Objective. To analyse the dynamics, gender, age, and geographical peculiarities of cerebrovascular disease (CVD) mortality in Ukraine, to estimate the indicator for the coming years.Materials and methods. A retrospective CVD mortality study was conducted in Ukraine. Mortality database (MDB) of the World Health Organization (WHO) and the data of the Ministry of Health of Ukraine (MoH) were used as the starting material.Time series analysis and regression analysis, hazard ratio (HR) were used.Results. From 1991 to 2012, CVD mortality decreased by 7.2% (from 220.4 to 204.6 per 100,000 population).CVD mortality rate is close to 0 at the age of 0 to 29 years, it exponentially increases with growing-up and aging of the population, and reaches its maximum at the age of 75 to 90 years (181 deaths per 10,000 men and 178 – in women). It was found that 99% of CVD deaths were at the age of over 45 years, 90% – over 60 years, 59% – over 75 years.Based on the mortality rates in 2012, at the time of the birth, CVD death risk in men is 0.18% (of 10,000 boys born, 18 will die of CVD at some point of life), in women – 0.23% (of 10,000 girls born, 23 will die of CVD at some point of life).The population of men aged 15 to 74 years, CVD death risk is 1.7-2.6 times higher than in women of the same age. At the age of 0 to 14 and from 75 to 90 years, parity is observed. At the age of 45 to 90 years, men and women have an equal CVD death risk.The essential heterogeneity of CVD mortality was revealed in different regions of Ukraine – the difference between the highest (472.1) and the lowest (64.6) value is 407.5 (630%).A strong highly significant inverse correlation was established between the value of health care (HC) costs and CVD mortality in Ukraine (r = -0.72, p = 0.00). In turn, the value of HC costs depends on GDP (r = 0.99, p = 0.00). By 2020, the estimated CVD mortality in Ukraine is 217-225 per 100,000 population.Conclusions. Over the period studied, Ukraine has a consistently high CVD mortality rate with low decline. In women, CVD mortality is higher than in men, but in some age periods, the situation is reversed. In different regions of Ukraine, mortality varies considerably, in the south-eastern regions, the value is extremely high. A strong highly significant inverse correlation between the value of HC costs and CVD mortality in Ukraine indicates that in the next 5 years a significant reduction in CVD mortality rate is not expected.

Scientometric database is a search engine and it’s also a tool to monitor citations of scientific publications. Scientometric indicators characterize the state of journal and the dynamics of its demand, determine the extent of publication activity and citation rates. Ukrainian Science Citation Index (USCI) is created for scientometric monitoring of individual and collective subjects of scientific activity in Ukraine. But unfortunately USCI is not count scientometric indicators of scientific editions. Russian Science Citation Index (RSCI) is the only Cyrillic scientometric database. Analytical tools SCIENCE INDEX by RSCI a complex analytical and statistical study, which provides data on publications and citations of articles and assess the level of scientific journals. For most scientometric indicators of Ukrainian Neurosurgical Journal (UNJ) ranks high in the rankings among the 63 scientific medical journals of Ukraine and 7 journal of CIS countries on the subject of “neurosurgery”, included in the base of RSCI. International practice scientometric research is based on using two databases Web of Science and SciVerse Scopus. UNJ is not included in the database. An important objective of the editorial board UNJ is to increase the scientific and practical level of journal and its further integration into the abstract database and scientometric database.

