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Biomedical subjects

V V Krylov

Publications and source records attributed to V V Krylov.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

[Local fibrinolytic technique in surgery of traumatic inctracranial hemorrhages].

The emergence of neuroimaging techniques and new surgical technologies (neuroendocopy, navigation systems) in neurosurgery has substantially changed views of surgery for traumatic intracranial hematomas. The local fibrinolytic technique that has been applied to 40 victims aged 18 to 67 years (mean age 42.1 +/- 2 years) who had 18-to-97-cm3 hematomas is a promising direction of mini-invasive surgery for traumatic intracranial hematomas in patients in the compensated and subcompensated state. There were 32 males and 8 females. The procedure of the surgical intervention involves drainage of intracranial hematoma, followed by clot lysis and liquid blood aspiration along the drainage. A good outcome with a complete hematoma removal and clinical symptom regression was observed in 26 patients, a fair result with preservation of moderate neurological symptoms at hospital discharge was noted in 2 patients; 3 victims died. Recurrent bleedings were seen in 4 patients with epidural hematomas. A morphological study revealed the typical features of the morphogenesis of traumatic hematomas and perifocal brain tissue during local fibrinolytic therapy, which suggests that the area of damaging effect of bleeding on the adjacent brain tissue is decreased. Local fibrinolysis in surgery of traumatic intracranial hematomas may be considered to be one of the promising lines of treatment policy along with the existing traditional and current techniques and may be used as the method of choice in surgery of traumatic intracranial hematomas in patients in the compensated state. Removal of epidural hematomas through local fibrinolysis should be limited due to a high risk of recurrent hemorrhage and may be made only in a restricted contingent of patients with severe concomitant injury and concurrent somatic diseases when the risk of combined anesthesia and that of a longer operation are rather high. Moreover, of promise is that subtentorial epidural hematomas may be aspirated without trepanation of the posterior cranial fossa and the surgery may be performed under local anesthesia.

Adult↗
PubMedDate not supplied

[The diagnosis and method of surgical treatment in dislocation of the brain under the falx cerebri in craniocerebral trauma].

In 6.6% of cases a severe craniocerebral trauma is accompanied with dislocation of the brain under the falx cerebri with incarceration of the cingulate gyrus. The diagnosis of dislocation under the falx in intracranial traumatic hematoma and brain contusion-crushing is discussed. Falxotomy may be among the methods for the prevention or correction of incarceration of the cingulate gyrus. The authors suggest an operative approach for performing falxotomy with little injury as well as a surgical instrument for one-stage clipping of the inferior sagittal sinus and its division.

Acute Disease↗
PubMedDate not supplied

[The information value of the EEG in the acute period of subarachnoid hemorrhage as a consequence of rupture of intracranial aneurysms].

The article deals with the results of electroencephalographic (EEG) examination of 65 patients in the acute period of subarachnoid hemorrhage of nontraumatic genesis. The revealed changes in the electrical activity of the brain are compared with the level of disturbed consciousness, the severity of the clinical condition, and the presence of complicated or noncomplicated form of subarachnoid hemorrhage. The main factors determining the degree of disorders of the EEG pattern are discussed. It is shown that the EEG data possess high prognostic significance in determining the outcome of operative treatment of patients in the acute period of the disease.

Acute Disease↗
PubMedDate not supplied

[Proteolytic enzymes in the prevention and treatment of early ventilatory complications following lung resection in patients with tuberculosis].

The authors examined 259 patients with tuberculosis of the lungs before and after partial resection of the lungs. Proteolytic enzymes were administered endotracheally in the pre- and postoperative periods to 132 patients (main group), 127 patients (control group) received a placebo. Endotracheal administration of proteolytic enzymes in the main group reduced the number of early pleuropulmonary complications of the type of atelectasis and hypoventilation by half to one third and accelerated their resolution by 3-4 times as compared to these values in the control group. Fibrous changes and pleural adhesions on the side of the operation formed from the early pleuropulmonary complications more often in the control than in the main group. The function of external respiration was restored under the effect of the proteolytic enzymes in the control group 1-2 months after segmental and combined resection, in the control group it was restored 3-4 months and later after the operation.

Adult↗
PubMedDate not supplied

[Prognosis of the outcome of early surgery of rupture of arterial aneurysm of the brain].

The prognostic significance of 10 preoperative and 3 intraoperative factors was studied. The severity of the patient's condition, the EEG changes, an intracranial hematoma, and correspondence of the region of the operation with the zone of the vascular spasm were the most informative preoperative signs of the prognosis of the outcome of early operations. Bleeding during the operation and the duration of the arrest of the blood flow in the main vessel were the most informative intraoperative signs.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of intracranial hematoma in the acute period of rupture of cerebral aneurysm].

