Pub Date : 2023-10-18DOI: 10.17650/1683-3295-2023-25-3-69-77
D. S. Druzhinin, A. S. Karapetyan, M. L. Novikov, E. S. Druzhinina
Aim. To describe clinical and instrumental characteristics of patients with primary solitary and multiple tumors of the peripheral nerves. Materials and methods. Data from 45 patients were analyzed. In accordance with the examination results, the patients were retrospectively divided into 2 groups: 1) with solitary tumors: schwannomas ( n = 22), neurofibromas ( n = 10), perineuriomas ( n = 5), neurofibrosarcomas ( n = 2); 2) with multiple tumors: schwannomatosis ( n = 3) and neurofibromatosis ( n = 3). Results. The study did not show differences in the severity of motor deficit and the results of neurophysiological exams between solitary and multiple tumors; however, differences between pathomorphological types were observed. The most benign disease course was observed in patients with schwannomas, including multiple schwannomas; severe motor deficit was observed in patients with neurofibrosarcomas and crossover neurofibromas. Pain component was characteristic of neurofibrosarcomas, neurofibromas and melanotic schwannoma; perineuriomas were characterized by painless progression. Conclusion. Compulsory scan along the nerve allows to find tumors in clinically intact areas and other nerves.
{"title":"Peripheral nerve tumors in adults and children: clinical and diagnostic characteristics","authors":"D. S. Druzhinin, A. S. Karapetyan, M. L. Novikov, E. S. Druzhinina","doi":"10.17650/1683-3295-2023-25-3-69-77","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-69-77","url":null,"abstract":"Aim. To describe clinical and instrumental characteristics of patients with primary solitary and multiple tumors of the peripheral nerves. Materials and methods. Data from 45 patients were analyzed. In accordance with the examination results, the patients were retrospectively divided into 2 groups: 1) with solitary tumors: schwannomas ( n = 22), neurofibromas ( n = 10), perineuriomas ( n = 5), neurofibrosarcomas ( n = 2); 2) with multiple tumors: schwannomatosis ( n = 3) and neurofibromatosis ( n = 3). Results. The study did not show differences in the severity of motor deficit and the results of neurophysiological exams between solitary and multiple tumors; however, differences between pathomorphological types were observed. The most benign disease course was observed in patients with schwannomas, including multiple schwannomas; severe motor deficit was observed in patients with neurofibrosarcomas and crossover neurofibromas. Pain component was characteristic of neurofibrosarcomas, neurofibromas and melanotic schwannoma; perineuriomas were characterized by painless progression. Conclusion. Compulsory scan along the nerve allows to find tumors in clinically intact areas and other nerves.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943107","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}
Pub Date : 2023-10-17DOI: 10.17650/1683-3295-2023-25-3-34-42
S. V. Mishinov, N. A. Koporushko, V. V. Stupak
Background. Despite its long history, cranioplasty remains a topical problem of neurosurgery, due to the increasing number of traumatic brain injury, the consequences of which are the main driver in preserving the population of patients with postcranioectomy skull defects. As a rule, these defects are extensive, and the use of individual implants in these cases is the method of choice. Over the past 5 years, the use of products created by medical additive manufacturing has increased, in this regard, the assessment of long-term results of surgical interventions with their use is an actual issue of modern medicine. Aim. To evaluate the results of surgical treatment of patients with skull defects of various etiologies using individual titanium implants made by three-dimensional printing. Materials and methods. The study analyzed 94 cases of cranioplasty using individual titanium implants made by three-dimensional printing using DMLS (Direct Metal Laser Sintering) technology. The minimum follow-up period was 12 months from the moment of the intervention. Traumatic brain injury and its consequences was the dominant cause of skull bone defects ( n = 56, 59.6 %). The average area of defects in the study group was 99.2 ± 43.4 cm 2 . For men ( n = 53), this parameter corresponded to 106.7 ± 44.7 cm 2 , for women ( n = 41) – 89.5 ± 40.1 cm 2 . Results. The total number of complications in the study group was 12 (12.7 %) cases, of which 5 (5.3 %) cases were recorded during the in hospital stay of patients, 7 (7.4 %) – during outpatient follow-up. One complication was not related to the performed surgical intervention. Removal of the implant was required in 7 (7.4 %) cases. The terms of implant removal varied from 0 to 14 months from the moment of the performed intervention. The survival rate of individual titanium implants for more than 12 months was 92.6 %. Conclusion. The data on the presence of complications after cranioplasty vary from study to study, while the results of reconstructive interventions performed using individual titanium implants are of significant interest, the use of which has increased significantly over the past five years due to the introduction of additive medical production into clinical practice.
