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  • 1
    Electronic Resource
    Electronic Resource
    Cavernous malformations of the optic chiasma (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 29-36 
    Details
    ISSN: 0942-0940
    Keywords: Cavernous malformation ; optic chiasma ; magnetic resonance imaging ; surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Two cases of cavernous malformation of the optic chiasm are reported, and 12 previously reported cases are reviewed. The first patient presented with gradually progressive and the second patient with a subacute chiasmal syndrome. Total excision was performed in both cases. Visual function improved slightly after surgery in the first patient while the other showed marked improvement. Although cavernous malformations are angiographically occult, pre-operative diagnosis has become possible based on the characteristic features such as repeated haemorrhages in multiple sinusoidal structures as revealed by magnetic resonance imaging (MRI). A gliotic interspace between the malformation and normal neural tissue provides a plane of cleavage for dissection which permits total excision without causing new deficits. Review of previously reported cases revealed that chiasmal cavernous malformations haemorrhage more frequently than those in the brain. Early diagnosis with total excision is the treatment of choice for cavernous malformations of the optic chiasma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411432
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  • 2
    Electronic Resource
    Electronic Resource
    Changes in serum cytokine concentrations after neurosurgical procedures (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 970-976 
    Details
    ISSN: 0942-0940
    Keywords: Cytokine ; interleukin-6, neurosurgery ; steroid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cytokine responses to surgical trauma have been studied in 70 patients undergoing various neurosurgical procedures. Serum concentrations of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), interleukin-8, (IL-8), tumour necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) were measured before and after surgery using enzyme-linked immunosorbent assays. The serum concentrations of IL-1ß, IL-8, TNF-α, and IFN-γ did not change significantly following neurosurgical operations. In contrast, serum IL-6 levels were significantly elevated following surgery, peaking at postoperative day 1 and then gradually decreasing. Maximum IL-6 concentrations were considerably higher in patients who underwent surgery for brain tumours or aneurysms as compared with patients who had a ventriculoperitoneal shunt, neurovascular decompression or transsphenoidal adenomectomy. Intra-operative use of methylprednisolone, which is known to block the production and action of cytokines, suppressed the increase in IL-6 levels after surgery. There was a statistically significant correlation between the IL-6 peak concentration and the length of surgery in patients not treated with steroids, but not in patients treated with steroids. Additionally patients who underwent supratentorial surgery had higher peak concentrations of IL-6 than those who underwent infratentorial surgery. These results suggest that IL-6 is an early marker of tissue damage and may be useful in assessing the extent of postoperative stress.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411287
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Intra-Arterial Infusion of Fasudil Hydrochloride for Treating Vasospasm Following Subarachnoid Haemorrhage (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 13-19 
    Details
    ISSN: 0942-0940
    Keywords:  Keywords:Cerebral vasospasm; fasudil hydrochloride; intra-arterial infusion; subarachnoid haemorrhage.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  In this pilot study we treated cerebral vasospasm in patients with subarachnoid haemorrhage to assess intra-arterial fasudil hydrochloride. We analysed effects of intra-arterial infusion on angiographically evident cerebral vasospasm in 10 patients including 3 with symptoms of vasospasm. Over 10 to 30 min 15 to 60 mg was administered via the proximal internal carotid artery or vertebral artery following standard angiography, without superselective techniques. A total of 24 arterial territories (21 internal carotid, 3 vertebral) were treated. Angiographic improvement of vasospasm was demonstrated in 16 arterial territories (local dilation in 2, diffuse dilation in 14) in 9 patients. In 2 symptomatic patients, intra-arterial fasudil hydrochloride was associated with resolution of symptoms without sequelae. In the third symptomatic patient the benefit of fasudil hydrochloride was only temporary, and a large cerebral infarction occurred. All asymptomatic patients showed no progression of angiographic to symptomatic vasospasm after treatment with intra-arterial fasudil hydrochloride. No adverse effect was encountered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050260
