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  • 1
    Electronic Resource
    Electronic Resource
    Thrombin Activity in CSF after SAH is Correlated with the Degree of SAH, the Persistence of Subarachnoid Clot and the Development of Vasospasm (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 579-584 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Fibrinopeptide; subarachnoid haemorrhage; thrombin; vasospasm.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  We previously reported that the coagulation system in cerebrospinal fluid (CSF) is strongly activated in the early stage of a subarachnoid haemorrhage (SAH). We evaluated the relationship among thrombin activity, degree of SAH, amount of clearance of SAH, and vasospasm. The CSF levels of fibrinopeptide A (FPA) were measured by radio-immunoassay in 36 SAH patients, who were diagnosed by computerized tomography (CT) within 12 hours and on whom surgery was performed within 48 hours. Clearance of SAH (%) was evaluated as the size of the clot in the basal cistern visualized between the initial and postoperative CT. The mean level of FPA in the patients of Group 3 (Fisher's CT classification) (182.2 ng/ml) was significantly higher than those in the patients of Group 2 (36.2 ng/ml). There was a significant difference in the mean level of FPA between patients with (47.6 ng/ml) and without infarction (408.3 ng/ml). In 18 of the 27 patients of Group 3 for whom the clearance of the SAH was determined, the patients showing a lower clearance rate (〈50%) of SAH demonstrated a significantly higher rate of infarction and a significantly higher level of FPA (466.6 ng/ml) than did the patients with a higher clearance rate (〉50%) of SAH (79.2 ng/ml). These results suggest that, the thrombin activity in CSF is correlated with the degree of SAH, the persistence of subarachnoid clot and the development of vasospasm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050143
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  • 2
    Electronic Resource
    Electronic Resource
    Chronic expanding epidural haematoma (1995)
    Springer
    Acta neurochirurgica 132 (1995), S. 150-153 
    Details
    ISSN: 0942-0940
    Keywords: Epidural haematoma ; chronic epidural haematoma ; chronic expanding haematoma ; haematoma membrane
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An encapsulated fluid epidural haematoma in a 9-year-old boy was successfully evacuated by a simple burr hole procedure 5 months after a minor head injury. Clinicopathological findings suggested that chronic expansion of an initially unsuspected epidural haematoma occurred as a result of repeated haemorrhages from the haematoma membrane, resulting in an unusually long delayed appearance of clinical evidence. This case demonstrates that a chronic expanding process similar to that seen in chronic subdural haematoma needs to be considered as a possible complication of epidural haematoma and indicates an important role for the haematoma membrane in the chronic expansion of epidural haematoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01404865
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Superior sagittal sinus thrombosis treated with combined local thrombolytic and systemic anticoagulation therapy (1997)
    Springer
    Acta neurochirurgica 139 (1997), S. 332-335 
    Details
    ISSN: 0942-0940
    Keywords: Superior sagittal sinus thrombosis ; local thrombolytic therapy ; anticoagulation therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We recently encountered a patient with thrombosis of the superior sagittal sinus of an idiopathic cause. The patient was treated initially with combined local thrombolytic therapy through the burr hole over the superior sagittal sinus and systemic anticoagulant therapy. Continuous ventricular drainage and hyperbaric oxygenation therapy were used to control the increased intracranial pressure. The superior sagittal sinus was successfully recanalized. Whereas the patient suffered a complication with subacute subdural haematoma, he was successfully treated with the combination of these therapies. The rationale and approach are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808829
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  • 4
    Electronic Resource
    Electronic Resource
    Current Treatment Strategies and Factors influencing Outcome in Patients with Bacterial Brain Abscess (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 1263-1270 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Brain abscess; infection; mortality; outcome; intraventricular rupture of brain abscess.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  We clearly determined the key to managing patients with brain abscess by retrospectively evaluating the factors affecting poor outcome in these patients. This study included 113 patients with brain abscess diagnosed in the CT era. Basic characteristics and therapeutic parameters were estimated as independent predictors of poor outcome by using univariate and multivariate logistic regression analysis. Patients with poor outcomes more frequently had deeply-located abscesses (p〈0.02), IVROBA (intraventricular rupture of brain abscess) (p〈0.001) and were in a severely deteriorated neurological state (p〈0.001) than those with good outcomes. Multiple logistic regression analysis predicted that IVROBA (ORs, 24.5; 95% CI, 3.04 to 197.9) and severely deteriorated cases (ORs, 13.7; 95% CI, 2.34 to 80.8) resulting from IVROBA increased the relative risk of poor outcome. Patients with IVROBA more frequently had also deeply-located abscesses (p〈0.005), positively immunocompromised states (p〈0.05) an (p〈0.003) than those without IVROBA. Patients with metastatic abscess had also IVROBA (p〈0.006). Multiple logistic regression analysis anticipated that deeply-located abscess (ORs, 3.90; 95% CI, 1.38 to 11.04), and metastatic abscess (ORs, 12.26; 95% CI, 1.35 to 111.2) increased the relative risk of IVROBA. Patients in an obtunded state and with marked neurological deficit had IVROBA more often than patients in an alert state and/or mild neurological deficit (ORs, 3.23; 95% CI, 1.17 to 8.86, (p〈0.03) before treatment. Our findings suggest that IVROBA strongly influences poor outcome in patients with brain abscess. The key to decreasing poor outcomes may be the prevention and management of IVROBA, by evaluating intracranial pressure pathophysiology. IVROBA should be aggressively treated by aspiration methods for the abscess coupled with appropriate intravenous and intrathecial administration of antibiotics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050248
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Phenytoin as a liquid material for embolisation of tumours (1999)
    Springer
    Neuroradiology 41 (1999), S. 320-323 
    Details
    ISSN: 1432-1920
    Keywords: Key words Meningioma ; embolisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We carried out embolisation with phenytoin in seven patients with meningiomas; in three by cannulation of the middle meningeal artery during surgery and in four by microcatheter introduced into the middle meningeal artery. Phenytoin (125–500 mg) diluted with saline (25 mg/ml) was injected slowly as a bolus. There was no evidence of devascularisation in two meningiomas treated with 125 mg and 150 mg of phenytoin. Large areas of ischaemic and haemorrhagic necrosis were found in five meningiomas treated with 250–500 mg. After embolisation, the tumour blush disappeared, with preservation of the feeding arteries. Total resection of the tumour was performed with minimum blood loss. Caution and proper use are emphasised to avoid increase in tumour volume and reflux. Phenytoin could be a suitable material for superselective embolisation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050756
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    Paper (German National Licenses)
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