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Main properties of ionizing radiation as a factor affecting the organism are described. Data on molecular and cellular mechanisms of the radiation injury of the central nervous system, impacts of the radioactive irradiation on the vascular system of the brain adn on a hematoencephalitic barrier, a system effect of radiation on the brain are discussed.

In the late period even following mild closed brain injury, diseases of the viscera and the body's systems develop as a result of diffuse lesions in the brain regions. Experimental studies have shown that this is associated with impaired self-regulatory mechanisms responsible for energy metabolic processes in the brain.

Antitumour activity of cerebral cells at different stages of ontogenesis (embryonic, new-born, adult) has been studied. Researches have been carried out at killer-activity patterns in vitro with target-cells and tumour transplantation under mice kidney's capsule in vivo. It has been established that mice cerebral cells' suspension can decrease the tumour transplants' growth under kidney's capsule. Antiproliferative activity of embryonic and new-born mice cerebral cells was much higher than adult one. The kidney and liver new-born mice cells had no antiproliferative activity at all.

It is indicated that all subjects who had acute grade I radiation sickness of the Chernobyl accident showed disorders of the brain functions 5-6 years later. They evidence involvement of all brain structures but especially the subcortical brainstem portions. Marked memory reduction was also noted. The neurological deficit was not pronounced but the patients developed a syndrome of significant disadaptation, which had a progressive character. The authors propose to term these changes as postradiation encephalopathy of primary-radiation and intoxication genesis.

The study was made of correlations arising between psychopathological symptoms (PPS) observed in organic brain lesions in acute posttraumatic, postoperative and posthemorrhagic periods in 111 patients with objective data on cerebral circulation and cerebrovascular reactivity (CVR). PPS included mental conditions of delirium type: of classical form (106 cases), of atypical forms (5 cases). In PPS there appeared a tendency to an increase in the values of cerebral circulation and CVR. PPS patterns and regions of elevated CVR were found related. Long-term persistence of PPS in the acute disease eventuated into a reduction of psychic functions and total and regional hemodynamics. In atypical delirium against preexisting encephalopathy the trend to hyperreactivity of the brain vessels disappeared during a short period.

The paper concerns the results of 30 years of investigations of the Kiev Research Institute of Neurosurgery into correlations between syndromes of mental activity reduction (coma, stupor, global and lacunar dementias, Alzheimer-like and Pick-like syndromes, personality changes by the frontal type, stable neurosis-like conditions, Korsakov's syndrome, disturbed consciousness by the amentive type) in patients with organic brain lesions and objectively recordable changes in cerebral hemodynamics. It has been established that the pathological mechanisms of formation of different syndromes of mental activity reduction are naturally related to deceleration of the general and regional volumetric cerebral blood flow (RVCBF) and a decrease of the general and regional reaction of cerebral vessels (RCV). In this respect, the character of the psychopathological syndrome is specified by localization (lobar and interhemispheric) of the primary deceleration of the RVCBF and RCV decrease; by the rate of augmentation of those changes, their intensity and duration, constancy or periodicity; background against which there develops the hypoxic process; as well as by the development of the underlying disease.

Analysis of 210 cases of brain concussion and contusion showed that the general cerebral and focal symptoms of trauma of the brain are pronounced much more markedly and persist longer in combination of craniocerebral trauma (CCT) and diabetes mellitus than in CCT and normal blood sugar content. Inclusion of vasoactive agents Cavinton and Complamin into the scheme of complex therapy accelerates regression of the neurological symptomatology. The clinical course of diabetes mellitus may be aggravated by the CCT, which shows that additional correction of antidiabetic therapy is necessary.

Advances in the study of the molecular mechanisms of the pathogenesis of closed craniocerebral trauma (CCCT) which was conducted on an experimental model, a clinical equivalent of CCCT, allow one to form a new view of the course of traumatic disease and its division into periods. The data obtained provide evidence that increase of the pathological process in the posttraumatic period is of a skipping and cascade character. The existence of such breaks makes it possible to distinguish periods with consideration for the pathogenetic essence of the pathological changes. 1. The period of intensified metabolic processes, "conflagration of metabolism". 2. The period of development of energy deficit in the nerve tissue. 3. The period of development of cell intoxication processes and secondary structural changes. 4. The period of formation of posttraumatic homeostasis (a) in the regimen of stable homeostasis, (b) in the regimen of stress and subsequent exhaustion of the activity of adaptation systems with the formation of late-term progressive sequelae.

The authors studied the condition of regional volumetric cerebral blood flow and local vascular reactivity in experimental mild and moderate craniocerebral trauma in 31 animals with alloxan diabetes and in 29 animals with isolated brain injury. It is shown that alloxan diabetes aggravates cerebral vascular disorders occurring in injury to the skull and brain. Vasoactive agents Cavinton and xantinol nicotinate promote regression of the changed cerebral blood flow.

