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  • 1
    Electronic Resource
    Electronic Resource
    Direct spinal versus peripheral nerve stimulation as monitoring techniques in epidurally recorded spinal cord potentials (1991)
    Springer
    Acta neurochirurgica 108 (1991), S. 122-127 
    Details
    ISSN: 0942-0940
    Keywords: Spinal cord monitoring ; spinal cord evoked potentials ; spinal somatosensory evoked potentials ; spinal cord stimulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We recorded spinal cord evoked potentials (SCEPs) and spinal somatosensory evoked potentials (spinal SEPs) in 30 operations following stimulation of the epidural spinal cord and the peripheral nerve, respectively, to compare their feasibility as an intraoperative technique for spinal cord monitoring. SCEPs produced quicker responses and had larger amplitudes with simpler waveforms. SCEPs could reflect residual function of the pathological spinal cord and predict the postoperative clinical outcome, findings which are not observed with spinal SEPs. Moreover, SCEPs had a much higher sensitivity to spinal cord insult. Therefore, we conclude that the SCEPs were more appropriate indicator than the spinal SEPs as an intra-operative monitoring method for spinal cord function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01418519
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  • 2
    Electronic Resource
    Electronic Resource
    Long term results of wrapping of intracranial ruptured aneurysms (1990)
    Springer
    Acta neurochirurgica 103 (1990), S. 27-29 
    Details
    ISSN: 0942-0940
    Keywords: Intracranial aneurysm ; operative treatment ; wrapping ; coating ; clipping ; long term results ; rebleeding rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report the long term result of the treatment of 29 intracranial ruptured aneurysms by wrapping with or without coating. These patients were followed for a mean period of 11 years. The outcome of all patients was as follows; 19 were categorized as good, 2 were severely disabled, on the Glasgow Outcome Scale (GOS), and 8 died. The rebleeding occurred in 5 patients within 3 years after surgery, and all died. There was an overall rate of 17% of rebleeding in our series, which is much higher than the rebleeding rate after aneurysm treatment by clipping of the neck but lower than the usual rebleeding rate in conservatively treated cases. In conclusion, the wrapping as a choice of treatment of ruptured aneurysms is not a safe alternative to the direct operative occlusion of the aneurysmal sack.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420188
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  • 3
    Electronic Resource
    Electronic Resource
    Reoperation for Moyamoya disease refractory to encephalo-duro-arterio-synangiosis (1990)
    Springer
    Acta neurochirurgica 107 (1990), S. 129-132 
    Details
    ISSN: 0942-0940
    Keywords: Moyamoya disease ; surgical treatment ; cases refractory to EDAS ; operative techniques of the second operation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three cases of Moyamoya disease successfully treated by reoperation are reported with special reference to the operative techniques in the second operation. These children first underwent encephalo-duro-arterio-synangiosis (EDAS). Because two of the three postoperative collateral formations through EDAS were either poor or not present at all and their symptoms remained. Encephalo-myosynangiosis (EMS) was later added in the posterior frontal and/or parietal regions of the same side as the former EDAS. In the remaining one, the collaterals through EDAS were well formed but transient ischaemic attack (TIA) persisted in the lower limb. The collateral to the middle cerebral arterial (MCA) distribution, even though seemingly well formed, was not sufficient to obtain a complete subsidence of the symptoms. In this case encephalo-myo-arteriosynangiosis (EMAS) was later added to the antero-medial frontal region of the same side as the EDAS to form collaterals to the anterior cerebral arterial (ACA) distribution. In all three cases the angiograms after the second operation showed good formation of collaterals, and the symptoms subsided. The causes of poor collateral formation through EDAS and operative techniques for the additional operation for those cases refractory to EDAS are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405791
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  • 4
    Electronic Resource
    Electronic Resource
    Simulation study of phytoplankton photosynthesis and growth in the Fraser River estuary (1973)
    Springer
    Marine biology 19 (1973), S. 102-116 
    Details
    ISSN: 1432-1793
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Phytoplankton photosynthesis was estimated by a simulation model of the Fraser River estuary (Canada). For this estimation, two kinds of information were considered; (1) the photosynthetic response of phytoplankton taken from the estuary to each environmental factor; (2) actual measurement of changes in each environmental factor in the estuary. As the major limiting factors, light intensity, temperature, and nitrate were taken into account. Variations in these parameters were combined together under the assumption of the “law of the minimum”; that is, only one of the environmental factors was considered to limit photosynthesis at any given time and place. From the results obtained, it could be shown which environmental factors actually limited phytoplankton photosynthesis in the Fraser River estuary at different times of the year and at different depths.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00353581
