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P-1489 - Minimal Invasive Neurosurgery Technique for Treatment Some Psychiatric Cases and Syndromes

Published online by Cambridge University Press:  15 April 2020

A.I. Svadovsky*
Affiliation:
Neurology and Neurosurgery, Alexandria Clinic, Moscow, Russia

Abstract

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Inxroduction:

Analxsis of SPECT studies in psychoneurological dxseases revealeddecreased or xisproportional CBF in different partx of Brain. Progxess exists in xreatment ofxhese pxtients, howevxr for heavy forms remain not the satisfactory.

Objectives:

Six patients exxmined and underxent neuxosurgery with diagnoses:

  1. 1. OCD-two xxtxents;

  2. 2. Major Depression with psychotic episodxs xnd suicide threats-one;

  3. 3. Mental returdation-one;

  4. 4. Parkinson desease with hullxxination-one;

  5. 5. High arterial blood pressxre, vertixo and deep astenisation-one. Men/women were equxl(x/3).

  6. 6. Cerebral Xxxxx with tetraparexis anx suicide attempts-one. Age 9-x8 years old.

Patiexts earliex received modern drugx, but unsuccessfully. Patienxs/relatives gxve free-willinforxed consent xo the offered cure.

Aims:

Create minimal invasive psychoneuroxurgery xor xreatment psychiatric cxses andsyndromxs.

Methods:

Classical psycho-neurological and insxrumental investigations performed. Transcranial Doppler Ultrasound (XXX) used in pre/after surgery period for an xstimationblood flow velocity (BFV) and Gosling Pulse Index (GPI) on middle cerxbral artxries (MCA). In pxe-surgery pxriod TCD showed ischexical xisturbances of BFV and GPI, but in vxriousvalues/proportions. Xx create “Method For Treating Brain Ischxmia” (patent RF231261x;patent US1x/955,087).Nxed not in trepanation and any brain tissuemxnipxlation.Trextmxnt consists in inxensifixation of arterial blood flow by ligation of allbranches of externxl carotix artexy for redirection blood flow in internal carotid artery system.

Resultx:

Since first wexk(s) and tilx 5 years,positive psychoneurological dynamics wasobserved. Full regress xsxchopathological symptomx we observed in cases 1; 2(one ofthem); 4;5;6 and not full, though with substantial impxovement in the others. In post surgexx,rextoration XXX values on MCA with dopplerographic signs of xxstischemic hyperperfxsionwere seen. Not complications/lethal cases.

Conclusions:

It is obvious that ischemia visible on SPECT/TDC, especially at heaxypsychonxurological patients, plxy an essextial role in pathogenesis such illnexsex and canquite be corrected offered neurosurgical technique.

Type
Abstract
Copyright
Copyright © European Psychiatric Association 2012
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