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This article is dedicated to a controversial topic for Russian society, namely the campaign #%HeBomcbCKa3amb (#IamNotAfraidToSpeak) that took place in VKontakte's Russian speaking community in July 2016. First the article is based on a theoretical framework that draws attention to the concept of contentious politics and feminist movement. Second, I analysed the messages associated with #IamNotAfraidToSpeak, and argue that the campaign raised the visibility of the problem of domestic violence and patriarchal culture in the post-Soviet Russia, and this helped increase the significance of women's linguistic agency and made #IamNotAfraidToSpeak the first large-scale feminist movement in Russia. Moreover, in addition to the theoretical background, the paper focuses on a case study: The #%HeBomcbCKa3amb(#IAmNotAfraidToSpeak) campaign of July 2016 on VKontakte. Keywords: gender-based violence in Russia, feminist movements, former Soviet, flashmob, #IamNotAfraidToSpeak, VKontakte., Introduction The campaign #[phrase omitted] (in English #IamNotAfraidToSpeak) started on Russian VKontakte on July 5, 2016. The hashtag initially appeared in Ukraine, when activist Anastasia Melnychenko encouraged women to fight [...]

The paper analyses the concept of Russian Idea used by Russian nationalists. A concept that is at the core of the identity of the Russian people. Accordingly, the analysis is based on a theoretical framework that draws attention to the controversial concept of the Russian idea that is reviewed considering changes in the history of the Russian state. Whether formulated by church hierarchs, statesmen, philosophers, ethnologists, or contemporary politicians, various stages in its conceptualization have helped build patriotism in the country. Moreover, in addition to the theoretical framework, the paper focus on a case study: the February Revolution, known as February Bourgeois Democratic Revolution or the March Revolution (8-16 March 1917). Keywords: Russian Idea, ideology, post-Soviet, chauvinism, imperialism, Introduction It is difficult to speak about the concept of Russian Idea: the adherents of this concept were and are opponents and at times even political adversaries. There has been [...]

Background: Brain arteriovenous malformations (AVMs) are challenging vascular lesions. Extensive follow-up studies are necessary to refine the therapeutic algorithm, and to improve long-term survival in these patients. The aim of the study was to assess surgical outcomes, and to evaluate overall long-term mortality in patients treated for brain AVMs. Methods: This retrospective single-center study included 191 patients with brain AVMs, admitted between 2012 and 2022. Clinical and angiographical particularities have been analyzed, to identify factors that might influence early outcome and overall long-term mortality. Results: Out of 79 patients undergoing surgery, 51 had ruptured AVMs with total resection achieved in 68 cases (86.1%). Deep venous drainage was associated with incomplete resection. Female sex, admission modified Rankin Scale (mRS) > 2, and eloquent location were independent predictors of poor outcomes. Multiple venous drainage was associated with a higher risk of worsened early outcome. Eloquent brain region involvement, conservative treatment, increasing age, admission mRS > 2, and comorbidities significantly decrease survival in brain AVM patients. Patients treated with interventional treatments had significantly better survival than the conservatively managed ones, when adjusting for age and admission mRS. Conclusion: The study identified female sex, poor neurologic status on admission and eloquence as independent prognostic factors for a negative outcome after surgery. Patients who received interventional treatment had significantly better survival than patients managed conservatively. We recommend employing tailored, proactive management strategies as they significantly enhance longterm survival in brain AVM patients. [ABSTRACT FROM AUTHOR]

