Results of gamma-knife radiosurgery treatment for intracranial metastases of renal-cell cancer and prognostic factors influencing on the survival (joint study of three Eastern European Centers).

Gamma-Knife radiosurgery treatment for intracranial metastases of renal-cell cancer results are presented. Treatments were made in 3 Eastern European Centers: in Prague, Moscow and St. Petersburg from 2000 to 2011.

[Effect of hemotransfusion on brain oxygenation and metabolism in patients with intracranial hemorrhages].

The paper analyzes the impact of anemia correction on the time course of changes in oxygen tension in the brain and on the biochemical composition of brain interstitial fluid (tissue microdialysis) in the affected and conditionally intact hemisphere in 8 patients with intracranial hemorrhages and a reduced awakening level up to 4-8 scores by the Glasgow coma scale. Anemia correction in patients with intracranial hemorrhage was shown to fail to change oxygen tension in the brain and to be followed by a reduction in lactate/pyruvate ratio in the involved cerebral hemisphere. Only in significant anemia (Hb < 7 g/dl), hemotransfusion elevated cerebral perfusion pressure, by increasing mean blood pressure.

[Correction of intracranial hypertension syndrome using hyperosmolar solutions in patients with severe brain damage (multicenter randomized clinical study)].

The paper presents the results of a muticenter study of the effect of 3 hyperosmolar solutions (15% mannitol solution, 10% sodium chloride solution, and the combined solution HyperHAES containing 7.2% sodium chloride and hydroxyethyl starch 200/0.5) on the value of intracranial pressure (ICP) (invasive ICP monitoring) and systemic hemodynamic parameters (PiCCOplus) in 94 clinical cases of intracranial hypertension (ICP more than 20 mm Hg) in 25 patients with acute cerebral pathology (severe brain injury, aneurysmatic subarachnoid hemorrhage).

[Effect of volemic status on brain oxygenation and metabolism in patients with intracranial hemorrhages].

The paper analyzes the impact of the volemic status and its correction on systemic hemodynamic parameters (transpulmonary thermodilution PiCCO plus technique), the value of intracranial pressure and the biochemical composition of brain interstitial fluid (tissue microdialysis) in the affected and conditionally intact hemisphere in 8 patients with intracranial hemorrhages and a reduced awakening level up to 4-8 scores by the Glasgow coma scale. It has been shown that in patients with significant metabolic disturbance in the involved hemisphere, hypovolemia correction using hydroxyethyl starch 130/0.4 is accompanied by activated oxidative phosphorylation and a lower lactate/pyruvate ratio, without changing the of blood pressure and increasing pulmonary extravascular water.

[Role of multicomponent neuromonitoring in the determination of intensive care tactics in a female patient with subarachnoidal hemorrhage due to cerebral arterial aneurysmal rupture].

The paper describes a case of aneurysmal subarachnoidal hemorrhage in a female patient during intensive care involving the whole set of the latest neuromonitoring parameters: intracranial and cerebral perfusion pressure, brain tissue oxygen tension and temperature, as well as a set of biochemical parameters studied by the tissue microdialysis technique. The high diagnostic value of the parameters that cannot be changed by any other neuromonitoring modalities is shown.

[Intracranial pressure, cerebral perfusion and metabolism in acute period of intracranial hemorrhage].

Estimation of the volume of cerebral lesion, reversibility of ischemia and prognosis of the disease determinate management tactics in patients with severe head injuries and non-traumatic intracranial hemorrhages. Data of multimodal neuromonitoring in patients with intracranial hemorrhage in the earlier stages of comatose period were analyzed in this paper. They included incracranial pressure, cerebral perfusion pressure, bulb oxymetry, brain oxygen tension, tissue microdialysis.

[Lipid regulation in suppurative infectious diseases].

The paper discusses the results of study of lipid peroxidation (LP) in patients with various forms of purulent surgical infection. A conclusion is drawn from the analysis of the obtained data that the difference in the forms of the pyoseptic processes is determined to a great measure by the concrete state of free-radical lipid oxidation which acts as a regulatory mechanism of the inflammatory reaction, changing the permeability of biomembranes at the tissue, cell, and organism levels. The conducted research holds promise for the creation of modern and progressive variants of pathogenetic intensive therapy.