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  • 4
    Electronic Resource
    Electronic Resource
    Microclip haemostasis for surgical treatment of cerebral arteriovenous malformations (1995)
    Springer
    Acta neurochirurgica 136 (1995), S. 95-98 
    Details
    ISSN: 0942-0940
    Keywords: Arteriovenous malformation ; vascular clip ; microclip ; haemostasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The authors describe newly designed microclips and their utility in obtaining haemostasis during the surgical resection of cerebral arteriovenous malformations. The microclips are particularly well-suited for controlling bleeding from small fragile vessels often encountered on the periphery of large arteriovenous malformations during the final stages of a surgical procedure. Histological examination of these vessels revealed very thin dilated walls without elastic layers, causing easy rupture. Hence, haemostasis using conventional means, such as bipolar coagulators, can be extremely difficult. We have used microclips on such vessels in 14 patients with arteriovenous malformations and controlled bleeding successfully.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411443
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  • 5
    Electronic Resource
    Electronic Resource
    Interleukin-6 and Development of Vasospasm after Subarachnoid Haemorrhage (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 943-951 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cerebral vasospasm; interleukin-6; interleukin-8; subarachnoid haemorrhage (SAH).
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  The authors characterized the role of interleukins in the cerebrospinal fluid (CSF) in the development of vasospasm after subarachnoid haemorrhage (SAH), particularly interleukin-6 (IL-6).  Concentrations of interleukin-1β (IL-1 β), IL-6, and interleukin-8 (IL-8) were measured serially in CSF of 24 patients and in serum of 9 patients with SAH and correlated clinically. Additionally, the effects of the same cytokines on the cerebral arteries of dogs were analyzed on angiograms after intracisternal injection. Changes in levels of eicosanoids, angiogenic factors, and soluble cell adhesion molecules were investigated in the CSF of injected dogs.  CSF concentrations of IL-6 and IL-8 were elevated significantly above control levels from the acute stage of SAH until the chronic stage. Patients with symptomatic vasospasm had significantly higher levels of IL-6 as well as IL-8 in CSF on days 5 and 7. Intracisternal injection of IL-6 induced long-lasting vasoconstriction in five out of eight dogs, while IL-8 did not. The diameter of canine basilar artery after IL-6 was reduced 29±5% from pretreatment diameter at 8 hours. Prostaglandins E2 and I2 were elevated in CSF for the first 4.5 hour of this IL-6-induced vasospasm. Neither angioenic factors such as platelet-derived growth factor-AB and vascular endothelial growth factor nor soluble cell adhesion molecules were significantly elevated in CSF.  IL-6, which increases to very high concentrations in CSF after SAH, may be important in inducing vasospasm, as IL-6 produced long-lasting vasoconstriction in the canine cerebral artery, which may be partly related to activation of the prostaglandin cascade.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050197
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  • 6
    Electronic Resource
    Electronic Resource
    Obituary: Kenichiro Sugita, M.D., 1932–1994 a renaissance man (1995)
    Springer
    Acta neurochirurgica 133 (1995), S. 1-2 
    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/BF01404938
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  • 7
    Electronic Resource
    Electronic Resource
    Motion and image artifacts of various intracranial aneurysm clips in a magnetic field (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1241-1245 
    Details
    ISSN: 0942-0940
    Keywords: Intracranial aneurysm clip ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Deflection angles of 36 types of Sugita intracranial aneurysm clips (Elgiloy), 2 types of Yasargil clips (Phynox), A Kirschner chip (SUS316) and a silver clip were examined by suspending each in a 1.5-tesla MRI (TOSHIBA MRT-200/FXII). Image artifacts of 5 types of intracranial aneurysm clips were also studied quantitatively with respect to their ratio of artifcat/actual clip size using a spin-echo sequence with T1-weighted (Time of repetition (TR)=500 ms, Time of echo (TE)=20 ms) and T2-weighted (TR=2000 ms, TE=80 ms) images. All the Sugita clips from mini type to long type showed a deflection angle of less than 1.0 degree, the Yasargil clips less than 2.0 degrees, the Kirschner chip less than 6.0 degrees, and the silver chip did not move at all. Both brands of clips are therefore suitable for intracranial applications. The artifact size was directly proportional to the clip size and weight, though the ratio of artifact/actual width tended to decrease proportionately as the actual size and weight increased. The ratio of the width seemed slightly bigger than that of the length, but the difference did not reach statistical significance. There was no significant difference in the ratio of image artifacts/clip size between T1- and T2-weighted images.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01809754
