[Topographic-anatomic grounding cervical-distalvertebral reconstruction of V3 segment vertebral artery vertebral artery].

Using 10 block-mounts "brain-base of skull- cervical spine" there were detected morphometric peculiarities of vertebral artery on the level C(I)-C(II) of spines of vertebra and of premastoidal part of cervical artery. Were effectuated 20 distalvertebral reconstructions. Were precised stages and technique of realization.

[Selection of surgical approach to aneurysms of distal regions of the basilar artery].

Twenty-nine patients with basilar artery aneurysms were operated on using one of three approaches: pterional, orbitozygomatical, and subtemporal. The efficiency of surgery and the frequency of surgical complications are analyzed in detail in relation to the data of an angiographic study and the intraoperative pattern. Three (10.3%) patients died in the postoperative period. In most cases, the pterional approach is adequate for clipping almost any aneurysm of the distal portions of the basilar artery; the use of the orbitozygomatical approach in patients with aneurysm of the same location is determined by its extent and/or adhesions with the adjacent brain structures. Current neuroimaging techniques are of the most informative value in choosing a surgical treatment policy in each specific case.

[Evaluation of disorders in the liquor circulation in craniocerebral trauma]. / Otsenka porazheniia sistemy likvoroobrashcheniia pri cherepno-mozgovoi travme.

The modern methods of complex examinations of the brain in craniocerebral trauma are addressed and the possibilities of the topographic-and-anatomic substantiation in the forensic-medical (expert) evaluation of traumatic lesions of liquor-circulation structural elements are elucidated in the paper. Morphometry data characterizing the dislocation manifestations are presented with respect to the dislocation intensity and severity.

[Neurinomas and neurofibromas of the jugular foramen: diagnosis and surgical treatment]. / Diagnostika i khirurgicheskoe lechenie nevrinom i neirofibrom iaremnogo otverstiia.

The paper analyzes the authors' experience in treating 16 patients with neurinomas and neurofibromas of the jugular foramen. A tumor was located intracranially (Type A) in 1 case, at the level of the base of the skull (Type B) in 7 cases, extracranially (type C) in 3 cases, and extra- and intracranially (Type D) in 5. All the patients were operated on. One-stage removal was performed in 15 patients, in 1 case a tumor was removed in 2 steps. By taking into account differences in the site of the tumors, the authors used the following accesses: retrosigmoid, supracondyllar, extreme lateral transcondylar, retroauricular transtemporal, extended retroauricular transtemporal, lateral cervical. While planning accesses, it is necessary to bear in mind not only the direction of growth of these tumors, but also the pathways of collateral venous blood flow.

[The methodological bases of topographic neuropathomorphology]. / Metodologicheskie osnovy topograficheskoi neiropatomorfologii.

This paper describes the major features of topographic and anatomical studies of CNS structures, CSF circulation system, extracerebral structures and vertebral column. These methods include brain fixation, which is able to prevent post mortem brain deformation due to decalcification (even for block-preparations like "brain-skull base" or "posterior cerebral fossa-cervical spine"). The author also presents the following methods: spatial reconstruction of the brain and skull base subtracted from the series of slices of different thickness and various planes of transection; biopsy investigation of cerebral midline structures and CSF system in relation with skull base and convex structures; staged microdissection of tumors; filling of arterial and venous systems. All these modalities were used in examining the topographical features of craniopharyngiomas, hypophyseal adenomas, parasagittal and sagittal meningiomas, pineal tumors, VIII cranial nerve neurinomas, arachnoid cysts and in developing surgical approaches to the tumors of the third ventricle, skull base and foramen magna.

[The morphological bases of the pathology of the cerebrospinal fluid circulatory system in gunshot wounds of the head]. / Morfologicheskie osnovy patologii sistemy likvoroobrashcheniia pri ognestrel'nykh raneniiakh golovy.

