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  • 1
    Electronic Resource
    Electronic Resource
    Gene therapy for glioblestome multiforme: in vivo tumor transduction with the herpes simplex thymidine kinase gene followed by ganciclovir (1997)
    Springer
    Journal of molecular medicine 75 (1997), S. 300-304 
    Details
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001090050116
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  • 2
    Electronic Resource
    Electronic Resource
    Effect of CNTF on ischaemic cell damage in rat hippocampus (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 580-583 
    Details
    ISSN: 0942-0940
    Keywords: Ciliary neurotrophic factor (CNTF) ; cerebral ischaemia ; delayed neuronal cell death ; rat hippocampus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The neuroprotective effect of neurotrophic factors has been demonstrated in experimental cerebral ischaemia recently. These include nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), and basic fibroblast growth factor (basic FGF). The neuroprotective effect of ciliary neurotrophic factor (CNTF), however, has not been studied so far. We have examined the neuroprotective effect of recombinant rat CNTF in a rat forebrain ischaemia model. A continuous infusion of CNTF was started 1 week before the induction of ischaemia and continued until 1 week after the ischaemia. Reversible forebrain ischaemia was induced by 7 minutes of bilateral carotid occlusion with hypotension. Neuronal cell death in the hippocampal CA1 sector was evaluated 1 week after the ischaemia. For the control group artificial CSF (cerebrospinal fluid) was infused instead of CNTF. Per cent neuronal cell death was 83.4 ± 5.9% (mean ± SEM, n=5) in the control group, and 71.1 ± 10.0% (mean ± SEM, n=5) in the CNTF group. Although percentage of neuronal cell death was lower in the CNTF group, the difference was not statistically significant. This result suggests that the protective effect of CNTF in the rat forebrain ischaemia model may be limited compared with other neurotrophic factors. It is considered that the number of neurons protected by CNTF may be small.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411179
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  • 3
    Electronic Resource
    Electronic Resource
    Clinical, Angiographic, and Sonographic Findings After Structured Treatment of Cerebral Vasospasm and Their Relation to Final Outcomes (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 677-690 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Intensive care; endovascular therapy; barbiturate coma; cerebral vasospasm.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  Objective. To report the early clinical results, quantitative angiographic and sonographic findings, and final outcome in patients with symptomatic vasospasm who had undergone surgical occlusion of the aneurysm and a structured protocol including aggressive intensive care management, endovascular procedures (EP), and barbiturate coma (BC).  Results. Thirty consecutive patients (19 women, 11 men, age: 51±8 years) underwent 38 EP for the treatment of 81 vascular territories (15 balloon dilatations and 66 papaverine infusions). Overall angiographic vasospasm in the intradural ICA improved significantly from 44. 7±19.8% to 16.5±16%, in the MCA from 44.2±14.7% to 14.4±14%, and in the ACA from 38.7±18.6% to 13.3±12%. Mean flow velocities (Vm) in the MCA and ACA decreased significantly from 135±48 cm/sec to 87±32 cm/sec and from 110±36 cm/sec to 84±30 cm/sec, respectively. No significant Vm improvement in the ICA could be demonstrated. Six patients (20%) developed intractable vasospasm after repeated EP and five patients underwent BC. The correlation coefficient between percentage of angiographic vasospasm and Vm increase was −0.19 (p=NS) for the ICA, 0.2 (p〈0.001) for the MCA, and 0.3 (p〈0.05) for the ACA. Correlation coefficient between percentages of angiographic and sonographic improvement was −0.12 (p=NS) for the ICA, 0.42 (p〈0.001), and 0.1 (p〈0.05) for the ACA. Early clinical improvement after EP was observed in 73% of patients and was significantly associated with favourable outcome (GOS 4–5). Sixteen patients (53%) had a GOS 5, six patients (20%) a GOS 4, six patients (20%) a GOS 3, and two patients (6.6%) died as consequence of devastating vasospasm.  Conclusions. Changes in vessel diameter and increases of Vm during vasospasm correlate weakly. In spite of the fact that significant differences in vessel diameter and Vm were demonstrated after treatment, a moderately good correlation between percentages of angiographic and Vm improvement was observed only in the M1 segments. In our experience, a reduction of mortality and disabilities can be achieved with a maximal structured treatment of vasospasm. Early clinical improvement after endovascular treatment is strongly associated with favourable outcome, nevertheless, cost-benefit and controlled trials are necessary to evaluate these techniques.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050362
