首页 > 最新文献

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko最新文献

英文 中文
[The FOUR scale in assessing patients with acute cerebral insufficiency]. [评价急性脑功能不全患者的FOUR量表]。
Q4 Medicine Pub Date : 2026-01-01 DOI: 10.17116/neiro20269001157
O Z Arslanov, A A Belkin, A V Kulikov, N S Nagaev

Treatment and rehabilitation of patients with acute cerebral insufficiency necessitate critical objectives (assessment of brain damage severity and prediction of potential outcomes). Despite the role of this stage, current consciousness assessment methods often lack sufficient accuracy and objectivity. A promising approach is the Full Outline of UnResponsiveness scale (FOUR) providing objective patient evaluation compared to traditional Glasgow Coma scale.

Objective: To evaluate clinical significance of the FOUR scale for patients with cerebral insufficiency.

Material and methods: A prospective single-center study included 200 patients with acute cerebral insufficiency. Analysis employed ROC curves, logistic regression and correlation methods.

Results: The FOUR scale demonstrated high prognostic accuracy in comatose patients (AUC=0.944 vs. 0.742 for GCS, p< 0.001). Strong correlations were found between FOUR scores and GOS grades (rs=0.7546, p<0.0001), as well as prediction of mortality (OR=3.4, 95% CI 2.1-5.6). For patients with chronic consciousness disorders, the FOUR scale showed benefits (AUC=0.936 vs. 0.745 for GCS).

Conclusion: The FOUR scale represents an optimal monitoring tool for patients with cerebral insufficiency.

急性脑功能不全患者的治疗和康复必须达到关键目标(评估脑损伤严重程度和预测潜在结果)。尽管这一阶段的作用,目前的意识评估方法往往缺乏足够的准确性和客观性。与传统的格拉斯哥昏迷量表相比,一种有希望的方法是提供客观的患者评估的无反应性量表(FOUR)。目的:评价FOUR量表对脑供血不足患者的临床意义。材料和方法:一项前瞻性单中心研究纳入了200例急性脑功能不全患者。分析采用ROC曲线、logistic回归及相关分析方法。结果:FOUR量表在昏迷患者中显示出较高的预后准确性(AUC=0.944,而GCS为0.742,p 0.001)。发现FOUR评分与GOS分级(rs=0.7546, p0.0001)以及预测死亡率(OR=3.4, 95% CI 2.1-5.6)之间存在强相关性。对于慢性意识障碍患者,FOUR量表显示出益处(AUC=0.936 vs. 0.745)。结论:FOUR量表是脑供血不足患者的最佳监测工具。
{"title":"[The FOUR scale in assessing patients with acute cerebral insufficiency].","authors":"O Z Arslanov, A A Belkin, A V Kulikov, N S Nagaev","doi":"10.17116/neiro20269001157","DOIUrl":"https://doi.org/10.17116/neiro20269001157","url":null,"abstract":"<p><p>Treatment and rehabilitation of patients with acute cerebral insufficiency necessitate critical objectives (assessment of brain damage severity and prediction of potential outcomes). Despite the role of this stage, current consciousness assessment methods often lack sufficient accuracy and objectivity. A promising approach is the Full Outline of UnResponsiveness scale (FOUR) providing objective patient evaluation compared to traditional Glasgow Coma scale.</p><p><strong>Objective: </strong>To evaluate clinical significance of the FOUR scale for patients with cerebral insufficiency.</p><p><strong>Material and methods: </strong>A prospective single-center study included 200 patients with acute cerebral insufficiency. Analysis employed ROC curves, logistic regression and correlation methods.</p><p><strong>Results: </strong>The FOUR scale demonstrated high prognostic accuracy in comatose patients (AUC=0.944 vs. 0.742 for GCS, <i>p<</i> 0.001). Strong correlations were found between FOUR scores and GOS grades (rs=0.7546, <i>p<</i>0.0001), as well as prediction of mortality (OR=3.4, 95% CI 2.1-5.6). For patients with chronic consciousness disorders, the FOUR scale showed benefits (AUC=0.936 vs. 0.745 for GCS).</p><p><strong>Conclusion: </strong>The FOUR scale represents an optimal monitoring tool for patients with cerebral insufficiency.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"90 1","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158605","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}
引用次数: 0
[Overall survival prediction scale for patients with grade 4 brain astrocytoma]. [4级脑星形细胞瘤患者总生存预测量表]。
Q4 Medicine Pub Date : 2026-01-01 DOI: 10.17116/neiro20269001165
P V Datsenko, A S Chuguev, V A Gerasimov, A D Kaprin

Objective: To create a prognostic scale for overall survival in grade 4 astrocytomas based on molecular biological data.

Material and methods: After morphological confirmation of WHO grade 4 astrocytoma (2021 WHO classification criteria), 175 patients were classified as GBM (grade 4) without IDH1 mutations; IDH1 mutation was detected in 25 patients (12.5%; G4 astrocytoma). Molecular biological analysis of IDH1 gene mutations and MGMT promoter methylation was performed in 194 (97%) patients.

Results: To study concomitant significance of IDH1 mutation and MGMT promoter methylation in grade 4 gliomas, we created the IDH1/MGMT index(0 - IDH1+/MGMT+; 1 - IDH1/MGMT (+/-); 2 - IDH1-/MGMT-). This predictor was digitized in 194 patients who underwent molecular analysis. The most informative classification matrix according to overall survival was as follows: IDH1/MGMT index (OR=1.712; p=0.0004), REP (OR=1.971; p=0.0001), functional status before microsurgery at the lowest possible level (OR=1.797; p=0.001). Simple summation of numerical indicators for factors 1-3 in each patient allowed us to identify 5 prognostic classes: class 1 (0-1 points), class 2 (2 points), class 3 (3 points), class 4 (4 points), class 5 (5 points). Log-rank criterion for Kaplan-Meier survival curves revealed significant differences between classes (χ2=55.780; p<0.001). The median survival rates were 71.5, 42.3, 23.6, 17.4 and 8.1 months, respectively. Significant differences in survival were noted between almost all neighboring classes: classes 1-2 (χ2=3.21; p=0.073), classes 2-3 (χ2=5.77; p=0.016), classes 3-4 (χ2=6.03; p=0.014), classes 4-5 (χ2=11.97; p=0.0005). In "classes 1-3" in prognostic scale, median overall survival was 44.98 months (n=53; 95% CI: 20.5-69.4) for 3 Gy fractionation regimen and only 23.23 months (n=78; 95% CI: 17.3-29.1; χ2=9.28; p=0.002) for 2 Gy regimen. There were other results for classes 4-5. Median overall survival for 3 and 2 Gy fractionation regimens was low: 17.41 (n=28; 95% Cl: 13.8-21.0) and 15.83 months (n=41; 95% Cl: 11.7-20.0; -2=0.59; p=0.442), respectively.

