Russian journal of neurosurgery最新文献

{"title":"Intraoperative neuromonitoring in surgery of supratentorial brain tumors. Part 2. Assessment of sensory conductivity, impact at outcomes and method restrictions","authors":"A. Dmitriev, M. Sinkin, V. Dashyan","doi":"10.17650/1683-3295-2022-24-3-73-79","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-73-79","url":null,"abstract":"Among methods of assessment of sensory conductivity of neuromonitoring in surgery of supratentorial tumors somatosensory evoked potential phase reversal are used most commonly to identify location of central sulcus. Method's uniqueness lies in possibility of its usage in patients with severe paresis before operation. Its sensitivity reaches 97 % but decreases with tumor location in Rolandic area.In monitoring of visual evoked potentials integrity of visual pathways are estimated, that is actually in lesions of occipital and posterior temporal lobes. Accuracy of visual evoked potentials reaches 94 %. In contrast to mapping of visual pathways method is more unbiassed because is not founded on subjective patient's feelings and can be applied in general anesthesia.Neuromonitoring's usage increases extent of eloquent tumor resection in 2 to 5 times and decreases the number of permanent neurological deficit in 2 times after surgery.Accuracy of neuromonitoring decreases in reoperations and in ischemic damage due to angiospasm. To maintain high predictive value of the method amount of monitoring muscles should be inverse proportionally to the density of subcortical pathways in area of resection.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"612 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116335541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary to M.J. Encarnacion's article “Functional outcome at 6 months of surgical traumatic brain injury: A single Caribbean Center pilot study”","authors":"А. Э. Талыпов","doi":"10.17650/1683-3295-2022-24-3-37-37","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-37-37","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"668 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132528252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of subdural hematoma volume: Comparative analysis of calculation methods","authors":"V. V. Vinogradov, B. S. Chubun, D. E. Alekseev, A. Rafaelyan, K. A. Dikikh, D. V. Svistov","doi":"10.17650/1683-3295-2022-24-3-23-31","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-23-31","url":null,"abstract":"Background. Accurate calculation of the volume of subdural hematomas of traumatic, vascular, and other origins during diagnosis is complicated which leads to difficulties in selection of optimal tactics of neurosurgical treatment. Aim. To preform comparative analysis of accuracy of different methods of subdural hematoma volume calculations to increase the quality of evaluation of the results of radiological methods in selection of surgical tactics.Materials and methods. Data from preoperative computed tomography of 20 patients (15 men and 5 women between the ages of 20 and 60 years) with confirmed diagnosis of subdural hematoma who were examined and treated at the Neurosurgery Clinic of the Kirov Military Medical Academy were used. Four groups were formed based of the calculation method: two groups using formulas for volume of ellipsoid or convexo-concave lens (the shape most accurately representing the shape of subdural hematoma); electronic algorithm of volume calculation (Gamma MultiVox D2 software, Gammamed-Soft, Russia); control method (manual sectional calculation of areas of the formed structures with subsequent summation).Results. Deviations between the obtained values varied between +18 and -16 %. Deviations for calculations using ellipsoid volume formula were +46 and -19 %; using convexo-concave lens formula +38 and -35 %, respectively. Electronic calculation algorithm (Gamma MultiVox D2) showed the best accuracy compared to other methods including the control method.Conclusions. Comparative analysis of the accuracy of the studied methods of calculation of subdural hematoma volume showed that median results are statistically similar which allows for selection and use of these methods in accordance with the neurosurgeon's preferences.Study of the algorithm based on ellipsoid volume shows low specificity of this method, comparatively high deviations of the results from the true value with a trend toward overprediction.Calculation using volume of convexo-concave lens showed intermediate result if the shape of the hematoma corresponded to the ideal chape of a figure enclosed between two segments of a sphere. In cases where the shape did not correspond to the convexo-concave lens, both overprediction and underprediction of hematoma volume were observed.Calculations using the Gamma MultiVox D2 software showed the highest accuracy, lowest range of deviation from the control data, best versatility, independence from both the shape and location of the subdural hematoma, as well as selection of a section used in other algorithms for the measurements.It should be noted that accuracy of determination of subdural hematoma volume by the studied methods is directly proportional to time necessary for calculation.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131860506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-functioning ventricular catheter as a cause of brain abscess in a child: case report","authors":"S. S. Gaibov, I. A. Zacharchyk, A. S. Serobyan, E. V. Zacharchyk, D. P. Vorobyev, R. Kim","doi":"10.17650/1683-3295-2022-24-3-68-72","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-68-72","url":null,"abstract":"Introduction. The occurrence of a brain abscess caused by a non-functioning ventricular catheter is a rare complication. This approach can be considered a preventive measure for the occurrence of infectious complications. Klebsiella pneumoniae, as an etiological factor in the occurrence of brain abscess, is relatively rare according to literature.Aim. To present our experience of treating a child with hydrocephalus who developed a brain abscess caused by a nonfunctioning ventricular catheter.Materials and