Pericranial sinus. Definition, diagnosis, surgical treatment.

Pericranial sinus (Sinus pericranii - SP) is a rare pathology of the extra-intracranial cerebral venous system. However, SP is not just an additional transosseous canal that connects the extra- and intracranial venous systems. This "emissary vein" connects the intracranial sinus and the variceally extended thin-walled veins localized on the outer surface of the skull where blood flows fun in opposite directions.

[Specific features of brain tumors and their surgical treatment of first 2 years of life infants].

The authors present a retrospective analysis of results of examination and surgical treatment of 74 infants not older than 24 months with brain tumors of different localization, operated in the same clinic during 15 years. Attention is paid to specific clinical course, character of blastomatous process, surgical strategy and postoperative period in this age category of infants.

[Intraoperative monitoring and its practical value in operations for tumors of the posterior cranial fossa in children].

The work is based on an analysis of the course of anesthetic aid, operative and early postoperative period in 62 patients aged from 15 months to 18 years with tumors of the posterior cranial fossa. The analysis concerned changes to the indices of systemic hemodynamics, findings of electrophysiological monitoring (electroencephalogram, acoustic stem induced potentials) and their interrelation with the outcomes of surgery. It was found that permanent disturbance of the heart rate such as bradycardia and tachycardia as well as the decreased indices of latency of peaks of the acoustic stem induced potentials and inter-peak intervals registered at the stage of removal of tumors of the posterior cranial fossa must be taken into consideration in the estimation of indications to medicinal narcosis in the postoperative period.

[Combined treatment of brain stem tumors].

During the two recent decades the introduction of new technologies to neurosurgery resulted in certain progress in diagnosis and combined treatment of brain stem tumors which still remain the most complex problems of neurooncology. Using the present-day diagnostic complex including a thorough dynamic neurological examination, neurophysiological investigations, and visualization methods allowed not only to detect the primary forms of brain stem tumors and their sizes but also to reveal the topographoanatomical interrelationships with the stem structures that allowed to determine the chances of surgical, combined treatment or the radiation and chemotherapy treatment only. The article gives an analysis and the clinical course of the diagnosis and combined treatment of 333 children and adult patients with primary, secondary and peri-trunkal tumors of the brain stem.

[Use of modern technologies in the diagnosis and combined treatment of brain stem tumors].

The latest technologies, introduced into neurosurgery during the last 2 decades of the 20th century, ensured progress in the diagnostics and treatment of brainstem tumors--pathologies that remain until now a most complicated problem in neurooncology. The modern diagnostic tools comprising profound dynamic neurological and neurophysiological examinations (AVP, EEG) visualization techniques (CT, MRT with contrasting, MRT, spectroscopy, PET) provide for detecting not only the initial signs of stem tumors and their sizes but also their topographic interaction with the stem structures; it, in its turn, opens up a possibility to choose between the combined surgical treatment and the radiotherapy or chemotherapy alone. The clinical course, diagnosis and combined treatment of 333 children and adults with tumors bordering on the brainstem are analyzed within the case study.

[Differential diagnosis of posterior cranial fossa: potentialities and unsolved problems].

Brain CT was made in 720 patients with tumors of the central nervous system. The subtentorial site of the process was encountered in 50.4% of cases.

[The clinical aspects of hydrocephalus in children].

Neurological findings of 37 hydrocephalic children are analysed. The involvement of cranial nerves into a pathological process is shown. Optic, oculomotor, and abducent nerves and the first branch of the trigeminal nerve more frequently suffer.

[The surgical procedure in spinal cord hernias of large size combined with hydrocephalus].

The paper analyzes the examination and treatment of 77 patients with myelomeningoceles. It is shown that the prognosis of treatment depends on the size and content of the hernial sac, the specific features of deformities of the liquor-containing system and the severity of liquor circulatory disorders. Both specific features of myelodysplasia manifestations and those of liquor circulatory disorders should be borne in mind in choosing the optimum surgical policy for myelomeningoceles.

[Epileptic seizures after cerebrospinal fluid shunting operations].

The paper analyzes one of the complication of spinal fluid bypass surgeries, i.e. epileptoid seizures.

[Subdural exudate in bacterial meningitis in children].

A subdural exudate (SE) complicating bacterial meningitis in 28 children was diagnosed by the findings at diaphanoscopy, subdurography, thermography, CT, EEG, echo-EG, rheo-EG in the evidence of aggravating neurological symptoms. SE drainage was carried out in all the cases, in 20 patients it was bilateral. CNS age-specific anatomicophysiological features responsible for emergence of the exudate primarily in the anterior hemispheric compartments subject to consequent atrophy are considered when assessing mechanisms of the exudate development in infants.

[Selective involvement of the gastrointestinal tract in amyloidosis in a female patient with periodic disease and intact kidneys].

The authors describe a rare case of amyloidosis in a female patient suffering from periodic disease (PD) for 18 years without any clinico-laboratory signs of renal impairment but with marked clinical, (malabsorption, cachexia), endoscopic, x-ray and other manifestations of gastrointestinal amyloidosis. This case is of interest since patients suffering from amyloidosis due to PB develop malabsorption very rarely, namely in 2-3% of cases. As a rule, it develops in patients with pronounced chronic renal failure on hemodialysis or with a history of kidney transplantation.

[The treatment of hydrocephalus by ventriculosinustransversotomy].

An anastomosis was established between the lateral ventricle and the lateral transverse sinus (ventriculosinustransversostomy) in the treatment of 32 patients aged from 2 months to 32 years suffering from hydrocephalus of various etiology. Hydrocephalus took a compensated course after the operation in 28 patients. Infectious complications developed in 2 patients.