Conclusion: The new prognostic scale for overall survival, based on molecular data, allows not only to predict further course of disease, but also to recommend irradiation 3 Gy for patients in classes 1-3 as an alternative to radiotherapy.

目的:建立基于分子生物学数据的4级星形细胞瘤总生存期预后量表。材料与方法:经WHO分级4级星形细胞瘤(2021 WHO分级标准)形态学确认,175例患者为GBM(4级),无IDH1突变;25例(12.5%;G4星形细胞瘤)检测到IDH1突变。对194例(97%)患者进行IDH1基因突变和MGMT启动子甲基化的分子生物学分析。结果:为了研究IDH1突变和MGMT启动子甲基化在4级胶质瘤中的伴随意义,我们创建了IDH1/MGMT指数(0 - IDH1+/MGMT+; 1 - IDH1/MGMT (+/-);2 - idh1 -/ mgmt -)。对194名接受分子分析的患者进行了数字化预测。根据总生存率,最具信息量的分类矩阵如下:IDH1/MGMT指数(OR=1.712; p=0.0004), REP (OR=1.971; p=0.0001),显微手术前功能状态尽可能低(OR=1.797; p=0.001)。对每位患者1-3个因素的数值指标进行简单汇总,我们可以确定5个预后等级:1级(0-1分)、2级(2分)、3级(3分)、4级(4分)、5级(5分)。Kaplan-Meier生存曲线的Log-rank标准显示,组别(χ2=55.780; pχ2=3.21; p=0.073)、组别2-3 (χ2=5.77; p=0.016)、组别3-4 (χ2=6.03; p=0.014)、组别4-5 (χ2=11.97; p=0.0005)之间存在显著差异。在预后量表的“1-3级”中,3gy分治方案的中位总生存期为44.98个月(n=53, 95% CI: 20.5 ~ 69.4),而2gy分治方案的中位总生存期仅为23.23个月(n=78, 95% CI: 17.3 ~ 29.1, χ2=9.28, p=0.002)。4-5班还有其他结果。3 Gy和2 Gy分治方案的中位总生存期较低,分别为17.41个月(n=28; 95% Cl: 13.8-21.0)和15.83个月(n=41; 95% Cl: 11.7-20.0; -2=0.59; p=0.442)。结论:基于分子数据的新的总生存预后量表不仅可以预测疾病的进一步病程,而且还可以推荐1-3级患者接受3gy的放疗,作为放疗的替代方案。
{"title":"[Overall survival prediction scale for patients with grade 4 brain astrocytoma].","authors":"P V Datsenko, A S Chuguev, V A Gerasimov, A D Kaprin","doi":"10.17116/neiro20269001165","DOIUrl":"https://doi.org/10.17116/neiro20269001165","url":null,"abstract":"<p><strong>Objective: </strong>To create a prognostic scale for overall survival in grade 4 astrocytomas based on molecular biological data.</p><p><strong>Material and methods: </strong>After morphological confirmation of WHO grade 4 astrocytoma (2021 WHO classification criteria), 175 patients were classified as GBM (grade 4) without <i>IDH1</i> mutations; <i>IDH1</i> mutation was detected in 25 patients (12.5%; G4 astrocytoma). Molecular biological analysis of <i>IDH1</i> gene mutations and MGMT promoter methylation was performed in 194 (97%) patients.</p><p><strong>Results: </strong>To study concomitant significance of <i>IDH1</i> mutation and MGMT promoter methylation in grade 4 gliomas, we created the <i>IDH1</i>/MGMT index(0 - <i>IDH1</i>+/MGMT+; 1 - <i>IDH1</i>/MGMT (+/-); 2 - <i>IDH1</i>-/MGMT-). This predictor was digitized in 194 patients who underwent molecular analysis. The most informative classification matrix according to overall survival was as follows: <i>IDH1</i>/MGMT index (OR=1.712; <i>p</i>=0.0004), REP (OR=1.971; <i>p</i>=0.0001), functional status before microsurgery at the lowest possible level (OR=1.797; <i>p</i>=0.001). Simple summation of numerical indicators for factors 1-3 in each patient allowed us to identify 5 prognostic classes: class 1 (0-1 points), class 2 (2 points), class 3 (3 points), class 4 (4 points), class 5 (5 points). Log-rank criterion for Kaplan-Meier survival curves revealed significant differences between classes (<i>χ</i><sup>2</sup>=55.780; <i>p</i><0.001). The median survival rates were 71.5, 42.3, 23.6, 17.4 and 8.1 months, respectively. Significant differences in survival were noted between almost all neighboring classes: classes 1-2 (<i>χ</i><sup>2</sup>=3.21; <i>p</i>=0.073), classes 2-3 (<i>χ</i><sup>2</sup>=5.77; <i>p</i>=0.016), classes 3-4 (<i>χ</i><sup>2</sup>=6.03; <i>p</i>=0.014), classes 4-5 (<i>χ</i><sup>2</sup>=11.97; <i>p</i>=0.0005). In \"classes 1-3\" in prognostic scale, median overall survival was 44.98 months (<i>n</i>=53; 95% CI: 20.5-69.4) for 3 Gy fractionation regimen and only 23.23 months (<i>n</i>=78; 95% CI: 17.3-29.1; <i>χ</i><sup>2</sup>=9.28; <i>p</i>=0.002) for 2 Gy regimen. There were other results for classes 4-5. Median overall survival for 3 and 2 Gy fractionation regimens was low: 17.41 (<i>n</i>=28; 95% Cl: 13.8-21.0) and 15.83 months (<i>n</i>=41; 95% Cl: 11.7-20.0; -2=0.59; <i>p</i>=0.442), respectively.</p><p><strong>Conclusion: </strong>The new prognostic scale for overall survival, based on molecular data, allows not only to predict further course of disease, but also to recommend irradiation 3 Gy for patients in classes 1-3 as an alternative to radiotherapy.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"90 1","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158622","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}
引用次数: 0
[Facial neuropathy in early postoperative period after resection of cerebellopontine angle tumor using various modalities of intraoperative neurophysiological monitoring: a systematic review and meta-analysis]. [多种方式术中神经生理监测在桥小脑角肿瘤切除术后早期面神经病变中的应用:一项系统综述和meta分析]。
Q4 Medicine Pub Date : 2026-01-01 DOI: 10.17116/neiro202690011100
E G Seliverstova, M V Sinkin, A A Grin

