Laparoscopic approach is common in pelvic tumor surgery. Several small samples of patients after laparoscopic resection of presacral neurogenic tumors were described. Safety and advantages of this intervention are interesting. OBJECTIVE:To analyze clinical outcomes of laparoscopic resection of presacral neurogenic tumors. MATERIAL AND METHODS:Eleven patients including 2 children aged 11 and 17 years underwent laparoscopic tumor resection between 2021 and 2024. We estimated tumor size and localization, surgery time, blood loss, complications, postoperative hospital-stay, histological diagnosis and continued growth or recurrence in the follow-up period. The median follow-up was 19.2 (3-36) months. RESULTS:Tumor size ranged from 4 to 10 cm, mean surgery time - 153.6 min, blood loss - 356.4 ml. Postoperative complications developed in 7 patients, including acute urinary retention, neuropathic pain syndrome, hematomas and dynamic intestinal obstruction. Total resection was achieved in 8 (72.7%) patients, subtotal resection - 2 (18.2%), partial resection - 1 (9.1%) case. Tumors were predominantly neurogenic: 6 (54.5%) - sacral nerve schwannomas, 1 (9%) - NF1-related schwannomatosis, 1 (9%) - meningioma, 1 (9%) - ganglioneuroma, 1 (9%) - fibromyxoid sarcoma, 1 (9%) - solitary fibrous tumor. There were no recurrences, continued growth or recurrence of preoperative symptoms in the follow-up period. CONCLUSION:Laparoscopic resection of presacral neurogenic tumors is an effective surgical technique with good visualization of surgical field and possible gross total resection.

The study is devoted to considering the effectiveness of modern approaches to the development of diagnostic technology for analyzing MRI images in neuro-oncology, based on artificial intelligence (AI) and computer vision. Such approaches are necessary for rapid and diagnostically effective analysis to implement the principle of individualized medicine. Material and methods. An analysis of the effectiveness of the choice of AI technologies for the formation of processes of segmentation and classification of neuro-oncological MRI images has been presented. AI was trained on its own annotated database (SBT Dataset), containing about 1000 clinical cases based on archival data from preoperative MRI studies at the Federal Neurosurgical Center (Novosibirsk, Russian Federation), in patients with astrocytoma, glioblastoma, meningioma, neuroma, and with metastases of somatic tumors, with histological and histochemical postoperative confirmation. Results and discussion. The effectiveness and efficiency of the developed technologies was tested during the international BraTS competition, in which it was proposed to segment and classify cases from a dataset of neuro-oncological patients prepared by the competition organizers. Conclusions. The methodological approaches proposed in the article in the development of diagnostic systems based on AI and the principles of computer vision have shown high efficiency at the level of dozens of world leaders and can be used to develop software and hardware systems for diagnostic neuroradiology with the functions of a “doctor’s assistant.”

Background. Meningiomas are the most common extracerebral intracranial neoplasms. Radicality of meningioma resection largely depends on its consistency, size, and closeness to important anatomical structures. Preoperative prognosis of meningioma density plays an important role in selection of surgical access and operative inventory, general radicality of tumor resection, and neurological outcome after surgery.Aim. To determine predictors of intracranial meningioma consistency using magnetic resonance imaging and T1, T2‑mapping technique.Materials and methods. The study included 96 patients with primary meningiomas who underwent surgery at the Federal Neurosurgical Center (Novosibirsk) between 2018 and 2021. Magnetic resonance images were analyzed using calculation of the ratio between signal intensity on T1‑weighted and T2‑weighted images with subsequent group and correlation statistical analysis for comparison of T1, T2‑mapping results with clinical, histological and intraoperative data.Results. Statistically significant increase in the signal intensity and standard deviation from the mean intensity on T1, T2‑maps of psammomatous meningiomas compared to all other subtypes was observed. Additionally, positive correlation between signal intensity form meningiomas on T1, T2‑maps and intraoperative data on tumor consistency was found.Conclusion. Images obtained using T, T2‑mapping technique are as informative as traditional T2‑weighted images for evaluation of intracranial meningioma consistency. Additionally, they allow to obtain absolute intensity values. Further prospective studies are necessary for confirmation of the obtained results.

