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  • 1
    Electronic Resource
    Electronic Resource
    Anévrismes sacculaires rompus du système vertébro-basilaire (1969)
    Springer
    Acta neurochirurgica 20 (1969), S. 105-122 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Diese Untersuchung der rupturierten sackförmigen Aneurysmen des Vertebralis-Basilaris-Systems umfaßt 107 Fälle, davon 19 eigene Beobachtungen. Die klinischen Zeichen weisen nur sehr selten auf einen Sitz des Aneurysmas in diesem Gefäßbezirk hin. Daraus ergibt sich, daß die Diagnose ausschließlich mit der Vertebralis-Angiographie gestellt werden kann, und daß diese zweckmäßigerweise doppelseitig ausgeführt wird. Begleitende Gefäßspasmen sind selten. Ihr prognostischer Wert ist gering. Die chirurgische Ausschaltung des Aneurysmas scheint zur Zeit die beste Behandlung zu sein, zumal kürzlich eingeführte neue technische Möglichkeiten (hypertonische Lösungen, optische Vergrößerung) es ermöglicht haben, die operativen Risiken erheblich zu mindern, und weil nur sie eine dauerhafte Heilung gewährleistet.
    Abstract: Summary This study of ruptured saccular aneurysms of the vertebro-basilar system, consists of 107 cases (19 of them were personal cases). The clinical signs very seldon indicated that the ruptured aneurysm lay on the vertebro-basilar system. Because of this the diagnosis can only be made by vertebral angiography which should be carried out bilaterally. Accompanying vascular spasm is rare and is of little prognostic significance. Exclusion of the aneurysm by surgery appears to be definitely the best treatment since recent technical developments (e.g. hypertonic solutions, magnifying optical systems) have allowed a considerable reduction in the risks of surgery and since it alone is capable of producing a definite cure.
    Notes: Résumé Cette étude des anévrismes sacculaires rompus du système vertébrobasilaire porte sur 107 cas, dont 19 personnels. De l'ensemble des signes cliniques recueillis, il ressort que leur groupement est très rarement évocateur du siège vertébro-basilaire de l'ectasie rompue. Par conséquent, seule l'angiographie vertébrale peut apporter la solution diagnostique et ce d'autant plus qu'elle sera bilatérale. Quant au spasme vasculaire associé, il est rare et sa valeur pronostique faible. L'exclusion chirurgicale de l'anévrisme parait actuellement la meilleure thérapeutique d'autant que de récents artifices techniques (solutions hypertoniques, magnification optique) ont permis de diminuer notablement les risques de l'intervention, et qu'elle est seule susceptible d'aboutir à une guérison définitive.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401956
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  • 2
    Electronic Resource
    Electronic Resource
    A new surgical approach to the third ventricle with interruption of the striothalamic vein (1979)
    Springer
    Acta neurochirurgica 47 (1979), S. 135-147 
    Details
    ISSN: 0942-0940
    Keywords: Third ventricle ; surgical approach ; striothalamic vein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the removal of tumours that develop within the third ventricle, most approaches are not entirely satisfactory. Therefore, a new approach has been devised: transfrontal exposure of the anterior portion of the frontal horn; coagulation and section of the striothalamic vein in order to open up the roof of the third ventricle; use of a blunt spatula introduced in the foramen of Monro and pushed backwards under the choroïd plexus. This approach has been used in ten cases. Postoperative mortality has been nil; the surgical approach has not apparently been responsible for any sequelae. It is simple and gives a good view of the third ventricle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406399
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  • 3
    Electronic Resource
    Electronic Resource
    Surgery of hydrocephalus: past, present and future (1992)
    Springer
    Acta neurochirurgica 116 (1992), S. 155-160 
    Details
    ISSN: 0942-0940
    Keywords: Hydrocephalus ; ventriculo-cisternostomy ; shunt complications ; CSF overdrainage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The treatment of hydrocephalus, over the centuries, underwent three stages of evolution. During antiquity, middle ages and Renaissance, hydrocephalus was not understood. Medical treatment was useless; surgery was hopeless. The second stage extends from the XIXth century to the end of the first half of the XXth century. CSF circulation was now understood; surgery however, remained inefficient, but some patients survived with arrested hydrocephalus. The third stage begins in the nineteen fifties with the development of silicone shunts with a valve. Surgery transforms the prognosis of hydrocephalus, but the number of post-operative complications creates new problems. The different attempts that have been made during these past two decades to solve these problems are reviewed. They have resulted in a reduction of the mechanical and infectious complications. CSF overdrainage has been minimized. Percutaneous ventriculocisternostomies have in some cases replaced shunts. In the future, to improve outcome in these hydrocephalics, surgery, when indicated, should be performed as early as possible. Knowledge and prevention of the causes of hydrocephalus should be developed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01540869
