ABSTRACT
Pericranial sinus (Sinus pericranii - SP) is a rare pathology of the extra-intracranial cerebral venous system. However, SP is not just an additional transosseous canal that connects the extra- and intracranial venous systems. This "emissary vein" connects the intracranial sinus and the variceally extended thin-walled veins localized on the outer surface of the skull where blood flows fun in opposite directions. We present a literature review and two case reports of patients with pericranial sinus who underwent surgical treatment. We discuss the problems related to etiology, clinical signs, diagnosis, and surgical treatment of the anomaly.
Subject(s)
Neurosurgical Procedures/methods , Sinus Pericranii/diagnosis , Sinus Pericranii/surgery , Cerebral Angiography , Cerebral Veins/abnormalities , Cerebral Veins/diagnostic imaging , Cerebral Veins/surgery , Cerebrovascular Circulation , Child , Humans , Magnetic Resonance Angiography , Male , Neurosurgical Procedures/instrumentation , Sinus Pericranii/pathology , Sinus Pericranii/physiopathology , Tomography, Spiral Computed , Treatment OutcomeABSTRACT
The authors present a retrospective analysis of results of examination and surgical treatment of 74 infants not older than 24 months with brain tumors of different localization, operated in the same clinic during 15 years. Attention is paid to specific clinical course, character of blastomatous process, surgical strategy and postoperative period in this age category of infants.
Subject(s)
Brain Neoplasms , Hydrocephalus/etiology , Intracranial Hemorrhages/etiology , Intracranial Hypotension/etiology , Neurosurgical Procedures , Postoperative Complications , Brain Neoplasms/complications , Brain Neoplasms/pathology , Brain Neoplasms/physiopathology , Brain Neoplasms/surgery , Female , Humans , Infant , Male , Neurosurgical Procedures/adverse effects , Neurosurgical Procedures/methods , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The work is based on an analysis of the course of anesthetic aid, operative and early postoperative period in 62 patients aged from 15 months to 18 years with tumors of the posterior cranial fossa. The analysis concerned changes to the indices of systemic hemodynamics, findings of electrophysiological monitoring (electroencephalogram, acoustic stem induced potentials) and their interrelation with the outcomes of surgery. It was found that permanent disturbance of the heart rate such as bradycardia and tachycardia as well as the decreased indices of latency of peaks of the acoustic stem induced potentials and inter-peak intervals registered at the stage of removal of tumors of the posterior cranial fossa must be taken into consideration in the estimation of indications to medicinal narcosis in the postoperative period.
Subject(s)
Capnography/methods , Electrocardiography/methods , Electroencephalography/methods , Infratentorial Neoplasms/surgery , Monitoring, Intraoperative/methods , Neurosurgical Procedures/methods , Plethysmography/methods , Adolescent , Blood Pressure , Child , Child, Preschool , Heart Rate , Humans , Infant , Infratentorial Neoplasms/physiopathology , Reproducibility of Results , Treatment OutcomeSubject(s)
Brain Neoplasms/pathology , Cervical Vertebrae , Glioblastoma/secondary , Spinal Neoplasms/secondary , Temporal Lobe , Adolescent , Brain Neoplasms/therapy , Combined Modality Therapy , Diagnosis, Differential , Follow-Up Studies , Glioblastoma/diagnosis , Glioblastoma/therapy , Humans , Magnetic Resonance Imaging , Male , Neoplasm Metastasis , Spinal Neoplasms/diagnosis , Spinal Neoplasms/surgeryABSTRACT
During the two recent decades the introduction of new technologies to neurosurgery resulted in certain progress in diagnosis and combined treatment of brain stem tumors which still remain the most complex problems of neurooncology. Using the present-day diagnostic complex including a thorough dynamic neurological examination, neurophysiological investigations, and visualization methods allowed not only to detect the primary forms of brain stem tumors and their sizes but also to reveal the topographoanatomical interrelationships with the stem structures that allowed to determine the chances of surgical, combined treatment or the radiation and chemotherapy treatment only. The article gives an analysis and the clinical course of the diagnosis and combined treatment of 333 children and adult patients with primary, secondary and peri-trunkal tumors of the brain stem.
