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NATIONAL CENTER FOR NEUROSURGERY

2013

Master classes of 2013

On May 13-18, 2013 the master class on a subject was held: "Stimulation of deep structures of a brain in case of motive frustration" with participation Ferydoon Adzhara - the associated professor of department of neurosurgery, the head of department of functional neurosurgery of university of Pamukkale, Denizli, the Republic of Turkey.


Within the budget program 031 "Implementation of international standards in the field of hospital management" for 2013 for rendering services of a mentoring - "involvement of foreign specialists in the main clinical directions" in JSC RNTsNH in 2013 specialists from Russia, Ukraine, Turkey, the Czech Republic and Lithuania were invited.

Vascular neurosurgery

From August 5 to August 17, 2013 on the subject "Vascular Neurosurgery" the mentor Arimantas Tamashauskas – Professor, the neurosurgeon, the principal of clinic of Neurosurgery, the Director of institute of neurosciences, the Lithuanian University of sciences of health (Kaunas, Lithuania) was invited. The main interest was shown on introduction of new methods of treatment of patients with vascular lesions of a brain, to surgery of the basis of a skull and minimum invasive neurosurgery. In respect of work of a lecture, seminars on the main aspects of vascular neurosurgery, consultation of patients and discussion of tactics of treatment, work with doctors, participation in operations vascular lesions of a brain, demonstration and the analysis of operations on brain vessels.


Seminars on the following subjects were held:

1. Arterial aneurisms of vessels of a brain by definition of a condition of sick and diagnostic inspection. 

2. Principles of microsurgical excision of arteriovenous malformation, tactics and methods of treatment of AVM. 

3. Selection of tactics and time of treatment of arterial aneurisms, endovascular and microsurgery. 

4. Unexploded aneurisms and huge aneurisms. 

5. Ischemic lesions of a brain. Methods of a research of patients with an ischemic lesion of a brain (ST, Duplekh, MRT, an angiography, etc.). Decision-making for selection of a method of treatment: kontservativny or surgical. 

6. Ischemic lesion of a brain: selection of patients for a dekompressovy craniotomy in an acute phase of an ischemic infarct. Treatment of patients with illness of Moua-Moua, indication and selection of patients to extra-intracranially shunting.

The next lectures are given:

1. Aneurisms of forward department of Viliziyev of a circle, perioperativny treatment, selection of a method of treatment and the microsurgical equipment when cliping aneurisms. 

2. Classification of vascular lesions of a brain. 

3. Aneurisms of back department of Viliziyev of a circle, perioperativny treatment, selection of a method of treatment and the microsurgical equipment when cliping aneurisms. 

4. Methods of surgical treatment at stenoses of an internal carotid. A carotid endarteriektomiya without shunt and with shunting. Intraoperative monitoring of the patient. 

5. Gipertenzny intratserebralny hematomas. Diagnostics and assessment of a condition of patients and selection of a method of treatment: open surgery, stereotactical surgery, conservative treatment. A hematoma aspiration by means of intraoperative diagnostics by ultrasound and an aktiliza.

Physical therapy in treatment and rehabilitation of patients of a neurosurgical profile

From August 12 to August 23, 2013 on the subject "Physical Therapy in Treatment and Rehabilitation of Patients of a Neurosurgical Profile" the manager of department of physical therapy and medical rehabilitation of SZGMU of I. I. Mechnikov, the head of the laboratory of high laser and magnetic technologies, for 20 years is the chief specialist on physical therapy of St. Petersburg, the deputy chief specialist of the Russian Federation for rehabilitation for the Northwest region Kiryanova Vera Vasilyevna. The publication more than 500 operations on physical therapy, from them 5 monographs. Author of 26 patents. The developer and the author of the new directions in physical therapy: photochromotherapy, an abdominal decompression in physical therapy, physical therapy in a mycology, physical therapy in neurosurgery in the sharp period. Editor-in-chief of Not Medicinal Medicine log, president of SPb and Northwest physiotherapeutic association.

Consultations were held and the next lectures are given: 

1. System and pathogenetic approach in assignment of physical factors in treatment and rehabilitation of patients of a neurosurgical profile, classification of physical factors. Direct galvanic current. 

