ABSTRACT
The article is devoted to an important problem that has not only medical but also social significance--clinical and epidemiological aspects of head trauma. These studies were not performed in the Republic of Yemen, but they would allow organization of rationally planned medical care system, improvement of quality, reduced disability and mortality due to traumatic brain injury.
Subject(s)
Craniocerebral Trauma , Medical Records/statistics & numerical data , Social Problems/prevention & control , Adolescent , Adult , Age Factors , Community Health Services/methods , Craniocerebral Trauma/epidemiology , Craniocerebral Trauma/etiology , Female , Health Services Needs and Demand , Hospital Records/statistics & numerical data , Humans , Incidence , Male , Middle Aged , Prevalence , Sex Factors , Trauma Severity Indices , Yemen/epidemiologyABSTRACT
Almost 90 years has passed from the moment of the development of transcranial approach to the cranio-orbital area and orbital cavity. But the application of the method was limited due to using mainly extracranial approaches. The authors have analyzed results of studying the parameters of transcranial approach to 32 orbits of 16 corpses of adult subjects, and results of treatment of 24 patients with neoplasms of the cranio-orbital area and orbit, operated by transcranial approach. The indications to different modifications of the approach and to each of the intermuscular approaches to the orbital nerve were established.
Subject(s)
Craniotomy/methods , Orbit/surgery , Orbital Neoplasms/surgery , Adult , Cadaver , Female , Humans , MaleSubject(s)
Foreign-Body Migration/surgery , Laminectomy/methods , Spinal Cord Compression/surgery , Spinal Cord Injuries/surgery , Wounds, Gunshot/surgery , Diagnosis, Differential , Follow-Up Studies , Foreign-Body Migration/complications , Foreign-Body Migration/diagnostic imaging , Humans , Lumbar Vertebrae , Male , Radiography , Spinal Cord Compression/diagnostic imaging , Spinal Cord Compression/etiology , Spinal Cord Injuries/complications , Spinal Cord Injuries/diagnostic imaging , Wounds, Gunshot/complications , Wounds, Gunshot/diagnostic imaging , Young AdultABSTRACT
An analysis of 32 case histories of patients with gunshot wounds of the cervical part of the spine and spinal cord in combination with cranio-cerebral injuries is presented. In 11 patients with injuries of the spine and spinal cord it was shown that in 4 patients tetraplegia persisted in the postoperative period, 3 patients had Brown-Sequard syndrome, 1 patient had superior paraparesis, 3 patients had pelvis disorders. Rehabilitation procedures started as early as possible allow minimization of the neurological problems and, correspondingly, the degree of disability of the patients.
Subject(s)
Cervical Vertebrae/injuries , Head Injuries, Penetrating/diagnosis , Multiple Trauma , Neurosurgical Procedures/methods , Spinal Injuries/diagnosis , Wounds, Gunshot/diagnosis , Adult , Follow-Up Studies , Head Injuries, Penetrating/surgery , Humans , Male , Spinal Injuries/surgery , Tomography, X-Ray Computed , Trauma Severity Indices , Wounds, Gunshot/surgeryABSTRACT
All medical information sources available in Aden (Yemen) over 1998-2000 showed that there were 862 victims with brain injury. The prevalence of brain injury was 2.19 cases per 1,000; that being 1.6 cases in adults and 4.8 in children per 1000 of the pediatric population. The main causes of brain injury were domestic and road traffic accident in 54.7 and 40% of cases, respectively. Mild brain injury (mild brain concussion and contusions) was equally stated with severe one (moderate-to-severe brain contusions, as well as cerebral compression). Closed brain injuries predominated (in 732 (84.9%) 732 victims) over open ones (in 130 (15.1%)). The findings will make it possible to implement a number of organizational measures to improve medical service of this group of seriously ill patients and to reduce disability and mortality.
Subject(s)
Brain Injuries/epidemiology , Accidents, Traffic/statistics & numerical data , Adolescent , Adult , Aged , Brain Concussion/epidemiology , Brain Injuries/etiology , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Prevalence , Yemen/epidemiologyABSTRACT
Problems of anesthesiological maintenance, measures of the postoperative management and results of surgical treatment of 76 patients with an oncological process on the base of the posterior cranial fossa are discussed. An analysis of informative-regulatory and adaptational reactions of organism is made on the basis of the intervalogram in the course of operative interventions near by the cerebral trunk. The results are estimated.
