Вестник неврологии, психиатрии и нейрохирургии最新文献

{"title":"Psychogenic factors and aggressive behavior in patients with multi-infarct dementia","authors":"B.D. Tsygankov, Yu.V. Dobrovolskaya, U.Kh. Gadzhieva, I.V. Stepanova","doi":"10.33920/med-01-2309-01","DOIUrl":"https://doi.org/10.33920/med-01-2309-01","url":null,"abstract":"The article is devoted to the study of the relationship between psychogenic factors and aggressive behavior in patients with multi-infarct dementia in order to develop methods of psychocorrection, improve the quality of lives of patients and those caring for them, as well as to increase the effectiveness of treatment. Material and methods: 49 patients (n=49) with a diagnosis of multi-infarct dementia (F01.1) and accompanying aggressive behavior took part in the study. Clinical-anamnestic, clinical-psychopathological, and psychometric diagnostic methods were used. Results: in 27 patients (87.1%), physical aggression was statistically significantly more common due to the relatives’ careless daily care implementation, which led to an increase in the chances of developing physical aggression and its severity. In 78.6% of cases (in 22 patients), physical aggression occurred statistically significantly more often with the violation of the daily routine and was associated with the risk of developing physical aggression and a greater degree of its severity. Irritability was statistically significantly more common in 13 subjects (56.5% of cases) due to their own helplessness and was associated with higher chances of the irritability development and its severity. In 17 patients (68%), verbal aggression was statistically significantly more common and occurred when the patients’ appeals to caregivers were not understood, which led to an increase in the odds ratio of the verbal aggression development and its severity. The relationship between the patients’ aggression and the caregivers’ negative attitude towards them was not found. Conclusions: the data obtained indicate that patients with multi-infarct dementia most often show physical aggression, which is closely related to such factors as \"the relatives’ careless daily care implementation\" and \"the violation of the daily routine\". In addition, the patients were characterized by the manifestation of irritability due to \"their own helplessness against the background of the underlying disease\" and the manifestation of verbal aggression when \"the relatives did not understand their appeals\".","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136377731","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":"Psychological defenses in patients with autonomic nervous system disorder","authors":"I.V. Khyanikyainen, N.A. Rzheutskaya","doi":"10.33920/med-01-2309-03","DOIUrl":"https://doi.org/10.33920/med-01-2309-03","url":null,"abstract":"In order to identify psychosocial characteristics of individuals with autonomic nervous system disorder (ANSD), 104 patients of the organized population of Petrozavodsk (n=104; mean age 36.8±10.7 years; gender index 1:1) were examined. The control group included healthy individuals (n=30; mean age 36.1±5.5 years; gender index 1:1; p=0.761). The ANSD diagnosis was confirmed by means of the Questionnaire for identifying signs of vegetative changes and the Study scheme for detecting signs of vegetative disorders (Vein A.M. et al., 2003), as well as by palpatory examination using the Markelov-Naryshkin method. The calculation of the Kerdo index in the patients with ANSD showed a predominance of sympathicotonia (40.38% and 50.0% of cases among men and women, respectively) over parasympathicotonia (21.15% of the patients without gender differences). In addition, psychological defenses (PD) were investigated using the method of the Life Style Index (LSI) (R. Plutchik, H. Kellerman, R. Conte, 1979). It was found that the patients with ANSD were characterized by an increase in the overall stress index of psychological defense mechanisms due to “regression” (22.28±15.45 (0) / 35.57±14.6 (9.33±5.31)), “projections” (23.97±17.61 (10.78±3.59) / 31.23±18.05 (12.83±6.11)), and “substitutions” (20.43±12.74 (5.65±1.15) / 16.29±10.85 (6.67±3.98)), with statistically rarer use of “denial” (36.71±15.42 (47.68±13.98) / 34.18±17.64 (51.8±14.37) percentiles among men with ANSD (healthy individuals) / women with ANSD (healthy individuals); p=0.001). Gender specificity was noted only in relation to the PD “reactive education”, with its predominant use by women 37.88±23.71 (compared with 23.27±19.37 percentiles in men; p<0.01). The identified psychosocial predictors are aimed at timely diagnosis and optimization of medical and psychological rehabilitation of patients with ANSD.