methods. The material for the study was the clinical history of a 4-year-old patient with a brain abscess caused by a non-functioning ventricular catheter left after the replacement of the shunt system.Results. The prevention of such a complication is the complete removal of the elements of the ventriculoperitoneal shunting during its replacement. When an abscess is formed, the most appropriate method is its open removal along with a non-functioning catheter, since this allows the pathological focus to be sanitized as much as possible. This approach can be considered a preventive measure for the occurrence of infectious complications in the future. If a condition occurs when there is a combination of a brain abscess against the background of a non-functioning catheter, SPS and there are no inflammatory changes in the cerebrospinal fluid, it is advisable to remove the brain abscess along with the capsule and catheter, as well as removing the peritoneal catheter from the abdominal cavity. This tactic is also justified when the total removal of the abscess capsule is impossible, or there are already inflammatory changes in the cerebrospinal fluid and it is necessary to sanitize it.Of great clinical interest is also the study of the microbiological aspects of this pathology. Klebsiella pneumoniae, which was isolated during a microbiological study in this clinical example, as an etiological factor in the occurrence of a brain abscess, is rare according to the literature.Conclusion. The problem of the occurrence and treatment of infectious complications after liquor-reshunting operations during hydrocephalus is an urgent task in neurosurgery. Based on the analysis of the literature, it can be said that the rarity of publications on this topic makes even individual reports relevant, and today there is no way to propose a specific strategy for a non-functioning ventricular catheter.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"abs/2301.10807 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117308839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of tumors of the supplementary motor area","authors":"I. M. Alekseev, A. Zuev","doi":"10.17650/1683-3295-2022-24-3-90-99","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-90-99","url":null,"abstract":"Background. The supplementary motor area is a part of the medial frontal cortex, that is located just anterior to the primary motor cortex entirely within the interhemispheric fissure. This area belongs traditionally to the secondary motor cortex and perhaps it is the least studied motor region of the brain. While functions and symptoms of a damage to the primary motor and the premotor cortex areas have been well known and described for a long time, study of the supplementary motor area has been limited to fundamental neuroimaging and electrophysiological researches, and a practical side of the issue and clinical significance of this region remained outside the interest of researchers.Aim. To present the anatomical and functional features of the supplementary motor area, the clinical symptoms of its lesion, to analyze all the data available today and aspects of surgical treatment of tumors in this region.Materials and methods. A search in scientific databases (PubMed, etc.) led to the selection and analysis of sixty-two literary sources. The review is mainly devoted to the aspects and risk factors of surgical treatment of pathologies localized in this region.Results. According to its anatomical and functional characteristics, the supplementary motor area is a heterogeneous region - it has two separate subregions in it. In addition to the motor function of the supplementary motor area, its role has also been reliably established in the implementation of working memory processes, language, perceptual, cognitive and other functions. Such a number of functions performed by the supplementary motor area is associated with numerous neural connections of this area. For example, the frontal aslant tract has been described recently, and it connects medial part of the superior frontal gyrus with the pars opercularis of the inferior frontal gyrus. This tract, apparently, is associated with the implementation of language function in the dominant hemisphere and function of working memory in the non-dominant hemisphere.When the supplementary motor area is affected, various neurological motor and speech symptoms can occur, in particular, the supplementary motor area syndrome, which is characterized by the development of akinetic mutism in patients and, in most cases, is completely reversible within a few days or months. Among all pathologies in this area, tumors are most common, especially gliomas, which can also manifest themselves with various clinical symptoms both in the preoperative and postoperative periods.Conclusion. Critically important preoperative planning, informing the patient about the spatio-temporal picture of the predicted postoperative clinical disorders and the timing of rehabilitation are critically important. It is recommended to use methods of intraoperative neuronavigation, as well as intraoperative neurophysiological monitoring. It is necessary to further study the supplementary motor area and the peculiarities of its surgery in order to ","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127736166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities of microsurgical training using a stereomicroscope and simple instruments","authors":"K. Babichev, A. Stanishevskiy, R. S. Martynov, D. V. Svistov","doi":"10.17650/1683-3295-2022-24-3-38-45","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-38-45","url":null,"abstract":"Background. Modern neurosurgery requires the surgeon to be skilled in microsurgical techniques to be able to operate efficiency and safety. Maintaining and developing these skills is one of main goal for neurosurgery. Optimal use of simple models for microsurgical techniques. For this purpose, we use an stereomicroscope and simple microinstruments to enable training without interruption from the main activity or at home.Aim. To introduce a microneurosurgery training based on use of stereomicroscope and