Введение. Опухоли головного мозга являются одним из преобладающих факторов риска развития венозных тромбоэмболических осложнений (ВТЭО). В частности, при глиомах нарушения системы гемостаза обусловлены ведущей ролью тканевого фактора и депрессией клеточной активации системы фибринолиза. В то же время оценка коагуляционного статуса при менингиомах практически не проводилась. Цель исследования: оценка коагуляции у пациентов с глиомами и менингиомами головного мозга для прогноза микротромботического риска. Материалы и методы. Проведено проспективное неконтролируемое наблюдательное нерандомизированное исследование. У 43 пациентов с глиомой и 54 пациентов с менингиомой головного мозга выполнена оценка параметров гемостаза. Ретроспективно анализировалась основная информация о пациентах: характеристика новообразований по результатам магнитно-резонансной томографии, сопутствующие заболевания и гистология опухолей, результаты анализов крови до операции. Наличие тромбоза подтверждалось дуплексным сканированием вен нижних конечностей до и после хирургического лечения. Результаты. Частота развития ВТЭО среди пациентов с новообразованиями головного мозга составила 23,7%, в том числе c глиомами – 25,6%, с менингиомами – 22,2%. Значимыми факторами тромботического риска у пациентов с глиомой явились снижение значений международного нормализованного отношения (МНО), активированного частичного тромбопластинового времени (АЧТВ), фибриногена (р < 0,01), количества тромбоцитов (р < 0,05) и повышение протромбина по Квику, содержания D-димера (р < 0,01) и количества лейкоцитов (р < 0,05), увеличение возраста (р < 0,001), сопутствующая артериальная гипертензия и фенотип IDH-wildtype с повышением уровня фермента изоцитратдегидрогеназы в сыворотке (р < 0,05). У больных с менингиомой определено повышение содержания D-димера (р < 0,01), более старший возраст и наличие сопутствующего ожирения (р < 0,05). Корреляционный анализ Спирмена в группе с глиомами показал, что повышение уровня D-димера коррелирует с увеличением экспрессии маркера пролиферативной активности ядра опухолевой клетки Ki-67 (R = 0,532; р < 0,01) и степенью гистологической злокачественности опухоли (Grade) по общепринятой в онкологии шкале – системе классификации, оценки, разработки и экспертизы рекомендаций (Grading of Recommendations Assessment, Development and Evaluation) (R= 0,406; р < 0,05), а увеличение количества лейкоцитов положительно коррелирует с объемом новообразования (R = 0,561; р < 0,001), Grade (R = 0,428; р = 0,01) и Ki-67 (R = 0,397; р < 0,05). Заключение. Повышенный риск развития ВТЭО связан с гиперкоагуляцией у пациентов с глиомами и менингиомами головного мозга. Увеличение содержания D-димера и количества лейкоцитов коррелирует с прогрессированием глиом. Introduction. Brain tumors are one of the predominant risk factors for the development of venous thromboembolic complications (VTEС). In particular, in gliomas, hemostasis disorders are attributable to the leading role of tissue factor and the depression of cellular activation of the fibrinolysis system. At the same time, there was virtually no assessment of the coagulation status in meningiomas. Аim: toevaluate coagulation in patients with brain gliomas and meningiomas for the prediction of microthrombotic risk. Materials and Methods. A prospective, uncontrolled, observational, non-randomized study was conducted. Hemostasis parameters were evaluated in 43 patients with brain gliomas and 54 patients with brain meningiomas. The basic information about patients, the characteristics of tumors according to magnetic resonance imaging (MRI) findings, concomitant diseases, tumors histology, and the results of laboratory blood tests before surgery were retrospectively analyzed. The presence of thrombosis was confirmed by veins duplex scanning of the lower extremities before and after surgical treatment. Results. VTEС incidence among patients with brain tumors was 23.7%, with 25.6% among those with gliomas and 22.2% among those with meningiomas. Significant thrombotic risk factors in patients with gliomas were decreased values of international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (p < 0.01), platelet count (p < 0.05) and increased prothrombin according to Quick, D-dimer level (p < 0.01) and leukocyte count (p < 0.05), increased age (p < 0.001), concomitant arterial hypertension and IDH-wildtype phenotype with increased levels of isocitrate dehydrogenase enzyme in serum (p < 0.05). In patients with meningiomas, an increase in D-dimer level (p < 0.01), older age, and the presence of concomitant obesity (p < 0.05) were identified. Spearman correlation analysis in the group with gliomas showed that an increase in D-dimer level correlated with an increase in the expression of the tumor cell nuclear proliferative activity marker Ki-67 (R = 0.532; p < 0.01) and the degree of histological tumor malignancy (Grade) according to the generally accepted scale in oncology – Grading of Recommendations Assessment, Development and Evaluation (R = 0.406; p < 0.05), while the increase in leukocytes count positively correlates with neoplasm volume (R = 0.561; p < 0.001), Grade (R = 0.428; p = 0.01) and Ki-67 (R = 0.397; p < 0.05). Conclusion. An increased VTEC risk is associated with hypercoagulability in patients with brain gliomas and meningiomas. Increased D-dimer level and leukocyte count correlate with glioma progression.

