The features of life quality at patients with brain tumors in accordance of mass lesions localization and their histopathlogical specific characters were studied. The self-evaluation of life quality measurements, received on the base of SF-36 questionnaire, which was filled by patients in preoperative period, was compared to results in control group of healthy volunteers. It was stated that life quality decreased among patients with brain tumors with the particular low estimation of Role-Physical Functioning and Role-Emotional Functioning. The tumor localization more defines the features of life quality decreasing comparing with histopathlogical specific characters of brain tumor. The localization of mass lesion in frontal lobes more affects the Role-Physical and Role-Emotional Functionings in comparison with tumor localization in parietal lobes. The worsening of life quality in terms of Role-Physical Functioning and Bodily pain is maximally expressed at patients with metastases into brain comparing with patients suffered from primary intra- or extracerebral mass lesions. The information about patient’s emotional state and about adequacy of his life quality estimation in preoperative period can be useful for optimization of relationship between physician and patient as well as for achievement of more favorable course of disease in postoperative period.

Objective: to determine the features of clinical manifestation, diagnostic methods and surgical strategy in treatment of craniovertebral junction (CVJ) spondylitis of various etiology. Material and methods: we present the surgical treatment outcomes at 37 patients with CVJ spondylitis, among them 19 patients had tuberculous spondylitis and 18 - spondylitis of nonspecific etiology. Results: the inflammatory injuries of CVJ had pathobiomechanic and morphological features in accordance with stage and localization of pathological process. These peculiarities should be classified according to developed three-column pathobiomechanic model of inflammatory processes in craniovertebral region. The middle column is the main one whose damage degree influences on segment stability. The preservation of support structures determines the choice of surgical strategy as well as method and extent of surgical intervention. It is necessary to create the posterior support complex using occipitospondylodesis in the case of inflammatory processes of CVJ with the damage of first support column while the injury of anterior and middle support columns require the performing of two support complexes by the way of simultaneous occipitospondylodesis and anterior craniovertebral or atlantoaxial stabilization by autograft after transoral removal of inflammatory focus. Conclusion: the suggested strategy of surgical treatment of CVJ spondylitis allowed achieving favorable outcomes in all cases with reversal of neurological signs and formation of bone ankylosis in atlantoaxial area with reconstruction of support ability of cervical spine.

Objective was to improve the neurosurgical treatment outcomes at patients suffered from brain echinococcus disease. Material and methods. We observed 34 patients (20 women and 14 men) who was examined and treated because of brain echinococcus disease in neurosurgical department of National Hospital of Ministry of Public Health of Kyrgyz Republic within period from 2008 till 2013. The CT/MRI data revealed unicameral cysts at 21 (61,8%) patients; multiple (daughterly) cysts - at 8 (23,5%) patients; cysts with calcification - at 2 (5,9%) persons and parasitic cysts with decomposition and pus formation - at 3 (8,8%) patients. Results. The most patients in this study (24 (70,6%) among 34 persons) were operated on with the usage of ozonous normal saline solution (ONSS) for sanation of residual parasitic cavity. The residual cavity after removal of chitinous capsula of echinococcus cyst was filled by 10-15 mg/l ONSS and was packed by gauze pads. The exposure was 10-15 minutes with following removal of gauze pads and ONSS. The use of 10-15 mg/l ONSS leads to irreversible ultrastructural changes in germinal elements of echinococcus (hydatid cysts), whereby they lost the capability to generate the secondary cysts. The longer-term effects from ONSSS result in total (100%) destruction of echinococcus cell components. Conclusion. Ozon is the effective antiparasitic agent and can be used for desinfection of echinococcus residual cavities aimed to prevention of disease relapses.

Objective. To review the results of intraoperative indocyanine green videoangiography (ICG-VA) usage during clipping of cerebral aneurysms distinguishing the interpretation features of obtained data in accordance with time of contrast injection - before or after aneurysm clipping. Material and methods. We conducted ICG-VA at 28 patients with ruptured cerebral aneurysms among them 12 persons were operated on in acute period of hemorrhage and 16 patients - in delayed or cold period. This procedure was performed using operative microscope OPMI Pentero with plug-in Infrared-800 module, which was switched on at the certain stage of operation. There were 34 examination in total with contrast injection before aneurysm clipping in 12 cases and after clipping - 22 observations. Results. The high informative value of ICG-VA was demonstrated during revision of clipping site for patency determination of parent artery and perforating branches. The differences in angiographic signs of aneurysm elimination from blood flow depending on method of contrast injection were determined. The inversion of ICG-VA data was described in particular, indicating the aneurysm elimination in case of preliminary contrast of arteries, when applied clip may block some quantity of contrast in aneurysmal body whereas the contrast agent is washing out from parent vessels. Conclusion. ICG-VA is the optimal method for objective estimation of aneurysm clipping adequacy. The hemodynamics features in examined region before and after temporary or permanent clips placement must be taken into consideration. ICG-VA decreases the risk of possible complications in aneurysm surgery; the clip replacement was necessary in our 5 clinical observations.

