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N V Arutiunov

Publications and source records attributed to N V Arutiunov.

15 recordsLinked to original sources
PubMed2003

Unusual intraventricular herniation of the suprasellar arachnoid cyst and its successful endoscopic management.

A child with a benign intrinsic tectal tumor and obstructive hydrocephalus developed a huge intraventricular cystic lesion following insertion of a shunt, which was complicated by a subdural-subarachnoid bleeding. The lesion was identified to be an entrapped chiasmatic cistern, which disrupted the septum pellucidum in front of the third ventricle and filled gradually the anterior horn of the lateral ventricle. The condition was successfully treated endoscopically by fenestration of the cyst and a third ventriculostomy. Probable mechanisms of such unusual cyst formation and general management strategies in patients with obstructive hydrocephalus are discussed.

Central Nervous System Cysts↗
PubMedDate not supplied

[A cryptococcal granuloma of the midbrain].

The paper describes the most infrequent case of cryptococcal granuloma of the midbrain in a HIV-negative female patient aged 41 years. The patient with midbrain lesion without signs of meningitis was found to have a bulky midbrain opercular formation that was regarded as a nodal glioma. The diagnosis of cryptococcal granuloma was established after removal of the formation (via occipito-transtentorial access with dissection of the lamina tecti) and pathomorphological examination. Microbiological studies verified the diagnosis. Despite the initiation of specific treatment with amphotericin B, the patient died on day 12 following surgery for cryptococcal meningoencephalitis.

Adult↗
PubMedDate not supplied

[A study of the spinal fluid flow by magnetic resonance imaging].

The study was undertaken to examine the potentialities of new MRI techniques (MR-myelocysternoventriculography and phasic contrast-enhanced MRI with reference to a cardiac cycle) in visualizing the spinal fluid system and flow in different groups of neurosurgical patients. MR-myelocysternoventriculography was based on the sequences of SSFP-3D (Signa, GE, 1.5 T) and PSIF-3D (Magnetom 42SP, Siemens, 1.0 T). These regimens were applied to obtain highly T2*-weighed images. These techniques were used in 280 patients. Phasic contrast-enhanced MRI with reference to a cardiac cycle was performed in the axial (through the aqueduct of the cerebrum) and sagittal projects (CINE-2D mode, Signa GE). This technique was employed to study 30 patients and 5 healthy volunteers. MRI-cysternography based on SSFP-3D- and PSIF-3D sequences is recommended as the method of choice in evaluating the 3rd ventriculostoma and, in combination with spiral computed tomography, in detecting fistulas of the base of the skull. Phasic contrast-enhanced MRI with reference to a cardiac cycle yielded the values of spinal fluid flow through the aqueduct of the cerebrum in health: Vsyst max = 4.1 +/- 1.3 cm/sec; Vsyst mean = 2.5 +/- 1.4 cm/sec; Vdiast max = 3.4 +/- 1.5 cm/sec; Vdist mean = 2.5 +/- 1.7 cm/sec (N = 5). The prospect of the technique is to develop recommendations and to predict prognosis while making bypass surgery for ventriculostomas and cystostomas.

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

[Surgical treatment of meningiomas of the craniovertebral junction].

The results of surgical treatment in 21 patients with meningiomas of the craniovertebral junction are presented. Main clinical diagnostic criteria in relation to the site of a tumor relative to the brain stem are considered. The basic surgical approaches used in the surgical treatment of meningiomas of the craniovertebral junction are described. These include posterior, median, posterolateral, transcondylar approaches. Surgical techniques to remove meningiomas having a matrix of varying areas were concretized, this is also done in relation to the consistency of a tumor. The outcomes of surgical treatment are analyzed. Possible postoperative complications and measures of their prevention and treatment are considered.

Adult↗
PubMedDate not supplied

[Results of endoscopic ventriculostomy of the III ventricle in the treatment of occlusive hydrocephalus].

