Chapters authored
Cerebral Vasospasm: Mechanisms, Pathomorphology, Diagnostics, Treatment
Cerebral vessels constriction is one of the leading causes of mortality and disability in patients with acute cerebral circulatory disorders. The most dangerous type of acute cerebrovascular disease accompanied by high mortality is ruptured cerebral aneurysms with subarachnoidal hemorrhage (SAH). Following a constriction of the cerebral vessels on the background of SAH is the reason for brain ischemia. This chapter will focus on the mechanisms of formation of cerebral vascular spasm, pathomorphological aspects of the cerebral vessels constriction, and the stages of vascular spasm—the development of constrictive-stenotic arteriopathy, contractural degeneration of smooth muscle cells, and endothelial damage. We will cover classifications of cerebral vessels constriction by prevalence and severity, modern methods of clinical and instrumental diagnostics and treatment including paroxysmal sympathetic hyperactivity syndrome associated with the development of secondary complications, a longer stay of the patients in the ICU, higher disability and mortality.
Part of the book: Cerebrovascular Diseases
General Anesthesia and Autonomic Nervous System: Control and Management in Neurosurgery
The chapter is devoted to the control and management of the autonomic nervous system during general anesthesia in neurosurgery. The brainstem and supratentorial cerebral centers of autonomic regulation are the most important structures for control and management during general anesthesia using pharmacological defense with α2-adrenergic agonists and opioid analgesics. We discuss the questions of the depth of anesthesia (BIS-monitoring) and antinociceptive defense, variability of heart rate (variational cardiointervalometry), hemodynamic monitoring during neurosurgical operation, intraoperative thermometry, the meaning of trigeminocardiac reflex and its classification in neurosurgery, perioperative events causing autonomic distress syndrome development and methods of its prophylaxis and treatment, pathomorphological signs of vegetative distress syndrome. Control of the neuromuscular block and photoplethysmography assessment of perfusion index (PI) as methods of the adequacy of general anesthesia and neurovegetative stability.
Part of the book: Autonomic Nervous System
Epileptic Focus in Drug-Resistant Epilepsy: Structure, Organization, and Pathophysiology
The chapter focuses on how different cutting-edge techniques can be used to study electrophysiological, pathomorphological, and biochemical changes in the “epileptic focus” area of the cerebral cortex and white matter to see how epileptic seizures become drug-resistant and how it affects the other regions of the brain. The authors highlight the significance of neuroinflammation and apoptosis in the epilepsy pathogenesis providing EEG characteristics and describing structural changes in the cortex and white matter under such conditions as focal cortical dysplasia and epileptic leukoencephalopathy. Particular focus is given to structural and functional changes in the hippocampus and the role of hippocampal sclerosis in epilepsy. Key conceptions regarding the epileptic focus formation are outlined.
Part of the book: Epilepsy
CSF Bypass Surgery in Children with Hydrocephalus: Modern Possibilities, Prospects and Ways of Solving the Correction of Complications
The chapter discusses modern and promising approaches to the use of CSF shunting operations in children. CSF shunting operations remain the only effective method for correcting persistent CSF circulation disorders in CSF resorption disorders with the development of intracranial hypertension and hydrocephalus. The chapter is devoted to general ideas about CSF dynamics and biomechanical properties of the craniospinal system that affect CSF dynamics, and gives a pathogenetic assessment of CSF dynamics in the development of intracranial hypertension and hydrocephalus. Aspects of genetics and genomics of anomalies in hydrocephalus are touched upon. Pathological changes in the brain around old ventricular shunts are described. The authors consider the types of CSF shunting operations for hydrocephalus in children. Possible complications of CSF shunting operations are analyzed with the algorithm for their correction and management tactics for this group of patients.
Part of the book: Frontiers in Hydrocephalus