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Biomedical subjects

V V Peresedov

Publications and source records attributed to V V Peresedov.

At least 19 recordsLinked to original sources
PubMed1999

Strategy, technology, and techniques of surgical treatment of supratentorial intracerebral hematomas.

The present study targets the problem of the surgical approach to treatment of intracranial hematomas. We examined a total of 242 patients with clinically evident spontaneous nontraumatic intracerebral hematomas. The majority of patients (79%) were treated in the acute phase of stroke. The patients underwent one of the following treatments: (a) In 731 patients, the hematomas were removed following craniotomy and cortiectomy performed under direct visualization, with a mortality rate of 42.5%; (b) in 64 patients, the hematomas were evacuated stereotactically, with a mortality rate of 21.9%; (c) in four patients, only ventricular drainage was used; and (d) 101 patients were treated with routine nonsurgical methods (comprising the pharmaceutical or conservative group), with a mortality rate of 49.5%. The overall mortality rate was 40%. In 43 patients, a special balloon was implanted into the hematoma cavity after evacuation to prevent recurrent bleeding. Although the first part of this work is now finished, further study of the dynamics of hemorrhage and additional results are needed prior to making a decision on how to divide patient management into the two categories of surgical and nonsurgical treatment.

Adult↗
PubMed1997

[Thalamic hypertensive hemorrhage].

We performed statistic analysis of the results of both conservative and surgical (by means of laying on the external ventricle drain--EVD) treatment of 23 patients with thalamic (medial) hypertensive hemorrhage (THH) admitted to the hospital in the first two days of the stroke's beginning. We also investigated clinical tomographic factors which had influence either on the choice of the treatment or on the prognosis of the disease. The frequency of the lethal cases in EVD-group (6 observations) was about twice lower than in analogous group of patients treated conservatively (17 cases). In conservative treatment prognostically unfavourable factors in acute period of the stroke were the following: the awakening level lower than 10 points according to Glasgow Scale, development of acute obstructive hydrocephalus, dislocation of brain stem, break of blood into cerebral ventricles (of II-IV degree), the volume of hemorrhage more than 10 ml for thalamic and thalamo-capsular location and more than 5 ml for thalamo-mesencephalic location. Monitoring of intracranial pressure in patients with THH which had factors mentioned above revealed the development of steadfast intracranial hypertension by days 5-7 maximally. The laying on EVD was indicated in patients with unfavourable signs of THH by means of ventricle drainage. The controlled decrease of intracranial pressure increased the level of awakening, meanwhile it decreased the degree of hydrochephalus and dislocation of brain stem.

Acute Disease↗
PubMed1996

[Angioneurosurgery at the Institute of Neurology of the Russian Academy of Medical Sciences].

The Angioneurosurgery Clinic exists in Institute of Neurology of Rus. Acad. Med. Sci. for 30 years (from 1965). The main scientific approaches have been formed here in these years. Some of investigations meet the requirements in general neurology in the field of clinical neurology: surgery in head main arteries pathology; surgical intervention in hemorrhage insults resulting from hypertension, atherosclerosis as well as from aneurysm rupture; the treatment of extrapyramidal diseases (stereotaxic and functional neurosurgery; surgical methods of control and therapy of operative complications; combined treatment of neuroectodermal brain tumors.

Academies and Institutes↗
PubMed1993

[Hemorrhages into the cerebral hemispheres and acute obstructive hydrocephalus: new findings in their pathogenesis and the treatment procedure].

CT study of 106 patients with non-traumatic supratentorial intracerebral hemorrhages in the acute period has found a fairly high incidence (29.3%) of the occurrence of acute obstructive hydrocephalus (AOH). It is regarded to be one of the important constituents in the process of an increase in the brain volume leading alongside with other factors to an elevation of the intracranial pressure and dislocation of the brainstem. AOH had no tendency towards the reverse development, was resistant to conservative methods of treatment and usually ended in lethal outcome. Only the differentiated surgical treatment in 250 patients with hemorrhagic stroke including that in hematomas with AOH performed predominantly by the stereotactic method as well as ventricular drainage used as an auxiliary or independent operation provided success of the treatment. In certain volumes and localizations of the hematoma the stereotactic method had an advantage over the open method, as a result of this the postoperative mortality rate decreased 2.5 times. The importance of the timely (CT) detection of AOH and the differentiated surgical treatment as the method of treating a kind of critical condition in patients with cerebral hemorrhages is emphasized.

Acute Disease↗
PubMed1990

[Characteristics of collateral circulation in the ophthalmic artery before and after cerebral revascularization in patients with multiple occlusive diseases of the major arteries of the head].

The status of the collateral blood flow was examined before and after establishment of ++extra-intracranial microarterial anastomosis (EICMA) in 70 patients with occlusion of the internal carotid artery. Of these, 93% of the patients also had lesions of the other main arteries of the head. It has been established that in concomitant lesions of the main arteries of the brain, the role of the ophthalmic artery (OA) rises as to the compensation for the blood flow in the damaged hemisphere. Involvement of the ophthalmic anastomosis into blood supply of the damaged hemisphere was found to inversely correlated to EICMA function. Active functioning of EICMA brings about a decrease of the retrograde blood flow in the OA and in some cases, alteration in the direction of the blood flow in that artery, namely from retrograde to antegrade. Nevertheless additional blood flow via EICMA promotes elevation of the level of the cerebral blood flow in the regions of the middle cerebral artery basin, supplied via the microarterial anastomosis.

Adult↗
PubMed1987

Stereotactic clipping of arteriovenous malformations of the brain.

