[Possibilities of using results of head computed tomography in victims with traumatic brain injuries]. / Vozmozhnosti ispol'zovaniya rezul'tatov komp'yuternoi tomografii golovy u poterpevshikh s cherepno-mozgovoi travmoi.

The constant increase in the number of neurotraumas in the country leads to an increase in forensic examinations of a persons. In Russia, about 600 thousand people receive craniocerebral injuries annually, of which 50 thousand die, others are potentially will be in forensic examination during or after treatment. With an increase in the total number of such examinations, the number of erroneous conclusions is expected to increase. If it is impossible for the radiologist included in the commission to review the results of computed tomography of the head performed in the hospital, the experts are forced to use the data that are recorded in the medical documents. The present study revealed the percentage of erroneous interpretations in such descriptions, systematized typical errors, calculated the sensitivity, specificity and accuracy of computed tomography in craniocerebral injury.

[Clinical example of complex diagnostic and treatment of patient with temporomandibular joint internal derangements with arthroscopic surgery]. / Klinicheskii primer effektivnosti kompleksnogo algoritma diagnostiki i lecheniya patsientov s vnutrennimi narusheniyami visochno-nizhnechelyustnogo sustava s primeneniem artroskopicheskoi khirurgii.

OBJECTIVE: Improvement and evaluation of effectiveness of the arthroscopic surgery based on individual anatomical sizes in the treatment of patients with the temporomandibular disorders (TMD). MATERIAL AND METHODS: The article presents the results of complex treatment of patient with TMJ internal derangements and osteoarthritis using arthroscopic surgery. In the pre- and postoperative period, the patient was examined clinically, as well as by computed tomography (CT) and magnetic resonance imaging (MRI). In the preoperative period, the individual sizes of anatomical structures and their localization were determined according to MRI data. That made it possible to carry out surgical intervention with minimal risk. During the operation, fibrous adhesions inside the joint were eliminated with a cold plasma coblator, the disc was mechanically moved to its normal position. At the end of the operation, blood plasma and hyaluronic acid were injected into the joint. RESULTS: As a result of the treatment, an increase in mouth opening by 80% of the initial state, disappearance of crepitus sounds, and complete relief of pain syndrome were documented. According to objective examination methods (MRI, CT), the elimination of internal disorders, restructuring and regeneration of intra-articular elements were recorded. CONCLUSION: No complications were revealed during the surgery. Arthroscopic TMJ surgery performed according to the described protocol is an effective and safe procedure that allows quickly restore the mobility of intra-articular elements, eliminate pain and improve the patient's quality of life.

[Cognitive disorders in Behçet's disease]. / Kognitivnye narusheniia pri bolezni Bekhcheta.

AIM: To study the prevalence of cognitive disorders (CD) and clinical/pathogenetic correlations of CD in patients with Behçet's Disease (BD). MATERIAL AND METHODS: One hundred and six BD patients were enrolled in the study. The majority of patients were natives of the North Caucasus (51.9%). Mean age was 33.3±0.98 years, mean illness duration 148.5±10.4 months. All the patients met the criteria of the International Study Group for BD (1990) classification. The disease activity was assessed by scoring system BDCAF. A diagnosis of a mental disorder (MD) was established by the psychiatrist in accordance with the ICD-10 using a semi-structured interview. The Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Anxiety Rating Scale (HAM-A), a pathopsychological method 'Pictograms', clinical/psychological methods for assessment of cognitive functions (memory, attention concentration, logic thinking) were administered. Brain MRI was done in 44 (41.5%) BD patients. The study was conducted in the frames of the interdisciplinary program 'Stress factors and mental disorders in immune-mediated inflammatory rheumatic diseases'. RESULTS: CD of mild to moderate severity were diagnosed in 82 (77.4%) and anxiety-depressive disorders in 81 (76.4%) of BD patients. The patients with CD were older compared to patients without cognitive disorders (34.3±1.07 vs 29.0±2.14, p=0.006). Patients with CD were most often (84.1% vs 50.0%, p=0.001) diagnosed with anxiety-depressive disorder (anxiety, chronic/recurrent depression). MADRS scores were higher (16.1±0.74 vs 12.2±1.06, p=0.005) though did not exceed the moderate level. The impact of chronic psychosocial stressors was detected more often in CD patients. MRI results showed that the frequency of chronic multifocal, predominantly subcortical, changes in the white matter was higher in CD patients. CONCLUSION: CD are characteristic of most patients with BD. They are associated with the age, anxiety-depressive disorders, chronic stressors and minor brain multifocal subcortical parenchymal MRI lesions.

