The Role of P2Y6 Receptors in the Mechanisms of the Neuroprotective Effect of Citicoline.

Spontaneous bioelectrical activity of the brain and the duration of gasping were recorded in mice during modeling of global strangulation ischemia of the brain against the background of preventive administration of citicoline. The maximum neuroprotective effect of citicoline was observed when it was administered 60 min before the simulation of ischemia and was completely prevented by preliminary administration of a selective P2Y6 receptor antagonist MRS2578. The obtained experimental data attest to the leading role of receptor mechanisms in the implementation of neuroprotective activity of citicoline.

Surgical management of anterior clinoidal meningiomas: consensus statement on behalf of the EANS skull base section.

BACKGROUND: The optimal management of clinoidal meningiomas (CMs) continues to be debated. METHODS: We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of these tumors. The data from the literature along with contemporary practice patterns were discussed within the task force to generate consensual recommendations. RESULTS AND CONCLUSION: This article represents the consensus opinion of the task force regarding pre-operative evaluations, patient's counselling, surgical classification, and optimal surgical strategy. Although this analysis yielded only Class B evidence and expert opinions, it should guide practitioners in the management of patients with clinoidal meningiomas and might form the basis for future clinical trials.

Correction to: Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries.

[This corrects the article DOI: 10.1186/s41016-020-00194-1.].

Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries.

Globally, the discipline of neurosurgery has evolved remarkably fast. Despite being one of the latest medical specialties, which appeared only around hundred years ago, it has witnessed innovations in the aspects of diagnostics methods, macro and micro surgical techniques, and treatment modalities. Unfortunately, this development is not evenly distributed between developed and developing countries. The same is the case with neurosurgical education and training, which developed from only traditional apprentice programs in the past to more structured, competence-based programs with various teaching methods being utilized, in recent times. A similar gap can be observed between developed and developing counties when it comes to neurosurgical education. Fortunately, most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice. In context to this understanding, a symposium was organized during the World Federation of Neurological Surgeons (WFNS) Special World Congress Beijing 2019. This symposium was the brain child of Prof. Yoko Kato-one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons. Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries. This paper summarizes the outcome of these presentations, with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.

[INFLUENCED ARBEPOETINALFA TO REDUCE THE NUMBER OF BLOOD TRANSFUSION IN CHILDREN WITH NON-SYNDROMIC CRANIOSYNOSTOSIS.]

BACKGROUND: According to the literature, the prevalence of non-syndromic forms of craniosynostosis in children is very high. Given that the treatment of this pathology and surgery performed only at an early age of the child, the need for transfusion arise very often. THE AIM: To study the efficacy ofpreoperative use of darbepoetin alfa in combination with intraoperative normovolemic hemodilution to reduce the number of blood transfusions during surgery and in the early postoperative period. MATERIALS AND METHODS: The study included 70 children between the ages of 6 months up to 12 months, divided into two groups: a control group (n=34) without stimulation of erythropoiesis and the study group (n =36) using apre-stimulation oferythropoiesis darbepoetin alfa. RESULTS: In the control group, blood transfusion was performed in 79% of cases, compared with the test group-22% of cases. Also, the patients ofthe study group determined a statistically significant (p<0. 05) increase the level of red blood cells, hemoglobin and reticulocytes. CONCLUSION: In children up to a year with various forms ofnon-syndromic craniosynostosis preoperative stimulation of erythropoiesis in conjunction with normovolemic hemodilution reduces the number of blood transfusions 3 times, or to opt out of its holding.

[The clinical picture of nonsyndromic craniosynostosis in children].