背景。尽管有悠久的历史，颅成形术仍然是神经外科的一个热门问题，由于创伤性脑损伤的数量不断增加，其后果是保留颅骨切除术后颅骨缺损患者群体的主要驱动因素。通常，这些缺陷是广泛的，在这些情况下使用单个植入物是选择的方法。在过去的5年里，医用增材制造产品的使用有所增加，在这方面，评估手术干预的长期效果是现代医学的一个实际问题。的目标。目的探讨应用三维打印技术制作的个体化钛种植体治疗各种原因的颅骨缺损的手术效果。材料和方法。本研究分析了94例使用DMLS(直接金属激光烧结)技术三维打印制作的单个钛种植体颅骨成形术。最小随访期为干预后12个月。外伤性脑损伤及其后果是颅骨缺损的主要原因(n = 56, 59.6%)。研究组的平均缺损面积为99.2±43.4 cm 2。对于男性(n = 53)，该参数对应于106.7±44.7 cm 2，对于女性(n = 41)，该参数对应于89.5±40.1 cm 2。结果。研究组共发生并发症12例(12.7%)，其中5例(5.3%)发生在住院期间，7例(7.4%)发生在门诊随访期间。其中一个并发症与手术干预无关。7例(7.4%)需要移除种植体。从进行干预的那一刻起，种植体移除的期限从0到14个月不等。单个钛种植体12个月以上的存活率为92.6%。结论。关于颅骨成形术后并发症存在的数据因研究而异，而使用单个钛植入物进行重建干预的结果非常令人感兴趣，由于在临床实践中引入了添加剂医疗生产，其使用在过去五年中显着增加。
{"title":"Results of cranioplasty using individual titanium implants","authors":"S. V. Mishinov, N. A. Koporushko, V. V. Stupak","doi":"10.17650/1683-3295-2023-25-3-34-42","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-34-42","url":null,"abstract":"Background. Despite its long history, cranioplasty remains a topical problem of neurosurgery, due to the increasing number of traumatic brain injury, the consequences of which are the main driver in preserving the population of patients with postcranioectomy skull defects. As a rule, these defects are extensive, and the use of individual implants in these cases is the method of choice. Over the past 5 years, the use of products created by medical additive manufacturing has increased, in this regard, the assessment of long-term results of surgical interventions with their use is an actual issue of modern medicine. Aim. To evaluate the results of surgical treatment of patients with skull defects of various etiologies using individual titanium implants made by three-dimensional printing. Materials and methods. The study analyzed 94 cases of cranioplasty using individual titanium implants made by three-dimensional printing using DMLS (Direct Metal Laser Sintering) technology. The minimum follow-up period was 12 months from the moment of the intervention. Traumatic brain injury and its consequences was the dominant cause of skull bone defects ( n = 56, 59.6 %). The average area of defects in the study group was 99.2 ± 43.4 cm 2 . For men ( n = 53), this parameter corresponded to 106.7 ± 44.7 cm 2 , for women ( n = 41) – 89.5 ± 40.1 cm 2 . Results. The total number of complications in the study group was 12 (12.7 %) cases, of which 5 (5.3 %) cases were recorded during the in hospital stay of patients, 7 (7.4 %) – during outpatient follow-up. One complication was not related to the performed surgical intervention. Removal of the implant was required in 7 (7.4 %) cases. The terms of implant removal varied from 0 to 14 months from the moment of the performed intervention. The survival rate of individual titanium implants for more than 12 months was 92.6 %. Conclusion. The data on the presence of complications after cranioplasty vary from study to study, while the results of reconstructive interventions performed using individual titanium implants are of significant interest, the use of which has increased significantly over the past five years due to the introduction of additive medical production into clinical practice.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038835","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}
Pub Date : 2023-10-17DOI: 10.17650/1683-3295-2023-25-3-24-33
I. V. Senko, V. S. Kisilev, A. O. Sosnov, A. M. Perfiliev, P. D. Matveev, P. Yu. Ivanova, D. A. Rzaev
Background. Due to rare occurrence of distal cerebral aneurysms, there are very few publications devoted to endovascular treatment. Due to current progress in the endovascular surgery, the number of successfully cured patients with distal aneurysms has been increasing recently. Aim. To determine technical capabilities and evaluate results of endovascular treatment of patients with distal intracranial aneurysms. Materials and methods. The work is based on analysis of data of endovascular treatment among 45 patients with distal cerebral aneurysms in two neurosurgical departments of federal medical centers. Of the 45 analyzed cases 30 were without aneurysm rupture and 15 were with rupture. Results. Endovascular treatment of the distal aneurysms made it possible to achieve good treatment results (4–5 points on the Glasgow Outcome Scale (GOS)) in 97.8 % of cases: 5 points on GOS – in 68.9 %, 4 points on GOS – in 28.4 %. One (2.2 %) fatal outcome was obtained. The most frequent methods of embolization were embolization of aneurysm by coils with stent assistance (37.8 %) and installation of a flow-diverter stent (28.9 %). Embolization with only coils (20 %) or occlusion of parent artery (13.3 %) were used less frequently. In 3 out of 6 patients, the occlusion of parent artery was not planned. Conclusion. Development of endovascular surgery and technical capabilities of performing operations in the distal cerebral arteries has made it possible to form a multidisciplinary approach to choosing the optimal method of shutting off the distal aneurysm from the bloodstream, taking into account the modern possibilities of open surgery. This is especially important for patients in serious condition due to ruptured aneurysm.
