Relevance. The study of the genetic mechanisms of the Chiari malformation is based on the study of genes of a possible predisposition to this pathology in combination with environmental factors that form the pathogenetic chain of the disease. Objectives of the research — to analyze foreign and Russian publications. Based on the literature, study the hypothesis of the genetic aspects of the pathogenesis of Chiari malformation. Findings. Based on the data of domestic and foreign literature, one can judge a breakthrough in the study of the genetic nature of the Chiari malformation, however, there is still no consensus on the pathogenesis of this disease, the responsible gene causing the pathology also remains unidentified. Further study of the genetically determined mechanism of the malformation will help in an interdisciplinary approach for gene diagnostics and personalized prevention of the craniovertebral region pathology.
Background: Cochlear dysfunction, is considered one of the difficult topical and important areas in modern otorhinolaryngological practice. Diagnosis and treatment of cochlear dysfunction is even more complicated in combined pathologies. There have been reported only few cases of a combined with Arnold-Chiari malformation with hearing impairment.Case description: 34 years old male, was admitted in Republican Clinical Hospital G.G. Kuvatov under neurosurgical care. Patients main complaints was hearing loss associated with "tinnitus" on the left sided, morning headaches, dizziness, and unstable gait. The patient noted a gradual loss of hearing on his left ear over the years. He was diagnosed to have Arnold chiari malformation type 1 with combined hearing loss. Conclusion:Good planned surgical strategies and operative techniques the hearing loss was restored, and his neurological symptoms was relieved.
Since the active introduction of neuroimaging methods, the prevalence of registered children with craniovertebral anomalies, including the Chiari malformation (CM), has a statistically significant tendency to increase. Minimally invasive surgical interventions are the most acceptable in pediatric neurosurgery, however, currently experience has been accumulated enough that does not confirm the universality of this method, due to the high frequency of reoperations at an older age, as well as a decrease of children’s quality of life in the interoperative periods. Considering the imperfection of treatment strategy mentioned above, the aim of this article was to analyze modern surgical interventions in pediatric and adult neurosurgeons with confirmation of our own results as an example of a clinical case of Chiari malformation in our clinic.
Chiari malformation in the onset of the disease can manifest itself in a different clinical symptom complex. The literature describes isolated cases of a combination of Chiari malformation with hearing impairment. The article presents a description of a clinical case of a combination of Chiari malformation with a pontocerebellar cyst combined with unilateral hearing loss in a 34-year-old patient. As a result of the neurosurgical treatment, hearing restoration and regression of existing neurological symptoms were achieved.
The presence of associated cerebral aneurysm and abdominal aortic aneurysm is an extremely rare degenerative vascular pathology. The article describes a two-stage treatment of a patient with aneurysms that occur in different types of blood vessels characterized by different hemodynamic conditions. A 56-year-old man suffering from hypertension complained of abdominal pain, headache, and dizziness. The exam-ination revealed multiple aneurysms: in the abdominal and iliac arteries, as well as an ophthalmic artery aneurysm of the internal carotid ar-tery. Surgical interventions were carried out in stages: osteoplastic pterional craniotomy with aneurysm clipping of the right internal carotid artery with vascular ultrasound and endoprosthesis of abdominal aorta and iliac arteries with a stent graft. The patient was discharged in a satisfactory condition. Regression of clinical disease manifestations was found. It was shown that the key point was to create a multidisci-plinary team and determine the stages of surgical treatment when managing such patients.KEYWORDS: abdominal aortic aneurysm, iliac artery aneurysm, cerebral aneurysm, hypertension, degenerative pathology, treatment stages.FOR CITATION: Gilemkhanov A.R., Plechev V.V., Ishmetov V.Sh. et al. Step surgical treatment of a patient with abdominal aortic and internal carotid artery aneurysms. Russian Medical Inquiry. 2020;4(7):463–466. DOI: 10.32364/2587-6821-2020-4-7-463-466.
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