[Modern approaches to the diagnosis of head injury]. / Printsipy sovremennoi diagnostiki cherepno-mozgovoi travmy.

The diagnosis of head injury should be based on certain principles. Each of them is important and has its own history. The authors summarize the experience of treatment of head injury using clinical and neuroimaging methods at the NN Burdenko Neurosurgery Institute (now the NN Burdenko National Research Center for Neurosurgery) for more than 30 years. The following principles of diagnosis of head injury were suggested and tested in clinical practice: severity of patient's state; clinical syndromes; topical diagnosis; neuroimaging; phasicity; age-related approach; data synthesis; sufficiency; individual approach. Taken together, these principles provide complete personalized diagnosis and prognosis which allow choosing an optimal management of the patient. The strategy for better diagnosis, prognosis and treatment of head injury is the combined use of clinical, neuroimaging and ethical approaches.

Teaching history of medicine at Russian medical schools: past, present, and future.

Teaching history of medicine at Russian medical schools has a long tradition. It always reflected the general political situation in the country. The present program has been approved by the Ministry of Health 10 years ago. History of medicine is an obligatory subject taught at the first or second year of medical school. The course usually has 40 hours, equally split between lectures and seminars, and the program is focused on Russian medicine. Here we analyze the existing textbooks on the history of medicine and their drawbacks (ideologization, inventing of national priorities in medical discoveries, and avoiding the 20th-century medicine). To improve teaching of the history of medicine, longer courses and written exams are needed. There is also an evident need of writing a new textbook on the history of medicine.

Roots and routes of Russian neurosurgery (from surgical neurology towards neurological surgery).

Regular and purposeful neurosurgical interventions started at the end of the nineteenth century. Both surgical and neurological roots of the emerging speciality could be traced. The surgical roots of neurosurgery were the invention of anaesthesia, aseptics and antiseptics which made brain operations relatively safe and markedly reduced postoperative mortality. The neurological roots were the improvement of topical diagnosis in neurology and the understanding of the anatomy and physiology of the nervous system. The first operating room at the neurology department of the Russian Military Medical Academy was established in 1897 by the famous Russian neurologist and psychiatrist Vladimir Bekhterev (1857-1927). According to Bekhterev, neurology should become a surgical speciality like gynaecology or opthalmology and "neurologists will take a knife in their hands and do what they should do". Bekhterev's pupil Ludwig Puusepp (1875-1942) became the first full-time Russian neurosurgeon ("surgical neurologist"). He headed the first university course in surgical neurology in the world organised in 1909 at Bekhterev's Psychoneurological Institutte in St. Petersburg and bacame professor of surgical neurology in 1910. The role of neurologist might be illustrated by the development of a sterotactic instrument named "encephalometer" designed by D. Zernov in 1889 and improved by G. Rossolimo in 1907. The idea was to map cerebral structures in degrees of latitude and longitude similar to mapping the terrestrial globe in order to localise the brain lesion and enhance its minimally invasive removal....

On the history of psychosurgery in Russia.

The history of psychosurgery in Russia can be divided into 3 periods: The first period starts at the turn of the century under the initiative of Bekhterev. His pupil and one of the fathers of Russian neurosurgery Puusepp performed leucotomy-like cuttings of frontal association fibers in manic-depressive cases and psychic equivalents of epileptics as early as 1906-1910. The second period includes the time from the late 1930ies till the late 1940ies. The classical leucotomy of Moniz and Lima, with some modifications, was used for treatment of schizophrenia and severe pain. In 1950 psychosurgery was prohibited by the special order of the Minister of Health of the USSR for ideological reasons. The third period starts in the early 1980ies with the acceptance of modern stereotactic techniques for treatment of intractable pain and obsessive-compulsive disorders.

Endo-suprasellar teratoma with teeth formation. Case report.

A highly ossified teratoma was diagnosed and surgically treated in a 2-year old girl. More than 150 teeth were macroscopically identified during the operation. Pathological study established the diagnosis of mature teratoma with teeth formation. Only six analogous cases have been reported previously and only two patients survived the operation.