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Biomedical subjects

N K Serova

Publications and source records attributed to N K Serova.

At least 19 recordsLinked to original sources
PubMed2002

Compensatory mechanisms in patients with benign intracranial hypertension syndrome.

135 patients from 16 to 59 years old with benign intracranial hypertension syndrome (BIH) due to postinflammatory processes (A), venous outflow disorders (V), and endocrinological disorders (G) were investigated by CT, MRI, MRI-Ag, carotid-Ag and constant pressure infusion test. All the obtained data were analyzed and possible relationships between the parameters of CSF dynamics and the clinical data were evaluated. Correlative analysis of the obtained data was performed and the main mechanisms of compensation of BIH syndrome were established. In patients of group A disturbances of CSF absorption system with high level of CSF outflow resistance (R) and secondary elevation of brain elastance (EL) were common. In patients of this group venous disorders were of secondary nature and appeared in a later period of the disease. The patients of group V showed increased intrasinus pressure, which correlated to high R and EL. In patients of group G we found the signs of CSF hyper-production with high level of EL. Increased R in patients of this group seemed to be a secondary reaction. The investigation identified the main stages of evolution and compensation of hypertension in the patients with BIH syndrome. The obtained data may be used in optimizing the conservative therapy and indications for lumboperitoneal shunting.

Adolescent↗
PubMed1996

Removal of a cranio-orbital foreign body by a supraorbital-pterion approach.

Foreign body removal in blind, penetrating craniocerebral injuries, especially those involving craniobasal localization, could entail additional brain trauma risk. Under such conditions one can use surgical approaches for tumor removal or clipping of intracranial aneurysms. In this report, we present a case of blind, penetrating craniofacial injury in which a supraorbital-pterion approach for foreign body removal was used. Craniography, carotid angiography, and computed tomography data, including three-dimensional imaging, were taken into consideration while planning the operation.

Adolescent↗
PubMed1996

Late diagnosis and removal of a large wooden foreign body in the cranio-orbital region.

The rare case of a large wooden foreign body impaled in the cranio-orbital region, and its late diagnosis and successful removal, is presented. A 26-year-old man was admitted to a regional hospital after suffering a severe penetrating craniocerebral injury from a motorcycle accident. Two months after the accident, computed tomographic examination at Burdenko Neurosurgical Institute revealed a large foreign body located in the cranio-orbital region and penetrating the right temporal lobe, with surrounding abscess development. Radiological examination, including three-dimensional computed tomography, enables one to choose the optimal surgical approach and to remove the foreign body, thereby avoiding purulent, inflammatory complications.

Accidents, Traffic↗
PubMedDate not supplied

[Amaurosis after surgical gauze fixation of walls of a giant fusiform internal carotid aneurysm].

A 42-year-old male patient was operated on for a giant fusiform aneurysm of the right internal carotid artery. Extracranial-intracranial bypass was first performed. Despite suction decompression, the aneurysm could not be clipped for its fusiform neck, and it was coated with surgical gauze. Before surgery, his bilateral visual acuity was 1.0; there was a complete left homonymic hemianopia, the fundus oculi was normal. On postoperative day 1, the visual functions were unchanged. Then there was a visual loss in the right eye that progressed to blindness 2 weeks after surgery. The authors consider variants of the pathogenesis of blindness: 1) development of foreign-body granuloma and surgical gauze-induced optochiasmal arachnoiditis; or 2) thrombosis of the aneurysm and thickening of its wall with compression of the right optic nerve. One-year follow-up revealed that the visual acuity of the right eye recovered (1.0), but the right optic disk became pale, the left optic disk was normal. A complete left homonymous hemianopia was unchanged. Spontaneous recovery of visual acuity makes the second hypothesis of the pathogenesis of blindness more preferable.

Adult↗
PubMedDate not supplied

[Delayed radiation-induced optic neuropathy in patients with tumors in the chiasmal-sellar area after radiation therapy].