Objective: To analyze the incidence of facial neuropathy after microsurgical resection of cerebellopontine angle (CPA) tumors using various intraoperative neurophysiological monitoring (IONM) scenarios.

Material and methods: We analyzed 792 articles from PubMed, Google Scholar, Web of Science, and e-library databases and selected 35 eligible studies. There were 4.657 patients including 1.173 ones with facial neuropathy after CPA tumor resection. Statistical analysis was performed using OpenMeta Analyst software. Differences were significant at p< 0.05.

Results: The pooled incidence of postoperative facial neuropathy after CPA tumor resection was 28.9% (95% CI: 23.3% - 34.6%). In case of multimodal IONM, this value decreased to 23.5% (95% CI: 17.9% - 29.2%). This demonstrates significant effectiveness of this approach compared to direct facial nerve stimulation and resting EMG monitoring.

目的:分析不同术中神经生理监测(IONM)场景下桥小脑角(CPA)肿瘤显微手术切除后面神经病变的发生率。材料和方法:我们分析了来自PubMed、b谷歌Scholar、Web of Science和电子图书馆数据库的792篇文章,并选择了35篇符合条件的研究。CPA肿瘤切除术后出现面神经病变的患者有1.173例,共4657例。使用OpenMeta Analyst软件进行统计分析。差异有统计学意义,p< 0.05。结果:CPA肿瘤切除术后面神经病变的总发生率为28.9% (95% CI: 23.3% ~ 34.6%)。在多模态IONM的情况下,这个值下降到23.5% (95% CI: 17.9% - 29.2%)。这表明,与直接面神经刺激和静息肌电图监测相比,这种方法具有显著的有效性。
{"title":"[Facial neuropathy in early postoperative period after resection of cerebellopontine angle tumor using various modalities of intraoperative neurophysiological monitoring: a systematic review and meta-analysis].","authors":"E G Seliverstova, M V Sinkin, A A Grin","doi":"10.17116/neiro202690011100","DOIUrl":"https://doi.org/10.17116/neiro202690011100","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the incidence of facial neuropathy after microsurgical resection of cerebellopontine angle (CPA) tumors using various intraoperative neurophysiological monitoring (IONM) scenarios.</p><p><strong>Material and methods: </strong>We analyzed 792 articles from PubMed, Google Scholar, Web of Science, and e-library databases and selected 35 eligible studies. There were 4.657 patients including 1.173 ones with facial neuropathy after CPA tumor resection. Statistical analysis was performed using OpenMeta Analyst software. Differences were significant at <i>p</i>< 0.05.</p><p><strong>Results: </strong>The pooled incidence of postoperative facial neuropathy after CPA tumor resection was 28.9% (95% CI: 23.3% - 34.6%). In case of multimodal IONM, this value decreased to 23.5% (95% CI: 17.9% - 29.2%). This demonstrates significant effectiveness of this approach compared to direct facial nerve stimulation and resting EMG monitoring.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"90 1","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158539","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}
引用次数: 0
[Complexity index of microsurgical treatment of unruptured cerebral aneurysms]. [未破裂脑动脉瘤显微外科治疗复杂性指数]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro20258903128
F V Grebenev, Sh Sh Eliava, An N Konovalov, G V Danilov, Yu V Pilipenko, A S Kheyreddin, O B Belousova, D N Okishev, D E Semenov, G Sh Mamedbekova, Yu V Koledova

Background. Although the concepts of «complex aneurysm» and «technically complex aneurysm» are widely used at present, there is no generally accepted definition. Moreover, the criteria are often subjective. Depending on the parameters included, complex aneurysms comprise 5-9.7% of all patients with cerebral aneurysms [1, 2]. Complex aneurysms have higher risk of complications, whose accurate assessment is difficult. In case of unruptured aneurysms, analysis of this risk is of particular importance.

Objective: To develop the microsurgical complexity index in the treatment of unruptured aneurysms for objective assessment of complexity of microsurgical treatment and prediction of complications.

Material and methods: The study included 850 patients with a single unruptured aneurysm who underwent microsurgical treatment. Postoperative outcomes and incidence of various complications were analyzed depending on anatomical and morphological characteristics of aneurysm.

Results: We developed the microsurgical complexity index for the treatment of unruptured aneurysms and appropriate web application (www.isam.rf). Patients with severe neurological disorders at discharge comprised 2.5%, and mortality rate was 0.47%. New neurological deficit after surgery occurred in 9.3% of cases. Moderate and severe in-hospital complications occurred in 8.6% of cases. Non-radical exclusion of aneurysm was observed in 4.1% of cases. In case of complexity index «0», the incidence of various complications was lower compared to the group as a whole by 1.8-5.7%, index «1» - by 0.1-2.7%, index «2». The incidence of in-hospital complications Clavien-Dindo grade III-V was lower by 0.3%. The incidence of functional status mRS score 4-6 did not differ from the group as a whole, and the incidence of other complications was higher by 0.9-3.6%. In case of complexity index «3», the incidence of all complications was higher by 0.6-12.8%, index «4» - by 10.8-22.6%, index «5-6» - by 3.9-22.7%.