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  • 8
    Electronic Resource
    Electronic Resource
    Vasodilation by intrathecal lipopolysaccharide of the cerebral arteries after subarachnoid haemorrhage in dogs (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 330-337 
    Details
    ISSN: 0942-0940
    Keywords: Angiography ; dog ; inducible nitric oxide synthase ; lipopolysaccharide ; subarachnoid haemorrhage ; tumour necrosis factor-α
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To investigate the influence of inducible nitric oxide synthase on cerebral arteries after subarachnoid haemorrhage (SAH) in vivo, lipopolysaccharide (LPS), a major inducer of inducible nitric oxide synthase, was injected intracisternally into control and SAH model dogs. Intracisternal injection of LPS (0.5 mg) produced a long-lasting, submaximal vasodilation of the basilar artery of control dogs on angiography. This effect became significant at 4 hours after LPS injection and plateaued after 6 hours. This vasodilation was reduced by NG-monomethyl-L-arginine. Vasopressin slightly suppressed the vasodilation, while bradykinin increased it. The concentration of L-arginine in CSF decreased after LPS injection, while that of L-citrulline increased. In cytokines, the concentration of tumour necrosis factor-α (TNF-α) in CSF increased transiently at 4 hours after LPS injection, while interleukin-1β, interleukin-6, interferon-γ did not change. These data suggest that vasodilation by LPS is mainly due to nitric oxide predominantly synthesized by an inducible nitric oxide synthase, proximally induced by TNF-α. Our data make it unlikely that SAH itself induces the inducible nitric oxide synthase in vascular tissue, since isolated endotheliumdenuded basilar artery from SAH model dogs did not respond to L-arginine. In SAH model dogs, the degree of vasodilation by LPS differed with the severity of vasospasm. Vasodilation was much greater in mild than in severe vasospasm in dogs, and was increased by superoxide dismutase. These findings suggest that the induction of inducible nitric oxide synthase or its activity may be less effective in severe vasospasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411745
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  • 9
    Electronic Resource
    Electronic Resource
    Suprasellar ectopic pituitary adenoma (1997)
    Springer
    Acta neurochirurgica 139 (1997), S. 94-95 
    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/BF01850878
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    Paper (German National Licenses)
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  • 10
    Electronic Resource
    Electronic Resource
    A new table-fixed soft tissue retractor for the anterior cervical spinal surgery (1997)
    Springer
    Acta neurochirurgica 139 (1997), S. 235-237 
    Details
    ISSN: 0942-0940
    Keywords: Anterior cervical fusion ; instrumentation ; retractor ; spinal surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Since surgeons sometimes encounter difficulty in keeping self-retaining soft tissue retractors in the proper position for anterior cervical spinal surgery, we have developed a new, simple soft tissue retractor system, which is fixed to the side rails of the operating table via retractor stands. All three joints of the retractor can be tightened simultaneously with a single handle. Each of two retractor blades can keep its position independent of the other thereby maintaining a well-exposed operative field for a long period of time. Fine adjustments of the blade position, after fixation of the retractors, is possible by sliding the head of the blade assembly along the axis of a ratchet mechanism. We have used these retractors in 43 surgical exposures, including 35 for anterior cervical fusion, 2 for posterior thoraco-lumbar decompression, and 6 for carotid endarterectomy. There have been no complications related to tissue damage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01844757
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    Paper (German National Licenses)
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