[Positron emission tomography in the diagnosis of recurrent growth of brain tumors].

The authors analyzed the results of 11C-methionine positron emission tomography (PET) in 101 patients with suspected recurrent brain tumor. The diagnosis was confirmed in 72 patients. The increased 11C-methionine uptake in the initial tumor area is considered to be a crucial PET evidence of a recurrent tumor. On the other hand, brain tissue histological changes associated with surgery, radiation, and chemotherapy were characterized by the low uptake of the tracer. The sensitivity and specificity of PET scanning in detecting tumor recurrence were found to be 95.8 and 96.5%, respectively. 11C-methionine PET is proposed as a reliable technique for early differentiating between a recurrent brain tumor and treatment-induced nonneoplastic changes.

[New criteria for positron emission tomographic diagnosis of brain glioma using 11C-methionine]. / Novye kriterii v positronno-émissionno-tomograficheskoi diagnostike gliom golovnogo mozga s ispol'zovaniem 11C-metionina.

The study was based on the data of positron emission tomography (PET) and L-[methyl]-[11C]-methionine used in 117 patients with suspected brain tumor. PET data on 74 patients with histologically verified cerebral tumors were analyzed in detail. New additional criteria for assessing PET scans, which formed the PET syndromes of astrocytomas, anaplastic astrocytomas, and glioblastomas. Operative and histological verification confirmed the high validity of the proposed criteria for defining the type of a tumor.

[Diagnosis and therapy of resistant temporal epilepsy]. / Diagnostika i lechenie rezistentnykh visochnykh épilepsii.

A complex research of epileptogenic focus (electroencephalography, invasive electroencephalography, MRI, PET) has allowed to localize a primary epileptogenic zone in medial temporal epilepsy in amygdale in 52% of the patients, in the anterior hippocampus--in 30% cases, a simultaneous and equivalent involvement of both amygdale and anterior hippocampus was diagnosed in 18% of the patients examined. Stereotaxic selective amygdalehippocampotomy was found to be effective in patients with resistant medial and lateral temporal epilepsy. The attacks stopped in 36% of the cases. In other patients frequency and duration of epileptic paroxysms considerably reduced, the structure of the paroxysms changed.

[Functional stereotaxy with magnetic resonance tomographic guidance]. / Funktsional'naia stereotaksiia s magnitno-rezonansno-tomograficheskim navedeniem.

The paper summarizes experience with stereotactic operations by magnetic resonance imaging data by using a Russian OREOL stereotactic manipulator. It describes methods of preoperative preparation of patients by employing diagnostic magnetic resonance tomographs. A number of points of the procedure for identification and localization of deep target structures from magnetic resonance images in parkinsonism, temporal epilepsy and some mental disorders.

[Positron-emission tomography in the diagnosis of brain damage in patients in the late period of craniocerebral trauma]. / Pozitronno-émissionnaia tomografiia v diagnostike povrezhdenii golovnogo mozga u bol'nykh v otdalennom periode cherepno-mozgovoi travmy.

PET data were compared with the results of computerized tomography (CT) and the neurological status of patients. The areas of decreased local cerebral blood flow (LCBF) and reduced local cerebral metabolic glucose rates exceeded those of brain injury shown by CT predominantly in patients with brain posttraumatic cysts. In a group of patients with posttraumatic atrophy documented by CT, PET demonstrated cortical and/or subcortical lesions in most cases, providing objective evidence for neurological symptoms. PET is a useful technique to demonstrate regional brain dysfunction in the presence of morphological integrity as assessed by CT.

[Local cerebral blood flow and oxygen tension at different stages of surgical intervention in patients with meningiomas of the superior sagittal sinus]. / Lokal'nyi mozgovoi krovotok i napriazhenie kisloroda na razlichnykh étapakh khirurgicheskogo vmeshatel'stva u bol'nykh s meningiomami verkhnego sagittal'nogo sinusa.

The local cerebral blood flow, oxygen tension, local impedance and intragastric pressure were examined in 13 patients with meningiomas of the middle third of the apical sagittal sinus at various stages of surgery including those after ablation of the intrasinus node and its reconstruction. In all the patients the decompressive cranial trepanation showed a blood stream enhancement but on the meningioma side. It is concluded that the degree of disturbances of oxygenative metabolism and blood circulation after the removal and reconstruction of the intrasinus node was dependent on the variant of the sinus injury.

[The surgical treatment of meningiomas of the superior sagittal sinus (the surgical approach and technic)]. / Khirurgicheskoe lechenie meningiom verkhnego sagittal'nogo sinusa (taktika i tekhnika operatsii).

The authors analyze the results of surgical management of 242 patients with upper sagittal sinus meningiomas who have been treated in the past 20 years. All the patients were divided into 3 groups in accordance with the surgical policy and techniques of interventions and anesthesiological support. The type of sinus wall tumor lesion and its associated cerebral blood outflow disorders detected by electrophysiological studies in pre- and intraoperative periods determined surgical policy which along with microsurgical technique of recovery of the intact sinus and superficial veins of the brain enhanced the efficiency of operations up to 92.2% and reduced fatal outcomes to zero.

[Microsurgical revascularization of the brain with an autograft of the greater omentum (experimental research)]. / Mikrokhirurgicheskaia revaskuliarizatsiia golovnogo mozga autotransplantatom bol'shogo sal'nika (éksperimental'noe issledovanie).

The paper deals with improvement of procedures for autografting a greater omental fragment to the vascular layer of the brain in its experimental ischemic lesions. The findings suggest that a functional vasculature has formed between the omentum and the meninx vasculosa just at hour 24 postautografting. This provides evidence to recommend the method for clinical application to compensate cerebral circulatory disorders in tumor-induced and vascular abnormalities in the brain.

[Clinical picture and complex treatment of septic thromboses of the cavernous sinuses]. / Nekotorye voprosy kliniki i kompleksnogo lecheniia septicheskikh trombozov kavernoznykh sinusov.

Under analysis are etiology, clinical picture and diagnosis of a septic thrombosis of cavernous sinuses in 28 patients. The authors have shown the interrelationship between local manifestations of the disease, injuries of the brain and its sheaths and septic complications (abscessing pneumonia as the most severe of them). A scheme of the complex treatment of patients with thrombosis of the cavernous sinus is proposed. The leading role in this treatment is played by intracarotid infusion of antibiotics in combination with anticoagulant drugs, vasodilatatory agents and novocaine as well as the therapy of septic complications (abscesses of the face and hairy part of the head, meningoencephalitis, pneumonia).