Pichkur L. Neurosurgical treatment of patients with pediatric cerebral palsy

Dissertation is devoted to improvement of treatment efficiency at patients with pediatric cerebral palsy (PCP) through use and perfection of neurosurgical operations, directed on warning of irreversible changes in movemet shere, activation of CNS compensatory-renewing processes on the basis of experimental ground, methodological providing development and clinical application of neurotransplantation.Impaired myelination of nervous fibers is one of the leading mechanisms in PCP development. In experiment in vitro and in vivo we proved that neurogenic cells of fetal brain promote remyelination of the fibers and prevent their demyelination.Complex of methods has been suggested to assess the embryonic neurogenic cells quality. It was established that for neurotransplantation it is feasible to use fetal nervous tissue of 8-9 weeks gestation, the cells of which preserve functional activity and morphological identity when properly cultivated.Having analyzed the results of fetal nervous tissue transplantation into cerebral cortex at 145 patients with different forms of PCP we developed an algorithm for predicting treatment efficacy as well as for determining indications and contraindications for this method.37 patients (8 children were operated at first time, 29 - after neurotransplantation) with excessive spasticity in extremities have undergone selective fasciculotomy of the nerves and microDREZotomy. High efficacy of the suggested methods was proved.An algorithm for neurosurgical treatment of patients with PCP was developed.