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  • 1
    Electronic Resource
    Electronic Resource
    Haemodynamic changes in the cerebral circulation of the cat during occlusion of the middle cerebral artery (1978)
    Springer
    Acta neurochirurgica 43 (1978), S. 183-191 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In a group of 21 cats, the middle cerebral artery pressure (MCAP) was recorded by means of a catheter introduced into the artery at its origin, just distal to the occlusion. The effects of hypertension, hypercapnia, and hypocapnia were studied. In a group of five cats, both middle cerebral arteries (MCA) were catheterized and the pressure was recorded simultaneously on both sides. In another group of five cats, O2 tension measurements were made with the aid of oxygen electrodes in the brain tissue, the occluded MCA, and the common carotid artery. Some of the results obtained in this study are compared with the results of a previous study where monkeys were used as experimental animals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01587954
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  • 2
    Electronic Resource
    Electronic Resource
    The basilar artery bifurcation: Microscopical anatomy (1987)
    Springer
    Acta neurochirurgica 85 (1987), S. 50-55 
    Details
    ISSN: 0942-0940
    Keywords: Arteria basilaris bifurcation ; arteriae chorioideae posteriores ; arteriae interpedunculares profundae ; arteriae thalamo perforantes ; posterior portion of the Circle of Willis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An anatomical study is performed with the aid of the operating microscope of the basilar artery bifurcation and the posterior portion of the Circle of Willis. The anatomical variations of the superior cerebellar arteries, the P 1 segment of the posterior cerebral arteries and the posterior portion of the posterior communicating arteries are described as well as the anatomical variations of the small branches originating from these arteries: the arteriae interpedunculares profundae, the arteriae thalamo perforantes and the arteriae chorioideae posteriores.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402371
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  • 3
    Electronic Resource
    Electronic Resource
    Unruptured intracranial arteriovenous malformations with hereditary haemorrhagic telangiectasia (1993)
    Springer
    Acta neurochirurgica 121 (1993), S. 34-42 
    Details
    ISSN: 0942-0940
    Keywords: Unruptured (familial) arteriovenous malformations ; hereditary haemorrhagic telangiectasia ; decision analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Clinical decision analysis is applied to treatment decisions for three patients with unruptured familial intracranial arteriovenous malformations (AVMs) in association with hereditary haemorrhagic telangiectasia (HHT). The grades of the AVMs—according to Spetzler—were 1-0-0 (two patients aged 12 and 14) and 2-0-1 (one patient aged 43). The AVM in one patient (graded 1-0-0) was operated on without sequelae. In the decision analysis, life expectancy is used as an outcome measure, with and without quality of life adjustment and discounting for time preference. It is concluded that neurosurgical treatment is the optimal strategy for all three patients. Because no conclusive data are available concerning the natural history and neurosurgical treatment of unruptured AVMs, we recommend the prospective application and testing of AVM grading systems. General treatment guidelines balancing the lifetime risk of haemorrhage, risk of incomplete extirpation and surgical mortality and morbidity are given. The analysis suggests that patients with low-graded AVMs which have not bled should be treated surgically, unless they are older than 60 years and have an increased risk of incomplete extirpation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405180
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  • 4
    Electronic Resource
    Electronic Resource
    First clinical experience with excimer assisted high flow bypass surgery of the brain (1995)
    Springer
    Acta neurochirurgica 134 (1995), S. 66-70 
    Details
    ISSN: 0942-0940
    Keywords: High flow extra-intracranial bypass ; brain ischaemia ; giant aneurysm ; excimer laser assisted anastomosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A new type of revascularization of the brain is used in patients with brain ischaemia, caused by an occlusion of one or both internal carotid arteries, and in patients in whom the internal carotid artery has been deliberately occluded for the treatment of a giant aneurysm of the internal carotid artery. A so-called high flow extra-intracranial bypass operation is performed. An arterial or venous transplant is interposed between a branch of the external carotid artery or the external carotid artery itself and the intracranial portion of the internal carotid artery. The anastomosis with the intracranial portion of the internal carotid artery is made without temporary occlusion of the recipient artery and with the aid of the newly developed Excimer laser assisted anastomosis technique. The results of animal experiments and of a clinical series of 9 patients are reported.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01428506
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  • 5
    Electronic Resource
    Electronic Resource