2. Microelements in neurorehabilitation. Pulse currents: electrodream, elektrotrankvilization, transkranialny electrostimulation. Diadinamoterapiya in treatment and rehabilitation of patients of a neurosurgical profile. 

3. The sinusoidal modulated currents. Neurosimilar currents. Variation electromagnetic fields, a darsonvalization in neurorehabilitation. 

4. Alternating electric currents and fields – an induktotermiya. An UHF – therapy at patients of a neurosurgical profile. 

5. KVCh – therapy. Radiative energy. Infrared radiation. Terragertsevy range of infrared radiation. Photochromotherapy. 

6. Laser radiation. Magnetotherapy. Cryotherapy - the mechanism of physiological and medical action, the indication and a contraindication, an equipment, techniques of holding procedures in neurorehabilitation. 

7. Sanatorium factors in neurorehabilitation. Balneotherapy, mud cure. Abdominal decompression. Ultrasound. 

8. Physical therapy in treatment and rehabilitation of patients with a craniocereberal injury. Physical therapy in treatment and rehabilitation of patients with damage of a front nerve. Physical therapy in treatment and rehabilitation of patients with a spinal injury. 

9. Physical therapy in treatment and rehabilitation of violations of brain blood circulation. Physical therapy in treatment and rehabilitation of perinatal violations of brain blood circulation. Physical therapy in treatment and rehabilitation of a cerebral palsy. 

10. Physical therapy in treatment and injury of peripheral nerves. Physical therapy in treatment and rehabilitation in case of neurologic displays of osteochondrosis of a backbone. Recovery treatment at oncological patients.

Practical training with doctors and nurses of separation of physical therapy and water mud cure and separation of neurorehabilitation on the following subjects is given: 

1. Operation with devices of a direct current: "Flow", Elfor, pulse currents: techniques, dispensing, security regulation. 

2. Operation with devices: "Амплипульс", "Tone-1", techniques, dispensing, contraindication. 

3. Microwaves of DMV and SMV of the range: equipment, techniques and dispensing. 

4. FTO: Ultrasound: equipment, techniques, dispensing. 

5. Magnetotherapy – an equipment, techniques of holding procedures, dispensing. 

6. Photochromotherapy, dispensing, treatment techniques. 

7. Photochromotherapy – LED radiation in wavelength of 470 nanometers: indications, techniques, dispensing. 

8. An equipment on laser therapy. Treatment techniques, dispensing, indications. 

9. Sanatorium factors: balneotherapy, mud cure, techniques, dispensing.

Prekhirurgichesky diagnostics and selection of patients for surgical treatment the pharmakorezistentnykh of forms of an epilepsy 

From August 19 to August 23, 2013 on the subject "Prekhirurgichesky Diagnostics and Selection of Patients for Surgical Treatment the Pharmakorezistentnykh of Forms of an Epilepsy" the associate professor of a neurology, neurosurgery and medical genetics of RNIMU by it N. I. Pirogova, the manager of laboratories of prekhirurgichesky diagnostics of an epilepsy of institute of a children's neurology and an epilepsy of a name of the prelate Luka, prekhirurgichesky diagnostics of an epilepsy of unit of neurosurgery of the Russian Children's Hospital of Moscow of the Russian Federation Chadayev Victor Alekseevich was invited. In respect of work: lectures, discussion of the main questions of prekhirurgichesky diagnostics of an epilepsy, consultation of patients and discussion of tactics of their conservative and surgical treatment.

Lectures on subjects are given: 

1. Symptomatic temporal and ekstratemporalny focal epilepsies. Gemisferny epileptic syndromes. Clinic, diagnostics, treatment. Prekhirurgichesky video EEG monitoring. 

2. Prekhirurgichesky diagnostics of refractory forms of an epilepsy. Definition of indications to prekhirurgichesky diagnostics. Protocol of prekhirurgichesky inspection. Invasive video EEG monitoring (subdural lattices, video stereo-EEG-monitoring)". Protection of functionally irreplaceable zones of a brain (брэйн mepping, lateralizuyushchy intrakarotidny test of WADA). Palliative surgical techniques: kallozotomiya, implatation of a stimulator of a vagus nerve.

