[Possibilities of dynamic phase contrast MRI of cerebrospinal fluid for performing a tap test in a patient with idiopathic normotensive hydrocephalus]. / Vozmozhnosti dinamicheskoi fazovo-kontrastnoi MR-likvorografii pri vypolnenii tap-testa u patsienta s idiopaticheskoi normotenzivnoi gidrotsefaliei.

Idiopathic normotensive hydrocephalus (iNH) is a widespread disease in elderly patients. The effectiveness of iNG treatment and the subsequent quality of patients' lives directly depends on timely and early diagnosis. The criteria for diagnosing iNG that are used in neuroimaging can also be found in patients without clinical manifestations of this disease, and the widely used tap-test is an invasive technique with a rather low sensitivity. The need for early diagnosis and initiation of treatment before the development of irreversible damage to brain structures determines the relevance of the search for an accessible, minimally invasive, accurate and safe diagnostic method. The article presents a clinical observation of the use of phase-contrast MRI of cerebrospinal fluid (CSF) in a female patient with a positive response to the tap test with a quantitative analysis of changes in CSF flow parameters and ALVI and Evans indices depending on the time after CSF evacuation. Phase-contrast MRI of CSF with a quantitative assessment of CSF flow parameters in combination with an assessment of the ALVI index has the potential to increase the accuracy of diagnosing iNH and is of scientific interest for further research.

[The problem of pharmacoresistant tremor in Parkinson's disease and essential tremor]. / Farmakorezistentnyi tremor pri bolezni Parkinsona i essentsial'nom tremore.

MR-guided focused ultrasound (MRg-FUS) is a new noninvasive method for the treatment of contralateral disabling and pharmacoresistant tremor. Clinical studies have confirmed the high efficacy and safety of using MRg-FUS in patients with essential tremor and Parkinson's disease, in short and long-term studies. Advantages of this method in comparison with currently used invasive and noninvasive technics, potential brain target areas, the possibility of bilateral intervention, indications and contraindications are discussed.

[Dissection of brachiocephalic arteries as a complication of open neurosurgery: case report and literature review]. / Dissektsiya brakhiotsefal'nykh arterii kak oslozhnenie otkrytoi neirokhirurgicheskoi operatsii: sluchai iz praktiki i obzor literatury.

BACKGROUND: Abnormal styloid processes cause dissection of supra-aortic arteries in some cases. In total, about 33 cases have been described in the world and national literature. However, there were no dissections associated with neurosurgery. At the same time, anomalies of styloid process may be an unidentified cause of many spontaneous dissections of brachiocephalic arteries. OBJECTIVE: To analyze modern data on dissection of brachiocephalic arteries associated with anomalies of styloid process and describe dissection in a 44-year-old patient with deviated styloid processes after posterior cranial fossa surgery. MATERIAL AND METHODS: Searching for literature data was performed using the keywords "dissection of the cervicocerebral arteries", "dissection of the brachiocephalic arteries", "stylocarotid syndrome" and "Eagle syndrome" in the PubMed and Medscape databases. We also describe a patient hospitalized for microsurgical resection of cystic-solid hemangioblastoma of medulla oblongata who developed postoperative dissection of both internal carotid and vertebral arteries. RESULTS: We found 1777 papers between 01/01/1900 and 01/18/2021. In most cases, ICA dissection was not a result of stylocarotid syndrome. There were 121 full-text Russian- or English-language articles. We selected 46 most relevant publications. Analyzing these papers, we found that small distance between the tops of styloid processes and internal carotid arteries can be a risk factor of dissection of brachiocephalic arteries in addition to styloid process elongation. Our patient was diagnosed with just such an anomaly. CONCLUSION: Anomalies of styloid processes can cause dangerous vascular complications. Therefore, the length and abnormal deviation of styloid process should be considered when planning intraoperative position of a patient associated with prolonged neck flexion.

[COVID-19-associated stroke]. / COVID-19-assotsiirovannyi insul't.

Neurological complications of COVID-19 occur in almost a third of patients. According to various studies, the frequency of cerebrovascular manifestations in patients with a positive test result for SARS-CoV-2 ranges from 1% to 3%. The most common manifestation was acute ischemic stroke. Cerebrovascular complications in COVID-19 patients are likely multifactorial. They can be associated with coagulopathy, systemic inflammatory response, endothelial dysfunction and microthrombosis, as well as organ failure, impaired cardiac functions. The peculiarities of stroke in patients with COVID-19 include occlusion of large vessels, involvement of several vascular pools, a high incidence of damage to the vertebrobasilar system, a cryptogenic nature and a high severity of the course with high mortality and disability. Particular attention should be paid to impaired cognitive functions as a clinical manifestation of the consequences of stroke associated with a new coronavirus infection.

[The organization of medical service of the Interior Ministry of Russia in 2017].

The article presents a comprehensive analysis and assessment of the state of regional characteristics of morbidity with temporary disability, disability and mortality of employees of the internal affairs bodies of Russia. The source of the data was medical statistical reports generated by the medical and sanitary units of the Ministry of Internal Affairs of Russia using lexical analysis of medical documentation.

