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  • 1
    Electronic Resource
    Electronic Resource
    Surgery of hydrocephalus: past, present and future (1992)
    Springer
    Acta neurochirurgica 116 (1992), S. 155-160 
    Details
    ISSN: 0942-0940
    Keywords: Hydrocephalus ; ventriculo-cisternostomy ; shunt complications ; CSF overdrainage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The treatment of hydrocephalus, over the centuries, underwent three stages of evolution. During antiquity, middle ages and Renaissance, hydrocephalus was not understood. Medical treatment was useless; surgery was hopeless. The second stage extends from the XIXth century to the end of the first half of the XXth century. CSF circulation was now understood; surgery however, remained inefficient, but some patients survived with arrested hydrocephalus. The third stage begins in the nineteen fifties with the development of silicone shunts with a valve. Surgery transforms the prognosis of hydrocephalus, but the number of post-operative complications creates new problems. The different attempts that have been made during these past two decades to solve these problems are reviewed. They have resulted in a reduction of the mechanical and infectious complications. CSF overdrainage has been minimized. Percutaneous ventriculocisternostomies have in some cases replaced shunts. In the future, to improve outcome in these hydrocephalics, surgery, when indicated, should be performed as early as possible. Knowledge and prevention of the causes of hydrocephalus should be developed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01540869
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  • 2
    Electronic Resource
    Electronic Resource
    A new surgical approach to the third ventricle with interruption of the striothalamic vein (1979)
    Springer
    Acta neurochirurgica 47 (1979), S. 135-147 
    Details
    ISSN: 0942-0940
    Keywords: Third ventricle ; surgical approach ; striothalamic vein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the removal of tumours that develop within the third ventricle, most approaches are not entirely satisfactory. Therefore, a new approach has been devised: transfrontal exposure of the anterior portion of the frontal horn; coagulation and section of the striothalamic vein in order to open up the roof of the third ventricle; use of a blunt spatula introduced in the foramen of Monro and pushed backwards under the choroïd plexus. This approach has been used in ten cases. Postoperative mortality has been nil; the surgical approach has not apparently been responsible for any sequelae. It is simple and gives a good view of the third ventricle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406399
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  • 3
    Electronic Resource
    Electronic Resource
    Anévrismes sacculaires rompus du système vertébro-basilaire (1969)
    Springer
    Acta neurochirurgica 20 (1969), S. 105-122 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Diese Untersuchung der rupturierten sackförmigen Aneurysmen des Vertebralis-Basilaris-Systems umfaßt 107 Fälle, davon 19 eigene Beobachtungen. Die klinischen Zeichen weisen nur sehr selten auf einen Sitz des Aneurysmas in diesem Gefäßbezirk hin. Daraus ergibt sich, daß die Diagnose ausschließlich mit der Vertebralis-Angiographie gestellt werden kann, und daß diese zweckmäßigerweise doppelseitig ausgeführt wird. Begleitende Gefäßspasmen sind selten. Ihr prognostischer Wert ist gering. Die chirurgische Ausschaltung des Aneurysmas scheint zur Zeit die beste Behandlung zu sein, zumal kürzlich eingeführte neue technische Möglichkeiten (hypertonische Lösungen, optische Vergrößerung) es ermöglicht haben, die operativen Risiken erheblich zu mindern, und weil nur sie eine dauerhafte Heilung gewährleistet.
    Abstract: Summary This study of ruptured saccular aneurysms of the vertebro-basilar system, consists of 107 cases (19 of them were personal cases). The clinical signs very seldon indicated that the ruptured aneurysm lay on the vertebro-basilar system. Because of this the diagnosis can only be made by vertebral angiography which should be carried out bilaterally. Accompanying vascular spasm is rare and is of little prognostic significance. Exclusion of the aneurysm by surgery appears to be definitely the best treatment since recent technical developments (e.g. hypertonic solutions, magnifying optical systems) have allowed a considerable reduction in the risks of surgery and since it alone is capable of producing a definite cure.