OBJECTIVE:To analyze the postoperative outcomes in patients with craniovertebral meningiomas with preoperative justification of surgical approach depending on tumor localization. MATERIAL AND METHODS:We examined 36 patients with craniovertebral meningiomas. The Karnofsky, Frankel and cranial nerve dysfunction scales were used to assess functional status of patients. Preoperative contrast-enhanced MRI was valuable to verify tumor matrix. MRI and assessment of neurological status were performed 2 weeks and 1 year after surgery. RESULTS:Mean preoperative Karnofsky score was 65.52±6.41, in postoperative period - 71.71±14.16, after 1 year - 86.9±5.61. Baseline dysfunction of caudal cranial nerves was noted in 22.2% of patients. After 2 postoperative weeks, this value increased to 55.6% (20 patients). After one postoperative year, mild dysfunction of caudal cranial nerves persisted in 9 patients (25%). Patients were divided into 3 groups depending on localization of tumor matrix in sagittal plane: lower third of the clivus - 15 (41.7%) patients, level of foramen magnum - 18 (50%) patients, level of C1-C2 vertebrae - 3 (8.3%) patients. Two groups were distinguished depending on localization of tumor matrix in axial plane: anterior (anterolateral) - 27 patients (75%), posterior (posterolateral) - 9 patients (25%). We analyzed the relationship between tumor volume, localization of matrix and incidence of postoperative complications. CONCLUSION:Localization of tumor matrix at the level of the lower third of the clivus is accompanied by larger tumor volume and higher complication rate compared to localization of neoplasm at the level of foramen magnum and C1-C2 vertebrae. Posterolateral approach is optimal for anterior and anterolateral tumors, while median suboccipital approach is advisable for posterior and posterolateral tumors.

Intermediate nerve neuralgia (INN) is a rare pathology with difficult diagnostics and currently there is no generally accepted surgical management protocol. In this regard, an optimal surgical strategy in this case is a difficult task. The aim was to determine an optimal approach for surgical management of patients with INN using intraoperative neurophysiological monitoring (IONM).The INN was diagnosed in a patient, a vestibulo‑cochlear complex dissection with intermediate nerve sectioning under IONM control of was performed intraoperatively. There was the earache regression, but there were gustatory disorders in the anterior portion on the left side of the tongue in the early postoperative period. In the late postoperative period, a delayed facial nerve paresis and signs of liquorrhea were diagnosed, which were completely regressed after reoperation and medication. The follow‑up period was more than 12 months; a stable regression of otoalgia was achieved. Intermediate nerve sectioning is an effective and common technique for the treatment of patients with INN. IONM improves surgical results and reduces a likelihood of different complications.

