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Article: Khirurgicheskoe lechenie epilepsii u bol'nykh s gipotalamicheskimi gamartomami.

Melikyan, A G

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2022 Volume 86, Issue 4, Page(s) 83–88

Abstract: The purpose of this review was to analyze the current ideas about various techniques and methods for treating epilepsy in patients with hypothalamic hamartomas including microsurgery, endoscopy, radiofrequency thermal destruction, stereotactic laser ... ...

Title translation	Surgical treatment of epilepsy in patients with hypothalamic hamartomas.
Abstract	The purpose of this review was to analyze the current ideas about various techniques and methods for treating epilepsy in patients with hypothalamic hamartomas including microsurgery, endoscopy, radiofrequency thermal destruction, stereotactic laser ablation and radiosurgery. Data characterizing their effectiveness, limitations and complications are considered. Conclusion: When choosing the optimal treatment option, it is necessary to take into account patient age and course of disease, anatomical and topographic features of hamartoma location, previous attempts of treatment, opinion of the patient and his guardians, as well as surgical experience.
MeSH term(s)	Epilepsy/etiology ; Epilepsy/surgery ; Hamartoma/complications ; Hamartoma/surgery ; Humans ; Hypothalamic Diseases/complications ; Hypothalamic Diseases/surgery ; Magnetic Resonance Imaging ; Radiosurgery/methods ; Treatment Outcome
Language	Russian
Publishing date	2022-08-05
Publishing country	Russia (Federation)
Document type	Journal Article ; Review
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro202286041
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Article: Stereoelektroentsefalografiya. Kratkii istoricheskii ocherk i obzor sovremennykh metodov implantatsii glubinnykh elektrodov, ispol'zuemykh dlya diagnostiki i lecheniya epilepsii.

Khapov, I V / Melikyan, A G

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2021 Volume 85, Issue 2, Page(s) 99–106

Abstract: More than 30% of patients with symptomatic epilepsy are resistant to drug therapy and therefore surgical treatment is the method of choice for such patients. Search and localization of the epileptogenic zone and all parts of the neural networks involved ... ...

Title translation	Stereoelectroencephalography (seeg): a brief historical review of modern deep electrode implantation methods used for diagnosis and treatment of epilepsy.
Abstract	More than 30% of patients with symptomatic epilepsy are resistant to drug therapy and therefore surgical treatment is the method of choice for such patients. Search and localization of the epileptogenic zone and all parts of the neural networks involved in stereotypic seizures are the most important objectives of pre-surgical evaluation and the prerequisite for the successful surgery. In the last decade, stereotactic implantation of multiple intracerebral multi-contact electrodes (SEEG) has been increasingly used for this purpose. The article includes a brief history of SEEG and a description of the major techniques for stereotactic implantation of electrodes. Information on accuracy (errors and deviations from planned target) and on complications are summarized. The data on the clinical value of the method and how these data affected the results of subsequent treatment are highlighted. The method of thermocoagulation and its results are briefly considered.
MeSH term(s)	Drug Resistant Epilepsy/diagnosis ; Drug Resistant Epilepsy/surgery ; Electrodes, Implanted ; Electroencephalography ; Epilepsy/diagnosis ; Epilepsy/surgery ; Humans ; Seizures ; Stereotaxic Techniques
Language	Russian
Publishing date	2021-04-17
Publishing country	Russia (Federation)
Document type	Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro20218502199
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Article: Mikrokhirurgicheskaya rezektsiya gipotalamicheskikh gamartom s transkalleznym transforaminal'nym dostupom.

Melikyan, A G / Vlasov, P A / Trunin, Yu Yu

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2022 Volume 86, Issue 4, Page(s) 5–13

Abstract: Objective: Transcallosal transseptal interforniceal approach is recognized as the most appropriate route to resect sessile hypothalamic hamartomas but individuals with obliterated cavum septi pellucidi may pose difficulties to access these lesions ... ...

