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  • 1
    Electronic Resource
    Electronic Resource
    New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gammacamera cisternography, with data evaluation by the digital multichannel analyzer (1978)
    Springer
    Acta neurochirurgica 43 (1978), S. 19-50 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although well described and intensively used for diagnostic purposes, the ventricular reflux as a gammacisternographic phenomen has not yet been satisfactorily explained, and its physiopathology is a subject of controversy. Based on our method of quantitative gammacisternography and gamma-ventriculography we study the evolution of the tracer concentrations in two main chambers: -the basal cisterns together with the upper cervical canal, considered as a functional unity (the distribution area) and -the ventricular system. We propose the mathematical analysis of a theoretical model which represents the normal and pathological situations of these two chambers, as a method for measuring ventricular volume and ventricular tracer clearance. From the correlation in results with patients and models, we suggest turbulence as the main factor in generating backmixing or total mixing, the appearance of which is called ventricular reflux. We deny the existence of a real inversion of CSF flow. The spinal canal velocity of isotope flow is proposed as additional evidence of turbulence. The normal general dynamics of CSF are delineated, and we propose the following factors that lead to ventricular reflux: -partial obstruction to epicortical CSF flow; -total obstruction to epicortical CSF flow. Their principal characteristics are given, and the importance of using their quantitative parameters in descriptions of patients is stressed. Different aspects in the evolution of hydrocephalus, transependymal resorption, and factors involved in hydrodynamic changes etc. are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01809224
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  • 2
    Electronic Resource
    Electronic Resource
    Growth and development in thalassaemia major patients with severe bone lesions due to desferrioxamine (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 368-372 
    Details
    ISSN: 1432-1076
    Keywords: Key words Growth ; Development ; Thalassaemia major ; Desferrioxamine ; Bone lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nine transfusion-dependent β-thalassaemia major patients (seven males and two females), aged 4–15 years, with growth retardation and severe rickets-like radiological lesions due to continuous subcutaneous chelation therapy with desferrioxamine (45–75 mg/kg body weight, 6–7 times/week), were seen in our centre during the last 8 years. Serum ferritin levels ranged from 976 to 4115 μg/l. There was a progressive decline in growth velocity in these patients 2–3 years before the appearance of rickets-like radiological lesions. All patients underwent surgery to correct genu valgum and/or slipped capital epiphyses. The final height was below the 3rd percentile in six patients (SDS: from –2.9 to –5.2). The short stature was mainly due to a disproportion between upper and lower segments. Six of the patients had an associated sensorineural hearing loss. Conclusion Our data emphasize the importance of an accurate surveillance of the toxic effects of desferrioxamine treatment and warn of the risk of overtreating patients with low iron overload and also suggest a possible individual idiosyncrasy to the adverse effects of chelation therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01955263
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  • 3
    Electronic Resource
    Electronic Resource
    Growth and development in thalassaemia major patients with severe bone lesions due to desferrioxamine (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 368-372 
    Details
    ISSN: 1432-1076
    Keywords: Growth ; Development ; Thalassaemia major ; Desferrioxamine ; Bone lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nine transfusion-dependent β-thalassaemia major patients (seven males and two females), aged 4–15 years, with growth retardation and severe rickets-like radiological lesions due to continuous subcutaneous chelation therapy with desferrioxamine (45–75 mg/kg body weight, 6–7 times/week), were seen in our centre during the last 8 years. Serum ferritin levels ranged from 976 to 4115 μg/l. There was a progressive decline in growth velocity in these patients 2–3 years before the appearance of rickets-like radiological lesions. All patients underwent surgery to correct genu valgum and/or slipped capital epiphyses. The final height was below the 3rd percentile in six patients (SDS: from −2.9 to −5.2). The short stature was mainly due to a disproportion between upper and lower segments. Six of the patients had an associated sensorineural hearing loss. Conclusion Our data emphasize the importance of an accurate surveillance of the toxic effects of desferrioxamine treatment and warn of the risk of overtreating patients with low iron overload and also suggest a possible individual idiosyncrasy to the adverse effects of chelation therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01955263