simple microinstruments that can be used for daily training.Materials and methods. Simple microinstruments and stereomicroscope were used for anastomosis and suturing training. All equipment and tools were purchased on the AliExpress online trading platform. We suture neighboring fibers of the gauze with 9/0-12/0 nylon under fixed and highest magnification. Chicken blood vessels were used as a material for anastomosis training. A long segment of blood vessel from the proximal brachial artery to the distal radial artery was used for anastomosis. End-to-side anastomosis was practiced first, and the training continued with end-to-end anastomosis of the appropriate segments. Also, we used homemade box made of LEGO for training dexterity and maneuverability in the limited and deep field. Progress in changing microsurgical skills was assessed by the duration and quality of suturing and anastomoses.Results. The instruments used for these models were affordable, simple and easy to use. The simple, but the same time effective training, is the suture neighboring fibers of the gauze. Daily training allowed us improve the skills of anastomosis reducing time for anastomosis end-to-side from 40 min to 22 min 40 sec. The same results we noticed using suture neighboring fibers of the gauze, reducing time of exercises by 15 min. This training system is somewhat of a drawback compared to the simulation of a real clinical setting. However, due to the extremely easy accessibility and accessibility, the stereomicroscope and simple instrument allow us to use them for daily training. This resulted in a steep learning curve of the technique.Conclusion. This study suggests an effective and feasible method for microneurosurgical training using stereomicroscope and simple microinstruments. The improvement of our manual skills, marked by constant training, testifies about the necessity of microsurgical training both in the training of neurosurgeons and in the future.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131851328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcome at 6 months of surgical traumatic brain injury: A single Caribbean Center pilot study","authors":"M. Encarnacion, I. P. Baez, J. Paulino, R. E. Barrientos Castillo, R. Nurmukhametov, I. E. Efe","doi":"10.17650/1683-3295-2022-24-3-32-36","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-32-36","url":null,"abstract":"Background. This is the first prospective study that evaluates the functional outcome after a surgical procedure secondary to a traumatic brain injury, in a single center, in Dominican Republic.Aim. To determine the functional status of surgically treated patients 6 months post-trauma, the relative risk of poor prognosis and association of functional status with the predictive variables of the International Mission for Prognosis and Analysis of Clinical Trials in traumatic brain injury.Materials and methods. A prospective, longitudinal study was conducted in a cohort of 22 patients surgically treated for a traumatic intracranial injury at Dr. Ney Arias Lora Traumatology Hospital in Dominican Republic. We applied the International Mission for Prognosis and Analysis of Clinical Trials calculator, (pupillary response, hemoglobin, hypoxia, age, motor response, computed tomography lesion, hypotension, etc.) prior to surgery and the Extended Glasgow Outcome Scale 6 month after surgery to determine the functional outcome. The International Mission for Prognosis and Analysis of Clinical Trials form was modified by adding preoperative glucocorticosteroids and rehabilitation therapy. The SPSS database (15.0 version, Chicago Il.) was used. Central tendency measures and Fisher's test were applied. Thus, p ≤0.05 with a 95 % confidence interval was considered statistically significant.Results. The predictive variables associated with a poor prognosis were motor response (p = 0.01), hypoxia and hypotension (p = 0.05). Alterations in motor response was associated with increased morbidity and mortality (RR: 10; 95 % CI: 3-22). Normal flexion was found in all patients with good recovery (p = 0.04).Conclusion. As a result, 67 % of patients had a good functional result (moderate disability and good recovery). Mortality was 23 %. Preoperative motor response is a powerful prognostic factor in traumatic brain injury.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122554354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcircular occlusion of the posterior inferior cerebellar artery aneurysm: a case report","authors":"V. Kiselev, E. D. Anisimov, D. Galaktionov","doi":"10.17650/1683-3295-2022-24-3-61-67","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-61-67","url":null,"abstract":"Background. Aneurysms of the posterior inferior cerebellar artery are a rare vascular pathology among both intracranial aneurysms and aneurysms of the vertebrobasilar territory. Due to the proximity of the caudal nerves, microsurgical treatment may be accompanied by the development of bulbar disorders, so endovascular occlusion is the method of choice for aneurysms of origin of the posterior inferior cerebellar artery. However, anatomical features in the vertebrobasilar territory and individual characteristics of the aneurysm often make antegrade catheterization of the artery difficult. In such cases, alternative methods should be used, one of which is transcircular access through the posterior communicating artery.Aim. To present the result of endovascular treatment of a patient with complex aneurysm of the posterior inferior cerebellar artery, performed with through a transcirculation approach.Materials and methods. The article analyzes the results of the patient's treatment at the Federal Neurosurgical Center (Novosibirsk) of the Ministry of Health of Russia. Surgical intervention consisted of endovascular occlusion of the aneurysm of the right posterior inferior cerebellar artery with stent-assistance. A specific feature of this case was the acute angle of posterior inferior cerebellar artery discharge from the vertebral artery, which significantly hampered the direct endovascular catheterization of the aneurysm and increased the risks of intraoperative complications. A transcirculation approach through the posterior communicating artery was chosen as an access. After discharge, the patient underwent a follow-up examination 6 months later.Results. Excellent clinical and angiographic results (occlusion classification (RROC - Raymond Roy I) were noted both at the time of the patient's discharge and during follow-up based on the results of control angiograms.Conclusion. The use of transcirculation endovascular access to the proximal aneurysm of the posterior inferior cerebellar artery made it possible to obtain a good result of surgical treatment.