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  • 4
    Electronic Resource
    Electronic Resource
    Thermal diffusion blood flow monitoring during aneurysm surgery (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 726-731 
    Details
    ISSN: 0942-0940
    Keywords: Thermal diffusion ; cerebral blood flow ; temporary clipping ; cerebral aneurysm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cortical blood flow (CoBF) monitoring with a thermal diffusion flow probe was performed during the clipping of aneurysms of the ICA and MCA regions, on a series of patients during the acute stage of subarachnoid haemorrhage. Emphasis was placed on the CoBF recovery after temporary clip release. Since the absolute value in this technique is unreliable, recovery of blood flow after temporary clipping is represented as %CoBF according to the following equation: %CoBF recovery = (CoBFpost-CoBFintra)/(CoBFpre-CoBFintra) Presumably, this parameter checks the patency of the concerned cerebral vessels during clipping and/or release. Percent recovery of more than 100%, indicating postischaemic reactive hyperaemia, was observed immediately after release of the temporary clips in 8 of the 9 cases evaluated. In one case, with prolonged temporary clipping (37 min), no immediate recovery was observed after clip release, suggesting no-reflow phenomenon. The value slowly recovered after local administration of papaverin and returned to the pre-occlusion level within 20 minutes. Thermal diffusion CoBF monitoring may be useful in detecting the possible no-reflow phenomenon, that may lead to ischaemic complication, even after successful aneurysm clipping.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411479
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  • 5
    Electronic Resource
    Electronic Resource
    Colour-coded Doppler sonographic study of the haemodynamics in the parent artery of intracranial aneurysms (1999)
    Springer
    Neuroradiology 41 (1999), S. 553-562 
    Details
    ISSN: 1432-1920
    Keywords: Key words Ultrasonography transcranial Doppler ; aneurysm intracranial ; haemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the haemodynamics in the parent artery of 17 small (〈 9 mm) and 17 large (L 9.5 mm) saccular aneurysms by transcranial colour-coded Doppler sonography (TCCD) and related the findings to digital subtraction angiography (DSA). We measured flow velocity within the parent artery and, by positioning the Doppler gate within the colour flow image close to the ostium of the aneurysm, obtained a superselective Doppler spectral waveform. The parameters measured included the time-averaged maximal velocity (TAMX), peak systolic, and end-diastolic velocity and pulsatility index (PI). The values were compared to the contralateral side and between small and large aneurysms. DSA was analysed for parent artery stenosis. Mean systolic velocities in the parent arteries of large aneurysms were significantly higher than in the contralateral normal artery (1.08 ± 0.23 vs 0.80 ± 0.23 m/s; P = 0.0003) and higher than in the parent artery of small aneurysms (0.89 ± 0.18 m/s; P = 0.01). Increased systolic velocity accounted for a higher PI in the parent artery of large aneurysms (mean 1.48 ± 0.42) than on the other side (0.87 ± 0.12; P = 0.0001) and in the parent artery of small aneurysms (0.85 ± 0.14; P = 0.0001). PI proximal to seven thrombosed large aneurysms was higher (mean 1.85 ± 0.38) than close to unthrombosed large aneurysms (1.23 ± 0.22; P = 0.0005). Increased PI and systolic velocities could not be shown within branches of 5 large aneurysms and were reversible in the parent artery of four patients examined again after occlusion of the aneurysm. Systolic velocities and PI did not differ significantly (P = 0.41 and P = 0.25, respectively) in ruptured and unruptured aneurysms. Stenosis of the parent artery was not shown by DSA in any case.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050804
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  • 6
    Electronic Resource
    Electronic Resource
    Endovascular treatment of cerebral vasospasm: assessment of treatment effect by cerebral angiography and transcranial colour Doppler sonography (1999)
