Comparative analysis of combined treatment methods for patients with single brain lesions.

Unlabelled: Primary brain metastases are common in oncology. Preoperative stereotactic radiosurgery followed by surgical resection is a perspective approach.

Objective: To evaluate own experience of preoperative radiosurgery followed by surgical resection (RS+S) of metastasis regarding local control, leptomeningeal progression, surgical and radiation-induced complications; to compare treatment outcomes with surgical resection and subsequent radiotherapy (S+SRT).

Bullet embolism of internal carotid artery. (A case report and literature review).

Bullet vascular embolism is a rare complication of gunshot wounds with risk of dire consequences and even death. Bullet embolism of internal carotid artery is extremely rare. Therefore, there is no uniform approach to the treatment of these patients.

Surgical treatment of cervical neurovascular bundle tumors.

Objective: To determine the main principles of a patient-oriented individual approach to diagnosis and surgical treatment of cervical neurovascular bundle tumors considering the capabilities of neurosurgical hospital.

Material And Methods: There were 92 patients with cervical soft tissue tumors affecting neurovascular bundle. Age of patients ranged from 9 to 81 years (mean 47).

The first application of intraoperative mri for analysis of cerebral perfusion in surgical brain revascularization.

Background: Effectiveness of surgical revascularization in patients with chronic cerebral ischemia depends on restoration of circulation in the damaged artery. Modern methods do not take into account dynamic changes in cerebral perfusion after extra-intracranial microvascular anastomosis (EICMA) and do not allow timely localizing the areas of persistent perfusion deficit. We propose a new method for determining the tactics of surgical cerebral revascularization based on intraoperative MRI (iMRI) perfusion data.

Factors of effective neovascularization after surgical treatment of moyamoya disease.

Background: Moyamoya disease is a chronic cerebrovascular disease with complex pathophysiology. This disease is characterized by unique and unclear features of neoangiogenesis in natural course of disease and after surgical treatment. Natural collateral circulation was discussed in the first part of the article.

Variants of collateral cerebral circulation in moyamoya disease.

Background: Moyamoya disease is a chronic progressive cerebrovascular disease with a complex pathophysiology and unique features of neoangiogenesis. These features are still known only to a few specialists, although they determine clinical course and outcomes of disease.

Objective: To determine the nature and degree of neoangiogenesis in restructuring the natural collateral circulation in patients with moyamoya disease and its effect on cerebral blood flow.

Artificial intelligence guided predicting the length of hospital-stay in a neurosurgical hospital based on the text data of electronic medical records.

Background: Rational use of internal resources of hospitals including bed fund turnover is important objective in high-tech medicine. Machine learning technologies can improve neurosurgical care and contribute to patient-oriented approach.

Objective: To evaluate the quality of AI-guided predicting the length of hospital-stay in a neurosurgical hospital based on the text data of electronic medical records in comparison with expectations of patients and physicians.

Defining activities in neurovascular microsurgery training: entrustable professional activities for vascular neurosurgery.

Background: Entrustable professional activities (EPAs) represent an assessment framework with an increased focus on competency-based assessment. Originally developed and adopted for undergraduate medical education, concerns over resident ability to practice effectively after graduation have led to its implementation in residency training but yet not in vascular neurosurgery. Subjective assessment of resident or fellow performance can be problematic, and thus, we aim to define core EPAs for neurosurgical vascular training.

Predicting the Length of Stay in Neurosurgery with RuGPT-3 Language Model.

In this study, we update the evaluation of the Russian GPT3 model presented in our previous paper in predicting the length of stay (LOS) in neurosurgery. We aimed to assess the performance the Russian GPT-3 (ruGPT-3) language model in LOS prediction using narrative medical records in neurosurgery compared to doctors' and patients' expectations. Doctors appeared to have the most realistic LOS expectations (MAE = 2.

Length of Stay Prediction in Neurosurgery with Russian GPT-3 Language Model Compared to Human Expectations.

