Library

X
feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Versorgung des Schädel-Hirn-Traumas im neurochirurgischen Zentrum (1996)
    Springer
    Der Chirurg 67 (1996), S. 1114-1122 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Brain injury ; Traumatic intracranial hematoma ; Intracranial hypertension. ; Schlüsselwörter: Schädel-Hirn-Trauma ; traumatische intrakranielle Blutung ; Hirndrucktherapie.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Die aktive und intensive Behandlung eines Patienten mit Schädel-Hirn-Trauma (SHT) erhöht seine Chance auf Erholung deutlich im Vergleich zum Spontanverlauf. Trotz rückläufiger Morbidität und Letalität hat sie aber wegen der Irreversibilität einmal stattgehabter cerebraler Schäden Grenzen. Im Mittelpunkt steht die Vermeidung primärer und sekundärer Schäden durch die Beherrschung einer intrakraniellen Druckerhöhung als Folge von Blutungen, Hirnschwellung und Liquorzirkulationsstörungen. Als Eckpfeiler der Therapie haben sich bei traumatischen Blutungen ihre operative Evakuation, beim Ödem die Gabe von Mannitol und eine milde Hyperventilation und beim Liquorüberdruck eine therapeutische Liquordrainage etabliert. Bei therapieresistenten Hirndrücken kann auf Barbiturate und auf kurzzeitige, aggressive Hyperventilation zurückgegriffen werden.
    Notes: Summary. Aggressive treatment of patients with severe head injury increases the chance for survival and good functional outcome in most cases. To prevent irreversible cerebral lesions, the key point of treatment is the management of intracranial hypertension caused by intracranial hematomas, brain edema and impaired circulation of cerebrospinal fluid (CSF). Therapeutic standards are surgery of traumatic hematoma, osmotherapy and mild hyperventilation for brain edema, and CSF drainage. In highly elevated intracranial pressure (ICP) administration of barbiturates and forced hyperventilation can be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050112
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Die Therapie des chronischen subduralen Hämatoms im ersten Lebensjahr (1999)
    Springer
    Monatsschrift Kinderheilkunde 147 (1999), S. 586-588 
    Details
    ISSN: 1433-0474
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Bei den chronisch subduralen Hämatomen handelt es sich um eine hygromähnliche Flüssigkeitsansammlung zwischen Dura und Arachnoidea, die nur selten aussschließlich aus Blut besteht und in der angloamerikanischen Literatur auch als „subdural effusion” bezeichnet wird. Die Genese auch dieser Hämatome ist in der Regel traumatisch, sie treten jedoch mit Latenz auf. Nur sehr wenige Fälle sind im Zusammenhang mit Hirntumoren, Infarkten oder Hämophilie beschrieben [10]. Die klinischen Symptome sind meist unspezifische Zeichen der diffusen intrakraniellen Druckerhöhung mit zunehmendem Kopf- umfang bei gespannter Fontanelle, erhöhter Irritabilität, Nahrungsverweigerung, Erbrechen und Lethargie [10]. In seltenen Fällen kommt es zu zerebralen Krampfanfällen. Der Häufigkeitsgipfel liegt im Alter von 6 Monaten. Nach Vollendung des 1. Lebensjahres finden sich die chronisch subduralen Hämatome im Kindesalter nur noch sehr selten. Bei frühzeitiger Diagnose ist die Prognose der chronisch subduralen Hämatome sehr günstig. Deshalb müssen sie trotz ihrer Seltenheit im frühen Kindesalter in der Differentialdiagnose der intrakraniellen Drucker- höhung im ersten Lebensjahr berücksichtigt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050466
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Lumbale Luxationsfraktur mit Paraplegie nach Beckengurtverletzung Fallbericht (1996)
    Springer
    Der Unfallchirurg 99 (1996), S. 905-908 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Lumbale Luxationsfraktur ; Paraplegie ; Key words Lumbar luxation fracture ; Paraplegia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: This report details a traumatic spinal column lesion due to a lap seat belt. A healthy 22-year-old woman was involved in a car accident and suffered a lumbar luxation fracture at the level L 1 – L 2. She developed acute transsectional symptoms with paraplegia and severe hyperpathia in her legs. Plain radiographs (antero-posterior and lateral projection) and lumbar CT scans demonstrated an instabile flexion-distraction fracture with ventral compression of the vertebral body of L 2 and ventrolisthesis of L 1 over L 2. Surgical reposition of the luxation fracture and removal of a spinal epidural hematoma was performed 4 h after the trauma. Stabilization was achived by monosegmental dorsal transpedicular spondylodesis with a fixateur interne. In follow-up the neurological deficits markedly improved. Six months after the trauma, the patient is able to walk, has no paresis and no genitourinary disturbances; only mild dysesthesia remains. This posttraumatic course confirms that spinal traumas below L 1 which spare the conus have a favorable prognosis, because the peripheral nerves of the cauda equina are able to recover. This injured patient was the only one using a lap seat belt; the other four passengers in the same compact car – wearing lap and diagonal seat belts – suffered no harm. We conclude that lap seat belts are not acceptable as an adequate security standard in modern automobile technology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050073
