[Cervical spondylogenic myelopathy: diagnostics, treatment, prognosis].

The authors present a review of literature focusing on state-of-art of surgical management of cervical spondylogenic myelopathy (CSM). Pathophysiology of CSM, evaluation and differential diagnosis are also described. Special attention is given to the value of neurophysiological aspects in pre- and postoperative examination.

[Identification of highly specific electroencephalographic patterns in patients with neuroepithelial tumors of the III ventricle by algorithmic methods].

An algorithm was suggested for identifying highly specific electroencephalographic (EEG) patterns in neurooncologic patients. The algorithm provides selection of patients with their further classification into main and control groups based on the already existing database of EEG indicators; requests to it; generation of mono-indicator candidates for EEG-patterns on the basis of a 4-dipole table for selecting and verifying sensitive and specific EEG patterns and outlining the best ones. Our material included 368 patients with basal-diencephalic tumors.

[Possibilities of wavelet-syncronization method for estimation of the spatial distribution of components of auditory evoked potentials in healthy subjects].

Event-related potentials (ERP) are informative indicators of higher nervous activity of healthy people and patients in pathological states. Traditionally, methods of ERP processing include peak-time characteristics, topographical mapping and localization of equivalent dipole sources. At the same time, estimation of ERP synchronization is complicated by a short duration of the process.

[Intraoperative identification of oculomotor, trochlear and abducent nerves in surgery of invasive cranioorbital tumors (new technique)].

Background: Aim of the study was to evaluate effectiveness of intraoperative identification of oculomotor nerves (OMN) in resection of skull base tumors invading superior orbital fissure and cavernous sinus.

Materials And Methods: 69 patients with cranioorbital tumors operated in Burdenko Neurosurgical Institute (Moscow, Russia) since 2000 until 2005 were included in the study. They were divided into 2 groups: 19 patients treated with intraoperative identification of OMN and 50 patients in the control group.

[Compression cervical spine cord injury in patients with posterior cranial fossa tumors operated on in the sitting position: two cases with different outcomes].

The paper describes two cases of posterior cranial fossa pathology, operated on in the sitting position on the operating table. In one case, symptoms of cervical spine injury caused by undiagnosed preoperative cervical spine pathology emerged in a female patient in the early postoperative period. In the other case, cervical spine pathology was diagnosed before surgery and evoked potentials were monitored to prevent possible cervical spine injury in the sitting position during an operation.

[Planning of surgical approach to intracerebral tumors of the hemispheres using fMRI, neuronavigation, and electrophysiological monitoring].

The paper discusses pre- and intraoperative application of different guiding techniques (frameless neuronavigation, fMRI, electrophysiological monitoring). We performed comparative analysis of different combinations of these methods. 74 patients with intracerebral tumors involving eloquent areas (sensorimotor cortex in 56 and speech zones in 18) were operated.

[The use of stabilo-training with feedback in the rehabilitation of patients with posttraumatic Korsakov's syndrome].

The complex research, including clinical scales (FIM, Mayo-Portland) and data on stabilography and electroencephalography (EEG) studies, was conducted in 10 patients with posttraumatic Korsakov's syndrome (KS) before and after the rehabilitation course using stabilo-training (ST) with feedback (7-12 sessions). A control group consisted of 18 healthy people. In patients with KS, more severe cognitive (memory) disorders were noted before ST that was correlated with the maximal reduction of coherence in all frequency bands in frontal and parietal-occipital areas as well as in the long diagonal pairs between the left frontal and the right parietal-occipital areas which was most distinct for the alpha-band.

[Identification of the cochlear nerve in surgical removal of vestibular schwannomas].

Review of methods which allow intraoperative identifying and monitoring of cochlear and facial nerves in resection of vestibular schwannomas is presented. We describe a case of successful identification and functional preservation of facial and cochlear nerves in a patient with acoustic neuroma. Detailed description of neurophysiological and neurosurgical aspects of surgical technique intended to preserve auditory functions is given.

[Motor responses in transcranial magnetic stimulation and somatosensory evoked potentials in patients with pain syndromes].

The main goal was to evaluate the motor and somatosensory systems by recording evoked motor responses (EMRs) during transcranial magnetic stimulation (TMS) and somatosensory evoked potentials (SEPs) in patients with neurogenic pain syndromes before and after implantation of the systems for chronic antipain epidural stimulation. Fifteen patients with neurogenic pain syndromes and a control group of 15 apparently healthy examinees were examined. The patients were found to have a significant reduction in the motor thresholds of EMRs during TMS and an increase in the amplitude of EMRs after implantations of the systems.

