[Electrodiagnostic evaluation in differential diagnosis and neurosurgical treatment of radiculopathies caused by spine disorders. Diagnostic value and methodology]. / Elektromiograficheskie metody v differentsial'noi diagnostike i obosnovanii neirokhirurgicheskogo lecheniya radikulopatii, vyzvannykh zabolevaniyami pozvonochnika. Informativnost' i metodologiya.

One of the most common causes of radiculopathy requiring neurosurgical treatment is a herniated disc. Magnetic resonance imaging (MRI) is still the main diagnostic approach for this lesion. However, MRI does not allow assessing the functional state of the root. Neurophysiological examination assesses the function of peripheral nervous system. These methods are used for differential diagnosis of causes of neurological symptoms and determine the level of the nerve root injury. OBJECTIVE: To assess the role of electromyography including paraspinal muscle mapping in diagnosis of radiculopathies following spine diseases. MATERIAL AND METHODS: We have analyzed literature data in the Scopus, Pubmed, and RSCI databases and selected 93 references for primary reviewing. Final analysis enrolled the manuscripts with a detailed description of neurophysiological examinations and data on sensitivity/specificity of these methods. RESULTS: Needle electromyography (EMG) is the most informative neurophysiological method for diagnosis of radicular damage. Sensitivity of EMG is up to 90% for lumbosacral radiculopathy. Electromyography of the paraspinal muscles can be used in case of of cervical, thoracic and lumbar radiculopathy in addition to EMG of limb muscles. Therefore sensitivity increases to 100%. Diagnostic value of nerve conduction study (NCS) is low, and performing NCS without EMG is not useful. CONCLUSION: In neurosurgical practice electrodiagnostic (EDX) should be performed for differential diagnosis of radiculopathy and peripheral nervous system lesions, to determine the level of radicular compression, and when physical examination does not correspond with neuroimaging or MRI is not possible to perform.

[Resection of a giant fusiform aneurysm of the pericallosal artery with «hemi-bonnet bypass¼ procedure (case report and literature review)]. / Vyklyuchenie gigantskoi fuziformnoi anevrizmy perikalleznoi arterii s primeneniem obkhodnogo shuntirovaniya po tipu «hemi-bonnet bypass¼. Sluchai iz praktiki i obzor literatury.

A 30-year-old woman with giant fusiform aneurysm of the azygos anterior cerebral artery is reported. Clipping of the aneurysm followed by modeling of pericallosal artery was performed in 2017. However, further enlargement of the aneurysm has been observed for subsequent 2 years. The patient underwent redo surgery with excision of the aneurysm followed by «hemi-bonnet bypass¼ procedure (anastomosis between superficial temporal artery and anterior cerebral artery with radial artery as an interposition graft). Literature data on reconstructive surgery in the treatment of complex pericallosal artery aneurysms are reviewed.

[Quantitative evaluation of uveoscleral outflow for optimization of glaucoma treatment]. / Metod kolichestvennoi otsenki uveoskleral'nogo ottoka dlya optimizatsii lecheniya glaukomy.

UNLABELLED: The leading role in glaucoma treatment is now played by prostaglandin analogues (PGAs), whose point of application is the uveoscleral outflow of aqueous humor. Quantitative evaluation of the latter is, however, a problem yet unsolved. AIM: To assess the clinical applicability of a new method for quantitative evaluation of the uveoscleral outflow in human eyes, which is meant to help with optimization of glaucoma therapy. MATERIAL AND METHODS: Patients with early (n=33) and advanced (n=30) primary open-angle glaucoma (POAG) were enrolled. Besides the routine ophthalmic examination, all patients had their uveoscleral outflow quantified with our method. Basing on these findings, we have analyzed the effect of different hypotensive eye drops, namely, betaxolol 0.5% (selective beta-1-blocker), brinzolamid 1% (carbonic anhydrase inhibitor), travoprost 0.004% (prostaglandin analogue) and travoprost 0.004%/timolol 0.5% fixed combination (TTFC; prostaglandin analogue plus non-selective beta-blocker). RESULTS: In early POAG, the uveoscleral outflow facility (Cfu) without treatment was 0.06±0.06, after betaxolol 0.5% as well as brinzolamid 1% use - 0.05±0.03, while after travoprost 0.004% and FCTT use - 0.10±0.06 and 0.08±0.05 correspondingly. In advanced POAG, Cfu was 0.04±0.03 without treatment, 0.06±0.04 - after betaxolol 0.5% or brinzolamid 1% use, 0.1±0.05 - after travoprost 0.004% use, and 0.1±0.04 - after FCTT use. CONCLUSION: Quantitative evaluation of the uveoscleral outflow with the new method that has not only been justified, but also clinically tested, provides an opportunity to optimize POAG treatment.