Search

The study included 12 operated patients with medullocervical gliomas. Two of them had hemangioblastomas, 6-ependymomas, 4-astrocytomas with different degree of dedifferentiation. The gross total tumor removals were achieved in 4 patients with ependymomas and patient with hemangioblastomas. Two patients with ependymomas and one with hemangioblastoma had their tumors removed subtotally. All astrocytomas were partially excised. The neurological long tract signs were alleviated almost in all ependymoma and hemangioblastoma patients after surgery. Complication rate was the highest in the astrocytoma group. The authors discussed indications and contraindications for surgery depending on the tumor type.

Heart activity was studied by electrocardiography (ECG) and variation pulsometry in patients aged from 17 to 44 1-21 days after light brain trauma. Homeostatic imbalance between suprasegmental structures of the brain was established. Disintegrated activity of these structures results in increase of ECG and variation pulsometry may be additional criteria for assessment of interactions between sympathetic nervous system and different levels of heart rhythm regulation.

The dynamics of brain edema and swelling was studied according to the indices of separate impedancemetry in the early posttraumatic period in 36 patients with severe craniocerebral trauma. Swelling of the brain predominated on the 1st and 2nd days in most patients. Later, depending on the severity of the posttraumatic period, the swelling may grow or be replaced by edema with subsequent normalization. A parallelism was revealed between the severity of brain edema and swelling, the intracranial pressure value, and the severity of the patient's condition.

A three-four year dynamic study of 211 patients (age: 15-60 years) with a history of mild head injury revealed that the younger group of patients (from 20 to 30 years) showed within 3-4 years after the injury a more complete restoration of the higher nervous activity processes than patients of other age groups. In patients suffering of cerebrovascular diseases before mild head injury the dynamics of this restoration depended on the treatment carried out before the head injury.

Brain contusion in children becomes fatal only when the cerebrocranial trauma is very serious and coarse diffuse lesions occur in the whole brain. Foci of intracerebral hemorrhages are relatively rare in such cases. A special form of affection--diffuse involvement of the brain is often encountered in children and young persons. In patients of the older age groups a fatal outcome may occur not only in a severe but also in a relatively mild trauma; it is due to the trauma itself and also to secondary pathological reactions on the part of the cardiovascular and other systems of the organism. The contusion foci in elderly and old-aged individuals are characterized as a rule by extensive hemorrhages. The younger the patient, the more is the tendency towards manifestation of the regularities characteristic of the child organism, and, in contrast, the older the patient and the more pronounced the signs of premature advanced age, the higher is the frequency of complications and fatal outcomes in relatively mild cerebrocranial trauma.

The features of the clinical course and diagnosis of intracerebral hematomas are described from the analysis of 57 patients with post-traumatic intracerebral hematomas. It is shown that late formation of hematomas may occur. The results of surgical management of hematomas are analyzed. Wide trephination followed by radical removal of the hematoma is the optimum surgical procedure. It is noted that the results of treatment are determined by the rate of formation and volume of the hematoma and the patient's age.