[Secondary spondylogenic epidural abscess]. / Vtorichnyi spondilogennyi épidural'nyi abstsess.

The article presents the results of a retrospective analysis of 200 patients with hematogenous osteomyelitis of the spine who were treated in the Tyumen Regional Clinical Hospital #2. Neurological disorders were present in 37 patients (group I); 163 patients (group II) had no neurological disorders; according to CT and MRI, secondary spondylogenic epidural abscess was diagnosed in 24 patients. At admission, the severity of neurological deficit assessed using the Frankel scale was as follows: Grade A - 6 cases, Grade B - 7 cases, Grade C - 17 cases, Grade D - 5 cases, and Grade E - 2 cases (epidural abscess without neurological deficit). At discharge, the severity of neurological deficit was as follows: Grade A - 3 cases, Grade B - 2 cases, Grade C - 13 cases, Grade D - 11 cases, and Grade E - 8 cases. In group I, 35 out of 37 patients underwent surgery; of these, 21 patients had improvements. There were no statistically significant differences in neurological deficit changes between patients with and without epidural abscess. In 12 patients, the neurological status remained unchanged. Two patients died. We present an analysis of the severity of neurological symptoms, depending on the spinal lesion level, and the results of microbiological tests. Changes in neurological symptoms in lesions of various spinal parts are described. Cervical spine lesions and the process caused by S. aureus are shown to significantly increase the risk of neurological disorders. An active surgical approach for complicated forms of spinal osteomyelitis provided partial or complete regression of neurological disorders in 62.2% of cases.

EEG biomarkers of activation of the lymphatic drainage system of the brain during sleep and opening of the blood-brain barrier.

The lymphatic drainage system of the brain (LDSB) is the removal of metabolites and wastes from its tissues. A dysfunction of LDSB is an important sign of aging, brain oncology, the Alzheimer's and Parkinson's diseases. The development of new strategies for diagnosis of LDSB injuries can improve prevention of age-related cerebral amyloid angiopathy, neurodegenerative and cerebrovascular diseases. There are two conditions, such as deep sleep and opening of the blood-brain-barrier (OBBB) associated with the LDSB activation. A promising candidate for measurement of LDSB could be electroencephalography (EEG). In this pilot study on rats, we tested the hypothesis, whether deep sleep and OBBB can be an informative platform for an effective extracting of information about the LDSB functions. Using the nonlinear analysis of EEG dynamics and machine learning technology, we discovered that the LDSB activation during OBBB and sleep is associated with similar changes in the EEG θ-activity. The OBBB causes the higher LDSB activation vs. sleep that is accompanied by specific changes in the low frequency EEG activity extracted by the power spectra analysis of the EEG dynamics combined with the coherence function. Thus, our findings demonstrate a link between neural activity associated with the LDSB activation during sleep and OBBB that is an important informative platform for extraction of the EEG-biomarkers of the LDSB activity. These results open new perspectives for the development of technology for the LDSB diagnostics that would open a novel era in the prognosis of brain diseases caused by the LDSB disorders, including OBBB.