    Notes: Résumé Cette étude des anévrismes sacculaires rompus du système vertébrobasilaire porte sur 107 cas, dont 19 personnels. De l'ensemble des signes cliniques recueillis, il ressort que leur groupement est très rarement évocateur du siège vertébro-basilaire de l'ectasie rompue. Par conséquent, seule l'angiographie vertébrale peut apporter la solution diagnostique et ce d'autant plus qu'elle sera bilatérale. Quant au spasme vasculaire associé, il est rare et sa valeur pronostique faible. L'exclusion chirurgicale de l'anévrisme parait actuellement la meilleure thérapeutique d'autant que de récents artifices techniques (solutions hypertoniques, magnification optique) ont permis de diminuer notablement les risques de l'intervention, et qu'elle est seule susceptible d'aboutir à une guérison définitive.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401956
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  • 4
    Electronic Resource
    Electronic Resource
    Medulloblastoma in childhood. Survival and functional results (1979)
    Springer
    Acta neurochirurgica 48 (1979), S. 1-15 
    Details
    ISSN: 0942-0940
    Keywords: Medulloblastoma ; survival ; functional results ; side-effects of radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report on a series of 57 medulloblastomas in children operated upon between 1964 and 1976. Among these children, 44 completed the treatment with radiotherapy to the whole central nervous system. The postoperative mortality rate is 10.5%. Postoperative deaths occurred mainly in infants or when a tumour involved the brain stem. The five-year survival rate is 54% in the whole series. It rose to 71% in the patients who completed the treatment with radiotherapy. The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. IQ varies from 70 to 90 in 58% of the children; it is below 70 in 31%. Behavioural disturbances are found in 93% of cases. 82% have defective spatial orientation, dysphasia, or dysgraphia. In order to evaluate the responsibility of X-ray therapy for the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances. No relation was found between these disturbances and a persistent ventricular dilatation or an endocrine dysfunction. However the endocrine assessment showed growth hormone deficiency in 65% of the children, short stature in 55%, and compensated hypothyroïdism in 58%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406016
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  • 5
    Electronic Resource
    Electronic Resource
    Medical abortion: ethics, laws and religious points of view (1996)
    Springer
    Child's nervous system 12 (1996), S. 507-514 
    Details
    ISSN: 1433-0350
    Keywords: Prenatal diagnosis ; Abortion ; Religious points of view ; Abortion laws
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Central nervous system malformations are now frequently detected prenatally. Unfortunately, the progress in diagnosis having far outstripped that in therapeutics, the only question to answer is usually whether the pregnancy should be continued or terminated. Pediatric neurosurgeons have to deal with such problems more and more often. They are asked to give an opinion on the prognosis. In many cases the law requires their involvement in the decision about the possibility of a “therapeutic”, or more correctly a medical, abortion. The final decision is based on the religious attitutes of the family and the neurosurgeon and on the law of the country in which the medical abortion would be performed. This article reviews the points of view of the main religions and also the laws in different countries. This knowledge may be of some help to neurosurgeons, especially when the religious attitudes of those involved are different or when their final decision is not in accordance with the law of the country.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00261602
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  • 6
    Electronic Resource
    Electronic Resource
    A department of pediatric neurosurgery in a pediatric hospital (1995)
    Springer
    Child's nervous system 11 (1995), S. 38-40 
    Details
    ISSN: 1433-0350
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00338424
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  • 7
    Electronic Resource
    Electronic Resource
    Vasomotor origin of intracranial pressure waves in hydrocephalic infants (1980)
    Springer
    European journal of nuclear medicine 5 (1980), S. 511-514 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract By measuring cerebral blood volume (CBV) and intracranial pressure (ICP) variations at the same running time during sleep, it has been demonstrated that the ICP wave which appears during the REM sleep in hydrocephalic infants is produced by intracerebral vaso-dilatation. Nine infants with stabilized hydrocephalus were investigated by non-invasive means: REM phases were distinguished with the usual polysomnographic electrodes. Intracranial pressure was measured with a fontanel palpation transducer and CBV variations were obtained by recording 99mTc activity at the head level after in vivo labelling or red cells with 99mTc — pertechnetate. The timeactivity curves, obtained from regions of interest and selected on the sequential radioisotope images, show that an increased ICP wave, occurring during the REM period, is related to a simultaneous increase in the blood volume, limited to the cerebral sector and not to the area of the external carotid artery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252041