OBJECTIVE: to study clinical presentations of nonsyndromic craniosynostosis (NCS) in children. MATERIAL AND METHODS: Authors analyzed 56 cases of different forms of NCS. To verify the diagnosis, all children underwent computed tomography with 3D cranial reconstruction. RESULTS AND CONCLUSION: The distribution of diagnoses was as follows: scaphocephaly - 28 (50%) patients, trigonocephaly - 21 (38%), different forms of plagiocephaly - 7 (12%). On admission to the hospital, 25 (43%) patients were diagnosed with perinatal CNS damage, 10 (18%) were born premature, 33 (59%) had neurological deviations. The clinical picture of NCS was polymorphic that might explain an increase in the number of children with late-diagnosed craniosynostosis. The early diagnosis of NCS which is the basis for using less invasive surgical methods is particularly important for prognosis.

Functional and metabolic changes in the brain in neuropathic pain syndrome against the background of chronic epidural electrostimulation of the spinal cord.

Changes in functional and metabolic activities of the brain were evaluated by EEG and positron-emission/computer tomography with 18F-fluorodeoxyglucose in patients with neuropathic pain syndrome previous to and 3 months after implantation of a system for chronic epidural spinal cord stimulation. In most cases, the use of a nerve stimulator was followed by alleviation of neuropathic pain and partial normalization of functional and metabolic activities of brain structures responsible for pain perception, emotiogenic, behavioral, and autonomic responses.

[Biportal endoscopic removal of choroid papilloma of the lateral ventricle in a child].

The article is devoted to the use of minimally invasive techniques for removing intraventricular tumors; this topic is currently relevant to pediatric neurosurgery. As an example, a clinical case of complete removal of a choroid plexus papilloma in a child using the neuroendoscopic technique through the biportal approach is provided. This tumor is most commonly found in pediatric practice. Taking this into account, the use of minimally invasive surgical methods for treating this pathology is very important. The published data relating to this pathology, as well as to the use of neuroendoscopy for this disease, are fragmentary today. Therefore, one of the objectives of this work was to analyze the literature regarding etiopathogenesis, clinical presentation, diagnostic features, and some aspects of surgical treatment of choroid plexus papilloma, in connection with which this work is primarily of practical interest.

Effect of cyclopentyladenosine on lipid peroxidation during focal cerebral ischemia.

The antioxidant effect of an adenosine A1 receptor agonist cyclopentyladenosine was studied on the model of focal cerebral ischemia. Ischemic injury of the brain was accompanied by changes in LPO processes (in the blood and brain tissue) and failure of some factors for antioxidant protection (peroxidase and catalase) that inactivate reactive metabolites. Changes in the ratio between LPO and antioxidant protection were less pronounced after treatment with cyclopentyladenosine.

[Surgical aspects of endoscopic treatment of sagittal craniosynostosis (scaphocephaly) in children].

The article is devoted to the surgical treatment of sagittal craniosynostosis in children. Among non-syndromic monosynostosis sagittal craniosynostosis (scaphocephaly) is the most common. Treatment of children with craniosynostosis should begin as soon as possible. Endoscopic method refers to minimally invasive technique in surgical correction of craniosynostosis. This article presents a features of surgical treatment at all stages of the endoscopic cranioplasty. Presented data is based on the experience of treatment of 20 children with primary sagittal craniosynostosis. Treatment was performed using endoscopic techniques, special tools designed specifically for the endoscopic cranioplasty.

[Anticonvulsant and neuroprotective effects of cyclopentyladenosine on the model of convulsive status in rats].

The neuroprotective and anticonvulsant effects of cyclopentyladenosine (CPA) have been studied on a new experimental model of the convulsive status in rats aged 3-4 months and 10 days. The convulsive status was modeled by intracerebroventricular injection of ferakril (water-soluble polymer of polyacrylic acid) solution. It is established that prophylactic administration of CPA results in a relatively lower degree of neurological deficit, both in the acute phase and on the next day, compared to the untreated control. Considering that adenosine receptor agonists are analogs of the natural metabolites that have minimal side effects and expressed neuroprotective properties, the use of agents of this group is perspective for both prevention and treatment of seizure conditions in neurology and neurosurgery.

[Effect of cyclopentyladenosine on the orientation, exploratory, and emotional behavior of rats with model brain injury].

