USATOV S. Investigation of brain hemispheric gliomas perifocal zone for the purpose of their treatment optimization

The dissertation considering improvement of treatment effectiveness for patients with supratentorial gliomas resulting from complex study of perifocal zone pathogenesis and its clinical, morphological, biochemical and immunological characteristics.The following methods were applied: clinical exmination, MRI, neurohistological studies, biochemical studies of tissue metabolism and energy exchange, immunological studies includeg defenition of the population and subpopulation destribution of lymphocytes, investigation of their proliferative activity, assessment of tumor necrotic factor, a-interferon and glicolitic enzyme neuronal specific enolase. Clinical and MRI comparison was performed/ Correlation between the size of perifocal zone and intracranial pressure was established, specific tactics of medical and surgical treatment was definded depending on the size of perifocal zone.The results of brain glioma features relationship with MRI data, their structure, localization and clinical manifestation, application of appropriate medical and surgical treatment were analysed. Extensive perifocal zone associated with significant increase of intracranial pressure and brain structures dislocation is considering as extremely unfavorable prognostic factor (mortaling rates up to 93%).Obtained data demonstrate necesserity of removal of perifocal zones during the surgery in patients with anaplastic gliomas.