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  • 1
    ISSN: 1432-1459
    Keywords: Sinus thrombosis ; Computed tomography ; Magnetic resonance imaging ; Thalamus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The case is reported of a patient with primary thrombosis of the internal cerebral veins who presented initially with unilateral and later developed bilateral thalamic lesions revealed by computed tomography. Magnetic resonance imaging and angiography confirmed the diagnosis. Upon anti-coagulation the patient recovered nearly completely.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Cerebral CT ; Nonionic contrast media ; Isotonic dimer ; Double-blind method ; Iodixanol ; Iohexol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Iodixanol is a new nonionic dimer, isotonic with blood at all clinically relevant concentrations. Iodixanol (270 mg I/ml) was compared in a double-blind, randomized, parallel-group, phase-III study to the monomeric nonionic iohexol (300 mg I/ml) for evaluation of safety, tolerability and radiographic efficacy during cerebral CT. One hundred adult patients scheduled to undergo contrast-enhanced cerebral CT were randomly allocated to receive either iodixanol or iohexol. All completed the trial. Safety was evaluated by recording discomfort and other adverse events, tolerance by assessing intensity and incidence of discomfort. Radiographic efficacy was assessed from the diagnostic information and the radiographic density. No serious adverse events occurred. One patient (2 %) in the iodixanol group and one patient (2 %) in the iohexol group experienced a transient reddening at the neck and lower neck-line, respectively. Both contrast agents were well tolerated. One patient (2 %) in the iodixanol group and two patients (4 %) in the iohexol group experienced a sensation of warmth (discomfort) in connection with the injection. No difference between the two contrast media were noted radiographically. This comparison between iodixanol and iohexol showed both contrast media to be safe, well-tolerated and efficacious for use in cerebral CT.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 9 (1999), S. 1061-1065 
    ISSN: 1432-1084
    Keywords: Key words: White matter disease ; Metabolic disease ; Demyelination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Metabolic disorders of the brain are rare, complex and confusing. The diagnostic modality of choice nowadays is MRI. The high diagnostic sensitivity, however, is coupled with a lack of specificity and usually results in the depiction of similar appearing but clinically diverse white matter processes. For this reason it is essential to perform the MRI as early as possible during the course of the disease and to keep in close contact to the referring clinician to optimize image interpretation. Another precondition is to know the natural course of brain myelination and to know how this appears on the individual MR machine with different parameters. In some diseases like phenylketonuria MRI seems to be an excellent tool to monitor dietary treatment and patient compliance. In patients after radio- and / or chemotherapy MRI reveals the radiation induced leucencephalopathy and can usually differentiate between a recurrent malignancy.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 0942-0940
    Keywords: Middle cerebral artery occlusion ; cerebral blood flow ; ischaemia ; reperfusion ; laser Doppler flowmetry ; hydrogen clearance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Monitoring cerebral blood flow during focal ischaemia and reperfusion with established techniques such as hydrogen clearance and autoradiography is difficult. Laser Doppler flowmetry is a new technique, it allows one to continuously measure blood flow in small tissue samples. The objective of this study was to compare laser Doppler flowmetry with hydrogen clearance using a new single fiber probe to obtain measurements in deep brain structures and then to show the temporal profile of cerebral blood flow during focal ischaemia and after reperfusion. First, the single fiber laser Doppler method was compared with the hydrogen clearance method in ten Wistar rats. Second, focal cerebral ischaemia was induced in fifteen Wistar rats using a model of middle cerebral artery occlusion based on the intravascular insertion of a nylon suture; reperfusion occurred after withdrawal of the suture. The laser Doppler probe was placed in the lateral caudatoputamen, and local cerebral blood flow was measured continuously before and during occlusion as well as after reperfusion. The relative blood flow values obtained by the laser Doppler method and the hydrogen clearance method showed a good correlation (r=0.76) and a linear relationship. A rapid decrease in laser Doppler flowmetry to 42±16% of former baseline values was seen with occlusion of the middle cerebral artery; during occlusion cerebral blood flow remained at this level. Reperfusion resulted in a heterogeneous pattern of cerebral blood flow as laser Doppler flowmetry values ranged from 25% to 134% of baseline values. The effects of middle cerebral artery occlusion and reperfusion on cerebral blood flow can be monitored on-line with laser Doppler flowmetry. Our findings suggest that this method, with the high spatial and temporal resolution characteristics of its new single fiber probe, allows one to continuously measure microcirculatory blood flow in deep brain structures.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 0942-0940
    Keywords: Aneurysm ; internal carotid artery ; proximal paraclinoid segment ; carotid-ophthalmic ; balloon occlusion ; clipping
