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  • 1
    ISSN: 0942-0940
    Keywords: Intracerebral mass haematoma ; blood pressure ; brain oedema ; tissue elastance ; fluid conduction ; experimental and clinical data
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This is an investigation into the prognostic factors of 117 patients with spontaneous normo- and hypertensive intracerebral haematomas, supported by animal experiments. Preserved tissue elastance and fluid conduction enables the drainage of intrinsic haematoma serum into the CSF spaces in normotensive patients, who showed an increased extension of a perifocal hypodensity in the CT. Arterial hypertension decreased the possibility of fluid resolution. Our experimental studies showed that in hypertensive cases the serum remained trapped in the haematoma, which explains the small hypodense area around the haematoma in most of the hypertensive cases. If as an exception in hypertensives a perifocal hypodensity develops then it acts as additional space-occupying factor. Corresponding observations were made in hypertensive animals which showed a reduced serum movement out of the haematoma, but an increased Evans-Blue content in the perifocal tissue. Both pathological mechanisms explain the poorer prognosis in patients with intracerebral haematomas associated with high arterial blood pressure.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 92 (1988), S. 106-117 
    ISSN: 0942-0940
    Keywords: Sacral space-occupying lesions ; sacral tumours ; surgical management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nine cases of space-occupying lesions of the sacral bone are presented. The problems of the clinical diagnosis, which in many cases comes too late, are discussed together with the indications for surgical treatment in this special group of tumours. The main clues are provided by the changes in the X-rays as well as the more modern imaging techniques (CT and MRI). The surgical technique aims at a most radical tumour removal with preservation of the sacral nerve roots, after which stabilisation of the sometimes weakened pelvic girdle may be necessary. The good prospects of complete removal of these tumours of the sacrum with satisfactory results seem to be very little known and justifies further dissemination of this information.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 24 hours following a cold induced oedema in cats rCBF was measured in the lesion area, the bluish stained cortex immediately adjacent to the lesion, a cortical area remote from the lesion, and in the contralateral uninjured hemisphere. Thereafter the brain was frozen and the respective tissue areas were removed and analyzed for water and electrolyte content as well as metabolite concentrations. It seems, that in the neighbourhood of a local lesion at least 3 different brain regions can be differentiated with regard to their characteristic pattern of data. In non-oedematous regions either hyperaemia or hypoaemia could be observed. In areas with local brain oedema rCBF was reduced inversely proportional to the tissue water content. It seems that the “luxury perfusion syndrome” represents only one of several possibilities of regional flow pattern around a local brain lesion and its occurrence is confined to non-oedematous areas. Reduction of rCBF by 20% in the remote and by 33% in the adjacent oedematous areas does not cause significant changes in the tissue concentrations of phosphocreatine, ATP and ADP, while lactate and the L/P ratio are clearly elevated. A significant drop of the high-energy compounds is found in the lesion, where the flow was reduced by about 62%. This indicates that the local tissue hypoxia occurs as a result of the diminution in local microcirculation.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1435-2451
    Keywords: Nervous lesion ; Kind of lesion ; Therapeutic measurements ; Nervenläsion ; Verletzungsarten ; Therapiemöglichkeiten
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In weniger als 1 % der Fälle sind Nervenschäden nach schweren Unterschenkelverletzungen operativ zu versorgen: NC-Klinik: 28 rekonstruktive Eingriffe am Unterschenkel, jedoch 362 am Unterarm in 15 Jahren; Unfallchirurgische Klinik: 264 schwerste Unterschenkel- und Fußverletzungen, darunter nur zwei Nervenverletzungen. Der N. peronaeus ist häufiger betroffen als der N. tibialis. Auch bei erhaltener Kontinuität des Nerven können endoneurale Blutungen und innere Zerreißungen zu ausgedehnten axonalen Schäden führen. Die Art der Nervenläsion (Neuropraxie, Axonotmesis, Neurotmesis) sollte möglichst in den ersten drei Monaten geklärt werden, da sie die Prognose als auch die in den ersten sechs Monaten einzuleitenden operativen Maßnahmen bestimmen.
    Notes: Summary In less than 1 % of the cases nervous lesions after severe lower leg lesions demand surgical treatment: Neurosurgical Clinic: 28 reconstructive interventions on the lower leg, however, 362 on the forearm in 15 years; Clinic of Accident Surgery: 264 severest lower leg- and foot-injuries, among them only two nervous lesions. The n. peronaeus is more frequently affected than the n. tibialis. Even if continuity of the nerve is maintained, endoneural bleeding and internal ruptures can lead to extensive axonal lesions. The kind of nervous lesion (neurapraxia, axonotmesia, neurotmesia) should be clarified during the first three months, if possible, since it determines the prognosis as well as the kind of operative treatment during the first six months.
    Type of Medium: Electronic Resource
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