Effects of a local compression brain injury and the preventive application of cyclopentyladenosine (CPA) on the behavior of rats in the open field test was investigated. It is established that the local injury of a parietal cortex causes intensification of the orientation--research behavior and an increase in the emotional stress in rats. A protective action of CPA was manifested by a decrease in the expressiveness and duration of disturbances in the emotional and orientation--research behavior of animals in the open field test.

[Efficiency of neuroendoscopic operations in achieving shunt independency in hydrocephalus with liquor-shunting system dysfunction].

OBJECTIVE: to evaluate the efficiency of endoscopic treatments in achieving shunt independency in patients with hydrocephalus and shunt dysfunction. SUBJECTS AND METHODS: endoscopic treatment was performed in 28 patients (15 males and 13 females) aged 7.0 +/- 1.2 years (0.5-24 years) with hydrocephalus and CSF shunt dysfunction. The interval between the first shunt implantation and endoscopic surgery (the time of shunt dependency) was 43.4 +/- 7.8 months (5-180 months). All operations were made using the universal Gaab neuroendoscopic system (Karl Storz GmbH and Co., Germany). The follow-up lasted 49.4 +/- 6.9 months (6-120 months). RESULTS: All the patients were successfully operated on, without intraoperative complications and deaths being observed. Surgical interventions were as follows: endoscopic ventriculocisternostomy (n=23), endoscopic aqueductoplasty (n=1), and endoscopic cystoventriculocistemrnostomy (n=4). In 24 of the 28 patients, the symptoms of intracranial hypertension regressed completely. CSF shunt reimplantation was required in 3 cases and prolonged external drainage in 1 case of existing ventriculitis. It should be noted that 24 of the 28 patients became shunt-independent; a shunt was removed in 13.

Neuroendoscopic procedures in achievement of shunt independence: outcome analysis of 28 patients with shunt malfunction.

OBJECTIVE: The authors review their experience of the TV-controlled endoscopic technique in the treatment of shunt malfunction in 28 patients suffering from hydrocephalus. MATERIAL AND METHODS: We treated 28 patients (6.6+/-1.2 years) with shunt malfunctions by a neuroendoscopic procedure. The number of reimplantations of the shunt systems prior to the neuroendoscopic procedure varied from 1 to 13. Duration of the shunt dependency has averaged to 42.7+/-8.1 months (range: 5-180 months). All procedures were performed with the Gaab I neuroendoscope and Gaab II miniature neuroendoscope. All patients presented with neurological signs and deficits. The follow-up period has averaged to 32.3+/-6.2 months (4-114 months). CONCLUSION: Endoscopic surgery offers an effective technique in the surgical treatment of shunt malfunction. On the basis of our experience, the use of a neuroendoscopic procedure for shunt malfunction allows us to achieve shunt independence in 82.1% and shunt removal in 50.0%. The introduction of these methods is recommended in neurosurgical centers that are traditionally widely engaged in the treatment of hydrocephalus.

[The topographic anatomy of the interpeduncular cistern and endoscopic ventriculocisternostomy in the region of the bottom of the third ventricle].

The interpeduncular cistern was microanatomically studied on 14 anatomic specimens of the brain. It was divided into 2 parts: superficial (free) and deep (vascular). The upper interpeduncular cistern wall was divided into hypothalamic and mesencephalic parts. The interpeduncular cistern is connected with the ambient, pretontine, carotid, cerebellopontine, oculomotor, and peduncular cisterns. It is a composite space-occupying, structural formation. Liliequist's membrane is the basic membranous component of a cistern. The proposed division makes it possible to study different parts of the interpeduncular cistern qualitatively and quantitatively and to define clear topographic and anatomic criteria as a guideline in this field.

[Protective effect of A-agonists in a minimum invasive model of spinal cord ischemia in rats]. / Zashchitnoe deistvie A-agonistov na maloinvazivnoi modeli ishemii spinnigo mozga u krys.