{"title":"Endovascular treatment of distal cerebral aneurysms","authors":"I. V. Senko, V. S. Kisilev, A. O. Sosnov, A. M. Perfiliev, P. D. Matveev, P. Yu. Ivanova, D. A. Rzaev","doi":"10.17650/1683-3295-2023-25-3-24-33","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-24-33","url":null,"abstract":"Background. Due to rare occurrence of distal cerebral aneurysms, there are very few publications devoted to endovascular treatment. Due to current progress in the endovascular surgery, the number of successfully cured patients with distal aneurysms has been increasing recently. Aim. To determine technical capabilities and evaluate results of endovascular treatment of patients with distal intracranial aneurysms. Materials and methods. The work is based on analysis of data of endovascular treatment among 45 patients with distal cerebral aneurysms in two neurosurgical departments of federal medical centers. Of the 45 analyzed cases 30 were without aneurysm rupture and 15 were with rupture. Results. Endovascular treatment of the distal aneurysms made it possible to achieve good treatment results (4–5 points on the Glasgow Outcome Scale (GOS)) in 97.8 % of cases: 5 points on GOS – in 68.9 %, 4 points on GOS – in 28.4 %. One (2.2 %) fatal outcome was obtained. The most frequent methods of embolization were embolization of aneurysm by coils with stent assistance (37.8 %) and installation of a flow-diverter stent (28.9 %). Embolization with only coils (20 %) or occlusion of parent artery (13.3 %) were used less frequently. In 3 out of 6 patients, the occlusion of parent artery was not planned. Conclusion. Development of endovascular surgery and technical capabilities of performing operations in the distal cerebral arteries has made it possible to form a multidisciplinary approach to choosing the optimal method of shutting off the distal aneurysm from the bloodstream, taking into account the modern possibilities of open surgery. This is especially important for patients in serious condition due to ruptured aneurysm.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038656","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}
Pub Date : 2023-10-17DOI: 10.17650/1683-3295-2023-25-3-17-23
M. Yu. Volodukhin, I. A. Podshivalov, D. R. Khasanova, R. N. Khairullin
Aim. To present the experience of stenting of the extracranial internal carotid artery (ICA) in case of tandem steno-occlusive carotid lesion in the most acute phase of ischemic stroke.Materials and methods. From December 2018 to December 2021, 29 patients with acute ischemic stroke, because of tandem steno-occlusive lesions of the ICA and intracranial arteries, underwent endovascular surgery to restore cerebral blood flow.Results. Successful restoration of cerebral blood flow (according to the mTICI 2b–3 scale) achieved in 22 (75.9 %) patients. Four (13.8 %) patients had stent thrombosis in the early postoperative period. The incidence of symptomatic hemorrhagic transformation observed in 2 (6.9 %) patients. The frequency of a favorable functional outcome (Rankine 0–2) on the 30th day was 20.7 %, mortality – 24.1 %.Conclusion. Stenting of the extracranial ICA in patients with acute ischemic stroke improves the efficiency of restoration of cerebral blood flow. The use of low doses of glycoprotein receptor blockers prevents stent thrombosis in the early period after implantation and does not increase the incidence of symptomatic hemorrhagic complications.
{"title":"Experience of stenting of the extracranial part of the internal carotid artery in patients with acute ischemic stroke","authors":"M. Yu. Volodukhin, I. A. Podshivalov, D. R. Khasanova, R. N. Khairullin","doi":"10.17650/1683-3295-2023-25-3-17-23","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-17-23","url":null,"abstract":"Aim. To present the experience of stenting of the extracranial internal carotid artery (ICA) in case of tandem steno-occlusive carotid lesion in the most acute phase of ischemic stroke.Materials and methods. From December 2018 to December 2021, 29 patients with acute ischemic stroke, because of tandem steno-occlusive lesions of the ICA and intracranial arteries, underwent endovascular surgery to restore cerebral blood flow.Results. Successful restoration of cerebral blood flow (according to the mTICI 2b–3 scale) achieved in 22 (75.9 %) patients. Four (13.8 %) patients had stent thrombosis in the early postoperative period. The incidence of symptomatic hemorrhagic transformation observed in 2 (6.9 %) patients. The frequency of a favorable functional outcome (Rankine 0–2) on the 30th day was 20.7 %, mortality – 24.1 %.Conclusion. Stenting of the extracranial ICA in patients with acute ischemic stroke improves the efficiency of restoration of cerebral blood flow. The use of low doses of glycoprotein receptor blockers prevents stent thrombosis in the early period after implantation and does not increase the incidence of symptomatic hemorrhagic complications.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038655","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}
Pub Date : 2023-10-17DOI: 10.17650/1683-3295-2023-25-3-43-58
K. V. Shevchenko, V. N. Shimansky, S. V. Tanyashin, V. K. Poshataev, V. V. Karnaukhov, M. V. Kolycheva, K. D. Solozhentseva, Yu. V. Strunina
Background. Hydrocephalus can be developing by a traumatic brain injury, intracranial hemorrhage, tumor, meningitis of congenital malformation of the central nervous system. When the cause of the hydrocephalus is unclear it is supposed as idiopathic hydrocephalus. The most important classification features are the etiology and level of CSF obstruction. The classification was improved and developed with diagnostic and surgical methods simultaneously. Currently, the neurosurgeons have the possibility for usage of various methods and techniques of surgical treatment with their advantages and disadvantages. Systematization of radiological parameters is necessary to make a decision about the type of the surgery. Aim. To analyze and systematize the neuroimaging characteristics of various forms of idiopathic hydrocephalus in adults, to assess the possible classification of idiopathic hydrocephalus. Materials and methods. Between October 2011 and March 2021 290 patients with idiopathic adult hydrocephalus were operated at the