Library

X
feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Lokale Sauerstoffversorgung des zerebralen Kortex während Thiopental- und Propofolanästhesie (1994)
    Springer
    Der Anaesthesist 43 (1994), S. 534-538 
    Details
    ISSN: 1432-055X
    Keywords: Schlüsselwörter: Propofol – Thiopental – Lokale zerebrale Sauerstoffversorgung – Spektrophotometrie ; Key words: Propofol – Thiopentone – Local cerebral oxygen supply – Spectrophotometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Because the brain is highly vulnerable to damage from even a brief imbalance of oxygen delivery and demand, intraoperative disturbances of local oxygen supply must be avoided. Until now, there has been no method allowing fast and reliable intraoperative measurement of the local oxygen supply in the human brain. Intraoperative investigations were therefore performed using the Erlangen micro-lightguide spectrophotometer. Methods. Intraoperative investigations of local intracapillary haemoglobin saturation (SO2) were performed during neurosurgical interventions using the Erlangen micro-lightguide spectrophotometer (EMPHO). Measurements were performed in eight patients (age 31 – 67 years) during neurosurgical interventions. Three received thiopentone anaesthesia, and three received propofol. In two patients thiopentone anaesthesia was later changed to propofol. The EMPHO enables rapid, non-invasive measurement of local intracapillary SO2. White light from a Xenon-arc lamp is transmitted by a 250-µm micro-lightguide to the tissue. The remitted (reflected) light is led by 6 micro-lightguides surrounding the illuminating one to a rotating band-pass interference filter disk. Light in the range of 502 to 630 nm is detected with a photomultiplier. In this range haemoglobin shows an SO2-dependent spectrum, which is then analysed. Because the measurements are performed with micro-lightguides, high spatial resolution is attained. Representative measurements can be performed in a very short period of time (approx. 60 s); thus, the EMPHO enables rapid monitoring of local SO2 in the brain. Results. The effect of propofol and thiopentone anaesthesia on the distribution of local intracapillary haemoglobin saturation was investigated during neurosurgical interventions. The arterial PCO2 was similar in both groups (31±0.7 and 31±0.5 mm Hg, respectively). There were also no differences in arterial blood pressure. The FiO2 was 0.28±0.04 in the thiopentone group and 0.30±0.1 in the propofol group. In all patients receiving propofol anaesthesia higher local SO2 values were found, even if the patients first received thiopentone (values in parenthesis). The mean local SO2 amounted to 65.4% (57.3%) in the propofol group and 38.8% (45.2%) in the thiopentone group. The number of values below 25% SO2 was 5.6% (5.8%) in the propofol group and 18.7% (19.1%) in the thiopentone group.
    Notes: Zusammenfassung. Der Einfluß von Propofol- und Thiopentalnarkose auf die Verteilung der lokalen intrakapillären Sauerstoffsättigung des Hämoglobins (sO2) wurde bei 8 Patienten intraoperativ während neurochirurgischer Eingriffe untersucht. Die Patienten waren im Alter zwischen 31 und 67 Jahren. Drei der Patienten erhielten eine Thiopentalnarkose, 3 weitere eine Propofolnarkose. Zwei der Patienten erhielten in der ersten Hälfte der Operation Thiopental, in der zweiten Hälfte Propofol. Die Werte dieser Patienten sind in Klammern. Die mittlere lokale sO2 betrug in der Propofolgruppe 65,4% (57,3%). Während Thiopentalnarkose wurden 38,8% (45,2%) gemessen. Der Anteil der Werte unter 25% sO2 betrug in der Propofolgruppe 5,6% (5,8%), in der Thiopentalgruppe 18,7% (19,1%).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001010050089
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Zum Einfluß des Ca-Antagonisten Nimodipin auf die globale und regionale Hirndurchblutung (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 8-15 
    Details
    ISSN: 1432-1440
    Keywords: Calcium antagonism ; Nimodipine ; Cerebral blood flow ; Global cerebral blood flow ; Regional cerebral blood flow ; Vasospasm ; Stroke
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of Nimodipine on the global and regional cerebral blood flow were studied in 42 patients with cerebrovascular disorders. In 25 patients with focal deficits such as transitory ischemic attack (TIA), prolonged reversible ischemic neurological deficit (PRIND), and minor stroke due to arteriosclerosis, and in eleven patients with cerebral vasospasm after subarachnoid hemorrhage, the cerebral blood flow was measured by133Xenon inhalation technique 60 min after oral administration of 40, 60, or 80 mg Nimodipine. In 6 patients with vasospasm the effects of Nimodipine i.v. were examined. The result in twelve patients with minor stroke who were only given placebo (lactose; “test-retest”) was identical regional (rCBF) and global (CBF) cerebral blood flow before and 60 min after; placebo, blood pressure, and arterial pCO2 remained constant as well. After Nimodipine, however, the CBF increases, the increase after vasospasm being significant when taking the pCO2 in the Wilcoxon test into account. The rCBF increases much more in the regions with low perfusion rates than in well-perfused areas. This is also observed in the patients with TIA, PRIND, or minor stroke, most clearly after oral administration of 60 mg, whereas regions with normal perfusion rates show little reaction. The blood pressure was lowered, depending on the initial pressure. There was no evidence of a steal phenomenon.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01537480
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Decompressive craniectomy to treat intracranial hypertension in head injury patients (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1327-1329 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051068