    Scanning Electron Microscopic Evaluation of Nonocclusive Excimer Laser-Assisted Anastomosis in Rabbits (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 1399-1407 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Vascular anastomosis; laser-assisted anastomosis; scanning electron microscopy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Background. The nonocclusive Excimer laser-assisted bypass technique has been described in previous studies and proved to be a promising bypass operation in vascular brain surgery. Little is known about the morphological regeneration process of the laser-assisted anastomosis in time.  By way of a scanning electron microscopic study we examined the way in which the anastomosis site created by the nonocclusive Excimer laser-assisted anastomosis technique becomes endothelialized.  Methods. In 14 rabbits the internal jugular vein was placed in a loop on the abdominal aorta. The distal anastomosis was made using the nonocclusive Excimer laser-assisted technique. The proximal anastomosis was made either laser-assisted or conventional end-to-side. After clipping of the aorta between the two anastomoses sites the vein served as a bypass. To evaluate the endothelialization at the laser-assisted anastomosis site in time, a scanning electron microscopic study was performed.  Results. In the first hours after the bypass operation a new intimal surface is formed by fibrin and activated platelets. Some leukocytes are seen during the first days. The endothelialization process of the laser-assisted anastomosis site begins one day after the operation. The gradual endothelialization process evolved along two lines. First, endothelial cells grow from the side of the aorta to the bypass. Second, after one day solitary (blood-borne) endothelial cells deposit on the laser edge and the sutures, covering the platelet aggregates.  Conclusions. The endothelialization of the Excimer laser-assisted anastomosis is more or less completed 9 days after the operation. The edge created by the laser becomes smoother after a few days and is gone for the most part after 9 days.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010070012
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  • 6
    Electronic Resource
    Electronic Resource
    Changes in local cerebral blood flow, local EEG, and flow in the distal stump of the middle cerebral artery in cats with occlusion of the middle cerebral artery (1982)
    Springer
    Acta neurochirurgica 61 (1982), S. 227-240 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The local EEG, the local cerebral blood flow (1CBF), and the flow in the distal stump of the occluded middle cerebral artery were simultaneously recorded in 28 acute experiments in cats. Nembutal anaesthesia was used eleven times, and Halothane anaesthesia 17 times. The recordings were made via platinum electrodes: 12 in the ischaemic hemisphere, and 2–3 in the opposite non-ischaemic hemisphere. The flow in the occluded middle cerebral artery was recorded via a platinum electrode introduced into this artery via the transorbital approach. The changes in 1EEG, 1CBF, and middle cerebral artery flow were studied during normotension, hypertension, and hypotension. A beneficial effect of hypertension was noted in the acute phase of brain ischaemia. Hypertension counteracted also the “diaschisis” in the non-ischaemic part of the ischaemic hemisphere and in the opposite non-ischaemic hemisphere. A correlation between 1EEG changes and 1CBF changes was noted. In addition an interesting discrepancy was observed between the rapid H2 clearance in the middle cerebral artery stump and the much slower H2 clearance in the ischaemic brain area. Significant differences between experiments under Halothane and experiments under Nembutal anaesthesia were noted. In the acute phase those changes are probably the result of the different levels of blood pressure in those two groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01740087
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  • 7
    Electronic Resource
    Electronic Resource
    The influence of changes in arterial CO2 and blood pressure on the collateral circulation and the regional perfusion pressure in monkeys with occlusion of the middle cerebral artery (1975)
    Springer
    Acta neurochirurgica 32 (1975), S. 161-173 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 7 baboons and 5 macaques the effects of hypercapnia, hypocapnia, hypertension, and combinations of hypertension plus hypocapnia and of hypertension plus hypercapnia on the regional perfusion pressure (rPP) in the brain area rendered ischaemic by occlusion of the middle cerebral artery (MCA) were studied. A new technique for recording the pressure in the occluded MCA was used. The regional tissue pressure (rTP) was recorded with the so called wick type pressure transducers. Hypercapnia produced a marked decrease in rPP in the ischaemic brain area. Hypertension, especially in combination with hypocapnia, produced a very pronounced increase in rPP in the ischaemic brain area. The clinical implications of these findings are discussed. Occlusion of the homolateral common carotid artery (CCA) was followed by a very slight and transient drop in the occluded MCA pressure. Occlusion of the contralateral CCA was followed by a marked and persistent drop in the occluded MCA pressure. When a large intracranial cerebral artery such as the middle