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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 138 (1996), S. 1241-1245 
    ISSN: 0942-0940
    Keywords: Intracranial aneurysm clip ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Deflection angles of 36 types of Sugita intracranial aneurysm clips (Elgiloy), 2 types of Yasargil clips (Phynox), A Kirschner chip (SUS316) and a silver clip were examined by suspending each in a 1.5-tesla MRI (TOSHIBA MRT-200/FXII). Image artifacts of 5 types of intracranial aneurysm clips were also studied quantitatively with respect to their ratio of artifcat/actual clip size using a spin-echo sequence with T1-weighted (Time of repetition (TR)=500 ms, Time of echo (TE)=20 ms) and T2-weighted (TR=2000 ms, TE=80 ms) images. All the Sugita clips from mini type to long type showed a deflection angle of less than 1.0 degree, the Yasargil clips less than 2.0 degrees, the Kirschner chip less than 6.0 degrees, and the silver chip did not move at all. Both brands of clips are therefore suitable for intracranial applications. The artifact size was directly proportional to the clip size and weight, though the ratio of artifact/actual width tended to decrease proportionately as the actual size and weight increased. The ratio of the width seemed slightly bigger than that of the length, but the difference did not reach statistical significance. There was no significant difference in the ratio of image artifacts/clip size between T1- and T2-weighted images.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 136 (1995), S. 29-36 
    ISSN: 0942-0940
    Keywords: Cavernous malformation ; optic chiasma ; magnetic resonance imaging ; surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two cases of cavernous malformation of the optic chiasm are reported, and 12 previously reported cases are reviewed. The first patient presented with gradually progressive and the second patient with a subacute chiasmal syndrome. Total excision was performed in both cases. Visual function improved slightly after surgery in the first patient while the other showed marked improvement. Although cavernous malformations are angiographically occult, pre-operative diagnosis has become possible based on the characteristic features such as repeated haemorrhages in multiple sinusoidal structures as revealed by magnetic resonance imaging (MRI). A gliotic interspace between the malformation and normal neural tissue provides a plane of cleavage for dissection which permits total excision without causing new deficits. Review of previously reported cases revealed that chiasmal cavernous malformations haemorrhage more frequently than those in the brain. Early diagnosis with total excision is the treatment of choice for cavernous malformations of the optic chiasma.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 138 (1996), S. 970-976 
    ISSN: 0942-0940
    Keywords: Cytokine ; interleukin-6, neurosurgery ; steroid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cytokine responses to surgical trauma have been studied in 70 patients undergoing various neurosurgical procedures. Serum concentrations of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), interleukin-8, (IL-8), tumour necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were measured before and after surgery using enzyme-linked immunosorbent assays. The serum concentrations of IL-1ß, IL-8, TNF-α, and IFN-γ did not change significantly following neurosurgical operations. In contrast, serum IL-6 levels were significantly elevated following surgery, peaking at postoperative day 1 and then gradually decreasing. Maximum IL-6 concentrations were considerably higher in patients who underwent surgery for brain tumours or aneurysms as compared with patients who had a ventriculoperitoneal shunt, neurovascular decompression or transsphenoidal adenomectomy. Intra-operative use of methylprednisolone, which is known to block the production and action of cytokines, suppressed the increase in IL-6 levels after surgery. There was a statistically significant correlation between the IL-6 peak concentration and the length of surgery in patients not treated with steroids, but not in patients treated with steroids. Additionally patients who underwent supratentorial surgery had higher peak concentrations of IL-6 than those who underwent infratentorial surgery. These results suggest that IL-6 is an early marker of tissue damage and may be useful in assessing the extent of postoperative stress.
    Type of Medium: Electronic Resource
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