Pathomorphology of structural elements of the liquor circulation system and its three components (liquor production, circulation, and outflow) in gunshot wounds of the head is discussed. Their role in the development of traumatic diseases of the brain and its complications is analyzed. Classification and characteristics of the main pathomorphological variants of liquor circulation disorders in gunshot wounds of the skull and brain are presented.

[A macro- and microscopic study of the status of the deep and median structures of the lymph circulatory system in craniocerebral trauma]. / Makro-mikroskopicheskoe issledovanie sostoianiia glubinnykh i sredinnykh struktur sistemy likvoroobrashcheniia pri cherepno-mozgovoi travme.

Craniocerebral injuries involve changes in the vascular plexuses and ependyma of the ventricles, and the severity of these changes varies, depending on the duration of the posttraumatic period and severity of the injury. Analysis of the time course of pathomorphological changes in the cerebral ventricular structures extend our notions on the role and impact of liquor circulation in the pathogenesis of craniocerebral injury. Structural changes in the vascular plexuses may disorder the function of the blood-liquor barrier and promote the development of hydrocephalus. Changes in the structure of the ependymal membrane may involve dysfunction of the liquor-encephalic barrier of the inner surface of the brain and promote the development of brain edema.

[Subarachnoid hemorrhage: etiologic variants, pathogenetic features and morphology]. / Subarakhnoidal'noe krovoizliianie: étiologicheskie varianty, patogeneticheskie osobennosti i morfologiia.

8 etiological variants of subarachnoidal hemorrhage are considered, its complications (rupture into the ventricles, development of the arterial spasm, brain edema) and sequelae (aseptic leptomeningitis, external hydrocephaly). Three stages in the subarachnoidal hemorrhage course are distinguished. The analysis of the vascular alterations and ventricular ependyma in cases of the rupture into the brain ventricles is performed. The study of morphological substrates of the liquor circulation in both macro- and microscopical level is recommended in all cases of subarachnoidal hemorrhage.

[Midbrain structures and the cerebrospinal fluid circulation system in central nervous system disease]. / Izuchenie sredinnykh struktur mozga i sistemy likvoroobrashcheniia v usloviiakh patologii tsentral'noi nervnoi sistemy.

The author offers an original method of the study of the midbrain structures and liquor circulation system (the third ventricle, brain water-pipe, the fourth ventricle) in the small cavity in the course of autopsy. The position of the middle structures is characterized by means of the angle measuring of their borders against bone structures of the base and vault of the skull. The method allows to assess morphometrically the degree of dislocation of the middle structures in pathological conditions accompanied by brain edema.

[Topographic-anatomical basis for forensic medical assessment of central structures of the brain in craniocerebral trauma]. / Topografoanatomicheskoe obosnovanie sudebno-meditsinskoi otsenki sostoianiia sredinnykh struktur golovnogo mozga pri cherepno-mozgovoi travme.

The paper is devoted to a method for topographic anatomic validation of a forensic medical evaluation of the status of the brain median structures in craniocerebral injury. Morphometric data are presented characterizing dislocation of the brain median structures in edema.

[The pathomorphological characteristics of the vascular plexuses and ependyma of the cerebral ventricles in human craniocerebral trauma]. / Patomorfologicheskie osobennosti sosudistykh spletenii i épendimy zheludochkov golovnogo mozga cheloveka pri cherepno-mozgovoi travme.

The morphology of the studied substrates was analyzed in lethal craniocerebral injuries of various origins and in various periods after it was suffered. The data on the pattern and time course of pathomorphologic shifts and functions extend the general notions on the role of the liquor circulation system in the pathogenesis of craniocerebral injury. These results may serve as additional expert criteria of the mechanisms of brain injury.

[Ultrastructure of the cerebrospinal fluid-brain barrier of the cerebral ventricles and blood-brain barrier of the vascular plexus in experimental aseptic leptomeningitis]. / Ul'trastruktura likvoroéntsefalicheskogo bar'era zheludochkov mozga i gematoéntsefalicheskogo bar'era sosudistykh spletenii pri éksperimental'nom asepticheskom leptomeningite.

