Contemporary aspects of diagnosis and surgical treatment of cranio-orbital tumors

IMSP Institutul Oncologic, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011In this study, we analysed 186 patients with orbital tumours spread to adjacent regions (paranasal sinus, cranial cavity, facies soft tissues). Major importance in diagnosis and treatment tactic determination have (besides anamnestic dates, clinical symptoms and radiography) NMR and CT. New surgical treatment methods (besides classical ones) have revealed a high degree of cure (91,4%) in cases with benign tumours and pseudotumours. In cases with malignant tumours, the 4-years survival rate was 52,3%.În studiul dat s-a analizat un lot de 186 de bolnavi cu tumori a orbitei cu răspândire în regiunile adiacente (sinusurile paranazale, cavitatea craniană, țesuturile moi ale feții). O importanță majoră in diagnostic şi aprecierea tacticii de tratament, pe lângă anamneză, simtomatică clinică şi radiografie are RMN şi tomografia computerizată. Aplicarea noilor metode de tratament chirurgical (pe lângă cele clasice) au relevat un grad înalt (91,4%) de vindecare la bolnavii cu tumori benigne şi formațiuni pseudotumorale. În cazul tumorilor maligne rata de supraviețuire la 4 ani a constituit 52,3%

Spontaneous intracerebral supratentorial hemorrhage: general aspects and updates in surgical treatment

Laboratory of Neurosurgery Anesthesia and Reanimation, Institute of Neurology and Neurosurgery, Department of Neurology, Institute of Emergency Medicine, Department of Radiology and Medical Imaging, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: Spontaneous intracerebral hemorrhage (SIH) accounts for 9 to 25% of all strokes and is associated with a high morbidity and mortality, with less than 40% of affected persons surviving 1 year. The condition commonly presents a sudden onset of focal neurological deficits with accompanying headache, nausea, vomiting, elevated blood pressure and altered consciousness. Medical treatment commonly includes airway support, blood pressure control, management of cerebral edema, symptomatic therapy such as anticonvulsive medication, anticoagulation reversal etc. Different surgical options such as open craniotomy, stereotactic aspiration, endoscopic evacuations with or without thrombolysis have also been considered. Most of these techniques have already been implemented successfully in the Republic of Moldova. According to the data of the Institute of Neurology and Neurosurgery and the Institute of Emergency Medicine for the period 2011-2014, just within these two institutions were performed 137 neurosurgical interventions, including 67 interventions involving minimally invasive techniques with local fibrilolysis and 70 interventions involving other minimally invasive surgery or conventional craniotomy. The obtained results are in concordance with those reported by other European institutions. Conclusions: The continuous efforts to improve the outcome of SIH during the recent years have led to the development of a variety of minimally invasive techniques, most of which have already been adopted by the autochthonous surgeons. New randomized controlled trials are required to establish the suitability of these techniques for different clinical situations and SIH localizations

Local fibrinolysis in spontaneous supratentorial hematomas: comparison with surgical and medical treatment

Institute of Neurology and Neurosurgery, Department of Neurology and Neurosurgery, Institute of Emergency Medicine, and Department of Radiology and Medical Imaging, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldov