Visual functions in the postsurgical period are among the most important factors determining the quality of life in patients with tumors of sellar region. Advances in surgical treatment of patients with sellar tumors require exact evaluation of degree the optic nerves and chiasm being involved in the pathological process. The problem of approapriate surgical treatment cannot be solved without its consideration in the neuroophthlmological aspect. The main purpose of intra-operative monitoring of visual evoked potentials is well-timed revealing and prevention of damage of the visual system.

Severe head traumas in combination with multiple injuries of polytrauma are important factors for the prognosis of morbidity and mortality in patients. The prognosis mainly depends on the presence of primary mechanic brain injury and the development of secondary brain damage. In patients with traumatic brain injury, intracranial hypertension against multifocal injuries secondary to cerebral edema is a major problem. We have made literature review.

The pathology of cranioorbital region draws attention of surgeons of various specialities because of close and difficult anatomic mutual relation of a cavity of a skull, an orbit and additional sinuses of a nose. To various pathological processes, in particular to tumours of this localization, were long since developed extracranial and transcranial approaches depending on primary diffusion of pathological processes. The group of extracranial approaches is especially numerous and includes both transorbital, and approaches through additional sinuses of a nose. Division of transcranial approaches is based on presence or absence of necessity of mobilisation in the course of approach supraorbital edge.

Polytrauma has a number of the clinical features caused by system processes of pathogenesis of critical conditions. On the basis of experience of treatment of 553 patients with brain bruises with extracranial damages and accompanied by a traumatic shock, essentially new approach is developed by authors in diagnostics of this pathology, providing pathogenesis’ caused possibility of increase of severe craniocerebral trauma in the sharp period of traumatic illness.

We represent cases of women which presented with meningiomas associated with pregnancy. This tumor associated with pregnancy not often but if it occurs, meningioma is having fast growth. We describe the case of 43-years-old woman with huge malignant meningioma and a hemorrhage in it which under-went craniotomy during the 38th week of pregnancy because of sharp deterioration. The surgical procedure and postoperative period were relatively easy. Besides we have made literature review.

Metastatiс spread of neoplasms to the pituitary gland is a relatively common finding in autopsy series of cancer patients. The majority of these patients were asymptomatic. Only 1% of all pituitary surgeries are performed to treat tumors that have metastasized to the pituitary gland. From 1993 through 2008, 3 patients with symptoms arising from tumor metastasis to the pituitary gland were evaluated at the Russian Polenov Neurosurgical Institute.

Breast and lung cancers are the most common diseases that metastasize to the pituitary.In two patients, the primary malignancy was breast. In one case, the primary tumor was lung. Diabetes insipidus, anterior pituitary dysfunction, visual field defects, headache/pain, and ophthalmoplegia were the most commonly reported symptoms. Differentiation of pituitary metastasis from other pituitary tumors based on neuroimaging alone can be difficult, although certain features, such as thickening of the pituitary stalk, invasion of the cavernous sinus, and sclerosis of the surrounding sella turcica, can indicate metastasis to the pituitary gland. Although surgical series have not shown any significant survival benefits given by tumor resection, the patient's quality of life may be improved.

The research of clinical characteristics of different tick mixed infections etiological variants in children — tick-borne encephalitis, ixodid tick-borne borreliosis, granulocytic anaplasmosis and monocytic ehrlichiosis in human in Kemerovo region showed a possibility of feverish meningeal and meningoencephalitic forms of disease. The comparative analysis of mono- and mixed infections according to the principal clinical criteria showed the predominance of non-specific symptoms and more severe clinical course in mixed etiology, the pathognomonic for ixodid tick-borne borreliosis symptoms are rare. One of the main causes of severity of state and sequences of the disease is the autotoxemia syndrome. The use of the luciferase method in the diagnosing of the autotoxemia syndrome in tick mixed infections allows to predict the development of severe forms of the disease.

242 patients with discirculatory encephalopathy were examined: 120 of them were the liquidators of the Chernobyl nuclear disaster and 122 patients were without radiation anamnesis. We studied the variants of structural changes of the main brain arteries by ultrasonic scanning. We arrived at a conclusion that that liquidators of the Chernobyl APP had an acute form of main brain arteries’ affection. Radiation effect correlates with the significant hemodynamics stenosis of the internal carotid artery (r = 0,5; р < 0,05).