Subject(s)
Anesthesia , Brain Neoplasms/surgery , Meningeal Neoplasms/surgery , Meningioma/surgery , Neurilemmoma/surgery , Paraganglioma, Extra-Adrenal/surgery , Postoperative Care , Chronic Disease , Cranial Fossa, Posterior , Humans , Treatment OutcomeABSTRACT
As many 116 patients were examined for the clinical course and electroencephalographic changes as well as for the x-ray, CT and NMR-tomography data, on the basis of which different forms of multifocal epilepsy were distinguished: with unilateral epileptic foci (cortical and cortico-subcortical form), bitemporal and with multiple bilateral epileptic foci. The data provided make it possible to differentiate between multifocal epilepsy and generalized epilepsy and to perform surgical treatment using the optimal surgical intervention.
Subject(s)
Electroencephalography , Epilepsies, Partial/diagnosis , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Epilepsies, Partial/classification , Epilepsies, Partial/physiopathology , Epilepsy, Post-Traumatic/classification , Epilepsy, Post-Traumatic/diagnosis , Epilepsy, Post-Traumatic/physiopathology , Epilepsy, Temporal Lobe/classification , Epilepsy, Temporal Lobe/diagnosis , Epilepsy, Temporal Lobe/physiopathology , Female , Humans , Male , Middle AgedABSTRACT
An analysis of findings of complex clinical examinations and treatment of 46 patients with open cranio-cerebral traumas was made. Specific features of clinical manifestations are shown which are substantially different from closed cranio-cerebral traumas. They are primary infection of the cranio-cerebral wound, haemorrhage, liquorrhea, foreign bodies in the cranial cavity. Curative measures for the first aid, indications and contraindications for early surgical treatment, its technique are elucidated.
Subject(s)
Brain Injuries/diagnosis , Skull Fractures/diagnosis , Wounds, Penetrating/diagnosis , Brain Concussion/diagnosis , Brain Concussion/surgery , Brain Injuries/surgery , Combined Modality Therapy , Emergencies , First Aid , Humans , Skull Fractures/surgery , Time Factors , Wounds, Penetrating/surgeryABSTRACT
Various methods of surgical intervention were applied differentially in 116 patients with multifocal epilepsy. From analysis of the late-term results it was found that the cortical form of multifocal epilepsy is treated most effectively by open and the cortico-subcortical form--by combined operations (use of stereotaxis during an open operation). The most rational operations in bitemporal epilepsy are bilateral one-stage stereotaxic interventions on the mediobasal temporal structures or successive (at various intervals) performance of stereotaxic operation on one temporal lobe and open operation on the contralateral temporal lobe. The effect was positive in 78.3% of cases.
Subject(s)
Epilepsies, Partial/surgery , Electroencephalography/methods , Epilepsies, Partial/diagnosis , Follow-Up Studies , Humans , Stereotaxic TechniquesABSTRACT
Modern principles of diagnosis and specific treatment of different kinds of cranio-cerebral traumas are elucidated on the basis of the authors' personal experience and literature data.
Subject(s)
Brain Injuries/surgery , Brain Concussion/therapy , Brain Injuries/diagnosis , Cerebral Hemorrhage/etiology , Cerebral Hemorrhage/surgery , Critical Care/methods , Diagnosis, Differential , Emergencies , HumansABSTRACT
The work analyses 328 cases of epilepsy in children 114 of whom had multifocal epilepsy. The specific features of the clinical course of multifocal epilepsy and the findings of complex examination are presented. In view of the difficulties in making the diagnosis of multifocal epilepsy and, particularly, in determining the localization of the foci of epileptic activity in the cortical and subcortical brain structures, besides the commonly accepted methods of epilepsy management, the authors used a combined method which allowed intraoperative study of the bioelectric activity not only of the cortex but simultaneously of the subcortical structures by stereotaxis; on basis of the findings they determined the character and volume of the intervention.
Subject(s)
Epilepsy/surgery , Amygdala/surgery , Cerebral Angiography , Child , Electroencephalography , Epilepsy/diagnosis , Epilepsy/diagnostic imaging , Hippocampus/surgery , Humans , Pneumoencephalography , Thalamic Nuclei/surgeryABSTRACT
The authors point out the outstanding merits of academician N. N. Burdenko in the organization and development of national neurosurgery, and also tremendous successes achieved by soviet specialists of neurosurgery in the diagnosis and treatment of mono- and multifocal epilepsy, cerebral vascular lesions, brain tumors in adults and children, craniocerebral trauma. An attention is given to the main tasks of further development of different aspects of neurosurgery.
Subject(s)
Neurosurgery/history , History, 20th Century , Nervous System Diseases/history , Russia , Russia (Pre-1917)ABSTRACT
A new method of surgical treatment in dealing with severe forms of multifocal epilepsy-stereotaxic intervention on subcortical structures during open craniotomy--is proposed. The method allows stereoelectrographic examinations to be performed during open operative interventions, helps discover subcortical epileptogenic foci, establish functional interrelationship of the chosen subcortical structure and the cortical epileptogenic focus and to undertake a differentiated intervention on the cortical, subcortical and both these foci at the same time.