Objective . To determine the correlation between access to health care and stroke mortality, to define the prospects of stroke mortality in Ukraine based on study results. Materials and methods. Correlation and regression analysis of indicators from 55 countries ranked with Bloomberg as Most Efficient Countries for Health Care was used. Indicators was derived from publicly available databases. Results. High significant moderate correlations (r=0.36, p=0.003) were obtained between stroke mortality and country area, stroke mortality and Urban population (r=-0,48, p=0,000). We found weak but non significant correlation (r=0.16, p=0.116) between stroke mortality and hospital beds density, and the lack of correlation (r=-0.05, p=0.359) between stroke mortality and physicians density. However it should be noted that we have analyzed total number of beds and doctors, not only stroke specializing. An analysis of the health expenditure (as % of GDP and US$ per capita) and stroke mortality revealed an appreciable (on the Chaddock scale) inverse correlation (r=-0.50, p=0.000 and r=-0.56, p=0.000 respectively) between these parameters. The value for Health expenditure per capita (current US$) in Ukraine was US$313 as of 2013, that is 5-15 times lower than in developed countries (US$1462-4978). As a result, the mortality rate per 100,000 is 133.05 in Ukraine vs 72.1-29.8 in developed countries. Conclusions.  1. The stroke mortality rate is largely determined by health care financing. 2. The country area and urban population percentage is important factor influencing the stroke mortality rate. 3. Population numbers and population density does not influence on stroke mortality. 4. Ukraine’s Health expenditure amounts are not sufficient in order to ensure the timely specialized care for population across the country, including stroke care. 5. Ukrainian Health Care System reforms, healthy lifestyle promotion as a preventive measure against cerebrovascular diseases may not reduce stroke mortality to acceptable values under insufficient funding conditions and low level population welfare. 6. In order to reduce the stroke death rate to the range of 60–80 persons per 100,000 of population increase of health spending to US$(1462±316) is needed, to the range of 40–60 persons — US$(1508±351), to the range of 20–40 persons — US$(4978±1793) accordingly. 7. Сombating сerebrovascular diseases and the result expectations should be based on the real economy possibilities.

Scientometric database is a search engine and it’s also a tool to monitor citations of scientific publications. Scientometric indicators characterize the state of journal and the dynamics of its demand, determine the extent of publication activity and citation rates.Ukrainian Science Citation Index (USCI) is created for scientometric monitoring of individual and collective subjects of scientific activity in Ukraine. But unfortunately USCI is not count scientometric indicators of scientific editions.Russian Science Citation Index (RSCI) is the only Cyrillic scientometric database. Analytical tools SCIENCE INDEX by RSCI a complex analytical and statistical study, which provides data on publications and citations of articles and assess the level of scientific journals. For most scientometric indicators of Ukrainian Neurosurgical Journal (UNJ) ranks high in the rankings among the 63 scientific medical journals of Ukraine and 7 journal of CIS countries on the subject of “neurosurgery”, included in the base of RSCI.International practice scientometric research is based on using two databases Web of Science and SciVerse Scopus. UNJ is not included in the database.An important objective of the editorial board UNJ is to increase the scientific and practical level of journal and its further integration into the abstract database and scientometric database.

The first issue of Ukraine’s first journal that covers issues of diagnosis and treatment of neurosurgical pathology, was published in April 1995. Journal had called the “Bulletin of Ukrainian Association of Neurosurgeons”. For the period 1996-1999 published eight issues. The journal re-registered as Ukrainian Neurosurgical Journal (UNJ) in November 1999. Under this title has published 63 issues. As at September 2015 published a total of 71 issue. A total 1,473 publications printed in the pages of the journal during its existence.The UNJ archived by the Vernadsky National Library of Ukraine, its included in the Russian Science Citation Index (RSCI). UNJ scientific publications also indexed Google Scholar and the world’s largest bibliographic database WorldCat.The UNJ online version http://theunj.org/ created in the framework of the “Scientific Periodicals of Ukraine” (SPU) on based publishing platform Open Journal Systems of International scientific community Public Knowledge Project in 2015. SPU cooperation with leading international scientific databases and information resources makes it easier for publishers processes entering their publications in prestigious refereed databases, directories and search engines. This greatly increases the availability of journal for scientists, and thus contribute its publication activity.

The first issue of Ukraine’s first journal that covers issues of diagnosis and treatment of neurosurgical pathology, was published in April 1995. Journal had called the “Bulletin of Ukrainian Association of Neurosurgeons”. For the period 1996-1999 published eight issues. The journal re-registered as Ukrainian Neurosurgical Journal (UNJ) in November 1999. Under this title has published 63 issues. As at September 2015 published a total of 71 issue. A total 1,473 publications printed in the pages of the journal during its existence. The UNJ archived by the Vernadsky National Library of Ukraine, its included in the Russian Science Citation Index (RSCI). UNJ scientific publications also indexed Google Scholar and the world’s largest bibliographic database WorldCat. The UNJ online version http://theunj.org/ created in the framework of the “Scientific Periodicals of Ukraine” (SPU) on based publishing platform Open Journal Systems of International scientific community Public Knowledge Project in 2015. SPU cooperation with leading international scientific databases and information resources makes it easier for publishers processes entering their publications in prestigious refereed databases, directories and search engines. This greatly increases the availability of journal for scientists, and thus contribute its publication activity.