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Experience with the infratentorial supracerebellar approach in lesions of the quadrigeminal region, posterior third ventricle, culmen cerebelli, and cerebellar peduncle (1992)
    Springer
    Acta neurochirurgica 114 (1992), S. 135-138 
    Details
    ISSN: 0942-0940
    Keywords: Infratentorial supracerebellar approach ; quadrigeminal region ; pineal tumour ; third ventricle tumour
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report about our experience with the infratentorial supracerebellar approach in 23 patients operated on for lesions located in the posterior part of the third ventricle, quadrigeminal plate, culmen cerebelli and cerebellar peduncle. Three patients had transient worsening of their deficits immediately after surgery. Three patients developed haemorrhages post-operatively requiring surgical evacuation. One of them died. None of the patients developed specific complications which could without any doubt be attributed to the approach. We concluded that in combination with intra-operative CSF drainage and the sitting position the infratentorial supracerebellar approach allows safe access to lesions situated in an area limited by the posterior part of the third ventricle, the fastigium level and both cerebellar peduncles.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01400602
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Osteoplastic frontal sinusotomy and extradural microsurgical repair of frontobasal cerebrospinal fluid fistulas (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 245-254 
    Details
    ISSN: 0942-0940
    Keywords: Cerebrospinal rhinorrhoea ; ethmoid sinus ; frontal sinus ; head injury ; skull base tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The choice of the surgical approach and operative technique for the management of cerebrospinal fluid (CSF) fistulas of the anterior cranial fossa are still a controversially discussed topic. Although “extracranial” approaches through the paranasal sinuses are becoming increasingly more popular among otolaryngologists and maxillo-facial surgeons, most neurosurgeons traditionally prefer the “intracranial” repair of CSF fistulas by a craniotomy. We present an approach through the frontal sinus for the repair of dural defects behind the posterior wall of the frontal sinus and at the floor of the anterior cranial fossa. The operative procedure comprises the following main steps: 1) exposure of the anterior wall of the frontal sinus by a bicoronal incision; 2) excision of the anterior wall without frontal burr holes; 3) bilateral removal of the posterior wall of the fronal sinus; 4) extradural inspection of the dura behind the frontal sinus and above the cribriform plate, ethmoidal roof, and orbital roof bilaterally; 5) closure of dural tears by direct suture and a periosteal graft; 6) reinsertion of the anterior wall of the frontal sinus and fixation with titanium micro plates. Twenty-five patients operated upon using this technique are described. The aetiology of the frontobasal lesion was traumatic in 23, and an ethmoid carcinoma in two. In all patients, the dural fistulas were successfully repaired during the initial procedure. One patient died from sudden circulatory arrest after an uneventful postoperative course of nine days. Otherwise, there were no postoperative complications. This technique affords atraumatic extradural inspection and repair of dural fistulas bilaterally behind the frontal sinus, and above the cribriform plate and the ethmoidal and orbital roofs with none or minimal brain retraction. It therefore allows early repair of CSF fistulas also in patients with severe brain injury. Although we consider the extradural closure of fistulas the method of choice, this approach also allows for a combined extradural-intradural procedure, thus enabling the surgeon to treat associated intradural pathologies, such as traumatic lesions or tumours of the frontal cranial base.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411734
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    Early aneurysm surgery: a 7 year clinical practice report (1988)
    Springer
    Acta neurochirurgica 90 (1988), S. 91-102 