Conclusion: Original index may be valuable for more objective assessment of the risks of microsurgical treatment of aneurysms depending on anatomical and morphological characteristics and stratification of aneurysms according to their complexity. Aneurysms with index ≥3 may be classified as a group of complex aneurysms.

背景。虽然目前“复杂动脉瘤”和“技术上复杂动脉瘤”的概念被广泛使用,但没有一个普遍接受的定义。此外,这些标准往往是主观的。根据参数的不同,复杂动脉瘤占所有脑动脉瘤患者的5-9.7%[1,2]。复杂动脉瘤有较高的并发症风险,难以准确评估。在未破裂动脉瘤的情况下,分析这种风险是特别重要的。目的:建立显微外科治疗未破裂动脉瘤复杂性指数,以客观评价显微外科治疗的复杂性,预测并发症的发生。材料和方法:该研究包括850例接受显微手术治疗的单个未破裂动脉瘤患者。根据动脉瘤的解剖形态特点,分析其术后结局及各种并发症的发生率。结果:我们建立了治疗未破裂动脉瘤的显微外科复杂性指数和适当的web应用(www.isam.rf)。出院时出现严重神经障碍的患者占2.5%,死亡率为0.47%。9.3%的病例术后出现新的神经功能缺损。中重度院内并发症发生率为8.6%。非根治性动脉瘤排除率为4.1%。在复杂性指数为“0”的情况下,各种并发症的发生率比整个组低1.8-5.7%,指数为“1”- 0.1-2.7%,指数为“2”。院内并发症Clavien-Dindo III-V级发生率降低0.3%。功能状态mRS评分4-6的发生率与对照组整体无差异,其他并发症发生率高0.9-3.6%。在复杂性指数为“3”的情况下,所有并发症的发生率高0.6-12.8%,指数为“4”的发生率高10.8-22.6%,指数为“5-6”的发生率高3.9-22.7%。结论:根据动脉瘤的解剖形态特征和复杂程度对动脉瘤进行分层,原创性指标可更客观地评价显微手术治疗的风险。指数≥3的动脉瘤可归为一组复杂动脉瘤。
{"title":"[Complexity index of microsurgical treatment of unruptured cerebral aneurysms].","authors":"F V Grebenev, Sh Sh Eliava, An N Konovalov, G V Danilov, Yu V Pilipenko, A S Kheyreddin, O B Belousova, D N Okishev, D E Semenov, G Sh Mamedbekova, Yu V Koledova","doi":"10.17116/neiro20258903128","DOIUrl":"https://doi.org/10.17116/neiro20258903128","url":null,"abstract":"<p><p>Background. Although the concepts of «complex aneurysm» and «technically complex aneurysm» are widely used at present, there is no generally accepted definition. Moreover, the criteria are often subjective. Depending on the parameters included, complex aneurysms comprise 5-9.7% of all patients with cerebral aneurysms [1, 2]. Complex aneurysms have higher risk of complications, whose accurate assessment is difficult. In case of unruptured aneurysms, analysis of this risk is of particular importance.</p><p><strong>Objective: </strong>To develop the microsurgical complexity index in the treatment of unruptured aneurysms for objective assessment of complexity of microsurgical treatment and prediction of complications.</p><p><strong>Material and methods: </strong>The study included 850 patients with a single unruptured aneurysm who underwent microsurgical treatment. Postoperative outcomes and incidence of various complications were analyzed depending on anatomical and morphological characteristics of aneurysm.</p><p><strong>Results: </strong>We developed the microsurgical complexity index for the treatment of unruptured aneurysms and appropriate web application (www.isam.rf). Patients with severe neurological disorders at discharge comprised 2.5%, and mortality rate was 0.47%. New neurological deficit after surgery occurred in 9.3% of cases. Moderate and severe in-hospital complications occurred in 8.6% of cases. Non-radical exclusion of aneurysm was observed in 4.1% of cases. In case of complexity index «0», the incidence of various complications was lower compared to the group as a whole by 1.8-5.7%, index «1» - by 0.1-2.7%, index «2». The incidence of in-hospital complications Clavien-Dindo grade III-V was lower by 0.3%. The incidence of functional status mRS score 4-6 did not differ from the group as a whole, and the incidence of other complications was higher by 0.9-3.6%. In case of complexity index «3», the incidence of all complications was higher by 0.6-12.8%, index «4» - by 10.8-22.6%, index «5-6» - by 3.9-22.7%.</p><p><strong>Conclusion: </strong>Original index may be valuable for more objective assessment of the risks of microsurgical treatment of aneurysms depending on anatomical and morphological characteristics and stratification of aneurysms according to their complexity. Aneurysms with index ≥3 may be classified as a group of complex aneurysms.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"28-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188150","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}
引用次数: 0
[Intraoperative neurophysiological monitoring in surgery for spinal intramedullary tumors]. [术中神经生理监测在脊柱髓内肿瘤手术中的应用]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro202589031108
M O Kudymets, N A Konovalov, S V Kaprovoy, R A Onoprienko, A B Kozlova, Yu M Poluektov, N I Bychkovskii

Despite modern advances in neurosurgery, treatment of intramedullary spinal cord tumors is still associated with postoperative neurological impairment and high incidence of adverse outcomes. Intraoperative neurophysiological monitoring allows real-time functional assessment of spinal cord conduction pathways and accurate tumor resection. Currently, concomitant monitoring of somatosensory and motor evoked potentials, as well as D-wave is the most common. This excludes damage to both sensory and motor pathways. In modern literature, there are some differences in methods of intraoperative neurophysiological monitoring, such as sensitivity and specificity of the method, criteria of «alarm» during surgical treatment of intramedullary tumors and correlation of neurophysiological monitoring parameters with postoperative neurological status of patients.