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Atraumatic rCBF measurement: An aid in the timing of surgery and the management of spasm following SAH (1982)
    Springer
    Acta neurochirurgica 63 (1982), S. 43-51 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; vasospasm ; rCBF measurement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We tested the ability of a non-invasive regional cerebral blood flow (rCBF) measurement to show vasospasm. The correlations between the flow values, the clinical condition, the CT scan and angiography were also studied. During none of the measurements were there any negative side effects on the patients. A bad clinical condition was usually accompanied by low flow data during the rCBF investigation. In accordance with local clinical signs (e.g., hemiparesis) we observed corresponding local hypoperfusion. These results were also confirmed by several follow-up studies in which good correlations between the rCBF findings, the angiography and the CT scan were found. As the rCBF investigation can be repeated within a very short time, we used this method for the testing of vasoactive drugs. Nimodipine® (Bayer) showed promising results which suggest further clinical investigations. The main problem connected with the rCBF measurement is the limited ability of the patient to cooperate. For the detection of vasospasm the low resolution both in localisation and depth of this method is of only minor importance. We partly overcame this disadvantage by developing a special respirator enabling us to investigate artificially ventilated patients. We think that the measurement of rCBF is an important aid for the timing of the operation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728854
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 5
    Electronic Resource
    Electronic Resource
    Partial Recovery of Paraplegia due to Spontaneous Intramedullary Ependyma Haemorrhage (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 219-220 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050028
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 6
    Electronic Resource
    Electronic Resource
    Stable-Xenon-CT: Effects of Xenon inhalation on EEG and cardio-respiratory parameters in the human (1987)
    Springer
    Acta neurochirurgica 87 (1987), S. 129-133 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral blood flow ; computed tomography ; electroencephalography ; stable xenon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effects of inhalation of a 33% Xenon-O2 mixture over a period of 5 minutes on EEG and cardio-respiratory parameters were studied in 18 human volunteers. This dosage is similar to that used clinically in Xenon-CT studies. In 4 cases no EEG power change was observed during the study. In the 14 other subjects EEG variations were seen. The most prominent change was an increase in Β EEG power. No change was observed in θ and δ EEG power. The findings seem to correlate with the early induction (excitation) phase of an anaesthetic. Hyperventilation was observed before the study and increased during the Xenon inhalation. Blood pressure remained stable while the heart rate tended to decrease a little. All these changes disappeared rapidly following the termination of the Xenon inhalation. The effects are minimal and should not reduce the clinical value of CBF measurement using the Xenon-CT method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476063
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 7
    Electronic Resource
    Electronic Resource
    Plasma osmolality, osmoregulation and prognosis after head injury (1992)
    Springer
    Acta neurochirurgica 116 (1992), S. 33-37 
    Details
    ISSN: 0942-0940
    Keywords: Plasma osmolality ; brain damage ; osmoregulation ; prognosis ; intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 108 Patients with severe brain damage were examined for the course of plasma osmolality. In addition plasma values of Na+, K+, glucose and blood urea nitrogen (BUN) were measured simultaneously by auto-analyzer. The clinical status was registered daily by using a modified Glasgow coma scale. Outcome of the injured patients was registered by using the Glasgow outcome scale. 60 patients survived, 48 died, 39 of brain damage and 9 of secondary diseases, such as infection or embolism. Sustained severe brain damage is generally followed by disturbances of metabolic regulation. Quite often the osmotic regulation is disturbed. In most cases these disturbances are of hyperosmolar nature, their extent and duration being correlated to the prognosis. Hyposmolar deregulation occurs less frequently, and occasionally lead to peracute brain oedema (e.g. SIADH-syndrome). These dys-regulations are interpreted as disturbances of the central function of the diencephalon, in lethal cases even as “hypothalamic death”. Blood osmolality measurements should therefore be made early in states of acute cerebral disease to help establish a prognosis, control the treatment of water imbalance and to determine contra-indications to osmotherapy
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01541250
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 8
    Electronic Resource
    Electronic Resource
    Neurovascular compression and essential hypertension (1991)
    Springer
    Neuroradiology 33 (1991), S. 2-8 
    Details
    ISSN: 1432-1920
