Stereotactic radiosurgery has firmly entered the arsenal of methods for treating vestibular schwannomas along with traditional surgical removal, providing high control of tumor growth and a low level of functional complications. Meanwhile, there is evidence of a possible relationship between the irradiation performed and the subsequent development of non-occlusive hydrocephalus. Purpose: to retrospectively assess the current level of development of hydrocephalus after stereotactic radiosurgery for vestibular schwannomas. Materials and methods: of 541 patients who received treatment with the Gamma Knife for unilateral vestibular schwannoma, 456 (84.3%) patients initially had no signs of non-occlusive hydrocephalus (group 1), while in 85 (15.7%) patients, MRI signs of internal non-occlusive hydrocephalus were revealed at the time of radiosurgery (group 2), of whom in 1 case VP shunting had previously been performed. In all cases, non-occlusive hydrocephalus at the time of SRS had a compensated course without clinical manifestations. Results: after radiosurgery, the development of de novo non-occlusive hydrocephalus in 7 (1.5%) patients from group 1 and its progression in 11 (12.9%) patients from group 2 were noted. The overall incidence of non-occlusive hydrocephalus after radiosurgery was 3.3%. Ventriculoperitoneal shunting was required in 3 cases in group 1 and 7 cases in group 2 due to the occurrence of neurological symptoms (1.8%). Conclusion: In some cases, radiosurgery can lead to decompensation of existing non-occlusive hydrocephalus, but it rarely occurs de novo. The asymptomatic course of non-occlusive hydrocephalus allows for SRS, as the risk of decompensation with subsequent need for VP shunting is low. Patients with non-occlusive hydrocephalus before SRS require more careful monitoring with assessment of neurological status and control MRI.
{"title":"Non-occlusive hydrocephalus after radiosurgery for vestibular schwannomas","authors":"S. R. Ilyalov, S. Banov, A. Golanov, D. Usachev","doi":"10.33920/med-01-2401-14","DOIUrl":"https://doi.org/10.33920/med-01-2401-14","url":null,"abstract":"Stereotactic radiosurgery has firmly entered the arsenal of methods for treating vestibular schwannomas along with traditional surgical removal, providing high control of tumor growth and a low level of functional complications. Meanwhile, there is evidence of a possible relationship between the irradiation performed and the subsequent development of non-occlusive hydrocephalus. Purpose: to retrospectively assess the current level of development of hydrocephalus after stereotactic radiosurgery for vestibular schwannomas. Materials and methods: of 541 patients who received treatment with the Gamma Knife for unilateral vestibular schwannoma, 456 (84.3%) patients initially had no signs of non-occlusive hydrocephalus (group 1), while in 85 (15.7%) patients, MRI signs of internal non-occlusive hydrocephalus were revealed at the time of radiosurgery (group 2), of whom in 1 case VP shunting had previously been performed. In all cases, non-occlusive hydrocephalus at the time of SRS had a compensated course without clinical manifestations. Results: after radiosurgery, the development of de novo non-occlusive hydrocephalus in 7 (1.5%) patients from group 1 and its progression in 11 (12.9%) patients from group 2 were noted. The overall incidence of non-occlusive hydrocephalus after radiosurgery was 3.3%. Ventriculoperitoneal shunting was required in 3 cases in group 1 and 7 cases in group 2 due to the occurrence of neurological symptoms (1.8%). Conclusion: In some cases, radiosurgery can lead to decompensation of existing non-occlusive hydrocephalus, but it rarely occurs de novo. The asymptomatic course of non-occlusive hydrocephalus allows for SRS, as the risk of decompensation with subsequent need for VP shunting is low. Patients with non-occlusive hydrocephalus before SRS require more careful monitoring with assessment of neurological status and control MRI.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503190","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}
E. I. Glushchenko, K. V. Gubskaya, L. V. Sinitsyna, Y. Malygin
Affective disorders occupy one of the leading places in the structure of comorbidity in multiple sclerosis, but the questions concerning etiopathogenesis, qualification, diagnosis, and prediction of these disorders remain controversial. The most important consequences of affective disorders in MS include a decrease in the patient's quality of life, adherence to treatment, and their daily activities, and an increased risk of suicide and death from cardiovascular diseases. In this regard, the need for early detection and prediction of the development of depression in patients with MS is obvious. The following factors are considered among the predictors of the development of emotional distress and affective disorders: social, psychological, demographic, neurocognitive, and treatment-related factors, neuroimaging data, lifestyle features, comorbidities, characteristics of multiple sclerosis and its social implications. Specifically, younger age at the time of diagnosis, the presence of dyssomnia, fatigue, consumption of dairy products, atrophy of cortical areas in the frontal lobes, and decreased white matter volume of the uncinate fasciculus predict the development of depression. This article reviews the features of depressive and bipolar spectrum disorders in patients with MS.
