Neurosurgery and Neurology of Kazakhstan

3,4,5,6

Authors: V.N. Zhdanova

Objectives. Review the causes of the oculomotor disoders and dysfunctions of the III,IV,VI cranial nerves in neurosurgical patients. Methods. The study involved the analysis of case histories of 700 patients with oculomotor disoders, treated in 2000-2013 at the Institute of Neurosurgery. Oculomotor disturbances were found in 368 women and 332 men, aged 18-78 years (mean age 38 ± 3 years), to the right - the 374, on the left - the 326. Comprehensive clinical, neurological and neuroophthalmological examination, neurovisual methods (magnetic resonance, computer tomography of the brain, craniography) were made. Results and Conclusions. Isolated dysfunction III cranial nerve observed in patients with pathology of the internal carotid artery (saccular aneurysms), brain tumors (meningeomas of medial part sphenoid bone), tumors of the orbit, in patients with brain injury (severe traumatic brain injury, fractures of the skull base, subdural hematoma). Isolated defeat VI cranial nerve seen in patients with pathology in vertebralbasilar pool, tumors of the cerebellopontine angle, in patients with severe traumatic brain injury (brain injury, fractures of the skull base). Associated lesions III,IV,VI cranial nerves varying degrees of dysfunction observed in patients with pathology of the infraklinoid part of the internal carotid artery (carotid-cavernous fistula), brain tumors (meningeomas of medial part sphenoid bone, pituitary adenoma), tumors of the orbit, combined brain injury and kranioorbital trauma (fracture orbital bones, small and large wings sphenoid bone), inflammatory diseases involving the superior orbital fissure syndrome and syndrome of the cavernous sinus. The reasons of the oculomotor disoders in patients with neurosurgical diseases, to our knowledge, are vascular processes ( 41,4%), brain tumors (37,2%), severe brain injury (20,1%), inflammation (1.3%). Key words: cranial nerves, oculomotor disorder, cerebral arterial aneurisms, brain injory, brain tumors.

10,11,12

Authors: Y.V.Yesikova

Objectives. The purpose of the study is to investigate the prevalence , features and severity of cognitive dysfunctions in patients of the «Medical and social institutions for the elderly and disabled generic Semey.» with prior stroke attack. Methods. The medical records of patients with prior stroke attack observed in the medical- rehabilitation department «MSU nursing generic Semey « was analyzed. «Mini- COG» (Borson S., 2000) test, which is a combination of tests on memorization, reproduction and drawing of clocks, was used to identify cognitive deficits. Test reveals predemention impairment and dementia. Sensitivity of the test is 99 %, specificity - 93%. Results. The medical records of 27 patients who have had a stroke investigated, 23 due to cerebral infarction and 4 cerebral hemorrhage . 15 males and 8 females in ischemic brain lesions, and 3males and 1 female in hemorrhage group. Hemorrhages to heart attacks ratio was 1:6, the male to female ratio was - 2:1. Conclusion. Cognitive dysfunctions are prevalent in ischemic brain lesions. The results showed the age dependence of cognitive impairment, indicating the depletion of the so-called «cerebral reserve» and should be considered in a treatment plan. Key words: cognitive dysfunction, stroke, old age