N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of Russia: onset of symptoms in adulthood; no indications of the etiology of hydrocephalus and congenital hydrocephalus. The age of the patients was 50 ± 18.2 (18–85) years. The magnetic resonance images of patients were evaluated for the size of the ventricles, condition of convexital and basal subarachnoid spaces, obstruction of the CSF pathways, and changes in the position of the premamillary membrane, septum pellucidum, the roof of the 3rd ventricle and the tonsils of the cerebellum, the size of the sella turcica, the angle of the corpus callosum. The frequency of each of these parameters is statistically estimated for each form of idiopathic hydrocephalus. Results. Aqueduct stenosis has become the most frequent form of idiopathic hydrocephalus. Hydrocephalus in obstruction of the foramen of Monroe, aqueduct, foramen of Magendie, and cisterns of the posterior cranial fossa was significantly more characteristic of young people ( p <0.05). Hydrocephalus with obstruction of convexital CSF spaces can be called hydrocephalus of the elderly ( p <0.001). Hydrocephalus without verified signs of occlusion CSF pathways occurs equally in all age groups. The FOHR index was significantly more important, and only in case of cisternal obstruction. Enlargement one or both lateral ventricles and flattening of the roof of the 3rd ventricle is characterized for Monro’s foramen obstruction ( p <0.001). The membrane at the outlet of the 4th ventricle and the absence of the “flow void” was typically only for patients with obstruction of the foramen of Magendie ( p <0.001). Ventral dislocation of the premamillary membrane was characteristic of obstruction of the cerebral aqueduct, the foramen of Magendie, and cisterns of the posterior cranial fossa. Compression of the convexital CSF spaces occurred in case of obstruction of the aqueduct, the foramen of Magendie, b
{"title":"Surgical aspects of classification and neuroimaging characteristics of idiopathic hydrocephalus in adults","authors":"K. V. Shevchenko, V. N. Shimansky, S. V. Tanyashin, V. K. Poshataev, V. V. Karnaukhov, M. V. Kolycheva, K. D. Solozhentseva, Yu. V. Strunina","doi":"10.17650/1683-3295-2023-25-3-43-58","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-43-58","url":null,"abstract":"Background. Hydrocephalus can be developing by a traumatic brain injury, intracranial hemorrhage, tumor, meningitis of congenital malformation of the central nervous system. When the cause of the hydrocephalus is unclear it is supposed as idiopathic hydrocephalus. The most important classification features are the etiology and level of CSF obstruction. The classification was improved and developed with diagnostic and surgical methods simultaneously. Currently, the neurosurgeons have the possibility for usage of various methods and techniques of surgical treatment with their advantages and disadvantages. Systematization of radiological parameters is necessary to make a decision about the type of the surgery. Aim. To analyze and systematize the neuroimaging characteristics of various forms of idiopathic hydrocephalus in adults, to assess the possible classification of idiopathic hydrocephalus. Materials and methods. Between October 2011 and March 2021 290 patients with idiopathic adult hydrocephalus were operated at the N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of Russia: onset of symptoms in adulthood; no indications of the etiology of hydrocephalus and congenital hydrocephalus. The age of the patients was 50 ± 18.2 (18–85) years. The magnetic resonance images of patients were evaluated for the size of the ventricles, condition of convexital and basal subarachnoid spaces, obstruction of the CSF pathways, and changes in the position of the premamillary membrane, septum pellucidum, the roof of the 3rd ventricle and the tonsils of the cerebellum, the size of the sella turcica, the angle of the corpus callosum. The frequency of each of these parameters is statistically estimated for each form of idiopathic hydrocephalus. Results. Aqueduct stenosis has become the most frequent form of idiopathic hydrocephalus. Hydrocephalus in obstruction of the foramen of Monroe, aqueduct, foramen of Magendie, and cisterns of the posterior cranial fossa was significantly more characteristic of young people ( p <0.05). Hydrocephalus with obstruction of convexital CSF spaces can be called hydrocephalus of the elderly ( p <0.001). Hydrocephalus without verified signs of occlusion CSF pathways occurs equally in all age groups. The FOHR index was significantly more important, and only in case of cisternal obstruction. Enlargement one or both lateral ventricles and flattening of the roof of the 3rd ventricle is characterized for Monro’s foramen obstruction ( p <0.001). The membrane at the outlet of the 4th ventricle and the absence of the “flow void” was typically only for patients with obstruction of the foramen of Magendie ( p <0.001). Ventral dislocation of the premamillary membrane was characteristic of obstruction of the cerebral aqueduct, the foramen of Magendie, and cisterns of the posterior cranial fossa. Compression of the convexital CSF spaces occurred in case of obstruction of the aqueduct, the foramen of Magendie, b","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038657","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}
Pub Date : 2023-10-17DOI: 10.17650/1683-3295-2023-25-3-10-16
L. B. Likhterman
The author describes the life’s journey of Fyodor Andreevich Serbinenko, the founder of endovascular surgery, creator of a new chapter in the teaching on cerebral blood flow, and shares memories of friendship with this great scientist and beautiful person. F.A. Serbinenko had developed a brand‑new approach to treatment of cerebral vascular pathologies, namely, low‑trauma intravascular reconstructive interventions, as well as a complex of original endovascular operations for severe vascular pathologies, opened the first in the world department of endovascular surgery in Moscow, became the founder of the Russian school of endovascular surgeons. The principles and techniques of intravascular interventions developed by F.A. Serbinenko has been continuously developed and improved by his disciples and followers and are widely used in current clinical practice.
