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  • 1
    Electronic Resource
    Electronic Resource
    Immunomodulators interfere with angiopathy but not vasospasm after subarachnoid haemorrhage in rabbits (1991)
    Springer
    Acta neurochirurgica 108 (1991), S. 81-84 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; immunology ; angiopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The present study deals with the effects of immunomodulators on the morphology of intracerebral arterial walls in rabbits with experimental subarachnoid haemorrhage (SAH). Immunostimulators: thymostimuline and inosine dimethylamino-isopropanol-p-acetamido-benzoate were found to aggravate the angiopathic changes, whereas immunosuppressive drugs — cyclosporine A and azathioprine appeared to prevent the damage. The authors consider the possibility of using immunosuppressive drugs in patients with ruptured intracranial aneurysms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01407672
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  • 2
    Electronic Resource
    Electronic Resource
    A strategy for analyzing multiple parameters with application to aneurysmal SAH patients all of them clipped but treated with and without cyclosporine (1993)
    Springer
    Acta neurochirurgica 122 (1993), S. 194-199 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; cyclosporine A ; neurological outcome ; statistics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The study evaluated the effectiveness of the combination of nimodipine and cyclosporine A vs nimodipine alone in the prevention of delayed neurologic deficit in 82 (31 plus 51) patients in whom intracranial aneurysms were clipped within 72 h after subarachnoid haemorrhage. The tests performed included examination of the neurological condition before and after operation, angiography of cerebral arteries to visualize vasospasm, and analysis of the distribution and amount of blood in the brain fluids and/or tissue according to Fisher's scale. Inclusion of cyclosporine A in the treatment was clearly beneficial for the neurological condition. While cyclosporine A did not appear to produce a statistically significant improvement as evaluated by the chi-square test, a positive result was obtained following analysis of the correlation coefficients after Pearson in combination with the logistic log-linear regression analysis. The results argue against the utility of the chi-square test for verifying clinical data obtained in a limited number of patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405528
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Impaired in vitro proliferative response of suppressor lymphocytes in patients with subarachnoid haemorrhage from ruptured intracranial aneurysm (1993)
    Springer
    Acta neurochirurgica 122 (1993), S. 240-243 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; immunology ; mitogenic response of lymphocytes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Proliferative response to mitogens concanavalin A, phytohaemoagglutinin and pokeweed mitogen, and other chosen indicators of the activity of the immune system were assayed in peripheral blood mononuclear cells isolated from blood of patients with subarachnoid haemorrhage from ruptured aneurysm. Healthy blood donors served as control group. The SAH group displayed impaired response to concanavalin A, which is a mitogen specific for suppressor cells. It is suggested that the impaired activity of suppressor cells pre-existed in patients with subarachnoid haemorrhage, and after intracranial bleeding it might have contributed to the development of late neurological deficits.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405536
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  • 4
    Electronic Resource
    Electronic Resource
    Cyclosporine a prevents neurological deterioration of patients with SAH — A preliminary report (1991)
    Springer
    Acta neurochirurgica 112 (1991), S. 25-27 
    Details
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; early aneurysm clipping ; cyclosporine A ; neurological outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the present study we found that the neurological outcome in patients anaesthetised for early clipping (up to 72 h after SAH) of a ruptured aneurysm and treated with cyclosporine A was significantly better than the neurological state of control patients without immuno-suppressive treatment. The results justify the presumption that auto-immune reactions are involved in the deterioration of the postoperative neurological state of patients with SAH after rupture of an intracranial aneurysm. Supplementing a standard surgical and pharmacological treatment with cyclosporine A seems to reduce the undesirable neurological consequences of the immunologically, induced vascular disturbance after SAH.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402450
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  • 5
    Electronic Resource
    Electronic Resource
    HLA antigens and intracranial aneurysms (1992)
    Springer
    Acta neurochirurgica 116 (1992), S. 1-5 
    Details
    ISSN: 0942-0940
    Keywords: Intracranial aneurysm ; HLA complex ; auto-immunoaggression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The frequencies of the HLA-A, -B and -DR were determined in a group of 59 transplant donors who died from subarachnoid haemorrhage within three days following the rupture of intracranial aneurysm (the SAH group) and compared with those of a control group consisting of 389 donors who died from other causes. The only significant difference was in the increased frequency in the SAH group of non-typed (“empty”) -DR loci in association with the DR7 phenotype. The most probable explanation of this finding is that in the SAH group the frequency of DR7 homozygotes is several times higher than in the general population, and that bearing the DR7 allele in homozygotic form is associated with a very high risk of developing potentially fatal intracranial aneurysmal haemorrhage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01541246
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  • 6
    Electronic Resource
    Electronic Resource
