[Cerebro-cardial disorders in hemorrhagic stroke]. / Tserebrokardial'nye narusheniia pri gemorragicheskom insul'te.

AIM: To elucidate relationships brain-heart in hemorrhagic stroke depending on the size and location of hematoma and initial state of the heart. MATERIAL AND METHODS: Clinical and paraclinical methods were used in acute and rehabilitation periods in 160 patients with hemorrhagic stroke. RESULTS: Symptoms of cerebrocardial syndrome in hemorrhagic stroke include arrhythmias (tachycardia, bradycardia, extrasystole, cardiac fibrillation, sick sinus syndrome), blocks (transient bundle-branch block), myocardial dystrophy, in IHD--ischemic myocardial disorders up to subendocardial myocardial infarction. Its severity in massive hemispherical hematomas was due to compression of the brain trunk. CONCLUSION: Pathogenesis of cerebrocardial syndrome rests on impaired central autonomic regulation occurring in stroke.

[Follow-up study of patients operated for traumatic subdural hematoma]. / Katamnez bol'nykh, operirovannykh po povodu travmaticheskikh subdural'nykh gematom.

In 56 patients operated for traumatic subdural hematomas clinical manifestations were analysed (8 main syndromes of the remote period) as well as the degree of neurologic rehabilitation and the level of social-occupational adaptation. Such adaptation appeared to be rather high: 66.1% of the patients were able to resume work. The highest lethality was in the acute period; the worst rehabilitation and follow-up adaptation were observed in elderly and old patients who were in comatose state before the operation and had severe accompanying contusion of the brain. Policy of drug treatment was determined in patients with traumatic subdural hematomas regarding peculiarities and manifestations of the syndromes (urgent operation, if necessary--cranioplasty, psychologic support in the remote period, resorption therapy and symptomatic drugs).

[Nervous system changes in adrenal failure]. / Izmenenie nervnoi sistemy pri nadpochechnikovoi nedostatochnosti.

AIM: To study nervous systems in chronic adrenal failure (CAF). MATERIAL AND METHODS: 262 patients with CAF were studied clinically, biochemically and electrophysiologically before and after treatment. RESULTS: The patients were found to have syndromes of vegetovascular dystonia by hypotonic type, syncopal paroxysms, myastenic, minor strokes, dyscirculatory-dysmetabolic encephalopathy, polyneuropathy. A direct correlation was established between the severity and duration of adrenal failure (AF), lowering of adrenal cortex hormones, coefficient Na/K and clinical manifestations of the neurological syndromes. Adequate hormone replacing and symptomatic therapy promoted a regress of neurological disorders in most of the patients especially in mild and moderate AF. CONCLUSION: Adequate therapy corrects neurological disturbances in patients with chronic NN.

[Role of autonomic nervous system in pathogenesis and clinical manifestation of arterial hypertension in Icenko-Cushing disease]. / Rol' vegetativnoi nervnoi sistemy v patogeneze i klinicheskikh proiavleniiakh arterial'noi gipertonii pri bolezni Itsenko-Kushinga.

AIM: To study the role of autonomic nervous system (ANS) in pathogenesis and clinical symptoms of arterial hypertension (AH) in Icenko-Cushing disease (ICD). MATERIALS AND METHODS: Clinical and paraclinical parameters (vegetative reflexes, special tables, 10 words memory and Spilberg's tests, ECG, electroencephalography, computed tomography, MR-tomography, hormonal status) were studied in 48 ICD patients before and after treatment (adenomectomy, irradiation of the hypophysis, adrenalectomy, parlodel, chlotidin chemotherapy). RESULTS: 94.5% of patients with active ICD had blood hypertension and vegetovascular asthenia. There was a trend to cerebrovascular impairment. In spite of biochemical and clinical ICD remission lipothemia persisted in many patients. CONCLUSION: Pathogenesis of blood hypertension in ICD is related to hypersecretion of ACTH and corticosteroids but further progress of the disease depends on phenotypic features of autonomic nervous system and developing defects of CNS.

[Spinal cord injury in multiple myeloma]. / [Porazhenie spinnogo mozga pri mnozhestvennoi mielome]

Myelomic spinal cord damage may be a result of both its compression and vascular disorders (squeezing of an artery, disorders of venous outflow). Diagnosis is based on evaluation of the following signs: normochromic anemia; increase of ESR, total protein and calcium levels; discovery of M-gradient in protein fractions of gamma-zone; multiple regions of destruction in spondylogramme. In doubtful cases magneto-resonance and computer tomography were the most informative. Highly effective was therapy with intensive chemoprogramme including either a range of preparations (alkeran, BGNU, cyclophosphan, adriblastina, prednisolon) or a combination of polychemotherapy with irradiation. The operation was indicated in both insufficiency of conservative therapy and increasing of the symptoms of the damage.

[The diagnosis, treatment and prevention of early stages of cerebral blood flow insufficiency]. / Diagnostika, lechenie i profilaktika rannikh stagii nedostatochnosti mozgovogo krovoobrashcheniia.

Biomicroscopy of bulbar conjuctiva as well as oencephalography were quite informative for discovery of subclinical manifestations of disorders of cerebral circulation (DCC). That conclusion resulted from the observation of 133 patients with early forms of vascular pathology of brain. Besides, to find the early signs, it was also worth while to perform some biochemical studies (coagulogram, studies of both rheologic properties and lipids of blood). In order to establish discirculatory encephalopathy it was also expedient to use ultrasonic dopplerography and electroencephalography. Efficiency of some medical-prophylactic measures (normalization of the diet, weight, muscular activity, administration of antiatherosclerotic drugs) that prevented the progression of aorta's stenosis was also demonstrated.

