Introduction. The problem of head injury at elderly and senile patients is actual nowadays because of the constantly increasing number of such persons among whole population as well as peculiarities of head injury at these patients. The development of prognostic criteria for surgical treatment of elderly patients with head injury is necessary to define the volume of surgical intervention, in-time prevention of complications and treatment outcome estimation. Objective. To determine the prognostic value of age at patients with head injury.

Material and methods. We conducted prospective trial to study risk factors for unfavorable outcome in two patient groups of various age with head injury: 1st group included patients older than 60 years old (n=2520 and 2d group – patients of age from 14 till 60 years (n=1305). We estimated the influence of following risk factors in both groups: trauma mechanism, presence of combined extracranial damages, arterial hypotension, depression of conscious level before operation, data of brain computer tomography (CT), intracranial pressure level and development of complications in postoperative period.

Results. The significant increase of unfavorable outcomes (vegetative state or lethality) among elderly patients has been revealed. The most significant risk factors for patients at age of 60 years and older are follows: depression of conscious level before operation, degree of brain lateral dislocation and degree of basal cisterns compression according to CT data, episodes of arterial hypotension and development of pyoinflammatory complications in postoperative period.

Conclusion. Received data confirmed the significant change of outcomes structure and various degree of risk factors influence at elderly patients with head injury comparing with younger patients.

Objective. Examination of topographic, anatomical and morphometric characteristics of ACA-ACoA complex.

Material and methods. Our study is performed using 26 block-specimens «brain-skull base-cervical spine», eliminated from dead, whose death had nothing to do with pathology of central nervous system. Step-bystep microdissection of basal cisterns was performed to release arteries of ACA-ACoA complex with following morphometry and photography after fixation of block-specimens. 

Results. Topographic and anatomical characteristics of ACA-ACoA complex were clarified. Anatomical features of perforating arteries arising from ACA-ACoA complex were studied in detail. 

Material and methods. Retrospective analysis of results of 70 transportations at у 22 patients, including 5 patients with severe head injury and 17 patients with intracranial hemorrhages due to cerebral aneurysms rupture was performed. Received data indicate on the possibility of high-level safety control providing during in-hospital transportation of critically ill patients with predominant CNS damage.

Objective. To improve the surgical treatment outcomes at patients with occlusive hydrocephaly in case of liquor-shunt system disfunction by differentiated usage of endoscopic ventriculocisternostomy of III ventricle fundus (EVCS III).

 Material and methods. We have analyzed data of 60 patients with liquor-shunt system disfunction. All patients were divided into two groups. Basic group included 32 patients with liquor-shunt system disfunction underwent EVCS III. Comparison group included 28 patients underwent conventional treatment of shunt disfunction – revision and/or reconstruction of shunt system. Groups were uniform concerning some basic characteristics (age, sex, duration of shunt-addiction, number of re-operations)/ All patients in basic group were operated on using neuroendovideoscopic devices: rigid and semi-rigid endoscopes, flexible operated fiberscope.

Results. All patients were operated on without any intraoperative complications and stood well in postoperative period. There were no lethal cases. Surgery treatment success after EVCS III was lower (87,8%) in earliest postoperative period comparing with comparison group (100%) (р<0,01) due to early disfunctions after endoscopic operations. However successful results in delayed postoperative period in basic group amount to 78,8% comparing with 53,6% (p<0,05) in comparison group due to greater amount of repeated liquor-shunt systems disfunctions in comparision group. Comparative analysis revealed that EVCS III is more effective method (100%) for hydrocephaly treatment in the case of Sylvian aqueduct occlusion and liquor-shunt system disfunction comparing with conventional treatment (33,3%) (p<0,001). Though efficacy of conventional treatment of shunt disfunction with revision and/or reconstruction of shunt system among patients with occlusion at the level of IV ventricle and liquor-shunt system disfunction compound 100% comparing with efficacy of EVCS III in earliest (75% (p<0,05)) and delayed (50%(p<0,005)) postoperative periods.

Conclusion. Endoscopic ventriculocisternostomy of III ventricle fundus is alternative therapy method for treatment of occlusive hydrocephaly in the case of liquor-shunt system occlusion. The usage of this method allows achieving shunt-independency at 78,8% of patients in delayed postoperative period and at 45,5% of patients (0 % in basic group) after total removal of liquor-shunt system causing minimal numbers of complications (3,0% comparing with 17,9%), that leads to significantly improvement of patients’ life quality and increase of social adaptation level.

This literature review presents the problem of revascularization surgery for cerebral aneurysms treatment. This article enlights the history of revascularization surgery as well as describes the basic types of bypasses and points out the future trends for development of this modality in cerebral aneurysms treatment.

Nowadays the problem of on-time diagnosis and adequate treatment of primary central nervous system lymphoma is one of the top medical questions due to constantly increasing cases of this disease among people of middle and elderly age. This article presents the brief review of diagnosis problems and comparative estimation of efficacy of current methods for PL CNS treatment. The main histological types of lymphoma, tumor localizations, neurovisualization features as well as aspects of surgical, radiation and chemotherapy treatment modalities are enlighted in this written work.

This article enlights the diagnostics features of posttraumatic basal liquorrhea (PBL) which is one of the most frequent complications of severe head injury. Our article includes epidemiologic data as well as description of PBL clinical signs and detailed review of laboratory and instrumental methods of PBL diagnostics: β2-transferrin and β-trace protein tests, CT of skull base, MRI of brain and paranasal sinuses, CT- and MRI- and isotope cisternography. The modern diagnostic algorithm for patients with suspicion onto penetrating head injury and PBL is presented.

Purpose of the project is the analysis of results of surgical treatment of cerebrovascular disorders in Altaiski krai according to Regional vascular Center.

Materials and methods. 265 patients were operated, of whom 151 patient with ruptured arterial aneurysm (AA) and 114 with hypertensive intracerebral hematoma (HIH). In all patients diagnose was confirmed with «gold standard» of investigation: computer tomography with angioprogramme and selective angiography. The principal methods of neurosurgical treatment of AA were clipping (107), and endovascular occlusion of the cavity of aneurysm with microspirals (44). HIH were evacuated by craniotomy (74) and by punctional aspiration with local fibrinolysis (40).

Results: Analysis of the centre’s research showed that 48% of patients seeked medical care during the first hours of the stroke. Only 52% of patients hospitalized in vascular Center immediately. The overall fatality rate in patients with the AA was 19%, with HIH-26%. In Endovascular interventions lethality was 5%, with punctional aspiration with local fibrinolysis — 7%. Method of selection of operative treatment during hemorraghic stroke depends on the severity of the patient’s condition during admission, time from the beginning of the disease.

Conclusions. During very acute period of rupture of AA endovascular method is preferred and in the acute period — open intervention. During HIH-method of selection of operative treatment depends on the severity of the patient’s condition and volume of hematoma.