    Details
    ISSN: 0942-0940
    Keywords: Ruptured aneurysm ; early surgery ; pre- and postoperative management ; morbidity ; mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary One hundred and fifty patients with intracranial aneurysms, operated on consecutively in the early stage in our department, were re-evaluated retrospectively. Seven surgeons operated on 159 aneurysms in 150 patients. Seventy-nine percent of the patients were in grades I–III (scale of Hunt and Hess), 21% in grades IV–V. Seventyone percent had a severe haemorrhage (classification of Fisheret al.), 21% had an intracerebral haematoma. Intraoperative CSF drainage was an almost indispensable tool while postoperative external drainage did not prove to be helpful in preventing vasospasm and/or hydrocephalus. Induced hypotension was abandoned in favour of temporary clipping. Thirteen percent of the patients suffered a permanent or fatal immediate postoperative deterioration, while 11% developed delayed neurological deficits. Five percent were related to vasospasms alone, they were all transient. Five percent had vasospasm combined with other complications. One of them had permanent and the other one fatal deficits. One percent deteriorated due to embolism or occluded vessels. The results improved with the introduction of the calcium channel blocker nimodipine, induced hypertension and transcranial Doppler sonographic control of the vasospasm. Patients in good preoperative condition had a good early outcome in 69%. The result was fair in 21% and poor in 4%, while 6% of the patients died. In the poor condition group 22% of the patients made a good, 13% a fair, and 59% a poor recovery, 16% of whom died. We conclude that today the results of early surgery are becoming similar to those of delayed surgery and that the importance of vasospasm for an unfavourable outcome is insignificant in comparison with lesions produced by the haemorrhage and operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01560561
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 7
    Electronic Resource
    Electronic Resource
    Morbidity and mortality after early aneurysm surgery — a prospective study with nimodipine prevention (1989)
    Springer
    Acta neurochirurgica 96 (1989), S. 1-7 
    Details
    ISSN: 0942-0940
    Keywords: Early aneurysm surgery ; morbidity ; mortality ; vasospasm ; nimodipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Based on the outcome in 116 consecutive patients who were subjected to early aneurysm operation combined with additional nimodipine treatment, and who were controlled by transcranial Doppler (TCD) sonography, a morbidity and mortality analysis was performed. Of the 84 patients who preoperatively were in Hunt & Hess grades III, 79 patients (94%) were considered to show a favourable (good-fair) late recovery, while one patient (1%) had a poor outcome, and four patients (5%) died. Of the 32 poor condition patients (H & H IV–V), 17 (53%) showed a favourable recovery, while seven (22%) had a poor outcome, and eight patients (25%) died. Altogether, 20 patients (17%) had an unfavourable (poor-dead) outcome. Only two of these patients showed delayed ischaemic deterioration, one as a consequence of a secondary occlusion of perforating branches from the basilar artery and one with decompensated vasospasm after the evacuation of an epidural haematoma and a longlasting severe systemic hypotension; both these patients died. In another six of the patients with an unfavourable outcome, this was mainly related to a complicated surgery. The unfavourable outcome was related to primary brain damage produced by the subarachnoid haemorrhage (SAH) in ten patients and in two patients to internal medical complications. In addition to the two patients who died following delayed deterioration, secondary neurological dysfunction occurred in 11 patients. In 10 of these patients transient neurological dysfunction was attributed to vasospasm or to a combination of vasospasm with intraoperative or postoperative complications. One further case of delayed deterioration was attributed to secondary occlusion of the internal carotid artery after a complicated operation. From these data we conclude that following early aneurysm operation combined with intravenous nimodipine treatment, vasospasm alone is no more a major clinical problem. Morbidity and mortality are mainly related to primary effects of the SAH and/or complicated surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01403488
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 8
    Electronic Resource
    Electronic Resource
    Morphological changes following experimental intraventricular haemorrhage and intraventricular fibrinolytic treatment with recombinant tissue plasminogen activator (2000)
