[The topographic mapping of evoked bioelectrical activity and other methods for the functional neural visualization of the brain]. / Topograficheskoe kartirovanie vyzvannoi bioélektricheskoi aktivnosti i drugie metody funktsional'noi neirovizualizatsii mozga.

The paper is concerned with comparative characterization of brain functional imaging used in medicine today: bioelectrical activity mapping, assessment of spatial changes in cerebral blood flow by radionuclide and hydrogen clearance, NMR imaging, PET-scan, magnetoencephalography and thermoencephaloscopy. Original researches in neurosurgery clinic with the use of the mapping of evoked potentials enable the conclusion to be drawn about advisability of applying these methods in treatment and diagnostic practice. Besides, the mechanisms of compensation for higher mental functions in organic brain lesions are discussed.

[Relations between the phagocytic activity of monocytes and the lateralization of brain injuries]. / Zavisimost' fagotsitarnoi aktivnosti monotsitov ot lateralizatsii povrezhdenii golovnogo mozga.

According to the authors' opinion, the different character of alterations in phagocytic activity of monocytes in primary derangement of the dominant and subdominant hemispheres results from the different functional significance of the hemispheres. The most pronounced neurogenous immune dysfunction occurs because of an injury to the dominant hemisphere. The two mechanisms of alterations in phagocytic activity of monocytes are of importance during the posttraumatic period in severe brain contusions: the central one related to neurogenous immune dysfunction and secondary one related to infectious complications.

[Diagnostic value of spinal fluid immunoglobulins in cerebral arachnoiditis]. / Diagnosticheskoe znachenie immunoglobulinov spinnomozgovoi zhidkosti pri tserebral'nykh arakhnoiditakh.

The authors believe that the deficiency of immunoglobulins A in the cerebrospinal fluid (CSF) of patients with arachnoiditis may be explained by an increase in their consumption due to antigenic aggression in relation to the meninges, which results in extremely low values of the circulating immunoglobulins A. The absence of immunoglobulins A in the CSF of patients with cerebral arachnoiditis is one of the components of its pathogenesis owing to impairment of permeability of the blood brain barrier and fixation of antigens in the tissues of the brain and meninges.

[Intrathecal synthesis of immunoglobulins G in patients with nervous system neoplasms]. / Intratekal'nyi sintez immunoglobulinov klassa G u neiroonkologicheskikh bol'nykh.

Brain tumor development and their recurrence are accompanied by an increase in IgG levels in liquor as well as in the number of circulating immunocomplexes and by the presence of blockage factors in liquor. The data presented in the paper, on the whole, illustrate the development of autoimmune reactions, which happen to be mechanisms involved in the pathogenesis of brain tumor growth and recurrence. Surgical removal of tumor is followed by a reduction in the rates of IgG synthesis.

[Gastrointestinal hemorrhage in neurosurgical patients]. / Zheludochno-kishechnye krovotecheniia u neirokhirurgicheskikh bol'nykh.

Analysis of 445 fatal cases among which 21 were marked by profuse gastroduodenal hemorrhage showed that this complication develops in ulceration of the mucous-membrane in the upper parts of the digestive tract and occurs most frequently in affection of the hypothalamic region and brain stem. Gastrointestinal hemorrhages are caused to a certain measure by medication with massive doses of corticosteroids in the stage of tension of the general adaptation syndrome, hypoxia of the mucous membrane, azotemia, and other disorders of homeostasis. Gastrointestinal hemorrhages greatly aggravate the condition of neurosurgical patients, they are diagnosed with difficulty, and their prevention calls for a complex approach.

[The reactivity of the mononuclear phagocytes in the acute period of craniocerebral trauma]. / Reaktivnost' mononuklearnykh fagotsitov v ostrom periode cherepno-mozgovoi travmy.

The article analyses the condition of one of the main links of the defence status--the cells of the mononuclear phagocytotic system in the acute period of craniocerebral trauma (CCT). The authors established the existence of a dependence of the functional condition of the peripheral blood monocytes on the CCT severity. Disorders of the monocyte functional condition (phagocytosis, monocyte test) were most marked in a severe CCT. Early (in the first 24 hours after the trauma) activation of mononuclears develops in such case. Standard nonspecific response of monocytes to traumatic damage is maintained in mild CCT.

[Pulmonary complications of severe craniocerebral injuries and their prevention (clinico-morphologic aspects)]. / Legochnye oslozhneniia tiazheloi cherepno-mozgovoi travmy i ikh profilaktika (kliniko-morfologicheskie aspekty).

Prevention of pulmonary complications according to the generally accepted principles was conducted in 47 patients with severe craniocerebral trauma (control group). At the same time, 32 patients were subjected to a high long-term peridural block at the Th2-6 level (main group). Pneumonia developed in 59.6% of patients in the control group, 71.4% of them died. In the main group pneumonia occurred in 40.7% of patients, 84.6% of them died. A complex of changes corresponding to the "shock-lung" syndrome was detected macroscopically and histologically in the dead patients of the control group. Histological examination in the main group showed that high long-term peridural block led to a 2-3-fold reduction in the frequency of such characteristic signs of "shock lung" as congestive hyperemia, hemorrhage into the alveoli and intraalveolar edema, desquamation of alveolocytes and atelectasis. The authors warn against the danger of the development of immunodepression in the T-system of immunity due to the effect of the block on the intensity of sympathetic efferentation to the thymus.