Six clinical observations of a rare condition, delayed radiation-induced optic neuropathy (RON) are presented. RON developed in patients with brain tumors treated by radiotherapy and radiosurgery; in the majority of patients the condition developed during exposure to therapeutic doses; its incidence was 0.5% of the total number of patients treated by radiotherapy during this period. Asymmetrical chiasmal syndrome developed rapidly in all the patients. Clinical diagnosis of RON was confirmed by magnetic resonance tomography in all cases, and in one case by morphological analysis. Conservative therapy including hyperbaric oxygenation just stabilized the visual function. Remote period of observation was 42 months.

Adult↗
PubMedDate not supplied

[Periocular skin depigmentation, developing after removal of a cranioorbital meningioma].

The paper gives a case of periocular skin depigmentation developing after neurosurgical treatment for hyperostotic cranioorbital meningioma. It also shows a natural history of the tumor, as seen in a series of sequential CT scans. The patient was operated on 13 years after the onset of the disease. Five months following surgery, a well-defined periocular depigmentation appeared on the operated side. This remained unchanged on a follow-up visit at months 12. As follows from the presented review of known cases of periocular depigmentation, the described postneurosurgical depigmentation has not yet been reported.

Adult↗
PubMedDate not supplied

[Neuro-ophthalmological symptoms in patients with para-clinoid aneurysms].

Neuroophthalmological symptoms in patients with large and giant paraclinoid aneurysms is presented, based on analysis of case histories, examination of visual functions, and evaluation of ophthalmoscopic picture. Variants of paraclinoid aneurysm location with respect to optic tract structures and the visual function are discussed. Methods of modulating the peripheral and central neurons of the optic tract are described.

Adolescent↗
PubMedDate not supplied

[Use of automatic static perimetry for the diagnosis of visual analyzer lesion in neurosurgical patients].

Emphasis is laid on how important to use clinical perimetry in the diagnosis of visual disturbances that are common in neurosurgical pathology. The authors compare kinetic perimetry with automatic static one. They consider the advantages of computerized perimetry used in patients with chiasmocellular diseases in visual analyzerlesion in the cerebral hemispheres, in congestive optic disks, anterior optic ischemic neuropathy, and visual dysfunctions.

Automation↗
PubMedDate not supplied

[Aspergillosis of the central nervous system (clinical observation and review of literature)].

Aspergillosis of the central nervous system presents a challenge faced with the problems arising from the establishing the diagnosis, the low efficiency of treatment, and high mortality rates (about 95% as shown by some data). This paper presents a clinical case of a patient with aspergillosis-induced central nervous system lesion verified by autopsy. Possible errors in the diagnosis and treatment of the patient are analyzed. The literature data including clinical cases, etiopathogenesis, and clinical manifestations and its possible complications are presented. Groups of patients at risk for invasive aspergillosis are considered. The paper gives the data available in the foreign literature on the methods and efficiency of treatment and mortality rates in different groups of patients. The urgency of the problem in the diagnosis and treatment of cerebral aspergillosis rises with the increased number of patients with immunological disorders due to infectious diseases (HIV), social (drug addiction, alcoholism), environmental, and other factors.

Adult↗
PubMedDate not supplied

[Iatrogenic metastasis of pineal tumors].

Malignant pineal tumors (PT) tend to metastasize. In rare cases, this process is provoked by surgery. This paper describes four cases of iatrogenic metastasis of PT. Metastasis occurred: a) along the surgical approach path after tumor removal in 2 cases; b) along the biopsy cannula path; and c) along the ventriculoperitoneal catheter into the abdomen. The sources of metastases were pineoblastoma (n = 1), malignant teratoma (n = 1), germinoma (n = 1), and malignant germ-cell tumor of unknown genesis (n = 1). To prevent this complication due to high-grade PT, such as malignant germ-cell tumors and pineoblastomas, radiation of the whole brain, besides the sites of a tumor should be performed and, in some cases, in combination with chemotherapy.

