[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.

[Application of expanders in surgical treatment of an infant with large myelomeningoradiculocele].

In the article authors describe application of expanders for effective closure of skin defect after surgical removal of large myelomeningoradiculocele in an infant.

[Tactics of surgical intervention in multileveled obstructive hydrocephalus in children].

Ninety-three obstruction areas were revealed in 23 operated children aged 1.5 to 16 years who had multileveled obstructive hydrocephalus. Fifty-four endoscopic manipulations were performed. These included perforation of the bottom of the third ventricle in 9 children, resection of the cystic wall in 33, that of membranous commissures in 2, and interventriculostomy in 10. Open cystectomy was made in 1 case. Compensation of hydrocephalus was achieved in 16 (64%) children; there was no need for revision of the preinserted and nonfunctioning shunt in 5 cases. Internal drainage operations were ineffective in 7 cases (remaining liquor hyporesorption in 3 cases and uncoupling of ventricles and subarachnoidal spaces in 4), in this connection, VP shunts were implanted or the preinserted ones were preserved. In 3 (13%) children, complications (moderate ventricular hemorrhages (n=2) and an exacerbation of aseptic ventriculitis (n=1)) were successfully abolished. Four children underwent resurgery due to closure of the preapplied cystic stoma. There were no fatal outcomes. Thus, neuroendoscopic interventions are the most effective treatment for multileveled obstructive hydrocephalus. Of priority is the creation of liquor outflow from a larger cavity that induces severe compression of cerebral structures or dislocation occlusion and from the ventricular system cavities located more orally. The need for implantation of intra- and extracranial drainages emerges only when occlusion cannot be endoscopically eliminated.

[Intracranial endoscopic operations with ultrasonographic support in pediatric neurosurgery (the potentials and outlook)]. / Vnutricherepnye éndoskopicheskie operatsii s ul'trasonograficheskim obespecheniem v neirokhirurgichii detskogo vozrasta (vozmozhnosti i perspektivy).

The outcomes of intracranial endoscopic operations for occlusive hydrocephalus (65 interventions in 60 children) and intracranial hematomas (11 operations in 10 children) are analyzed. Indications and contraindications for intracranial endoscopic operations, equipment supply, specific features of their performance, and outcomes are discussed. In occlusive hydrocephalus, the outcomes were as follows: hydrocephalus stabilization (38%), complications (15%), mortality (3%), the follow-up lasting as long as 8 years. The dynamic evaluation of the intracranial status (clinical and sound monitoring) is the obligatory condition of intracranial endoscopic operations made for intracranial hematomas. There were no complications in children with intracranial hematomas after planned intracranial endoscopic operations. The application of flexible distal end-controlled endoscopic, ultrasound-stereotactically aimed, and double-maneuver-controlled systems (visual examination through the optic system of an endoscope in combination with intraoperative ultrasonographic monitoring) was shown to be optimal during intracranial endoscopic operations.

[Combined electroanesthesia: a nontraditional method of anesthesia in pediatric neurosurgery]. / Kombinirovannaia élektroanesteziia -- netraditsionnyi metod obezbolivaniia v detskoi neirokhirurgii.

A combination of electrical anesthesia with calypsol and nitrous oxide has been developed and used in neurosurgical operations performed to 142 children aged 8 days to 15 years, who were divided into two groups. Group 1 included 89 children administered electrical anesthesia in combination with calypsol and nitrous oxide, Group 2 consisted of 53 children, to whom only routine calypsol and nitrous oxide anesthesia was administered. The Lennar apparatus was used to administer electrical anesthesia. The adequacy of anesthesia was estimated on the basis of the clinical data and laboratory findings. The results have shown that a combination of electrical analgesia with calypsol and nitrous oxide provided sufficient protection of a child from surgical stress, was not associated with significant changes of the hypothalamo-hypophyseo-adrenal and thyroid functions and permitted a significant reduction (by 80.8%) of the drug load.