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131290796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organization and current understanding of speech function of the brain: literature review","authors":"A. M. Ismailov, A. Zuev","doi":"10.17650/1683-3295-2022-24-3-80-89","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-80-89","url":null,"abstract":"Introduction. History of study of speech function of the brain has started in the middle of the 19th century. First studies discovered cortical representations of speech in the brain, proposed different theories of speech function structure. Technological breakthroughs of the 20th century allowed to study not only cortical representations of speech function but also complex connections of the white matter important for practical work of neurosurgeons. Deeper studies of speech led to revisions of the old theories, proposals of new theories. Current study methods showed complexity of speech organization, multifunctionality of speech tracts.Aim. To analyze and systemize historical and current scientific data on organization of speech function of the brain, as well as methods of preoperative evaluation and intraoperative techniques of identification of speech zones in the cerebral cortex.Materials and methods. As a results of data search in the PubMed database, 77 articles published between 1954 and 2020 were selected.Results. Studies of characteristics of speech function are widely represented in current scientific literature, and their number grows every year. Some researchers study individual speech aspects: cortical representation, individual speech tracts. Others deal with general consequences of speech impediments after tumor resection, strokes, traumas. The authors cross-linked and systemized numerous data from different sources of information.Conclusion. Speech function of the brain is one of the most complexly organized aspects of the higher nervous function, and it is being actively researched worldwide. Implementation of such revolutionary examination techniques as intraoperative mapping of the cerebral cortex, magnetic resonance tractography provided a plethora of new information on morphofunctional characteristics of speech function. Further studies of speech function of the brain and systematization of the obtained data are necessary for deeper understanding of the details of speech organs' functionality. Advances in this direction will help surgeons avoid unwanted neurological deficit in communication ability, one of the most important abilities, and improve patients' quality of life.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122416836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal aneurysm of median artery of the corpus callosum: case report","authors":"V. Feniksov, R. Kambiev, D. A. Nikolaev, D. S. Glukhov","doi":"10.17650/1683-3295-2022-24-3-52-60","DOIUrl":"https://doi.org/10.17650/1683-3295-2022-24-3-52-60","url":null,"abstract":"Background. There are many variations of the developmental pathology of the anterior communicating artery with such forms as aplasia, hypoplasia, duplication, triplication and etc. The presence of the median artery of the corpus callosum is a rare pathology of the anterior part of the circle of Willis and, according to the literature the frequency is 4,5-14,2 %. About 81 % of cases, the occurrence of the median artery of the corpus callosum is combined with the presence of anterior communicating artery trifurcation. The incidence of distal anterior cerebral artery aneurysms has been estimated to be from 1.5 to 9.0 % of all intracranial aneurysms, while the median artery of the corpus callosum is rarely mentioned in the literature, the author of the article did not find cases of descriptions of distal anterior cerebral artery aneurysms in the PubMed. It should be borne in mind that when conducting radiation diagnostics, up to one third of all cases of the median artery of the corpus callosum remain undetected.Aim. To present a clinical case of successful surgical treatment of a distal aneurysm of the median artery of the corpus callosum in a patient K., 39 years old, performed using surgical neuronavigation.Materials and methods. A case report of the successful surgical management of 39-year-old patient with distal aneurysm of the median artery of the corpus callosum at the Sity Clinical Hospital No. 1 named after N.I. Pirogov of Moscow Healthcare Department. The patient had a saccular aneurysm of A2-3 segments of the median artery of the corpus callosum.Results. A microsurgical clipping of the distal aneurysm of the median artery of the corpus callosum using the right interhemispheric approach through the bifrontal craniotomy with a neuronavigational assistance was performed. The selective angiography of the intracranial arteries (10 mo after the clipping) no detected the signs of recanalization of the aneurysm.Conclusion. The deeper placement of the median artery of the corpus callosum (as compared with the anterior cerebral arteries) and the missing of anatomical landmarks complicates the surgical approach to the distal aneurysms of the median artery of the corpus callosum. The instrumentation of neuronavigation made it possible to perform minimal craniotomy and safe encephalotomy of the medial aspects of the frontal lobes (at site of the genu the corpus callosum) and reduce the operating time.","PeriodicalId":197162,"journal":{"name":"Russian journal of neurosurgery","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126550731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}