Title translation	Hypothalamic hamartoma microsurgical resection using transcallosal transforaminal approach.
Abstract	Objective: Transcallosal transseptal interforniceal approach is recognized as the most appropriate route to resect sessile hypothalamic hamartomas but individuals with obliterated cavum septi pellucidi may pose difficulties to access these lesions safely. Material and methods: Six patients aged 8-34 years (med - 15.5) with the rather small (medial volume - 1.2 cm Results: Early postop course was uneventful in all cases. Total or near total lesion removal was revealed on post-surgery images in cases with Type II hamartomas. No one of patients with ligated septal veins exhibited any signs of venous infarcts. Median known FU is 3 years (14 months - 5 years). Three patients were free of every seizure at the last check (50%). Two other patients nevertheless persisting mild recent memory deficit, were able to live independently and reported rare non-disabling events. AE-medication was discontinued in 2 patients, in other three cases it was tapered and simplified. Conclusion: In a subset of carefully selected patients with rather small Delalande-Type II sessile hypothalamic hamartomas in case of obliterated Cavum Septi Pellucidum the transcallosal transforaminal approach may be attempted in alternative to conventionally used transseptal interforniceal route with similar outcome and acceptable morbidity.
MeSH term(s)	Drug Resistant Epilepsy/surgery ; Hamartoma/diagnostic imaging ; Hamartoma/pathology ; Hamartoma/surgery ; Humans ; Hypothalamic Diseases/diagnostic imaging ; Hypothalamic Diseases/pathology ; Hypothalamic Diseases/surgery ; Neurosurgical Procedures/methods
Language	Russian
Publishing date	2022-08-05
Publishing country	Russia (Federation)
Document type	Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro2022860415
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Article: Perekrestnaya afaziya (Crossed aphasia) v neirokhirurgicheskoi praktike: opisanie sluchaev i obzor literatury.

Buklina, S B / Kaftanov, A N / Melikyan, A G / Kopachev, D N / Batalov, A I

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2022 Volume 86, Issue 1, Page(s) 103–111

Abstract: Background: Crossed aphasia in dexstral (CAD) is an extremely rare disorder. To date, about 200 cases have been described in the literature.: Material and methods: The authors report 4 cases of CAD. Luria's neuropsychological examination was carried ... ...

Title translation	Crossed aphasia in neurosurgical practice: case report and literature review.
Abstract	Background: Crossed aphasia in dexstral (CAD) is an extremely rare disorder. To date, about 200 cases have been described in the literature. Material and methods: The authors report 4 cases of CAD. Luria's neuropsychological examination was carried out. Functional asymmetry in the arm was analyzed using the Annett questionnaire. MRI and intraoperative findings confirmed localization of lesion in the right hemisphere in all patients. Results: A 59-year-old right-handed man developed frontotemporal aphasia after previous resection of right-sided glioblastoma of fronto-insular-temporal region. In a 31-year-old right-handed man, crossed aphasia occurred after extensive hemorrhage from arteriovenous malformation into the right frontotemporoparietal region. A 39-year-old right-handed man developed severe combined aphasia after resection of diffuse glioma of the right insular-temporal region. A 10-year-old right-handed boy developed aphasia with word forgetting after resection of a large tumor of the right temporal lobe. All patients had impaired dynamic praxis. Other cognitive functions were intact. Conclusion: The authors discuss possible combinations of functions in one hemisphere for both right-handers and left-handers and emphasize diverse types of functional asymmetries described in the literature. Different localizations of functions in right-handers and left-handers indicate that local zones with different methods of information processing (successive or simultaneous) can coexist in one hemisphere. Therefore, the functions requiring different processing of information (for example, speech with praxis or spatial functions) can develop in one hemisphere. Cognitive impairment depends not only on the type of functional asymmetry, but also on localization of lesion. Crossed aphasia in right-handers indicates the rarest normal type of functional brain asymmetry with localization of speech functions in the right hemisphere. Possible aphasia in right-handers following damage to homologues of speech zones in the right hemisphere can require additional examination of these patients.
MeSH term(s)	Adult ; Aphasia/diagnostic imaging ; Aphasia/etiology ; Brain ; Child ; Functional Laterality ; Glioma/complications ; Glioma/diagnostic imaging ; Glioma/surgery ; Humans ; Male ; Middle Aged ; Temporal Lobe
Language	Russian
Publishing date	2022-02-15
Publishing country	Russia (Federation)
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro202286011103
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Article: Khirurgicheskoe lechenie epilepsii u detei s tuberoznym sklerozom.

