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  • 1
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Fibrinolyse ; Intrazerebrale Blutung ; CT ; Kontrastmittel ; Komplikation ; Key words Fibrinolysis ; Cerebral hemorrhage ; Computed tomography ; Contrast medium ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary
    Notes: Zusammenfassung
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0942-0940
    Keywords: Keywords: Spinal stenosis surgery; intervertebral disc surgery; treatment outcome; computed tomography.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ The discussion regarding factors that reliably predict the long-term surgical results in patients with lumbar spinal stenosis is still going on. This retrospective study analyses the relation between the dimensions of the dural sac and patients' clinical status before and after decompressive operations performed with or without additional discectomy.  The type of surgery performed in 134 patients and the dural sac dimensions measured on postmyelograpic computed tomography in 100 of these patients were related to the Prolo scores before surgery and at follow-up (mean 46 months). The degree of dural sac compression correlated significantly with the patients' postoperative Prolo score and with the difference between the pre- and postoperative scores. The dural sac diameters predicted outcome after surgery more reliably than the preoperative Prolo scores. There was no statistically significant difference in the outcome when comparing patients with and without additional discectomy.  The results presented suggest that the relief of symptoms after decompressive surgery for lumbar spinal stenosis correlates with the degree of the dural sac compression and that the simultaneous presence of disc herniation necessitating additional discectomy does not influence the postoperative outcome. However, these results have to be confirmed by prospective studies.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 142 (2000), S. 553-556 
    ISSN: 0942-0940
    Keywords: Keywords: MRI; postoperative findings; cervical discectomy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Background. The anterior approach for cervical discectomy with methacrylate-implant involves manipulations on vertebral bodies and ligaments. Foreign materials like methacrylate and fibrin sponge are inserted. On postoperative MRI it may be difficult to differentiate pathological from “normal” findings caused by routine manipulations.  Method. In this study 14 patients free of symptoms after anterior discectomy with methacrylate-implant were examined clinically and a MRI was performed on the 7th day after surgery and again after a 6 month follow-up. All patients had an uneventful recovery and no signs of inflammation after surgery.  Findings. Independent of the underlying pathology (e.g. soft or hard disc) 73% of the patients had a signal reduction within the vertebral bodies adjacent to the operated disc on T1-weighted spin-echo images on the 7th postoperative day. Signal intensities were normal after 6 months in all patients. Remarkable metal artifacts were present in one patient only. The methacrylate-implant could be identified as a hypo-intense structure on all sequences at any time without artifacts. In 80% of the cases a hyperintensity was found on T2-weighted images between the methacrylate-implant and the dura on the 7th postoperative day. A protrusion of the posterior ligament was present at the level of the operated disc on day 7 after surgery, which had resolved completely 6 months later. This may mimic residual disc tissue or osteophytes early after surgery.  Interpretation. It is very important to know this “normal” postoperative appearance of the cervical spine in order to avoid misinterpretations.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1920
    Keywords: Key words Creutzfeldt-Jakob disease ; Prion disease ; Magnetic resonance imaging ; Dementia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To ascertain whether increased grey matter signal intensity on T2-weighted images in patients with sporadic Creutzfeldt-Jakob disease (CJD) corresponds to the stage and severity of this disease, we correlated MRI findings in four of our own and previously reported patients with sporadic CJD with the clinical variants, neuropathological changes at autopsy, duration of the disease and survival time after MRI examination. Of 15 patients with the extrapyramidal type of CJD, 10 showed increased signal in the basal ganglia on T2-weighted images. One of seven patients with the Heidenhain variant had increased signal in the occipital cortex. Patients without increased grey matter signal intensity had a longer overall duration of CJD (P = 0.035). Although the interval between onset of neurological symptoms and MRI was not different, patients without increased grey matter signal also survived longer after MRI examination (P = 0.022).