    Keywords: Vertebral angiography ; Posterior fossa arteries ; Root entry zone ; Vagus and glossopharyngeal nerves ; Essential hypertension ; Neurovascular compression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The pathogenesis of essential hypertension still remains unclear. Recently, it has been supposed, that an arterial compression of the left root entry zone (REZ) of the cranial nerves IX and X by looping arteries may play a pathogenetic role. In this report we verified this hypothesis retrospectively by vertebral angiographies in 99 hypertensive and 57 normotensive patients. The angiographic findings were compared with the results obtained from an anatomic study, in which the positions of 10 left vagus/glossopharyngeal nerves in the skull were radiographically determined in 10 cadavers. By using a pattern of REZ topography developed from this information we obtained the following results: In 81% of the evaluable angiographies of hypertensive patients we found an artery in the left REZ of cranial nerves IX and X. The normotensive patients showed an artery in the REZ only in 41.7% of cases. Our results support the hypothesis that essential hypertension may be combined with neurovascular compression of the left REZ of cranial nerves IX/X.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00593324
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 9
    Electronic Resource
    Electronic Resource
    Neuroendoskopie und endoskopische Neurochirurgie (1997)
    Springer
    Der Nervenarzt 68 (1997), S. 459-465 
    Details
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Neuroendoskopie ; Ventrikulostomie ; Verschlußhydrocephalus ; Arachnoidalzysten ; Syringomyelie ; Key words Neuroendoscopy ; 3rd ventriculostomy ; Non-communicating hydrocephalus ; Arachnoid cyst ; Syringomyelia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The trend in recent neurosurgery is going toward further reduction of invasiveness and avoidance of traumatization of the brain, spinal cord, and peripheral nerves to reduce the risk of neurological and mental deficit. In this way, the duration of hospital stay and disablement can be shortened. An important „minimally invasive” technique is neuroendoscopy. The ventricular system and the sub- arachnoid space of the brain give suitable conditions for the use of an endoscope. Non-communicating hydrocephalus is the most frequent indication for an endoscopic ap- proach. However, arachnoid cysts, cystic tumors, and intraventricular lesions may also effectively be treated with an endoscope. Using special instruments, laser devices, and bipolar diathermy, even highly vascularized lesions, such as cavernomas, may be completely resected. Moreover, endoscopes are used in the treatment of various spinal diseases and carpal tunnel syndrome, as well as in endoscopy-assisted microsurgery.
    Notes: Zusammenfassung Auch in der Neurochirurgie geht der Trend zu immer weniger invasiven Operationstechniken, um große Trepanationen zu vermeiden, die präparative Traumatisierung von Hirn, Rückenmark und Nerven zu minimieren und damit das Risiko neurologischer und psychischer Störungen so gering wie möglich zu halten. Der Krankenhausaufenthalt und die Arbeitsunfähigkeit können so häufig verkürzt werden. Wesentliches „minimal invasives” Verfahren ist die Neuroendoskopie. Das Gehirn bietet mit seinen präformierten Hohlräumen, den Hirnkammern und dem Subarachnoidalraum gute Voraussetzungen für den Einsatz des Endoskopes. Die häufigste Indikation für einen neuroendoskopischen Eingriff stellt der Verschlußhydrozephalus dar. Aber auch Arachnoidalzysten, zystische Tumoren und kleinere intraventrikuläre Raumforderungen können effektiv endoskopisch über ein kleines Bohrloch behandelt werden. Durch Einsatz spezieller Instrumente, Laser und bipolarer Elektroden können selbst stark vaskularisierte Prozesse, z.B. Kavernome, komplett entfernt werden. Daneben werden Endoskope auch bei einer Reihe von spinalen Erkrankungen und dem Karpaltunnelsyndrom sowie adjuvant bei der mikrochirurgischen Operation eingesetzt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001150050148
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 10
    Electronic Resource
    Electronic Resource
    Treatment with nimodipine or mannitol reduces programmed cell death and infarct size following focal cerebral ischemia (2000)
    Springer
    Neurosurgical review 23 (2000), S. 145-150 
    Details
    ISSN: 1437-2320
    Keywords: Key words Focal cerebral ischemia ; Programmed neuronal death ; Nimodipine ; Mannitol ; Cerebroprotection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The present study was conducted to evaluate the effects of nimodipine and mannitol on infarct size and on the amount of apoptosis after transient focal cerebral ischemia. Focal cerebral ischemia was induced in male Sprague-Dawley rats (weight 300–380 g) by transient occlusion of the right middle cerebral artery (MCAO) using an intraluminal thread model. All animals underwent ischemia for 2 h, followed by 24 h of reperfusion. Group I (n=16) was untreated. Group II (n=16) received 15% mannitol (1 g/kg as bolus) and group III (n=9) received 15 µg/kg/h nimodipine intravenously beginning 15 min prior to MCAO. Twenty-four hours after reperfusion, the brain was taken and sectioned in coronal slices. The slices were stained with H&E and with the transferase dUTP nick-end labeling (TUNEL) technique. Histopathological analysis revealed a significant (P〈0.05) decrease in infarct size in the striatum with both drugs: mannitol (group II) 25.4±5.9% and nimodipine (group III) 21.5±11.0% versus control (group I) 34.9±7.0% and in the cortex 2.7±2.0% (group II) and 6.3±2.4% (group III) versus control 14.4±9.0% (group I). The number of apoptotic cells was statistically lower in the therapy groups (group III 9.6, group II 25.8) versus control (group I 57.9) (Mann-Whitney-Wilcoxon U-test Z〉1.96, P〈0.05). This study indicates that mannitol and nimodipine provide neuroprotection by preventing both the necrotic and apoptotic components of cell death after transient focal cerebral ischemia and may be effective as neuroprotective drugs for cerebrovascular surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011946
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...