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  • 1990-1994  (5)
  • Cerebral vasospasm  (2)
  • Acoustic neurinoma  (1)
  • Angiography  (1)
  • CDDP  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Prognosis of intracranial germ cell tumours: Effectiveness of chemotherapy with cisplatin and etoposide (CDDP and VP-16) (1993)
    Springer
    Acta neurochirurgica 120 (1993), S. 111-117 
    Details
    ISSN: 0942-0940
    Keywords: Germ cell tumour ; chemotherapy ; CDDP ; VP-16
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A co-operative study for patients with intracranial germ cell tumours was performed to analyze their prognosis and the effectiveness of Cisplatin/Etoposide (CDDP/VP-16) chemotherapy. A total of 46 patients; 30 primary and 16 recurrent cases were registered from 15 participating neurosurgical institutions in Japan. Based on histological criteria and tumour markers, they were classified into three groups; germinoma, germinoma with syncytiotro-phoblastic giant cell (STGC), and non-germinomatous malignant tumour. Sixteen patients were treated with CDDP/VP-16 chemotherapy alone and the other 30 patients were treated by a combination of surgery and/or radiation in addition to chemotherapy. Eleven out of 13 patients (85%) with germinoma showed a complete (n=10) or partial (n=1) response to CDDP/VP-16 chemotherapy even if their tumours were recurrent and there was evidence of CSF dissemination. For the germinoma with STGC and non-germinomatous malignant tumour, a high response rate; 100% for the former and 78% for the latter, could also be achieved in both the primary and the recurrent cases except in those cases of immature teratoma. Their survival times were still different between them. Two-year survival was 50% in germinoma with STGC and 48% in non-germinoma, while it was 88% in germinoma cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02112027
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Normovolaemic induced hypertension therapy for cerebral vasospasm after subarachnoid haemorrhage (1990)
    Springer
    Acta neurochirurgica 103 (1990), S. 18-26 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral vasospasm ; haemorrhagic infarction ; intracranial aneurysm ; normovolaemic induced hypertension therapy ; subarachnoid haemorrhage ; Swan-Ganz catheter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We showed that normovolaemic induced hypertension therapy was effective in reducing ischaemic symptoms attributed to cerebral vasospasm in 41 patients after subarachnoid haemorrhage. By inducing hypertension to 25% to 50% above normal systolic arterial blood pressure, we observed that in 17 of 24 cases (71%) neurological deficits improved. In four cases of haemorrhagic infarction, the blood pressure rose to over 50% of systolic arterial pressure, and a low density area was confirmed on computerized tomography (CT) scan prior to vasospasm. Induced hypertension was therefore not considered when a low density area was revealed on CT scan. Restriction of fluid input is usually a factor in producing hypovolaemia after a neurosurgical operation. Intravascular volume expansion has been reported effective in reversing ischaemic deficits. However, according to Poiseuille's equation, increasing blood volume to a state of hypervolaemia can not enhance flow. The cerebral blood flow (CBF) was raised by increasing perfusion pressure, reducing viscosity, or increasing blood vessel diameter. Intravascular volume expansion elevates not only systemic arterial pressure, but also pulmonary artery wedge pressure over 18 mmHg and cardiac index over 2.2. Since pulmonary oedema and congestive heart failure may develop, one should monitor haemodynamic parameters with the Swan-Ganz catheter as a preventive measure. We emphasize that normovolaemic induced hypertension, maintaining haemodynamics subset 1 of the comparable haemodynamic subsets, is effective in raising perfusion pressure of CBF.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420187
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Preservation of cochlear nerve function in acoustic neurinoma surgery (1993)
    Springer
    Acta neurochirurgica 123 (1993), S. 8-13 
    Details
    ISSN: 0942-0940
