[Collaboration of general surgeons with neurosurgeons: what does a general surgeon need to know about neurosurgery?]. / Zusammenarbeit der Neurochirurgie mit der Allgemeinchirurgie: Was muss der Allgemeinchirurg von der Neurochirurgie wissen?

BACKGROUND: The most freq+uent disorders and injuries requiring the joint attention of general surgeons and neurosurgeons are presented and analysed in this review. METHODS: The priorities and prognosis concerning diagnostic and surgical measures for patients in coma with multiple injuries, extra- and intraspinal tumours and brain metastases are analysed. RESULTS: The urgency of general surgical and neurosurgical measures is not ruled by a preformatted pattern but by the vital needs of the individual patient. CONCLUSION: The differentiation of vital from non-vital operations or with regard to prognosis necessary from inadequate general surgical and neurosurgical measures is of fundamental importance. The successive order of general surgical and neurosurgical interventions must be adjusted to the needs of each individual patient.

Deep brain stimulation and spinal cord stimulation for vegetative state and minimally conscious state.

OBJECTIVE: On the basis of the findings of the electrophysiological evaluation of vegetative state (VS) and minimally conscious state (MCS), the effect of deep brain stimulation (DBS) was examined according to long-term follow-up results. The results of spinal cord stimulation (SCS) on MCS was also examined and compared with that of DBS. METHODS: One hundred seven patients in VS and 21 patients in MCS were evaluated neurologically and electrophysiologically over 3 months after the onset of brain injury. Among the 107 VS patients, 21 were treated by DBS. Among the 21 MCS patients, 5 were treated by DBS and 10 by SCS. RESULTS: Eight of the 21 patients recovered from VS and were able to follow verbal instructions. These eight patients showed desynchronization on continuous electroencephalographic frequency analysis. The Vth wave of the auditory brainstem response and N20 of somatosensory evoked potential were recorded even with a prolonged latency, and pain-related P250 was recorded with an amplitude of more than 7 µV. In addition, DBS and SCS induced a marked functional recovery in MCS patients who satisfied the electrophysiological inclusion criteria. CONCLUSION: DBS for VS and MCS patients and SCS for MCS patients may be useful, when the candidates are selected on the basis of the electrophysiological inclusion criteria. Only 16 (14.9%) of the 107 VS patients and 15 (71.4%) of the 21 MCS patients satisfied the electrophysiological inclusion criteria.

[Active surgical policy in severe advanced complications and sequels of concomitant brain injury (a clinical case)]. / Aktivnaia khirurgicheskaia taktika pri tiazhelykh zatianuvshikhsia oslozhneniiakh i posledstviiakh sochetannoi cherepno-mozgovoi travmy (klinicheskoe nabliudenie).

The paper presents a clinical case with a good outcome, which shows the advantages of active and stepwise surgical policy in concomitant chronic extra- and intracranial pyoinflammatory and dystrophic complications with severe liquorocirculatory disorders and extensive skull defect due to severe brain injury.

[Neurotransplantation in the treatment of the sequelae of the apallic syndrome]. / Neirotransplantatsiia v lechenii posledstvii apallicheskogo sindroma.

The paper presents new results of embryonic tissue transplantation. Twenty-seven embryonic tissue transplantations into affected regions of brain cortex were performed on 21 patients with apallic syndrome. Motor and mental improvement were observed in sixteen recipients.