Objective: To assess the state of the neurosurgical service, the provision of neurosurgical care to the population of Ukraine in 2013 compared to 2012, and to explore the possibilities for its optimization.Materials. The results of a comprehensive study of clinical work, the bed capacity and staff levels of the neurosurgical departments of Ukraine in 2012 and 2013 were analyzed. Results. As of 01.01.2014, neurosurgical care in Ukraine was provided in a total of 134 units with a 3,899 neurosurgical bed capacity. In 2013, neurosurgical care was provided by 833 neurosurgeons, which is twice as many as in 2012 (1.83 neurosurgeons per 100,000 population). The number of patients per 1 million population treated in 2013 increased by 4.0% compared to 2012, and amounted to 2,350; the number of patients operated per 1 million population was 1,031 (3.5 growth against 2012). Surgical activity slightly decreased from 44.1% in 2012 to 43.9% in 2013 Overall mortality and postoperative mortality show the same tendency: from 2.9 to 2.8% and from 4.4 to 4.3 % respectivelyConclusions. With the high neurosurgical capacity in Ukraine, neurosurgical beds are largely underutilized. Positive dynamics in the performance of neurosurgical departments of Ukraine has been recorded, although there is an obvious lag compared to similar performance indicators in European countries. Neurosurgical bed and neurosurgical staff numbers are subject to audit, however, it is deemed advisable to reduce these numbers. It would be rational to convert low performance neurosurgical units into neurosurgical and neurological vascular care ones.

Objective: To examine the state of neurosurgical service in Ukraine.Materials and methods. The results of continuous study of hospital beds quantity, staffing and clinical work of neurosurgical units in Ukraine from 1998 to 2012 are given. Statistical data processing was carried out using time series analysis, correlation and regression analyzes.Results. In 2012 in Ukraine availability of neurosurgical beds was 0.86 per 10,000 (1 bed per 11,650 population), the availability of neurosurgeons — 1.82 per 100,000 (1 neurosurgeon per 54,813 population). 102,947 patients (2,260 per 1 million population) were treated in neurosurgical units and 45,350 of them (996 per 1 million population) have been operated. Surgical activity was 44.1%, postoperative lethality — 4.4%.Conclusion. The availability of neurosurgical beds and neurosurgeons in Ukraine is high enough. The intensity of beds use and operating load per one neurosurgeon are low. Indicators of highly specialized effective neurosurgical care providing have a strong positive trend in Ukraine. Ukrainian neurosurgery has a good reserve for intensive mastering of new areas of medical innovations.

The purpose. To determine the state and needs of neurosurgical care providing to patients with stroke in Ukraine.Materials and methods. We analyzed results of continuous analysis of neurosurgical departments’ activity in Ukraine in 1998–2012, and materials of the Center for Health Statistics of Ministry of Health of Ukraine.Results and discussion. In 2012 11 039 patients with stroke (24 per 100 000 population) have been treated in neurosurgical units, 4 666 of them (10 per 100 000 population) were operated, surgical activity was 42.3%, total lethality — 8.5%, postoperative lethality — 12%.In general in Ukraine 17% patients with stroke get specialized neurosurgical care. People in Kiev (about 46% of the needs), in Dnepropetrovsk (21%) and Ivano-Frankovsk (15%) regions are provided by neurosurgical help the best. None of the patients with stroke get neurosurgical care in Sumy and Chernovtsy regions.Conclusions. 1. Opportunities and quality of neurosurgical care to patients with stroke increased significantly. Improving the quality and quantity indicators is mainly due to neurovascular units’ activity in Kiev, Dnepropetrovsk, Donetsk.2. Existing neurovascular beds do not provide the need of patients with stroke in specialized care.3. To satisfy the need of patients with stroke in neurosurgical care 972 functioning neurovascular beds in regions of Ukraine are needed.

