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  • 1
    Electronic Resource
    Electronic Resource
    Fracture of the lumbar vertebral ring apophysis imitating disc herniation (1991)
    Springer
    Acta neurochirurgica 113 (1991), S. 52-56 
    Details
    ISSN: 0942-0940
    Keywords: Spine ; intervertebral discs ; fractures ; sciatica
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three cases of fracture of the lumbar ring apophysis representing type I, II, and III are described in detail and the natural history of these fractures is discussed. The symptoms of apophyseal fractures are usually low back pain, sciatica, tension signs, and neurological deficits, thus imitating the symptoms of lumbar disc herniation. Plain radiography and magnetic resonance are often inconclusive and computed tomography is essential for the true diagnosis. An explanation of the different types of fractures, based on the osteogenesis of the human vertebra, is proposed. Recognition of these fractures is essential for proper planing of surgery, and apophyseal ring fractures must be suspected when children and young adults show signs of lumbar disc herniation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402115
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Risk of infection after cerebrospinal fluid shunt: An analysis of 884 first-time shunts (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 1-7 
    Details
    ISSN: 0942-0940
    Keywords: Cerebrospinal fluid shunts ; complications ; hydrocephalus ; infections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Postoperative infections are major complications of cerebrospinal fluid (CSF) shunting in the treatment of hydrocephalus and other conditions with obstructed CSF circulation. In a retrospective study 884 first-time shunted patients with hydrocephalus operated on in the years 1958–1989 were investigated with special reference to the infection rate and to the influence of the following variables: time period, age of the patient, education of the neurosurgeon, length and time of the operation and the exact placement of the distal drain. The overall infection rate for all implanted CSF shunts was 7.4% (5.7–9.3%) and the acute rate of infection was 6.2% (4.6–7.9%). The rate of infection was virtually constant for all variables with the exception of the education of the neurosurgeon. Neurosurgical trainees particularly had a significantly higher rate of infection. Shunt infection is still a major complication. The infection rate has not declined in recent decades. It is not possible to relate any main cause to the infection rate. The literature recommends removal of the infected shunt combined with antibiotics. The use of prophylactic antibiotics is still controversial. No prospective, double-blind studies, including a sufficiently large number of patients to evaluate this issue, exist today.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411427
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  • 3
    Electronic Resource
    Electronic Resource
    Patient attitudes to myelography, computed tomography and magnetic resonance imaging when examined for suspected lumbar disc herniation (1995)
    Springer
    Acta neurochirurgica 133 (1995), S. 3-6 
    Details
    ISSN: 0942-0940
    Keywords: Patient attitude ; medical decision making ; intervertebral disc displacement ; lumbar disc
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In reports of diagnostic methods in disorders of the spine focus is centred on diagnostic resolution, while psychological effects and patients' discomfort are often disregarded. To get a comprehensive picture of the appropriateness of a new technology the latter factors need to be explored and included in an assessment. In a prospective study, eight patients with signs of lumbar disc herniation underwent myelography, computed tomography and magnetic resonance imaging. A structured patient interview on attitudes to these technologies was carried out after all three examinations had been carried out. Myelography was most often reported painful and unpleasant among the three modalities. Discomfort due to magnetic resonance imaging stem from the narrow calibre of the machine and the noise. In computed tomography immobilization was the main reason for discomfort. Altogether most patients preferred computed tomography. In view of the fact that myelography must be considered as diagnostically inferior to the other two examinations, the reported discomfort from myelography indicates that computed tomography and magnetic resonance imaging should be the primary examinations for patients with lumbar disc herniation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01404939
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  • 4
    Electronic Resource
    Electronic Resource
    A critical assessment of clinical diagnosis of disc herniation in patients with monoradicular sciatica (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 40-44 
    Details
    ISSN: 0942-0940
    Keywords: Intervertebral disc displacement ; neurological examination ; quality of test ; receiver operating characteristics curve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The diagnostic power or clinical parameters in the diagnosis of lumbar disc herniation in patients with monoradicular pain was evaluated in a prospective study with a 100% verification of the diagnosis. Eighty patients with monoradicular pain corresponding to the fifth lumbar or the first sacral nerve root were included. Pre-operatively a number of clinical parameters were recorded and compared to the intra-operative finding of a disc herniation. The parameters were analysed by receiver operating characteristic (ROC) curves. Results from the available literature were analysed by ROC curves for comparison. In 76% of the cases a disc herniation was discovered. The level of the disc herniation was correctly predicted in 93% of these cases by the location of the pain alone or supplemented by neurological signs. Apart from radicularly distributed pain, all parameters in the present study and in the literature had no or low diagnostic accuracy. Thus, in patients with monoradicular sciatica further clinical parameters do not add to the diagnosis of lumbar disc herniation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411722
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  • 5
    Electronic Resource
    Electronic Resource
    Computerized infusion test compared to steady pressure constant infusion test in measurement of resistance to CSF outflow (1992)
    Springer
    Acta neurochirurgica 119 (1992), S. 12-16 
    Details
    ISSN: 0942-0940
    Keywords: CSF dynamics ; resistence to CSF outflows ; CSF infusion test ; computerized analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Resistance to cerebro-spinal fluid outflow is together with intracranial pressure the most important parameter in the investigation of patients with disturbances of CSF dynamics. The methods for determination of resistance are either unreliable or too time-consuming for routine clinical use, which has limited the popularity of this kind of measurement. In this paper a method for computerized acquisition and processing of an infusion test is described. A good correlation to a standard technique is documented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01541775