    Springer
    Neuroradiology 41 (1999), S. 453-462 
    Details
    ISSN: 1432-1920
    Keywords: Key words Vasospasm ; cerebral ; Sonography ; transcranial colour Doppler ; Balloon angioplasty ; Papaverine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a retrospective study of 30 consecutive patients with symptomatic vasospasm the mean degree of narrowing as compared to the initial angiogram was 35 % (± 24 %) in 12 intradural internal carotid arteries (ICA), 42 % (± 17 %) in 42 proximal middle cerebral (MCA) and 38 % (± 19 %) in 27 anterior cerebral arteries (ACA). The corresponding increase in mean flow velocities from baseline values obtained by transcranial colour Doppler sonography (TCD) within 12 h of the first angiogram to the time of clinical vasospasm was considerably higher, with 49 % (± 34 %) in the ICA, 119 % (± 92 %) in the MCA and 147 % (± 170 %) in the ACA. Following superselective intra-arterial papaverine application in 66 arteries and balloon angioplasty of 15 arteries, 78 (96.3 %) of 81 dilated. Sustained clinical improvement was achieved in 22 patients (73.3 %). The mean reversal of angiographic vasospasm was 71 % for the ICA (range 10–100 %), 81 % for the MCA (range 9–100 %) and 82 % (range 0–100 %) for the A1 segment. The mean reduction of flow velocities after treatment was much less with 23 % (± 21 %) in the ICA, 32 % (± 24 %) in the MCA and 25 % (± 22 %) in the A1 segment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050784
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  • 7
    Electronic Resource
    Electronic Resource
    Cerebellomedullary compression in recessive craniometaphyseal dysplasia (1996)
    Springer
    Neuroradiology 38 (1996), S. S193 
    Details
    ISSN: 1432-1920
    Keywords: Key words Craniometaphyseal dysplasia ; Skeletal dysplasia ; Basilar invagination ; Magnetic resonance imaging ; Posterior cranial fossa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Craniometaphyseal dysplasia (CMD) is a very rare disorder of bone remodelling characterised by sclerosis of the skull base, vault and facial bones and metaphyseal splaying of tubular bones. The recessive form appears to be more severe than the dominant. Cranial nerve deficits have been reported in infancy and early childhood in a few patients, but the long-term history of recessive CMD is not well documented. We report cerebellomedullary compression in a girl with recessive CMD recognised at 14 years because of progressive truncal ataxia. MRI revealed backward angulation of the thickened clivus, narrowing of the foramen magnum and upward deviation of the cerebellum by a markedly thickened occipital squama, tonsillar herniation and obliteration of the infratentorial cerebrospinal fluid spaces. Posterior cranial fossa decompression resulted in marked improvement of the ataxia. Compression of posterior cranial fossa structures has to be considered in the natural history and management of CMD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050952
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  • 8
    Electronic Resource
    Electronic Resource
    Cerebellomedullary compression in recessive craniometaphyseal dysplasia (1996)
    Springer
    Neuroradiology 38 (1996), S. S193 
    Details
    ISSN: 1432-1920
    Keywords: Craniometaphyseal dysplasia ; Skeletal dysplasia ; Basilar invagination ; Magnetic resonance imaging ; Posterior cranial fossa
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Craniometaphyseal dysplasia (CMD) is a very rare disorder of bone remodelling characterised by sclerosis of the skull base, vault and facial bones and metaphyseal splaying of tubular bones. The recessive form appears to be more severe than the dominant. Cranial nerve deficits have been reported in infancy and early childhood in a few patients, but the long-term history of recessive CMD is not well documented. We report cerebellomedullary compression in a girl with recessive CMD recognised at 14 years because of progressive truncal ataxia. MRI revealed backward angulation of the thickened clivus, narrowing of the foramen magnum and upward deviation of the cerebellum by a markedly thickened occipital squama, tonsillar herniation and obliteration of the infratentorial cerebrospinal fluid spaces. Posterior cranial fossa decompression resulted in marked improvement of the ataxia. Compression of posterior cranial fossa structures has to be considered in the natural history and management of CMD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02278158
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