Anesthesiologia and resuscitation 

1) From September 30 to October 11, 2013 on this subject the mentor Thomas Tamoshuytis - the doctor the intensivist, the head of the intensive care department of neurosurgery, the doctoral candidate of clinic of an intensive care, the Lithuanian university of sciences about health, Lithuania was invited. The plan of work consisted of participation and consultation on various questions of activity of intensive care unit, revision of references on a research and treatment of patients, acquaintance to the existing base of diagnostics, medicines for the purpose of optimization of work of unit.


Lectures are given, seminars and discussions on the following topical issues of an intensive care are held.

1. About preparation and to observation of patients before and after planned neurosurgical operations, about the most frequent problems and methods of their decision. Scheme of postoperative anesthesia. 

2. Sepsis. 

3. Hypertensive crisis in neurosurgery, rate of pressure decrease, value and the prescribed medicines. The recommended tactics and medicines for a lowering of arterial pressure in the early and late postoperative period. Discussion of the medicines used for activization of work of a brain (neuroprotectors), practice of use, a dose, the beginning and duration of treatment. 

4. Use of ultrasonography in an intensive care: at catheterization of the central veins and arteries, blockade of plexuses of peripheric nerves. 

5. A delivery of patients in critical condition. The practice, protocols, tactics of a delivery and admixture used in intensive care unit in the Kaunas clinic. 

6. Monitoring of a brain. Discussion of parameters of microdialysis of a brain. Bulbus a bulbar saturation, value of radiological contrast researches for definition of perfusion of a brain, a possibility of use.

2) from October 21 to October 25, 2013 the associate professor, the doctor of medical sciences, the doctor the intensivist managing unit of the Anesthesiologia of neurosurgery in clinic of the Anesthesiologia of University of sciences of health of Lithuania in Kaunas, Lithuania, Diana Bilskene was invited. Consultations on various questions of activity in the field of an anesthesiologia of unit of an anesthesiologia and an intensive care, revision of references on the perioperatsionny period of patients, acquaintance to the existing base of the anesthesiology equipment, monitoring, medicines to the purpose to optimize work during anesthesia.

Seminars on the following subjects are held: 

1. Features of assessment of a predanestetichesky condition of the patient in neurosurgery. Factors of perioperatsionny risk. 

2. Influence on the central nervous system (CNS) the anesteticheskikh of medicines and other medicines applied during anesthesia. 

3. Preparation for anesthesia and operation, monitoring of vital signs. Multimodal neuromonitoring: clinical use". Discussion of questions of intraoperative monitoring of patients: discussion of system of monitoring of depth of anesthesia (dream depth) on the principle of an electroencephalography, such as entropy (entropy) or ENCORE Index bispektralny (BIS Bispectral Index), systems of monitoring of neuromuscular blockade (Monitoring of neuromuscular block) and possibility of use for qualitative anesthesia. 

4. Features of anesthesia in urgentny and planned neurosurgery: anesthesia during operation of a brain and vessels of a brain. 

3) from November 4 to November 8, 2013 professor, doctor Dilek Ozdzhengiz. Department of an anesthesiologia and resuscitation of medical faculty, Chukurov's university, Adana, Turkey. Publication of 5 books. Carries out scientific works to areas of an intensive care, children's anesthesiologia, holds consultations on psychology. There are 95 articles published in republican and in the international editions. Since 2006 is the representative of Turkey in the European association on children's pediatrics (ESPA (European Society of Pediatric Anesthesia) and continues activity as the member of National Council (ACORN). It was chosen as the board member of Association of the Turkish anesthesiologia and resuscitation for 2012-2014.


The seminar on the following interesting subjects is held: 

1 - neurophysiology 

2 - preoperative training of the neurosurgical patient (premedication, associated diseases, laboratory analyses) 

3 - preoperative observations 

4 - strategy of infusional therapy and ventilation 

5 - complications of provisions 

6 - air embolism.

Round table on a subject: Rational use of antibiotics. Modern technologies in nurse business (OARIT). On this subject from September 30 to October 11, 2013 for rendering services of mentoring Ingrida Urbonene - the senior specialist in patient care – the administrator on patient care of intensive care unit in neurosurgery of clinic of an intensive care of Hospital of the Lithuanian university of sciences of health "The Kaunas clinics" was invited.