{"title":"Qualification and predictors of the development of affective disorders in multiple sclerosi","authors":"E. I. Glushchenko, K. V. Gubskaya, L. V. Sinitsyna, Y. Malygin","doi":"10.33920/med-01-2401-12","DOIUrl":"https://doi.org/10.33920/med-01-2401-12","url":null,"abstract":"Affective disorders occupy one of the leading places in the structure of comorbidity in multiple sclerosis, but the questions concerning etiopathogenesis, qualification, diagnosis, and prediction of these disorders remain controversial. The most important consequences of affective disorders in MS include a decrease in the patient's quality of life, adherence to treatment, and their daily activities, and an increased risk of suicide and death from cardiovascular diseases. In this regard, the need for early detection and prediction of the development of depression in patients with MS is obvious. The following factors are considered among the predictors of the development of emotional distress and affective disorders: social, psychological, demographic, neurocognitive, and treatment-related factors, neuroimaging data, lifestyle features, comorbidities, characteristics of multiple sclerosis and its social implications. Specifically, younger age at the time of diagnosis, the presence of dyssomnia, fatigue, consumption of dairy products, atrophy of cortical areas in the frontal lobes, and decreased white matter volume of the uncinate fasciculus predict the development of depression. This article reviews the features of depressive and bipolar spectrum disorders in patients with MS.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502703","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}
The cosmetic outcome of cranioplasty performed with individual implants is an important component in assessing the results of surgical reconstructions of scull defects. Developing temporalis muscle atrophy affects the harmonic face contour and, in cases of using patient-specific implants (PSI), designed taking into account bone symmetry, may discredit this technique due to unsatisfactory cosmetic results. In this regard, an urgent task is to find the possibility of compensating for a visual defect by modifying the shape of individual implants in order to achieve good cosmetic results. 54 cases of performed cranioplasty were divided into two groups: in the first group (n=32), the implant was modeled symmetrically to the intact side of the skull; in the second group (n=22), the curvature of the plates was modified to compensate for the developing temporalis muscle atrophy. To standardize the zone potentially responsible for the temporal muscle atrophy, a refining marking of the KrÖnlein-Bryusova scheme was carried out. To determine the optimal structural element that increases the strength of the plates in the area of their free edge, a number of load experiments were carried out in a specialized computer environment. Good cosmetic efficacy for periods of at least 6 months after the operation using symmetrical implants and localization of defects in the temporal region was noted in 68.7 % of cases, while with the use of modified implants this figure amounted to 100 %. The results of digital modeling have established that the rounding of the free edge is the optimal structural element that increases the strength of the plates. The developed approaches have a high potential for implementation in neurosurgical practice when performing cranioplasty in patients with defects of the skull bones localized in the temporal rectangle zone.
