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Biomedical subjects

U B Makhmudov

Publications and source records attributed to U B Makhmudov.

At least 19 recordsLinked to original sources
PubMed1999

Petroclival meningioma. An attempt to define the role of skull base approaches in their surgical management.

BACKGROUND: Petroclival meningiomas represent a difficult surgical challenge. The introduction of modern techniques of skull base surgery has stimulated the interest of the neurosurgical community in the surgical management of these lesions, although very good results have been obtained by experienced neurosurgeons in cases of petroclival meningioma operated using traditional surgical approaches. METHODS: Thirty-one cases of petroclival meningioma have been operated on during a 4-year period using two different philosophies as far as the approach. Group A patients (13 cases) have been operated on using mostly either a subtemporal transtentorial or a retrosigmoid approach. Group B patients (18 cases) have been managed using a lateral skull base approach, either the anterior transpetrosal or the presigmoid approach. Translabyrinthine/transcochlear approaches have been used occasionally. RESULTS: Tumor dissection and removal seemed to be easier in skull-base operated patients. However, operations take longer and surgical complications such as cerebrospinal fluid leak and hearing loss were increased. Radical tumor removal could be achieved in an equal percentage of cases of both groups (77% vs. 83%). The early postoperative course was more favorable in group B patients. However, late permanent morbidity appeared to be similar in the two groups of patients. CONCLUSIONS: Skull base approaches facilitate tumor dissection and removal at the expense of increased surgical complications. However, the widened surgical field and increased angle of approach that the techniques of skull base surgery may offer can play a significant role in the removal of sizeable, infiltrative, and/or recurrent petroclival meningiomas.

Adult↗
PubMed1996

Trigeminal neurinomas. A series of 111 surgical cases from a single institution.

Neurinomas arising from the trigeminal nerve are rare (0.1-0.4% of intracranial tumours: 1-8% of all intracranial neurinomas). A series of 111 trigeminal neurinomas operated on at the Institute of Neurosurgery "N. N. Burdenko" of Moscow, Russia, during the period 1961-1994 is presented. Clinical features, diagnostic radiology, surgery and results of treatment are discussed. We distinguished four groups of trigeminal neurinomas: a) Posterior fossa tumours; b) Tumours of the Gasserian ganglion; c) "Dumb-bell" supra-subtentorial tumours; d) Neurinomas of the peripheral branches. The complex clinical symptomatology is related to the actual location of the lesion. Surgery of trigeminal neurinomas may be very difficult, particularly in cases of dump-bell supra-subtentorial lesions. In this series, 3 cases died postoperatively. Out of the 108 patients surviving surgery, long-term follow-up (min. 13 months, max. 33 years, average 13.5 years) was available in 98 cases. 84 patients (86.7%) showed good-to excellent results, with partial trigeminal deficit as the only surgical sequela. 13 patients (11.7%) had a symptomatic recurrence following incomplete tumour removal. Second surgery, ranging from 1.4 to 9 years (average 3.8 years) following the first operation, was judged radical in 9 cases (69.2), however, the rate of complications of repeated surgery was higher than that occurring after the first operation. The advent of microsurgery, together with the introduction of the techniques of skull base surgery and of modern diagnostic imaging tools, have improved surgical results in terms of increased radicality and reduced complications.

Adolescent↗
PubMed1992

Transoral approach to tumors of the clivus: report of two cases.

A transoral approach was used in 2 patients with tumors of the clivus, chordoma, and fibrochondro-chordosarcoma. Choice of the approach was based on data provided by craniofacial examination, radiographic examinations, magnetic resonance imaging, computed tomographic scans, and vertebral angiography, all of which suggested tumor involving the oropharynx and nasopharynx, with destruction of the clivus bone structure. This report demonstrates the feasibility of the transoral approach.

Adult↗
PubMed1990

Surgical management of hematomas of the brain stem.

