Tuberous sclerosis complex (TSC), also known as Bourneville disease, is an autosomal dominant orphan disease belonging to the group of phakomatoses. Morphologically, TSC is characterized by systemic hamartomas. This article presents a case of a patient diagnosed with TSC at the age of 24 according to the 2021 International TSC Clinical Consensus criteria. The diagnosis of TSC was established by the presence of more than three hypomelanotic macules, multiple cortical tubers and radial migration lines, and more than two subependymal nodules. This case report provides an overview of the epidemiology, clinical features, and diff erential diagnosis of TSC. Furthermore, it discusses the actual diagnostic criteria, including the value of fi nding genetic variants of unknown signifi cance in the diagnosis of TSC.
The article analyzes the activities of neurologist Vladimir Abramovich Lichtenstein during the Great Patriotic War through the prism of his memoirs. It examines the organization of medical services in the rear regions as well as the role of specialists from the Dagestan Medical Institute and evacuated physicians in aiding wounded Red Army soldiers. Special attention is paid to V.A. Lichtenstein’s scientific and practical work, his participation in the development of neurosurgical care and his contribution to new approaches in the treatment of gunshot injuries of the nervous system. There are described the working conditions of hospitals, the specifics of evacuation and the provision of medical care in extreme conditions based on archival materials and personal testimonies. It is emphasized that V.A. Lichtenstein advocated early surgical intervention in peripheral nerve injuries and contributed to the development of classification system for traumatic brain injuries. A significant part of the study is devoted to Lichtenstein’s own recollections, which reflect the circumstances of evacuation from front-line areas, movement with retreating troops, and the organization of hospital work under extremely difficult conditions. These memoirs make it possible to reconstruct the everyday practice of a physician, demonstrate the scale of difficulties associated with treating the wounded, and highlight the features of medical support in the first months of the war.
Stroke is the second leading cause of death and one of the main causes of disability worldwide. One of the common problems that arise in patients after a stroke is post-stroke cognitive impairments (PSCI). The use of neurotechnologies to enhance cognitive functions is a rapidly developing fi eld with promising results. This article provides brief information on the prevalence and mechanisms of PSCI, as well as various activities aimed at restoring cognitive functions that can improve patient’s quality of life.
Osmotic demyelinating syndrome (ODS) is a rare disorder that occurs when the osmotic pressure of the blood changes rapidly and leads to serious neurological disorders. Purpose : to conduct a review of literary sources of domestic and foreign authors examining ODS, and also to describe it using the example of our own clinical observation. Material and methods . A review of literary sources in Russian and English for the period 2015–2025 was conducted, using the RSCI and PubMed databases. A clinical case of a patient with ODS is presented. Results . A clinical case of osmotic demyelination syndrome is presented. Modern neuroimaging studies confi rmed central pontine and extrapontine myelinolysis. Neuroimaging and laboratory tests enabled the timely detection of severe multiorgan damage. This case highlights the need for timely diagnosis and a multidisciplinary approach to the management of this pathology. Conclusion. This clinical case highlights the complexity of diff erential diagnosis and the need for a comprehensive assessment of the patient’s condition, including additional diagnostic methods. The importance of interdisciplinary collaboration is evident, ensuring adequate disease management and improving treatment outcomes.
Study purpose . To assess the dynamics of cognitive status during the recovery period following ischemic stroke (IS) in patients with different metabolic statuses and to identify predictors of the development and progression of cognitive impairment (CI) in a group of patients with metabolic syndrome (MS). Material and methods . 237 patients diagnosed with ischemic stroke on the 21st day and 12 months after the onset of IS were examined. The patients were divided into two groups: group 1 — 115 patients with MS; group 2 — 122 patients without MS. The Clinical Dementia Rating Scale (CDR) was used to assess CI. The relationship (correlation coefficient (r), machine learning methods (information gain, i.g.)) between the CDR score and demographic, functional and laboratory parameters, IS characteristics, the presence of premorbid CI (IQCODE questionnaire), body mass index (BMI) and degree of compliance (MMAS-8 scale) was analyzed. Results . Twelve months after the onset of IS, a higher percent of patients with dementia was identified in group 1 (72.15%) compared to group 2 (34.51%). A correlation was found between the CDR index and LDL level (r = 0.397, i.g. = 0.346), IQCODE (r = 0.515, i.g. = 0.115), the number of metabolic factors (r = 0.468, i.g. = 0.411), MMAS-8 (r = -0.622, i.g. = 0.373), MS phenotypes: ‘hyperlipoproteinemia / hyperglycemia / obesity’, ‘hyperlipoproteinemia / arterial hypertension / obesity’ and full-factor intersection of metabolic factors in combination with the degree of IQCODE, MMAS-8 (i.g. = 0.216, i.g. = 0.221, i.g. = 0.301). Conclusion . Dysmetabolic disorders, both individually and in the context of MS, combined with low compliance, prestroke cognitive impairment, and age, contribute to a significant deterioration in CI during the recovery period of IS.
