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Abstract: Introduction: a case report of successful treatment of an extremely rare pathology (0,27-0,34%) - acute occlusion of both internal carotid arteries (ICA) is presented. Aim: was to show possibilities of endovascular surgery in the diagnosis and treatment of acute ischemic stroke (AIS) in patients with bilateral acute ICA occlusion. Materials and methods: a 38-year-old patient was hospitalized by ambulance with the diagnosis of AIS. Multispiral computed tomography (MSCT) revealed left ICA occlusion in the C2-C5 segment. Selective angiography of ICA was performed: right ICA - non-occlusive thrombosis C2-C3 segments; left ICA - thrombotic occlusion in C1 segment. Results: thrombaspiration was performed from the left ICA and right ICA; full recovery of antegrade cerebral blood flow was achieved in both ICA, according to the modified treatment in cerebral infarction score (mTICI) - 3. Patient was discharged after 28 days. At the time of discharge, the modified Rankin Scale (mRS) score was 3. 6 months after discharge mRS was 1. Conclusions: Selective angiography of both ICA in a patient with AIS enabled to detect right ICA thrombosis not detected by MCT, which in its turn changed the treatment tactics of the patient. Aspiration thromebctomy from both internal carotid arteries allowed to achiev full recovery of antergrade cerebral blood flow of both internal carotid arteries. References 1. The top ten cuases of death, WHO fact sheets 2020. https://www.who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-death 2. Shapoval IN, Nikitina SYu, Ageeva LI, et al. Zdravoochranenie v Rossii. 2019 [In Russ]. https://rosstat.gov.ru/storage/mediabank/Zdravoohran-2019.pdf 3. Aigner A, Grittner U, Rolfs A, et al. Contribution of established stroke risk factors to the burden of stroke in young adults. Stroke. 2017; 48: 1744-1751. https://doi.org/10.1161/STROKEAHA.117.016599 4. Gafarova AV, Gromova EA, Panov DО, et al. Social support and stroke risk: an epidemiological study of a population aged 25-64 years in Russia/Siberia (the WHO MONICA-psychosocial program). Neurology, Neuropsychiatry, Psychosomatics. 2019; 11(1): 12-20 [In Russ]. https://doi.org/10.14412/2074-2711-2019-1-12-20 5. Putaala J. Ischemic Stroke in Young Adults. Continuum. 2020; 26(2): 386-414. https://doi.org/10.1212/CON.0000000000000833 6. Si Y, Xiang S, Zhang Y. et al. Clinical profile of etiological and risk factors of young adults with ischemic stroke in West China. Clinical Neurology and Neurosurgery. 2020; 193. https://doi.org/10.1016/j.clineuro.2020.105753 7. Ekker MS, Boot EM, Singhal AB, et al. Epidemiology, aetiology, and management of ischaemic stroke in young adults. The Lancet Neurology. 2018; 17(9): 790-801. https://doi.org/10.1016/s1474-4422(18)30233-3 8. Chi X, Zhao R, Pei H, et al. Diffusion-weighted imaging-documented bilateral small embolic stroke involving multiple vascular territories may indicate occult cancer: A retrospective case series and a brief review of the literature. Aging Med. 2020; 3(1): 53-59. https://doi.org/10.1002/agm2.12105 9. Dietrich U, Graf T, Sch?bitzb WR. Sudden coma from acute bilateral M1 occlusion: successful treatment with mechanical thrombectomy. Case Rep Neurol. 2014; 6: 144-148. https://doi.org/10.1159/000362160 10. Pop R, Manisor M, Wolff V. Endovascular treatment in two cases of bilateral ischemic stroke. Cardiovasc Intervent Radiol. 2014; 37: 829-834. https://doi.org/10.1007/s00270-013-0746-4 11. Larrew T, Hubbard Z, Almallouhi E.et al. Simultaneous bilateral carotid thrombectomies: a technical note. Oper Neurosurg. 2019; 5(18): 143-148. https://doi.org/10.1093/ons/opz230 12. Storey C, Lebovitz J, Sweid A, et al. Bilateral mechanical thrombectomies for simultaneous MCA occlusions. World Neurosurg. 2019; 132: 165-168. https://doi.org/10.1016/j.wneu.2019.08.236 13. Braksick SA, Robinson CP, Wijdicks EFM. Bilateral middle cerebral artery occlusion in rapid succession during thrombolysis. Neurohospitalist. 2018; 8: 102-103. https://doi.org/10.1177/1941874417712159 14. Jeromel M, Milosevic Z, Oblak J. Mechanical recanalization for acute bilateral cerebral artery occlusion - literature overview with a case. Radiology and Oncology. 2020; 54(2): 144-148. https://doi.org/10.2478/raon-2020-0017
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Abstract: In this paper the use of spiral computed tomography (SCT) in dental implantation is discussed. It is shown that scanning itself and, what is even more important, post-processing of the images should be planned individually for each patient. SCT is declared to be a substantial part of the diagnostic strategy in patients with upper and lower dental arches defects, and with complete adentia. It is also crucial in assessment of long-term results of sinus lift procedure, and for detection of immediate and remote dental implant complications.