[The dynamics of the superslow potential fluctuations in the decaminute range after intracranial operations]. / Dinamika sverkhmedlennykh kolebanii potentsiala dekaminutnogo diapazona posle intrakranial'nykh operatsii.

It is shown that the dynamics of superslow fluctuations of potential (SSFP) in healthy individuals are similar to those in patients before the operation. In a favourable postoperative period SSFP lability is highest during the first week, particularly in the head quadrant adjacent to the zone of the operative wound. Subsequently the SSFP values came closer to the preoperative, i.e. corresponded to the characteristics of this type of brain activity in a healthy person.

[Local immune reactions of the cerebrospinal fluid in meningeal brain tumors]. / Mestnye immunnye reaktsii tserebrospinal'noi zhidkosti pri opukholiakh golovnogo mozga meningeal'nogo riada.

The paper analyzes the time course of immune processes in the cerebrospinal fluid of patients with primary meningeal tumors of the brain. It shows the formation of an immunobiochemical neoplastic process of varying degrees in relation to the magnitude of tumor malignancy. The paper also considers if the local immune system can trigger sanogenetic mechanisms in the postoperative period.

[The immunobiochemical composition of the blood and cerebrospinal fluid in the recurrence of meningeal tumors]. / Immunobiokhimicheskii sostav krovi i tserebrospinal'noi zhidkosti pri retsidivirovanii opukholei meningeal'nogo riada.

The analysis of immunological responsiveness and factors of nonspecific resistance in patients with relapsing meningiomas shows that there are prevalent autoimmune responses in the preoperative period and their gradual, but not final overcoming by the body after elimination of neoplastic relapse. At the same time the pathogenesis is closely associated with the formation of the autoimmune status in the peripheral system to a lesser extent and in the local immune one, to a greater extent after removal of primary meningioma in a patient.

[Characteristics of adaptive reactions of the body's immune system following operations for vascular anomalies]. / Osobennosti adaptatsionnykh reaktsii immunoi sistemy organizma posle operatsii po povodu sosudistykh anomalii.

Analysing the body's responses in 32 patients operated on for cerebral vascular aneurysms has shown that preoperatively there is activation of the peripheral blood antiprotease system, which appears to be associated with the impaired permeability of the vascular wall and with the activation of the hemostatic system and that their liquores contain sensitizing substances which are products of hemorrhages and cerebral detritus. On the whole, the immune responses of this group of patients are common to those of other groups of neurosurgical patients: acute-phase blood reaction, synthesizing-antibody binding of antigens, sanitating and brain tissue-transient neurosensitization. The use of mildronate contributes to the activation of the humoral link of the immune system on post-operative days 5-7, increases the serum antiprotease potential, by intensifying the body's responses, levels stress immunodeficiency and prolongs the time of neurosensitization.

[A system of individual immunotherapy with leakadin in the combined therapy of acoustic neurinomas]. / Sistema individual'noi immunoterapii leakadinom v kompleksnoi terapii nevrinom slukhovogo nerva.

Analyzing the immunological responsiveness of patients with acoustic neurinomas on the antitumor immunomodulator leacadin has revealed some significant features. In leacadin-treated patients, postimmunotherapy promotes the formation of high sanogenetic responses: an increase in the rigidity of the brain-immune system; elevations of the levels of antitumor factors of the immune system: T helper cells and locally synthesized antibodies; a decrease in neuro-sensitization after tumor removal, which prevents tumor stimulation and recurrence; an indirect reduction in the activity of T suppressors that inhibit immunological responses in growing neoplasm. Immunotherapy with the antitumor immunomodulator leacadin in patients with acoustic neurinomas contributes to the development and optimization of the tumor carrier's immunological adaptative responses, creates conditions for the optimal postoperative course and prevents recurrence.

[The immunological reactions and enzymatic activity of the cerebrospinal fluid in intracranial complications following neurosurgical operations]. / Immunologicheskie reaktsii i énzimaticheskaia aktivnost' tserebrospinal'noi zhidkosti pri vnutricherepnykh oslozhnenii posle neirokhirurgicheskikh operatsii.

The specific features of immunological responses and enzymatic activity of cerebrospinal fluid in the development of intracranial infectious complications were outlined in 16 neurosurgical patients after surgical interventions. On days 1-3-5 days after surgery, the immunobiochemical spectrum of cerebrospinal fluid showed substantial changes associated with the impaired permeability of the blood-brain barrier and the stress-induced transition of biochemical functional systems on the minimum functioning during anaerobic energy supply. Increasing lipid peroxidation processes reflect the result of catabolic reactions and energy deficiency, followed by intensive cytolysis of leukocytes and nerve cells. With this, antibody synthesis and great rises in the formation of circulating immune complexes is the essence of sanogenetic mechanisms basically aimed at eliminating the released and bound antigen in the given time interval.

