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  • 1
    Electronic Resource
    Electronic Resource
    Deep hypothermia cardiopulmonary bypass and direct surgery of two large aneurysms at the vertebro-basilar junction (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1057-1066 
    Details
    ISSN: 0942-0940
    Keywords: Vertebro-basilar junction ; cerebral aneurysm ; 3-D CT angiography ; hypothermia ; cardiopulmonary bypass
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This paper highlights two interesting cases of radial clipping of large aneurysms at the vertebro-basilar junction accompanied by a vascular anomaly, consisting of fenestration of the split basilar artery at its origin. Description of the inner and outer surface of the aneurysm were obtained pre-operatively, from analysis by 3D CT and 3D CT endoscopy of the form of the neck, parent vessels of the vertebral arteries on both sides, basilar artery and split basilar artery, as well as other details of branching. The neck exhibited a broad base in both cases. The height of the neck extended to the internal acoustic meatus, and it was possible to expose the circumference of the aneurysmal neck, peripheral basilar artery and both vertebral arteries proximally with an anterior transpetrosal approach. Based on the size of the aneurysm and the site being the anterior surface of the brain stem, clipping (consisting of interruption of the occluded portion and reconstruction of the parent vessels) was performed. In the first case it was achieved protecting the brain by hypothermia and barbiturates under deep hypothermia with extracorporal circulation, and in the second case, a state of circulatory arrest was used. This paper documents the report of two cases along with other cases treated so far.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01412308
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  • 2
    Electronic Resource
    Electronic Resource
    Characteristic findings of metrizamide CT cisternography in epidermoids (1984)
    Springer
    Acta neurochirurgica 73 (1984), S. 207-211 
    Details
    ISSN: 0942-0940
    Keywords: Epidermoid ; computed tomography ; CT cisternography ; metrizamide
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The characteristic findings of metrizamide CT cisternography in two cases of epidermoid are reported. The main finding was a “cauliflower-like” appearance and was thought to be caused by the irregular interstices of epidermoids. Metrizamide CT cisternography may be helpful in making a diagnosis of an epidermoid.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01400854
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Middle fossa transpetrosal-transtentorial approaches for petroclival meningiomas selective pyramid resection and radicality (1994)
    Springer
    Acta neurochirurgica 129 (1994), S. 113-120 
    Details
    ISSN: 0942-0940
    Keywords: Clivus ; cerebellopontine angle ; meningioma ; operative approach ; pyramid resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fourty-two patients with petroclival meningioma were operated upon by the middle fossa transpetrosal-transtentorial approaches since 1977. Half of those showed tumour extension into the middle fossa and one-third in the cavernous sinus. Seventeen (40%) had a large tumour of 40 mm in diameter or larger, and 8 of those had a broad attachment from the clivus to petrous pyramid of the temporal bone. The site of pyramid resection was selected from three types, depending on the tumour location and the patients' pre-operative hearing. There was no surgical mortality. Significant risk of lower cranial nerves palsy was minimal and useful hearing was preserved in 18 out of 21 patients. The follow-up, an average of 4 and a half years, showed tumours were completely eradicated in 32 patients (76%) and there was regrowfh in 3 (7%). Thirty-four patients (81%) were independent, 3 disabled and only one died of rapid tumour regrowth. The most influential factor on surgical results was the extent to which the tumour had invaded the brain stem. The presence or absence of arterial encasement and of peritumoural oedema on MRI were important in the selection for radical surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406489
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  • 4
    Electronic Resource
    Electronic Resource
    Aneurysm of the Ophthalmic Artery Trunk (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 321-322 
    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/s007010050304
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  • 5
    Electronic Resource
    Electronic Resource
    In vivo effect of visible light on feline cortical microcirculation (1993)
    Springer
    Acta neurochirurgica 121 (1993), S. 174-180 
    Details
    ISSN: 0942-0940
    Keywords: Acetylcholine ; endothelium-dependent vasodilation ; light-induced endothelial injury ; microcirculation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The present study was designed to test the hypothesis that prolonged illumination of the cerebral cortex, for instance during neurosurgical interventions, may affect the pial microcirculation. Experiments were performed with the closed window technique in cats. The cortical surface below the window was exposed to visible, cold light of 61,000 lumens/m2 (lux) over a period of 1 to 5 hours. Pial arterioles reacted with a slight initial dilatation to 106.8±2.6% of their resting diameter after switching to the high intensity light. Measurements of the cortical surface temperature showed an average temperature increase of 1.5±0.34 °C within the first 10 minutes of illumination. For assessment of pial vascular function, the responses to topical application of acetylcholine (ACh) were tested before and during the illumination period. The effect of sustained illumination on the cortical microcirculation consisted of abolition of the endothelium dependent relaxation due to ACh, and of intravascular thrombus formation, the latter, however, only in the presence of topically applied ACh. The suspected mechanism responsible for these functional alterations is light-induced generation of free oxygen radicals which are known to inactivate or destroy the endothelium-derived relaxing factor (EDRF). Further studies are recommended to elucidate the practical and clinical relevance of these findings to neurosurgical procedures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01809271
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  • 6
    Electronic Resource
    Electronic Resource
    Surgical approaches for vertebro-basilar trunk aneurysms located in the midline (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 402-410 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral aneurysm ; posterior circulation ; operative approach
