[Retrograde degeneration of visual pathway]. / Retrogradnaya degeneratsiya zritel'nogo puti.

BACKGROUND: Optical coherence tomography (OCT) gives the opportunity to examine retrograde degeneration of visual pathway damaged at various levels. OBJECTIVE: To estimate OCT data on retrograde degeneration of visual pathway damaged at various levels. MATERIAL AND METHODS: Ganglion cell layer (GCL) thickness was measured by OCT in 79 patients with visual pathway damaged at various levels and known duration of visual disturbances. Twenty-One patients were diagnosed with traumatic lesions of the optic nerves and/or chiasma. Fifty-eight patients had retro-genicular visual pathway damage. Thirty-three patients were examined for postoperative homonymous hemianopia after surgery for drug-resistant temporal lobe epilepsy. Twenty-five patients were diagnosed with occipital lobe damage following stroke (12 patients), surgery for arteriovenous malformation (11 patients) and traumatic brain injury (2 patients). All patients underwent assessment of visual acuity, automatic static perimetry, MRI/CT of the brain. Retinal ganglion cell complex was analyzed during OCT. RESULTS: GCL thinning following anterior visual pathway damage was detected in 20 out of 21 patients after ≥22 days. In case of post-genicular visual pathway damage, GCL thinning was found in 25 out of 58 patients (9 out of 33 ones after surgery for temporal lobe epilepsy and 16 out of 25 patients with occipital lobe lesion). After surgery for temporal lobe epilepsy, minimum period until GCL thinning detection after previous visual pathway damage was 3 months, in case of occipital lobe lesion - 5 months. CONCLUSION: Retrograde visual pathway degeneration is followed by GCL thinning and depends on the level of visual pathway lesion.

[Surgical treatment of a pregnant female with AVM hemorrhage]. / Khirurgicheskoe lechenie patsientki s krovoizliyaniem iz AVM vo vremya beremennosti.

Hemorrhages from arteriovenous malformations (AVMs) in pregnant females are rare, but they are known to lead to high maternal and infant mortality. There are no standards for AVM treatment in pregnant females. Many authors believe that AVM resection before delivery improves the prognosis for life and health of the mother and fetus. In this paper, we present a case of successful surgical treatment of a female patient with AVM hemorrhage at 20 weeks and address management issues of these patients.

[Improvement of visual functions after successful microsurgical exclusion of a giant aneurysm of the right internal carotid artery using revascularization techniques]. / Uluchshenie zritel'nykh funktsii posle uspeshnogo mikrokhirurgicheskogo vykliucheniia gigantskoi anevrizmy pravoi vnutrennei sonnoi arterii s primeneniem revaskuliariziruiushchikh metodik.

We describe a clinical case of successful treatment of a female patient with a giant paraclinoid aneurysm of the right ICA. The aneurysm had a pseudotumoral course and manifested as pronounced progressive visual impairments. The patient underwent microsurgery including trapping/clipping of the right ICA aneurysm after creation of an EICMA and a high-flow anastomosis between the ECA and the M2 segment of the MCA. The surgery enabled decompression of the optic nerves, avoiding their injury. Postoperatively, the patient underwent transcutaneous electrical stimulation of the optic nerves. The case feature was that the patient developed gradual restoration of the blind eye vision.

[Chiasm and optic nerve glioma manifested as hemorrhage (two clinical cases and a literature review)]. / Glioma khiazmy i zritel'nykh nervov, proiavivshaiasia krovoizliianiem (dva klinicheskikh nabliudeniia i obzor literatury).

The article presents two rare clinical cases of low-grade (WHO grade I-II) glioma of the anterior visual pathway structures, the chiasm and optic nerves, in adults. The feature of these cases was the benign nature of a chiasm and optic nerve glioma in adults as well as its presentation in the form of hemorrhage to the tumor and parenchymal and subarachnoid space, which to some extent complicated making the correct diagnosis. Removal of an intracerebral hematoma and open tumor biopsy were performed in one case, and removal of a hematoma and partial tumor resection followed by radiotherapy were performed in the other case.