BACKGROUND: This study was aimed at epidemiological analysis of unruptured intracranial aneurysms (IAs) regarding their location, size, multiplicity, type of intervention provided, and associated complications in the Kazakhstani population. METHODS: We performed a retrospective analysis of a cohort of 400 patients diagnosed with IA admitted to the Central Clinical Hospital of Almaty, Republic of Kazakhstan, a referral hospital for the treatment of cerebrovascular disease. Patients admitted between January 1, 2019 and December 31, 2019 with radiologically confirmed diagnosis of unruptured IA were included in the study. RESULTS: Overall, there were 400 patients with a 2.8 female/male ratio. The bulk of aneurisms – 96.0% – were of size <25 mm in diameter and single. Median age of patients was 55 years and the youngest patient was 22-years-old, while the oldest patient aged 83 years. The left internal carotid artery (ICA) was the most common site if IA localization followed by the right ICA. The left and right middle cerebral arteries were the second most common localization sites. More than a half of patients presented with aneurysm-related complications before the intervention, of which subarachnoid hemorrhage was the most common type. Embolization with or without stenting was performed in more than 50% of patients and 96.5% of all surgeries were not associated with complications. CONCLUSION: There is a need for careful consideration of clinical characteristics and surgical outcomes of patients with unruptured IA in a real-world practice as these data are needed for the development of management strategies.

Background: Endovascular stenting for atherosclerotic stenosis in the intra- and extracranial arteries is a minimally invasive procedure, but comprehensive studies on long-term complications following COVID-19 infection are lacking. Given the potential for increased rates of stent thrombosis, stroke, myocardial infarction, and mortality among COVID-19 patients, understanding the long-term outcomes of stenting for extra- and intracranial atherosclerotic stenosis is crucial for public health. This study addresses the dearth of extensive research on the long-term adverse outcomes associated with endovascular stenting procedures in patients who have experienced atherosclerotic stenosis in intracranial and extracranial arteries following COVID-19 infection. Methods: This retrospective study analyzed data from a tertiary hospital database, focusing on individuals who underwent extracranial or intracranial atherosclerotic stenting procedures at the Central Clinical Hospital JSC, Department of Neurosurgery, between 2016 and 2017, before the COVID-19 pandemic. The primary outcome measures to be evaluated include the incidence of stent thrombosis, ischemic stroke, myocardial infarction, and all-cause mortality. Results: The study followed 93 patients via telephone survey, but 12 did not respond, leaving 81 participants. Of these, 32 reported a prior COVID-19 infection confirmed by PCR testing, forming the COVID-19 group. The remaining 49 without confirmed COVID-19 infection comprised the control group. The 81 participants included 32 in the COVID-19 group and 49 in the control group, with no statistically significant differences in sex or age between the two cohorts. The binary logistic regression analysis revealed that the number of cigarettes smoked per day was a statistically significant predictor of myocardial infarction. This risk factor accounted for 23.6% of the observed myocardial infarctions, demonstrating a direct relationship between the number of cigarettes smoked and the probability of experiencing a myocardial infarction. Conclusion: The study found no significant differences in mortality, stroke, and heart attack rates between the COVID-19 and control groups. However, high blood pressure, heavy smoking, and high stress were linked to worse long-term outcomes.