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fourteen cases of midline vertebro-basilar trunk aneurysms were operated on by four routes of surgical approach: middle fossa anterior transpetrosal approach (ATP), presigmoid transpetrosal approach (PTP), conventional lateral suboccipital approach (LSO) or suboccipital transcondylar approach (STC). There was no mortality, but the morbitity was different depending on the surgical approach. In basilar trunk aneurysms located higher than the internal auditory canal, excellent results were obtainable by ATP, especially in the case of posteriorly projecting aneurysms. For midline vertebral aneurysms located lower than the internal auditory canal, STC resulted in less surgical complications than LSO. Extradural resection of the jugular tubercle was necessary for aneurysms located on the distal vertebral artery at or close to the vertebro-basilar junction. For vertebro-basilar junction aneurysms located at the level of the internal auditory canal, hearing was preserved by STC, but not by ATP or PTP. However, choice of the surgical approach may depend on the direction of the aneurysm and the technical accessibility of the skull base. All these skull base approaches reduced surgical complications of retraction damage to the cranial nerves and the brain stem. This holds true for all aneurysms arising from the midline vertebro-basilar trunk.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420302
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  • 7
    Electronic Resource
    Electronic Resource
    Effect of Hyperosmotic Solutions on Human Brain Tumour Vasculature (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 1135-1142 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Blood-brain barrier; microcirculation; metastatic brain tumour; tumour vasculature.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Reversible opening of the blood-brain barrier (BBB) has been used to increase delivery of chemotherapeutic agents into brain tumours, but it is complicated and requires general anaesthesia. Without affecting the normal BBB, and avoiding the complications of BBB modification by hyperosmotic solution, we tried an adequate minimal BBB disruption in brain tumours. Although the effect of BBB disruption on normal brain has been described, there are no reports of the effect of an impaired BBB on microcirculation. In this study, four patients underwent surgical resection of a glioblastoma multiforme (GM; n=1), astrocytoma (n=2), or metastatic brain tumour (n=1). Epicerebral microcirculation was observed in the operative field. Serial fluorescein microangiograms of the tumour and peritumoural area were obtained before and after BBB disruption was introduced intra-operatively by retrograde infusion of mannitol introducing a catheter via the temporal superficial artery back to the carotid bifurcation. On the initial microangiogram, staining by the fluorescein dye was observed in the GM and metastatic tumour but not in the astrocytoma; no extravasation of fluorescein dye was observed in the peritumoural areas. After BBB disruption, fluorescein perfusion increased and extravasation of fluorescein dye from the venules was observed in the GM and the metastatic tumour and in the peritumoural area of both lesions; BBB disruption started from venules in the peritumoural area without affecting the normal brain. However, such effects were not observed in the astrocytomas after BBB disruption nor in normal brain tissue in any patient. It appears that the integrity of the BBB is less stable in the peritumoural area of GM and metastatic brain tumours than it is in astrocytomas or normal brain. Osmotic BBB disruption may offer a method for achieving global delivery of therapeutic agents to brain tumours and peritumoural areas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050227
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  • 8
    Electronic Resource
    Electronic Resource
    Planning and surgical strategies for early management of vertebral artery and vertebrobasilar junction aneurysms (1995)
    Springer
    Acta neurochirurgica 134 (1995), S. 60-65 
    Details
    ISSN: 0942-0940
    Keywords: Anatomical landmarks ; cerebral aneurysms ; posterior circulation ; transcondylar approach
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Selection of the approach and technique for surgical repair of aneurysm of the vertebrobasilar artery system is mainly based on angiographic features. This report emphasizes that planning the surgical procedure should also include preoperative evaluation of the individual skull base configuration, as well as the relationship between aneurysm site and surrounding bony structures. These features are evaluated on thin slice CT scans using bone tissue algorithms and are particularly important for adequate exposure of distal vertebral artery (VA) or midline aneurysms, because these cases require drilling of the jugular tubercle. For the use of lateral approaches, the surgeon must be familiar with the extradural and intradural anatomy of the foramen magnum region and may rely on at least five anatomical landmarks for orientation during surgery: 1) the dural entrance of the vertebral artery; 2) the posterior condylar emissary vein; 3) the medial rim of the distal sigmoid sinus; 4) the hypoglossal canal; 5) the jugular tubercle. To increase the safety of the procedure, the authors recommend an individualized tailoring of the surgical approach according to the variable morphological situation of each patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01428505
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  • 9
    Electronic Resource
    Electronic Resource
    Phorbol ester-like action of staurosporine on the cAMP response to prostaglandin E"2 in two macrophage-like cell lines at distinct differentiation stages
    Amsterdam : Elsevier
    Cellular Signalling 4 (1992), S. 479-485 
    Details
    ISSN: 0898-6568
    Keywords: Prostaglandin E"2 ; cAMP ; differentiation ; macrophage-like cell lines ; phorbol 12-myristate 13-acetate ; protein kinase C ; staurosporine
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Medicine
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0898-6568(92)90017-3
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  • 10
    Electronic Resource
    Electronic Resource
    Effect of phorbol myristate acetate on release of arachidonic acid and its metabolites in the osteoblastic MOB 3-4 cell line and its subclone, MOB 3-4-F2
    Amsterdam : Elsevier
    Cellular Signalling 4 (1992), S. 51-59 
    Details
    ISSN: 0898-6568
    Keywords: H-7 ; Phorbol 12-myristate 13-acetate ; arachidonic acid ; osteoblastic cells ; phospholipas A"2 ; protein kinase C ; staurosporine
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Medicine
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0898-6568(92)90007-U
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