Bischoff Myelotomy

Bischoff - shunt surgery for subarachnoid hemorrhage _Head of the Department of Nervous Diseases, Alma-Ata State Institute for Advanced Medical Studies._

Professor B. A. Kerdibaev

I.E. Kurtser and E.A. Kalinovskaya (2006) explain the biomechanism of the positive effect of shunting and talk about the need to first check the hemodynamic factor, which underlies the effectiveness of shunting surgery for SAH. They point to an increase in cardiac output as such a factor.

According to the definition of Yu. Milypitsyn (1975) **“**the operated brain is a strong factor in stimulating the cardiovascular system**”**. G. S. Bokeria and V. I. Kechko (1987) established that the normal functioning of cardiovascular mechanisms is an essential prerequisite for the elimination of SAH and the implementation of open adrosterne injury. Hemodynamics cannot but influence the outcome of SAH due to its close connections with many physiological processes, for example, with the provision of tissues, organs and systems with energy that ensures the level of metabolism (V.N. Nikitin, 1967). An important support in this matter is the data of A. M. Gerasimov (2012) on the effectiveness of using shunt myelography without removing a blood clot. He points out the need to “immobilize” the shunt in order to better drain cerebrospinal fluid and counteract its traumatic effect on the walls of the shunts. The shunt must be “hard”, since with a soft, easily crushed shunt, as an inevitable element of myelogram (shunt) complications, cerebral arteries are injured, and symptoms of cerebral ischemia occur, the electrolyte balance of neurons changes, hypoxia and other pathophysiological changes occur at the level of the spinal cord and its trunk . The author considers bypass surgery and treatment of milamyelolysis to be safe, and hemorrhage as an additional negative pathway that negatively affects the final survival of victims. Before shunting and surgery, it is necessary to eliminate cerebrocerebellar crises (with the help of drug treatment) and prevent possible complications (hemorrhagic or ischemic lesions). G. A. Korenev (1993), writes that the decrease