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating adverse effect of bisphosphates, antiresorptive therapy or antiangiogenic agents that can potentially increase oxidative stress, leading to progressive osteonecrosis of the jaws. Despite the large number of published systematic reviews, there is a lack of potential MRONJ treatment protocols utilising photobiomodulation (PBM) as a single or adjunct therapy for preventive or therapeutic oncology or non-oncology cohort. Hence, this systematic review aimed to evaluate PBM laser efficacy and its dosimetry as a monotherapy or combined with the standard treatments for preventive or therapeutic approach in MRONJ management. The objectives of the review were as follows: (1) to establish PBM dosimetry and treatment protocols for preventive, therapeutic or combined approaches in MRONJ management; (2) to highlight and bridge the literature gaps in MRONJ diagnostics and management; and (3) to suggest rationalised consensus recommendations for future randomised controlled trials (RCTs) through the available evidence-based literature. This review was conducted according to the PRISMA guidelines, and the protocol was registered at PROSPERO under the ID CRD42021238175. A multi-database search was performed to identify articles of clinical studies published from their earliest records until 15 December 2023. The data were extracted from the relevant papers and analysed according to the outcomes selected in this review. In total, 12 out of 126 studies met the eligibility criteria. The striking inconsistent conclusions made by the various authors of the included studies were due to the heterogeneity in the methodology, diagnostic criteria and assessment tools, as well as in the reported outcomes, made it impossible to conduct a meta-analysis. PBM as a single or adjunct treatment modality is effective for MRONJ preventive or therapeutic management, but it was inconclusive to establish a standardised and replicable protocol due to the high risk of bias in a majority of the studies, but it was possible to extrapolate the PBM dosimetry of two studies that were close to the WALT recommended parameters. In conclusion, the authors established suggested rationalised consensus recommendations for future well-designed robust RCTs, utilising PBM as a monotherapy or an adjunct in preventive or therapeutic approach of MRONJ in an oncology and non-oncology cohort. This would pave the path for standardised PBM dosimetry and treatment protocols in MRONJ management. [ABSTRACT FROM AUTHOR]

This article is dedicated to a controversial topic for Russian society, namely the campaign #ЯнеБоюсьСказать (#IamNotAfraidToSpeak) that took place in VKontakte’s Russian speaking community in July 2016. First the article is based on a theoretical framework that draws attention to the concept of contentious politics and feminist movement. Second, I analysed the messages associated with #IamNotAfraidToSpeak, and argue that the campaign raised the visibility of the problem of domestic violence and patriarchal culture in the post-Soviet Russia, and this helped increase the significance of women’s linguistic agency and made #IamNotAfraidToSpeak the first large-scale feminist movement in Russia. Moreover, in addition to the theoretical background, the paper focuses on a case study: The #ЯНеБоюсьСказать(#IAmNotAfraidToSpeak) campaign of July 2016 on VKontakte. [ABSTRACT FROM AUTHOR]

This article discusses the use of endoscopic spine surgery (ESS) as a minimally invasive alternative to traditional surgery for lumbar disc herniation. The article presents six successful cases using the interlaminar approach, with favorable postoperative outcomes. However, the article also highlights potential complications and the need for caution during the procedure. The document provides a detailed description of the technique, which involves specialized instruments and a 4K camera system. It emphasizes the importance of proper patient selection and surgeon skill for successful outcomes. [Extracted from the article]

The paper analyses the concept of Russian Idea used by Russian nationalists. A concept that is at the core of the identity of the Russian people. Accordingly, the analysis is based on a theoretical framework that draws attention to the controversial concept of the Russian idea that is reviewed considering changes in the history of the Russian state. Whether formulated by church hierarchs, statesmen, philosophers, ethnologists, or contemporary politicians, various stages in its conceptualization have helped build patriotism in the country. Moreover, in addition to the theoretical framework, the paper focus on a case study: the February Revolution, known as February Bourgeois Democratic Revolution or the March Revolution (8-16 March 1917). [ABSTRACT FROM AUTHOR]

