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  • 1
    Electronic Resource
    Electronic Resource
    Elektronenmikroskopische Untersuchungen der atmosphärischen Luftverunreinigungen und des Schwebestaubes in Bergwerken (1960)
    Springer
    Medical microbiology and immunology 146 (1960), S. 267-275 
    Details
    ISSN: 1432-1831
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung Eine früher von den Verff. beschriebene Methode, mit der man staubbeladene Membranfilter für die elektronenoptische Untersuchung präparieren kann, wurde für weitere Messungen des Schwebestaubes in Bergwerken verwandt. Der durch das Schießen entwickelte Staub ließ hohe Staubkonzentrationen erkennen und zeigte ein enges Teilchenspektrum. Außerdem wurden mit der Membranfiltermethode Untersuchungen der atmosphärischen Luftverunreinigungen durchgeführt. Die in Düsseldorf entnommenen Staubproben wiesen vor allem Teilchen mit einer Korngröße unter 0,1Μ auf, während in Bochum vor allem Rußpartikeln in den Vordergrund traten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02162780
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  • 2
    Electronic Resource
    Electronic Resource
    Cavernous Haemangiomas of the Spinal Cord. A Review of 117 Cases (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 237-245 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cavernous haemangioma; vascular malformation; intramedullary; spinal cord; surgery; outcome.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes:  The data of 48 studies (published between 1903 and 1996), presenting information of all together 107 patients (108 lesions) regarding pre-treatment clinical and radiological factors, treatment strategies, and the outcome, plus our own experience of nine patients were retrospectively re-analyzed. The prognostic influence of pre-treatment factors was estimated with the chi-square statistics. Clinical evaluation before/after treatment was performed using the Frankel scale. The average bleeding rate was obtained from the ratio of percentage of first bleeding events in the population to the mean age of the population.  There were 47 males and 69 females (aged from twelve to 88 years). Thirty nine percent of the lesions were found in the cervical, 54% in the thoracic (30% upper, 24% lower) and 7% in the lumbar cord. The peak age of presentation was in the fourth decade, the median duration of symptoms was 32 months. Clinical symptoms before treatment were progressive in all cases. Three patterns of clinical presentation could be identified: a) episodes of stepwise clinical deterioration (30%), b) slow progression of neurological decline (41%), c) acute onset with rapid or gradual decline over weeks or months (26%). 58% of the lesions showed clinical or radiological signs of haemorrhage. In 66% of surgical patients (91 efficiently documented cases), clinical improvement was achieved, 28% remained unchanged and 6% deteriorated. Whereas age, sex and lesion location had no influence on the results, duration of symptoms (〈three years) correlated significantly to a better outcome (p〈0.02).  Surgical management in symptomatic patients is recommended. Once clinical signs caused by the malformation have appeared, the patients tend to experience progressive neurological deterioration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050293
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  • 3
    Electronic Resource
    Electronic Resource
    Book reviews (1988)
    Springer
    Acta neurochirurgica 93 (1988), S. 71-73 
    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/BF01409906
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  • 4
    Electronic Resource
    Electronic Resource
    Prognostic factors in the treatment of trigeminal neuralgia (1991)
    Springer
    Acta neurochirurgica 113 (1991), S. 11-17 
    Details
    ISSN: 0942-0940
    Keywords: Trigeminal neuralgia ; facial pain ; glycerol rhizolysis ; posterior fossa exploration ; microvascular decompression ; radio-frequency rhizotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 144 patients operated on for trigeminal neuralgia between June 1982 and May 1990 were followed for up to 8 years. 122 patients were treated by retrogasserian glycerol rhizolysis and 22 by posterior fossa exploration. The average age was 65 years. 89 patients were women and 55 men. The 1st branch was principally involved in 9 patients, the 2nd in 92 and the 3rd in 43. 32 patients had prior procedures. 102 of the 122 patients submitted to glycerol injection were rendered pain-free (84%). An additional 7 patients were relieved by a supplemental radiofrequency procedure, thus achieving an 89% success rate with the percutaneous approach. All 22 posterior fossa explorations were initially successful. 65 patients of the group treated percutaneously had some new postoperative objective and/or subjective sensory deficit as well as 13 of the patients operated on by posterior fossa exploration. Corneal sensation was decreased after 19 glycerol procedures including 3 who had a supplemental radio-frequency coagulation. No corneal hypaesthesia was seen after posterior fossa explorations. Kaplan-Meier analysis showed that at 5 years 59% of the percutaneous rhizolysis group were free of neuralgia and 68% of the patients treated by posterior fossa exploration. A number of patient characteristics and surgical factors were analysed for a possible correlation with outcome. Intact preoperative facial sensation was the most important progonostic factor for an initially successful operative result. Some degree of postoperative sensory deficit was the most important factor for long-term remission of neuralgia. However, of the 54 patients with a postoperative new sensory deficit who were available for long-term follow-up, 13 complained of persistent disturbing disaesthesias.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402108
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  • 5
    Electronic Resource
    Electronic Resource