Background. Clinically significant herniated intervertebral discs in the thoracic spine are quite rare, and the tactics of surgical treatment of a group of patients with this pathology remains debatable. The thoracoscopic technique has a number of advantages in the form of a shorter hospital stay and less severe pain in the surgical area compared to standard posterior surgical access.Aim. To evaluate the results of videothoracoscopic treatment of patients with discogenic thoracic myelopathy.Material and methods. The article analyzes the results of treatment of 21 patients hospitalized at the Federal Neurosurgical Center (Novosibirsk). According to the results of the examination, the patients were divided into 2 groups: with mild (10 patients) or ossified (11 patients) hernias. Each patient underwent video‑assisted thoracoscopic microdiscectomy. The median follow‑up was 29 (4 to 72) months.Results. At the time of discharge, 18 (85.7 %) patients showed no deterioration in neurological status, 2 (9.5 %) patients showed positive dynamics in the form of a decrease in the degree of hypertonicity and the degree of lower paraparesis. A satisfactory result of treatment in the late postoperative period was achieved in 14 (66.7 %) patients.Conclusion. Video‑assisted thoracoscopic surgery is an effective and safe method of surgical treatment of patients with discogenic thoracic myelopathy.

Background. Due to rare occurrence of distal cerebral aneurysms, there are very few publications devoted to endovascular treatment. Due to current progress in the endovascular surgery, the number of successfully cured patients with distal aneurysms has been increasing recently.Aim. To determine technical capabilities and evaluate results of endovascular treatment of patients with distal intracranial aneurysms.Materials and methods. The work is based on analysis of data of endovascular treatment among 45 patients with distal cerebral aneurysms in two neurosurgical departments of federal medical centers. Of the 45 analyzed cases 30 were without aneurysm rupture and 15 were with rupture.Results. Endovascular treatment of the distal aneurysms made it possible to achieve good treatment results (4–5 points on the Glasgow Outcome Scale (GOS)) in 97.8 % of cases: 5 points on GOS – in 68.9 %, 4 points on GOS – in 28.4 %. One (2.2 %) fatal outcome was obtained. The most frequent methods of embolization were embolization of aneurysm by coils with stent assistance (37.8 %) and installation of a flow-diverter stent (28.9 %). Embolization with only coils (20 %) or occlusion of parent artery (13.3 %) were used less frequently. In 3 out of 6 patients, the occlusion of parent artery was not planned.Conclusion. Development of endovascular surgery and technical capabilities of performing operations in the distal cerebral arteries has made it possible to form a multidisciplinary approach to choosing the optimal method of shutting off the distal aneurysm from the bloodstream, taking into account the modern possibilities of open surgery. This is especially important for patients in serious condition due to ruptured aneurysm.

BACKGROUND:Olfactory nerve schwannomas are extremely rare. Their origin is still unclear, since olfactory nerve has no Schwann cells. There are about 70 case reports of olfactory nerve schwannoma in the world literature. Original articles devoted to this issue are currently absent.RESULTS:We present a 55-year-old patient with olfactory nerve schwannoma who underwent surgery at the Federal Center of Neurosurgery in Novosibirsk. MRI revealed extracerebral mass lesion of anterior cranial fossa base with left-sided lateralization resembling meningioma of the olfactory fossa. The patient underwent microsurgical resection of mass lesion of anterior cranial fossa base through left-sided lateral supraorbital craniotomy. The tumor macroscopically resembled schwannoma. Total resection was carried out. Considering morphological structure and immunomorphological characteristics, we verified schwannoma Grade 1.CONCLUSION:Olfactory nerve schwannomas are rare tumors with benign histological structure. Relapses after total resection are unlikely. However, further research of this rare pathology and long-term postoperative follow-up are required.

