The dissertation deals with the problems of neurosurgical treatment of patients with apallic syndrome (AS) and his consequences by activation of reparation and plastic processes in cerebrum by embryonic nervous tissue transplantation. The work is based on the study of clinical manifestation and course, and result of surgical treatment sixty-four patients (38 men, 26 women, 1-38 years, mean 7,7±6,3) with apallic syndrome after traumatic brain injury (TBI) - 21(32,8%) cases and after atraumatic brain damage (ABD) - 43 (67,2%) cases. It was treated by embryonic neural tissue transplantation (ENTT) therapy and followed up at 1 to 10 years. The study was approveal by the local Ethics Committee in accordance with the Helsinki Declaration (2000). We are diagnosed persistent apallic syndrome (PAS) in 10 cases, chronic vegetative state (ChVS) in 8 cases and consequence apallic syndrome (CAS) in 46 cases (mobile - 26, unmobile - 20). The clinical condition before and long-term after surgical treatment defined by Rappaport Disability Rating Scale (RDRS) and Rancho Los Amigos levels cognitive function (RCFS). The neural graft (NG) is native fragment human embryonic tissue 1-2 mm3 and native or cryoconserved suspension neural cells, 7-9 weeks gestation, 36,7±11,5 106 cells in 1 ml suspension. The NG introduced intrathecal (8 cases), intraparenchymatously (46 cases) and intrathecal with intraparenchymatously (10 cases). The "Good" long-term result on RDRS (decrease on 6 to 10 scores) defined in 50% cases, "Minimal Change" (decrease on 3 to 5 scores) - in 34,5% cases. The "Poor" result on RDRS (include 3 died patients after 1,5; 2 and 9 years after surgery) complete 15,5% cases. The "Good" reintegration cognitive function on RCFS (increase 4-6 levels) defined in 12,5% patients, "Minimal Change" (increase 2-3 levels) - in 62,5% patients and "Poor" result - in 25% cases. Therefore, ENTT effective restorative procedure for patients with AS, more decreased disability and moderate reintegrated cognitive function in long-termperiod after surgery. We are defined the best result in patient with atraumatic brain damage and patients with mobile CAS.
