[Surgical treatment of large and giant vertebrobasilar aneurysms manifested by brainstem compression symptoms]. / Khirurgicheskoe lechenie krupnykh i gigantskikh anevrizm vertebrobaziliarnogo basseina, proiavliaiushchikhsia simptomatikoi kompressii stvola golovnogo mozga.

The study aim was to analyze the results of surgical treatment of vertebrobasilar (VB) aneurysms manifested by brainstem compression symptoms. MATERIAL AND METHODS: The study included 8 patients operated on in the period between 2014 and 2017. All patients underwent intravascular intervention; two patients had open surgery at the second stage. RESULTS AND CONCLUSION: Intravascular intervention, both alone and in combination with open surgery, is effective treatment of VB aneurysms whose clinical picture is manifested by brainstem compression symptoms. The use of flow-diverting stents in most cases has provided good radicalness in the long-term period, without worsening the functional outcome. Treatment of fusiform aneurysms of the basilar artery trunk requires separate consideration and an individual approach due to a high risk of thrombosis of short branches feeding the brainstem.

[Extrapontine myelinolysis developed after aneurysmal subarachnoid hemorrhage (a case report and literature review)]. / Ekstrapontinnyi mielinoliz, razvivshiisya posle anevrizmaticheskogo subarakhnoidal'nogo krovoizliyaniya (sluchai iz praktiki i obzor literatury).

TOPICALITY: Central pontine and extrapontine myelinolysis is a rare and dangerous form of the demyelinating process of undefined origin, the development of which is associated with a very low sodium level in the blood (hypernatremia). OBJECTIVE: To describe a rare case of extrapontine myelinolysis as a complication occurring in the hemorrhagic period of anterior communicating artery aneurysm rupture as well as to demonstrate that this condition can be diagnosed intravitally. CONCLUSION: Clinical vigilance of extrapontine myelinolysis may promote the timely diagnosis and treatment of this disease, which is a potential cause of death. Pulse-therapy with glucocorticoids provides the opportunity to achieve regression of neurological symptoms and to stabilize the patient's condition.

Arteriovenous malformation of the cervical spinal cord with unusual drainage into the cranial cavity.

A case of arteriovenous malformation of the cervical cord 20 years in duration, studied angiographically, using computerized tomography scans and magnetic resonance images, as well as findings at autopsy are presented. The malformation was fed by the right vertebral artery, which entered a giant saccular aneurysm-like structure located subdurally on posterior spinal cord surface, and terminated there. Plenty of vessels of various diameter were found in the spinal cord substance at this level (C4-C6). Blood flow drained via a grossly enlarged vein at the anterior spinal cord fissure into cranial cavity, where varicose posterior fossa veins could be clearly seen and a single vertebral artery was present.