{"title":"Founder of endovascular neurosurgery Fyodor Andreevich Serbinenko (1928–2002). For the 95<sup>th</sup> anniversary of birth","authors":"L. B. Likhterman","doi":"10.17650/1683-3295-2023-25-3-10-16","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-10-16","url":null,"abstract":"The author describes the life’s journey of Fyodor Andreevich Serbinenko, the founder of endovascular surgery, creator of a new chapter in the teaching on cerebral blood flow, and shares memories of friendship with this great scientist and beautiful person. F.A. Serbinenko had developed a brand‑new approach to treatment of cerebral vascular pathologies, namely, low‑trauma intravascular reconstructive interventions, as well as a complex of original endovascular operations for severe vascular pathologies, opened the first in the world department of endovascular surgery in Moscow, became the founder of the Russian school of endovascular surgeons. The principles and techniques of intravascular interventions developed by F.A. Serbinenko has been continuously developed and improved by his disciples and followers and are widely used in current clinical practice.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038833","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}
Цель. Оценить эффективность и безопасность применения крестцовой нейромодуляции (КНМ) у пациентов с нервно-мышечной дисфункцией мочевого пузыря (НМДМП) при патологии спинного мозга. Материалы и методы. Было обследовано в условиях неврологического отделения РНПЦ неврологии и нейрохирургии 22 пациента. Все пациенты прошли предварительное специализированное обследование и консультирование квалифицированным урологом с целью выявления урологических противопоказаний. Результаты. Давность патологии среди пациентов составила 13,4±9,9 года. Травматическая болезнь спинного мозга отмечалась в 14 случаях, врожденный порок развития спинного мозга – в 6 случаях. Описан разработанный алгоритм хирургического лечения пациентов с НМДМП, включающий поэтапное и дифференцированное использование КНМ. 21 из 22 пациентов успешно прошли этап интраоперационной тестовой стимуляции, а 20 – этап послеоперационной тестовой стимуляции. У 12 пациентов наблюдался сопутствующий синдром хронической тазовой боли, который значимо регрессировал от 50 до 100% у всех пациентов на фоне КНМ. Заключение. Разработанный и апробированный алгоритм хирургического лечения пациентов с НМДМП позволяет поэтапно дифференцированно отбирать пациентов вплоть до непосредственной имплантации крестцового нейростимулятора, что значительно снижает вероятность неэффективного применения методики КНМ. Purpose. To evaluate the effectiveness and safety of sacral neuromodulation (SNM) in patients with neuromuscular bladder dysfunction (NMBD) due to spinal cord pathology. Materials and methods. 22 patients were examined in the neurological department of the Republican Scientific and Practical Center for Neurology and Neurosurgery. All patients underwent preliminary specialized examination and consultation by a qualified urologist in order to identify urological contraindications. Results. The duration of pathology among patients was 13.4±9.9 years. Traumatic disease of the spinal cord was noted in 14 cases, congenital malformation of the spinal cord – in 6 cases. The developed algorithm for surgical treatment of patients with NMBD is described, including the staged and differentiated use of SNM. 21 of 22 patients successfully completed the intraoperative test stimulation stage, and 20 successfully completed the postoperative test stimulation stage. In 12 patients, concomitant chronic pelvic pain syndrome was observed, which significantly regressed from 50 to 100% in all patients against the background of SNM. Conclusion. The developed and tested algorithm for the surgical treatment of patients with NMBD allows for a step-by-step differentiated selection of patients up to the direct implantation of a sacral neurostimulator, which significantly reduces the likelihood of ineffective use of the SNM technique.
{"title":"Experience in the Use of Sacral Neuromodulation in Belarus for Neurogenic Urination Disorders: An Algorithm for Surgical Treatment","authors":"Г.В. Забродец, В.П. Боярчик, Р.Р. Сидорович, С.А. Лихачев, А.В. Строцкий, А.А. Рагузин, Ю.Н. Голец","doi":"10.34883/pi.2023.13.3.037","DOIUrl":"https://doi.org/10.34883/pi.2023.13.3.037","url":null,"abstract":"Цель. Оценить эффективность и безопасность применения крестцовой нейромодуляции (КНМ) у пациентов с нервно-мышечной дисфункцией мочевого пузыря (НМДМП) при патологии спинного мозга. Материалы и методы. Было обследовано в условиях неврологического отделения РНПЦ неврологии и нейрохирургии 22 пациента. Все пациенты прошли предварительное специализированное обследование и консультирование квалифицированным урологом с целью выявления урологических противопоказаний. Результаты. Давность патологии среди пациентов составила 13,4±9,9 года. Травматическая болезнь спинного мозга отмечалась в 14 случаях, врожденный порок развития спинного мозга – в 6 случаях. Описан разработанный алгоритм хирургического лечения пациентов с НМДМП, включающий поэтапное и дифференцированное использование КНМ. 21 из 22 пациентов успешно прошли этап интраоперационной тестовой стимуляции, а 20 – этап послеоперационной тестовой стимуляции. У 12 пациентов наблюдался сопутствующий синдром хронической тазовой боли, который значимо регрессировал от 50 до 100% у всех пациентов на фоне КНМ. Заключение. Разработанный и апробированный алгоритм хирургического лечения пациентов с НМДМП позволяет поэтапно дифференцированно отбирать пациентов вплоть до непосредственной имплантации крестцового нейростимулятора, что значительно снижает вероятность неэффективного применения методики КНМ. Purpose. To evaluate the effectiveness and safety of sacral neuromodulation (SNM) in patients with neuromuscular bladder dysfunction (NMBD) due to spinal cord pathology. Materials and methods. 22 patients were examined in the neurological department of the Republican Scientific and Practical Center for Neurology and Neurosurgery. All patients underwent preliminary specialized examination and consultation by a qualified urologist in order to identify urological contraindications. Results. The duration of pathology among patients was 13.4±9.9 years. Traumatic disease of the spinal cord was noted in 14 cases, congenital malformation of the spinal cord – in 6 cases. The developed algorithm for surgical treatment of patients with NMBD is described, including the staged and differentiated use of SNM. 21 of 22 patients successfully completed the intraoperative test stimulation stage, and 20 successfully completed the postoperative test stimulation stage. In 12 patients, concomitant chronic pelvic pain syndrome was observed, which significantly regressed from 50 to 100% in all patients against the background of SNM. Conclusion. The developed and tested algorithm for the surgical treatment of patients with NMBD allows for a step-by-step differentiated selection of patients up to the direct implantation of a sacral neurostimulator, which significantly reduces the likelihood of ineffective use of the SNM technique.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334447","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}
