[Pressure in intracranial saccular aneurysms in the presence of hypotension]. / Davlenie v intrakranial'nykh meshotchatykh anevrizmakh v usloviiakh gipotonii.

The pressure in saccular aneurysms of various localizations was studied in 6 patients during neurosurgical operations. The systolic, diastolic, mean, and pulse pressure in aneurysms with a wide neck corresponded to systemic pressure; in aneurysms with a narrow neck (3 patients) they were lower. In occlusion of the carotid artery on the neck, the pressure in the anurysms decreased. Pulsations disappeared in 3 patients. Fourteen patients with aneurysm of the internal carotid artery were followed-up for 2--17 years, after ligation of the carotid artery on the neck. There were no recurrent hemorrhages. Despite the clinical effect, however, due to possible complications this operation has limited indications (subclinoid aneurysms, refusal of patients to undergo intracranial operations).

[Artificial arterial hypotension during surgical treatment of intracranial aneurysms]. / Iskusstvennaia arterial'naia gipotoniia pri khirurgicheskom lechenii vnutricherepnykh anevrizm.

In studying the content of lactic and pyruvic acids in the cerebrospinal fluid of 31 patients during operation for intracranial aneurysms under halothane anesthesia, the authors established that the performance of these operations under protection of deep (40 mm Hg) and prolonged (up to 2 hrs 25 min) artificial arterial hypotension in an uncomplicated course of the surgical intervention was not attended with hypoxic damage of the brain. The danger of hypoxia developing became greater when acute disturbances of blood flow in the cerebral arteries (clipping of a vessel, spasm) occurred in the period of hypotension.

[Alteration of several indices of carbohydrate metabolism in the blood and cerebrospinal fluid following surgery on patients with intracranial aneurysms]. / Izmeneniia nekotorykh pokazatelei uglevodnogo obmena v krovi i spinnomozgovoi zhidkosti pri operatsiiakh u bol'nykh s vnutricherepnymi anevrizmami.

The content of the lactic acid (LA) and pyruvic acid (PA) was determined pre- and postoperatively in the arterial blood and CSF of 31 patients with intracranial aneurysms. A considerable elevation of the concentration of LA and PA was noted along with an increasing LA/PA in the CSF of patients with symptoms of ischaemic damage of the brain. During surgery under fluothane narcosis these patients also demonstrated a distinct elevation of the LA level along with an increasing LA/PA ratio. In the CSF the growing content of glycolysis metabolites was not accompanied by LA/PA changes. The employment of artificial hypotension had no important effect upon the changes of these parameters in the CSF.

[Changes in cerebrospinal fluid lactate and pyruvate levels during brain surgery under fluotane anesthesia]. / Izmeneniia urovnia laktata i piruvata v spinnomozgovoi zhidkosti pri operatsiiakh na mozga pod ftorotanovym narkozom

The lactate and pyruvate content in the arterial blood and CSF of 24 patients operated on the brain under fluothane anesthesia with artificial ventilation of the lungs was measured. Towards the end of the operation and anesthesia a sizably elevated lactate level and accumulation of its excess in the blood were noted, these shifts having been more marked with hypocapnic ventilation of the lungs. An increased concentration of lactate and pyruvate in the cerebrospinal fluid was not attended by accumulation of lactate excess.