The intraoperative prophylaxis of local ischemical brain damage in neurosurgical patients with cerebral aneurysm

Savvina, I.A.; Cherebillo, V. Yu.; Zabrodskaya, Yu. M.; Petrova, Anna Olegovna; Sergeev, A V; Paltsev, Artem; Malkhozova, A M

doi:10.17116/hirurgia201905157

Cited by 3 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prophylaxis of local cerebral ischemia and cerebral vasospasm following temporary occlusion of the afferent artery during surgical clipping cerebral aneurysm was proposed with short intervals of vessels occlusion in combination with intraoperative intravenous administration of Inosine+Nicotinamide+Riboflavin+Succinic Acid ( 20,0 ml). Such tactics expands the tolerability to artery occlusion in patients operated in the "cold" period, reduces the possibility of neurological deficit, reduces the recovery period and resuscitation bed-day after neurosurgery [61]. Outcomes in patients with IVH and ICH + IVH were also analyzed depending on the degree and prevalence of vasospasm [1].…”

Section: Treatment Of Cerebral Vessels Constrictionmentioning

confidence: 99%

Cerebral Vasospasm: Mechanisms, Pathomorphology, Diagnostics, Treatment

Savvina¹,

Zabrodskaya²,

Petrova³

et al. 2022

Cerebrovascular Diseases - Elucidating Key Principles

View full text Add to dashboard Cite

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.

show abstract

Section: Treatment Of Cerebral Vessels Constrictionmentioning

confidence: 99%

Cerebral Vasospasm: Mechanisms, Pathomorphology, Diagnostics, Treatment

Savvina¹,

Zabrodskaya²,

Petrova³

et al. 2022

Cerebrovascular Diseases - Elucidating Key Principles

View full text Add to dashboard Cite

show abstract

On temporary clipping in cerebral aneurysm surgery (literature review).

Shnyakin,

Botov,

Loseva

2023

Bulletin of Neurology, Psychiatry and Neurosurgery

View full text Add to dashboard Cite

Temporary clipping (TC) of the parent artery is a standard procedure in cerebral aneurysm surgery. According to a number of studies, TC lasting up to 5 minutes is safe in terms of the development of ischemic complications. In cases where a longer TC is required, it is recommended to alternate vessel shutdown with periods of reperfusion, which allows the procedure to be repeated many times without the risk of ischemia. The article presents a review of current scientific publications on TC in cerebral aneurysm surgery, showing that this is a very unpredictable procedure in terms of the development of complications, even when performed within the recommended time parameters. There are cases of ischemia with TC lasting less than 5 minutes and the opposite situation, when TC lasting more than 10–20 minutes does not lead to the development of complications. The review also presents current ideas on how to improve the safety of TC, including the use of intraoperative neurophysiological monitoring.

show abstract

Intraoperative selective cerebral angiography for microsurgical treatment of cerebral arteriovenous malformations in a hybrid operating room

Menshikov,

Sergeev,

Cherebillo

et al. 2024

Bulletin of Neurology, Psychiatry and Neurosurgery

View full text Add to dashboard Cite

Arteriovenous malformations (AVMs) of the brain are a congenital anomaly of the development of cerebral vessels, when instead of a normal capillary bed, a «network» of pathologically altered vessels is formed, through which arterial blood is shunted into the drainage venous system. Due to the thinned wall of the pathological vessels and high pressure in them, patients with AVMs are at risk of intracerebral hemorrhage up to 4 % annually, which determines the vital need for their treatment. Microsurgical removal of brain AVMs is considered the most radical and effective treatment method, the main goal of which is to completely disable the body of the malformation, since the remaining part can lead to the risk of postoperative bleeding. To ensure effective control over the completeness of AVM removal intraoperatively, two methods have been developed: selective cerebral angiography (SCAG) and indocyanine green video angiography (ICG-VA). According to the literature, SCAG provides a number of advantages in the intraoperative diagnosis of residual AVM parts compared to ICG-VA. The article analyzes our own experience in using intraoperative SCAG in the surgical treatment of AVM in a hybrid operating room and examines the literature data on the topic of the paper. Our study highlights the importance of using the method of intraoperative control through SCAG in order to improve the effectiveness of surgical treatment of cerebral AVMs.

show abstract

The intraoperative prophylaxis of local ischemical brain damage in neurosurgical patients with cerebral aneurysm

Cited by 3 publications

References 6 publications

Cerebral Vasospasm: Mechanisms, Pathomorphology, Diagnostics, Treatment

Cerebral Vasospasm: Mechanisms, Pathomorphology, Diagnostics, Treatment

On temporary clipping in cerebral aneurysm surgery (literature review).

Intraoperative selective cerebral angiography for microsurgical treatment of cerebral arteriovenous malformations in a hybrid operating room

Contact Info

Product

Resources

About