http://repository.usmf.md:80/xmlui/handle/20.500.12710/431 2026-06-13T21:55:30Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/1814 Cefaleea ca manifestare clinică a adenoamelor hipofizare Condrea, Eugen The objective of the study is to analyze the presence of headache in pituitary tumors and their characteristics, the relationship between tumor size, biological type, local extension and intrasellar pressure (ISP). This is a prospective study, of 64 consecutive patients presenting with primary pituitary masses at Neurosurgical department of Institute of Neurology and Neurosurgery of Chisinau, Republic of Moldova from January 2005 to December 2009. We analyzed all basic characteristic of headache and divided them into groups by age, sex, type of headache (laterality, site, severity, quality, frequency, duration, associated symptoms, , time of onset, trigger, alleviating factors and familial history) and tumor characteristics (type, size, quiasmatic compression, cavernous sinus invasion, sella turcica distruction, cystic or solid mass and intrasellar pressure). We observed a statistic significant correlation between headache and tumor size, optic chiasm compression, sellar destruction, cavernous sinus invasion and ISP. Biochemical- neuroendocrine factors, mainly in prolactinomas, seem to be an important factor in the determination of headache. The presence of headache in pituitary tumors is related to a combination of factors, including ICP, tumor extension, relationship within the sellar structures, patient predisposition, familial history, and functional disturbances. Obiectivul acestui studiu este de a analiza prezenţa cefaleei în adenoamele hipofizare şi relaţia dintre dimensiunile tumorii, tipul biologic, extinderea tumorii şi presiunea intraselară (PIS). Acesta este un studiu prospectiv a 64 de pacienţi trataţi, cu tumori ale hipofizei, în cadrul Institutului de Neurologie şi Neurochirurige în perioada anilor 2005 - 2009. Au fost analizate repartizarea după vârstă, sex, cefalee (lateralitatea, partea, severitatea, calitatea, frecvenţa, durata simptomelor asociate, timpul de debut, trigerii, factorii predispozanţi şi anamnesticul familial), precum şi caracteristicile tumorii (tipul tumorii, dimensiunile, compresia chiasmală, invadarea sinusului cavernos, distrucţia şeii turceşti, consistenţa chistică sau solidă a tumorii şi PIS). Au fost apreciaţi ca factori statistici semnificativi pentru tumoarea hipofizară şi dimensiunile acesteia compresia chiasmală, disctrucţia selară, invadarea sinusului cavernos şi PIS. Factorii biochimici neuroendocrini, în special în prolactinoame, par a juca un rol determinant în cadrul cefaleei. Prezenţa cefaleei în adenoamele hipofizare este raportată la o combinaţie de factori, inclusiv PIS, extinderea tumorală. Sunt importante interrelaţiile tumorii cu structurile selare, predispoziţia pacientului, anamnesticul familial şi dereglările funcţionale în cadrul axului hipotalamo hipofizar. Institutul de Neurologie şi Neurochirurgie 2010-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/1815 Monitoring-ul neurofiziologic intraoperator în practica neurochirurgicală Peciul, Andrei; Borodin, Sergiu; Dogaru, Constanţa; Munteanu, Liuba IONM is the application of a variety of electrophysiological and vascular monitoring procedures during surgery to allow early warning and avoidance of injury to nervous system structures.This article highlights advances in IOM technologies including the use of motor and somatosensory evoked potentials to assess the integrity of descending corticospinal and ascending somatosensory pathways, electromyography to assess the integrity of cranial nerves or spinal nerve roots, various approaches including brainstem auditory evoked potentials and cochlear nerve action potentials to enhance the safety of vestibular schwannoma surgery. IOM este o metodă de evaluare a înregistrărilor activităţii electrofiziologice a structurilor nervoase şi a modificărilor fluxului sangvin cerebral cu scop de prevenire şi de evitare a afectării acestor structuri pe parcursul intervenţiei chirurgicale. Acest articol reflectă rolul IOM prin determinarea potenţialelor evocate somato-senzoriale şi motorii folosite pentru a aprecia integritatea căilor de conducere ascendente şi descendente ale sistemului nervos, de asemenea electromiografia ca metodă de apreciere a integrităţii nervilor cranieni şi spinali. Înregistrarea potenţialelor evocate auditive sau potenţialele de trunchi cerebral prezintă utilitate prin reducerea riscului de lezare a nervului vestibulocochlear în caz de schwanom vestibular. Coordonator ştiinţific: Andronachi Victor Institutul de Neurologie şi Neurochirurgie 2010-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/1812 Parkinson’s desease. Neurosurgical stereotactic treatment as a combined treatment Dogaru, Constanţa; Borodin, Sergiu; Peciul, Andrei; Ciobanu, Alexandru PD is a chronic and progressive disorder of the central nervous system. For patients with Parkinson's disease who have become unresponsive to pharmacotherapy or have developed severe motor complications due to medical therapy, a number of symptomatic neurosurgical interventions are available: thalamotomy, thalamic stimulation and pallidotomy. Neurosurgical therapies may increasingly complement and extend pharmacologic management of Parkinson's disease. Boala Parkinson este o boală degenerativă a sistemului nervos central. Pentru pacienții cu BP ce nu prezintă un raspuns pozitiv la tratamentul conservator - medicamentos, iar dereglarile motorii sunt datorate tratamentului farmacoterapeutic, sunt recomandate câteva abordari neurochirurgicale de stimulare cerebrală profundă şi lezională, acestea fiind: talamotomia, stimularea talamică și palidotomia. Tratamentul neurochirurgical în BP eventual intensifica, potențează și complimentează tratamentul farmacologic. Scientific coordinator: Dan Lîsii Institute of Neurology and Neurosurgery 2010-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/1813 Transsphenoidal surgery in complex treatment of pituitary adenoma Condrea, Eugeniu Objective: to compare the results of a different type of surgical treatment of pituitary adenomas, to report the efficacy and safety of microsurgical removal of adenomas via transsphenoidal surgery. Methods: 67 patients with pituitary adenomas underwent surgical treatment in the department of neurosurgery of Institute of Neurology and Neurosurgery from January 2005 through December 2009. Postoperative results were classified uniformly during the period of the study. Surgical intervention with use of standard transnasal transsphenoidal approach was performed on 45 patients. 22 patients were operated via transcranial approach mainly using of right subfrontal approach. Results: According to hormonal activity operated adenomas were spread as following: prolactinomas -16, 3%, somatotropinomas- 27, 8%, corticotropinomas – 8, 2%, thireotropinomas -0, 5%, and hormonally inactive tumors – 47, 2%. Among operated patients were 36 (53, 7%) males and 31(46, 3%) females. The mean age was 37, 6 ± 5, 4 years. Male/female rate was 1, 2:1. There were 50 macroadenomas (76%) and at 11 patients tumor invaded one or both cavernous sinuses. The overall rate of surgical success in transsphenoidal surgery was 65%, compared to 34% in transcranial surgeries. The surgical outcome was better in microadenomas treated with transsphenoidal approach than in macroadenomas treated with transcranial route (82% and 51% respectively), whereas tumors invading the cavernous sinus had a poorer outcome. In patients with nonfunctioning pituitary adenomas no residual adenomas were present in 62% cases. Normalization of visual defects occurred in 22 (52%) of 45 patients with visual disturbances. One patient died as a consequence of surgery (1, 4%). Institute of Neurology and Neurosurgery 2010-01-01T00:00:00Z