Melikyan, A G / Kozlova, A B / Vlasov, P A / Dorofeeva, M Yu / Shishkina, L V / Agrba, S B

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2023 Volume 87, Issue 2, Page(s) 5–16

Abstract: Most children with tuberous sclerosis (TS) present with intractable seizures. Various factors including demography, clinical data and surgery option are mentioned to affect the outcome after epilepsy surgery in these cases.: Objective: To evaluate ... ...

Title translation	Epilepsy surgery in children with tuberous sclerosis.
Abstract	Most children with tuberous sclerosis (TS) present with intractable seizures. Various factors including demography, clinical data and surgery option are mentioned to affect the outcome after epilepsy surgery in these cases. Objective: To evaluate some demographic and clinical variables probably related to seizure outcome. Material and methods: Thirty-three children, median age 4.2 ys (7.5 mths-16 ys), with TS and DR-epilepsy underwent surgery. Within overall 38 procedures (redo surgery was needed in 5 cases), tuberectomy (with or without perituberal cortectomy) was performed in 21 cases, lobectomy - 8, callosotomy - 3, various disconnections (anterior frontal, TPO and hemispherotomy) - 6 patients. Standard preoperative evaluation included MRI and video-EEG. Invasive recordings were used in 8 cases, coupled by MEG and SISCOM SPECT in some cases. ECOG and neuronavigation were used routinely during tuberectomies, and stimulation and mapping were employed in cases with lesions overlapping or near to eloquent cortex. Surgical complications: wound CSF leak ( Results and conclusion: Among different variables potentially influencing the outcome after epilepsy surgery in cases with TS, the most important one is seizure type. If prevalent, focal type may be a biomarker of favorable outcomes and probability to become free of seizures.
MeSH term(s)	Child ; Humans ; Child, Preschool ; Tuberous Sclerosis/complications ; Tuberous Sclerosis/diagnostic imaging ; Tuberous Sclerosis/surgery ; Treatment Outcome ; Retrospective Studies ; Epilepsy/diagnostic imaging ; Epilepsy/etiology ; Epilepsy/surgery ; Seizures ; Electroencephalography/methods ; Magnetic Resonance Imaging ; Drug Resistant Epilepsy/diagnostic imaging ; Drug Resistant Epilepsy/surgery
Language	Russian
Publishing date	2023-03-28
Publishing country	Russia (Federation)
Document type	English Abstract ; Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro2023870215
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Article: Khirurgicheskoe lechenie epilepsii u detei s fokal'nymi kortikal'nymi displaziyami tsentral'nykh izvilin.

Agrba, S B / Kozlova, A B / Shishkina, L V / Vlasov, P A / Shevchenko, A M / Melikyan, A G

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2023 Volume 87, Issue 2, Page(s) 17–21

Abstract: Focal cortical dysplasias are known to be the most frequent and furtive lesions leading to intractable epilepsy in children. Epilepsy surgery in central gyri, been effective in 60-70% of cases, is still significantly challenging due to the high risk of ... ...