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  • 4
    Electronic Resource
    Electronic Resource
    The empty sella syndrome (1977)
    Springer
    Acta neurochirurgica 38 (1977), S. 111-120 
    Details
    ISSN: 0942-0940
    Keywords: Empty sella ; pituitary adenomas ; roentgentherapy ; pregnancy ; rhinorrea ; occult CSF fistula ; recurrent meningitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Ten cases of the empty sella syndrome are presented. In four a pituitary adenoma had been treated by surgery with or without radiotherapy. In three women there was a close relation with pregnancy, and two boys had congenital malformations. Five cases presented with appearances of pseudotumour, and the remainder had cerebrospinal fluid (CSF) fistulas. Four fistulas were spontaneous, one was post-traumatic aggravated by the intrasellar implantation of YT-90. Two were occult CSF fistulas causing recurrent meningitis. Gamma cisternography and iodocisternography proved to be good diagnostic tests, both for the empty sella and for CSF fistulas. Nine cases were operated on. In four an intrasellar cyst was present. In the other five an empty sella with deficient or absent diaphragm was found. Treatment of most cases consisted of covering the floor of the sella with lyophilized dura, which was fixed in place with biological glue.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401547
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  • 5
    Electronic Resource
    Electronic Resource
    Neue Aspekte der Liquordynamik beim Menschen durch sequentielle Kameraszintigraphie und Auswertung mit Digitalanalysator (1977)
    Springer
    Acta neurochirurgica 36 (1977), S. 9-28 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary 1. The use of rapid sequential gamma camera scintigraphy in conjunction with computer aided storage and evaluation of data has been shown to be a promising method for the analysis of CSF dynamics in man. 2. Using this method rapid flow of CSF in the basal cisterns can be studied. The further course of tracer activity in different CSF compartments can be followed, and slow currents may be demonstrated. 3. Using this technique the patterns of varying regional CSF dynamics and reabsorption states can be examined. Intracranial activity after 24 hours is 40 to 45% and after 48 hours 20 to 30% of initial global activity. 4. The similar behaviour of CSF circulation patterns in the basal cisterns, cisterna magna, and upper cervical area leads us to suggest that this complex of spaces forms a functional unity which may be called “The distribution center of CSF”. Further movements of tracer substance seem to start from this complex. 5. In the well recognised CSF pathways over the cerebral convexities some characteristic patterns of fluid flow are demonstrated. The flow times at different situations over the convexities are given. 6. Analysis of spinal CSF flow shows that there are considerable variations in spinal CSF dynamics. 7. Finally, the different uses of this method in various situations are indicated.
    Notes: Zusammenfassung 1. Die Anwendung der sequentiellen Kamera-Szintigraphie mit Auswertung von Zeit-Aktivitätskurven beliebiger regions of interest erweist sich als eine Methode zum Studium der Liquordynamik beim Menschen. 2. Mit dieser Methode kann zunächst festgestellt werden, wo sich die Tracersubstanz in den ersten Sekunden nach der intrathekalen Applikation ansammelt, so daß rasche Liquorbewegungen demontsriert werden können. Sodann kann der weitere Verlauf über Minuten, Stunden und Tage dokumentiert werden, so daß langsame Strömungen und das Liquorverhalten an den Resorptionsstätten dargestellt werden kann. 3. Mittels der Region of interest-Technik kann auf Änderungen der Aktivitätskonzentration und damit auf Liquorströmungsverhältnisse sowie auch in gewissen Umfange auf Resorptionsgrößen geschlossen werden. 4. Eine besonders rasche und offensichtlich umlaufende Liquorzirkulation ist im Bereich von Cisterna magna, Cisterna pontis, Cisterna interpeduncularis, Cisterna chiasmatica und oberer Zervikalkanal bis C3 erkennbar. Im Hinblick auf ihr einheitliches Verhalten wird der Gesamtbereich dieser Liquorräume als Verteilerkreis angesprochen. 5. Über der Hirnkonvexität sind physiologischerweise Hauptströmungszonen erkennbar, die sich mittels der Region of interest-Technik für weitere Analysen anbieten. 6. Im Spinalkanal wird eine langsame kranio-caudale Strömung bis zum Duraendsack nachgewiesen. Das Problem der spinalen Liquorresorption ist nicht zuletzt wegen der Möglichkeit von kaudo-kranialen Gegenströmungen durch weitere Untersuchungen abzugrenzen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405983
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  • 6
    Electronic Resource
    Electronic Resource
    Diastematomyelia (1979)
