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Objective: To evaluate the results of diagnosis and treatment of patients with cerebrovascular diseases (CVD) using modern technologies Methods: The results of the diagnosis and treatment of 105 patients with CVD for the period from January 2018 to May 2022 were evaluated. The age of the patients ranged from 10 to 75 years. The Glasgow Coma (GCS) and Hunt-Hess (HHS) Scales were used to assess the severity of the disease. In patients with arteriovenous malformation (AVM), the Spetzler-Martin grading scale was used to determine the size, location, and drainage into the deep cerebral veins. The Fisher scale was used in all cases of subarachnoid hemorrhage (SAH). Additional research methods included computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA). Results: Of the 105 patients, operations were performed in 55, the remaining 50 patients underwent conservative treatment (due to refusal of surgery). The main reasons for the development of non-traumatic intracranial hematomas (NICH) were: hypertension – in 30 (28.5%) cases, arterial aneurysm (AA) – in 12 (11.4%) cases, AVM – in 20 (19.5%) cases and other causes in 8 (7.6%) patients. Out of 38 (69.1%) patients operated on during the acute period, 5 (9.1%) underwent surgery during the first 5 days, while 12 (21.8%) – were operated on within 10-14 days. The following interventions were performed: external ventricular drainage – 10, removal of blood clots from the basal cisterns – 1, clipping of vessels – 7, and decompressive craniotomy – 37. In the group of operated patients, mortality was 9.1% (5 patients); mortality in the conservative treatment group constituted 40% (20 patients). Conclusion: The wider use of modern and highly informative imaging methods resulted in increased detection of asymptomatic AVMs and AA. This, in turn, contributed to the application of adequate treatment techniques in a relatively safe period of the disease, thereby reducing the frequency of deaths and serious complications.

The presented literature review shows up-to-date information about the possibilities and new methods of magnetic resonance angiography in patients with cerebral aneurysms who have undergone surgical treatment. The articles for analyses have been taken from the PubMed database. The most important aspects of the implementation and the possibilities of improving magnetic resonance angiography protocols for visualization and postoperative control of treated cerebral aneurysm have been considered.

This study aims to determine the existing pathways of collateral cerebral circulation in parasagittal meningiomas that cause superior sagittal sinus occlusion based on literature review and analysis of own clinical observations. Results of clinical and instrumental examination of 221 patients treated in Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov from 2000 to 2021 were subjected to retrospective and prospective analysis. Inclusion criteria were:patient age of 18+, parasagittal extracerebral tumor according to computed tomography/magnetic resonance imaging, histologically verified meningioma, superior sagittal sinus occlusion (type V-VI according to M.P. Sindou and J.E. Alvernia) according to selective cerebral angiography. This study is based on the analysis of examination of 43 patients who met the inclusion criteria. The selected patients were analyzed for demography (sex, age), brain computed tomography/magnetic resonance imaging before and after intravenous contrast enhancement, and computed tomography angiography and selective cerebral angiography data. Transformed venous drainage pathways were analyzed depending on the location of superior sagittal sinus occlusion by parasagittal meningioma: anterior, middle, or posterior third of the superior sagittal sinus. It was determined that preoperative diagnosis of parasagittal meningiomas that, based on brain computed tomography/magnetic resonance imaging, has signs of type V or VI superior sagittal sinus invasion according M.P. Sindou and J.E. Alvernia, must include selective cerebral angiography. Dynamic images of selective cerebral angiography in the venous phase allows to fully assess the established pathways of collateral blood flow and the blood flow direction. Information on collateral venous circulation in case of superior sagittal sinus occlusion by parasagittal meningioma is extremely important in a surgery planning. It helps avoiding iatrogenic damage to eloquent veins, which increases radical tumor removal with maintaining/improving a patient’s functional state in the early postoperative period and improving long-term treatment outcomes. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Juvenile angiofibroma is a rare neoplasm of the nasopharynx. It occurs almost exclusively in boys during adolescence. It is a richly vascularized neoplasm which, despite its benign histopathological character, tends to invasive growth and recurrence. The aim of the study is to review current data on juvenile angiofibroma.Brief description of the state of knowledge: Juvenile angiofibroma primary develops on the posterolateral wall of the nasal cavity, growing out of the wedge-palatal opening. Common symptoms resulting from its location, there are bleeding and nasal obstruction. Tumor diagnosis is based in imaging tests - CT and MRI, in which juvenile angiofibroma exhibits some distinctive features. CT and MR examinations demonstrate the typical the location and route of spread of juvenile angiofibroma and allow to assess the extent of the tumor. The angiography allows for confirmation diagnosis of a vascular tumor and enables preoperative embolization. Surgical treatment is the most common therapeutic procedure and irradiating the tumor, depending on its location. Due to the vascularnature of the tumor, the basic preoperative procedure is tumor vessel embolization, which allows reducing blood loss during surgery.Conclusions: Juvenile angiofibroma shows some characteristic features - it occurs at a similar age, in one sex and in one localization in the organism. Due to the invasive tumor growth, the risk of bone destruction and relapse, the role of imaging tests is important, allowing the diagnosis of a tumor at an early stage of its development.

Objective. To investigate the morphological characteristics of ruptured aneurysms in a group of patients under and over 50 years of age. Material and methods. The investigation enrolled 123 people with ruptured saccular cerebral aneurysms, in whom digital subtraction angiography was carried out in 2011 to 2015. The study took into account the localization of aneurysms, the diameter of the aneurysm dome, the diameter of the aneurysm neck, the axial size of the aneurysmal sac, the distance from the aneurysm neck plane to the aneurysm dome measurement plane, dome-to-neck ratio, axial dimension-to-neck diameter ratio, and aneurysm volume. Results. The diameter of the aneurysm dome (Mann–Whitney U (60; 63)=1384.0; p=0.01), that of the aneurysm neck (U (60; 63) = 1283; p=0.002), aneurysm volume (U (60;63) = 1244.5; p=0.001) were statistically significantly higher in the older age group with a positive correlation with the age of patients. Conclusion. The older age group patients with ruptured cerebral aneurysm had high values of dome and neck diameters and aneurysm volume with a positive correlation between these indicators and the age of patients.

The aim of this study was a comparison of diagnostic efficacy of non contrast enhanced MR-angiography (MRA) and CT-angiography (CTA) with digital subtraction angiography (DSA) in patients with atherosclerotic lesions of internal carotid arteries. We examined 70 patients with stenosis of carotid arteries. A stenosis degree of more than 50% (assessed by DSA) was considered as hemodynamically significant. Besides neurological survey the examination of extracranial arteries was performed, whichincluded MRA, CTA and DSA. In each case we analysed a plane on which a degree of a stenosis was assessed as maximum. To characterize each modality we evaluated sensitivity, specificity and positive predictive value. A coincidence rate for CTA and DSA was 95%, for MRA and DSA 89%. We can conclude that CTA and MRA can be use for an appropriate evaluation of stenosis of interna carotid arteries.

ABSTRACT. The digital subtraction aortic arteriography with the transaxillar venous approach was successfully performed in a patient with multifocal atherosclerosis and inability to underwent any transarterial procedures. Fine-quality angiographic images of the thoracic and abdominal aorta and the arteries of lower extremities were obtained. The total volume of the injected non-ionic contrast medium Ultravist-370 was 210 ml.