Title translation	Surgical treatment of epilepsy in children with focal cortical dysplasia in central gyri.
Abstract	Focal cortical dysplasias are known to be the most frequent and furtive lesions leading to intractable epilepsy in children. Epilepsy surgery in central gyri, been effective in 60-70% of cases, is still significantly challenging due to the high risk of postoperative permanent neurological impairment. Study aims: Assessment of the outcome after epilepsy surgery in children with FCD in central lobules. Material and methods: Nine patients, median age 3.7 ys, IQR=5.7 ys (min 1.8- max 15.7 ys) with FCD in central gyri and DR-epilepsy underwent surgery. Standard preoperative evaluation included MRI and video-EEG. Invasive recordings were used in 2 cases, coupled by fMRI in 2. An ECOG and neuronavigation, as well as stimulation and mapping of primary motor cortex were used routinely during the procedure. Gross total resection was achieved in 7 patients according to postoperative MRI. Results and conclusions: Six patients with new or worsening of already existing hemiparesis recovered within a year after surgery. At the last FU (med 5 ys) favorable outcome (Engel class IA) has been achieved in 6 cases (66.7%), while two patients with persisting seizures reported seizing less frequently (Engel II-III). Three patients were able to discontinue AED-treatment and four children resumed development with improvement in cognition and behavior.
MeSH term(s)	Humans ; Child ; Child, Preschool ; Focal Cortical Dysplasia ; Retrospective Studies ; Epilepsy/diagnostic imaging ; Epilepsy/etiology ; Epilepsy/surgery ; Seizures ; Drug Resistant Epilepsy/diagnostic imaging ; Drug Resistant Epilepsy/surgery ; Electroencephalography ; Magnetic Resonance Imaging/methods ; Treatment Outcome
Language	Russian
Publishing date	2023-04-01
Publishing country	Russia (Federation)
Document type	English Abstract ; Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro20238702117
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Article: Uroki 101 gemisferotomii u detei s polusharnoi simptomaticheskoi epilepsiei. Chast' II: oslozhneniya i oshibki.

Melikyan, A G / Kushel, Yu V / Sorokin, V S / Vlasov, P A / Demin, M O / Shults, E I / Shevchenko, A M / Strunina, Yu V

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2021 Volume 85, Issue 6, Page(s) 44–52

Abstract: Objective: To evaluate the spectrum of pitfalls and complications after hemisherotomy basing on a retrospective study of a large consecutive pediatric cohort of patients from a single institution.: Material and methods: One hundred and one patients ( ... ...

Title translation	Lessons learnt from 101 hemispheric pediatric epilepsy surgeries part ii: pitfalls and complications.
Abstract	Objective: To evaluate the spectrum of pitfalls and complications after hemisherotomy basing on a retrospective study of a large consecutive pediatric cohort of patients from a single institution. Material and methods: One hundred and one patients (med. age - 43 months) with refractory seizures underwent hemispherotomy. Developmental pathology was the anatomical substrate of disorder in 42 patients. The infantile post-stroke scarring and gliosis was the origin of epilepsy in the majority of 43 cases with acquired etiology. The progressive pathology (RE, S-W and TS) was the etiology in the rest of children (16 cases). The lateral periinsular technique was used to isolate the sick hemisphere in 55 patients; the vertical parasagittal approach was employed in 46 cases. Median perioperative blood loss constituted 10.5 ml/kg, but was markedly larger in kids with hemimegaly (52.8 ml/kg); 57 patients needed hemotransfusion during surgery. Median length of stay in ICU was 14.7 hours, and the length of stay in the hospital until discharge - 6.5 days. Eight patients underwent second-look surgery to complete sectioning of undercut commissural fibers. FU is known in 91 patients (med. length - 1.5 years). Results: Major surgical complications with serious hemorrhage and/or surgery induced life-threatening events developed in 7 patients (one of them has died on the 5 Conclusion: Children with developmental etiology, particularly those with hemimegalencephaly, are most challengeable in terms of perioperative hemorrhage and serious complications. Patients with relapse or persisting seizures should be evaluated for the possibility of incomplete hemispheric isolation and have good chances to become SF by re-doing hemispherotomy.
MeSH term(s)	Child ; Child, Preschool ; Electroencephalography ; Epilepsy/etiology ; Epilepsy/surgery ; Hemispherectomy/adverse effects ; Humans ; Retrospective Studies ; Seizures ; Treatment Outcome
Language	Russian
Publishing date	2021-12-24
Publishing country	Russia (Federation)
Document type	Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro20218506144
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Vliyanie radikal'nosti operativnogo vmeshatel'stva na rezul'taty lecheniya atipichnoi teratoidno-rabdoidnoi opukholi tsentral'noi nervnoi sistemy u detei.