Введение. Артериальная гипертензия, повышенный уровень холестерина, сахара крови, курение и пожилой возраст являются факторами риска атеросклеротического ишемического инсульта и транзиторной ишемической атаки. Другие факторы риска, которые также рассматриваются в качестве причин атеросклеротического ишемического инсульта, требуют подтверждений: ожирение, отсутствие физической активности, психосоциальные факторы, характер питания. Хирургическим стандартом лечения атеросклеротических заболеваний интра-экстракраниальных сосудов является эндоваскулярное стентирование и каротидная эндартерэктомия. Целью данного исследования было выявление основных факторов риска до и послеоперационных осложнений и определение критериев для правильного отбора пациентов к оперативному лечению при интра и экстракраниальном атеросклеротическом поражении артерий. Методы. Проведён ретроспективный анализ данных 725 историй болезни пролеченных случаев с атеросклеротическим поражением экстра- и интракраниальных артерий, оперированных на базе клиники АО «Центральная клиническая больница» города Алматы в отделении нейрохирургии за период с 2016 по 2021 год. В основную группу вошли 212 случаевс интракраниальным расположением атеросклеротических бляшек, в контрольную группу - 513 случаев с экстракраниальным. Результаты. Определены предикторы развития осложнений (ОНМК) при атеросклерозе до операции: наличие ИБС повышало шанс развития ОНМК в 4,882 (95% ДИ: 3,313 – 7,194), курение в 2,659 раза (95% ДИ: 2,151-3,288), сахарный диабет в 1,2 раза (95%ДИ:0,868-1,648), гиперхолестеринемия в 1,248 раза (95% ДИ:1,099 – 1,416), гипертонический криз в 1,04 раз (95%ДИ: 1,000-1,085). Экстракраниальное поражение сосудов имело обратную связь с развитием осложнений. Наличие сахарного диабета в 3,870 повышало шанс развития осложнения после операции (тромбоз стентов) (95% ДИ: 0,959 -15,614). Выводы. При наличии факторов риска: курение, сахарный диабет, гиперхолестеринемия, гипертонический криз и возраст старше 60 лет необходим более пристальный контроль к выполнению профилактических мероприятий и лечению особенно при интракраниальном поражении артерий. Перед плановой операцией для лечения атеросклероза особенно необходима стабилизация уровня сахара крови и строгое выполнение рекомендаций эндокринолога относительно терапии. Background. Arterial hypertension, high cholesterol, blood sugar, smoking and old age are risk factors for atherosclerotic ischemic stroke and transient ischemic attack. Other risk factors that are also considered as causes of atherosclerotic ischemic stroke require confirmation: obesity, lack of physical activity, psychosocial factors, dietary patterns. The surgical standard for the treatment of atherosclerotic diseases of intra-extracranial vessels is endovascular stenting and carotid endarterectomy. The aim of this study was to identify the main risk factors for pre- and postoperative complications and to determine the criteria for the correct selection of patients for surgical treatment with intra- and extracranial atherosclerotic arterial disease. Methods. A retrospective analysis of 725 case histories of treated cases with atherosclerotic lesions of extra- and intracranial arteries, operated on the basis of the clinic of JSC "Central Clinical Hospital" in Almaty in the Department of Neurosurgery for the period from 2016 to 2021, was carried out. The main group included 212 cases with intracranial atherosclerotic plaques, the control group included 513 cases with extracranial plaques. Results. The predictors of the development of complications (stroke) in atherosclerosis before surgery were determined: the presence of coronary artery disease increased the chance of developing stroke by 4.882 (95% CI: 3.313–7.194), smoking by 2.659 times (95% CI: 2.151–3.288), diabetes mellitus by 1.2 times (95% CI: 0.868-1.648), hypercholesterolemia - 1.248 times (95% CI: 1.099 - 1.416), hypertensive crisis - 1.04 times (95% CI: 1.000-1.085). Extracranial vascular lesions had an inverse relationship with the development of complications. The presence of diabetes in 3.870 increased the chance of developing a...

Менингиомы - наиболее частые первичные опухоли головного мозга у взрослых, составляющие примерно треть всех внутричерепных новообразований, занимая 2-е место, уступая лишь глиомам. Хирургическое лечение остается методом выбора, но для достижения хороших прогностических результатов, снижения интраоперационных осложнений рекомендовано проведение предхирургической эмболизации менингиомы. В данной статье мы демонстрируем доступную и безопасную технику пункционной трансовальной эмболизации сфенопетрокливальной менингиомы с использованием жидкого клея, который диффузно проникал во всю паренхиму опухоли без миграции наружу...

Background Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke, disproportionately affecting populations with significant vascular risk factors. Although ICAS imposes a considerable health burden, research on this condition in Central Asia remains scarce, especially among the Kazakh population. This study analyzes demographic characteristics, treatment outcomes, and procedural challenges associated with ICAS in 216 patients treated at a single institution. Methods: This retrospective study included patients with ≥70% intracranial artery stenosis confirmed by imaging and presenting with ischemic symptoms. All patients underwent angioplasty and stenting with dual antiplatelet therapy (DAPT). Data collected included demographics, comorbidities, stenosis characteristics, procedural details, and outcomes assessed by the modified Rankin Scale (mRS). Results The median age was 63.5 years (IQR: 57–68.6), and 73.7% were male. Hypertension was the most common comorbidity (98%), followed by ischemic heart disease (58%) and diabetes mellitus (40.9%). Multi-location ICAS was significantly associated with patients over 75 years of age (p=0.025). Additionally, obesity and stenosis severity greater than 70% showed trends toward significance, with p-values of 0.064 and 0.079, respectively. Stenosis predominantly affected the internal carotid artery (54.5%) and vertebrobasilar system (31.6%). The average hospital stay was longer for posterior circulation stenosis (7.1 days) compared to anterior circulation (4.7 days). The periprocedural complication rate was 0.7%, with two deaths attributed to ischemic complications. At follow-up, 4 patients experienced worsening mRS scores (>2), particularly those with severe stenosis in the basilar artery and M1 segment. Conclusion: ICAS in the Kazakh population is strongly associated with hypertension and aging, with posterior circulation stenosis contributing disproportionately to worse outcomes. The low complication rates highlight the safety of modern endovascular techniques. However, further research is needed to optimize treatment strategies for severe and multi-location ICAS, particularly in Central Asian populations.