[Clinical and neurophysiological characteristics of motor cortical responsiveness during prolonged cranial osteoplasty]. / Kliniko-neirofiziologicheskie kharakteristiki reaktivnosti motornoi kory golovnogo mozga v usloviiakh prolongirovannoi kranioosteoplastiki.

The data of global and stimulation poly-EMG were used to estimate the outcomes of multimodality treatment of sequelae of brain injury and stroke, which was based on the vasoactive effects of prolonged cranial osteoplasty. Thirteen patients (7 males and 6 females) aged 19 to 64 (mean 42 +/- 4) years who had signs of left- (n = 2) and right-sided (n = 11) spastic hemiparesis. Global and stimulation poly-EMG, which involved recording and analysis of resting and total EMG under the maximum voluntary tension, M-waves H-reflexes, transcranially evoked potentials. The muscles of the shoulder, forearm, hand, femur, leg, and foot were studied. The surgical procedure developed at the Russian Research Center "VTO" for stimulation of cerebral blood flow in combination with conventional conservative treatments (physiotherapy, therapeutical exercises, and adequate drug therapy) was shown to increase the transmission coefficient of an efferent signal in the motor cortex-spinal motor neurons-muscle system, which is clinically accompanied by improved coordination of simple and complex movements realized with the participation of the muscles of both the paretic and contralateral extremity. The ambiguous effects of the vasoactive factors of prolonged osteoplasty on the functions of unequally modal pathologically changed cerebral motor structures were noted. The findings may be considered as evidence for the low traumatic ability of the VTO's techniques for replacing posttraumatic defects of skull vault bones.

[The functional status of the cerebral cortex after replacement of skull base bone defects]. / Funktsional'noe sostoianie kory golovnogo mozga pri zameshchenii defektov kostei svoda cherepa.

The functional status of the cerebral cortex was evaluated by EEG before and different periods after prolonged cranial osteoplasty made by the type of replacement of skull base bone defects in patients with dyscirculatory encephalopathies of various genesis. Seven patients aged 20 to 50 years undergone repair of skull base bone defects (both posttraumatic and simulated) by the procedures developed at the Russian Research Center "VTO" were examined. The bioelectrical activity of the brain was recorded and analyzed on a PEGASUS digital 16-channel EEG system (EMS, Austria) by using the Fourie prompt conversion test (spectral analysis) and amplitude-frequency mapping. After multimodality treatment, all the patients showed a positive changes in the whole range of EEG parameters, which appeared as an increase in basic rhythm power, a decrease in the focal area of slow-wave activity and in the interhemispheral asymmetry coefficient, which in combination of neurological regression is regarded as indirect evidence for the vasoactivity of prolonged cranial osteoplasty.