We examined of 116 patients with chronic cystic mastitis, 38 patients with malignant mammary neoplasm, and 29 patients without any pathologic of mammary. We estimated complaints of patients their life and medical history, and depression which was estimated by scales of Beak. In our research depression disorder dominates in group patients with chronic cystic mastitis - 49%, in group with breast cancer it consists — 34%, and in control group — 35%.

Spinal tumor surgery is one of the hardest neurosurgical branch, which requires microsurgical equipment and intraoperative monitoring. Spinal tumor diagnostics can be very difficult because of clinical signs same for other disease in case of acute clinical manifestation. Severity of disease is burdened with concomitant somatic symptomatology. According to histology, dissemination and vertebral lesion, each definite case should be examined individually and in complex. Only the surgical method is not enough for the decision of spinal tumor problem. It is obvious, than problem of pathogenesis, diagnostics and operative treatment of spinal cord tumors is task of current importance at present stage of neurological and neurosurgical development. This article presents surgery results for patients treated at Russian Neurosurgical Institute named after prof. A.L.Polenov, neurooncology department in period of time 1999—2007.

The article presents review of literature for spinal tumors most common in practice. Intraoperative tumor description, histological verification and tactics are presented. Totality of resection of lesion, and methods of instrumentation in case of vertebral column instability are discussed. In spite of lot of the literature, adequate decision is very hard in case of spinal cord and vertebral tumor. Severity of disease is burdened with concomitant somatic symptomatology, neglect of disease, dissemination of the process, vertebral metastases in case of unoperated primary tumor. According to histology, dissemination and vertebral lesion, each definite case should be examined individually and in complex. Only the surgical method is not enough for the decision of spinal tumor problem.

Clinical examination of an efficacy assessment of treatment of patients in the early reduction term after mild closed craniocerebral trauma (MCCCT) is carried out. In inspection it is included 27 patients after MCCCT with manifestations of an autonomic dysfunction syndrome. The diagnosis was established on the clinical examination, paraclinic inspection, research of the vegetative status, and also an author's method computer finger tremorography. Course treatment was carried out by a drug neurometabolic activity (propionate dihydrate). Authentic efficacy of treatment of an autonomic dysfunction manifestations in patients in the early reduction term after MCCCT. The method computer finger tremorography reliably displays a state of normalization of vegetative functions.

The study of functional nervous system state in 53 fire fighters and 31 gas-rescuers, performed using the electroneuromyographic examination including the registration of M-response and F-wave, has revealed the distal disturbances of motive axons of the peripheral nerves. The findings were found to be more often observed in the range of the normative values which corresponded to the latent (clinically not pronounced) disorders. The induced of stimulation electroneuromyography have been revealed which were found to be more significant for studying the toxic disorders of the peripheral nerves.

The article provides the results of the research preformed with the purpose to study the efficiency of methods, focused on restoration of balance at patients with multiple sclerosis during exacerbation and remission stages. The received data testify to efficiency of a course of neurorehabilitation treatment for restoration of balance at multiple sclerosis both during exacerbation of and remission of the disease.

The goal of the research was studying the clinical-laboratory manifestations of toxemic and complex immune syndromes in patients with malignant cerebral tumors, and also studying the possibilities of correction of such syndromes by means of the programs for infusion-desintoxication therapy in combination with plasmapheresis. Basic biochemical substrates of toxemia and complex immune syndrome are oligopeptides, substances of nonprotein nature (of high, low and average molecular weight) and circulating immune complexes. Plasmapheresis provides for their excretion, which allows to reduce the degree of autoimmune aggression and toxemia effectively. Application of haemodilution and preliminary-prepared autohaemocomponents for compensation of blood loss at surgical interventions, promotes for decrease of toxemia manifestations and complex immune syndrome in the nearest post-surgery term.

