of the coil into the vessel. In 2 (22.2 %) cases, residual aneurysm was detected after clipping, which was occluded with coils. The rate of total aneurysm occlusion at discharge was 94.7 %. All patients were discharged from the hospital with favorable results (score ≤2 points on the modified Rankine scale). Stable effective occlusion after 3 months was noted in 17 (89.5 %) aneurysms, 2 (10.5 %) aneurysms were filled at the level of the neck.Conclusions. Combined endovascular and microsurgical treatment is a technically feasible treatment option for MCA and is considered in patients where the conventional approach with either method has failed or is associated with a high risk of complications. Our series has demonstrated the safety and efficacy of combined MCA treatment.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122378439","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":"Spontaneous occlusion of the cerebral arteriovenous malformations","authors":"D. Shchehlov, O. Svyrydiuk, S.V. Chebanyuk, O. Slobodian, M. Vyval","doi":"10.26683/2786-4855-2022-1(39)-34-39","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-1(39)-34-39","url":null,"abstract":"Spontaneous occlusion of arteriovenous malformations (AVM), characterized by complete disappearance of the AVM nidus and early venous drainage, and is a rare. The frequency of this phenomenon varied from 0.1 to 1.3 %.We analyzed two cases of spontaneous occlusion of cerebral AVMs with a non-hemorrhagic debut after 3 and 13 years in women aged 28 and 40 years, respectively. In both cases AVM was diagnosed during routine neuroimaging because of headache. Both patients had superficial small malformations. After discussing the risks of surgical treatment, both patients refused to perform any intervention. Scheduled angiography was performed 3 years after the diagnosis to follow-up the course of the disease and revealed complete disappearance of the AVM. Another patient noted persistent regression of headache after 3 years. Follow-up angiography was performed 13 years after diagnosis and confirmed spontaneous occlusion of the AVM. Given the data on the recurrence of the disease after spontaneous occlusion, such patients require long-term follow-up.When an AVM ruptures, hemodynamic changes may explain the thrombosis of the malformation, but the mechanisms of spontaneous occlusion in non-ruptured AVM remain unclear.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131593302","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":"Use of telemedicine in neuro intervention practice","authors":"D. Shchehlov, J. Fiehler, V. Kalousek, M. Vyval, O. Svyrydiuk, A. Kyselyova","doi":"10.26683/2786-4855-2022-1(39)-50-53","DOIUrl":"https://doi.org/10.26683/2786-4855-2022-1(39)-50-53","url":null,"abstract":"A decade ago, telemedicine was considered a cumbersome and unattainable technology, but now the rapid development of telecommunications provides the basis for its dissemination as a reliable and useful direction in treatment. This method of medical care has recently begun to be used in Ukraine.Interventional neuroradiology is one of the most technologically advanced and leading areas of modern medicine with a wide range of tools for minimally invasive treatment of various vascular pathologies of the nervous system. Over the past 3 years, due to the restrictions associated with the COVID-19 pandemic, as well as the russian-ukrainian war, cooperation between specialists in this field has become much more complicated. And first of all it concerns the education of the specialists and the introduction of new methods of endovascular treatment in Ukraine. In such conditions, the integration of telemedicine into clinical practice is one of the priorities.","PeriodicalId":325397,"journal":{"name":"Ukrainian Interventional Neuroradiology and Surgery","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122125152","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}