Subject(s)
Brain Stem Neoplasms/surgery , Adolescent , Algorithms , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Male , Neoplasm Invasiveness , Neoplasm Staging , Neurosurgical Procedures/methodsABSTRACT
The latest technologies, introduced into neurosurgery during the last 2 decades of the 20th century, ensured progress in the diagnostics and treatment of brainstem tumors--pathologies that remain until now a most complicated problem in neurooncology. The modern diagnostic tools comprising profound dynamic neurological and neurophysiological examinations (AVP, EEG) visualization techniques (CT, MRT with contrasting, MRT, spectroscopy, PET) provide for detecting not only the initial signs of stem tumors and their sizes but also their topographic interaction with the stem structures; it, in its turn, opens up a possibility to choose between the combined surgical treatment and the radiotherapy or chemotherapy alone. The clinical course, diagnosis and combined treatment of 333 children and adults with tumors bordering on the brainstem are analyzed within the case study.
Subject(s)
Brain Neoplasms , Brain Stem , Adolescent , Adult , Antineoplastic Agents, Alkylating/administration & dosage , Antineoplastic Agents, Alkylating/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/diagnosis , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/drug therapy , Brain Neoplasms/mortality , Brain Neoplasms/radiotherapy , Brain Neoplasms/surgery , Cerebral Angiography , Chi-Square Distribution , Child , Child, Preschool , Combined Modality Therapy , Electroencephalography , Female , Humans , Lomustine/administration & dosage , Lomustine/therapeutic use , Magnetic Resonance Imaging , Male , Ophthalmoscopy , Procarbazine/therapeutic use , Prognosis , Radiotherapy Dosage , Time Factors , Tomography, Emission-Computed , Tomography, X-Ray Computed , Vincristine/therapeutic useABSTRACT
Brain CT was made in 720 patients with tumors of the central nervous system. The subtentorial site of the process was encountered in 50.4% of cases. The paper outlines the skialogic characteristics of tumors having varying structures: medulloblastomas, ependymomas, astrocytomas, angioreticulomas, truncal gliomas, metastases, epidermoids, neurinomas, meningiomas, chemodectomas, arteriovenous malformations. Difficulties in determining the histostructure of tumors on the basis of skialogic manifestations were noted. Anatomic and skialogic approaches which may assume the type of neoplasmic process were outlined.
Subject(s)
Brain Neoplasms/diagnostic imaging , Cranial Fossa, Posterior , Adult , Child , Cranial Fossa, Posterior/diagnostic imaging , Diagnosis, Differential , Echoencephalography , Electroencephalography , Humans , Male , Tomography, X-Ray ComputedABSTRACT
Neurological findings of 37 hydrocephalic children are analysed. The involvement of cranial nerves into a pathological process is shown. Optic, oculomotor, and abducent nerves and the first branch of the trigeminal nerve more frequently suffer. There are significant dysfunctions of the posterior longitudinal fascicle.
Subject(s)
Hydrocephalus/diagnosis , Child , Child, Preschool , Cranial Nerves/physiopathology , Eye Movements , Female , Fundus Oculi , Humans , Hydrocephalus/physiopathology , Hydrocephalus/surgery , Infant , Male , Neurologic ExaminationABSTRACT
The paper analyzes the examination and treatment of 77 patients with myelomeningoceles. It is shown that the prognosis of treatment depends on the size and content of the hernial sac, the specific features of deformities of the liquor-containing system and the severity of liquor circulatory disorders. Both specific features of myelodysplasia manifestations and those of liquor circulatory disorders should be borne in mind in choosing the optimum surgical policy for myelomeningoceles. The optimum surgical approach to treating large-sized myelomeningoceles concurrent with hydrocephalus is demonstrated to one-stage plastic surgery of the hernial hilus and drainage of the subarachnoidal space of the terminal cistern into the abdomen.
Subject(s)
Hydrocephalus/surgery , Meningomyelocele/surgery , Acute Disease , Chi-Square Distribution , Child, Preschool , Humans , Hydrocephalus/cerebrospinal fluid , Hydrocephalus/complications , Hydrocephalus/diagnosis , Infant , Meningomyelocele/cerebrospinal fluid , Meningomyelocele/complications , Meningomyelocele/diagnosis , Methods , Postoperative Complications/epidemiologyABSTRACT
The paper analyzes one of the complication of spinal fluid bypass surgeries, i.e. epileptoid seizures. It is suggested that a significant role in the occurrence of seizures is played by irritation of the brain with an implantable drainage system, namely with the thickened drainage portion plunged into the brain at the junction of a pump and a ventricular catheter. The study provides evidence for the value of the presence of pathology risk for seizures which occurs after anastomosis implantation. This risk appears as EEG epileptoid activity even in the absence of clinical manifestations. Infectious complications and poor anastomosis drainage function are shown to be essential for the implantable anastomosis to provoke the seizures. The authors give recommendations to prevent epileptoid seizures following bypass surgeries and treat them if they occur, which allows this complication to be effectively combatted.
