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  • 1
    Electronic Resource
    Electronic Resource
    Balloon angioplasty immediately after surgical clipping for symptomatik vasospasm on admission. Report of four cases (1995)
    Springer
    Neurosurgical review 18 (1995), S. 79-84 
    Details
    ISSN: 1437-2320
    Keywords: Angioplasty ; balloon catheter ; subarachnoid hemorrhage ; surgical treatment ; vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In spite of recent advancements in the management of ruptured aneurysm, there are still controversies as to how to threat the patients in serious conditions, one of these concerning whether to operate patients admitted with symptomatic vasospasm (vasospasm on admission) and when. While early surgery may protect patient from further rupturing, it may also increase risk of worsening by inducing much more vasospasm. Four cases of severe vasospasm associated with aneurysmal subarachnoid hemorrhage (SAH) were reported. All of these cases showed symptomatic and angiographical vasospasm on their admission 3–11 days after initial attack of SAH. All cases had a preoperative clinical grading using Hunt & Kosnik of IV, and were treated by early surgery with clipping followed by percutaneous balloon angioplasty (PTA) immediately after clipping. Two cases returned to their previous occupations, while one case remained bed ridden and one died in spite of therapy. Early surgery in this series actually prevented further rupturing, but it is not clear whether PTA immediately after clipping may prevent further deterioration by progression of vasospasm. For selected cases especially those with reversible ischemia, this combined treatment may offer more favorable results than late surgery with conservative medical care. Further investigation is necessary to support the validity of this therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00417662
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Evaluation of regional cerebral blood flow using single photon emission tomography for the selection of patients for local fibrinolytic therapy of acute cerebral embolism (1996)
    Springer
    Neurosurgical review 19 (1996), S. 231-236 
    Details
    ISSN: 1437-2320
    Keywords: Cerebral blood flow ; cerebral embolism ; fibrinolysis ; HM-PAO ; ischemic flow threshold ; SPECT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To clarify the indications for local fibrinolytic therapy for acute cerebral embolism, correlation among initial regional cerebral blood flow (rCBF) abnormalities, recanalization timing, and computed tomographic scan (CT) findings two days later were evaluated in 17 cases. All cases included had embolic occlusion of middle cerebral or internal carotid arteries which showed no abnormal findings on initial CT corresponding to the acute events but did show abnormal CBF reduction on initial single photon emission computed tomography (SPECT). Relative rCBF was evaluated as the percentage radioisotope counts in the region of interest (ROI) of the affected side against the corresponding ROI in the unaffected contralateral side. Within 6 hours from onset, there was a tendency towards reversed time dependent tolerance of cortical infarction with residual relative rCBE. Hemorrhagic transformation was observed in one case whose relative rCBF was 35% or less. In 10 patients whose occluded arteries were not recanalized within 6 hours, cortical areas with residual relative rCBF of 70% or more did not develop infarction. In conclusions, a pre-therapeutic rCBF study using SPECT is considered to be mandatory: cases with moderate ischemia involving the cortex with residual relative rCBF of between 35% and 70% may be good candidates for local fibrinolytic therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00314837
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Clinical and angiographic follow-up of childhood-onset moyamoya disease (1995)
    Springer
    Child's nervous system 11 (1995), S. 591-594 
    Details
    ISSN: 1433-0350
    Keywords: Cerebral angiography ; Childhood onset ; Intracranial hemorrhage ; Long-term follow-up ; Moyamoya disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To clarify the differences between childhood-onset moyamoya disease and that with onset in adulthood, we studied the clinical course and angiographic findings of adult patients (over 20 years of age) with moyamoya disease of childhood onset (up to 15 years of age). The clinical course in 25 patients could be assessed. The follow-up period was 5–27 years. Neurological deficits were noted in 11/23 and mental disorders in 9/21. In all except one, the illness had started before the age of 7 years. Neither neurological nor mental condition changed during or after adolescence (15–20 years of age). Two patients died of intracranial hemorrhage. The disease progressed in angiographic stage until adolescence, but had stabilized or almost stabilized by the age of 20 years. This study indicates that moyamoya disease with onset in childhood carries high morbidity and mortality. The disease advances in angiographic stage between childhood and adolescence, but stabilizes or almost stabilizes between adolescence and adulthood.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00300998
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Attempts to induce immune-mediated cerebral arterial injury for an experimental model of moyamoya disease (1992)
    Springer
    Child's nervous system 8 (1992), S. 263-267 
    Details
    ISSN: 1433-0350
    Keywords: Cerebral arterial injury ; Cerebral arteritis ; Experimental model ; Intracisternal injection ; Moyamoya disease ; Serum sickness
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To examine the possible role of immune complex-mediated reactions in moyamoya disease, a novel experimental system using a serum sickness vasculitis model combined with intracisternal administration of antibodies or antigens was developed. Twenty-eight male Japanese white rabbits were divided into four experimental groups. Group I was treated twice with intravenous injections of heterologous serum. In group II, intracisternal administration of antibodies or antigens was combined with the second injection of serum. Group III received a single intravenous injection of antigens simulaneously with intracisternal administration of antibodies. Group IV was a technical control group. Cerebral arteritis, although likely in the initial process, was induced only in groups II and III. This study suggests that the cerebral arteries rarely develop arteritis in a serum sickness model alone. The cerebral arteries may require additional intracisternal administration of antibodies or antigens to induce in situ deposition of immune complexes around them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00300793
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    Paper (German National Licenses)
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