Olkhova, L V / Kushel, Yu V / Kadyrov, Sh U / Melikyan, A G / Gorelyshev, S K / Popov, V E / Schultz, E I / Ryzhova, M V / Zheludkova, O G

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2021 Volume 85, Issue 2, Page(s) 17–25

Abstract: The purpose of this study was to assess the influence of resection quality on overall survival and disease-free survival in children with atypical teratoid-rhabdoid tumors (ATRT). The study included children younger than 18 years old for the period from ... ...

Title translation	Influence of resection quality on postoperative outcomes in children with atypical teratoid-rhabdoid tumor of the central nervous system.
Abstract	The purpose of this study was to assess the influence of resection quality on overall survival and disease-free survival in children with atypical teratoid-rhabdoid tumors (ATRT). The study included children younger than 18 years old for the period from 2008 to 2019. There were 134 interventions in 105 patients with ATRT including 11 redo resections («second-look» surgery) and 18 procedures for tumor recurrence. Age of patients ranged from 2 to 168 months (median 21 months). Patients with supratentorial tumors prevailed (50.5%), infratentorial neoplasms were diagnosed in 45.7% of patients, spinal cord lesion - 3.8% of cases. At the first stage, all patients underwent surgical treatment. Total resection was achieved in 34 (32.4%) patients, subtotal - 37 (35.2%) patients, partial resection - 30 (28.6%) patients. Biopsy was performed in 4 (3.8%) patients. Quality of resection and age at surgery significantly influenced overall and disease-free survival. Extended resection of tumor followed by adjuvant chemo- and radiotherapy are required to improve survival although ATRTs are high-grade neoplasms with poor prognosis.
MeSH term(s)	Adolescent ; Central Nervous System Neoplasms/surgery ; Child ; Disease-Free Survival ; Humans ; Infant ; Infratentorial Neoplasms ; Rhabdoid Tumor/surgery ; Teratoma/surgery
Language	Russian
Publishing date	2021-04-17
Publishing country	Russia (Federation)
Document type	Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro20218502117
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Article: Uroki 101 gemisferotomii u detei s polusharnoi simptomaticheskoi epilepsiei. Chast' I. Iskhody lecheniya pristupov.

Melikyan, A G / Kozlova, A B / Vlasov, P A / Shishkina, L V / Demin, M O / Shults, E I / Buklina, S B / Nagorskaya, I A / Strunina, Yu V

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2021 Volume 85, Issue 5, Page(s) 15–21

Abstract: Objective: To evaluate variables that may predict the outcome after hemispherotomy basing on a retrospective study of a large consecutive pediatric cohort of patients from a single institution.: Material and methods: One hundred and one patients with ...

