[Pronoran in the treatment of mental organic syndrome in the elderly]. / Lechenie pronoranom psikhoorganicheskogo sindroma v pozdnem vozraste.

Efficacy and tolerability of pronoran (piribedil) was investigated in an open clinical trial including 21 patients, aged 61-85 years, with initial cognitive disturbances of cerebral vascular genesis. Along with a clinical and somatic examination, the Clinical Global Impression (CGI) scale, the Mini Mental State Examination (MMSE) test, the Sandoz Clinical Assessment Geriatric (SCAG) scale and a scale for side-effects were used. Pronoran was prescribed in a dosage 50-100 mg/day during 3 months. Patients were examined at base line and on the treatment day 14, 42 and 90. A positive clinical effect on mild cognitive impairment was achieved after 1.5 months and maintained to the end of 3 month therapy. Pronoran improves ability to sustain attention, learning and memory, organization of thinking and executive mental function. It also has a mild antidepressive and antianxiety action, being safe for elderly patients.

[The status and dynamics of occupational morbidity in the Novgorod region]. / Sostoianie i dinamika professional'noi zabolevaemosti v Novgorodskoi oblasti.

The article deals with results obtained by analysis of occupational morbidity by registration materials according to Russian Health Ministry Order No 176 (05/28/01).

[Features of retinal hemodynamics and the optic nerve in developing primary atrophy in tumors of the chiasmal-sellar area]. / Osobennosti gemodinamiki setchatki i zritel'nogo nerva v razvitii pervichnoi atrofii pri opukholiakh khazmal'no-selliarnoi oblasti.

The pathogenesis of primary optic atrophy of different severity, caused by tumors in the chiasmal-sellar area is analyzed as exemplified by 109 patients. The severity of primary optic atrophy depended on the duration of visual disorders. The patients were divided into 2 groups with early and late stages of visual disorders. Use of objective methods of examination (fluorescent angiography, densitometry, and fluorophotocalibrometry) helped detect the earliest changes in the fundus oculi microcirculation, accurately determine the severity of optic atrophy, and more completely evaluate the hemodynamic disorders in the ocular artery system.

[The ophthalmological symptoms of chiasmatic gliomas in children in the pre- and postoperative periods]. / Oftal'mologicheskie simptomy gliom khiazmy u detei v do- i posleoperatsionnom periode.

The paper outlines the ophthalmological symptomatology in 61 children aged 2.5 to 15 years who had great and giant chiasmal gliomas. The ophthalmological symptomatology among the first clinical manifestations was found in 86.9% of cases and remained prevalent throughout the follow-up. There was a correlation between the status of visual functions and the site of a tumor. The tumor affected mainly the chiasma in 6.6% of cases, the chiasma and the both optic nerves in 26.2%, the chiasma and an optic nerve in 62.2%. The ophthalmological and neurological symptomatologies are of value in choosing a surgical treatment. A subtotal and partial removal of the tumor was performed in 51 and 10 patients, respectively. Its removal resulted in an improvement and stabilization of visual functions in 14.3 and 41.1% of cases, respectively. Thirty-three patients were followed up for 4 months to 8 years. Visual improvement occurred in 36.4% in the late period. There was a relapse in 9.1% of cases.

[The visual functions of patients with traumatic carotid-cavernous anastomoses]. / O zritel'nykh funktsiiakh u bol'nykh s travmaticheskimi karotidno-kavernoznymi soust'iami.

The visual functions in 100 patients with traumatic carotid-cavernous anastomoses were studied. In 54% of cases the visual functions were impaired, in 33% they were lost to various degrees, 21% of patients were practically blind. The most frequent cause of disorders of visual functions were hemodynamic changes in the optic nerve and retina, a less frequent cause was traumatic damage to the optic nerve in its canal. These factors may coexist. The graver the craniocerebral trauma the more probable are sharp loss of visual functions and the development of coarse pathology of the fundus oculi.

[The clinical picture and diagnosis of optic nerve gliomas in adults]. / Klinika i diagnostika gliom zritel'nogo nerva u vzroslykh.

Gliomas of the optic nerve are more often in childhood and adolescence. The present paper analyzes the clinical features and diagnosis of optic nerve gliomas in 41 adult patients aged 15 to 56. Comparative analysis of the clinical picture and diagnostic specificities in optic nerve gliomas in adults and children has revealed a longer duration of the disease, less manifest exophthalmos and dilatation of the optic canal on the side of the tumor in adults. Analysis of computerized tomography data has prompted singling out 2 types of optic nerve glioma images: (1) spindle-shaped dilatation of the optic nerve in the orbit and (2) even thickening of the optic nerve along its whole length in the orbit. Each of these glioma tomographic images is associated with specific clinical features. Differential diagnosis between optic nerve gliomas and meningiomas in adults in described.

[Dermoid cysts of the orbit spreading into the cranial cavity]. / Dermoidnye kisty glaznitsy, rasprostraniaiushchiesia v polost' cherepa.

Operations were performed through a transcranial approach on 12 patients with dermoid cysts of the orbit spreading into the cranial cavity. All patient had a defect in the orbital roof which extended to the lateral wall in 8 patients. The capsule of the cyst was connected with the dura mater and the orbital periosteum with adhesions. With the use of an operative microscope or operative magnifying glass and microsurgical instruments the dermoid cysts were removed without injuring the dura mater and orbital periosteum and good functional and cosmetic results were produced.