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  • 4
    Electronic Resource
    Electronic Resource
    Medulloblastoma in childhood. Survival and functional results (1979)
    Springer
    Acta neurochirurgica 48 (1979), S. 1-15 
    Details
    ISSN: 0942-0940
    Keywords: Medulloblastoma ; survival ; functional results ; side-effects of radiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors report on a series of 57 medulloblastomas in children operated upon between 1964 and 1976. Among these children, 44 completed the treatment with radiotherapy to the whole central nervous system. The postoperative mortality rate is 10.5%. Postoperative deaths occurred mainly in infants or when a tumour involved the brain stem. The five-year survival rate is 54% in the whole series. It rose to 71% in the patients who completed the treatment with radiotherapy. The study shows that the life of survivals is frequently impaired by mental or behavioural disturbances. IQ varies from 70 to 90 in 58% of the children; it is below 70 in 31%. Behavioural disturbances are found in 93% of cases. 82% have defective spatial orientation, dysphasia, or dysgraphia. In order to evaluate the responsibility of X-ray therapy for the development of these sequelae, the results have been compared to those of a series of cerebellar astrocytomas surgically removed, but not irradiated. The comparison shows that radiotherapy is at least partially responsible for the mental and behavioural disturbances. No relation was found between these disturbances and a persistent ventricular dilatation or an endocrine dysfunction. However the endocrine assessment showed growth hormone deficiency in 65% of the children, short stature in 55%, and compensated hypothyroïdism in 58%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406016
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  • 5
    Electronic Resource
    Electronic Resource
    A department of pediatric neurosurgery in a pediatric hospital (1995)
    Springer
    Child's nervous system 11 (1995), S. 38-40 
    Details
    ISSN: 1433-0350
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00338424
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  • 6
    Electronic Resource
    Electronic Resource
    Lumbosacral lipomas with spina bifida (1988)
    Springer
    Child's nervous system 4 (1988), S. 354-360 
    Details
    ISSN: 1433-0350
    Keywords: Lumbosacral lipomas ; Lipomyelomeningoceles ; Spinal-lipomas ; Spina bidida ; Occult spinal dysraphism ; Fat metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathological and metabolic characteristics, as well as the anatomical and functional evolution of lumbosacral lipomas, were studied in a series of 73 patients operated on between 1970 and 1983. The pathological study showed that they are mainly composed of adipocytes, but that they also possess fibrous tissue, vessels, and nerve fibers. Innervated muscle fibers, contracting under proper nerve stimulation, were found in several cases. Lipogenesis and lipolysis are the same in lumbosacral lipomas and in normal fat tissue. However, these lipomas can grow with the rest of the fatty pool. Moreover, spontaneous progressive worsening of the clinical status has been observed in 36% of the cases. Surgery is efficient and not harmful to the patient. Postoperative mortality was nil. Early postoperative worsening occurred in 2.7% of the cases. The 6% rate of late postsurgical deteriorations should be compared to the 36% to 56% rate found when patients are not operated on. Three different mechanisms are responsible for clinical worsening: compression or stretching of the cord, and cord injury on the posterior upper limit of the spinal defect. In each case, one mechanism is prevalent. Three different types of lumbosacral lipomas can thus be individualized. The surgical implications of these data are discussed. The necessity for early and systematic surgical treatment is pointed out.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00270610
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  • 7
    Electronic Resource
    Electronic Resource
    Acute intracranial hematomas in term neonates (1986)
    Springer
    Child's nervous system 2 (1986), S. 191-194 
    Details
    ISSN: 1433-0350
    Keywords: Neonatology ; Intracranial hematomas ; Hydrocephalus ; Dystocic deliveries ; Perinatal anoxia ; Bleeding disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acute intracranial hematomas in 17 term neonates are reported: 3 were subdural in the posterior fossa; 14 supratentorial, either subdural (8), intracerebral (1 frontal, 4 occipital) or intraventricular (1). The hematomas were aspirated in 3 cases and surgically evacuated in 10. In the remaining 4, the effusion was left in situ. Three patients died: 2 due to dramatic preoperative deterioration and 1 to hemostatic difficulties during surgery. In the 14 survivors, neurological sequellae are major in 3, nil or minor in 11. Comparison of these cases to the 110 others already published allows the following conclusions: (1) the cause of such hematomas is usually multifactorial, combining obstetrical trauma, anoxia and/or coagulation disorders; (2) early diagnosis of the hematoma requires early echography and/or tomodensitometry; (3) when the hematoma causes a midline shift, the authors advocate its early evacuation by aspiration, or craniotomy if it is clotted; (4) the prognosis is poor when there is associated severe perinatal anoxia; if there is no anoxia, the prognosis seems good, but as the follow-up is usually short, definite conclusions are difficult; (5) in our series hydrocephalus requiring treatment occurred in 2 of the 14 survivors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00706809
