[Osmolality and ion concentration in the cerebrospinal fluid and blood serum in epilepsy and ischemic stroke]. / Osmolial'nost' i kontsentratsiia ionov v likvore i syvorotke krovi pri épilepsii i ishemicheskom insul'te.

A sharp (16.4%) increase of blood serum osmolality very close to the critical values was found in acute period of ischemic stroke, while sodiumemia exceeded the normal levels by 50 mmol/l and more. Meanwhile, the concentrations of Na ions in liquor of such patients was not significantly increased. The levels of Ca, K, Mg ions as well as the osmolality of blood serum and liquor were stable too. The alterations of these parameters were not significantly changed in epileptic patients out of fits. Both the analysis of the reasons of hyperosmia and hypersodiumemia development and the search for the methods of their prophylaxis and correction will be quite important in further investigations.

[Stereotaxic thalamotomy in the combined treatment of Gilles de la Tourette's disease]. / Stereotaksicheskaia talamotomiia v kompleksnom lechenii bolezni Zhilia de lia Turetta.

The manifestations of Tourette's disease, represent the combination of neurologic and psychopathologic symptomatology. The patients show such manifestations as tics and obsessions while both groups of symptoms are fairly resistant to conservative therapy. The authors describe a case where stereotaxic cryodestruction of the ventrolateral nucleus of the thalamus was applied in addition to the treatment of the patient with medicamentous agents, psychotherapy and measures of social rehabilitation. Of special interest are descriptions of the effects of electric stimulation of different brain structures during the patient's preparation for the final stage of neurosurgical intervention. The patient has been followed up for 1.5 yr.

[Stereotaxic cingulotomy in the complex treatment of a schizophrenic patient with obsessive-compulsive disorder, resistant to treatment]. / Stereotaksicheskaia tsingulotomiia v kompleksnom lechenii bol'nogo shizofreniei s terapevticheski rezistentnymi obsessivno-kompul'- sivnymi narusheniiami.

The authors describe a case of continuous conservative treatment of a patient suffering from severe obsessions. At the definite stage of the disease, the patient underwent psychosurgical operation--bilateral anterior stereotaxic cingulotomy . The surgical intervention was necessitated by dramatic and steady deterioration of the patient's condition, loss of work fitness, suggesting official registration of disability; appearance of suicidal intentions. After the operation the patient started his work again in accordance with his specialty; the question about disability registration did not arise any more.

[Methods of improving the quality of emergency aid in acute neurologic pathology]. / Metody povysheniia kachestva ékstrennoi pomoshchi pri ostroi nevrologicheskoi patologii.

The quality of emergency aid in acute neurological pathology was assessed using the linear discriminant analysis of data obtained in 1436 cases. The aid may be substantially improved provided the questions of exactly targeted hospitalization be solved. The information obtained at the prehospital stage does not ensure the reliable differentiation between the 12 major forms of acute neurological states. The methods are designed allowing the correct choice of hospital for the patients' admission (infectious, toxicological, neurosurgical units) with due consideration of a minimum of clinico-anamnestic indices. This also makes possible the differentiation of the groups of patients needing emergency neurosurgery or intensive care.

[Late results of operations in patients with epilepsy with marked mental disorders]. / Otdalennye rezul'taty operatsii u bol'nykh épilepsiei s vyrazhennymi narusheniiami psikhiki.

The article reports data concerning 260 patients with epilepsy who were treated by different variants of operations on the open brain. The duration of the catamnesis ranged from 3 to 17 years. It is shown that the results of the treatment are determined by some initial data, in particular, the features of the psychopathological and neuropsychological disorders and their degree. Criteria of the selection of patients with epilepsy and mental disorders for surgical management are formulated.

[Diagnostic characteristics of acute neurologic pathology at the prehospital stage]. / Osobennosti diagnostiki ostroi nevrologicheskoi patologii na dogospital'nom étape.

Clinically verified files of 1436 patients with 12 most frequent forms of acute neurological pathology were studied for the rate and causes of prehospital diagnostic errors. The information obtained before the patient's admission was evidenced to be insufficient for the reliable differentiation of the ailment nature. In cases when precise diagnosis appears impossible at the site of first medical aid, its efficiency can be increased by correct choice of special hospital.

[Basis for choosing the surgical treatment method in intracranial hematomas in combined craniocerebral injury and concomitant shock]. / Obosnovanie vybora sposoba khirurgicheskogo lecheniia vnutricherepnykh gematom pri sochetannoi cherepno-mozgovoi travme, soprovozhdaiushcheisia shokom.

A comparative evaluation of the antishock effectiveness of the ablation of intracranial hematomas by means of various surgical accesses was made. The method of mathematical analysis based on the principle of "moving averages was used. It was shown that the potential antishock effectiveness of the ablation of intracranial hematomas was maximum after using cutter openings and minimum after using the osteoplastic access.

Balloon catheter technique for dilatation of constricted cerebral arteries after aneurysmal SAH.

The authors describe the technique and explain the reason for the use of an intravascular balloon catheter technique in the treatment of vasospasm in cases of subarachnoid haemorrhage due to rupture of a cerebral aneurysm. In 33 patients with SAH 105 major cerebral arteries were dilated (in the system of internal carotid and basilar arteries). Only in one case vasodilatation could not be accomplished. The effect of dilatation of vasospastic arteries was stable and the functional state of the brain was ameliorated, local and general cerebral dysfunctional signs and symptoms due to vasospasm regressed. The authors discuss indications and contraindications for intravascular balloon dilatation of spastic arteries, the time for the operation, the length of arteries to be dilated, and the possible mechanism of amelioration of cerebral blood flow to the brain stem.

[1st attempt at dilating spastic cerebral arteries in the acute stage of rupture of arterial aneurysms]. / Nachal'nyi opyt dilatatsii spazmirovannykh mozgovykh sosudov v ostrom periode razryva arterial'nykh anevrizm.

The article deals with the substantiation, techniques, and possibilities of treating long-term spasm of the cerebral vessels in patients with ruptured arterial aneurysms by means of an intravascular intervention, dilatation of the spastic vessels with a balloon catheter. Thirty-three large cerebral vessels (internal carotid arteries, the basilar artery, and their branches) were dilated in 13 patients. Vasodilation could not be accomplished in only one patient in the group discussed. The increase in the vascular lumen proved to be stable, and the functional state of the brain in patients subjected to surgical treatment of spasm of the cerebral vessels improved. The authors discuss the indications for and the performance of the suggested intervention, the time of its performance, the boundaries of vasodilatation, and possible mechanisms of circulation improvement in the brain stem. The duration of the effect of dilatation of the spastic cerebral vessels is, according to the authors, the most complex problem.