    Springer
    Acta neuropathologica 100 (2000), S. 561-567 
    Details
    ISSN: 1432-0533
    Keywords: Key words Cerebral haemorrhage ; Intraventricular haemorrhage ; Ependyma ; Tissue plasminogen activator
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intraventricular haemorrhage (IVH) occurs in up to 50% of patients with primary intracerebral haemorrhage and aneurysmal subarachnoid haemorrhage. It is a significant and independent contributor to mortality and morbidity in these intracranial haemorrhages. Using a model of isolated IVH, we assessed the morphological changes induced by intraventricular bleeding and investigated the effects of intraventricular fibrinolytic treatment following IVH. IVH was induced in 32 pigs by intraventricular infusion of 10 ml autologous blood along with thrombin. The treatment group received an intraventricular injection of 1.5 mg (1 mg/ml) tissue plasminogen activator (tPA) following the injection of blood. The placebo group received the same volume of normal saline. Morphological examinations of the brains were carried out 7 days and 6 weeks following IVH. The ventricles were incompletely filled with blood and significantly enlarged in the placebo group 7 days after the IVH. In contrast, no residual intraventricular clots were visible in the animals treated with tPA, and the diameters of the lateral ventricles had returned to normal within 7 days. Marked losses of the ependymal covering of the ventricular walls were found in the placebo-treated animals, while the ependymal layer was largely intact in the animals treated with tPA. No haemorrhages induced by tPA were observed. The results indicate that intraventricularly administered tPA significantly enhances the lysis of intraventricular blood clots, accelerates the resolution of acute posthaemorrhagic hydrocephalus, and preserves the integrity of the ependymal layer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004010000219
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 9
    Electronic Resource
    Electronic Resource
    Large colloid cyst in lateral ventricle simulating brain tumour (1990)
    Springer
    Acta neurochirurgica 104 (1990), S. 151-155 
    Details
    ISSN: 0942-0940
    Keywords: Neuroepithelial cyst ; colloid cyst ; lateral ventricle ; CT ; MRI ; stereotactic puncture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This case report describes a patient presenting with symptoms of increased intracranial pressure, whose computerized tomographic (CT) scan was highly suggestive of a large low-grade glioma invading the basal ganglia. Magnetic resonance imaging (MRI) revealed a well-demarcated space-occupying mass of increased intensity in the left lateral ventricle and adjacent white matter. Following stereotactic biopsy, which yielded a homogeneous jelly-like material, the mass was removed microsurgically and was found to be most like a colloid cyst on histological examination. Discussion focusses on the clinical and differential diagnostic implications of this very unusual combination of findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01842834
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 10
    Electronic Resource
    Electronic Resource
    Microsurgery of deep-seated cavernous angiomas: Report of 26 cases (1991)
    Springer
    Acta neurochirurgica 108 (1991), S. 91-99 
    Details
    ISSN: 0942-0940
    Keywords: Cavernous angioma ; complications ; indications for surgery ; vascular malformation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors review 26 patients with deep-seated cavernous angiomas which were removed by microsurgery. Ten of the angiomas were located in the insula and basal ganglia, 2 in the thalamus, 5 in the midbrain, 8 in the pons, and 1 in the brachium pontis. The patients were among 73 consecutive cases operated on between August 1983 and December 1989 for symptomatic cavernous angiomas in various locations. In 11 cases total excision of the cavernoma was achieved without producing additional neurological deficits. Postoperative neurological recovery was delayed in 7 patients. In the remaining 8, the complicated postoperative course was caused by bleeding from residual parts of the malformation or damage to long-tract pathways in two cases, respectively, vascular injury during dissection in three cases, and paradoxical air embolism in one case. In order to achieve a satisfactory surgical result, it is stressed that particular attention has to be paid to the operative approach, to careful dissection and complete removal of the malformation, to perforating arteries, and to anomalous venous drainage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01418515
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...