Title translation	Lessons learnt from 101 hemispherotomies in children with symptomatic epilepsy. Part I: seizure outcome.
Abstract	Objective: To evaluate variables that may predict the outcome after hemispherotomy basing on a retrospective study of a large consecutive pediatric cohort of patients from a single institution. Material and methods: One hundred and one patients with refractory seizures and variable decline in development ( Results and conclusion: Developmental pathology, infantile spasms and younger age onset of seizures are negative predictors for achievement of SF-status (
MeSH term(s)	Child ; Child, Preschool ; Electroencephalography ; Encephalitis/surgery ; Epilepsy/diagnostic imaging ; Epilepsy/etiology ; Epilepsy/surgery ; Hemispherectomy ; Humans ; Infant ; Retrospective Studies ; Seizures/diagnostic imaging ; Seizures/etiology ; Seizures/surgery ; Treatment Outcome
Language	Russian
Publishing date	2021-10-29
Publishing country	Russia (Federation)
Document type	Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro20218505115
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Article: Khirurgicheskoe lechenie épilepsii u deteĭ s glioneĭronal'nymi opukholiami mozga: morfologiia, magnitno-rezonansno-tomograficheskaia semiologiia i faktory, vliiaiushchie na iskhod.

Melikyan, A G / Shishkina, L V / Vlasov, P A / Kozlova, A B / Schultz, E I / Kushel, Yu V / Korsakova, M B / Buklina, S B / Varukhina, M D

Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko

2020 Volume 84, Issue 1, Page(s) 6–22

Abstract: Introduction: Glioneuronal tumors (GNT) are usually found in children (less than 1.5% of all neoplasms of the brain). With rare exceptions, they are benign and usually manifest only by epilepsy, which is quite often resistant to treatment with AE drugs. ...

Title translation	Surgical treatment of epilepsy in children with gloneuronal brain tumors: morphology, MRI semiology and factors affecting the outcome.
Abstract	Introduction: Glioneuronal tumors (GNT) are usually found in children (less than 1.5% of all neoplasms of the brain). With rare exceptions, they are benign and usually manifest only by epilepsy, which is quite often resistant to treatment with AE drugs. Tumor removal usually helps to cope with epileptic seizures, however, a number of issues regarding diagnosis and surgical treatment (interpretation of morphological data and classification, epileptogenesis and topography of the epileptogenic zone, the value of intraoperative invasive EEG and the optimal volume of resection) remain debatable. Aim: To describe the morphology, electro-clinical picture and MR-semiology in patients with gloneuronal brain tumors, as well as to analyse the results of their surgical treatment and the factors determining its outcome. Material and methods: 152 children with a median age of 8 years were treated surgically (There were 64 gangliogliomas, 73 DNT, 15 cases where the tumor classification failed - GNT NOS). In children under 2 years of age, temporal localization of the tumor prevailed. In 81 cases, ECoG was used during the operation. Surgical treatment complications: transient neurological deficit (in 15 cases); hematomas removed without consequences (in 2 cases), infectious (osteomyelitis of bone bone flap in 2 cases). We analyzed: the age of the epilepsy onset (median - 4 years 7 months) and its duration (median - 23.5 months), the type of seizures, as well as the features of MR-semiology and morphology of tumors and adjacent areas of the brain. The volume of tumor resection was verified by MRI (in 101 cases) and CT (in each case). The follow-up was collected through face-to-face meetings, with repeated video EEG and MRI, as well as telephone interviews. We studied the effect of a number of parameters characterizing the patient and features of his/her operation on the outcome of treatmen. Results: Among 102 patients in whom the follow-up history is one year or more (median - 2 years), a favorable outcome (Engel IA) was observed in 86 of them (84%); 55 of them (54%) at the time of the last examination stopped drug AE treatment. Radical tumor removal and younger age at the time of surgery were statistically significantly associated with a favorable result. Conclusion: In children with gloneuronal brain tumors, removal of the tumor is effective and relatively safe in the treatment of symptomatic epilepsy. Radical tumor resection and earlier intervention are the most important prerequisites for a favorable outcome and persistent remission of seizures.
MeSH term(s)	Brain Neoplasms/surgery ; Child ; Electroencephalography ; Epilepsy/surgery ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Treatment Outcome
Language	Russian
Publishing date	2020-03-24
Publishing country	Russia (Federation)
Document type	Journal Article
ZDB-ID	603458-5
ISSN	0042-8817
ISSN	0042-8817
DOI	10.17116/neiro2020840116
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