[Growing teratoma syndrome in a patient with intracranial germ cell tumor].

A six-year-old patient with non-germinomatous germ cell tumor of the chiasmatic-sellar area developed polyuria and polydipsia as the first symptoms of the disease. Then there were signs of precocious puberty and vision impairment. MRI examination revealed a shiasmatic sellar tumor and occlusive hydrocephalus. Tumor marker levels in blood serum were elevated. The alpha-fetoprotein level was increased 5-fold; human chorionic gonadotropin 20-fold. These levels increased over time. The patient received 2 cycles of PEI multiagent chemotherapy (Ifosfamide 1.5 g/m(2), Cisplatin 20 mg/m(2), Etoposide 100 mg/m(2)) during 5 days and 1 cycle of second-line multiagent chemotherapy (Cisplatin 100 mg/m(2) for 1 day and Endoxan 1500 mg/m(2) for 2 days). Despite the decrease in tumor marker levels to normal values, the patient's vision still deteriorated. MRI examination revealed that tumor size increased and its structure changed. Total tumor resection led to vision improvement and regression of intracranial hypertension. Histological analysis of tumor tissue only revealed a mature teratoma. This phenomenon, known as growing teratoma syndrome, is very rare among patients with intracranial non-germinomatous germ cell tumors.

[Experience of using neuroendoscopy in treatment of noncommunicating hydrocephalus in infants].

320 children were operated on for occlusive hydrocephalus for 10 years (2003-2012). Infant patients amounted to 93.4%, of these newborns were 29.2%. An endoscopic technique was used to restore physiological liquor circulation and compensate for hydrocephalus without shunt implantation. The positive outcome was observed in 75% of cases. Occlusion of the subarachnoid space occurred in the other cases, which required a combination of neuroendoscopic intervention and shunt implantation. There were no complications and mortality associated with an operative trauma.

[Mapping of the motor-sensory cortex by functional magnetic resonance tomography in frontoparietal tumors]. / Kartirovanie motorno-sensornoi kory golovnogo mozga metodom funktsional'noi magnito-rezonansnoi tomografii pri opukholiakh lobno-temennoi oblasti.

The potentialities of functional magnetic resonance imaging (FM-RI) in the preoperative mapping of the motor-sensory cortex of the brain in 24 patients with frontoparietal tumors and 5 healthy volunteers were studied. A good reproducibility of results was achieved while using a simple irritation paradigm as finger flexion-extension. The obtained activation maps were projected to the region of anterior and posterior central gyri and to the central sulcus. Imposition of the maps of motor-sensory cortical activation with routine T1-weighed images allows a surgeon to gain an insight into the mutual location of a tumor and a functionally significant portion of the cortex, by reducing the intraoperative risk of damage to this area. The intraoperative determination of the central sulcus by the evoked potential method in 4 patients confirmed the results obtained after FMRI. The relationship of the obtained activation maps to the presence of venous structures in the area concerned requires further studies on the modes of clarifying the site of functionally significant cortical areas in the brain.

[The computed and magnetic resonance tomographic anatomy of the normal hippocampal area and in neurosurgical pathology]. / Komp'iuterno- i magnitno-rezonansno-tomograficheskaia anatomiia oblasti gippokampa v norme i pri neirokhirurgicheskoi patologii.

To make a correct diagnosis, a volumetric presentation of the anatomy of perihippocampal fluid spaces (PHFS) may be useful if there are abnormalities in the medial portion of the temporal region. Pathological processes in the region result in changes in the normal anatomy of PHFS. Hippocampal atrophy accompanied by enlarged PHFS is a sign of Alzheimer's disease (1081 patients). These changes are best detected on frontal MR images, but they can be seen at routine CT study. Hydrocephalus (88 patients) is characterized by dilatation of the lower horn of the lateral ventricles without increased dimensions of the transverse fissure. Normotensive hydrocephalus and Alzheimer's disease may be differentiated in evaluating the PHFS. The understanding of the anatomy of PHFS is useful in making a better assessment of the degree of both intra- and extracerebral tumors (in 296 patients) and arterioventricular malformations (in 12 patients) in the medial portions of the temporal regions.