[Neurological and psychiatric disorders in BehÒ«et's disease]. / Nevrologicheskie i psikhicheskie rasstroistva pri bolezni Bekhcheta.

The data of the literature on epidemiology, clinical manifestations, diagnosis and treatment of Behcet's disease are presented. Particular attention is paid to international recommendations (2014) on the classification, diagnostic criteria and treatment of neurological symptoms of BehÒ«et disease.

[The new MRI pulse sequence: experience in emergency neuroradiology].

The new pulse sequence (PS) has been obtained on MRI tomography Ellipse, B=0,15 and Biospec 70/30, B=7 T. The new pulse images of the brain combine features of FLAIR and its sensitivity to magnetic field heterogeneity. We named its PS as the T2 Fluid Attenuation Gradient Echo (T2 FLAGE). The T2 FLAGE characteristics of tissue contrast as well as its efficacy in detection of ICH have been assessed in 57 patients with acute stroke and in 16 experimental rats. The analysis of tissue contrast of lesions and normal brain structure has revealed the greater visibility of T2 FLAGE images compared to FLAIR. At the same time, the images sensitivity of magnetic field heterogeneity is retained. The ROC-analysis has shown that T2 FLAGE images are more effective in differential diagnosis of stroke type compared to FLAIR.

[The effect of cerebrolysin in dosage 50 ml on the volume of lesion in ischemic stroke].

The purpose of this randomized, double-blind, placebo-controlled study was to assess safety and efficacy of cerebrolysin used in dosage 50 ml in acute ischemic stroke. Forty-seven patients with ischemic stroke, aged 45-85 years, who were admitted to a clinical unit within the first 12 h after stroke onset were included in the study. A quantitative time-related MRI analysis of the dynamics of neurological deficit revealed the more rapid decrease of stroke volume to the 28th day in the group treated with cerebrolysin (45.4% versus 43.6% in the placebo-group (p < 0.05)). No side-effects of treatment with cerebrolysin was found. The results of this prospective, randomized, placebo-controlled study suggest the positive effect of cerebrolysin on the dynamics of volume lesion in patients with ischemic stroke.

[Comparative assessment of MR-semiotics of acutest intracerebral hematomas in low- and extra high-field frequency magnetic resonance tomography].

An objective of the study was to compare sensitivity of low- and extra high-field frequency magnetic resonance (MR) tomography of acutest intracerebral hematomas (ICH) and to assess differences between symptoms in obtained images. A study was conducted using experimental ICH in rats (n=6). Hematomas were formed by two injections of autologic blood into the brain. MR-devices "Bio Spec 70/30" with magnetic field strength of 7 T and "Ellipse-150" with magnetic field strength of 0,15 T were used in the study. MR-tomography was carried out 3-5 h after the injections. Both MR-devices revealed the presence of pathological lesion in all animals. Extra highfield frequency MR-tomography showed the specific signs of ICH caused by the paramagnetic effect of deoxyhemoglobin in T2 and T2*-weighted images (WI) and low frequency MR-tomography - in T2*-WI only. The comparable sensitivity of low- and extra high-field frequency MR-devices in acutest ICH was established.

[Experimental hemorrhagic stroke: the study of neuropeptides (MIF, selank) in the intraperitoneal injection].

The aim of this study was to examine Taftsin derivates--macrophage inhibitory factor (MIF, Thr-Lys-Pro) and heptapeptide selank (Thr-Lys-Pro-Arg-Pro-Gly-Pro) in the model of experimental intracerebral hemorrhage in rats. The double autologous blood injection in the basal nucleus was used as a model of intracerebral hemorrhage. Animals ware randomly divided into three groups--the control group (n = 5) was treated with saline, the second group (n = 5) was injected with MIF in dose 150 mkg/ kg/day, the third group (n = 5) received Selank in dose 300 mkg/kg/day. Intraperitoneal injection of peptides was used. Body weight assessment, neurological examination and brain MRI were performed in 24, 72 hours and 10 days after the hematoma formation. The effect of neuropeptides on the functional restoration in animals, in the absence of the effect on hematoma volume and perifocal edema, was found. The significant reduction of perifocal edema and hematoma volume was observed in the 10th day after the hematoma formation in all experimental groups (p < 0.05). Only the control group of animals showed the significant (p < 0.05) weight loss in the 3rd day after the operation. The rate of neurological deficit was different: the significant improvement assessed with Menzes and limb placing test scales was seen only in the groups treated with neuropeptides in the 10th day.

[MRI semiotics features of experimental acute intracerebral hematomas].