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.

Operations were conducted on 83 patients for total (49) or subtotal (34) removal of craniopharyngioma. A dependence of the possibilities of effective radical operations for these tumors on the variant of their localization in the infundibulo-hypophyseal region was revealed. The use of microsurgical techniques made the operation more radical and improved its results. The features of the surgical techniques in endosuprasellar, suprasellar extraventricular and intraventricular craniopharyngiomas are described. After radical operation 26 patients died. The outcomes of radical operations were least favourable in intraventricular craniopharyngiomas. The provision of conditions excluding damage to medio-basal brain areas which are of greatest functional importance is or primary significance in radical operations.

The article deals with the results of histochemical study of some redox and proteolytic enzymes (SDH, MDH, NAD-diaphorase, LDH, and acid and alkaline phosphatase) in experiments on animals in various periods after infliction of a craniocerebral injury and on autopsy material, i.e. the brain of patients who had died from severe craniocerebral injury incompatible with life. It is shown that the activity of all enzymes decreases (SDH, MDH, NAD-diaphorase, and alkaline phosphatase) or increases (LDH, acid phosphatase) in various periods after the injury. The results were compared with the findings of morphological examination of the same brain areas performed by means of neurohistological methods.

The authors discuss the results of electron-microscopic study of the synaptic contacts in the brain of rabbits during 4 months after experimental brain concussion. A complex of ultrastructural changes of the cerebral synaptic apparatus with a characteristic dynamics of development in time and space is described, and its peculiarities and features distinguishing it from other types of pathology as well as its role in the pathogenesis of craniocerebral injury are discussed.

Chemotherapy with endolumbar methotrexate injection was carried out on 52 patients suffering from malignant cerebral tumors. Of the patients, 44 had previously undergone an operation with subtotal removal of the neoplasm. The dosage and method for administering the methotrexate injection, and the duration of treatment have been determined. Chemotherapy with methotrexate results in a decrease in the size of the neoplasm which can be recorded by means of instrumental methods of examination. The pathomorphological analysis indicates a distinctly destructive effect of the preparation on malignant cerebral tumors.

The article presents some data concerning influence of humoral factor received from blood serum of injured animals on humoral and cell immune response of animals. The results show that administration of humoral factor prevents stress-induced devastation of thymus, improves humoral immune response to antigen test (sheep erythrocytes) and restores hypersensitivity of decelerated type (HDT) reactions. Immune stimulating effects are observed both right after cranial trauma and some time later -- 5-7 days after the injury.

The work analyses the specific features of the clinical picture, diagnosis, and treatment of craniocerebral injury because of 7 car accidents (225 patients) and in common accidents of everyday life (210 patients). Craniocerebral injury in car accidents is very severe (high incidence of massive and multiple contusions of the brain, fractures of the skull bones, intracranial hematomas) and is often combined with injury to the viscera and bones. Thorough clinical and neurological examination, x-ray of the skull, echoencephalography, cerebral angiography, and trephination of the skull help to disclose and identify exactly the character of the cerebral damage. The therapeutic complex in craniocerebral injury because of car accidents includes measures of intensive therapy and, if indicated, surgical intervention. Traumatism occurring as the result of car accidents is characterized by coarser cerebral functional defects and graver invalidism of patients in contrast to accidents of everyday life.

The reactions of cellular immunity to malignant gliomas of the rat brain were studied by measuring the electrophoretic mobility of indicator cells (the EPM test). The appearance of sensitization coincided in time with the development of the glioma's own vascular network possessing no barrier function. The sensitization was constant in character and persisted till the death of the tumor-carriers. The EPM test did not reveal qualitative differences in sensitization in intracerebral and subcutaneous glioma growth.

Spinal cord hypothermia was conducted in 113 patients. It led to a decrease of bleeding from the tissues during the operation, reduced edema of the spinal cord, diminished spasticity of muscles, improved motor function of the affected limbs, and alleviation of the pain syndrome. Hypothermia of the spinal cord also caused changes in motoneuron excitability and circulation, both local and general, and shifts in body thermoregulation.

The morphological and clinical peculiarities, the findings of auxiliary examination methods, and the results of surgical and combined treatment of oligodendrogliomas of the cerebral hemispheres in 122 patients are discussed. The growth of oligodendrogliomas from the subependymal zone in two directions, into the cavity of the cerebral ventricles or extraventricular, is their morphological peculiarity. The authors show 12 variants of the localization of the tumor. The criteria for the diagnosis of oligodendroglioma are diffuse headache at the onset of the disease not of a hypertensive character; the prevalence of focal symptoms of irritation at the onset of the disease and of general cerebral symptoms over focal symptoms in the stage of decompensation; frequent epileptic seizures in the structure of which generalized attacks predominate in the early stages of the disease; rare occurrence of alduminosis in the cerebrospinal fluid; calcifications seen on the craniogram and relatively rare appearance of craniographic signs of hypertension. The most effective method of treatment in most cases is a radical operation with excision of the initial growth zone; combination of operation with chemotherapy applied during the operation and in the postoperative period is indicated in dedifferentiated oligodendrogliomas.