    Thalamic Astrocytomas: Surgical Anatomy and Results of a Pilot Series Using Maximum Microsurgical Removal (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 1327-1337 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Astrocytoma; microsurgery; microsurgical anatomy; thalamus.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Deep-seated astrocytomas within the basal ganglia and the thalamus are considered unfavourable for microsurgical removal since the circumferential neighbourhood of critical structures limits radical resection. On closer assessment, the thalamus has a unique configuration within the basal ganglia. Its tetrahedric shape has 3 free surfaces and only the ventrolateral border is in contact with vital and critical functional structures, e.g. the subthalamic nuclei and the internal capsule. The purpose of the present study was to investigate the feasibility of maximum microsurgical removal in a series of intrinsic thalamic astrocytomas.  14 patients with intrathalamic astrocytomas grades 1 to 4 as diagnosed by previous stereotactic biopsy or intra-operative frozen section were selected for maximum microsurgical removal. The infratentorial supracerebellar approach from the contralateral side was used for 4 limited neoplasms of the pulvinar. For the other 10 larger and more extensive processes a parieto-occipital transventricular approach was chosen.  Final histology gave the result of astrocytoma grade 1 or 2 in 4 patients, and of astrocytoma grade 3 or 4 in 10 patients. Postoperative MRI confirmed reduction of the tumor mass by 80 to 100% in 11 of 14 cases. Regional ancillary radiotherapy with 60 Gy was administered postoperatively for astrocytomas grades 3 and 4. Two patients operated on via the posterior transventricular approach had new postoperative partial hemianopia. Five of the 14 patients finally needed a ventriculo-peritoneal shunt. During the follow-up time of 6 to 52 months, tumor progression/recurrence was observed in 6 of the 10 high grade and none of the low grade neoplasms.  The present pilot series demonstrates the feasibility of the microsurgical concept. Comparison with other treatment modalities, such as brachytherapy, requires future consideration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010070001
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  • 6
    Electronic Resource
    Electronic Resource
    Interdisciplinary Management Results in 100 Patients with Ruptured and Unruptured Posterior Circulation Aneurysms (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 359-367 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cerebral aneurysms; endovascular treatment; interdisciplinary therapy; posterior circulation; vertebro-basilar arteries.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  The authors report on a series of 100 posterior circulation aneurysms managed by surgical and endovascular procedures. The series consisted of 41 elective admissions more than 14 days after SAH or for unruptured aneurysms and 59 acute admissions after subarachnoid haemorhage (SAH).  In this first interdisciplinary series after the introduction of electrolytically detachable coils, surgical clipping was maintained as treatment of choice in good grade patients while endovascular therapy was primarily offered for patients in poor clinical grade or if the aneurysm was judged difficult to be accessed surgically. A total of 70 patients underwent aneurysm elimination, 54 surgically and 16 by the endovascular route. In 30 patients the aneurysm was not treated, either because of persisting grade 5 WFNS after SAH or because the risk of treatment appeared excessive with some complex unruptured aneurysms. A complication leading to permanent morbidity or mortality occurred after 5 surgical and 1 endovascular procedure (8.6%). Regarding overall management results after acute SAH, 14 of the total of 59 patients admitted with acute SAH died, corresponding to a management mortality of 24%.  Although the present series cannot provide statistically firm conclusions, the authors believe from the actual experience and the accumulating literature, that the principal complementary aspect of the two treatment modalities is aneurysm location. Size and shape do not appear to be a primary factor to favour one or the other modality. The hope that endovascular therapy improves the prognosis of poor grade patients with posterior circulation aneurysms probably has been overstated. The good results of endovascular treatment with small narrow-necked aneurysms on proximal arteries of the posterior circulation, as seen in the present series and as reported in the accumulating literature, suggest that in future surgical and endovascular treatment should be considered as alternatives in these special cases while in large and broad-necked aneurysms surgery should be considered first.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050311
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  • 7
    Electronic Resource
    Electronic Resource
    Haemodynamic stress in lateral saccular aneurysms (1987)
    Springer
    Acta neurochirurgica 86 (1987), S. 98-105 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral aneurysm ; fluid dynamics ; haemodynamic stress ; wall shear stress ; viscoelastic fluid ; experimental aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The flow velocities in lateral glass and silastic aneurysm models were quantitatively measured with the non-invasive laser Doppler method. The influences of the elasticity of the wall, the pulse wave and the properties of the perfusion medium on the intra-aneurysmal circulation were investigated. As shown previously, the inflow into the aneurysm arose from the downstream lip and was directed toward the centre of the fundus. Backflow to the parent vessel took place along the walls of the fundus. With non-pulsatile perfusion, flow velocities in the centre of the standardized aneurysms varied between 0.4 and 2% of the maximum velocity in the parent vessel. With pulsatile perfusion, flow velocities in the centre of the fundus ranged between 8 and 13% of the flow velocity in the axis of the parent vessel. Flow velocities in the aneurysms were slower with a macromolecular perfusion medium with blood like properties compared to a glycerol/water solution. Flow velocity measurements near the aneurysmal wall allowed the estimation of the shear stresses at critical locations. The maximum shear stresses at the downstream lip of the aneurysm were in the range of the stresses measured at the flow divider of an arterial bifurcation. The present results suggest that in human saccular aneurysms intra-aneurysmal flow and shear stress on the wall are directly related to the pulsatility of perfusion,i.e. the systolic/diastolic pressure difference and that the tendency to spontaneous thrombosis depends on the viscoelastic properties of the blood, namely the haematocrit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402292