The authors have developed a new technique for the stereotactic clipping of the feeding vessels of deep-seated arteriovenous malformations (AVM), for use when direct attack may be very dangerous or impossible. A special clipping device and the technique for its application are described. The instrument is introduced through a burr hole using the stereotactic apparatus designed by the authors. The clipping is monitored by intraoperative angiography. The method was used in 32 patients with supratentorial AVMs. It is concluded that in selected cases the method is effective, is less traumatic and gives successful results.

Adolescent↗
PubMed1987

[Evaluation of the function of extracranial-intracranial microarterial anastomoses in occlusive diseases of the main arteries of the head (Doppler and angiographic study)].

The comparison of the results of Doppler and angiographic examinations of 82 patients with combined occlusive disorders of the major arteries of the head before and after creating an extra-intracranial microarterial bypass showed a high informative value of Doppler sonography as a noninvasive method of the diagnosis of impairments of the cerebral arteries and as a method of control of microarterial anastomosis functioning. Placement of a microanastomosis between the external carotid and middle cerebral arteries eliminated or reduced the steal-phenomenon in relation to the brain or vertebral-basilar bed in combined lesions of the major arteries of the head.

Adult↗
PubMed1987

[Dynamics of the recovery of motor functions after the stereotaxic removal of intracerebral hematomas (clinical computed tomographic study)].

The recovery of impaired motor functions in patients with intracerebral haemorrhages depends on many factors. It has been proved that surgical removal of intracerebral hematomas improves the survival rate. Yet, the results of recovery primarily depend on the type of surgery. A new method of stereotaxic removal of intracerebral hematomas has a number of advantages over the open method, primarily low traumatism. The prognosis of the recovery of motor ability is determined by not only the type of surgery but by a number of other factors as well, namely, the volume and localization of the hematoma, the degree of deformation of the brain stem and the timing of surgical intervention. The results of clinical employment of the new method in 51 patients should be considered encouraging while the operation of stereotaxic removal of intracerebral hematomas appears rather promising.

Adult↗
PubMed1985

Stereotaxic evacuation of spontaneous intracerebral hematomas.

The authors describe a new device for removal of intracerebral hematomas, based on the principle of stereotaxic evacuation of these lesions proposed in 1978 by Backlund and von Holst. The optimum parameters of stereotaxic aspiration, including speed of screw rotation and amount of suction, have been determined experimentally. Computerized tomography scanning was used to locate the hematoma site, to assess its volume, and to determine stereotaxic coordinates. A new method of preventing rebleeding is also described. This procedure was used to aspirate hematomas in 32 patients with spontaneous intracerebral hemorrhage, including one case caused by aneurysmal rupture and one secondary to rupture of an arteriovenous malformation. All patients were operated on in a severely comatose or semicomatose state. In all but four cases, the hematomas were almost totally removed. Three patients were operated on twice because of recurrent bleeding. The mortality rate for the series was 22%. A preliminary conclusion is made that this new method is safer and less traumatic than open surgery in most cases of severe intracerebral hematoma.

Adult↗
PubMed1981

Spontaneous cure of ruptured intracranial arterial aneurysms.

The case of a patient who had spontaneous cure of an intracranial saccular aneurysm, documented by angiography, is reported. This occurred in a 41-year-old patient, admitted four months after recurrent subarachnoid hemorrhage due to an angiographically verified supraclinoid internal carotid artery aneurysm. The relevant literature is reviewed, and the possible mechanism of spontaneous aneurysmal thrombosis is briefly discussed. It is concluded that repeating angiography is not without merit in patients with already documented cerebral aneurysms who are referred for surgical treatment some time after a subarachnoid hemorrhage.

Adult↗
PubMed1980

Stereotaxic clipping of arterial and arteriovenous aneurysms of the brain.

A new method of stereotaxic clipping of arterial and AV aneurysms has been developed. The surgical technique and the special clipping device are briefly described. Successful results have been obtained in 30 clipping operations performed on 27 patients with arterial or AV aneurysms at different locations with follow-up ranging from 6 months to 6 years. There was one fatal outcome not directly related to the clipping operation.

Adolescent↗
PubMed1979

[Preoperative calculation for stereotaxic clipping of cerebral aneurysms].

Preoperative calculations employing geometric methods make it possible to determine the optimum site for forming the trephination opening and the position of the plane for parting the clips in operations of stereotaxic clipping. Some new special terms are suggested which are used in geometric constructions. The suggested method was applied in 23 operations on 20 patients with arterial and arteriovenous aneurysms of the brain treated by the method of stereotaxic clipping.

Arteriovenous Fistula↗
PubMed1977

Stereotaxic clipping of arterial aneurysms and arteriovenous malformations.

In carefully selected cases of arterial aneurysms and deep-seated arteriovenous malformations (AVM), when direct attack may be dangerous or impossible, the authors advocate stereotaxic clipping. A special device and technique for its application are described. The instrument is introduced through a trephine opening and clipping is monitored by angiography. Successful results have been obtained in 10 operations performed on eight patients, three of whom had arterial aneurysms (two internal carotid and one anterior cerebral-anterior communicating) and five with AVM's.

Adolescent↗
PubMedDate not supplied

[A method for correcting dislocation in hemorrhages into the cerebral hemispheres].

Hypertension consequent upon increasing brain edema, and intercerebral pressure gradient which is the cause of transverse dislocation diminish with the use of a method which provides for hydrodynamic equilibrium. The method consists in connecting the ventricle of the intact cerebral hemisphere to a balloon located in the cavity of the removed hematoma according to the principle of communicating vessels. The craniospinal pressure gradient is removed by additional catheterization of the spinal subarachnoid space and its connection to the ventricle and balloon according to the same principle.

Brain Edema↗