[Neurologic manifestations of subarachnoid and parenchymatous hemorrhages caused by arterial aneurysm].

Overall 155 patients with subarachnoidal and parenchymatous hemorrhages from arterial aneurysms, mainly of the anterior part of the circle of Willis, were examined. The intensity of subarachnoidal and parenchymatous hemorrhages varied, with the ++diencephalo-hypothalamic area being largely involved. The volume of intraparenchymatous hemorrhages ranged from 10 to 90 ml.

[Hemorrhage caused by cerebral arterial aneurysm].

The analysis of clinical pictures and pathomorphology of cerebral damage (intra-operative and autopsy material) was performed on 387 patients with first or second rupture of cerebral arterial aneurysms. Clinicopathological peculiarities of the aneurysmic intracranial hemorrhages were derived. Intracranial pathomorphological determinants of the severity of the patients' conditions at the acute stage were determined, including the intracerebral hematomas resulting in dislocation syndrome and paving the way to penetration of arterial blood spring into the ventricles on the second rupture of the aneurysm.

[Clinico-anatomic correlations in traumatic ventricular hemorrhage].

A total of 265 patients with intracerebroventricular hemorrhages were investigated for correlation between clinical manifestations and craniographic, echoencephaloscopic and cerebral angiographic data and brain pathomorphology. Intracerebroventricular hemorrhages were found in cases of severe craniocerebral trauma complicated, as a rule, with skull bones fractures, polar-basal cantusional foci, and intracerebral (rarely meningeal) hematomas. Relationship was established between the severity of craniocerebral lesions and intesites of intracerebroventricular hemorrhages which varied in character depending on the volume of adjacent intracerebral hemorrhage and the area covered by contusional polar-basal foci.

[Difficulties in the timely diagnosis of traumatic intracranial hematomas].

Difficulties and errors of the urgent diagnosis of posttraumatic intracranial hemorrhages are major factors delaying the early detection of an extremely dangerous and potentially fatal complication of brain trauma. These also postpone the recovery after surgical intervention and impair its effect. In emergency ambulance centers 326 cases of intracranial hemorrhages were reviewed and diagnostic errors analysed over 10 years.

[Surgical tactics in contusions of the cerebral hemispheres].

The author conducted complex examination of 540 patients who were operated on for brain contusion. Comparison of the clinical and instrumental findings with the pathomorphological changes in the brain (disclosed during operation or autopsy) revealed the structural features of contusion foci of convex and pole-basal localization which were factors underlying the three-dimensional enlargement of the affected brain lobe in cases of increasing perifocal edema. The results of surgical management were analysed according to the character of the contusion foci, the extent of traumatic softening of the white matter in the zone of the contusion, and the volume of surgical debridement of the foci.

[Tactics of the surgeon in intracranial hematomas associated with contusion foci of the cerebral hemispheres].

Under analysis was the experience with the treatment of 540 patients with intracranial hematomas as foci of contusion of the brain. A conclusion is made of the necessary surgical treatment of contusion foci of the brain involving deep layers of great hemispheres and followed by extensive white softening of the brain. The method of aspiration with a standard electric operative aspirator should be used for evacuation of the softened brain matter.

[Clinico-anatomic parallels in brain tumors complicated by intracranial hemorrhages].

An analysis of 17 cases of intracranial hemorrhage associated with brain tumours is presented. In two-thirds of observations the tumours were malignant, in one-third they were benign and could be referred to glial ones. Two variants of clinical manifestations of tumour hemorrhages into the brain were identified.

[Volume dynamics of contusion foci of the cerebrum].

Of 740 patients with severe contusions of the brain a group of patients with expansion of the contusion foci was differentiated. In 31.8% of the patients, the contusion foci were localized in the polar-basal portions of the frontal and/or temporal lobes and in 2.

[Determination of the degree of severity of cerebral contusions].

Three degrees of severity of the brain contusion are generally distinguished today for working out the most rational and purposeful treatment. It is quite difficult to judge the severity of the contusion from the neurological picture alone because neurological manifestations of the brain contusions are very diverse and dynamic in character. The authors analysed 630 case records of patients with contusion of the brain and disclosed signs most characteristic of each degree of contusion.

[Clinico-anatomic variants of the course of cerebral hemisphere contusions].

An analysis of 237 cases of brain hemisphere contusions verified at operation or on autopsy has made if possible to distinguish between three variants of the traumatic disease which corresponded to the three pathoanatomical forms of the contusion. Convexital contusions (pathoanatomically-chiefly cortical or cortico-subcortical) ran the most favourable course and were characterized by distinct focal symptoms prevailing over slight, in most cases, general cerebral disturbances. Polarobasal contusions (anatomically - extensive or massive, i.

[Technic for surgical intervention in severe brain contusions and crushing].

Basal contusions of the frontal and temporal lobes of the brain, occurring as a contrecoup as a rule, are particularly severe and are marked by a high mortality. The 10-year practice of the Sklifosovsky Scientific Research Institute of Emergency Aid in the surgical management of cerebral contusion was aimed at the search for a less traumatic craniotomy approach and the most sparing and radical, within reasonable limits, intervention on the cerebral focus. Analysis of the work done enables us to choose the method described in the article, comprising extensive infratemporal craniotomy which excludes the frontal, temporal, and parietal, lobes, and to recommend combining intervention on the focus with internal decompression and active aspiration of the wound discharge from the cranial cavity in the first 24 hours after the operation.