{"title":"Cosmetic outcomes of cranioplasty using individual titanium implants","authors":"S. V. Mishinov","doi":"10.33920/med-01-2401-09","DOIUrl":"https://doi.org/10.33920/med-01-2401-09","url":null,"abstract":"The cosmetic outcome of cranioplasty performed with individual implants is an important component in assessing the results of surgical reconstructions of scull defects. Developing temporalis muscle atrophy affects the harmonic face contour and, in cases of using patient-specific implants (PSI), designed taking into account bone symmetry, may discredit this technique due to unsatisfactory cosmetic results. In this regard, an urgent task is to find the possibility of compensating for a visual defect by modifying the shape of individual implants in order to achieve good cosmetic results. 54 cases of performed cranioplasty were divided into two groups: in the first group (n=32), the implant was modeled symmetrically to the intact side of the skull; in the second group (n=22), the curvature of the plates was modified to compensate for the developing temporalis muscle atrophy. To standardize the zone potentially responsible for the temporal muscle atrophy, a refining marking of the KrÖnlein-Bryusova scheme was carried out. To determine the optimal structural element that increases the strength of the plates in the area of their free edge, a number of load experiments were carried out in a specialized computer environment. Good cosmetic efficacy for periods of at least 6 months after the operation using symmetrical implants and localization of defects in the temporal region was noted in 68.7 % of cases, while with the use of modified implants this figure amounted to 100 %. The results of digital modeling have established that the rounding of the free edge is the optimal structural element that increases the strength of the plates. The developed approaches have a high potential for implementation in neurosurgical practice when performing cranioplasty in patients with defects of the skull bones localized in the temporal rectangle zone.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503250","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}
D. Starchik, A. S. Khudas, A. V. Еvtushenko, A. V. Pastarnak
The trigeminal nerve is a complex anatomical formation that performs very important tasks in terms of functionality. This article focuses on the study of the exit of the trigeminal nerve and its syntopy with arteries. It is the study of the location of nearby vessels relative to the nerve and their neurovascular conflict that determines the relevance of this work. The prevalence of trigeminal neuralgia (TN) is quite high and amounts to 40–60 patients per 100,000 population, and the incidence according to the World Health Organization is within 2–4 people per 10,000 population. The maximum risk of neurovascular conflict is observed in the age group of people from 45 to 60 years. It is also known that women suffer from neuralgia significantly more often than men. Not only the exact diagnosis, but also the selection of the most appropriate treatment tactics will depend on the result of studies of the individual anatomical features of the pons area. The authors of the article studied 17 preparations of the base of the brain of middle-aged individuals, fixed in a 7 % formalin solution. Of the 17 preparations studied, neurovascular relationships were noted in 14, which is 82.4 % of the total. As a result of morphometric measurements, the data on the length and width of the pons, the thickness of the trigeminal nerve roots, and the middle cerebellar peduncles were obtained. Statistical data processing and photographic documentation were carried out. The clinical manifestations of the disease, diagnostic options, and various methods of treatment were considered. The most effective method of treating neurovascular conflict is surgery, the first mention of which dates back to 1934.
{"title":"Features of trigeminal nerve exit on the base of the brain: neurovascular conflict","authors":"D. Starchik, A. S. Khudas, A. V. Еvtushenko, A. V. Pastarnak","doi":"10.33920/med-01-2312-04","DOIUrl":"https://doi.org/10.33920/med-01-2312-04","url":null,"abstract":"The trigeminal nerve is a complex anatomical formation that performs very important tasks in terms of functionality. This article focuses on the study of the exit of the trigeminal nerve and its syntopy with arteries. It is the study of the location of nearby vessels relative to the nerve and their neurovascular conflict that determines the relevance of this work. The prevalence of trigeminal neuralgia (TN) is quite high and amounts to 40–60 patients per 100,000 population, and the incidence according to the World Health Organization is within 2–4 people per 10,000 population. The maximum risk of neurovascular conflict is observed in the age group of people from 45 to 60 years. It is also known that women suffer from neuralgia significantly more often than men. Not only the exact diagnosis, but also the selection of the most appropriate treatment tactics will depend on the result of studies of the individual anatomical features of the pons area. The authors of the article studied 17 preparations of the base of the brain of middle-aged individuals, fixed in a 7 % formalin solution. Of the 17 preparations studied, neurovascular relationships were noted in 14, which is 82.4 % of the total. As a result of morphometric measurements, the data on the length and width of the pons, the thickness of the trigeminal nerve roots, and the middle cerebellar peduncles were obtained. Statistical data processing and photographic documentation were carried out. The clinical manifestations of the disease, diagnostic options, and various methods of treatment were considered. The most effective method of treating neurovascular conflict is surgery, the first mention of which dates back to 1934.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176267","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}
The article provides a review of the scientific literature on affective disorders in the structure of post-COVID syndrome. The issues of etiopathogenesis are revealed from the perspective of the modern paradigm based on the biopsychosocial model of the development of mental disorders. Features of clinical picture, psychopathology, dynamics, and psychopharmacotherapy are discussed. The relevance of studying affective disorders in the post-COVID period is caused by the prevalence of COVID-19 among the population and the burden of the SARS-CoV-2 pandemic, in order to clarify the typology and clinical features and further develop diagnostic algorithms and ways of therapeutic interventions.