Electron-microscopy of tumours, diagnosed by light optics as ependymoastrocytomas, helped to ascertain the common features in the ultrastructural organization of their tumorous tissue: a complex of organ-specific signs of ependymomas is constantly manifested in all the scrutinized parts of the tumorous nodes. This makes it possible to regard ependymoastrocytomas as a variant of ependymomas and not tumours of a mixed origin.

In 35 patients with deep-lying and medial gliomas (25 cases of glioblastoma multiforma, 10 cases of dedifferentiated astrocytoma), stereotactic cryodestructions were performed after preceding biopsies. Diagnosis was made in the usual manner, mainly by means of angiography. Sites of action were the tumour mass proper and the blood supply zones. In some cases, partial removal of the tumour was carried out in the usual way before or after cryodestruction. There are 3 kinds of further development after cryodestruction: regression, slow progression and rapid progression. Progression was found in 14 patients; 9 patients died within 2 weeks after the operation. In their cases, cryodestruction was by far insufficient. Dedifferentiated astrocytomas showed more a regressive behaviour than multiform glioblastomas. The possibility of local chemotherapy was also utilised.

The authors describe 3-, 5-, 7- and 9-layer linear and concentric structures discovered in brain bioptates of patients with cerebral infantile paralysis. They were found to be specific to this disease. The assumptions on the origin and role of these ultrastructures in the pathogenesis of cerebral infantile paralysis are formulated.

Electron microscopy of two hundred brain tumours of various origin allowed the authors to elaborate the main principles of electron microscopic diagnosis. A comprehensive approach to determining the comparative diagnostic value of the morphological signs of the tumour and the initial normal tissue and the high resolving capacity of the electron microscope provide for trustworthy identification of tissue origin of the new growth that is examined. The electron microscopic method is particularly important when diagnostic difficulties arise on the light-optic level of the morphological examination.

Analysis of 401 cases with contusion of the cerebral hemispheres showed that in patients with craniocerebral trauma and essential hypertension the incidence of traumatic intracranial hematoma was 1.3-1.4 times higher and the incidence of acute cerebral circulatory disorders (mainly cerebral infarctions) was 4-5 times higher. Isolated contusion of the cerebral hemispheres in patients with essential hypertension was characterized by less manifested symptoms of internal hypertension and the dislocation syndrome. The combination of craniocerebral injury and essential hypertension has a marked effect on the clinical manifestations of both the craniocerebral trauma and essential hypertension.

An analysis of 133 cases furnished a background to the study of features specific for the clinical course, symptomatology, diagnosis and surgical treatment of patients with multiple traumatic intracranial hematomas. The available clinical material was scrutinized in 3 groups of cases under observation (with "floor-wise", bilateral and "neighbouring" multiple intracranial hematomas) by using a complex set of up-to-date auxilliary diagnostic methods of investigation (EEG, echoencephalography, serial angiography, etc). The results of the surgical treatment were studied depending upon the specificity marking the clinical evolution of the disease, as well as upon the method and technique of the operative intervention.

A marked antitumor effect of the agents studied was demonstrated in experiments on three strains of gliomas of the brain of rats (two rapidly-growing and one slowly-growing tumor). Phthorafur increased the survival of the animals with one of the rapidly-growing tumors (strain No. 35) and often had a marked side effect. Adriablastin inhibited the development of rapidly-growing gliomas but was ineffective in experiments with slowly-growing glioma. NMU considerably increased the survival of the animals in all experiments but recovery was not encountered. In treatment with NMU, a cell population resistant to this agent occurred in the gliomas. A new glioma strain was obtained during the experiments; it was insensitive to therapeutic doses of NMU and differed in morphology from the initial highly-sensitive tumor (strain No. 2211). The prospects of using agents of the nitrosomethyl urea group in the chemotherapy of gliomas are discussed.

Case-histories of 1077 victims of cerebro-cranial injuries, 38 per cent of whom were admitted in the state of alcoholic ebriation, were analyzed. Alcoholic ebriation was found to materially change the clinical picture of the cerebro-cranial trauma, simulating, sometimes, a picture of a traumatic brain lesion. Curative measures aimed at the treatment of the traumatic lesion of the brain were applied in a complex set, depending upon the nature and the severity of the cerebro-cranial injury, the phase (stage) and degree of alcoholic ebriation.