Neurosurgery and Neurology of Kazakhstan

6-12

Authors: A. Zlotnik, A. Leibowitz, E. Brotfain, A. Zhumadilov, Y. Shapira, A.Z. Nurpeisov

Patient positioning in surgical procedures has serious implications on clinical outcome. While surgical approach and exposure are considered by surgeons, frequently, the importance of properly positioning the patient, accounting for the clinical situation and co-morbidities, is overlooked. This is particularly true in many neurosurgical procedures, which require prolonged anesthesia and immobilization. Traditionally, it is the anesthesiologists’ responsibility to look after the well being of the patient, and maintain an adequate physiological environment, promoting full recovery. In this review, we analyze the different positions common in neurosurgery considering and balancing between surgical exposure, hemodynamic implications, patient comfort and neurological outcomes. The latter should be given particular attention, as it might be difficult to differentiate between neurological deficits which are a result of the patient’s position, and those that are part of the underlying condition or surgical complication. Some positions interfere with standard monitoring or necessitate temporary interruption of or ventilation and continuous IV treatment. These as should be taken into account as well, reducing the interruption to the minimum. Finally, several complications are associated with specific positions and the approach to these complications is discussed. The review has been divided into two separate parts. In the previous issue of the journal we discussed the problems, related to head, neck and body positioning including supine and lateral position. Here we offer you the second part of the review, discussing benefits and problems related to prone and sitting position and specific complications including venous air embolism, blindness in prone position and pneumocephalus.

17-19

Authors: К.B. Yrysov., E.А. Аbdykalykov

The data of 103 patients with sharp traumatic intracranial hematomas investigated. Basing on the investigations differential diagnostic signs are developed and methods of surgical treatment of the given category of patients are defined. It was determined that revealing and removal of hematomas is the leading point in surgical tactic of acute intracranial traumatic hematomas. Trephination it is shown at heavy patients and is reliable medical-diagnostic intervention. Key words: Skull-brain trauma, acute traumatic intracranial hematomas, diagnostic, surgical management, efficacy of different surgical intervention varieties.

27-32

Authors: Е.V. Yerezhepov

In the clause the basic questions of the organization of a stage of the primary narcological help are considered. In particular the problems and the complexities arising at the organization of the given stage are analyzed. Existing forms of rendering of the primary narcological help are in detail described. The attention is paid to the necessity of corresponding preparation of the personnel involved at the given stage. Keywords: the primary narcological help, the organization

37-44

Authors: К.О. Imanbekov, Е.А. Spiridonov

In the given clause the review of modern data about the distribution of the problem and non-problem use of drug substances in the world is resulted. The attention is paid to validity and necessity of differentiation of forms of drug usage for the correct organization of the narcological help. Data on the most widespread and effective methods of an estimation of weight of displays of dependence on PAS are resulted. Necessity of use of the given tools for the definition of indications to passage of programs of out-patient medical-social rehabilitation is proved. Key words: psychoactive substances, weight of dependence, ways of an estimation.