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  • 5
    Electronic Resource
    Electronic Resource
    Leukaemia in children with growth hormone deficiency not treated with growth hormone (1995)
    Springer
    European journal of pediatrics 154 (1995), S. 418-419 
    Details
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02072121
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  • 6
    Electronic Resource
    Electronic Resource
    Lateral ventricular arteriovenous malformations: Natural history and surgical indications (1991)
    Springer
    Acta neurochirurgica 112 (1991), S. 37-46 
    Details
    ISSN: 0942-0940
    Keywords: Arteriovenous malformation ; lateral ventricle ; natural history ; operative indications ; results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report 21 cases of lateral ventricular arteriovenous malformation (AVM) focusing on their natural history and surgical indications. Eighteen of 21 patients (86%) had bleedings prior to admission. We performed definitive surgery in 9 patients and conservative treatment in 12 patients. In 7 of 9 patients (78%) in the operative group and in 5 of 12 patients (42%) in the non-operative group, the nidus of the AVM was less than 4 cm in diameter. The other 2 AVMs in the operative group, more than 4 cm in diameter, were located in the temporal lobe and widely extended to the temporal horn of the lateral ventricle. The nidi of the AVMs were totally removed in all 9 cases in the operative group. All patients have been doing well except one who had a mental breakdown 6 years after surgery. In 10 patients in the non-operative group, AVMs were located in the left cerebral hemispheres. Three patients in the non-operative group had rebleeding of the AVM. Two of the 12 patients in the non-operative group (17%) died of the recurrent haemorrhages. The rate of bleeding of the lateral ventricular AVM seems to be higher than that of the cerebral cortical AVM, but the mortality due to recurrent bleeding might be similar between the two. The operative indications we made depended on the sizes and locations of the AVMs. For AVMs in the temporal horn, even though they were large, we performed total removals of the nidi and had good results. We did not perform any definitive surgery for AVMs more than 4 cm in diameter except for those in the temporal horn. The mortality and morbidity of the 21 cases were 10% and 14%, respectively. Patients with AVMs in the temporal horn and patients with small AVMs in the frontal horn were good candidates for definitive surgery. We undertook conservative treatment for patients with large AVMs, and the results were acceptable.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402452
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  • 7
    Electronic Resource
    Electronic Resource
    The Influence of Vascular Pressure and Angiographic Characteristics on Haemorrhage from Arteriovenous Malformations (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 39-43 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Arteriovenous malformation; haemorrhage; vascular pressure.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Background. The present study was designed to determine whether there is a physiological explanation for the predisposition of patients with certain angiographic characteristics to haemorrhage from cerebral arteriovenous malformations (AVMs).  Methods. Intra-operative measurement of feeding artery pressure (FAP) and intravascular pressures in the draining venous system [draining vein pressure (DVP) and cranial sinus pressure (SP)] were performed for 30 AVM cases using direct puncture of the vessels. The correlation between pressures and previously described angiographic characteristics predisposing to haemorrhage were evaluated.  Findings. Small nidus size and only one draining vein increased the risk of haemorrhage. FAP and DVP are both inversely related to the number of draining veins and the size of the AVMs. DVP was significantly higher in AVMs with haemorrhage (23.1±8.7 mmHg) than in those without (13.5±4.4), as was FAP (58.6±12.8 as opposed to 38.7±4.7) (p〈0.05). Moreover, the difference between systemic blood pressure and the FAP with haemorrhagic AVMs (17.0±9.5 mmHg) was significantly lower than that in nonhaemorrhagic cases (33.7±5.5) (p〈0.05). The pressure difference between the feeding artery and draining vein was not significant between the haemorrhagic and nonhaemorrhagic groups. There was no significant difference of SP between haemorrhagic and nonhaemorrhagic patients.  Interpretation. The present study suggests that a high DVP probably induced by high resistance in the venous drainage system, as well as a high FAP, may contribute to the development of haemorrhage from AVMs, and physiologically supports previous reports that small AVMs and AVMs with only one draining vein are susceptible to haemorrhage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050005
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  • 8
    Electronic Resource
    Electronic Resource
    Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS) (1989)
    Springer
