НЕЙРОХИРУРГИЧЕСКИЕ ПРОБЛЕМЫ КЛИПИРОВАНИЯ  АРТЕРИАЛЬНЫХ АНЕВРИЗМ ГОЛОВНОГО МОЗГА

M.M. Mamytov; U.U. Kozubaev

doi:10.54890/1694-8882-2024-3-117

M.M. Mamytov U.U. Kozubaev

DOI:

https://doi.org/10.54890/1694-8882-2024-3-117%20

Abstract

Despite improvements in diagnostic methods and microsurgical techniques for treating arterial aneurysms of the cerebral vessels, there remains a high probability of mortality and persistent disability among the working population. This scientific work presents the results of examination and surgical treatment of 86 patients operated on from 2017 to 2023 y. at the Neurosurgery Clinic of the National Hospital. The age of the patients ranged from 23 to 78 years (average age - 47±1.7 years), among them there were 48 (55.8%) men, 38 (44.2%) women. All patients underwent MRI or CT angiography of cerebral vessels; in 47 (54.6%) patients, cerebral aneurysm was confirmed by selective cerebral angiography. The size of the aneurysms ranged from miliary (3.0 mm to giant sizes 25.0-30.0 mm). All patients were subjected to surgical treatment. The tactics of administration, the results of surgical treatment and complications of patients with this pathology are described in detail.

Keywords:

arterial aneurysm, cerebral vessels, microsurgical treatment, clipping, SAH, intracerebral hemorrhage.

Author Biographies

M.M. Mamytov, Kyrgyz State Medical Academy named after I.K. Akhunbaev

Department of Neurosurgery for undergraduate and postgraduate education

U.U. Kozubaev, Kyrgyz State Medical Academy named after I.K. Akhunbaev

Department of Neurosurgery for undergraduate and postgraduate education

References

1. Расулов Ш.О., Абдуллаев Н.А., Бурнашев М.И. Результаты лечения сложных аневризм сосудов головного мозга. Российский нейрохирургический журнал имени профессора А.Л. Поленова. 2023;15(S1):115-116.

2. Krystkiewicz K, Ciszek B, Szylberg Ł, Tosik M, Harat M. Morphological Analysis of Cerebral Artery Fenestrations and Their Correlation with Intracranial Aneurysms. World Neurosurg. 2021;156:e85-e92. https://doi.org/10.1016/j.wneu. 2021.08.137

3. Крылов В.В., Укачев В.В., Добровольский Г.Ф. Микрохирургия аневризм вилизиева многоугольника. М.:Антидор. 2004. 160 с.

4. Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 1980;6:1–9.

5. Chalouhi N, Ali MS, Jabbour PM, Tjoumakaris SI, Gonzalez LF, Rosenwasser RH, et al. Biology of intracranial aneurysms: role of inflammation. J Cereb Blood Flow Metab. 2012;32(9):1659-1676. https://doi.org/10.1038/jcbfm.2012.84

6. Wang Y, Emeto TI, Lee J, Marshman L, Moran C, Seto SW, et al. Mouse models of intracranial aneurysm. Brain Pathol. 2015;25(3):237–247. https://doi.org/10.1111/ bpa.12175

7. Иванов Д.В. Факторы разрыва аневризм сосудов головного мозга: обзор литературы. Российский журнал биомеханики. 2018;22(4):473-484.

8. Killer-Oberpfalzer M, Aichholzer M, Weis S, Richling B, Jones R, Virmani R, et al. Histological analysis of clipped human intracranial aneurysms and parent arteries with short-term follow-up. Cardiovasc Pathol. 2012;21(4):299–306. https://doi.org/10.1016/j.carpath.2011.09.010

9. Рузикулов М.М. Микрохирургическое лечение больных с неразорвавшимися бессимптомными аневризмами сосудов головного мозга. Российский нейрохирургический журнал имени профессора А.Л. Поленова. 2023;15(S1):9.

10. Galiano G, Velasco J. Finite element approximation of a population spatial adaptation model. Math Biosci Eng. 2013;10(3):637–47. https://doi.org/ 10.3934/mbe.2013.10.637

11.Karadimas SK, Silva MA, Starke RM. Lateral Supraorbital Approach for Microsurgical Clipping of Recurrent Ruptured Fetal Posterior Communicating Artery Aneurysm Initially Treated With Woven Endobridge Embolization and Flow Diversion: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown). 2024 Jun 7. https://doi.org/10.1227/ons.0000000000001222

12. Juvela S, Poussa K, Lehto H, Porras M. Natural history of unruptured intracranial aneurysms: a long-term follow-up study. Stroke. 2013;44(9):2414–21. https://doi.org/10.1161/STROKEAHA.113.001838

13. Природов А.В, Бахарев Е.Ю, Хаджиев З.Б, Гринь А.А., Синкин М.В., Уткина И.И. Хирургическое лечение множественных аневризм сосудов головного мозга: обзор литературы и клиническое наблюдение Нейрохирургия. 2021;23(4):72-81. https://doi.org/10.17650/1683-3295-2021-23-4-72-81

14. Rosen DS, Macdonald RL. Grading of subarachnoid hemorrhage: modification of the world World Federation of Neurosurgical Societies scale on the basis of data for a large series of patients. Neurosurgery. 2004;54:566–575

15. Sadamasa N, Nozaki K, Hashimoto N. Disruption of gene for inducible nitric oxide synthase reduces progression of cerebral aneurysms. Stroke. 2003;34 (12):2980–4.

16. Шитов А.М., Сазонов И.А., Белоусова О.Б., Элиава Ш.Ш. Периферические аневризмы сосудов головного мозга: клиника и диагностика. Медицинский вестник ГВКГ им. Н.Н. Бурденко. 2023;1(11):39-47.