    Keywords: Acoustic neurinoma ; cochlear nerve ; hearing preservation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A total of 55 cases with unilateral acoustic neurinoma which were operated on by the lateral suboccipital approach was studied to elucidate factors which influence postoperative hearing acuity. We analyzed several factors: preoperative hearing level, tumour size, tumour consistency (cystic or solid), and anatomical location of the cochlear nerve. The size of the tumours ranged from 1.2 to 5.8 cm in diameter. Thirty of 55 cases (55%) preoperatively had remaining cochlear function. The smaller the size of tumour, the higher was the preoperative hearing level excepting those tumours with a diameter of 5 cm or greater, which had relatively good hearing and often contained large cysts. As to the consistency of the tumours, 41 were solid and 14 were cystic, where 19 (46%) and 11 (79%) cases had had preoperative hearing, respectively. Anatomical continuity of the cochlear nerve was maintained at surgery in 15 of 30 cases with preoperatively remaining hearing; cochelar function was preserved after surgery in 9 of the 15 cases. It was located counter-clockwise (caudally) to the facial nerve at an angle of 50 degrees on average when they were projected on the right side. The distance or interrelation between the two nerves had no bearing on postoperative hearing preservation. Postoperatively, hearing acuity was improved in 6 cases (20%) with a mean value of 5.6 dB, unchanged in 3 (10%), and deteriorated in 21 (70%) among the 30 cases with remaining preoperative-hearing. When the tumour was less than 2 cm or cystic, better hearing preservation was expected. Hearing was preserved in 4 cases of the 19 solid tumours (21%) and in 5 of the 11 cystic tumours (45%). No cases with preoperative hearing deficit greater than 60 dB showed postoperative improvement to a useful hearing level.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476279
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  • 4
    Electronic Resource
    Electronic Resource
    Effects of prophylactic intrathecal administrations of nicardipine on vasospasm in patients with severe aneurysmal subarachnoid haemorrhage (1994)
    Springer
    Acta neurochirurgica 131 (1994), S. 19-25 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral vasospasm ; cerebral aneurysm ; calcium antagonist ; nicardipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Calcium antagonists are currently most widely used for chronic cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH). However, the vasodilatory effects of systemically administered calcium antagonists can be limited secondary to hypotension. We previously compared intrathecal and intravenous routes of administration of nicardipine. Intrathecal administration of nicardipine significantly dilated spastic basilar arteries on day 7 in a two-haemorrhage canine model of vasospasm. In the present communication, the effects of prophylactic, serial administration of intrathecal nicardipine on vasospasm was examined in 50 patients. Patients were classified as Fisher SAH group 3 and all had their aneurysms clipped within 3 days of SAH. Following placement of a cisternal drain, 2 mg of nicardipine was injected, three times each day for an average of 10 days. The control group consisted of 91 similar patients with cisternal drainage not treated with nicardipine. Intrathecal administration of nicardipine decreased the incidence of symptomatic vasospasm by 26%, angiographic vasospasm by 20% and increased good clinical outcome at one month after the haemorrhage by 15%. Postoperative angiograms revealed that patients in the nicardipine group showed less vasospasm of major cerebral arteries, near the tip of a drain in the basal cistern, but vasospasm in the A2 and M2 segments was not decreased. Radio-isotope cisternography suggested that nicardipine might not reach the subarachnoid space around A2 and M2 segments. Nine patients complained of headache probably secondary to nicardipine induced vasodilation. Two patients suffered from mengingitis, both were successfully treated. Intrathecal administration nicardipine appears to be effective in the treatment of vasospasm, but side effects were significant.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401450
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Contribution of meningeal arteries to cerebral arteriovenous malformations (1993)
    Springer
    Neuroradiology 35 (1993), S. 205-209 
    Details
    ISSN: 1432-1920
    Keywords: Cerebral arteriovenous malformation ; Meningeal arterial feeders ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied 52 patients with cerebral arteriovenous malformations (AVMs) by selective angiography and found that half received supply from meningeal branches of the external carotid artery. The frequency of meningeal arteral contribution was significantly higher in superficial AVMs, especially in the temporal, parietal and occipital regions. Larger lesions and higher shunt with steal phenomena on angiography were other factors favouring a meningeal arterial contribution. Diffuse AVMs with pial arterial networks around the nidus commonly received meningeal blood supply. In the past, meningeal feeders have been though to be congenital, but this study suggests that they may develop during growth of the AVM.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00588495
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    Paper (German National Licenses)
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