Background. Hemangioblastomas are considered rare tumours that are located, in most cases, in the posterior cranial fossa. In most of cases, spinal hemangioblastomas are identified on the thoracic and cervical levels and can be associated in one-third of cases with von Hippel Lindau Syndrome. Material and methods. In this paper, we are presenting our clinic's experience with spinal hemangioblastomas and the follow-up of the patients in the last 10 years. Results. In our study, we included six men and three women with a mean age of 45 years, ranging between 36 to 61 years. The mean hospitalization days was 17 days. Among nine patients, there were identified 12 tumors. Six patients presented cervical spine hemangioblastomas, two of them had thoracic spine lesions and in one case, the tumour was identified at the lumbar level. Furthermore, two patients presented multiple lesions. Two patients had been associated with von Hippel Lindau Syndrome. In all cases, surgery was the therapeutic approach. Discussions. Despite the rapid advance of technology and the new alternatives for the treatment of these lesions, surgical resection of hemangioblastomas remains the gold standard treatment. Conclusions. Hemangiolbastomas are benign tumours that can be associated with von Hippel Lindau. A whole-body scan is required to confirm or exclude this syndrome. Even though the surgical treatment for asymptomatic patients remains debatable, surgical intervention is the only treatment that can lead to the total removal of the tumour. [ABSTRACT FROM AUTHOR]

OBJECTIVES Lumbar spinal stenosis is a common degenerative disease, most frequently encountered in the elderly. Lumbar stenosis is a progressive and dynamic process and is characterized by narrowing of the spinal canal due to multifactorial degenerative factors. Spinal stenosis leads to neurological deficits, severely impairing quality of life and requires surgical treatment. MATERIALS AND METHODS We performed a retrospective study including 560 consecutive patients with neurogenic claudication and back pain operated for central lumbar stenosis, in the Fourth Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni Bucharest, over a 5-year time period, from June 2014 to June 2019. 59,4% were female and 40,6% were male. Mean age was 66 years old. All patients were clinically and radiologically tested for instability with flexion-extension x-rays. All patients underwent unilateral laminectomy with bilateral spinal canal decompression. RESULTS Of the 560 patients included in our study all were considered "stable". All patients were operated using the unilateral transmedian subspinous approach with bilateral spinal canal decompression. 44.6% of patients were treated for multiple level stenosis. 55.4% were treated for single level stenosis. Postoperative check-ups did not reveal instability syndrome in any patient. Symptom remission was noted in 95.3% of cases. 4.7% of patients had reminiscent back pain that subsided with bed rest. CONCLUSIONS Lumbar stenosis requires surgical treatment. Quality of life is influenced by number of levels involved, pre-operative duration of symptoms, associated spinal pathology and surgical technique. The great majority of patients operated using unilateral laminectomy with bilateral spinal canal decompression experienced favorable results and symptom remission. Destabilization syndrome din not occur in any cases using this surgical technique. [ABSTRACT FROM AUTHOR]

OBJECTIVES Craniocerebral injuries are a global health problem and a challenge for the society. A significant problem in craniocerebral injuries are the skull fractures and their management. Rigid fixation of bone fragments in the process of repairing skull fractures may be difficult. The optimal method of reconstruction and fixation of the bone fragments remains a matter of discussion. MATERIALS AND METHODS We performed a retrospective study on a number of 972 patients with traumatic brain injury admitted in the Neurosurgery IV department of Bagdasar-Arseni Clinical Emergency Hospital, over a period of 5 years, between January 2014 and December 2018.Out of the total number of patients, 289 were also diagnosed with skull fractures. Out of all the surgeries performed, we present 3 representative patients. RESULTS A 50 years old male patient was brought in at the Emergency room with a craniocerebral trauma, GCS 12 points, tonico-clonical seizures. The CT exam showed a right parieto-occipital extradural hematoma, right parieto-occipital skull fracture and bilateral frontal brain concussions. The patient was operated, the extradural hematoma was evacuated and the fracture as realigned. A 29 years old male patient was brought at the Emergency room after having suffered a craniocerebral trauma by assault, GCS 13 p, accusing headaches, a right temporal skin wound and mild aphasia. The CT scan revealed a right extradural cerebral hematoma and a right temporal linear fracture. The extradural hematoma was evacuated. The bone flap was set back in place using 3 titanium clamps. The postoperative evolution was very good. A 24 years old patient presented for cranio-cerebral trauma by assault, being hit with an ax in the head. The patient had no neurological deficits, GCS 15 points and an occipital skin wound. The CT evaluation indicated a left occipital compound depressed fracture. The floating bone pieces were resected and the occipital fracture was reduced. There were no postoperative complications. CONCLUSIONS Complex skull fractures after brain injury can be a surgical challenge. However, the use of modern titanium clamps can help in reconstructing the normal anatomy of the affected area. [ABSTRACT FROM AUTHOR]