Work was carried out immediately with nurses of units of an anesthesiologia, resuscitation and an intensive care, unit of pathology of the central nervous system, and also unit of spinal neurosurgery, pathology of a peripheric nervous system. During work: observation over patients, correct use of the medical equipment, importance of documentation, antiepidemiological control, technology of sanation, methods of communication with patients.

Children's neurosurgery 

From October 7 to October 17, 2013 JSC RNTsNH was visited by the doctor of medical sciences, professor, the neurosurgeon, the principal of unit of neurosurgery of children's age of Federal State Budgetary Institution Rossiyskogo of research neurosurgical institute of the prof. A. L. Polenov, St. Petersburg, Russia - William Aramovich Hachatryan. Is the editor-in-chief of the "Neurosurgery and Neurology of Children's Age" magazine, the member of editorial council of the Neurosurgery Questions magazine, the Rossiyskaya Neyrokhirurgiya online magazine, "Neurosurgery and Neurology of Kazakhstan" magazine, "Russian neurosurgical magazine", and also one of founders, organizers and the vice-president of society of children's neurosurgeons of Russia. In respect of work of a lecture, seminars on the main aspects of children's neurosurgery, consultation of patients and discussion of tactics of treatment, work with doctors, mentoring at the neurosurgical operations referred on excision of tumors of a brain, an epilepsy, hydrocephalus, malformations of a head and spinal cord and backbone, vascular lesions of a brain at children. Work with neurosurgeons of unit of children's neurosurgery. 


The next lectures are given:  

1. Functional, reconstructive and low-invasive neurosurgery. 

2. Epilepsy surgery. 

3. Surgery of tumors of ZChYa. 

4. Surgery of tumors 3 ventricles. 

5. Hydrocephalus. Surgical treatment. 

6. Prenatal neurosurgery. Patrimonial hemorrhages. The revascularizing operations in neuropediatrics. 

7. Malformations of a head and spinal cord. Kiari malformation. A syndrome of the fixed spinal cord.

The seminar on a subject is held: "Current trends of development of pediatric neurosurgery". 8 operative measures are carried out.

From November 04 to November 08, 2013 on this subject Professor Sebakhattin Hadzhiyakupoglu - the neurosurgeon of department of neurosurgery of University Chukurova, Adana (Turkey). Has about 198 scientific works, 90 of which in the international editions.


Lectures on subjects are given: 

1. Survey of the neurosurgical patient, collection of the anamnesis and neurologic inspection. 

2. Development and metabolism of the central nervous system. 

3. Brain aneurisms. Complications. 

4. Treatment tserebrovaskulyarnykh brain disease. 

5. Century of science and importance scientific publications. 

6. Types of surgeries in case of vascular diseases of a brain. 

Consultations of patients and 3 surgeries are held.

Reconstructive surgery of a skull

From October 28 to November 01, 2013 on the subject "Reconstructive Surgery of a Skull" - professor Kravchuk Alexander Dmitriyevich is neurosurgeon, within 10 years the member of the European Academy of multidisciplinary neurotraumatology is the chief researcher of scientific research institute of neurosurgery of N. N. Burdenko. Is a part of an editorial board of the "Neurosurgery and Neurology of Kazakhstan" magazine. Is a winner of the State award of the Russian Federation for a cycle of the works devoted to reconstructive surgery of consequences of a craniocereberal injury in peace time and in fighting conditions. In the work plan of a lecture, seminars on the main aspects of reconstructive surgery of a skull, consultation of patients and discussion of tactics of treatment, work with doctors, a mentoring in case of the neurosurgical transactions directed to removal of tumors of bones of the code of a skull with primary kranioplastiky, defects of the code of a skull.


The next lectures are given: 

1. Reconstructive surgery of a skull – the current state of a problem. 

2. Modern principles of diagnostics and treatment of normotenzivny hydrocephaly. 

The video seminar is shown: "Features of carrying out reconstructive surgery of a skull with use of preliminary computer modeling and stereolithograph". Practical classes are given: "Features of intraoperative production of implants with use of computer modeling and stereolithograph". 2 surgical interventions on reconstruction of defect of a skull are carried out.