Nine patients with brain-stem hematoma were admitted to the authors' institute during the period from 1985 to 1988. Clinical symptoms and signs pointed to pontine involvement in most cases. Progressive clinical deterioration was quite common and usually led to a clinical diagnosis of brain-stem intra-axial tumor. Angiography was noncontributory; computerized tomography (CT) was the main diagnostic test. This gave evidence of different pathological characteristics, including masses showing highly increased density, nonhomogeneous hyperdense lesions, and isodense lesions with peripheral contrast enhancement. No clear correlation was found, however, between the presumed duration of the clinical picture and the CT characteristics of the lesion. In the last four cases, magnetic resonance imaging was performed using a 0.015-tesla resistive system. This examination usually confirmed the presence of a brain-stem mass already shown by previous CT scans. There were, however, no cases in which direct evidence of an intra-axial vascular malformation could be obtained. The patients were all treated surgically with an attempt at total removal of the lesion and thorough inspection of the hematoma cavity and biopsy. Evidence of "cryptic" arteriovenous malformation was obtained in six of the nine cases. There were minor transitory complications in three cases. All of the patients were able to resume their previous activity, and none suffered recurrence of the symptoms following the operation. It may be concluded that surgery is the treatment of choice for brain-stem hematoma.

Adult↗
PubMedDate not supplied

[Surgical treatment of cholesteatomas (epidermoid cysts) of the posterior cranial fossa].

In 1985 to 2000, the Academician N. N. Burdenko Research Institute of Neurosurgery, Russian Academy of Medical Sciences, examined and operated on 78 patients with epidermoidal cysts of the posterior cranial fossa. A complex of clinical symptoms of epidermoidal cysts of the posterior cranial fossa and their computed tomographic (CT) and magnetic resonance imaging (MRI) scans were studied. Based on clinical and X-ray evidence, their diagnosis was correctly made in 87.2% of cases. A procedure was developed for radical removal of epidermoidal cysts of the posterior cranial fossa. The stages and surgical treatment policy were elaborated. Total tumor removal was made in 81.25% of the patients. In other cases, a part of a capsule was left due to its close relationship to the adjacent neurovascular structures. Two patients with epidermoidal cysts of the cerebellopontile angle who had undergone radical tumor removal died in the immediate postoperative period. The cause of the two patients were ischemic attack in the brain stem. The quality of surgical treatment was assessed by examining changes in the patients' neurological status, CT and MRI evidence prior to surgery and in different periods after it. Recent radiological studies and microsurgical techniques completely ensure radical removal of epidermoidal cysts of by yielding a good postoperative outcome.

Adolescent↗
PubMedDate not supplied

[Retrosigmoid suboccipital access].

Retrosigmoid suboccipital access has been widely used in neurosurgical care for more than a century. It has been employed in different vascular diseases and tumors of the brain. The authors provide examples of how to use the retrosigmoid suboccipital access, a patient's position during its application and techniques. All stages of performance of the access, including trepanation of the internal acoustic meatus, are considered in detail. Emphasis is laid in the advantages and disadvantages of this access. The basic stages of the access are illustrated. Correct application of the retrosigmoid suboccipital access is stated to yield a good view of primarily the cerebellopontile angle and causes no its associated complications.

Brain Neoplasms↗
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

[Neurinomas and neurofibromas of the jugular foramen: diagnosis and surgical treatment].

The paper analyzes the authors' experience in treating 16 patients with neurinomas and neurofibromas of the jugular foramen. A tumor was located intracranially (Type A) in 1 case, at the level of the base of the skull (Type B) in 7 cases, extracranially (type C) in 3 cases, and extra- and intracranially (Type D) in 5. All the patients were operated on. One-stage removal was performed in 15 patients, in 1 case a tumor was removed in 2 steps. By taking into account differences in the site of the tumors, the authors used the following accesses: retrosigmoid, supracondyllar, extreme lateral transcondylar, retroauricular transtemporal, extended retroauricular transtemporal, lateral cervical. While planning accesses, it is necessary to bear in mind not only the direction of growth of these tumors, but also the pathways of collateral venous blood flow.

Adolescent↗
PubMedDate not supplied

[Primary meningioma of the ventricle IV].

A clinical observation of a rare neurosurgical pathology, i.e. meningioma growing in the cavity of ventricle IV, is reported. The female patient underwent a surgery of tumor eradication. Issues related with diagnostics, treatment tactics and disease prognostication are discussed on the basis of literature survey. Practical recommendations on treatment tactics are provided with regard for the discussed published data and the mentioned clinical case.

Adult↗
PubMedDate not supplied

[Preoperative embolization of the internal carotid artery in surgical treatment of meningioma in the base of the anterior and middle cranial fossae].

