[Shunting as a method of treatment of some forms of dementia].
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Biomedical subjects
Publications and source records attributed to F S Goven'ko.
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Eleven children with injuries to the cranial nerves were examined. It has been revealed that as a result of surgical interventions, the facial nerve gets affected more frequently. The results of the treatment often appear unsatisfactory because of the late referral of the victims to hospitals for operative treatment.
The investigation of blood flow in injured nerves in 14 patients by the method of hydrogen clearance has revealed substantial difference of the blood flow value in children and adults. The authors consider that it may be of significance for the interpretation of differences in the course of regeneration in patients of different age.
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A comparative assessment of results of autoplasty and the epineural suture in 32 cases was made on the basis of a well-known scores system. It was established that under similar or close conditions influencing the regeneration the results proved to be the same in both groups. It suggests that the epidural suture is the method of choice in those children where it is not associated with technical difficulties. Autoplasty is indicated in cases where putting the epidural suture is impossible or difficult.
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A clinical study of 32 children and 136 adults followed up for 1 month to 5 years and more after an epineural suture has shown that in children the restoration of movements and sensitivity is 1.5-2 times faster than in adults. Motor function is restored to a fairly good extent in over 60% of both children and adults. Sensitivity in children recovers much better than in adults.
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Having examined the discriminational sensitivity with Weber's dividers in 244 patients 1-10 and more years after epineural suture of the median, ulnar and palmar digital nerves, the authors established that this type of sensitivity restored slowly, incompletely and rarely. Discrimination of two points was better restored after suture of the palmar digital nerves, it was worse after suture of the median nerve and was the worst after suture of the ulnar nerve. The factors adversely affecting the restoration of discriminational sensitivity included a high level of damage (upper arm, the upper third of the forearm) and a considerable delay with surgery.
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