尽管神经外科在现代取得了进展,髓内脊髓肿瘤的治疗仍然与术后神经功能障碍和高发生率的不良后果有关。术中神经生理监测可以实时评估脊髓传导通路的功能,准确切除肿瘤。目前,最常见的是同时监测体感和运动诱发电位,以及d波。这就排除了对感觉和运动通路的损害。在现代文献中,术中神经生理监测的方法存在一些差异,如方法的敏感性和特异性、髓内肿瘤手术治疗时的“报警”标准、神经生理监测参数与患者术后神经状态的相关性等。
{"title":"[Intraoperative neurophysiological monitoring in surgery for spinal intramedullary tumors].","authors":"M O Kudymets, N A Konovalov, S V Kaprovoy, R A Onoprienko, A B Kozlova, Yu M Poluektov, N I Bychkovskii","doi":"10.17116/neiro202589031108","DOIUrl":"https://doi.org/10.17116/neiro202589031108","url":null,"abstract":"<p><p>Despite modern advances in neurosurgery, treatment of intramedullary spinal cord tumors is still associated with postoperative neurological impairment and high incidence of adverse outcomes. Intraoperative neurophysiological monitoring allows real-time functional assessment of spinal cord conduction pathways and accurate tumor resection. Currently, concomitant monitoring of somatosensory and motor evoked potentials, as well as D-wave is the most common. This excludes damage to both sensory and motor pathways. In modern literature, there are some differences in methods of intraoperative neurophysiological monitoring, such as sensitivity and specificity of the method, criteria of «alarm» during surgical treatment of intramedullary tumors and correlation of neurophysiological monitoring parameters with postoperative neurological status of patients.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188153","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}
引用次数: 0
[Perioperative complications in surgery for craniosynostosis in children: a systematic review and meta-analysis]. [儿童颅缝闭锁手术围手术期并发症:系统回顾和荟萃分析]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro202589031114
B A Bashiryan, L A Satanin, O A Gadzhieva, G V Danilov, Yu V Strunina, I K Kokaeva, V A Tere

Objective: To study the structure, incidence and risk factors of perioperative complications in children with craniosynostosis (CS).

Material and methods: A systematic searching of data was performed for analysis of perioperative complications and adverse events following surgical correction of CS in patients younger 24 months.

Results. a: Systematic review included 33 manuscripts. The overall incidence of complications and adverse events was 9.8%. In patients after endoscopic surgeries, this rate was 7.2%, whereas open reconstructive surgeries were followed by 13.5% morbidity.

Conclusion: The most common surgical complications in pediatric craniosynostosis surgery were intraoperative blood loss requiring transfusion (35.7%), dural tears (3.8%), cerebrospinal fluid leaks (0.7%), hematomas (1.6%), and surgical site infections (1.6%). Non-surgical complications included non-surgical infections (1.1%), respiratory (1.2%) and neurological disturbances (0.5%). Fever (3.4%) is an undesirable phenomenon and can aggravate postoperative period after surgery for CS.

目的:探讨儿童颅缝闭锁(CS)围手术期并发症的结构、发生率及危险因素。材料与方法:系统检索资料,分析年龄小于24个月的CS术后围手术期并发症及不良事件。a:系统综述包括33篇稿件。并发症和不良事件的总发生率为9.8%。在内镜手术后的患者中,这一比例为7.2%,而开放重建手术后的发病率为13.5%。结论:儿童颅缝闭合术中最常见的手术并发症是术中出血需要输血(35.7%)、硬脑膜撕裂(3.8%)、脑脊液漏(0.7%)、血肿(1.6%)和手术部位感染(1.6%)。非手术并发症包括非手术感染(1.1%)、呼吸系统(1.2%)和神经系统障碍(0.5%)。发热(3.4%)是一种不良现象,可加重CS术后时间。
{"title":"[Perioperative complications in surgery for craniosynostosis in children: a systematic review and meta-analysis].","authors":"B A Bashiryan, L A Satanin, O A Gadzhieva, G V Danilov, Yu V Strunina, I K Kokaeva, V A Tere","doi":"10.17116/neiro202589031114","DOIUrl":"10.17116/neiro202589031114","url":null,"abstract":"<p><strong>Objective: </strong>To study the structure, incidence and risk factors of perioperative complications in children with craniosynostosis (CS).</p><p><strong>Material and methods: </strong>A systematic searching of data was performed for analysis of perioperative complications and adverse events following surgical correction of CS in patients younger 24 months.</p><p><strong>Results. a: </strong>Systematic review included 33 manuscripts. The overall incidence of complications and adverse events was 9.8%. In patients after endoscopic surgeries, this rate was 7.2%, whereas open reconstructive surgeries were followed by 13.5% morbidity.</p><p><strong>Conclusion: </strong>The most common surgical complications in pediatric craniosynostosis surgery were intraoperative blood loss requiring transfusion (35.7%), dural tears (3.8%), cerebrospinal fluid leaks (0.7%), hematomas (1.6%), and surgical site infections (1.6%). Non-surgical complications included non-surgical infections (1.1%), respiratory (1.2%) and neurological disturbances (0.5%). Fever (3.4%) is an undesirable phenomenon and can aggravate postoperative period after surgery for CS.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"114-121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188156","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}
引用次数: 0
[Dynamics of permeability of the blood-brain barrier after FUS thalamotomy according to contrast-enhanced MRI]. [对比增强MRI显示FUS丘脑切除术后血脑屏障通透性的动态变化]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro20258904151
M B Dolgushin, K A Prischepina, M Yu Martynov, I S Gumin, E A Katunina, I V Senko, R T Tairova, A V Dvoryanchikov

Objective: To study the dynamics of permeability of the blood-brain barrier (BBB) after focused ultrasound (FUS) thalamotomy in patients with tremor of different origin through visualization phenomena, assessment of the tendency of contrast accumulation level change at MRI in coagulation necrosis focus over different time intervals.