Вступ. За даними світової статистики, щороку у 0,35–5,1 на 1000 новонароджених під час пологів виникає травма плечового сплетення. Більшості з них показана хірургічна корекція цього пошкодження, що передбачає використання не лише стандартних методів відновної нейрохірургії. Матеріали і методи. В клініці відновної нейрохірургії оперовані 22 пацієнти з наслідками пошкодження плечового сплетення під час пологів з використанням методики тривалої електростимуляції. Всім хворим здійснений невроліз та декомпресія пучків плечового сплетення, до яких підведені платинові електроди системи електостимуляції. Тривалу електростимуляцію проводили з використанням вітчизняних систем Нейсі 3М. Система індивідуальна, дає можливість хворому використовувати її самостійно в домашніх умовах, проводити сеанси електростимуляції кілька разів на добу протягом тривалого часу, що значно підвищує ефективність методу. Результати. У 19 (86%) хворих досягнуті позитивні результати у вигляді збільшення сили та обсягу рухів верхньої кінцівки різного рівня, покращення чутливості в кінцівці. Висновок. Тривала електростимуляція є ефективним та безпечним методом впливу на функціональний стан нервово–м’язового апарату верхньої кінцівки після травми плечового сплетення під час пологів.

Introduction. Annually up 0.35 to 5 to 1000 of newborns suffer severe injury of brachial plexus at delivery. The majority of newborns require surgery to restore proper functioning of brachial plexus.Materials and methods. 22 patients with implications of injury of brachial plexus at delivery underwent surgery during which the electrical stimulation system has been implanted. We performed neurolysis and decompression of neural structures of brachial plexus in all of patients, followed by implantation of platinum-based electrodes upon abovementioned neural structures of brachial plexus. Every single patient who underwent surgery applied individual system for prolonged electrical stimulation “Нейси-3M”. This individual system allows one to perform electrical stimulation several times a day during a long period of time, this approach significantly increases the efficacy of treatment.Results. In 19 (86%) patients range of motion improved significantly, strength of muscles of shoulder and upper extremity, sensation also improved significantly.Conclusion. Prolonged electrical stimulation of structures of brachial plexus is safe and effective method of influence on functional status of injured at delivery neuromuscular apparatus of upper extremity.

Вступ. У структурі травм опорно-рухового апарату ушкодження периферійних нервів становить до 6%, з них 90% — верхньої кінцівки. Матеріали і методи. Представлені результати хірургічного лікування 73 хворих з наслідками ушкодження довгих гілок плечового сплетення з використанням тривалої електростимуляції. Результати. З хворих, яким проведена електростимуляція, позитивний ефект (повне, хороше та задовільне відновлення нерва) простежений у 76,7%, тільки хірургічного лікування — 42,9%. Незначне покращення або неефективність лікування відзначене у 23,3% хворих після стимуляції нерва і більш ніж вдвічі більше (у 57,1%) — без тривалої нейростимуляціїї. Висновки. Використання тривалої електростимуляції є безпечним та дієвим лікувальним компонентом в комплексі відновного лікування хворих з приводу ушкодження довгих гілок плечового сплетення.

Introduction. 6% of all injuries of locomotive apparatus are injuries of peripheral nerves, up to 90% are injuries of upper extremity.Materials and methods. We present results of surgical treatment of 73 patients with consequences of long branches of brachial plexus injury with invasive chronic electrical stimulation.Results. The positive effect (full, good and satisfactory recovery of nerve) was achieved in 76.7% of patients who underwent nerve stimulation and 42.9% of patients, which have been subjected only to the standard surgical treatment. A slight improvement or treatment failure observed in 23.3% of patients with nerve stimulation and in 57.1% of patients without long-term neurostimulation.Conclusions. Invasive chronic electrical stimulation is safe method in complex restorative treatment of long branches of brachial plexus injuries.

Introduction. Effective measures at cerebrovascular disease (CVD) are primary and secondary measures for prevention of brain blood circulation disorders that are used within global (WHO) and national programs.Materials and methods. Results of continuous research of treatment work in Ukrainian neurosurgical units in 2001–2010 years, data of WHO, indicators of neurosurgical and neurologic services in Ukraine and Russian Federation were analyzed.Results and their discussion. In 2010 twice more patients with CVD have been treated than in 2001 (respectively 4837 and 8923). For this period surgical activity grew in 1.4 times (from 33.8 to 47.2%), the number of operations increased in 2.7 times — from 1637 — in 2001 to 4215 — in 2010, the postoperative lethality decreased from 17.2 to 12.3%.Conclusions. Specialization of vascular units and centers — is one of the major factors, influencing on improvement of secondary prevention at patients after vascular attack. Level of providing of CVD secondary neurosurgical prevention is highest in Kiev, sufficient — in Dnepropetrovsk and Kharkov regions and nonsufficient — in other regions of the country.