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Biomedical subjects

V V Krylov

Publications and source records attributed to V V Krylov.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[The surgical treatment of arterial aneurysms in the acute period of subarachnoid hemorrhage].

The paper presents the surgical outcomes of 300 patients with brain arterial aneurysms. A total of 43% of the patients were admitted to the unit within the first 72 hours of the onset of hemorrhage, 165 patients were operated on within the first fortnight, 135 were operated on in later periods. The aneurysms of the anterior communicating artery, internal carotid, middle cerebral artery were 42, 24, and 22%, respectively. Multiple aneurysms were 12% according to the Hunt and Hess classification, the preoperative severity of the patients was as follows: Degree I, 39 (13%), patients, Degree II, 130 (43%), Degree III, 106 (36%), Degree IV, 18 (6%), Degree V, 7 (2%). In 14% of the patients, aneurysm rupture was accompanied by the formation of intracerebral hematoma. The qualitative analysis of angiograms revealed vascular spasm in 70% of cases, the quantitative one indicated it in 80%. Aneurysm clipping was performed in 269 patients, its wrapping with a free muscle flap was done in 31 patients. Among the patients operated on, the mortality was 35% in the first fortnight of the onset of the disease and 17% during operations in later periods.

Aneurysm, Ruptured↗
PubMedDate not supplied

[Ischemic complications in the development of fatal outcomes after the rupture of cerebral aneurysms].

A total of 320 unoperated-on patients who had died due to rupture of arterial aneurysms of the brain were clinically and anatomically examined. The incidence rate of ischemic infarct of the brain exposed to sections was 15.3%. In 11.3% of cases, ischemic infarct was the main cause of death, while in 4.1% it was concurrent. The time course of changes in the patient's status due to cerebral ischemia, typical changes on a brain computed tomogram and cerebral angiogram were shown.

Adult↗
PubMedDate not supplied

[Hydrocephalus and its significance in the early surgical treatment of cerebral aneurysms].

The clinical course of acute arterial aneurysm rupture and computed tomographic findings of the brain were analysed in 100 patients. Hydrocephalus was detected in 27% of cases. There was a relationship between the development of hydrocephalus and the nature of intracranial hemorrhage, the site of aneurysm, as well as the specific features of neurological symptomatology in hydrocephalus. Analyzing the results of surgical treatment of aneurysms in 85 patients indicated that there was an increase in the number of unfavourable functional outcomes and a decrease in good ones after early operations made in the presence of hydrocephalus.

Acute Disease↗
PubMedDate not supplied

[Several results of the use of variation pulsometry in the course of hyperbaric oxygenation in patients after clipping of aneurysms of cerebral vessels].

Dynamic computer study of cardiointervalogram with determination of tension index (TI) has been conducted in the course of hyperbaric oxygenation (HBO) in 15 patients operated on for aneurysm ruptures in cerebral vessels. It has been established that TI evaluation makes it possible to register an adaptogenic effect of hyperoxia in these patients and is recommended for the continuation of HBO therapy which in some cases requires 10-12 sessions.

Aneurysm, Ruptured↗
PubMedDate not supplied

[The diagnosis of multiple aneurysms in the acute period of subarachnoid hemorrhage].

Among arterial aneurysms of the brain, multiple aneurysms occur on the average in 12.9% patients as evidenced by angiographic studies and in 22.7 as shown by autopsies. The study was undertaken to examine 66 patients with multiple aneurysms who had undergone surgical treatment. Their mean age was 45 years. The examination has demonstrated that total cerebral angiography should be performed to diagnose multiple aneurysms. The comprehensive studies of the patients that involved neurological examinations, computed tomography of the brain and total cerebral angiography have enabled the ruptured aneurysms to be detected in 68% of cases and in 85% when aneurysms are located in various vascular beds. While defining the surgical policy for patients with multiple aneurysms in the acute hemorrhagic period, it is necessary to bear in mind that there can be repeated hemorrhages from the previously unbled aneurysms.

Acute Disease↗
PubMedDate not supplied

[Prognosis of ischemic complications following early surgical treatment of cerebral aneurysms].

A summarized severity index has been defined on the basis of 11 preoperative findings from clinical and neurological studies, cerebral angiography, computerized tomography of the brain, and electroencephalography in 71 patients operated on for early aneurysmal rupture. The value of the summary severity index has a closely linear negative correlation with the likelihood of favourable postoperative outcomes: with a high summarized index, a risk for postoperative ischemic events and deaths increases. The paper shows it advisable to predict postoperative ischemic complications while defining indications for early aneurysmal surgical treatment.

Adolescent↗
PubMedDate not supplied

[Intraoperative hemorrhages during the surgical treatment of aneurysms of the cerebral vessels].