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  • 8
    Electronic Resource
    Electronic Resource
    Vasomotor origin of intracranial pressure waves in hydrocephalic infants (1980)
    Springer
    European journal of nuclear medicine 5 (1980), S. 511-514 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract By measuring cerebral blood volume (CBV) and intracranial pressure (ICP) variations at the same running time during sleep, it has been demonstrated that the ICP wave which appears during the REM sleep in hydrocephalic infants is produced by intracerebral vaso-dilatation. Nine infants with stabilized hydrocephalus were investigated by non-invasive means: REM phases were distinguished with the usual polysomnographic electrodes. Intracranial pressure was measured with a fontanel palpation transducer and CBV variations were obtained by recording 99mTc activity at the head level after in vivo labelling or red cells with 99mTc — pertechnetate. The timeactivity curves, obtained from regions of interest and selected on the sequential radioisotope images, show that an increased ICP wave, occurring during the REM period, is related to a simultaneous increase in the blood volume, limited to the cerebral sector and not to the area of the external carotid artery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00252041
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  • 9
    Electronic Resource
    Electronic Resource
    Consensus: long-term outcome in hydrocephalus (1994)
    Springer
    Child's nervous system 10 (1994), S. 64-69 
    Details
    ISSN: 1433-0350
    Keywords: Hydrocephalus ; Etiology ; Treatment ; History ; Outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Developments in the treatment of hydrocephalus and its outcome are traced from the time of Hippocrates up to the present day. various factors that have been suspected of influencing the outcome are discussed and their relative importance for long-term outcome is reviewed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313587
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  • 10
    Electronic Resource
    Electronic Resource
    Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery (1995)
    Springer
    Child's nervous system 11 (1995), S. 340-345 
    Details
    ISSN: 1433-0350
    Keywords: Malignant tumors of the posterior fossa ; Intellectual outcome ; Radiotherapy to posterior fossa ; Radiotherapy to cerebral hemispheres ; Radial surgery ; Brain stem lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to determine the respective parts played by cerebral hemisphere irradiation, posterior fossa irradiation, and surgery in the poor late functional results often observed in children treated for medulloblastoma. To do this we compared the intellectual outcome in a series of 59 children operated on for medulloblastoma, who had received whole-brain irradiation, to that observed in a series of 37 children operated on for ependymoma of the posterior fossa, who had received radiotherapy only on the posterior fossa. Only patients who had survived for more than 2 years without recurrence were included. At the assessment 1 year after treatment, intellectual outcome was somewhat better in the ependymoma group, but the difference was not statistically significant. At the long-term follow-ups at 5 and 10 years the results remained stable in the children treated for ependymoma, around 60% having an IQ above 90, whereas the intellectual level of the children treated for medulloblastoma was seen to have deteriorated progressively: 20% had an IQ above 90 5 years after treatment and only 10% at the 10-year followup. This progressive degradation is most likely due to the irradiation of the cerebral hemispheres, as this prophylactic irradiation constituted the only difference between the two groups. Moreover, irradiation to the posterior fossa did not seem to affect intellectual functions, since in the group of children with ependymomas the proportion of IQs above 90 was high and remained stable over the years. Surgery was certainly responsible for some poor results. The percentage of IQs above 90 observed 1–2 years after treatment was between 70 and 80 when no postoperative complications occurred, and only between 20–40% in the presence of postoperative complications. Postoperative aggravation was in most cases related to a brain-stem lesion. These results encourage the reduction, when possible, of irradiation to the cerebral hemispheres and underline the importance of the quality of surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00301666
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