OBJECTIVES Brain metastases occur in advanced cancer patients and account for more than half of intracranial tumours in adults. Brain metastases require multimodal treatment. Prognosis is generally poor with low survival rate. MATERIALS AND METHODS We performed a retrospective study including patients with brain metastases operated, in two neurosurgical departments (Third and Fourth Departments of Neurosurgery), from Emergency Clinical Hospital Bagdasar-Arseni Bucharest, from January 2009 to December 2018. The aim of this study is to identify prognostic factors associated with survival rate. RESULTS A total number of 674 patients underwent surgery for brain metastases, over a period of time 10 years. Mean age at the time of diagnosis was 57 years and median age was 59 years. 63.4% were males and 36.6% females. The most common symptoms were intracranial hypertension in 39.1% cases, right hemiparesis 30.7% cases, aphasia 8.74%, left hemiparesis 7.7%, ataxia 5.8%, vertigo 2.56% and tonico-clonical seizures in 2.2% of patients. 46.8% of patients had no medical history of cancer. The most frequent location of primary tumour was pulmonary in 54.7% cases, followed by breast cancer in 22.6% and renal cancer in 5.7%. 22.8% of cases had multiple lesions. 26.2% of tumours were found in the right frontal lobe, 14.7% in the left frontal lobe, 11.47% parietal on left, 8.19% parietal on right, 4.9% in vermis. Total resection was obtained in 91.6% cases, subtotal resection in 1.5% and near total resection in 3%. Histopathological exam showed differentiated carcinoma in 52.38%, 23.8% adenocarcinoma, 19% low differentiated carcinoma, anaplastic carcinoma in 1.3% cases and melanoma metastases in 3.4. The outcome was favourable in 97% of patients and 3% were deceased.9.77% of patients also underwent gamma knife radiosurgery. During the long-term follow-up 5.2% of patients presented tumour recurrences and from these patients 85.7% of the recurrent tumours were resected and 14.3% benefit from gamma knife radiosurgery, with good outcome. CONCLUSIONS Survival in patients with brain metastases is poor. Survival rate is positively correlated with primary cancer site, primary cancer control, higher Karnofsky score at admission, location, number of cerebral metastases, rate of resection, leptomeningeal invasion and adjuvant oncologic treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVES Meningiomas, are usually slow growing tumours arising from the meninges, the membranous layers surrounding the central nervous system. These types of tumours typically grow inward, toward the brain. Furthermore, most of the times, these tumours respect the adjacent structures, invasive meningiomas being a seldom occurrence. MATERIALS AND METHODS Here we present a rare case of transitional meningioma invading the adjacent bone structure, periosteum and skin, the difficulties of the surgical procedure and particularities of the reconstruction of the anatomical layers in order to prevent further complications such as CSF leaks or infection. RESULTS A 71 years old male patient was admitted to our clinic presenting left hemiparesis, increased intracranial pressure syndrome and a right frontal deformation of the skull. The MRI investigation showed a massive fronto-temporal tumour developing both intra and extracranially, highly enhanced by gadolinium, completely destroying the bone at its level. The tumour was carefully resected from the periosteum, leaving only the subcutaneous layer and skin in place. Afterwards, the infiltrated bone was isolated and using ronguers, resection of the bone was achieved up to the level of normal tissue. The tumour was slowly disected from the normal dura mater and the brain. The tumour was adherent to the sylvian vessels. Reconstruction of the dural layer was conducted using synthetic Collagen, which was sutured as a double layer using the healthy dura edges as anchoring points. Due to the fact that the tumour was associated with cerebral edema, the decision of leaving decompressive craniectomy was made. The patient had a favourable postoperative evolution, with neurological improvement and no complications. The control CT scan showed total resection of the tumour. CONCLUSIONS The total resection of the tumoral process is preferred, but in order to maintain the functional anatomy of the region is mandatory to have a plan for reconstruction. [ABSTRACT FROM AUTHOR]