[Meningiomas of the optic nerve (clinical picture, diagnosis and morphology)]. / Meningiomy zritel'nogo nerva (klinika, diagnostika, morfologiia).

The clinical, diagnostic, and morphological findings in 31 patients with meningiomas of the optic nerve are analysed. Three groups of patients, each with a definite type of image on computed tomography, are distinguished. It is shown that the difficulty of preoperative identification of intracanalicular and intracranial spreading of a meningioma of the optic nerve determines the expediency of a transcranial approach with resection of the roof of the orbit for examination of the optic nerve for its whole distance from the posterior pole of the eyeball to the chiasm.

[Results of surgical treatment of gliomas of the optic nerve]. / Rezul'taty khirurgicheskogo lecheniia gliom zritel'nogo nerva.

The work discusses the catamnestic data on 55 children aged from 10 months to 17 years who underwent operation for glioma of the optic nerve by the one-stage cranio-orbital method. A recurrent tumor was found in 6 patients in postoperative periods of 1 to 5 years. Its source was a nonremoved intracanalicular part of the optic nerve involved in the tumor. Chronic trophic uveitis was encountered in some patients after the operation, which led to subatrophy of the eyeball. Exacerbation of uveitis simulated growth of the tumor into the optic disk in some cases, due to which enucleation of the eyeball was performed.

[Hemodynamics of the fundus oculi and brain of patients with parasagittal meningiomas]. / Gemodinamika glaznogo dna i mozga bol'nykh s parasagittal'nymi meningiomami.

The retinal blood flow was studied by fluorescent angiography of the fundus oculi in 22 patients with parasagittal meningiomas before and after surgery. A total of 82 fluorescence-angiographic examinations were performed and disorders of retinal hemodynamics were found irrespective of the presence or absence of intracranial hypertension. Prolongation of the venous phase of retinal circulation alone without signs of intracranial hypertension is an early symptom of impaired venous flow from the cranial cavity and deficient development of pathways compensating for venous drainage. The arterial phase is prolonged at a later stage of the tumorous process, when the cerebral blood flow is much slower. Marked disorders of retinal venous blood flow are still found one month after removal of parasagittal meningiomas. It is shown that the flow of venous blood from the cranial cavity is mainly impaired in patients with parasagittal meningiomas.

[Heredo-familial arachnoiditis of the optic chiasm (clinical picture and results of neurosurgical treatment)]. / Semeino-nasledstvennyi optokhiazmal'nyi arakhnoidit (klinika i rezul'taty neirokhirurgicheskogo lecheniia).

The authors report that Leber's optic atrophy is a familial hereditary optochiasmatic arachnoiditis: 70 patients from 44 families are analysed. In 17 families a medicogenetic analysis was conducted at least in three generations and a recessive type of heredity was determined in most cases. Fifty-five patients underwent operation after ineffective nonoperative treatment. Optochiasmatic arachnoiditis was found in all patients during surgery. Visual functions improved six months after the operation in half the patients. The similarity of the clinical picture of familial hereditary optochiasmatic arachnoiditis with that of infectious-allergic meningitis dictates the need for studying the familial medical history of all patients with retrobulbar neuritis.

[Cranio-orbital meningiomas and their surgical treatment]. / Kranioorbital'nye meningiomy i ikh khirurgicheskoe lechenie.

Since 1968 the authors performed operations on 241 patients for cranio-orbital tumors, 156 of which (64.7%) were meningiomas: 103 (42.8%) were hyperostotic and 53 (22%) were nodular. The authors describe the features of the diagnosis and clinical picture of hyperostotic and modular forms of cranio-orbial meningiomas and the direction of their prevalent growth (intracranial, intraorbital, and extracranial). Unilateral exophthalmos and hyperostosis are characteristic signs of cranio-orbial meningiomas. Single-stage transcranial approach is the only adequate method for the surgical management of cranio-orbial meningiomas at the early stage of the disease. Original modification of this method were elaborated depending on the form and the prevalent direction of the growth of meningiomas. In the early stage of the disease, a wide transcranial approach with the use of microsurgical techniques provides for the radical removal of the tumor, preservation of the eyeball and its neuromuscular apparatus and disappearance or considerable reduction of exophthalmos.

[Features of the circulation of the fundus oculi in patients with cerebral arteriovenous aneurysms and arteriosinus anastomoses]. / Osobennosti krovoobrashcheniia glaznogo dna u bol'nykh s arteriovenoznymi anevrizmami i arteriosinusnymi soust'iami golovnogo mozga.

Hemodynamics of the fundus oculi was studied in 41 patients with arteriovenous aneurysms and arteriosinus anastomoses by fluorescent angiography. Fifty-eight fluorescent angiographic examinations of the fundus oculi were performed. The findings were compared with the clinical course of the disease and the degree of the development of the arteriovenous shunt. Analysis of the fluorescent angiograms in patients with a normal fundus oculi showed that the disorders of its hemodynamics reflect the degree of changes in the cerebral circulation in the brain vascular disease that is studied. Prolongation of the venous phase of the retinal hemodynamics is the first sign and prolongation of the arterial phase too, a later sign of changes in cerebral circulation.