Prof. Andrii SIRKOUkraine
Mechnikov Dnipropetrovsk regional hospital
| 2005 to present | Head of Center for Cerebral Neurosurgery Dnipropetrovsk regional clinical hospital |
| 2001 - 2022 | Professor of Department Neurology and Neurosurgery Dnipro State Medical Iniversity |
| 2021 - | President of Ukrainian Neurosurgical Association |
Neurosurgery, neurotraumatology
Andrii Sirko
President of the Ukrainian Neurosurgical Association (UNA)
Andrii Sirko is a Doctor of Medicine, Professor, Honored Doctor of Ukraine, Professor of the Department of Nervous Diseases and Neurosurgery, Dnipro State Medical University, head of the Neurosurgical Department No. 2, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipropetrovsk Region Council. A. Sirko is a valid member of the European Association of Neurosurgical Societies (EANS). A. Sirko has been representing Ukraine in the military committee of the World Federation of Neurosurgical Societies (WFNS) since 2016. Neurosurgery Expert in the Healthcare Department of Dnipropetrovsk Region State Administration, member of the specialized scientific council D 26.557.01, member of the editorial board of the Ukrainian Neurosurgical Journal, honorary editor of the international journal: Archives in Neurology & Neuroscience.
Main fields of scientific research: neurotrauma, neuro-oncology, combat gunshot brain injuries and wounds, restorative and reconstructive neurosurgery. Authored 339 research papers (14 included in Scopus and Web of Science) and 23 declaratory utility model patents of Ukraine. Authored 8 monographs, 4 of which are about combat-related central and peripheral nervous system traumas. Invited lecturer at international congresses, symposia, and conferences (the 4th WFNS training course in Ukraine: Modern Aspects of Neurotrauma, the 25th Annual Conference of Neurotrauma Society of India, the XVI World Congress of Neurosurgery, the neurosurgical meeting: Posterior Fossa/Cranial Base Neurosurgery, the Committee for European Education in Anaesthesiology (CEEA)).
A top specialized neurosurgical care provider to the ATO/OOS participants in the East of Ukraine. Certificate of merit awarded by the Verkhovna Rada of Ukraine: For Services to the Ukrainian People. Dignity and Honor badge awarded by the Central Military Academy of the National Guard of Ukraine; Badge of Honor awarded by the Ministry of Defense of Ukraine
Surgical treatment of severe penetrating brain injuries. Lessons learned from 10 years of the Russian-Ukrainian war
1109 14:00-14:10
Military Neurosurgery/302A
OBJECTIVE Since February 2022, the number of casualties in the Russian-Ukrainian war have dramatically increased, with a high incidence of penetrating traumatic brain injuries (pTBIs). To date, there has been limited evaluation of pTBI of the anterior skull base involving the paranasal sinuses. The objective of this study was to highlight the authors’ experi- ence with this injury pattern and identify specific factors associated with favorable short-term (1-month) outcome and survival.
METHODS The authors conducted a single-institution retrospective review of patient data collected from the 1st year of the Russian-Ukrainian war at a frontline civilian Ukrainian hospital. To prevent complications from conservative treatment of pTBI with paranasal sinus injury, a protocol of early primary neurosurgical treatment including debridement/hematoma evacuation, repair of dural defects with vascularized pericranial flaps, and titanium plating of external/skull base defects was implemented. Using 1-month postoperative Glasgow Outcome Scale scores, the authors defined a favorable outcome as good recovery/moderate disability and a poor outcome as severe disability/vegetative state/death. Patient demographics, injury characteristics, imaging findings, and postoperative complications were assessed. Logistic regres- sion models were used to estimate the effect of patient characteristics on unfavorable outcome or survival.
RESULTS From February 2022 to February 2023, there were 141 pTBIs (20%) involving the paranasal sinuses, 134 (95%) due to blast fragmentation. One hundred eighteen patients (84%) had a favorable outcome. Most patients with pTBIs (69%) had other nonbrain-related injuries. While 48 patients (34%) presented with preoperative CSF leak, only
1 patient (0.7%) had persistent postoperative CSF leak, which was managed with lumbar drainage. High admission Glasgow Coma Scale (GCS) score, favorable injury lateralization (single hemisphere involved), and low Injury Severity Score (ISS) were associated with significantly increased odds of favorable short-term outcome, whereas high admission GCS scores and no midline shift were associated with significantly increased odds of survival.
CONCLUSIONS This was the largest single-year study on neurosurgical treatment of wartime pTBI involving the para- nasal sinuses. Implementation of primary neurosurgical intervention at the time of presentation demonstrated promising early results and a shift away from expectant management of this injury pattern. The association of high admission GCS score, low ISS, favorable injury lateralization, and no midline shift on favorable short-term outcomes or survival has not been previously documented with this injury pattern.