OBJECTIVES Almost 20% of all carcinomas of unknown primary site are classified as high grade tumours. With a wide variety of neoplasms being able to metastasize to the skull, the present histopathologic diagnostic techniques are not enough to clearly indicate the primary tumour. Skull metastases are diagnosed in 15-20% of all cancer patients. MATERIALS AND METHODS We report a case of very large multiple metastases in the skull of a 60 years old male patient with no medical history of neoplasms. RESULTS A 60-years old male is admitted to the hospital presenting two cranial tumours, the first of which located parieto-occipital on the right side and the second one frontal on the left side. The neurological examination was normal. We performed investigations that indicated two large osteolytic lesions. The right parieto-occipital one measured 71/73/18 mm and the left frontal one 95/30/17 mm. The frontal tumour was excised during the first surgical intervention, leaving a large bony defect. The dura mater was extremely infiltrated; thus, the lesion was dissected as much as possible while leaving the dura in place. The histopathological examination indicated a poorly differentiated carcinoma metastasis (high grade carcinoma). The right parietooccipital lesion was resected during a second surgical intervention, three weeks after the first one. After removing the tumoral mass, the dura mater appeared infiltrated, similar with the previous intervention. The histopathological examination result was the same with the first one, positive for poorly differentiated carcinoma metastasis. The patient was evaluated with a thoracic CT scan looking for a primary lesion. This investigation revealed a right hilar broncho-pulmonary lesion, most likely the primary tumour that metastasized to the skull. There were no postoperative complications and the patient was referred to an Oncology Hospital and also to the Thoracic Surgery Department. CONCLUSIONS Skull metastases are usually asymptomatic and may sometimes be the first or the only evidence of the malignancy. Positive diagnosis of skull metastases requires extensive examination in order to find the primary tumours. Brain metastases require multimodal treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVES Spondylolisthesis is a degenerative disease, characterized by forward slippage of a lumbar vertebra on the vertebral body below. Treatment of degenerative spondylolisthesis is still controversial. Vertebral instability is sometimes associated with degenerative spndylolisthesis which is why the surgical treatment with vertebral fixation still needs careful consideration. MATERIALS AND METHODS We performed a retrospective study including patients with operated degenerative spondylolisthesis from Fourth Departments of Neurosurgery), Emergency Clinical Hospital Bagdasar-Arseni Bucharest, from January 2014 to December 2018. The aim of this study is to assess postoperative results of two main surgical techniques, posterior decompression of neural elements alone and decompression followed by spinal stabilization +/- fusion. RESULTS A total number of 560 patients were operated for spondylolisthesis over a 5-year time period. Male/female ratio was 1.2. All patients underwent functional examination using radiography of the spine, lumbar region (flexion/extension) and were categorized in two main groups: patients with vertebral column instability and patients with vertebral column stability. 24% patients had decompression only and 76% of patients had decompression plus stabilization, of which 15% with fusion. Both surgical techniques were associated with favourable outcome, pain relief and neurological improvement. Early mobilization was possible in 80% of cases, most of these patients belonging to the decompression and spinal stabilization group. CONCLUSIONS Surgery is the treatment of choice in patients with symptomatic spondylolisthesis. Outcome is dependent on surgical technique. Decompression plus stabilization permits early mobilization of patients and is associated with shorter hospitalization. [ABSTRACT FROM AUTHOR]