Objective. To study the morphological changes in basilar artery and brain tissues during experimental nontraumatic subarachnoid haemorrhage using laboratory white rat as well as to compare the spasmogenic effect of venous and arterial autologous blood. Materials and methods. The study was performed using 18 laboratory white rat weighing 180-220 g. Venous and arterial autologous blood was injected in cistern magna twice. Neurological assessment of the animals was performed daily. Brain for morphological study was taken out at the 3rd, 4th, 5th, 6th and 7th day. Microscopy assessment was performed at the level of the upper third of the basilar artery using special histochemical stains (by Gram-Weigert, by Lie). Slide description was performed at the light microscope Leica DM 1000 with an increase of 400-1000 times, photomicrography was performed using digital camera Leica EC 3. Results. The direct qualitative evidences of cerebral vasospasm (reduction in luminal diameter of the basilar artery, thickening of the vessel wall, internal elastic membrane wrinkling, hypercontractive changes of smooth muscle cells) were identified. Vasospasm was detected on the 4th day, with maximum expression at day 5 and regression by 6-7 day. The direct indicators of brain ishemia in the form of capillary blood flow violations were identified at the pons level. There was no difference in spasmogenic effect comparing venous and arterial blood. Conclusion. The suggested model of autologous blood injection in cisterna magna of the rat is adequate and appropriate for further study of the cerebral vasospasm after nontraumatic subarachnoid haemorrhage as well as for investigation of the methods for cerebral vasospasm prevention and treatment.

The brain ischemia because of cerebral angiospasm develops at 33,5% patients suffered from nontraumatic subarachnoid hemorrhage as a result of aneurysm rupture and remains the main cause for deterioration in the condition or lethal outcome at such patients. The treatment of brain ischemia as a result of narrowing of basal brain arteries includes a lot of conservative and surgical methods however neither of them appears to have the priority in the regression of brain ischemia signs at such patients. The usage of extra-intracranial bypass in treatment of brain ischemia at patients with nontraumatic subarachnoid hemorrhage is one of the underinvestigated surgical methods. We have performed the analysis of 65 literature sources dedicated to this problem. Nowadays there are no clearly determined indications, criteria and algorithms for STA-MCA bypass usage at patients with cerebral angiospasm and brain ischemia. The most appropriate indications for STA-MCA bypass performance are the follows: aneurysms of internal carotid or middle cerebral arteries with progressive proximal angiospasm of М1 and М2 segments, first 8 hours after manifestation of focal neurological deficit, decrease of perfusion measurements in corresponding region and absence of severe ischemia areas in accordance with brain CT data. The STA-MCA bypass also can be considered as method of choice for brain ischemia treatment in the case of cerebral angiospasm and impossibility of endovascular methods application.

The simulation of surgical manipulations using various models should be the important part of practical training during residence in neurosurgery in the immediate future. This fact is indicated by continuously increasing number of papers concerning simulation training in medicine and in neurosurgery particularly indicate.

The various types of complications at patients with spinal trauma are described. The data concerning etiology, pathogenesis, clinical signs of complications related to course of traumatic disease of spinal cord are presented. The pyoinflammatory and vascular complications in pre-and postoperative periods as well as the data concerning the features of microflora at patients with spinal trauma are listed. The periods of various complications development are presented in relation to severity of spinal cord trauma, presence of concomitant injury as well as to trauma periods and surgical treatment. The prevention measures for avoiding complications in pre-and postoperative periods are presented. The technical complications of operative interventions on vertebral column and spinal cord connected with surgical approaches, implants placement, performance of corporectome and/or laminectomy for all vertebral levels are described in details. The data concerning various delayed complications in postoperative period because of spondylodesis failure as well as fracture and dislocation of fixators are also described.

This article describes in detail the features of step-by-step surgical technique for treatment of various lumbar degenerative diseases: intervertebral disk hernia, foraminal disk herniae, disk herniae of upper lumbar spine, central and lateral spinal stenoses, multilevel lesions. The techniques for prevention of epidural fibrosis and intraoperative complications are presented. This suggested surgical technique allows achieving maximal decompression of neurovascular structures of vertebral canal.

This article describes the topographical and anatomical features of OA and PICA course as well as the technique of bypass performance between OA and PICA and presents the clinical case. The male patient H., 60 years old with occlusion of right vertebral artery and critical stenosis of V4 segment of left vertebral artery who suffered from progressing vertebrobasilar insufficiency within last 6 months and every day «drop attacks» was operated on. The endovascular treatment did not performed because of severe toruosity of V3 segment of vertebral artery. The bypass performance between left OA and left PICA was conducted using frameless neuronavigation. There were no any incidents in postoperative period; the control CT-angiography revealed the patent bypass. The patient was discharged on 16th postoperative day with full regression of «drop attacks».

The clinical case of surgical treatment of idiopathic myelocele at the level of thoracic spine is presented. The idiopathic myelocele is the rare pathology, which leads to gradual progression of myelopathy. The clinical signs of this disease in all previously described observations are similar however the pathogenesis and etiology are not clear until the present. The good functional outcome in terms of elimination of spinal cord compression and regress of neurological deficit was achieved in the most clinical cases surgically treated.

This article presents the clinical case of delayed sequela development - contracture of temporo-mandibular joint (TMJ) at female patient suffered from craniofacial trauma. The main aspects of pathogenesis, diagnostics and surgical treatment of this pathology are discussed.

This article presents the doctrine concerning sequellae of head injury. The definitions of these consequences are described with clearly distinction of the terms «sequellae» and «complications» of head injury. The classification of head injury sequellae is described in details with the definition of tissular, liqourodynamic and vascular consequences. The detailed description of their neurological and neurovisualization characteristics is presented. The conceptual approaches to reconstructive and minimally invasive neurosurgery of posttraumatic pathology of brain were developed.