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  • 8
    Electronic Resource
    Electronic Resource
    Haemodynamic stress in terminal aneurysms (1988)
    Springer
    Acta neurochirurgica 93 (1988), S. 18-23 
    Details
    ISSN: 0942-0940
    Keywords: Cerebral aneurysm ; experimental aneurysm ; haemodynamic stress ; laser-Doppler-anemometer ; wall shear stress
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The flow velocities in glass and silastic aneurysm models located at bifurcations were quantitatively determined using the non-invasive laser-Doppler method. The geometrical relation between aneurysm and parent vessels was found to be the primary factor governing the intra-aneurysmal flow pattern. Flow was stagnant in straight terminal models, with the aneurysm forming an extension of the afferent vessel, as long as the outflow through the branches of the bifurcation was balanced. Average flow velocities in the fundus were small but turbulent flow fluctuations of high amplitudes were observed. Asymmetric outflow through the branches of the bifurcation induced a rotatory intra-aneurysmal circulation from the dominant to the subordinate branch. The circulation in angled terminal aneurysms with the aneurysmal axis at a 45 degree angle to the plane of the bifurcation was a vortex, which was a natural consequence of the excentric inflow from the afferent vessel. Maximum flow velocities measured in the centre plane of the angled terminal aneurysms were in the range of 50 to 80% of the axial velocity in the afferent vessel. The elasticity of the models did not affect the global turnover rates but it damped the intra-aneurysmal pulse wave. On the basis of the measured velocity gradients near the walls maximum shear stresses on the wall of human terminal aneurysms were estimated to be in the order of 50 dynes/cm2 (5 Pascal), a value that is similar to the maximum wall shear stresses estimated for lateral aneurysms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01409897
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  • 9
    Electronic Resource
    Electronic Resource
    Carotid endarterectomy — When to do it, how to do it? (1995)
    Springer
    Acta neurochirurgica 137 (1995), S. 121-127 
    Details
    ISSN: 0942-0940
    Keywords: Carotid endarterectomy ; cerebrovascular disease ; surgical technique ; quality control programme
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary With the completion of the major carotid endarterectomy trials the indications for this procedure can be defined. The procedure, if done by experienced teams, has been shown to improve the chance of stroke free survival in symptomatic and asymptomatic patients with a high-grade stenosis of the internal carotid artery. In asymptomatic patients the risk reduction gained by prophylactic carotid endarterectomy may be small in relation to the risk of coincident factors particularly coronary artery disease. The benefit gained by carotid endarterectomy depends closely on the risk of the procedure itself, and a single little flaw during the management can annulate the benefit of the operation in asymptomatic patients. There are still considerable controversies with regard to peri-operative management and surgical technique, e.g., the necessity of routine pre-oper-ative arteriography has recently been questioned. Quality control programmes become a requirement with the publication of performance standards for carotid endarterectomy. According to a consensus of the American Heart Association, the surgical morbidity/mortality must be less than 6% for symptomatic carotid lesions and less than 3% for asymptomatic lesions. The present review discusses the steps of the pre-operative work-up, the procedure itself and the post-operative management with the aim to identify accepted safety standards as well as areas of uncertainty.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02187182
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  • 10
    Electronic Resource
    Electronic Resource
    Closure of Recurrent Frontal Skull Base Defects with Vascularized Flaps – A Technical Case Report (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 1353-1358 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: CSF rhinorrhea; skull base defects; vascularized flaps.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Techniques for vascularized reconstruction of the anterior cranial fossa floor defects causing recurrent cerebrospinal fluid fistula are discussed in this report. The closure employs the use of local random- or axial-pattern vascularized flaps in simple cases. In complicated cases (for instance, status after repeated exploration) the tissue of the cranial base is severely compromised and shows low potential for healing. Non-vascularized grafts only add avital scars to the already present ones leading to recurrent fistulas. Free vascularized flaps show more mechanical strength and less scar contraction, resistance to infections and survive better in a compromised surrounding, thus leading to long term sealing in such cases. The technical issues of vascularized closure of defects of the frontal skull base are discussed in this report.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010070004
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