[Short-latency evoked potentials in evaluation of the severity and localization of traumatic lesions of the brain]. / Korotkolatentnye vyzvannye potentsialy v otsenke tiazhesti i lokalizatsii travmaticheskogo porazheniia golovnogo mozga.

Acoustic stem evoked potentials (ASEP) and early components of somatosensory evoked potentials (SSEP) were studied in 36 patients with craniocerebral trauma and compared with those of normal individuals. The results demonstrate the advantages of using SSEP for appraising the patients' condition. This is manifested by the fact that the ASEP parameters do not correlate with the clinical data on the severity of the patients' condition (Glasgow scale) and the indices of the outcome scale, while, in contrast, the SSEP parameters are in good correlation with the clinical findings.

[Evaluation of the basal metabolic requirements of patients with grave brain lesions]. / Otsenka obshchikh metabolicheskikh potrebnostei u bol'nykh s tiazhelym porazheniem golovnogo mozga.

Basal metabolism (BM) was studied in 26 patients with a brain lesion treated at the neuro-resuscitation department. The complex of examination methods included dynamic appraisal of total energy expenditure and contribution of carbohydrates, fats, and proteins to the total energy expenditures by indirect calorimetry in combination with tests for daily nitrogen excretion, determination of biochemical indices characterizing BM: total lymphocyte count, concentration of blood total protein, albumin, blood urea nitrogen, and creatinine. It is shown that the character and degree of changes of BM depend on the clinico-neurological features of the disease in the postoperative (posttraumatic) period. Aspontaneity of various genesis leads to reduction of total energy expenditure by 18-25% of the normal values. Increased motor activity and the spasmodic syndrome increase total energy expenditure by 30-50%. Concurrent development of infectious complications increases total energy expenditure and changes its structure at the cost of increase of protein expenditure (proteins become responsible for up to 50% of energy expenditure). Indirect calorimetry in combination with tests for daily nitrogen losses is recommended for the evaluation and correction of BM disorders in patients requiring intensive therapy.

[Oxygenation of glioblastomas and normal brain tissue during radiation therapy]. / Issledovanie oksigenatzii glioblastom i normal'noi tkani golovnogo mozga pri luchevoi terapii.

Eight patients underwent simultaneous polarographic studies of pO2 in the brain normal tissue and glial tumors under the conditions of inhaling 100% oxygen and a hypoxic gaseous mixture (10% of oxygen and 90% of nitrogen). It has been established that the inhalation of 100% oxygen causes an increase in pO2 in the brain normal tissue and tumor by 100-115%. A short-term moderate gaseous hypoxia leads to a decrease in pO2 both in the brain normal tissue and tumor by 30% on an average.

[Colloid osmotic pressure of the blood of patients with neurosurgical pathology]. / Kolloidno-osmoticheskoe davlenie krovi u bol'nykh s neirokhirurgicheskoi patologiei.

Colloid-osmotic blood pressure (COP) was measured for the first time in 56 neurosurgical patients by means of an oncometer made by the "Knauer" Firm. The examination was conducted in dynamics: prior to operation, on the 1st, 5th and 10th postoperative days. The control group was formed of 25 donors. The study showed that before the operation the COP in neurosurgical patients depends on the character of the disease. In neuro-oncological patients and in patients with diseases of the cerebral vessels of COP was increased prior to the operation. It decreased immediately after the operation, remained low on the 5th postoperative day and gradually returned to normal level on the 10th day of treatment. In the decompensation phase, the COP remained drastically low till the patient's death. The reduction of COP was mainly caused by a fall in the total protein concentration. No correlation was found between COP and osmolality, its components, the value of pH, hematocrit and albumin concentration. The value of COP is a highly informative test for appraising protein and water metabolism. It provides for the purposeful application of substitution therapy and parenteral and enteral feeding in neurosurgical patients.

[Pressure-volume relation in the craniospinal cavity in the presence of supra- and subtentorial pathology. II. Changes in local intracerebral pressure subsequent to cerebrospinal fluid compression and decompression of the brain]. / Sootnoshenie ob"em-davlenie v kraniospinal'noi polosti pri supra- i subtentorial'noi polosti pri supra- i subtentorial'noi patologii. Soobshchenie II. Izmenenie lokal'nogo vnutrimozgovogo davleniia pri likvornoi kompressii i dekompressii golovnogo mozga.

Comparative measurements of cerebrospinal fluid pressure (FP) and local intracerebral pressure of the interstitial fluid (ICPIF) both during their spontaneous changes and during artificial changes in cerebrospinal fluid volume were conducted in 15 neuro-oncological patients in the postoperative period. ICPIF pressure was measured by means of a double-layer perforated capsule perceiving pressure of the surrounding interstitial fluid. In patients who underwent removal of a tumor from the posterior cranial fossa ICPIF ranged from -15.8 to +9.5 mm Hg, and FP from 15 to 37.5 mm Hg. In patients subjected to removal of meningioma of the chiasmal-sellar area ICPIF ranged from -11.2 to +0.4 mm Hg, while FP ranged from 4 to 18.7 mm Hg. In artificial decrease in FP to 5 mm Hg and subsequent increase to 35-50 mm Hg, ICPIF changed as a rule, though only slightly (from 0.5 to 10 mm Hg), and often the changes in FP and ICPIF were opposite in direction. In approximately 1/3 of cases ICPIF did not change while the changes in FP ranged from 5 to 50 mm Hg. The possible causes of changes in intracerebral pressure in dosaged FP changes are discussed and a conclusion is drawn that the changes in ICPIF are not a simple reflection of FP dynamics but are linked with the effect exerted on the interstitial fluid by some factors among which are changes in intra-capillary pressure and tension in the cerebral tissue.

[Pressure-volume ratio in the craniospinal cavity in supra- and subtentorial pathology. I. Changes in cerebrospinal fluid pressure in cerebrospinal fluid compression and decompression of the brain]. / Sootnoshenie ob"em--davlenie v kraniospinal'noi polosti pri supra- i subtentorial'noi patologiii. Soobshchenie I. Izmenenie likvornogo davleniia pri likvornoi kompressii i dekompressii golovnogo mozga.

The p-V dependence in the craniospinal cavity was studied by the method of dosaged change in the cerebrospinal fluid volume in 15 neurooncological patients who underwent operation for tumor of the posterior cranial fossa in the chiasmal-sellar area. It is shown that this dependence, reflecting the biophysical properties of the intracranial system, has distinguishing features in patients with supra- and subtentorial pathology. For instance, in FP values close to zero the resilience of the intracranial system is higher in patients with supratentorial processes than in patients with subtentorial pathology. In artificial c.s.f. compression, intracranial system resilience grows gradually in patients with basal pathology and increases much more rapidly in patients with subtentorial pathology. The authors discuss the possible causes of the difference in P-V dependence in the groups of patients who were examined and the significance of the obtained information in substantiating intensive therapy in the immediate postoperative period.

[Results of mass spectrometry studies of oxygen and carbon dioxide tension and blood flow in the brain tissue of neurosurgical patients]. / Rezul'taty mass-spektrometricheskikh issledovanii napriazheniia kisloroda, uglekislogo gaza i krovotoka v tkani mozga u neirokhirurgicheskikh bol'nykh.

The results of composite appraisal of the tissue tension of oxygen, carbon dioxide, and regional blood flow in the brain of 21 patients during the early period after neurosurgical operations are discussed. The dynamics of the efficacy indices of the cerebral circulation and gas exchange were studied during intensive therapy of postoperative pathological conditions. It was established that the use of some of the components of intensive therapy in severe intracranial pathological conditions is attended with changes in cerebral gas homeostasis.