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Biomedical subjects

Konstantin V Slavin

Publications and source records attributed to Konstantin V Slavin.

8 recordsLinked to original sources
PubMed2006

Peripheral neurostimulation for treatment of intractable occipital neuralgia.

OBJECTIVE: Medically intractable pain caused by occipital neuralgia (ON) can be very difficult to control with traditional pain management. Peripheral nerve stimulation (PNS) may serve as a good alternative to destructive surgical manipulations used currently for the treatment of severe ON. METHODS: We analyzed records of 14 consecutive patients (9 women and 5 men; mean age, 43.3 yr) with intractable ON treated with PNS during the period from April 2002 to November 2004. Five patients had unilateral and nine had bilateral PNS electrodes inserted for trial, which was considered successful if patient reported at least 50% decrease of pain on the visual analogue scale. Ten patients proceeded with system internalization, and their long-term results were analyzed. RESULTS: At the time of the last follow-up examination (5-32 mo, mean 22 mo), seven patients (70%) with implanted PNS systems continue to experience beneficial effects of stimulation, including adequate pain control, continuous employment, and decrease in oral pain medications intake. Two patients had their systems explanted because of loss of stimulation effect or significant improvement of pain, and one patient had part of his hardware removed because of infection. CONCLUSION: Overall, the beneficial effect from chronic stimulation in our series persisted in more than half of the patients for whom procedure was considered and in 80% of those who significantly improved during the trial and proceeded with internalization. Thus, chronic PNS may be a safe and relatively effective method for long-term treatment of chronic pain syndrome in patients with medically intractable ON.

Adult↗
PubMed2004

Treatment of hemiballismus with stereotactic pallidotomy. Case report and review of the literature.

Hemiballismus is a relatively rare movement disorder that is characterized by uncontrolled, random, large-amplitude movements of the limbs. It is usually caused by a vascular lesion that involves the contralateral subthalamic nucleus (STN) (also known as the nucleus hypothalamicus or corpus luysi) and its afferent and efferent pathways. The authors present a case of medically intractable hemiballismus in a 70-year-old woman who was successfully treated with stereotactic posteroventral pallidotomy. In agreement with the data reported earlier by other groups, the microrecording performed during the pallidotomy showed a decreased rate of firing of the pallidal neurons, supporting the theory of impaired excitatory input from the STN to the internal part of the globus pallidus. Stereotactic pallidotomy may be the procedure of choice in the treatment of medically intractable hemiballismus. Intraoperative microrecording significantly improves the precision of the stereotactic targeting and should be considered a standard part of the pallidotomy protocol.

Action Potentials↗
PubMed2004

The treatment of cancer pain.

Pain is probably one of the most common cancer symptoms. In addition to being a major source of suffering and disability, cancer pain is extremely frightening for patients and their families. This review discusses the current options for treating cancer pain, focusing on the pharmacological agents currently available and briefly exploring some of the surgical options for pain management. The authors propose to adjust the World Health Organization (WHO) pain management ladder from its current three-step approach to a more sophisticated five-step algorithm that includes physical and psychological modalities along the entire continuum of care and adds two more steps related to neuromodulative and neurodestructive procedures once the opioids fail.

Analgesics, Non-Narcotic↗
PubMed2003

Current management of intraventricular hemorrhage.

BACKGROUND: Intraventricular hemorrhage (IVH) continues to present a challenge to neurosurgeons, often being accompanied by significant morbidity and mortality. The purpose of this paper is to present a review of the recent literature concerning the treatment of patients with IVH, and describe our current management scheme for this disorder. METHODS: A literature search was conducted to identify key articles pertaining to the pathophysiology and treatment of IVH, focusing on the more recent articles. The bibliographies of selected papers were also screened for additional useful publications. RESULTS: Management of IVH is primarily directed at controlling intracranial pressure through an external ventricular drain (EVD), but this catheter often becomes occluded by coagulated blood. The fibrinolytic system of the cerebrospinal fluid is limited, and blood may remain in the ventricles for months after a hemorrhage. IVH has a poor prognosis, partly because of the continuing mass effect of blood clots on the ventricular walls. Therefore, investigators have administered fibrinolytic agents directly into the ventricles of patients with IVH. Clinical studies of fibrinolytic therapy for IVH have found a 30 to 35% reduction in mortality with treatment, but have not yet clearly documented an improved neurologic outcome for the survivors. CONCLUSIONS: Fibrinolytic therapy may be life saving in severe cases of IVH. While many issues need to be resolved, our current practice is to administer intraventricular tissue plasminogen activator (t-PA or alteplase) if hemorrhage involves > or =30% of the volume of one of the lateral ventricles and/or the 3(rd) or 4(th) ventricle. We currently give t-PA after ruling out or treating a possible source of further bleeding, such as an unsecured aneurysm.