Оn the basis of the heart rate variability analysis in 41 patients during acute period of nontraumatic intracranial hemorrhages it was revealed that dynamics of the vegetative dysfunction rise was characterized by transition from reflex to humoral metabolic type of regulation. The reduction of reactivity of vegetative nervous system parasympathetic part during respiratory and active orthostatic test was noted. The method of evaluation of vegetative nervous system reactivity by means of heart rate variability analysis recorded before, during and after lumbar puncture with measure of cerebrospinal fluid pressure was worked out. It allows to evaluate the reactivity of suprasegmental centers (adequate, insufficient, exhaustion), raises accuracy of detection of adaptive organism resources with the detachment of the disease course variant and helps to reveal correlation of exertion extent of suprasegmental centers with hypertensive hydrocephalic syndrome.

The disease Gilles de la Tourette (generalized teak, disease or syndrome Tourette and others) — respecting rare organic disease of the encephalon, revealing presence varied hyperkinesias and vocals of the breaches.

Under observation was found 26 children at age with 7 before 14 years with different degree evidence motor and vocals frustration at period with 2002 on 2007. Of them boys 21 (80,7%), girls 5 (19,2%). All children got the traditional treatment by used our department with addition of Korteksin preparation in medical drug blockade in points Vg 15, 16. Korteksin in complex treatment disease Gilles de la Tourette promotes more quick and more long removal motor and vocals frustration.

Neurologic, radiological inspection of 30 men (middle age is 36,5 ± 7,5) with a muscular-tonic syndrome at a cervical osteochondrosis. According to an index of a muscular syndrome on 3 degrees of weight 3 groups of patients are allocated. Diagnostics by device MСU allows to reveal authentically and precisely dysfunction in the certain group of muscles of a neck and to spend their adequate training, promoting duly correction. The medical technique of device MCU leads to full recourse muscular-tonic and liquidations of a painful syndrome at muscular-tonic syndrome I and to II degree, significant recourse of expressiveness of syndromes at sick of a cervical osteochondrosis with muscular-tonic a syndrome of III degree. Formation of a correct muscular stereotype provides achievement of proof medical effect, preventive maintenance of a reflex painful syndrome in a cervical department of a backbone and prevention of chronic disease.

Methods of surgical treatment of patients with skull base meningiomas using high intensity infrared laser radiation (ND-YAG laser) at a wavelength of 1.06 micron were developed. The paper presents results of Nd-YAG laser application in skull base meningioma removal with assessment of its efficacy as compared with conventional surgical methods.

Despite a significant advance in microsurgery of the parasagittal brain meningiomas the problem of its surgical treatment is not closed at the present time. This is due to the fact that parasagittal meningiomas can ingrow to the sinus lumen. In this cases the possibility of tumor resection using conventional techniques is limited. Attempts at the tumor radical removal lead to a massive operating blood loss, a stable severe neurological deficit and decrease the quality of life. This results in high recurrence rate of parasagittal meningiomas also. The paper presents the results of ND-YAG laser use in the removal of parasagittal meningiomas with assessment of its application efficacy as compared with conventional techniques.

The problem of search and development of new approaches to integrated treatment of patients with malignant brain glioma remain one of the most urgent issues for contemporary neurosurgery and neurooncology. In spite of the applied efforts the results of a complex therapy for malignant glioma, especially for glioblastoma, are utterly unsatisfactory. Immunotherapy is one of the directions searching for a generation of cytotoxic cells able to lyse the tumor. Combination of various immunotherapeutic approaches is regarded the most perspective way. Since 1999 Neurosurgical Clinic of Novosibirsk Research Institute of Traumatology and Orthopaedics was carrying out clinical trials of combined immunotherapy within complex therapy of patients with malignant brain glioma in compliance with two protocols.

The clinical characteristic of the remote consequences of the closed cranio-cerebral trauma оn the basis of complex neurological, psychophysiological, electrophysiological inspection 171 patients was given. The big variety of clinical symptoms is stacked in displays of a syndrome of intracranial hypertensia, vegetovascular and neurotic syndromes. Allocation of the specified syndromes was proved by results of laboratory researches of patients. It is established, that at younger age (25—35 years old) at patients after the closed craniocerebral trauma it is formed a syndrome of intracranial hypertensia, in more senior period of a life (35—45 years old) displays of vegetovascular and neurotic syndromes take place.

