Laboratory of pathoanatomy

Head of the Laboratory - Doctor of Medical Science, Prof. Medvedev Yury Aleksandrovich

The Laboratory of Pathoanatomy, as well as the Institute, was organized 75 years ago. It was one of three units forming the Institute. Academician Anichkov N.N., an outstanding native pathoanatomist, did much for the newly-organized laboratory. Prof. Garshin V.G.and Prof. Gakkel V.P. (the author of the first monograph on morphology of tumors of the nervous system), who made great contribution to our science, worked there. Prof. Chaika T.V., a follower of Anichkov N.N., was the head of the laboratory for 30 years. It was that very time when the work on pathologic anatomy of craniocerebral trauma had been carried out. It has not lost its significance up to now and was a starting-point for research of neurosurgeons-traumatologists. Its author was Goryachkina G.P., who became a classic of morphology of craniocerebral trauma during her life-time.

History of the Laboratory and achievements of its employees are described in detail in jubilee editions published earlier. We shall dwell only on the last 15 years. The first fundamental topic of research, which united efforts of pathoanatomists, was a problem of tanatogenesis in neurosurgical patients. The obtained data allowed to define new medical-biological notions: vegetative distress-syndrome, reduced respiratory distress-syndrome, a doctrine of mosaic distribution of water and electrolytes within the brain, etc. A syndrome of acute cardiac insufficiency was described; its role and significance in mortality of neurosurgical patients was clarified; a notion of hemodynamic block in lesser circulation was formulated. It permitted to consider an effect of venous congestion in the system of the superior vena cava on development of intracranial hypertension.

Responses of endocrine organs to severe craniocerebral trauma were studied; morphology of changes in the hypothalamic area in diencephalic-catabolic and areactive syndrome was described. It turned out that the most important developments were those pertaining to diagnosis of disorders of water-electrolyte metabolism and carried out on sectional material and discovery of unknown syndrome, i.e. compression of the pituitary gland in the Turkish saddle (intrasellar hypertension). This discovery was registered by the International Academy of Authors of Scientific Discoveries and Inventions. Its authors got silver medals.

The second promising trend was research in the field of pathologic anatomy of cerebrovascular neurosurgical diseases. It was initiated by Matsko D.E. who described morphology of intracranial aneurysms in his thesis for a degree of a Candidate of Medical Science. Pathologic anatomy of developmental defects of vessels of the brain and spinal cord was studied profoundly. It resulted in defense of a thesis for a degree of a Doctor of Medical Science by Matsko D.E.

The book entitled "Aneurysms and Developmental Defects of Cerebral Vessels", summarizing the material of two theses, presenting the first classification of cerebral aneurysms and demonstrating new approaches to study of aneurysm formation, was published in 1993 (Medvedev Yu.A., Matsko D.E.). This book and "Sketches on Pathology of the Nervous System" edited by Medvedev Yu.A. and Matsko D.E., were the first to describe morphology of places of branching of cerebral arteries (bifurcations), i.e. a "springboard" where aneurysms are formed. This research led to discovery of a segmentary structure of the Willis circle (Medvedev Yu.A., Zabrodskaya Yu.M.) and an unknown disease - distentio juncturarum circuli arterialis cerebri (Medvedev Yu.A., Bersnev V.P., Zabrodskaya Yu.M.). Both discoveries were registered by the International Academy of Authors of Scientific Discoveries and Inventions in 1999-2000. They served the basis for working out a new conception of aneurysm origin set forth in "Origin of Bifurcation Aneurysms of Basal Arteries: A New Conception" published in 2000 (Medvedev Yu.A., Zabrodskaya Yu.M.). Research of many years revealed sources of persistent recurrence of cerebral arteriovenous malformations. It made it possible to describe extravascular clusters of endothelial cells tending to formation of a vascular network. The notion of epileptic leukoencephalopathy was formulated (Medvedev Yu.A.).A thesis of Kudaibergenova A.G. became a finishing touch in a cycle of developments of great practical value. It is devoted to chronometry of brain contusion foci. A thesis of Zyablitseva I.F. written a bit earlier contains recommendations on determination of a term which has passed since the moment of hemorrhage and encephalomalacia.

Brochures with recommendations and manuals for doctors, elucidating practically all the problems studied at the Laboratory, were published. The employees received four patents on their inventions. Publication of the first fundamental "Atlas of CNS Tumors" is worth mentioning separately (Matsko D.E., Korshunov A.G., 1998). This atlas is better than analogous foreign publications in many aspects. Thus, it has won the recognition of pathoanatomists and neurosurgeons of Russia and countries of the CIS.