[Direct spontaneous high-flow carotid-cavernous fistula in a 9-month-old child after nasolacrimal duct repair]. / Pryamoe spontannoe vysokopotochnoe karotidno-kavernoznoe soust'e u rebenka 9 mesyatsev, razvivsheesya posle plastiki sleznogo kanala.

Successful treatment of direct spontaneous carotid-cavernous fistula in a 9-month-old child and review of the literature devoted to this issue are reported in the manuscript. Spontaneous high-flow carotid-cavernous fistula is extremely rare in children. Detailed diagnosis of the fistulae includes CT-angiography and cerebral subtraction angiography. Previous surgeries (nasolacrimal canal repair in this case) may be considered as an etiological factor of carotid-cavernous fistula. Transarterial transfemoral endovascular embolization of the fistula with microcoils ensured closure of abnormal communication and complete regression of clinical manifestations in our case.

[Penetrating orbitocranial injury: a review of the literature and a case report of injury by a watercolor brush in a 3-year-old child]. / Pronikaiushchaia orbitokranial'naia travma: obzor literatury s opisaniem klinicheskogo sluchaia raneniia akvarel'noĭ kistochkoĭ u rebenka 3 let.

We present a rare case of orbitocranial penetrating injury by a watercolor brush in a 3-year-old child. Injuries of this localization can affect important orbital structures (eyeball, blood vessels, nerves, muscles) and cause severe intracranial damages. In some cases, diagnosis of these injuries in children may be difficult due to the lack of marked clinical manifestations. The presented clinical case illustrates the approaches for choosing methods for diagnosis of injury in childhood and subsequent treatment options.

[Surgical treatment of «Mirror¼ aneurysms of the internal carotid artery]. / Khirurgicheskoe lechenie «zerkal'nykh¼ anevrizm vnutrennei sonnoi arterii.

BACKGROUND: A relatively high occurrence of "mirror" aneurysms of the anterior cerebral circulation in neurosurgical practice necessitates generalization of experience of using different surgical approaches. The choice of treatment is usually associated with the number of surgical stages. MATERIAL AND METHODS: Forty nine patients (19 males and 30 females) with mirror aneurysms of the anterior circulation underwent one- and two-step surgery at the Novosibirsk Federal Center of Neurosurgery in 2013-2015. The total number of bilateral aneurysms was 51 couples (102 aneurysms). The patients' age ranged from 19 to 66 years (mean age, 47.1±11.6 years). Most of the patients (47) underwent elective surgery; 2 patients were operated on in acute subarachnoid hemorrhage. RESULTS: Sixty nine microsurgical operations and 19 endovasal interventions were performed during the main step. Microsurgery alone was used in 34 cases; endovascular surgery alone was performed in 6 cases; a combination of the techniques was used in 9 cases. Ten patients underwent one-step surgery, and 39 patients underwent two-step surgery. The radicalness of surgery amounted to 94.1% for the microsurgical technique and 83.3% for the endovasal technique. The excellent and good functional outcome (modified Rankin scale, 0-2) was achieved in 46 (93.9%) patients, and the poor outcome (mRs, 3-5) was observed in 3 (6.1%) patients. CONCLUSION: Generalization of the results indicates that one-stage surgery is more preferable in the treatment of mirror cerebral aneurysms. However, the two-stage approach remains important and, in the case of certain anatomical peculiarities, is the only possible treatment. A combination of microsurgical and endovascular techniques improves clinical outcomes in treatment of mirror aneurysms of the anterior part of the cerebral arterial circle.