Cerebral Hemorrhage↗
PubMed2003

Infratentorial intracranial pressure monitoring in neurosurgical intensive care unit.

Monitoring intracranial pressure (ICP) is an important element of neurosurgical critical care that is used primarily as an indicator of adequate cerebral perfusion. Such monitoring is usually done with intraparenchymal, subdural or intraventricular pressure sensor connected to a pressure transducer system. In the past, multiple studies have shown that there are certain pressure gradients between various intracranial compartments, especially if there is some focal intracranial pathological process. Several clinical and laboratory studies measured ICP inside the posterior fossa by placing the sensor into the cisterna magna or the cerebellopontine angle. None of them, however, monitored direct intraparenchymal pressure in the posterior fossa. Such measurement may be a more sensitive way to assess focal swelling, ischemia and tissue perfusion in the posterior fossa structures. We simultaneously monitored supratentorial ICP using an external ventricular drain placed in the lateral ventricle and infratentorial ICP with an intraparenchymal sensor inserted into the cerebellum. We subsequently analyzed data from five patients with different posterior fossa pathology each of which had simultaneous supra- and infratentorial ICP recordings for up to five days. We found difference in ICP between the infratentorial and supratentorial compartments and this difference changed over time. In this article, we discuss feasibility and safety of simultaneous infra- and supratentorial ICP monitoring in patients with the posterior fossa pathology.

Adult↗
PubMed2002

Intra-operative microrecording equipment: comparative analysis of commercially available microrecording systems.

Intra-operative microrecording is an important and complex part of various neurosurgical procedures in the field of functional neurosurgery, primarily stereotactic destructive and neuromodulative operations for treatment of movement disorders. The growing demand for quality microrecording devices has resulted in the development and marketing of several commercially available systems. We analyzed several of these systems and compared them with each other, trying to emphasize their strong and weak features, in the hope that this analysis will help surgeons choose the microrecording system appropriate for the needs and preferences of each particular user. Just as every stereotactic surgeon should be familiar with the principles of stereotaxis and the details of the particular stereotactic frame he or she is using, it is essential for neurosurgeons in this field to understand the principles of microrecording and certain technical details of the recording equipment in order to avoid major instrumentation-related malfunctions and to be able to perform on-site troubleshooting if such a malfunction occurs.

Computer Systems↗
PubMed2002

Eagle syndrome: entrapment of the glossopharyngeal nerve? Case report and review of the literature.

Eagle syndrome is characterized by unilateral pain in the oropharynx, the side of the face, and the earlobe. It is caused by an elongated styloid process; resection of the elongated process eliminates the pain. Although quite rare, this syndrome is well represented in the oral, ear, nose, and throat surgery literature. In the neurosurgical literature, on the other hand, there is little if any mention of Eagle syndrome. The author presents a case of a woman who suffered from severe pain in the throat, the side of the face, and the ear. After the diagnosis of Eagle syndrome was made based on radiographic findings and was confirmed using a local anesthetic block, resection of the elongated styloid process was performed, resulting in complete and lasting pain relief. Eagle syndrome, which is caused by compression of the glossopharyngeal nerve as it passes the elongated styloid process, may be classified as an entrapment syndrome deserving of neurosurgical attention. The goal of this report is to familiarize neurosurgeons with Eagle syndrome and its diagnostic work up and treatment.

Adult↗