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136378554","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":"Vestibular schwannomas with neuroimaging signs of spontaneous regression: frequency of continued growth after surgery","authors":"M. Yu. Kurnukhina, A. M. Brevdo, V. Yu. Cherebillo, G. V. Gavrilov, D. Sh. Ashryapova, A. O. Politova","doi":"10.33920/med-01-2309-06","DOIUrl":"https://doi.org/10.33920/med-01-2309-06","url":null,"abstract":"Purpose. To determine the frequency of continued growth after surgical treatment in patients with neuroimaging signs of spontaneous regression of vestibular schwannoma. Material and methods. The study included 55 patients with histologically verified vestibular schwannoma. For a comparative assessment of the results of the study, 2 groups were formed: group I included 58.2 % of patients who had no signs of spontaneous regression (gender ratio — 1:4, more often — women), group II included 41.8 % of patients with the presence of one of the MR signs of regression (gender ratio was 1:1.3). The following parameters were analyzed as the studied MR characteristics: the presence of scalloped borders, the filling of the internal auditory canal with cerebrospinal fluid, and the heterogeneity of the accumulation of contrast agent by the tumor. The retrosigmoid access was used for the patients of the studied groups. Results. The patients with these neuroimaging parameters were characterized by a prolonged asymptomatic period which led to the diagnosis of vestibular schwannoma in the late stages — KOOS 4 (𝜒2=4.8; p<0.03). In the patients with MR characteristics of spontaneous regression with any size of vestibular schwannoma, a high frequency of continued growth after surgical treatment was revealed (p<0.05), which demonstrates the «aggressiveness» of the course of the disease. The results obtained indicate the need for increased oncological alertness in these patients. Conclusions. A detailed study of the MR characteristics of spontaneous regression of vestibular schwannomas can improve the patients’ quality of life and treatment outcomes.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136377729","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":"Comparative analysis of the results of surgical treatment of chronic subdural hematomas by craniotomy and burr hole surgery","authors":"K. B. Yrysov, A. Zh. Seideldaev, Zh. T. Tashibekov, A. A. Kanyev","doi":"10.33920/med-01-2309-04","DOIUrl":"https://doi.org/10.33920/med-01-2309-04","url":null,"abstract":"A chronic subdural hematoma is a disease of the elderly. The analysis of a series of more than 200 surgical interventions for chronic subdural hematoma over a 5‑year period is presented. The clinical picture and neurosurgical treatment are considered with a special emphasis on the surgical technique. Material and methods. In the period from 2017 to 2022, a retrospective analysis of 120 patients (74 men and 46 women, with a mean age of 77.4 years [ranging from 24 to 89 years]) suffering from chronic subdural hematoma was performed. Results. 88 craniotomies and 32 burr holes were performed. Forty-two patients after craniotomy (28 %) required surgical revision, in contrast to 6 patients after burr hole surgery (14 %). Craniectomy was performed as a last resort after at least 3 previous evacuations. Conclusion. Craniotomy seems to have a higher chronic subdural hematoma recurrence rate; therefore, burr hole surgery should be a preferable technique. Craniectomy may be a good therapy option for complicated recurrent chronic subdural hematomas.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136377732","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 transforaminal epidural blocks in patients with radiculopathy caused by herniated disc of the cervical spine","authors":"A. L. Krivoshapkin, I. D. Savitskiy, A. O. Gushcha, V. S. Klimov, G. S. Sergeev, I. A. Savitskaya, A. S. Gaytan, O. A. Abdullaev","doi":"10.33920/med-01-2309-07","DOIUrl":"https://doi.org/10.33920/med-01-2309-07","url":null,"abstract":"Aim of the research. To study the efficacy and safety of treating patients with cervical radicular pain that is resistant to conservative treatment. Material and methods. The results of treatment of 30 patients with herniated discs of the cervical spine and persistent radicular pain syndrome, who had an indication for surgical treatment, were studied. All subjects underwent transforaminal epidural block (TEB), and in case of its low efficiency, the patients were offered surgical treatment. The patients'condition was assessed in dynamics over 2 years, including on the basis of indicators of the visual analog scale (VAS), the Neck Disability Index (NDI) questionnaire, and motor dysfunction in the limb according to the MRC Scale for Muscle Strength (MRC). Results. After 1 month: 21 (70 %) patients noted a significant (at least 50 %), persistent decrease in the intensity of radicular pain during the first month after TEB; a decrease in NDI values was noted in all patients. In 83.3 % (n-10) of the patients, there was a complete recovery of motor function in the limb. Two (6.7 %) patients underwent surgical treatment. After 24 months: All patients maintained a decrease in NDI scores (median 4 [0;6]). In 21 (70 %) patients, a stable positive effect from the conducted TEB remained. Four (13.3 %) patients were operated on, while five (16.7 %) patients