Pub Date : 2023-09-29DOI: 10.34883/pi.2023.13.3.036
Т.Н. Чернуха, С.А. Лихачев, О.В. Глеб, Г.В. Зобнина
Цель. Оценить результаты комплексного лечения хронической мигрени (ХМ) в сочетании с лекарственно-индуцированной головной болью (ЛИГБ) с использованием метода транскраниальной электроанальгезии (ТЭА). Материалы и методы. В основную группу вошел 61 пациент с ХМ в сочетании с ЛИГБ. 31 пациент получал стандартную терапию согласно клиническим протоколам и курс ТЭА. Контрольную группу составили 30 пациентов, получавших стандартную терапию. Все пациенты самостоятельно заполняли дневники головной боли в течение как минимум одного месяца, указывали интенсивность головной боли по визуальной аналоговой шкале (ВАШ). Также применялся Headache Impact Test (индекс HIT-6) с определением четырех степеней воздействия на повседневную активность и Лидский опросник зависимости (ЛОЗ) – Leeds Dependence Questionnaire (LDQ) до и после курса лечения. Для транскраниальной электротерапии использовался прибор «Радиус-01 Кранио» (Россия). Результаты. При оценке эффективности лечения в основной и контрольной группе методом множественного регрессионного анализа установлено достоверное снижение дней головной боли в месяц в исследуемой группе, снижение интенсивности по ВАШ и отсутствие влияния включения в комплексную терапию ТЭА на количество приступов головной боли (Multiple R=0,714, р=0,02). Таким образом, полученные данные позволяют сделать вывод о положительном влиянии ТЭА на ЛИГБ при ХМ. Заключение. Назначение методики электроанальгезии у пациентов с ХМ более предпочтительно при наличии ЛИГБ. ТЭА может быть рекомендована к более широкому применению у пациентов с ХМ, отягощенной ЛИГБ, в повседневной практике. Purpose. To evaluate the results of complex treatment of chronic migraine (CM) in combination with medication-overuse headache (MOH) using the method of transcranial electroanalgesia (TEA). Materials and methods. The study group included 61 patients with CM in combination with DIH. 31 patients received standard therapy, according to clinical protocols, and a course of TEA. The control group consisted of 30 patients who received standard therapy. All patients self-completed headache diaries for at least one month, indicating the intensity of headache on a visual analogue scale (VAS). The Headache Impact Test (HIT-6 index) with four levels of impact on daily activities and the Leeds Dependence Questionnaire (LDQ) were also assessed before and after treatment. The device "Radius-01 Cranio" (Russia) was used for transcranial electrotherapy. Results. The method of multiple regression analysis revealed a significant decrease in headache days per month in the study group, a decrease in intensity according to the VAS scale, and no effect of including TEA in complex therapy on the number of headache attacks (Multiple R=0.714, p=0.02). Thus, the data obtained allow us to conclude that TEA has a positive effect on DIH in CM. Conclusion. The appointment of electroanalgesia technique in patients with CM is more preferable in the presence of DIH. TEA may be recommended for wider us
{"title":"Transcranial Electroanalgesia as an Auxiliary Treatment for Chronic Migraine with Medication Abuse","authors":"Т.Н. Чернуха, С.А. Лихачев, О.В. Глеб, Г.В. Зобнина","doi":"10.34883/pi.2023.13.3.036","DOIUrl":"https://doi.org/10.34883/pi.2023.13.3.036","url":null,"abstract":"Цель. Оценить результаты комплексного лечения хронической мигрени (ХМ) в сочетании с лекарственно-индуцированной головной болью (ЛИГБ) с использованием метода транскраниальной электроанальгезии (ТЭА). Материалы и методы. В основную группу вошел 61 пациент с ХМ в сочетании с ЛИГБ. 31 пациент получал стандартную терапию согласно клиническим протоколам и курс ТЭА. Контрольную группу составили 30 пациентов, получавших стандартную терапию. Все пациенты самостоятельно заполняли дневники головной боли в течение как минимум одного месяца, указывали интенсивность головной боли по визуальной аналоговой шкале (ВАШ). Также применялся Headache Impact Test (индекс HIT-6) с определением четырех степеней воздействия на повседневную активность и Лидский опросник зависимости (ЛОЗ) – Leeds Dependence Questionnaire (LDQ) до и после курса лечения. Для транскраниальной электротерапии использовался прибор «Радиус-01 Кранио» (Россия). Результаты. При оценке эффективности лечения в основной и контрольной группе методом множественного регрессионного анализа установлено достоверное снижение дней головной боли в месяц в исследуемой группе, снижение интенсивности по ВАШ и отсутствие влияния включения в комплексную терапию ТЭА на количество приступов головной боли (Multiple R=0,714, р=0,02). Таким образом, полученные данные позволяют сделать вывод о положительном влиянии ТЭА на ЛИГБ при ХМ. Заключение. Назначение методики электроанальгезии у пациентов с ХМ более предпочтительно при наличии ЛИГБ. ТЭА может быть рекомендована к более широкому применению у пациентов с ХМ, отягощенной ЛИГБ, в повседневной практике. Purpose. To evaluate the results of complex treatment of chronic migraine (CM) in combination with medication-overuse headache (MOH) using the method of transcranial electroanalgesia (TEA). Materials and methods. The study group included 61 patients with CM in combination with DIH. 31 patients received standard therapy, according to clinical protocols, and a course of TEA. The control group consisted of 30 patients who received standard therapy. All patients self-completed headache diaries for at least one month, indicating the intensity