Preoperative embolization is a widely used technique that may decrease blood supply to rich-vascurized tumors of the brain. Its use allows a neurosurgeon to safely remove a tumor of different histological nature and site. The objects of preoperative embolization are most commonly meningiomas at convexital or parasagittal sites. According to the data available in the literature, the internal carotid or ocular artery was embolized in not more than 10 cases. The described case underwent successful embolization of the involved internal carotid whose branches took an active part in supplying blood to the meningioma of the base of the skull. This permitted total resection of a generalized meningioma of the anterior and middle parts of the base of the skull.

Adult↗
PubMedDate not supplied

[Hemangioblastomas of central nervous system].

Hemangioblastomas of the central nervous system are benign, richly blood-supplied tumors that may be encountered in its any part, more commonly in the cerebellar hemispheres. Supratentorially, they occur rarely. In the literature there are reports on less than 100 cases of tumors at this site. The histogenesis of hemangioblastomas has not been clearly ascertained so far. Magnetic resonance imaging is the only valid diagnostic study of hemangioblastomas. Hemangioblastomas may be presented as sporadic forms and a manifestation of the Hippel-Lindau syndrome. In the latter case, hemangioblastomas are associated with angiomas of the retina and other viscera. Surgery of hemangioblastomas is the basic treatment. Radiosurgery is the method of choice for patients with Hippel-Lindau disease. The main cause of postoperative death is bleeding to the brain stem and the remaining portions of the tumor. Endovascular embolization of the vessels supplying blood to the tumor may be used to diminish postoperative bleeding. Recurrences are mainly associated with incomplete surgical tumor removal. Chemotherapy is not indicated in hemangioblastomas. Radiation therapy may be used after partial tumor removal.

Central Nervous System Neoplasms↗
PubMedDate not supplied

[The diagnosis of brain cholesteatomas].

The authors analyse the results of radiological examination of 65 patients with cholesteatomas of the brain and the value of the main neuroradiological methods in the diagnosis of the disease. The specific features of the CT-picture of these tumors are discussed. The article describes cases of atypical CT isodensity cholesteatomas and cholesteatomas of increased density as well as cases in which a vascular network of the tumor capsule was demonstrated by angiography. The indices of the contrast range of brain cholesteatomas are analysed. The algorithm of radiodiagnosis of cerebral cholesteatomas is elaborated on the basis of the results of the study.

Adolescent↗
PubMedDate not supplied

[Malignant tumors involving the skull base: methods of treatment and results].

The paper presents experience with surgical and combined treatment of 197 patients with malignant tumors involving the skull base and extracranially originating. The authors have defined indications for and contraindications to different types of surgical treatment, developed methods for radical and palliative tumor removal, which are based on a comprehensive approach considering the basic principles of oncology and neurosurgery. Assessing the immediate and long-term results of surgical treatment by mathematical statistical methods could reveal the major factors influencing survival rates in patients after surgery and the duration of a relapse-free period.

Adolescent↗
PubMedDate not supplied

[The translabyrinthine approach to neurinomas of the 8th nerve].

Experience in the use of the translabyrinthine approach in removal of neurinomas of the eighth nerve in 14 patients is analysed. It was established that the indications for translabyrinthine removal of this type of new growths should be determined from comparison of the size of the tumor and the size of the operative field with consideration for the inevitable destruction of the hearing apparatus in accomplishing the approach. The translabyrinthine approach was found to be most adequate for small tumors (measuring less than 25 mm in size). The stage-by-stage accomplishment of the translabyrinthine developed by the authors, removal of the tumor, closure of the postoperative wound, and adherence to the suggested methodical instructions ensure atraumatic performance of the operation and prevent operative and postoperative complications. In the presence of strictly determined indications, translabyrinthine removal of neurinomas of the eighth nerve is an operation causing little injury and producing favourable results.

Adult↗
PubMedDate not supplied

[Scintigraphy in the diagnosis of tumors of the 8th cranial nerve].

The indications for and the diagnostic value and the method of radioisotope gammaencephalography (GEG) in tumors of the 8th nerve and similar diseases (47 cases) were studied. The optimum time for conducting scintigraphy for the detection of tumors of the 8th nerve is 2 1/2-3 hours after injection of the isotope. Small tumors up to 2 cm in size are not revealed by GEG, stage II and stage III tumors are clearly demonstrated. GEG makes it possible to differentiate tumors of the 8th nerve from arachnoiditis of the cerebellopontine angle and stem encephalitis.

Arachnoiditis↗