[Clinical and neurophysiological characteristics of motor cortical responsiveness during prolonged cranial osteoplasty].

The data of global and stimulation poly-EMG were used to estimate the outcomes of multimodality treatment of sequelae of brain injury and stroke, which was based on the vasoactive effects of prolonged cranial osteoplasty. Thirteen patients (7 males and 6 females) aged 19 to 64 (mean 42 +/- 4) years who had signs of left- (n = 2) and right-sided (n = 11) spastic hemiparesis. Global and stimulation poly-EMG, which involved recording and analysis of resting and total EMG under the maximum voluntary tension, M-waves H-reflexes, transcranially evoked potentials. The muscles of the shoulder, forearm, hand, femur, leg, and foot were studied. The surgical procedure developed at the Russian Research Center "VTO" for stimulation of cerebral blood flow in combination with conventional conservative treatments (physiotherapy, therapeutical exercises, and adequate drug therapy) was shown to increase the transmission coefficient of an efferent signal in the motor cortex-spinal motor neurons-muscle system, which is clinically accompanied by improved coordination of simple and complex movements realized with the participation of the muscles of both the paretic and contralateral extremity. The ambiguous effects of the vasoactive factors of prolonged osteoplasty on the functions of unequally modal pathologically changed cerebral motor structures were noted. The findings may be considered as evidence for the low traumatic ability of the VTO's techniques for replacing posttraumatic defects of skull vault bones.