of headache on a visual analogue scale (VAS). The Headache Impact Test (HIT-6 index) with four levels of impact on daily activities and the Leeds Dependence Questionnaire (LDQ) were also assessed before and after treatment. The device \"Radius-01 Cranio\" (Russia) was used for transcranial electrotherapy. Results. The method of multiple regression analysis revealed a significant decrease in headache days per month in the study group, a decrease in intensity according to the VAS scale, and no effect of including TEA in complex therapy on the number of headache attacks (Multiple R=0.714, p=0.02). Thus, the data obtained allow us to conclude that TEA has a positive effect on DIH in CM. Conclusion. The appointment of electroanalgesia technique in patients with CM is more preferable in the presence of DIH. TEA may be recommended for wider us","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334145","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}
Pub Date : 2023-09-29DOI: 10.34883/pi.2023.13.3.044
Александр Николаевич Яковлев, Л.В. Шалькевич, Т.Н. Чернуха, А.К. Сташков, А.А. Мелюкова, М.В. Гаманицкая, К.О. Гирис
Синдром Клиппеля – Фейля (СКФ) представляет собой врожденный порок развития позвоночника (преимущественно шейных и верхнегрудных позвонков) в виде их аномального сращения, нарушения деления или физиологической сегментации. Развитие синдрома Клиппеля – Фейля преимущественно ассоциировано с генетическими мутациями в следующих генах: GDF6, GDF3, MEOX1, MYO18B, RIPPLY2, BAZ1B, FREM2, SUFU, VANGL1, KMT2D. Клинически синдром проявляется мультисистемной патологией, среди которой ведущие симптомы представлены неврологическими нарушениями. В статье приводится опыт off-lable-терапии ботулиническим токсином типа А рефлекторно-тонического и болевого синдромов у ребенка вследствие СКФ. Проведенная ботулинотерапия в раннем постинъекционном периоде привела к оптимизации мышечного тонуса мышц-мишеней – musculus trapezius и musculus levator scapulae с обеих сторон, увеличению активных и пассивных движений головы, снижению выраженности болевого синдрома. Таким образом, ботулинотерапия при СКФ может использоваться для повышения качества жизни пациентов, профилактики соединительнотканного перерождения вовлеченных в патологический процесс мышц, может позволить отсрочить оперативное вмешательство или избежать его использования. Klippel-Feil syndrome is a congenital malformation of the spine (mainly the cervical and upper thoracic vertebrae), in the form of their abnormal fusion, division disorders or physiological segmentation. Emergence of KFS is mostly associated with genetic mutations in following genes: GDF6, GDF3, MEOX1, MYO18B, RIPPLY2, BAZ1B, FREM2, SUFU, VANGL1, KMT2D. Clinically, the syndrome is manifested by multisystem pathology in which the leading symptoms belong to neurological disorders. The article presents the experience of off-lable therapy with botulinum toxin type A (BTA) reflex-tonic and pain syndrome in a child due to KFS. The botulinum toxin therapy performed in the early post-injection period led to the optimization of the muscle tone of the target muscles: musculus trapezius and musculus levator scapulae on both sides, an increase in active and passive head movements, and a decrease in the severity of pain syndrome. Therefore, botulinum toxin therapy in the case of KFS can be used for increasing patient life quality, prevention of connective tissue muscles degeneration and can allow to delay or avoid surgery.
{"title":"Botulinotherapy of Neurological Disorders in Children with Klippel-Feil Syndrome: A Case Report","authors":"Александр Николаевич Яковлев, Л.В. Шалькевич, Т.Н. Чернуха, А.К. Сташков, А.А. Мелюкова, М.В. Гаманицкая, К.О. Гирис","doi":"10.34883/pi.2023.13.3.044","DOIUrl":"https://doi.org/10.34883/pi.2023.13.3.044","url":null,"abstract":"Синдром Клиппеля – Фейля (СКФ) представляет собой врожденный порок развития позвоночника (преимущественно шейных и верхнегрудных позвонков) в виде их аномального сращения, нарушения деления или физиологической сегментации. Развитие синдрома Клиппеля – Фейля преимущественно ассоциировано с генетическими мутациями в следующих генах: GDF6, GDF3, MEOX1, MYO18B, RIPPLY2, BAZ1B, FREM2, SUFU, VANGL1, KMT2D. Клинически синдром проявляется мультисистемной патологией, среди которой ведущие симптомы представлены неврологическими нарушениями. В статье приводится опыт off-lable-терапии ботулиническим токсином типа А рефлекторно-тонического и болевого синдромов у ребенка вследствие СКФ. Проведенная ботулинотерапия в раннем постинъекционном периоде привела к оптимизации мышечного тонуса мышц-мишеней – musculus trapezius и musculus levator scapulae с обеих сторон, увеличению активных и пассивных движений головы, снижению выраженности болевого синдрома. Таким образом, ботулинотерапия при СКФ может использоваться для повышения качества жизни пациентов, профилактики соединительнотканного перерождения вовлеченных в патологический процесс мышц, может позволить отсрочить оперативное вмешательство или избежать его использования. Klippel-Feil syndrome is a congenital malformation of the spine (mainly the cervical and upper thoracic vertebrae), in the form of their abnormal fusion, division disorders or physiological segmentation. Emergence of KFS is mostly associated with genetic mutations in following genes: GDF6, GDF3, MEOX1, MYO18B, RIPPLY2, BAZ1B, FREM2, SUFU, VANGL1, KMT2D. Clinically, the syndrome is manifested by multisystem pathology in which the leading symptoms belong to neurological disorders. The article presents the experience of off-lable therapy with botulinum toxin type A (BTA) reflex-tonic and pain syndrome in a child due to KFS. The botulinum toxin therapy performed in the early post-injection period led to the optimization of the muscle tone of the target muscles: musculus trapezius and musculus levator scapulae on both sides, an increase in active and passive head movements, and a decrease in the severity of pain syndrome. Therefore, botulinum toxin therapy in the case of KFS can be used for increasing patient life quality, prevention of connective tissue muscles degeneration and can allow to delay or avoid surgery.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334668","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}