Neuroophthalmology 

From November 4 to November 8, 2013 on the subject "neuroophthalmology" Professor, Doctor Gulkhanym Hadzhyyakupogly have been invited. Since 1993 deals with issues of neuroophthalmology, squint and electrophysiology at department of eye diseases of medical faculty of University of Chukurov. Since 1998 is a member of the Turkish Ophthalmologic magazine. Since 2001 the chairman of the International and National congresses, and since 2002 the chairman of the International and national symposiums. During this period directs branch in Chukurov's city and the Turkish Ophthalmologic magazine. The member of the European magazine on squint.


Lectures on subjects are given: 

1. Sudden loss of sight. Neuroophthalmologic disturbances at a diabetes mellitus.  

2. Cyclovertical deviations.  

3. Neurogenic ptosis. Paresis 3.pary ChMN, neuroophthalmologic features.  

Consultations are held and 40 cases in respect of diagnosis and tactics of operation of patients are discussed.

Functional neurosurgery 

From November 04 to November 08, 2013 on the subject "Functional Neurosurgery" Urgosik Dyusan was invited by M.D., Ph.D. - neurosurgeon of clinic of Na Homolce Prague (Czech Republic). The main work was referred on stimulation of deep structures of a brain (DBS) to patients with Parkinson's illness. Practical works on a stereotaxis, training with system of planning SurgiPlan Electa were carried out. Consultations of patients with motive disorders for the purpose of further selection for an operative measure are held.


The next lectures are given: 

1. Selection of patients. 

2. Signs of illness of Parkinson, tremor, dystonia. 

3. Stimulation of deep structures of a brain - the stereotaxic procedure, including electro-micro registration. 

4. History stimulation of deep structures of a brain. 

From November 25 to November 29, 2013 on the subject "functional neurosurgery" in JSC RNTsNH Associate professor Ferydoon Adzhar - the principal of unit of functional neurosurgery of University of Pamukkale, Denizli (Turkey) was invited. Professor F. Adzhar has vast experience of surgical treatment of motive disorders, recognized world neurosurgical community in the field of functional neurosurgery. In respect of work of consultation of patients, selection for surgical treatment. Together with doctors 6 patients with motive disturbances were operated and implanted DBS electrodes. 

From November 25 to November 29, 2013 Associate professor Goksimin Adzhar is a neurologist of University of Pamukkale, Denizli (Turkey).


Lectures on subjects are given: 

1. Medikamentno-rezistentnaya epilepsy, description of importance of recognition of pharmako-refractory patients and definition of time of the direction of patients for prekhirurgichesky assessment. 

2. Preoperative non-invasive assessment of patients with an epilepsy. 

3. Motor and not motor signs of the Parkinson's illness (PI). 

4. Modern approaches of surgical treatment of illness of Parkinson. 

5. Dystonia and tremor. 

6. Review of DBS of programming.

Consultations are held and recommendations concerning drug and expeditious treatment are made. A practical training with video examples of some key clinical signs BP, importance of differential diagnostics of BP is given, infrequent examples of illness which can lead to difficulty when determining the diagnosis are given. Ekstrakranialny surgery of tumors of the bases of a skull and pathological processes of C1-C2 of vertebrae.   

From November 18 to November 22, 2013 on this subject the doctor of medical sciences, the neurosurgeon, the leading researcher of scientific research institute of neurosurgery of N. N. Burdenko of the Russian Academy of Medical Science, professor of department of neurosurgery of RMAPO - Shkarubo Alexey Nikolaevich, Moscow, Russia was invited. Is a member Evropeyskaya, the World and Russian associations of neurosurgeons. I am a winner of the national award "Calling", and also the award "For Saving of the People". I am an official consultant of the main hospital of the Ministry of Internal Affairs of the Russian Federation and the central military hospital of FSB of the Russian Federation. It is noted by departmental awards (medals and the breastplate) of the Ministry of Internal Affairs of the Russian Federation and the letter of thanks of FSB of the Russian Federation. In 2013 "The honored inventor of the Russian Federation" is presented to an honorary title.