The study indicated that intraoperative hemorrhages more frequently occurred at early surgery. During operations made in the first 7, 8-14 days of and after a fortnight of aneurysmal rupture, the incidence of hemorrhage was 27.5, 23, and 22%, respectively. Intraoperative hemorrhage more commonly occurred from carotid aneurysms at surgery within the first 14 days after the onset of bleeding and from anterior connective arterial aneurysm at surgery made later. Intraoperative hemorrhage deteriorated surgical outcomes. In bleeding from the anterior communicans, carotid, and middle cerebral artery aneurysms, the postoperative mortality showed 1.5-, 2-, and 2.5-fold increases, respectively. At the same time, the outcomes of interventions depended on the duration of temporary clipping of the great cerebral arteries.

Cause of Death↗
PubMedDate not supplied

[The procedure for the surgical treatment of intracranial arterial aneurysms in cerebral vascular spasm and ischemia].

Analysis of the data of clinical neurological examinations, cerebral angiography, computed tomography, and electroencephalography in 77 patients with early cerebral aneurysmal rupture made it possible to identify three clinical types of vascular spasm-induced cerebral ischemia: compensated, subcompensated, and decompensated. specific characteristics of each type of cerebral ischemia are given. It is shown that early surgical treatment policy for aneurysms in vascular spasm must be determined by the clinical type of cerebral ischemia.

Adult↗
PubMedDate not supplied

[The diagnosis of peacetime firearms craniocerebral wounds in the acute period].

The paper deals with the diagnostic potentialities of using various techniques in the wounded persons with arms-induced brain injuries. The diagnosis of arms-induced wounds of the skull and brain must be comprehensive and made concurrently with therapeutical measures. The instrumental methods must be applied to the extent accessible for the given wounded person and a study should be stopped immediately after a diagnosis is established.

Acute Disease↗
PubMedDate not supplied

[Temporary preventive clipping of the major brain arteries in the surgical treatment of arterial aneurysms].

Preventive temporary clipping of the carrying arteries reduces the incidence of intraoperative hemorrhage in anterior connecting arterial aneurysms from 26 to 13%, in middle cerebral arterial arterial aneurysms from 29 to 4%. In anterior connecting arterial aneurysms, the use of preventive temporary clipping of the carrying arteries fails to affect surgical outcomes. In middle cerebral arterial arterial aneurysms, this procedure decreases postoperative mortality from 17 to 12% by reducing the incidence of intraoperative hemorrhage; however, the rates of disability due to possible brain ischemia in the middle cerebral arterial bed rates increases from 32 to 40%.

Aneurysm, Ruptured↗
PubMedDate not supplied

[The morphology of the vascular spasm in cerebral aneurysm rupture].

The vessels of the basis cerebri were histologically examined in 45 patients who had died from arterial aneurysmal rupture. Angiography had made at the clinic detected cerebral vasospasm of varying severity and extent. All autopsies showed ischemic encephalomalacia in specimens. The findings indicated that arteriostenosis angiographically identified as vasospasm, by causing ischemic events was induced by morphological changes in the arterial wall. The arterial structural changes found were characterized by subsequent changes in the intima, elastic membrane, and medial layer.

Adult↗
PubMedDate not supplied

[Remarks on the pathogenesis of brain contusions occurring by a counterimpact mechanism in the acute period of their development].

Clinical course, CT, EEG and EP data as well as a cerebral blood flow and central hemodynamics parameters of 1727 patients with brain contusions were analyzed. It has been concluded that features of cerebral countercoup injuries do not match with definition of cerebral contusion. Countercoup injuries should be considered as secondary traumatic lesions with hemangiopathic and ischemic components. Their progress or regress depends on changes of CBF and integrity of vascular walls of regional vessels.

Acute Disease↗
PubMedDate not supplied

[Forced permanent clipping of the internal carotid artery in operations for cerebral arterial aneurysms].

Incidence, causes and results of permanent ICA clipping during arterial cerebral aneurysm surgery were analyzed in randomized group of 470 patients. Permanent ICA clipping was performed in 6 cases (1.3% of all surgeries). The causes of permanent ICA clipping were ICA wall rupture in 4 (0.9%) cases, bleeding from aneurysms of the ophthalmic segment of the internal carotid artery (ICA) in 2 (0.4%). Atherosclerotic changes of ICA were found and verified by biopsy in all cases of ICA rupture. Two variants of rupture were identified. ICA aneurysm avulsion from the artery in the area of aneurysmal neck with vascular wall defect development in 2 (0.6%) cases; in the second variant, ICA rupture was caused by frontal lobe traction. In the study group aneurysms of ophthalmic segment of ICA were found in 19 cases: intraoperative bleeding rate was 31% (6 cases). ICA was clipped in 33% of all cases of intraoperative bleeding. Among 6 patients with permanent ICA clipping, 5 died. Deaths were caused by cerebral infarction in 4 cases and acute blood loss in 1 case.

Adult↗