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  • 1
    Electronic Resource
    Electronic Resource
    Course of intracranial pressure after extirpation of posterior fossa tumours (1984)
    Springer
    Acta neurochirurgica 70 (1984), S. 11-19 
    Details
    ISSN: 0942-0940
    Keywords: Intracranial pressure ; hydrocephalus ; posterior fossa tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Forty-seven patients with posterior fossa tumours underwent continuous monitoring of intracranial pressure (ICP) in the early postoperative period by means of an intraventricular catheter. ICP values were very low on the day of operation and subsequently became normal in 37 patients. ICP values were raised in 10 patients. The relationship between the ICP and the clinical course was investigated. Patients were subdivided according to the clinical postoperative course into three groups: good, temporarily deteriorated, poor clinical course. The two first groups showed lower values in the ICP than the third one, nevertheless the relationship between the ICP and the posteroprative clinical course is marked but not strict. Our data may have some clinical relevance for the treatment of hydrocephalus before extirpation of posterior fossa tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406038
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    The transcallosal approach for lesions affecting the lateral and third ventricles (1991)
    Springer
    Acta neurochirurgica 111 (1991), S. 103-107 
    Details
    ISSN: 0942-0940
    Keywords: Corpus callosum ; disconnection syndrome ; intraventricular tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The study was carried out on a series of 42 patients who underwent surgery through a midline approach. Lesions were in the anterior part of the third ventricle in 32 cases, in the frontal horns in 6, in the trigone in 3, and in both lateral and thrid ventricles in 1 case. The third ventricle was approached through Monro's foramen in 22 cases and through an interfornicial route in 9 cases. Surgical mortality occurred in 2 cases (5%). Permanent morbidity occurred in another 2 cases (5%): it consisted of slight intellectual deterioration in one case and slight fixed pyramidal signs in the other. Transient mutism was the most frequently observed post-operative complication. Thirty-one patients were reviewed and submitted to neuropsy-chological tests in the late postoperative period to investigate the presence of intellectual deterioration or disturbances in the interhemispheric transfer of motor, somataesthetic and visual information. All patients showed only the presence of short-term memory disturbance. Furthermore, 12 patients tested before surgery also showed the presence of short-term memory deficits in the preoperative period. We conclude that a midline approach is the most direct and safe route to the third ventricle as well as to the frontal horns and trigone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01400496
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Multiple meningiomas (1983)
    Springer
    Acta neurochirurgica 68 (1983), S. 33-43 
    Details
    ISSN: 0942-0940
    Keywords: Brain tumours ; congenital disease ; multiple meningiomas ; neurofibromatosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Multiple meningiomas are a seldom encountered neoplasm. Most authors report an incidence ranging from 1 to 3% of all meningiomas. The routine use of CT has resolved diagnostic problems involved with multiple meningiomas; nevertheless, they still present several nosologic problems. In fact, it may be difficult to differentiate “true multiple meningiomas”, defined as a distinct entity by Cushing in 1938, from simple recurrences or the special variant (forme fruste) of von Recklinghausen's disease. Our report deals with nine cases of multiple meningiomas selected from a series of 372 meningiomas operated from 1968 to 1981 at our hospital. Cases were divided into a) multiple simultaneous meningiomas (five cases), b) multiple meningiomas successively detected at different localizations (two cases), and c) multiple meningiomas associated with neurofibromatosis (two cases). Only five of these nine cases, four from the first group and one from the second, were true multiple meningiomas. Pathogenetic factors related to true multiple meningiomas are discussed in relation to the literature reports. However, the different hypotheses proposed do not offer a definite explanation of the multicentricity of these tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01406200
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Early postoperative angiographic findings after carotid endarterectomy (1988)
    Springer
    Acta neurochirurgica 95 (1988), S. 114-120 
    Details
    ISSN: 0942-0940