Adolescent↗
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

[A role of laser retinal tomography in the study of patients with congestive optical disks].

A Heidelberg retina tomograph II was used to examine 35 (55 eyes) patients with intracranial hypertension caused by brain tumors. Ophthalmoscopy revealed no changes in the optic disk in 6 eyes, mild, moderate, and severe congestive optic disks (COD) in 6, 14, and 29 eyes, respectively. The volume of the neuroretinal rim (V) and the area of the Optic disk (S) were measured. There was a significant difference in V (p < 0.01) and S (p < or = 0.02) with the intact optic disk, in mild, moderate, and severe COD. One-week-to-one-month follow-ups after tumor removal showed that in 12 patients the positive or negative changes, as evidenced by the readings of a retina tomograph, corresponded to those in the ophthalmoscopic pattern. Laser retinal tomography is an objective and accurate study of the stereometric parameters of COD in patients with intracranial hypertension, which permits a follow-up of COD.

Brain Neoplasms↗
PubMedDate not supplied

[Magnetic resonance imaging of the orbital portion of the optic nerve at different stages of papilledema].

High-resolution magnetic resonance image makes it possible to examine the radiological anatomy of the orbital portion of the optic nerve in patients with papilledema. The longitudinal diameters of the orbital portion of the optic nerve and its subarachnoidal space were measured on coronal images just behind the eyeball, in the middle of the latter and the orbital apex, and at the orbital apex in 10 healthy volunteers and 20 patients with papilledema. In patients with papilledema, the diameter of the subarachnoidal space of the optic nerve was increased as compared with that in the control group. In its moderate form, that of the optic nerve was significantly increased as compared to the control group. In patients with severe papilledema and secondary atrophy, the diameter of the optic nerve just behind the eyeball was significantly less than that in patients with moderate papilledema. It may be suggested that elevated intracranial pressure leads to the dilated subarachnoidal space of the optic nerve. The clinical and X-ray signs of atrophy of the optic nerve are detectable in patients with severe papilledema and secondary atrophy.

Disease Progression↗
PubMedDate not supplied

[The microsurgical treatment of arteriovenous malformations of the thalamus].

The article analyzes the clinical data of 48 patients with arteriovenous malformations of the thalamus, who were examined at the Burdenko Institute of Neurosurgery, AMS USSR, from 1970 to 1989. The experience in surgical treatment is based on 25 cases. The authors describe in detail the indications for surgical treatment, adequate surgical approaches, and the method for removal of the malformations. Neuropsychological and electrophysiological methods of examination of patients in dynamics were applied to evaluate the results of surgery.

Cerebral Angiography↗
PubMedDate not supplied

[Visual functional changes in patients with pituitary adenoma: results of transnasal-transsphenoidal tumor removal].

The study was based on the analysis of case histories of 371 patients with pituitary adenoma who were examined and treated at the Acad. N. N. Burdenko Institute of Neurosurgery in 1999 to 2004. The patients' age was 13 to 75 years; the peak of the disease fell on the age of 40-50 years. Females were 61% and males 39%. The symmetrical and asymmetric chiasmal syndrome was detected in 42 and 58% of patients, respectively. Early chismal syndrome was identified in 32% of patients; insignificant and significant one being in 27 and 41%, respectively. According to the stage of visual disorders, the patients were divided as follows: those with an early stage (62.9%) and those with a late stage (37.1%). An analysis has indicated that the pattern of visual disorders correlates with the site, predominant growth, and sizes of a tumor. Early postoperative visual functions restore mainly in patients with early-stage visual disorders, which is accounted for by timely decompression of visual fibers and their better blood supply. Functional block cessation, axonal transport recovery, and, probably, visual fiber remyelination result in positive changes in the late postoperative period.

Adenoma↗