[The pterional approach].
Explore the source record for details and available documents.
Cephalometry↗
Biomedical subjects
V N Shimanskiĭ
Publications and source records attributed to V N Shimanskiĭ.
[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↗
[Compression of the inferior cerebellar artery-induced compression of the medulla oblongata in Arnold-Chiari malformation as a cause of essential hypertension].
Cerebrovascular abnormalities (primarily looping of cerebellar arteries) are almost without exception concurrent with the Arnold-Chiari syndrome and hydrocephalus. Persistent essential hypertension may be a manifestation of pathological vessel-brain contact. Customary microvascular decompression may lead to blood pressure stabilization in the postoperative period for a long time. The paper presents a clinical case of a 52-year female patient with the Arnold-Chiari syndrome who underwent microvascular decompression of the left posterior inferior cerebellar artery at the level of the medulla oblongata. Surgical treatment regressed preoperative cerebellar, bulbar, and truncal symptoms, lowered blood pressure from 190/100 to 120/80 mm Hg, and stabilized it at this level.
Arnold-Chiari Malformation↗
[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↗
[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↗
[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↗
[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↗
[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↗
[Multiple cerebral abscess caused by Nocardia brasilientis].
Streptococcus aureus, streptococci, and enterobacteria were major causative agents of abscesses of the brain. At present, associated infection is responsible for 60% of cerebral abscesses. When systemic and specific immunities are diminished, a risk for cerebral abscesses caused by fungi increases. Among them, there are the most common fungi Candida species or Aspergillus species. The paper gives an example of successful complex treatment of multiple cerebral abscesses caused by an association of Nocardia brasiliensis and Staphylococcus epidermidis. The specific feature of the observation was the correct diagnosis before intraoperative verification of cerebral abscesses. The disease developed in the presence of diminished systemic immunity and in the absence of specific immunity to Nocardia. Immunodeficiency could be caused by prior herpetic infection, Epstein-Barr disease, a wasp bite. The pathogen that was able to cause microstrokes played an indubitable role in the pathogenesis of the disease, which predisposed to the development of cerebral abscesses in patients with immunodeficiency. Impaired blood circulation in the occipital region could be also induced by wasp venom.
Brain Abscess↗
[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↗
[Microsurgical anatomy of the area of the superior orbital fissure].
The microsurgical anatomy of the upper rima palpebrarum region was studied in 7 specimens of the base of the skull. The basic indicators in preparing specimens of the upper rime palpebrarum region are the upper and lower tendons of the lateral rectus, the upper orbital vein, the frontal and trochlear nerves. These indicators allow one to dissect cavernous sinusal formations to the rear and orbital formations to the front.
Abducens Nerve↗
[A craniofacial approach to disseminated tumors of the anterior portions of the cranial base].
The authors have developed a modified craniofacial approach. Its essence is to extend a facial cut along the mid-forehead after Weber-Fergusson into the frontoparietotemporal region, by forming a common soft tissue craniofacial graft. The above access was used in 17 patients with benign tumors of the base of the skull, involved into the ethmoidal sinus, anterior cranial fossa, medial portions of one or both eye sockets, sphenoidal sinus, medial portions of one or both maxillary sinuses, nasal cavity, and nasopharynx. The use of this access increases the radical rate of removal of extended craniofacial tumors. The specific policy features of surgery and postoperative management.
Adolescent↗
[The microsurgical anatomy of the orbit].
Explore the source record for details and available documents.
Cadaver↗
[Surgery of the base of the skull].
To treat pathological processes, primarily tumors, in the base of the skull is one of the most intricate neurosurgical problems. In the past decade, interest in this problem has greatly increased due to the advent of new methods of diagnosis, up-to-date neurosurgical equipment and to a greater cooperation of physicians of related disciplines: ophthalmologists, otosurgeons, plastic surgeons. The authors present and summarize the experience accumulated by the researchers of the N. N. Burdenko Institute of Neurosurgery in the past 10 years in treating basal tumors. Based on a great deal of clinical findings, approaches are proposed in treating some groups of basal tumors, such and pituitary adenomas, craniopharyngiomas, meningiomas at various sites, trigeminal and acoustic neurinomas, and malignant neoplasms of the base of the skull. The conditions required for successful surgical treatment of the processes in the base of the skull are described in detail. One of them is a correct determination of a surgical approach.
Cranial Nerve Neoplasms↗