refused surgical treatment and continued conservative treatment with a positive effect over time. Thus, all patients showed a significant decrease in the intensity of radicular and local pain in the neck with a median of 0 [0;0]. A complete restoration of muscle strength was found in all patients with moderate paresis of the arm before manipulation (n-12). Only 5 patients (16.7 %) retained periodic moderate (not exceeding 3 points by the VAS) local pain in the neck, and four (13.3 %) patients noted periodic, mild (not exceeding 3 points by the VAS) radicular pain. Conclusion. The use of TEB in the treatment of patients with radiculopathy caused by herniated discs of the cervical spine prevents the need for surgical treatment in 70 % of the patients, while maintaining a high quality of life.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136378556","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 interventional therapy and exercise therapy for non-specific low back pain","authors":"A.Yu. Novikov, L.P. Goldobina, Sh.M. Safin, Yu.O. Novikov","doi":"10.33920/med-01-2309-05","DOIUrl":"https://doi.org/10.33920/med-01-2309-05","url":null,"abstract":"Introduction. Conservative treatment of non-specific low back pain (NSLBP) is not always effective. While the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants is currently a recognized criterion standard in the NSLBP treatment, the use of interventional therapy needs further clarification, and its use in combination with exercise therapy is not sufficiently covered. Aim. To evaluate the effectiveness of selective interventional therapy in combination with individual exercise therapy in patients with NSLBP. Materials and methods. A randomized controlled trial included 124 patients with NSLBP, aged 46.2±10.1 years, with a disease duration from 1 to 12 years. In the main group (n=102), selective interventional therapy with individual exercise therapy was used. The patients of the control group (n=22) were treated in accordance with the standard of medical care for NSLBP. The efficacy of treatment was evaluated using the developed quantitative assessment of biomechanical disorders of the spine. Results. The study showed that selective interventional therapy in combination with exercise therapy in patients with non-specific low back pain has an effect on various links in the pathogenesis of this disease. After the course of treatment, there was a significant decrease in biomechanical disorders (p<0.001), as well as in the intensity of pain according to VAS both after treatment and during catamnestic examination (p<0.001). Moreover, the highest rates were detected with discogenic pain syndrome, and the lowest rates - with spondyloarthrosis. Conclusion. Selective interventional therapy in combination with individual exercise therapy in patients with NSLBP contributes to the rapid recovery of biomechanical disorders in the spine and stable long-term remission.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136378555","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 large posttraumatic false aneurysm of the S2 segment of the subclavian artery: clinical case and literature review","authors":"M. M. Muminzhonova, G. I. Antonov, G. E. Chmutin, E. R. Miklashevich, S. Yu. Gladyshev, I. I. Shumakov, S. V. Melnichuk, Z. S. Kaitova, A. V. Fedyanin, A. B. Kulmuradov, M. I. Galkina, E. G. Chmutin","doi":"10.33920/med-01-2309-02","DOIUrl":"https://doi.org/10.33920/med-01-2309-02","url":null,"abstract":"Introduction. Pseudoaneurysms of the subclavian artery are a rare pathology and most frequently occur due to trauma. According to the current literature, subclavian artery aneurysms account for 1 % of all peripheral artery aneurysms. This pathology, although rare, may be accompanied by the risk of rupture, thrombosis, or distal embolism of the arterial lumen. Objective. To demonstrate a clinical case of a patient with successful treatment of subclavian artery pseudoaneurysm by means of modern minimally invasive endovascular technique. Material and methods. The article presents our clinical case with the use of endovascular technique for the treatment of large posttraumatic pseudoaneurysm of the S2 segment of the left subclavian artery using the Bard LifeStream balloon stent graft.Discussion. Currently, direct surgery is considered to be the gold standard of treatment in extracranial aneurysms. Meanwhile, availability of minimally invasive methods allows minimizing the risk by performing endovascular treatment and thus reducing the risk of foreign bodies and infectious complications associated with a large volume of surgical intervention in direct surgery, reducing damage to the brachial plexus, decreasing the number of beddays, and contributing to early rehabilitation measures. The strategy of choice in favor of endovascular treatment should be individual for each patient taking into account such factors as localization, aneurysm size, compression of nearby cranial nerves, and concomitant pathology with high risk of open surgical treatment. Conclusions. Careful selection of patients for endovascular technique will ensure good long-term outcome using all advantages of this technique. At present, it is still relevant and crucial to minimize complications and iatrogenic postoperative lesions in patients with this disease. For this reason, endovascular surgeries should be performed at the stage of specialized medical care by an experienced surgeon.Key words: subclavian artery, false aneurysm, posttraumatic aneurysm, stent graft, endovascular treatment, open surgery, minimally invasive surgery.