[Central regulatory disorders in the clinical picture of the early postoperative period in patients with tumors of the midbrain]. / Tsentral'nye reguliatornye narusheniia v klinike rannego posleoperatsionnogo perioda u bol'nykh s opukholiami srednego mozga.

Neurological, clinical, biochemical examinations, electroencephalography, computer and magnetic resonance tomography of the brain of 336 patients with brain stem and para-brain stem tumors resulted in conclusion that nonspecific autonomic-endocrine reaction caused by disorders in central regulation was the main component of early postoperative period. The first type of such disorders included cases with rather stable indices of both hemodynamics and ionic-osmotic homeostasis characterized by favourable course. Unstable hemodynamics and tendency to increase of osmolarity and serum levels of sodium and glucose as well as unfavourable course of this period were typical for the second type.

[The neurological aspects of chromaffinoma]. / Nevrologicheskie aspekty khromaffinomy.

Vegetative dysfunction with episodes of tachycardia, hypertension, paleness, general hyperhidrosis, subfebrile condition, hyperglycemia manifest first among clinical symptoms of chromaffinoma. In respect to these symptoms severity the crises observed in chromaffinoma are classified as minor or major. Major crises may be cerebral, epileptiform, cardial and abdominal. The crises are attributed to hypercatecholaminergic arterial hypertension. A reliable laboratory diagnosis of the disease involves urinary measurements of catecholamines and their metabolites. Manifold increase of the latter concentrations may serve the diagnostic indication. The only effective treatment is the removal of the tumor from the adrenals.

[Neurological changes in insulinoma]. / Nevrologicheskie izmeneniia pri insulinome.

Hypoglycemic disease is characterized by neurasthenic and encephalopathic syndromes. Three stages, an initial one, a stage marked by pronounced alterations and rehabilitation one (after insulinoma removal) were distinguished. Hypoglycemic paroxysms manifest themselves by syncopal, epileptic, pseudostroke and psychomotor excitation. Of paramount importance for diagnosis are EEG studies during fasting or rastinon test. Surgical removal of insulinoma results in normalization of neurological disturbances.

[The status of the nervous system in mechanical jaundice]. / Sostoianie nervnoi sistemy pri mekhanicheskoi zheltukhe.

In mechanical jaundice there may arise two kinds of CNS abnormalities: light disorders consistent with clinical signs of the underlying disease and neurological complications such as encephalopathy, encephalomyelopathy, polyneuropathies, neurasthenia. Neurological disorders are attributed mainly to initial severe autotoxication as well as hemodynamic affections. Of importance are also other risk factors (premorbid personality traits, advanced age, etc.).

[Diagnosis and treatment of chronic spinal arachnoiditis]. / Diagnostika i lechenie khronicheskogo spina'lnogo arakhnoidita.

Altogether 61 patients with chronic spinal arachnoiditis underwent clinical and laboratory studies for deranged functions of the nervous system. The main neurologic syndromes, the results of examining cerebrospinal fluid and spondylo- and myelography data are given. At the first stage the treatment should be conservative. Surgical intervention is indicated when symptoms of compression increase.

[Psychoneurotic disorders in cardial achalasia]. / Nervno-psikhicheskie narusheniia pri akhalazii kardii.

Major syndromes of psychoneurologic disorders in cardial achalasia are described. Their major pathogenic mechanisms were revealed in a combined clinico-electrophysiological study involving psychological testing. Differentiated methods treatment of psychoneurologic complications of cardial achalasia are described (sedative, neuroleptic drugs, general enforcing and supporting therapies) that proved effective in catamnestic observations.

[Cholestatic toxic-vascular encephalopathy and encephalomyelopathy]. / Kholestaticheskaia toksiko-sosudistaia éntsefalopatiia i éntsefalomielopatiia.

Patients with mechanical jaundice showed signs of organic lesions of the nervous system: the syndrome of cholestatic encephalopathy (n = 56) and encephalomyelopathy (n = 9). Pathomorphological disorders are presented in the form of toxico-hypoxic changes of the neural cells and neuroglia in combination with organic changes in the vascular wall and functional disturbances of the blood flow and the cerebrospinal fluid dynamics. It is suggested that marked autointoxication and hemodynamic disturbances play the leading role in the pathogenesis of neurological disorders in mechanical jaundice.

[Neurologic disorders in myeloma disease]. / Nevrologicheskie narusheniia pri mielomnoi bolezni.

A comprehensive examination involving the use of electroencephalography (EEG), rheoencephalography of the main vessels of the head (REG) and vessels of the limbs, electromyography with the application of neurohistological investigation was conducted in 120 myeloma patients. Neurological disorders systematized into syndromes of encephalopathy, local spondylalgia, radiculalgia, myelopathy, meningomyelopolyradicular and encephalomyelopolyradiculoneuropathic syndromes were observed in 91.7% of the cases. The leading role in the pathogenesis of neurological disturbances was played by toxico-dyscirculatory disorders secondary to infiltration of vessel walls by plasmatic cells, dysproteinosis, kidney failure, as well as mechanical impact of the deformed vertebral column on the spinal cord, its radices and vessels. Modern medicated correction of neurological disturbances is considered necessary in myeloma.