[The identification and functional tracking of the facial nerve during the removal of tumors of the cerebellopontine angle].

Intracranial identification by electrostimulation and monitoring of the status of the facial nerve was intraoperatively used in 21 patients with cerebellopontine angle tumors of varying histological structure. Monopolar and bipolar electrostimulation, as well as electromyography and mechanography for recording the function of the facial nerve were compared. During removal of cerebellopontine angle tumors, identification and monitoring of the function of the facial nerve provide anatomic retention of this nerve when the tumor is radically eliminated.

[Neuromonitoring: its current status and developmental outlook].

A comparative analysis of monitoring techniques in neurosurgery is presented. Different facets of indications and possibilities of different techniques of monitoring as well as appropriate ways of their application are considered. The promise of multimodal monitoring is justified.

[Somatosensory evoked potentials in the assessment of cerebral ischemia in combined operations for intracranial aneurysms].

Combined surgery of extra-intracranial anastomosis (EICA) and occlusion of the afferent vessel by means of a balloon catheter was made in 14 patients with giant aneurysms of the internal carotid (IC) and middle meningeal artery (MMA). MMA was excluded without previously creating EICA in another patient. The purpose of the study was to define the informative value of a somatosensory evoked potential (SSEP) as an intraoperative criteria for possible permanent occlusion of the major vessel.

[Monitoring of eye movements in surgery of the brain stem and parastem structures].

Intraoperative electrooculograms (EOG) of 44 patients with bulky formations in the posterior cranial fossa demonstrated a good correlation of the sum of EOG waves caused by mechanical stimulation (aspiration, retraction, etc.) and the sum of complexes of EOG waves, on one hand, and the outcome, on other, in patients with brain stem involvement and less so in those with involvement of the cerebellum. The method is not informative for predicting the status of stem structures in surgery on the pontocerebellar angle.

[Intraoprative identification and monitoring of motor structures of the brain stem].

The purpose of this work was to evaluate the method of identification of motor structures of the bottom of the IV ventricle in order to find the zone through which it is possible to safely approach the bulky formation and to assess the efficacy of subsequent monitoring of these structures for the prevention of their intraoperative injury. Fourteen patients with bulky tumors of the caudal portions of the brain stem aged 4 to 57 were examined. Motor structures of the brain stem (nerves VII or IX, X, and XII, depending on the site of injury) were identified by direct electrostimulation of the surface of the rhomboid fossa and recording of the motor functions by mechanography of EMG.

[Somatosensory evoked potentials in the evaluation of the effectiveness of intensive therapy of ischemic complications in neurosurgical patients].

Nineteen patients with ischemic disorders of brain circulation were examined. All of them were in a critical state and in need of intensive vasoactive therapy. Somatosensory evoked potentials (SSEP) were examined in both hemispheres in all of them, this being followed by monitoring on the side of the predominant involvement.

[Monitoring of short latent evoked potentials during brain stem surgery].

The studies were carried out in 33 patients with intrastem volumetric tumors. In 6 patients the monitoring was impossible because of technological problems. Somatosensory evoked potentials (SSEP) were recorded in 10 and acoustic stem evoked potentials (ASEP) in 18 out of 27 patients and the findings correlated to changes in the neurological status on day 1 postoperation.

[A dipole localization method in analyzing the auditory brain-stem evoked potential].

The localization of generators of brainstem auditory evoked response (BAER) has been studied in one patient using the method of dipole localization based on the spatial distribution of BAER over the surface of the head. It has been found that in formation of all BAER waves the activity of several generators overlaps. It is especially marked for the peaks I', II', III and III'--their potential distribution can not be described by single-dipole model, thus preventing the defining of their generation site.

[Diagnosis of lesions of the central nervous system in patients with systemic lupus erythematosus].

A total of 60 patients with systemic lupus erythematosus (SLE) were under observation; 36 of them had clinical symptoms of the CNS affection and 25 persons included into the control group exhibited no psychic disorders during the clinical examination. Besides, routine clinico-laboratory examinations accepted in rheumatology, the patients were subjected to cranial computer tomography (CT), electroencephalography, examination of cerebral hemodynamics with a radionuclide partechnetate 99mC as well as to psychological testing. Neuropsychic disorders developed during the first four years after the onset of the disease and are grouped in the following way: neurological, border-line, neuropsychic, affective, psychotic, intellectual-mnestic.