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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 4 (1982), S. 249-250 
    ISSN: 1279-8517
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 107 (1990), S. 56-60 
    ISSN: 0942-0940
    Keywords: Ectopic ; intraosseous ; meningioma ; skull base
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Four cases of primary intraosseous meningiomas were seen among 373 cases of intracranial meningiomas operated upon in the Neurosurgical Clinic of the Krankenhaus Nordstadt, Hannover, FRG between January 1978 and December 1988. These 4 cases represent 1% of all intracranial meningiomas. Patients' age ranged between 21 and 66 years; 2 were females and 2 males. Presenting symptoms were localized orbital pain in 1 case, protrusion of the eye in 1 patient, pain in the orbit and forehead and protrusion of the eye in 1 patient, and peripheral facial palsy in 1 case. Symptoms lasted between 3 and 10 years. Two tumours were in the bony orbit, 1 in the bony orbit and in the frontal bone and 1 in the temporal bone. All tumours were surgically completely removed. All patients are clinically and computer tomography free of tumour 1 to 8 years after the operation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Bone mineral density ; Cervical vertebrae ; Experimental study ; Single-energy quantitative CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Earlier studies have shown that single-energy quantitative computed tomography (SEQCT) is a reliable method for bone mineral density (BMD) measurements in thoracic and lumbar vertebrae. Moreover, SEQCT has proved to be a useful parameter in the selection of appropriate implants in cervical spondylodesis. The aim of this study was to determine the accuracy of SEQCT in cervical vertebrae BMD measurement. BMD with reference to calcium hydroxyapatite (Ca10[PO4]6[OH]2) was assessed by SEQCT in 100 human vertebral bodies of the cervical spine. Bone cylinders were then cut from the appropriate region of interest. The cylinder volume was determined by the liquid displacement technique. The density of the mineral component was measured following incineration at 1100 °C for 24 h. The calculated BMD was correlated with the SEQCT values, resulting in a coefficient of r = 0.79 (P 〈 0.01). Mean SEQCT values were significantly lower than those determined by direct density assessment (t-test for coupled sampling, P 〈 0.02). This result was in agreement with studies on thoracic and lumbar vertebrae. These data suggest that SEQCT can reliably measure BMD in the cervical spine.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 118 (1992), S. 27-32 
    ISSN: 0942-0940
    Keywords: Meningioma ; clivus ; petrous pyramid ; sigmoid sinus ; transverse sinus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirty-six patients with petroclival meningiomas underwent surgery between 1978 and 1990. The tumours accounted for 13% of a total of 284 skull base meningiomas operated upon during the same time period. The most frequent neurological signs related to cranial nerve deficits, mainly of the 8th, 5th, and 7th nerves respectively. The approaches to the petroclival region were: retromastoid, pterional, subtemporal, and combined retromastoid-subtemporal. In 12 patients we used a modification of the retromastoid-subtemporal approach with preservation of the sigmoid and transverse sinus (presigmoid approach). “Total” tumour removal was achieved in 27 cases (75%). There was no postoperative death, and in 83% of cases no severe morbidity. With careful pre-operative evaluation, improved operative approaches and microsurgical techniques the treatment of petroclival meningiomas has been considerably improved.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 130 (1994), S. 125-139 
    ISSN: 0942-0940
    Keywords: Facial nerve paralysis ; facial nerve reconstruction ; facio-facial nerve anastomosis ; hypoglossal-facial nerve anastomosis ; nerve transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 160 patients with various intraor extracranial pathologies were treated by microsurgical facial nerve reconstruction at Nordstadt Neurosurgical Clinic between 1978 and 1993. Facial nerve reconstruction was accomplished along the anatomical course of the facial nerve from its origin at the brainstem, within the mastoid, at the stylomastoid foramen and within the face. Mostly, reconstruction was indicated because of nerve discontinuity (n=61), whereas facial nerve reanimation with a donor nerve such as the contralateral facial nerve or the ipsilateral hypoglossal nerve was indicated in 99 cases of loss of a proximal nerve stump. Depending on the site of the lesion reinnervation started at 5 to 15 months postoperatively lasting for 2 to 3 years with overall satisfactory results. 69% of all the patients regained good symmetry on rest, complete eye closure equivalent to House-Brackmann-Score III: Patients with complete failures either suffered of non-related diseases such as cancer leading to death before the estimated time of recovery or were exposed to radiation or received facial nerve reconstruction after long-standing facial deficit and marked muscular atrophy. The indication of the adequate method depends on the clinical course with or without preexisting facial paresis, on considering the intraoperative state of the facial nerve, the identification and microsurgical preparation of adequate nerve stumps, as well as on the adaptation techniques and the postoperative guidance of the patient. We conclude that facial nerve reconstruction by transplantation at either site of the nerve course or by reanimation with a donor nerve are effective and reliable procedures of treatment leading to satisfactory functional and cosmetic results.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 138 (1996), S. 514-519 
    ISSN: 0942-0940