{"title":"Affective disorders in the structure of post-COVID syndrome (literature review)","authors":"O. V. Druzhkova, D. F. Khritinin","doi":"10.33920/med-01-2312-05","DOIUrl":"https://doi.org/10.33920/med-01-2312-05","url":null,"abstract":"The article provides a review of the scientific literature on affective disorders in the structure of post-COVID syndrome. The issues of etiopathogenesis are revealed from the perspective of the modern paradigm based on the biopsychosocial model of the development of mental disorders. Features of clinical picture, psychopathology, dynamics, and psychopharmacotherapy are discussed. The relevance of studying affective disorders in the post-COVID period is caused by the prevalence of COVID-19 among the population and the burden of the SARS-CoV-2 pandemic, in order to clarify the typology and clinical features and further develop diagnostic algorithms and ways of therapeutic interventions.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176445","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}
The aim of the research was to study the clinical and psychopathological characteristics of patients with pulmonary tuberculosis in the active phase and identified anxiety and depressive disorders. The study included 145 patients with anxiety-depressive disorders: 85 patients with a diagnosis of pulmonary tuberculosis who were being treated in a phthisiological hospital (the main group) and 60 patients with anxiety-depressive disorders without a history of tuberculosis, who were under follow-up and treatment in a psychoneurological dispensary (comparison group). In addition, in the main clinical group, two subgroups were identified depending on the length of hospital stay: with hospital stays of up to 2 months (44 patients) and over 2 months (41 patients). The study assessed the level of anxiety-depressive disorders, asthenia, the nature and intensity of psychosomatic complaints, and signs of vegetative changes. The study showed the presence of more intense psychosomatic complaints, asthenic disorders, and signs of autonomic disorders among the patients with pulmonary tuberculosis compared to those without tuberculosis. Furthermore, in the main clinical group, there was an increase in anxiety-depressive symptoms, asthenic manifestations, and signs of vegetative changes during a longer stay in the phthisiological hospital. The obtained results are presented in the context of the concept of «psychosomatic proportion», implying the ratio of subjective and objective components of patients» psychosomatic status (intensity and structure of psychosomatic complaints and objectively detectable somatovegetative changes in the body). It is concluded that tuberculosis determines a more severe course of affective spectrum disorders and negatively affects the general psychosomatic state of patients, while a long stay in a phthisiological hospital contributes to the chronic course and aggravation of anxiety-depressive disorders, which indicates the need for timely detection and treatment of affective pathology, as well as taking into account predictors of its development in order to elaborate an integrated approach to the therapy of tuberculosis and concomitant mental disorders.
{"title":"Clinical and psychopathological characteristics of patients with pulmonar y tuberculosis and anxiety-depressive disorders treated in a phthisiological hospital","authors":"D. A. Minochkin, A. Y. B. A. Yu. Berezantsev","doi":"10.33920/med-01-2312-01","DOIUrl":"https://doi.org/10.33920/med-01-2312-01","url":null,"abstract":"The aim of the research was to study the clinical and psychopathological characteristics of patients with pulmonary tuberculosis in the active phase and identified anxiety and depressive disorders. The study included 145 patients with anxiety-depressive disorders: 85 patients with a diagnosis of pulmonary tuberculosis who were being treated in a phthisiological hospital (the main group) and 60 patients with anxiety-depressive disorders without a history of tuberculosis, who were under follow-up and treatment in a psychoneurological dispensary (comparison group). In addition, in the main clinical group, two subgroups were identified depending on the length of hospital stay: with hospital stays of up to 2 months (44 patients) and over 2 months (41 patients). The study assessed the level of anxiety-depressive disorders, asthenia, the nature and intensity of psychosomatic complaints, and signs of vegetative changes. The study showed the presence of more intense psychosomatic complaints, asthenic disorders, and signs of autonomic disorders among the patients with pulmonary tuberculosis compared to those without tuberculosis. Furthermore, in the main clinical group, there was an increase in anxiety-depressive symptoms, asthenic manifestations, and signs of vegetative changes during a longer stay in the phthisiological hospital. The obtained results are presented in the context of the concept of «psychosomatic proportion», implying the ratio of subjective and objective components of patients» psychosomatic status (intensity and structure of psychosomatic complaints and objectively detectable somatovegetative changes in the body). It is concluded that tuberculosis determines a more severe course of affective spectrum disorders and negatively affects the general psychosomatic state of patients, while a long stay in a phthisiological hospital contributes to the chronic course and aggravation of anxiety-depressive disorders, which indicates the need for timely detection and treatment of affective pathology, as well as taking into account predictors of its development in order to elaborate an integrated approach to the therapy of tuberculosis and concomitant mental disorders.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176630","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}
I. E. Danilin, M. Artemieva, A. I. Ivanov, V. A. Venkova
Non-suicidal self-injurious behavior is almost never monosymptomatic. It is frequently combined with eating disorders, in particular bulimia nervosa. A description of a clinical case of improvement in the condition of a patient with non-suicidal self-injurious behavior and bulimia nervosa when using topiramate as part of combination therapy is presented.
