ORIGINAL RESEARCH
The coronavirus of severe acute respiratory syndrome-2 (SARS-CoV-2) and the coronavirus infection caused by it, along with damage to the respiratory system, can lead to disorders of the central and peripheral nervous system. The article presents literature data and own observations of neurological disorders in patients with coronavirus disease in the superacute period. Pronounced neurological disorders are mainly observed in severe coronavirus disease and include acute ischemic stroke, subcortical micro- and macrobleeding, acute necrotizing encephalopathy, Guillain-Barre syndrome. Factors potentially complicating the course of coronavirus disease and contributing to the development of neurological complications are hypertension, diabetes mellitus, chronic diseases of the heart and respiratory system. Based on existing publications and our own observations, we have systematized information about the relationship between coronavirus disease and neurological disorders, about possible factors contributing to the occurrence of stroke. The possibilities of using chest MSCT as the only method of radiation diagnostics for the early detection of viral pneumonia in patients receiving emergency and emergency care at the regional vascular center of BUZOO «GC BSMP No. 1» are considered. The use of this method, in the ultra-acute period of acute ischemic stroke, during the first 40 minutes from the moment of admission, can significantly reduce the time of diagnosis and mortality in patients with acute ischemic stroke and viral pneumonia.
The aim of this work is to evaluate the universality of non-contrast MR perfusion (PCASL) in determining the rate of cerebral blood flow (CBF) of brain gliomas using magnetic resonance scanners with different magnetic field strengths. The maximum and normalized CBF values, which received on 1.5 and 3.0 T MRI in the same patients with histologically verified high grade gliomas (III, IV grade), were compared with each other. The data obtained by us are reliably comparable, which allows us to consider pCASL as a universal technique for scanners with different magnetic strengths.
MEDICAL TECHNOLOGIES
Purpose — to study the possibilities of clinical application of MR-myelography techniques in static and dynamic modes in patients with various neurological and neurosurgical pathologies accompanied by CSF dynamics disorders. On the Philips 1.5 and 3.0 T MRI scanners, an extended protocol for examination of patients with cerebrospinal fluid disorders was presented. The protocol includes, in addition to routine sequences (T1-, T2-WI, FLAIR), thin-slice MP-myelography in a static mode (CSF-DRIVE, 3DMYUR) with soft tissues signal suppression. Also, a cinema-technique of MR myelography (CSF-PCA) in the optimal projection and a phase-contrast method with a quantitative assessment of the cerebrospinal fluid flow at the pathology level and at adjacent levels were performed. The assessment of the diagnostic significance of the proposed research protocol was carried out. The extended study protocol was applied in patients with idiopathic normotensive hydrocephalus, obstructive hydrocephalus, Chiari malformation type I, in patients with syringomyelia at the level of the cervical spinal cord and showed high efficiency in assessing of cerebrospinal fluid dynamics in patients with a neurological and neurosurgical profile. The use of extended approach allows to more fully evaluate the state of the cerebrospinal fluid system, the patency of the cerebrospinal fluid (the presence of additional septa / membranes, partial / complete stenosis and narrowing), as well as preand postoperative morpho-functional changes.
The purpose of the study — to create an original algorithm of MR-morphometry for identifying FCD zones. Based on the use of the ANTs and FSL programs, an algorithm for MR morphometry was developed. It was used to generate maps of the z-index of the blur of the transition of gray and white matter and the thickness of the crust (Junction and thickness maps).
An algorithm for automatic detection of focal cortical dysplasia zones has been developed. The MRI morphometry method is a promising technique for additional assessment of pathological changes in focal cortical dysplasia.
CONTINUING MEDICAL EDUCATION
Traumatic brain injury (TBI) is the main cause of disability and mortality among young people, and neurological dysfunctions can persist many years after injury. One of the main type of TBI is diffuse axonal injury (DAI). The prevalence of diffuse axonal injury is often underestimated in computed tomography (CT) and routine magnetic resonance imaging (MRI). In such cases, diffusion-tensor MRI (DT MRI) and diffusion-kurtosis MRI (DK MRI) provide additional information about the integrity of the brain tissue, which cannot be obtained using standard MRI. In this review, we examined the contribution of DT MRI and DK MRI methods to understanding the pathophysiology and prognosis of DAI to help experts interested in planning new studies and participating in the care of patients with TBI.
CLINICAL OBSERVATIONS AND BRIEF REPORTS
This paper presents a rare case of spinal arteriovenous metameric syndrome (SAVMS) with lesions localized in the lower thoracic spine with the presence of two closely spaced arteriovenous malformations intramedullary and extradural (intravertebral) localization. The possibilities of minimally invasive contrast dynamic MR-angiography (TRICKS) in the diagnosis of the main components of vascular malformations and in determining the level of their arterial blood supply have been demonstrated.
Venous angioma is a common developmental abnormality of the cerebral venous vessels. Usually, this pathology is not accompanied by any symptoms and is detected accidentally during MRI studies conducted for other reasons. In our article, we present a rare clinical case when venous angioma caused symptoms due to its location, which led to the development of the aqueductal stenosis.