    Keywords: Chordoma ; radiotherapy ; spinal neoplasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among a series of 511 spinal tumours treated in the Department of Neurosurgery at the Nordstadt Hospital in Hannover, Germany, between September 1977 and August 1994, 23 operations for spinal chordomas in 9 patients (3 females, 6 males) were performed. After an average period of 7±12 months (2 weeks to 5 years) patients presented at an average age of 45±17 years with pain (68%), gait ataxia (14%), motor weakness (9%) or sphincter disturbances (9%). A complete resection was achieved in 11 operations and a subtotal tumour removal in 12 instances. After subtotal removal, 5 tumours were treated postoperatively using local high dose radiotherapy (60–70 Gy). Overall, every chordoma recurred with the passage of time unless en-bloc resection of the tumour had been performed. The recurrence-free interval tended to be longer after radiotherapy. Analysis of postoperative results revealed a significant positive effect of radiotherapy for motor function, pain, Karnofsky score, and survival. In conclusion, en-bloc resection should be performed whenever localization and extension of the tumour allow one to do so. Surgery should be followed by local high dose radiotherapy.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0942-0940
    Keywords: Keywords: Hydrocephalus; rats; CSF dynamics; CSF outflow study.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Objective. To evaluate whether changes of CSF outflow resistance and compliance in hydrocephalus can be assessed by an intrathecal infusion which is performed at a sinusoidal varying rate. Methods. Hydrocephalus was produced in 10 Sprague Dawley rats by instillation of 0.0375 g of kaolin in 0.9% saline into the cisterna magna. Measurements were performed 4 weeks later: With each animal both, three successive constant rate infusions (0–0.02 ml/min) and a sinusoidal infusion (0–0.02 ml/min, frequency 0.006 Hz) were performed. 6 normal animals served as control. The pressure recordings of both infusion techniques were used for the assessment of the CSF outflow resistance. The time constant and the pressure volume index were calculated only from the sinusoidal input testing. Results. The sinusoidal test as well as the constant rate infusion both demonstrated a severe impairment of CSF absorption. By the sinusoidal input, a decreased compliance was confirmed additionally. Thus, the sinusoidal infusion test demonstrated a high resistance and low compliance hydrocephalus in the kaolin-treated group. A simple graphical procedure is presented which allows an easy assessment of CSF dynamics by the sinusoidal infusion test.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 24 hours after a circumscribed cold injury of the cortex dog brains were perfused from the lateral ventricle and the frontal subarachnoidal space to the cisterna magna with an artificial CSF containing trace amounts of35S-labelled thiosulphate. Simultaneously the extracellular tracer was administered intravenously. Extracellular fluid volume was estimated and found to be increased from 10 to 15% in the oedematous cortex and from 10 to 27% in the oedematous white matter. The actual size of ECS in oedematous white matter, however, must be larger as indicated by the relative alterations of thiosulphate distribution, tissue water, sodium and chloride. Apparently a small part of the fluid accumulation affects the cellular compartment in oedematous white matter. It may be concluded from the close spatial correspondence of the spreading of I131 albumin and Evans blue, the increase in water and sodium content, and the enlargement of the TSS that the dilated extracellular channels are filled with a plasma like oedema fluid, derived from blood.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 27 (1972), S. 87-110 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The effect of tension at the suture line on the regeneration of severed peripheral nerves was studied in 88 sciatic nerves of rabbits. Three experimental groups, in which differing tension relationships existed, were compared with each other. 1. 26 sciatic nerves were cut and merely sutured end-to-end. 2. 27 sciatic nerves were cut and, after the resection of a 5 mm length, they were rejoined end-to-end under increased tension. 3. 27 sciatic nerves were cut and the gap between the nerve stumps was bridged without tension using a 5 mm length of autologous nerve graft. Morover, 8 sciatic nerves were cut and left in situ as a control. The effects of regeneration were studied in the operated animals clinically, electromyographically, and with quantitative histology until the 17th week following section. The experimental results, utilising the development of muscle power in plantar flexion, the amplitude of the muscle action potential, and the counting of nerve fibres indicated that even a slight increase of tension at the suture line considerably impeded regeneration as compared with simple end-to-end suture or to the autologous tension-free nerve grafts.
    Notes: Zusammenfassung Der Einfluß der Spannung an der Nahtstelle auf die Regeneration durchtrennter peripherer Nerven wurde an 88 Kaninohenischiadici untersucht. 3 Versuchsgruppen, bei denen unterschiedliche Spannungsverhältnisse herrschten, wurden miteinander verglichen: 1. 26 Ischiadici wurden durchtrennt und End-zu-End vernäht. 2. 27 Ischiadici wurden durchtrennt und nach einer Resektion von 5 mm Länge unter erhöhter Spannung End-zu-End vereinigt. 3. 27 Ischiadici wurden durchtrennt und die vorliegende Dehiszenz der Nervenstümpfe durch die Interposition 5 mm langer autologer Nerventransplantate spannungsfrei überbrückt. Nebenbei wurden 8 Ischiadici durchtrennt in situ belassen. Der Regenerationserfolg wurde an den operierten Tieren bis zu 17 Wochen lang klinisch, elektromyographisch und quantitativ histologisch untersucht. Die Untersuchungsergebnisse der Muskelkraftentwicklung bei der Plantarflexion, der Amplituden der Muskelantwortpotentiale nach Nervenreizung und der Nervenfaserzählung weisen darauf hin, daß schon eine geringfügige Erhöhung der Spannung an der Nahtstelle die Nervenregeneration gegenüber der einfachen End-zu-End-Naht ohne Nervensubstanzverlust und der spannungslosen autologen Nerventransplantation erheblich beeinträchtigt.
    Type of Medium: Electronic Resource
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