In respect of work of a lecture, seminars on the main aspects of ekstrakranialny surgery of tumors of the basis of a skull and pathological processes of kraniovertebralny transition, consultation of patients and discussion of tactics of treatment, work with doctors, mentoring at the neurosurgical operations referred on excision of tumors of the basis of a skull and pathological processes of kraniovertebralny transition. Work with neurosurgeons of unit of pathology of a CNS.

Lectures on subjects are given: 

1. History and the prospects of development of an endoscopy in neurosurgery. 

2. Ekstrakranialny surgery of the basis of a skull and pathological processes of C1-C2 of vertebrae. 

3. Skull basis plasty.

Consultations of patients with various tumors and not tumoral diseases of the basis of a skull, kraniovertebralny transition are held. 9 surgical interventions are carried out.

Children's neurosurgery: innovations, development and leaving in nurse business.  

From November 18 to November 29, 2013 on this subject Keziban Shirin – the nurse of department of neurosurgery of the Istanbul University was invited (Turkey). Now is the board member of the magazine of nurses of neurosurgery. Has the certificate of a training at first aid. Took part in different courses on clinical practice and the general therapy. Except domestic and foreign articles, promoted development of a nursing care in the research works.

Practical training with nurses on subjects is given: 

1. Pediatrics and assessment of neurosurgery on "A scale of a coma of Glasgow".

2. Measurements and monitoring of a syndrome of the increased intracranial pressure. 

3. Tumors of a back cranial fossa. 

4. A nursing care at brain tumors at children's age 

5. Pediatric pharmaceutical mistakes. 

6. Congenital injury of a brain and nursing care 

7. Epilepsy and characteristic of epileptic seizures. 

8. Epilepsy and nursing care. 

9. Hydrocephalus and nursing care. 

10. Tracheostomy.

Transcranial accesses at microsurgical excision of tumors of a brain

From December 04 to December 10, 2013 on the subject "Transcranial Accesses at Microsurgical Excision of Tumours of a Brain" Smolanka Volodymyr Ivanovich is the doctor of medical sciences, professor, the manager of department of a neurology, neurosurgery and psychiatry of DVNZ of the Uzhhorod national university, the director of regional clinical center of neurosurgery and neurology, Uzhhorod, the President of the Ukrainian Association of neurosurgeons.


The author of 148 scientific works, including in magazines "Stroke", "Neurology", "European Journal of Neurology". Prepared more than 20 methodical developments for doctors and students. The author of National clinical protocols on an ischemic stroke and epilepsy. Holds 4 Patents of Ukraine and the copyright certificate for the invention. Under its management one is protected doctor's and two master's theses. In May, 2013 it is elected the President of the Ukrainian Association of neurosurgeons. The member of the specialized Academic Council from neurosurgeons in case of DU "Institute of neurosurgery of A.P.Romodanov of NAMN of Ukraine. Is a fixed teacher of the European Association of neurosurgeons and the European Association of neurologists. Member of Training committee of the European Association of Neurosurgeons. Individual member of the European Association of neurosurgeons. Vice-president of All-Ukrainian public organization "Ukrainian Association of Fight against a Stroke". Deputy chief editor of scientific and practical magazines "Vascular Diseases of a Brain" and "Lancet Neurology Ukraine". Member of Editorial board of magazines "International Journal of Stroke", "The Ukrainian neurosurgical magazine". "For Merits" of the III degree, is awarded the order by the letter of the Verkhovna Rada of Ukraine, the certificate of honor of the Ministry of Health of Ukraine. Winner of the first national medical award "The Best Doctor of Ukraine" (2012).

The next lectures are given: 

1. Accesses to a lobby and average cranial pole. 

2. Features of microsurgical removal meningiy. 

3. Features of microsurgical removal of tumors of the average line and back cranial pole. 

4. Accesses to a back cranial pole. 

5. Features of removal epidermoidnykh of tumors.

Consultations of patients and analysis of patients in intensive care unit after transaction, the recommendation of treatment. Analysis of patients in department of pathology of TsNS arriving on hospitalization. Determination of tactics of treatment of patients with tumors of the basis of a skull and ZChYa. A practical training with neurosurgeons. Carrying out surgical interventions.