The paper presents data of a retrospective analysis of the outcomes of endoscopic ventriculostomy of the 3rd ventricle, obtained in a consecutive series of 120 patients aged 5 months to 58 years who had occlusive hydrocephalus and operated on at the Research Institute of Neurosurgery, Russian Academy of Medical Sciences, in 1995-2000. In most cases (n = 112), hydrocephalus was caused by a block at the level of the cerebral aqueduct. In more than 50% of the patients, different tumors were responsible for occlusion. In 96 (80%) cases, the operation led to the elimination of occlusion and to the regression of symptoms just after surgery. Complications were few and observed in 19 patients, ventriculitis (n = 7) and intracranial hemorrhages (n = 6) being most common. No death occurred. Seventy three patients were followed up for 1 month to 5 years (mean 1.5 years). Eliminated occlusion and steady-state remission were found in 64 (87.7%) cases. Improvement was strongly correlated with an increase in the reserve craniovertebral content capacity estimated by measuring the pulse amplitude of blood flow in the tentorial sinus in body position-changing tests. In 9 patients, the symptoms of hydrocephalus remained or recurred after short-term improvement. In 3 of them, this occurred with anatomically competent anastomoses between the 3rd ventricle and cisterns. In the other 6 cases, the obliteration and anatomic incompetence of ventriculostoma were responsible for a relapse. In 8 of the 9 patients, shunting had to be made subsequently in the period of 1 to 6 months. The paper also considers some biophysical aspects of cerebrospinal fluid circulation and discusses indications for endoscopy. It is concluded that endoscopic ventriculostomy of the 3rd ventricle is the method of choice in the treatment of patients with obstructive hydrocephalus.

Adolescent↗
PubMedDate not supplied

[Basilar skull fractures: clinical and prognostic aspects].

The incidence of basilar skull fractures and their clinical and prognostic aspects were studied in victims with varying severity of brain injury. Of 947 cases, 449 (46%) patients were diagnosed as having basilar skull fracture and 181 (18.6%) had basal spinal fluid leakage. The frequency of fractures and basal spinal fluid leakage increased in proportion to the severity of brain injury. The above 14-day history of spinal fluid leakage was an absolute indication for surgical fistula closure.

Adolescent↗
PubMedDate not supplied

[X-ray diagnosis of hemangioblastomas of the posterior cranial fossa].

A series of observation covered four patients with hemangioblastomas of the posterior cranial fossa. The study analyzed the infomative value of CT, MRI (with and without contrast enhancement), vertebral angiography, MR angiography and perfusion CT in the diagnosis and differential diagnosis of hemangioblastomas of the posterior cranial fossa and tumors of another origin. Perfusion CT study (estimation of the relative cerebral blood volume) has indicated that hemangioblastomas in relation to the medulla is an increased perfusion area. The analysis of complex radiological study in patients with hemangioblastomas of the posterior cranial fossa has demonstrated that perfusion CT may be useful in differentiating hemangioblastomas from other contrasted neoplasms. Moreover, perfusion CT provides additional information on tumor hemodynamic changes.

Contrast Media↗
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

[Intracranial cysts of different etiologies--the correlations between data from ultralow-field magnetic resonance tomography and results from biochemical analysis].

The paper presents the results of comprehensive examination of 7 patients with intracranial cysts of various etiology and 1 with cholesteatoma. In addition to magnetic resonance imaging with an ultralow magnetic field intensity of 0.4 T, a biochemical assessment of the content of cysts was made. The cystic contrast range on T1 and T2 tomograms was evaluated. The levels of protein, total iron, and percentage of total solids of the cystic content were measured in the biochemical study. On T2 tomographs, the intensity of a signal from cysts on T2 tomographs was significant and differed in each case to a lesser extent. On T1 tomographs, the intensity of a signal was different in each case and increased virtually linearly as the concentration of protein increased up to 10%. The presence of paramagnetic active iron ions (reduced hemoglobin) in the cysts resulted in a much greater elevation of a signal on T1 tomograms. The findings are given as plots that associate the relative intensity of a signal with the concentration of protein. The total solids in the cysts examined predominantly showed protein.

Brain↗
PubMedDate not supplied

[The use of computed tomography in stereotaxic operations in dyskinesia patients].

Experience with 366 CT-stereotactic operations in varying movement disorders (Parkinson's disease, cerebral palsy, torsion dystonia, torticollis, hemihyperkinesis) is presented. Different deep structures, such as thalamic nuclei, subthalamic structures, palladium, putamen, caudate nucleus, dentate nucleus, and brachium conjunctivum or combination of these structures, were selected as a stereotactic target point. Anodic or radiofrequency stimulation, implantation of chronic intracerebral electrodes and neurotransplantation were used as methods of exposure. A procedure for CT-stereotactic determination of supratentorial and subtentorial target points is described. CT-guided stereotactic procedures in the treatment of dyskinesia are precise and less traumatic than ventriculography-guided procedures.

Adolescent↗