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136378557","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 aspects of the development of anxiety and depressive disorders in students of higher medical educational institutions after COVID-19","authors":"A. S. Nilova, N. V. Filippova, Yu. B. Barylnik, I. A. Glushakov, V. D. Glushakova","doi":"10.33920/med-01-2305-01","DOIUrl":"https://doi.org/10.33920/med-01-2305-01","url":null,"abstract":"The study of anxiety and depressive disorders has not lost its relevance for many decades, and is even more relevant due to the possibility of their development after illnesses caused by new infectious agents. Currently, anxiety and depressive disorders can be attributed not only to general medical, but also to social problems. These disorders affect all aspects of the patient's life and disrupt his/her social adaptation. Anxiety and depression are the most common mental disorders with a high incidence and have become a major public health issue worldwide. The purpose of this work was to analyze the possibility of development of depression and anxiety in students of higher medical educational institutions who had the novel coronavirus infection. The results of the study confirmed the possible relationship between the development of anxiety and depressive disorders in students in higher medical schools during the year after the COVID-19 caused by SARS-CoV-2.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136345492","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":"Using guided breathing exercises to prevent mental health complications in the post-COVID period","authors":"N. I. Mikulyak, N. L. Ilyina, A. A. Nemova, I. A. Sorokin","doi":"10.33920/med-01-2305-02","DOIUrl":"https://doi.org/10.33920/med-01-2305-02","url":null,"abstract":"The novel coronavirus infection has been one of the major public health issues of the past few years. Most COVID-19 patients report loss of energy, difficulty concentrating, memory loss and difficulty remembering, decreased motivation and mood. The purpose of our work was to determine the differences between general performance and brain rhythms in COVID-19 patients and those who had not been infected, and to assess the effects of breathing exercises (BE) on changes in these parameters in order to recommend the proposed therapy. The parameters of bioelectrical activity of the brain in patients after the novel coronavirus infection and those who had not been infected were studied by means of hardware-software complex «Omega-M». Statistical processing was performed using Microsoft Office.During the study, the following significant changes were observed: decreased efficiency in COVID-19 sufferers, reduced alpha and beta rhythms and negligible changes after BE compared to those who had not had COVID-19, and higher delta and theta waves and lack of their normalization after BE in COVID-19 sufferers. Based on the results obtained, it can be concluded that the use of guided breathing exercises can be recommended after COVID-19.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136345711","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":"Features of pathogenesis and course of acute cerebrovascular accident associated with the novel coronavirus infection COVID-19","authors":"D.N. Zadumina, V.V. Skvortsov","doi":"10.33920/med-01-2305-03","DOIUrl":"https://doi.org/10.33920/med-01-2305-03","url":null,"abstract":"The novel coronavirus infection was first identified in December 2019 in Wuhan, China. It caused significant morbidity and mortality in most parts of the world. A third of patients with COVID-19 develop disorders of the nervous system. The SARS-CoV-2 virus is the causative agent of COVID-19. Structural features of the SARS-CoV-2 virion determine the possible affinity for a number of receptors expressed on the membrane of nerve cells. SARS-CoV-2 can cause stroke by several mechanisms: 1) affecting the vascular wall, 2) COVID-19 coagulopathy, 3) myocardial damage with brain embolism or destabilization of an already existing atherosclerotic plaque. Strokes in patients with COVID-19 are characterized by a more severe course and high mortality.The occurrence of stroke with COVID-19 is relatively common in young age groups, in patients without risk factors for stroke.","PeriodicalId":495560,"journal":{"name":"Вестник неврологии, психиатрии и нейрохирургии","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136345470","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}