Patients, relatives, doctors, and healthcare providers anticipate the evidence-based length of stay (LOS) prediction in neurosurgery. This study aimed to assess the quality of LOS prediction with the GPT3 language model upon the narrative medical records in neurosurgery comparing to doctors' and patients' expectations. We found no significant difference (p = 0.

[Ischemic complications following surgical treatment of moyamoya disease: risk factors and prevention].

Background: One of the most difficult problems in surgical treatment of moyamoya disease is prevention of ischemic perioperative complications. The risk of these events is significantly higher compared to other cerebrovascular diseases (up to 30%).

Objective: To identify unfavorable prognostic factors of perioperative cerebral ischemic complications, to determine the group of high-risk patients and to develop the guidelines for perioperative management of these patients.

[Combined cerebral revascularization for moyamoya disease].

Introduction: Combined cerebral revascularization with direct and indirect components is recognized as the most appropriate method for treating patients with Moyamoya disease all over the world, however, large studies on its effectiveness in Russia have not yet been conducted.

The Aim Of The Study: Was to evaluate the results of combined cerebral revascularization in patients with Moyamoya disease with an analysis of the clinical state and perfusion and angiographic features of neoangiogenesis.

Material And Methods: For the period from 2013 to 2020 in N.

Internal Carotid Artery Injury in Transsphenoidal Surgery: Tenets for Its Avoidance and Refit-A Clinical Study.

One of the most serious/potentially fatal complications of transsphenoidal surgery (TSS) is internal carotid artery (ICA) injury. Of 6230 patients who underwent TSS, ICA injury occurred in 8 (0.12%).

[Discussion of the manuscript Combined double-barrel direct and indirect bilateral cerebral revascularization in the treatment of moyamoya disease. Discussion and literature review].

First of all, I would like to thank my colleagues for their interest in this article [1] and note the relevance of the problem of surgical treatment of moyamoya disease, which provoked this discussion. Moyamoya disease is a rare, atypical pathology for our country, the diagnosis and treatment of which is controversial among specialists, and the lack of agreed protocols is the cause of differences in the interpretation of the results of surgical treatment of such patients.

[Modern trends in diagnosis and surgical treatment of moyamoya disease].

This review is devoted to moyamoya disease. It is a rare chronic steno-occlusive cerebrovascular disease. However, moyamoya disease is increasingly diagnosed by neurosurgeons in our country.

[A 20-year experience in surgical treatment of steno-occlusive lesion of craniocervical arteries at the Burdenko Neurosurgical Center].

Introduction: Surgical treatment of cerebral ischemia at the Burdenko Neurosurgical Center for the period from 1999 to 2019 is analyzed in the paper. The details of the treatment strategy in patients with steno-occlusive lesion of craniocervical arteries followed by cerebral ischemia developed over 20 years are discussed in the article. We have analyzed the features of surgical interventions on the major craniocervical arteries in a neurosurgical clinic and the results of this treatment.

[Combination of double and indirect two-sided revascularization of the brain in the treatment of moyamoya disease].

An adult patient with progressive chronic cerebral ischemia associated with moyamoya disease who underwent combined revascularization of both cerebral hemispheres in step-by-step fashion is reported in the article. The feature of this case is a large volume of revascularization procedures with double-barrel extra-intracranial anastomoses combined with indirect synangioses. This surgical approach ensured early postoperative development of extensive collateral network and complete compensation of impaired cerebral circulation.

Local Cerebral Hemodynamics after Superficial Temporal Artery-Middle Cerebral Artery Bypass in Patients with Symptomatic Carotid Occlusions.

Context: Physiological insights into blood flow alterations in cortical vessels after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery are important for the prognosis of bypass sustainability and hemodynamic patency.

Aims: This study aims to assess the impact of STA-MCA bypass on local hemodynamics for patients with symptomatic carotid occlusions and Moyamoya disease.

Settings And Design: This article presents a prospective nonrandomized study of intraoperative blood flow measurements in cortical branches of MCA and donor vessel before and after cerebral revascularization.