    Keywords: Carotid stenosis ; angiography ; carotid endarterectomy ; cerebral revascularization ; cerebrovascular diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This report reviews the early postoperative evaluation of 70 patients who underwent carotid bifurcation endarterectomy within our department (before patients' releasing). Angiography was performed by femoral catheterization or the retrograde brachial route; three times only digital venous techniques were employed. No complications due to radiological procedures occurred. Postoperative angiographic findings include asymptomatic occlusion of ICA, occlusion of ECA, the presence of mural thrombi, diffuse surface roughness, intimal flaps and kink of ICA. Dilatation of the arteriotomized segment was detected with a high rate of frequency. Postoperative vascular changes are then analyzed in relation to surgical techniques, to early postoperative clinical course and to the occurrence of late re-stenoses.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01790771
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  • 5
    Electronic Resource
    Electronic Resource
    Management of symptomatic carotid stenoses with coincidental intracranial aneurysms (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1386-1390 
    Details
    ISSN: 0942-0940
    Keywords: Carotid endarterectomy ; coincidental aneurysm ; percutaneous transluminal angioplasty
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary There are at present strong indications for surgery in patients suffering from symptomatic extracranial carotid stenoses of 〉70%. Surgery of coincidental aneurysms is a still debated problem, but there is general agreement that it is indicated in selected cases according to the patient's life-expectancy and size and site of the aneurysm. The coexistence of these two lesions raises a decisionmaking problem. We reviewed 389 endarterectomies and found 12 intracranial berry aneurysms in 10 (2.6%) patients. All the 10 patients were harbouring a symptomatic carotid stenosis of 〉70%. Since the correction of a stenosis increases blood flow to an aneurysm, our approach was to first operate on the intracranial lesion and then the stenosis in 7 patients harbouring aneurysms 〉5 mm. Two patients affected by small aneurysms 〈5 mm of an A2 azygos and left internal carotid artery underwent left endarterectomy only. The last patient was submitted first to percutaneous angioplasty of a left stenosis, then to open surgery of a contralateral middle cerebral aneurysm and finally to intravascular occlusion of a small aneurysm of the left internal carotid bifurcation by menas of a coil; this policy was adopted in order to restore normal haemodynamic conditions before the intracranial procedure. There was no mortality or permanent morbidity following surgery for aneurysm or endarterectomy. Transient morbidity occurred in 2 cases after clipping of aneurysms of the anterior communicating and middle cerebral arteries. Our results suggest that surgery of coincidental aneurysms may give good results even when there is a severe symptomatic stenosis in the neck. Moreover, the presence of a small intracranial aneurysm does not seem to be an additional risk factor for endarterectomy. When the lesions are on different sides, it may be better to treat the stenosis first if it decreases the ipsilateral cerebral blood flow.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411116
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  • 6
    Electronic Resource
    Electronic Resource
    Surgery and Stenting As Combined Treatment of a Symptomatic Tandem Stenosis of the Carotid Artery (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 1177-1181 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Carotid endarterectomy; percutaneous transluminal angioplasty; stenting.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ International co-operative studies have demonstrated a benefit from surgery for symptomatic and asymptomatic patients affected by internal carotid artery stenosis of 60–70%. The presence of a tandem lesion, intracranial or extracranial, may annul the benefit of surgery. Such patients may thus represent a challenging problem for management if age, good general conditions and a normal neurological status favour a therapy. A 54-year-old man developed transient ischaemic attacks of the left hemisphere; his general condition was good, and neurological status was normal. Angiography showed a tight stenosis at the left common carotid artery near the ostium and at the homolateral carotid bifurcation. At first, a self-expanding wall stent was placed at the level of the common carotid artery stenosis, and immediately after a standard endarterectomy under general anaesthesia was performed. The postoperative course was normal and was complicated only by the presence of a mild deficit of the hypoglossal nerve due to the presence of a high bifurcation. The early and late outcome of our case suggests that stenosis of the proximal common carotid artery may be successfully treated by stenting. While awaiting additional data about this new technology, endovascular techniques and surgery may be complementary in the management of patients suffering from such tandem lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050415
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    Paper (German National Licenses)
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