[Convexity hyperostotic meningioma en plaque: a systematic review]. / Ploskostnye giperostoticheskie meningiomy svoda cherepa. Sistematicheskii obzor literatury.

BACKGROUND: Planar hyperostotic meningiomas account for 2-9% of intracranial meningiomas. They are characterized by planar node following the contours of the inner surface of the skull. Hyperostosis is present in most cases. Timely diagnosis of skull base tumors is usually simple due to early involvement of the cranial nerves. However, convexity meningiomas en plaque usually reach large dimensions that complicates surgery and radiotherapy. OBJECTIVE: To analyze the current state of diagnosis, molecular biology and surgical treatment of hyperostotic meningiomas en plaque. MATERIAL AND METHODS: A systematic review was performed in accordance with the PRISMA guidelines. Searching for literature data included the following keywords: «planar meningioma¼, «hyperostotic meningioma¼, «meningioma en plaque¼, «infiltrative meningioma¼. We reviewed the PubMed and Google Scholar databases until May 2023 and enrolled only full-text Russian-, English- or French-language reports. RESULTS AND DISCUSSION: Among primary 332 reports, 35 references met the inclusion criteria. We found less severity or absence of focal neurological symptoms, comparable incidence of intracranial hypertension and no histological differences between planar and nodular meningiomas. Analysis of molecular biological features of planar meningiomas, including cell cultures, is feasible. There is no consensus regarding surgical treatment and radiotherapy. Most publications are case reports. CONCLUSION: The results of treatment of planar hyperostotic meningiomas, especially large and giant ones, are unsatisfactory. There is no a generally accepted algorithm for treating patients in the literature. This problem requires further research.

[Brainstem arachnoid cyst: case report and review]. / Arakhnoidal'naya kista stvola mozga: opisanie klinicheskogo sluchaya i obzor literatury.

There are no literature data on brainstem arachnoid cysts in humans. OBJECTIVE: To describe the clinical case of brainstem (pontomesencephalic) arachnoid cyst and to analyze classification, pathogenesis, differential diagnosis and treatment of this pathology considering literature data and own experience. MATERIAL AND METHODS: A 29-year-old patient with pontomesencephalic arachnoid cyst is reported. The disease manifested in childhood with a headache aggravated by bending and pushing. Later, syncope, vegetative-visceral paroxysms, mild oculomotor disturbances, transient paresthesia and numbness of the left half of the face occurred. Headaches became significantly more severe and resulted nausea and vomiting. Magnetic resonance imaging (MRI) revealed a two-chambered arachnoid cyst. A smaller chamber was localized in interpeduncular cistern, a larger one - in brainstem. RESULTS AND DISCUSSION: Differential diagnosis included cystic glioma and Virchow-Robin space enlargement. Fenestration of the cyst wall within interpeduncular cistern was performed via right-sided pterional approach. The diagnosis was verified by histological examination. The follow-up period was 14 months. We observed postoperative cyst reduction confirmed by MR data and regression of all symptoms except for minimal signs of medial longitudinal fasciculus dysfunction. CONCLUSION: Correct surgical approach for brainstem arachnoid cyst complicated by progressive neurological deterioration is confirmed by postoperative regression of cyst and symptoms.

[Acute concomitant traumatic brain injury--a comprehensive diagnosis at different phases of treatment].

INTRODUCTION: The combination of traumatic brain injury with extracranial lesions is observed in 50-70% of cases. The results of treatment of patients with concomitant traumatic brain injury are much worse than with isolated injuries, deaths on different data ranges from 12 to 69%. PURPOSE: To study the effect of diagnostic and therapeutic measures at different stages of health care co-head injury victims and to create an algorithm of the best diagnosis and treatment of patients according to specific region. MATERIAL AND METHODS: 615 patients with concomitant TBI admitted to the Andijan branch of the Republican Research Centre of Emergency Medicine (Uzbekistan) between 2005 and 2011. RESULTS: The average age of victims was 44.2 +/- 1.2 years (16-76 years). Diffuse brain damage was detected in 193 (31.4%) patients. Died in the hospital 95 (15.4%) of the injured. The most common cause was traffic accident. In the first days after injury leading cause of death was blood loss and shock, and only then - the massive intracranial injuries (damage?) and intracranial hematoma. CONCLUSION: Critical, in addition to establishing the nature of head trauma and associated injuries, is timely diagnosis and treatment of blood loss and shock.

[The combined treatment of patients with primary gliomas of the lateral ventricles and the septum pellucidum]. / Kombinirovannoe lechenie bol'nykh s pervichnymi gliomami bokovykh zheludochkov i prozrachnoi peregorodki.

The authors' material was based on the analysis of 49 patients with primary gliomas of the lateral ventricles and transparent septum who were treated from 1988 to 1992. The main method of patients' selection was to analyze clinical and topographic data obtained from computed and magnetic resonance tomographic studies. In 39 (79.6%) cases, the tumors were found in the cavity of the lateral ventricles, in 10 (20.4%) cases there was a partial paraventricular growth when the bulk of the tumors was located in the lumen of the lateral ventricles. Out of the 49 patients examined, 46 (93.3%) were operated on, while 3 (6.1%) patients were found inoperable. In 37 (80.4%) cases, an external ventricular drain was set at the end of an operation. The operative material was histologically studied in 46 cases. Following the operation, 24 (52.2%) patients underwent split fractional radiation therapy with a total focal dose of 60 Gy. The postoperative mortality was 15.2%. The follow-up of patients was from 1 to 4 years. The combined treatment of patients substantially prolonged the relapseless period of the disease. At the same time, the postoperative longevity of patients with malignant gliomas of the lateral ventricles and transparent septum becomes similar to that of the relapseless period in patients with low-grade gliomas untreated with radiation rays.