Here, we propose a method of forecasting the development of the heavy forms of the tick-borne encephalitis using diagnostic tables. The method is based on evaluation of the patients with syndrome of endogenous intoxication using immunological and biochemical data along with evaluation of the clinical manifestations. We also propose an advanced form of the method that includes data based on the genotype of OAS1 — the gene, coding oligonucleotidesynthetase needed for immune response to RNA viruses. OAS1 genotype is an important risk factor since the differences in catalytic activity of OAS1 isoenzymes result in different susceptibility to the virus of the tick-borne encephalitis.

Depression and anxiety were examined by Hospital Anxiety and Depression Scale and Spilberger Scale in 217 multiple sclerosis patients treated by Betaferon. The concentration of blood serotonin was determined by immunoenzyme analysis in 71 of them. The multiple sclerosis patients had progressive high levels of depression ((7,55 ± 3,61) points; р = 0,000) and anxiety ((7,55 ± 3,61) points; р = 0,000), and the decreased blood serotonin concentration ((210 ± 134,2) versus (269 ± 98,8) ng/ml; р = 0,036 in healthy people). The level of anxiety was related to the level of serotonin depression. Betaferon did not correct the affective disorders in multiple sclerosis patients, except the decreasing the degree of anxiety, and did not normalize the level of blood serotonin, that suggest the use of selective serotonin reuptake inhibitors during immunomodulating therapy.

In period of 2001—2004 in Tashkent we observe growing concomitant craniocerebral and skeletal injuries (CCCSI) on 4,8% per annum. People of working age (at the age of 21—60) often get concomitant craniocerebral and skeletal injuries (CCCSI) though males dominate at the age of 21—40. But at the age of 15—20 and above 60 years old females get a CCCSI in 2—2,5 times higher, than males.

Patients admission to hospital at different times greatly differentiates: the largest was in period from 13 to 18 hours and smallest was from 0 to 6 hours. Road trauma appearance is principal cause of concomitant craniocerebral and skeletal injuries (CCCSI) in Tashkent in all the years of observation. It has the tendency to grow from 19,4 to 29,1%. Noticeable growing of concomitant craniocerebral and skeletal injuries (CCCSI) is alarming at the work and in sport. The severe skeleton injuries were dominant among all kind of injuries.

The outcomes of concomitant craniocerebral and skeletal injuries (CCCSI) in 834 patients in the large industrial city of Tashkent during 2001—2004 are analyzed in this research. The best functional recovery rates were recorded in group IV. The complete loss of work ability number amounts 4,7% from total survived patients. The severe skeleton injuries forms the biggest II group of patients. Death from craniocerebral injuries occurred in 16,1% of patients.

Death rates increased by 9,7% times during four years of the research. Annual rate of increase of craniocerebral injuries was 4,9%. The prevalent parts of population were young (21—40 years) and middle-aged (41—60 years) persons, men — 77%. The highest death outcomes occurrence was in III group and severe skeleton injuries. Predominate cause of death — is severe skeleton injuries, lead to bleeding, DIС-syndrome, all kinds shock and severe craniocerebral injuries (SCCI) lead to brain edema and dislocation.

In this article results of the clinical-immunological analysis with different forms tick-borne encephalitis of Tomsk Region during the period from 2000 to 2008 are represented. The revealled disbalance of cytokines alongside with breach of the expressions cytokines's receptor by limphocytes's cells, can be one of the main of the reasons to inefficiency answer when introducing the infectious agent in organism and shaping the chronic form to infectious pathology, in particular, with long presence of the antigen of the virus tick-borne encephalitis in blood. The trend to increase the level sick with long presence of the antigen of the virus tick-borne encephalitis in blood, with prevalence of the persons feminine flap, mainly average and senior age for the last years is given.

To study the peculiarities of parameters autonomic regulation at various types of stroke in the acutest and after the acute stroke periods, and also the degrees of their influence on the forecast at stroke are appreciated results of the spectral analysis of heart rate variability in patients with hemorrhagic stroke and ischemic stroke. The indexes of heart rate variability for patients with a fatal outcome are exposed.