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A method is described in which we use a combined endovascular balloon-catheter technique and open microneurosurgical approach for clipping aneurysms of the proximal paraclinoidal intracranial segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via a double-lumen balloon-catheter, clip application to large and critically located aneurysms is facilitated applying evacuation-decompression to the trapped arterial segment under intra-operative SEP-monitoring.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 33 (1991), S. 338-340 
    ISSN: 1432-1920
    Keywords: Hema ; Latex balloon ; Silicone balloon ; Interventional therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The endovascular treatment of intracranial aneurysms with detachable balloons requires filling materials that harden reliably and are compatible with the balloon. While the incompatibility of latex balloons and hema from different manufacturers is known, no incompatibility has been assumed thus far if both balloon and hema were from the same manufacturer. In two series of experiments, we filled a total of 20 latex balloons with hema as recommended by the balloon manufacturer. Within an observation time of 4 weeks all latex balloons ruptured. At the time of rupture, the balloons had gained 5–10% in weight, most likely due to osmotic shifts in water. Simultaneously, hardening of the hema resulted in a loss of elasticity of the latex. Until these compatibility problems are solved, silicone rather than latex balloons should be used with permanent filling materials such as hema for the endovascular treatment of intracranial aneurysms.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1920
    Keywords: Magnetic resonance imaging ; Glioblastoma ; Surgery ; Methaemoglobin ; Hydrogen peroxide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Postoperative magnetic resonance imaging (MRI) of glioblastomas to assess residual tumour should be performed within the first 4 days following surgery. Early methaemoglobin formation near the resection site may mimic residual tumour if only gadolinium-DTPA-enhanced images are obtained. In a prospective study 24 of 54 patients (44%) showed well-defined areas of increased signal intensity on unenhanced T1-weighted images performed soon after surgery. By in vitro experiments we showed that hydrogen peroxide used in neurosurgery as a styptic agent accelerates formation of methaemoglobin when added to whole blood samples.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1920
    Keywords: Cerebral ischaemia ; Magnetic resonance imaging ; Contrast media ; Superparamagnetic iron oxide ; Stroke model ; Cerebral blood flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An imaging technique capable of detecting ischaemic cerebral injury at an early stage could improve diagnosis in acute or transient cerebral ischaemia. We compared the ability of superparamagnetically contrastenhanced MRI and conventional T2-weighted MRI to detect ischaemic injury early after unilateral occlusion of the middle cerebral artery in 12 male Wistar rats. Permanent vessel occlusion was achieved by a transvascular approach, which has the advantage of not requiring a craniectomy. At 45–60 min after the procedure, the animals had conventional T2-weighted MRI before and after administration of a superparamagnetic contrast agent (iron oxide particles). Unenhanced images were normal in all animals. After administration of iron oxide particles, the presumed ischaemic area was clearly visible, as relatively increased signal, in all animals; this high signal area corresponded to the area of ischaemic brain infarction seen on histological studies. Magnetic susceptibility effects of iron particles cause low signal in normally perfused cerebral tissue, whereas tissue with reduced or absent blood flow continues to give relatively high signal. Our results suggest that superparamagnetic iron particles may significantly reduce the interval between an ischaemic insult and the appearance of parenchymal changes on MRI.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Neuroradiology 38 (1996), S. 663-668 
    ISSN: 1432-1920
    Keywords: Key words Temporal bone ; Spiral (helical) computed tomography ; Three-dimensional reconstruction ; Otological surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the usefulness of spiral CT for preoperative information on the individual anatomy of the temporal bone in a computed three-dimensional (3D) display. In 87 patients with various otological diseases, 3D reconstructions were performed based on spiral high-resolution CT (HR-CT) by volume-rendering on an independent workstation. The positions of the ossicles, facial nerve, labyrinth and vestibular aqueduct relative to reference points were comprehensively demonstrated by thresholding or interactive segmentation. Spiral CT enables 3D display of otosurgical operation sites in a shorter scan time than conventional CT. 3D reconstructions improve the surgeon's understanding of individual anatomy and thus help in surgical planning. This is particularly important for surgery of temporal bone tumours, middle ear deformities, cochlear implants and saccotomy.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1920
    Keywords: Key words Aneurysm, intracranial ; Haemorrhage, subarachnoid ; Vasospasm ; Embolisation ; Spasmolysis, intra-arterial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe two patients with subarachnoid haemorrhage due to a ruptured intracranial aneurysm and severe symptomatic vasospasm. The aneurysm was occluded with detachable coils followed by intra-arterial infusion of papaverine to treat vasospasm as an one-stage procedure. There was significant resolution of the vasospasm. The long-term clinical outcome in one patient was excellent, the other still has minor deficits. Combined endovascular aneurysm therapy followed by intra-arterial spasmolysis with papaverine is a technically feasable therapeutic alternative in patients with symptomatic vasospasm.
    Type of Medium: Electronic Resource
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