[The immune reactions of the cerebrospinal fluid in victims of gunshot wounds of the skull and brain in relation to the treatment procedure and outcome]. / Immunnye reaktsii tserebrospinal'noi zhidkosti u postradavshikh s ognestrel'nymi raneniiami cherepa i golovnogo mozga v zavisimosti ot taktiki i iskhoda lecheniia.

The paper shows the formation of immunopathological syndromes in the cerebrospinal fluid in the victims with gunshot wounds in relation to the policy and outcome of treatment. Suturing the dura mater during a primary surgical treatment should be regarded as a protective process to limit antigen release, the development of immunological paralysis and autoimmunization. Deaths are caused by the neurogenic immune dysfunction induced by the inadequate functioning of the psychoneuroimmunoendocrine connections of the whole body.

[The characteristics of the functional activity of cellular immunity factors in relation to the use of general anesthetics from different pharmacological groups in operations for optic nerve neurolysis]. / Osobennosti funktsional'noi aktivnosti faktorov kletochnogo immuniteta v zavisimosti ot ispol'zovaniia obshchikh anestetikov razlichnykh farmakologicheskikh grupp pri operatsiiakh nevroliza zritel'nykh nervov.

The functional activity of cellular immunity was studied in 26 patients with opticochiasmatic arachnoiditis as a model of autoimmune involvement of the brain after administration of common anesthetics of different pharmacological groups. Injection of ketamine as the induction and basic component of general combined anesthesia leads to reduction of neurosensitization induced by the pathologic process; it is paralleled by the optimal activation of the suppressor component of lymphocytes and a reduction of sensitization to brain antigen. In contrast to ketamine, barbiturates augment neurosensitization and lead to depression of the lymphocyte activity, this confirming the anti-immunopathological effect of barbituric acid derivatives. Ketamine is advisable for patients with various immunopathological states.

[The pathogenetic, clinical and treatment problems of the mental disorders in brain trauma]. / Voprosy patogeneza, kliniki i lecheniia psikhicheskikh narushenii pri travme golovnogo mozga.

Authors examine the questions of pathogenesis and clinic of mental disorders caused by cerebrum traumata, as well as the peculiarities of its diagnosis and treatment. There is a principle scheme of systematized post-aggressive reaction after cerebrum injury which emphasises the necessity to study the pathophysiological process from the point of view of norm in pathology, development of protective mechanisms and individual peculiarities (sanagenetical approach). The structural and syndromological method is proposed to appreciate mental disorders and distinguish the variants of psychopathological syndromes. Therapy aspects of some mental disorders are interpreted from the point of view of sanagenetical position.

[Characteristics of the diagnosis and prevention of pulmonary complications of severe cranio-cerebral injuries]. / Osobennosti diagnostiki i profilaktiki legochnykh oslozhnenii tiazheloi cherepno-mozgovoi travmy.

Under study was the clinico-roentgenological dynamic of the lung state in 79 patients with severe cranio-cerebral trauma. High continuous peridural blocade performed from the moment of admission to the hospital was shown to prevent the development of hard reactive alterations in the lungs. This method however fails to control acute severe aspiration pneumonia.

[The concept of the adaptive functional dominant of the CNS in clinical neurotraumatology]. / Kontseptsiia adaptivnoi funktsional'noi dominanty TsNS v klinicheskoi neirotravmatologii.

A conception of the adaptive functional dominant of the CNS is proposed for the description of general regularities of the course of patho- and sanogenesis in neurotramatologic patients. It was shown that the forming adaptive dominant is responsible for the development of adaptive processes in the posttraumatic period. The interaction of the functional dominant and adaptive potential of sanogenesis leads to the course of the disease with the natural outcome as recovery, complication or lethal outcome.

[Effect of high long-term peridural blockade on the indicators of cellular and humoral immunity in severe cranio-cerebral trauma]. / Vliianie vysokoi dlitel'noi peridural'noi blokady na pokazateli kletochnogo i gumoral'nogo immuniteta pri tiazheloi cherepno-mozgovoi travme.

The investigation of indices of the humoral and cell immunity in 48 patients with severe cranio-cerebral injuries and results of high prolonged peridural blockade in 21 patients has shown the efficacy of this curative measure for preventing "shock lung". The blockade has been found however to inhibit indices of immunity and should not be longer than 48 hours.

[A system of individual psycho- and immunotherapy in neuroanesthesiological practice]. / Sistema individual'noi psikho- i immunoterapii v neiroanesteziologicheskoi praktike.

Effects of the newly developed system of individual immunotherapy on the immune reactions of patients with disc hernias were examined in order to validate the use of immunotherapy in neuroanesthesiology. Preoperative treatment in the form of standard immunotherapy with an immunomodulating agent leakadin has been shown to lead mainly to activation of the humoral immunity. A system of individually selected immunotherapy activates both humoral and cellular immunity and, judging from the helper-suppressor coefficient, the processes regulating the immune reactions as well.