[Brain function recovery after prolonged posttraumatic coma].

OBJECTIVE: To explore the characteristics of brain function recovery in patients after prolonged posttraumatic coma and with long-unconscious states. MATERIAL AND METHODS: Eighty-seven patients after prolonged posttraumatic coma were followed-up for two years. An analysis of a clinical/neurological picture after a prolonged episode of coma was based on the dynamics of vital functions, neurological status and patient's reactions to external stimuli. RESULTS AND CONCLUSION: Based on the dynamics of the clinical/neurological picture that shows the recovery of functions of the certain brain areas, three stages of brain function recovery after a prolonged episode of coma were singled out: brain stem areas, diencephalic areas and telencephalic areas. These functional/anatomic areas of brain function recovery after prolonged coma were compared to the present classifications.

[Selection criteria for parameters of electric current in trans-CSF brain stimulation in patients with posttraumatic vegetative state].

Trans-CSF brain stimulation is on of applied methods of stimulation in posttraumatic vegetative state. The paper analyzes application of this technique under the control by different methods of electrophysiological monitoring. Authors suggest principles of selection of stimulation parameters and detectable criteria of its effectiveness.

[Peculiarities of disorders of brain bioelectrical activity spatial-time organization in patients with different consciousness depression after severe head injury].

Specific changes of bioelectrical brain activity was found in 27 patients with different level of posttraumatic consciousness depression by the methods of crosscorrelation, coherence and factor analysis of EEG. The changes of activity of morphofunctional systems of intracerebral integrations were revealed partially by decreasing of unspecific activity from brainstem structures reflected with increasing of slow wave activity and decreasing of EEG coherence in alpha- and beta-range. Depression of system organization of interconnections of bioelectrical brain activity in frontal and occipital regions of both hemispheres was also detected, and testified about decreasing of intercortical and thalamocortical brain system action under brain dislocation. The changes of integrative brain system activity, provides interhemispheric interaction, had the specific characted. Our results propose a "facilitation" of activity of system, providing "direct" interhemispheric connections through corpus callosum and other commissural tracts of telencephalon as a sequel of mesodiencephalon structures depression with steady reciprocal, antiphase relations of slow weve activity in symmetrical areas of hemispheres in coma II patients. The data of our research had shown no complete disintegration of system brain activity in coma II patients in spite of consciousness and brainstem reflexes depression.

[Effects of transliquoral electrical brain stimulation on the wakefulness-sleep cycle in rats].

Peculiarities of natural behavior in unanesthesired Wistar strain rats, and their electrogram patterns under the liquor brainstem electrical stimulation were in the focus of present study. Analysis of the electrogram specters of somatosensory and auditory areas of the cortex, hippocampus, mediodorsal thalamic nucleus, lateral periaqueductal gray and fastigial cerebellar nucleus revealed authentic increasing of teta-waves most significantly during slow-wave sleep period under the electrostimulation. The increasing of complete wakefulness-sleep cycles was found after multiple (15-20 per hour) stimulations. Possible homeostatic effect of the liquor brainstem electrical stimulation on somnogenic mechanisms are discussed.

[Trans-CSF electrostimulation of the brain in patients with posttraumatic vegetative state (theoretical basis and preliminary results)].

Theoretical basis of trans-CSF electrostimulation of the brainstem in posttraumatic vegetative state is described. Clinical and electrophysiological effects of the technique are presented.

[Posttraumatic vegetative status: clinical picture, diagnosis, and potentialities of treatment].

Based on the results of treatment in 167 patients with severe brain injury, the authors estimated the immediate outcomes of the injury within 4 months. In particular, the regularities and frequency of formation of the traumatic vegetative status were established. The specific MRI signs are described in this condition. Its new treatment by transliquor electrostimulation of the brain stem is proposed.

[Experimental research of biological inertness of nickel-titanium alloy with memory of the form].

Research was conducted on 26 adult outbred male and female mice, which were implanted with nickel-titanium wire in the paravertebral zone. The tissues surrounding the implants were studied macroscopically and histologically 2-8 months after the implantation. It was found that the morphological changes of tissues after nickel-titanium wire implantation were detected by microscopical study at the time intervals greater than 2 months after the operation. They included the formation of a thin connective tissue capsule in close vicinity to the implant. No signs of reactive changes in the distant tissues and organs were detected. It is concluded, that the nickel-titanium alloy possesses high degree of biological inertness and may be used for making fixating devices with the memory of mechanical shape that are employed in cranioreconstructive surgery.

[Clinico-neurological features, diagnostics and surgical treatment of posttraumatic chronic subdural hematomas].

The article presents results of a complex clinico-neurological and radiological examination of 47 patients with posttraumatic chronic subdural hematomas. Clinical features of the course of chronic hematomas against the background of a severe cranio-cerebral injury are established. On the basis of an analysis of data of a complex examination and results of the surgical treatment, the indications to using different methods of surgery are specified. The optimum methods of surgical treatment of patients with chronic subdural hematomas were found to be minimally invasive operations.