Early identification of risk groups is essential for effective and target prevention of venous thromboembolic events (VTE) in all areas of surgery. For this purpose, the authors has developed and put into practice an algorithm distinguishing the groups of low, moderate and high risk of VTE among neurosurgical patients.OBJECTIVE:To assess predictive value of the developed algorithm for elective neurosurgical interventions.MATERIAL AND METHODS:The study included 7914 patients who underwent surgery between January 2018 and December 2019. According to the algorithm, we identified the groups of low (1536 (19%) patients), moderate (4554 (58%) patients) and high risk (1824 (23%) patients). Moreover, patients were divided into subgroups depending on surgical procedure. We analyzed the incidence of VTE and mortality in all groups.RESULTS. INCIDENCE:Of VTE with a 95% confidence interval in the low-risk group was 0.65% [0.26; 1.04], in the moderate risk group - 1.82% [1.47; 2.24], in the high-risk group - 12.61% [11.02; 14.09]. When comparing various surgical interventions, we revealed more common VTE after vascular microsurgery (15.62%), in patients with brain tumors (12.63%) and spinal cord tumors (6.52%).CONCLUSION:The risk stratification algorithm has demonstrated its convenience and significant predictive value for determining the risk of VTE among elective neurosurgical patients. In addition, different incidence of VTE was demonstrated in patients with various neurosurgical diseases.

Introduction. Current approaches used to predict the recurrence of diffuse large B-cell lymphoma (DLBCL) with involvement of the central nervous system (CNS) need to be improved. Data from national studies on the incidence and clinical and laboratory characteristics of primary CNS DLBCL and secondary CNS involvement in systemic DLBCL are fragmentary and do not allow us to assess the overall picture. Aim. An assessment on the territory of the Siberian metropolis of data on the incidence and clinical and laboratory characteristics of DLBCL patients with primary CNS lymphoma (PCNSL) and secondary CNS involvement, as well as validation of the CNS-International Prognostic Index (CNS-IPI) on this sample. Materials and methods. The study group consisted of 47 patients with PCNSL and 35 with secondary CNS involvement in systemic DLBCL, the comparison group consisted of 202 patients with DLBCL without CNS involvement. Results. All patients with secondary CNS involvement in DLBCL belonged to the medium and high risk groups (p = 0.007) according to the CNS-IPI, which confirms its prognostic value. The risk factors for secondary CNS involvement in DLBCL were ECOG performance status ≥ 2, HIV infection, age over 60 years, a history of chronic kidney disease, ≥ 2 extranodal sites, and high expression of Ki-67 (>75% positive tumor cells), non-GCB subtype of lymphoma, and presence of anemia. When assessing the characteristics of the clinical course of the disease, a number of peculiarities of the primary and secondary CNS involvement in DLBCL were identified. In particular, in terms of overall survival, the PCNSL group had a more favorable prognosis (p = 0.051). Conclusion. The results of the study confirm the importance of the CNS-IPI as a tool of a hematologist to determine the group of patients needing prevention of recurrence of DLBCL in the CNS. New data on a higher incidence of chronic kidney disease, arterial hypertension and thyroid disorders in the group of patients with PCNSL require further study.

Introduction. Trigeminal neuralgia is a fairly rare disease manifested by acute paroxysmal pain of the type of electric shock in the innervation zone of one or more branches of the trigeminal nerve. Trigeminal neuralgia is usually sporadic, but familial cases have also been described. The study of familial cases of the disease can help in understanding the causes and mechanisms of the development of trigeminal neuralgia. We present a series of 4 families in which 2 family members in one generation suffered from trigeminal neuralgia, all patients underwent surgical treatment in our center.The study objective. The study of familial cases of the disease can help in understanding the causes and mechanisms of the development of trigeminal neuralgia.Materials and methods. For the analysis, data were collected on patients with familial trigeminal neuralgia who were operated on in our center from August 2015 to October 2020.Results. In our series, the majority of patients were women, the average age was 36.5 years, in all cases right side was involved, and, in most cases the second trigeminal division was affected. Most of the patients had neurovascular conflict. All patients underwent microvascular decompression as a primary operation in our center. Intraoperative neurovascular conflict was identified in all cases; in half of the cases, complete regression of pain syndrome was noted after first surgical procedure. Conclusion. In our study, no clinical or anatomical factors were found in comparison to sporadic cases of trigeminal neuralgia.