Subject(s)
Cerebrospinal Fluid Shunts/adverse effects , Epilepsy/etiology , Postoperative Complications/etiology , Adolescent , Adult , Age Distribution , Cerebrospinal Fluid Shunts/methods , Cerebrospinal Fluid Shunts/statistics & numerical data , Child , Child, Preschool , Disease Susceptibility , Electroencephalography , Epilepsy/diagnosis , Epilepsy/epidemiology , Humans , Incidence , Infant , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Risk FactorsABSTRACT
A subdural exudate (SE) complicating bacterial meningitis in 28 children was diagnosed by the findings at diaphanoscopy, subdurography, thermography, CT, EEG, echo-EG, rheo-EG in the evidence of aggravating neurological symptoms. SE drainage was carried out in all the cases, in 20 patients it was bilateral. CNS age-specific anatomicophysiological features responsible for emergence of the exudate primarily in the anterior hemispheric compartments subject to consequent atrophy are considered when assessing mechanisms of the exudate development in infants.
Subject(s)
Meningitis, Bacterial/complications , Subdural Effusion/etiology , Acute Disease , Critical Care , Female , Humans , Infant , Influenza, Human/complications , Influenza, Human/diagnosis , Influenza, Human/therapy , Male , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/therapy , Meningitis, Meningococcal/complications , Meningitis, Meningococcal/diagnosis , Meningitis, Meningococcal/therapy , Meningitis, Pneumococcal/complications , Meningitis, Pneumococcal/diagnosis , Meningitis, Pneumococcal/therapy , Meningitis, Viral/complications , Meningitis, Viral/diagnosis , Meningitis, Viral/therapy , Neurologic Examination , Punctures/methods , Subdural Effusion/chemistry , Subdural Effusion/diagnosis , Subdural Effusion/therapy , Subdural SpaceSubject(s)
Arteriovenous Fistula/diagnostic imaging , Brain/blood supply , Cerebral Veins/abnormalities , Intracranial Arteriovenous Malformations/diagnostic imaging , Varicose Veins/diagnostic imaging , Arteriovenous Fistula/pathology , Brain/diagnostic imaging , Brain/pathology , Cerebral Veins/diagnostic imaging , Cerebral Veins/pathology , Humans , Infant , Intracranial Arteriovenous Malformations/pathology , Male , Radiography , Terminology as Topic , Varicose Veins/pathologyABSTRACT
The authors describe a rare case of amyloidosis in a female patient suffering from periodic disease (PD) for 18 years without any clinico-laboratory signs of renal impairment but with marked clinical, (malabsorption, cachexia), endoscopic, x-ray and other manifestations of gastrointestinal amyloidosis. This case is of interest since patients suffering from amyloidosis due to PB develop malabsorption very rarely, namely in 2-3% of cases. As a rule, it develops in patients with pronounced chronic renal failure on hemodialysis or with a history of kidney transplantation. In this particular case, the patient demonstrated selective marked damage to the gastrointestinal tract, with the kidneys remaining practically intact. A possibility of the indicated variety of amyloidosis should be considered in specification of the genesis of persistent diarrhea in PB patients.
Subject(s)
Amyloidosis/diagnosis , Familial Mediterranean Fever/diagnosis , Gastrointestinal Diseases/diagnosis , Kidney/physiology , Adolescent , Amyloidosis/etiology , Chronic Disease , Diarrhea/diagnosis , Diarrhea/etiology , Familial Mediterranean Fever/complications , Female , Gastrointestinal Diseases/etiology , HumansABSTRACT
An anastomosis was established between the lateral ventricle and the lateral transverse sinus (ventriculosinustransversostomy) in the treatment of 32 patients aged from 2 months to 32 years suffering from hydrocephalus of various etiology. Hydrocephalus took a compensated course after the operation in 28 patients. Infectious complications developed in 2 patients. Occlusion of the shunt occurred 3-36 months after the operation in 6 cases. Ventriculosinustransversostomy may be the method of choice in the treatment of hydrocephalus when the application of the generally accepted c.s.f. shunting operations is inexpedient. Ventriculosinustransversostomy proves adequate in combination with operations on the region of the pineal gland and the posterior cranial fossa.