Vascular complications succeeding anterior cervical spine surgery are rare, but their consequences represent a major burden for the patient. Cerebral infarction following anterior cervical discectomy and fusion (ACDF) is uncommon. However, screening for risk factors before surgery should become mandatory. We present the case of a patient with no significant medical history who underwent ACDF for a C5/C6 herniated disc with myelopathy. Although the surgery was uneventful, after the surgery, partial right palpebral ptosis and miosis were noted, suggestive of Horner syndrome. On the fifth postoperative day, the patient experienced left hemiplegia and drowsiness. An emergency CT scan and cerebral MRI revealed ischemia in the right middle cerebral artery territory. The patient was transferred to a neurology center for mechanical thrombectomy, which revealed a complete occlusion of the right internal carotid artery. The procedure had to be halted due to blood extravasation at the internal carotid artery bifurcation to prevent further complications. An angio-CT examination of the cervical arteries exposed a soft atheromatous plaque on the right internal carotid artery, immediately after the bifurcation. Despite the patient having no significant medical history, blood tests indicated dyslipidemia. At the two-month follow-up, the patient remained hemiplegic, with mild dysphasia. Performing carotid and vertebral Doppler ultrasound before cervical spine surgery might be useful, whenever possible, to assess high-risk factors for ischemic events and avoid such debilitating complications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Butnariu et al.)

Background/Objectives: Approximately half of the patients harboring supratentorial brain arterio-venous malformations (stAVMs) present with hemorrhage, and another considerable proportion suffer from epileptic seizures. An important milestone in the management of this vascular pathology is acknowledging their natural history, especially across long periods of time. The aim of this study was to assess the predictive factors for hemorrhage and for epileptic seizures as presenting symptoms in stAVMs. Methods: We retrospectively analyzed patients with stAVMs admitted to our institution between 2012 and 2022 and evaluated predictive factors for hemorrhage and the risk factors associated with epileptic seizures. Results: The cohort included 169 patients, 78 of them (46.2%) presenting with intracerebral hemorrhage (ICH). Seventy-seven (45.5%) patients suffered from epileptic seizures. The annual hemorrhagic rate was 1.28%/year. Unruptured lesions ( p = 0.001, OR 3.1, 95% CI 1.6-6.2), superficial venous drainage ( p = 0.007, OR 2.7, 95% CI 1.3-5.7) and large nidus size ( p = 0.025, OR 4, 95% CI 1.2-13.5) were independently associated with seizures. Among unruptured lesions, superficial venous drainage (OR 2.6, p = 0.036, 95% CI 1.06-6.3) and frontal/temporal/parietal location (OR 2.7, p = 0.040, 95 CI% 1.04-6.9) significantly increased the risk of seizures as a presenting symptom in multivariate analysis. Patients younger than 18 ( p = 0.003, OR 4.5, 95% CI 1.6-12.2), those with AVMs < 3 cm ( p = 0.03, OR 2, 95% CI 1.07-3.9) or those with deep located AVMs ( p = 0.035, OR 2.3, 95% CI 1.06-5.1) presented statistically more often with ICH in multivariate regression. Small size (HR 1.8, 95% CI 1.09-3, p = 0.022) and exclusively deep venous drainage (HR 2.2, 95% CI 1.2-4, p = 0.009) were independent predictors for ICH, in time-dependent birth-to-diagnosis analysis. After shifting the birth-to-diagnosis curve by 10 years, unique arterial feeder demonstrated a positive correlation with ICH presentation as well. Conclusions: Small AVMs, those with exclusively deep venous drainage, unique arterial feeder or deep location may pose higher hemorrhagic risks for the patient, and therapeutic strategies should be tailored accordingly. When managing unruptured brain AVMs, it is important to consider the risk of developing seizures, in addition to the lifelong risk of hemorrhage, in determining the optimal treatment approach for each patient.