The study objective is to study the results of the differentiated method of surgical revascularization of the brain for the treatment of pediatric patients with moyamoya angiopathy. Materials and methods . Twelve surgical interventions were performed on 12 hemispheres in 8 patients (4 male, 4 female) with moyamoya angiopathy from December 2015 to March 2020. The age of patients ranged from 6 months to 14 years old, the average age is 8 years old. To clarify the clinical course of the disease the Y. Matsushima classification was used: type I (n = 3), type III (n = 2), type IV (n = 2) and type V (n = 1) of Y. Matsushima. Stages of the disease are classified according to J. Suzuki: stage III was revealed in 5 patients, stage IV— in 3. Cerebral angiography, magnetic resonance imaging of the brain and vessels were performed; computed tomography perfusion of the brain was made in every patient. Encephaloduroarteriomyosynangiosis was used in 2 hemispheres. Extra-intracranial bypass and encephaloduro-myosynangiosis in 1; extracranial-intracranial bypass and encephaloduroarteriomyosynangiosis — in 2; extracranial-intracranial bypass and encephaloduromyoperiosteosynangiosis in 5 hemispheres; double-barreled bypass and encephaloduromyosynangiosis — in 1 hemisphere; double-barreled bypass and encephaloduromyoperiosteosynangiosis — in 1 hemisphere. In the follow-up period (6—36 months) neurological status testing, digital subtraction angiography (6 vascular territories), magnetic resonance imaging of the brain and vessels and computed tomography perfusion of the brain were performed. Results . All patients in the follow-up period had no clinically significant ischemic events on the side of surgical intervention; there was an increase in the perfusion of the brain in comparison with preoperational values. In 1 case, transient ischemic attack occurred on the nonoperated hemisphere that did not recur after surgery. There was a regression of symptoms among children with initial neurological deficits. The angiographic result, in accordance with the method suggested by Y. Matsushima, was excellent (A group) and good (B group), except the case of moyamoya syndrome and case after indirect revascularization in zone of brain atrophy. Based on our experience, we have determined the optimal method of suturing the wound with a good cosmetic effect. Conclusion . We can assume, that differentiated method in surgical treatment of pediatric patients with moyamoya angiopathy is highly effective for the prevention of ischemic stroke, and also has good clinic, angiographic and cosmetic result. With suitable arterial sizes, combined revascularization showed better results than indirect, especially in the clinically significant hemisphere.

Venous thromboembolic complications (VTE) are an actual problem for all surgical specialties, and neurosurgery was no exception. Data on the incidence of deep vein thrombosis and pulmonary embolism vary over a wide range: from 0 to 34 % andfrom 0 to 3.8 %, respectively. According to some estimates, VTE are in second place among the causes of postoperative mortality in neurosurgery, which makes the study of this topic relevant and undoubtedly important for improving the quality of care for patients. The article provides an overview of modern scientific literature, relevant data on the frequency of occurrence of VTE. The issues of pathogenesis, risk stratification and methods for the prevention of deep vein thrombosis and pulmonary embolism are highlighted.

BACKGROUND:Non-invasive EEG reveals epileptogenic zone in 70% of patients. In other cases, invasive EEG monitoring is indicated. Various implantation strategies and techniques of intracranial EEG (icEEG) potentially provide different outcomes. Choosing the optimal icEEG technique may be challenging.OBJECTIVE:To analyze the results of icEEG in adults with temporal lobe epilepsy and to determine the algorithm for selection of optimal invasive EEG technique.MATERIAL AND METHODS:The study included 82 patients with temporal lobe epilepsy who underwent invasive EEG. Effectiveness of invasive EEG was determined by detection of epileptogenic zone and post-resection outcomes. Postoperative results were analyzed throughout more than 6-month follow-up period using the Engel grading system. Statistical analysis was conducted using the Fisher's exact test.RESULTS:Epileptogenic zone was revealed in 72 (88%) cases. Invasive EEG was supplemented by another modality in 3 (4%) patients. Mean follow-up period after resection was 17 months in 45 patients. Favorable outcomes were achieved in 31 (69%) cases. Statistical analysis showed that identification of epileptogenic zone depends existing of lesion and symptoms of seizures. Selection algorithm for optimal technique of invasive EEG was determined considering own results and literature data.CONCLUSION:Invasive EEG results and post-resection outcomes demonstrated favorable efficacy of original algorithm. The last one may be used in decision-making on optimal technique of invasive EEG in adults with temporal lobe epilepsy.