The CSF-encephalic barrier of brain ventricles was examined at the submicroscopic level at different times of experimental aseptic leptomeningitis. In the acute period of the pathology, (3 to 7 days) the integrity of the bar was found to be disturbed because of acute inflammatory phenomena. In the subacute period (15 to 30 days), CSF hypertension was demonstrable. In the chronic period (90 days), the development of dystrophic and degenerative processes in the structures of the ependyma and vascular plexus were related to the disorders in CSF- and hemodynamics of the brain. Occlusion of the CSF tract was found to be associated with the impairment of the integrity of the blood- and CSF-encephalic barriers, marked edema end disintegration of the nerve tissue.

[The topographic anatomical basis for ventriculosinusal shunting in hydrocephalus in nursing and young infants]. / Topografoanatomicheskoe obosnovanie ventrikulo-sinusnogo shuntirovaniia pri gidrotsefalii u detei grudnogo i rannego vozrasta,

The peculiarities in the structure and topographic anatomical relations of the superior longitudinal, lateral, and sigmoid sinuses were studied on block preparations of the posterior cranial fossa of 14 children under 3 years of age who died from somatic diseases. It was shown that intrasinus inclusions preventing catheterization of the sinus (bands and septa) were absent at the junction of the first angle of the sigmoid sinus with its descending part. The authors recommend this area for shunting operation--ventriculosinusotomy--in progressive hydrocephalus.

[The translabyrinthine approach to neurinomas of the 8th nerve]. / Translabirintnyi dostup k nevrinomam VIII nerva.

Experience in the use of the translabyrinthine approach in removal of neurinomas of the eighth nerve in 14 patients is analysed. It was established that the indications for translabyrinthine removal of this type of new growths should be determined from comparison of the size of the tumor and the size of the operative field with consideration for the inevitable destruction of the hearing apparatus in accomplishing the approach. The translabyrinthine approach was found to be most adequate for small tumors (measuring less than 25 mm in size). The stage-by-stage accomplishment of the translabyrinthine developed by the authors, removal of the tumor, closure of the postoperative wound, and adherence to the suggested methodical instructions ensure atraumatic performance of the operation and prevent operative and postoperative complications. In the presence of strictly determined indications, translabyrinthine removal of neurinomas of the eighth nerve is an operation causing little injury and producing favourable results.

[Arachnoid cysts (pathomorphological studies)]. / Arakhnoidal'nye kisty (patomorfologicheskie issledovaniia).

Based on a macro- and microscopic analysis of the material of 2 section cases and 29 biopsies of persons operated on for arachnoidal cysts two types of cysts were distinguished: 1) arachnoidal cysts that occurred as a result of isolated congenital pathology of the leptomeninx; 2) cysts representing a manifestation of the combined developmental abnormality of the CNS occurring in the form of arachnoidal cysts coupled with intracerebral ones and with pathology of the adjacent cortical parts in the form of gross impairment of its architectonics and developmental abnormality of cerebral vessels.

[Microsurgical anatomy of structures of the cerebellopontile angle in meningiomas of the posterior surface of the pyramid of the temporal bone]. / Mikrokhirurgicheskaia anatomiia obrazovanii mostomozhechkovogo ugla pri meningiomakh zadnei poverkhnosti piramidy visochnoi kosti.

The data of 153 operations and 38 autopsies were used to study the microtopographoanatomical relationships of structures of the cerebellopontile angle in meningiomas of the posterior surface of the pyramid of the temporal bone. The details of the microtopography of the structures of the cerebellopontile angle were studied on 6 block-specimens with meningiomas and during 20 operations by means of an operating microscope. The authors revealed variants of the relationship of the cerebellopontile angle structures with the tumors depending on the site and direction of their growth.