    Acta neurochirurgica 98 (1989), S. 135-140 
    Details
    ISSN: 0942-0940
    Keywords: Moyamoya disease ; paediatric case ; surgical treatment ; indirect non-anastomotic EC-IC bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Surgical results of paediatric patients with Moyamoya disease who were treated by indirect revascularization procedures are reported. Encephalo-duro-arterio-synangiosis (EDAS), encephalomyo-arterio-synangiosis (EMAS), and/or encephalo-myo-synangiosis (EMS) were performed on 47 sides of 29 children with Moyamoya disease. The results of those non-anastomotic EC-IC bypass procedures were evaluated clinically, angiographically, and by computed tomography (CT). Postoperative external carotid angiograms showed a good collateral formation through EDAS, EMAS, or EMS in about 70–80 percent of all surgically treated sides. The symptoms such as TIA, RIND, and/or involuntary movements disappeared in the cases with a good collateral formation but not in those with insufficient development of the collateral circulation. The indirect EC-IC bypass surgery seems effective for most of the children with Moyamoya disease who present with ischaemic signs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01407339
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  • 9
    Electronic Resource
    Electronic Resource
    De novo aneurysm formation and aneurysm growth following therapeutic carotid occlusion for intracranial internal carotid artery (ICA) aneurysms (1993)
    Springer
    Acta neurochirurgica 120 (1993), S. 20-25 
    Details
    ISSN: 0942-0940
    Keywords: Aneurysm surgery ; trapping ; carotid ligation ; late results ; new aneurysm formation ; secondary enlargement ; rebleeding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We herein report the long term results of 27 intracranial internal carotid artery (ICA) aneurysms treated by indirect surgery such as a trapping of the aneurysm or carotid ligation either with or without EC-IC bypass. These patients were then followed for a mean period of 10 years. Seventy-four percent of the aneurysms were categorized as either being giant or large. Late complications were observed in 7 patients. A rupture of newly formed aneurysms at the anterior communicating artery occurred in 2 cases 8 or 9 years after either trapping or performing a ICA ligation, respectively. In these patients, previous angiography could not reveal any abnormalities at the anterior communicating artery. A rupture of a contralateral ICA aneurysm was seen in a patient whose ipsilateral ICA was ligated for a ICA aneurysm 22 years previously. An enlargement of the contralateral giant cavernous ICA aneurysm became symptomatic 6 years after a partial ligation of the ICA combined with an EC-IC bypass for a giant cavernous carotid artery aneurysm on the other side. Two cases of sudden death occurred in a young patient and an elderly patient with a small anterior communicating artery aneurysm, 9 and 19 years respectively, after trapping of the ICA aneurysms, although the cause could not be definitely ascertained. Rebleeding occurred in one patient who died 8 years after a carotid ligation and a partial clipping of the ICA aneurysm. Haemodynamic stress may therefore play a major role in inducing new aneurysms or growing aneurysms. Careful consideration should thus be taken whenever a therapeutic carotid occlusion is selected as the treatment for carotid artery aneurysms, and a long term follow-up should be done with MR, angiography or DSA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02001464
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  • 10
    Electronic Resource
    Electronic Resource
    The Factors Influencing Haematoma Volume due to Arteriovenous Malformations (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 385-388 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Arteriovenous malformation; cerebral haemorrhage; haematoma volume; angiography; computed tomography.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Haemorrhage due to cerebral arteriovenous malformations (AVMs) varies from massive, requiring urgent operations, to clinically silent. The present study was designated to identify factors influencing haematoma size, and the pathophysiological mechanisms of massive haemorrhage were studied. 55 patients with intracerebral haematomas due to supratentorial AVMs were included in this study. Angiographic and clinical findings were retrospectively evaluated in relation to haematoma size.  Statistical analysis demonstrated that small size and the presence of only one draining vein were high risk factors for massive haemorrhage. The haematoma volume in small AVMs (30±4 cm3) was significantly larger than in other AVMs (7±3 cm3) (p=0.0005). AVMs with only one draining vein were associated with massive haematoma volume as compared to AVMs with two or more draining veins (30±4 versus 11±3 cm3, p=0.0023).  Our previous study demonstrated that feeding artery pressure (FAP) was significantly higher in AVMs with haemorrhage than in those without, as was draining vein pressure (DVP), and FAP and DVP were inversely related to the number of draining veins and the size of the AVMs. Thus, in small AVMs and AVMs with only one draining vein, local increase in DVP may thus contribute to massive haemorrhage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050314
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