{"title":"Efficacy of therapy for non-suicidal self-injurious behavior in a bulimia nervosa patient (a clinical case report)","authors":"I. E. Danilin, M. Artemieva, A. I. Ivanov, V. A. Venkova","doi":"10.33920/med-01-2312-06","DOIUrl":"https://doi.org/10.33920/med-01-2312-06","url":null,"abstract":"Non-suicidal self-injurious behavior is almost never monosymptomatic. It is frequently combined with eating disorders, in particular bulimia nervosa. A description of a clinical case of improvement in the condition of a patient with non-suicidal self-injurious behavior and bulimia nervosa when using topiramate as part of combination therapy is presented.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176555","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}
E. Tkachenko, V. S. Anvarkhuzhaev, M. E. Kuzminova, A. I. Raevskaya
This article presents a clinical case report of the development of facial nerve neuropathy associated with diabetes mellitus in a 47‑year-old patient. The paper presents the data of general and neurological examinations and the results of additional laboratory and instrumental studies.
{"title":"Facial nerve neuropathy associated with hyperglycemia","authors":"E. Tkachenko, V. S. Anvarkhuzhaev, M. E. Kuzminova, A. I. Raevskaya","doi":"10.33920/med-01-2312-08","DOIUrl":"https://doi.org/10.33920/med-01-2312-08","url":null,"abstract":"This article presents a clinical case report of the development of facial nerve neuropathy associated with diabetes mellitus in a 47‑year-old patient. The paper presents the data of general and neurological examinations and the results of additional laboratory and instrumental studies.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176815","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}
I. P. Molchanov, I. O. Masaleva, D. A. Artsybashev, V. V. Volkov, N. V. Bolomatov
Introduction. The neuroradiological picture of multiple sclerosis (MS) is characterized by a focal demyelinating process in the central nervous system. Gender-specific patterns of demyelination are attributed to a propensity for neurodegenerative or proinflammatory phenotypes in different sexes. The heterogeneity of studies examining the correlation between the prevalence of focal lesions and the degree of disability necessitates the assessment of the contribution of gender characteristics in MS to the rates of disability in patients. The purpose of the study is to assess gender differences in the localization of the demyelinating process and the relationship between the morphological and quantitative characteristics of the lesion and the indicators of the disability scale in multiple sclerosis. Materials and methods. A prospective analysis of magnetic resonance imaging data using goodness-of-fit tests and correlation analysis was carried out on 76 patients (47 women, 29 men; mean age 41.3±11.3) with relapsing remitting multiple sclerosis during a period of stable remission, receiving outpatient care in the Kursk Regional Multidisciplinary Clinical Hospital for the years 2019–2022. Results. The quantitative indicator of the frequency of localization of lesions in the corpus callosum is characterized by a predominance in the male population (62 %) compared to female population (42.5 %) (p<0.05). Lesions in the cerebellum and cervical spinal cord were found predominantly in men: 48.3 % versus 21.3 % in women, and 75.9 % versus 36.1 %, respectively (p<0.05; p<0.001). According to the frequency quantitative value of the periventricular localization of the demyelinating process, a prevalence was recorded in males (96.5 %) compared to females (70.2 %) (p<0.05). In the studied sample, there were significant differences in the number of lesions in different gender groups (p<0.05), which, however, did not affect the degree of disability of patients. Correlation analysis demonstrated the presence of a moderate positive relationship between the size of the leading lesion and Expanded Disability Status Scale (EDSS) scores in females (ρ=0.287; p<0.05). Conclusion. Gender-specific features of the neuroradiological picture in multiple sclerosis are characterized by the spatial predominance of the demyelinating process in men (periventricular localization, cerebellum, corpus callosum, cervical spinal cord) and the size of the leading lesion in women, comparable to the degree of disability of patients.
