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Biomedical subjects

A N Shkarubo

Publications and source records attributed to A N Shkarubo.

10 recordsLinked to original sources
PubMedDate not supplied

[The excessive cerebrospinal fluid drainage syndrome as a complication of the surgical treatment of hydrocephalus].

The paper presents a clinical case of severe excess cerebrospinal spinal fluid drain syndrome with hematomas of the cerebral hemispheres being formed in a 18-year-old young man undergone ventriculoatriostomy with mean-pressure pump implantation. A complication occurred 6 months after surgery and ran progressively. Closed external drainage of hematomas greatly reduced their volumes, but deteriorated the patient's condition due to the development of excess drain syndrome. Replacement of the mean-pressure pump by a high-pressure one rapidly normalized the patient's status.

Adolescent↗
PubMedDate not supplied

[Malignant transformation of epidermoid cyst].

The paper presents a rare case of malignant transformation of an epidermoid cyst to the keratinizing type of squamous cell carcinoma. In a 47-year-old female patient with severe visual disturbances, MRI scans revealed a large supracellular tumor spreading to the third ventricle and medial portions of temporal lobes. The tumor was removed. A histological study of its biopsy specimen showed signs of both a benign process (epidermoid cysts) and its malignant epidermoid degeneration to the keratinizing type of squamous cell carcinoma. After 12-month combined therapy there was a continuous tumor growth with a significant dissemination within the base of the skull. The pathogenesis of epidermoid cysts, possible causes of malignant transformation, modalities of treatment and prognosis are briefly discussed.

Brain Neoplasms↗
PubMedDate not supplied

[Comparative assessment of the results of different surgical treatments in patients with pituitary adenomas infiltrating the cavernous sinus].

Benign pituitary tumors or adenomas are highly common, occasionally inclined to infiltrate the adjacent structures, the cavernous sinus in particular. Despite the fact that drug and radiation therapy are at present widely used treatments, surgical procedures remain highly topical. Different modifications of two basic surgical methods (transcranial intradural and transsphenoidal) that fail to completely remove a tumor from the cavernous sinus in most cases are mostly frequently used as before. Attempts to improve surgical procedures and introduction of current technologies have led to the emergence of an extradural method for tumor removal from the cavernous sinus and to the introduction of endoscopic monitoring during transsphenoidal operations. A strategy of two-stage removal of pituitary tumors has simultaneously been developed. The paper presents the results of surgical treatment of 297 patients with pituitary adenomas growing into the cavernous sinus, by using currently available procedures: transsphenoidal, transcranial intradural, and intra-extradural, and two-stage ones. The findings have confirmed that transsphenoidal removal of pituitary adenomas is the safest method. However, this method has a number of limitations in cases with tumor being grown into the cavernous sinus especially when there is a medial displacement of the intracavernous segment of the internal carotid artery. Moreover, secondary tumor nodes that may be removed by transcranial intradural access are a contraindication to its use. With this, attempts to remove a tumor from the cavernous sinus fail to ensure the desired completeness of removal from the cavernous sinus. The application of an intra-extradural access is the most adequate procedure for tumor removal from the cavernous sinus. The two-stage removal is the most adequate procedure in cases of simultaneously significant spread of a tumor intracranially and into the structures of the base of the skull.

Activities of Daily Living↗
PubMedDate not supplied

[Chiasmatic cavernoma].

Hemorrhage into the structures of the anterior visual pathway, apoplexy of the chiasma or optic nerves, is a rare pathology that can be caused by different pathological processes among which cavernous angioma and arteriovenous malformation are more frequently mentioned. The cause of chiasmatic apoplexy may be also hemorrhage into the tumor--chiasmatic glioma of blood penetration into the chiasma in pituitary apoplexy. The authors describe a rare case of chiasmatic apoplexy whose cause was chiasmatic cavernoma. In addition to acute visual disorders suggesting the involvement of the left optic nerve, chiasma, and left visual pathway, 23-year-old patient had endocrine disorders as polyuria, polydipsia, which first suggests craniopharyngioma and glioma of the chiasma. A capsule and hematomic clots were removed from the thickened left optic nerve and left chiasmatic half during surgery. Only did a morphological study involving immunohistochemical analysis permit identification of the process as hemorrhage from cavernous micromalformation with the formation of hematoma.

