[The age-related factor in the pathology of consciousness in craniocerebral trauma]. / Vozrastnoi faktor v patologii soznaniia pri cherepno-mozgovoi travme.

In children (n = 103), elderly and old persons (n = 42), abnormal consciousness was comparatively studied in the acute period of brain injury. The revealed clinical features were compared with the previously described syndromes of consciousness disorders in young and middle-aged patients. The authors consider it appropriate to identify quantitative (deafening, sopor, coma) and qualitative (obscure consciousness, confusion, and mixed types differing in the ratio of productive to deficiency symptoms). Depressed consciousness was found to be prevalent in children, obscure consciousness was most typical in adults, confusion was common in elderly and old patients. The low presentation of productive disorders and their low association mainly with brain injury in patients who are on the different poles of ontogenesis are explained in the context of the teaching of cerebral functional asymmetry.

[Long-term results of the surgical treatment of parasagittal meningiomas]. / Otdalennye rezul'taty khirurgicheskogo lecheniia parasagittal'nykh meningiom.

The article analyses the late results of surgical treatment of 123 patients with parasagittal meningiomas of various localization along the superior sagittal sinus (SSS) and falx cerebri (FC). Invalidism of patients after operations for meningiomas of the middle third of the sagittal line is still high because of stable motor defects. The results of operations for SSS resection without restoration of venous outflow of the hemisphere are poorer. Recurrences of the disease were revealed in one fourth of patients in different periods after surgery. The possibility of rehabilitation of the patient after an operation for recurrences of the tumor considerably reduces with each subsequent recurrence.

[Late results of surgical treatment of tumors of the posterior cranial fossa in children]. / Otdalennye rezul'taty khirurgicheskogo lecheniia opukholei zadnei cherepnoi iamki u detei.

The work is based on the analysis of the course followed by the disease in 533 patients aged 18 months to 15 years who underwent operation for benign and malignant tumors of the cerebellum and fourth ventricle in the period between 1964 and 1975. The late results were appraised in 1980-1981 in 269 patients. The minimum follow-up period of the surviving patients is 5 years, the maximum period 16 years. Catamnestic study showed that among all tumors of the posterior cranial fossa in children, only cerebellar astrocytoma and chorioidpapilloma were marked by a favourable late prognosis. Total sparing removal of these tumors leads to practical recovery of most patients.

[Catamnestic evaluation of the results of surgical and combined treatment of pituitary tumors]. / Katamnesticheskaia otsenka rezul'tatov khirurgicheskogo i kombinirovannogo lecheniia opukholei gipofiza.

The work deals with the study of the results of surgical and combined treatment of 455 patients with adenoma of the hypophysis who were operated on between 1971 and 1977. the catamnestic follow-up periods ranged from 2 to 7 years and more. Microsurgical techniques were used in operations on 146 patients, 309 patients underwent operation by the traditional method. Among 455 patients, 190 were treated by surgery alone, whereas 265 patients received combined treatment (surgical intervention and radiotherapy, mostly in the postoperative period). Study of the results of catamnestic investigation showed that with the use of microsurgical techniques the intervention was more radical and tumors with pronounced extrasellar growth could be removed. The current diagnostic and surgical means as well as combined therapy (surgery combined with radiotherapy) do not solve the problem of the prevention of recurrent tumors of the hypophysis. Recurrences were observed in 22.1% of cases after surgical intervention and in 11.1-15.18% of cases after combined treatment. Combined therapy produces poorer results from the standpoint of correction of the visual and hormonal disorders. The existence, of a considerable number of recurrences makes necessary exact identification of the histobiological and hormonal nature of the whole group of adenomas because the classification accepted today does not meet the essence of the clinical problems encountered in the treatment of these tumors. An exact classification of adenomas of the hypophysis according to their spread is necessary.

[Social and medical rehabilitation of patients subjected to surgery on account of aneurysms of the anterior connecting artery]. / Sotsial'naia i meditsinskaia reabilitatsiia bol'nykh, operirovannykh po povodu anevrizmy perednei soedinitel'noi arterii.

The report contains data concerning occupational and social rehabilitation of 46 patients operated on for aneurysma of the anterior communicative artery. It was established that the occupational prognosis depends upon the severity of the hemmorhage, character of surgical operation. Of significance are the conditions of work, time after the surgical operation. The authors mark that in 2/3 of the operated on patients the working capacity is being restored. A spontaneous restoration of diaturbed functions is slow and is not always sufficient. With this purpose it is expedient to repeat courses of a general tonic and special rehabilitative therapy. A favourable factor in the readaptation of patients is their early engagement in working activities. The authors give their recommendations for medical labour expert testimony for this category of patients.