[Sensations of patients and their satisfaction during awake craniotomy]. / Oshchushcheniya patsientov i ikh udovletvorennost' pri provedenii kraniotomii v soznanii.

Awake craniotomy (AC) has gained fantastic popularity over the past years. This approach is no longer the destiny of only highly specialized neurosurgical centers. Technical features of AC are completely developed. However, certain aspects of patients' sensations and their satisfaction are still unclear. The review is devoted to these issues. It was shown that AC is positively evaluated by the vast majority of patients. Many patients would choose this technique for redo surgery. However, there are certain important details that can adversely affect satisfaction of patients. Thus, these features should be considered in AC.

[Modern aspects of reconstructive surgery of skull defects]. / Sovremennye aspekty rekonstruktivnoi khirurgii defektov cherepa.

The aim of this study is to systematize the modern methods used for reconstruction of extensive and complex skull defects. Special attention is paid to computer technologies, including 3D imaging and CAD/CAM. Laser-based stereolithography is thoroughly reviewed among other additive technologies. We present our view of the problem associated with proper timing of cranioplasty and choice of materials for it. Complications of skull defect reconstruction are also discussed.

[Spinal stroke in a pregnant female with an endodermal cyst of the cervical spinal cord (a case report and literature review)]. / Ostroe narushenie spinal'nogo krovoobrashcheniya u beremennoi s endodermal'noi kistoi sheinogo otdela spinnogo mozga (sluchai iz praktiki i obzor literatury).

AIM: The study purpose was to present a clinical case of spinal stroke in a pregnant female, which was caused by an endodermal cyst of the cervical spinal cord, and to analyze treatment tactics. RESULTS: A 20 week pregnant female presented with acute transverse spinal cord injury at the of C3-C5 spinal segment level. CT revealed an extramedullary space-occupying lesion in the ventrolateral position, with compression of the spinal cord at this level. The patient in the state of progressive deterioration with respiratory failure was transferred to the Neurosurgical Institute on the 5th day after disease onset. The patient underwent surgery on the 7th day after disease onset. Doctors of various specialties participated in preparation for surgery. During surgery, total resection of the space-occupying lesion and spinal cord decompression were performed. An obstetrician-gynecologist conducted intraoperative fetal monitoring by ultrasound. The histological diagnosis was an endodermal cyst. There was no improvement of neurological symptoms in the early postoperative period. After stabilization of the condition, the patient was discharged for follow-up care at the place of residence. According to the follow-up report, the patient underwent the cesarean section because of exacerbation of lung infection and a significant delay in the fetal development. After a few days, the patient died due to multiple organ failure. The child was alive, in serious condition, under mechanical ventilation. CONCLUSION: In the case of spinal stroke, the decision on treatment tactics should be made no later than 12 hours after its onset; otherwise, the outcome is usually unfavorable, and a neurological deficit is irreversible. The decision about continuing pregnancy should be made individually in each case, and an approach to the choice of appropriate treatment tactics should be multi-disciplinary.