Adult↗
PubMedDate not supplied

[Tactics of surgical treatment for an inflammatory process of C0-C(I)-C(II) segments in the craniovertebral joint instability].

Pathological processes of C0-C(I)-C(II) segments, such as the clivus, atlas arch, dens, and body of the C, vertebra pose major problems for diagnosis and treatment. On removal of a sizable pathological focus, there may be instability of the craniovertebral segment, secondary displacement, and spinal compression syndrome. Therefore these patients frequently need stabilization of the craniovertebral transition. Patients with initial instability of the craniovertebral junction and subluxation of C(I)-C(II) segments are an intricate problem. The authors describe a rare case of an inflammatory process of C0-C(I)-C(II) segments with craniovertebtal junction instability. A differential diagnosis was made between chordoma, osteoblastoma, and an inflammatory focus at the above site. The following tactics was undertaken: the first stage was occipitospondylosynthesis with "Vertex" system with osteoplasty under Halo-traction; the second stage included transoral removal of a pathological removal of the dens and body of the C(II) vertebra, left lateral mass of the CI vertebra, and lower clivus. After removal of the pathological focus, there were portions of the abnormally changed bone with rarefaction without tumor tissue. Histologic studies revealed the signs of a chronic inflammatory process. A five-month follow-up showed that neurological symptoms and craniovertebral junction instability regressed. The control computed tomography made 5 months after surgery demonstrated the radical elimination of the pathology and the absence of C, vertebral subluxation. Thus, there is evidence for the tactics of successive operations (a stabilizing operation--posterior occipitospondylosynthesis (desirably under Halo-traction), followed by removal of a pathological focus via transoral access) in pathological processes of the craniovertebral C0-C(I)-C(II) in cases of initial craniovertebral junction instability.

Atlanto-Occipital Joint↗
PubMedDate not supplied

[The surgical treatment of dysembryogenetic tumors in the sella-sphenoid location by a transnasal-trans-sphenoid approach].

In 1979-1993, a total of 1,320 patients with tumors of various histological patterns were operated on by transnasal and transsphenoidal access. Among them, 57 patients had dysembryogenetic tumors: craniopharyngiomas (n = 37), chordomas (n = 10), angiofibromas (n = 6), Rathke's pouch cysts (n = 2), epidermoid cysts (n = 2). Eleven patients were operated on by a combined access (transcranial, then transnasal). The paper gives in detail the clinical aspects, X-ray diagnostic features of dysembryogenetic tumors of sellar-sphenoidal site, identifies their basic growth variants. It also describes the specific features of the access and operation techniques. Indications and contraindications for surgery have been developed. Tumors were totally and subtotally removed in 82.5% of patients. Visual improvements were observed in 74.4%. It is concluded that the transnasal and transsphenoidal access maybe used as the major method of surgical treatment and combined surgical treatment of dysembryogenetic tumors of sellar-sphenoidal site.

Adolescent↗
PubMedDate not supplied

[Surgery of the base of the skull].

To treat pathological processes, primarily tumors, in the base of the skull is one of the most intricate neurosurgical problems. In the past decade, interest in this problem has greatly increased due to the advent of new methods of diagnosis, up-to-date neurosurgical equipment and to a greater cooperation of physicians of related disciplines: ophthalmologists, otosurgeons, plastic surgeons. The authors present and summarize the experience accumulated by the researchers of the N. N. Burdenko Institute of Neurosurgery in the past 10 years in treating basal tumors. Based on a great deal of clinical findings, approaches are proposed in treating some groups of basal tumors, such and pituitary adenomas, craniopharyngiomas, meningiomas at various sites, trigeminal and acoustic neurinomas, and malignant neoplasms of the base of the skull. The conditions required for successful surgical treatment of the processes in the base of the skull are described in detail. One of them is a correct determination of a surgical approach.

Cranial Nerve Neoplasms↗