[Local cerebral hemodynamics following STA-MCA bypass in patients with symptomatic carotid occlusions].

Purpose: To assess changes in local hemodynamic parameters in patients with symptomatic ICA occlusions and moyamoya disease after placement of extracranial-intracranial bypass (EC-IC bypass).

Material And Methods: The study included 112 patients who underwent surgical treatment at the National Scientific and Practical Center for Neurosurgery in the period between 1999 and 2015. Of these, 105 patients had ICA occlusions, and 7 patients had moyamoya disease.

[Resection and correction of the common carotid artery to enable an endovascular approach for treatment of a giant ICA aneurysm (a case report and literature review)].

The article reports a clinical case of endovascular treatment of a female patient with a giant aneurysm of the cavernous internal carotid artery complicated by gross ipsilateral bending of the proximal third of the common carotid artery. To ensure an adequate endovascular approach to the aneurysm, open repair of the common carotid artery and elimination of its bending were performed at the first stage. This enabled successful placement of a flow-diverting stent into the internal carotid artery at the aneurysm level at the second stage, resulting in good technical and clinical outcomes.

[Carotid endarterectomy in patients with symptomatic occlusions of the contralateral internal carotid artery].

The main aim of the study was to investigate the effect of carotid endarterectomy on the prognosis of chronic cerebral ischemia in patients with symptomatic occlusions of the contralateral internal carotid artery, assess risks of surgical complications, and substantiate the staged surgical approach for treatment of patients with this pathology. The article analyzes the experience in surgical treatment of 83 patients with symptomatic ICA occlusions who underwent surgery for contralateral carotid artery stenosis. In 40 patients, only carotid endarterectomy (CEA) was performed on the side of hemodynamically significant stenosis (group 1).

[Simultaneous reconstruction of the carotid and vertebral arteries using a temporary intraluminal shunt (a clinical case)].

The article describes a case of one-stage surgical treatment of a patient with progressive chronic cerebral ischemia caused by combined steno-occlusive lesions of the carotid and vertebral arteries. The disease was complicated by intolerance to temporary occlusion of the carotid artery due to an incomplete circle of Willis. We performed extra-anatomic carotid-vertebral artery bypass with subsequent ipsilateral carotid endarterectomy.

[Creation of extracranial-intracranial microvascular anastomosis under regional anesthesia (a case report and a review of the literature)].

The article describes a case of successful surgical treatment of an 81-year-old male patient with symptomatic occlusion of the internal carotid artery that led to severe impairment of cerebral hemodynamics and was accompanied by severe gait and equilibrium disorders. Given the patient's age and his positive medical history, he underwent surgery for the creation of an extracranial-intracranial microvascular anastomosis under regional anesthesia, with spontaneous breathing and a baseline level of consciousness being maintained. In the postoperative period, the patient achieved a marked clinical effect in the form of complete regression of syncopal conditions and gait disorders associated with recovery of cerebral perfusion in the right MCA territory.

[Perfusion criteria of the EICMA efficacy in patients with symptomatic occlusion of the internal carotid artery].

Aim: To investigate changes in cerebral perfusion in patients with unilateral internal carotid artery occlusion before and after surgical revascularization of the brain, depending on the clinical efficacy of surgical treatment.

Material And Methods: The study included 60 patients with unilateral ICA occlusions who underwent placement of an extra-intracranial microvascular anastomosis (EICMA). All patients underwent a CT perfusion study before and after cerebral revascularization.

An anastomosis between the internal carotid and vertebral arteries in the treatment of a patient with bilateral carotid arteries occlusions.

The article presents a case of successful surgical treatment of a patient with progressive chronic cerebral ischemia due to occlusions of both internal carotid arteries combined with occlusion of the vertebral artery in the first and second segments. We describe a surgical technique that includes an auto arterial carotid-subclavian bypass in the third segment of the vertebral artery, with an extracranial portion of the occluded internal carotid artery (after preliminary thromboendarterectomy) being used as a shunt. Previously, the patient had undergone surgery for creating bilateral EICMA.