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  • 6
    Electronic Resource
    Electronic Resource
    Frequency and causes of shunt revisions in different cerebrospinal fluid shunt types (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 189-194 
    Details
    ISSN: 0942-0940
    Keywords: Cerebrospinal fluid shunts ; hydrocephalus ; revision rate ; shunt types
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Shunt complications and revisions are common in hydrocephalic patients treated with a ventriculo-atrial or a ventriculo-peritoneal shunt. The reported revision rate differs very much but the rate of revision is close to 50% in many papers. Data from 884 hydrocephalic patients treated with various shunt types in the period 1958–1989 were recorded retrospectively in order to evaluate the frequency of revision for various shunt types and secondly to analyse the specific reasons for the shunt revisions. The rate of shunt revision was 45%. The Pudenz shunt was revised more often (62%) than the remaining shunt types. The Hakim and the Orbis-Sigma shunts had fewer revisions (35% and 27%, respectively) than the other observed shunt types. A defect of or an obstruction in the ventricular catheters was a frequent cause of revision followed by a defect or an obstruction of the distal catheter, a displacement of the distal catheter and an acute infection. Because of the higher rate of revision for the Pudenz shunt the rate of the above mentioned specific complications is also higher in most of the subgroups for that specific shunt type. Driven by these experiences it is reasonable to seek to develop and introduce new shunt types in an attempt to reduce the complication rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01410625
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  • 7
    Electronic Resource
    Electronic Resource
    Contrast enhanced computed tomography and magnetic resonance imaging in the diagnosis of recurrent disc herniation (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1256-1260 
    Details
    ISSN: 0942-0940
    Keywords: Intervertebral disc displacement ; recurrence ; computed tomography ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A positive result of re-operation in patients with recurrent symptoms after lumbar disc surgery is likely only if a new disc herniation is present. An improved ability to differentiate between recurrent disc herniation and scar tissue by contrast enhanced CT and MRI is suggested in earlier studies. In a prospective study 29 patients were selected for operation for suspected recurrent disc herniation. The inclusion of the patients was based on clinical symptoms and signs and myelography or non-enhanced CT. All patients were examined by CT and MRI both with and without intravenous contrast pre-operatively. The examinations were evaluated blind on a five point scale and statistical analysed by a regret function. Intravenous contrast improved the diagnostic power of both CT and MRI. MRI was superior to CT in both non-enhanced and enhanced examinations. MRI with intravenous contrast enhancement is proposed as the primary examination in patients with suspected recurrent disc herniation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411052
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  • 8
    Electronic Resource
    Electronic Resource
    The effect of nimodipine on ICP and CBF in patients with normal-pressure hydrocephalus (1990)
    Springer
    Acta neurochirurgica 102 (1990), S. 11-13 
    Details
    ISSN: 0942-0940
    Keywords: Intracranial pressure ; cerebral blood flow ; perfusion pressure ; nimodipine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Eight patients with normal-pressure hydrocephalus (NPH) were studied. The resting mean arterial blood pressure (MABP) was 100 (90–125)mmHg and the mean intracranial pressure (ICP) was 11 (5–17)mmHg. ICP and MABP were continuously measured intraventricularly and intra-arterially, respectively. Changes in global cerebral blood flow (CBF) were estimated by the arteriovenous oxygen difference method. Intravenous nimodipine (15 microgram/kg/hour) was given in the first 2 hours and 30 microgram/kg/hour in the next 2 hours. MABP was reduced 23 (4–47)mmHg (p〈0.05). ICP was increased 3 (0–10)mmHg (p 〈 0.05). CBF was unchanged in the group on the whole, but in 4 of patients a major drop in perfusion pressure was seen, and CBF decreased 6, 11, 23 and 34%, respectively. Thus these findings underline the importance of maintaining the perfusion pressure under treatment with nimodipine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402178
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  • 9
    Electronic Resource
    Electronic Resource
    Magnetic resonance imaging, computed tomography, and myelography in the diagnosis of recurrent lumbar disc herniation (1990)
    Springer
    Acta neurochirurgica 102 (1990), S. 122-126 
    Details
    ISSN: 0942-0940
    Keywords: Recurrent lumbar disc herniation ; MRI ; CT ; myelography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirteen patients with recurrent symptoms after lumbar discectomy were evaluated. All the patients were enrolled in the study on the basis of clinical symptoms and signs only. The patients were examined with MRI, CT, and myelography in order to compare a) the clinical findings with the imaging investigations, b) the predictive value of the different investigations, and c) the clinical and investigative results with the operative findings. All patients were operated upon according to the clinical findings, and the surgical results were used as the final diagnosis. In six patients a new disc herniation was detected. In the remaining cases surgery revealed either scar tissue or nothing to explain the recurrence of the symptoms. The three imaging modalities were analysed by receiver operating characteristic (ROC) curves. The areas under the ROC curves were 0.68 for MRI, 0.83 for CT, and 0.43 for myelography. The difference in areas between CT and myelography was significant (p〈0.05). The results indicate that CT has the highest predictive value for demonstrating the recurrence of a lumbar disc herniation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405425
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  • 10
    Electronic Resource
    Electronic Resource
    The electronic states of TeO"2
    Amsterdam : Elsevier
    Chemical Physics Letters 144 (1988), S. 450-454 
    Details
    ISSN: 0009-2614
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology , Physics
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0009-2614(88)87294-4
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