[Cell therapy for ischemic stroke. Stem cell types and results of pre-clinical trials]. / Kletochnaia terapiia ishemicheskogo insul'ta. Tipy stvolovykh kletok i rezul'taty doklinicheskikh issledovanii.

The literature review addresses the use of stem cells (SC) in ischemic stroke (IS). Part 1 of the paper overviews the results of experimental animal studies. Characteristics of different SC types and results of their studies in experimental models of IS are presented in the first section, the second section considers pros and cons of the methods of SC injection.

[Cell therapy for ischemic stroke. Results of clinical trials and perspectives of clinical application in the Russian Federation]. / Kletochnaia terapiia ishemicheskogo insul'ta. Rezul'taty klinicheskikh issledovanii i perspektivy primeneniia v Rossiiskoi Federatsii.

The first part of the review summarized the results of preclinical animal studies using stroke models that demonstrated the efficacy of cell therapy. The second part presents the proposed mechanisms of action of stem cells, optimal therapeutic window for cell transplantation, the results of completed clinical trials on humans in the period from 2010 to 2017, as well as the legal aspects of the use of cell technologies in the Russian Federation.

Intravenous xenotransplantation of human placental mesenchymal stem cells to rats: comparative analysis of homing in rat brain in two models of experimental ischemic stroke.

Mesenchymal stem cells from human placenta obtained after term natural delivery were cultured and labeled with vital dye Dil of magnetic fluorescing microparticles. The labeled cells were transplanted intravenously to rats with occlusion of the median cerebral artery. Penetration of cells through the brain-blood barrier and their distribution in the brain of experimental animals were studied on serial cryostat sections. Two models of cerebral artery occlusion associated with different traumatic consequences were used. The efficiency of crossing the blood-brain barrier by transplanted cells, the number of mesenchymal cells attaining the ischemic focus and neurogenic zones, and the time of death of transplanted cells largely depended on the degree and nature of injury to the central nervous system, which should be taken into account when planning the experiments for evaluation of the effects of cell therapy on the models of neurological diseases and in clinical studies in the field of regenerative neurology.

[An experimental model of focal brain ischemia in rats based on the endovascular microsurgery].

An endovascular model of focal brain ischemia in rats with controlled duration of reperfusion of 1h has been studied. The reliability of experimental model for localization and volume of ischemic lesion (basal ganglia, hippocampus, parietal-temporal regions; the volume of lesion focus on MRI T2-weighted image (T2-WI) in the first day after brain ischemia 146.4 +/- 44.7 mm3) has been worked out. We conducted the clinical monitoring including assessment of neurological deficit, behavioral tests and performed MRI of the brain on 1st, 5th and 10-17th days after the occlusion of middle cerebral artery (MCA), including regimes of diffusion-weighted image (DWI) and T2-WI, and carried out a histological study of the brain. The regress of neurological deficit was seen on the 14th day after surgery. Behavioral tests revealed the reduction of movement activity of animals in the case group 7 days after the MCA occlusion. Compared to the first day after surgery, the decrease of volume lesion focus on DWI and T2-WI was observed on the 5th day (p < 0.05) as well, with the following decrease to the 10-14th days. The histological picture in the lesion foci corresponded to the brain infarction on the 5th and 14th days after surgery.

Mechanisms of positive effects of transplantation of human placental mesenchymal stem cells on recovery of rats after experimental ischemic stroke.

Mesenchymal stem cells isolated from human placenta and in vitro labeled with fluorescent magnetic microparticles were intravenously injected to rats 2 days after induction of focal cerebral ischemia (endovascular model). According to MRT findings, transplantation of mesenchymal stem cells led to an appreciable reduction of the volume of ischemic focus in the brain. Two or three weeks after transplantation, labeled cells accumulated near and inside the ischemic focus, in the hippocampus, and in the subventricular zone of both hemispheres. Only few human mesenchymal stem cells populating the zone adjacent to the ischemic focus started expressing astroglial and neuronal markers. On the other hand, transplantation of mesenchymal stem cells stimulated proliferation of stem and progenitor cells in the subventricular zone and migration of these cells into the ischemic zone. Positive effects of transplantation of these cells to rats with experimental ischemic stroke are presumably explained by stimulation of proliferation of resident stem and progenitor cells of animal brain and their migration into the ischemic tissue and adjacent areas. Replacement of damaged rat neurons and glial cells by transplanted human cells, if it does take place, is quite negligible.

Use of bone marrow mesenchymal (stromal) stem cells in experimental ischemic stroke in rats.

The effects of human mesenchymal stem cells on neurological functions and behavioral reactions of animals and on damaged brain tissue were studied on the model of focal cerebral ischemia in rats. Homing and differentiation of transplanted mesenchymal stem cells were also studied. Significant regression of neurological disorders after cell transplantation was noted, no appreciable shifts were detected by magnetic resonance tomography. Homing of transplanted cells was detected mainly in the zone of focal ischemia. Some cells died, others exhibited signs of differentiation into neurons and glia.