Introduction. Invasive video-EEG monitoring (invasive EEG) is indicated in patients with refractory focal epilepsy while localization of the epileptogenic zone is unclear. Methods of invasive EEG in different groups of patients demonstrate variable results.Objective: to analyse the results of invasive EEG via subdural and depth electrodes in patients with refractory temporal lobe epilepsy with mesial temporal lobe seizures.Materials and methods. The series of 37 patients who underwent invasive EEG from 2013 to 2020 was retrospectively analysed. The study includes primary adult patients with structural refractory focal epilepsy with mesial temporal lobe seizures without tumor and vascular pathology. Patients were divided onto 3 groups: 1) with foramen ovale electrodes 2) subdural strip electrodes and 3) combination of subdural strips and depths electrodes. The results of anteromedial temporal lobectomy after 6 months were classified according to Engel scale.Results. A group with foramen ovale electrodes included 7 patients, subdural strips – 23, combination – 7. The seizure onset zone was detected in 36 (97 %) cases. Serious complications were observed in 2 (29 %) cases in the group with foramen ovale electrodes. The mean follow-up in 23 (76 %) patients after resective surgery was 28.3 months. Favourable results (Engel I, II) were observed in 4 (80 %) patients with foramen ovale electrodes, in 8 (67 %) patients with subdural electrodes, in 6 (100 %) with combination. Unfavourable results (Engel III, IV) were noted in 1 (20 %) patient with foramen ovale electrode, in 4 (33 %) patients with subdural strips.Conclusion. All the presented modalities of invasive EEG are effective for localizing of seizure onset zone in this category of patients. Foramen ovale electrode using may be limited due to increased risk of complications.

Venous thromboembolic events (VTE) can significantly complicate postoperative period in neurosurgical patients. It is known that patients with brain tumors are especially susceptible to VTE.OBJECTIVE:To determine the incidence and risk factors of VTE in patients with various brain tumors.MATERIAL AND METHODS:All patients with brain tumors underwent surgery in 2019 (n=610). They were divided into the groups depending on tumor type: sellar region, intracerebral, extracerebral neoplasms and metastases. All patients underwent screening and prevention of VTE in accordance with the protocol accepted in the hospital. We analyzed the incidence of VTE in each group and significance of various risk factors.RESULTS:Overall incidence of VTE was 14.9% (91 cases). Deep vein thrombosis (DVT) was the most common - 85 cases (93.4%). Less common events were DVT combined with pulmonary embolism (PE) (n=5, 5.5%) and PE alone (n=1; 1.1%). PE caused death in 2 cases (0.3%). In patients with sellar tumors, incidence was 21.7% [13.4%; 29.35%], among intracerebral tumors - 13.8% [9.04%; 18.62%], extracerebral neoplasms - 15.4% [11.02%; 19.69%], metastases - 7.9% [1.32%; 11.84%]. Univariate and multivariate analysis revealed some risk factors of VTEs such as gender, age, surgery time, length of ICU-stay over 12 hours, body mass index >30 kg/m2. Moreover, risk factors have different significance in patients with different types of tumors.CONCLUSION:In this study, we found a high incidence of VTE among patients with brain tumors. Incidence and risk factors of VTE depend on the type of tumor.

Meningiomas are rare in children and distinguished from the tumors in adults by clinical and biological aspects. Moreover, some histological forms and localizations are even casuistic in adults. There were 178 patients younger 18 years old with brain tumors. All patients underwent surgery at the pediatric department for 5-year period. Meningiomas were diagnosed in 5 cases that accounted for 2.8% of the total number of brain tumors in children. The authors reported children with intracranial meningiomas and discussed certain features of the course of disease in these patients.