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Section 6. Medical science
researches noted that ligature of the anterior one third of the sag-gital sinus can cause venous ischemia ofbrain matter and secondary lesion of brain, the result of which can be lethal outcome in some cases [6]. In the studies of Romani R. group of other researchers (2011, 2012) it was also noted that injure and ligature of the anterior one third of the saggital sinus and anterior collector cerebral veins significantly increase the risk of postoperative edema of brain matter and venous infarction of brain [8; 9].
In spite of the fact, that LSO approach was easy, fast, less traumatic and preserving the anatomical integrity, as well as all other
approaches had its shortcomings, such as impossibility of circle of Willis posterior part upper segment aneurysm exposure and shortcomings fir giant aneurysms of brain.
Conclusions. Thus, lateral supra orbital approach can be used as an alternative for classic approaches in surgery of circle of Willis anterior circulation aneurysm. And it diminishes not only the time of operative intervention, but also lesions of anatomic structures. It does not cause cosmetic defects during postoperative period and, what is the most important, diminishes grinding of scull base and the risk of complications linked with that procedure.
References:
1. Al-Mefty O., Anand VK.: Zygomatic approach to skull-base lesions. J. Neurosurg. 1990 73: 668-673.
2. Figueiredo E.G., Deshmukh P., Zabramski J.M., Preul M.C., Crawford N.R., Spetzler R.F.: The pterional-transsylvian approach: an analytical study. Neurosurgery. 2008 Jun; 62 (6 Suppl 3): 1361-7.
3. Gonzalez L.F., Zabramski J.M.: Anatomic and clinical study of the orbitopterional approach to anterior communicating artery aneurysms. Neurosurgery. 2004 Apr; 54 (4): 1031-2.
4. Hernesniemi J., Ishii K., Niemela M., Smrcka M., Kivipelto L., Fujiki M., Shen H.: Lateral supraorbital approach as an alternative to the classical pterional approach. Acta Neurochir Suppl. 2005; 94: 17-21.
5. Krayenbuhl N., Isolan G.R., Hafez A., Ya^argil M.G.: The relationship of the fronto-temporal branches of the facial nerve to the fascias of the temporal region: a literature review applied to practical anatomical dissection. J. Neurosurg. Rev. 2007 Jan; 30 (1): 8-15.
6. Nakamura M., Roser F., Struck M., Vorkapic P., Samii M.: Tuberculum sellae meningiomas: clinical outcome considering different surgical approaches. Neurosurgery. 2006 Nov; 59 (5): 1019-28.
7. Reisch R., Perneczky A., Filippi R.: Surgical technique of the supraorbital key-hole craniotomy. Surg. Neurol. 2003 59: 223-227.
8. Romani R., Laakso A., Kangasniemi M., Lehecka M, Hernesniemi J.: Lateral supraorbital approach applied to anterior clinoidal meningiomas: experience with 73 consecutive patients. Neurosurgery. 2011 Jun;68 (6): 1632-47.
9. Romani R, Laakso A, Kangasniemi M, Niemela M, Hernesniemi J.: Lateral supraorbital approach applied to tuberculum sellae meningiomas: experience with 52 consecutive patients. Neurosurgery. 2012 Jun;70 (6): 1504-18.
10. van Lindert E., Perneczky A., Fries G., Pierangeli E.: The supraorbital keyhole approach to supratentorial aneurysms: concept and technique. Surg. Neurol. 1998 49: 481-490.
11. Zabramski J.M., Kiris T., Sankhla S.K., Cabiol J., Spetzler R.F.: Orbitozygomatic craniotomy. J. Neurosurg. 1998 Aug. 89: 336-341.
Masharipov Fakhriddin Ataevich, Musayev Tahir Sadikovic, Dadamyants Natalia Gamletovna, Nizov Oleg Nikolayevich,
Akhmedov Rustam Alimdzhanovich
Republican research Centre of Emergency Medicine (RRCEM)
Tashkent, Uzbekistan
Dynamics of brachial artery blood flow indexes at complicated transcondylar and supracondylar humeral fractures in children
Abstract: Surgical treatment results 51 children with trans- and supracondylar humeral bone fractures complicated by brachial artery injuries. Main clinical symptoms, significance of applying up-to-date technologies (pulsioxymetry, color duplex scanning) in diagnostics of brachial artery injuries and peculiarities of blood flow dynamic control on injured limb in the post-operative period have been illustrated. At well-timed diagnostic and active surgical correction of injured brachial artery peripheral circulation on injured limb has been recovered in 96,5% of cases.
Keywords: trans — and supracondylar humeral bone fractures, brachial artery injury, blood circulation disorder, pulsioxymetry, color duplex scanning.
Introduction
Trans- and supracondylar humeral fractures in children are not only the most frequent but they are the most serious bones injuries which can be complicated by neurovascular column injury. By different authors' data trans- and supracondylar humeral fractures in children from 2 to 14% cases can be complicated by neurovascular
column interposition which provokes limb ischemia and peripheral nerves disorders [1; 2; 5; 8]. Victims are performed closed reposition or bones fragments operative stabilization by emergency indication, but vessels and nerves injuries are revealed later when nonreversible changes have already developed in the limb. Majority of authors [3; 4; 6; 7] think that these injuries refer to a special