    Is vascular angiopathy following intracranial aneurysm rupture immunologically mediated? (1992)
    Springer
    Acta neurochirurgica 117 (1992), S. 34-37 
    Details
    ISSN: 0942-0940
    Keywords: SAH, IgM-C3 vascular deposits ; angiopathy ; neurological outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Immunofluorescence studies showed the presence of IgM and/ or C3 in the endothelium of intracranial aneurysms in 5 out of 6 patients with subarachnoid haemorrhage (SAH). In none of them were the immune deposits found in the gyrus rectus. Cortical tissue of 4 epileptic patients which served as a control give negative results. Serum studies on femoral artery wall used as an antigenic substrate did not reveal circulating antibodies of the IgM or IgG class. Our studies strongly suggest that the IgM and/or C3 immune deposits located in the endothelium of intracranial arteries may play a role in post SAH neurological complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01400632
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  • 7
    Electronic Resource
    Electronic Resource
    2-Chloro-2′ deoxyadenosine prevents angiopathic changes in cerebral arteries in experimental SAH in rabbits (1993)
    Springer
    Acta neurochirurgica 122 (1993), S. 118-121 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; cerebral angiopathy ; immunosuppression ; 2-chloro-2′-deoxyadenosine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We compared the morphology of the basilar artery walls in rabbits with experimental subarachnoid haemorrhage (SAH) without and with concomitant treatment with a novel immunosuppressive drug, 2-chloro-2′-deoxyadenosine (2 CdA). The treatment was successful in the prevention of the angiopathic changes, most likely due to its ability to inhibit lymphocyte activation in response to mitogenic signals. Since lymphocyte (and monocyte?) activation may play an important role in the development of the delayed neurological deficits in patients following SAH, the use of 2 CdA to prevent these deficits shall be considered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01446997
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  • 8
    Electronic Resource
    Electronic Resource
    Immunological method for prediction of progress in neurological deficit in patients with intracranial aneurysm rupture (1989)
    Springer
    Acta neurochirurgica 97 (1989), S. 67-70 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; immunoskin test ; prediction of neurological status ; intracranial aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Skin tests of nonspecific antigens (immunoskin test Sevac) were performed on patients suffering from intracranial aneurysms, scheduled for surgical clipping. It was found that high antibody titre correlated well with the severity and progress of neurological deficit developing after surgery. This deficit was absent in patients who exhibited low antibody titre in response to the skin test before surgery. These results indicate that the immunological processes may play a role in the development of neurological deficit after neurosurgical procedures. Thus the skin test employed may have prognostic value in predicting neurological deficit following intracranial aneurysm surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01577742
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  • 9
    Electronic Resource
    Electronic Resource
    Successful prevention of neurological deficit in SAH patients with 2-chlorodeoxyadenosine (1993)
    Springer
    Acta neurochirurgica 124 (1993), S. 61-65 
    Details
    ISSN: 0942-0940
    Keywords: SAH ; immunosuppression ; 2-chlorodeoxyadenosine ; neurological outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty patients suffering from subarachnoid haemorrhage due to ruptured intracranial aneurysm and operated on within 72 h after SAH were treated with an experimental immunosuppressive drug 2-chlorodeoxyadenosine (2-CDA). dose 0.05 mg/kg/day i.v. for 7 days. The 2-CDA treatment was started immediately after angiographic confirmation of ruptured aneurysm, and the standard pharmacological treatment (nimodipine and steroids) was also given. 50% of patients were severely threatened by “delayed vasospasm” or late neurological deficit (Fisher's score 3 or 4). The neurological outcome (assessed 8–12 weeks after SAH) was good (GOS=1) in 70%, and fair (moderate disability, GOS=2) in 25%. A single case of severe disability (GOS=3), as well as two cases of less than perfect outcome (GOS=2), were related to unusual pre- or intraoperative complications. We conclude that the low doses of 2-CDA can be considered as a valuable adjunct to the standard pharmacotherapy of SAH patients operated on early.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01401123
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  • 10
    Electronic Resource
    Electronic Resource
    Acute surgery in intracranial aneurysms (1990)
    Springer
    Acta neurochirurgica 103 (1990), S. 1-4 
    Details
    ISSN: 0942-0940
    Keywords: Intracranial aneurysms ; early aneurysm surgery ; calcium channel blockers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the last 3,5 years (up to August 1988) out of 450 patients with surgically treated intracranial aneurysms in 100 cases (22%) acute surgery was performed (up to 72 h after SAH). Patients in grade I-III (WFNS scale) were operated upon. In all the cases there were supratentorial aneurysms. CSF drainage during the operation was used routinely and nimodipine topically, in intravenous infusion and orally was applied. In all the cases, but one, the aneurysms was clipped. Follow-up — 1 year. Assessment of the results was done using the Glasgow Outcome Scale (GOS). Full recovery was obtained in 78 patients and further 5 patients are independent. There were 14 deaths, in 7 patients due to postoperative vasospasm. Symptomatic ischaemia developed in 25 patients, however, in 15 of them it was fully reversible, due to the possibility of aggressive antivasospastic treatment (hypervolaemia, induced arterial hypertension). The relatively worse results were obtained in patients with chronic arterial hypertension.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01420184
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