Biomedical subjects
Publications and source records attributed to M S Gel'fenbeĭn.
Patients with various forms of cerebral circulation impairment were examined. The changes of evoked truncal acoustic potentials (ETAP) point to a lesion of the brain stem formations predominantly at a mesencephalic level. It has been shown that ETAP correlate with the neurological symptomatology.
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This paper reviews ultrasonic methods used at present to evaluate hemodynamic parameters of different organs and velocity characteristics of circulating blood. The ultrasonic methods make it possible not only to diagnose different vascular lesions but also to investigate the effects of unusual environmental parameters on the human body. The paper give a classification of the existing and advanced procedures based on ultrasonic location when applied to determine hemodynamic characteristics of the cardiocerebrovascular system. The paper presents a description of ultrasonic methods used in studying the heart (velocity characteristics of the circulation of cardioelements), brain (pulse oscillations of vessel blood filling in the cranial cavity), and large arteries (blood filling and blood flow velocity.
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The study indicated that intraoperative hemorrhages more frequently occurred at early surgery. During operations made in the first 7, 8-14 days of and after a fortnight of aneurysmal rupture, the incidence of hemorrhage was 27.5, 23, and 22%, respectively. Intraoperative hemorrhage more commonly occurred from carotid aneurysms at surgery within the first 14 days after the onset of bleeding and from anterior connective arterial aneurysm at surgery made later. Intraoperative hemorrhage deteriorated surgical outcomes. In bleeding from the anterior communicans, carotid, and middle cerebral artery aneurysms, the postoperative mortality showed 1.5-, 2-, and 2.5-fold increases, respectively. At the same time, the outcomes of interventions depended on the duration of temporary clipping of the great cerebral arteries.
Preventive temporary clipping of the carrying arteries reduces the incidence of intraoperative hemorrhage in anterior connecting arterial aneurysms from 26 to 13%, in middle cerebral arterial arterial aneurysms from 29 to 4%. In anterior connecting arterial aneurysms, the use of preventive temporary clipping of the carrying arteries fails to affect surgical outcomes. In middle cerebral arterial arterial aneurysms, this procedure decreases postoperative mortality from 17 to 12% by reducing the incidence of intraoperative hemorrhage; however, the rates of disability due to possible brain ischemia in the middle cerebral arterial bed rates increases from 32 to 40%.
The contralateral pterional approach was used in the surgical treatment of 17 patients with cerebral aneurysms. Six of them had solitary aneurysms in the ophthalmological segment and fork of the carotid artery, the aneurysms were clipped by the contralateral approach. Eleven patients were found to have multiple aneurysms in different carotid beds and the main artery, the aneurysms were clipped from blood flow by applying the pterional approach, including the contralateral one. The contralateral pterional approach may be the method of choice in surgery for cerebral aneurysms.