The aim of this study was to assess the possibility of revealing intracerebral hematomas (ICH), using MRI, within the first hours after onset and to determine their MRI semiotics features. Thirty animals with experimental ICH were studied. A method of two-stage introduction of autologous blood was used to develop ICH as human spontaneous intracranial hematomas. Within 3-5h after blood introduction to the rat brain. The control MRI was performed in the 3rd and 7th days after blood injections. ICH were definitely identified in the first MRI scans. The MRI semiotics features of acute ICH and their transformations were assessed. The high sensitivity of MRI to ICH as well as the uniform manifestations in all animals were shown. In conclusion, the method has high specificity for acute ICH detection.

[Improvement of MRI effectiveness in the detection of intracerebral hematoma. Double inversion recovery].

A study aimed at developing the pulse consequence, the double inversion recovery (DIR), using low field magnetic tomography, and assessing its effectiveness in the detection of intracerebral hematoma. The research has been conducted at "Ellipse" MR tomograph. The new pulse sequence has been created by the modification of the regular FLAIR, its technical parameters were as follows: the first TI - 90 ms, the second TI - 1300 ms, TR - 4665 ms, echo - 3. Twenty-seven patients have been enrolled in the study. The tissue contrast coefficients on FLAIR and DIR images have been compared. It has been shown that the contrast coefficient of normal brain structures and brain lesions on the DIR images in regard to the white matter are significantly higher than on the FLAIR images. Results of the study revealed that the dynamics of MR symptoms of intracerebral hematoma is faster on the DIR images compared to the FLAIR ones. This finding can be used for detection of intracerebral hematoma in difficult clinical cases.

[New possibilities of neuroprotection in the treatment of ischemic stroke].

A multicenter prospective double-blind placebo-controlled study was carried out in 62 patients with hemisphere ischemic stroke of atherothrombotic or cardiothrombotic character. Thirty-two patients, a main group, received intramuscular injections of cortexin, a domestic drug, in dosage 20 mg daily during 10 days from the first 6 hours from the development of symptoms of stroke, and 30 patients, a control group, received basic treatment and intramuscular injections of placebo in dosage 20 mg daily during 10 days. Patient's state was assessed before treatment and on 3rd, 7th, 11th and 28th days using the NIHSS scale for assessment of disease severity, intensity of focal neurologic deficit and dynamics of clinical parameters and the modified Rankin scale and Barthel index as a functional outcome measures. The data obtained suggest an efficacy of cortexin in the treatment of patients with acute ischemic stroke as compared to placebo. Safety of the drug was confirmed in the study.

[Diagnosis of acutest nontramatic intracerebral hemorrhages as evidenced by low-field magnetic resonance imaging].

Magnetic resonance imaging (MRI) is traditionally considered to be an ineffective method for diagnosing acutest intracerebral hematomas (ICH). The present study was to estimate the real capacities of MRI in this brain pathology. MRI was performed in 54 patients in accordance with the standard protocol. The diagnosis was verified at autopsy. ICH was ascertained to have a specific MRI pattern. The study demonstrated the high efficiency of MRI in the acutest period.

[Ultrasonography and magnetic resonance imaging in diagnosing recurrent and metastatic ovarian cancer].

The paper deals with the capacities of ultrasonography (USG) and magnetic resonance imaging (MRI) in diagnosing recurrent and metastatic ovarian cancer along with routine clinical and laboratory studies (physical examination, measurement of the tumor-associated serum antigen CA-125) in 95 patients with ovarian cancer after primary special treatment. MRI is preferable to USG in evaluating the extent of a tumorous process and the invasion of a tumor into the adjacent tissues, which is of great value in defining a further treatment policy.

[Magnetic resonance imaging (MRI) in the diagnosis of recurrences of ovarian cancer in the small pelvis].

The paper provides the results of small pelvic magnetic resonance tomography (MRI) in 62 patients with ovarian cancer after primary special treatment. Out of them 50 patients were found to have recurrences and metastases of the underlying disease, 12 patients had clinical remission. The study yielded MR signs and MR semiotics of recurrences of ovarian cancer in the small pelvis. The capacities of MRI with low and high intensities of a magnetic field were comparatively studied in the diagnosis of recurrences and metastases of ovarian cancer.

[Flexion-extension movements in the adult thoracic spine]. / Sgibatel'no-razgibatel'nye dvizheniia v grudnom otdele pozvonochnika u vzroslykh.

The flexion-extension mobility of the thoracic spine was studied by examining 120 patients who had no complaints about the thoracic spine. Its quantitative characteristics that assess the contribution of some segments to the movements of the thoracic spine were developed. Sexual differences of the developed quantitative characteristics of the motor function of the thoracic spine were defined. The specific features of changes in the motor function were analyzed in adult females and males.