cerebral artery (MCA) is occluded, the microvasculature in the ischaemic brain area may become maximally dilated, and may exhibit loss of autoregulation and loss of CO2 responsiveness (Harper1, Meyer2, Symon3). Under these conditions the regional cerebral blood flow (rCBF) in the ischaemic area follows passively changes in regional perfusion pressure (rPP). In experimental animals with occlusion of the MCA we studied the ischaemic brain area rPP which depends on: a) the pressure in the occluded MCA, and b) the regional tissue pressure (rTP) in the ischaemic brain area. To measure the pressure in the occluded MCA we introduced a catheter into the MCA at its origin via the transorbital approach. To measure the rTP in the ischaemic area we introduced a so called wick catheter into the brain area supplied by the occluded MCA. The effects of arterial CO2 changes and drug induced hypertension on the rPP were studied in 7 baboons and 5 macaques.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405451
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  • 8
    Electronic Resource
    Electronic Resource
    The basilar artery bifurcation in situ approached via the Sylvian route (50x) (1986)
    Springer
    Acta neurochirurgica 80 (1986), S. 109-115 
    Details
    ISSN: 0942-0940
    Keywords: Basilar artery ; Sylvian fissure ; aneurysm of basilar artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In human cadavers with the brain in situ the basilar artery bifurcation was approached via the Sylvian (pterional) route. The anatomical details of three variants of the Sylvian approach are described.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01812284
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  • 9
    Electronic Resource
    Electronic Resource
    GABAA Receptor Function in the Early Period After Transient Forebrain Ischaemia in the Rat (1993)
    Oxford, UK : Blackwell Publishing Ltd
    European journal of neuroscience 5 (1993), S. 0 
    Details
    ISSN: 1460-9568
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of this study was to evaluate the function of the GABAA receptor following transient forebrain ischaemia. The GABA-stimulated chloride (36Cl−) uptake into synaptoneurosomes was determined as an indicator of GABAA receptor function. Synaptoneurosomes were isolated from control rats and rats in which the forebrain was made ischaemic by way of the two-vessel occlusion model. Animals subjected to ischaemia were killed at the end of the ischaemic insult and at 30 min or 2 or 5 h of recirculation. The results showed a reduction of 75% in GABA-mediated 36Cl− uptake in synaptoneurosomes isolated from animals shortly (〈0.5 h) after the ischaemic episode (P 〈 0.01). After longer recirculation periods the GABA-mediated 36Cl− uptake reached preischaemic control levels. To investigate whether alterations in 36Cl− uptake were related to the synaptoneurosomal metabolic status, the synaptoneurosomal ATP content was measured. The time course of the ATP recovery correlated with the recovery of the GABA-mediated 36Cl− uptake (r= 0.7, P 〈 0.001). To investigate the importance of ATP in GABA-mediated 36Cl−uptake more directly, synaptoneurosomes isolated from control rats were exposed to chemically induced ATP depletion with rotenone, an inhibitor of oxidative phosphorylation. This resulted in similar reductions in both ATP level and GABA-stimulated 36Cl− uptake as observed after in vivo ischaemia. These findings indicate that GABAA receptor function is transiently impaired in the early postischaemic period in a way which is closely related to alterations in cellular energy metabolism. The relevance of these findings to the development of ischaemic cell death is discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1460-9568.1993.tb00946.x
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  • 10
    Electronic Resource
    Electronic Resource
    Detection of unruptured familial intracranial aneurysms by intravenous digital subtraction angiography (1987)
    Springer
    Neuroradiology 29 (1987), S. 272-276 
    Details
    ISSN: 1432-1920
    Keywords: Unruptured familial intracranial aneurysms ; Elective screening ; Intravenous digital subtraction angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors discuss the detection of intracranial aneurysms (IA) by means of intravenous digital angiography (ivDSA) in (a)symptomatic first degree relatives of families in which two or more individuals have IA. ivDSA is an almost noninvasive and low-risk diagnostic procedure. Screening, by means of ivDSA, of two affected families is described. In family I which includes 7 members with proven IA, ivDSA has been carried out in 36 asymptomatic individuals: in one, a 6x15 mm aneurysm was found at the left posterior communicating artery (PCoA). In family II, including one member with a proven IA and another with a subarachnoid hemorrhage, ivDSA has been carried out in 4 members: one aneurysm with a diameter of 6 mm was found at the left PCoA. Conventional cerebral angiography (CCA) confirmed both IA's. Neurosurgical treatment followed. The advantages and disadvantages of ivDSA vs. CCA as elective screening procedure in such cases are discussed. Screening of asymptomatic first degree relatives of cases with familial IA by means of ivDSA is strongly advocated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00451766
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