Material and methods: The study included 10 patients (8 - with Parkinson's disease, 2 - with essential tremor). MRI of the brain was performed before the procedure, MRI of the brain with contrast enhancement («Gadobutrol») was carried out after 2 and 24 hours, 1, 3, 6 and 12 months from FUS thalamotomy. The volume and nature of contrast accumulation in the impact area were evaluated.

Results: Observations show that the performance of FUS thalamotomy leads to a temporary impairment of the BBB permeability. This is confirmed by the data of dynamic accumulation of contrast substance in MRI in the area of coagulation necrosis.

Conclusion: The analysis of the dynamic changes of volume and patterns of accumulation of contrast substance in MRI in the area of coagulation necrosis after FUS thalamotomy was performed during the study. The obtained data demonstrate almost complete absence of contrast enhancement 24 hours after intervention, that may indicate a partial restoration of the structural-functional integrity of BBB after its transient disruption in the early postoperative period.

目的:通过可视化现象研究不同来源震颤患者聚焦超声(FUS)丘脑切开术后血脑屏障(BBB)通透性的动态变化,评价凝血坏死病灶MRI造影剂积累水平在不同时间间隔内的变化趋势。材料与方法:本研究纳入10例患者,其中8例为帕金森病,2例为特发性震颤。术前进行脑MRI检查,在FUS丘脑切除术后2小时、24小时、1、3、6和12个月进行脑MRI增强(“Gadobutrol”)检查。评估了撞击区造影剂堆积的体积和性质。结果:观察表明,FUS丘脑切除术导致血脑屏障通透性的暂时性损害。MRI显示凝血坏死区造影剂的动态积累证实了这一点。结论:本研究分析了FUS丘脑切除术后凝血坏死区造影剂体积的动态变化和积聚模式。获得的数据显示干预后24小时几乎完全没有增强,这可能表明血脑屏障在术后早期短暂破坏后部分恢复了结构功能完整性。
{"title":"[Dynamics of permeability of the blood-brain barrier after FUS thalamotomy according to contrast-enhanced MRI].","authors":"M B Dolgushin, K A Prischepina, M Yu Martynov, I S Gumin, E A Katunina, I V Senko, R T Tairova, A V Dvoryanchikov","doi":"10.17116/neiro20258904151","DOIUrl":"https://doi.org/10.17116/neiro20258904151","url":null,"abstract":"<p><strong>Objective: </strong>To study the dynamics of permeability of the blood-brain barrier (BBB) after focused ultrasound (FUS) thalamotomy in patients with tremor of different origin through visualization phenomena, assessment of the tendency of contrast accumulation level change at MRI in coagulation necrosis focus over different time intervals.</p><p><strong>Material and methods: </strong>The study included 10 patients (8 - with Parkinson's disease, 2 - with essential tremor). MRI of the brain was performed before the procedure, MRI of the brain with contrast enhancement («Gadobutrol») was carried out after 2 and 24 hours, 1, 3, 6 and 12 months from FUS thalamotomy. The volume and nature of contrast accumulation in the impact area were evaluated.</p><p><strong>Results: </strong>Observations show that the performance of FUS thalamotomy leads to a temporary impairment of the BBB permeability. This is confirmed by the data of dynamic accumulation of contrast substance in MRI in the area of coagulation necrosis.</p><p><strong>Conclusion: </strong>The analysis of the dynamic changes of volume and patterns of accumulation of contrast substance in MRI in the area of coagulation necrosis after FUS thalamotomy was performed during the study. The obtained data demonstrate almost complete absence of contrast enhancement 24 hours after intervention, that may indicate a partial restoration of the structural-functional integrity of BBB after its transient disruption in the early postoperative period.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"51-60"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971907","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}
引用次数: 0
[Complications of gunshot wounds and blunt injuries of the spine and spinal cord in early period]. [早期枪弹伤和脊柱脊髓钝性损伤的并发症]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro20258904130
A V Esipov, G I Antonov, V A Manukovsky, I I Ivanov, S Yu Timonin, A O Kelin, Yu V Strunina

Combat injuries to the spine and spinal cord refer to rare, but some of the most severe. Currently, there is a need to improve the treatment and rehabilitation of patients with injuries to the spine and spinal cord. However, the complicated course of the wound infection can become a critical factor influencing the treatment outcome.

Objective: To analyze the structure of complications in the early period and determine the factors that have the greatest influence on the incidence of their development in gunshot wounds and closed injuries to the spine and spinal cord under modern conditions.

Material and methods: The work analyzed the results of a prospective examination and treatment of 300 injured subjects, who received medical care at various stages of medical evacuation. A total of 65.6% of the injured had gunshot wounds, 34.4% - closed injuries to the spine. Mine blast injuries were the most common - 88%, and missile wounds - 12%. Age of the patients ranged from 18 to 59 years, median age was 34. Most observed patients (79.6%) had combined injuries.

Results: The incidence of surgical complications during the treatment in the Vishnevsky Central Military Clinical Hospital in the group of gunshot wounds amounted to 28%, in closed injuries - 7.8%, complications of the wound infection 42.4% and 17.6%, respectively. Liquorrhea has been observed only in the group with gunshot wounds in 5.2% of cases. The instability of surgical hardware has not been recorded in any case. The highest incidence of purulent-septic complications was recorded in the group with gunshot wounds and amounted to 26%, and in the group with closed injuries - 9%. Purulent meningitis has been developed in 3% of patients, all of them had gunshot wounds to the spine. Postoperative wound pyogenesis has been noted in 2.7%. Overall mortality was 6%.

Conclusion: The combination of the damage and severe nature of the injury are common for gunshot wounds and closed injury to the spine and spinal cord. The risk of surgical complications (purulent-septic, postoperative liquorrhea) for patients with gunshot wounds is higher. More frequent development of complications of wound disease, namely pulmonary, urological, infectious (pneumonia), is typical. Wound liquorrhea also statistically significantly increases the possibility of surgical complications.