Checkup of 215 patients in the late period after the dick herniation surgical treatment. Middle age (45,6 ± 0,6) years. Postoperative period is (7,4 ± 0,4) years. The patients were examined: neurological status, lumbar spine radiography, magnetic resonance imaging procedure, spinal canal ultrasound investigation, muscular syndrome index determination. Revealed pain syndrome caused by the disk herniation relapse in operated and adjacent segments, spondylosis and spondylarthrosis, spinal canal stenosis, aseptic epiduritis. The pain syndrome at those patients entails by development of the muscular syndrome and pathologic motor skill.

Checkup of 215 patients with pain syndrome relapse in the late period of the diskectomy. Middle age (45,6 ± 0,6) years. The patients were examined: neurological status, lumbar spine radiography, magnetic resonance imaging procedure. Depression revealed by Zung scale. Revealed depressive disorders occur in 47% patients. Mild and masked depression predominates. Depressive disorders occur mainly in the disk herniation relapse in operated and adjacent segments, by spinal canal stenosis and cicatricial-commissural epiduritis. Post-discharge adjustment in patients with pain syndrome relapse in the late postoperative period must be carry out consider depressive disorders.

Checkup of 63 patients with pain syndrome relapse in the late period of disk herniation surgery by posterior approach. Among them there were 38 women (60,3%) and 25 men (39,7%). Middle age (44,3 ± 1,1) years. Ultrasonic examination was carried on the ultrasound scanner «Sonoline-Elegka» («Siemens») with the multi — frequency sensor 2,5—5,0 megahertz. Ultrasonography displays in the late period of the disk herniation surgery in 65,1% cases disk herniation and protrusion, in 23,8% cases — the spinal canal stenosis, in 44,4% — radicular canals stenosis, in 46% cases — cicatrical epiduritis visualization. These pathologic alteration and combination of them are the main causes of the pain relapse in the late period of the disk herniation surgery.

The results of examination and surgically treatment of 50 patients with sciatic nerve and branches lesions are presented in paper. Sciatic nerve and branches injury and degree of their damage is diagnosed, functional outcome were described, tactic and treatment recommendations were given in dependence to injury mechanisms, location, surgical techniques.

Jodantipyrin is an antiviral medicament, inductor of endogenous interferon. It relates to the group of nonsteroidal antiinflammatory medicaments of pyrazolone derivative. The principal mechanism of Jodantipyrin antiviral effect is its ability to induce endogenous interferons of the 1 st and 2 nd types, what has been confirmed by the results of numerous and detailed preclinical and clinical trials. At the present time a long-term experience of this medicament application as a prophylactic agent in case of tick-borne encephalitis and data of postmarketing monitoring of the medicament safety have been accumulated. This experience confirms efficacy of the medicament in prophylaxis of tick-borne encephalitis.

2—3% of head and neck tumors are comprised by nasal and paranasal sinus’ masses. Complex method based on surgcical operation with maximal cytoreduction is the mainstay of treatment. Pecularities of surgical planning and technique in treatment of paranasal sinus tumors invading the skull base are considered in the article. Short- and long-term surgical results have been analyzed. Long-term results first of all depend on radicality of operation, histological structure of the tumor and its sensitivity to ajunctive methods of treatment. These used techniques are the only possible in this kind of mass lesions.

The paper presents results of clinical and laboratory investigation of 106 patients with chronic brain ischemia (CBI) I-II stages (44 males and 62 females). The age of examined patients varied from 38 to 67 years (mean age was 55,6 ± 2,2). The diagnosis of CBI was estimated according to the generally accepted criteria. Results of laboratory investigation of 22 practically healthy people (10 males and 12 females) served as control. The age of control group varied from 35 to 64 years (mean age was 53,2 ± 2,1). Laboratory diagnostics included detection levels of circulating endothelial cells, autoantibodies to encephalitogenic protein, neuron-specific enolase and protein S-100. Reliable changes of immune status as well as signs of endothelium dysfunction was revealed. These indices are expressed in patients with CBI II stage. Direct correlation between intensity of endothelium dysfunction and activity of autoimmune aggression in brain was revealed.