The authors analyse the results of surgical treatment of intracranial hematomas in the acute period of ruptures of arterial aneurysms in 38 patients. The surgical tactics and volume of surgical intervention are determined according to the rate of the clinical manifestations of the hematoma and the severity of the patients' condition. Rupture of the hematoma into the ventricles of the brain and a hematoma more than 60 cm3 in volume are of unfavourable prognostic significance in ruptures of aneurysms attended by the formation of a hematoma. A vascular spasm in the presence of a hematoma is not a dominant factor determining the outcome of the operation.

Acute Disease↗
PubMedDate not supplied

[Surgical treatment of cerebral aneurysms complicated by vasospasm in the acute period].

The results of clipping of an aneurysm in the acute period of subarachnoid hemorrhage are analysed. It is shown that vascular spasm is an increased risk factor if it involves up to 3-4 and more arterial basal segments and is attended by marked general cerebral and focal neurological symptomatology and gross disorders of cerebral function. Such vascular spasm is unfavourable from the standpoint of prognosis in determining the outcomes of the operation.

Acute Disease↗
PubMedDate not supplied

[Effect of temporary interruption of blood flow through the major intracranial vessels on the outcome of surgical treatment of arterial aneurysms].

During operations for clipping an aneurysm, the blood flow along the artery supplying this aneurysm was temporarily arrested in some patients to prevent intraoperative hemorrhage. It has been proved that the arrest of blood flow along the main vessel for more than 20 minutes during an operation in the acute period of subarachnoidal hemorrhage, particularly in the presence of a vascular spasm, aggravates the course of the postoperative period and is conducive to the lethal outcome.

Acute Disease↗
PubMedDate not supplied

[Results of surgical treatment of intracranial arterial aneurysms].

The results of surgery for arterial aneurysms of the brain are analysed. It was found that the severity of the patient's condition rather than the time of the operation had an effect on the outcome of surgery. The severity of the patient's condition and the outcome of the operation were determined first of all by the presence of the intracranial hematoma, cerebrovascular spasm, escape of blood into the ventricles of the brain, and the degree of manifestation of subarachnoid hemorrhage. The advantage of early operations for the prevention of repeated ruptures of the aneurysm is pointed out.

Adolescent↗
PubMedDate not supplied

[Analysis of causes of death in the acute period of ruptured intracranial aneurysms].

The causes of death of 80 patients with ruptured aneurysms of the brain are analysed; 37 of them underwent operation. Intracranial hypertension with edema and dislocation of the brain was the main cause of death both of patients who were operated on and of those not subjected to surgery. Intensive subarachnoid hemorrhage, vascular spasm, intracranial hematoma, and the escape of blood into the ventricles of the brain lead to the development of intracranial hematoma. Besides, in patients who were operated on, edema of the brain developed as a consequence of its injury during manipulations and clipping of a large vessel. In some cases, death of patients with ruptured intracranial aneurysms was due to extracranial factors.

Adolescent↗
PubMedDate not supplied

[The x-ray anatomical structure of the anterior portions of the circulus arteriosus (Willisi) cerebri in aneurysms of the anterior cerebral-anterior communicating arteries].

The angiographic findings were analyzed in 136 patients with aneurysms of forebrain and anterior communicating arteries and 27 patients examined for brain extravascular abnormality. Depending on the magnitude of effects of one of the internal carotids on the blood supply anterior communicating and forebrain arteries, symmetric and asymmetric filling variants for the anterior portions of Willis' circle were identified. The symmetric variant was detected in 30% of cases and in 67% of controls, the asymmetric was revealed in 70 and 33%, respectively. One of the ICAs was prevalent in filling the anterior portions of Willis's circle in 70.3% of patients with aneurysms and in 90.6% of cases the diameter of its ipsilateral segment A1 was larger than of the segment contralateral to A1. Aneurysms were located in the trunk of the anterior communicating artery in 13% of cases and in the corner of the forebrain artery and the anterior communicating artery in 87% of cases. Most aneurysms were located on the side of the prevailing segment A1. The influence of a hemodynamic factor on the formation of aneurysms in the area of the anterior communicating and forebrain arteries.

Adult↗
PubMedDate not supplied

[Role of ischemic cerebral infarction in the development of lethal outcomes in ruptured intracranial arterial aneurysm].

Analysis of 320 autopsy cases of death after the rupture of brain arterial aneurysms (AA) without a surgical treatment is performed. The frequency of ischemic infarction among these cases was 15.3% and in 11.2% the infarction was an immediate cause of death. The lethal outcome due to the infarction occurred at the end of the 1st and during the 2nd week with a maximum at 9-12 days. Ischemic infarction as a cause of death usually had a wide zone of spread involving 2 and more brain lobes. The thrombosis of the big brain artery was a cause of ischemic complications in 19.4% of cases. Morphological alterations of the basis cerebri in such cases consisted of changes in the intima, elastic membrane, medial layer and adventitia resulting in the lumen narrowing.

Adult↗