战斗损伤脊柱和脊髓是罕见的,但有些是最严重的。目前,有必要改善对脊柱和脊髓损伤患者的治疗和康复。然而,伤口感染的复杂过程可能成为影响治疗效果的关键因素。目的:分析现代条件下枪弹伤及脊柱脊髓闭合性损伤早期并发症的结构,确定对其发展影响最大的因素。材料和方法:本工作分析了在医疗后送的不同阶段接受医疗护理的300名受伤受试者的前瞻性检查和治疗结果。65.6%的伤者为枪伤,34.4%为脊柱闭合性损伤。地雷爆炸伤是最常见的- 88%,导弹伤- 12%。患者年龄18 ~ 59岁,中位年龄34岁。大多数观察到的患者(79.6%)有合并损伤。结果:维什涅夫斯基中央军事临床医院在治疗过程中,枪伤组手术并发症发生率为28%,闭合性伤口发生率为7.8%,伤口感染并发症发生率为42.4%,17.6%。只有5.2%的枪伤患者出现了口酒。手术器械的不稳定性在任何情况下都没有记录。脓毒性并发症发生率最高的是枪伤组,为26%,闭合性损伤组为9%。化脓性脑膜炎在3%的患者中发展,他们都有脊柱枪伤。术后伤口化脓发生率为2.7%。总死亡率为6%。结论:脊柱脊髓枪伤及闭合性损伤多为损伤性和严重性相结合。枪伤患者发生手术并发症(脓毒性、术后遗尿)的风险较高。更常见的是伤口疾病的并发症,即肺部、泌尿系统、感染性(肺炎)。伤口口漏也显著增加了手术并发症的可能性。
{"title":"[Complications of gunshot wounds and blunt injuries of the spine and spinal cord in early period].","authors":"A V Esipov, G I Antonov, V A Manukovsky, I I Ivanov, S Yu Timonin, A O Kelin, Yu V Strunina","doi":"10.17116/neiro20258904130","DOIUrl":"https://doi.org/10.17116/neiro20258904130","url":null,"abstract":"<p><p>Combat injuries to the spine and spinal cord refer to rare, but some of the most severe. Currently, there is a need to improve the treatment and rehabilitation of patients with injuries to the spine and spinal cord. However, the complicated course of the wound infection can become a critical factor influencing the treatment outcome.</p><p><strong>Objective: </strong>To analyze the structure of complications in the early period and determine the factors that have the greatest influence on the incidence of their development in gunshot wounds and closed injuries to the spine and spinal cord under modern conditions.</p><p><strong>Material and methods: </strong>The work analyzed the results of a prospective examination and treatment of 300 injured subjects, who received medical care at various stages of medical evacuation. A total of 65.6% of the injured had gunshot wounds, 34.4% - closed injuries to the spine. Mine blast injuries were the most common - 88%, and missile wounds - 12%. Age of the patients ranged from 18 to 59 years, median age was 34. Most observed patients (79.6%) had combined injuries.</p><p><strong>Results: </strong>The incidence of surgical complications during the treatment in the Vishnevsky Central Military Clinical Hospital in the group of gunshot wounds amounted to 28%, in closed injuries - 7.8%, complications of the wound infection 42.4% and 17.6%, respectively. Liquorrhea has been observed only in the group with gunshot wounds in 5.2% of cases. The instability of surgical hardware has not been recorded in any case. The highest incidence of purulent-septic complications was recorded in the group with gunshot wounds and amounted to 26%, and in the group with closed injuries - 9%. Purulent meningitis has been developed in 3% of patients, all of them had gunshot wounds to the spine. Postoperative wound pyogenesis has been noted in 2.7%. Overall mortality was 6%.</p><p><strong>Conclusion: </strong>The combination of the damage and severe nature of the injury are common for gunshot wounds and closed injury to the spine and spinal cord. The risk of surgical complications (purulent-septic, postoperative liquorrhea) for patients with gunshot wounds is higher. More frequent development of complications of wound disease, namely pulmonary, urological, infectious (pneumonia), is typical. Wound liquorrhea also statistically significantly increases the possibility of surgical complications.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"30-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971910","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}
引用次数: 0
[Dynamics of caudal cranial nerves' functions after resection of ventrolateral craniovertebral meningioma: clinical case and literature review]. [颅椎腹外侧脑膜瘤切除术后尾侧脑神经功能的动态变化:临床病例及文献复习]。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro20258904198
V V Stepanenko, K S Gordienko, A V Trashin, V A Shamanin, Yu A Shulev

Surgery of meningiomas of the craniocervical region is one of the most difficult parts of neurosurgery due to the closeness of the brainstem, caudal group of the cranial nerves (CNs) and vertebral artery. According to the literature, suffering of the caudal group of CNs is between 20 and 55% according to different authors. In their dysfunction, the recovery of CNs is long-term and requires joint efforts by both the medical team and the patient and his family.

Objective: To demonstrate the dynamics of the restoration of CNs functions (over 12 years) in patient after resection of the ventrolateral craniocervical meningioma.

Material and methods: The article describes a clinical case of patient with ventrolateral meningioma of the craniocervical region. The tumor was resected (Simpson II) from a posterolateral access with transcondylar extension.

Results: The dynamics of caudal CNs recovery over 12 years has been traced and presented. In this clinical case, the main restoration of caudal CNs function has been observed during the first 6 months after surgery and remained unchanged thereafter.

Conclusion: Based on the literature data and presented clinical observation, it appears that the resection of meningiomas from the lower third of the clivus is predictably associated with a high risk of caudal CNs dysfunction, that should be considered when planning an operation and a postoperative rehabilitation program.