We described the experience of a microscope-based navigational system for opening of the posterior wall of the internal auditory canal (IAC) via the retrosigmoid route. Computed tomographic findings for 47 acoustic neuroma cases were divided into three groups, on the basis of the relationship between the labyrinth and the sigmoid-fundus line (medial,on the line,or lateral). The shortest distances between the most medial labyrinthine extension (MMLE) and the resection line were measured. In 20 acoustic neuroma operations, the different features and the practicality of the microscope-based navigational system for opening of the IAC were evaluated.

The mean anatomic localization errors were (0,67 ± 0,2) mm for navigation to the IAC and (0,71 ± 0,37) mm for navigation to the posterior semicircular canal. The average distances between the MMLE and the resection line were 3,65; 3,36, and 2,0 mm for the lateral, on-the-line, and medial groups, respectively. Direct contouring of structures at risk does not take into account the localization error, nor does it provide reliable navigational information. A novel indirect contouring concept that takes into account the localization error (the safety corridor method) was therefore introduced.

Surgery has remained the mainstay for the management of hydatid cysts. The success of any operation depends to a great extension how well the optimal surgical approach is chosen and which method of residual cyst sanitation. The purpose of the study was to analyze of complications after combined cyst, brain and abdominal, surgery. The complications associate with depth, size and relation to adjacent organs.

Brain tumours cause considerable concern due to a high mortality and there are increasing efforts to provide adequate care. The goal of this study was to determine the incidence of brain tumours in Kyrgyz Republic. A population based study was performed. Patients from Kyrgyz Republic with incident intracranial tumours diagnosed in 2005 and 2007 (by CT, MRI or histology) were identified retrospectively using multiple sources. Differences in incidence by tumour type, age and sex were examined. Eight hundred and eighty four patients with incident brain tumours were identified (456 primary tumours and 428 secondary tumours). The commonest primary tumours were neuroepithelial tumours (53,5%), meningeal tumours (19,5%), and sellar tumours (16,5%). The crude yearly incidences of primary and secondary tumours were 30,3 and 28,3 per 100 000 respectively. About 50% of patients with secondary tumours had an underlying lung cancer. The incidence of primary and secondary tumours increased markedly with age. Meningeal tumours were more common in women. This study shows that the incidence of intracranial tumours in Kyrgyz Republic is considerably higher than previously thought. Brain tumours are a significant cause of morbidity and mortality in Kyrgyz Republic, and further research into their aetiology and treatment is urgently required.

The aim was to study the indexes of the autoimmune affection of the nervous system in patients with rheumatoid arthritis (RA) after mild cranial traumas (CT). Under the observation there were 16 patients with neurological signs of RA, got mild CT. The group of compare consisted of 30 patients with RA and the nervous system lesions but without CT in the histories of lives. 30 healthy people were in the control group. The blood for the investigations was got 6 times from patients of the main group: on the 2^nd, 15^th, 30^th, 60^th, 90^th, and 120^th days after the CT. The autoimmune affection of the nervous system was diagnosed by the help of definition of the cerebrolysin-dependent activation of the B-lymphocytes by the method of quantitive cytophluorimetry. It was found that B-cells of RA patients with the nervous system lesions were sensitized to the nervous tissue. Even mild CT of the RA patients noticeably raises the activity of the immune system pointed on the tissue of the CNS. Usage of the standard treatment could not prevent such changes which were the brightest to the 15^th day after CT.

The aim of the work was to study the laboratory indexes of the autoimmune affections of the nervous system during mild cranial traumas (CT) of patients with rheumatoid arthritis (RA). Under the examination there were 16 patients with neurological signs of RA got the mild CT. The group of compare consisted of 30 patients with RA and the nervous system lesions without traumas of it in the life histories. The control group consisted of 30 healthy people. The autoimmune affection of the nervous system was diagnosed by definition of the antibody-synthetic activity of the B-cells over the cerebrolysin. The work confirms presence of the autoimmune component of the CT pathogenesis and gives prove of need of rheumatologist or immunologist participation in the treatment of patients with RA with CT. Described laboratory method of the B-cells activity definition can be recommended as a complementary diagnostic method of the nervous system affections during RA, presence and activity of the autoimmune component of the CT pathogenesis in such patients.

Examination of ecological factors in their impact of beginning of acute malfunction of cerebral blood circulation in population of one of the industrial regions of Novosibirsk. The article shows endogenous and exogenous effects of impact of appropriate factors.