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1920
    Keywords: Key words Sarcoidosis ; Magnetic resonance imaging ; Brain neoplasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sarcoidosis may also present as an extra- or intra-axial mass involving the central nervous system. These lesions are sometimes operated upon, because a neoplasm is suspected. We report two cases of unusual tumour-like extra- and intra-axial sarcoidosis. The extra-axial mass was just medial to the jugular foramen. Its morphology and signal characteristics differed from the more common lesions in this area. The intra-axial mass was in the temporal lobe, with only minor leptomeningeal involvement. Extra-axial sarcoidosis can be confused with a meningioma because these lesions can give relatively low signal on T2-weighted images. Intra-axial masses are presumed to represent a propagation and fusion of multiple leptomeningeal granulomas through the Virchow-Robin spaces in the brain; this pattern can be sought on contrast-enhanced T1-weighted images.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1920
    Keywords: Key words Cytomegalovirus encephalitis ; Lymphoma ; cerebral ; Wernicke's encephalopathy ; Magnetic resonance imaging ; AIDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a 29-year-old HIV-positive patient admitted with dysarthria, ataxia and somnolence. Imaging findings were typical of Wernicke's encephalopathy, but autopsy revealed cytomegalovirus encephalitis and primary cerebral lymphoma.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Aneurysma ; vertebrobasilär ; Embolisation ; Operation ; Key words Aneurysm ; vertebrobasilar ; Embolization ; Surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Evaluation of clinical and morphological results in 44 consecutive patients with 45 aneurysms of the posterior circulation. Methods: Retrospective analysis of patient charts and angiograms of all vertebrobasilar aneurysms diagnosed in our department between 10/95 and 08/99. All aneurysms were treated. Results: 36/44 pts had a hemorrhage. Hunt/Hess (HH) gradings were as follows: HH1 in 10, HH2 in 6, HH3 in 9, HH4 in 10 cases, and HH5 in 1 case. 38 pts with 39 aneurysms were treated exclusively in the endovascular way, 3 pts with 3 aneurysms were operated on. 3 patients had to be operated upon following insufficient endovascular treatment. Endovascular treatment resulted in 63% total and 27% subtotal occlusions, results being stable in 85%. For our pts as a whole, the grading according to the Glasgow Outcome Scale (GOS) was GOS1 in 4, GOS3 in 8, GOS4 in 7, and GOS5 in 25 cases. Conclusion: Despite a less favourable clinical status of pts pre-treatment, the results of our interdisciplinary concept compare favourably with those of other surgical or interventional groups.
    Notes: Zusammenfassung Fragestellung: Klinische und morphologische Ergebnisse der endovaskulären Behandlung bei 44 konsekutiven Patienten mit 45 Aneurysmen der hinteren Zirkulation. Methodik: Retrospektive Auswertung der Krankenblätter und Angiogramme aller von 10/95 bis 08/99 diagnostizierten vertebrobasilären Aneurysmen. Alle Aneurysmen wurden behandelt. Ergebnisse: Bei 36/44 Patienten lag eine Blutung vor. Die Graduierung entsprach in 10 Fällen HH1 nach Hunt/Hess (HH), in 6 Fällen HH2, in 9 Fällen HH3, in 10 Fällen HH4 und in 1 Fall HH5. 38 Patienten mit 39 Aneurysmen wurden ausschließlich endovaskulär, 3 Patienten mit 3 Aneurysmen ausschließlich operativ behandelt. 3 Patienten mit 3 Aneurysmen mußten wegen unbefriedigender endovaskulärer Behandlung anschließend operiert werden. Endovaskulär konnten 63% der Aneurysmen total, weitere 27% subtotal ausgeschaltet werden, in 85% war das Behandlungsergebnis stabil. Für die gesamte Patientengruppe entsprach die Graduierung nach der Glasgow Outcome Skala (GOS) in 4 Fällen GOS1, in 8 GOS3, in 7 GOS4 und in 25 Fällen GOS5. Schlußfolgerungen: Trotz eines schlechteren klinischen Ausgangszustands der Patienten vor Behandlung sind die Ergebnisse unseres interdisziplinären Konzepts vergleichbar mit denen operativer oder interventioneller Arbeitsgruppen.
    Type of Medium: Electronic Resource
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