颅颈区脑膜瘤的手术是神经外科手术中最困难的部分之一,因为脑干、脑神经尾端群和椎动脉紧密相连。根据文献,根据不同作者的说法,尾端中枢神经系统的痛苦在20%到55%之间。中枢神经系统功能障碍的恢复是长期的,需要医疗团队和患者及家属的共同努力。目的:探讨颅颈腹外侧脑膜瘤术后中枢神经功能恢复的动态变化(超过12年)。材料与方法:本文报告一例颅颈区腹侧脑膜瘤的临床病例。肿瘤从后外侧经髁延伸通路切除(Simpson II)。结果:跟踪并介绍了12年来尾侧中枢神经系统恢复的动态。在本临床病例中,在手术后的前6个月观察到尾侧中枢神经功能的主要恢复,此后保持不变。结论:根据文献资料和目前的临床观察,从斜坡下三分之一处切除脑膜瘤可预见与尾部神经功能障碍的高风险相关,在计划手术和术后康复计划时应考虑到这一点。
{"title":"[Dynamics of caudal cranial nerves' functions after resection of ventrolateral craniovertebral meningioma: clinical case and literature review].","authors":"V V Stepanenko, K S Gordienko, A V Trashin, V A Shamanin, Yu A Shulev","doi":"10.17116/neiro20258904198","DOIUrl":"https://doi.org/10.17116/neiro20258904198","url":null,"abstract":"<p><p>Surgery of meningiomas of the craniocervical region is one of the most difficult parts of neurosurgery due to the closeness of the brainstem, caudal group of the cranial nerves (CNs) and vertebral artery. According to the literature, suffering of the caudal group of CNs is between 20 and 55% according to different authors. In their dysfunction, the recovery of CNs is long-term and requires joint efforts by both the medical team and the patient and his family.</p><p><strong>Objective: </strong>To demonstrate the dynamics of the restoration of CNs functions (over 12 years) in patient after resection of the ventrolateral craniocervical meningioma.</p><p><strong>Material and methods: </strong>The article describes a clinical case of patient with ventrolateral meningioma of the craniocervical region. The tumor was resected (Simpson II) from a posterolateral access with transcondylar extension.</p><p><strong>Results: </strong>The dynamics of caudal CNs recovery over 12 years has been traced and presented. In this clinical case, the main restoration of caudal CNs function has been observed during the first 6 months after surgery and remained unchanged thereafter.</p><p><strong>Conclusion: </strong>Based on the literature data and presented clinical observation, it appears that the resection of meningiomas from the lower third of the clivus is predictably associated with a high risk of caudal CNs dysfunction, that should be considered when planning an operation and a postoperative rehabilitation program.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"98-105"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971946","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}
引用次数: 0
[Surgical treatment of intracerebral frontal lobe tumors. Part II: speech functional system]. 脑额叶肿瘤的外科治疗。第二部分:语音功能系统。
Q4 Medicine Pub Date : 2025-01-01 DOI: 10.17116/neiro202589061114
A E Bykanov, T S Bezbabicheva, D I Pitskhelauri

Complexity of neurosurgery for intracerebral frontal lobe tumors is determined by adjacent cortical and subcortical functional zones and white matter fibers connecting these areas and responsible for various neurocognitive functions. When removing frontal lobe gliomas in dominant hemisphere, neurosurgeons are forced to interact with speech functional system. Recent studies have shown that neuroanatomical basis of speech is more complex, multicomponent and integrated system than previously thought. Postulates of classical model of speech analyzer organization do not coincide with results of modern researches in speech physiology and pathophysiology. According to modern neuroscience, cognitive functions of the brain are realized by distributed groups of connected and synchronized networks of neurons rather separate neural centers as previously assumed. To understand such a complex cognitive system as speech, it is necessary to recognize not only elementary components of this system, but also their interaction and appropriate new properties. This review systematizes modern ideas about organization of speech functional system from the perspective of neurosurgery for glial frontal lobe tumors.

脑内额叶肿瘤神经外科手术的复杂性取决于邻近的皮层和皮层下功能区以及连接这些区域并负责各种神经认知功能的白质纤维。在切除优势脑半球额叶胶质瘤时,神经外科医生被迫与语言功能系统相互作用。近年来的研究表明,语言的神经解剖学基础比以前认为的更为复杂,是一个多成分的综合系统。经典语音分析机构模型的假设与现代语音生理学和病理生理学的研究结果不一致。根据现代神经科学,大脑的认知功能是由分布的神经元群连接和同步网络实现的,而不是像以前认为的那样是独立的神经中枢。要理解语音这样一个复杂的认知系统,不仅需要认识这个系统的基本组成部分,还需要认识它们之间的相互作用和相应的新特性。本文从神经外科治疗额叶神经胶质肿瘤的角度,对言语功能系统组织的现代观点进行了系统的综述。
{"title":"[Surgical treatment of intracerebral frontal lobe tumors. Part II: speech functional system].","authors":"A E Bykanov, T S Bezbabicheva, D I Pitskhelauri","doi":"10.17116/neiro202589061114","DOIUrl":"https://doi.org/10.17116/neiro202589061114","url":null,"abstract":"<p><p>Complexity of neurosurgery for intracerebral frontal lobe tumors is determined by adjacent cortical and subcortical functional zones and white matter fibers connecting these areas and responsible for various neurocognitive functions. When removing frontal lobe gliomas in dominant hemisphere, neurosurgeons are forced to interact with speech functional system. Recent studies have shown that neuroanatomical basis of speech is more complex, multicomponent and integrated system than previously thought. Postulates of classical model of speech analyzer organization do not coincide with results of modern researches in speech physiology and pathophysiology. According to modern neuroscience, cognitive functions of the brain are realized by distributed groups of connected and synchronized networks of neurons rather separate neural centers as previously assumed. To understand such a complex cognitive system as speech, it is necessary to recognize not only elementary components of this system, but also their interaction and appropriate new properties. This review systematizes modern ideas about organization of speech functional system from the perspective of neurosurgery for glial frontal lobe tumors.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 6","pages":"114-119"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640459","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}
引用次数: 0
期刊
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1