    Springer
    Acta neurochirurgica 51 (1979), S. 91-96 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The diagnostic and therapeutic aspects of 10 cases of diastematomyelia are reported. The cutaneous, orthopaedic, neurological, and radiological signs and symptoms are discussed and emphasized. Different embryological and physiopathological aspects are commented on. Surgical treatment is recommended in all cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401799
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  • 7
    Electronic Resource
    Electronic Resource
    Lateral percutaneous spinothalamic tractotomy (1988)
    Springer
    Acta neurochirurgica 93 (1988), S. 100-103 
    Details
    ISSN: 0942-0940
    Keywords: Intractable pain ; percutaneous spinothalamic tractotomy ; percutaneous cordotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The main elements of the perrcutaneous spinothalamic tractotomy technique by the lateral approach are presented and the results obtained in 163 consecutive patients are communicated. We emphasize the importance of its early use in cases of intractable pain avoiding drug addiction. The simplicity of the method permits a less strict selection of the patients compared with the classic open cordotomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402889
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  • 8
    Electronic Resource
    Electronic Resource
    Dandy-Walker malformation and the contribution of radioisotopic studies of cerebral spinal fluid dynamics to its diagnosis (1982)
    Springer
    Acta neurochirurgica 61 (1982), S. 319-324 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary One case of Dandy-Walker malformation is described. The diagnosis was mainly reached by dynamic isotope studies of CSF, and was confirmed by axial computerized tomography. The importance of these examinations is discussed, not only as a means of understanding the aetiopathology, but especially because of the functional information they give and the therapeutic consequences they have.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01743875
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  • 9
    Electronic Resource
    Electronic Resource
    New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gamma camera cisternography, with data evaluation by the digital multichannel analyzer (1977)
    Springer
    Acta neurochirurgica 38 (1977), S. 1-12 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The use of the sequential gamma camera technique with evaluation of the stored information in the digital analyzing system to investigate CSF dynamics quantitatively has given interesting new information about the circulation in the epicortical SA space. The streaming of I131HSA-labelled CSF in a protracted bolus or bulk was submitted to quantitative and temporal analysis by defining theactivity maxima, and theiramounts as well as theirtimes of appearance. Different modalities of activity evolution in various regions make it possible to define three main types of circulatory disturbance, which are: 1. Global epicortical inhibition 2. circumscribed epicortical inhibition by a. restriction of the SA space b. dilatation of the SA space, and 3. gamma cisternographic asymmetry, apparently due to restriction, with a fully functioning but dilated SA space and no real inhibition. The pathological conditions in the SA space leading to these different flow disturbance modalities are presented, and the necessity to perform quantitative and temporal analysis for definition of the functional flow conditions is emphasized.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401540
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  • 10
    Electronic Resource
    Electronic Resource
    New aspects of cerebrospinal fluid dynamics in humans investigated by sequential gamma camera cisternography, with data evaluation by the digital multichannel analyzer (1978)
    Springer
    Acta neurochirurgica 45 (1978), S. 53-88 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the final part of this series we present all of the clinical material, and the patients are classified by different cisternographic syndromes on the dynamic basis offered for our method: dynamic disconnection between ventricular system and basal cisterns, brain atrophy, initial dynamic decompensation or prehydrocephalus, communicating hydrocephalus with and without epicortical fluid circulation. A nomogram method for clinical estimation of CSF production based on the mathematical properties of our analysis of the ventricular reflux is proposed. The different normal and pathological characteristics of fluid movements in the spinal canal are given, and their importance as signs of turbulence in the posterior fossa are emphasized. Different aspects of the dynamics of CSF production are shown and discussed, and an evolving conception of hydrocephalus development is presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01774383
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