Введение. База данных – это упорядоченный набор структурированных информативных данных, представленных для хранения в электронных файлах в системе компьютера. Эти данные легко управляемы, изменяемы, легко обновляются, контролируются и упорядочиваются. В большинстве своем базы данных для проведения записи и запросов данных используют языки для структурирования. Цель. Изучение отдельных проблем формирования базы данных для проведения медицинских исследований в сфере неврологии и нейрохирургии с учетом особенностей сохранения личной информации, а также поиск подхода к объединению общих прикладных понятий для проведения совместных научных исследований в России и Республике Беларусь. Материалы и методы. Изучены отдельные проблемы, оказывающие влияние на формирование понятия базы данных, с целью проведения медицинских исследований в сфере неврологии и нейрохирургии с учетом особенностей сохранения личных данных пациентов. Методологической основой исследования являются общенаучный метод, метод формальной логики и системного анализа, синтез, индукция, метод описания и сравнения. Результаты. Понятие «персональные данные» впервые зафиксировал Закон «Об информации, информатизации и защите информации» (абз. 24 ст. 1 Закона «Об информации, информатизации и защите информации» в Республике Беларусь и Федеральный закон «Об информации, информационных технологиях и о защите информации» от 27.07.2006 № 149-ФЗ в России). Защита информации о частной жизни физического лица и персональных данных этими законами как в Беларуси, так и в России рассматривается как принцип правового регулирования информационных отношений (абз. 5 ст. 4 Закона «Об информации, информатизации и защите информации» Республики Беларусь, а также ст. 5 Федерального закона «Об информации, информационных технологиях и о защите информации» от 27.07.2006 № 149-ФЗ в последней редакции), а сохранение и неразглашение персональных данных – как цель защиты информации (абз. 3 ст. 27 Закона «Об информации, информатизации и защите информации» Республики Беларусь и последняя редакция Федерального закона «Об информации, информационных технологиях и о защите информации» от 27.07.2006 № 149-ФЗ, статья 3 «Принципы правового регулирования отношений в сфере информации, информационных технологий и защиты информации»). Согласие субъекта персональных данных на обработку специальных персональных данных не требуется, если действие производится в целях организации оказания медицинской помощи. Однако должно быть соблюдено условие, что такие персональные данные обрабатываются медицинским, фармацевтическим или иным работником здравоохранения, на которого возложены обязанности по обеспечению защиты персональных данных. Учитывая наличие множества особенностей в конкретной отрасли медицины, должна учитываться совокупность факторов. Одно из главных требований состоит в том, что обработка персональных данных должна ограничиваться достижением заранее заявленных конкретных целей. Одной из особенностей обследования пациентов с невроло
{"title":"Legal Regulation of Information Relations when Creating a Database of Medical Research for Neurological and Neurosurgical Patients","authors":"А.В. Белецкий, Т.В. Жукова, С.А. Лихачев, Ю.Г. Шанько, А.В. Борисов, С.М. Полякова, К.А. Самочерных, Н.Е. Иванова, Ю.М. Забродская","doi":"10.34883/pi.2023.13.3.039","DOIUrl":"https://doi.org/10.34883/pi.2023.13.3.039","url":null,"abstract":"Введение. База данных – это упорядоченный набор структурированных информативных данных, представленных для хранения в электронных файлах в системе компьютера. Эти данные легко управляемы, изменяемы, легко обновляются, контролируются и упорядочиваются. В большинстве своем базы данных для проведения записи и запросов данных используют языки для структурирования. Цель. Изучение отдельных проблем формирования базы данных для проведения медицинских исследований в сфере неврологии и нейрохирургии с учетом особенностей сохранения личной информации, а также поиск подхода к объединению общих прикладных понятий для проведения совместных научных исследований в России и Республике Беларусь. Материалы и методы. Изучены отдельные проблемы, оказывающие влияние на формирование понятия базы данных, с целью проведения медицинских исследований в сфере неврологии и нейрохирургии с учетом особенностей сохранения личных данных пациентов. Методологической основой исследования являются общенаучный метод, метод формальной логики и системного анализа, синтез, индукция, метод описания и сравнения. Результаты. Понятие «персональные данные» впервые зафиксировал Закон «Об информации, информатизации и защите информации» (абз. 24 ст. 1 Закона «Об информации, информатизации и защите информации» в Республике Беларусь и Федеральный закон «Об информации, информационных технологиях и о защите информации» от 27.07.2006 № 149-ФЗ в России). Защита информации о частной жизни физического лица и персональных данных этими законами как в Беларуси, так и в России рассматривается как принцип правового регулирования информационных отношений (абз. 5 ст. 4 Закона «Об информации, информатизации и защите информации» Республики Беларусь, а также ст. 5 Федерального закона «Об информации, информационных технологиях и о защите информации» от 27.07.2006 № 149-ФЗ в последней редакции), а сохранение и неразглашение персональных данных – как цель защиты информации (абз. 3 ст. 27 Закона «Об информации, информатизации и защите информации» Республики Беларусь и последняя редакция Федерального закона «Об информации, информационных технологиях и о защите информации» от 27.07.2006 № 149-ФЗ, статья 3 «Принципы правового регулирования отношений в сфере информации, информационных технологий и защиты информации»). Согласие субъекта персональных данных на обработку специальных персональных данных не требуется, если действие производится в целях организации оказания медицинской помощи. Однако должно быть соблюдено условие, что такие персональные данные обрабатываются медицинским, фармацевтическим или иным работником здравоохранения, на которого возложены обязанности по обеспечению защиты персональных данных. Учитывая наличие множества особенностей в конкретной отрасли медицины, должна учитываться совокупность факторов. Одно из главных требований состоит в том, что обработка персональных данных должна ограничиваться достижением заранее заявленных конкретных целей. Одной из особенностей обследования пациентов с невроло","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334538","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}
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