ABSTRACT
A case of a patient resident from Tuva who had cerebral cysticercosis is presented. The diagnosis was established on the basis of the available clinical symptoms, brain RCT and NMRI findings and a positive serological reaction (enzyme immunoassay) with C. cellulosus antigen. The patient received 2 courses of treatment with the Russian drug azinox (praziquantel) in a daily dose of 50 mg/kg body weight thrice before meal. Prednisolone was additionally given in a daily dose of 30 mg. The course of treatment was 14 days. The first treatment days were marked by worse headache. Thereafter treatment induced no complications. Better condition, less headache, lower serological reaction titers, regressed cerebral structural changes were observed after the treatment. RCT and NMRI revealed transformation of cysts to high-density foci and calcificates.
Subject(s)
Anthelmintics/therapeutic use , Cysticercus , Neurocysticercosis/drug therapy , Praziquantel/analogs & derivatives , Praziquantel/therapeutic use , Administration, Oral , Adult , Animals , Anthelmintics/adverse effects , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Antibodies, Helminth/blood , Brain/diagnostic imaging , Brain/pathology , Cysticercus/isolation & purification , Drug Administration Schedule , Drug Therapy, Combination , Headache/chemically induced , Humans , Magnetic Resonance Imaging , Male , Neurocysticercosis/blood , Neurocysticercosis/diagnosis , Praziquantel/adverse effects , Prednisolone/administration & dosage , Prednisolone/therapeutic use , Serologic Tests , Tomography, X-Ray ComputedABSTRACT
The results of surgical treatment of 12 patients with non-traumatic intracerebellar hemorrhages are analyzed in this paper. The following parameters were assessed: clinical signs and symptoms, the level of consciousness, location and size of the lesion, the brain stem deformation, the rupture of hematoma into the adjacent ventricle, and hydrocephalus. In all patients with fulminant course as well as in the majority of patients with acute or subacute course when the brain stem compression progresses and seems to be unresponsive to medical treatment, surgery is strongly indicated. Among the surgical procedures, placement of the external ventricular drainage and extensive midline suboccipital craniectomy are curative. These procedures proved to be effective in reducing the brain stem compression. Patients with chronic intracerebral hematomas are followed conservatively.
Subject(s)
Cerebellar Diseases/therapy , Cerebral Hemorrhage/therapy , Adolescent , Adult , Aged , Brain Stem/diagnostic imaging , Brain Stem/surgery , Cerebellar Diseases/diagnostic imaging , Cerebellar Diseases/mortality , Cerebellum/diagnostic imaging , Cerebellum/surgery , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/mortality , Drug Therapy, Combination , Female , Humans , Male , Middle Aged , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The paper specifies indications and contraindications for brain microrevascularization and carotid endarterectomy in patients with atherosclerotic tandem stenosis of the internal carotid (IC) and provides strong evidence for the succession of their implementation. It also notes the role of tandem lesion as a factor predisposing to IC occlusion after carotid endarterectomy. It is shown that brain microrevascularization serves as the method of choice, when other correcting measures for cerebral blood flow disorders fail, and aims largely at preventing local cerebral ischemia.
Subject(s)
Arteriosclerosis/surgery , Carotid Stenosis/surgery , Adult , Arteriosclerosis/diagnosis , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/surgery , Carotid Stenosis/diagnosis , Cerebral Angiography , Cerebral Revascularization , Contraindications , Endarterectomy, Carotid , Female , Humans , Ischemic Attack, Transient/diagnosis , Ischemic Attack, Transient/surgery , Male , Middle Aged , Radionuclide Imaging , Ultrasonography , Xenon RadioisotopesABSTRACT
The status of the collateral blood flow was examined before and after establishment of ++extra-intracranial microarterial anastomosis (EICMA) in 70 patients with occlusion of the internal carotid artery. Of these, 93% of the patients also had lesions of the other main arteries of the head. It has been established that in concomitant lesions of the main arteries of the brain, the role of the ophthalmic artery (OA) rises as to the compensation for the blood flow in the damaged hemisphere. Involvement of the ophthalmic anastomosis into blood supply of the damaged hemisphere was found to inversely correlated to EICMA function. Active functioning of EICMA brings about a decrease of the retrograde blood flow in the OA and in some cases, alteration in the direction of the blood flow in that artery, namely from retrograde to antegrade. Nevertheless additional blood flow via EICMA promotes elevation of the level of the cerebral blood flow in the regions of the middle cerebral artery basin, supplied via the microarterial anastomosis.
Subject(s)
Carotid Artery Diseases/physiopathology , Cerebral Revascularization/methods , Collateral Circulation/physiology , Intracranial Arteriosclerosis/physiopathology , Ophthalmic Artery/physiology , Adult , Aged , Carotid Artery Diseases/complications , Carotid Artery Diseases/surgery , Carotid Artery, Internal/surgery , Female , Humans , Intracranial Arteriosclerosis/complications , Intracranial Arteriosclerosis/surgery , Male , Middle AgedABSTRACT
Concurrent affection of the main arteries of the head is the cause of vascular cerebral insufficiency in more than half of the patients, which makes necessary combined operations on the extra- and intracranial arteries. The sequence of the operations is determined by the degree of the threat of occlusion of the stenosed artery or by the side on which the cerebrovascular insufficiency is manifested. Information on the regional cerebral blood flow and the results of ultrasonic dopplerography and computed tomography are additional criteria for determining the sequence and the terms of the operations. Experience in 61 combined operations allows the authors to consider them to be an effective method for the surgical management of concurrent affections of the main arteries of the head.
Subject(s)
Carotid Artery Diseases/surgery , Cerebrovascular Disorders/surgery , Vertebral Artery , Adult , Blood Flow Velocity , Cerebral Angiography , Cerebral Revascularization , Cerebrovascular Disorders/diagnosis , Endarterectomy , Humans , Middle Aged , Regional Blood Flow , Ultrasonography , Xenon RadioisotopesABSTRACT
The comparison of the results of Doppler and angiographic examinations of 82 patients with combined occlusive disorders of the major arteries of the head before and after creating an extra-intracranial microarterial bypass showed a high informative value of Doppler sonography as a noninvasive method of the diagnosis of impairments of the cerebral arteries and as a method of control of microarterial anastomosis functioning. Placement of a microanastomosis between the external carotid and middle cerebral arteries eliminated or reduced the steal-phenomenon in relation to the brain or vertebral-basilar bed in combined lesions of the major arteries of the head.
Subject(s)
Cerebral Angiography , Cerebral Revascularization , Cerebrovascular Disorders/surgery , Ultrasonography , Adult , Cerebrovascular Disorders/diagnosis , Cerebrovascular Disorders/diagnostic imaging , Female , Humans , Male , Middle AgedABSTRACT
The morphological changes in the walls of 40 arterial microanastomoses were studied in experiments. The initial signs of endothelization appear in 3 days and the process ends by the 9th-12th day. The tissue reaction to the different suture material is of the same type and its degree is not linked with the type of synthetic thread used. Minimum injury inflicted to the intima and the other coats of the vascular wall and pre- and postoperative use of acetylsalicylic acid are measures preventing occlusion and stenosis of the anastomosis.