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  • 8
    Electronic Resource
    Electronic Resource
    Malignant hemispheric tumors in childhood (1993)
    Springer
    Child's nervous system 9 (1993), S. 131-135 
    Details
    ISSN: 1433-0350
    Keywords: Supratentorial tumors ; Astrocytomas ; Ependymomas ; Secondary malignancies ; Paediatric patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty-four malignant hemispheric tumors in children less than 15 years old were treated in the pediatric neurosurgical department of the H ôpital des Enfants Malades between 1970 and 1989. (1) These tumors evolved rapidly in most cases. However the pre-operative evolution in 20% of the patients had a duration of more than 6 months, which favors the hypothesis that at least one-fifth of these tumors result from malignant transformation of a benign lesion. This observation should prompt neurosurgeons to operate on all benign hemispheric tumors as soon as they are diagnosed. (2) Five of the 64 patients had two successive malignant diseases. In four cases the other malignant disease was an acute lymphoblastic leukemia. (3) Among the malignant hemispheric tumors, the grade III and IV astrocytomas had a dismal prognosis. As it is known from previous studies that grade I and II astrocytomas have a good prognosis in children, it can be concluded that grading these tumors is essential. By contrast, almost one out of two patients with malignant ependymoma was alive 5 years after treatment. This implies that the grading of ependymomas is of modest prognostic values. (4) The harmful effect of radiotherapy was evaluated by comparing the functional outcome of children operated for a benign hemispheric tumor to that of children operated and irradiated for a malignant hemispheric tumor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00272260
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  • 9
    Electronic Resource
    Electronic Resource
    The development of pediatric neurosurgery in Paris How to create something out of nothing: reflexions on the methodology (1997)
    Springer
    Child's nervous system 13 (1997), S. 465-470 
    Details
    ISSN: 1433-0350
    Keywords: Key words History of neurosurgery ; Pediatric neurosurgery ; Progress in pediatric neurosurgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Up to 1960, children in need of neurosurgical treatment in France were treated either in neurosurgical departments where anesthetists, nurses and neurosurgeons had no specialized training in pediatrics or in departments of pediatric surgery in which the specific aspect of neurosurgery was ignored. Clearly a mutation was needed before any progress could be made: the development of pediatric neurosurgery services. This essay tells the story of the creation of the first pediatric neurosurgery service in France, of the difficulties encountered and of the strategies applied to overcome them. It also recalls the discussions about what size such a service should be and whether it should be located in a general hospital or in a pediatric hospital. During the second half of the twentieth century, progress in neurosurgery, and more specifically in pediatric neurosurgery, has been tremendous. The contribution of the pediatric neurosurgery service at Les Enfants Malades in Paris is briefly summarized.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003810050120
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  • 10
    Electronic Resource
    Electronic Resource
    Lumbosacral lipomas with spina bifida (1988)
    Springer
    Child's nervous system 4 (1988), S. 354-360 
    Details
    ISSN: 1433-0350
    Keywords: Lumbosacral lipomas ; Lipomyelomeningoceles ; Spinal-lipomas ; Spina bidida ; Occult spinal dysraphism ; Fat metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathological and metabolic characteristics, as well as the anatomical and functional evolution of lumbosacral lipomas, were studied in a series of 73 patients operated on between 1970 and 1983. The pathological study showed that they are mainly composed of adipocytes, but that they also possess fibrous tissue, vessels, and nerve fibers. Innervated muscle fibers, contracting under proper nerve stimulation, were found in several cases. Lipogenesis and lipolysis are the same in lumbosacral lipomas and in normal fat tissue. However, these lipomas can grow with the rest of the fatty pool. Moreover, spontaneous progressive worsening of the clinical status has been observed in 36% of the cases. Surgery is efficient and not harmful to the patient. Postoperative mortality was nil. Early postoperative worsening occurred in 2.7% of the cases. The 6% rate of late postsurgical deteriorations should be compared to the 36% to 56% rate found when patients are not operated on. Three different mechanisms are responsible for clinical worsening: compression or stretching of the cord, and cord injury on the posterior upper limit of the spinal defect. In each case, one mechanism is prevalent. Three different types of lumbosacral lipomas can thus be individualized. The surgical implications of these data are discussed. The necessity for early and systematic surgical treatment is pointed out.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00270610
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