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Abstract: The article provides a case report of the patient with mediastinitis. This case report shows the importance of multispiral computed tomography in the diagnostics of tumors of this localization, demonstrates the need of proper preparation of patient for examination and use of CT with intravenous contrast enhancement, multiplanar reconstruction images to obtain information about the nature of blood flow, determining the structure of esophagus walls and the ratio of detected changes with surrounding organs and vascular structures, which is particularly important for treatment planning. References 1. Arslan E., Sank M., Iюэk A.F. et al. Treatment for esophageal perforations: analysis of 11 cases. Ulus. Travma Acil. Cerrahi. Derg. 2011; Nov 17(6): 516-20. 2. Lyman D. Spontaneous esophageal perforation in a patient with mixed connective tissue disease. Open Rheumatol. J. 2011; 5: 138-43. 3. S. M.P., Soares E.F., Santos C.A. et al. Risk factors for mediastinitis after coronary artery bypass grafting surgery. Rev. Bras. Cir. Cardiovasc. 2011; 26(1): 27-35. 4. Komarov B.D., Kanshin N.N., Abakumov M.M. Povrezhdenija pishhevoda. [Injures of esophagus ]- М.: Medicina, 1981; 175. [In Russ] 5. Petrov B.A. Khirurgija pishhevoda. [Surgery of the esophagus] Khirurgija. 1967; 10; 9-15 6. Toshhakov R.A., Nechiporenko I.N., Putenikhin S.V. Mediastinit i rezul'taty ego khirurgicheskogo lechenija. [Mediastinitis and the results of surgical treatment] Zdravookhranenie Turkmenistana. 1992; 4; 41-43. [In Russ] 7. Randjelovic T., Stamenkovic D. Mediastinitis-diagnosis and therahy. Acta Chir. Iugosl.2001 ; 48; 3; 55-59. 8. Santiago E. Rossi, H. Page McAdams, Melissa L. Rosado-de-Christenson, Teri J. Franks, Jeffrey R. Galvin. Fibrosing Mediastinitis. RadioGraphics. 2001; 21: 737-757. 9. Strohm P., Muller C., Jonas J., R. Bahr Esophageal perforation. Etiology, diagnosis, therapy. Chirurg. 2002; 73 (3): 217-222. 10. Abakumov M.M. Mekhanicheskie povrezhdenija pishhevoda: Dis..dokt.med.nauk [The mechanical damage to the esophagus]:14.00.27 - Khirurgija . NII SP im. N.V. Sklifosovskogo. М., 1979; 434 [In Russ] 11. Ivanov A.Ja. Abscessy i flegmony sredostenija. [Mediastinal abscess and phlegmon] Medgiz, 1959;147 [In Russ]. 12. Komarov B.D., Abakumov M.M., Pogodina A.N. Ostryjj gnojjnyjj mediastinit (klinika, diagnostika, lechenie). [Acute purulent mediastinitis (clinical picture, diagnosis, treatment)] Khirurgija. 1985; 10; 151-152 [In Russ]. 13. Braxton J.H., Marrin C.A., McGrath P.D. еt ак Mediastinitis and long-term survival after coronary artery bypass graft surgery. Ann. Thorac. Surg. 2000; 70 (6): 2004-7 14. Vancjan Eh.N. , Chernousov A.F., Chissov V.I. Povrezhdenija pishhevoda pri buzhirovanii. [Damage to the esophagus during bougienage] Khirurgija.1976; 4: 83-88 [In Russ]. 15. Kvardakova O.V Znachenie rentgenologicheskogo issledovanija v ocenke techenija gnojjnogo mediastinita. [The value of radiologic studies to evaluate the flow of purulent mediastinitis ] Date of last access: March 19, 2012 at link: http://vestnik.rncrr.ru/vestnik/v9/papers/kMadrakova_v9.htm [In Russ]. 16. Shraer, T.I. Taktika khirurga pri perforacii grudnogo otdela pishhevoda. [Tactics of the surgeon with thoracic esophageal perforation.] Grudnaja khirurgija.1966; 5: 82-88 [In Russ]. 17. Demetriades D., Theodorou D., Cornwell E .et al. Evaluation of penetrating injuries of the neck: prospective study of 223 patients. World J. Surg.1997; 21(1): 41-47. 18. Hunt D.R., Wills V.L.. Weis B. еt ак Management of esophageal perforation after pneumatic dilation for achalasia. Ulus. Travma Derg. 2001; 7(1): 22-7. 19. Robicsek, F. Postoperative sterno