[Multifocal brain lesions]. / Mnogoochagovye porazheniya golovnogo mozga.

Despite the current laboratory and instrumental approaches to the diagnosis, a patient with multiple brain lesions remains a difficult one. The reason is that these lesions can be caused by a variety of disorders, including rare ones and atypical forms. Distinguishing neoplastic lesions from non-neoplastic CNS disorders is crucial due to different treatment options. The authors report the case of a patient with multiple brain lesions, present a literature review of diseases to be differentially diagnosed with multifocal brain lesions and suggest a simple algorithm for the differential diagnosis. Timely clinical evaluation and a multidisciplinary approach are required for making a definitive diagnosis that is extremely important to start the appropriate therapy.

[Experience of endoscopic removal of hypertensive intracerebral hemorrhage].

AIM: This study was aimed at assessing the efficacy of endoscopic technique in surgery for hypertensive intracerebral hemorrhage. MATERIAL AND METHODS: This paper focus on our experience (11 cases) of endoscopic removal of hypertensive intracerebral hemorrhage. The paper presents examples of endoscopic removal of hematomas located in the basal ganglia (9 cases) and in the posterior fossa (2 cases), causing occlusion at the fourth ventricle. In 3 patients (27%) with intraventricular hemorrhage, the removal of acute hematomas from the ventricular system with simultaneous endoscopic triple ventriculostomy was performed. Intervention was carried out within the first 6 hours in patients with hemispheric hematomas (in 90% of cases) and within 3-5 hours in patients with PCF hematomas. RESULTS: The article analyzes the functional outcomes in the early and late postoperative period. Complete regression of neurological symptoms was achieved in 4 (36%) patients and the remaining 7 (64%) patients had a moderate disability at discharge. CONCLUSION: In our opinion, endoscopic removal of hypertensive intracerebral hemorrhage is a promising method that meets all existing aspects of modern neurosurgery. The combination of rigid and flexible endoscopy provides new capabilities in surgery of patients with intraventricular hemorrhage.