The neuroprotective properties of N6-cyclohexyladenosine (CHA) and N6-cyclopentyladenosine (CPA), adenosine receptor agonists (A-agonists), were studied on a model of spinal cord ischemia (SCI) in rats (most closely reproducing the analogous clinical pathological process in humans). The SCI model was induced by intravasal occlusion of the abdominal aorta and its branches. CHA and CPA were introduced by intracerebroventricular injections in a dose of 25 micrograms/kg, 60 min before SCI induction. The protective effect was judged by comparing the patterns of neurological and histopathological disturbances in the untreated control (ischemia) and on the CHA or CPA background. The A-agonist CPA produced a pronounced, statistically reliable neuroprotector effect on the minimum invasive SCI model studied. CHA is also a statistically reliable but less effective neuroprotector. The A-agonists may have good prospects in clinics.

Changes in the steady-state potential in rats with focal cerebral ischemia receiving cyclopentyladenosine.

Brain function and neuroprotective activity of cyclopentyladenosine in rats with focal cerebral ischemia were evaluated by recording the steady-state potential. Cerebral ischemia was modeled by intravasal occlusion of the left internal carotid and middle cerebral arteries and bilateral occlusion of the common carotid arteries. Recording of the steady-state brain potential during experimental ischemia allowed identifying the development of ischemic depolarization by a negative potential shift. Changes in the steady-state potential after cyclopentyladenosine administration reflected delayed development of ischemic depolarization in the nervous tissue. Cyclopentyladenosine holds much promise for the protection of nerve cells from ischemic injury.

New minimally invasive model of spinal cord ischemia in rats.

We developed a new minimally invasive model of spinal cord ischemia in rats: intravascular occlusion of the abdominal aorta and its branches. This model can be used on small laboratory animals and allows qualitatively and quantitatively evaluating the morphofunctional state of the nervous system during spinal cord ischemia by clinical manifestations and histological changes. Selective intravascular occlusion determines minimal invasiveness and adequacy of the proposed model to in vivo pathological processes. This model of spinal cord ischemia can be used in experimental pharmacology for evaluation of neuroprotective activity of various drugs and bioactive substances.

[Protective effect of cyclopentyladenosine in a minimally invasive model of acute cerebral focal ischemia in rats]. / Zashchitnoe deistvie tsiklopentiladenozina na maloinvazivnoi modeli ostroi fokal'noi ishemii golovnogo mozga u krys.

The neuroprotector properties of cyclopentyladenosine (CPA), an adenosine receptor agonist, were studied on a model of focal brain ischemia in rats (reproducing a clinical pathological process in humans). The model of the focal brain ischemia in rats was induced by intravasal occlusion of left carotid artery, middle cerebral artery, and by bilateral occlusion of both carotid arteries. CPA was introduced by intracerebroventricular injections in a dose of 25 micrograms/kg, 60 min before ischemia induction. The protective effect was judged by comparing the neurological and histopathological disturbances in the control (untreated ischemia) and on the CPA background. CPA injections produced a pronounced neuroprotector effect on the minimum-invasive focal brain ischemia model in rats.

[Protective effect of adenosine receptor agonists in a model of spinal cord injury in rats]. / Zashchitnoe deistvie agonistov adenozinovykh retseptorov na modeli travmaticheskogo povrezhdeniia spinnogo mozga u krys.

Possibilities of the neuroprotector therapy using adenosine and cyclopentyladenosine (CPA), an adenosine receptor agonist, were studied on a model of spinal cord injury by compression in rats (most closely reproducing the analogous clinical pathological process in humans). The model was induced by slow, graded compression of the spinal cord at the thoracic level. Adenosine and CPA were introduced 60 min before injury by subcutaneous injections in a dose of 300 and 2.5 micrograms/kg, respectively. The protective effect was judged by comparing the neurological, electromyographic, and histopathological changes in animals with the model injury and in the control group (adenosine and CPA background). The A1-agonist CPA injections produced a pronounced, statistically significant neuroprotector effect on the given spinal cord injury model in rats. The neuroprotective effect of adenosine was significant but not as strong. It is concluded that it is expedient to use A-agonists in clinics.