neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2025-27-4-123-134neurosurgery-1767Research ArticleПУБЛИЦИСТИКАPUBLICISMПревентивная нейрохирургия и врачебная этикаPreventive neurosurgery and medical ethicshttps://orcid.org/0000-0002-9811-9442УсачевД. Ю.UsachevD. Yu.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0001-6103-9329ЭлиаваШ. Ш.EliavaSh. Sh.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-9948-9816ЛихтерманЛ. Б.LikhtermanL. B.

125047, ул. 4‑я Тверская-Ямская, 16

Leonid Boleslavovich Likhterman

16 4th Tverskaya-Yamskaya St., Moscow 125047

Likhterman@nsi.ruhttps://orcid.org/0000-0002-0798-2604ЯковлевС. Б.YakovlevS. B.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-3112-8256КравчукА. Д.KravchukA. D.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0001-8911-2372ОхлопковВ. А.OkhlopkovV. A.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0001-5787-484XЛукшинВ. А.LukshinV. A.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

https://orcid.org/0000-0002-0932-4752КоноваловА. Н.KonovalovA. N.

125047, ул. 4‑я Тверская-Ямская, 16

16 4th Tverskaya-Yamskaya St., Moscow 125047

ФГАУ «Национальный медицинский исследовательский центр нейрохирургии им. акад. Н. Н. Бурденко» Минздрава РоссииРоссияN. N. Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of RussiaRussian Federation202515012026274123134Copyright © Усачев Д.Ю., Элиава Ш.Ш., Лихтерман Л.Б., Яковлев С.Б., Кравчук А.Д., Охлопков В.А., Лукшин В.А., Коновалов А.Н., 20262026Усачев Д.Ю., Элиава Ш.Ш., Лихтерман Л.Б., Яковлев С.Б., Кравчук А.Д., Охлопков В.А., Лукшин В.А., Коновалов А.Н.Usachev D.Y., Eliava S.S., Likhterman L.B., Yakovlev S.B., Kravchuk A.D., Okhlopkov V.A., Lukshin V.A., Konovalov A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1767

В работе представлен анализ быстро развивающегося нового направления в клинической дисциплине «нейрохирургия» – предупредительной нейрохирургии. Благодаря нейровизуализационным технологиям предупредительная нейрохирургия уже сегодня получила широкое распространение при церебральных аневризмах и артериовенозных мальформациях, стенозирующих процессах сонных и других магистральных артерий, кровоснабжающих мозг, а также в детской нейроонкологии, оставаясь пока «случайной» при опухолях центральной нервной системы у взрослых. На основе опыта НМИЦ нейрохирургии им. акад. Н. Н. Бурденко рассмотрены различные аспекты нового направления – врачебная этика, систематизация, показания и противопоказания к оперативному вмешательству исходя из принципа «non nócere» применительно к практически здоровому человеку. Акцентировано внимание на необходимости ускоренной разработки философии, методологии и юридического регулирования превентивной нейрохирургии с учетом ее особенностей.

This paper explores the rapidly growing field of preventive neurosurgery, a promising area in modern clinical practice. With the help of advanced neuroimaging technologies, this approach is already widely used to treat cerebral aneurysms, arteriovenous malformations, and stenotic processes in major arteries supplying the brain, as well as in pediatric neuro-oncology. However, its application to tumors of the central nervous system in adults remains limited and less systematic. Drawing on the experience of the N. N. Burdenko National Medical Research Center for Neurosurgery, the paper examines key aspects of preventive neurosurgery, including ethical considerations, guidelines for decision-making, and criteria for when surgery is appropriate or not. A special focus is placed on the principle of «non nócere» (do no harm), particularly when dealing with individuals who are otherwise healthy. The authors highlight the urgent need to develop a robust framework for this field, encompassing its philosophy, methodology, and legal aspects, to address the unique challenges of preventive neurosurgery.

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The authors declare that there are no conflicts of interest present.