[Study of the changes in carbohydrate metabolism as a diagnostic test of acute hypothalamic syndrome in severe cranio-cerebral trauma]. / Izmeneniia uglevodnogo obmena kak diagnosticheskii test ostrogo gipotalamicheskogo sindroma pri tiazheloi cherepno-mozgovoi travme.

A total of 66 patients who suffered a severe isolated or concomitant craniocerebral injury were examined. Additionally, a study was made of some indicators of carbohydrate metabolism in the general circulatory bed, acid-base state of the arterialized blood, partial oxygen tension and hemoglobin saturation with arterial blood oxygen. In 10 patients, the same indicators were compared to EEG alterations and the pulse constituent of the finger photoplethysmogram. It was revealed that alterations in carbohydrate metabolism in the form of lactic acidosis and anaerobiosis developed not only because of hemodynamic and ventilatory disorders. Analogous alterations were also seen in the course of the development of the acute hypothalamic syndrome (AHS) with the lack of ventilatory and hemodynamic disorders. The above disorders of carbohydrate metabolism may serve as one of the early diagnostic tests of AHS development and be used for the control over the treatment efficacy and prediction.

[Post-dislocation lesions of the midbrain and pons in neurosurgical patients]. / Postdislokatsionnye porazheniia srednego mozga i mosta mozga u neirokhirurgicheskikh bo'lnykh.

The study of clinico-neurological, electroencephalographical and pathological data in 37 patients with post-dislocation lesions of midbrain and pons Varolii yielded identification of the syndroms of isolated functioning of brainstem-cerebral and brainstem-spinal systems: mesencephalo-pontine, supramesencephalic, unilateral. Clinico-physiological features characteristic of these syndromes are discussed as different from those of acute brain dislocations. Their value in diagnosis and prediction of the death of brain as an organ.

[Prophylaxis of brain edema in neurosurgical operations]. / Profilaktika oteka golovnogo mozga pri neirokhirurgicheskikh operatsiiakh.

Rational surgical approaches providing for preservation of the arteries and veins of the brain and minimal mechanical damage to it during the removal of tumors, the use of adequate anesthesia which prevents the development of vegetative reactions of central origin, and postoperative correction of the patients' condition under clinical and physiological control allow the development of cerebral edema to be prevented. Experience in the management of 1,447 patients with intracranial, mainly extracerebral, tumors showed that postoperative lethality can be reduced from 27.0 to 4.3%.

[Autonomic shunting in complete traumatic transection of the spinal cord]. / Vegetativnoe shuntirovanie pri polnom travmaticheskom pereryve spinnogo mozga.

Study of vasomotor reactions, EEG, and ECG in complete traumatic lesions of the spinal cord showed consecutive changes in the functioning of the sympathetic apparatus of an isolated spinal system which passed through the following phases: the phase of separated vegetative reactions, the phase of their inhibition, phase of restoration, phase of afferent vegetative shunting, phase of efferent vegetative shunting with restoration of cerebral control of sympathetic innervation. The expediency of taking into account these phases in planning treatment and rehabilitation of such patients is pointed out.

[Clinico-physiologic evaluation of the viability of the brain as an organ in segmental lesions of the brain stem]. / Kliniko-fiziologicheskaia otsenka zhiznesposobnosti golovnogo mozga kak organa pri segmentarnykh porazheniiakh ego stvola.

Segmental lesions of the brain stem with the dissociation syndrome may prevail in the clinical picture of the disease in neurosurgical patients with total cerebral hypoxia as well as with primary or secondary local lesions of the stem. Coarse segmental lesions of the stem, which are often not associated with total affection of the brain, lead to death of the brain as an organ in functionally preserved structures above and below the level of dissociation.

[Changes in total hemodynamics of central genesis following removal of basal meningiomas]. / Izmeneniia obshchei gemodinamiki tsentral'nogo geneza pri udalenii bazal'nykh meningiom

The removal of basal intracranial meningiomas in 54 patients, even under general anesthesia with neuro-autonomous blocking, was accompanied by cardiovascular reactions caused by both reflex effects and direct excitation of brain stem structures. These reactions were always of a pressor nature only. Postoperatively, the vascular reactions were also of a pressor nature and presented themselves as components of either a non-specific stress response or a developing diencephalo-catabolic syndrome. Taking into account that the leading cause of the vascular disorders in stress responses and the diencephalo-catabolic syndrome is the irritative process in the brain stem structures, it is important for the prevention and management of these disorders to suppress by pharmacological means the irritation of the median formations with simultaneous blood replacement and conduction of maintenance cardiac therapy.

[Clinico-electroencephalographic characteristics of the condition of brain stem systems following surgical and non-surgical brain injury]. / Kliniko-élektroéntsefalograficheskaia kharakteristika sostoianiia sistem mozgovogo stvola pri operatsionnoi i neoperatsionnoi travme golovnogo mozga

The paper is concerned with a study of the stem structures in 186 patients during and following a removal of brain tumors and in 42 patients with acute brain traumas. A correlation of the EEG, the clinical picture and action of the central adreno- and cholinolytics and adrenomimetics demonstrated that in acute influences on the stem it is always in an irritative state. A significant degree of stem structures irritation during its direct affection is accompanied by an appearance in the EEG of synchronized low forms of fluctuations and clinical symptoms of vegetative hyperergia. In such conditions, besides measures of normalizing the hemodynamics and CSF circulation it is necessary to use preparations of a central adreno- and cholinolytic action.