{"title":"Sexual dimorphism of clinical and radiological characteristics in patients with multiple sclerosis","authors":"I. P. Molchanov, I. O. Masaleva, D. A. Artsybashev, V. V. Volkov, N. V. Bolomatov","doi":"10.33920/med-01-2312-07","DOIUrl":"https://doi.org/10.33920/med-01-2312-07","url":null,"abstract":"Introduction. The neuroradiological picture of multiple sclerosis (MS) is characterized by a focal demyelinating process in the central nervous system. Gender-specific patterns of demyelination are attributed to a propensity for neurodegenerative or proinflammatory phenotypes in different sexes. The heterogeneity of studies examining the correlation between the prevalence of focal lesions and the degree of disability necessitates the assessment of the contribution of gender characteristics in MS to the rates of disability in patients. The purpose of the study is to assess gender differences in the localization of the demyelinating process and the relationship between the morphological and quantitative characteristics of the lesion and the indicators of the disability scale in multiple sclerosis. Materials and methods. A prospective analysis of magnetic resonance imaging data using goodness-of-fit tests and correlation analysis was carried out on 76 patients (47 women, 29 men; mean age 41.3±11.3) with relapsing remitting multiple sclerosis during a period of stable remission, receiving outpatient care in the Kursk Regional Multidisciplinary Clinical Hospital for the years 2019–2022. Results. The quantitative indicator of the frequency of localization of lesions in the corpus callosum is characterized by a predominance in the male population (62 %) compared to female population (42.5 %) (p<0.05). Lesions in the cerebellum and cervical spinal cord were found predominantly in men: 48.3 % versus 21.3 % in women, and 75.9 % versus 36.1 %, respectively (p<0.05; p<0.001). According to the frequency quantitative value of the periventricular localization of the demyelinating process, a prevalence was recorded in males (96.5 %) compared to females (70.2 %) (p<0.05). In the studied sample, there were significant differences in the number of lesions in different gender groups (p<0.05), which, however, did not affect the degree of disability of patients. Correlation analysis demonstrated the presence of a moderate positive relationship between the size of the leading lesion and Expanded Disability Status Scale (EDSS) scores in females (ρ=0.287; p<0.05). Conclusion. Gender-specific features of the neuroradiological picture in multiple sclerosis are characterized by the spatial predominance of the demyelinating process in men (periventricular localization, cerebellum, corpus callosum, cervical spinal cord) and the size of the leading lesion in women, comparable to the degree of disability of patients.","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176364","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}
K. V. Shevchenko, V. Shimanskiy, S. V. Tanyashin, V. K. Poshataev, V. V. Karnaukhov, Y. Strunina, K. Solozhentseva, I. N. Pronin, L. R. Gabrielyan, I. O. Kugushev
The development of research on CSF flow disorders made it possible initially to divide hydrocephalus into «communicating» and «non-communicating», and subsequently to distinguish the concepts of «intraventricular» and «extraventricular» obstruction. Improvement of radiological imaging technologies has allowed determining the exact level of CSF obstruction. In some cases, CSF flow disorders combine signs of different forms of hydrocephalus. Their correct classification allows selecting the type of surgical treatment, which reduces the rate of complications and patient»s dependence on the doctor. Purpose of the research: To study the radiological signs of hydrocephalus in idiopathic obstruction at the level of the posterior cranial fossa cisterns. Materials and methods. This study included adult patients (18 years old and over) whose disease was idiopathic in nature. From 2007 to 2020, 289 patients diagnosed with idiopathic hydrocephalus were treated at the N. N. Burdenko National Medical Research Center of Neurosurgery. Of these, 65 patients (18.7 %) had clinical and radiological signs of extraventricular obstruction. The male to female ratio was 25 and 40 (38.5 % and 61.5 %), respectively. A variety of radiological signs were assessed and their origin and occurrence in various forms of idiopathic hydrocephalus were determined. Results. FOHR was the highest (compared with other forms of idiopathic hydrocephalus (mean 0.52)). Other ventricular indices were also high. None of them correlated with the patient»s condition. Ventral dislocation of the premamillary membrane was detected in 89.2 %. Turkish saddle was of normal size in 51 (78.4 %) patients, while its enlargement was found in 13 (20 %) patients. A change in the periventricular signal was noted in 18.4 %. Aqueduct and IV ventricle outlets were patent in all cases as evidenced by CSF pulsation artifacts in T2 3D CUBE. The cerebral aqueduct was dilated in 63 (96.9 %) patients. Enlargement of the cisterna magna associated with hypotrophy of the caudal cerebellum was noted in 90.7 %, and this sign was significant for extraventricular cisternal obstruction (p <0.001). In addition to the T2 mode, the presence of sagittal sections in cisternography modes (FIESTA or CISS) was a prerequisite. By means of these modes, the ventral dislocation of the premamillary membrane was more clearly visualized, the presence of obstacles to the CSF flow in the cerebral aqueduct was excluded, and, most importantly, it was possible to determine the presence of additional membranes in the subarachnoid spaces between the ventral surface of the brain stem and the clivus. These were found in 100 % of the patients, which was also a significant pathognomonic sign (p < 0.001). Conclusion. The MRI picture of hydrocephalus with obstruction at the level of the posterior cranial fossa cisterns has specific signs. It combines the signs of other forms of hydrocephalus, chronic disease in combination with symptoms of the CSF pathw
{"title":"Neuroradiological characteristics of hydrocephalus due to idiopathic extraventricular CSF pathways obstruction","authors":"K. V. Shevchenko, V. Shimanskiy, S. V. Tanyashin, V. K. Poshataev, V. V. Karnaukhov, Y. Strunina, K. Solozhentseva, I. N. Pronin, L. R. Gabrielyan, I. O. Kugushev","doi":"10.33920/med-01-2312-09","DOIUrl":"https://doi.org/10.33920/med-01-2312-09","url":null,"abstract":"The development of research on CSF flow disorders made it possible initially to divide hydrocephalus into «communicating» and «non-communicating», and subsequently to distinguish the concepts of «intraventricular» and «extraventricular» obstruction. Improvement of radiological imaging technologies has allowed determining the exact level of CSF obstruction. In some cases, CSF flow disorders combine signs of different forms of hydrocephalus. Their correct classification allows selecting the type of surgical treatment, which reduces the rate of complications and patient»s dependence on the doctor. Purpose of the research: To study the radiological signs of hydrocephalus in idiopathic obstruction at the level of the posterior cranial fossa cisterns. Materials and methods. This study included adult patients (18 years old and over) whose disease was idiopathic in nature. From 2007 to 2020, 289 patients diagnosed with idiopathic hydrocephalus were treated at the N. N. Burdenko National Medical Research Center of Neurosurgery. Of these, 65 patients (18.7 %) had clinical and radiological signs of extraventricular obstruction. The male to female ratio was 25 and 40 (38.5 % and 61.5 %), respectively. A variety of radiological signs were assessed and their origin and occurrence in various forms of idiopathic hydrocephalus were determined. Results. FOHR was the highest (compared with other forms of idiopathic hydrocephalus (mean 0.52)). Other ventricular indices were also high. None of them correlated with the patient»s condition. Ventral dislocation of the premamillary membrane was detected in 89.2 %. Turkish saddle was of normal size in 51 (78.4 %) patients, while its enlargement was found in 13 (20 %) patients. A change in the periventricular signal was noted in 18.4 %. Aqueduct and IV ventricle outlets were patent in all cases as evidenced by CSF pulsation artifacts in T2 3D CUBE. The cerebral aqueduct was dilated in 63 (96.9 %) patients. Enlargement of the cisterna magna associated with hypotrophy of the caudal cerebellum was noted in 90.7 %, and this sign was significant for extraventricular cisternal obstruction (p <0.001). In addition to the T2 mode, the presence of sagittal sections in cisternography modes (FIESTA or CISS) was a prerequisite. By means of these modes, the ventral dislocation of the premamillary membrane was more clearly visualized, the presence of obstacles to the CSF flow in the cerebral aqueduct was excluded, and, most importantly, it was possible to determine the presence of additional membranes in the subarachnoid spaces between the ventral surface of the brain stem and the clivus. These were found in 100 % of the patients, which was also a significant pathognomonic sign (p < 0.001). Conclusion. The MRI picture of hydrocephalus with obstruction at the level of the posterior cranial fossa cisterns has specific signs. It combines the signs of other forms of hydrocephalus, chronic disease in combination with symptoms of the CSF pathw","PeriodicalId":447580,"journal":{"name":"Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176505","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：